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Volume 43 (1); February 2018
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Open Lecture on Statistics
Statistical notes for clinical researchers: covariance and correlation
Hae-Young Kim
Restor Dent Endod 2018;43(1):e4.   Published online January 5, 2018
DOI: https://doi.org/10.5395/rde.2018.43.e4
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Editorial
Appreciations to peer reviewers in 2017: contributions to the journal, Restorative Dentistry & Endodontics
Byeong-Hoon Cho, Su-Jung Shin
Restor Dent Endod 2018;43(1):e6.   Published online January 12, 2018
DOI: https://doi.org/10.5395/rde.2018.43.e6
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Corrigendum
Corrigendum: Corrections to the funding. Quantification of the tug-back by measuring the pulling force and micro computed tomographic evaluation
Su-Jin Jeon, Young-Mi Moon, Min-Seock Seo
Restor Dent Endod 2018;43(1):e8.   Published online January 24, 2018
DOI: https://doi.org/10.5395/rde.2018.43.e8
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Research Articles
Root canal irrigants influence the hydrophobicity and adherence of Staphylococcus epidermidis to root canal dentin: an in vitro study
Venkateshbabu Nagendrababu, Omer Sheriff Sultan, Sreedharan Kannathasan, Amir Shahreza Patel, Ebenezer Chitra, Prasanna Neelakantan, Fabian Davamani
Restor Dent Endod 2018;43(1):e1.   Published online December 7, 2017
DOI: https://doi.org/10.5395/rde.2018.43.e1
AbstractAbstract PDFPubReaderePub
Objectives

To determine the effect of root canal irrigants on the hydrophobicity and adherence of Staphylococcus epidermidis (S. epidermidis) to root canal dentin in vitro.

Materials and Methods

Root dentin blocks (n = 60) were randomly divided into 4 groups based on the irrigation regimen: group 1, saline; group 2, 5.25% sodium hypochlorite (NaOCl); group 3, 5.25% NaOCl followed by 17% ethylenediaminetetraacetic acid (EDTA); group 4, same as group 3 followed by 2% chlorhexidine (CHX). The hydrophobicity of S. epidermidis to root dentin was calculated by cell surface hydrophobicity while the adherence was observed by fluorescence microscopy, and bacteria were quantified using ImageJ software (National Institutes of Health). Statistical analysis of the data was done using Kruskal-Wallis test and Mann-Whitney U test (p = 0.05).

Results

The hydrophobicity and adherence of S. epidermidis to dentin were significantly increased after irrigating with group 3 (NaOCl-EDTA) (p < 0.05), whereas in group 4 (NaOCl-EDTA-CHX) both hydrophobicity and adherence were significantly reduced (p < 0.05).

Conclusions

The adherence of S. epidermidis to dentin was influenced differently by root canal irrigants. Final irrigation with CHX reduces the bacterial adherence and may impact biofilm formation.

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Influence of size and insertion depth of irrigation needle on debris extrusion and sealer penetration
Emel Uzunoglu-Özyürek, Hakan Karaaslan, Sevinç Aktemur Türker, Bahar Özçelik
Restor Dent Endod 2018;43(1):e2.   Published online December 22, 2017
DOI: https://doi.org/10.5395/rde.2018.43.e2
AbstractAbstract PDFPubReaderePub
Objectives

To determine the effect of size and insertion depth of irrigation needle on the amount of apical extruded debris and the amount of penetration depth of sealer using a confocal laser scanning microscope (CLSM).

Materials and Methods

Twenty maxillary premolars were assigned to 2 groups (n = 10), according to the size of needle tip, 28 G or 30 G. Buccal roots of samples were irrigated with respective needle type inserted 1 mm short of the working length (WL), while palatal roots were irrigated with respective needle type inserted 3 mm short of the WL. Prepared teeth were removed from the pre-weighed Eppendorf tubes. Canals were filled with F3 gutta-percha cone and rhodamine B dye-labeled AH 26 sealer. Teeth were transversally sectioned at 1 and 3 mm levels from the apex and observed under a CLSM. Eppendorf tubes were incubated to evaporate the irrigant and were weighed again. The difference between pre- and post-weights was calculated, and statistical evaluation was performed.

Results

Inserting needles closer to the apex and using needles with wider diameters were associated with significantly more debris extrusion (p < 0.05). The position of needles and level of sections had statistically significant effects on sealer penetration depth (p < 0.05 for both).

