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Fulltext An in vitro Comparison of Bond Strength of Different Sealers/Obturation Systems to Root Dentin Using the Push-Out Test at 2 Weeks and 3 Months after Obturation

Yap WY, Che Ab Aziz ZA, Azami NH, Al-Haddad AY, Khan AA

Med Princ Pract, 2017;26(5):464-469.
PMID: 28934753 DOI: 10.1159/000481623

OBJECTIVE: To evaluate the push-out bond strength and failure modes of different sealers/obturation systems to intraradicular dentin at 2 weeks and 3 months after obturation compared to AH Plus®/gutta-percha.
MATERIALS AND METHODS: A total of 180 root slices from 60 single-canal anterior teeth were prepared and assigned to 5 experimental groups (n = 36 in each group), designated as G1 (AH Plus®/gutta-percha), G2 (TotalFill BC™ sealer/BC-coated gutta-percha), G3 (TotalFill BC™ sealer/gutta-percha), G4 (EndoREZ® sealer/EndoREZ®-coated gutta-percha), and G5 (EndoREZ® sealer/gutta-percha). Push-out bond strengths of 18 root slices in each group were assessed at 2 weeks and the other 18 at 3 months after obturation using a universal testing machine. Data were analyzed using repeated measures ANOVA. An independent t test was used to compare the mean push-out bond strength for each group at 2 weeks and 3 months after obturation.
RESULTS: The mean push-out bond strengths of G4 and G5 were significantly lower than those of G1, G2, and G3 (p < 0.05) at both 2 weeks (G1: 1.46 ± 0.29 MPa, G2: 1.74 ± 0.43 MPa, G3: 1.74 ± 0.43 MPa, G4: 0.66 ± 0.31 MPa, G5: 0.74 ± 0.47 MPa) and 3 months after obturation (G1: 1.70 ± 1.05 MPa, G2: 3.69 ± 1.20 MPa, G3: 2.84 ± 0.83 MPa, G4: 0.14 ± 0.05 MPa, G5: 0.24 ± 0.10 MPa). The mean push-out bond strengths of G2 (3.69 ± 1.20 MPa) and G3 (2.84 ± 0.83 MPa) were higher at 3 months compared to 2 weeks after obturation (G2: 1.74 ± 0.43 MPa, G3: 1.33 ± 0.29 MPa).
CONCLUSION: The TotalFill BC™ obturation system (G2) and the TotalFill BC™ sealer/gutta-percha (G3) showed comparable bond strength to AH Plus®. Their bond strength increased over time, whereas the EndoREZ® obturation system (G4) and EndoREZ sealer (G5) had low push-out bond strength which decreased over time.
Characterization of the root and canal anatomy of maxillary premolar teeth in an Iraqi subpopulation: a cone beam computed tomography study

Aljawhar AM, Ibrahim N, Abdul Aziz A, Ahmed HMA, Azami NH

Odontology, 2023 Nov 13.
PMID: 37957521 DOI: 10.1007/s10266-023-00870-5

This study aims to evaluate the number of roots and root canal morphology types of maxillary premolars in relation to a patient's gender and age in an Iraqi population using two classification systems. Cone beam computed tomography (CBCT) scans of 1116 maxillary premolars from 385 patients were evaluated for the number of roots and root canal morphology types according to Vertucci's classification and Ahmed et al. classification systems. Differences in the number of roots and root canal morphology types with regard to tooth type, patients' gender and age groups were evaluated and the degree of bilateral symmetry was determined. Chi-squared test was used for statistical analysis. About 51.1% of the 1st premolars were double rooted. The majority (87.9%) of the 2nd premolars were single rooted. The three-rooted form presented in only 1.2% and 0.7% of the 1st and 2nd premolars, respectively. Vertucci Type IV (Ahmed et al. code 2MaxP B1P1) and Vertucci Type I (Ahmed et al. code 1MaxP1) were the most common canal morphology types in the 1st and 2nd premolars, respectively. Females showed a lower number of roots and a higher prevalence of Vertucci Type I configuration (P
From Endodontic Therapy to Regenerative Endodontics: New Wine in Old Bottles

Lim GS, Wey MC, Azami NH, Noor NSM, Lau MN, Haque N, et al.

