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Aslan T, Esim E, Üstün Y. Finite element evaluation of dentin stress changes following different endodontic surgical approaches. Odontology 2024:10.1007/s10266-023-00882-1. [PMID: 38184512 DOI: 10.1007/s10266-023-00882-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 12/04/2023] [Indexed: 01/08/2024]
Abstract
The aim was to compare the effect of different endodontic surgical treatments on the stress distributions in dentin of a simulated first mandibular molar tooth using the finite element analysis method. Three surgical endodontic procedures (apical resection, root amputation, and hemisection) were simulated in a first mandibular molar. Biodentine or mineral-trioxide-aggregate was used to repair the surgery site in apical resection and root amputation models; the remaining root canal spaces were filled with gutta-percha. Access cavities were restored using resin composite. In hemisection model, root canal was filled with gutta-percha, and coronal restoration was finished with a monolithic zirconia crown. A sound tooth model was created as a control model. An oblique force of 300 N angled at 45° to the occlusal plane was simulated. Maximum von Mises stresses were evaluated in dentin near the surgery regions and the entire tooth. Apical resection/Biodentine and apical resection/mineral-trioxide-aggregate models generated maximum von Mises stresses of 39.001 MPa and 39.106 MPa, respectively. The recorded maximum von Mises stresses in root amputation models were 66.491 MPa for root amputation/Biodentine and 73.063 MPa for root amputation/mineral-trioxide-aggregate models. The highest maximum von Mises stress value among all models was observed in the hemisection model, measuring 138.87 MPa. Hemisection induced the highest von Mises stresses in dentin, followed by root amputation and apical resection. In apical resection, Biodentine and mineral-trioxide-aggregate did not show a significant difference in stress distribution. Biodentine in root amputation may lead to lower stresses compared to mineral-trioxide-aggregate.
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Affiliation(s)
- Tuğrul Aslan
- Department of Endodontics, Faculty of Dentistry, Erciyes University, Turhan Baytop Street, No. 1, Yenidoğan District, Talas, Kayseri, 38280, Turkey.
| | - Emir Esim
- Department of Mechatronics Engineering, Faculty of Engineering, Erciyes University, Kayseri, Turkey
| | - Yakup Üstün
- Department of Endodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
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Sairaman S, Solete P, Jeevanandan G, Antony SDP, Kavoor S, Adimulapu HS. Comparative analysis of novel heat-treated retreatment file system on the removal of obturating material using nano-computed tomography. JOURNAL OF CONSERVATIVE DENTISTRY AND ENDODONTICS 2024; 27:82-86. [PMID: 38389750 PMCID: PMC10880466 DOI: 10.4103/jcde.jcde_224_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 11/01/2023] [Accepted: 11/04/2023] [Indexed: 02/24/2024]
Abstract
Introduction The aim of nonsurgical retreatment is to remove the previous filling material followed by chemo-mechanical preparation of the canal to achieve proper disinfection of the root canal system. This is then followed by re-obturation. This study evaluates the time taken to retrieve the gutta-percha and the quantity of remaining filling material after retreatment with two different file systems. The quantity of remaining filling material was assessed using nano-computed tomography (CT) due to its increased accuracy. Materials and Methods Forty extracted single-rooted teeth were split into two groups at random and decoronated and obturated at a standard root length of 16 mm. Solite RS3 (SRS-3) Retreatment and ProTaper Universal Retreatment (PTUR) systems were used to retrieve the gutta-percha after a preoperative nano-CT scan. Postoperative nano-CT scan was taken and both the scans were superimposed to quantify the remaining filling material. The time taken to remove gutta-percha was measured using a stopwatch. The statistical analysis comparing the two groups was conducted using the independent t-test. Results The quantitative analysis of remaining filling material using nano-CT showed no statistical difference between both the file systems used (P > 0.05). However, SRS-3 took significantly less time in the removal of gutta-percha (P < 0.05). Conclusion Hence, we can conclude that there is no significant difference in the amount of remaining filling material between both the file systems. However, time taken to remove the gutta-percha was lesser in SRS-3 compared to PTUR file system.
