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Background: Multi-rooted teeth with extensive dental defects often face challenges in stability and biomechanical failure. High-performance polymer PEEK materials, with properties closer to dentin, show promise in reducing stress concentration and preserving tooth structure. This report aimed to explore the use of a highly retentive polyetheretherketone (PEEK) for manufacturing custom-made split post and core for the restoration of grossly destroyed endodontically treated molars. Clinical considerations: A 40-year-old female patient presented with complaints of loss of tooth substance in the posterior mandibular tooth. This case involved the digital design and fabrication of PEEK split post and core to restore multirooted molar with insufficient dental tissue remnants. The restorations were evaluated over a 3-year follow-up using the World Federation criteria (FDI). The restoration was clinically evaluated through intraoral examination, radiographic assessment, and subjective patient satisfaction, and was deemed clinically good according to FDI criteria. Conclusion: The outstanding mechanical properties of PEEK, coupled with the structure of the split post, provide an effective treatment option for weakened multirooted teeth. Simultaneously, the restoration configuration effectively addressed the challenge of varying postinsertion directions, and the interlocking mechanism between the primary and auxiliary posts enhanced the stability of the post and core. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Successful management of a rare case involving both dens evaginatus and dens invaginatus in the same tooth, monitored over a 24‐month follow‐up. Dens invaginatus (DI) is a congenital dental anomaly characterized by the presence of a tooth that resembles a "tooth within a tooth." Conversely, dens evaginatus (DE) is a developmental anomaly distinguished by an additional tubercle or cusp on the tooth's crown. Both DI and DE can result in pulpal and periapical diseases in the affected tooth. This article presents a case of a healthy 14‐year‐old male with recurrent swelling under the chin and a wound with pus drainage on the right side of the submental area, associated with his left mandibular lateral incisor affected by both DI and DE. Clinical and radiographic examinations revealed that the tooth was necrotic and had a chronic apical abscess. Cone beam computed tomography (CBCT) confirmed Oehlers' type III DI and a talon cusp on the lingual surface of the same tooth. The patient underwent orthograde endodontic treatment. Passive ultrasonic activation of a 5.25% NaOCl solution and a mixture of Ca(OH)2 and a 2% chlorhexidine solution were utilized to effectively clean and eliminate the persistent pus discharge. After the resolution of the patient's symptoms, the apical third of the root canal and the invaginated space were filled with a plug of mineral trioxide aggregate (MTA), while the remaining root canal was filled using a sealer‐based obturation technique. A 24‐month follow‐up visit revealed complete bone regeneration in the previously affected periradicular tissues. [ABSTRACT FROM AUTHOR]

Objective: To investigate the incidence of accessory canals and the variation in root canal morphology of permanent mandibular incisors and canines in Pakistani population using Cone Beam Computed Tomography (CBCT). Methods: A cross-sectional study was conducted in University College of Dentistry, The University of Lahore, Pakistan after getting institutional ethical permission from January 2020 to September 2022. The data included records of 111 patients consisting of 444 permanent mandibular incisors and 222 permanent mandibular canines. Accessory root, root canals and Vertucci canal configuration for each tooth was recorded. Data analysis was done using SPSS v20. Descriptive statistics were calculated for each anatomical parameter. Chi-square test was applied to determine association of gender with the presence of accessory roots and root canals. Results: Among the 111 records evaluated, 48.6% were males and 51.4% were females. No accessory root was found in the central and lateral incisors. However, an accessory root was found in 4.9% of the canines. The incidence of accessory canals in the central incisors, lateral incisors and canines was 18.9%, 25.2% and 10.4% respectively. The most common canal configuration in teeth with accessory canals was Type-III, followed by Type-II and Type-V. Conclusion: None of the central or lateral incisor showed accessory root while it was detected in 4.9% canines. The frequency of accessory root canal was found to be 18.9%, 25.2% and 10.4% in central incisors, lateral incisors and canines respectively. The most common canal configuration was Type-I, followed by Type-III and Type-II. Type-V, VI and VII were less common. [ABSTRACT FROM AUTHOR]

The effects of Easydo Activator (EA), a new sonic irrigation system, on sealer penetration at the root apex were compared to needle irrigation (NI) and passive ultrasonic irrigation (PUI) in this study. Forty-two single-rooted teeth were prepared and randomly divided into three groups (n = 14): group 1: NI; group 2: PUI; and group 3: EA. A solution of 3% sodium hypochlorite (NaOCl) was used for irrigation. Nine teeth in each group were filled with AH Plus sealer mixed with CY5 fluorescent dye and a single gutta-percha cone. The sealer penetration area, maximum penetration depth and percentage of sealer penetration at 5 mm and 1 mm from the apex were analyzed by confocal laser scanning microscopy (CLSM). The remaining 5 teeth in each group were subjected to test smear layer scores by scanning electron microscopy (SEM). The CLSM evaluation showed that increases in the area, depth and percentage of sealer penetration were detected at 1 and 5 mm from the root apex in the PUI group compared with the NI group, and greater increases were observed in the EA group (P < 0.05). The SEM experiment showed that the lowest scores for the smear layer and debris removal were achieved by the EA group when compared with the PUI and NI groups (P < 0.05). In conclusion, EA was superior to PUI and NI regarding sealer penetration at the root apex during endodontic treatment, and it could provide a new technical idea for clinical root canal therapy. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the effects of the application of universal adhesive in the etch-and-rinse (ER) strategy with a manual brush (MB) or rotary brush (RB) in adhesion to dentin impregnated (WB) or not (NB) with bioceramic sealer, at 24 h and 1 year. Eighty-eight crowns of bovine incisors were divided into four groups (n=22): WB-MB, WB-RB, NB-MB, NB-RB. After the restorative protocol, dentin penetrability was evaluated by confocal microscopy. Bond strength was evaluated by microtensile test. Data were analyzed using one-way ANOVA/Tukey tests (α=0.05). NB-RB and WB-RB exhibited greater extensions of resin tags in dentin. At 24 h, WB-RB and NB-MB showed the highest and lowest values of bond strength, respectively. At 1 year, WB-MB and WBRB demonstrated the highest bond strength values. The RB increases the formation of resin tags and residues of bioceramic sealer provides higher bond strength in the ER strategy. [ABSTRACT FROM AUTHOR]

Three-dimensional obturation of the root canal system is the primary goal of endodontic treatment. Endodontic sealers should fill any irregularities in the root canal system and penetrate as deeply as possible into the dentinal tubules. They should also ensure that the gutta-percha points adhere well to the dentinal walls of the root canal without leaving voids at their margins. The purpose of this study was to evaluate contemporary imaging techniques used for in vitro testing of selected specimens consisting of tooth scrapings after endodontic treatment with gutta-percha and selected endodontic sealers: AH Plus-Dentsply Sirona, Well Root ST-Vericon, Korea, and AH Bioceramics Sealer-Dentsply Sirona. The following imaging techniques were used in the evaluation: scanning electron microscopy (SEM), confocal laser scanning microscopy (CLSM), micro-computed tomography (micro-CT), surgical microscopy, and light microscopy. A comparison of the imaging methods (SEM, CLSM, micro-CT, surgical microscopy, light microscopy) showed significant differences in their suitability for assessing the penetration depth of endodontic sealers into dentinal tubules in vitro. Based on the analysis of the imaging methods, it was concluded that confocal microscopy and SEM were the most objective and accurate methods for visually assessing the quality of root canal filling in vitro. However, the high cost of specimen preparation and the limited availability of specialized equipment are factors that limit their use in clinical settings. [ABSTRACT FROM AUTHOR]

