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Biomedical subjects

P Lambrechts

Publications and source records attributed to P Lambrechts.

At least 19 recordsLinked to original sources

Effects of ceramic surface treatments on the bond strength of an adhesive luting agent to CAD-CAM ceramic.

OBJECTIVES: The objective of this study was to evaluate the effect of different surface treatments on the micro-tensile bond strength (microTBS) of an adhesive luting agent to CAD-CAM ceramic. The hypothesis tested was that neither of the surface treatments would produce higher bond strength of the adhesive luting agent to CAD-CAM ceramic. METHODS: Ceramic specimens of two different sizes (6 mm x 8 mm x 3 mm; 13 mm x 8 mm x 4 mm) were fabricated from ProCAD ceramic blocs (Ivoclar-Vivadent) with a low-speed diamond saw. The ceramic blocks were divided into seven groups and submitted to the following surface treatments: group 1: no treatment; group 2: etching with 37% H(3)PO(4); group 3: etching with 37% H(3)PO(4)+silane; group 4: etching with 37% H(3)PO(4)+silane+adhesive resin; group 5: etching with 4.9% HF acid; group 6: etching with 4.9% HF acid+silane; group 7: etching with HF acid+silane+adhesive resin. After surface treatment, two differently sized porcelain disks were bonded together with a composite luting agent (Variolink II, Ivoclar-Vivadent). The specimens were stored for 24h in distilled water at 37 degrees C prior to microTBS testing. One-way analysis of variance was used to test the influence of surface treatment and Scheffe multiple comparisons test determined pair-wise statistical differences (p<0.05) in microTBS between the experimental groups. RESULTS: The mean microTBSs (standard deviation) are: group 1: 12.8 (+/-4.6)MPa; group 2: 19.1 (+/-5.0)MPa; group 3: 27.4 (+/-11.1)MPa; group 4: 34.0 (+/-8.9)MPa; group 5: 37.6 (+/-8.4) MPa; group 6: 34.6 (+/-12.8)MPa; group 7: 34.5 (+/-5.1)MPa. Statistical significant differences were found between group 1 and groups 3-7, and between group 2 and groups 4-7. All specimens of groups 1-4 exhibited adhesive failures, while a combination of adhesive and mixed (adhesive and cohesive) failures was observed in the specimens of groups 5-7. CONCLUSIONS: The results show that surface treatment is important to bond to ceramic and suggests that etching is needed preferably with hydrofluoric acid than with phosphoric acid.

Acid Etching, Dental↗

Restoring cervical lesions with flexible composites.

OBJECTIVES: Flexure at the tooth cervix has been suggested to dislodge cervical restorations more rapidly. The objective of this randomized controlled clinical trial was to test the hypothesis that a higher composite flexibility better withstands tooth flexure stress. METHODS: One hundred and forty-two non-carious cervical lesions were restored with composites with contrasting stiffness. Seventy-one patients randomly received two cervical restorations placed following two out of the three experimental groups: (1) the three-step etch-and-rinse adhesive Permaquick applied with the stiff micro-hybrid composite Amelogen Hybrid (PMQ/A-Hy, Ultradent), (2) Permaquick applied with the more flexible micro-filled composite Amelogen Microfill (PMQ/A-Mi, Ultradent), or (3) the 'golden standard' three-step etch-and-rinse adhesive Optibond FL applied with the micro-hybrid composite Prodigy (O-FL/Pro, Kerr). RESULTS: The recall rate at 7 years was 80%. No statistically significant difference was found for any of the parameters evaluated neither between both adhesives, nor between both composites (McNemar, p>0.05). Eleven percent of the O-FL/Pro restorations were clinically unacceptable due to loss of retention (5.5%) and severe marginal discoloration (5.5%). In the PMQ-group, 22% of the PMQ/A-Mi restorations (8% loss of retention, 5% severe enamel margin defects, 3% severe dentin margin defects, 6% severe marginal discoloration, 3% extreme sensitivity) and 19% of the PMQ/A-Hy restorations (13% loss of retention, 3% severe enamel margin defects, 3% severe marginal discoloration) needed repair or replacement. SIGNIFICANCE: The clinical performance of the three adhesive/composite combinations was good and reliable during the 7-year clinical trial. It was concluded that the composite stiffness does not affect the clinical longevity of cervical composite restorations.