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Affiliation(s)
- Sruthi Sairaman
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Pradeep Solete
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Ganesh Jeevanandan
- Department of Pediatric and Preventive Dentistry, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - S. Delphine Priscilla Antony
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Sowmya Kavoor
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Hima Sandeep Adimulapu
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
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Lin F, Feng X, Ordinola-Zapata R, VanHeel B, Fok ASL. Load capacity and fracture modes of instrumented tooth roots under axial compression. Dent Mater 2023; 39:938-945. [PMID: 37648562 DOI: 10.1016/j.dental.2023.08.177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 08/23/2023] [Indexed: 09/01/2023]
Abstract
OBJECTIVE To investigate the influences of root canal instrumentation on the load capacity and fracture modes of tooth roots under axial compression by performing mechanical tests and finite element analysis (FEA). METHODS Thirty bovine incisor roots were trimmed into cylinders of 5.0 mm diameter. They were randomly divided into two groups, one with root canals instrumented to ∼2.0 mm in diameter, and one without instrumentation. The specimens were fractured under uniaxial compression at a crosshead speed of 0.2 mm/min, and then micro-CT was used to reveal the fracture patterns in three dimensions. FEA was further performed, using the extended finite element method (XFEM), to compare the compression-induced stress distributions and the initiation and propagation of root fractures in both groups. RESULTS The mean fracture load of the non-instrumented group (2334 ± 436 N) was statistically significantly higher than that of the instrumented group (1857 ± 377 N) (p < 0.01). Three types of root fractures were identified according to the path and length of the cracks: end-face crack, partial-length crack, and full-length crack. As to the fracture modes, the incidence of partial-length root fracture was the highest in both groups (60% for the non-instrumented group and 53.3% for the instrumented group), followed by that of full-length fracture (26.7% and 40%, respectively) and then end-face fracture (13.3% and 6.7%, respectively). The percentage of full-length fracture was slightly higher in the instrumented group. FEA showed that the compression induced higher Tresca stresses but lower maximum principal stresses in the canal walls of the instrumented group. The XFEM simulations predicted that the fracture of both groups initiated from the outer root surface near an end face and propagated axially to the middle third of the root and radially towards the root canal. These numerical results agreed well with our experimental findings. SIGNIFICANCE Within the limitation of this study, it was found that root canal instrumentation could significantly decrease the load capacity of tooth roots and potentially increase their susceptibility to full-length root fracture under uniaxial compression.
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Affiliation(s)
- Fei Lin
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China
| | - Xiqiao Feng
- Institute of Biomechanics and Medical Engineering, Department of Engineering Mechanics, Tsinghua University, Beijing 100084, China
| | - Ronald Ordinola-Zapata
- Division of Endodontics, Department of Restorative Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN 55455, USA
| | - Bonita VanHeel
- Minnesota Dental Research Center for Biomaterials and Biomechanics, School of Dentistry, University of Minnesota, Minneapolis, MN 55455, USA
| | - Alex S L Fok
- Minnesota Dental Research Center for Biomaterials and Biomechanics, School of Dentistry, University of Minnesota, Minneapolis, MN 55455, USA.
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Haupt F, Dullin C, Krebs M, Hettwer-Steeger I, Kanzow P, Rödig T. Micro-CT evaluation of frozen and embalmed human cadavers on the effect of root canal preparation on microcrack formation in old dentin. PLoS One 2023; 18:e0281124. [PMID: 36716302 PMCID: PMC9886256 DOI: 10.1371/journal.pone.0281124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 01/13/2023] [Indexed: 02/01/2023] Open
Abstract
The aim of this study was to evaluate the existence of preoperative dentinal defects among differently preserved dentoalveolar bone-blocks (frozen vs. embalmed) and to investigate the effect of varying apical forces (low: <4 N, high: 4-8 N) during root canal preparation on microcrack formation using micro-computed tomography (micro-CT). Thirteen embalmed and seven frozen bone-blocks containing 1-3 single rooted teeth were collected. The teeth were evenly divided into three groups (n = 10): FLow (frozen, <4 N), ELow (embalmed, <4 N), EHigh (embalmed, 4-8 N). After working length determination all specimens were scanned preoperatively. Root canal preparation was performed using nickel-titanium instruments sizes 25/.06 and 40/.06 (F6 SkyTaper; Komet, Lemgo, Germany). A postoperative scan was performed and image stacks were co-registered. All cross-sectional images were screened to identify the presence of dentinal defects. The results were expressed as the percentage of teeth/slices presenting dentinal defects. The statistical analyses were performed with Kruskal-Wallis-Test and Mann-Whitney-U-Test (α = 5%). Embalmed specimens presented a significantly higher percentage of slices with preoperative microcracks (p<0.05) than frozen specimens. No significant difference between groups was observed regarding the induction of microcracks (p>0.05). Root canal preparation does not induce microcracks in dentoalveolar bone-blocks from donors of old age, irrespective of the preservation method and the apically directed forces.
