Objectives: This prospective clinical trial evaluated the clinical performance of ceramic partial coverage indirect adhesive restorations (PCIARs) in posterior teeth luted with a light-cured composite resin. Methods: From April 2016 to January 2017, a total of 60 patients (27 males, 33 females; mean age: 42.2 +/- 10.86 years old) received 83 glass-ceramic PCIARs (26 onlay, 57 overlay) made of IPS Emax CAD (Ivoclar Vivadent). All restorations were luted with a light-cured composite resin (Filtek Z250, 3 M ESPE) by two operators. Two independent calibrated examiners blinded to the operators performing the treatment evaluated the restorations at baseline, 1-year, and 5-year following FDI World Dental Federation criteria including esthetic, functional, and biological properties. Data were analyzed with the Friedman test and the Wilcoxon sign test (p p < 0.05). Results: None of the restorations failed due to fracture or retention loss. One restoration was clinically unsatisfactory because of secondary caries. Marginal staining (p:0.000), marginal adaptation (p:0.018) showed significant differences between 1-year and 5-year recall. Conclusions: The PCIARs demonstrated excellent clinical performance at 1-year period. The degradation parameters appeared as minor staining and minor irregularities after 5-year, without any affect on the clinical performance.

This study evaluated the management preferences in a deep carious vital tooth. A questionnaire was e-mailed to members of the Turkish Dental Association. The questionnaire included a photograph and radiographs of an extremely deep carious molar (#16) of a 30-year-old man suffering from cold and chewing sensitivity. The dentists were asked to choose treatments for pulp exposure of <1, 1-2, and ≥2 mm and a permanent restoration. Chi-squared test was used to analyse data (p < 0.05). 504 (4.84%) of 10 411 dentists responded. When the pulp exposure was <1 mm: direct pulp capping (84.9%); 1-2 mm: root canal treatment (49.6%); ≥2 mm: root canal treatment (85.7%) were the most preferred treatments. 69.6% of the respondents chose direct composite restorations. If the tooth would be an abutment, most respondents preferred root canal treatment, regardless of the perforation size. The extent of pulp exposure and the type of permanent restoration influenced the treatment decision-making process.

Purpose: Minimally invasive endodontics (MIE) is a contemporary concept aiming to maximize tissue protection without compromising treatment outcomes.This survey study assessed the awareness and implication of MIE among dentists in Turkey. Methods:A digitally conducted survey was delivered to the dentists electronically.They were enquired about their demographic characteristics, awareness of the MIE and its clinical application; their approach to pulp exposure; access cavity and instrument systems preference; the preparation size and taper choice; and whether they used an additional irrigation protocol and a magnification system.The data were statistically analyzed using Chi-square and Fisher's exact tests.The statistical significance was set as p < 0.05.Results: 63.5% were aware of MIE, but only 31.2% applied it routinely.Endodontists' and less experienced participants' awareness was significantly higher (p = 0.000).During pulp exposure, in the absence and presence of spontaneous pain, 77.9% chose direct pulp capping and 81.4% root canal treatment, respectively.56.8% preferred traditional and 42.3% conservative access cavities.The most preferred preparation sizes were #30/0.06,#25/0.06 and #30/0.04 for single-rooted, #25/0.06,and #25/0.04 for multi-rooted teeth.45.7% activated the irrigant, and 27.5% used a magnification system. Conclusion:MIE-performing participants more frequently preferred vital pulp therapies, conservative access, and using a loop.

This study assessed the outcome of shaping the mesial roots of mandibular first molars containing band-shaped isthmuses with an isthmus floor located at the apical third with Reciproc Blue and Rotate instruments in terms of canal transportation, canal aberrations and unprepared apical canals. Pair-matched mesial roots of mandibular first molars according to their isthmus location (distance from apical foramina) and size were constructed based on quantitative measurements (length, major and minor diameter at isthmus roof and floor) on preoperative micro-CT scanning (n = 10). The pair-matched specimens were prepared either using Reciproc Blue R25 (25.08v) or Rotate (15.04, 20.05, 25.06) instruments and then subjected to a second micro-CT scanning. Micro-CT scans were analysed to evaluate the canal transportation at the apical foramen and isthmus floor levels and the frequency of procedural errors (separated instruments, artificial canal preparation, cross shaping and unprepared apical canals). Canal transportation values were compared using Mann–Whitney U, and the distribution of procedural errors was compared with chi-square tests with a 5

