Proof-of-Principle Experiment for Testing Strong-Field Quantum Electrodynamics with Exotic Atoms: High Precision X-Ray Spectroscopy of Muonic Neon

To test bound-state quantum electrodynamics (BSQED) in the strong-field regime, we have performed high precision x-ray spectroscopy of the 5g-4f and 5f- 4d transitions (BSQED contribution of 2.4 and 5.2 eV, respectively) of muonic neon atoms in the low-pressure gas phase without bound electrons. Muonic atoms have been recently proposed as an alternative to few-electron high-Z ions for BSQED tests by focusing on circular Rydberg states where nuclear contributions are negligibly small. We determined the 5g_{9/2}- 4f_{7/2} transition energy to be 6297.08±0.04(stat)±0.13(syst)  eV using superconducting transition-edge sensor microcalorimeters (5.2-5.5 eV FWHM resolution), which agrees well with the most advanced BSQED theoretical prediction of 6297.26 eV.

Deexcitation Dynamics of Muonic Atoms Revealed by High-Precision Spectroscopy of Electronic K X Rays

We observed electronic K x rays emitted from muonic iron atoms using superconducting transition-edge sensor microcalorimeters. The energy resolution of 5.2 eV in FWHM allowed us to observe the asymmetric broad profile of the electronic characteristic Kα and Kβ x rays together with the hypersatellite K^{h}α x rays around 6 keV. This signature reflects the time-dependent screening of the nuclear charge by the negative muon and the L-shell electrons, accompanied by electron side feeding. Assisted by a simulation, these data clearly reveal the electronic K- and L-shell hole production and their temporal evolution on the 10-20 fs scale during the muon cascade process.

Serum amyloid A, C-reactive protein and remnant-like lipoprotein particle cholesterol in type 2 diabetic patients with coronary heart disease

Background: Serum amyloid A (SAA) and C-reactive protein (CRP) have been suggested to be involved in the process of coronary heart disease (CHD) and to be potential markers and/or predictors of CHD. Remnant-like lipoprotein particles (RLPs), which are regarded as atherogenic remnant lipoprotein, are reported to be increased in type 2 diabetic patients. We assessed the association of CHD with SAA, CRP and RLP-cholesterol in type 2 diabetic patients.

Methods: One hundred and twenty-six diabetic patients without CHD and 41 patients with CHD were recruited from our hospital. Plasma SAA was measured by the latex agglutination nephelometric immunoassay. Plasma high-sensitivity CRP was measured by a latex immunoturbidity method. Plasma RLP-cholesterol was measured by an immunoabsorption enzyme method.

Results: The mean standard deviation values of RLP-cholesterol in patients with and without CHD were 0.22 (0.26) mmol/L and 0.15 (0.10) mmol/L, respectively ( P <0.05). Median (interquartile ranges) for SAA in patients with and without CHD were 7.4 (4.2-11.2) mg/L and 3.9 (2.2-5.9) mg/L, respectively ( P <0.001). Median (interquartile ranges) for CRP in patients with and without CHD was 1.14 (0.45-2.08) mg/L and 0.43 (0.19-1.25) mg/L, respectively ( P <0.001). For all patients, the Spearman rank correlation statistics for RLP-cholesterol compared with SAA and with CRP were 0.213 ( P <0.05) and 0.301 ( P <0.01), respectively.

Conclusion: These data suggest that SAA, CRP and RLP-cholesterol are increased in type 2 diabetic patients with CHD, and that the inflammatory proteins correlate with remnant lipoprotein.