Composite Resins↗

Bonding effectiveness of adhesive luting agents to enamel and dentin.

OBJECTIVES: The bonding effectiveness of five adhesive luting agents to enamel and dentin using different application procedures was determined using a micro-tensile bond strength protocol (microTBS). METHODS: Enamel/dentin surfaces of human third molars were flattened using a high-speed diamond bur. Composite resin blocks (Paradigm, 3M ESPE) were luted using either Linkmax (LM; GC), Nexus 2 (NX; Kerr), Panavia F (PN; Kuraray), RelyX Unicem (UN; 3M ESPE) or Variolink II (VL; Ivoclar-Vivadent), strictly following manufacturers' instructions. For some luting agents, modified application procedures were also tested, resulting in four other experimental groups: Prompt L-Pop+RelyX Unicem (PLP+UN; 3M ESPE), Scotchbond Etchant+RelyX Unicem (SE+UN; 3M ESPE), Optibond Solo Plus Activator+Nexus 2 (ACT+NX; Kerr) and K-Etchant gel+Panavia-F (KE+P; Kuraray). The experimental groups were classified according to the adhesive approach in self-adhesive (UN), etch-and-rinse (ACT+NX, NX, KE+P, SE+UN and VL when bonded to enamel) and self-etch adhesive luting agents (LM, PLP+UN, PN and VL when bonded to dentin). The specimens were stored for 24h in distilled water at 37 degrees C prior to microTBS testing. The Kruskal-Wallis test was used to determine pairwise statistical differences (p<0.05) in microTBS between the experimental groups. RESULTS: When bonded to enamel, ACT+NX (15 MPa) and UN (19.6 MPa) scored significantly lower than VL (49.3 MPa), LM (49.2 MPa), PN (35.4 MPa) and SE+UN (35.2 MPa), while PLP+UN (23.5 MPa) showed a significantly lower microTBS than VL (49.3 MPa) and LM (49.2 MPa). No significant differences were noticed between VL (49.3 MPa), LM (49.2 MPa), NX (37.9 MPa), KE+PN (38.8 MPa), PN (35.4 MPa) and SE+UN (35.2 MPa). Regarding the bonding effectiveness to dentin, all luting agents bonded equally effectively (UN: 15.9 MPa; LM: 15.4 MPa; PN: 17.5 MPa; NX: 22.3 MPa), except VL (1.1 MPa), SE+UN (5.9 MPa) and ACT+NX (13.2 MPa). VL revealed an exceptionally high number of pre-testing failures, most likely due to a combined effect of not having cured the adhesive separately and an insufficiently light-cured luting agent. SIGNIFICANCE: Following a correct application procedure, the etch-and-rinse, self-etch and self-adhesive luting agents are equally effective in bonding to enamel and dentin. Several factors negatively influenced bond strength such as bonding RelyX Unicem to enamel without prior phosphoric acid etching; no separate light-curing of a light-polymerizable adhesive prior to cementation, use of a light-polymerizing adhesive converted into a dual-polymerizing adhesive, and use of a dual-cure luting agent with a low auto-polymerizable potential.

Acid Etching, Dental↗

Bactericidal effect of Nd:YAG laser irradiation on some endodontic pathogens ex vivo.

