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Background: Endodontic treatment is the most common method for resolving pulpal and periapical pathology. However, various studies have reported that almost 11%-13% of all teeth that undergo extraction after endodontic treatment show the presence of cracks, craze lines, and vertical root fractures. Teeth with inadequate post endodontic restoration are more prone to fracture and coronal leakage, resulting in the diffusion of oral fluids, bacteria, bacterial products, and possibly root canal treatment failure. Furthermore, studies have advocated the use of endodontically treated teeth with restorative materials that have a similar or higher elastic modulus than the tooth for providing stiffness against forces that cause root fracture. Intraorifice barriers made of restorative materials that can bond to radicular dentin could thus be used to reinforce the radicular dentin while also preventing coronal microleakage. Although the sealing ability of intraorifice barriers has been widely compared in the literature, there have been few studies on the strengthening effect of the materials used in the study as intraorifice barriers when placed into the root canal. As a result, the current in vitro study aims to assess the effect of various materials as intraorifice barriers (Cention N, Resin modified glass ionomer cement, and short fiber reinforced flowable composite) on the force required fracture teeth after root canal treatment. Methods: This in vitro study will be done on extracted human mandibular premolars with single root canal where after doing root canal treatment 2-3 mm obturating material would be replaced by intra orifice barriers (Cention N, resin modified glass ionomer cement [RMGIC], and short fiber reinforced flowable composite). The force required to fracture teeth will be calculated using universal testing machine.

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Background: The aim of the study was to compare the root reinforcement potential of different light cured intraorifice barriers (TheraCal, lime-lite, Ionoseal and resin-modified glass-ionomer [RMGI] [Fuji II LC]) with or without bonding agent placed in the orifice of endodontically treated and bleached teeth. Materials and Methods: In this experimental in vitro study, single-rooted bovine teeth were instrumented and obturated with gutta-percha. Except the control group, in other specimens, gutta-percha was removed 3 mm under cementoenamel junction. Then, the specimens were divided into seven groups according to the bases was applied: TheraCal LC, TheraCal LC with bonding agent, Lime-Lite, Lime-Lite with bonding agent, Ionoseal, Ionoseal with bonding agent, and RMGI (Fuji II LC). After internal bleaching, the teeth were decoronated. Then, all the groups were subjected to fracture resistance testing using Universal Testing Machine. For evaluating fracture resistance, analysis of variance and Tukey's test were used and for comparing the mode of fracture fisher test was applied in SPSS software. The significance was determined at (α = 0.05) confidence interval. Results: The group of TheraCal LC with bonding agent showed better fracture resistance as compared to the control group (P = 0.004). Although there was no statistically significant difference in the pairwise comparison between the other groups. Conclusion: TheraCal LC with bonding agent can be used as intraorifice barriers with good fracture resistance in endodontically treated and bleached teeth.

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Background and Aim: This study aimed to evaluate the effects of bleaching agents on the fracture resistance of endodontically treated teeth using different intraorifice barrier (IOB) materials. Materials and Methods: The endodontic treatment was performed for 160 mandibular premolars, and then, the teeth were divided into four groups according to the IOB: Ionoseal, Biodentine, ProRoot MTA, and TheraBase. Then, these teeth were subdivided into four subgroups (n = 10) based on the bleaching agents as distilled water (control), hydrogen peroxide 35% (HP), sodium perborate (SP), and carbamide peroxide 37% (CP). The access cavities were restored with composite resin after applying the bleaching agents for 7 days. The fracture resistance test was performed using a universal testing machine. Data were statistically analyzed, and the significance level was set at 5%. A scanning electron microscope was used to evaluate the effect of bleaching agents on the surfaces of IOBs. Results: The highest fracture resistance values were observed in Biodentine groups with significant differences compared to Ionoseal and ProRoot MTA (P <.05). The distilled water groups showed significantly the highest fracture resistance compared to SP and HP groups (P <.05). There was no significant difference between SP, HP, and CP groups (P >.05). It was demonstrated that the morphological surface of the intact IOBs (control) was different from the surface of IOBs treated with bleaching agents. Conclusion: The intracoronal bleaching procedures affected negatively the fracture resistance of the endodontically treated teeth.

