This study evaluated the effect of 17% EDTA and 7% maleic acid (MA) irrigation on microleakage of mineral trioxide aggregate (MTA) and Biodentine® (BD) used as root-end filling materials. 60 root samples were instrumented, resected, and filled with MTA or BD after irrigation with 17% EDTA, 7% MA, or saline (control). Microleakage was evaluated at 24 hours, 7 days, and 14 days. 7% MA removed smear layer better than 17% EDTA and resulted in less microleakage for both materials, especially BD. MTA showed better adaptation than BD when used with 17% EDTA. Overall, 7%
Synopsis presentation Evaluation of tubular penetration depth of a sealer aft...pratiklovehoney
Evaluation of tubular penetration depth of a sealer after irrigation with four root canal irrigants of different origin- 6% Morinda Citrifolia juice, 0.2% Chitosan, 17% EDTA, 3% NaOCl-an in vitro study
Erosive cola-based drinks affect the bonding to enamel surface: an in vitro s...AD Dental
Erosive cola-based drinks affect the bonding to enamel surface: an in vitro study
Leslie Caroll CASAS-APAYCO, Vanessa Manzini DREIBI, Ana Carolina HIPÓLITO, Márcia Sirlene Zardin GRAEFF, Daniela RIOS, Ana Carolina MAGALHÃES, Marília Afonso Rabelo BUZALAF, Linda WANG
J Appl Oral Sci. http://dx.doi.org/10.1590/1678-775720130468
Abstract
Objective: This study aimed to assess the impact of in vitro erosion provoked by different cola-based drinks (Coke types), associated or not with toothbrushing, to bonding to enamel. Material and methods: Forty-six bovine enamel specimens were prepared and randomly assigned into seven groups (N=8): C- Control (neither eroded nor abraded), ERO-RC: 3x/1-minute immersion in Regular Coke (RC), ERO-LC: 3x/1-minute immersion in Light Coke (LC), ERO-ZC: 3x/1-minute immersion in Zero Coke (ZC) and three other eroded groups, subsequently abraded for 1-minute toothbrushing (EROAB-RC, EROAB-LC and EROAB-ZC, respectively). After challenges, they were stored overnight in artificial saliva for a total of 24 hours and restored with Adper Single Bond 2/Filtek Z350. Buildup coronal surfaces were cut in 1 mm2-specimens and subjected to a microtensile test. Data were statistically analyzed by two-way ANOVA/Bonferroni tests (a=0.05). Failure modes were assessed by optical microscopy (X40). The Interface of the restorations were observed using Confocal Laser Scanning Microscopy (CLSM). Results: All tested cola-based drinks significantly reduced the bond strength, which was also observed in the analyses of interfaces. Toothbrushing did not have any impact on the bond strength. CLSM showed that except for Zero Coke, all eroded specimens resulted in irregular hybrid layer formation.
Conclusions: All cola-based drinks reduced the bond strength. Different patterns of hybrid layers were obtained revealing their impact, except for ZC.
Comparative evaluation of antimicrobial efficacy of q mix™/ dental implant co...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
Synopsis presentation Evaluation of tubular penetration depth of a sealer aft...pratiklovehoney
Evaluation of tubular penetration depth of a sealer after irrigation with four root canal irrigants of different origin- 6% Morinda Citrifolia juice, 0.2% Chitosan, 17% EDTA, 3% NaOCl-an in vitro study
Erosive cola-based drinks affect the bonding to enamel surface: an in vitro s...AD Dental
Erosive cola-based drinks affect the bonding to enamel surface: an in vitro study
Leslie Caroll CASAS-APAYCO, Vanessa Manzini DREIBI, Ana Carolina HIPÓLITO, Márcia Sirlene Zardin GRAEFF, Daniela RIOS, Ana Carolina MAGALHÃES, Marília Afonso Rabelo BUZALAF, Linda WANG
J Appl Oral Sci. http://dx.doi.org/10.1590/1678-775720130468
Abstract
Objective: This study aimed to assess the impact of in vitro erosion provoked by different cola-based drinks (Coke types), associated or not with toothbrushing, to bonding to enamel. Material and methods: Forty-six bovine enamel specimens were prepared and randomly assigned into seven groups (N=8): C- Control (neither eroded nor abraded), ERO-RC: 3x/1-minute immersion in Regular Coke (RC), ERO-LC: 3x/1-minute immersion in Light Coke (LC), ERO-ZC: 3x/1-minute immersion in Zero Coke (ZC) and three other eroded groups, subsequently abraded for 1-minute toothbrushing (EROAB-RC, EROAB-LC and EROAB-ZC, respectively). After challenges, they were stored overnight in artificial saliva for a total of 24 hours and restored with Adper Single Bond 2/Filtek Z350. Buildup coronal surfaces were cut in 1 mm2-specimens and subjected to a microtensile test. Data were statistically analyzed by two-way ANOVA/Bonferroni tests (a=0.05). Failure modes were assessed by optical microscopy (X40). The Interface of the restorations were observed using Confocal Laser Scanning Microscopy (CLSM). Results: All tested cola-based drinks significantly reduced the bond strength, which was also observed in the analyses of interfaces. Toothbrushing did not have any impact on the bond strength. CLSM showed that except for Zero Coke, all eroded specimens resulted in irregular hybrid layer formation.
