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Volume 44 (4); November 2019
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Review Article
Dental care for patients taking antiresorptive drugs: a literature review
Minju Song
Restor Dent Endod 2019;44(4):e42.   Published online November 1, 2019
DOI: https://doi.org/10.5395/rde.2019.44.e42
AbstractAbstract PDFPubReaderePub

Antiresorptive drugs (ARDs), such as bisphosphonates or denosumab, that prevent bone resorption are widely used in patients with osteoporosis or with cancer that has metastasized to the bones. Although osteonecrosis of the jaw (ONJ) is a well-documented complication of ARD use, the benefits ARDs outweigh the complication. Thus, research has focused on finding ways to prevent or reduce the risk of developing ONJ. Dentists, as part of a multi-professional team, have a critical role in preventing ONJ. However, many dentists tend to hesitate to provide dental care to patients with ONJ, or tend to think that it is a problem to be dealt with by oral surgeons. This review gives an overview of ARD-related ONJ and provides the guidelines for dental care in patients taking ARDs to lower the risk of developing ONJ.

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Research Articles
Cyclic fatigue resistance of the WaveOne Gold Glider, ProGlider, and the One G glide path instruments in double-curvature canals
Damla Kırıcı, Alper Kuştarcı
Restor Dent Endod 2019;44(4):e36.   Published online September 9, 2019
DOI: https://doi.org/10.5395/rde.2019.44.e36
AbstractAbstract PDFPubReaderePub
Objectives

The aim of this study was to compare the cyclic fatigue resistance of the WaveOne Gold Glider, ProGlider and One G glide path instruments in artificial double-curvature canals.

Materials and Methods

This study included 15 WaveOne Gold Glider (size 15/0.08), 15 ProGlider (size 16/0.08), and 15 One G (size 16/0.06) nickel titanium files. The files were used in accordance with the manufacturer's instructions until they were broken in artificial double-curvature canals made of stainless steel. The time to fracture was recorded via a digital stopwatch and the number of rotations until fracture was also calculated. The data were statistically analyzed via the Kruskal-Wallis test.

Results

The highest average number of rotations until fracture of the files was found for the WaveOne Gold Glider, followed by ProGlider and One G in order. Statistically significant differences were present between all groups of files (p < 0.05).

Conclusions

In our study, the resistance of the WaveOne Gold Glider nickel-titanium (Ni-Ti) file to cyclic fatigue in S-shaped curved canals was found to be higher than that of the ProGlider and One G Ni-Ti files.

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The effect of individualization of fiberglass posts using bulk-fill resin-based composites on cementation: an in vitro study
Rodrigo Barros Esteves Lins, Jairo Matozinho Cordeiro, Carolina Perez Rangel, Thiago Bessa Marconato Antunes, Luís Roberto Marcondes Martins
Restor Dent Endod 2019;44(4):e37.   Published online October 18, 2019
DOI: https://doi.org/10.5395/rde.2019.44.e37
AbstractAbstract PDFPubReaderePub
Objectives

This study evaluated the bond strength of various fiberglass post cementation techniques using different resin-based composites.

Materials and Methods

The roots from a total of 100 bovine incisors were randomly assigned to 5 treatment groups: G1, post + Scotchbond Multi-Purpose (SBMP) + RelyX ARC luting agent; G2, relined post (Filtek Z250) + SBMP + RelyX ARC; G3, individualized post (Filtek Z250) + SBMP; G4, individualized post (Filtek Bulk-Fill) + SBMP; G5, individualized post (Filtek Bulk-Fill Flow) + SBMP. The samples were subjected to the push-out (n = 10) and pull-out (n = 10) bond strength tests. Data from the push-out bond strength test were analyzed using 2-way analysis of variance (ANOVA) with the Bonferroni post hoc test, and data from the pull-out bond strength test were analyzed using 1-way ANOVA.