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Affiliation(s)
- Franziska Haupt
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
- * E-mail:
| | - Christian Dullin
- Department of Diagnostic and Interventional Radiology, University Medical Center Göttingen, Göttingen, Germany
| | - Marcel Krebs
- Department of Pathology, University Medical Center Göttingen, Göttingen, Germany
| | | | - Philipp Kanzow
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
| | - Tina Rödig
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
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Çiftçioğlu E, Keleş A, Akbal Dinçer G, Ateş MO, Küçükay ES. Shaping ability of WaveOne Gold and OneReci by using two apical sizes: a micro-computed tomographic assessment. PeerJ 2023; 11:e15208. [PMID: 37131992 PMCID: PMC10149051 DOI: 10.7717/peerj.15208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 03/19/2023] [Indexed: 05/04/2023] Open
Abstract
Backround OneReci (MicroMega, Besançon, France) is a recently introduced single-file reciprocating system with scarce information revealed on its shaping ability. This study aimed to compare the shaping abilities of OneReci and a well-documented single-file reciprocating system WaveOne Gold (WOG; Dentsply Maillefer, Ballaigues, Switzerland) and evaluate the effect of increased apical enlargement on the preparation quality, using micro-computed tomography (micro-CT). Methods After an initial micro-CT scanning, twenty mesial root canals of mandibular molars were anatomically matched. The canals were assigned to two experimental groups (n = 10), using OneReci or WOG in different canals of the same root. The glide paths were created, and root canals were prepared twice, using size 25 and 35 instruments of the systems, respectively. The specimens were scanned with micro-CT after each preparation. The increase in canal volume, amount of dentin removal, unprepared root canal surface, canal transportation, centering ratio and preparation times were assessed. The data were analysed with independent sample t-tests, variance analyses, Friedman and Mann-Whitney U tests. The significance level was set at 5%. Results Each preparation increased the canal volume and dentin removal while decreasing the unprepared root surface. The difference between the systems became significant after preparation with size 35 instruments (p < 0.05). Regarding canal transportation and centering ratio, the difference was insignificant (p > 0.05). The first preparation step (glide path + size 25 instrument) was significantly faster in the OneReci group (p < 0.05). Conclusions Preparation with size 25 instruments of the systems appeared to be safe with similar shaping performances. Larger apical preparation promoted significantly higher dentin removal, volume increase, and prepared surface area in WOG.
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Affiliation(s)
| | - Ali Keleş
- Abant Izzet Baysal University, Bolu, Turkey
- Ondokuz Mayis University, Samsun, Turkey
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Dorado S, Arias A, Jimenez-Octavio JR. Biomechanical Modelling for Tooth Survival Studies: Mechanical Properties, Loads and Boundary Conditions-A Narrative Review. MATERIALS (BASEL, SWITZERLAND) 2022; 15:7852. [PMID: 36363451 PMCID: PMC9657341 DOI: 10.3390/ma15217852] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 11/02/2022] [Accepted: 11/04/2022] [Indexed: 06/16/2023]
Abstract
Recent biomechanical studies have focused on studying the response of teeth before and after different treatments under functional and parafunctional loads. These studies often involve experimental and/or finite element analysis (FEA). Current loading and boundary conditions may not entirely represent the real condition of the tooth in clinical situations. The importance of homogenizing both sample characterization and boundary conditions definition for future dental biomechanical studies is highlighted. The mechanical properties of dental structural tissues are presented, along with the effect of functional and parafunctional loads and other environmental and biological parameters that may influence tooth survival. A range of values for Young's modulus, Poisson ratio, compressive strength, threshold stress intensity factor and fracture toughness are provided for enamel and dentin; as well as Young's modulus and Poisson ratio for the PDL, trabecular and cortical bone. Angles, loading magnitude and frequency are provided for functional and parafunctional loads. The environmental and physiological conditions (age, gender, tooth, humidity, etc.), that may influence tooth survival are also discussed. Oversimplifications of biomechanical models could end up in results that divert from the natural behavior of teeth. Experimental validation models with close-to-reality boundary conditions should be developed to compare the validity of simplified models.
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Affiliation(s)
- Saúl Dorado
- Department of Mechanical Engineering, Escuela Técnica Superior de Ingeniería ICAI, Universidad Pontificia Comillas, 28015 Madrid, Spain
| | - Ana Arias
- Department of Conservative and Prosthetic Dentistry, School of Dentistry, Complutense University, 28040 Madrid, Spain
| | - Jesus R. Jimenez-Octavio
- Instituto de Investigación Tecnológica, Escuela Técnica Superior de Ingeniería ICAI, Universidad Pontificia Comillas, 28015 Madrid, Spain
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Marvaniya J, Agarwal K, Mehta DN, Parmar N, Shyamal R, Patel J. Minimal Invasive Endodontics: A Comprehensive Narrative Review. Cureus 2022; 14:e25984. [PMID: 35859953 PMCID: PMC9287844 DOI: 10.7759/cureus.25984] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 06/14/2022] [Indexed: 11/29/2022] Open
Abstract
It is the aim of any surgical procedure to restore the tooth to its normal form and function, as well as to restore the tooth's appearance when it is appropriate to do so. One of the primary purposes of endodontic therapy is to clear out the root canal system of germs, pulpal remains, and other foreign matter. A tooth's biomechanical properties have to be compromised in order to achieve this goal; hence the tooth has a poor prognosis for restorative success. The remaining dental structure and restorations have a significant impact on the long-term viability of an endodontically treated tooth. Minimally invasive endodontics (MIE) is an endodontic technique that aims to maintain as much of the healthy coronal, cervical, and radicular tooth structure as possible. Access opening, root canal cleaning and shaping, and surgical endodontics are all possible applications for MIE in endodontic treatment. The objective of new-age endodontics is minimum intervention, and this review article examines a variety of methods that may be combined at each level of endodontics to reach this goal. A favorable outcome with minimally invasive treatment may be achieved while preserving the tooth's natural structure with careful case selection.
