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    Assessment of the biocompatibility of mineral trioxide aggregate, bioaggregate, and biodentine in the subcutaneous tissue of rats
    (Wolters Kluwer Medknow Publications, 2015) Simsek, N.; Alan, H.; Ahmetoglu, F.; Taslidere, E.; Bulut, E. T.; Keles, A.
    Objective: The objective of this study was to evaluate the tissue inflammation caused by three endodontic repair materials. Materials and Methods: The materials included micro mega-mineral trioxide aggregate (MM-MTA), bioaggregate (BA), and biodentine (BD), which were implanted into the subcutaneous tissue of rats. The tissue samples for histological examination were prepared. The infiltration of lymphocytes and macrophages into the tissue was examined to assess the inflammatory response. Results: Lymphocyte infiltration: A significant increase was detected in the MM-MTA and BA groups on the 7th and 14th days as compared with the control (7th day P = 0.0001, 14th day P = 0.0176). There was no difference between the groups on the 45th day (P = 0.1730). Lymphocyte infiltration had decreased over time in all groups. Macrophage infiltration: There was a significant increase by the 7th day in the test groups as compared to the control group (P = 0.007). However, there was no difference between the experimental groups on the 14th (P = 0.2708) and 45th (P = 0.1291) days. Conclusion: While MM-MTA and BA showed a similar biocompatibility, BD was more biocompatible than MM-MTA and BA in the 1st week of the experiment. However, there was no difference between the materials at the end of the 45th day. MM-MTA, BA, and BD can be considered suitable endodontic repair materials.
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    Endodontic treatment of a maxillary lateral incisor with vital pulp, periradicular lesion and type III dens invaginatus: a case report
    (Wiley, 2010) Keles, A.; Cakici, F.
    P>Aim To report the healing of a periradicular lesion and maintaining vitality of the pulp following endodontic treatment of the invaginated canal of a dental invagination. Summary Dens invaginatus is a developmental malformation resulting from invagination of the tooth crown or root before calcification has occurred. A case of type III dens invaginatus, an invagination that extends from the crown to the apex, in the maxillary right lateral incisor with a healthy pulp and large peri-invagination periodontitis is reported. Non-surgical root canal treatment of the invagination was performed. There appeared to be no communication between the main root canal and the invaginated canal. The invaginated canal was filled by lateral condensation of gutta-percha and a calcium hydroxide sealer. The final restoration of the tooth was completed using composite, and the tooth was reviewed after 1 and 2 years. Non-surgical root canal treatment of the invagination retained the pulp in a health condition and resulted in resolution of a substantial peri-invagination lesion. Key learning points Even though there are no symptoms, radiography should be performed in teeth that exhibit anatomical differences from the contralateral tooth. Even if there is extensive apical pathology in a tooth with type III dens invaginatus, pulp sensibility tests should be performed. Correct diagnosis and treatment planning are fundamental when treating dens invaginatus.
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    Micro-CT evaluation of root filling quality in oval-shaped canals
    (Wiley, 2014) Keles, A.; Alcin, H.; Kamalak, A.; Versiani, M. A.
    AimTo assess the percentage volumes of filling materials and voids in oval-shaped canals filled with either cold lateral compaction or warm compaction techniques, using micro-computed tomography (micro-CT). MethodologyTwenty-four single-rooted maxillary premolar teeth with oval-shaped canals were selected and the root canals prepared and assigned to two groups (n=12), according to the filling technique: cold lateral compaction (CLC) or warm vertical compaction (WVC). Each specimen was scanned using a micro-CT device at an isotropic resolution of 12.5m. Percentage volumes of root filling materials and voids were calculated, and data were statistically analysed using Student's t-test and Friedman's test, with a significance level of 5%. ResultsOverall, mean percentage volumes of gutta-percha, sealer and voids were 82.333.14, 13.42 +/- 2.91 and 4.26 +/- 0.74 in the CLC group and 91.73 +/- 4.48, 7.70 +/- 4.44 and 0.57 +/- 0.44 in the WVC group, respectively, with a statistically significant difference between groups (P<0.05). At the apical level, differences in the percentage volumes of filling materials and voids between groups were not significant (P>0.05). ConclusionsNo root fillings were void free. Warm vertical compaction produced a significantly greater volume of gutta-percha and a significantly lower percentage of voids than those achieved with cold lateral compaction. Distribution of sealer and voids within the root canal space after root filling was unpredictable, irrespective of the technique used.