Conclusions

Following preparation, inserting narrower needles compatible with the final apical diameter of the prepared root canal at 3 mm short of WL during final irrigation might prevent debris extrusion and improve sealer penetration in the apical third.

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Root canal volume change and transportation by Vortex Blue, ProTaper Next, and ProTaper Universal in curved root canals
Hyun-Jin Park, Min-Seock Seo, Young-Mi Moon
Restor Dent Endod 2018;43(1):e3.   Published online December 24, 2017
DOI: https://doi.org/10.5395/rde.2018.43.e3
AbstractAbstract PDFPubReaderePub
Objectives

The aim of this study was to compare root canal volume change and canal transportation by Vortex Blue (VB; Dentsply Tulsa Dental Specialties), ProTaper Next (PTN; Dentsply Maillefer), and ProTaper Universal (PTU; Dentsply Maillefer) nickel-titanium rotary files in curved root canals.

Materials and Methods

Thirty canals with 20°–45° of curvature from extracted human molars were used. Root canal instrumentation was performed with VB, PTN, and PTU files up to #30.06, X3, and F3, respectively. Changes in root canal volume before and after the instrumentation, and the amount and direction of canal transportation at 1, 3, and 5 mm from the root apex were measured by using micro-computed tomography. Data of canal volume change were statistically analyzed using one-way analysis of variance and Tukey test, while data of amount and direction of transportation were analyzed using Kruskal-Wallis and Mann-Whitney U test.

Results

There were no significant differences among 3 groups in terms of canal volume change (p > 0.05). For the amount of transportation, PTN showed significantly less transportation than PTU at 3 mm level (p = 0.005). VB files showed no significant difference in canal transportation at all 3 levels with either PTN or PTU files. Also, VB files showed unique inward transportation tendency in the apical area.

Conclusions

Other than PTN produced less amount of transportation than PTU at 3 mm level, all 3 file systems showed similar level of canal volume change and transportation, and VB file system could prepare the curved canals without significant shaping errors.

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Micro-computed tomographic evaluation of canal retreatments performed by undergraduate students using different techniques
Emmanuel João Nogueira Leal Silva, Felipe Gonçalves Belladonna, Marianna Fernandes Carapiá, Brenda Leite Muniz, Mariana Santoro Rocha, Edson Jorge Lima Moreira
Restor Dent Endod 2018;43(1):e5.   Published online January 15, 2018
DOI: https://doi.org/10.5395/rde.2018.43.e5
AbstractAbstract PDFPubReaderePub
Objectives

This study evaluated the amount of remaining root canal filling materials after retreatment procedures performed by undergraduate students using manual, rotary, and reciprocating techniques through micro-computed tomographic analysis. The incidence of instrument fracture and the instrumentation time were also evaluated.

Materials and Methods

Thirty maxillary single rooted teeth were prepared with Reciproc R25 files and filled with gutta-percha and AH Plus sealer by the continuous wave of condensation technique. Then, the specimens were assigned to 3 groups (n = 10), according to the retreatment technique used: manual, rotary, and reciprocating groups, which used K-file, Mtwo retreatment file, and Reciproc file, respectively. Retreatments were performed by undergraduate students. The sample was scanned after root canal filling and retreatment procedures, and the images of the canals were examined to quantify the amount of remaining filling material. The incidence of instrument fracture and the instrumentation time were recorded.

Results

Remaining filling material was observed in all specimens regardless of the technique used. The mean volume of remaining material was significantly lower in the Reciproc group than in the manual K-file and Mtwo retreatment groups (p < 0.05). The time required to achieve a satisfactory removal of canal filling material and refinement was significantly lower in the Mtwo retreatment and Reciproc groups (p < 0.05) when compared to the manual K-file group. No instrument fracture was observed in any of the groups.

Conclusions

Reciproc was the most effective instrument in the removal of canal fillings after retreatments performed by undergraduate students.

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Comparison of bond strengths of ceramic brackets bonded to zirconia surfaces using different zirconia primers and a universal adhesive
Ji-Yeon Lee, Jaechan Ahn, Sang In An, Jeong-won Park
Restor Dent Endod 2018;43(1):e7.   Published online January 22, 2018
DOI: https://doi.org/10.5395/rde.2018.43.e7
AbstractAbstract PDFPubReaderePub
Objectives

The aim of this study is to compare the shear bond strengths of ceramic brackets bonded to zirconia surfaces using different zirconia primers and universal adhesive.

