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A study was performed of the healing rate of teeth subjected to endodontic microsurgery after a minimum follow-up of 5 years with an analysis of the influence of different pre- and postoperative factors on the outcome.This was a retrospective study of patients subjected to endodontic microsurgery with the use of mineral trioxide aggregate (MTA) for retrograde filling between January 2011 and December 2015. In patients with multiple treated teeth, only 1 random tooth was selected for the statistical analysis. Clinical and radiographic parameters were used to assess healing. Simple binary logistic regression models were used to analyze the influence of patient age and sex, the type of tooth, prior radiographic lesion size, the presence of a post, the type of restoration, and the apical extent of prior filling of the root canal on the endodontic microsurgery success rate. Two calibrated observers evaluated the periapical radiographs on an independent basis.A total of 111 patients (63.1% women and 36.9% men) were included in the study. Of the 111 teeth analyzed, 90 were classified as healed (mean healing rate = 81.1%). Patient age and sex, the presence of a post, the type of tooth, the type of restoration, and the apical extent of prior filling of the root canal had no significant impact on the outcome. Large lesions (5 mm) were associated with a lower healing rate than smaller lesions, although the difference was not significant. Anterior teeth had a significantly higher healing rate (93.8% maxillary and 100% mandibular) than molars (70.8% maxillary and 57.1% mandibular) (P.05). The differences between the anterior teeth and the molars were statistically significant.The mean healing rate of teeth subjected to endodontic microsurgery was 81% after 5-9 years of follow-up. The success rate was lower for upper and lower molars than for teeth in the anterior zone, although the sample was small and further studies are needed to establish whether the type of tooth influences the treatment outcome.

An apicomarginal defect can be explained as a total loss of buccal alveolus extending from the original crestal bone to the apex of the tooth. This study presents a case of an apicomarginal defect in a first left molar subjected to periapical surgery with vestibular cortex block replacement and A-PRF + membrane coating approximately one year ago. One-year clinical follow-up was performed, with no evidence of recurrence. This case report discusses periapical surgical treatment and the importance of an interdisciplinary approach to the management of teeth with apicomarginal defects. Key words:Periapical surgery, apicomarginal defect, A-PRF+, bone graft.

Although many studies have related smoking to peri-implantitis and marginal bone loss, little is known of its potential impact on dental implant osseointegration. The present clinical study explores the influence of smoking on secondary stabilization based in radiofrequency analysis. A total of 194 implants in 114 patients were included. Implant stability was evaluated on the day of surgery and at a minimum of 90 days after implantation, when osseointegration is considered to have been completed. The evolution of implant stability was compared between 2 groups: smokers and nonsmokers. The following variables were also analyzed: implant brand and model, length, diameter, insertion torque, bone density according to the Misch classification, location of the implant, and patient age and gender. The results showed that smoking did not affect the primary stability of the implant, although it was associated with a marked decrease in secondary stability. The nonsmokers showed a gain of 2.69 points (95% confidence interval [CI]: 1.529–3.865; P < .001) in the osseointegration process. However, in the smokers group, implant stability was seen to decrease 0.91 points (95% CI: −3.424 to 1.600; P < .004), generating a difference of 3.61 points between smokers and nonsmokers. Smoking is thus concluded to be an important factor that must be taken into account when seeking good implant osseointegration outcomes.

Human dental pulp stem cells (HDPSCs) are of special relevance in future regenerative dental therapies. Characterizing cytotoxicity and genotoxicity produced by endodontic materials is required to evaluate the potential for regeneration of injured tissues in future strategies combining regenerative and root canal therapies. This study explores the cytotoxicity and genotoxicity mediated by oxidative stress of three endodontic materials that are widely used on HDPSCs: a mineral trioxide aggregate (MTA-Angelus white), an epoxy resin sealant (AH-Plus cement), and an MTA-based cement sealer (MTA-Fillapex). Cell viability and cell death rate were assessed by flow cytometry. Oxidative stress was measured by OxyBlot. Levels of antioxidant enzymes were evaluated by Western blot. Genotoxicity was studied by quantifying the expression levels of DNA damage sensors such as ATM and RAD53 genes and DNA damage repair sensors such as RAD51 and PARP-1. Results indicate that AH-Plus increased apoptosis, oxidative stress, and genotoxicity markers in HDPSCs. MTA-Fillapex was the most cytotoxic oxidative stress inductor and genotoxic material for HDPSCs at longer times in preincubated cell culture medium, and MTA-Angelus was less cytotoxic and genotoxic than AH-Plus and MTA-Fillapex at all times assayed.

