Background: Insolubility is the main requirement for ideal root end filling material to provide perfect sealing ability. Moreover, alkalinity and bioactivity provide great chance for tissues healing and remineralization. So, the aim of this work was to evaluate the chemical composition, solubility, pH change, and calcium ion release of recently introduced commercial mineral trioxide aggregate (MTA) endodontic repair cement (Harvard, Universal HandMix MTA) compared with ProRoot MTA repair material. Methods: Solubility was evaluated after 7-and 14-day immersion time of specimens in phosphate buffer saline solution (PBS); the mean weight loss was evaluated and solubility was calculated as a percentage of the weight loss. For assessment of pH change and calcium ion release polyethylene tubes filled with the materials were soaked in distilled water for 7 and 14 days. Measurement of pH change was done by analytical pH meter. Concentrations of calcium ion release were measured using inductively coupled plasma optical emission spectroscopy. Data were statistically analyzed by independent sample t test and paired sample t test at 5% significance level. Results: Harvard MTA endodontic cement showed significant lower solubility and higher pH values compared with that of ProRoot MTA. ProRoot MTA exhibited significant higher calcium ion release value after 14 days (P value ≤ 0.05). Conclusion: Harvard, Universal HandMix MTA repair cement with its different chemical composition; exhibits a low solubility with enhanced alkaline pH value compared to ProRoot MTA repair material.

Endodontic rotary NiTi files have been used with or without gutta-percha solvents saving time

Introduction: new materials and techniques were developed to achieve adequate root canal obturation by complete filling of the canal space with a stable, biocompatible material that prevents the ingress of bacteria and/or its by-products to periapical tissue.The purpose of this study was to evaluate quality of two different root canal sealer and filling techniques using cone beam computerized tomography (CBCT) Materials and methods: Seventy-two root canals were prepared using protaper next rotary system. Root canals were divided into two equal groups 36 teeth each. Group I: teeth were obturated using single cone technique with MTA fill apex sealer. Group II: teeth were obturated using continuous wave technique with resin-based sealer (AH plus). The voids within filling materials as well as along dentin walls were examined using CBCT.Result: results revealed that the difference between different thirds was extremely statistically significant in single cone technique, while in continuous wave technique there was no significant difference between thirds. There was no significant difference between both techniques in apical and middle third, while in cervical third there was a significant difference, as single cone showed more voids. Both techniques showed accepted working length of the obturation. Conclusions:CBCT is an accurate tool for assessment of root canal filling quality. There were more voids present in coronal third in both techniques. Continuous wave technique showed fewer voids in cervical third compared to single cone technique. The present study showed that none of the root canal obturated teeth were gap-free.

Introduction Achieving a hermetic apical seal is mandatory to prevent ingress of any microorganisms or periapical fluids into the root canal system. Therefore it is essential to develop new materials having favorable physical, chemical and biological properties.Aim the purpose of this study was to use scanning electron microscopy to compare the marginal adaptation of new formulation of MTA (Harvard MTA), MTA flow and glass ionomer as root end filling materials using ultrasonic root-end preparation.Methodology Thirty-nine extracted single rooted human teeth were prepared using Protaper Next file system (Dentsply/Sirona) and filled with gutta-percha and MTA fillapex sealer (MTA Fillapex; Angelus, Londrina, Brazil) and obturated using cold lateral compaction technique. The apical 3 mm of the roots were sectioned perpendicular to the long axis of the roots. A 3-mm depth root-end cavity was prepared with ultrasonic tips powered by an Enac ultrasonic device. The teeth were randomly allocated into three groups of 13 teeth each according to filling materials tested. Group I the samples were filled with Harvard MTA (Universal, Handmix, Germany, Harvard), Group II filled with MTA Flow (Ultradent Products Inc., South Jordan,UT, USA), group III filled with glass ionomer (Fuji II, GC gold label 2, GC International, Japan). Using SEM the distance between the tested materials and the surrounding dentin was measured at different points. ResultsAccording to the results of Kruskal-Wallis, there was significant difference between the three experimental groups at P value 0.01. The Man Whitney test was used for two-by-two comparison of the groups which revealed no statistical significant difference between MTA flow and MTA Harvard group however; there was statistically significant difference in Glass Ionomer group. Conclusion SEM resultsshowed the presence of gaps in the root-end filling materials in all groups. MTA flow has the best marginal adaptation followed by MTA Harvard while the Glass Ionomer showed the least marginal adaptation.

