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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]

A proper bond between root canal filling materials and dentin surface is essential to resist dislodgement and guarantee long-term success. Blood exposure is likely to occur in various clinical situations in which calcium silicate-based materials are used; therefore, it is fundamental to render data concerning the influence of blood on bond strength. The present study aims to evaluate the effect of blood contamination on the push-out bond strength obtained with three different biomaterials to root canal dentin; Ninety extracted human mono-radicular permanent teeth were selected. The root canals were prepared with Gates Glidden burs until a diameter of 1.10 mm was achieved. Teeth were then randomly divided into six experimental groups (n = 15) according to the presence/absence of blood contamination and biomaterial used for root canal filling (ProRoot® MTA, BiodentineTM, and TotalFill® BC Putty). After one week, each root was sectioned in three segments (coronal, middle, and apical regions). Specimens were then submitted to push-out bond strength tests. Fracture pattern evaluation was performed. The significance level was set at 5%.; Blood contamination did not affect the push-out bond strength of any of the three tested calcium silicate-based cements (p > 0.05). Regardless of blood contamination, TotalFill showed statistically higher push-out bond strength when compared with Biodentine (p = 0.040) and MTA (p = 0.004). Biodentine exhibited higher bond strength than MTA (p = 0.043). Biomaterials' comparison within each radicular segment revealed statistically superior bond strength of both Biodentine and TotalFill over MTA (p < 0.05) in the coronal segment. TotalFill presented higher push-out bond strength regarding the apical segment compared to Biodentine (p = 0.003). Fractures were mostly adhesive.; Overall results indicate TotalFill presents the highest push-out bond strength values, followed by Biodentine and, lastly, MTA. Blood contamination did not affect the dislodgement resistance. Biomaterials' comparison within each radicular segment revealed both TotalFill and Biodentine as the preferable alternatives for application in the coronal region. TotalFill might be the biomaterial of choice for placement in the apical region. [ABSTRACT FROM AUTHOR]

Introduction The purpose of this study was to compare tooth discoloration that occurs in teeth filled with ProRoot MTA (DENTSPLY Tulsa Dental Specialties, Tulsa, OK) or Biodentine (Septodont, Saint Maur des Fossés, France) over the course of 1 year. Methods Twenty-eight intact premolars were resected 2 mm apical to the cementoenamel junction and the pulp tissues extirpated via the cervical cut. After the preparation of occlusal access to the pulp chamber, specimens were assigned into 4 groups according to a stratified randomization sampling process: group 1, negative control (dry sterile cotton pellet); group 2, positive control (blood-moistened cotton pellet); group 3, ProRoot WMTA (DENTSPLY Tulsa Dental Specialties); and group 4, Biodentine. The experimental materials were condensed into the crowns and the access sealed with glass ionomer restorative cement. Color was assessed at baseline (before placement of the materials), immediately after material filling, after 6 weeks of storage, and after 1 year using the Commission International de I'Eclairage L*a*b* system. Change in color, ΔE, was compared among groups and over time using analysis of variance. Results The 4 groups showed a significant decrease in L* values over time. Differences between Biodentine and WMTA were detected after 1 year, with the greater variation associated with WMTA ( P = .001). The 4 groups presented a significant increase in ΔE from baseline to 1 year. All groups revealed perceptible color changes (ΔE > 2.3) between immediately after material filling and after 6 weeks and after 6 weeks and 1 year. After 1 year, no differences could be detected between Biodentine and WMTA. Conclusions Delayed tooth discoloration was detected for the 2 materials at the 1-year evaluation, but it was more evident for ProRoot MTA than Biodentine. Luminance was the most affected parameter, with a higher decrease for ProRoot MTA. [ABSTRACT FROM AUTHOR]

Aim: The purpose of the present study is to assess the color stability of two calcium silicate-based cements (CSCs) used in regenerative endodontic procedures (REPs). Methods: A total of 40 acrylic single-rooted transparent teeth, with immature apex, were used. Root canals were filled up to 3 mm below the level of the cementoenamel junction, with either saline solution (Mineral Trioxide Aggregate (MTA)/saline and Biodentine/saline) or blood (MTA/blood and Biodentine/blood). Subsequently, ProRoot MTA® or BiodentineTM was placed in the root canal to create a cervical barrier. Color measurement was carried out at four different evaluation periods (3 h, 72 h, 7 days, and 6 months). Shade analysis within the L* a* b* color space was performed and color variation (∆E) calculated. The significance level for statistical analysis was set at p < 0.05. Results: The four groups showed a significant decrease in L* values over time. The ΔE value increased over time for all groups but was not statistically significant for the Biodentine/blood group. Two-way ANOVA showed no interaction between the CSC and treatment (contact with saline solution or blood). CSC used was the factor responsible for ΔE over time, inducing statistically significant color variations from T3H to T7D (p = 0.04) and T3H to T6M (p < 0.01). After 6 months, MTA/saline had 5.08 (p = 0.001) higher ΔE than Biodentine/Saline and the MTA/blood had 3.65 (p = 0.009) higher than Biodentine/blood. Conclusions: After 6 months, regardless of blood exposure, Biodentine exhibits superior color stability compared to MTA. Biodentine might be a suitable alternative to MTA as a cervical barrier material in REPs. [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]