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Emerging clinical evidences highlight the association of Interleukin-8 (IL8) with endodontic pulpitis. Relatively higher expression of IL8 has been found in the pulp samples of pulpitis patients with moderate/severe pain. It is speculated that IL8 can be considered as a potential target for therapeutics of endodontic pulpitis. A library consisting of 3072 small molecules from the ZINC database was used to identify potential lead molecules with drug-like properties against the IL8. Based on the in-silico structure-assisted drug designing involving molecular docking, MD simulations, and MMPBSA analyses, we found a small molecule ZINC14613097 inhibits IL8. This study provides a new lead molecule than can be further validated in in-vitro, in-vivo, and ongoing clinical studies for the therapeutic management of endodontic pulpitis.

Objective The concept of minimally invasive endodontics recommends less-invasive vital pulp therapy (VPT) modalities over more aggressive traditional endodontic approaches in mature permanent teeth with carious pulp exposure, including irreversible pulpitis (IP) cases. Consequently, VPT needs to be compared with root canal therapy (RCT) in terms of treatment outcomes. This randomized clinical trial compares the results of full pulpotomy using two calcium-silicate cements, i.e., mineral trioxide aggregate (MTA) and calcium-enriched mixture (CEM) cement, with RCT in mature permanent teeth. Materials and methods A total of 157 carious pulp exposure cases in two academic centers with/without established IP were selected/included/randomly appointed to three study arms; (i) RCT (n = 51) as the reference treatment, (ii) pulpotomy with ProRoot MTA (PMTA; n = 55), and (iii) pulpotomy with CEM cement (PCEM; n = 51) as two alternative VPT treatments. Two-year clinical/radiographic results were the outcomes of interest. Data were statistically analyzed through the analysis of variance, chi-square, Fisher exact test, and Kruskal–Wallis. Results At 2-year recall, 147 teeth were examined (6.4% dropout). All molars, except for one, were clinically functional/symptom-free, and there was no statistical difference between the three study arms (p = 0.653). The radiographic success rates in RCT, PMTA, and PCEM arms were 98%, 100%, and 97.9%, respectively, without statistically significant differences (p = 0.544). Conclusion In the management of mature permanent teeth with/without established IP, all experimental groups exhibited equivalent/comparable results. Clinical relevance Simple VPT using MTA/CEM can be suggested/recommended as a viable advantageous alternative to RCT for the management of carious pulp exposures with/without sign/symptoms of IP.

Aim: To evaluate the incidence and severity of postoperative pain following root canal treatment in nonvital pulps with hand and rotary instrumentation techniques in Chhattisgarh population. Materials and Methods: Sixty asymptomatic single-canaled nonvital teeth were selected and were divided into two groups of 30 each. Group I: 30 single-canalled teeth were treated in a single visit and prepared with hand file system. Group II: 30 single-canaled teeth treated in a single visit and prepared with K3-rotary file system. Group I and II were divided into two subgroups of 15 each (Group IA, IB and Group IIA, IIB) which were irrigated with 2% chlorhexidine and 5.25% sodium hypochlorite, respectively. The patients were recalled at 24, 48, and 72 h and at 1 week to record the incidence and severity of postoperative pain by using visual analog scale. Results: Results showed low incidence and severity of postoperative pain following a single-visit treatment with rotary instrumentation when compared to hand instrumentation technique. No statistical significant difference was observed between the groups at different time intervals, i.e., at 24, 48, and 72 h and at 1 week. The use of recent endodontic techniques and devices reduces the postoperative pain. Conclusions: Postoperative pain after root canal treatment ranged from mild to severe and it can happen even after high-standard root canal treatment. There is low incidence and severity of postoperative pain following a single-visit treatment with rotary instrumentation when compared to hand instrumentation technique.

In-depth knowledge of common and aberrant pulp morphology is essential for appropriate diagnosis and treatment planning prior to commencing root canal treatment. Radicular morphology of mandibular premolars has been extensively studied. Considerable variation in the number of canals and roots found in these teeth has been reported. Aim The purpose of this study is to investigate the root and root canal morphology of mandibular first premolar among Saudi Arabian subpopulation in Aseer using CBCT. Methods Cone-beam computed tomography images of Mandibular first premolar were taken from 166 patients which were referred to Armed Forces Hospitals Southern Region (AFHSR), Khamis Mushayt, Asir region Saudi Arabia. All the images were assessed by two Evaluators (An Endodontist and a Radiologist). Inter-examiner reliability was determined and was assessed by KAPPA value. Results The mandibular first premolar (n = 216) distributed as 120 teeth in female and 96 teeth in male. Out of the 120 teeth examined in female groups one canal was seen in 95 (79.2%) teeth, two canals in 19 (15.8%) teeth and three canals in 6 (5%) teeth where as in the Male group out of 96 teeth, 52 (54.1%) teeth showed one canal, 32 (33.3%) teeth with two canals whereas 12 (12.5%) teeth showed presence of three canals. Chi-Square test for mandibular first premolars demonstrated the chance of second canal in the mandibular first premolar more in male than female and these differences was statistically significant (P ≤ 0.05). Conclusion Endodontic therapy of mandibular premolars is a challenge for clinician because of their frequent morphological and anatomical abnormalities. Proper knowledge about number of root canals and canal configuration is a key to success in Endodontic. There is a great variability in different population regarding the root canal configuration in mandibular pre-molars. However, most studies state the mandibular first premolar has one root canal. Also, the most prevalent type of root canal found was Type I vertucci.