Conclusions: All cola-based drinks reduced the bond strength. Different patterns of hybrid layers were obtained revealing their impact, except for ZC.
Comparative evaluation of antimicrobial efficacy of q mix™/ dental implant co...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
About failures of root canal treatment and retreatment. This presentation describes about various techniques for gutta percha removal, posts removal, pastes removal, and removal of separated instrument
Design of Water Disinfection Unit using CopperSONAL GARG
Design and Development of Household Water Purifier using Copper to remove recontamination of water which occurs due to various reasons like cross contamination, leakage, poor handling and storage.
this presentation includes various obturating materials, sealers which are used for binding the gutta percha points inside the root canals, what is difference between standard and non standardized gutta percha and various newer methods for obturation are also included.
About failures of root canal treatment and retreatment. This presentation describes about various techniques for gutta percha removal, posts removal, pastes removal, and removal of separated instrument
Design of Water Disinfection Unit using CopperSONAL GARG
Design and Development of Household Water Purifier using Copper to remove recontamination of water which occurs due to various reasons like cross contamination, leakage, poor handling and storage.
this presentation includes various obturating materials, sealers which are used for binding the gutta percha points inside the root canals, what is difference between standard and non standardized gutta percha and various newer methods for obturation are also included.
The bond strength of endodontic sealers to root /prosthodontic coursesIndian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
Micro-computed tomographic assessment of dentinal microcrack formation in str...DR.AJAY BABU GUTTI M.D.S
Micro-computed tomographic assessment of
dentinal microcrack formation in straight and
curved root canals in extracted teeth prepared
with hand, rotary and reciprocating instruments IEJ 2021
Comparison of Different Dentin Pretreatment Protocols on the Bond Strength of...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Composite dental restorations represent a unique class of biomaterials with severe restrictions on biocompatibility, curing behaviour, aesthetics, and ultimate material properties. These materials are presently limited by shrinkage and polymerization-induced shrinkage stress, limited toughness, the presence of unreacted monomer that remains following the polymerization, and several other factors. Fortunately, these materials have been the focus of a great deal of research in recent years with the goal of improving restoration performance by changing the initiation system, monomers, and fillers and their coupling agents, and by developing novel polymerization strategies.
One of the most dreaded nightmares of any clinician is broken instruments in the midst of an endodontic treatment. NiTi rotary instruments show a high incidence of instrument fracture despite their favourable qualities.
A biofilm is a highly organized structure consisting of bacterial cells enclosed in a self-produced extracellular polymeric matrix attached on a surface. Root canal infections are biofilm mediated. The complexity and variability of the root canal system, together with the multi-species nature of biofilms, make disinfection of this system extremely challenging.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
5. • To eliminate diseased Tissues and obtain an apical seal to
prevent the ingress of Residual irritants into the
periradicular area.