AIM: To define the role of neodymium:yttrium-aluminum-garnet (Nd:YAG) lasers in root canal disinfection along with a minimally invasive treatment concept. METHODOLOGY: The hypothesis was tested ex vivo that Nd:YAG laser irradiation has a bactericidal effect on endodontic pathogens inoculated in root canals. Resultant colony-forming unit counts were associated with observations of bacterial cell structural changes using conventional scanning electron microscopy (CSEM) and environmental scanning electron microscopy (ESEM) on inoculated dentine surfaces, following indirect and direct Nd:YAG laser irradiation, respectively. RESULTS: The Nd:YAG laser irradiation (1.5 W, 15 Hz, four times for 5 s) of Enterococcus faecalis inoculated canals resulted in a significant reduction (P < 0.05, Wilcoxon signed rank test) of the bacterial load, meaning a 99.7% kill, but no sterilization. The CSEM procedure verified that the extent of radiation damage was in line with the total amount of laser energy applied. After 2 h of incubation and three cycles of indirect laser treatment (i.e. through a 1-mm-thick dentine disc), no morphologically intact bacteria of Actinomyces naeslundii or Streptococcus anginosus were discernible. However, when micro-colonies of S. anginosus and specially biofilms of E. faecalis were present after 2 days, the in situ experiment using ESEM and direct laser treatment showed that bacterial eradication was reduced in deep layers. CONCLUSIONS: The Nd:YAG laser irradiation is not an alternative but a possible supplement to existing protocols for canal disinfection as the properties of laser light may allow a bactericidal effect beyond 1 mm of dentine. Endodontic pathogens that grow as biofilms, however, are difficult to eradicate even upon direct laser exposure.

Actinomyces↗

Development of a self-etch adhesive for resin-modified glass ionomers.

The favorable self-adhesiveness of resin-modified glass ionomers (RMGIs) might be even further improved if the time-consuming and technically sensitive etch-and-rinse pre-treatment step with polyalkenoic acids could be avoided. We undertook this study to assess the effectiveness of an experimental self-etch adhesive for RMGIs that does not need to be rinsed off. Ultrastructural analysis and micro-tensile bond strength testing to enamel and dentin of a RMGI restorative material and a RMGI adhesive were performed after 4 different surface pre-treatments: no conditioning; 25% polyalkenoic acid; an experimental self-etch adhesive; and 37.5% phosphoric acid followed by the experimental self-etch adhesive. The use of an experimental self-etch adhesive increased the bond strength of RMGIs, especially after an additional conditioning step. Interfacial analysis showed the formation of a thin hydroxyapatite-containing hybrid layer. The self-etch technique enhances the user-friendliness of RMGIs and lowers their technique-sensitivity, while maintaining desirable characteristics of the conventional etch-and-rinse approach with polyalkenoic acids.

Acid Etching, Dental↗

Extension of a one-step self-etch adhesive into a multi-step adhesive.

UNLABELLED: One-step self-etch adhesives are undoubtedly the most user-friendly adhesives, but have been associated with lower bonding effectiveness as compared to two-step and three-step adhesives. Conversion of a one-step self-etch system into a two-step self-etch adhesive by adding a bonding step, or into a three-step etch&rinse adhesive by adding a beforehand etching step and a bonding step might be tempting in order to improve bond strength. OBJECTIVES: The objective of this study was to investigate whether adding application steps influences the bond strength of a one-step self-etch adhesive. METHODS: In this study, the bonding effectiveness of two experimental one-step self-etch adhesives and three different commercial adhesives to enamel and dentin was determined using a micro-tensile bond-strength protocol. This procedure was repeated for the experimental adhesives transformed into two-step self-etch and three-step etch&rinse adhesives. In addition, their interaction with tooth tissue was investigated using TEM and Feg-SEM. RESULTS: Transforming a one-step into a two-step self-etch adhesive did improve the bond strength to enamel and dentin, though not significantly. By adding a preceding etching step, the bond strength to enamel was significantly improved, but that to dentin was decreased considerably. The latter must be attributed to hampered resin infiltration of the one-step self-etch adhesive within the relatively deeply exposed collagen fibril network. SIGNIFICANCE: Additional application of a hydrophobic bonding agent slightly improved bonding effectiveness. Adding a preceding etching step is beneficial for enamel but should be avoided for dentin as this will decrease bond strengths, and may even jeopardize the bonding durability.