OBJECTIVES The aim of this study was to compare the ability of undergraduate students to reach working length (WL) in second mesiobuccal root canals (MB2) of maxillary first molars (n = 210) by using Reciproc Blue without glide path preparation, and One Curve with glide path preparation. METHODS The students (n = 105) attended theoretical and practical courses. The first group (n = 53) shaped MB2 root canals using the One Curve system and then Reciproc Blue; the second group (n = 52) shaped MB2 root canals following the reverse sequence. Participants completed a questionnaire. The chi-square and Mann-Whitney U test were used for statistical analysis using significance of p < 0.05. RESULTS The full WL was reached and shaping procedures were completed without complications in Reciproc Blue and One Curve groups at rates of 86.67% and 82.85%, respectively (p > 0.05). Treatment time was shorter in Reciproc Blue (p < 0.05). More (62.9%) students felt the One Curve system safer, while 61% felt the Reciproc Blue system faster. CONCLUSIONS Within the limitations of this study, instrument kinematics and glide path preparation did not interfere with undergraduate students' ability to achieve the WL in MB2 root canals.

Backround:OneReci (MicroMega, Besançon, France) is a recently introduced single-file reciprocating system with scarce information revealed on its shaping ability. This study aimed to compare the shaping abilities of OneReci and a well-documented single-file reciprocating system WaveOne Gold (WOG; Dentsply Maillefer, Ballaigues, Switzerland) and evaluate the effect of increased apical enlargement on the preparation quality, using micro-computed tomography (micro-CT). Methods:After an initial micro-CT scanning, twenty mesial root canals of mandibular molars were anatomically matched. The canals were assigned to two experimental groups (n = 10), using OneReci or WOG in different canals of the same root. The glide paths were created, and root canals were prepared twice, using size 25 and 35 instruments of the systems, respectively. The specimens were scanned with micro-CT after each preparation. The increase in canal volume, amount of dentin removal, unprepared root canal surface, canal transportation, centering ratio and preparation times were assessed. The data were analysed with independent sample t-tests, variance analyses, Friedman and Mann-Whitney U tests. The significance level was set at 5%. Results:Each preparation increased the canal volume and dentin removal while decreasing the unprepared root surface. The difference between the systems became significant after preparation with size 35 instruments (p < 0.05). Regarding canal transportation and centering ratio, the difference was insignificant (p > 0.05). The first preparation step (glide path + size 25 instrument) was significantly faster in the OneReci group (p < 0.05). Conclusions:Preparation with size 25 instruments of the systems appeared to be safe with similar shaping performances. Larger apical preparation promoted significantly higher dentin removal, volume increase, and prepared surface area in WOG.

Objective: Bioceramic-based sealers, in combination with bioceramic-coated gutta-perchas, have become more commonly used in root canal obturation.The present study aimed to assess the influence of laser-assisted dentin conditioning compared with conventional conditioning protocols on the push-out bond strength (PBS) of a bioceramic-based root canal filling.Material and Methods: Sixty extracted mandibular premolars with one root canal were instrumented with EndoSequence rotary files up to size 40/0.04.Four types of dentin conditioning protocols were used: 1) 5.25% NaOCl (control), 2) 17% EDTA+5.25%NaOCl, 3) Diode laser-agitated 17% EDTA+5.25%NaOCl, 4) Er,Cr:YSGG laser irradiation+5.25%NaOCl.Teeth were obturated using the single-cone technique with Endo-Sequence BC sealer+BC points (EBCF).After having obtained 1-mm-thick horizontal slices from the apical, middle and coronal root thirds, push-out test was carried out, and failure modes were determined.The data were analyzed by two-way analysis of variance and Tukey's test with a significance level of p<0.05.Results: The apical segments showed the highest PBS in all groups (p<0.05).In the apical segments, EDTA+NaOCl and diode laser agitated EDTA increased the PBS compared to the control (p=0.0001) and Er, Cr: YSGG laser (p=0.011 and p=0.027, respectively) groups.Both laser-used groups revealed significantly higher PBS values in the middle and coronal segments than EDTA+NaOCl (p<0.05).The bond failure was predominantly cohesive without any significant difference among the groups (p>0.05).Conclusions: Laser-assisted dentin conditioning had distinct effects on the PBS of the EBCF at different root segments.Although Er, Cr: YSGG was ineffective in the apical segments, generally, laser-assisted dentin conditioning affected PBS more favorably than conventional irrigation groups, with a more pronounced effect in the diode laser-agitated EDTA group.