Realizou-se um estudo "in vitro" avaliando a capacidade de selamento de 3 cimentos de obturação de canal através de testes de infiltração. 40 incisivos inferiores foram instrumentados pela técnica escalonada e divididos em 4 grupos. Os dentes foram obturados pela técnica da condensação lateral da guta-percha, tendo como variação o cimento de obturação. Fill Canal, Sealer 26, N-Rickert foram testados e comparados com o grupo controle no qual não se utilizou cimento, apenas cones de guta-percha. A penetração linear de corante foi medida após desmineralização e diafanização dos espécimens. Os resultados mostram diferenças estatisticamente diferentes entre os grupos. Os menores níveis de infiltração ocorreram no grupo Fill Canal, seguido pelos grupos N-Rickeft e Sealer 26., It is an "in vitro" study to evaluate the sealing ability of 3 root canal sealers using a dye leakage/clearing method. 40 lower incisors were instrumented by the step-back technique and divided into 4 groups. The teeth were filled with lateral condensation of guta-percha varying the root canal sealer. Fill Canal, Sealer 26, N-Rickert were tested and compared to the control group in which guttapercha cones with no seater were used. Linear dye penetration was measured after demineralizatÎon and clearing. Statistical analysÏs showed significant differences among the groups. The lowest leakage values were found in the Fill Canal group followed by the N-Rickert and the Sealer 26 groups.

Background: Exact diagnosis, efficient cleaning, shaping as well as disinfection of the root canals lead to successful root canal treatment. The present study compared three different irrigating systems in root canal treatment. Methodology: Sixty recently extracted permanent mandibular molars were classified into four groups: Group I, II, III, and IV with 15 teeth each. Group I comprised Endo-Irrigator Plus system. Group II comprised EndoActivator, Group III utilized passive ultrasonic irrigation (PUI), and Group IV was control, in which no activation of the irrigant was done. Stereomicroscope (X20) magnification was used for checking isthmus cleanliness. The scoring criteria were divided into score 1–5 depending on the amount of debris in root canal walls. Results: The mean ± standard deviation debris removal score in Group I was 2.6 ± 0.80, in Group II was 3.8 ± 0.72, in Group III was 3.9 ± 1.06, and in Group IV was 4.2 ± 0.82. The difference was significant (P < 0.05). Conclusion: Authors found that Endo-Irrigator Plus exhibited better cleaning efficacy followed by EndoActivator and PUI.

Successful non‐surgical orthograde retreatment of a tooth with external root resorption in apical third of root and overfilling material beyond the apical barrier which was diagnosed with the help of cone beam computed tomography (CBCT), was reported. Biodentine was used as the treatment of choice for obturation of resorption area., Overfilling management can be done by performing nonsurgical endodontic procedure. Gutta‐percha of coronal and middle third of root should be removed by mechanical instruments; however, in apical, removal should be done by hand instrument. Biodentine can be considered as the treatment of choice for filling the perforating external root resorption.

Objectives The aim of this study was to compare the volume variation and maintenance of the root canal position when using the ProGlider 16.02 (PG) and the WaveOne Gold Glider 15.02 (WOGG) file systems for glide path preparation. Materials and Methods Twenty-four moderately curved mesiobuccal canals of maxil-lary first molars were selected and randomly divided into two groups: PG and WOGG. The selected teeth were scanned using microtomography before and after root canal preparation to assess centralization and linear transport at 1, 3, 5, and 7 mm from the apical foramen. Statistical Analysis The data were analyzed with the Mann–Whitney U test. The level of significance was 5%. Results There were no significant differences in volume variation or root canal transport (p > 0.05). There was a significant difference in the centralization of the root canal at 3 mm from the foramen (p < 0.05). Conclusions WOGG and PG instruments presented similar results regarding the root canal volume increase and transport. WOGG caused higher decentralization at 3 mm from the apical foramen.

