Aim To evaluate in a laboratory study, the effect of different canal irrigant solutions and activation techniques on transforming growth factor (TGF‐β1), insulin growth factor‐1 (IGF‐1), bone morphogenetic protein‐7 (BMP‐7) and vascular endothelial growth factor‐A (VEGF‐A) release levels from the dentine of extracted premolar teeth. Methodology Seventy premolar teeth with single root and canal were used. The lengths of the root segments were standardized to 12 mm, and the root canals were prepared up to size 100 with hand files. All surfaces of the teeth were covered with nail polish except the inner root canal surface. The root canals were irrigated with 1.5% NaOCl. Ten teeth were allocated to the control group. The remaining sixty teeth were divided into 2 main groups according to the chelating agent used (17% EDTA, 10% Citric acid; CA) and 3 subgroups (n = 10) according to irrigation activation technique (conventional syringe irrigation (CSI), passive ultrasonic irrigation (PUI) and Er:YAG laser activation). After the activation procedure, the root segments were placed into eppendorf tubes containing 1 mL of phosphate‐buffered saline solution and kept at 37℃. TGF‐β1, IGF‐1, BMP‐7 and VEGF‐A release levels from dentine were measured using the enzyme‐linked immunosorbent assay (ELISA) method at 24 h and at day 7. The volume of root canals was calculated using cone‐beam computed tomography. The growth factor levels were calculated in ng/mL except VEGF‐A (pg/ml). Normality analysis of the data was evaluated with the Kolmogorov–Smirnov test. Statistical analysis was performed using the Mann–Whitney‐U and Wilcoxon tests. Results Regardless of the activation type and sampling time, EDTA caused significantly more IGF release than did CA, whereas EDTA and CA were equally effective for the release of the other growth factors. For either EDTA or CA, the lowest and highest growth factor release levels were observed in the CSI and Er:YAG laser groups, respectively (p < .05). All of the growth factors were released significantly more at 24 h than on day 7 (p < .05). Conclusions Irrigation activation techniques with EDTA or CA increased the release levels of all growth factors from the dentine of canal walls in extracted premolar teeth.
Aim:The present study aims to examine the impact of various laser-assisted irrigation activation techniques on the removal of Ca(OH)2 from coronal and apical artificial grooves prepared in canal walls. Materials and Methods:The root canal instrumentation procedures of sixty extracted mandibular premolar teeth were performed using ProTaper Universal system. The grooves were prepared in the coronal and apical regions of the root canals. Ca(OH)2 was placed into the grooves for 1 week. Teeth were allocated into 4 groups according to the irrigation techniques of EDTA (n=15): needle irrigation, PIPS, Nd:YAG laser, and Er:YAG laser. The percentage of Ca(OH)2 remnants was quantified using image analysing software (Image J). For the statistical analysis, one-way analysis of variance and post-doc LSD tests were used (P = .05). Results: For apical grooves, PIPS and Er:YAG laser groups were statistically more effective than needle irrigation and Nd:YAG laser groups (P < .05). No significant difference was determined between PIPS and Er:YAG laser groups; needle irrigation and Nd:YAG laser groups (P > .05). For coronal grooves, all of the groups showed statistically similar results (P > .05). Conclusion: Within the limitations of this laboratory study, Er:YAG laser and PIPS techniques enhanced Ca(OH)2 removal ability of EDTA in apical region.
Epidermolysis bullosa is a congenital genetic disease that causes blistering and erosion of the skin and mucosa. The main known forms include simple, junction, dystrophic and mixed subtypes. This case report presents the endodontic management and 1‐year follow‐up of a 27‐year‐old female patient with epidermolysis bullosa who was referred to the Faculty of Dentistry, Kırıkkale University, Turkey. An extraoral examination showed that the patient had multiple scars and blisters. The intraoral examination revealed ankyloglossia, microstomia, shallow buccal and vestibular sulci, enamel hypoplasia, gingival inflammation, mouth ulcers, symptomatic and asymptomatic deep caries, a tooth with an apical lesion and a tooth with pulpitis. The dental treatment was divided into four stages: (i) oral hygiene motivation and elimination of gingival bleeding, (ii) restorative and/or endodontic procedures, (iii) extractions and prosthetic treatments and (iv) recall appointments. A 1‐year follow‐up radiographic examination of the periapical status of the root canal treatments was clear.
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