6. INDICATIONS
FOR
SURGICAL
RETREATMENT
Irretrievable root canal
fillings
Calcified canals
Procedural errors
- Instrument
fragmentation
- Non negotiable ledging
- Over instrumentation &
apical fracture
Presence of dowels
Anatomic variations
Apical cyst
• Need for Biopsy
• Large inaccessible perforations
• Need to establish drainage
• Conventional treatment and
retreatment failed
• Conventional retreatment
impractical due to irretrievable
prosthetic restoration
7.
8.
9. ORGANIC
ACIDS
The combination of EDTA and NaOCl is most commonly used for
the smear layer removal.
17% EDTA is not efficient in removal of smear layer especially in
the apical third of the root canal system.
It has also been reported to be cytotoxic.
7% maleic acid (MA) is a mild organic acid which has
shown to remove the smear layer significantly better
than 17% EDTA in apical third of root canal system
when used as a root canal irrigant.
13. • MTA prevents microleakage, is biocompatible, promotes
regeneration of the original tissues when place in contact
with periradicular tissues.
Torabinejad M, Chivian N. Clinical applications of mineral trioxide aggregate. J Endod 1999
MTA has been investigated as one of the best root end filling material in
endodontics.
• MTA provides a better seal than amalgam, IRM, and EBA
cement when used as a root-end filling material
Tang HM, Torabinejad M, Kettering JD. Leakage evaluation of root end filling materials using
endotoxin. J Endod 2002
14. Laurent et al. evaluated the genotoxicity, cytotoxicity,
and effects on target cells specific functions of BD.
They concluded that BD is a biocompatible material.
Induction of specific cell Responses to a Ca(3) SiO(5)-based posterior restorative
material. Dent Mater 2008;
15.
16.
17. Aim
To evaluate the effect of 17% ethylenediaminetetraacetic acid
(EDTA) and 7% maleic acid (MA) irrigation on microleakage of
mineral trioxide aggregate (MTA) and Biodentine® (BD) when
used as a root-end filling material.
18.
19. Sixty human anterior teeth were
decoronated and subjected to root
canal instrumentation.
3 mm of apical root portion was resected, and
root-end cavities were prepared using
ultrasonic tips. Teeth were then randomly
divided into two groups (n = 30).
Group 1 - Root End Cavity To
Be Filled With MTA;
Group 2 - Root End Cavity To
Be Filled With BD.
Each group was further divided into three
subgroups A, B, and C based on irrigation
regimen. About 5 mL of all irrigating
solutions were used for 1 min.
Group A - 17% EDTA
Group B - 7% MA
Group C - 0.9% saline.
After final irrigation, root-end
cavities were filled with
respective root end filling
material.
Specimens were then subjected to
microleakage analysis at 24 h, 7
days and 14 days using
GLUCOSE FILTRATION
TECHNIQUE.
SMEAR LAYER EVALUATION
6 central incisors were subjected to root
canal instrumentation and irrigation with
7% MA and 17% EDTA.
Then, these samples were analyzed
under the standard error of the
mean data was analyzed using
one-way ANOVA, Bonferroni test,
Mann–Whitney U-test and
Kruskal–Wallis test.
20. Sixty human
maxillary central
incisors with relative
similar extracted for
periodontal reasons
were selected.
Inclusion
criteria -
caries free, single
root canal, and
completely formed
apex
Exclusion
criteria -
open apex or
incompletely formed
apex, root
resorptions, cracks,
and endodontic
restorations).
Teeth were thoroughly
cleaned using
ultrasonics and stored
in 0.2% of sodium
azide at 4°C until the
experiment.
The crowns of all
teeth were
decoronated using a
diamond disc at the
CEJ so that the
coronal surface was
perpendicular to the
long axis of the root
and the remaining root
length was adjusted to
15 mm
SPECIMEN PREPARATION
21. ROOT CANAL
PREPARATION
The working length was
established by inserting a no. 10 K
file into each root canal until it
was just visible at apical foramen
(observed by magnifying loupes)
and by subtracting 1 mm from this
point.
The canal was enlarged
to size F3 using
ROTARY PROTAPER
FILES.
About 5 mL of 2.5%
NaOCl was used as
irrigant for 1 min
between each instrument
change.
Final irrigation was done
with 5 mL of distilled
water for 1 min, and the
canals were then dried
using paper points.