Acetone↗

Bond strength of a mild self-etch adhesive with and without prior acid-etching.

UNLABELLED: The self-etch approach provides dentists with a generation of user-friendly and less technique-sensitive adhesives. Nevertheless, some concern has been raised regarding their bonding effectiveness to enamel, in particular when so-called 'mild' self-etch adhesives are employed. OBJECTIVES: The purpose of this study was to test the hypothesis that the two-step self-etch adhesive Clearfil SE Bond (C-SE; Kuraray, Osaka, Japan) bonds equally effective to enamel/dentin either with or without prior etching with phosphoric acid. METHODS: Bur-cut enamel/dentin surfaces prepared from human molars were partially split in two halves by cutting a shallow groove. One half was first etched with 40% phosphoric acid (K-etchant), while protecting the other half by holding a razor blade in the groove. Next, C-SE was applied strictly following the manufacturer's instructions, after which the surface was built up using Z100 (3M Espe). After 24-h water storage, micro-specimens were prepared with the interface circularly constricted using a Micro-Specimen Former, prior to micro-tensile bond strength (MPa) measurement. In addition, interfaces of C-SE with enamel/dentin prepared with and without beforehand acid etching were examined by Feg-SEM and TEM. RESULTS: Beforehand etching significantly increased the bonding effectiveness of C-SE to enamel. A clearly more micro-retentive surface was revealed by TEM and Feg-SEM when enamel was etched. Phosphoric-acid etching prior to C-SE application on dentin significantly decreased the muTBS to dentin. TEM provided indications of a low-quality hybrid layer after beforehand phosphoric-acid etching. CONCLUSION: Using C-SE, additional etching with phosphoric acid to improve bonding effectiveness should be limited to enamel.

Acid Etching, Dental↗

Micro-rotary fatigue of tooth-biomaterial interfaces.

The bonding effectiveness of restorative materials to tooth tissue is typically measured statically. Clinically tooth/composite bonds are however subjected to cyclic sub-critical loads. Therefore, in vitro fatigue testing of dental adhesives should predict better the in vivo performance of adhesives. The objective of this study was to determine the fatigue resistance of two representative adhesives, a self-etch and an etch&rinse adhesive, bonded to enamel and dentin. Therefore, tooth/composite interfaces were cyclically loaded using a miniaturized version of a rotating beam fatigue testing device. Subsequently, the load at which 50% of the specimens fail after 10(5) cycles, was determined as the median micro-rotary fatigue resistance (microRFR). For both adhesives, the microRFR was about 30-40% lower than the corresponding micro-tensile bond strength (microTBS) to both enamel and dentin. Analysis of the fracture surfaces by Feg-SEM revealed typical fatigue fracture patterns. It is concluded that resin/tooth interfaces are vulnerable to progressive damage by sub-critical loads, with the 3-step etch&rinse adhesive being more resistant to fatigue than the 2-step self-etch adhesive.

Adhesiveness↗

Clinical effectiveness of contemporary adhesives: a systematic review of current clinical trials.