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Aim: This study aimed to evaluate and compare the impact of different bleaching agents on the fracture resistance of endodontically treated teeth when using either GC Fuji type 2 glass ionomer cement (GIC) or Shofu Glass Ionomer RX EASE as intraorifice barriers (IOB). Materials and Methods: A total of 80 single-rooted human maxillary central incisors were prepared and obturated. Three millimeters of gutta-percha was then removed from the orifice. The specimens were divided into two primary groups based on the type of IOB material used: GC Fuji type 2 GIC and Shofu Glass Ionomer RX EASE (n = 40). Each group was further divided into four subgroups based on the bleaching agent used: Carbamide peroxide (CP) 37%, sodium perborate (SP), hydrogen peroxide (HP) 35%, and distilled water used as the control (n = 10). The teeth were subjected to fracture resistance testing. Results: The study found that the order of root fracture resistance was control > CP > SP > HP. There was no statistically significant difference in fracture resistance between GC Fuji type 2 GIC and Shofu Glass Ionomer RX EASE when used as IOB materials. Conclusion: The study concluded that the choice of bleaching agent significantly affects the fracture resistance of endodontically treated teeth. It was observed that fracture resistance is lowest with HP, followed by SP and CP. Both GC Fuji type 2 Glass Ionomer and Shofu Glass Ionomer RX EASE are effective as IOB.

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Introduction: Endodontic procedure leads to the loss of tooth structure resulting in fractures. Intraorifice barriers of bonded restorative materials placed in the cervical third of tooth may help in increasing fracture resistance. Materials and Methods: Human mandibular premolars (n = 75) underwent decoronation to adjust working length at 14 mm and prepared up to F3. They were obturated using gutta-percha and resin sealer AH-Plus and randomly divided into five groups (n = 15), Group 1: Control obturated with gutta-percha only. Groups 2, 3, 4, and 5 had placement of intraorifice barriers after the removal of 3 mm coronal gutta-percha such that Group 2: RMGI, Group 3: Self-adhering flowable composite, Group 4: Bulkfill Flowable Composite, and Group 5: mineral trioxide aggregate (MTA). Mounting of specimens was done in acrylic resin to expose coronal 3 mm and tested using the universal testing machine. Results: Group 1 (control) showed least fracture strength among all groups. Among those with intraorifice barriers, Group 2 Resin-modified glass ionomer cement showed maximum fracture resistance followed by Group 4 (Bulkfill composite) and Group 5 (self-adhering flowable composite) and least by Group 5 (MTA). Conclusion: The type of intraorifice barrier had a significant impact on root fracture resistance.

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AIM: The purpose of this in vitro study was to evaluate the intraorifice sealing ability of light-cured glass-ionomer cement (LC-GIC), Tetric N-Flow, and ProRoot mineral trioxide aggregate (MTA) against Enterococcus faecalis and Proteus vulgaris. MATERIALS AND METHODS: Crowns of the eighty human mandibular teeth were decapitated. Working length determination was performed, after which cleaning and shaping were carried out. A uniform orifice diameter of 1.3 mm, at its widest point, was made. Once instrumentation was completed, the canals were irrigated and then obturated. A heat carrier was used to remove gutta-percha to the depth of 3.5 mm. Samples were then divided into a control group (Group 1) with no barrier, and three groups, namely, Group 2, Group 3, and Group 4, were restored with the LC-GIC, Tetric N-Flow, and ProRoot MTA, respectively. The groups were further subdivided into Subgroup A for checking bacterial leakage against E. faecalis and Subgroup B, against P. vulgaris. All samples were subjected to the bacterial leakage test and observed daily for the appearance of turbidity after which statistical analysis was performed. RESULTS: Group 1 showed leakage in, as early as, 3 days. The longest time for the turbidity to appear was shown by Group 4 with an average of 31 days. The mean number of days for turbidity to appear in Group 2 and Group 3 was 23 and 24 days, respectively. Group 4 showed the best intraorifice sealing ability with a significant difference. CONCLUSION: The teeth with an intraorifice coronal seal had better protection against microbial leakage. Among all materials used, the ProRoot MTA showed the best intraorifice sealing ability. CLINICAL SIGNIFICANCE: Use of the ProRoot MTA promises long-term results in the endodontically treated teeth as compared with other materials.