22. APICAL ROOT
RESECTIONS
Done by removing
3 mm of the apex
at a 90° angle to
the long axis of the
root with a
diamond bur
Under water coolant at
a high-speed. 3-mm
deep root-end cavities
were prepared using
the ultrasonic tip
(JT-4B size - 0.3 mm)
at a low power setting
using water coolant.
Cutting with the
ultrasonic tips
were performed
using back and
forth motion with
the tip enveloped
in water spray.
23. N= 60
GROUP C
0.9% SALINE
n=10
GROUP B
7% MALEIC
ACID
n=-10
GROUPA
17% EDTA
n=10
GROUP 2
BIODENTINE
(n=30)
GROUP 1
MTA (n=30)
24. • MTA and BD were mixed according to the manufacturer’s
instructions, and the root-end cavities were filled with the
respective material.
• A customized endodontic hand plugger was placed in the
root canal 3 mm short of root apex, which formed a coronal
matrix before filling with root-end material.
• Excess material from root-end cavity was removed with
wet cotton pellets, and the roots were kept in 100%
humidity at 37°C for 48 h.
• About 5 mL of all the irrigating solutions were used for 1 min
using a disposable syringe and 28 gauge needle.
• Final irrigation in all the groups was performed with 5 mL of
distilled water for 1 min.
• After final irrigation, root-end cavities were dried with paper
points.
25. The coronal part of each root was glued to one end of a modified plastic dropper (in which both ends
were cut to accommodate specimen and the glass tube) using cyanoacrylate.
Through other end, a glass tube of 15 cm in length was connected. A seal was obtained using
cyanoacrylate glue and sticky wax.
The assembly was then placed in a sterile 5 ml glass bottle covered with paraffin sheet and sealed
with sticky wax.
The tracer used was a 1 mol/L glucose solution (pH = 7.0), whose density was 1.09 × 103 g/L and
viscosity 1.18 × 10–3 Pas at 37°C.
About 5 ml of glucose solution, containing 0.2% sodium azide (NaN3), was injected into the
modified dropper from glass tube until the top of the solution was 14 cm higher than the top of
specimen, which created a hydrostatic pressure of 1.5 kPa (15 cm H2O).
The glass bottle contained 1 ml of 0.2% aqueous solution of NaN3, in which glucose that leaked
through the restored canal was collected.
GLUCOSE PENETRATION MODEL Evaluation of microleakage
26. A 100-μL aliquot of the solution was drawn from the glass beaker using a micropipette
after 24 h, 7 days and 14 days.
After drawing the sample, 100 μL of fresh 0.2% NaN3 was added to glass bottle reservoir
to maintain a constant volume of 1 mL.
If there was any decrease in the volume in the control bottle due to evaporation, a
corresponding amount of sterile deionized water was added to the glass beaker.
The sample was then analyzed with a glucose kit in a colorimeter at 500 nm wavelength.
Two blinded independent evaluators conducted the colorimetric determination of glucose
concentration.
The results of leakage in all groups were calculated as mmol/L from the respective optical
density observed in colorimeter.
Measurement of microleakage
27. Scanning electron microscopic analysis
Six human single-rooted maxillary
central incisors were selected and
prepared as mentioned previously.
Once the samples were prepared, they
were divided into two groups
(n = 3)
The apical segment were then split
into two halves using a straight
chisel and stored in deionized water
at 37°C
until standard error of the mean
analysis
Group 1- irrigated with 5 mL
of 17% EDTA solution for 1
min
Group 2 - irrigated with 5
mL of 7% MA solution for 1
min.
Finally, all the samples
were irrigated with 5 mL
of distilled water for 1
min.
The apical third of all the
samples were then
horizontally cut
Longitudinal grooves were prepared
on
the buccal and lingual surfaces of
each of the apical segment using a
diamond disc at a slow speed
without penetrating the
root canal
The specimens were dehydrated
using ascending grades of ethyl
alcohol and were then mounted on
metallic stubs, gold sputtered using
an ion sputter
Examined under scanning
electron microscope for
presence or absence of smear
layer.
Photomicrographs were taken
to observe the surface
morphology at ×1500
magnification and 10 KV
29. Stereomicroscopic
analysis
Five representative samples from each group:
(a) 17% EDTA and MTA;
(b) 7% MA and MTA;
(c) 17% EDTA and BD;
(d) 7% MA and BD were selected
Sectioned horizontally using diamond disc under water spray.
