Publications by authors named "A Serper"

44 Publications

Sealer penetration: effect of separated file's cross-section, taper and motion characteristics.

Clin Oral Investig 2021 Mar 19;25(3):1077-1084. Epub 2020 Jun 19.

Department of Endodontics, Faculty of Dentistry, Hacettepe University, Sihhiye, 06100, Ankara, Turkey.

Objectives: The separated root canal instruments may affect the quality of root canal filling, hence the success of endodontic treatment. The aim of this study was to evaluate the effects of separated file fragments of nickel-titanium rotary systems with different cross-section, taper and motion characteristics on the apical sealer penetration in oval-shaped root canals via confocal laser scanning microscope (CLSM).

Materials And Methods: Distal roots of 60 mandibular molars with oval-shaped root canals were randomly divided into 4 groups as follows: group 1, FlexMaster Nickel Titanium Rotary File System (NTRFS) (separated instrument: 30/.06); group 2, ProTaper Next NTRFS (X3); group 3, ProTaper Universal NTRFS (F3); group 4, Revo-S NTRFS (AS30/.06). Root canals were filled with gutta-percha and AH plus labelled with 0.1% rhodamine B using a warm vertical compaction technique. Each specimen was horizontally sectioned at 1st, 3rd and 5th mm from apical foramen. Amount of maximum and average penetration depths, penetration percentage and sealer penetrated area were measured and analysed with one-way repeated measures of ANOVA and the Bonferroni post hoc tests. p < 0.05 was considered significant.

Results: The penetration depth, percentage and penetrated area of the sealer increased from apical to coronal in all systems. The maximum and average penetration depths and penetration areas were higher in FlexMaster and Revo-S groups at the 3rd mm (p < 0.05). At the 5th mm, the Revo-S group had a higher penetration percentage, when compared with ProTaper Next and ProTaper Universal groups (p < 0.05).

Conclusions: In the 1st mm, separated fragments of any system did not allow the penetration of the sealer, while it was observed that the files with constant taper showed more positive results in terms of sealer penetration at apical 3rd and 5th mm.

Clinical Relevance: In the presence of a separated file, the taper of the file might significantly affect the amount of penetrated sealer into the dentinal tubules as compared with the cross-section and motion characteristics of the file.
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March 2021

Micro-CT evaluation of the removal of root fillings using the ProTaper Universal Retreatment system supplemented by the XP-Endo Finisher file.

Int Endod J 2019 Jul 22;52(7):1070-1076. Epub 2019 Feb 22.

Department of Anatomy, Faculty of Medicine, Hacettepe University, Ankara, Turkey.

Aim: To compare the removal of root fillings in extracted teeth using the ProTaper Universal Retreatment system (PTUR) followed by a supplementary preparation with the XP-Endo Finisher file.

Methodology: The mesiobuccal root canals of 30 extracted mandibular first molars were instrumented with ProTaper Universal NiTi files up to F2 and filled with one of the following sealers using a single-cone technique (n = 10): AH Plus, NeoMTA Plus and EndoSequence BC. The root fillings were removed using the PTUR system with additional apical preparation using ProTaper F2 and F3 files. Then, an additional preparation with an XP-Endo Finisher file was performed. The samples were scanned using micro-CT before and after retreatment and again after the use of the XP-Endo Finisher to assess the volume of remaining filling material. Data were analysed by Kruskal-Wallis and Friedman's two-way analysis of variance tests with Bonferroni correction.

Results: No significant difference in the initial filling volume was observed amongst the groups (P > 0.05). The amount of filling materials in each group decreased significantly after retreatment with rotary files (P < 0.05). After initial retreatment, the volume of the remaining filling amongst the groups was similar (P > 0.05). Additional preparation with the XP-Endo Finisher improved the removal of filling materials regardless of the sealer type (P < 0.05).

Conclusions: In the mesiobuccal root canals of extracted mandibular first molars, additional preparation using an XP-Endo Finisher file, after using the PTUR system and F3 ProTaper instruments, enhanced the removal of filling materials from root canals.
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July 2019

Effect of perforation size and furcal lesion on stress distribution in mandibular molars: a finite element analysis.

Int Endod J 2019 Mar 1;52(3):377-384. Epub 2018 Oct 1.

Department of Endodontology, Faculty of Dentistry, Hacettepe University Sıhhiye, Ankara, Turkey.

Aim: To compare the effect of furcal perforations of various sizes on the biomechanical response of mandibular first molars with or without periodontal bone loss at the furcal region via three-dimensional (3D) finite element analysis (FEA).

