The mechanism responsible for hydrogen-peroxide- or sodium-hypochlorite-induced reductions in dentin bond strength is unknown. This in vitro study tested the hypothesis that these oxidizing agents were responsible by attempting to reverse the effect with sodium ascorbate, a reducing agent. Human dentin was treated with these oxidants before or after being acid-etched and with or without post-treatment with sodium ascorbate. They were bonded with either Single Bond or Excite. Hydrogen peroxide reduced the bond strengths of both adhesives, while sodium hypochlorite produced reduction in adhesion of only Single Bond (p < 0.05). Following treatment with sodium ascorbate, reductions in bond strength were reversed. Transmission and scanning electron microscopy showed partial removal of the demineralized collagen matrix only by sodium hypochlorite. The observed compromised bond strengths cannot be attributed to incomplete deproteinization and may be related to changes in the redox potential of the bonding substrates.

Oxygen inhibits polymerization of resin-based materials. We hypothesized that compromised bonding to bleached enamel can be reversed with sodium ascorbate, an anti-oxidant. Sandblasted human enamel specimens were treated with distilled water (control) and 10% carbamide peroxide gel with or without further treatment with 10% sodium ascorbate. They were bonded with Single Bond (3M-ESPE) or Prime&Bond NT (Dentsply DeTrey) and restored with a composite. Specimens were prepared for microtensile bond testing and transmission electron microscopy after immersion in ammoniacal silver nitrate for nanoleakage evaluation. Bond strengths of both adhesives were reduced after bleaching but were reversed following sodium ascorbate treatment (P < 0.001). Resin-enamel interfaces in bleached enamel exhibited more extensive nanoleakage in the form of isolated silver grains and bubble-like silver deposits. Reduction of resin-enamel bond strength in bleached etched enamel is likely to be caused by a delayed release of oxygen that affects the polymerization of resin components.

No abstract

Instrument fracture can be an unpleasant mishap during non‐surgical root canal treatment. While most stainless‐steel instruments appear to fail by excessive amounts of torque, the combined action of torsional stress and cyclic loading (i.e. fatigue, as a result of rotational bending, or repeated torsion) is responsible for the breakage of NiTi rotary files in use. Factors affecting the incidence and mode of failures include the instrumentation technique, use of torque‐controlled motor, the dimension and surface condition of the instrument, rotation rate, radius (and, to a certain extent, angle) of canal curvature, and the presence of a straight‐line access and a ‘glide path’ to the apical portion of the canal. If breakage should occur clinically, the patient should be informed of the incident and consideration should be given as to whether or not to remove the fragment. Managed properly, the presence of a broken fragment per se may not adversely affect the outcome of root canal treatment. This review examines the various aspects (including mechanisms, contributing factors, prognosis and management) of instrument fracture. Emphasis is placed on the separation of nickel–titanium rotary files and ways to prevent this in the clinical situation.

The survival of the vital pulp in teeth restored with a single-unit CMC was significantly higher than those serving as an abutment of a fixed-fixed bridge. Maxillary anterior teeth used as bridge abutments had a higher rate of pulpal necrosis than any other tooth types.

The fatigue behaviour of NiTi rotary instrument is typical of most metals, provided that the analysis is based on the surface strain amplitude, and showed a high-cycle and a LCF region. The LCF life is adversely affected by water.

This study aimed to investigate the composition of microflora in endodontically treated teeth associated with asymptomatic periapical lesions in southern Chinese patients. Twenty-four teeth which had received nonsurgical root canal treatment more than 4 years previously, and which presents an acceptable coronal restoration with a periapical radiolucent area, were re-treated nonsurgically. Bacteriological samples were obtained after removal of the old root canal filling. The samples were inoculated on enriched trypticase soy agar and four selective media for incubation at 37 degrees C in both a carbon dioxide-enriched atmosphere and anaerobically. Eighteen teeth that had received gutta-percha root canal fillings were grouped for analysis, 12 (66.7%) of which contained cultivable microorganisms. The total colony forming units per ml of transport medium ranged from 0 to 2.3 x 10(5). The number of bacterial genera recovered ranged between 0 and 6, with facultative gram-positive cocci being the most prevalent group of bacteria isolated. Facultative anaerobic bacteria were present in all, whereas strict anaerobic bacteria were found in 3 out of the 12 teeth with positive growth. The size of the periapical rarefaction did not show any relationship with the quantity of microorganisms recovered. Coagulase-negative staphylococci, streptococci and Pseudomonas aeruginosa were most frequently isolated in this group of patients. The possible origin of these organisms is discussed.

Multiple use of ProTaper S1 pre-disposed the instrument to microcrack formation and wear of the cutting edges. There was a low prevalence of plastic deformation and most ProTaper S1 instruments failed without discernible sign of unwinding of the flutes. Further studies should address the mode of failure and the role of debris particles in the fracture mechanism.