The samples were then observed under stereomicroscope at ×10 magnification
for the marginal adaptation of root-end filling material to the root canal walls.
30. Statistical
analysis
Statistical analysis for inter-group comparison was done using
one-way ANOVA and Bonferroni test, and that of intra-group
comparison was done using Mann–Whitney U-test and Kruskal–
Wallis test.
In the smear layer evaluation, the inter-examiner’s reliability was
verified using the Kappa test.
The level of statistical significance was set at P < 0.05.
31. MICROLEAKAGE
In MTA group, saline (control) showed maximum leakage at all the time
intervals (P < 0.001) as compared to that of 17% EDTA and 7% MA.
There was no significant difference between 17% EDTA and 7% MA.
Bar graph demonstrating comparison of microleakage using different
irrigants in mineral trioxide aggregate group
32. In BD group, saline (control group) showed the maximum leakage at all the time intervals (P <
0.001) as compared to that of 17% EDTA and 7% MA groups.
There was a significant difference between 17% EDTA and 7% MA group at 48 h (P = 0.008),
7 days (P < 0.001) and 14 days (P = 0.002), with 17% EDTA demonstrating higher leakage
MICROLEAKAGE
Bar graph demonstrating comparison of microleakage using different irrigants in
Biodentine group
33. Bar graph demonstrating
comparison of microleakage
between mineral trioxide
aggregate and Biodentine at 48 h
On intercomparison at different time, at 48 h in 17% EDTA group,
BD showed significant higher leakage than that of MTA (P <
0.001).
However, in 7% MA (P = 0.172) and saline group (P = 0.65) there
were no significant difference between BD and MTA.
34. Bar diagram showing comparison of microleakage between
mineral trioxide aggregate and Biodentine at 7 and 14 days
At 7 and 14 days, 17% EDTA
(P< 0.001), 7% MA(P < 0.001),
and saline (P = 0.034) groups
demonstrated significant more
leakage in BD as
compared to MTAgroup
35. SMEAR
LAYER
EVALUATION
Kappa test results for smear layer evaluation showed that there was no
statistical significant difference between the two examiners for both 7% MA
and 17% EDTA groups.
About 7% MA was able to remove the smear layer better than 17% EDTA.
There was no smear layer on root canal walls, and the tubules were open in
7% MA group.
In 17% EDTA-treated specimens, tubules were partially obliterated with
smear layer.
36. STEREOMICROSCOPIC
EVALUATION
Poor marginal adaptation of BD to root canal walls treated with
17% EDTA as compared to 7% MA.
The adaptation of MTA to the root canal walls treated with 17%
EDTA and 7% MA was found to be good.
Stereomicroscope
photograph demonstrating
adaptation of root end filling
material to root-end cavity.
(a) 17% EDTA and MTA
(b) 7% MA and MTA
(c) 17% EDTA and BD
(d) 7% MA and Biodentine
A B
C D
37. • In this study, all irrigation groups both in MTA
and BD showed microleakage over time, but saline
demonstrated significant higher leakage than that
of 17% EDTA and 7% MA.
• No significant difference in the microleakage between 17%
EDTA and 7% MA group
• MTA was used as root-end filling material. This could be
attributed to the good adaptation of MTA to root canal
walls as reported by various studies.
Torabinejad M, Hong CU, McDonald F, Pitt Ford TR. Physical and chemical properties
of a new root-end filling material. J Endod 1995
38. • 17% EDTA and 7% MA, with 17% EDTA group
showing more leakage.
• Improper marginal adaptation of BD to root canal
walls treated with 17% EDTA.
• It has been reported that the adhesion of BD to the
root canal walls is most likely through the tag like
structures formed within the dentinal tubules
leading to micromechanical retention
Atmeh AR, Chong EZ, Festy F, Watson TF. Dentin-cement
interfacial interaction: Calcium silicates and polyalkenoates. J Dent Res2012
BIODENTINE
• Calcium and Silicon ion uptake into dentin leading to the
formation of tag like structures was higher in BD than
MTA
Han and Okiji
• Dentin in apical third of root canal system is sclerosed.
