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Intentional replantation (IR) may offer a solution for persistent periapical lesions associated with endodontically treated teeth. A 35-year-old male patient presented with pain associated with the left mandibular second molar and hypoesthesia. Upon clinical examination, increased probing pocket depth in the mid-buccal surface was detected. Cone beam computed tomography revealed a previous non-surgical root canal treatment, with root canal filling material extrusion adjacent to the inferior alveolar nerve, a fractured instrument in the mesial root, and a large periapical radiolucency involving both teeth 37 and 36. A diagnosis of symptomatic post-treatment apical periodontitis was established. After discussing treatment options with the patient, an IR of tooth 37 was performed. Extra-oral procedures were completed in 17 min. At 9 months, hypoesthesia resolution was reported, and apical healing was radiographically observed. After 2.5 years, the replanted tooth showed extensive root resorption. An extraction with alveolar ridge preservation, using leukocyte-platelet rich fibrin (L-PRF), was performed. Six months after tooth extraction and regeneration, implant placement surgery was carried out. IR presents a valid treatment modality for the management of post-treatment apical periodontitis. When orthograde retreatment or apical microsurgery prove to be unfeasible, IR is a unique procedure with the potential to promote tooth preservation in properly selected cases. Although unsuccessful after 2.5 years, the IR of tooth 37 allowed for bone regeneration, the maintenance of tooth 36 vitality, and hypoesthesia resolution. [ABSTRACT FROM AUTHOR]

Objective: This review aims to assess structural, chemical, and mechanical properties of coronal dentin after endodontic irrigation. Materials and Methods: Reporting followed the PRISMA extension for scoping reviews. An electronic search was carried out in PubMed, Embase, and Cochrane Library. Records filtered by language and published up to November 4, 2022 were independently screened by two researchers. Studies evaluating structural, chemical, or mechanical properties of human permanent coronal dentin after irrigation within the scope of nonsurgical root canal treatment were included. Data were extracted regarding study type, sample description and size, experimental groups, outcome, evaluation method, and main findings. Results: From the initial 1916 studies, and by adding 2 cross‐references, 11 in vitro studies were included. Seven studies provide ultrastructural and/or chemical characterization, and six assessed microhardness and/or flexural strength. One percent to 8% sodium hypochlorite (NaOCl) and 1%–17% ethylenediaminetetraacetic acid (EDTA) were the most commonly tested solutions, with contact times of 2–240 min (NaOCl) and 1–1440 min (EDTA) being evaluated. Conclusions: Overall, the literature is consensual regarding the inevitable impact of NaOCl and chelating agents on coronal dentin, with both deproteinizing and decalcifying effects being concentration‐ and time‐dependent. The alteration of mechanical parameters further confirmed the surface and subsurface ultrastructural and chemical changes. Clinical Significance: Endodontic treatment success highly depends on restorative sealing. Understanding the result of exposing coronal dentin, the main substrate for bonding, to irrigants' action is crucial. The deproteinizing and decalcifying effects of NaOCl and chelating agents are both concentration‐ and time‐dependent, causing surface and subsurface ultrastructural, chemical, and mechanical alterations. [ABSTRACT FROM AUTHOR]

Objectives: This clinical study aimed to evaluate and compare the diagnostic accuracy of intraoral periapical radiography (PR) and cone beam computed tomography (CBCT) in detecting external apical root resorption (EARR) in orthodontic patients during the retention phase. Methods: The research involved 41 Caucasian patients who had undergone comprehensive orthodontic treatment, with a total of 328 teeth analyzed. The Kappa values for inter- and intra-examiner agreement were high for both PR and CBCT, indicating a robust level of agreement among examiners. The study used a four-point scale for classifying EARR. Results: This study showed comparable accuracy, sensitivity, and specificity between PR and CBCT when using the most stringent criterion of "Definitely present". The data suggested that CBCT outperformed PR when using a less stringent criterion ("Definitely present" or "Probably present"), particularly for maxillary incisors. However, overall diagnostic performance, as measured by the area under the ROC curve, showed only a slight advantage for CBCT over PR. Areas under the ROC curve range between 0.85 and 0.90 for PR and between 0.89 and 0.92 for CBCT. According to DeLong's test, there is no evidence to conclude that the area under the ROC curve is different for PR and CBCT. Conclusions: Both PR and CBCT are accurate diagnostic tools for identifying EARR, with PR being deemed more suitable for routine clinical use due to its cost-effectiveness and lower radiation exposure. The findings emphasize the importance of considering the risk-benefit ratio when deciding on imaging modalities for monitoring EARR in orthodontic patients. [ABSTRACT FROM AUTHOR]

