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    Can ultrasonography be used to determine working length in endodontic treatment? An in vitro study
    (Springer, 2024) Eren, Irem; Sariyilmaz, Oznur; Eren, Hakan; Sariyilmaz, Evren; Uslu, Gulsah
    This study was conducted to evaluate efficacy of ultrasonography (USG) in determining working length in in-vitro conditions. Twenty five access cavities of maxillary incisor teeth were opened and actual working lengths (AWL) were measured with dental operating microscope. The working length were then measured with an electronic apex locator and USG. USG and apex locator measurements were statistically analyzed using one sample t-test and compared with AWL. The mean AWL measurment was 20.68 mm. USG measured the working length slightly longer (21.09 mm) than the measurements of apex locator (20.64 mm). Statistical analysis showed that the USG method provided similar measurements to electronic apex locators and with no statistical difference with actual working length (P < .05). USG emerges as a promising method for working length measurement that allows simultaneous visualization of root tip anatomy in cases where electronic apex locators may be insufficient and there is buccal cortical bone loss.
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    Effect of Sodium Hypochlorite and EDTA on Surface Roughness of HyFlex CM and HyFlex EDM Files
    (Wiley, 2018) Uslu, Gulsah; Ozyurek, Taha; Yilmaz, Koray
    The aim of the present study was to compare the effect of exposure to sodium hypochlorite (NaOCl) and ethylenediaminetetraacetic acid (EDTA) on the surface topography and roughness of HyFlex controlled memory (CM) and HyFlex electrical discharge machining (EDM) using atomic force microscopy (AFM). Twenty HyFlex EDM (25/.08) and 20 HyFlex CM (25/.06) files were divided into five groups (n = 4). One group served as a negative control group. The files in the other groups were exposed to 5.25% NaOCl and 17% EDTA solutions at 37 degrees C for 5 and 10 min, respectively, and examined using AFM after each exposure. The data were analyzed using one-way ANOVA test. The lowest values were observed in the control group of HyFlex EDM files (p < .05). The highest values were observed in the HyFlex EDM and HyFlex CM files immersed in EDTA for 10 min (p < .05). In conclusion, the tested irrigants had a significant negative effect on the surface porosity of NiTi files. The immersion of NiTi files in irrigants during cleaning and sterilization procedures results in corrosion and surface deformation of the files, and this can lead to unexpected file fracture during clinical use. Thus, the investigation of effect of ethylenediaminetetraacetic acid (EDTA) and sodium hypochlorite (NaOCl) on surface topography of HyFlex files is important.
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    Evaluation of different irrigation activation techniques for the removal of various medicaments from a simulated internal resorption cavity: an in vitro study
    (Springer Heidelberg, 2024) Sariyilmaz, Oznur; Uslu, Gulsah; Sariyilmaz, Evren; Keskin, Neslihan Busra
    ObjectivesThis 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 methods108 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.ResultsXPF 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.ConclusionsXPF and PUI techniques enhance medicament removal efficacy. Bio-C Temp was more difficult to remove from the IRR cavities than other medicaments.Clinical relevanceBio-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.
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    Fracture strength of endodontically treated teeth restored with different fiber post and core systems
    (Springer, 2020) Ozyurek, Taha; Topkara, Can; Kocak, Imran; Yilmaz, Koray; Gundogar, Mustafa; Uslu, Gulsah
    The aim of this study was to investigate the effects of different post and core systems, CAD/CAM crown placement on fracture strength of endodontically treated mandibular premolar teeth. One hundred forty single-rooted premolar teeth were randomly divided into a control group and six experimental groups as follows: control group (Group 1); FiberSite post luting with Clearfil DC Core Plus (Group 2); RelyX Fiber post luting and core build up with Clearfil DC Core Plus (Group 3); RelyX Fiber post luting with Clearfil DC Core Plus and core build up with Filtek Bulk Fill Posterior (Group 4); specimens that received CAD/CAM crowns after the same procedures performed in Groups 2, 3, and 4, respectively (Groups 5, 6, and 7). Fracture strength tests were performed, and the failure modes were recorded. Data were statistically analyzed using one-way ANOVA and post hoc Tukey tests. The highest fracture resistance was observed in the control group and among the experimental groups in Group 4. Groups 3 and 5 showed similar fracture resistance followed by Group 2. The lowest fracture resistances were seen in the samples of Groups 6 and 7. While the fracture strength of Group 2 increased after the crown placement (Group 5), the fracture strength of Group 3 and Group 4 decreased (P < 0.05). While the specimens in Groups 1, 2, 3, and 4 predominantly showed favorable failure, unfavorable failure was more frequent in Groups 5, 6, and 7.
