• Restorative Dentistry and Endodontics
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• v.40 no.2
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• pp.155-160
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• 2015

Objectives: Achieving adequate anesthesia with inferior alveolar nerve blocks (IANB) is of great importance during dental procedures. The aim of the present study was to assess the success rate of two anesthetic agents (bupivacaine and lidocaine) for IANB when treating teeth with irreversible pulpitis. Materials and Methods: Sixty volunteer male and female patients who required root canal treatment of a mandibular molar due to caries participated in the present study. The inclusion criteria included prolonged pain to thermal stimulus but no spontaneous pain. The patients were randomly allocated to receive either 2% lidocaine with 1:80,000 epinephrine or 0.5% bupivacaine with 1:200,000 epinephrine as an IANB injection. The sensitivity of the teeth to a cold test as well as the amount of pain during access cavity preparation and root canal instrumentation were recorded. Results were statistically analyzed with the Chi-Square and Fischer's exact tests. Results: At the final step, fifty-nine patients were included in the study. The success rate for bupivacaine and lidocaine groups were 20.0% and 24.1%, respectively. There was no significant difference between the two groups at any stage of the treatment procedure. Conclusions: There was no difference in success rates of anesthesia when bupivacaine and lidocaine were used for IANB injections to treat mandibular molar teeth with irreversible pulpitis. Neither agent was able to completely anesthetize the teeth effectively. Therefore, practitioners should be prepared to administer supplemental anesthesia to overcome pain during root canal treatment.

• Restorative Dentistry and Endodontics
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• v.42 no.3
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• pp.200-205
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• 2017

Objectives: The aim of this in vivo study was to assess the accuracy of 2 third-generation electronic apex locators (EALs), Propex II (Dentsply Maillefer) and Root ZX II (J. Morita), and radiographic technique for locating the major foramen (MF). Materials and Methods: Thirty-two premolars with single canals that required extraction were included. Following anesthesia, access, and initial canal preparation with size 10 and 15 K-flex files and SX and S1 rotary ProTaper files, the canals were irrigated with 2.5% sodium hypochlorite. The length of the root canal was verified 3 times for each tooth using the 2 apex locators and once using the radiographic technique. Teeth were extracted and the actual WL was determined using size 15 K-files under a ${\times}25$ magnification. The Biostat 4.0 program (AnalystSoft Inc.) was used for comparing the direct measurements with those obtained using radiographic technique and the apex locators. Pearson's correlation analysis and analysis of variance (ANOVA) were used for statistical analyses. Results: The measurements obtained using the visual method exhibited the strongest correlation with Root ZX II (r = 0.94), followed by Propex II (r = 0.90) and Ingle's technique (r = 0.81; p < 0.001). Descriptive statistics using ANOVA (Tukey's post hoc test) revealed significant differences between the radiographic measurements and both EALs measurements (p < 0.05). Conclusions: Both EALs presented similar accuracy that was higher than that of the radiographic measurements obtained with Ingle's technique. Our results suggest that the use of these EALs for MF location is more accurate than the use of radiographic measurements.

• Restorative Dentistry and Endodontics
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• v.34 no.5
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• pp.406-414
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• 2009

The purpose of this study was to examine the effect of hydrogen peroxide at different application time and concentrations on the microtensile bond strength of resin restorations to the deep and the pulp chamber dentin. A conventional endodontic access cavity was prepared in each tooth, and then the teeth were randomly divided into 1 control group and 4 experimental groups as follows: Group 1, non treated; Group 2, with 20% Hydrogen peroxide ($H_2O_2$); Group 3, with 10% $H_2O_2$; Group 4, with 5% $H_2O_2$; Group 5, with 2.5% $H_2O_2$; the teeth of all groups except group 1 were treated for 20, 10, and 5min. The treated teeth were filled using a Superbond C&B (Sun medical Co., Shiga, Japan). Thereafter, the specimens were stored in distilled water at $37^{\circ}C$ for 24-hours and then sectioned into the deep and the chamber dentin. The microtensile bond strength values of each group were analyzed by 3-way ANOVA and Tukey post hoc test(p < 0.05). In this study, the microtensile bond strength of the deep dentin (D1) was significantly greater than that of the pulp chamber dentin (D2) in the all groups tested. The average of microtensile bond strength was decreased as the concentration and the application time of $H_2O_2$ were increased. Analysis showed significant correlation effect not only between the depth of the dentin and the concentration of $H_2O_2$ but also between the concentration of H202 and the application time(p < 0.05), while no significant difference existed among these three variables(p > 0.05). The higher $H_2O_2$ concentration, the more opened dentinal tubules under a scanning electron microscope(SEM) examination.

