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Aim: To evaluate the indication of the endodontic treatment for vital intact teeth with the root apex involved in large radicular cystic lesions of endodontic origin. Methodology: This prospective cohort study enrolled healthy participants with radicular cysts of endodontic origin and with the root apex of vital intact teeth involved in the bone defect, as determined by cone beam computed tomography (CBCT). Thirty‐two sound vital teeth were analysed by thermal (TPT) and electric pulp tests (EPT) before surgery (T0) and 1 week (T1), 2 weeks (T2), 3 months (T3) and 6 months (T4) post‐surgery. Student's t‐test (p <.05) was used to compare the EPT values at baseline and T4. anova (p <.05) was used to analyse the EPT variations for all maxillary and mandibular teeth. McNemar test (p <.05) was used to compare the results according to variation in EPT values gathering by variation, no variation and no response. Results: At T1, 75 and 65.7% of teeth responded positively whilst 25 and 34.3% did not respond to EPT and TPT, respectively. The variation of the EPT values between T0 and T1 was observed for 50.0% of teeth, whilst no variation was noticed in 25.0% of teeth. At T4, 90.6 and 87.5% of teeth responded positively whilst 9.4 and 12.5% did not respond to EPT and TPT, respectively. At T4, variation of the EPT values between T0 and T4 was observed for 28.1%, whilst no variation was noticed in 62.5% of teeth. There were no statistical differences in EPT results between T0 and T4 (p >.05), but significant differences were observed for EPT values between T1 and T4 (p <.05), and between mandibular and maxillary teeth. The pulp sensibility of maxillary teeth worsened after surgery, before reverting progressively to T0 values, whilst no statistically significant differences were observed for mandibular teeth at the different time points. Conclusions: These data support the inconsistence of the prophylactic endodontic treatment in healthy vital teeth with apex involvement in large cystic lesions of endodontic origin. Post‐surgery follow‐up with TPT and EPT is recommended to assess pulp status. [ABSTRACT FROM AUTHOR]

This study investigated variation in working length during multiple‐visit endodontic treatment. Patients (N = 106) with pulpitis or pulp necrosis, with or without apical periodontitis, were included. During the first appointment, glide path was performed with ProGlider and shaping with ProTaper Next. Working length was detected four times. Working length was then re‐recorded prior to filling during the second appointment and a 0.5 mm threshold was selected as the minimum clinically meaningful variation. A logistic regression model was used to evaluate the impact of tooth anatomy, preoperative pulp status, apical periodontitis and lesions of endodontic origin on working length variation. Working length varied between first and second appointments in 34% of patients. The presence of apical periodontitis was the only variable significantly associated with variation in working length (p = 0.011). These data suggest that working length should be re‐checked prior to root canal filling to prevent procedural errors. [ABSTRACT FROM AUTHOR]

The aim of this in vitro study was evaluate the effect of application of synthetic hydroxyapatite on fiber post bond strength to radicular dentine. Forty, single-root teeth were endodontically treated and an 8 mm post space was prepared. Specimens were randomly placed in four groups ( n = 10 in each) and treated using the following fiber post luting procedures: group 1, 17% EDTA + Panavia SA; group 2, 17% EDTA + Teethmate Desensitizer + Panavia SA; group 3, All-Bond Universal + Duo-Link Universal; and group 4, All-Bond Universal + Teethmate Desensitizer + Duo-Link Universal. Fiber posts were luted in the post space and light-cured for 120 s using a light-emitting diode ( LED) lamp. After 7 d of storage at 37°C, the teeth were cut into 1-mm-thick slices, which were subjected to a push-out test until failure using a universal testing machine. Two specimens per group were prepared for scanning electron microscopy analysis. An energy-dispersive X-ray spectroscopy detector was used for elemental analysis of the specimen surface. The results were statistically analyzed using one-way anova. The fiber post bond strength was statistically significantly increased after the application of Teethmate Desensitizer to post space walls, either with a 10- MDP-containing self-adhesive cement or with a universal adhesive. Scanning electron microscopy and EDAX analysis showed that Teethmate Desensitizer created a calcium phosphate precipitate over post space dentinal tubules, which significantly improved the bond strength of the fiber post luted with 10-methacryloyloxydecyl dihydrogen phosphate (10- MDP)-containing adhesive systems. [ABSTRACT FROM AUTHOR]

The aim of this in-vitro study was to evaluate the bond strength of fiber posts cemented in a root canal filled using various root-canal obturation techniques. A total of 33 monoradicular samples, treated endodontically, were randomly assigned to three groups according to the root-canal obturation technique: group 1, continuous-wave technique; group 2, plastic-obturator-core technique; and group 3, cross-linked gutta-percha obturator-core technique. Fiber posts were luted in each sample and each was sectioned perpendicular to the post axis. The push-out test was performed using a universal machine and the maximum failure load was recorded in MPa mm−2. Several samples were randomly chosen for scanning electron microscopy evaluation. The mean debris and dentinal tubule-opening scores were calculated separately in the coronal and apical portions. Bond strength was significantly higher in group 1 than in groups 2 and 3. Debris scores were significantly higher in the apical portion of groups 2 and 3 than in group 1. Within the limitations of this study it can be affirmed that thermoplasticized alpha gutta-percha seemed to worsen the cleaning of post-space walls and hence reduced fiber-post bond strength. [ABSTRACT FROM AUTHOR]

Introduction Methods Results Conclusion Computer simulations are stimulating increased attention in dentistry. Augmented reality superimposes a virtual scenario over an existing reality and allows interaction with it. Virtual reality (VR) simulates a fully immersive situation permitting the user to experience the full environment in real time. Haptic technology provides tactile and realistic force feedback for the user to experience the immersive situation as if they were really there. Preclinical training is important to gain familiarity with difficult surgical techniques and to implement interpersonal skills. Developing a valid assessment of surgical simulation is challenging.This paper wants to present a newly realized VR simulation in endodontic microsurgery through the developmental digital workflow, the demonstration of a haptic VR scenario and student self‐assessment and self‐reflection feedback.The volumes were exported in a stereolithography format to prepare and optimize in terms of shape and shade for the VR simulation. The graphics and touchable haptic solid were created using Virteasy Editor, which allows the transformation of 3D surfaces into graphical and volumetric haptic solids depending on their material (enamel, dentine, pulp and bone).Users were asked to execute the osteotomy and root‐resection preparation. The assessment criteria were determined, and the feedback statements were created by a questionnaire with fixed answers. Objective and qualitative criteria for assessing the preparation were obtained from the literature.This study provides proof that it is possible to provide reliable and clinically relevant qualitative feedback with a VR simulator.VR simulation offers an innovative approach with all the benefits of clinical experience. It permits you to save your own progress and review the assessment at any time. [ABSTRACT FROM AUTHOR]