Objective:This study evaluated the radiographic outcome of root canal treatments (RCTs) performed by general dental practitioners (GDPs) with focus on tooth type and quality of root filling. Materials and methods:The target population included all patients receiving root filling by GDPs in City of Helsinki in 2010-2011. Equal numbers of each tooth type (anteriors, premolars, molars) by jaw were included, resulting in 426 teeth. Pre- and post-operative periapical radiographs were assessed to evaluate periapical status and quality of root filling. Statistical evaluation utilized Chi-squared tests, Cohen's kappa and logistic regression modelling. Results:The overall success rate of RCT was 67.4%, being 76.8%, 69.7% and 55.6% (p

Background/Aim: The aim of this study was to compare the apical extrusion during endodontic retreatment using three different endodontic systems. Material and Methods: 120 extracted human teeth were ex vivo endodontically treated and retreatment was performed using three different endodontic systems. Samples were divided into 3 groups, A-retreatment with Hedstroem hand files, B-retreatment with Pro Taper Retreatment files and C-retreatment with Pro Taper Gold files. Apically extruded material was collected in pre-measured Eppendorfs on a laboratory scale (10-5g). The amount of the extruded material was measured after the retreatment. The data were analysed using the the statistical software: STATISTICA 7.1 and SPSS for Windows 20. Results: The statistical analysis of the data revealed significant differences between the three endodontic retreatment systems (P< 0.05). Apical extrusion in the A endodontic system is significantly greater than the rotary (B and C) endodontic systems. Conclusions: In ex vivo conditions the results of this study showed significant statistical difference between three investigated endodontic retreatment systems concerning the amount of apically exuded material. The largest amount of material suppressed periapically was proven for Hedstroem hand instruments.

Aim: To review the reported defect and fracture rates of various NiTi instrumentation systems and identify factors that may influence the chance of NiTi file separation clinically.Data Sources: PubMed, EMBASE, and SCOPUS with controlled vocabulary and keywords in various combinations to identify articles that reported on the defects and/or fracture of NiTi instrument used clinically (Jan 1980 till Aug 2021), with additional search manually by going through the list of references of the initially screened articles. Those satisfying the inclusion and exclusion criteria were entered into the analysis.Study Eligibility Criteria, Participants, and Interventions: All studies from the said databases reporting on NiTi root canal instruments that were deformed or separated during normal clinical use.Study Appraisal and Synthesis Methods: Studies with data available and suitable for meta-analysis were grouped according to the general design of the NiTi instruments for comparison. Safety quotient value was calculated based on the rate of instrument distortion and fracture.Results: Various instrument designs exhibited different incidences of distortion and fracture, hence a different “safety quotient” (ratio of the amount of deformed instruments to that of fractures in use). Heat-treated files showed the highest safety quotient value. All brands of NiTi file demonstrated a statistically significantly lower incidence of fracture, if treated as disposable instruments after clinical use in a patient.Limitations: Inclusion of articles written in English only, and grouping of file systems into general design types in the analysis.Conclusions and Implications of Key Findings: NiTi endodontic files should be scrutinized for defects before being used in the root canal. Disposing the NiTi instruments after clinical use in a patient (so-called “single use”) is recommended for minimizing fracture clinically. Certain instrument designs tend to show discernible deformation before they should fracture in the next use.

Calcium silicate-based cements (CSCs) are widely used in various endodontic treatments to promote wound healing and hard tissue formation. Chitosan-based accelerated Portland cement (APC-CT) is a promising and affordable material for endodontic use. This study investigated the effect of APC-CT on apoptosis, cell attachment, dentinogenic/osteogenic differentiation and mineralization activity of stem cells from human exfoliated deciduous teeth (SHED). APC-CT was prepared with various concentrations of chitosan (CT) solution (0%, 0.625%, 1.25% and 2.5% (w/v)). Cell attachment was determined by direct contact analysis using field emission scanning electron microscopy (FESEM), while the material extracts were used for the analyses of apoptosis by flow cytometry, dentinogenic/osteogenic marker expression by real-time PCR and mineralization activity by Alizarin Red and Von Kossa staining. The cells effectively attached to the surfaces of APC and APC-CT, acquiring flattened elongated and rounded-shape morphology. Treatment of SHED with APC and APC-CT extracts showed no apoptotic effect. APC-CT induced upregulation of DSPP, MEPE, DMP-1, OPN, OCN, OPG and RANKL expression levels in SHED after 14 days, whereas RUNX2, ALP and COL1A1 expression levels were downregulated. Mineralization assays showed a progressive increase in the formation of calcium deposits in cells with material containing higher CT concentration and with incubation time. In conclusion, APC-CT is nontoxic and promotes dentinogenic/osteogenic differentiation and mineralization activity of SHED, indicating its regenerative potential as a promising substitute for the commercially available CSCs to induce dentin/bone regeneration.

