Iranian Endodontic Journal最新文献

Introduction: This study compared the cleaning effectiveness of NeoNiTi, 2Shape and Revo_S rotary instruments.

Materials and methods: Fifty mandibular molar mesial roots were selected with an angle of curvature less than 20 degrees divided into three groups (n=15). Five samples were selected as negative control group. In all three systems, the final file was 25, 6%. The score of debris and smear layer in three thirds (coronal, middle and apical) of the root canal walls were evaluated using scanning electron microscopic (SEM) magnification. The data were analyzed using the Kruskal Wallis and Mann Whitney U tests for intergroup comparison (P≤0.05) and Freidman and Wilcoxon signed-rank test was employed for intragroup comparison (P≤0.05).

Results: Residual debris of the 2Shape system in the apical region was significantly higher than the other two systems (P=0.039). Revo_S and 2Shape groups had significantly higher quantities of debris in the apical than the coronal region (P=0.029 and P=0.02, respectively). In the 2Shape group, the amount of mid-region debris was significantly higher (P=0.005) than the coronal. In inter-group comparison there was no significant difference in residual smear layer between the systems. In intra-group comparison in all three systems, the amount of smear layer in the coronal third was significantly higher than in the other two areas. (P=0.017, P<0.001 and P=0.032, respectively).

Conclusion: 2Shape left the highest amount of debris in the apical region. The amount of debris in Revo_S and 2Shape groups in the apical region was significantly higher than in the coronal. The amount of smear layer in all three groups in the coronal area was higher than the middle and apical areas.

Introduction: Apical surgery aims to eradicate the apical part of the root and the lesion to enhance the healing. The sealing ability of retrograde filling material is an essential factor affecting the success rate of the surgery. Mineral trioxide aggregate (MTA) is the gold standard of retrograde filling materials, with approved sealing capability and biocompatibility. Newly introduced root repair material with an approved antibacterial effect similar to MTA is Nano-fast cement (NFC) which should be investigated for its sealing ability. This study aimed to evaluate the sealing ability of NFC vs. MTA.

Materials and methods: Root apices of 48 single-rooted teeth were resected at 90 degrees and were prepared at 3 mm depth. The teeth were randomly divided into 2 experimental groups (n=21), negative control group (n=3), and positive control group (n= 3). MTA and NFC plugs were condensed as retrograde filling material. The samples were evaluated by a modified fluid filtration device for 1 hour. The measurement was conducted at 24 h, 1, and 3 months. Data were analyzed by Friedman Test and Kruskal-Wallis test.

Results: According to the results, NFC at 3-months interval showed the least microleakage, and MTA had the highest at the baseline. However, the results between the two groups were not statistically significant in all intervals. NFC reached the ideal sealing ability within 1 month, which was reached for MTA after 3 months.

Conclusions: The results of this in vitro study showed that the microleakage value of NFC is comparable to MTA. In light of current findings, NFC shows characteristics of a suitable calcium silicate-based cement. Further clinical researches are needed to introduce the NFC as retrograde apical plug or for other endodontic applications.

Introduction: This randomized clinical trial aimed to determine whether the XP-endo finisher combined with or without foraminal enlargement has any significant effect on the incidence and intensity of postoperative pain in necrotic pulps.

Materials and methods: Clinical pain levels were measured after 6, 12, 24, 48, and 72 hours and at 7 postoperative days. All treatments were performed by an endodontist in a single visit. One hundred and twenty patients were included. All patients had a single tooth treated. The patients were divided into four groups: No FE (None Foraminal Enlargement) (n=30), FE (Foraminal Enlargement) (n=30), No FE+XPF (None Foraminal Enlargement+XP-endo Finisher) (n=30) and XPF+FE (XP-endo Finisher and Foraminal Enlargement) (n=30). The canals were irrigated with sodium hypochlorite, shaped using WaveOne Gold Medium file, and then filled by using a matching single cone and AH-Plus sealer. The cavity was filled using glass ionomer cement. Pain intensity was assessed using the visual analog scale. The data were analyzed with the ANOVA and Games-Howell test. The significance level was 5%.