Results

The data for push-out bond strength presented higher values for G2 and G5, mainly in the cervical and middle thirds, and the data from the apical third showed a lower mean push-out bond strength in all groups. No significant difference was noted for pull-out bond strength among all groups. The most frequent failure modes observed were adhesive failure between dentine and resin and mixed failure.

Conclusions

Fiberglass post cementation using restorative and flowable bulk-fill composites with the individualization technique may be a promising alternative to existing methods of post cementation.

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Effect of vibratory stimulation on pain during local anesthesia injections: a clinical trial
Sajedeh Ghorbanzadeh, Hoda Alimadadi, Nazanin Zargar, Omid Dianat
Restor Dent Endod 2019;44(4):e40.   Published online October 24, 2019
DOI: https://doi.org/10.5395/rde.2019.44.e40
AbstractAbstract PDFPubReaderePub
Objectives

This study aimed to assess the effect of DentalVibe on the level of pain experienced during anesthetic injections using 2 different techniques.

Materials and Methods

This randomized crossover clinical trial evaluated 60 patients who required 2-session endodontic treatment. Labial infiltration (LI) anesthesia was administered in the anterior maxilla of 30 patients, while inferior alveolar nerve block (IANB) was performed in the remaining 30 patients. 1.8 mL of 2% lidocaine was injected at a rate of 1 mL/min using a 27-gauge needle. DentalVibe was randomly assigned to either the first or second injection session. A visual analog scale was used to determine participants' pain level during needle insertion and the anesthetic injection. The paired t-test was applied to assess the efficacy of DentalVibe for pain reduction.

Results

In LI anesthesia, the pain level was 12.0 ± 15.5 and 38.1 ± 21.0 during needle insertion and 19.1 ± 16.1 and 48.9 ± 24.6 during the anesthetic injection using DentalVibe and the conventional method, respectively. In IANB, the pain level was 14.1 ± 15.9 and 35.1 ± 20.8 during needle insertion and 17.3 ± 14.2 and 39.5 ± 20.8 during the anesthetic injection using DentalVibe and the conventional method, respectively. DentalVibe significantly decreased the level of pain experienced during needle insertion and the anesthetic injection in anterior LI and mandibular IANB anesthesia.

Conclusions

The results suggest that DentalVibe can be used to reduce the level of pain experienced by adult patients during needle insertion and anesthetic injection.

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The effect of preheating resin composites on surface hardness: a systematic review and meta-analysis
Ali A. Elkaffas, Radwa I. Eltoukhy, Salwa A. Elnegoly, Salah H. Mahmoud
Restor Dent Endod 2019;44(4):e41.   Published online October 29, 2019
DOI: https://doi.org/10.5395/rde.2019.44.e41
AbstractAbstract PDFPubReaderePub
Objectives

This paper presents a systematic review and meta-analysis of the effect of preheating on the hardness of nanofilled, nanoceramic, nanohybrid, and microhybrid resin composites.

Materials and Methods

An electronic search of papers on MEDLINE/PubMed, ScienceDirect, and EBSCOhost was performed. Only in vitro studies were included. Non-English studies, case reports, clinical trials, and review articles were excluded. A meta-analysis of the reviewed studies was conducted to quantify differences in the microhardness of the Z250 microhybrid resin composite using the Comprehensive Meta-Analysis software.

Results

Only 13 studies met the inclusion criteria for this systematic review. The meta-analysis showed that there were significant differences between the non-preheated and preheated modes for both the top and bottom surfaces of the specimens (p < 0.05). The microhardness of the Z250 resin composite on the top surface in the preheated mode (78.1 ± 2.9) was higher than in the non-preheated mode (67.4 ± 4.0; p < 0.001). Moreover, the microhardness of the Z250 resin composite on the bottom surface in the preheated mode (71.8 ± 3.8) was higher than in the non-preheated mode (57.5 ± 5.7, p < 0.001).

Conclusions

Although the results reported in the reviewed studies showed great variability, sufficient scientific evidence was found to support the hypothesis that preheating can improve the hardness of resin composites.

