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Öğe Apical extrusion of intracanal debris and irrigant following use of various instrumentation techniques(MOSBY-ELSEVIER, 2008) Kustarci, Alper; Akpinar, Kerem Engin; Er, KuersatObjective. The purpose of this study was to compare in vitro the amount of debris and irrigant extruded apically from extracted teeth, using manual technique and crowndown pressureless technique by K3, RaCe, and FlexMaster instruments. Study design. Sixty human single-rooted mandibular premolar teeth were randomly assigned to 4 groups, 15 teeth each. The teeth in 4 groups were instrumented until the working length with RaCe, K3, FlexMaster, and K-type stainless steel instruments respectively. Debris and irrigant extruded from the apical foramen were collected into vials and the amounts were determined. The data obtained were analyzed using Kruskal-Wallis 1-way analysis of variance and Mann-Whitney U tests, with alpha=0.05 as the level for statistical significance. Results. No statistically significant difference was observed among the groups in terms of debris extrusion ( P >.05). On the other hand, a statistically significant difference was observed between K3 and manual technique groups in terms of irrigant extrusion ( P >.05). The difference between other groups was not statistically significant ( P >.05). Conclusion. Based on the results, all instrumentation techniques produced extruded debris and irrigant; however, the engine-driven nickel-titanium systems were associated with less apical extrusion and irrigant.Öğe Assessment of dentinal tubule penetration of AH plus, MTA Fillapex and Sealapex after various disinfection procedures: A confocal laser scanning microscopic study(AVES, 2023) Zan, Recai; Akpinar, Kerem Engin; Topçuoğlu, Hüseyin Sinan; Hubbezoğlu, Ihsan; Demir, Arzu ŞeymaObjective: The aim of this study is to evaluate and compare dentinal tubule penetration of various root canal sealers obturated after the application of different irrigation activation procedures by a laser scanning confocal microscope. Methods: A total of 150 extracted human permanent mandibular premolar single-rooted teeth were selected and randomly divided into 3 main groups according to the sealer type (n = 50) as AH Plus, MTA Fillapex, and Sealapex. Each main group was randomly subdivided into 5 subgroups according to the irrigation activation protocols (n = 10): Potassium–titanyl–phosphate laser irradiation, conventional needle, intra-kit, sonic irrigation, and ultrasonic irrigation procedures. After the activation procedures, the root canals were obturated with AH Plus, MTA Fillapex, and Sealapex mixed with 0.1% fluorescent rhodamine B isothiocyanate. Specimens were sectioned at 3, 6, and 9 mm from the apex. All sections were examined under a confocal laser scanning microscope to calculate the dentinal tubule penetration area. Results: Data were analyzed using a 3-way analysis of variance and Tukey’s post hoc tests (P =.05). Sealapex indicated a statistically lesser penetration than the other group (P <.05), MTA Fillapex ensured deeper penetration than AH Plus (P <.05). Ultrasonic irrigation provided sig-nificantly deeper penetration than other activation procedures (P <.05). The statistically high-est percentage and the maximum depth of sealer penetration were shown in coronal third for all groups (P <.05). Conclusion: The selection of root canal sealer, irrigation activation procedures, and root canal region plays a crucial role on the dentinal tubule penetration. AH Plus and MTA Fillapex applied with ultrasonic irrigation could achieve deeper sealer penetration in dentinal tubules. © 2023, AVES. All rights reserved.Öğe Assessment of toxicity and oxidative DNA damage of sodium hypochlorite, chitosan and propolis on fibroblast cells(SOCIEDADE BRASILEIRA DE PESQUISA ODONTOLOGICA, 2018) Ugur Aydin, Zeliha; Akpinar, Kerem Engin; Hepokur, Ceylan; Erdonmez, DemetThe objective of this study was to evaluate and compare the cytotoxicity and genotoxicity on human fibroblast cell lines of sodium hypochlorite (NaOCl), chitosan and propolis as root canal irrigating solutions. Human fibroblast cells were exposed to chitosan, propolis and NaOCl for 4 and 24 h. Cell viability was assessed by 2,3-bis-(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide, and oxidative DNA damage was assessed by determination of 8-hydroxydeoxyguanosine (8-OHdG) level with an ELISA kit. The data of cell cytotoxicity were analysed statistically using a test of one-way analysis of variance at a significance level of p < 0.05. In the NaOCI group, the 8-OHdG level was higher than in the chitosan group, but there was no statistical difference when compared with the other groups (p < 0.05). It was determined that the irrigation solutions were cytotoxic, depending on the dose and time. NaOCl was the most toxic solution after both 4and 24 h of exposure (p < 0.05). Chitosan and propolis may be alternatives to NaOCl for irrigation solutions, because they are both less toxic and produce less oxidative DNA damage.