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BACKGROUND: The aim of this study was to compare the cyclic fatigue resistance (CFR) of the newly developed pediatric nickel-titanium (NiTi) rotary file systems for root canal preparation of primary teeth. METHODS: Eighty pediatric NiTi rotary file systems files were used in this study, including 20 EasyInSmile X-Baby (25/0.04), 20 Scope miniScope (25/0.04), 20 EndoArt Pedo Gold (25/0.04), and 20 EndoArt Pedo Blue (25/0.04) files. Static CFR tests; performed on a custom-made stainless steel block with an inner diameter of 1.5 mm, an angle of curvature of 60° and a curved artificial canal with a radius of curvature of 5 mm. The test system was filled with distilled water and the temperature was kept constant at 35 ± 1 °C. The files were rotated in the simulated canal until fracture occurred. The number of cycles to failure (NCF) data was recorded, and all the fracture surfaces of the files were evaluated using scanning electron microscopy (SEM). One-way ANOVA and Tukey tests were used for statistical analysis of the data, and the significance level was set at p < 0.05. RESULTS: EndoArt Pedo Blue showed the highest NCF values (2668.10 ± 755.26), while the miniScope showed the lowest NCF values (453.65 ± 72.51), with a statistically significant difference between all the tested file systems (p < 0.05). There was no statistical difference in terms of fractured fragment lengths among all tested files (p > 0.05). CONCLUSION: The EndoArt Pedo Blue file system showed the best CFR performance among the four file systems specifically designed for primary teeth.

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OBJECTIVES: This study assessed the antibacterial activity of both separate and combined uses of 5.25% sodium hypochlorite (NaOCl), 2% chlorhexidine (CHX), 17% ethylenediaminetetraacetic acid (EDTA), 3% hydrogen peroxide (H2O2), MTAD, SmearClear (SC) and 13.8% chlorine dioxide (ClO2) irrigation solutions against Enterococcus faecalis. MATERIALS AND METHODS: Two hundred eighty single rooted human premolars were randomly grouped into 26 test and 2 control (negative and positive) groups and were incubated for 24 h with E. faecalis, except for the negative control group. The tested solutions were as follow: NaOCl; CHX; ClO2; MTAD; SC; EDTA; H2O2; NaOCl + CHX; NaOCl + MTAD; SC + NaOCl; EDTA + NaOCl; H2O2 + NaOCl; ClO2 + CHX; CHX + MTAD; SC + CHX; EDTA + CHX; CHX + H2O2; ClO2 + MTAD; SC + ClO2; EDTA + ClO2; ClO2 + H2O2; SC+MTAD; EDTA+MTAD; MTAD + H2O2; SC + H2O2; and EDTA + H2O2. Optic density values were recorded at 0, 6, 12, 18, 24, 30, 36, 42 and 48 h and bacterial growth curve created for each solution. RESULTS: The CHX, MTAD and ClO2 showed a high potential for the elimination of E. faecalis, both alone and in all combinations. The EDTA, H2O2, H2O2+ EDTA, H2O2 + NaOCl and SC + NaOCl groups showed less antibacterial activity than the other groups. The SC + CHX group showed the best antibacterial effect against E. faecalis. CONCLUSION: The SC + CHX combination can be recommended as the most effective irrigation regimen against E. faecalis in persistent endodontic infections.

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The organic tissue dissolution properties of irrigating solutions are important for the success of endodontic treatment. Chlorine dioxide (ClO2) has been recently proposed as an irrigation solution in endodontics. The organic tissue dissolution property of sodium hypochlorite (NaOCl) is well-known and extensively investigated, but apparently no data have been published on tissue-dissolving properties of ClO2. The aim of this in vitro study was to compare organic tissue dissolution capacity of NaOCl and ClO2. In this study, 5.25% NaOCl, 13.8% ClO2, and, as a control, isotonic saline solutions (0.9% NaCl) were used. Thirty bovine pulp specimens were previously weighed and immersed for 20 minutes in each test solution (changing the solution every 2 minutes). The pulp specimens were then blotted dry and weighed again. The percentage of weight loss was calculated and statistically analyzed by using one-way analysis of variance and post hoc Tukey honestly significant difference tests. Saline solution did not dissolve the organic tissue. Both 5.25% NaOCl and 13.8% ClO2 dissolved the tissue pieces more effectively than saline control (P < .05). No statistically significant difference was found between the tissue-dissolving properties of 5.25% NaOCl and those of 13.8% ClO2 (P > .05). Within the limitations of this in vitro study, it was concluded that ClO2 and NaOCl are equally efficient for dissolving organic tissue.