Materials and Methods

Fifty zirconia blocks (15 × 15 × 10 mm, Zpex, Tosoh Corporation) were polished with 1,000 grit sand paper and air-abraded with 50 µm Al2O3 for 10 seconds (40 psi). They were divided into 5 groups: control (CO), Metal/Zirconia primer (MZ, Ivoclar Vivadent), Z-PRIME Plus (ZP, Bisco), Zirconia Liner (ZL, Sun Medical), and Scotchbond Universal adhesive (SU, 3M ESPE). Transbond XT Primer (used for CO, MZ, ZP, and ZL) and Transbond XT Paste was used for bracket bonding (Gemini clear ceramic brackets, 3M Unitek). After 24 hours at 37°C storage, specimens underwent 2,000 thermocycles, and then, shear bond strengths were measured (1 mm/min). An adhesive remnant index (ARI) score was calculated. The data were analyzed using one-way analysis of variance and the Bonferroni test (p = 0.05).

Results

Surface treatment with primers resulted in increased shear bond strength. The SU group showed the highest shear bond strength followed by the ZP, ZL, MZ, and CO groups, in that order. The median ARI scores were as follows: CO = 0, MZ = 0, ZP = 0, ZL = 0, and SU = 3 (p < 0.05).

Conclusions

Within this experiment, zirconia primer can increase the shear bond strength of bracket bonding. The highest shear bond strength is observed in SU group, even when no primer is used.

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The effect of root canal preparation on the surface roughness of WaveOne and WaveOne Gold files: atomic force microscopy study
Taha Özyürek, Koray Yılmaz, Gülşah Uslu, Gianluca Plotino
Restor Dent Endod 2018;43(1):e10.   Published online February 2, 2018
DOI: https://doi.org/10.5395/rde.2018.43.e10
AbstractAbstract PDFPubReaderePub
Objectives

To examine the surface topography of intact WaveOne (WO; Dentsply Sirona Endodontics) and WaveOne Gold (WOG; Dentsply Sirona Endodontics) nickel-titanium rotary files and to evaluate the presence of alterations to the surface topography after root canal preparations of severely curved root canals in molar teeth.

Materials and Methods

Forty-eight severely curved canals of extracted molar teeth were divided into 2 groups (n = 24/each group). In group 1, the canals were prepared using WO and in group 2, the canals were prepared using WOG files. After the preparation of 3 root canals, instruments were subjected to atomic force microscopy analysis. Average roughness and root mean square values were chosen to investigate the surface features of endodontic files. The data was analyzed using one-way analysis of variance and post hoc Tamhane's tests at 5% significant level.

Results

The surface roughness values of WO and WOG files significantly changed after use in root canals (p < 0.05). The used WOG files exhibited higher surface roughness change when compared with the used WO files (p < 0.05).

Conclusions

Using WO and WOG Primary files in 3 root canals affected the surface topography of the files. After being used in root canals, the WOG files showed a higher level of surface porosity value than the WO files.

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Mineral content analysis of root canal dentin using laser-induced breakdown spectroscopy
Selen Küçükkaya Eren, Emel Uzunoğlu, Banu Sezer, Zeliha Yılmaz, İsmail Hakkı Boyacı
Restor Dent Endod 2018;43(1):e11.   Published online February 4, 2018
DOI: https://doi.org/10.5395/rde.2018.43.e11
AbstractAbstract PDFPubReaderePub
Objectives

This study aimed to introduce the use of laser-induced breakdown spectroscopy (LIBS) for evaluation of the mineral content of root canal dentin, and to assess whether a correlation exists between LIBS and scanning electron microscopy/energy dispersive spectroscopy (SEM/EDS) methods by comparing the effects of irrigation solutions on the mineral content change of root canal dentin.

Materials and Methods

Forty teeth with a single root canal were decoronated and longitudinally sectioned to expose the canals. The root halves were divided into 4 groups (n = 10) according to the solution applied: group NaOCl, 5.25% sodium hypochlorite (NaOCl) for 1 hour; group EDTA, 17% ethylenediaminetetraacetic acid (EDTA) for 2 minutes; group NaOCl+EDTA, 5.25% NaOCl for 1 hour and 17% EDTA for 2 minutes; a control group. Each root half belonging to the same root was evaluated for mineral content with either LIBS or SEM/EDS methods. The data were analyzed statistically.

Results

In groups NaOCl and NaOCl+EDTA, the calcium (Ca)/phosphorus (P) ratio decreased while the sodium (Na) level increased compared with the other groups (p < 0.05). The magnesium (Mg) level changes were not significant among the groups. A significant positive correlation was found between the results of LIBS and SEM/EDS analyses (r = 0.84, p < 0.001).