Context: The main objective of endodontic therapy is to achieve a sterile environment and three-dimensional filling of the root canals. Endodontic sealers play an important role in the obturation of the root canal system as they may provide a seal, which prevents the penetration of bacteria. Sealers are meant to entomb residual bacteria, prevent leakage of nutrients, and ideally possess antibacterial properties. Aim: The aim of the study was to evaluate and compare the antimicrobial effectiveness of calcium silicate-based bioceramic root canal sealers against Enterococcus faecalis and Staphylococcus aureus using the agar diffusion method. Materials and Methods: The materials were divided into four groups of nine samples each for both E. faecalis and S. aureus. Group I (control group) - MTA-Fillapex (Angelus), Group II - BioRoot RCS (Septodont), Group III - Bio-C Sealer (Angelus), and Group IV - Dia-Root Bio Sealer (Diadent). To evaluate the antibacterial activity of the samples, the agar diffusion method was utilized. To begin, a bacterial suspension was evenly spread onto sterile Petri dishes using sterile swabs. Four wells of 4 mm diameter were then punched, and the sealers were mixed following the manufacturer's instructions and placed onto the prepared wells. The Petri dishes were then incubated at 37°C for 72 h. After incubation, the zones of inhibition around each well were measured at 24 h, 48 h, and 72 h, and the resulting values were statistically analyzed. Statistical Analysis Used: The data were analyzed using the ANOVA and post hoc Tukey's test. Results: Calcium silicate-based root canal sealers showed significantly better efficacy than the control group. BioRoot RCS (3.44 ± 1.13 mm) showed maximum antibacterial effect against E. faecalis at 24 h, 48 h, and 72 h time intervals. Bio-C Sealer (16.44 ± 1.42 mm) showed maximum antibacterial effect against S. aureus at 24 h, 48 h, and 72 h time intervals. The effectiveness of root canal sealants eventually decreased over a period. Based on analysis using the ANOVA test, a statistically significant difference (P = 0.05) was observed between the mean values of antimicrobial efficacy of sealers against both E. faecalis and S. aureus. Conclusions: The study's findings lead to the conclusion that BioRoot RCS showed a maximum antibacterial effect against E. faecalis and Bio-C Sealer showed maximum antibacterial effect against S. aureus at 24 h, 48 h, and 72 h. [ABSTRACT FROM AUTHOR]

Background: The present study evaluated the effect of a bioceramic intracanal medicament (Bio-C Temp) on the push-out bond strength of bioceramic cements. Methods: Forty-eight human single-canaled premolars were prepared and randomly divided into three groups: Group (A) received no intracanal medicament; Group (B) calcium hydroxide (CH); and Group (C) Bio-C Temp. After medicament removal, the roots were sectioned transversely. The slices in each group were separated into two subgroups (n = 16): in Subgroup (1), mineral trioxide aggregate (MTA) was placed, and in Subgroup (2) Bio-C Repair. Push-out bond strength was determined using a universal testing machine, applying a constant compressive force on the cement until bond failure. The failure mode was also evaluated. Data were analyzed using the Chi-square test and two-way ANOVA followed by Tukey's post hoc tests. The level of significance was set at 5%. Results: The pushout bond strength of Bio-C Repair was significantly higher than that of MTA irrespective of intracanal medication (p = 0.005). The placement of Bio-C Temp was associated with significantly lower bond strength (p = 0.002, p = 0.001). Conclusion: Bio-C Repair showed better bond strength compared to MTA, irrespective of intracanal medication. Bio-C Temp intracanal medicament, however, decreased the bond strength of both these cements. [ABSTRACT FROM AUTHOR]

Aim: The current study compared the push-out adhesive strength of glass fiber-reinforced posts with a silane-treated surface versus a universally adhesive-treated surface. In both cases, a universal self-adhesive cement was used. Materials and Methods: Thirty bovine teeth were used in an in vitro experiment. Through cutting, the root and coronal sections were divided. Subsequently, the manufacturer’s recommendations were followed for the placement of glass fiber-reinforced posts through root canal therapy, guttapercha removal, and canal shaping. On the basis of how the posts were treated prior to cementation, the samples were split into three groups (n = 10). Posts in group A (control) did not get any prior treatment. Posts in group B had previously received a silane treatment. Posts in Group C had previously been coated with universal adhesive. Following the application of RelyX Ultimate universal self adhesive cementation, the samples were segmented and subjected to a Push-Out test at a speed of 1mm/min on a universal testing apparatus. Intergroup ANOVA was used to evaluate the adhesive strength means (measured in MPa), and Tukey’s post hoc test was performed afterward, with a significance level of P < 0.05. Results: Compared to the glass fiber-reinforced posts pre-treated with silane (P = 0.003) and the control group (P < 0.001), the adhesive strength of the posts pre-treated with universal adhesive was significantly higher. Similarly, the adhesive strength of the glass fiber-reinforced posts that had been pre-treated with silane was considerably higher than that of the control group (P = 0.012). Conclusion: Posts reinforced with glass fiber and pre-treated with universal adhesive exhibited notably greater adhesive strength compared to those pre-treated with silane. When compared to utilizing universal self-adhesive cement without pre-treatment, both pre-treatment techniques greatly increased the adhesive strength of glass fiber-reinforced posts. [ABSTRACT FROM AUTHOR]

Introduction This study aimed to compare the effectiveness of two endodontic cleaning techniques, passive ultrasonic irrigation (PUI) and the XP-endo Finisher R (XPR) system, in removing residual filling material during endodontic retreatment procedures. Materials and Methods: Forty mandibular premolars with oval canals were divided into four groups based on the sealer used (AH-Plus or Bio-C Sealer) and the cleaning technique employed (PUI or XPR). To ensure uniformity of canal volume among groups, initial micro-CT scans were conducted. The canals were instrumented, filled, and then re-instrumented before undergoing either PUI or XPR cleaning techniques. Residual filling material volumes were assessed through micro-CT scans, and statistical analysis was performed using the Kruskal-Wallis and Mann-Whitney U tests. Results: Following instrumentation, there was no significant difference in residual filling material volumes between AH-Plus and Bio-C Sealer groups (1.35 mm³ and 1.02 mm³, respectively; P>0.05). However, after supplementary cleaning techniques, XPR-cleaned specimens exhibited significantly less residual material compared to PUI-cleaned specimens (0.01 mm³ and 0.29 mm³ for Bio-C Sealer, and 0.07 mm³ and. 0.30 mm³ for AH-Plus, P<0.05). Conclusion: The XPR system was found to be more effective than PUI in removing residual filling material from Bio-C Sealer-filled root canals. This highlights its potential as a useful supplementary cleaning technique in endodontic retreatment procedures. [ABSTRACT FROM AUTHOR]