Objectives We assessed the impact of type of tooth on the outcome of root canal treatment (RCT) according to factors potentially weakening the prognosis such as preoperative apical periodontitis (AP) and treatment modality (primary or secondary RCT). Materials and methods We scrutinized patient documents including pre- and postoperative radiographs of 640 permanent teeth receiving non-surgical RCT at Helsinki University Clinic in 2008–2011. Of teeth, 44% were molars, 32% premolars, and 24% anterior teeth. Patients’ mean age was 51.5 years; 51% were male. AP was present in 60.5% of teeth preoperatively. We used the periapical index (PAI) to assess the radiographs and defined radiographically “healthy” and “healing” cases as successful. Statistical evaluation included chi-squared tests, Fisher’s exact tests, t tests, and logistic regression modeling. Results The overall success rate (SR) was 84.1%; 88.3% for primary and 75.5% for secondary RCT (p

The successful outcome of endodontic treatment is dependent on complete cleaning, shaping as well as three dimensional obturation of the root canal system. A conventional radiograph is a two-dimensional replication of a three-dimensional object and does not provide any conclusive evidence for canal curvatures. An accurate knowledge of the tooth anatomy and curvature is essential to avoid procedural errors. 100 freshly extracted human teeth were used in this study. Digital images were obtained using the plywood JIG and Schneider’s technique. These images were analyzed using the VixWin Pro digital image analyzing software (Gendex system). Statistical analysis was done using paired t test. The canal curvature average values measured using Jig method and Schneider method for mandibular teeth are 28.23° (±9.96) and 22.07° (±9.46) respectively. The smallest/largest curvature angles measured using Jig method and Schneider technique are 12/52° and 8/44° respectively. Canal curvature average values measured using Jig method and Schneider method for maxillary teeth were 23.40° (±11.36) and 19.23° (±11.94) respectively. The smallest/largest average curvature angles measured using Jig method, Schneider technique were 9/70° and 5/72° respectively. The values of the canal curvature angle obtained during routine radiographs in clinics have lower curvature angle and higher radius values as compared to the values obtained by this innovative JIG technique. Therefore, a clinician should always keep in mind the difference while measuring the curvature angle on radiographs during root canal treatment.

In December 2019, the coronavirus disease 2019 (COVID-19) was first identified as an acute infectious disease in Wuhan, China, and subsequently led to an ongoing pandemic. At the onset of the pandemic, dental professionals were understood to face the greatest exposure risk to SARS-CoV-2 due to aerosolization of fluids from the oral cavity and respiratory airways. As a result, dental professionals, including academic institutions and their students and residents, halted much of their operations to minimize exposure risks and potentially slow the spread of infection to peers and patients alike. Currently, there is little in the literature that describes the changes that academic institutions have implemented in the face of pandemics. This study will discuss the chronology, modifications, and possible resultant outcomes of COVID-19 related events in respect to graduate endodontic programs in the United States.

Endodontic microsurgery is a highly predictable treatment option in most cases when conventional endodontic treatment is not feasible. Nevertheless, mandibular molars are still considered by clinicians to be the most difficult type of teeth, with the lowest success rate. In recent years, endodontic microsurgery has been attempted more frequently with the emergence of modern cutting-edge technologies such as dental operating microscopes, various microsurgical instruments, and biocompatible materials, and the success rate is increasing. This review describes the current state of the art in endodontic microsurgical techniques and concepts for mandibular molars. Notably, this review highlights contemporary equipment, technology, and materials.

Objectives The purpose of this systematic review of the literature is to investigate which of the epoxy-based cements and those based on Tricalciumsilicate (MTA, Bioceramic) have the best sealing capacity through the analysis of studies that have provided a survey model in vitro of bacteria leakage. Source The articles were identified using electronic databases such as PubMed, Scopus, the search was conducted between 8.12.2020 and 31.12.2020 and a last search was conducted on 2.12.2021. Study selection 678 records were identified and after removing the duplicates we obtain 481 records, with the first phase of screening and selection of records we reached 204 and with the application of the inclusion and exclusion criteria we selected 31 articles, only 9 studies made a direct comparison between the two endodontic cement categories and presented data that could be included in the metaanalysis. Data The meta-analysis of first outcome shows an odds ratio of 2.70 C.I.(Confidence Interval) [1.54, 4.73], the test for overall effect has a p value = 0.0005 with a heterogeneity index of I 2 of 9%; The second outcome meta-analysis shows an Odds Ratio of 1.50 C.I. (Confidence Interval) [0.92, 2.46] with a p value of 0.10 with an I 2 of 79%. Conclusion the sealing ability is higher for epoxy resins than for tricalcium silicate-based cements, for observation periods longer than 90 days. Clinical relevance The knowledge of the cement that determines the best sealing ability and resistance to microbial leakage, can be of help for the dentist who has to face clinical situations such as endodontic retreatments whose failure is determined by the persistence of bacteria in the endodontic canals., sealing ability; microbial leakage; endodontic; epoxy resin; MTA