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Cyclic fatigue resistance of M-Pro and RaCe Ni-Ti rotary endodontic instruments in artificial curved canals: a comparative in vitro study
Hadeer Mostafa El Feky, Khalid Mohammed Ezzat, Marwa Mahmoud Ali Bedier
Restor Dent Endod 2019;44(4):e44.   Published online November 7, 2019
DOI: https://doi.org/10.5395/rde.2019.44.e44
AbstractAbstract PDFPubReaderePub
Objectives

To compare the flexural cyclic fatigue resistance and the length of the fractured segments (FLs) of recently introduced M-Pro rotary files with that of RaCe rotary files in curved canals and to evaluate the fracture surface by scanning electron microscopy (SEM).

Materials and Methods

Thirty-six endodontic files with the same tip size and taper (size 25, 0.06 taper) were used. The samples were classified into 2 groups (n = 18): the M-Pro group (M-Pro IMD) and the RaCe group (FKG). A custom-made simulated canal model was fabricated to evaluate the total number of cycles to failure and the FL. SEM was used to examine the fracture surfaces of the fragmented segments. The data were statistically analyzed and comparisons between the 2 groups for normally distributed numerical variables were carried out using the independent Student's t-test. A p value less than 0.05 was considered to indicate statistical significance.

Results

The M-Pro group showed significantly higher resistance to flexural cyclic fatigue than the RaCe group (p < 0.05), but there was no significant difference in the FLs between the 2 groups (p ≥ 0.05).

Conclusions

Thermal treatment of nickel-titanium instruments can improve the flexural cyclic fatigue resistance of rotary endodontic files, and the M-Pro rotary system seems to be a promising rotary endodontic file.

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Influence of 10-MDP concentration on the adhesion and physical properties of self-adhesive resin cements
Kazuhiko Shibuya, Naoko Ohara, Serina Ono, Kumiko Matsuzaki, Masahiro Yoshiyama
Restor Dent Endod 2019;44(4):e45.   Published online November 12, 2019
DOI: https://doi.org/10.5395/rde.2019.44.e45
AbstractAbstract PDFPubReaderePub
Objectives

Self-adhesive resin cements contain functional monomers that enable them to adhere to the tooth structure without a separate adhesive or etchant. One of the most stable functional monomers used for chemical bonding to calcium in hydroxyapatite is 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP). The aim of this study was to evaluate the influence of the10-MDP concentration on the bond strength and physical properties of self-adhesive resin cements.

Materials and Methods

We used experimental resin cements containing 3 different concentrations of 10-MDP: 3.3 wt% (RC1), 6.6 wt% (RC2), or 9.9 wt% (RC3). The micro-tensile bond strength of each resin cement to dentin and a hybrid resin block (Estenia C&B, Kuraray Noritake Dental) was measured, and the fractured surface morphology was analyzed. Further, the flexural strength of the resin cements was measured using the three-point bending test. The water sorption and solubility of the cements following 30 days of immersion in water were measured.

Results

The bond strength of RC2 was significantly higher than that of RC1. There was no significant difference between the bond strength of RC2 and that of RC3. The water sorption of RC3 was higher than that of any other cement. There were no significant differences in the three-point bending strength or water solubility among all three types of cements.

Conclusions

Within the limitations of this study, it is suggested that 6.6 wt% 10-MDP showed superior properties than 3.3 wt% or 9.9 wt% 10-MDP in self-adhesive resin cement.