Results: The XPF+FE group experienced a higher level of pain, being classified on the visual analog scale as moderate for 48 postoperative hours and mild for 7 postoperative days (P<0.05). In the other groups, the pain was mild, only with different time intervals (P>0.05).

Conclusions: Foraminal enlargement associated with XP-endo Finisher may cause moderate postoperative pain.

Gemination is a rare phenomenon in the maxillary posterior teeth. Endodontic treatment of these teeth requires special care due to the bizarre anatomy particularly when it is accompanied by a C-shaped canal system. This report illustrates a patient with a rare geminated C-shaped maxillary second molar comprised of two sections in its crown, including a geminated section attached to a normal coronal of a second maxillary molar diagnosed with the pulpal status "necrosis" and "irreversible pulpitis" in geminated section and the molar respectively. Thus, endodontic treatment was performed on both parts of the tooth. Two months follow-up revealed well-functioning teeth with normal status of periapical tissue with no mobility or abnormality. Successful treatment of unusual anatomical teeth requires adherence to biomechanical principles of canal preparation and coronal restoration.

The superior lateral incisors are primarily affected by the developmental deformity known as dens invaginatus (DI). Oehler's type III DI has the highest complexity rendering a root canal treatment (RCT) an arduous challenge for this type, so early diagnosis and treatment before pulp involvement are important. This report presents two maxillary lateral incisors with type IIIb DI, the left one being associated with a periapical lesion and the right one with normal pulp. A nine-year-old boy was referred to our clinic complaining of mobility of the maxillary left lateral incisor (LLI) associated with gumboil throughout the previous two months. Periapical radiolucency was visible on radiographs, as well as an invagination that crosses the apical foramen from the pulp chamber in both maxillary lateral incisors. The pulp of the main canal of LLI was vital and pseudo canals were necrotized and associated with chronic apical abscess. Based on the condition of the main pulp of maxillary lateral incisors, two separate treatments were carried out. RCT was done only for the pseudo canals in the LLI, while the main root canal was preserved. The right maxillary lateral incisor (RLI) had vital pulp with normal periapical tissue So the invagination was sealed as the tooth was erupting. During the one-year follow-up period, the development of the root in LLI with a thick root wall and closed apex was observed in the periapical radiograph but pseudo canals became infected and the tooth became symptomatic, therefore retreatment for pseudo canals was carried out. The RLI root was developed and the tooth was clinically asymptomatic, so it didn't need further treatment. Maintaining pulp vitality is crucial for type III Dens invaginated young permanent teeth since it could support root formation and improve long-term prognosis, and in cases with pulp involvement, non-surgical RCT is clinically predictable.

Introduction: To assess the methodological quality of systematic reviews (SRs) that evaluated the association between apical periodontitis (AP) and chronic diseases.

Materials and methods: A systematic search was performed in the databases PubMed, Virtual Health Library, Scopus, Cochrane Library, Embase, Web of Science and Open Grey. SRs that evaluated the association between any chronic disease and AP, and that had performed a valid risk of bias assessment were included. The AMSTAR-2 tool was used for quality assessment and each included systematic review received a final categorization as having "high", "moderate", "low", or "critically low" quality.

Results: Nine studies that met the eligibility criteria were included. The diseases investigated were cardiovascular diseases, diabetes mellitus, HIV, osteoporosis, chronic liver disease, blood disorders and autoimmune diseases. The systematic reviews included in this umbrella review showed a 'low' to 'high' quality of evidence.

Conclusion: There are substantial heterogeneity and several methodological concerns in the included studies. It was observed a positive association between diabetes mellitus and apical periodontitis with limited evidence, no association between HIV and apical periodontitis and a positive association between apical periodontitis and cardiovascular disease, blood disorders, chronic liver disease, osteoporosis and autoimmune diseases with moderate evidence.

Introduction: Diagnosis of dental pulp status on the basis of clinical signs in many cases helps clinicians to better resolve patient problems. Various studies have shown no correlation between clinical and histologic findings. The aim of the present study was to evaluate the associations between clinical findings and histological features in extracted decayed teeth with acute pulpitis.