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Neelakantan P, Vishwanath V, Taschieri S, Corbella S. Present status and future directions ‐ Minimally invasive root canal preparation and periradicular surgery. Int Endod J 2022; 55 Suppl 4:845-871. [DOI: 10.1111/iej.13750] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 04/06/2022] [Accepted: 04/11/2022] [Indexed: 11/30/2022]
Affiliation(s)
- P. Neelakantan
- Faculty of Dentistry The University of Hong Kong Hong Kong SAR
| | - V. Vishwanath
- Faculty of Dentistry The University of Hong Kong Hong Kong SAR
| | - S. Taschieri
- Department of Biomedical Surgical and Dental Sciences Università degli Studi di Milano Milan Italy
- IRCCS Istituto Ortopedico Galeazzi Milan Italy
- Department of Oral Surgery Institute of Dentistry I. M. Sechenov First Moscow State Medical University Moscow Russia
| | - S. Corbella
- Department of Biomedical Surgical and Dental Sciences Università degli Studi di Milano Milan Italy
- IRCCS Istituto Ortopedico Galeazzi Milan Italy
- Department of Oral Surgery Institute of Dentistry I. M. Sechenov First Moscow State Medical University Moscow Russia
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Patel S, Bhuva B, Bose R. Vertical root fractures in root treated teeth-current status and future trends. Int Endod J 2022; 55 Suppl 3:804-826. [PMID: 35338655 PMCID: PMC9324143 DOI: 10.1111/iej.13737] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/22/2022] [Accepted: 03/23/2022] [Indexed: 11/28/2022]
Abstract
Vertical root fracture (VRF) is a common reason for the extraction of root filled teeth. The accurate diagnosis of VRF may be challenging due to the absence of clinical signs, whilst conventional radiographic assessment is often inconclusive. However, an understanding of the aetiology of VRFs, and more importantly, the key predisposing factors, is crucial in identifying teeth that may be susceptible. Thorough clinical examination with magnification and co-axial lighting is essential in identifying VRFs, and although CBCT is unable to reliably detect VRFs per se, the pattern of bone loss typically associated with VRF can be fully appreciated, and therefore, increases the probability of correct diagnosis and management. The prevalence of VRFs in root filled teeth is significantly greater than in teeth with vital pulps, demonstrating that the combination of loss of structural integrity, presence of pre-existing fractures and biochemical effects of loss of vitality, are highly relevant. Careful assessment of the occlusal scheme, presence of deflective contacts and identification of parafunctional habits is imperative in both preventing and managing VRFs. Furthermore, anatomical factors such as root canal morphology, may predispose certain teeth to VRF. The influence of access cavity design and root canal instrumentation protocols should be considered although the impact of these on the fracture resistance of root filled teeth is not clearly validated. The post-endodontic restoration of root filled teeth should be expedient and considerate to the residual tooth structure. Posts should be placed 'passively' and excessive 'post-space' preparation should be avoided. This narrative review aims to present the aetiology, potential predisposing factors, histopathology, diagnosis and management of VRF and present perspectives for future research. Currently, there are limited options other than extraction for the management of VRF, although root resection may be considered in multi-rooted teeth. Innovative techniques to 'repair' VRFs using both orthograde and surgical approaches require further research and validation. The prevention of VRFs is critical; identifying susceptible teeth, utilizing conservative endodontic procedures, together with expedient and appropriate post-endodontic restorative procedures is paramount to reducing the incidence of terminal VRFs.
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Affiliation(s)
- Shanon Patel
- Department of Endodontology, King's College London Dental Institute, London, UK.,Specialist Practice, London, UK
| | - Bhavin Bhuva
- Department of Endodontology, King's College London Dental Institute, London, UK
| | - Raul Bose
- Department of Endodontology, King's College London Dental Institute, London, UK
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Santos TDSA, Abu Hasna A, Abreu RT, Tribst JPM, de Andrade GS, Borges ALS, Torres CRG, Carvalho CAT. Fracture resistance and stress distribution of weakened teeth reinforced with a bundled glass fiber-reinforced resin post. Clin Oral Investig 2022; 26:1725-1735. [PMID: 34435252 DOI: 10.1007/s00784-021-04148-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 08/14/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To make an in vitro assessment of fracture resistance of weakened and non-weakened teeth receiving intraradicular reinforcement using Rebilda bundled glass fiber-reinforced composite posts (GT), Rebilda conventional glass fiber posts (RP), or both systems combined (GT + RP). MATERIALS AND METHODS Eighty sound bovine incisors were prepared and divided randomly into eight groups as follows: (a) nWnR: without simulating weakness, and without intraradicular reinforcement; (b) WnR: simulating weakness, but without intraradicular reinforcement; (c) nWGT: without simulating weakness, but with GT; (d) WGT: simulating weakness, and with GT; (e) nWRP: without simulating weakness, but with RP; (f) WRP: simulating weakness, and with RP; (g) nWGTRP: without simulating weakness, but with GT + RP; (h) WGTRP: simulating weakness, and with GT + RP. The specimens were subjected to the load-to-fracture test using the DL-2000MF universal testing machine. The finite element method assessed the mechanical behavior and stress distribution in endodontically treated teeth. RESULTS The groups nWGTRP and WGTRP presented the best results in the load-to-fracture test, with the former being better than the latter, but with no statistically significant difference (P > 0.05). However, there was a significant difference between these and the other groups (P < 0.05), except for nWRP. Stress distribution inside the canal wall was different among the groups, with promising mechanical behavior for nWGTRP and nWRP. CONCLUSIONS The Rebilda conventional fiber post (RP), combined with the Rebilda bundled glass fiber-reinforced composite post (GT) improves the resistance and stress distribution of immature teeth. CLINICAL RELEVANCE Longitudinal fracture is less frequent in teeth restored with GT and RP posts.
