Candida albicans (C. albicans) is the fungus most frequently isolated from endodontic root canal infections. Although recognized by dental pulp and periradicular tissue cells that elicit immune responses, it eludes host defenses and elicits cell death. Then, C. albicans binds tooth dentin, forms biofilms, and invades dentinal tubules to resist intracanal disinfectants and endodontic treatments. Insensitive to most common medicaments, it survives sequestered within biofilms and intratubular dentin. Thus, C. albicans has been associated with cases of persistent or refractory root canal infections. Its treatment strategies may require alternative intracanal irrigants, intracanal medicaments such as chlorhexidine gel or human beta defensin-3 (HBD3), Ca-Si-based obturating materials, and microsurgical procedures.

The time domain entombment of bacteria by intratubular mineralization following orthograde canal obturation with mineral trioxide aggregate (MTA) was studied by scanning electron microscopy (SEM). Single-rooted human premolars (n=60) were instrumented to an apical size #50/0.06 using ProFile and treated as follows: Group 1 (n=10) was filled with phosphate buffered saline (PBS); Group 2 (n=10) was incubated with Enterococcus faecalis for 3 weeks, and then filled with PBS; Group 3 (n=20) was obturated orthograde with a paste of OrthoMTA (BioMTA, Seoul, Korea) and PBS; and Group 4 (n=20) was incubated with E. faecalis for 3 weeks and then obturated with OrthoMTA–PBS paste. Following their treatments, the coronal openings were sealed with PBS-soaked cotton and intermediate restorative material (IRM), and the roots were then stored in PBS for 1, 2, 4, 8 or 16 weeks. After each incubation period, the roots were split and their dentin/MTA interfaces examined in both longitudinal and horizontal directions by SEM. There appeared to be an increase in intratubular mineralization over time in the OrthoMTA-filled roots (Groups 3 and 4). Furthermore, there was a gradual entombment of bacteria within the dentinal tubules in the E. faecalis inoculated MTA-filled roots (Group 4). Therefore, the orthograde obturation of root canals with OrthoMTA mixed with PBS may create a favorable environment for bacterial entombment by intratubular mineralization.

The aim of this study was to investigate the effect of thermomechanical treatment on mechanical and metallurgical properties of nickel-titanium (NiTi) rotary instruments. Eight kinds of NiTi rotary instruments with sizes of ISO #25 were selected: ProFile, K3, and One Shape for the conventional alloy; ProTaper NEXT, Reciproc, and WaveOne for the M-wire alloy; HyFlex CM for the controlled memory- (CM-) wire; and TF for the R-phase alloy. Torsional fracture and cyclic fatigue fracture tests were performed. Products underwent a differential scanning calorimetry (DSC) analysis. The CM-wire and R-phase groups had the lowest elastic modulus, followed by the M-wire group. The maximum torque of the M-wire instrument was comparable to that of a conventional instrument, while those of the CM-wire and R-phase instruments were lower. The angular displacement at failure (ADF) for the CM-wire and R-phase instruments was higher than that of conventional instruments, and ADF of the M-wire instruments was lower. The cyclic fatigue resistance of the thermomechanically treated NiTi instruments was higher. DSC plots revealed that NiTi instruments made with the conventional alloy were primarily composed of austenite at room temperature; stable martensite and R-phase were found in thermomechanically treated instruments.