Introduction: Ultrasonic vibration for metallic post removal seems to be a unanimous choice between endodontists and general practitioners for providing the best results and having the highest safety. This study compared the time required by ultrasonic vibration for removing metallic post (MP) when 1 or 2 ultrasonics devices are used. Materials and Methods: One hundred and fifteen teeth with MPs from 105 patients, indicated for nonsurgical endodontic retreatment were divided into 2 groups according to the number of ultrasonic devices used (G1-1 device) and (G2-2 devices). In G1, the MP was worn with a transmetal bur, alongside the wear of the cement line (around 2 mm deep). Then, an ultrasonic tip attached to an ultrasonic unit, with a power of 100% was activated at the level of the post, with constant water spray at a level of 1 mm above the axial surface of the tooth. The position of the tip was changed between buccal and lingual surfaces every 10 seconds until the MP was removed. In G2 the same procedures were performed as described in G1, but two ultrasonic tips were activated simultaneously at buccal and lingual surfaces until the MP was removed. The vibration time necessary for removing each MP was recorded using a chronometer. Results: The mean time was 131.10±29.68 seconds (mean±standard error of the mean) for MP removal using one ultrasonic device, and 24.86±6.88 seconds for two devices. The time required for MP removal using two ultrasonic devices was significantly less than when using one ultrasonic device (P<0.001). Conclusion: The technique with 2 ultrasonic devices proved to be more efficient than the one using only 1 ultrasonic device. [ABSTRACT FROM AUTHOR]

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Objective: To investigate the fracture resistance and failure modalities of anterior endocrown restorations fabricated employing diverse ceramic materials, and bonded using various cementation methodologies. Materials and methods: Forty maxillary central incisors were divided into two main groups based on the ceramic materials used; GroupI (Zir): zirconia endocrwons (Zolid HT+, Ceramill, Amanngirrbach) and GroupII (E-Max): e-max endocrowns (IPS e.max CAD, Ivoclar Vivadent). Both groups were further split into two subgroups depending on the cementation protocols; subgroup IA "ZirMDP": endocowns cemented with MDP primer + MDP resin cement, subgroup IB (ZirNon-MDP): cemented with MDP primer + non-MDP resin cement, subgroup IIA (E-maxMDP): cemented with MDP primer + MDP resin cement, subgroup IIB (E-maxNon-MDP): cemented with MDP primer + non-MDP resin cement. (n = 10/subgroup). Endocrowns were manufactured using CAD/ CAM. Teeth were subjected to 10,000 thermal cycles. The fracture test was performed at 45o with a palatal force direction until the fracture occurred. Test results were recorded in Newton. The failure mode was examined using a stereomicroscope. A One-way ANOVA test was utilized to compare different groups regarding fracture strength values. Tukey's Post Hoc was utilized for multiple comparisons. Results: The comparative analysis of fracture strength across the diverse groups yielded non-significant differences, as indicated by a p-value exceeding 0.05. Nonetheless, an observable trend emerged regarding the mode of failure. Specifically, a statistically significant prevalence was noted in fractures localized within the endocrown/tooth complex below the cementoenamel junction (CEJ) across all groups, except for Group IIB, "E-max Non-MDP," where fractures within the endocrown/tooth complex occurred above the CEJ. Conclusions: Combining an MDP-based primer with an MDP-based resin cement did not result in a significant effect on the anterior endocrown fracture strength. Clinical relevance: Regardless of the presence of the MDP monomer in its composition, adhesive resin cement achieved highly successful fracture strength when used with MDP-based ceramic primers. Additionally, ceramic materials exhibiting elastic moduli surpassing those of dentin are discouraged due to their propensity to induce catastrophic fractures within the tooth structure. [ABSTRACT FROM AUTHOR]

Endodontic retreatment is a procedure to remove root canal filling material from the tooth, followed by cleaning, shaping, and obturation of the canals. Treatment outcomes may be influenced by incomplete removal of filling materials. The present literature review aimed to identify the techniques and materials used to remove Bioceramic Sealers (BCS) from the root canal system using Micro-Computed Tomography (Micro-CT) and Scanning Electron Microscopy (SEM). A search of the PubMed, Web of Science, Scopus, Science Direct, and Google Scholar databases using applicable keywords such as "BCS" and "calcium silicate-based sealer" and "retreatment" and "retreatability" and "micro-CT" and "SEM" identified studies on techniques and materials used to remove BCSs from the root canal system, as assessed by micro-CT and SEM. A total of 46 studies were included in the review. Of these, 32 studies used Nickel-titanium (NiTi) rotary instruments, 11 used reciprocating systems, and three compared continuous nickel-titanium rotary and reciprocating systems with rotary systems and reciprocation in removing filling materials. Apical patency and Working Length (WL) could be achieved in a canal obturated with gutta-percha and a BCS. The review revealed that removing filling materials using various instrumentation protocols can be successful but incomplete. Both rotary and reciprocating systems can efficiently remove root-filling material. Using supplemental techniques can improve the cleanliness of the root canal during retreatment. Solvents require less time to reach the WL and achieve patency; however, they leave a larger amount of residual root canal-filling material than non solvents. Additionally, the formation of dentinal microcracks remains controversial during the non surgical retreatment of canals filled using BCSs. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to compare the effect of two calcium silicate-based and an epoxy resin-based root canal sealers on postoperative pain and analgesic intake following single-visit root canal treatment. Materials and Method: Ninety patients with at least one first or second molar tooth diagnosed as symptomatic irreversible pulpitis and symptomatic apical periodontitis were selected and allocated into three groups (n=30) according to the sealer used. Root canals were prepared using Protaper Gold instruments (Dentsply Sirona) in a crown down technique and irrigated with 2.5% NaOCl (Calyx, India) and saline solution. Root canal filling was then accomplished with a single cone obturation technique and treated in a single visit by the same endodontist. Patients were told to use a Visual Analog Scale (VAS) to rate their postoperative pain severity as none, minimal, moderate, or severe after 6 h, 24 h, 48 h, 5 days and 7 days following obturation using the appropriate sealers. The need for analgesic intake was also recorded. The data were statistically analyzed. Results: Results showed a significant difference among the studied groups. Bio-C Sealer Ion+ reported the least pain score followed by Nishika Canal Sealer BG and AH plus sealer at all the time intervals recorded. The intergroup analysis, revealed was a significant difference in postoperative pain at 6 h (p=0.000) and 24 h (p = 0.028), but not at 48 h, 5 day or 7 days (P > 0.05). VAS ratings for all the three groups decreased over time. Also, there were significant differences between the means of analgesic intake among 3 groups (p=0.022). Analgesic intake in group BIO-C Sealer Ion+ is significantly lesser than AH Plus and Nishika Canal Sealer BG group. Conclusion: Calcium silicate-based sealer (Nishika Canal Sealer BG and Bio-C Sealer Ion+) resulted in significantly lower levels of pain as compared to epoxy resin-based sealer (AH Plus) at 6h and 24-h interval, there was no significant difference in postoperative pain occurrence at 48-h, 5 day and 7-day period. The analgesic intake in Bio-C Sealer Ion+ group is significantly lesser than Nishika Canal Sealer BG and AH Plus group. [ABSTRACT FROM AUTHOR]

Aims: This ex vivo study aimed to assess the dissolving capacity of 2.5% sodium hypochlorite using eight agitation protocols within swine pulp tissue. Subjects and Methods: Twelve lower first premolars were prepared and split into the fragments with a groove housing porcine dental pulp. Groups were assigned based on agitation systems: manual, passive ultrasonic, Easy Clean and XP-Endo Finisher. Two agitation time protocols were applied: One min (3 s × 20 s cycles) and 2 min (6 s × 20 s cycles). Wilcoxon Mann–Whitney U test was used to compare the groups. Results: Both time frames demonstrated superior results compared to manual group (P > 0.5). However, in the two min groups, no significant differences were observed among the other protocols (P < 0.5). Intriguingly, increasing cycle numbers significantly improved results within each group (P > 0.5). Conclusion: Extending the chemical agitation time during final irrigation enhances tissue removal, regardless of the irrigation protocol employed. [ABSTRACT FROM AUTHOR]