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Affiliation(s)
- Thaís da Silva Alves Santos
- Department of Restorative Dentistry, Endodontics Division, Institute of Science and Technology, São Paulo State University (UNESP), Av. Francisco José Longo 777, São Dimas, São José dos Campos, SP, 12245-000, Brazil
| | - Amjad Abu Hasna
- Department of Restorative Dentistry, Endodontics Division, Institute of Science and Technology, São Paulo State University (UNESP), Av. Francisco José Longo 777, São Dimas, São José dos Campos, SP, 12245-000, Brazil.
| | - Ricardo Toledo Abreu
- Department of Restorative Dentistry, Endodontics Division, Institute of Science and Technology, São Paulo State University (UNESP), Av. Francisco José Longo 777, São Dimas, São José dos Campos, SP, 12245-000, Brazil
| | - João Paulo Mendes Tribst
- Department of Dental Materials and Prosthodontics, Institute of Science and Technology, São Paulo State University (UNESP), São José dos Campos, Brazil
| | - Guilherme Schmitt de Andrade
- Department of Dental Materials and Prosthodontics, Institute of Science and Technology, São Paulo State University (UNESP), São José dos Campos, Brazil
| | - Alexandre Luiz Souto Borges
- Department of Dental Materials and Prosthodontics, Institute of Science and Technology, São Paulo State University (UNESP), São José dos Campos, Brazil
| | - Carlos Rocha Gomes Torres
- Department of Restorative Dentistry, Operative Dentistry Division, Institute of Science and Technology, São Paulo State University (UNESP), São José dos Campos, Brazil
| | - Cláudio Antonio Talge Carvalho
- Department of Restorative Dentistry, Endodontics Division, Institute of Science and Technology, São Paulo State University (UNESP), Av. Francisco José Longo 777, São Dimas, São José dos Campos, SP, 12245-000, Brazil
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Haupt F, Riggers I, Konietschke F, Rödig T. Effectiveness of different fiber post removal techniques and their influence on dentinal microcrack formation. Clin Oral Investig 2021; 26:3679-3685. [PMID: 34893941 PMCID: PMC8979865 DOI: 10.1007/s00784-021-04338-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 12/06/2021] [Indexed: 10/31/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the effectiveness of different fiber post removal techniques and to correlate dentinal loss with microcrack formation. MATERIALS AND METHODS Forty-five extracted single-rooted teeth were root canal treated and fiber posts were adhesively luted. Specimens were divided into three groups (n = 15) according to the removal technique: long-shaft round bur (EndoTracer #08, Komet, Lemgo, Germany), SonicFlex Endo (KaVo, Biberach, Germany), DT Post Removal Kit (VDW, Munich, Germany). Roots were scanned before post cementation and after post removal using micro-computed tomography. Dentin loss, residual luting material, working time, and the induction of microcracks were assessed. Statistical analysis was performed by using multiple contrast tests (max-t tests, α = 0.05). Correlations between parameters dentin loss/new microcracks and dentin loss/residual material were calculated using Kendall's tau. RESULTS Post removal with SonicFlex Endo resulted in the highest amount of removed dentin with significant differences to the round bur and the DT Post Removal Kit. No technique was found to completely remove the post and luting material. All techniques induced microcracks with the DT Post Removal Kit presenting the highest number of new defects. No correlation between dentin loss and new microcracks was observed. Deviations from the original root canal occurred in all groups, but no perforation was observed. CONCLUSIONS All techniques resulted in dentin loss, residual luting material, and the formation of microcracks. However, no correlation between dentin loss and the induction of microcracks was observed. CLINICAL RELEVANCE As all techniques resulted in microcrack formation and dentin loss, this study emphasizes the risk of iatrogenic damage due to post removal procedures.