High-resolution MALDI-TOF MS study on analysis of low-molecular-weight products from photo-oxidation of poly(3-hexylthiophene)

High-resolution matrix-assisted laser desorption/ionization (MALDI) time-of-flight mass spectrometry (TOF MS) was used for the analysis of the low-molecular-weight products from the photo-oxidation of poly(3-hexylthiophene) (P3HT) in solution and thin film. Eight new peak series were observed in the low-mass range of the mass spectra of the products degraded in solution, and the formulas of the eight components were determined from the accurate mass. From SEC/MALDI-TOF MS, two components were identified as the degraded products, and the other six components were derived from the fragmentation of the degraded products during the MALDI process. A mechanism for the formation of these components was proposed on the basis of the results of MALDI-TOF MS. For the thin film degradation, a part of products in the solution degradation were observed, which supports that the oxidation of P3HT in solution and thin film proceeded in the same mechanism. This study shows that high-resolution MALDI-TOF MS is effective for the analysis of the low-molecular-weight products from P3HT photo-oxidation and expected to be feasible for the degradation analyses of other polymers. Copyright © 2015 John Wiley & Sons, Ltd.

Differential diagnosis of vertical root fractures using reconstructed three-dimensional models of bone defects

OBJECTIVES

The purpose of this study was to evaluate the accuracy of diagnosing vertical root fractures (VRFs) by comparing the volume of bone defects in VRFs with those in non-VRFs on reconstructed three-dimensional (3D) models (TDMs) using CBCT.

METHODS

32 maxillary pre-molars and anterior teeth with radiolucent areas were evaluated on pre-operative CBCT images. Of the 32 teeth, 16 had a fractured root (VRF group) and 16 had a non-fractured root (non-VRF group). The radiolucent area of each tooth was traced in each dimension [mesiodistal, buccolingual and horizontal (the apicoincisal aspect)] by two observers, and 3D images were reconstructed with the Amira(®) software (Visage Imaging Inc., Richmond, Australia). The volume, V, of the TDM was divided into the coronal side and the periapical side at the horizontal slice through the apical foramen, and v was defined as the volume of the coronal side. The values of v/V were calculated for all cases. The Mann-Whitney U test was used to compare values between the VRF group and the non-VRF group (p < 0.05). A receiver operating characteristic (ROC) curve was constructed to select the optimal cut-point.

RESULTS

There was a statistically significant difference in the value of v/V between the two groups (p < 0.05). With a cut-point derived from the ROC curve, and the sensitivity, specificity and accuracy of predicting the VRFs were 1.00, 0.75 and 0.88, respectively.

CONCLUSIONS

Lesions resulting from VRFs can be distinguished from those of non-VRFs on 3D CBCT images with a high degree of accuracy, based on their different 3D shapes.

Odontoblastic syncytium through electrical coupling in the human dental pulp

We have previously reported a dye-coupling network between odontoblasts (OBs). However, it is still unclear how the information detected by the odontoblasts is transmitted. The aim of this study was to characterize the odontoblastic syncytium electrophysiologically in the human dental pulp. Pulpal cells were freshly isolated from human premolars immediately after extraction. Under a light microscope, coupled or small clusters (3-20) of odontoblasts, each of which had a monopolar process (95-280 µm) and an oval cell body, were easily observed to be lined up in parallel. Cells were used for electrophysiological recording within 3 hrs in the dual patch-clamp configuration. Electrical couplings were found between odontoblasts (37/40 pairs). Voltage gating showed directional independence between pairs of odontoblasts. The time constant to a current decay increased with the number of clustered odontoblasts. Nine of 37 pairs isolated from young patients were electrically coupled, but could not be voltage-clamped. Transjunctional currents were blocked by octanol. These results suggest that odontoblasts form a syncytium that is directionally independent via symmetric gap junction channels in the odontoblastic layer. Young odontoblasts with a high electrical conductance to neighboring cells may be related to high potential of information transmission or calcification.

Initial fibroblast attachment to Erbium:YAG laser-irradiated dentine

AIMS

To evaluate the effects of Erbium (Er):YAG laser irradiation on the morphology of resected dentine surfaces, and to investigate fibroblast attachment to laser-irradiated dentine surfaces.

