e-ISSN 2459-1726
Turkish Endodontic Journal (TEJ) - Turk Endod J: 8 (2)
Volume: 8  Issue: 2 - 2023
ORIGINAL RESEARCH
1.Do variations in the concentrations of EDTA and citric acid affect the release of different growth factors from the dentin matrix?
Dilek Hançerlioğulları, Ali Türkyılmaz, Ali Erdemir
doi: 10.14744/TEJ.2023.85570  Pages 43 - 48
Purpose: To investigate the release levels of transforming growth factor beta-1 (TGF-β1), bone morphogenetic protein-7 (BMP-7), insulin-like growth factor-1 (IGF-1), and vascular endothelial growth factor-A (VEGF-A) from the dentin matrix using 10% and 17% ethylenediaminetetraacetic acid (EDTA) and 10% and 20% citric acid during regenerative endodontic procedures.
Methods: Fifty mandibular single-rooted premolar teeth were used. 8-mm cylindrical roots were irrigated with 1.5% sodium hypochlorite. Root segments were divided into groups by 20 mL of final irrigants: saline, 10% or 17% EDTA, and 10% or 20% citric acid. The samples were placed into culture medium and kept in an incubator at 37°C for 24 h. The supernatants were collected to measure the levels of growth factors with an enzyme-linked immunosorbent assay. The data were evaluated using a one-way analysis of variance.
Results: EDTA or citric acid increased the release levels of all growth factors compared to the control group. The greatest amount of TGF-β1 release was measured with 17% EDTA; however, it was not significantly different from 10% citric acid. The lowest amount of BMP-7 released was with 10% citric acid, which was significantly different from the other groups.
Conclusion: The 17% EDTA and 10% citric acid solutions had a similar effect on the release of growth factors from the dentin matrix.

2.Dentists’ awareness and clinical implications of minimally invasive endodontics: A survey study
Elif Çiftçioğlu, Rezan Sungur Güzel, Ceren Cebeci, Çağla Gülhan, Enver Sedat Küçükay
doi: 10.14744/TEJ.2023.29290  Pages 49 - 56
Purpose: Minimally invasive endodontics (MIE) is a contemporary concept aiming to maximize tissue protection without compromising treatment outcomes. This survey study assessed the awareness and implication of MIE among dentists in Turkey.
Methods: A digitally conducted survey was delivered to the dentists electronically. They were enquired about their demographic characteristics, awareness of the MIE and its clinical application; their approach to pulp exposure; access cavity and instrument systems preference; the preparation size and taper choice; and whether they used an additional irrigation protocol and a magnification system. The data were statistically analyzed using Chi-square and Fisher’s exact tests. The statistical significance was set as p < 0.05.
Results: 63.5% were aware of MIE, but only 31.2% applied it routinely. Endodontists’ and less experienced participants’ awareness was significantly higher (p = 0.000). During pulp exposure, in the absence and presence of spontaneous pain, 77.9% chose direct pulp capping and 81.4% root canal treatment, respectively. 56.8% preferred traditional and 42.3% conservative access cavities. The most preferred preparation sizes were #30/0.06, #25/0.06 and #30/0.04 for single-rooted, #25/0.06, and #25/0.04 for multi-rooted teeth. 45.7% activated the irrigant, and 27.5% used a magnification system.
Conclusion: MIE-performing participants more frequently preferred vital pulp therapies, conservative access, and using a loop.

3.YouTube as an information and education source for use of mineral trioxide aggregate in endodontics: Quality and content analysis
Dilek Hançerlioğulları, Ali Türkyılmaz, Sevda Dürüst Barış, Ali Erdemir
doi: 10.14744/TEJ.2023.30602  Pages 57 - 61
Purpose: This study aimed to evaluate the content and educational quality of videos on YouTube about mineral trioxide aggregate (MTA) in endodontics.
Methods: YouTube (https: //www.youtube.com/) was searched for videos using the search term “endodontics, MTA,” which was determined using Google Trends. The video contents were analyzed under three categories (etiology, procedure, and prognosis) and the Global Quality Score (GQS). The descriptive statistics were evaluated, and the statistical analyses included Fleiss Kappa, Kruskal-Wallis, and Tamhane’s T2 test.
Results: The total number of videos, 67.5% were uploaded by specialists. The content completeness was significantly different among the uploaders (4.2±1.69). The highest mean GQS was found for videos published by specialists (4.03±1.09). The videos generally shared content about furcation perforation repair, management of teeth with open apex and apical plug technique, and product presentations.
Conclusion: Specialists should post more videos focused on information about MTA in root canal treatment and regenerative endodontics.