Öğe Comparative study of apically extruded debris using one manual and two rotary instrumentation techniques for endodontic retreatment(ELSEVIER TAIWAN, 2012) Kustarci, Alper; Altunbas, Demet; Akpinar, Kerem EnginBackground/purpose: The aim of the this study was to compare the amount of debris apically extruded during endodontic retreatment using two rotary nickel-titanium (NiTi) instruments (K3 and R-Endo) and Hedstrom files. Materials and methods: Forty-five extracted human mandibular premolar teeth were used in this study. Root canals of the teeth were filled before being randomly assigned to three groups. In group 1, gutta-percha was removed with K3 (SybronEndo, West Collins, CA, USA) rotary NiTi instruments. In group 2, gutta-percha was removed with R-Endo (Micro-Mega, Besancon, France) rotary NiTi instruments. In group 3, gutta-percha was removed using Hedstrom files (Dentsply Maillefer, Ballaigues, Switzerland). Debris extruded from the apical foramen was collected into Eppendorf tubes. The liquid inside the tubes was dried, and the debris in each group was weighed and compared. Data were statistically analyzed using one-way analysis of variance, and Kruskal-Wallis test and Mann-Whitney U test. Results: Although all retreatment techniques resulted in apical extrusion, groups 1 and 2 produced significantly less apical extrusion than group 3 (P < 0.05). No statistically significant difference was found between groups 1 and 2 (P > 0.05). Conclusion: All retreatment techniques produced extruded debris during endodontic retreatment; however, both rotary NiTi systems were associated with less apical extrusion than manual instrumentation with Hedstrom files. Copyright (c) 2012, Association for Dental Sciences of the Republic of China. Published by Elsevier Taiwan LLC. All rights reserved.Öğe Comparative study of apically extruded debris using one manual and two rotary instrumentation techniques for endodontic retreatment (vol 7, pg 1, 2012)(ELSEVIER TAIWAN, 2012) Kustarci, Alper; Altunbas, Demet; Akpinar, Kerem Engin…Öğe Comparison of shaping ability of two different rotary nickel-titanium preparation systems and two different hand preparation systems in curved root canals(Cumhuriyet University Faculty of Dentistry, 2010) Konanli, Melih; Timur Esener, I.; Akpinar, Kerem Engin; Kuştarci, AlperPurpose: The purpose of this study was to compare shaping ability of Quantec LX and Profile 29 rotary NiTi instruments and Nitiflex and stainless steel hand instruments in curved canals. Material and Methods: In this present study, mesial canals of 48 mandibular molar teeth possesing 25-40° of curvature angle were separated into 4 groups in a manner each group including 12 canals. The preparation groups were Nitiflex and H hand instruments, Profile 29 and Quantec LX rotary NiTi instruments. At the end of the study, changes of canal curvature and working lenght, instrument fractures and perforations were recorded. Data were analysed statistically using Wilcoxon, Kruskal-Wallis and Mann-Whitney U tests. Results: More changes of canal curvature and working lenght were observed in the rotary NiTi preparation systems than stainless steel files. In the stainless steel and Nitiflex files, no instrument fracture was found. Stainless steel files group was occured strip perforations, while rotary NiTi preparation systems were occured lateral preforations. Conclusion: In conclusion, rotary NiTi preparation systems were found to prepare curved root canals more effective than hand preparation systems.Öğe Evaluation of Bacterial Microleakage of Root Canals Irrigated with Different Irrigation Solutions and KTP Laser System(MARY ANN LIEBERT, INC, 2013) Simsek, Neslihan; Akpinar, Kerem Engin; Sumer, ZeynepObjective: The aim of this study was to evaluate bacterial microleakage of the root canals irrigated with different irrigation solutions and the potassium-titanyl-phosphate (KTP) laser system and filled with gutta-percha and AH26 root canal sealer. In addition, the effect of the irrigation solutions on dentin surface was evaluated with a scanning electron microscope (SEM). Background data: A few studies have reported that KTP laser has the capacity to remove the smear layer. Many researchers have demonstrated that propolis has a bactericidal effect. Both are important effects on root canal treatments. Materials and methods: One hundred and twenty single-root single-canal mandibular premolar teeth were used for this study. The root canals were prepared by Dentaport Root ZX and ProTaper rotary instruments with the crown-down technique. The specimens were randomly divided into five groups of 20 teeth each. Each group was irrigated with 17% ethylenediaminetetraacetic acid (EDTA), 20% propolis, 2.5% sodium hypochlorite (NaOCl), 2% chlorhexidine gluconate (CHX), and KTP laser, respectively. A total of 20 teeth were used as controls-10 positive controls and 10 negative controls-which were irrigated with distilled water. The root canals were filled with gutta-percha and AH-26. The external surfaces of specimens were covered with three layers of nail varnish except the apical third. The teeth were inserted into Eppendorf plastic tubes and suspended in glass bottles containing sterile broth. All specimens were inoculated every 5 days with Enterococcus faecalis. The contamination onset time was continuously recorded, as turbidity was the first indication of contamination in a period of 30 days. Results: All statistical analysis was performed using the SPSS for Windows version 15.0 software. A chi(2) test was computed and the statistical significance was set at p < 0.05. The controls behaved as expected. Conclusions: This study showed that different irrigation solutions and KTP laser allowed microleakage of E. faecalis.