Curr Stem Cell Res Ther, 2021;16(5):577-588.
PMID: 33198618 DOI: 10.2174/1574888X15999201116162256

The concept of regenerative endodontics wherein one can replace damaged pulp structures and recuperate the functionality in erstwhile necrotic and infected root canal systems has been a cutting-edge technology. Though the notion started as early as the 1960s, even before the discovery of stem cells and regenerative medicine, it was in the 2000s that this procedure gained momentum. Ever since then, researchers continue to discover its essential benefit to immature teeth and its ability to overcome the caveats of endodontic therapy, which is commonly known as root canal treatment. Further, through this therapy, one can redevelop root even in immature teeth with necrotic pulps, which overall helps in maintaining skeletal and dental development. Past literature indicates that regenerative endodontic procedures seem to be successful, especially when compared with other conventional techniques such as Mineral Trioxide Aggregate apexification. Besides, many clinicians have begun to apply regenerative endodontic procedures to mature teeth in adult patients, with several clinical case reports that have shown complete resolution of signs and symptoms of pulp necrosis. Generally, the three most desirable outcomes anticipated by clinicians from this procedure include resolution of clinical signs and symptoms, root maturation and redevelopment of the neurogenesis process. Despite this, whether these objectives and true regeneration of the pulp/dentin complex are achieved is still a question mark. Following the discovery that regenerative endodontics indeed is a stem cell-based treatment, addressing the fundamental issue surrounding stem cells might assist in achieving all identified clinical outcomes while favoring tissue formation that closely resembles the pulp-dentin complex.
Physicochemical, mechanical and biological properties of nano-calcium silicate-based cements: a systematic review

Majeed R, Elnawawy HM, Kutty MG, Yahya NA, Azami NH, Abu Kasim NH, et al.

Odontology, 2023 Oct;111(4):759-776.
PMID: 36864211 DOI: 10.1007/s10266-023-00786-0

This systematic review evaluated the effects of nano-sized cement particles on the properties of calcium silicate-based cements (CSCs). Using defined keywords, a literature search was conducted to identify studies that investigated properties of nano-calcium silicate-based cements (NCSCs). A total of 17 studies fulfilled the inclusion criteria. Results indicated that NCSC formulations have favourable physical (setting time, pH and solubility), mechanical (push out bond strength, compressive strength and indentation hardness) and biological (bone regeneration and foreign body reaction) properties compared with commonly used CSCs. However, the characterization and verification for the nano-particle size of NCSCs were deficient in some studies. Furthermore, the nanosizing was not limited to the cement particles and a number of additives were present. In conclusion, the evidence available for the properties of CSC particles in the nano-range is deficient-such properties could be a result of additives which may have enhanced the properties of the material.
Correction: Physicochemical, mechanical and biological properties of nano-calcium silicate-based cements: a systematic review

Majeed R, Elnawawy HM, Kutty MG, Yahya NA, Azami NH, Abu Kasim NH, et al.

Odontology, 2023 Oct;111(4):777.
PMID: 37147494 DOI: 10.1007/s10266-023-00818-9
Application of a new system for classifying root canal morphology in undergraduate teaching and clinical practice: a national survey in Malaysia

Ahmed HMA, Che Ab Aziz ZA, Azami NH, Farook MS, Khan AA, Mohd Noor NS, et al.

Int Endod J, 2020 Jun;53(6):871-879.
PMID: 32003029 DOI: 10.1111/iej.13271

AIM: To evaluate and compare the feedback of final year undergraduate dental students in eight Malaysian dental schools on the application of a new system for classifying root canal morphology in teaching and clinical practice.
METHODS: One PowerPoint presentation describing two classification systems for root canal morphology (Oral Surgery Oral Medicine Oral Pathology, 1974 38, 456 and its supplemental configurations, International Endodontic Journal 2017, 50, 761) was delivered to final year undergraduate dental students in eight dental schools in Malaysia by two presenters (each presented to four schools). To examine students' feedback on the utility of each system, printed questionnaires consisting of six questions (five multiple choice questions and one open-ended question) were distributed and collected after the lecture. The questionnaire was designed to compare the classification systems in terms of accuracy, practicability, understanding of root canal morphology and recommendation for use in pre-clinical and clinical courses. The exact test was used for statistical analysis, with the level of significance set at 0.05 (P = 0.05).
RESULTS: A total of 382 (out of 447) students participated giving a response rate of 86%. More than 90% of students reported that the new system was more accurate and more practical compared with the Vertucci system (P 0.05). The students' responses for all questions were almost similar for both presenters (P > 0.05).
CONCLUSIONS: The new system of International Endodontic Journal 2017, 50, 761 for classifying root and canal morphology was favoured by final year undergraduate dental students in Malaysia. The new system has the potential to be included in the undergraduate endodontic curriculum for teaching courses related to root and canal morphology.