• In the presents tudy, in BD group, there may not have
been complete tag formation inside the apical sclerosed
root canal dentin which would have led to its
improper marginal adaptation.
Vasiliadis L, Darling AI, Levers BG. The amount and distribution of sclerotic human
root dentine. Arch Oral Biol 1983
MTA and IRM were significantly superior
to BD in terms of marginal adaptation
when used as root-end filling material.
Soundappan et al. J Dent 2014
39. Within the BD group, the 17% EDTA irrigation group showed more microleakage as
compared to that of the 7% MA group.
• Effective removal of smear layer in the apical third
of the root canal dentin by 7% MA when compared
to that of 17% EDTA ( SEM )
Present study
• Smear layer removal ability of 7% MA is better than 17%
EDTA, especially in the apical third of root canal system.
Ballal et al. J Endod 2009
• Postobturation apical seal following irrigation with 7% MA or 17% EDTA evaluated using
dye leakage under vacuum method was better with 7% MA than 17% EDTA.
• The authors attributed the minimal leakage with 7% MA irrigation due to its efficient smear
layer removal in the apical third.
Ballal et al. J Endod 2009
40.
41. Hence, in the present study ultrasonic (US) retro tip was preferred to prepare
the root end cavity as US retro tips have many advantages over traditional
round bur. US retro tips produced cleaner, well-centered, and more conservative
root-end cavities.
42. In this study ,7% MA was used because it has been reported that, MA, when used at a
higher concentration than 7%, caused damage to the intertubular dentin
Time-dependent effects of EDTA on dentin structures. J.Endod 2002;
The irrigation time in the present study was set to 1 min because irrigation
with 17% EDTA for more than 1 min has shown to cause excessive
peritubular and intertubular dentinal erosion.
Time-dependent effects of EDTA on dentin structures. J.Endod 2002;
43. METHODS TO
EVALUATE SEALING
ABILITY OFROOTEND
FILLINGS
Dye leakage
Fluid filtration
Bacterial penetration
Radiolabelled isotopes
Electromechanical tests
DYE PENETRATION TEST
• Advantages - simplicity and cost
effectiveness.
• Disadvantages - can lead to observers
bias, cannot be reproducible and
comparable.
Bacterial penetration
• Advantage- more relevant
• Disadvantage- maintaining asepsis
is critical
RADIOISOTOPE LABELING
AND ELECTROCHEMICAL
METHODS
• Radiation hazard and
require sophisticated materials
• Less frequently used
FLUID FILTRATION
ADVANTAGES- sensitive, nondestructive and reproducible
DISADVANTAGES- lack of standardization of the measurement
time, applied pressure, diameter of the tube containing the bubble,
and the length of the bubble
44. A new quantitative method using glucose for
analysis of endodontic leakage
Xu et al- Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005;
• If the bacteria enter the root canal system from oral cavity, the bacteria
that
might have survived after root canal preparation and obturation could
multiply
and potentially lead to periapical inflammation.
• Hence, the use of glucose as a tracer in endodontic microleakage studies
would be more clinically relevant than using other tracers
ADVANTAGES
• Quantitative
technique
• Sensitive
• Nondestructive
• Clinically relevant.
GLUCOSE AS A TRACER
• small molecular size
• known nutrient for the
bacteria
45. • Compared glucose penetration and fluid filtration method for measuring leakage and
• Glucose penetration technique was more sensitive in detecting leakage along root fillings.
Shemesh et al.
46. Time Periods
For Evaluation
Of
Microleakage
• Leakage was evaluated at 48 h followed by 7days and 14 days
• They reported that microbial leakage was reduced significantly
as setting time increased from 4 h to 2 days or 1 week.
• There was no significant reduction in leakage when the setting
time was increased from 2 days to 1 week.
The maximum period for the assessment of leakage was taken as 14 days.
In accordance with Chogle et al
Intracanal assessment of mineral trioxide aggregate setting and sealing properties.
Gen Dent 2007
47. • Within the limitations of this study, it can be
concluded that MTA had a better sealing ability as
compared to that of BD when root-end cavities were
irrigated with 7% MA.