4.The effect of different retreatment systems and root canal sealers on the fracture resistance of endodontically retreated samples: A laboratory study
Nevran Derinler, Burcu Ateş, Berfu Polat, Deniz Bender, Emel Uzunoğlu Özyürek
doi: 10.14744/TEJ.2023.50479  Pages 62 - 68
Considering previous literature, it has been thought that different file motions and root canal sealers used during retreatment may affect the fracture resistance of the endodontically retreated teeth. This study aims to compare the fracture resistance values of retreated teeth with two different file systems and re-obturated with gutta-percha and different sealers. Sixty extracted lower premolars were prepared up to ProTaper Universal-F4 (PTU) and filled with resin-based sealer (RBS) and gutta-percha. Thirty teeth were re-prepared with PTU retreatment files and ProTaper Universal-F5. The remaining 30 teeth were re-prepared with Reciproc-50 files. Fifteen teeth from each group were filled with RBS, or calcium
silicate-based root canal sealer (CSBS), and F5 or R50 gutta-percha. After the setting of filling materials, a fracture test was performed. Data were analyzed with a two-way ANOVA and chi-square test (p < 0.05). There was no significant difference among the groups (p > 0.05). The lowest mean was observed in the PTU-CSBS group (277.80 ± 105.47 N), and the highest mean was observed in the PTU-RBS group (335.05 ± 121.05 N). A buccolingual irreparable fracture was common in all groups (p < 0.05). Specimens retreated either with rotational or reciprocating files could be re-obturated with a combination of guttapercha and RBS or CSBS.

5.An in vitro evaluation of the effect of intracoronal bleaching in teeth discolored by triple-antibiotic paste
Gülşah Yenier Yurdagüven
doi: 10.14744/TEJ.2023.96268  Pages 69 - 76
Purpose: The purpose of the study is to evaluate the effect of intracoronal bleaching agents (IBA) on discolored teeth with triple-antibiotic paste (TAP).
Methods: Twenty-six extracted maxillary incisors were discolored for 3 weeks with TAP, containing metronidazole, ciprofloxacin, and doxycycline. Following CIE L*a*b* system, colors were measured at baseline and at 1, 2, and 3 weeks. Specimens, bleached intracoronally, were randomly divided into two groups (n = 13): 35% hydrogen peroxide (HP) and 37% carbamide peroxide (CP). Color changes (ΔE) were based on the spectrophotometric measurements at baseline, 3rd, 6th, and 9th days and analyzed using analysis of variance, Bonferroni, and Student t-tests (p < 0.05).
Results: The discoloration increased from baseline to week 3 with significant difference (p < 0.05). The highest ΔE value was observed at week 3 (16.54 ± 5.90). In HP, there was no significant difference on the 6th day compared to the 3rd day (p > 0.05) but a significant difference on the 9th day (p < 0.05). In CP, ΔE was not statistically different among evaluated days. On day 9, HP had a significantly higher ΔE than CP (p = 0.032).
Conclusion: TAP caused clinically unacceptable ΔE, increasing over time (ΔE ≥ 3.3). IBA was found effective on discolored teeth. 35% HP was more effective than CP on the 9th day.

6.Research trends on bioceramics in endodontics: A bibliometric analysis from 2001 to 2020
Sıla Nur Usta, Pilar Valderrama-Baca, Maria Teresa Arias-Moliz
doi: 10.14744/TEJ.2023.53825  Pages 77 - 86
Purpose: This study aimed to identify the top 100 articles about bioceramics in endodontics using the average number of citations per year (A/Y) metric and compare them with the top 100 most-cited articles.
Methods: A detailed search strategy was conducted on the “Clarivate Analytics Web of Science, All Databases”. After ranking the articles in descending order based on their A/Y and citation counts, 100 articles of each list were selected and analyzed concerning publication year, journals, country, institution, authors, study design, the field of study, evidence level, and keywords.
Results: The number of citations in 2001–2010 was significantly higher (p < 0.05). Journal of Endodontics, the United States, and the University of Bologna were the most productive journal, country, and institution. The most frequent first authors were Camilleri and Torabinejad. The main study fields and most used keywords were ‘material properties’ and ‘Silicates’.
Conclusion: The A/Y metric has allowed identifying fairly-recent influential articles about bioceramics; therefore, it could be used as a valid alternative. Future developments in the material properties of bioceramics could lead to the effective use of these materials for various endodontic treatments. Recent research trends implicating innovative materials or techniques might raise new interest areas regarding this field.

SYSTEMATIC REVIEW & META ANALYSIS
7.Research trends regarding chemomechanical preparation and obturation of root canals in the Science Citation Indexed Endodontics Journals: Bibliometric analysis of 2001–2005 and 2016–2020
Nilay Ezentaş, Emel Uzunoğlu Özyürek
doi: 10.14744/TEJ.2023.72473  Pages 87 - 96
Purpose: Articles published in the Australian Endodontic Journal, Journal of Endodontics, and International Endodontic Journal were analyzed in two different periods.
Methods: Articles published in two different 5-year periods, 2001–2005 and 2016–2020, on the issues mentioned above the journals were evaluated by two researchers. The extracted parameters were the first author’s country, number of authors, national and international cooperation, type of study, number of citations, first author’s department and study topics. They were analyzed with the Chi-square independence test over the years.
Results: Mechanical preparation studies increased, while obturation studies decreased in the second period (p = 0.000). An increase was observed regarding authors’ number and national/international cooperation (p = 0.000). In vitro studies were significantly higher than clinical studies and animal experiments in both periods (p = 0.003). An increase was found in studies evaluating files’ root fracture formation (p = 0.000), apical debris extrusion (p = 0.000), and irrigation activation devices/methods (p = 0.005) in 2016–2020. Studies on microleakage lost their popularity in 2016–2020 (p = 0.000). An increase was also observed in clinical and radiographic follow-up studies after root canal treatment in 2016–2020 (p = 0.001).
Conclusion: Research topics change with technological, mechanical, physical, and biological developments, and researchers need to keep up to date with these changes to increase their chances of study acceptance.

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