OBJECTIVES: The purpose of this paper was to review current literature on the clinical effectiveness of contemporary adhesives when used to restore cervical non-carious class-V lesions. Restoration retention in function of time was recorded in order to find out if adhesives with a simplified application procedure are as clinically effective as conventional three-step adhesives. DATA SOURCES: Literature published from January 1998 up to May 2004 was reviewed for university-centred clinical trials that tested the clinical effectiveness of adhesives in non-carious class-V lesions. Restoration-retention rates per adhesive reported in peer-reviewed papers as well as IADR-AADR abstracts and ConsEuro abstracts were included and depicted as a function of time in graphs for each of the five adhesive classes (three- and two-step etch-and-rinse adhesives, two- and one-step self-etch adhesives, and glass-ionomers). The guidelines for dentin and enamel adhesive materials advanced by the American Dental Association were used as a reference. Per class, the annual failure rate (%) was calculated. Kruskal-Wallis analysis and Dwass-Steel-Chritchlow-Fligner pairwise comparisons were used to determine statistical differences between the annual failure percentages of the five adhesive categories. RESULTS: Comparison of retention of class-V adhesive restorations as a measure to determine clinical bonding effectiveness of adhesives revealed that glass-ionomers most effectively and durably bond to tooth tissue. Three-step etch-and-rinse adhesives and two-step self-etch adhesives showed a clinically reliable and predictably good clinical performance. The clinical effectiveness of two-step etch-and-rinse adhesives was less favourable, while an inefficient clinical performance was noted for the one-step self-etch adhesives. SIGNIFICANCE: Although there is a tendency towards adhesives with simplified application procedures, simplification so far appears to induce loss of effectiveness. Clinical performance can be correlated with, and predicted by, appropriate types of laboratory study.

Adhesives↗

Microscopic observation of bacteria: review highlighting the use of environmental SEM.

Throughout the years, various methods have been adopted to investigate bacteria involved in root canal infection and apical periodontitis. This paper reviews the most commonly used microscopic techniques and discusses their possibilities, limitations and sample preparation. In particular, a recently developed variant of scanning electron microscope (SEM), referred to as environmental SEM (ESEM), is highlighted due to its potential impact across the diverse field of biomaterials research. The performance of this ESEM technique for bacterial observation of endodontic pathogens was illustrated by a practical approach. The paper concludes with a discussion on the possible use of ESEM for testing endodontic treatment modalities under environmental conditions in situ.

Bacteria↗

A critical review of the durability of adhesion to tooth tissue: methods and results.

The immediate bonding effectiveness of contemporary adhesives is quite favorable, regardless of the approach used. In the long term, the bonding effectiveness of some adhesives drops dramatically, whereas the bond strengths of other adhesives are more stable. This review examines the fundamental processes that cause the adhesion of biomaterials to enamel and dentin to degrade with time. Non-carious class V clinical trials remain the ultimate test method for the assessment of bonding effectiveness, but in addition to being high-cost, they are time- and labor-consuming, and they provide little information on the true cause of clinical failure. Therefore, several laboratory protocols were developed to predict bond durability. This paper critically appraises methodologies that focus on chemical degradation patterns of hydrolysis and elution of interface components, as well as mechanically oriented test set-ups, such as fatigue and fracture toughness measurements. A correlation of in vitro and in vivo data revealed that, currently, the most validated method to assess adhesion durability involves aging of micro-specimens of biomaterials bonded to either enamel or dentin. After about 3 months, all classes of adhesives exhibited mechanical and morphological evidence of degradation that resembles in vivo aging effects. A comparison of contemporary adhesives revealed that the three-step etch-and-rinse adhesives remain the 'gold standard' in terms of durability. Any kind of simplification in the clinical application procedure results in loss of bonding effectiveness. Only the two-step self-etch adhesives approach the gold standard and do have some additional clinical benefits.

Adhesives↗

Monomer-solvent phase separation in one-step self-etch adhesives.

One-step adhesives bond less effectively to enamel/dentin than do their multi-step versions. To investigate whether this might be due to phase separation between adhesive ingredients, we characterized the interaction of 5 experimental and 3 commercial self-etch adhesives with dentin using transmission electron microscopy. All adhesives were examined for homogeneity by light microscopy. Bonding effectiveness to dentin was determined with the use of a micro-tensile bond-strength protocol. The lower bond strength of the one-step adhesives was associated with light-microscopic observation of multiple droplets that disappeared slowly. Interfacial analysis confirmed the entrapment of droplets within the adhesive layer. The prompt disappearance of droplets upon application of a small amount of HEMA (2-hydroxyethyl methacrylate) or a HEMA-containing bonding agent, as well as the absence of droplets at the interface of all HEMA-containing adhesives, strongly suggests that the adhesive monomers separate from water upon evaporation of ethanol/acetone. Upon polymerization, the droplets become entrapped within the adhesive, potentially jeopardizing bond durability. This can be avoided by strong air-drying of the adhesive, thereby removing interfacial water and thus improving bonding effectiveness.

