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AimTo investigate the effect of several chelating solutions on transforming growth factor (TGF‐β) release from dentine discs and their subsequent impact on cellular behaviour.MethodologyHuman dentine discs were prepared with a standardized diameter and disinfected using 1.5% NaOCl for 5 min. The dentine discs were then exposed to 17% ethylenediaminetetraacetic acid (EDTA), 1% phytic acid (IP6), 9% etidronic acid (HEDP) or distilled water (DW). The release of transforming growth factor (TGF‐β) was quantified using ELISA. The proliferation of dental pulp stem cells (DPSCs) on the conditioned dentine discs was analysed using an MTT assay, and the cell morphology was observed by SEM. Migration of DPSCs towards the conditioned dentine discs was measured using a Transwell assay. Data for cell proliferation and migration were analysed using two‐way analysis of variance with a Bonferroni post hoc test; a Kruskal–Wallis test was used for analysing TGF‐β release.ResultsBoth HEDP and IP6 treatment triggered TGF‐β release and cell migration. The greatest TGF‐β release was observed after HEDP treatment as compared with EDTA and DW but there was no significant difference between the groups. In terms of cell migration, HEDP was more effective than EDTA (P < 0.05) whilst IP6 was similar to EDTA. Cell proliferation significantly increased with time after EDTA, DW and IP6 treatment (P < 0.05), whereas HEDP treatment did not induce cell proliferation (P > 0.05).ConclusionsIP6 and HEDP were effective chelating agents on TGF‐β release, and cell migration was as effective as EDTA.

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Aim To investigate the antibiotic prescribing patterns for endodontic infections based on the reports of Turkish dentists. Methodology A survey consisting of 20 questions on general information and 13 questions on antibiotic prescribing patterns for endodontic cases was delivered to the e‐mail addresses of general dentists and specialists via the database of the Turkish Dental Association. Collected data were analysed using Mc‐Nemar‐Bowker Test and multivariate ordinal logistic regression tests at the significance level of 0.05. Results A total of 1007 responses were obtained from 17 827 dentists. The majority of the participants were general dental practitioners (GDP, 80%) whilst 8% were Endodontists. Gender, clinical experience, affiliations and speciality were significant risk factors for antibiotic prescription (P < 0.05). GDPs prescribed antibiotics twice as much as all specialists and members of public hospitals prescribed antibiotics three times more than specialists and clinical academics (P < 0.05). Amoxicillin with clavulanic acid was the most prescribed antibiotic (90%), followed by Ornidazole (25%). Clindamycin was the drug of choice for the patients with penicillin allergy (59%). Infection and fever control (76%), prophylaxis (44%) and avoiding swelling and trismus during endodontic treatment (26%) were the most common reasons for antibiotic prescriptions. Completing a course of prescribed antibiotics was recommended by most (75%). Infective endocarditis, immunosuppression, artificial heart valve and mitral valve prolapse were the main causes of prophylaxis in descending order. Uncontrolled and extensive use of antibiotics by patients (62%) was mentioned as the most effective reason for antibiotic resistance. Up to 10% of participants prescribed antibiotics for symptomatic irreversible pulpitis, asymptomatic apical periodontitis with or without endodontic treatment (8, 12 and 11%, respectively). Up to 20% of dentists prescribed antibiotics for symptomatic apical periodontitis when the pulp was vital or necrotic (13 and 23%, respectively). Almost one third of the participants prescribed antibiotics for symptomatic apical periodontitis of previously treated teeth with or without radiographic lesions whilst 34% prescribed antibiotics for acute apical abscess with localized swelling without systemic involvement. Conclusions The majority of dentists reported they prescribed antibiotics inappropriately. It is necessary to improve the knowledge of dentists about antibiotics and their indications in endodontics.