Background: The aim of the present study was to evaluate the canal transportation and centering ability of ProTaper, HeroShaper and two Ni-Ti rotary systems developed for retreatment (ProTaperRetreatment and R-Endo). Materials and Methods: One hundred twenty mesial canals of mandibular molars with curvatures between 30-40 degrees and radii of curvatures between 4-9 mm were embedded in a modified muffle system. The teeth were randomly divided into 8 groups (n=15). The roots were sectioned horizontally at 3, 6 and 9 mm from the working length. Cross-sections were digitally photographed under standardized conditions. Half of the root canals were prepared with ProTaper and the rest with HeroShaper. Postoperative photographs were obtained. Root canals were obturated with the respective gutta-percha cones of the systems and AHPlus sealer. Following retreatment with four systems, photographs were assessed for the canal transportation in 8 directions, and centering ratio. Results: Initial shaping with ProTaper resulted in more significant transportation than HeroShaper (p<0.05). After retreatment, R-Endo yielded negative transportation values in the apical and mid-sections. In canals prepared with ProTaper, in the apical and coronal root sections ProTaperRetreatment, and in the mid-sections ProTaper revealed more acceptable re-shaping results. In the canals prepared with HeroShaper, after retreatment, transportation and centering ability were relatively efficient with HeroShaper in the apical and mid-sections; and with ProTaper in the coronal sections. Conclusion: All systems caused a certain amount of transportation and eccentricity. Protaper, ProtaperRetreatment and HeroShaper showed similar re-shaping performance with regard to the initial shaping procedure. However, R-Endo yielded insufficient root canal cleaning in the apical and mid-sections.

Amaç: Bu anket çalışmasının amacı, Türkiye'deki diş hekimlerinin kök kanallarının şekillendirilmesinde döner alet sistemlerinden hangisini tercih ettiğini nedenleri ile birlikte incelemektir. Gereç ve Yöntemler: İnternet platformu üzerinden oluşturulan anket Türkiye genelindeki diş hekimlerine ulaştırılmıştır. Döner alet sistemini kullanan diş hekimlerine hangi döner alet sistemini kullandıkları, kaç senedir kullandıkları, döner alet kullanımı ile ilgili bir eğitime katılıp katılmadığı, kullandıkları döner alet sisteminden beklentileri, tercihlerinde etkili olan faktörler, memnuniyetleri ve sisteminin en önemli dezavantajının ne olduğuna ilişkin sorular yöneltilmiştir. Veriler, SPSS programı ile analiz edilmiştir. Tanımlayıcı istatistikler ile birlikte kategorik değişkenlerin karşılaştırılmasında ki-kare ve Fisher's kesin testleri kullanılmıştır. Anlamlılık düzeyi p0,05). Sonuç: Çalışmaya katılan diş hekimleri, kullandıkları döner alet sistemlerinden genel olarak memnun olmakla birlikte, kullandıkları sistemi ideal bulmamaktadırlar.