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AIM: To evaluate the effect of intraorifice barriers and bases on the healing of apical periodontitis following root canal treatment in mandibular molars. METHODOLOGY: A total of 120 permanent mandibular molars with necrotic pulps and periapical radiolucencies (PAI score ≥ 3) were recruited. Root canal treatment was performed in all teeth using a standard protocol, following which they were randomly allocated to one of the three treatment groups: intraorifice barrier group: coronal 3-mm gutta-percha was removed and replaced with glass-ionomer cement (GIC) barrier. The floor of the pulp chamber was then sealed with 2-mm-thick GIC base followed by final composite resin restoration; base group: received 2-mm-thick GIC base before placement of composite resin restoration; and control group: had pulp chamber entirely filled with composite resin only. Follow-up was done at 3, 6, 9 and 12 months. Combination of clinical and radiographic parameters were used to assess treatment outcome. The data were analysed using Kruskal-Wallis, chi-square and Wilcoxon signed-rank tests and logistic regression analysis. RESULTS: At the end of 12 months, the base group had the most favourable healing (97.1%), whilst the control group had the least favourable healing (83.8%). The intraorifice barrier group had healing of 92.1%. However, there was no significant difference in healing between groups at the end of the follow-up period (P > 0.05). Additional subgroup analysis revealed a nonsignificant effect of periodontal status and root filling level on periapical healing. CONCLUSION: The use of an additional barrier under permanent restorations did not significantly improve the outcome of primary root canal treatment in posterior teeth after 12 months. However, its influence in the long term requires further evaluation.

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AIM: The aim of this study is to evaluate and compare the fracture resistance of endodontically treated teeth using four intraorifice barriers. MATERIALS AND METHODS: Fifty extracted single-rooted mandibular premolars were selected, decoronated, and prepared with rotary Protaper universal system and obturated with gutta-percha and AH Plus sealer. Samples were divided into five groups (n = 10) on the basis of intraorifice barrier material used. Group 1: Biodentine, Group 2: Conventional glass ionomer cement (GIC), Group 3: Resin-modified glass ionomer cement (RMGIC), Group 4: Nanohybrid composite, Group 5: No barrier (control).Except for control specimens, coronal 3-mm gutta-percha was removed and filled with different intraorifice barrier materials in respective groups. Fracture resistance of specimens was tested using universal testing machine. STATISTICAL ANALYSIS USED: One-way analysis of variance test and Post hoc Tukey's test. RESULTS: Mean fracture resistance of all experimental groups (with intraorifice barriers placed) were higher than control group (no intraorifice barrier placed). Biodentine showed the highest mean fracture resistance while RMGIC showed the least and the difference between their mean fracture resistance was statistically significant. There was no statistically significant difference among other experimental groups. CONCLUSION: Placement of intraorifice barriers in endodontically treated teeth can significantly increase fracture resistance and this increase in fracture resistance is material dependent.