METHODOLOGY

Dentine blocks obtained from single-rooted human teeth were divided into the following groups after sterilization in an autoclave: (i) Laser group treated with Er:YAG laser irradiation (30 mJ per pulse, 10 pps, 60 s); (ii) L-MTAD group treated with laser irradiation as in (i) plus a mixture of doxycycline, tetracycline isomer and citric acid; (iii) RC-Prep group treated with EDTA gel or cream (RC-Prep) and (iv) Control group left untreated. After each treatment, the dentine blocks were incubated with NIH/3T3 fibroblasts cultured to subconfluency in Dulbecco's modified Eagle's medium supplemented with 10% foetal bovine serum and antibiotics. The number of attached cells amongst the groups was analysed statistically at the 5% significance level. The dentine surface morphologies and cell attachments were evaluated by counting assays, histological observations and scanning electron microscopy (SEM).

RESULTS

The number of attached cells was significantly higher (P < 0.05) in the Laser group than in the RC-Prep and Control groups at 16 h. Dendritic cell extension of the fibroblasts was only observed in the Laser group at 8 h by SEM. In the histological analyses, significantly more attached cells were found on the dentine surfaces treated with laser irradiation.

CONCLUSIONS

Er:YAG laser irradiation induced morphological alterations in dentine surfaces, which may improve the attachment of fibroblasts to dentine.

MEPE Activated by Furin Promotes Pulpal Cell Adhesion

Matrix extracellular phosphoglycoprotein (MEPE) is predominantly expressed in osteoblasts, osteocytes, and odontoblasts and plays key biological roles in bone and dentin metabolism. Post-translational modifications are essential for its activation. This study tested the hypothesis that MEPE is activated through proteolytic processing by furin in dental pulp. MEPE was present in three sizes, 1 full-length and 2 cleaved fragments; the cleavage site was 146R↓147. The proprotein convertase family, particularly furin, was a candidate enzyme. Introducing a substitution at the cleavage site inhibited hydrolysis, but there was no cleavage of MEPE expressed in furin-deficient LoVo cells. Therefore, furin is a strong candidate for the proteolytic cleavage of MEPE. The C-terminal cleavage product promoted cell adhesion via its RGD motif. These results indicate that proteolytic processing by furin may activate MEPE during its secretion from odontoblasts and may play important roles in dentinogenesis and pulpal homeostasis. Abbreviations: MEPE, matrix extracellular phosphoglycoprotein; PTM, post-translational modifications; OLC, odontoblast-lineage cells.

Periapical bone defects of root filled teeth with persistent lesions evaluated by cone-beam computed tomography

AIM

To evaluate and categorize the bone defects of root filled teeth with persistent periapical lesions by cone-beam computed tomography (CBCT).

METHODOLOGY

Slice images of 532 teeth with persistent periapical lesions were obtained by CBCT in 427 patients and were examined by two endodontists. The periapical lesions were categorized into five types according to the characteristics of the bone defect based on CBCT images. The prevalence of each type was determined and analysed statistically at a 5% significance level using logistic regression.

RESULTS

Of the 532 teeth analysed, 67% had buccal or labial bone plate defects (type II), 4% palatal or lingual bone plate defects (type III), 7%'through and through' defects (type IV) and 10% apical root protrusions from the bone plate (type V). Mandibular teeth had a significantly greater prevalence of type I lesions (P=0.0005) and a significantly lower prevalence for types IV (P=0.041), V (P=0.001), V-1 (P=0.015) and V-2 (P<0.001) as compared to maxillary teeth.

CONCLUSION

CBCT accurately identified the type of periapical bone defect in persistent lesions. Because 10% of the teeth had apical root protrusions, which could not be identified by periapical radiography, the diagnostic information obtained by CBCT was an essential component of the treatment planning process.

Incidence of accessory canals in Japanese anterior maxillary teeth following root canal filling ex vivo

AIM

To investigate the vertical and horizontal distribution and the incidence of accessory canals in Japanese maxillary anterior teeth following root filling.

