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Öğe 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) Arıcan, Burçin; Gündoğar, Mustafa; Uslu, Gülşah; Özyürek, TahaBiomechanical 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.Öğe Letter to the Editor Regarding, Two-Dimensional Radiographs and CBCT Assessment of Concentrated Growth Factor and Platelet-Rich Fibrin Scaffolds in Regenerative Endodontic Treatment of Immature Incisors with Periapical Radiolucency: A Randomized Clinical Trial(Elsevier Science Inc, 2024) Eren, İrem[Anstract Not Available]Öğe Influence of endodontic access cavity design on mechanical properties of a first mandibular premolar tooth: a finite element analysis study(Springer Heidelberg, 2024) Özyürek, Taha; Uslu, Gülşah; Arıcan, Burçin; Gündoğar, Mustafa; Nekoofar, Mohammad Hossein; Dummer, Paul Michael HowellObjectives This 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 methods 3-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. Results The 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. Conclusion Preserving 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. Clinical significance: • The BEC design can be considered as a viable alternative in cases involving cervical lesions. • Oblique and multipoint forces were identified as critical loads impacting the failure probabilities of a root-filled single-rooted first premolar tooth.Öğe Comparative Analysis of Temperature Changes with Preheated and Intracanal Heated Solutions and Ultrasonic Activation in Immature Teeth(Elsevier Science Inc, 2025) Sarıyılmaz, Öznur; Sarıyılmaz, Evren; Keskin, CangülIntroduction: The aim of this study was to examine the temperature changes on root canal and root surface in immature teeth with thin dentinal walls when irrigation solutions are preheated or intracanal heated, as well as the additional effects of passive ultrasonic irrigation (PUI) on these temperature changes. Methods: Sixteen maxillary canine teeth were trimmed to a length of 20 mm and prepared to mimic immature teeth with an apical width of 1.3 mm by enlarging those using Gates Glidden burs. To measure temperatures inside the canal and on the root surface, one thermocouple was placed from the apex into the root canal, while the other thermocouple was positioned outside the root. Irrigation was performed by heating the irrigation solution with different methods (room temperature, preheated to 60 degrees C, 5 sec intracanal heated, 20 sec intracanal heated), and PUI was applied after each method. Temperature changes occurring inside the root canal and on the root surface were recorded and subjected to statistical analysis. Results: Using the irrigation solution preheated and intracanal heated resulted in a significant increase in both intracanal and root surface temperatures compared to using at room temperature (P < .05). The application of PUI significantly increased the temperature of the irrigation solution only at room temperature group (P < .05). None of the applications caused an increase in temperature on the root surface exceeding 10 degrees C. Conclusions: Applying PUI to heated solutions does not significantly increase the temperature in heating methods, but it does prolong heat retention in the canal by slowing down the cooling process. Although using preheated solution for 20 seconds results in higher intracanal temperatures, it should be noted that the solution cools rapidly within the canal. Short-term heating applications, such as 5 seconds, repeated frequently, can help maintain the high temperature during activation.Öğe The usefulness of ultrasonography as a dynamic measurement system for visualizing root canal working length: an in vivo study(BMC, 2024) Eren, İrem; Deniz, YeşimObjectiveAlthough apex locators are generally effective tools for determining root canal working length, they may produce inaccurate results in some cases. The present study aimed to evaluate the efficacy of ultrasonography as an alternative method for measuring root canal length.Materials and methodsForty-seven anterior teeth with apical lesions were selected for the study. Initially, an electronic apex locator was used to measure the working length. Subsequently, ultrasonography was employed to visualize the root apex and determine the working length. During ultrasound imaging, a K-file No. 15 was inserted into the root canal until its tip was visible on the ultrasound monitor. Measurements obtained from both methods were compared using an independent sample t-test. Correlations were assessed with the Pearson correlation coefficient, and agreement was determined using the Bland-Altman plot.ResultsThe mean working canal length was 19.9 mm for the apex locator and 20.6 mm for the ultrasonography-guided method. No significant differences were observed between the data obtained using the apex locator method and the data obtained using the ultrasonography guidance method. Furthermore, a high level of agreement was identified between the two techniques.ConclusionUltrasonography can be used to visualize the apex effectively and determine canal length, especially when canal length determination is uncertain for various reasons.Öğe Can ultrasonography be used to determine working length in endodontic treatment? An in vitro study(Springer, 2024) Eren, İrem; Sarıyılmaz, Öznur; Eren, Hakan; Sarıyılmaz, Evren; Uslu, GülşahThis 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.