Methodology: The 3D geometric basic model was reconstructed from the micro-computed tomographic images of an extracted mandibular first molar. Five different models were constructed from this molar in group 1 as follows: intact molar model, root filled (RCF) model and three models with furcal perforations (1, 2 and 3 mm in diameter) repaired with a calcium silicate-based cement (CSC). In group 2, a lesion simulating bone resorption at the furcal region was modelled on the models in group 1. A force of 200 N was applied to simulate normal occlusal loads. Static linear FEA was performed using the Abaqus software (Abaqus 6.14; ABAQUS Inc., Providence, RI, USA). The maximum principal stresses (P ) and maximum displacement magnitude were evaluated.

Results: The range of P values of the models in group 1, from high to low, was as follows: RCF + 3 mm perforation > RCF + 2 mm perforation > RCF + 1 mm perforation > RCF > intact model, and the range of P values of the models in group 2 was as follows: RCF + 3 mm perforation + furcal lesion > RCF + 2 mm perforation + furcal lesion > RCF + 1 mm perforation + furcal lesion > RCF + furcal lesion > intact model + furcal lesion. All of the models in group 2 exhibited lower P values and higher maximum displacement magnitude than their counterparts without lesions in group 1.

Conclusions: The size of the furcal perforation affected the accumulation and distribution of stress within the models. Mandibular molar teeth with large furcal perforations treated with a calcium silicate-based cement may be associated with an increased risk of fracture whether or not accompanied by bone resorption.
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March 2019

Obturation quality of calcium silicate-based cements placed with different techniques in teeth with perforating internal root resorption: a micro-computed tomographic study.

Clin Oral Investig 2019 Feb 5;23(2):805-811. Epub 2018 Jun 5.

Department of Anatomy, Faculty of Medicine, Hacettepe University, Ankara, Turkey.

Objectives: To evaluate and compare the obturation quality of mineral trioxide aggregate (MTA) and Biodentine placed with hand condensation or indirect ultrasonic activation technique in teeth models simulating perforating internal root resorption (IRR) using micro-computed tomographic (micro-CT) imaging.

Materials And Methods: Standardized models with perforating IRR cavities were created using 40 extracted single-rooted human teeth and randomly divided into four groups (n = 10). The specimens were obturated with either MTA or Biodentine and the placement technique applied was either hand condensation or indirect ultrasonic activation. Micro-CT scans were performed for the volumetric analysis of voids and filling materials in the resorption cavities and apical portion of the specimens. Data were analyzed using one-way analysis of variance and paired t test.

Results: No significant difference was observed between the groups in terms of the percentage volume of filling materials (p > 0.05). The apical portion of the specimens significantly presented less percentage volume of filling materials than the resorption cavities in each group (p < 0.05).

Conclusions: No placement technique produced void-free fillings in teeth with perforating IRR. There was no significant difference between the obturation quality of Biodentine and MTA. The obturation quality in the apical portion of the root canals was inferior than that in the resorption cavities.

Clinical Relevance: The obturation of the apical region of teeth with perforating IRR is challenging irrespective of the material type and placement technique.
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February 2019

Concentration and time-dependent effect of initial sodium hypochlorite on the ability of QMix and ethylenediaminetetraacetic acid to remove smear layer.

J Conserv Dent 2017 May-Jun;20(3):185-189

Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey.

Aims: The aim of this study was to compare the ability of 17% ethylenediaminetetraacetic acid (EDTA) and QMix with different concentrations and time exposures of initial sodium hypochlorite (NaOCl) to remove the smear layer from the root canals.

Materials And Methods: Eighty maxillary central incisors were used. After instrumentation, the teeth were divided into eight experimental groups according to the initial and final rinse. About 2.5% and 5% NaOCl were used during instrumentation and for 1 or 3 min was used as postinstrumentation initial irrigants, and 17% EDTA and QMix used as final irrigants. The apical and middle parts of the specimens were observed by scanning electron microscope.

Statistical Analysis Used: Data were analyzed using the Kruskal-Wallis, Mann-Whitney, and Friedman's test.

Results: Regardless of the type of final irrigant, QMix allowed more smear layer removal than EDTA after using 5% initial NaOCl for 3 min. In the apical part of the root canal walls, the smear layer was not completely removed.

Conclusion: QMix and EDTA were similarly effective in smear layer removal at the middle parts of the root canal regardless of the concentration and time exposure of initial NaOCl, while none of the irrigation protocols was able to remove smear layer at the apical parts.
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December 2017