Disruptions in the MBD5 gene have been linked with an array of clinical features such as global developmental delay, intellectual disability, autistic-like symptoms, and seizures, through unclear mechanisms. MBD5 haploinsufficiency has been associated with the disruption of primary cilium-related processes during early cortical development, and this has been reported in many neurodevelopmental disorders. In this study, we describe the clinical history of a 12-year-old child harboring a novel MBD5 rare variant and presenting psychomotor delay and seizures. To investigate the impact of MBD5 haploinsufficiency on neural primary cilia, we established a novel patient-derived cell line and used CRISPR-Cas9 technology to create an isogenic control. The patient-derived neural progenitor cells revealed a decrease in the length of primary cilia and in the total number of ciliated cells. This study paves the way to understanding the impact of MBD5 haploinsufficiency in brain development through its potential impact on neural primary cilia. [ABSTRACT FROM AUTHOR]

Biocompatibility of endodontic sealers is very important in endodontic treatment. The aim of this experiment was to study the biocompatibility of a new methacrylate-based root canal sealer (RealSeal®) and compare it with a standard control (Gutta-percha®). RealSeal® and Gutta-percha® points were implanted in the subcutaneous connective tissue of rats and studied after one week and eight weeks by light microscopy. Hematoxylin and eosin stained specimens were analised by means of histometric methods. The area occupied by the biomaterial (B) and by the surrounding fibrotic capsule (C) was calculated using appropriate software (Sigma Scan Pro 5). An index given by the ratio of these two areas (IBC) was used to evaluate the response of the organism to the biomaterial. No signs of acute inflammation were observed in the slides. The material was always surrounded by a thin fibrotic capsule. The Guttapercha® groups has an IBC variyng between 0.3630 and 0.7414 the 8th day and from 0.1562 to 0.2033 at 60th day, for a confidence interval of 95%. The RealSeal® groups has an IBC variyng between 0.1179 and 0.1522 at the 8th day and from 0.2263 to 0.3987 at the 60th day, for a confidence interval of 95%. Both materials show good compatibility, although the body response is different. To clarify the biocompatibility studies with a longer time of evolution are necessary. [ABSTRACT FROM AUTHOR]

Objectives: To compare the regenerative properties of human stem cells of the apical papilla (SCAPs) embedded in a platelet-rich plasma (PRP) scaffold, when implanted in vivo using an organotypic model composed of human root segments, with or without the presence of the bioactive cements – ProRoot MTA or Biodentine. Material and methods: SCAPs were isolated from third molars with incomplete rhizogenesis and expanded and characterized in vitro using stem cell and surface markers. The pluripotency of these cells was also assessed using adipogenic, chondrogenic, and osteogenic differentiation protocols. SCAPs together with a scaffold of PRP were added to the root segment lumen and the organotypic model implanted on the dorsal region of immunodeficient rats for a period of 4 months. Results: Presence of SCAPs induced de novo formation of dentin-like and pulp-like tissue. A barrier of either ProRoot MTA or Biodentine did not significantly affect the fraction of sections from roots segments observed to contain deposition of hard material (P > 0.05). However, the area of newly deposited dentin was significantly greater in segments containing a barrier of Biodentine compared with ProRoot MTA (P < 0.001). Conclusions and clinical relevance: SCAPs offer a viable alternative to other dental stem cells (DSCs) in their regenerative properties when enclosed in the microenvironment of human tooth roots. The present study also suggests that the presence of bioactive materials does not hinder or impede the formation of new hard tissues, but the presence of Biodentine may promote greater mineralized tissue deposition. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to evaluate the shear bond strength inherent to immediate and delayed definitive composite resin restorations, over three different biomaterials. Methods: Fifty-four aluminum blocks were randomly assigned to six experimental groups (n = 9) according to the biomaterial (Biodentine, TotalFill BC Putty, or PCM) and restoration timing (immediate or 7 days delayed). Regarding the restorative procedures, a two-step self-etch bonding system (Clearfil SE Bond) was applied and subsequently restored using a flowable composite resin (SDR). After shear bond strength testing, fracture pattern analysis was performed. The significance level was set at α = 0.05. Results: Within the immediate groups, Biodentine showed the highest mean shear bond strength value, with no statistically significant differences (P > 0.05) being detected when compared with both TotalFill (P = 0.072) and PCM (P = 0.232) groups. Regarding the delayed restoration groups, Biodentine and TotalFill presented the highest mean shear bond strength value, with statistical differences when compared with PCM (P = 0.002 and P = 0.043, respectively). No statistically significant differences (P > 0.05) were verified between both immediate and delayed groups for each tested biomaterial. Also, a statistically significant association was found between the fracture type and the biomaterial (P < 0.001). Conclusions and clinical relevance: Our findings suggest that all tested biomaterials present suitable alternatives which allow to perform restorative procedures immediately after pulp capping biomaterial placement (3 or 12 min, depending on the bioactive cement), therefore requiring one single appointment to complete the procedure. Biodentine and TotalFill BC Putty have shown superior shear bond strength results when compared with PCM, within a delayed timeframe (7 days). [ABSTRACT FROM AUTHOR]

