A comparative study of apical leakage of Apexit, Ketac-Endo, and Diaket root canal sealers

The purpose of this study was to compare the apical leakage of Ketac-Endo, Apexit, and Diaket. Fifty freshly extracted human maxillary anterior teeth were used. The anatomical crowns were removed at the amelocemental junction, and step-back preparation of the roots canals was performed with K-type files to size 40 using 2 ml of 5.25% NaOCl irrigant after each file change. The roots were randomly divided into five groups of 10 roots each: three experimental and two control groups. The experimental groups were as follows: group 1, Apexit; group 2, Ketac-Endo; and group 3, Diaket. Root canals were filled with one of the sealers and gutta-percha using lateral condensation. After the specimens were stored in 100% humidity at 37 degrees C for 2 wk, the roots were covered with two layers of nail polish and immersed in 2% methylene blue for 7 days. Each tooth was split into two sections, and dye penetration was evaluated independently by three examiners using a stereomicroscope at x20 magnification. Mann-Whitney U analysis showed that there was no significant difference between Apexit and Diaket (p > 0.05). However, there was significantly more leakage with Ketac-Endo (p < 0.05).     

Microtensile testing of dentin adhesives.

OBJECTIVES: This study was conducted in order to compare the microtensile and shear bond strengths of five commercial dentin adhesive systems. Scotchbond Multipurpose with maleic acid (SM), Scotchbond Multipurpose with phosphoric acid (SP), Scotchbond Multipurpose Plus (SBP), Clearfil Liner Bond System (CL), and Prime and Bond (PB) were tested. METHODS: Thirty extracted unerupted third molars, in groups of six teeth per adhesive system, were prepared for microtensile testing. The specimens were tested following a 24 h incubation at 37 degrees C in normal saline. Shear bond testing was performed on 35 additional teeth, using seven teeth per adhesive system. After testing, the fracture sites were observed using light microscopy and a scanning electron microscope to determine the type of failure involved. RESULTS: The microtensile test results (mean +/- SD) were SM, 24.6 +/- 7.2 MPa; SP, 28.8 +/- 11.8 MPa; SBP, 22.7 +/- 6.5 MPa; PB, 25.5 +/- 9.4 MPa; and CL, 36.8 +/- 10.0 MPa. A Bonferroni post-hoc test showed significantly (p < 0.05) greater strength for CL compared to SM, SP, SBP, and PB. The shear bond strength test results were SM, 19.4 +/- 4.4 MPa; SP, 24.5 +/- 8.4 MPa; SBP, 15.3 +/- 4.9 MPa; PB, 23.2 +/- 7.1 MPa; and CL, 24.8 +/- 3.5 MPa. No statistically significant differences were found among the shear bond strength test results. The shear bond test produced significantly more failures within dentin and composite than the microtensile method. SIGNIFICANCE: It is concluded that the microtensile test produced a more definitive assessment of adhesive bond strength than the shear bond test. Microtensile testing showed CL to be significantly stronger than SM, SP, SBP, and PB (p < 0.05).     

Restoration of irradiated patients using osseointegrated implants: Current perspectives

Statement of problem. The success rates of osseointegrated implants used to restore patients who were irradiated for head and neck tumors are influenced by radiation-induced changes in the hard and soft tissues.Purpose. This article examined, by review of the literature, current perspectives on the restoration of irradiated patients using osseointegrated implants.Results. In published reports that investigated both intraoral and extraoral applications, irradiation decreased implant success rates and the amount of reduction was dependent on the location within the craniofacial skeleton. The limited number of implants and patients in these studies precludes definitive conclusions regarding the efficacy of placing implants into irradiated tissues. The implants placed into the irradiated anterior mandible have demonstrated an acceptable implant success rate of 94% to 100% with a minimal risk of osteoradionecrosis. The efficacy of implants in the posterior mandible has not been examined. Implant success rates ranged from 69% to 95% in the irradiated maxilla for intraoral applications. Extraoral applications demonstrated excellent implant success rates in the temporal bone (91% to 100%). The rates in the anterior nasal floor have varied from 50% to 100%. The implant success rates in the frontal bone decreased as the length of the studies increased (96% to 33%). The long-term efficacy of implants in the irradiated frontal bone is poor. (J Prosthet Dent 1998;79:641-7.)     