METHODOLOGY

The study included maxillary teeth; 69 central incisors, 61 lateral incisors and 31 canines. After the canal systems had been dyed and root canal instrumentation had been carried out, all prepared canals were filled with gutta-percha without using sealer. Transparent specimens were then obtained and examined with a digital microscope for horizontal and vertical distributions of accessory canals.

RESULTS

The incidence of teeth with accessory canals in the apical 3 mm was 46%, 29% and 38% for the maxillary central incisors, lateral incisors and canines, respectively. The horizontal distribution was mainly buccal for central incisors, palatal for lateral incisors and distal and palatal for canines. There was a significant difference (P < 0.05) between the apical 3 mm and the rest of the root (16%, 20% and 19% for the maxillary central incisors, lateral incisors and canines, respectively) in terms of the presence of accessory canals.

CONCLUSIONS

A high percentage of accessory canals can be found in apical 3 mm of the root. The horizontal distribution of accessory canals differed amongst the tooth types studied.

Neuron-immune interactions in the sensitized thalamus induced by mustard oil application to rat molar pulp

We have reported that mustard oil application to the rat dental pulp induces neuronal activation in the thalamus. To address the mechanisms involved in the thalamic changes, we performed neuronal responsiveness recording, immunohistochemistry, and molecular biological analysis. After mustard oil application, neuronal responsiveness was increased in the mediodorsal nucleus. When MK801 (an N-methyl-D-aspartate receptor antagonist) was applied to the mediodorsal nucleus, the enhanced responsiveness was decreased. N-methyl-D-aspartate receptor 2D, glial fibrillary acidic protein, and antigen-presenting cell-related gene mRNAs in the contralateral thalamus were up-regulated at 10 minutes after mustard oil application, but were down-regulated within 10 minutes after the antagonist application. OX6-expressing microglia and glial fibrillary acidic protein-expressing astrocytes did not increase until 60 minutes after mustard oil application. These results suggested that the thalamic neurons play some roles in regulating the glial cell activation in the mediodorsal nucleus via N-methyl-D-aspartate receptor 2D during pulp inflammation-induced central sensitization.

Pressure-dependent hydrogen permeability extended for metal membranes not obeying the square-root law

Hydrogen permeability of metal membranes is generally defined by the square-root law, as the proportional coefficient of permeation flux to the square-root difference of the pressures on both sides of the membrane. However, deviation from the law has been widely reported for palladium, niobium, etc. Although n-th power instead of the square root has often been employed to determine permeability for these membranes, it has no theoretical base. These approaches do not consider concentration dependency of hydrogen diffusivity in the membrane. This study theoretically extended the definition of permeability by taking it into account, where square root of pressure was used throughout. The resultant permeability depended on pressure. This approach had the following four characteristics. First, the permeability could be qualitatively linked with pressure-dependent solution and diffusion coefficients. For this purpose, the solution coefficient was also extended from Sieverts' law. Second, the permeability could be easily evaluated from permeation flux dependent on feed-side pressure, usually measured in membrane study. Third, this approach enabled comparison of permeation ability irrespective of obeying permeation law. Fourth, permeation flux could be estimated for any pressure conditions visually and analytically. Thus, analytically estimated values were more precise than those using the conventional square-root law. These characteristics are successfully demonstrated using experimental results obtained not only for a palladium membrane in this study but also for palladium and niobium membranes in the literature.

[Primary thyrotracheal anastomosis for subglottic stenosis with tracheostomy]

A case of 42-year-old man with postintubation subglottic stenosis underwent primary thyrotracheal anastomosis. Since trachea had been incised longitudinally for previous tracheostomy, tracheal resection came to be longer. Therefore, we had to anastomose the incised trachea with thyroid cartilage even after the suprahyoid release. After the operation, he suffered from the tracheal collapse at the incised portion of the trachea One week after intubation, tracheal patency was achieved. We recommend horizontal incision for tracheostomy in patient with subglottic stenosis, when the following surgical approach is considered.