• Restorative Dentistry and Endodontics
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• v.34 no.6
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• pp.515-525
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• 2009

Clinical suggestion for the limitation of application time of NaOCl solution is needed to avoid large reductions in resin-dentin bond strength. The aim of this study was to measure the change of ${\mu}$-tensile bond strength after the various application time of 5.25% NaOCl solution to pulp chamber dentin in endodontic access cavity, and to evaluate the effect of 10% sodium ascorbate application for 10 min on bond strength after the treatment of 5.25% NaOCl solution. In this experiment, there were no statistical differences(p > 0.05) in bond strengths between upper chamber dentin and lower chamber dentin. NaOCl-treated group for 20 min did not show any significant decrease(p > 0.05) in bond strength than non-treated control group. In contrast to that, bond strengths of NaOCl-treated groups for 40 & 80 min were significantly lower(p < 0.05) than that of non-treated control group. 10% sodium ascorbate retreated group for 10 min after 5.25% NaOCl application for 40 min to chamber dentin showed the recovery of bond strength significantly. However, the bond strength of sodium ascorbate retreated group after 5.25% NaOCl application for 80 min was still significantly lower(p < 0.05) compared to the non-treated control group, which means the reductions in resin-dentin bond strength were not fully reversed. On the contrary, sodium ascorbate retreated group after 5.25% NaOCl application for 5 min showed significantly higher(p < 0.05) bond strength compared to the control group, which demonstrates its superior recovery effect. In SEM exminations of specimens retreated with 10% sodium ascorbate after NaOCl application for 40 & 80 min showed that resin tags were formed clearly and densely, but weakly in density and homogeneity of individual resin tag compared to the control specimen.

• Restorative Dentistry and Endodontics
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• v.8 no.1
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• pp.123-131
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• 1982

The purpose of this study was to observe the responses of the remaining pulp tissue after pulpotomy upon the several kinds of $Ca(OH)_2$ products and the responses of periapical tissue upon some root canal filling materials after extirpation. For pulpotomy, the class V cavities were prepared on the premolars, molars and upper canines, and the pulp was amputated. Each drug was placed over the amputated tissue and cavity was sealed with zinc oxide eugenol cement. The drugs which were used for the study were Dycal (Caulk Co. U.S.A.), Cavitec (Kerr Co. U.S.A.), Calvital, Nobudyne and Neodyne (Neo Dental Chemical Products). For extirpation, the endodontic cavities were prepared on the lingual surfaces of anterior teeth, and the pulp tissues were extirpated as routine method. After enlarging, irrigation, and measuring of root length by taking X-ray, each root canal filling material was filled in the canal with gutta percha cone, and endodontic cavity was sealed with zinc oxide eugenol cement. Zinc oxide eugenol, $Ca(OH)_2$ (Eli Lilly Co. U.S.A.) and Vitapex (Neo Dental Chemical Products) were used as root canal filling materials. Animals were sacrificed after 1, 3 and 6 weeks following the operation. The teeth were decalcified in formic acid, sectioned and stained with hematoxylin eosin. Microscopic examination revealed as follows. 1. Dycal: The dentin bridge formation was observed at the 3rd week after pulpotomy. Inflammatory conditions which were infiltration of inflammatory cells and dilatation of blood vessels were kept in remaining pulp tissue at the 6th week. 2. Calvital: The dentin bridge was observed at the 1st week after pulpotomy. As the time clasped, the pulp tended to be the fibrous degeneration. 3. Cavitec, Nobudyne and Neodyne: In the case of Cavitec and Nobudyne, the incompleted and irregular dentin bridge was observed at the 6th week, and in Neodyne, was observed at the 3rd week. The severe inflammatory changes were seen in the remaining pulp tissue. As the time clasped, the fibrous degeneration tended to spread in the remaining pulp tissue. 4. $Ca(OH)_2$: Osteocementum was formed at the 3rd week, the matrix of cementum and dentin were resorted, and infiltration of lymphocytes was seen in periapical tissue when $Ca(OH)_2$ was used as canal-filling materials. S. ZOE and Vitapex The cementum like substance was seen in periapical portion at the 1st week, when ZOE and Vitapex were used as root canal filling materials. As the time elapsed, the matrix of cementum and dentin tended to be resorted. At the 6th week, the inflammatory condition of periapical tissue was continued in the case of ZOE, but was reduced in the case of Vitapex.

• Restorative Dentistry and Endodontics
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• v.44 no.3
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• pp.33.1-33.12
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• 2019

Objectives: To evaluate the influence of the restorative technique on the mechanical response of endodontically-treated upper premolars with mesio-occluso-distal (MOD) cavity. Materials and Methods: Forty-eight premolars received MOD preparation (4 groups, n = 12) with different restorative techniques: glass ionomer cement + composite resin (the GIC group), a metallic post + composite resin (the MP group), a fiberglass post + composite resin (the FGP group), or no endodontic treatment + restoration with composite resin (the CR group). Cusp strain and load-bearing capacity were evaluated. One-way analysis of variance and the Tukey test were used with ${\alpha}=5%$. Finite element analysis (FEA) was used to calculate displacement and tensile stress for the teeth and restorations. Results: MP showed the highest cusp (p = 0.027) deflection ($24.28{\pm}5.09{\mu}m/{\mu}m$), followed by FGP ($20.61{\pm}5.05{\mu}m/{\mu}m$), CR ($17.62{\pm}7.00{\mu}m/{\mu}m$), and GIC ($17.62{\pm}7.00{\mu}m/{\mu}m$). For load-bearing, CR ($38.89{\pm}3.24N$) showed the highest, followed by GIC ($37.51{\pm}6.69N$), FGP ($29.80{\pm}10.03N$), and MP ($18.41{\pm}4.15N$) (p = 0.001) value. FEA showed similar behavior in the restorations in all groups, while MP showed the highest stress concentration in the tooth and post. Conclusions: There is no mechanical advantage in using intraradicular posts for endodontically-treated premolars requiring MOD restoration. Filling the pulp chamber with GIC and restoring the tooth with only CR showed the most promising results for cusp deflection, failure load, and stress distribution.