Objectives This micro-computed tomography (micro-CT) study analyzed band-shaped isthmuses having their floor at the apical third of the mesiobuccal roots of maxillary molars in terms of 2D and 3D morphological parameters. Materials and methods A total of 199 maxillary first molars were scanned with micro-CT. Twenty-seven specimens, confirmed to have a band-shaped isthmus, were further examined in terms of the isthmus length, volume, structure model index (SMI), and surface area. The distance of apical foramina of mesial canals from the isthmus floor and major-minor diameters, roundness, perimeter, and area of the isthmus roof and floor were compared. Statistical analyses were performed with descriptive statistics and t -test with a 5% significance threshold. Results The band-shaped isthmus frequency was 13.5% and its length reached up to 5.5 mm. The distances of the apical foramina of mesiobuccal canals (MB1 and MB2) from the isthmus floor were similar ( p > .05). Isthmus roof and floor showed significant differences in terms of their major diameter and area ( p < .05), whereas their minor diameter, roundness, and perimeter values were similar ( p > .05). Conclusion The band-shaped isthmuses are not rare and can reach through the half of the root length with oval cross-sections in the floor and roof anatomy. The distance between the isthmus floor and apical foramina did not differ between MB1 and MB2. Clinical relevance The band-shaped isthmus morphology contributes to the complexity of the apical anatomy of maxillary first molar teeth with various lengths and diameters.

Purpose:This in vitro study aimed to assess the performance of ProTaper Universal Retreatment (PTUR), Reciproc Blue (RB), and XP-endo Shaper (XPS) system in the removal of bioceramic root canal filling.Materials and methods:Forty-five human single-rooted mandibular premolars were prepared up to 30/.04 and filled with Endosequence BC sealer and BC points before being assigned into three groups (n=15). The root canal fillings were removed until reaching predetermined working length (WL) with PTUR in group 1, RB in group 2, and XPS in group 3. During the removal of the filling material, apically extruded debris was collected in pre-weighed Eppendorf tubes, and operation time was recorded with a digital chronometer. Reaching the WL and maintaining apical patency were evaluated separately. The data were statistically analyzed using Kruskal Wallis and Mann Whitney U tests.Results:The mean amount of extruded debris was highest in the PTUR group, although all instruments caused apical extrusion of debris. The mean time for reaching WL was longest for RB and shortest for XPS, with significant differences among the groups (p<0.05). Although the difference was not significant (p=0.799), in the PTUR group the WL was reached in 93.3% of the samples, which was higher than other groups (86.7%).Conclusion:All tested systems caused a certain amount of debris extrusion. XPS was associated with less extrusion while regaining more rapid access to the periapical area than PTUR and RB.

Irrigation dynamics of syringe irrigation with different needle designs (side-vented, double side-vented, notched) and ultrasonic irrigation in the root canal with internal root resorption were evaluated using a computational fluid dynamics model. A micro-CT scanned mandibular premolar was used for modeling internal root resorption. The needles and the ultrasonic tip were positioned at 2, 4, and 5 mm from the working length. The insertion depth and the irrigation model were found influential on the shear stress and the irrigant extension. The extension of the irrigant increased toward 2–5 mm from the working length. Ultrasonic irrigation revealed the highest shear stress values regardless of the insertion depth. The shear stress distribution on the resorption cavity walls gradually increased when the needles were positioned coronally. The residence time of the irrigant in the canal was affected by the needle position relative to the internal root resorption cavity and the needle type.

This study aims to assess the efficacy of various irrigation protocols on the dentinal tubule penetration of a bioceramic-based endodontic sealer. Sixty-four single-rooted extracted human mandibular incisors were used. After instrumentation, teeth were randomly divided into the following four groups (n = 16 each) according to the final irrigation technique: group 1, conventional endodontic needle (CEN); group 2, EndoActivator (EA); group 3, Er,Cr: YSGG laser; group 4, XP-endo Finisher (XPF). The root canals were finally irrigated with 17% EDTA and 5.25% NaOCl for 1 min (min) respectively. The teeth were then obturated with Endosequence BC Points and rhodamine B dye-labeled BC Sealer. After 2 weeks, 1-mm-thick transverse sections were cut 2 and 5 mm from the apex, and examined by confocal laser scanning microscopy at 5 × magnification. The total percentage of sealer penetration (TPSP), sealer penetration area (SPA), and maximum sealer penetration depth (MSPD) was measured. Data were analyzed by Kruskal–Wallis, Dunn’s multiple comparison, and Wilcoxon tests, with significance set at P < 0.05. At 2 mm level, no significant differences were detected among the groups (P > 0.05). At the 5 mm level, the XPF group showed significantly higher values for both TPSP and SPA in comparison with the Er,Cr: YSGG laser and CEN groups (P < 0.05), but no significant difference was observed with the EA group. The choice of different final irrigation techniques can affect dentinal tubule penetration.