Antigen-presenting cells in human radicular granulomas

Substantial numbers of dendritic cells have been detected in radicular granulomas. To test the hypothesis that local antigen presentation from dendritic cells to T-cells is involved critically in immunological responses within radicular granulomas, we compared characteristics of dendritic cells and macrophages by morphological and biological analyses. Under light microscopy, HLA-DR+ and CD68+ cells showed diverse profiles, including dendritic-shaped cells. Transmission electron microscopy revealed that HLA-DR+ dendritic cells, with long cytoplasmic processes and lacking distinct phagosomes, were concentrated in the lymphocyte-rich area. HLA-DR alpha-chain, CD83, and CD86 mRNAs from HLA-DR+ dendritic cells, and CD28 mRNA from CD28+ T-cells were up-regulated in lymphocyte-rich area. Scanning electron microscopy demonstrated that the density of gold particles on dendritic cells was higher than that on HLA-DR+ macrophages. These results suggest that dendritic cells in radicular granulomas are associated with local defense reactions as stronger antigen-presenting cells, as compared with macrophages.

Logistic regression equation to screen for vertical root fractures using periapical radiographs

OBJECTIVES

To develop a predictive equation to screen for vertical root fractures (VRFs) by numerically evaluating the shapes of radiolucent areas on the periapical radiographs of endodontically treated maxillary incisors and premolars.

METHODS

41 pre-operative periapical radiographs of maxillary incisors and premolars with radiolucent areas at root apices were used. Out of 41 teeth, 18 had a fractured root (VRF group) and 23 had a non-fractured root (non-VRF group). The periapical radiolucent area of each tooth was traced out by six examiners on a personal computer and two indices, "Complexity" and "Radial SD", were measured. For each index, the difference between the VRF and non-VRF groups and the interexaminer differences were analysed with two-way ANOVA at 5% significance level. Multiple logistic regression analysis was used to develop a predictive equation and the probability of VRF in all samples was calculated. A receiver operating characteristic (ROC) curve was constructed to select the optimal cut-point. Each sample was predicted as "VRF" or "non-VRF" with this cut-point.

RESULTS

For both "Complexity" and "Radial SD", the VRF group showed significantly greater values than the non-VRF group (P<0.05). With a cut-point derived from the ROC curve, sensitivity, specificity and efficiency of VRF were 0.68, 0.80 and 0.75, respectively.

CONCLUSIONS

VRF teeth have more complicated radiolucent areas compared with non-VRF teeth. By evaluating the shapes of radiolucent areas, a logistic regression equation to screen for VRF was calculated and this equation could contribute to the diagnosis of VRF.

Ex vivo evaluation of the ability of four different electronic apex locators to determine the working length in teeth with various foramen diameters

BACKGROUND

The aim of this ex vivo study was to evaluate the accuracy of four electronic apex locators (EALs) to determine the working length in teeth with various foramen diameters. Our previous study revealed that electronically measured canal length was influenced by the root canal diameter. It is not known whether foramen size would interfere with the reading accuracy of an EAL.

METHODS

A total of 36 extracted human lower single rooted premolar teeth were divided into four groups of nine teeth each. In groups A, B and C, the root canals were instrumented using #10-80, #10-100 and #10-120 K-files, and the tip of size #80, #100 and #120 K-files were permitted to pass through the apical foramen to a length of 1mm, respectively. In group D, the teeth were instrumented using #10-140 K-files and the tip of #140 K-file was permitted to pass through the apical foramen to a length of 5 mm. Thus, the average apical foramen diameters in groups A, B, C and D were approximately 0.82 mm, 1.02 mm, 1.22mm and 1.5 mm, respectively. The teeth were then mounted in 1% agar and four EALs were used: Root ZX, Foramatron D10, Apex NRG and Apit 7. For electronic measurement, sizes #10 and #80, #10 and #100, #10 and #120, and #10 and #140 K-files were used for groups A, B, C and D, respectively. During electronic measurement the canals were flushed with 6% sodium hypochlorite solution.