Background To introduce a new method for measurement of surface roughness of the endodontic instrument, before and after instrumentation, using the Field Emission Scanning Electronic Microscope (FE-SEM) combined with the ImageJ software. Methods Twenty J-shape resin blocks were divided into two groups, ten blocks of each group. Simulated root canal inside the resin block was 16 mm length, 600 angle of curvature, and radius of 4.5 mm. Ten WaveOne Gold Primary and 10 Reciproc Blue R25 instruments were used for root canal instrumentation. The instruments were scanned before and after instrumentation with special molds made to ensure the same areas at the point located 3 mm from the tips of the instruments using the FE-SEM. These scanned images were analyzed using the ImageJ. The arithmetical mean roughness (Ra), root mean square roughness (Rq), and the average distance between the highest peak and lowest valley in each sampling length (Rz) were calculated by ImageJ for quantitative analyses. The paired-t test was performed to analyze the data using the SPSS 22.0 at the significance of .05. Results Almost all surface roughness values were decreased. However, these decreases were not statistically significant (P > .05). Conclusions The FE-SEM combined with the ImageJ was the reliable and appropriate modality for measurement surface roughness of instruments.

Biocompatibility is an essential property for any vital pulp material that may interact with the dental pulp tissues. Accordingly, this study aimed to compare the chemical composition and ultrastructural morphology of Biodentine (Septodont, Saint Maur-des-Fosses, France), ProRoot MTA (Dentsply Tulsa Dental Specialties, Johnson City, TN, USA), and Bio-C Repair (Angelus, Londrina, PR, Brazil), as well as their biological effects on human dental pulp cells. Chemical element characterization of the materials was undertaken using scanning electron microscopy and energy dispersive X-ray analysis (SEM-EDX). The cytotoxicity was assessed by analyzing the cell viability (MTT assay), cell morphology (immunofluorescence assay), and cell attachment (flow cytometry assay). The results were statistically analyzed using ANOVA and Tukey&rsquo, s test (p &lt, 0.05). EDX revealed that ProRoot MTA and Biodentine were mostly composed of calcium, carbon, and oxygen (among others), whereas Bio-C Repair evidenced a low concentration of calcium and the highest concentration of zirconium. SEM showed adequate attachment of human dental pulp cells (hDPCS) to vital pulp materials and cytoskeletal alterations were not observed in the presence of material eluates. Remarkably, the undiluted Biodentine group showed higher viability than the control group cells (without eluates) at 24 h, 48 h, and 72 h (p &lt, 0.001). Based on the evidence derived from an in vitro cellular study, it was concluded that Bio-C Repair showed excellent cytocompatibility that was similar to Biodentine and ProRoot MTA.

Objectives This study tested the hypothesis that modifying the sequence of sodium hypochlorite (NaOCl)/ethylene diamine tetra-acetic acid (EDTA) irrigation during root canal shaping would improve apical cleanliness in moderately curved canals. Materials and Methods Forty-five root canals were prepared using Protaper Gold with three irrigation protocols. Standard irrigation (SI) used 0.5 mL 3% NaOCl between each instrument, followed by 5 mL 17% EDTA manually agitated for 30 seconds. Reverse irrigation (RI) used 0.5 mL of 17% EDTA between each instrument, then 5 mL of 3% NaOCl, manually agitated for 30 seconds. Reverse irrigation plus (RI+) was similar to RI, except NaOCl (5 mL), used as a final rinse, was allowed to interact for 3 minutes with dentin before manual agitation (30 seconds).Root canal cleanliness was evaluated under the scanning electron microscope (SEM) (Hulsmann score); the chemical composition of dentin after irrigation was analyzed by energy dispersive X-ray (EDX). Statistical Analysis Results were compared using Kruskal–Wallis ANOVA by ranks and Wilcoxon matched paired posthoc tests. A Chi-square test assessed whether the best cleanliness would demonstrate a significant association with one irrigation protocol; odds ratio calculation was performed using score “1” versus score “2 or more” (2+) (p < 0.05). Results In the apical region, cleanliness was better in RI+ than SI and both significantly better than RI. Odd ratios indicate that the cleanliness in RI+ was significantly better than RI and SI groups (p < 0.000 and 0.003, respectively). Independently of the irrigation protocol, EDX analyses showed no chemical alteration of root dentin. Conclusions Using 17% EDTA during shaping, followed by 3% NaOCl rinse for 3 minutes, improved apical cleanliness without inducing erosion of dentin.