Transition dynamics in experimental gingivitis in humans

This study was conducted in order to investigate the dynamics of the gingival inflammatory status during periods of plaque accumulation and thorough oral hygiene. After a period of prophylaxis, 42 volunteers were asked to abstain from all oral hygiene measures for 2 weeks, whereafter oral hygiene was reinstituted. In the absence of oral hygiene, plaque was found at virtually all sites after 7 days and the number of sites with gingivitis increased simultaneously. A reduction in gingival inflammation occurred subsequent to plaque removal. During phases of both plaque accumulation and thorough oral hygiene, sites were found to convert from non-inflamed to inflamed status concurrently, as in the reverse direction. No association between plaque and gingivitis was revealed. The gingival status of a single site was a poor predictor of its status on the subsequent occasion. The proportion of inflamed sites converting to non-inflamed status was greater than the proportion of non-inflamed sites converting to inflamed status at any time. The estimated incidence rate remained fairly constant during both the plaque accumulation phase and the oral hygiene phase, whereas the estimated recovery rate was considerable lower during the plaque accumulation phase compared to oral hygiene phase. The clinical appearance is the outcome of the dynamics between these rates. The steady-state prevalences derived from the estimated "incidence" and "recovery" rates were quite similar to the actual findings after 14 d of plaque accumulation and the subsequent 10 d of thorough oral hygiene.     

Condylar displacement and temporomandibular joint dysfunction following bilateral sagittal split osteotomy and rigid fixation

In this study changes in intercondylar width (ICW) and intercondylar angle (ICA) that occurred with rigid fixation after bilateral sagittal split osteotomy and mandibular advancement are documented and correlated with temporomandibular (TM) symptoms, magnitude of advancement, and mandibular shape. Even though individual changes occurred, there was no significant difference between the mean preoperative and postoperative ICA and ICW measurements. There was also no significant difference between the preoperative and postoperative incidence of TM pain or clicking. No correlation was found between the magnitude of advancement and the percent change in ICA or ICW, and the mandibular shape did not correlate to changes in ICW. This study suggests that screw osteosynthesis does not significantly change ICA or ICW. The fact that no significant increase in TM symptoms occurred indicates that the changes in condylar position that did occur were within the range of clinical adaptability of the patients.     

Fracture resistance of endodontically prepared teeth using various restorative materials

This study compares the fracture resistance of endodontically treated premolars with modified types of cavity preparations and restoration with either amalgam or composite resin. The greatest influence on fracture resistance was the remaining tooth structure. The effect of adequate wall support on tooth strength was compared with intact unprepared teeth.     

Microleakage: the effect of storage and cycling duration

This investigation revealed that the limited storage time or cycling durations used had no significant impact on the microleakage patterns of a resin-bonded composite in Class V preparations. Short-term cycling appears as effective in demonstrating marginal leakage as protracted cycling regimens. These findings may be helpful in interpreting and comparing various microleakage studies.     

A microbiological study of pre- and postoperative apicectomy sites

There is little information on the microbiology of periapical lesions, and no data on the residual microbial flora in the periapex, if any, after apicectomy procedures. Hence, 64 patients treated by apicectomy procedures were prospectively studied to assess the bacterial flora in the periapex and to evaluate the residual bacteria in postoperative apicectomy sites. Of the 64 lesions studied, 14 (22%) were sterile and 50 (78%) yielded bacteria preoperatively. Bacteria could be recovered from 28 (56%) of the latter lesions after apicectomy and curettage. A total of 105 bacterial strains was isolated from 50 lesions, yielding a range of 1–4 (mean 2.1) species per sample. The isolates comprised 84 (80%) facultative anaerobes and 21 (20%) strict anaerobes. A polymicrobial growth was obtained from 39 lesions whilst 11 lesions yielded pure cultures. On detailed microbiological analyses of 29 lesions, 40% of the isolates were identified as alpha-haemolytic streptococci, half of which were Streptococcus sanguis; anaerobic streptococci were the predominant anaerobes. None of the organisms or group(s) of organisms emerged as recalcitrant colonisers which were difficult to dislodge after surgical debridement. These data indicate that the majority of periapical lesions harbour a variety of flora which cannot be eradicated despite thorough apicectomy procedures.