Conclusions

Treatment with NaOCl for 1 hour altered the mineral content of dentin, while EDTA application for 2 minutes had no effect on the elemental composition. The LIBS method proved to be reliable while providing data for the elemental composition of root canal dentin.

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Plugger temperature of cordless heat carriers according to the time elapsed
Hoon-Sang Chang, Se-Hee Park, Kyung-Mo Cho, Jin-Woo Kim
Restor Dent Endod 2018;43(1):e12.   Published online February 7, 2018
DOI: https://doi.org/10.5395/rde.2018.43.e12
AbstractAbstract PDFPubReaderePub
Objective

The purpose of this study was to measure the temperature of the plugger tip of 3 cordless heat carriers set at 200°C.

Materials and Methods

Pluggers of the same taper (0.06, 0.08, 0.10) and similar tip sizes (sizes of 50 and 55) from 3 cordless heat carriers, namely SuperEndo-α2 (B & L Biotech), Friendo (DXM), and Dia-Pen (Diadent), were used and an electric heat carrier, System B (SybronEndo), was used as the control. The plugger tips were covered with customized copper sleeves, heated for 10 seconds, and the temperature was recorded with a computerized measurement system attached to a K-type thermometer at room temperature (n = 10). The data were analyzed with 2-way analysis of variance at a 5% level of significance.

Results

The peak temperature of the plugger tips was significantly affected by the plugger taper and by the heat carrier brand (p < 0.05). The peak temperature of the plugger tips was between 177°C and 325°C. The temperature peaked at 207°C–231°C for the 0.06 taper pluggers, 195°C–313°C for the 0.08 taper pluggers, and 177°C–325°C for the 0.10 taper pluggers. Only 5 of the 12 plugger tips showed a temperature of 200°C ± 10°C. The time required to reach the highest temperature or 200°C ± 10°C was at least 4 seconds.

Conclusion

When using cordless heat carriers, clinicians should pay attention to the temperature setting and to the activation time needed to reach the intended temperature of the pluggers.

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Case Reports
A simple technique for impression taking of teeth and functionally generated paths
Takatsugu Yamamoto, Yohei Sato, Hidehiko Watanabe, Amit Punj, Minoru Abe, Yasuko Momoi, Chikahiro Ohkubo
Restor Dent Endod 2018;43(1):e9.   Published online February 3, 2018
DOI: https://doi.org/10.5395/rde.2018.43.e9
AbstractAbstract PDFPubReaderePub

The objective of this case report is to introduce a simple technique for simultaneously taking a closed-mouth impression and functionally generated path (FGP) for a full coverage crown restoration. A monolithic zirconia crown was the restoration of choice. An alginate impression of the abutment tooth was taken to fabricate a custom-made closed-mouth impression tray covering the abutment tooth and the adjacent teeth. The tray had an FGP table and an abutment tray in cameo and intaglio surfaces, respectively. The impression was taken with silicone impression material after adjusting the abutment tray and inscribing the FGP using self-curing acrylic resins. Plaster casts were made from the impression, and a zirconia crown was fabricated. The crown was cemented to the abutment tooth with minimal adjustments. This simple technique resulted in a well-fitting crown that accounted for mandibular movements. Using the custom closed-mouth impression tray incorporating an FGP table simultaneously aids in fabricating an accurately fitting restoration that incorporates harmonious mandibular movements using a single impression capture.

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Management of dental erosion induced by gastro-esophageal reflux disorder with direct composite veneering aided by a flexible splint matrix
Sherin Jose Chockattu, Byathnal Suryakant Deepak, Anubhav Sood, Nandini T. Niranjan, Arun Jayasheel, Mallikarjun K. Goud
Restor Dent Endod 2018;43(1):e13.   Published online February 6, 2018
DOI: https://doi.org/10.5395/rde.2018.43.e13
AbstractAbstract PDFPubReaderePub

Dental erosion is frequently overlooked in clinical practice. The management of erosion-induced damage to the dentition is often delayed, such that extensive occlusal rehabilitation is required. These cases can be diagnosed by a careful clinical examination and a thorough review of the patient's medical history and/or lifestyle habits. This case report presents the diagnosis, categorization, and management of a case of gastro-esophageal reflux disease-induced palatal erosion of the maxillary teeth. The early management of such cases is of utmost importance to delay or prevent the progression of damage both to the dentition and to occlusal stability. Non-invasive adhesively bonded restorations aid in achieving this goal.

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