Neslihan Büşra Keskin

Purpose This study sought to evaluate the effectiveness of Shock Wave Enhanced Emission Photoacoustic Streaming (SWEEPS), XP-endo Finisher (XPF), Passive Ultrasonic Irrigation (PUI), and Conventional Syringe Irrigation (CSI) in the removal of calcium hydroxide (CH) from the mesial root canals of mandibular molars, utilizing micro-computed tomography (micro-CT). Methods: Forty mesial roots of mandibular molars were pair-matched according to canal morphology based on pre-operative micro-CT analysis and randomly assigned to four groups (n = 10). Following standardized canal preparation, CH was placed and stored for two weeks before removal using the assigned irrigation protocols. Micro-CT scans were obtained before and after CH removal, and the remaining CH volumes in the apical, middle, coronal, and total canal regions were quantitatively analyzed. Results: All methods significantly reduced CH volume compared with baseline at all root levels (p < 0.05). CSI demonstrated significantly lower CH removal in the coronal and middle thirds compared with the other groups and was less effective than XPF and SWEEPS in the apical region (p < 0.05). SWEEPS and XPF demonstrated markedly superior CH elimination compared to PUI in the apical third (p < 0.05). Conclusion: Although complete CH removal was not achieved with any technique, SWEEPS and XPF demonstrated relatively higher removal effectiveness. This in vitro study demonstrated that sophisticated irrigation activation strategies, including SWEEPS and XP-endo Finisher, improved the elimination of calcium hydroxide from intricate root canal systems.

Purpose: This study evaluated the antibacterial efficacy against Enterococcus faecalis (E. faecalis) biofilm of three irrigants combined with three irrigation activation protocols.Methods: One hundred standardized and sterilized single-rooted human teeth were inoculated with E. faecalis for 21 days and randomly assigned to three main groups based on the irrigant used, namely, NaOCl, Dual Rinse-HEDP, and Chitosan (CS) (n = 30 each). Each group was then further divided into three subgroups (n = 10) according to the activation method employed, namely, standard needle irrigation (SNI), passive ultrasonic irrigation (PUI), and sonic activation (SA). Reverse transcription quantitative polymerase chain reaction (RT-qPCR) was used to analyze bacterial reduction. The results were analyzed using two-way ANOVA (P < 0.05).Results: As compared with the other irrigation solutions, antibacterial activity was highest for NaOCl (P = 0.009). Regarding activation methods, CS had greater efficacy when combined with SA, whereas Dual Rinse-HEDP showed no significant difference across activation protocols. NaOCl was the most effective irrigant overall, particularly when used with SNI and PUI.Conclusion: NaOCl remains the gold standard for E. faecalis reduction. However, the antibacterial performance of CS can be significantly improved with sonic activation. Dual Rinse-HEDP maintains a consistent but limited antibacterial effect regardless of activation technique.

The aim of the study was to evaluate the surface areas and volumes of HyFlex EDM (HEDM) nickel-titanium (NiTi) files before and after multiple uses in mandibular molar root canal preparation. Twelve HEDM files with sizes of 10/.05 and 25/.08 were evaluated by micro–CT before and after a single use or multiple uses in root canal preparation. The mesiobuccal and mesiolingual root canals of thirty-six human mandibular molar teeth were instrumented using twelve 10/.05 (300 rpm and 1.8 Ncm) and twelve 25/.085 Ncm) HEDM files according to the manufacturer's recommendation. HEDM files were evaluated using micro–CT at four different timelines: 1) Intact file, 2) After instrumentation of one canal, 3) After instrumentation of two canals, and 4) After instrumentation of three canals. Each group's volume and surface area were analyzed by applying Friedman's test. Each group comparison was assessed using the Wilcoxon signed-rank test with Bonferroni correction. Intact HEDM 10/.05 and HEDM 25/.08 files showed significantly larger volumes and surface areas compared to the used instruments (p < 0.05). A significant decrease in the volume and surface area of the NiTi files was observed as the number of uses increased regardless of the file group. These findings emphasize the importance for clinicians to understand the structural changes in HEDM files during repeated use to ensure safe instrument reuse and prevent endodontic treatment failure.

Bu derleme biyoseramik esaslı kök kanal patlarının biyouyumluluğu, akıcılığı, antimikrobiyal özelliği, sökülebilirliği, periapikal iyileşme ve post operatif ağrı gibi biyolojik ve fiziksel özellikleri açısından yapılan çalışmalar ışığında sunulmaktadır. Bu derlemeye göre biyoseramik esaslı kök kanal patları geleneksel kök kanal patlarına göre daha üstün sonuçlar gösterse de kök kanal sisteminden sökülme zorluğu gibi dezavantajı bulunmaktadır.