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INTRODUCTION: Intraorifice barriers (IOBs) are usually used before internal bleaching for coronal sealing and the prevention of cervical resorption. The aim of this study was to investigate the effect of different IOBs on the fracture resistance (FR) of endodontically treated anterior teeth bleached with various bleaching agents (BAs). METHODS: After performing root canal treatment for 72 extracted bovine upper incisors, the coronal 3 mm of gutta-percha was removed, and samples were classified into 3 based on the type of IOB: calcium-enriched mixture, mineral trioxide aggregate, and resin-modified glass ionomer. After applying IOBs, samples of each group were subdivided into 4 based on the BA: carbamide peroxide 45% (CP), hydrogen peroxide 35% (HP), sodium perborate (PB), and distilled water as the control. At the end of bleaching, the access cavities were restored with composite resin. The FR was measured with a universal testing machine at a crosshead speed of 5 mm/min. The data were analyzed using 2-way analysis of variance and least significant difference post hoc tests (P < .05). RESULTS: The effect of BAs on the FR was significant (P < .05); however, the effect of the IOB and the interactive effect of these variables were not significant (P > .05). The FR in the HP and PB groups was significantly different from the control (P < .05) but that of CP was not significantly different from the control (P > .05). CONCLUSIONS: Mineral trioxide aggregate and calcium-enriched mixture act similarly to resin-modified glass ionomer as an IOB. CP, unlike HP and PB, did not significantly decrease the FR.

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INTRODUCTION: The purpose of this study was to investigate the fracture resistance of roots by using intraorifice barriers with glass fiber-incorporated ProRoot MTA and Biodentine. METHODS: The diametral tensile strength and compressive strength of ProRoot MTA and Biodentine were determined after incorporation of 5 wt% and 10 wt% alkali resistant (AR) glass fiber powder into both cements. On the basis of higher diametral tensile strength and compressive strength values, ProRoot MTA and Biodentine with 5 wt% AR glass fiber were selected for further testing as intraorifice barriers. The 14-mm-long root specimens obtained from extracted mandibular premolars (n = 60) were prepared with nickel-titanium rotary files and obturated with gutta-percha + AH Plus sealer. After removal of coronal 3 mm of root fillings, the roots were grouped with respect to the intraorifice barrier material (n = 12/group): (1) ProRoot MTA, (2) ProRoot MTA with 5 wt% AR glass fibers, (3) Biodentine, (4) Biodentine with 5 wt% AR glass fibers, and (5) control (no intraorifice barrier). The specimens were loaded vertically at 1 mm/min crosshead speed until vertical root fracture occurred. The data were evaluated statistically by using 2-way analysis of variance and Tukey tests. RESULTS: Both incorporation of glass fiber and the type of material significantly affected fracture resistance (both P = .002). Roots with glass fiber-reinforced Biodentine barriers showed the highest fracture strength (P = .000). CONCLUSIONS: Incorporation of 5 wt% AR glass fiber can significantly improve the reinforcement effect of ProRoot MTA and Biodentine when used as intraorifice barriers.

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AIM: To compare and evaluate the root reinforcement potential of four different intraorifice barriers: Mineral trioxide aggregate (MTA), resin-modified glass ionomer cement (RMGIC), fiber-reinforced composite (FRC), and nanohybrid composite (NC). MATERIALS AND METHODS: Seventy-five mandibular premolars were decoronated to a standardized length, and prepared and obturated with gutta-percha and AH Plus sealer. Except for control specimens, the coronal 3-mm gutta-percha was removed and filled with different materials. The specimens (75) were divided into five groups (n = 15) on the basis of the intraorifice barrier material used. Group 1: MTA, Group 2: RMGIC, Group 3: FRC, Group 4: NC, Group 5: no barrier (control). Fracture resistance of the specimens was tested. RESULTS: Fracture resistance of roots was significantly affected by the type of intraorifice barrier used and the following pattern was observed: RMGIC > FRC > NC > MTA. CONCLUSION: Intraorifice barriers can be regarded as a viable choice to reduce the occurrence of postendodontic root fractures. Among the four tested materials, RMGIC showed the maximum reinforcement.