The aim of the present study is to evaluate operative torque, torque at failure and the difference between these two values&mdash, the &ldquo, torque range&rdquo, &mdash, of two different NiTi files. We also sought to evaluate and compare these parameters for new and used files. Forty S-One 20.06 and forty M-Two 20.06 were tested, divided in four equal groups (n = 10) for each brand. Ten instruments from each brand performed three root canal treatments each on standardized extracted single-rooted teeth. Afterwards, each group was subjected to the following two tests: operative torque and torsional resistance. Mean values for all the tested groups were calculated. The results for new instruments showed that S-One developed significantly higher operative torque, but higher torsional resistance. The results for used instruments showed that the S-One 20.06 developed less operative torque and higher mean torsional resistance value compared to the M-Two. Moreover, the percentage reduction of both values was significantly higher for M-Two. The results of the present study showed a safer torsional behavior of the S-One. These results could be related to the heat treatment and the manufacturing process.

Over the last decade, biodegradable polymers (BP) replaced traditional non-degradable materials in dental and maxillo-facial surgery, in particular for bone regeneration and periodontal care, due to their ability to break down and be absorbed by the body without producing harmful degradation products, along with their great potential for controlled drug delivery, wound management, dental restorations, and tissue engineering. This review described the physical-chemical characteristics of these materials, classified them based on their sensitivity on hydrolytic or enzyme degradation, and described their recent application in both restorative and regenerative dentistry.

Background: Root canal treatment constitutes a treatment sequence for infected pulp to eliminate the etiological factors of pulp necrosis and periapical lesion. Enterococcus faecalis (E. faecalis) is an organism commonly found in a high proportion of root canal failure because of its ability to form biofilm. Degradation of extracellular polymeric substance (EPS) by oxidizing agents such as sodium hypochlorite is the first step in removing biofilm. However, the toxicity of sodium hypochlorite constitutes the main concern and, therefore, the safest alternative irrigants possible are required. The use of fruits, herbs and plants is widespread, especially in the fields of medicine and dentistry. Food crops are known to be rich in bioactive compounds, especially polyphenols, which have antioxidant and antimicrobial properties. Cocoa pod husk extract can, therefore, represent an alternative irrigant. Purpose: This study aimed to determine the minimum inhibitory concentration of cocoa pod husk extract in relation to the thickness of E. faecalis EPS biofilm. Methods: Four groups of E. faecalis cultured biofilm samples were analysed: group one contained E. faecalis without cocoa pod husk as a positive control; group two contained E. faecalis with 1.56% cocoa pod husk extract; group 3 contained E. faecalis with 3.125% cocoa pod husk extract; and group 4 contained E. faecalis with 6.25% cocoa pod husk extract. The biofilm thickness of all groups was measured by confocal laser scanning microscopy with statistical analysis subsequently undertaken by means of a post hoc test and Tukey HSD. Results: The average values of EPS biofilm thickness were as follows: group 1: 9500 nm; group 2: 8125 nm; group 3: 8000 nm; and group 4: 6375 nm. A post hoc Tukey HSD test indicated a significant difference between group 1 and group 4, while in group 2 and group 3 compared to group 1, there were no significant differences with the values of each being p = 0.340 and p = 0.267 (p>0.05). Conclusion: 6.25% cocoa pod husk extract reduces E. faecalis EPS biofilm thickness.

Aim: This prospective clinical study analyzed the 24-month outcome of conventional apical surgery retro-filled with calcium-silicate cement versus apical surgery with simultaneous orthograde retreatment by means of clinical and radiographic criteria. Materials and methods: This study included 83 teeth affected by persistent periapical lesions in 68 patients. Mean age was 52 years (median = 51 years; range 19–81 years). Twenty-eight cases were treated with apical surgery, 16 cases with apical surgery with simultaneous orthograde retreatment and 39 cases with orthograde retreatment in previously treated teeth established as control group. Periapical index score (PAI) was used as radiographic criteria. Teeth were examined at 6 months, 1 and 2 years and classified as healed (without any symptoms and PAI ≤ 2), healing (without any symptoms and PAI = 3) or diseased (with symptoms or PAI ≥ 4 and not functional) on the basis of radiographic and clinical criteria. At 24 months evaluation, healed and healing were considered as success and diseased and fracture as failure. Multilevel GLM model and an ordered logistic regression as statistical analysis was made with level of significance set at p

Background: Complete pulpectomy and elimination of wide range of microorganisms from infected primary root canals is not possible through conventional endodontic procedures. Thus, lesion sterilization and tissue repair (LSTR) therapy employing 3Mix tri-antibiotic paste have been used as an alternative endodontic modality for infected primary teeth. Aim: This study aims to evaluate the root resorption rate of endodontically treated mandibular primary molars with conventional endodontic treatment or LSTR therapy and to compare it with their healthy contralateral teeth. Materials and Methods: Fifty carious first and second primary mandibular molars from 25 healthy children aged 7–10 years were treated with two different endodontic procedures using LSTR Therapy and conventional endodontic treatment. The resorption rate of these teeth with healthy contralateral teeth was compared clinically and radiographically at 3, 6, 12 and 36 months using Chi-square test. Results: At 12 months, clinically, there was no difference in the outcomes of both groups but radiographically, statistically significant difference (P < 0.001) in root resorption between treated teeth and their controls in both the groups was observed. At 36 months, interradicular bone resorption around the crown of succedaneous teeth and their delayed eruption was noted in LSTR group. Conclusions: LSTR therapy could be a viable treatment modality for infected/nonvital primary molars with poor prognosis and intended to be maintained for shorter duration in the oral cavity as natural space maintainers.