The knowledge of the final-year dental students on antibiotic use in endodontics in Turkey was assessed. The study was conducted at 20 Dentistry Faculties. A questionnaire was sent to the universities including the concerning several scenarios about endodontic cases. 1113 final-year dental students participated in the study. Respondents' significant choice was not to administrate antibiotics in endodontic treatments of symptomatic irreversible pulpitis, pulp necrosis, acute apical periodontitis, chronic apical abscess with or without sinus tract, retreatment, inadequate local anaesthesia and patient requests (P > 0.05). In acute apical abscess (AAA) with diffuse cases, choice of antibiotic administration was statistically higher (P < 0.05), while in AAA-localised cases, the ratio of antibiotic administration versus non-administration was similar. Amoxicillin was found to be the first-choice antibiotic in patients without medical allergies, whereas in allergic patients the first choice was clindamycin. Final-year dental students have fundamental knowledge on the antibiotic administration in endodontics.

Objective: This study evaluated the angiogenesis-enhancing potential of a tricalcium silicate-based mineral trioxide aggregate (ProRoot MTA), Biodentine, and a novel bioceramic root canal sealer (Well-Root ST) in human dental pulp stem cells (hDPSCs), human periodontal ligament stem cells (hPLSCs), and human tooth germ stem cells (hTGSCs). Methodology: Dulbecco's modified Eagle's medium was conditioned for 24 h by exposure to ProRoot MTA, Biodentine, or Well-Root ST specimens (prepared according to the manufacturers' instructions). The cells were cultured in these conditioned media and their viability was assessed with 3-(4,5-dimethyl-thiazol-2-yl)-5-(3-carboxy-methoxy-phenyl)-2-(4-sulfo-phenyl)-2H tetrazolium (MTS) on days 1, 3, 7, 10, and 14. Angiogenic growth factors [platelet-derived growth factor (PDGF), basic fibroblast growth factor (FGF-2), and vascular endothelial growth factor (VEGF)] were assayed by sandwich enzyme-linked immunosorbent assay (ELISA) on days 1, 7, and 14. Human umbilical vein endothelial cell (HUVEC) migration assays were used to evaluate the vascular effects of the tested materials at 6-8 h. Statistical analyses included Kruskal-Wallis, Mann-Whitney U, and Friedman and Wilcoxon signed rank tests. Results: None of tricalcium silicate-based materials were cytotoxic and all induced a similar release of angiogenic growth factors (PDGF, FGF-2, and VEGF) (p>0.05). The best cell viability was observed for hDPSCs (p<0.05) with all tricalcium silicate-based materials at day 14. Tube formation by HUVECs showed a significant increase with all tested materials (p<0.05). Conclusion: The tricalcium silicate-based materials showed potential for angiogenic stimulation of all stem cell types and significantly enhanced tube formation by HUVECs.

Aim: To evaluate the limits of the shaping ability of MaxWire® alloy file in the treatment of pre-created large and curved root canals with different apical sizes by using cone-beam computed tomography (CBCT). Materials and methods: Forty-five permanent maxillary first molars with moderately curved palatal roots (20°-30°) were divided into three groups, and large root canals were created with apical diameter #35 (Group 1), #40 (Group 2) or #50 (Group 3) by using BioRace NiTi System. Then, they were reshaped with the MaxWire alloy file, XP-endo Shaper®. Canals were scanned before and after instrumentation by using the CBCT scanner. Canal transportation (CT), centering ratio (CR), % increased prepared area (PA), and % increased prepared outline (PO) at 2, 3, and 4 mm from the apex were calculated. Data were statistically analyzed at P < 0.05. Results: There was a significant difference in the mean increase in PO in all apical sizes and all three levels. At both 3 mm and 4 mm levels the maximum PA and PO were achieved in apical size 35, while at 2 mm level the maximum values were obtained in apical size 40. There was no statistically significant difference in CT and CR within groups at 2 mm distance from the apex. Conclusion: Max Wire alloy technology of this novel instrument makes it possible to clean and touch the dentin walls of large and curved root canals. Small FOV and small voxel size of CBCT could also be used in shaping ability studies in endodontics.