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Affiliation(s)
- Franziska Haupt
- Department for Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany.
| | - Insa Riggers
- Department for Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany
| | - Frank Konietschke
- Charité - University Medical Center Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Berlin, and Berlin Institute of Health, Institute of Biometry and Clinical Epidemiology, Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany
| | - Tina Rödig
- Department for Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany
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Gonzalez CS, Estevez R, Loroño G, García VDF, Caballero Montes JA, Rossi-Fedele G, Cisneros R. Etidronic acid and ethylenediaminetetraacetic acid associated with sodium hypochlorite have limited effect on the compressive fracture resistance of roots ex vivo. J Conserv Dent 2021; 23:484-488. [PMID: 33911358 PMCID: PMC8066680 DOI: 10.4103/jcd.jcd_527_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 11/20/2020] [Accepted: 12/06/2020] [Indexed: 12/04/2022] Open
Abstract
Aims: To assess the effect of etidronic acid (EA) mixed with sodium hypochlorite (NaOCl) and two ethylenediaminetetraacetic acid-containing preparations (EDTA and SmearClear) alternated with NaOCl, as a final rinse, on root fracture resistance to a compressive force. Materials and Methods: Seventy-two premolar roots were randomly allocated to the following groups according to the irrigant solutions. For the EA group, 9% EA + 2.5% NaOCl were used throughout the assays (n = 21). The remaining groups received 2.5% NaOCl during and immediately after chemo-mechanical instrumentation. Intermediately, the roots received 17% EDTA (n = 19), or SmearClear (n = 16), or no irrigation (control) (n = 16) plus a final rinse with 2.5% NaOCl. The specimens were subjected to a vertical compressive force loaded at a crosshead speed of 0.02 mm/s parallel to the long axis of the root until fracture occurred. The results were compared statistically using the one-way analysis of variance for intergroup comparisons. Results: The negative control presented with the highest values, whereas the SmearClear presented with the lowest values, though no significant differences were found when comparing the different groups (P = 0.82). Conclusions: The use of EA + NaOCl or two EDTA formulations in association with NaOCl does not affect the fracture resistance of previously chemo-mechanically prepared roots.
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Affiliation(s)
| | - Roberto Estevez
- Endodontic Unit, Engineering and Design, European University of Madrid, Madrid, Spain
| | - Gaizka Loroño
- Endodontic Unit, Engineering and Design, European University of Madrid, Madrid, Spain
| | | | | | - Giampiero Rossi-Fedele
- Endodontic Unit, Adelaide Dental School, The University of Adelaide, Adelaide, Australia
| | - Rafael Cisneros
- Endodontic Unit, Engineering and Design, European University of Madrid, Madrid, Spain
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Babich O, Sukhikh S, Pungin A, Ivanova S, Asyakina L, Prosekov A. Modern Trends in the In Vitro Production and Use of Callus, Suspension Cells and Root Cultures of Medicinal Plants. Molecules 2020; 25:molecules25245805. [PMID: 33316965 PMCID: PMC7763305 DOI: 10.3390/molecules25245805] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 12/05/2020] [Accepted: 12/07/2020] [Indexed: 02/06/2023] Open
Abstract
This paper studies modern methods of producing and using callus, suspension cells and root cultures of medicinal plants in vitro. A new solution for natural product production is the use of an alternative source of renewable, environmentally friendly raw materials: callus, suspension and root cultures of higher plants in vitro. The possibility of using hairy root cultures as producers of various biologically active substances is studied. It is proven that the application of the genetic engineering achievements that combine in vitro tissue culture and molecular biology methods was groundbreaking in terms of the intensification of the extraction process of compounds significant for the medical industry. It is established that of all the callus processing methods, suspension and root cultures in vitro, the Agrobacterium method is the most widely used in practice. The use of agrobacteria has advantages over the biolistic method since it increases the proportion of stable transformation events, can deliver large DNA segments and does not require special ballistic devices. As a result of the research, the most effective strains of agrobacteria are identified.
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Affiliation(s)
- Olga Babich
- Institute of Living Systems, Immanuel Kant Baltic Federal University, A. Nevskogo Street 14, 236016 Kaliningrad, Russia; (O.B.); (S.S.); (A.P.)
| | - Stanislav Sukhikh
- Institute of Living Systems, Immanuel Kant Baltic Federal University, A. Nevskogo Street 14, 236016 Kaliningrad, Russia; (O.B.); (S.S.); (A.P.)
- Department of Bionanotechnology, Kemerovo State University, Krasnaya Street 6, 650043 Kemerovo, Russia;
| | - Artem Pungin
- Institute of Living Systems, Immanuel Kant Baltic Federal University, A. Nevskogo Street 14, 236016 Kaliningrad, Russia; (O.B.); (S.S.); (A.P.)