Öğe Comparative evaluation of the remaining dentin volume following instrumentation with rotary, reciprocating, and hand files during root canal treatment in primary molars: An ex vivo study(Elsevier Taiwan, 2024) Eren, İrem; Sezer, BerkantBackground/purpose: The effectiveness of root canal treatments with different file systems in primary teeth is important in terms of clinical practice and the use of file systems that work with different principles in primary tooth pulpectomy is becoming widespread. The amount of remaining dentin in the coronal region of the root is important in terms of the prognosis of the tooth and the long-term success of the treatment in teeth that have undergone root canal treatment. The aim of this study was to evaluate the remaining dentin volume in the coronal part of the root after the use of rotary, reciprocating, and conventional hand files in primary tooth pulpectomy. Materials and methods: A total of 30 primary molars were divided into three groups. In each group, the preparations were made with three different file types: WaveOne Gold, which works with reciprocating motion; TruNatomy, which works with rotational motion; and conventional hand files. The three-dimensional images were evaluated for remaining dentin volume in the 2-mm coronal part of the root. Group means were compared using one-way analysis of variance, and post hoc analyses were performed with the Tukey test. Results: There was no statistically significant difference between the groups in terms of preoperative and postoperative dentin volume (P > 0.05). The mean difference after preparation was observed the most in the WaveOne Gold group and the least in the TruNatomy group. When the mean percentage differences were evaluated, it was observed that statistically significantly more dentin volume was preserved after the preparation with TruNatomy than with WaveOne Gold (P = 0.021). Conclusion: In primary tooth pulpectomy, file systems working with rotational motion can be preferred over file systems working with reciprocating motion in preserving the amount of dentin in the 2-mm coronal part of the root.Öğe 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) Sarıyılmaz, Öznur; Uslu, Gülşah; Sarıyılmaz, Evren; Keskin, Neslihan BüşraObjectives 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.Öğe Can ultrasonography be used to detect root perforation? An in vitro study(Wiley, 2025) Sarıyılmaz, Öznur; Eren, İrem; Sarıyılmaz, Evren; Eren, Hakan; Uslu, GülşahThis study assessed the usability of ultrasonography in detecting root canal perforations. The buccal side of incisor root were perforated. The actual lengths up to the perforation site were measured by visualisation of the tip of a file. Specimens were embedded in gypsum, and it was scraped to simulate bone resorption. Resorption cavities were filled with ultrasound gel. Measurements were taken by advancing a file through the canal until the tip became visible in the ultrasound image. 3D scans were obtained using cone-beam computed tomography (CBCT) and the distance between the coronal point of the resorption cavity and the reference point was measured. The actual distance of the resorption cavity from the reference point varied 6-10.6 mm. The same distances were measured via ultrasound as 5.7-10.9 mm, while measured using CBCT 6-10.5 mm. No significant differences were found. Ultrasonography shows promise for detecting root perforations, however further research is needed.Öğe Postoperative pain after different irrigation activation techniques: a randomized, clinical trial(Springer Japan, 2021) Gündoğar, Mustafa; Sezgin, Güzide Pelin; Kaplan, Sema Sönmez; Özyürek, Hande; Uslu, GülşahThe aim of this study was to assess the effectiveness of irrigation activation techniques on postoperative pain (PP) in mandibular premolar teeth with irreversible pulpitis after single-visit endodontic treatment. A total of 160 patients with symptomatic irreversible pulpitis were included in this prospective randomized clinical study. Four different activation methods were used in mandibular premolar teeth. In group 1, teeth were irrigated with side-port endodontic needles (NI) without any agitation; in groups 2 and 3, sonic activation was performed using EDDY and EndoActivator (EA), respectively; and in group 4, passive ultrasonic irrigation (PUI) was used. Patients’ analgesic intake—as well as pain intensity during and after treatment—were recorded at 8, 24, 48 h and 7 days. The data relating to age, sex and analgesic intake was evaluated using the Chi-square test and the preoperative pain and PP intensity at different time intervals was evaluated with the Kruskal–Wallis test at a 5% significance level. Highest PP was recorded at 8 h, pain intensity decreased in all groups by the time. Pain in the NI group was found higher than that of EDDY group at 24 h (P < 0.05). EA and PUI had caused mild pain and had similar pain scores at 24 h. (P > 0.05). No statistically difference was found among the groups with regard to analgesic intake (P > 0.05). Although there were slight differences in PP levels between the groups at 24 h, pain levels decreased in all groups after 24 h. Activation of the irrigation solution did not make any difference in terms of PP after 24 h.Öğe The Impact of Coronal Flaring Files on Pericervical Dentin Thickness in Mandibular Molars(American Association of Endodontists, 2024) Sarıyılmaz, Öznur; Sessiz, Rüya; Kocaman, Osman SefaIntroduction: This study aimed to assess the influence of different coronal flaring files on dentin removal in mandibular teeth using cone-beam computed tomographic (CBCT) images. Methods: CBCT images of 48 mandibular molar teeth were acquired and randomly divided into 2 main groups, with each main group further divided into 3 subgroups. In the first main group, root canal preparation was performed using TruNatomy (Dentsply Sirona, Ballaigues, Switzerland), ProTaper Gold (Dentsply Sirona), and One Curve (Micro-Mega, Besancon, France) files without the use of coronal flaring files. In the second main group, root canal preparation was performed using the same files with the use of coronal flaring files. After the completion of