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    Influence of endodontic access cavity design on mechanical properties of a first mandibular premolar tooth: a finite element analysis study
    (Springer Heidelberg, 2024) Ozyurek, Taha; Uslu, Gulsah; Arican, Burcin; Gundogar, Mustafa; Nekoofar, Mohammad Hossein; Dummer, Paul Michael Howell
    ObjectivesThis study aimed to investigate the influence of access cavity designs on the mechanical properties of a single-rooted mandibular first premolar tooth under various static loads using a finite element analysis.Materials and methods3-dimensional FEA designs were modeled according to the access cavity designs: an intact tooth (control), traditional access cavity (TEC-I), traditional access cavity with Class-II mesio-occlusal cavity design (TEC-II), conservative access cavity (CEC), ninja access cavity (NEC), caries-driven access cavity (Cd-EC), buccal access cavity (BEC) and bucco-occlusal access cavity (BOEC). After the simulated access cavity preparations, root canal treatment was simulated and three different static loads which mimicked oblique and vertical mastication forces were applied to the models. The stress distribution and maximum Von Misses stress values were recorded. The maximum stress values were obtained on both enamel and dentin under multi-point vertical loads.ResultsThe maximum stress values were obtained on both enamel and dentin under multi-point vertical loads. Under all load types, the minimum stress distribution was observed in the control group, followed by CEC, NEC and BEC designs. The highest stress concentration was detected in Cd-EC and TEC-II designs. Under single-point vertical loading, the stress was mostly concentrated in the lingual PCD area, while under multi-point vertical loading, the entire root surface was stress-loaded except for the lingual apical third of the root.ConclusionPreserving tooth tissue by simulating CEC, NEC and BEC access cavities increased the load capacity of a single-rooted mandibular first premolar following simulated endodontic treatment. center dot The BEC design can be considered as a viable alternative in cases involving cervical lesions.center dot Oblique and multipoint forces were identified as critical loads impacting the failure probabilities of a root-filled single-rooted first premolar tooth.
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    Mechanical Properties of the New Generation RACE EVO and R-Motion Nickel-Titanium Instruments
    (Mdpi, 2022) Basturk, Fatima Betul; Ozyurek, Taha; Uslu, Gulsah; Gundogar, Mustafa
    This study aimed to evaluate and compare the dynamic cyclic fatigue, torsional and bending resistance of two novel RACE EVO (FKG Dentaire SA, La Chaux de Fonds, Switzerland) and R-Motion (FKG) nickel-titanium instruments with traditional RaCe (FKG) instruments. RACE EVO, R-Motion and RaCe instruments with a size of 25 and taper of 0.06 were used. A dynamic cyclic fatigue test was used to assess the time to fracture. The fractured surfaces were further analyzed using scanning electron microscopy at x350 and x3000 magnifications. A torsional resistance test was performed to measure the maximum torsional strength and angle of rotation. Phase transformations with temperature were evaluated using differential scanning calorimetry. The results were statistically analyzed with a Kruskal-Wallis test at a 5% significance level. R-Motion had the highest time to fracture and the lowest torsional and bending resistance, whereas RaCe had the lowest time to fracture and the highest torsional and bending resistance (p < 0.05). In relation to the angle of rotation, RACE EVO instruments had the highest deformation capacity followed by R-Motion and RaCe instruments (p < 0.05). The greater cyclic fatigue resistance and lower torsional and bending resistance results indicate that the novel R-Motion and RACE EVO instruments are less rigid and more flexible than RaCe instruments.