Acid Etching, Dental↗

Characterization of the inorganic fraction of resin composites.

The purposes of this study were to determine the weight fraction of filler in thirty-nine resin-based materials including flowable and packable composites, and to examine the morphology of the filler particles. The percentages of inorganic fillers by weight were determined by Thermogravimetric Analysis and by ashing in air technique at 900 degrees C. The size and shape of the filler particles were examined using scanning electron microscopy (SEM) after dissolution of the organic matrix. The weight fraction of inorganic fillers ranged between 41.6 and 84.6%. Wide variations were found among materials of the same category. Values found in the present study were sometimes different from those given by the manufacturers. The SEM photomicrographs showed various shapes, and sizes of inorganic fillers. Compared with universal hybrid restorative materials, flowable composites have lower filler loading and packable resin composites did not show higher values as claimed by some manufacturers. Various factors may explain the observed discrepancies between the manufacturer's data and our results. The silane treatment as well as the incorporation of organic material as part of the fillers of the composite could be responsible for those differences.

Composite Resins↗

Progressive versus constant tapered shaft design using NiTi rotary instruments.

AIM: To evaluate the influence of a progressive versus constant tapered shaft design on canal preparation by NiTi rotary techniques. METHODOLOGY: A XMCT-scanner and custom-made software were used to nondestructively analyse the mesial canals of 10 extracted mandibular molars in 3D with a spatial resolution of 12.5 microm. Specimens (n = 10 per group) were scanned before and after preparation using ProTaper (progressive tapered) or K3 (constant tapered) files. Numerical values for volume, curvature, dentine removal and centring ratio were obtained in addition to a visual inspection for canal aberrations. Data were analysed by (multiway factorial) anova, Wilcoxon tests and t-tests. RESULTS: The volume of total dentine removal (mean +/- SD) was 1.21 +/- 0.66 mm(3) (ProTaper) and 1.06 +/- 0.23 mm(3) (K3) (P > 0.05), and the amount of dentine removal at all separate horizontal regions examined was comparable for both groups. The mean linear dentine removal (transportation) was in the range of 8-212 microm (ProTaper) and 4-187 microm (K3). The resultant centring ratio varied from 0.01 to 0.24 (ProTaper) and from 0.01 to 0.17 (K3), whilst different straightening patterns were observed. A centre displacement towards the furcation coronally was most pronounced for the ProTaper group whereas a centre displacement towards the outer side of the curvature more apically was only observed for the K3 group. No severe canal aberrations were found. CONCLUSIONS: The progressive tapered shaft design of the ProTaper instrument was less influenced by the mid-root curvature than the constant tapered design of the K3 instrument thereby providing a good centred apical preparation. However, ProTaper instruments tended to transport towards the furcation in the coronal region.

Analysis of Variance↗

Four-year water degradation of total-etch adhesives bonded to dentin.

Resin-dentin bonds degrade over time. The objective of this study was to evaluate the influence of variables like hybridization effectiveness and diffusion/elution of interface components on degradation. Hypotheses tested were: (1) There is no difference in degradation over time between two- and three-step total-etch adhesives; and (2) a composite-enamel bond protects the adjacent composite-dentin bond against degradation. The micro-tensile bond strength (microTBS) to dentin of 2 three-step total-etch adhesives was compared with that of 2 two-step total-etch adhesives after 4 years of storage in water. Quantitative and qualitative failure analyses were conducted correlating Fe-SEM and TEM. Indirect exposure to water did not significantly reduce the microTBS of any adhesive, while direct exposure resulted in a significantly reduced microTBS of both two-step adhesives. It is concluded that resin bonded to enamel protected the resin-dentin bond against degradation, while direct exposure to water for 4 years affected bonds produced by two-step total-etch adhesives.