| | - Svetlana Ivanova
- Natural Nutraceutical Biotesting Laboratory, Kemerovo State University, Krasnaya Street 6, 650043 Kemerovo, Russia
- Department of General Mathematics and Informatics, Kemerovo State University, Krasnaya Street 6, 650043 Kemerovo, Russia
- Correspondence: ; Tel.: +7-384-239-6832
| | - Lyudmila Asyakina
- Department of Bionanotechnology, Kemerovo State University, Krasnaya Street 6, 650043 Kemerovo, Russia;
| | - Alexander Prosekov
- Laboratory of Biocatalysis, Kemerovo State University, Krasnaya Street 6, 650043 Kemerovo, Russia;
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von Arx T, Maldonado P, Bornstein MM. Occurrence of Vertical Root Fractures after Apical Surgery: A Retrospective Analysis. J Endod 2020; 47:239-246. [PMID: 33098890 DOI: 10.1016/j.joen.2020.10.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 09/23/2020] [Accepted: 10/13/2020] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Vertical root fractures (VRFs) are among the most frequent causes of tooth loss, mainly of endodontically treated teeth. However, very few data is available about the occurrence of VRFs following apical surgery. METHODS Patient charts from 864 patients with 1058 teeth treated with apical surgery (September 1999 to December 2018) were retrospectively evaluated, if a VRF had occurred after surgery. The following, possibly influencing factors were analyzed: sex and age, type of treated tooth, primary versus resurgery, technique of root-end preparation, and timepoint of VRF diagnosis. Endpoints were either tooth extraction or the last follow-up. RESULTS The study cohort (55% women, 45% men) had a mean age of 52.00 ± 13.97 years (range 9-93 years). The overall rate of VRFs after apical surgery was 4% (42 of 1058 teeth). Among these 42 teeth, 33.3% were mandibular first molars and 26.2% were maxillary second premolars. The most frequently affected root was the mesial root of mandibular first molars (28.6%). With regard to the study parameters, significant differences of VRF rates were observed only for the type of tooth treated. CONCLUSIONS A low VRF rate of 4% was observed in this study. VRFs commonly occurred in maxillary premolars and mandibular molars, with the mesial root of mandibular first molars affected most frequently. This is in line with previous reports about VRFs in endodontically treated teeth without additional apical surgery.
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Affiliation(s)
- Thomas von Arx
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland.
| | - Paola Maldonado
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Michael M Bornstein
- Department of Oral Health and Medicine, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
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Wright PP, Scott S, Shetty S, Kahler B, Walsh LJ. Resistance to compressive force in continuous chelation. AUST ENDOD J 2020; 47:150-156. [PMID: 32902070 DOI: 10.1111/aej.12440] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 07/13/2020] [Accepted: 08/07/2020] [Indexed: 11/28/2022]
Abstract
Continuous chelation involves the simultaneous use of sodium hypochlorite and a chelating agent. Given the combination of a proteolytic agent and a demineralising chelator, this study aimed to investigate whether mixtures containing the weak chelators etidronate or clodronate and sodium hypochlorite could adversely affect the mechanical strength of teeth compared to the sequence sodium hypochlorite/EDTA/sodium hypochlorite. Matching pairs of bovine teeth were tested on a universal testing machine, and the compressive load at fracture was recorded. One root from each pair was prepared with the sequence, and the matching tooth was prepared with either water, the clodronate mixture or the etidronate mixture. No differences in load at fracture were seen between either mixture and the sequence. However, loads were higher in the teeth irrigated with water compared to the sequence. The results indicated that the continuous chelation mixtures did not alter tooth mechanical properties compared to the standard sequence.
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Affiliation(s)
- Patricia P Wright
- School of Dentistry, University of Queensland, Herston, QLD, Australia
| | - Suzanne Scott
- Australian e-Health Research Centre, CSIRO, North Ryde, NSW, Australia
| | - Sowmya Shetty
- School of Dentistry, University of Queensland, Herston, QLD, Australia
| | - Bill Kahler
- School of Dentistry, University of Queensland, Herston, QLD, Australia
| | - Laurence J Walsh
- School of Dentistry, University of Queensland, Herston, QLD, Australia
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Middle Mesial Canal Preparation Enhances the Risk of Fracture in Mesial Root of Mandibular Molars. J Endod 2020; 46:1323-1329. [DOI: 10.1016/j.joen.2020.05.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/20/2020] [Accepted: 05/27/2020] [Indexed: 11/19/2022]
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Ten Years of Micro-CT in Dentistry and Maxillofacial Surgery: A Literature Overview. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10124328] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Micro-computed tomography (micro-CT) is a consolidated imaging technology allowing non-destructive three-dimensional (3D) qualitative and quantitative analysis by the observation of microstructures with high resolution. This paper aims at delivering a structured overview of literature about studies performed using micro-CT in dentistry and maxillofacial surgery (MFS) by analyzing the entire set of articles to portray the state of the art of the last ten years of scientific publications on the topic. It draws the scenario focusing on biomaterials, in vitro and in/ex vivo applications, bone structure analysis, and tissue engineering. It confirms the relevance of the micro-CT analysis for traditional research applications and mainly in dentistry with respect to MFS. Possible developments are discussed in relation to the use of the micro-CT combined with other, traditional, and not, techniques and technologies, as the elaboration of 3D models based on micro-CT images and emerging numerical methods. Micro-CT results contribute effectively with whose ones obtained from other techniques in an integrated multimethod approach and for multidisciplinary studies, opening new possibilities and potential opportunities for the next decades of developments.
