Effect of autoclave sterilization on cyclic fatigue and torsional fracture resistance of NiTi rotary instruments.

The purpose of this study is to assess the effect of autoclave sterilization on the cyclic fatigue and torsional fracture resistance of ProTaper Universal (PTU), K3XF, HyFlex EDM (EDM), and TF adaptive (TFA). Sixty instruments from each file type were divided into two categories for cyclic fatigue group (CGr) and torsional fracture group (TGr). CGr and TGr were divided into three subgroups, respectively, consisting of ten instruments from each file type. Cyclic fatigue fracture test was performed using artificial canal made of stainless steel, and the mean number of cycles to failure (NCF) were determined. CGr1, the files were tested to establish baseline for NCF; CGr2, the files were tested cyclic fatigue after 10 cycles of autoclave; CGr3, instruments were autoclaved after being cycled to 25, 50, and 75% of corresponding NCF determined in CGr1, followed by cyclic fatigue test. The torsional fracture test was performed without autoclave (TGr1), after 3-cycle autoclave (TGr2), and 7-cycle autoclave (TGr3), respectively, which evaluated maximum torque and angular deflection. NCF, maximum torque and angular deflection were compared using one-way ANOVA with Bonferroni test. Two-way ANOVA was performed to determine the interaction between 'autoclave treatment' and 'type of NiTi file'. EDM showed highest NCF within the same autoclave treatment. TFA presented the lowest maximum torque and the highest angular deflection, and PTU presented the lowest angular deflection. Within the same NiTi file systems, most of NCF, maximum torque and angular deflection of tested files were not significantly influenced by autoclave condition.

Virtual Simulation of Autotransplantation Using 3-dimensional Printing Prototyping Model and Computer-assisted Design Program.

This case report describes an innovative virtual simulation method using a computer-aided rapid prototyping (CARP) model and a computer-aided design (CAD) program for autotransplantation of an immature third molar.A compromised left mandibular second molar (#18) was extracted and replaced by autotransplantation using an immature left mandibular third molar (#17). In order to minimize the surgical time and injury to the donor tooth, a virtual 3-dimensional (3D) rehearsal surgery was planned. Cone-beam computed tomographic images were taken to fabricate the 3D printing CARP model of the donor tooth and tentative extraction socket. Subsequently, both CARP models were scanned with an intraoral scanner (CEREC Omnicam; Dentsply Sirona, Bensheim, Germany) followed by superimposition and virtual simulation of osteotomy preparation of the recipient alveolus using the CAD analysis program. During the surgery, the extraction socket was precisely prepared according to the predetermined location and dimensions via virtual simulation rehearsal surgery using CAD analysis. The donor tooth was atraumatically transplanted into the prepared socket. The follow-up examination revealed that the root developed with a normal periodontal ligament and lamina dura.Virtual simulation using a 3D printing CARP model and a CAD program could be clinically useful in autotransplantation of an immature third molar by ensuring an atraumatic and predictable surgery.

Long-term follow-ups of revascularized immature necrotic teeth: three case reports.

Revascularization of immature necrotic teeth is a reliable treatment alternative to conventional apexogenesis or apexification. In case 1, a 12-year-old boy had his necrotic, immature mandibular left second premolar treated with a revascularization technique. At a24-month follow-up, periapical radiolucency had disappeared and thickening of the root wall was observed. In cases 2 and 3, a10-year-old boy had his necrotic, immature, bilateral mandibular second premolars treated with the same modality. At 48-month(in case 2) and 42-month (in case 3) follow-ups, loss of periapical radiolucencies and increases in the root wall thickness were also observed.

Effects of cavity configuration on composite restoration.

This study evaluated the effects of various cavity configurations on the bond strength, microleakage, flexural strength and elastic modulus of a hybrid (Clearfil AP-X) and a microhybrid (Esthet-X) composite restorative. After the specimens were made with C-factors of less than 1, 2.4 and 3.4, flexural strength and elastic modulus were evaluated in three-point bending using a mechanical testing machine. Fragments of the fractured specimens were selected randomly and the fracture surfaces were examined in SEM. To evaluate the microtensile bond strength and microleakage of composite restorations in bovine cavities, C-factors (ratio of bonded to non-bonded cavity surface) were controlled as 1.0, 2.3, 3.0 and 3.7. All specimens were stored in distilled water at 37 degrees C for 24 hours and tested in a universal testing machine (EZ Test, Shimadzu, Japan). For the microleakage test, teeth with restorations were stained with silver nitrate and examined by two examiners under a stereomicroscope at 40x magnification. The hybrid composite showed higher mechanical properties than the microhybrid composite. The flexural strength and elastic modulus of both composites decreased when polymerized under greater constraint, that is, with increasing C-factor. Mean microtensile bond strength to dentin was also decreased with increasing C-factor for both types of composites. Microleakage scores for the hybrid composite restorations were generally higher than the microhybrid composite.