Background and Objectives: Endodontic sealers are used to fill the gap between the root filling material and canal walls. Retrievability is an important requirement for sealers and root filling materials in non-surgical endodontic retreatment. This study sought to assess the retreatability of fluoride varnish, AH 26 and Mineral Trioxide Aggregate (MTA)-based sealers using Cone-Beam Computed Tomography (CBCT). Materials and Methods: This in vitro, experimental study evaluated 45 extracted single-rooted, single-canal human mandibular premolars. Teeth with cracks or fracture were excluded. The root canals were prepared using ProTaper Universal rotary system up to size F4 according to the manufacturer’s instructions. The teeth were then randomly divided into three groups of 5% fluoride varnish, AH 26 and MTA Fillapex. CBCT scans were obtained of the teeth with 200 μm voxel size. MATLAB R2012 software was used to quantify the amount of sealer remaining in the canal. Two observers evaluated the images. Data were analyzed using SPSS via the Kruskal-Wallis and Mann Whitney tests. Results: The amount of sealer remaining in the root canals was significantly different among the three groups (P<0.05). The amount of AH 26 sealer remaining in the root canals (1.91±1.46) was significantly greater than MTA Fillapex (0.62±0.26) and fluoride varnish, but the latter two were not significantly different in this respect (P>0.05). Conclusion: Considering the adequate adhesion of fluoride varnish to dentin, its cariostatic effect and low cost, it seems to be a suitable alternative to the commonly used endodontic sealers.
Background. Three-dimensional (3D) cone-beam computed tomography (CBCT) scans play an important role in dental diagnostics and treatment planning, especially in detecting vertical root fractures (VRFs). However, artifacts caused by high-density dental materials can negatively affect the quality of CBCT images by decreasing contrast and masking structures. Objectives. The aim of this study was to assess the efficacy of artifact removal software in detecting VRFs in endodontically treated teeth on CBCT scans. Material and methods. This study evaluated 70 endodontically treated single-rooted teeth. Half of the teeth were cracked by introducing a wedge into the canal and tapping gently with a hammer; the rest remained untouched as a control group. The teeth were then mounted in a bovine rib bone. Soft tissue was simulated using red dental wax. Cone-beam computed tomography scans were taken using the NewTom ® 3G, ProMax ® 3D and Cranex ® 3D CBCT systems, and the MATLAB software was applied. The images were evaluated by 2 oral and maxillofacial radiologists, and the results were recorded in a checklist. The data was analyzed using the κ coefficient, McNemar's test and the receiver operating characteristic (ROC) curves. Results. A significant inter-observer agreement was noted between the 2 observers in detecting VRFs using all CBCT systems. In all systems, the use of the MATLAB software improved the detection of VRFs, but the difference was not significant in the NewTom 3G (p = 0.119) and ProMax 3D (p = 0.455) systems. However, the difference was significant in the Cranex 3D system (p = 0.039). Conclusions. The MATLAB artifact removal software can enhance the detection of VRFs on CBCT scans to some extent.
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