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The purpose of this study was to evaluate the effect of immediate and delayed post space preparation on the apical sealing ability of EndoREZ, a methacrylate-based dual-cured resin sealer, with or without accelerator. Fifty extracted human teeth were endodontically prepared and randomly divided into 6 groups. Teeth in experimental groups 1, 2, 3, and 4 (n = 10) were filled with resin-coated gutta-percha and either EndoREZ with accelerator (A+) or EndoREZ without accelerator (A-) by the lateral compaction technique. In group1 (A+) and group2 (A-), the post space was prepared immediately at the time of obturation. In groups 3 (A+) and 4 (A-), the post space was prepared after storage in 100% humidity at 37 degrees C for 1 week. Groups 5 and 6 (n = 5) represented positive and negative control groups, respectively. Leakage was determined by computerized fluid filtration device. Complete leakage was observed in group 5, and no leakage was evident in group 6 (P = 1.000). In experimental groups, mean apical microleakage values (microL/cmH(2)O/min(-1)) were as follows: group 1, 2.77 +/- 0.79(a); group 2, 2.88 +/- 1.38(a); group 3, 19.95 +/- 7.85(c); group 4, 6.20 +/- 2.09(b) (different letters indicate significantly different groups, P < .005). Immediate post space preparation achieved better sealing than delayed post preparation at the apical end, regardless of whether the EndoREZ accelerator was used. There was no significant difference between the (A+) and (A-) in immediate post space preparation. However, more leakage was found when using (A+) than (A-) in delayed post preparation. Under the conditions of this study, it was concluded that EndoREZ accelerator seems not to provide clinicians with any advantage for rapid transition from endodontic treatment to post-endodontic restorative procedures immediately after completion of root canal therapy.

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AIM: This study compared the fracture resistance of endodontically-treated mandibular molars with mesio-occluso-distal (MOD) cavities restored using different restoration techniques. METHODOLOGY: Sixty sound extracted mandibular molars were randomly assigned to six groups (n=10). Group 1 did not receive any preparation. The teeth in Groups 2-6 received root canal treatment and a MOD cavity preparation. The teeth in Group 2 were kept unrestored. Group 3 was restored conventionally with amalgam. Group 4 was restored with a dentin bonding system (DBS, Clearfil SE Bond) and resin composite (CR) (Clearfil Photoposterior). Group 5 was restored with indirect hybrid ceramic inlay material (Estenia). In Group 6, polyethylene ribbon fiber (Ribbond) was inserted into cavities in a buccal-to-lingual direction and the teeth were then restored with DBS and CR. After finishing and polishing, the specimens, except for Group 2, were loaded to failure by a chewing simulation device (60,000 cycles x 50 N load, 1.3 Hz frequency) in an artificial environment at 37 degrees C. Each tooth was subjected to compressive loading perpendicular to the occlusal surface at a crosshead speed of 1 mm/minute. The mean loads necessary to fracture were recorded in Newtons and the results were statistically analyzed. RESULTS: The mean fracture values were as follows: Group 1: 2485.3 +/- 193.98a, Group 2: 533.9 +/- 59.4a, Group 3: 1705.8 +/- 135.7a, Group 4: 2033.3 +/- 137.6cd, Group 5: 2121.3 +/- 156.5d, Group 6: 1908.9 +/- 132.2cd. There were statistically significant differences between the groups annotated with different letters. Thus, Group 1 (intact teeth) had the greatest fracture resistance and Group 2 (non-restored teeth) the poorest. No statistically significant differences were found between Groups 3 (amalgam), 4 (resin composite) and 6 (polyethylene ribbon fiber reinforced composite) (p > 0.05). Group 5 (indirect hybrid ceramic inlay) had greater fracture resistance than Group 3 (p < 0.05). CONCLUSIONS: Within the limitations of this study, although all of the restoration groups were stronger than the prepared-only group, none of the restoration techniques tested was able to completely restore the fracture resistance lost from MOD cavity preparation. However, use of indirect hybrid inlay restorations in these teeth may be recommended, because this restoration technique indicated more favorable fracture failure modes than other restoration techniques used in this study and particularly greater fracture strength than amalgam restorations. The promising result of indirect hybrid inlay restorations may need to be confirmed by long-term clinical studies.

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