root canal preparation, a second set of CBCT images was obtained. Subsequently, the dentin removal and remaining critical dentin were assessed by measuring at 4 distinct points below the furcation level. Data were compared between groups using the Mann-Whitney U and Kruskal-Wallis tests with alpha set at 5%. Results: The ProTaper Gold files demonstrated higher dentin removal compared with the TruNatomy files. In the no-flaring groups, the One Curve files exhibited greater dentin removal than the TruNatomy files at specific levels. The use of coronal flaring files generally did not significantly impact dentin removal, except for certain cases in the TruNatomy and ProTaper Gold groups. Conclusions: The TruNatomy instrument group was more effective in preserving pericervical dentin compared with the other instrument groups. Coronal flaring files can be confidently used to preserve critical dentin during root canal treatment.Öğe Efficacy of different irrigant activation devices in removing dentin debris from an artificial isthmus connecting curved canals(John Wiley and Sons Inc, 2023) Plotino, Gianluca; Özyürek, Taha; Gündoğar, Mustafa; Uslu, Gülşah; Pedulla, Eugenio; Careddu, Roberto; Franco, VittorioThe aim of this study was to evaluate the debridement efficacy of sonic irrigation (EDDY; VDW, Munich, Germany and EndoActivator; Dentsply-Sirona, Ballaigues, Switzerland) and ultrasonically activated irrigation (Irrısafe; Satelec Acteon, Merignac, France) in a simulated canal isthmus connecting curved canals. Transparent resin blocks were produced containing two curved canals connected with an isthmus. The isthmus was then filled with dentin debris. Three irrigant activation cycles were performed and the amount of remaining debris was compared analysing pictures taken after each activation cycle. Data were statistically analysed using one-way ANOVA and post hoc Tukey tests at a significance level of p < 0.05. EDDY showed greater efficiency in removing dentin debris from the simulated isthmus than the other techniques tested. An increase in the activation time enhanced the efficiency of both EDDY and ultrasonically activated irrigation in debris removal.Öğe Comparison of the Effects of WaveOne Gold, TruNatomy, and Conventional Hand Files on Remaining Dentin Volume in the Coronal Part of the Root and Preparation Efficiency in Mandibular Molars(Elsevier Inc., 2023) Eren, İrem; Sezer, BerkantIntroduction: The use of file systems that work with different principles in root canal treatment is becoming widespread. The aim of this study was to evaluate the remaining dentine volume in the coronal region of the root and preparation efficiency after the use of conventional hand files, WaveOne Gold; which works with reciprocating motion, and TruNatomy; which works with rotational motion in the root canal treatment of mandibular molar teeth. Methods: All canals of permanent mandibular molars (n = 36) were used. Root canals in each group (n = 12) were prepared with conventional hand files, WaveOne Gold, and TruNatomy. The three-dimensional images were evaluated for remaining dentine volume in the coronal two-millimeter region of the root and change in volume of the entire root canal space. Results: There was no statistically significant difference between the groups in terms of mean differences pre and postpreparation (P > .05). The mean differences after preparation were observed the most in the WaveOne Gold group and the least in the TruNatomy group in the coronal two-millimeter region of the root and entire canal volume, but the differences were not significant (P > .05, P > .05, respectively). Conclusions: Conventional hand files, WaveOne Gold working with reciprocating motion, and TruNatomy working with rotational motion, which are the file systems used in the study, are not superior to each other in terms of remaining dentin volume in the coronal two-millimeter region of the root and preparation efficiency in the entire root canal space in mandibular molars.Öğe Investigation of the effectiveness of sonic, ultrasonic and new laser-assisted irrigation activation methods on smear removal and tubular penetration(Springer Science and Business Media Deutschland GmbH, 2023) Uslu, Gülşah; Gündoğar, Mustafa; Üngör, Mete; Özyürek, Taha; Erkan, Erhan; Keskin, Neslihan BüşraThe aim of this study was to examine the effectiveness of different irrigation activation methods on smear layer removal and tubular penetration. One hundred-five distal roots of mandibular molar teeth in total; 50 for smear removal efficiency (n = 10) analysis using scanning electron microscopy (SEM), and 55 roots were used to examine tubular penetration using confocal laser scanning microscope (CLSM). Five different irrigation activation methods were used in this study; conventional needle irrigation (CNI), sonic irrigation device of EDDY, passive ultrasonic irrigation (PUI), PIPS and SWEEPS techniques, which are two different laser irrigation activation methods. The obtained data were statistically analyzed and the significance level was determined as p < 0.05. At the apical level, the cleanest canal walls were observed when laser methods PIPS and SWEEPS were used, while in the middle third, there was no difference in smear removal efficiencies between all groups except for the CNI (p > 0.05). Penetration depths and percentages increased from apically to coronally in all groups. The PUI and EDDY generally showed similar penetration depths and percentages to the CNI, except at the coronal root level (p > 0.05). In all groups, when PIPS was used, it showed greater penetration depth and percentage (p < 0.05). PIPS and SWEEPS techniques showed lowest and similar smear scores compared to PUI and EDDY in the apical area where access and effectiveness of the irrigation solution are difficult.
