Comparative Micro-computed Tomographic Evaluation of the Sealing Quality of ProRoot MTA and MTA Angelus Apical Plugs Placed with Various Techniques.

INTRODUCTION: This study compared the effects of different mixing and placement techniques on sealing of ProRoot MTA (Dentsply Maillefer, Ballaigues, Switzerland) and MTA Angelus (Soluçoes Odontologicas, Londrina, Brazil) apical plugs using micro-computed tomographic (micro-CT) imaging. METHODS: Standardized divergent open apex models were created using 120 extracted maxillary incisors and divided into 8 groups (n = 15). ProRoot MTA and MTA Angelus were mixed manually or mechanically and introduced to form apical plugs by hand condensation or indirect ultrasonic activation for 10 seconds. The samples were scanned using micro-CT imaging, and volumetric analysis of the voids between the dentin walls and the apical plugs and the porosity inside MTA was performed. RESULTS: Irrespective of the mixing and placement techniques used, the voids between the dentin walls and the apical plugs in the MTA Angelus groups were greater than those in the ProRoot MTA groups (P < .05). The mechanically mixed groups were significantly less porous than the manually mixed groups (P < .05). Combined mechanical mixing and indirect ultrasonic activation yielded a less porous structure for both types of MTA than combined manual mixing and hand condensation (P < .05). Marginal adaptation for ProRoot MTA, both mixed and placed manually, was greater than for MTA Angelus (P < .05), but no difference was found when indirect ultrasonic activation was performed (P > .05). CONCLUSIONS: ProRoot MTA showed better marginal adaptation than MTA Angelus. Mechanically mixed products had better handling characteristics than the manually mixed product. Indirect ultrasonic activation did improve the adaptation of manually mixed MTA Angelus to the dentin walls.

Effect of the plant-based hemostatic agent Ankaferd Blood Stopper® on the biocompatibility of mineral trioxide aggregate.

BACKGROUND: Due to the detrimental effect of blood contamination on the physico-chemical properties of mineral trioxide aggregate (MTA), obtaining an effective hemostasis in the surgical crypt during apical surgery is of paramount importance. The purpose of this in vivo study was to analyze the effect of Ankaferd Blood Stopper® (ABS) contamination on the biocompatibility of MTA. METHODS: Forty of 56 Wistar-Albino rats were divided randomly and equally into two groups (MTA and MTA-ABS) according to whether or not a hemostatic agent was used. The remaining 16 rats were designated as the control group. Rats in the experimental groups received freshly mixed MTA-Angelus in polyethylene tubes, which were inserted into monocortical bore holes created in their tibias. In the MTA-ABS group only, 0.5 mL of ABS solution was administered topically on the defect sites followed by implantation of MTA tubes. Inflammation, foreign-body reaction (FBR), necrosis, fibrosis, and new bone formation (NBF) were studied 7, 30, 60, and 90 days after implantation. RESULTS: On day7, statistically significant differences were found in tissue reactions with regard to NBF and necrosis (p = 0.044 and p = 0.024, respectively), the latter being observed in 40 % of the samples only in the MTA-ABS group. Slight inflammation in all groups was confined to day-7 only. Mild necrosis was present in the MTA-ABS group only on day-7. Severity of the foreign body reaction and fibrosis was limited. New bone formation increased gradually over time in all groups, reaching a maximum on day-90. CONCLUSIONS: MTA and ABS-contaminated MTA are equally biocompatible. ABS does not impair the properties of MTA.

Examination of the prevalence of periapical lesions and technical quality of endodontic treatment in a Turkish subpopulation.

OBJECTIVE: The objective of this study was to investigate the prevalence of periapical lesions by evaluating the periapical status and to evaluate the relationship between the technical quality of endodontic treatments and presence of periapical lesions in a Turkish subpopulation. STUDY DESIGN: A total of 11,542 teeth of 438 patients were radiographically evaluated. Presence of endodontic treatment and obturation levels, coronal restorations, and degree of root canal curvature angles were noted. Apical status was assessed by the Periapical Index Scores (PAI). The χ(2) test was used for statistical analysis. RESULTS: Among all teeth, 179 (1.55%) had endodontic treatment and 189 (1.63%) had periapical lesions. Of 179 endodontically treated teeth, 68 (37.99%) had periapical lesions. The prevalence of periapical lesions was found to be significantly high among underfilled teeth (P < .001). In most underfilled teeth, the presence of severe curvatures was particularly of interest. Prevalence of inadequate coronal restorations was significantly high among the teeth with periapical lesions, whether endodontically treated or not (P < .001). CONCLUSIONS: The findings of the present study indicate that considerable effort should be spent by dental practitioners to improve the technical quality of root canal fillings.

Surgical retreatment of an invaginated maxillary central incisor following overfilled endodontic treatment: a case report.

This case report presents the periapical surgical retreatment of an Oehlers Class III invaginated maxillary central incisor with extruded root canal filling into the periapical lesion. After local anesthesia, a full-thickness mucoperiosteal flap was reflected, and the granulomatous tissue and extruded gutta-percha points were curetted carefully. A deep and wide root-end cavity was prepared and filled with mineral trioxide aggregate (MTA). At 6 months and 2 years after the treatment, the tooth exhibited no clinical symptoms, and the radiograph performed during the 2-year follow-up showed a complete periapical healing around the root end. The present report indicates that MTA retrofilling can be used successfully in the surgical retreatment of dens invaginatus type III cases in which the invagination exits apically.

Reactions of connective tissue to mineral trioxide aggregate and amalgam.

The purpose of this study was to evaluate the subcutaneous connective tissue reactions to ProRoot, mineral trioxide aggregate (MTA; Dentsply), and Oralloy, high-copper amalgam (Coltene). These materials were placed in polyethylene tubes and implanted into dorsal connective tissue of Wistar albino rats, and tissue biopsies were collected and histologically examined 7, 15, 30, 60, and 90 days after the implantation procedure. The presence of inflammation, predominant cell type, calcification, and thickness of fibrous connective tissue were recorded. Scores were defined as follows: 0, none or few inflammatory cells, no reaction; 1, < 25 cells, mild reaction; 2, 25 to 125 cells, moderate reaction; 3, > or = 125 cells, severe reaction. Fibrous capsule was categorized as "thin" when thickness was < 150 microm and "thick" at > 150 microm. Necrosis and formation of calcification were recorded. Both materials were well tolerated by the tissues in a 90-day evaluation period. One notable finding is the presence of dystrophic calcification in connective tissue adjacent to MTA; this finding is consistent with the hypothesis of hard tissue induction by this material.

Alzheimer's disease and dental management.

Alzheimer's disease (AD) is a major disorder of old age and the most common cause of dementia. Dementia is loss of intelligence, memory, and cognitive functions. It is usually associated with aging, but there are many possible causes. Older adults are the most rapidly growing segment of the population. To maintain lifelong good oral health, the elderly need regular dental care. This review of AD summarizes the causes, epidemiology, diagnosis, and dental management of patients with AD.

Surgical management of overfilling of the root canal: a case report.

Overfilling of the root canal is one of the most common errors encountered in dental practice. A 40-year-old woman complained of paresthesia and swelling affecting the left side of the mandible. Panoramic radiographs revealed that the root canal was overfilled; endodontic restorative material extended as far as the mandibular angle. Several months after surgical removal of the tooth and excess filling material, the symptoms subsided.