Objective: The present in vitro study aimed to evaluate the effect of a 980 nm diode laser irradiation on the bond strength of fiber posts to intracanal dentine. Mthods: Twenty-four extracted human maxillary central incisors were obtained. After root canal treatment, the samples were randomly divided into two groups (n=12): In group 1, root canal dentin was subjected to diode laser irradiation (980 nm, 1W, continuous wave) whereas group 2 was considered the control group and was not irradiated. Fiber posts were cemented using resin cement. The pull-out bond strength of the fiber posts was assessed with a universal testing machine. The data were analyzed by an independent samples t-test (α=0.05). Results: The average fracture strength of the laser-irradiated group (90.04 ± 30.45 MPa) was significantly higher than the control group (62.95 ± 22.09 MPa; P = 0.021). Conclusions: Diode laser irradiation to the root canal can increase the bond strength of fiber posts to intraradicular dentin. [ABSTRACT FROM AUTHOR]

Background: A xanthoma is a rare bone condition consisting of a predominant collection of lipid-rich, foamy histiocytes. The central xanthoma of the jaws is a unique benign tumor. Case report: A 15-year-old Caucasian male has been presented to our department. He had radiological changes in the area of the left mandibular angle, with an area of diffuse osteolysis of 3.0 cm by 2.0 cm. Computed tomography reveals an area of diffuse osteolysis that starts from the distal root of the lower second molar and reaches the ascending process. A bone biopsy was performed, which revealed a benign proliferative process composed of histiocytic cells involving and infiltrating trabecular bone in a background of loose fibrous connective tissue devoid of any other significant inflammatory infiltrate. The size of the formation was 2.9 cm by 2.0 cm. Immunohistochemical staining for CD68 was strongly positive and negative for S-100 and CD1a. From routine blood tests, cholesterol, triglycerides, and blood sugar are within normal values, which excludes systemic metabolic disease. Subsequent to the surgical intervention, the patient underwent postoperative assessments at intervals of 14, 30, 60 days, and a year later, revealing the absence of any discernible complications during the aforementioned observation periods. Conclusion: The diagnosis of primary xanthoma of the mandible is rare and can often be confused with other histiocytic lesions. A differential diagnosis should be made with nonossifying fibroma and Langerhans cell histiocytosis, as in our case. In these cases, immunohistochemistry with CD 68, S-100, and CD1a, as well as blood parameters, are crucial for the diagnosis. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to compare the efficacy of a resin-based canal sealer and a bioceramic canal sealer in obturating lateral canals, with and without the use of activation methods. Methods: Lateral canals were created at apical positions of 3, 5, and 8 mm in eighty 3D-printed maxillary central teeth. After root canal preparation, the teeth were embedded in 1.5% agar agar to simulate periodontal tissues. The teeth were divided into two main groups based on the type of root canal sealer and further categorized into four subgroups for activation methods: Conventional, EDDY, EndoActivator, and Passive Ultrasonic. Root canals were filled using the single cone technique, and images were captured at 17× magnification. Sealer penetration into lateral canals was measured using ImageJ software. Activation methods were compared using the Kruskal-Wallis test; root levels were compared using the Friedman test, and comparisons between sealers were made with the Mann-Whitney U test at a 95% confidence level. Results: Activation methods had no significant impact on sealer penetration for both types of sealers. In ultrasonic activation groups, the bioceramic sealer exhibited significantly higher penetration than the resin-based sealer at all root levels. In sonic activation groups, the bioceramic sealer showed significantly superior penetration, especially at the middle root level. Conclusion: Activation methods did not significantly alter sealer penetration into lateral canals. Bioceramic-based root canal sealer demonstrated enhanced penetration compared to resin-based sealer, especially with ultrasonic and sonic activation. [ABSTRACT FROM AUTHOR]

Aim: Evaluation of the antibacterial and cytotoxic properties of TotalFill and NeoSEALER Flo bioceramic sealers compared to AH Plus resin sealer. Materials and Methods: Modified direct contact test was used on three sets of sealers: Freshly mixed sealers, sealers that were 1-day old, and sealers that were 7-day old. After 24 h of incubation, the colony-forming units were digitally counted using Promega Colony Counter after 30 and 60 min of exposure to Enterococcus faecalis. For cytotoxic effect evaluation, 3-(4,5-dimethylthiazol-2-yl)-2-5-diphenyltetrazolium bromide assay was performed at three different time points: 24 h, 48 h, and 120 h after adding the sealer eluates to human gingival fibroblasts, to assess cell viability. Data were analyzed using mixed model analysis of variance followed by post hoc test. Results: TotalFill bioceramic sealer showed the highest bacterial reduction against E. faecalis throughout all intervals. AH Plus showed great antibacterial activity initially which reduced drastically after 7 days. All the sealers showed a reduction in their antibacterial activity with time. TotalFill and NeoSEALER Flo showed very high cell viability in contrast to AH Plus. Conclusion: TotalFill and NeoSEALER Flo demonstrate superior antimicrobial properties against E. faecalis which reduces with time. TotalFill and NeoSEALER Flo demonstrate acceptable biocompatibility against human gingival fibroblasts, which decreased over time. [ABSTRACT FROM AUTHOR]

Background: Optimal dimensional stability is required for successful root canal treatment. A sealant called EndoSeal mineral trioxide aggregate (MTA) was recently introduced to the market due to its favorable physical and chemical properties. On the other hand, AH Plus (AHP) is considered the gold-standard seal. Materials and Methods: In this ex vivo quasi-experimental study, 24 single-canal premolars extracted from humans were cleaned and shaped with a motorized and rotary file, then that is divided into two groups. The teeth of each group were filled with gutta F3 and each type of sealant. The teeth were scanned by a micro-computed tomography device after 24 h. After 7 days of storage in phosphate-buffered saline solution, the samples were re-scanned. Data were analyzed using SPSS software (version 2I). Descriptive data were presented as frequency, percentage, mean, and standard deviation. The Shapiro-Wilk and Kolmogorov-Smirnov tests were used to investigate the normality of the data.The Mann-Whitney test was used to compare the two groups, and the differences were ultimately not significant. The level of significance was set at 0.05 (P < 0.05). Results: The mean differences between sealer volumes before and after the intervention were not significantly different between the two groups indicating that the EndoSeal MTA sealer is not inferior to the gold-standard root canal sealer, AHP. Conclusion: EndoSeal MTA can be considered a reliable sealer in endodontic treatments and be subjected to further investigation. [ABSTRACT FROM AUTHOR]