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    Mechanical resistance of a mandibular first molar under the influence of different endodontic access cavity design: a 3D finite element analysis study
    (Taylor & Francis Ltd, 2025) Arican, Burcin; Gundogar, Mustafa; Uslu, Gulsah; Ozyurek, Taha
    Biomechanical properties of a mandibular first molar with different cavity designs [traditional access cavities (TEC-I & TEC-II), ninja access cavity (NEC), conservative access cavity (CEC), truss access cavity (Tr-EC), caries-driven access cavity (Cd-EC), caries-driven truss access cavity (Cd-TrEC)] were compared using finite element (FE) analysis. Models were subjected to three different loads. The highest stress distribution was observed on the enamel surface of the Cd-EC design and the dentin surface of the TEC-II. The stress was mainly concentrated on the lingual root surfaces and in the pericervical area. Enlarging the access cavity significantly increased stress distribution on enamel and dentin.
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    Postoperative pain after SWEEPS, PIPS, sonic and ultrasonic-assisted irrigation activation techniques: a randomized clinical trial
    (Springer, 2022) Erkan, Erhan; Gundogar, Mustafa; Uslu, Gulsah; Ozyurek, Taha
    To investigate the efficacy of a new laser irrigation activation system [shock wave-enhanced emission photo-acoustic streaming (SWEEPS)] in terms of postoperative pain after primary root canal treatment compared with other techniques, namely photon-induced photo-acoustic streaming (PIPS), sonic system with EDDY, passive ultrasonic system (PUI), and manual dynamic activation (MDA). Two hundred patients with symptomatic irreversible pulpitis in mandibular premolar teeth were enrolled and randomly allocated to five different irrigation activation groups (n = 40) after chemo-mechanical root canal preparation. For irrigation activation, the SWEEPS and PIPS tips were attached to the Er-YAG laser system in the respective groups, while the Irrisafe tip was used in the PUI group and the EDDY tip in the sonic group. In the MDA group, irrigation was agitated with the master gutta-percha cone. At postoperative hours 8, 24, and 48 and on day 7, pain intensity was evaluated using the 10-mm Visual Analog Scale (VAS) and analgesic intake was recorded. The Kruskal-Wallis test was used to analyze the VAS scores, and pain prevalence and analgesic intake were examined with the Pearson's chi-square test at the 5% significance level. The PIPS and SWEEPS groups had the lowest level and prevalence of pain when compared to the remaining groups (P < 0.001). The PUI, sonic and MDA groups did not differ in terms of pain scores at hours 8 and 48 (P > 0.05). On day 7, the highest score and pain prevalence were recorded in the MDA group (P < 0.001). There was no difference between the groups in terms of analgesic intake (P > 0.05). Laser-activated irrigation systems provided lower postoperative pain scores and levels compared to the other activation systems. The MDA group had the highest pain scores and incidence at the end of the seventh day.
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    Pull-out Retentive Resistance of Fiber Posts Restored with Different Core Materials
    (Galenos Publ House, 2022) Topkara, Can; Yilmaz, Koray; Gundogar, Mustafa; Uslu, Gulsah; Ozyurek, Taha
    Objective: This study aimed to assess the pull-out bonding resistance of FiberSite and RelyX Fiber posts constructed from core structures using various resin cement. Materials and Methods: Sixty mandibular premolar teeth were horizontally sectioned to create a root canal length of 15 +/- 1 mm. Up to size #40, samples were prepared and obturated with gutta-percha and root canal sealer. Three groups of specimens (n=20) were formed. FiberSite posts were luted and built-up using Clearfil DC Core Plus in Group 1, RelyX Fiber posts were luted and built-up using Clearfil DC Core Plus in Group 2, and RelyX Fiber Posts were luted and built-up using Filtek Bulk Fill Posterior in Group 3. Each specimen was vertically positioned in a universal testing machine and rotated at 0.5 mm/min until it dislodged. Oneway ANOVA and post hoc tests were used to evaluate the data. Results: The bonding strength of FiberSite posts was higher than that of RelyX Fiber posts (p<0.05). Clearfil DC Core Plus-built RelyX Fiber Posts exhibited higher bond strength than Filtek Bulk Fill Posterior-built posts (p<0.05). Conclusion: FiberSite posts provide better root canal dentin retention than RelyX Fiber posts with different core materials.