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Case Reports
Pulp revascularization with and without platelet-rich plasma in two anterior teeth with horizontal radicular fractures: a case report
Edison Arango-Gómez, Javier Laureano Nino-Barrera, Gustavo Nino, Freddy Jordan, Henry Sossa-Rojas
Restor Dent Endod 2019;44(4):e35.   Published online August 20, 2019
DOI: https://doi.org/10.5395/rde.2019.44.e35
AbstractAbstract PDFPubReaderePub

Pulp revascularization is an alternative treatment in immature traumatized teeth with necrotic pulp. However, this procedure has not been reported in horizontal root fractures. This is a case report of a 9-year-old patient with multiple horizontal root fractures in 2 upper central incisors that were successfully treated with pulp revascularization. The patient presented for treatment 2 years after the initial trauma, and revascularization was attempted after the initial treatment with calcium hydroxide had failed. Prior to pulp revascularization, cone-beam computed tomography and autoradiograms demonstrated multiple horizontal fractures in the middle and apical thirds of the roots of the 2 affected teeth. Revascularization was performed in both teeth; platelet-rich plasma (PRP) was used in one tooth (#11) and the conventional method (blood clot) was used in the other tooth (#21). Clinical and radiographic follow-up over 4 years demonstrated pulp calcification in the PRP-treated tooth. Neither of the 2 teeth were lost, and the root canal calcification of tooth #11 was greater than that of tooth #21. This case suggests that PRP-based pulp revascularization may be an alternative for horizontal root fractures.

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Guided endodontics: a case report of maxillary lateral incisors with multiple dens invaginatus
Afzal Ali, Hakan Arslan
Restor Dent Endod 2019;44(4):e38.   Published online October 21, 2019
DOI: https://doi.org/10.5395/rde.2019.44.e38
AbstractAbstract PDFPubReaderePub

Navigation of the main root canal and dealing with a dens invaginatus (DI) is a challenging task in clinical practice. Recently, the guided endodontics technique has become an alternative method for accessing root canals, surgical cavities, and calcified root canals without causing iatrogenic damage to tissue. In this case report, the use of the guided endodontics technique for two maxillary lateral incisors with multiple DIs is described. A 16-year-old female patient was referred with the chief complaint of pain and discoloured upper front teeth. Based on clinical and radiographic findings, a diagnosis of pulp necrosis and chronic periapical abscess associated with double DI (Oehler's type II) was established for the upper left lateral maxillary incisor (tooth #22). Root canal treatment and the sealing of double DI with mineral trioxide aggregate was planned for tooth #22. For tooth #12 (Oehler's type II), preventive sealing of the DI was planned. Minimally invasive access to the double DI and the main root canal of tooth #22, and to the DI of tooth #12, was achieved using the guided endodontics technique. This technique can be a valuable tool because it reduces chair-time and, more importantly, the risk of iatrogenic damage to the tooth structure.

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A case report of multiple bilateral dens invaginatus in maxillary anteriors
Shin Hye Chung, You-Jeong Hwang, Sung-Yeop You, Young-Hye Hwang, Soram Oh
Restor Dent Endod 2019;44(4):e39.   Published online October 21, 2019
DOI: https://doi.org/10.5395/rde.2019.44.e39
AbstractAbstract PDFPubReaderePub

The present report presents a case of dens invaginatus (DI) in a patient with 4 maxillary incisors. A 24-year-old female complained of swelling of the maxillary left anterior region and discoloration of the maxillary left anterior tooth. The maxillary left lateral incisor (tooth #22) showed pulp necrosis and a chronic apical abscess, and a periapical X-ray demonstrated DI on bilateral maxillary central and lateral incisors. All teeth responded to a vitality test, except tooth #22. The anatomic form of tooth #22 was similar to that of tooth #12, and both teeth had lingual pits. In addition, panoramic and periapical X-rays demonstrated root canal calcification, such as pulp stones, in the maxillary canines, first and second premolars, and the mandibular incisors, canines, and first premolars bilaterally. The patient underwent root canal treatment of tooth #22 and non-vital tooth bleaching. After a temporary filling material was removed, the invaginated mass was removed using ultrasonic tips under an operating microscope. The working length was established, and the root canal was enlarged up to #50 apical size and obturated with gutta-percha and AH 26 sealer using the continuous wave of condensation technique. Finally, non-vital bleaching was performed, and the access cavity was filled with composite resin.

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