Background: The rising demand for improved aesthetics has driven the utilization of recently introduced aesthetic materials for creating custom post and core restorations. However, information regarding the fracture resistance of these materials remains unclear, which limits their practical use as custom post and core restorations in clinical applications. Aim of the study: This study aimed to evaluate the fracture resistance of three non-metallic esthetic post and core restorations and their modes of failure. Materials and methods: Thirty-nine single-rooted human maxillary central incisors were endodontically treated. A standardized post space preparation of 9mm length was performed to all teeth to receive custom-made post and core restorations. The prepared teeth were randomly allocated to receive a post and core restoration made of one of the following materials (n=13): glass fiber-reinforced composite (FRC), polyetheretherketone (PEEK) and polymer-infiltrated ceramic-network (PICN). An intraoral scanner was used to scan all teeth including the post spaces. Computer-aided design and computer-aided manufacturing (CAD-CAM) was used to fabricate post and core restorations. Post and core restorations were cemented using self-adhesive resin cement. All specimens were subjected to fracture resistance testing using a universal testing machine. Failure mode analysis was assessed using a stereomicroscope and SEM. The data was statistically analyzed using One-Way ANOVA test followed by multiple pairwise comparisons using Bonferroni adjusted significance level. Results: Custom PEEK post and core restorations displayed the least fracture load values at 286.16 ± 67.09 N. In contrast, FRC exhibited the highest average fracture load at 452.60 ± 105.90 N, closely followed by PICN at 426.76 ± 77.99 N. In terms of failure modes, 46.2% of specimens with PICN were deemed non-restorable, while for PEEK and FRC, these percentages were 58.8% and 61.5%, respectively. Conclusions: Within the limitation of this study, both FRC and PICN demonstrated good performance regarding fracture resistance, surpassing that of PEEK. [ABSTRACT FROM AUTHOR]

Purpose: EDC (1-ethyl-3-(3-dimethylaminopropyl)carbodiimide hydrochloride) can increase dentin bonding longevity. This study aimed to evaluate the effect of final irrigation of the root canal with EDC on the bond strength (BS) longevity of an epoxy resin-based root-canal sealer. Materials and Methods: Twenty maxillary canines were sectioned and standardized for root length at 17 mm. Roots were instrumented and distributed into 2 groups according to the final irrigation protocol: EDTA 17%+NaOCl 2.5% (C) and EDTA 17%+NaOCl 2.5%+EDC 0.5M (EDC). The canals were dried and filled with AH Plus (Dentsply Sirona). Three slices were obtained per third, and the first slice from each third was used for the immediate push-out test (i) followed by analysis of the failure pattern (n = 10); the second slice from each third was used for the push-out test after 6-month aging (A) followed by analysis of the failure pattern (n = 10); the third slice from each third was used to examine the adhesive interface under confocal laser scanning microscopy (CLSM) (n = 10). Data were analyzed with ANOVA, Fisher's exact and Kruskal-Wallis tests. Results: Higher BSs were found for EDC-A (5.6 ± 1.9) than for EDC-I (3.3 ± 0.7), C-i (2.5 ± 1.0) and C-i (2.6 ± 1.0) (p = 0.0001), while C-A values were in some cases similar to C-i and in others similar to EDC-i. No statistically significant difference was observed between the thirds (p > 0.05), except for EDC-i, which showed lower BS for the cervical (2.79 ± 0.46) compared to the apical third (3.8 ± 0.5), while the middle third in some cases had values similar to those of the apical and in others to the cervical third (3.2 ± 0.7) (p = 0.032). More mixed adhesive failures were found in the cervical third, and more adhesive failures to the sealer occurred in the middle and apical thirds (p = 0.014). A significant difference was observed between treatments in terms of adaptation of the adhesive interface, with a higher percentage of good adaptation using EDC (66.7%) than using C (40%), and a lower percentage of poor adaptation with EDC (10%) compared to C (20%) (p < 0.05). Conclusion: Root canal irrigation with EDC increased the longevity of the adhesive interface of an epoxy resin-based rootcanal sealer. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effect of carbodiimide (EDC) and chitosan (CHI) on the enzymatic activity (EA) and bond strength (BS) of different composite cements to root dentin. Materials and Methods: Ninety (90) maxillary canines were sectioned, standardizing the length of the roots. The roots were endodontically treated, prepared, divided into 3 groups according to dentin treatment (distilled water [DW], CHI 0.2 wt%, or EDC 0.5M), and further subdivided into 3 subgroups according to composite cement (RelyX ARC [3M Oral Care], Panavia F 2.0 [Kuraray Noritaki], or RelyX U200 [3M Oral Care]). Of the slices obtained by sectioning, the most cervical of each third were subjected to a push-out test and the most apical were subjected to in-situ zymography. Half of the slices were analyzed immediately, and the other half after 6 months. The results were analyzed with ANOVA or the chi-squared test. Results: RelyX ARC showed higher BS associated with CHI, while RelyX U200 showed higher BS associated with EDC (p = 0.044). For Panavia F 2.0, the treatment did not influence BS (p > 0.05). For the cervical and middle thirds, no differences were observed between the cements, while the apical third revealed higher BS for RelyX U200 (p < 0.001). The highest percentage of adhesive-to-dentin failures was observed for Panavia F 2.0. EDC showed the lowest percentage of adhesive-to-dentin failures. According to zymographic analysis, DW and CHI showed greater fluorescence for RelyX ARC, while EDC exhibited the lowest fluorescence of all cements (p > 0.05). Conclusion: The different mechanisms of action of solutions for pre-treatment of intraradicular dentin yielded different results depending on the adhesive used. EDC resulted in higher bond strength and higher enzyme inhibition for RelyX U200, while the treatment with chitosan resulted in higher bond strength and lower enzymatic activity for RelyX ARC. Although EDC and chitosan treatments did not influence the bond strength for Panavia F 2.0, both resulted in higher enzyme inhibition for this composite cement. [ABSTRACT FROM AUTHOR]

Objectives: The impression technique highly influences the adaptation of ceramic restorations. Not enough information is available to compare the marginal (MF) and internal fit (IF) of endocrowns fabricated with various digitization techniques. Therefore, this in-vitro study aimed to compare the MF and IF of lithium disilicate (LDS) endocrowns fabricated through direct and indirect digital scanning methods. Materials and methods: One extracted maxillary molar was used to fabricate endocrowns. The digitization of the model was performed with (G1) direct scanning (n = 10) utilizing an intraoral scanner (IOS), (G2) indirectly scanning the conventional impression taken from the model using the same IOS (n = 10), (G3) indirectly digitalizing the obtained impression using an extraoral scanner (EOS) (n = 10), and (G4) scanning the poured cast using the same EOS (n = 10). The MF and IF of the endocrowns were measured using the replica method and a digital stereomicroscope. The Kruskal-Wallis test was used to analyze data. Results: The studied groups differed significantly (p<0.001). G2 (130.31±7.87 μm) and G3 (48.43±19.14 μm) showed the largest and smallest mean vertical marginal gap, respectively. G2 and G3 led to the highest and lowest internal gaps in all regions, respectively. With significant differences among the internal regions (p<0.001), the pulpal area demonstrated the most considerable misfit in all groups. Conclusions: Scanning the impression using an extraoral scanner showed smaller marginal and internal gaps. [ABSTRACT FROM AUTHOR]

Copyright of Turkiye Klinikleri Journal of Dental Sciences is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives Ensuring strong adhesion of silicate-based cement to dentin during root canal therapy is crucial for achieving optimal results. This review aims to evaluate how different intracanal medicaments impact the tensile bond strength of silicate-based cement in root canal treatments. Methods A thorough electronic search was performed using the PubMed and Google Scholar databases for articles published from 2000 to 2023. Results The studies included in this review evaluated the effects of various intracanal medicaments, including calcium hydroxide, chlorhexidine, triple antibiotic paste, double antibiotic paste, simvastatin, and bioactive glass, on the bond strength of silicate-based cements like mineral trioxide aggregate (MTA), Biodentine, and calcium-enriched mixture (CEM) cement. The results demonstrated varied impacts of these medicaments; some improved bond strength, while others had minimal effect. Specifically, calcium hydroxide frequently enhanced bond strength, and some antibiotic pastes showed similar benefits. In contrast, medicaments such as phenolic preparations and formaldehyde were found to have limited efficacy and potential toxicity. Conclusion The type, concentration, and application site of intracanal medicaments significantly impact bond strength. This review highlighted the potential advantages of these medicaments, including improved root canal disinfection and enhanced push-out bond strength of commonly used dental cements. These insights can help dental professionals optimize root canal treatments and improve patient outcomes. [ABSTRACT FROM AUTHOR]