Acid Etching, Dental↗

Adhesion/decalcification mechanisms of acid interactions with human hard tissues.

In order to study adhesion/decalcification mechanisms of acid interactions with human hard tissues such as bones and teeth, the chemical interaction of five carboxylic acids (acetic, citric, lactic, maleic, and oxalic) and two inorganic acids (hydrochloric and nitric) with enamel and two synthetic hydroxyapatite (HAp) powders with, respectively, a high and a low crystallinity were analyzed using X-ray photoelectron spectroscopy (XPS), atomic absorption spectrophotometry (AAS), and spectrophotometry (S). X-ray diffraction revealed that the crystallinity of the highly crystallized HAp was considerably higher than that of enamel while the crystallinity of the poorly crystallized HAp was similar to that of dentin and bone. XPS of acid-treated enamel demonstrated for all carboxylic acids ionic bonding to calcium of HAp. AAS and S showed for both HAps that all carboxylic and inorganic acids except oxalic acid extracted Ca significantly more than P, leading to a Ca/P ratio close to that of synthetic HAp (2.16 w/w). Oxalic acid extracted hardly any Ca, but substantially more P, leading to a significantly smaller Ca/P ratio than that of HAp. AAS showed that the calcium salt of oxalic acid hardly could be dissolved, whereas the calcium salts of all the other acids were very soluble in their respective acid solution. These results confirm the adhesion/decalcification concept (AD-concept) previously advanced. Depending on the dissolution rate of the respective calcium salts, acids either adhere to or decalcify apatitic substrates. It is concluded that the AD-concept that originally dictated the interaction of carboxylic acids with human hard tissues can be extended to inorganic acids, such as hydrochloric and nitric acid. Furthermore, HAp crystallinity was found not to affect the adhesion/decalcification behavior of acids when interacting with apatitic substrates, so that the AD-concept can be applied to all human hard tissues with varying HAp crystallinity.

Acids↗

Cervical external root resorption in vital teeth.

External resorptions associated with inflammation in marginal tissues present a difficult clinical situation. Many times, lesions are misdiagnosed and confused with caries and internal resorptions. As a result inappropriate treatment is often initiated. This paper provides three-dimensional representations of cervical external resorption, based on X-ray microfocus-tomographical scanning of a case, which will aid the dental practitioner in recognizing characteristic features during clinical inspection. In addition, histopathological examination reveals the cellular morphology of the adjacent tissues.

Adult↗

Smooth flexible versus active tapered shaft design using NiTi rotary instruments.

AIM: The aim of this study was to evaluate the influence of a smooth flexible versus active tapered shaft design on canal preparation by NiTi rotary techniques. METHODOLOGY: A XMCT-scanner (SkyScan 1072) and developed software (Bergmans et al. 2001) were used to nondestructively analyze the mesial canals of 10 extracted mandibular molars in 3D with a spatial resolution of 30 microm. Specimens (n = 10 per group) were scanned before (PRE) and after (POST) preparation using Lightspeed (smooth flexible) or GT-rotary (active tapered) files. Numerical values for volumes, dentine removal (net) transportation and centring ability were obtained in addition to a visual inspection on canal aberrations. Data were analyzed by Shapiro Wilk test, multiway factorial anova, Tukey-Kramer test, Wilcoxon test and t-test. RESULTS: Results indicated that the active tapered shaft removed significantly more dentine in the middle to apical portion of the root compared to the smooth flexible design. Both groups demonstrated some straightening, but no significant differences were found with respect to instrument types. However, absolute values for net transportation and centering ratio were small and no canal aberrations could be found. CONCLUSIONS: The smooth flexible shaft design did not improve the morphological characteristics of canal preparation by NiTi rotary instruments when compared with the active tapered design. Therefore, system selection should be based upon other criteria.

Analysis of Variance↗