RESULTS

Three-way ANOVA and Bonferroni test showed that EAL, file size and foramen size all had a significant influence on the measurement error (P<0.0001), with all the interactions between these three factors being significant (P<0.0001).

CONCLUSIONS

The four EALs were unreliable to determine the working length of teeth with a wide apical foramen, when using a small size file. The Root ZX and Foramatron D10 showed significantly better scores than the other two EALs and may be more reliable to determine the working length of teeth with a wide apical foramen, if a tight-fit file is used.

[Aortic dissection associated with traumatic pericardial rupture]

We report a case of a 76-year-old man with traumatic aortic dissection complicated with cardiac herniation due to traumatic pericardial rupture. He was involved in an automobile crush and was transferred to our hospital. His vital signs were stable except for atrial fibrillation. Enhanced computed tomography (CT) showed aortic dissection on the descending aorta, multiple left rib fractures, substernal hematoma and shift of the heart toward the left chest cavity. We performed emergency operation. Through left thoracotomy, pericardial rupture was observed. Dacron graft replacement of the descending aorta and pericardial patch plasty were performed. He was discharged on the 24th postoperative day. Careful attention should be paid to aortic injury and pericardial rupture in the patient with severe blunt chest trauma.

Phase transformation behaviour and bending properties of hybrid nickel?titanium rotary endodontic instruments

AIM

To investigate the bending properties of hybrid rotary nickel-titanium endodontic instruments in relation to their transformation behaviour.

METHODOLOGY

Four types of nickel-titanium rotary endodontic instruments with different cross-sectional shapes (triangular-based and rectangular-based) and different heat treatment conditions (super-elastic type and hybrid type with shape memory effect) were selected to investigate bending properties and phase transformation behaviour. Bending load of the instruments was measured in a cantilever-bending test at 37 degrees C with the maximum deflection of 3.0 mm. A commercial rotary instrument, ProFile (PF; Dentsply Maillefer, Ballaigues, Switzerland) was used as a reference for the bending test. Phase transformation temperatures were calculated from the diagrams obtained from differential scanning calorimetry. Data were analysed by anova and Scheffe's test.

RESULTS

The bending load values of the hybrid type that had undergone additional heat treatment at the tip were significantly lower (P < 0.05) than those of the super-elastic type with no additional heat treatment. The bending load values of rectangular-based cross-sectional shaped instruments were significantly lower (P < 0.05) than those of triangular-based cross-sectional shaped instruments. Phase transformation temperatures (M(s) and A(f) points) of the hybrid type were significantly higher (P < 0.05) than the super-elastic type. The M(f) and A(s) points of the tip part were significantly higher (P < 0.05) than those of the whole part of the hybrid instrument.

CONCLUSIONS

Additional heat treatment of hybrid nickel-titanium instruments may be effective in increasing the flexibility of nickel-titanium rotary instruments.

Effect of NOS inhibitor on cytokine and COX2 expression in rat pulpitis

Various kinds of chemical mediators are synthesized in the course of pulpitis; thus, control of their production would assist in inducing a reduction in pulpal inflammation. We hypothesized that nitric oxide (NO) would be an important mediator of pulpal inflammation. Pulpal inflammation was induced by the application of LPS in rat incisor pulp, and inducible nitric oxide synthase (iNOS) expression was evaluated by reverse-transcription/polymerase chain-reaction and immunohistochemical staining. After LPS application, iNOS mRNA was first detected after 3 hrs, peaked at 6 hrs, and decreased thereafter. iNOS-positive cells were macrophages and neutrophils. An NOS inhibitor caused drastic decreases in the expression of pro-inflammatory cytokines and COX2 mRNA, which was highly induced in the LPS-induced pulpitis. These results indicate that NO synthesis is related to the initiation of mediator production, and that its down-regulation should contribute to the prevention of pro-inflammatory mediator synthesis.