Three-dimensional obturation of the root canal system is the primary goal of endodontic treatment. Endodontic sealers should fill any irregularities in the root canal system and penetrate as deeply as possible into the dentinal tubules. They should also ensure that the gutta-percha points adhere well to the dentinal walls of the root canal without leaving voids at their margins. The purpose of this study was to evaluate contemporary imaging techniques used for in vitro testing of selected specimens consisting of tooth scrapings after endodontic treatment with gutta-percha and selected endodontic sealers: AH Plus-Dentsply Sirona, Well Root ST-Vericon, Korea, and AH Bioceramics Sealer-Dentsply Sirona. The following imaging techniques were used in the evaluation: scanning electron microscopy (SEM), confocal laser scanning microscopy (CLSM), micro-computed tomography (micro-CT), surgical microscopy, and light microscopy. A comparison of the imaging methods (SEM, CLSM, micro-CT, surgical microscopy, light microscopy) showed significant differences in their suitability for assessing the penetration depth of endodontic sealers into dentinal tubules in vitro. Based on the analysis of the imaging methods, it was concluded that confocal microscopy and SEM were the most objective and accurate methods for visually assessing the quality of root canal filling in vitro. However, the high cost of specimen preparation and the limited availability of specialized equipment are factors that limit their use in clinical settings. [ABSTRACT FROM AUTHOR]

Introduction and aim. An extraoral cutaneous sinus tract of endodontic origin represents a skin condition that appears due to an infection that could be primary or secondary to trauma accompanied by alveolar bony changes. It may be easily misdiagnosed and inappropriately treated due to lack of inadequate expertise on part of medical professionals followed by faulty treatment which can complicate the case further. Description of case. This case report intends to highlight a case of a sixteen-year-old male patient referred for an extraoral cutaneous sinus tract misdiagnosed and insufficiently treated by a general physician followed by general dentists for more than a month due to lack of proficiency in the field of endodontics. The clinical and radiographic examinations confirmed the pulpal origin due to trauma related to permanent mandibular incisors. A combination of non-surgical root canal therapy followed by periapical surgery was performed leading to a significant healing of the lesion. Conclusion. Accurate diagnosis is the key to treat draining sinus tracts of endodontic origin. Root canal treatment and endodontic surgery should be used judiciously for effectively eliminating the pathogens thus providing healing and repair mechanisms a chance to achieve the desired result. [ABSTRACT FROM AUTHOR]

This article, published in the Romanian Journal of Oral Rehabilitation, discusses the antioxidant effects of medicinal plants in oro-dental medicine. It explores the potential of bioactive compounds extracted from plants to reduce the risk of oro-dental pathologies such as periodontitis and oral cancer. The article emphasizes the importance of further research to determine the effectiveness of these compounds in vivo. It also highlights the role of a balanced lifestyle and healthy diet in preventing and reducing the risk of pathologies associated with oxidative stress. The document provides a table of medicinal plants known for their antioxidant effects and discusses their potential use in the treatment of oral diseases. It also includes references related to the antioxidant properties of medicinal plants and their potential applications in healthcare. [Extracted from the article]

A xanthoma is an extremely rare condition that affects the soft tissues and bones and is characterized by a predominance of lipid-rich foamy histiocytes. The onset of xanthomas is frequently accompanied by primary or secondary hyperlipidemia. Primary bone xanthomas are very uncommon benign bone lesions that are not linked to hyperlipidemia. Histopathologically, they are distinguished by histiocytes, an abundance of foam cells or xanthoma cells that contain lipids, and a paucity of multinucleated giant cells. There have only been four reports of primary maxillary xanthoma in the medical literature. We present a rare primary intrabony xanthoma of the anterior maxilla in a 23-year-old normolipidemic female patient with solitary radiolucency. Using CD68, S-100, and CD1a immunohistochemical staining, it is possible to distinguish between macrophage/non-Langerhans histiocytes and Langerhans histiocytes. Therefore, a diagnosis of a central xanthoma of the jaws must be made. [ABSTRACT FROM AUTHOR]

This study evaluated the feasibility of an automated method to delimit the required area to quantitatively analyze root filling voids and gaps from cross-sectional confocal laser scanning microscopy (CLSM) images. Root canals of maxillary canines were prepared with rotary instruments and filled by lateral compaction technique using gutta-percha and AH Plus sealer. The roots were stored (100% humidity, 37 °C) for a period of 24 h and then transversally sectioned to obtain 2-mm-thick slices from the apical and middle thirds. The areas corresponding to filling materials, gaps, and voids were manually delimited or automatically demarked by ImageJ software after converting the images to the RGB color system. Based on manual and automatic delimitations, the percentages of voids and gaps were calculated. Data of voids and gaps between middle and apical thirds were individually compared by paired t-test. Pearson's correlation test was used to assess the correlation of data between the methods. Irrespective of the method of area delimitation, no difference was observed between the root thirds for both voids and gaps, while the p-values calculated for each method were similar. Almost perfect correlations between the methods were observed for both outcomes. The proposed method to automatically delimit the areas corresponding to filling material, voids, and gaps appears to be a valid method to facilitate the quantitative analysis of defects in root canal fillings using topographic CSLM images. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to investigate the selection of postendodontic restorative materials and techniques for both anterior and posterior teeth by Indian endodontists and nonendodontists, along with other influencing factors. Methods: A total of 700 dentists, including both endodontists and nonendodontists, participated in this survey. The survey consisted of 22 questions and was administered through Google Forms and various online platforms. Participants were required to provide informed consent before completing the questionnaire. Results: The majority of endodontists (80.3%) and nonendodontists (72.6%) revealed a preference for resin composite as the primary restorative material for postendodontic restoration. Approximately half of the endodontists (50.0%) and 67.8% of nonendodontists typically waited for 1 week before proceeding with postendodontic restoration, with the presence of periapical lesions being the most common reason for this delay. Both endodontists (81.7%) and nonendodontists (73.4%) considered the amount of remaining tooth structure as the most crucial factor in guiding their choice of postendodontic restoration. The majority of both endodontists (75.3%) and nonendodontists (81.4%) preferred full-coverage crowns as the definitive postendodontic restoration. Furthermore, endodontists (95.4%) and nonendodontists (85.5%) reported that they only performed post and core restoration when necessary, and 84.7% of endodontists and 76.5% of nonendodontists believed that post and core restorations aided in supporting crowns. Conclusion: The outcomes of the survey imply that while endodontists in India demonstrate a more comprehensive comprehension of postendodontic restoration concepts, nonendodontists also exhibit a sufficient level of understanding essential for achieving clinical success. [ABSTRACT FROM AUTHOR]