Objectives: The aim of the current systematic review /meta-analysis was to perform a comparison of the outcomes of Calcium Enriched Mixture (CEM) and Mineral Trioxide Aggregate (MTA) as agents for pulpotomy in primary and permanent molars.The proposed PICO question was "Whenever there is vital pulp exposure in primary and permanent molars, what are the treatment outcomes of CEM compared to MTA pulpotomy regarding clinical and radiographic success?" Methods: We looked for published randomized clinical trials (RCTs) of the at least 12-month period; the search covered papers published up to July 2017 in PubMed (Medline) and Springer-Link databases. Meta-analysis was performed using R program 3.3.3 with specialized meta-analysis packages, namely rmeta, metaphor, and RGtk2. Data was reformulated dichotomously (success or other [healing, failure, or missing]) for the selected studies. The fixed effect model was tested, OR (Odds ratio), RR (Risk ratio), and 95% CI (Confidence interval) were calculated using the formulated raw dichotomous data of the selected studies. The heterogeneity among studies was assessed using standard chi-square test and Woolf's test. Mantel-Haenszel fixed-effect method was used to compute OR for the fixed model. The level of significance was at 0.05. Results: Four hundred forty-nine articles were gathered. Two reviewers screened the articles, and three RCTs were included in the study. After the assessment, three RCTs were suitable for meta-analysis tested by Mantel Haenszel method. Statistically, the insignificant difference was found between the success rate of CEM compared to MTA, with OR=0.92(95% CI, 0.57-1.49). RR= 0.94 (95% CI, 0.66-1.35). Test for heterogeneity showed p-values (0.4241, 0.4455) Conclusions: Systematic review /meta-analysis of the chosen RCTs showed that CEM pulpotomy in human teeth presented insignificant but superior clinical and radiographic success compared to those treated with MTA. Good quality and homogeneity of the included RCTs were yielded.

Aim: To evaluate effectiveness of multiple rotary file systems on removal of the filling materials during retreatment of oval-shaped root canals.Methods: 40 oval root canals were instrumented with ProTaper Next to size X4 (40/.06). The canals were then allocated into two equal groups according to the final rinse, Group I: with Biopure MTAD, and Group II: with 17% EDTA. All the canals were later obturated with bioceramic based root canal sealer and gutta-percha using cold lateral compaction technique. According to the used retreatment rotary system, each group were further subdivided into two equal subgroups including subgroups Ia & IIa using D-Race (DR1) (30/.10) + XP-endo Shaper (XPS) (30/.04) + XP-endo Finisher R (XPFR), and subgroups Ib & IIb using R-Endo retreatment files up to R3 (25/.04) + Revo-S rotary files up to (40/.06). CBCT scans were used to calculate the remaining amount of root filling materials based on a certain threshold given to identify the density of dentin from that of the gutta percha at the pre scan (after obturation), and that of air at the post scan (after retreatment). The dentin volumes were also recorded at both scans to analyze the amount of remaining filling materials.Results: No significant differences were recorded regarding the amount of residual filling material with the tested systems (p > 0.05). Intra subgroups assessments showed more filling material removed when using a larger sized final instrument (p < 0.001).Conclusions: Tested file systems were evenly efficient in removing filling materials from ovalshaped root canals of extracted molars. Types of chelators used and bioceramic based sealer had no significant validity on effectiveness of removal of root canal filling material.

AIM: This study compared the removal of the smear layer using 1% phytic acid or 17% ethylenediaminetetraacetic acid (EDTA) after root canal instrumentation with SmartTrack X3, Endo*star E, and ProTaper Gold rotary systems using an environmental scanning electron microscope (ESEM). METHODS: Sixty single-rooted unidentified extracted human maxillary anterior teeth were selected. The length of all the roots used was adjusted to 16 mm from the apex. Modified access cavities were done. Roots were equally and randomly allocated to three main groups (n = 20) corresponding to the rotary systems: group A1, SmartTrack X3; group A2, Endo*star E3; and group A3, ProTaper Gold. Each group was divided into two equal subgroups (n = 10), corresponding to the chelating agents applied as a final rinse: subgroup B1, 1% phytic acid, and subgroup B2, 17% EDTA. Roots were split in a buccolingual direction into two equal halves and examined under ESEM in the presence or absence of a smear layer at the cervical, middle, and apical segments. RESULTS: 1% Phytic acid and 17% EDTA recorded no statistically significant for removing the smear layer. For all subgroups, there was a significant difference in smear layer removal and more open dentinal tubules in the cervical segment versus the apical segment. CONCLUSION: In smear layer removal from root canals, 1% phytic acid was effective as 17% EDTA in smear layer removal form root canals after SmartTrack X3, Endo*star E3, or ProTaper Gold rotary systems instrumentation.