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Fu M, Huang X, Zhang K, Hou B. Effects of Ultrasonic Removal of Fractured Files from the Middle Third of Root Canals on the Resistance to Vertical Root Fracture. J Endod 2019; 45:1365-1370. [PMID: 31564462 DOI: 10.1016/j.joen.2019.08.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 08/09/2019] [Accepted: 08/16/2019] [Indexed: 11/24/2022]
Abstract
INTRODUCTION This study aimed to analyze the effects of ultrasonic removal of fractured files from the middle third of root canals on the vertical root fracture resistance. METHODS This study was an extension of a previous study assessing the effects of fractured file removal on dentinal microcracks. It included 18 bilaterally matched pairs of human mandibular incisors prepared and analyzed in the previous study. Briefly, 1 member of each pair was assigned to an ultrasonic or a control group. In the ultrasonic group, K-files were fractured in the middle third of canals followed by ultrasonic file removal and canal preparation. In the control group, the root canals were simply prepared. Micro-computed tomographic imaging was performed before and after treatment, and the cross-sectional root images were screened for microcracks. For the present study, 3-dimensional reconstruction was performed for volumetric assessments. The fracture resistance was measured using a universal testing machine. All data were statistically analyzed. RESULTS Fracture loads were significantly smaller in the ultrasonic group (P < .05). The percentage increase in the canal volume significantly influenced the root fracture resistance (P < .05), whereas microcracks had no significant effect (P > .05). CONCLUSIONS Ultrasonic removal of fractured instruments from the middle third of root canals lowers the vertical root fracture resistance, with increased dentin removal being the primary cause.
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Affiliation(s)
- Mei Fu
- Department of Endodontics, School of Stomatology, Capital Medical University, Beijing, China
| | - Xiaoxiang Huang
- Department of General Dentistry, School of Stomatology, Capital Medical University, Beijing, China
| | - Kunya Zhang
- School of Biomedical Engineering, Capital Medical University, Beijing, China
| | - Benxiang Hou
- Department of Endodontics, School of Stomatology, Capital Medical University, Beijing, China.
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Toledano M, Muñoz-Soto E, Aguilera FS, Osorio E, Pérez-Álvarez MC, García-Menocal JAD, Toledano-Osorio M, Osorio R. The mineralizing effect of zinc oxide-modified hydroxyapatite-based sealer on radicular dentin. Clin Oral Investig 2019; 24:285-299. [DOI: 10.1007/s00784-019-02938-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 05/02/2019] [Indexed: 11/30/2022]
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Li FC, Borkar S, Ramachandran A, Kishen A. Novel Activated Microbubbles-based Strategy to Coat Nanoparticles on Root Canal Dentin: Fluid Dynamical Characterization. J Endod 2019; 45:797-802. [PMID: 30948228 DOI: 10.1016/j.joen.2019.02.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 01/26/2019] [Accepted: 02/05/2019] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Activated microbubbles (MBs) have the potential to deliver nanoparticles in complex microspaces such as root canals. The objective of the study is to determine the fluid dynamical parameters associated with ultrasonic, sonic, and manual activation of MBs in simulated root canals and to assess the effectiveness of surface coating formed by delivering chitosan nanoparticles using activated MBs within root canals in extracted teeth. METHODS In stage 1, polydimethylsiloxane models were fabricated to determine the physical effects of MBs agitated manually (MM), sonically (MS), and ultrasonically (MU). Spherical tracer particles were used to visualize and record the fluid motion using an inverted microscope linked to a high-speed camera. The velocity, wall stress, and penetration depth were analyzed at regions of interest. In stage 2, 35 extracted human incisors were divided into 7 groups to evaluate the effectiveness of chitosan nanoparticle delivery using activated MBs (MM, MS, and MU groups). Field emission scanning electron microscopy and energy-dispersive X-rays were used to characterize the nanoparticle coating on root canal dentin and the degree of dentinal tubule occlusion. RESULTS In stage 1, velocity, wall stress, and penetration depth increased significantly in the MB groups compared with the control (P < .01). In stage 2, 70% of the dentin surface was coated, and 65% of the dentinal tubule was occluded with nanoparticle-based coating in the MM, MU, and water ultrasonic groups. Element analysis displayed the presence of dentin smear on the root canal surface for the MU and water ultrasonic groups. CONCLUSIONS Activated MBs enhanced fluid dynamical parameters when compared with water in simulated root canal models. Manual activation of MBs resulted in uniform and significant nanoparticle-based surface coating and tubule blockage in root canal dentin without dentin smear formation.
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Affiliation(s)
- Fang-Chi Li
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Suraj Borkar
- Department of Chemical Engineering and Applied Chemistry, University of Toronto, Toronto, Ontario, Canada
| | - Arun Ramachandran
- Department of Chemical Engineering and Applied Chemistry, University of Toronto, Toronto, Ontario, Canada
| | - Anil Kishen
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada.
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