Aim: The present study was conducted to evaluate the dentinal wall adaptation ability of different root canal sealers (mineral trioxide aggregate Fillapex [MTA], EndoSequence BC [ESBC] Sealer, and AH Plus) using a scanning electron microscope (SEM). Methods: Forty-five extracted single-rooted human maxillary incisor teeth were selected and divided into three equal groups (n = 15). Working length was established using a #15 K-type file. Canals were prepared with rotary Ni-Ti system to size 30/0.06 or 40/0.06 file using endomotor at 250 rpm, irrigated with 17% ethylenediaminetetraacetic acid, 3% NaOCl, and normal saline solution, and dried with paper points. Prepared canals were obturated with gutta-percha cones using the single-cone technique and appropriate sealers. Specimens were stored in saline solution at 37°C for 48 h and evaluated using a SEM. Unpaired t-test, one-way analysis of variance, and post-hoc tests verified the differences between groups and were considered significant at alpha = 5%. Results: None of the specimens showed a gap-free interface. Gaps compared between MTAF and ESBC did not show any statistically significant differences (coronal [P = 0.9757], middle [P = 0.5464], and apical [P = 0.2136] thirds). However, gaps found at the interface of sealer and dentinal wall in root canals filled with AH Plus showed extremely statistically significant differences when compared with MTAF and ESBC (P < 0.0001). Conclusion: Specimens obturated with MTAF and ESBC Sealer showed smaller gaps on SEM analysis than specimens filled with AH Plus. [ABSTRACT FROM AUTHOR]

Aim: Endodontic sealers with antimicrobial impact are considered relevant to prevent re-infection and ensure healing of damaged periapical tissue. Hence, this study aimed to assist the antimicrobial effect of newly developed nano-tricalcium silicate-58s bioactive glass (BG)-based endodontic sealer (C3S-BG-P), and compare its results with Nishika Canal Sealer BG and BioRoot™ oot canal sealer (RCS). Methods: The antimicrobial impact of endodontic sealers was evaluated by both agar diffusion test (ADT) and direct contact test (DCT) against Enterococcus faecalis and Candida albicans. In ADT, the diameter of inhibition zones was measured after 1, 2, and 3 days of incubation using Digimizer software program. In DCT, the sealers were allowed to set for 1, 7, and 14 days and then exposed to the microbial suspension for 24 h. The colony-forming unit was counted using ImageJ software program. The data were analyzed with ANOVA and Tukey's tests. Results: In ADT, all the tested sealers showed antimicrobial effect after 3 days, with no significant difference after 1 day, but the impact of C3S-BG-P and Nishika significantly higher than that of BioRoot after 2 and 3 days. In DCT, C3S-BG-P and Nishika had an antimicrobial effect against both isolates even after 14 days of their setting, whereas BioRoot had an effect for 7 days of its setting and lost its impact after 14 days. Conclusion: C3S-BG-P explored antimicrobial impact superior to that of BioRoot and nearly comparable to that of Nishika against E. faecalis and C. albicans, which last even after 14 days of its setting. [ABSTRACT FROM AUTHOR]

Background: The selection of post-core material holds significant importance in endodontically treated teeth, influencing stress distribution in the dental structure after restoration. The use of computer-aided design/computer-aided manufacturing (CAD/CAM) glass fiber post-core possesses a better adaptation for different root canal morphologies, but whether this results in a more favorable stress distribution has not been clearly established. Materials and methods: This study employed finite element analysis to establish three models of post-core crown restoration with normal, oversized, and dumbbell-shaped root canals. The three models were restored using three different materials: CAD/CAM glass fiber post-core (CGF), prefabricated glass fiber post and resin core (PGF), and cobalt-chromium integrated metal post-core (Co-Cr), followed by zirconia crown restoration. A static load was applied and the maximum equivalent von Mises stress, maximum principal stress, stress distribution plots, and the peak of maximum displacement were calculated for dentin, post-core, crown, and the cement acting as the interface between the post-core and the dentin. Results: In dentin of three different root canal morphology, it was observed that PGF exhibited the lowest von Mises stresses, while Co-Cr exhibited the highest ones under a static load. CGF showed similar stress distribution to that of Co-Cr, but the stresses were more homogeneous and concentrated apically. In oversized and dumbbell-shaped root canal remnants, the equivalent von Mises stress in the cement layer using CGF was significantly lower than that of PGF. Conclusions: In oversized root canals and dumbbell-shaped root canals, CGF has shown good performance for restoration of endodontically treated teeth. Clinical relevance: This study provides a theoretical basis for clinicians to select post-core materials for residual roots with different root canal morphologies and should help to reduce the occurrence of complications such as root fracture and post-core debonding. [ABSTRACT FROM AUTHOR]

This research aimed to assess the stress distribution in lower premolars that were obturated with BioRoot RCS or AH Plus, with or without gutta percha (GP), and subjected to vertical and oblique forces. One 3D geometric model of a mandibular second premolar was created using SolidWorks software. Eight different scenarios representing different root canal filling techniques, single cone technique with GP and bulk technique with sealer only with occlusal load directions were simulated as follows: Model 1 (BioRoot RCS sealer and GP under vertical load [VL]), Model 2 (BioRoot RCS sealer and GP under oblique load [OL]), Model 3 (AH Plus sealer with GP under VL), Model 4 (AH Plus sealer with GP under OL), Model 5 (BioRoot RCS sealer in bulk under VL), Model 6 (BioRoot RCS in bulk under OL), Model 7 (AH Plus sealer in bulk under VL), and Model 8 (AH Plus sealer in bulk under OL). A static load of 200 N was applied at three occlusal contact points, with a 45° angle from lingual to buccal. The von Mises stresses in root dentin were higher in cases where AH Plus was used compared to BioRoot RCS. Furthermore, shifting the load to an oblique direction resulted in increased stress levels. Replacing GP with sealer material had no effect on the dentin maximum von Mises stress in BioRoot RCS cases. Presence of a core material resulted in lower stress in dentin for AH Plus cases, however, it did not affect the stress levels in dentin for cases filled with BioRoot RCS. Stress distribution in the dentin under oblique direction was higher regardless of sealer or technique used. [ABSTRACT FROM AUTHOR]

Statement of the Problem: Fibro-osseous lesions (FLs), may rarely exhibit malignant features likewise undergo malignant transformation. Awareness of these features can assist in screening for potentially malignant cases and identifying low-grade central osteogenic sarcoma (LGCOS) that may mimic FLs. Purpose: The objective of this study was to determine the usability of an index in predicting malignant changes in jaw FLs. Materials and Method: This was a retrospective study where hematoxylin and eosin (H&E) slides and archival records of fibrous dysplasia (FD) and ossifying fibroma (OF) cases were reviewed. The sections were assessed for permeation of marrow spaces, stromal growth pattern, cytologic atypia, mitotic activity, and pattern of bone growth, which are parameters for diagnosing LGCOS. The predictive histologic index of malignancy (PHIM) was determined by a sum of the scores and graded as 0=nil, 1=low, 2 & 3=moderate, and 4 & 5=high. Data were presented using descriptive analysis. Results: Ninety-three cases of FLs met the inclusion criteria, consisting of 40(43%) cases of FD and 53(57%) cases of OF. The peak age of presentation for FD and OF was 2nd and 3rd decade. There was a female preponderance of 1:1.6. The maxilla was the most common site affected by FD, while the mandible was most commonly affected by OF. For FD cases, the PHIM was moderate in 10(25%) cases and low in 21(52.5%) cases. Similarly, for OF cases, 30(56.6%) cases had low grade PHIM while 10(17%) cases had moderate grade PHIM. Conclusion: The PHIM depicted low to moderate malignancy grade in some of the cases studied. Follow up studies would be necessary to assess the PHIM. [ABSTRACT FROM AUTHOR]