Postoperative pain after root canal treatment can be reduced by applying recent advances in endodontic techniques and equipment. This systematic review includes current knowledge about pain after nonsurgical root canal treatment, including predictors, related factors, effects of recent advances, and management. A literature search was performed using the PubMed, ScienceDirect, and Cochrane Library databases for articles published between 1990 and 2016. Search keywords included postoperative pain, nonsurgical treatment, single visit, recent advances in endodontics, and management of postoperative pain with endodontic treatment. Only original research studies were included; editorials, reviews, brief notes, conference proceedings, and letters to the editor were excluded. The initial search yielded 4941 articles, which were assessed and filtered using the selection criteria. Sixty-five studies met the inclusion criteria and were included in the review. The findings showed that pain after nonsurgical root canal treatment occurred in 3-69.3% of patients. Microorganisms were identified as the primary contributors to postoperative pain, and there was no significant difference in postoperative pain between single- and multiple-visit treatments. Postoperative pain after root canal treatment ranges from mild to moderate and occurs even after optimally performed procedures. Furthermore, adequate management of postoperative pain is often considered an indicator of clinical excellence. Application of recently developed endodontic techniques and devices will reduce postoperative pain. Furthermore, a flexible, severity-based drug administration plan can be used to control and manage pain after root canal treatment. Application of the current research findings will reduce pain following root canal treatment and improve patient outcomes.من الممكن إنقاص آلام ما بعد الجراحة لمعالجة القناة الجذرية من خلال تطبيق التطورات الحديثة في التقنيات والمعدات لعلاج الجذور. إن هذه المقالة المرجعية تقدم المعرفة الحالية حول الألم لمعالجة القناة الجذرية غير الجراحية بما في ذلك توقع الحدوث، والعوامل المرتبطة، وتأثيرات التطورات الحديثة، والعلاج. روجعت الأدبيات الطبية بين عامي ١٩٩٠م-٢٠١٦م باستخدام قواعد البحث PubMed, Cochrane, ScienceDirect. اشتملت الكلمات المفتاحية للبحث ألم ما بعد الجراحة، والعلاج غير الجراحي، وزيارة واحدة، والتطورات الحديثة في علاج الجذور، وعلاج ألم ما بعد جراحة الجذور. كما اشتملت المراجعة على الأبحاث الأصيلة فقط بينما تم استبعاد المقالات الافتتاحية، والمراجعات، والملاحظات المختصرة، ومحاضر المؤتمرات، والرسائل إلى المحرر. وأسفر البحث الأولي عن ٤٩٤١ مقالة، تم تقييمها وتصفيتها وفقا لمعايير الاختيار. وتوافقت ٦٥ مقالة مع معايير الاختيار، وتم تضمينها في هذه المقالة المرجعية. أظهرت النتائج حدوث ألم ما بعد معالجة القناة الجذرية غير الجراحية لدى ٣- ٣.٦٩٪ من المرضى. وتم تحديد الكائنات الحية الدقيقة كمسببات أساسية لألم ما بعد العلاج، ولم يكن هناك فرق في ألم ما بعد الجراحة بين زيارة واحدة وعدة زيارات علاجية. تراوح ألم ما بعد الجراحة لعلاج القناة الجذرية من خفيف إلى معتدل، وحدث حتى عند تنفيذ الإجراءات على النحو الأمثل. وبالإضافة إلى ذلك، يعتبر علاج ألم ما بعد الجراحة غالبا مؤشرا على التميز السريري. قلل تطبيق التقنيات والأجهزة الحديثة في علاج الجذور من ألم ما بعد الجراحة. بالإضافة إلى ذلك، يمكن أن يستعمل وصف الأدوية بشكل مرن بحسب حدة الألم للسيطرة على ألم ما بعد علاج القناة الجذرية. إن تطبيق نتائج هذا البحث سوف يقلل من ألم ما بعد علاج القناة الجذرية ويحسن نتائج المرضى.