The effects of file size, sodium hypochlorite and blood on the accuracy of Root ZX apex locator in enlarged root canals: an in vitro study

BACKGROUND

The initial electronic apex locator (EAL) length measurement is generally established with a small-sized file. It is not known whether file size would be interfering with the reading accuracy of the EAL. This study aimed to evaluate the effect of file size on the accuracy of Root ZX apex locator using an agar model when sodium hypochlorite solution or blood was present during electronic measurements in enlarged root canals.

METHODS

A total of 36 extracted lower premolars were used. In stage 1, the canals were instrumented using size 10-40 K-files with a size 40 K-file as the master apical file (MAF). The teeth were then divided randomly into two groups of 18 teeth each. In group A, the teeth were mounted in one per cent agar and irrigated with six per cent sodium hypochlorite solution (NaOCl), while in group B the teeth were mounted in agar and irrigated with human blood. In stage 2, the canals were enlarged using a size 60 K-file as the MAF. In stages 1 and 2, the apical portions of the canals were instrumented using the step-back sequence (up to a size 80 K-file). In stage 3, the canals were enlarged using a size 80 K-file as the MAF. In each stage, the length was measured with a Root ZX until the meter value reached 'APEX' using small and large size files.

RESULTS

Three-way ANOVA and Bonferroni test showed that file size, stage of preparation and type of irrigant all had a significant influence on the measurement error (P < 0.0001), with all the interactions between these three factors being significant (P < 0.0001).

CONCLUSIONS

As the diameter of the root canal increased, the measured length with the smaller size files became shorter. A file of a size close to the prepared canal diameter should be used for root length measurement in the presence of blood. In the presence of NaOCl, the Root ZX was highly accurate even when the file was much smaller than the diameter of the canal. The agar model was effective and suitable for testing EALs in vitro.

An ex vivo evaluation of a new root canal irrigation technique with intracanal aspiration

AIM

To evaluate the effectiveness of a new root canal irrigation technique with intracanal aspiration in removing the smear layer and to assess irrigant extrusion ex vivo.

METHODOLOGY

Thirty-five instrumented canals of extracted human canine teeth that had been resected apically by removing 3 mm of the root tip were divided into one control and four experimental groups of seven teeth each. The roots were fixed in a plastic case and surrounded with normal saline agar coloured with 1% acid red. No irrigation was performed in the control teeth. Each root canal in the experimental groups was irrigated with 9 mL of 14% ethylenediaminetetraacetic acid for 3 min, and then with 6 mL of 6% sodium hypochlorite (NaOCl) for 2 min. In the intracanal aspiration technique, the irrigant was delivered from the tip of an injection needle placed 12 mm from the apical root-end and an aspiration needle that was connected to a Root ZX apex locator placed 2 and 3 mm short of the apical root-end in groups 1 and 2, respectively. In the conventional method, the tip of an injection needle used for delivery of the irrigant and as an active electrode was placed 2 and 3 mm short of the apical root-end in groups 3 and 4, respectively, the tip of the aspiration needle was placed 12 mm from the apical root-end in these groups. The readings of the Root ZX during irrigation were recorded. The cleanliness of the canal was evaluated by scoring smear layer from scanning electron microscopy (SEM) images of the canal. Extrusion of NaOCl was detected by measuring the discoloured area of the agar around the apical root-end. The data obtained were statistically analysed by one-way anova, the Kruskal-Wallis test and Friedman's test.

RESULTS

In the SEM study, the canals in groups 1-3 were significantly cleaner than those in the control and group 4 (P < 0.05). The mean Root ZX readings in groups 1-3 were approximately "0.5". The discoloured area in group 3 was significantly larger than the other groups (P < 0.05).

CONCLUSIONS

Irrigation using the intracanal aspiration technique allowed more effective removal of the smear layer than that performed by the conventional method in an apically resected canine tooth. The intracanal aspiration technique produced limited extrusion of the irrigant beyond the apical foramen.