Background. This study aimed to systematically and comprehensively review the effect of various treatment variables on apically extruded debris (AED) during non-surgical root canal retreatment (NSRCRT). Methods. The study protocol is shared in the Open Science Framework database (https://osf. io/kjtdg/?view_only = 17060180705745ec9dae9a01614f3880). An electronic search was conducted up to July 2022 to reveal related studies. Two reviewers critically assessed the studies for eligibility against inclusion and exclusion criteria and data extraction. Quantitative data synthesis was performed, and the risk of bias in the studies was also evaluated. Results. Forty-six studies were included in the systematic review and 14 in the meta-analysis. Conflicting or limited evidence was found for the effect of sealer type, obturation technique, and solvent use. The manual instrumentation increased the amount of AED compared to rotary instrumentation during the removal of filling materials (P < 0.001). There was no significant difference in the amount of AED between the use of rotary and reciprocating files during the removal of filling materials (P = 0.181). Conclusion. Rotary instruments can be recommended instead of manual instruments during the removal of filling materials to control the amount of AED. Further studies with a low risk of bias are needed to clarify the effect of other treatment variables on AED during NSRCRT. [ABSTRACT FROM AUTHOR]

Aim: The objective of this in vitro micro-computed tomography investigation is to assess the efficacy of the ProTaper Universal Retreatment System in retreating oval-shaped root canals filled with three obturation procedures. Materials and Methods: Thirty-six lower incisors with a single oval root canal were prepared using XP-Endo Shaper up to size 30/0.04, and allocated into three equal groups based on the filling technique: Group 1: Warm vertical condensation technique; Group 2: GuttaCore obturators; Group 3: Cold lateral condensation technique. All samples were further retreated using the ProTaper Universal Retreatment system. Micro-CT analysis was performed before and after the retreatment procedure. Statistical analysis was performed with a significance level of 0.05. Data analysis was conducted using the Kolmogorov-Smirnov and Kruskal--Wallis H tests. Results: The best performance of the files was achieved when the removal of the filling in the entire canal was considered. However, this outcome was not statistically significant when compared with the other observed root canal levels. The retreatment procedure could not ensure thorough cleanliness of the canal walls from filling remnants, regardless of the obturation technique and observational level. Conclusions: The ProTaper Universal Retreatment system used for the removal of gutta-percha and sealer in oval-shaped root canals demonstrated equal effectiveness, regardless of the obturation technique used. [ABSTRACT FROM AUTHOR]

Copyright of Selcuk Dental Journal is the property of Selcuk Dental Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The effects of Easydo Activator (EA), a new sonic irrigation system, on sealer penetration at the root apex were compared to needle irrigation (NI) and passive ultrasonic irrigation (PUI) in this study. Forty-two single-rooted teeth were prepared and randomly divided into three groups (n = 14): group 1: NI; group 2: PUI; and group 3: EA. A solution of 3% sodium hypochlorite (NaOCl) was used for irrigation. Nine teeth in each group were filled with AH Plus sealer mixed with CY5 fluorescent dye and a single gutta-percha cone. The sealer penetration area, maximum penetration depth and percentage of sealer penetration at 5 mm and 1 mm from the apex were analyzed by confocal laser scanning microscopy (CLSM). The remaining 5 teeth in each group were subjected to test smear layer scores by scanning electron microscopy (SEM). The CLSM evaluation showed that increases in the area, depth and percentage of sealer penetration were detected at 1 and 5 mm from the root apex in the PUI group compared with the NI group, and greater increases were observed in the EA group (P < 0.05). The SEM experiment showed that the lowest scores for the smear layer and debris removal were achieved by the EA group when compared with the PUI and NI groups (P < 0.05). In conclusion, EA was superior to PUI and NI regarding sealer penetration at the root apex during endodontic treatment, and it could provide a new technical idea for clinical root canal therapy. [ABSTRACT FROM AUTHOR]

Introduction: One of the important factors contributing to the success of nonsurgical endodontic retreatment is the efficient removal of the obturating material from the root canal space. However, the fracture resistance of the tooth is likely to be affected by this procedure. Therefore, the study envisages assessing residual filling material in the root canals and the tooth's resistance to fracture postretreatment using different retreatment files. Materials and Methods: Ninety extracted mandibular premolars with one root and a single canal were decoronated, followed by chemo-mechanical preparation, and thereafter, using the lateral compaction method, root canals were obturated. The samples were divided into three groups (n = 30) in accordance with retreatment file systems, namely Hyflex Remover, Mtwo, and ProTaper. All three groups were subjected to the cone-beam computed tomography evaluation to assess remnants of obturating material inside the canals postretreatment, and the same samples were further assessed for fracture resistance, respectively. The collected data were evaluated using the statistical analysis using the Kruskal–Wallis and post hoc Bonferroni tests. Results: There were significant differences in the volume of residual filling among the tested groups in the cervical thirds (P < 0.05). The HyFlex remover file showed the highest fracture resistance (427.30 ± 33.53 N), followed by the Mtwo R (396.90 ± 27.17 N) and ProTaper R (378.50 ± 36.82 N). Conclusion: All the tested nickel-titanium retreatment files performed satisfactorily. Hyflex remover left the least amount of filling material in the cervical third and displayed the highest fracture resistance among the respective groups. [ABSTRACT FROM AUTHOR]

Introduction: With the importance of restricted access cavities, this study aimed to compare the cyclic fatigue and the centering ability of TruNatomy rotary file versus R-motion reciprocating file systems in premolars accessed by traditional versus ultraconservative access cavity preparations. Materials and Methods: Forty extracted intact maxillary first premolars were divided into two groups (n = 20/group) according to the access cavity design (traditional or ultraconservative). Each group was then subdivided according to the type of file used for instrumentation (TruNatomy [26/0.04] or R-motion [30/0.04] [n = 10 teeth/subgroup]). Cone-beam computed tomography (CBCT) scans were obtained for all the teeth before and after instrumentation. The teeth were accessed and instrumented by three in-and-out pecking motions repeated two times until the instrument reached the working length. Every instrument was only used to prepare one canal. For cyclic fatigue assessment, the used files, in addition to 10 brand-new TruNatomy and R-motion files that were used as control groups, were tested in stainless-steel artificial canals, and the time to fracture was used to determine the number of cycles to fracture (NCF). After obtaining and analyzing the before and after instrumentation CBCT images, the centering ability of the buccal roots was calculated at 3, 5, and 7 mm from the apex. Data were statistically analyzed. Results: There were no differences in NCF and centering ability of each file in both access cavities (P > 0.05). There were higher NCF values of the R-motion file compared to the TruNatomy file (P < 0.05). The R-motion file showed significantly higher centering than the TruNatomy file in the traditional access cavity at the 3 and 5 mm levels and the 3 mm level in the ultraconservative access cavity (P < 0.05). Conclusion: The R-motion file had significantly higher cyclic fatigue resistance and centering ability than the TruNatomy file. The ultraconservative access cavity had no unfavorable influence on the cyclic fatigue resistance and the centering ability of R-motion and TruNatomy files. [ABSTRACT FROM AUTHOR]