Amaç: Kök kanal tedavisi esnasında medikaman olarak kullanılan kalsiyum hidroksit kök kanal duvarlarından tamamen temizlenememektedir. Bu durum kök kanal tedavisinin prognozunu olumsuz etkilemektedir. Bu nedenle kanal dolgusu öncesi kalsiyum hidroksitin kanal duvarlarından uzaklaştırılması gerekir. Bu çalışmanın amacı oval kanala sahip tek köklü dişlerde kalsiyum hidroksit patının uzaklaştırılmasında farklı irrigasyon solüsyonlarının etkinliğinin değerlendirilmesidir. Gereç ve Yöntemler: 42 adet tek köklü diş Protaper Next X3 eğesine kadar genişletildi. Her dişe, çalışma uzunluğuna kadar kalsiyum hidroksit (KH, Kalsin, İzmir, Türkiye) yerleştirildi ve kanal ağızları geçici olarak kapatıldı. Örnekler 37°C distile su içinde 21 gün bekletildi. 21 gün sonunda örnekler, kalsiyum hidroksitin uzaklaştrılmasında kullanılan son irrigasyon solüsyonuna göre üç ayrı gruba ayrıldı (Sodyum hipoklorit (NaOCl), İrritrol, Klorheksidin (CHX), n=14). İrrigasyon işleminden sonra kök kanalları dikey olarak ikiye bölünerek kanal duvarlarında kalan kalsiyum hidroksit miktarı apikal ve koronal olacak şekilde stereomikroskop altında x20 büyütmede değerlendirildi. Veriler Kruskal-Wallis testleri kullanılarak p

Objectives: The introduction of artificial intelligence (AI) about great changes in the field of dentistry, but it has not yet been fully determined in which areas it will make a positive contribution to dentistry students. The objective of our study was to compare the diagnostic accuracy of undergraduate students (fourth‐year dentistry students [4DS] and final‐year dentistry students [5DS]) and AI when examining panoramic radiographs.Methods: Fifty panoramic radiographs and 1602 teeth were examined by 50 4DS who had not received a clinical practice internship, 50 5DS, and an AI application. The participants and the AI application evaluated the teeth seen in each radiograph one by one in terms of caries, fillings, teeth with root canal treatment, periodontal loss, extractions, crowns, teeth with apical lesions, and impacted and extracted teeth. Findings were recorded in an Excel chart. Chi‐square analysis was used to compare diagnostic success between the groups.Results: The results indicate that there was a statistically significant difference in the identified accuracy of caries, fillings, and extractions between the AI application and undergraduate students (p < 0.05). Although AI showed more identified accuracy in teeth with apical lesions, impacted teeth, and teeth with root canal treatment than in undergraduate students, there was no significant difference between them (p > 0.05).Conclusion: AI exhibited better results than undergraduate students especially in the detection of caries and fillings. AI could improve undergraduates’ accuracy in detecting caries, fillings, and extractions and help them make accurate treatment decisions. In cases where dentistry students are examining patients using panoramic radiographs, employing AI programs during their clinical training to confirm and strengthen the student's diagnosis may be a promising new development.

Objectives This study intended to evaluate patients’ attitudes toward the use of AI in dental radiographic detection of occlusal caries and the impact of AI-based diagnosis on their trust in dentists. Methods A total of 272 completed questionnaires were included in this study. In the first part of the study, approval was obtained from the patients, and data were collected about their socio-demographic characteristics. In the second part the 11-item Dentist Trust Scale was applied. In the third and fourth parts, there were questions about two clinical scenarios, the patients’ knowledge of attitudes toward AI, and how the AI-based diagnosis had affected their trust. Evaluation was performed using a Likert-type scale. Data were analyzed with the Chi-square, one-way ANOVA, and ordinal logistic regression tests (p < 0.05). Results The patients believed that “AI is useful” (3.86 ± 1.03) and were not afraid of the use of AI in dentistry (2.40 ± 1.05). Educational level was considerably related to the patients’ attitudes to the use of AI for dental diagnostics (p < 0.05). The patients stated that “dentists are extremely thorough and careful” (4.39 ± 0.77). Conclusions The patients displayed a positive attitude to AI-based diagnosis in the dental field and appear to exhibit trust in dentists. The use of Al in routine clinical practice can provide important benefit to physicians as a clinical decision support system in dentistry and understanding patients’ attitudes may allow dentists to shape AI-supported dentistry in the future.

Objectives This study aimed to assess the efficacy of different activation techniques in removing calcium hydroxide (Ultracal XS), Ledermix, and Bio-C Temp from simulated internal root resorption (IRR) cavities. Materials and methods 108 single-rooted maxillary incisors were prepared using Reciproc R50 files. Simulated IRR cavities, 2 mm in diameter and located 8 mm from the apex, were created. Ultracal XS, Ledermix, and Bio-C Temp were applied to the samples, grouped by irrigation activation techniques: Standard Needle Irrigation (SNI), EDDY, Passive Ultrasonic Irrigation (PUI), and XP-endo Finisher (XPF). Medicament removal efficacy was evaluated using a standardized scoring system. Statistical analysis was performed using the Kruskal-Wallis test. Results XPF and PUI were more effective than SNI in medicament removal across the groups, with no significant difference. EDDY showed no significant difference than other groups. Ledermix was more effectively removed in all activation groups compared to Bio-C Temp. The XPF was superior in removing Ultracal XS compared to Bio-C Temp. However, none of the groups achieved complete medicament removal. Conclusions XPF and PUI techniques enhance medicament removal efficacy. Bio-C Temp was more difficult to remove from the IRR cavities than other medicaments. Clinical relevance Bio-C Temp could be removed from the canals less effectively compared to calcium hydroxide and Ledermix. Among the tested irrigation activation methods, XPF and PUI were found to be more effective at removing the tested medicaments.