Materials and methods: One hundred permanent cavitated human teeth with mature apices and pulpitis, which were extracted for reasons not related to the present study, were evaluated. Demographic, clinical, and radiographic data were collected using pre-designed questionnaires. After tooth extraction, 5 micron-thick slices were prepared for microscopic assessment. General pathologist evaluated reactions to stimuli in all areas of the pulp tissue under a light microscope. When present, inflammation was classified according to the type and spread of cell detected and other histological findings, such as abscess formation, pulp stones, and pulpal fibrosis, were also recorded.

Results: We found significant associations between pain characteristics, such as pain type and duration, and histological status. Acute inflammation, severe chronic inflammation, and liquefactive necrosis increased with pain severity. Various histological sections showed the absence of pulpal inflammation.

Conclusions: We found a good agreement of patients' pain histories and pain characteristics with histological pulp status. Thus, the use of specified CHARTs and SCALEs that help patients provide the most accurate responses to questions about pain would aid the diagnosis of pulp status. In cases with an accurate pulpal diagnosis, the clinicians can manage pulpal protection when it is possible.

Introduction: The purpose of this in vitro study was to investigate the effect of incorporating silver nanoparticles (AgNPs) of herbal origin into mineral trioxide aggregate (MTA) on the push-out bond strength (PBS) and compressive strength (CS) in simulated furcal area perforations.

Materials and methods: In this in vitro study, simulated furcal area perforations (1.3 mm in diameter and 2 mm in depth) were created in 40 extracted human lower molar teeth, which were divided into two groups (n=20): MTA alone and MTA combined with AgNPs (2% wt). Using a universal testing machine, PBS was evaluated by performing push-out tests, while CS was assessed using cylindrical specimens. The normal distribution of data was checked using the Kolmogorov-Smirnov test, and statistical analysis was performed using two-way ANOVA.

Results: The CS results showed no significant difference between the MTA group at 4 and 21 days (P=0.297), but a significant difference was observed in the nanosilver/MTA group (P=0.013). However, there was no significant difference in the push-out bond strength among the study groups (P>0.05).

Conclusion: The incorporation of herbal origin silver nanoparticles did not significantly affect the PBS or CS of MTA.

Introduction: Nano-technology applied for the local delivery of different agents and/or drugs has made its path to endodontics. In the current study, the antibacterial efficacy of biopolymer-coated ceramic microparticles loaded with a modified combination of triple antibiotics, i.e. Penicillin G, Metronidazole and Ciprofloxacin (PMC), was evaluated against two strains of Enterococcus faecalis (E.faecalis); a standard clinical strain obtained from previously root-filled teeth with persistent periapical lesions, and compared to the most common antimicrobials used in endodontics.

Methods and materials: After synthesis of the polymer-coated microparticles loaded with antibiotics, the 21-day release of antibiotics were evaluated and a stock solution was produced using the maximum released amount of drugs and distilled water. The antibacterial activity of PMC, triple antibiotic paste (TAP), calcium hydroxide (CH), chlorhexidine (CHX) and sodium hypochlorite (NaOCl) against two bacterial strains was determined using "Minimum Inhibitory Concentration" and "Agar Diffusion Test". Additionally, "Microtiter Plate Assay" was performed to assess anti-biofilm properties.

Results: Minimum inhibitory concentration values reported for TAP and PMC were 1/256. PMC showed the maximum diameter of growth inhibition in both strains (33 mm and 35 mm), while CH had the minimum diameters (13 mm and13 mm). Based on microtiter plate assay, TAP showed higher biofilm formation than PMC. Biofilm formation was higher in the standard strain for PMC; however, NaOCl, CHX and CH completely inhibited biofilm formation.

Conclusions: Based on the findings of the present study, it could be concluded that PMC and TAP were the most effective medicaments against E.faecalis in its planktonic form; however, none could inhibit its biofilm formation. Further studies using larger sample size and "Confocal Scanning Laser Microscopy" are recommended.