Öğe Evaluation of the apical leakage amount of three different root canal filling techniques by dye penetration method(Gulhane Medical School, University of Health Sciences, 2012) Altunbaş, Demet; Kaya, Betül; Arslan, Dilara; Zan, Recai; Kuştarci, Alper; Akpinar, Kerem EnginThe purpose of this study was to evaluate the apical leakage amount of the root canals filled with Thermafil technique, thermoplasticized injectable gutta-percha technique and lateral condensation technique by dye penetration method. In the study, 45 extracted human maxillary incisor teeth were used. After root canal cleaning and shaping, the teeth were divided into three groups of 15 teeth in each according to the technique of root canal filling: Group 1; lateral condensation technique, Group 2; Thermafil technique and Group 3; thermoplasticised injectable gutta-percha technique. After filling the roots, the root surfaces were coated with a double layer of nail varnish, except for the 2 mm part of the apical area, and immersed in Indian ink for 15 days. Dye penetration at the apical level was assessed with the clearing technique. Results of the study were evaluated statistically by using Kruskal-Wallis and Mann-Whitney U tests. There were no statistically significant differences between Group 1 and Group 3, and Group 2 and Group 3 (p>0.05), while a statistically significant difference was found between Group 1 and Group 2 (p<0.05). The mean apical leakage values were, from lower to higher, Group 2, Group 3 and Group 1, respectively. In conclusion the least leakage was observed with Thermafil technique with the use of dye penetration method. Therefore Thermafil technique can be regarded as an efficient filling system in achieving a successful endodontic therapy. © Gülhane Askeri Ti{dotless}p Akademisi 2012.Öğe Fracture Resistance of Root-Filled Maxillary Premolar Teeth Restored with Current Dentin Bonding Adhesives(Univ Zagreb, Sch Dental Medicine, 2008) Siso, Seyda Herguner; Er, Kursat; Hurmuzlu, Feridun; Kustarci, Alper; Akpinar, Kerem EnginObjective: The aim was to study and compare the fracture resistance of root-filled premolar teeth restored with various dentin bonding adhesives (DBAs). Material and Methods: Eighty extracted single-rooted human maxillary premolar teeth were randomly assigned to eight groups (n=10). Group 1 (control) did not receive any preparation. From groups 2 to 8, the teeth were root filled and MOD cavities were prepared. Group 2 remained unrestored. Groups 3-8 were restored using the following DBAs: iBond (Heraeus Kulzer), G-Bond (GC Co.), Xeno III (Dentsply/Caulk), AdheSe (Ivoclar Vivadent), Clearfil Protect Bond (Kuraray) and Clearfil Tri-S Bond (Kuraray); all preparations were further restored with a resin composite (Renew, Bisco). All specimens were then stored in 100% humidity at 37 degrees C for 24 h, followed by thermal cycling 500 times between 5 degrees and 55 degrees C. Compressive loading of the teeth was performed by a universal testing machine at a crosshead speed of 1 mm min-1 until failure. The data were recorded in Newton (N) and were submitted to one-way ANOVA and Tukey post-hoc test. Results: The mean loads necessary to fracture the samples in each group were: group 1: 984.00 +/- 116.27a, group 2: 167.30 +/- 47.26b, group 3: 872.30 +/- 164.99a, group 4: 848.70 +/- 157.84a, group 5: 916.30 +/- 246.19a, group 6: 863.20 +/- 197.69a, group 7: 802.20 +/- 183.84a, group 8: 870.70 +/- 126.48a. Similar letters indicate statistically similar values (P>0.05). Conclusion: The type of DBAs had no influence on the fracture resistance of teeth.Öğe MAXILLARY FIRST PREMOLARS WITH THREE ROOT CANALS: TWO CASE REPORTS(ISTANBUL UNIV PRESS, ISTANBUL UNIV RECTORATE, 2017) Ugur, Zeliha; Akpinar, Kerem Engin; Altunbas, DemetIt is very important that the dentists have sufficient information about possible variations in the expected root canal configurations in order to achieve success in endodontic treatment. In addition to having adequate knowledge on the variations of the root canal anatomy, periapical radiographs from different angles, careful examination of the pulp chamber floor, and use of dental operation microscope during the procedure are also important factors that contribute to the diagnosis of the additional roots and canals. The aims of this article are to present the diagnostic approach and root canal treatments of two maxillary first premolar teeth with three canals in two patients.