BackgroundThe aim of the study is to evaluate the resistance vertical root fracture (VRF) of mineral trioxide aggregate (MTA) filled-immature permanent roots by using three different vehicles.Material and MethodsForty-extracted human single-rooted mandibular premolars were selected and the root length was standardized to the length of 9 mm. For simulation of immature tooth apices, peeso reamers were introduced into the root canals and the prepared roots were assigned into three experimental groups according the used vehicle (distilled water-DW, prophylene glycol-PG, chlorhexidine-CHX) and control group (n=10). To simulate a periodontal membrane, the apical 7 mm of all roots was covered with wax to obtain a 0.2- to 0.3-mm-thick layer before embedding the roots into acrylic cylinders. A vertical force was applied (1mm/min) using a universal testing machine and the maximum load (F-max) that fracture occurred and the fracture mode (splint or comminuted) was recorded. Data were presented as mean and standard deviations. Statistical analysis was performed using Kruskal-Wallis, Mann-Whitney U Test was used for multiple comparisons.ResultsThere were significant differences between fracture strength of experimental groups with that of control group (p<0.05). However, no statistically significant differences were found amongst the fracture strength values of the experimental groups (p>0.05). In all groups, split fracture was the most common fracture mode.ConclusionsMTA increases resistance of immature permanent teeth to VRF. Based on the results of this study, it can be concluded that mixing MTA with CHX or PG as the vehicle do not alter VRF resistance of simulated immature permanent roots. Key words:Immature teeth, MTA, vehicle, vertical root fracture.

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ObjectivesThe aim of this study was to compare the push-out bond strength and dentinal tubule penetration of root canal sealers used with coated core materials and conventional gutta-percha.Materials and MethodsA total of 72 single-rooted human mandibular incisors were instrumented with NiTi rotary files with irrigation of 2.5% NaOCl. The smear layer was removed with 17% ethylenediaminetetraacetic acid (EDTA). Specimens were assigned into four groups according to the obturation system: Group 1, EndoRez (Ultradent Product Inc.); Group 2, Activ GP (Brasseler); Group 3, SmartSeal (DFRP Ltd. Villa Farm); Group 4, AH 26 (Dentsply de Trey)/gutta-percha (GP). For push-out bond strength measurement, two horizontal slices were obtained from each specimen (n = 20). To compare dentinal tubule penetration, remaining 32 roots assigned to 4 groups as above were obturated with 0.1% Rhodamine B labeled sealers. One horizontal slice was obtained from the middle third of each specimen (n = 8) and scanned under confocal laser scanning electron microscope. Tubule penetration area, depth, and percentage were measured. Kruskall-Wallis test was used for statistical analysis.ResultsEndoRez showed significantly lower push-out bond strength than the others (p < 0.05). No significant difference was found amongst the groups in terms of percentage of sealer penetration. SmartSeal showed the least penetration than the others (p < 0.05).ConclusionsThe bond strength and sealer penetration of resin-and glass ionomer-based sealers used with coated core was not superior to resin-based sealer used with conventional GP. Dentinal tubule penetration has limited effect on bond strength. The use of conventional GP with sealer seems to be sufficient in terms of push-out bond strength.

ObjectivesThe aim of the present study was to compare the sealing efficacy of root fillings made by a single-cone technique with three different sealers and a cold lateral compaction technique with an epoxy sealer.Materials and methodsEighty extracted single-rooted human teeth were assigned to four experimental groups: group 1, single-cone and epoxy sealer; group 2, single-cone and calcium silicate-based sealer; group 3, single-cone and methacrylate resin-based sealer; and group 4, cold lateral compaction and epoxy sealer. Twenty extra teeth served as negative and positive controls. After preparation of a coronal post space, the sealing efficacy of the root fillings was assessed on a fluid transport setup. The results were analyzed using Kruskal-Wallis and Mann-Whitney U test.ResultsNo fluid transport was detected for the negative controls whereas all the positive controls showed rapid fluid transport. No significant difference was detected between groups 1, 3, and 4 whereas group 2 demonstrated significantly more fluid transport than all the other experimental groups.ConclusionsRoot fillings made by a single-cone technique with the epoxy or methacrylate-based sealers were as effective after post space preparation as those made by a cold lateral technique with the epoxy sealer in sealing the root canal.Clinical RelevanceSpecific root canal sealers in combination with single-cone technique represent a noteworthy alternative to the use of cold lateral compaction technique when a post space is required. The use of effective endodontic procedures with simplified technical implementation may positively affect endodontic outcome.