Aim A comparison was made between the root canal lateral condensation technique and other condensation techniques in which physical (temperature: Soft-Core®, Obtura II®) or chemical changes (condensation: Guttaflow®, Resilon®) may affect the dimensional stability of obturation and thus favor apical microleakage. Materials and methods A total of 212 single-root teeth removed for orthodontic or periodontal reasons were randomized to 5 groups of 40 teeth each. Six samples were used as positive controls, and another 6 as negative controls. The teeth were worked with the Hero 642 system, and each group was obturated using a different technique: lateral condensation, Obtura II®, Soft-Core®, Guttaflow® or Resilon®. The samples were immersed in black ink, and after 72 hours the teeth were transparentized using the technique described by Robertson. Filtration of the ink was measured under the stereoscopic microscope. Analysis of variance and post-hoc testing were used for the statistical analysis. Results The Soft-Core® obturated group showed significantly greater microleakage than the other groups, with no differences among the rest of the groups. Conclusions Under the conditions of this study, the teeth obturated with the Soft-Core® technique showed greater apical microleakage than the other systems.

Objectives. To compare the effectiveness of four instrument systems for preparing oval root canals: manual instrumentation (Step-Back technique), ProTaper Universal, ProTaper Next, and Wave One.Material and Methods. For the purpose of this assessment, 60 teeth extracted for orthodontic or periodontal reasons, specifically canines and premolars with full coronal and root anatomy, were used and 15 samples were assigned to each group. The section of the canals was compared before and after instrumenting and the section of untouched canal wall was measured using AutoCAD software. The data was analysed by means of Shapiro-Wilk, ANOVA, and Kruskal-Wallis tests.Results. In the apical third, 100% of the canals were prepared with all the systems. In the middle third, apvalue of 0.5989 in the Kruskal-Wallis test was obtained, which indicates no significant difference between the groups. At the coronal third level, the results obtained revealed that Wave One had a significantly lower mean average than the rest (p<0.05).Conclusions. There are no differences between the various root canal instrument systems in the apical and middle thirds. At the coronal third level, Wave One system showed performance significantly worse than the rest, among which there were no differences.

Two different electronic apex locators were used before extraction to determine working length in 116 root canals belonging to 34 molars. The results were then compared with postextraction working length measurements. The determinations were made before and after eliminating the canal contents and drying the interior. The results showed that 84.8% and 79.3% of the Odometer, and 89.6% and 88.7% of the Endocater readings for dry and nondry canals, respectively, occurred within the two 0.5-mm intervals closest to the apical constriction.

PURPOSE. The aim of this study was to compare the radiopacity of 6 modern resin cements with that of human enamel and dentine using the Digora digital radiography system, to verify whether they meet the requirements of ANSI/ADA specification no. 27/1993 and the ISO 4049/2000 standard and assess whether their radiopacity is influenced by the thickness of the cement employed. MATERIALS AND METHODS. Three 3-thickness samples (0.5, 1 and 1.5 mm) were fabricated for each material. The individual cement samples were radiographed on the CCD sensor next to the aluminium wedge and the tooth samples. Five radiographs were made of each sample and therefore five readings of radiographic density were taken for each thickness of the materials. The radiopacity was measured in pixels using Digora 2.6 software. The calibration curve obtained from the mean values of each step of the wedge made it possible to obtain the equivalent in mm of aluminium for each mm of the luting material. RESULTS. With the exception of Variolink Veneer Medium Value 0, all the cements studied were more radiopaque than enamel and dentin (P

A comparison was made of the ability of two root canal obturating techniques to prevent dye microleakage: gutta-percha lateral condensation and mechanically plasticized gutta-percha (JS Quick-fill). Twenty central incisors were prepared and obturated by each technique. After rendering the teeth transparent, linear dye penetration was found to be 0.48 and 0.52 mm, respectively. The difference between the two techniques was not significant. As for the distribution of the sealing cement (AH26) in the teeth obturated with JS Quickfill, the cement was located in the most peripheral zone of the obturation alongside the dentinal walls, whereas the gutta-percha was found in the central part of the canal obturating material.