Sustainability is becoming a key factor in the decision-making process of infrastructure projects throughout their lifecycles. In particular, the Environmental Impact Assessment (EIA) in the design phase is becoming a matter of significant importance, for both public and private sectors, given the long-term impacts of design decisions on the environmental performance of infrastructure projects. Traditionally, EIA is performed by a sustainability expert at the end of the design cycle, by which time the modification of design is both costly and time-consuming. In recent years, Building Information Modelling (BIM) is leveraged to better integrate EIA with the design practices. However, there are several limitations with how this integration is approached: (1) EIA is normally performed by software other than the one used for the design. This renders the continuous EIA based on incomplete BIM models difficult; (2) there is a lack of explicit data structure for the integration of EIA and BIM data. This limits the interoperability and flexibility of the EIA tools in terms of accommodating to different EIA databases; (3) in the majority of the cases the integration of EIA and BIM is not bidirectional, which results in the incapacity of the designers to immediately visualize the results of EIA in the design platform and to track the progress of the design in terms of EIA; and (4) the BIM-based EIA has rarely been implemented in an infrastructure project. Therefore, this research aims to develop a continuous BIM-based EIA for infrastructure projects that utilizes an explicit data structure to (1) systematically integrate data from various sources, and (2) enable bidirectional data exchange between BIM and EIA. The framework allows designers to run an automated EIA at any point in the design stage and immediately assess the Environmental Impact Score (EIS) of their design choices. A prototype is developed and tested on a case study to indicate the feasibility of the proposed framework. The framework is assessed in terms of functionality, ease of use, scalability, and contribution to raising sustainability consciousness through a workshop with experts. It is shown that the framework is able to quickly provide designers with accurate information about the potential environmental impact of all objects in infrastructure design projects. The workshop with experts showed that the tool clearly makes it easier to perform EIA compared to the existing, highly fragmented, process. This allows the design team to use this assessment on the same level as other design parameters in the decision-making process. • A framework for BIM-based automated environmental impact assessment of infrastructure projects is developed. • A data structure for BIM-based environmental impact assessment is proposed. • The changes in the design workflow are analyzed. • A prototype is developed and tested for a real infrastructure project. • It is demonstrated that the framework raises the sustainability consciousness of the design team. [ABSTRACT FROM AUTHOR]

The purpose of the present study was to assess the proper time to perform a restoration (immediately or delayed) after placement of two calcium silicate-based cements (CSCs) and to test the performance of two different restorative protocols regarding shear bond strength (SBS). Seventy-five acrylic blocks were randomly divided into five groups (n = 15). Specimens were filled with either ProRoot MTA (Dentsply Tulsa Dental) or Biodentine (Septodont). The restoration was performed at an immediate (12 min) or delayed (seven days) timeframe, using a resin-based flowable composite (SDR) (bonded to the CSC using a universal bonding system) or glass ionomer cement (GIC) as restorative materials. SBS was measured using a universal testing machine. Fractured surfaces were evaluated, and the pattern was registered. Statistical analysis was performed using the Dunn–Sidak post hoc test (P < 0.05). Biodentine/immediate SDR showed the highest mean SBS value (4.44 MPa), with statistically significant differences when compared to mineral trioxide aggregate (MTA)/GIC (1.14 MPa) and MTA/immediate SDR (1.33 MPa). MTA/GIC and MTA/immediate SDR did not present significant differences regarding SBS. No statistical differences were verified concerning mean SBS between both CSCs within the 7 day groups. MTA/delayed SDR (3.86 MPa) presented statistical differences compared to MTA/immediate SDR, whereas no differences were observed regarding Biodentine performance (Biodentine/immediate SDR and Biodentine/delayed SDR (3.09 MPa)). Bonding procedures directly on top of MTA might be preferably performed at a delayed timeframe, whereas Biodentine might allow for immediate restoration. [ABSTRACT FROM AUTHOR]