Background and aims. The sterilization of the entire root canal system represents the main goal of every endodontist, given the fact that the control of the microbial flora is the key point of every root canal treatment. The diversity of microorganisms found inside the root canal and also the resistance of some bacterial species to intracanal medications led to a continuous development of new endodontic products. The present study focuses on the comparison of the antibacterial and antifungal properties of different endodontic products, two commercially available, one experimental plant based extract, and two control substances. Methods. The disc diffusion assay was used to determine the antibacterial and antifungal properties of chlorhexidine, calcium hydroxide, a mix extract between Arctium lappa root powder and Aloe barbadensis Miller gel, Amoxicillin with clavulanic acid and Fluconazole (as control substances). Two of the most common microorganisms found in endodontic infections were chosen: Enterococcus faecalis (ATCC 29212) and Candida albicans ATCC(10231). Results. All tested substances showed inhibition zones around the discs, for Enterococcus faecalis and Candida albicans , including the experimental mix extract of Arctium lappa root powder with Aloe vera gel. Conclusion. The experimental mix extract of Arctium lappa root powder and Aloe vera gel is able to inhibit very resistant microorganisms, like Enterococcus faecalis and Candida albicans.

Objectives The aim of this in vivo study was to assess the accuracy of 2 third-generation electronic apex locators (EALs), Propex II (Dentsply Maillefer) and Root ZX II (J. Morita), and radiographic technique for locating the major foramen (MF). Materials and Methods Thirty-two premolars with single canals that required extraction were included. Following anesthesia, access, and initial canal preparation with size 10 and 15 K-flex files and SX and S1 rotary ProTaper files, the canals were irrigated with 2.5% sodium hypochlorite. The length of the root canal was verified 3 times for each tooth using the 2 apex locators and once using the radiographic technique. Teeth were extracted and the actual WL was determined using size 15 K-files under a × 25 magnification. The Biostat 4.0 program (AnalystSoft Inc.) was used for comparing the direct measurements with those obtained using radiographic technique and the apex locators. Pearson's correlation analysis and analysis of variance (ANOVA) were used for statistical analyses. Results The measurements obtained using the visual method exhibited the strongest correlation with Root ZX II (r = 0.94), followed by Propex II (r = 0.90) and Ingle's technique (r = 0.81; p < 0.001). Descriptive statistics using ANOVA (Tukey's post hoc test) revealed significant differences between the radiographic measurements and both EALs measurements (p < 0.05). Conclusions Both EALs presented similar accuracy that was higher than that of the radiographic measurements obtained with Ingle's technique. Our results suggest that the use of these EALs for MF location is more accurate than the use of radiographic measurements.

Objective To quantify the persistence of residues after endodontic retreatment related to the root canal obturation technique (lateral compaction or single cone) previously performed and the solvent used (xylol or Endosolv-R) in the cervical and root apical segment using digital radiograph. Materials and methods Forty root canals were prepared using the F2 instrument and filled with gutta-percha and AH Plus, 20 canals using #25 point by lateral compaction and the other 20 using F2 point by single cone. The root canals were transversely sectioned, and two segments (cervical and apical) were obtained. Radiographs were taken from the segment in buccolingual and mesiodistal direction, as well as the area that was originally filled with the root canal obturation was measured using ImageJ. After the specimens were set on special devices, the obturations were removed using the rotary system and divided into four groups (n = 10): G1 — lateral compaction and xylol; G2 — lateral compaction and Endosolv-R; G3 — single cone and xylol; and G4 — single cone and Endosolv-R. A new radiograph was taken and the area occupied by residues was measured. The persistence of residues was obtained from the obturation remaining in the root canal in percentage. The data were analyzed using Kruskal—Wallis test (p = 0.05). Results There was no difference among the examined groups, regardless of the radicular segment or the radiograph direction (p > 0.05). Conclusion The endodontic retreatment using xylol or Endosolv-R in the obturations previously performed by lateral compaction or single cone technique presented similar persistence of residues in the root canal, regardless of the radicular segment. How to cite this article Aranda-Garcia AJ, Kuga MC, Vázquez-Garcia FA, Tonetto MR, Bandeca MC, Lima SNL, Freitas J, Borges AH, Jordão-Basso KCF, do Carmo Monteiro JC. Persistence of Residues after Endodontic Retreatment related to the Obturation Technique and to the Solvent. World J Dent 2017;8(1):41-44.

Science and commerce advance together and the stem cell field is no exception. With the promise of cures for conditions as diverse as cancer, autism, neural degeneration, organ replacement and addiction, long-term preservation of dental stem cells is a growth market. The discovery nearly twenty years ago, of viable, multipotent, stem cells in dental pulp from both baby and adult teeth initiated, and drives, this market.The dental stem cell preservation services, “tooth banks”, focus on the collection of a child’s baby teeth, as they are shed naturally, and storage of the stem cells from within the pulp for therapeutic use in later years should the child require them. This review focuses on the procedures related to these stem cell storage services and may serve as an introduction for many to the practice of “tooth banking”.

Sterilization is a fundamental step in the reuse of endodontic instruments. The sterilization procedure involves disinfection, cleaning, washing, drying, packaging, and sterilization by heat. Heat sterilization can lead to changes in the physical and mechanical properties of dental instruments. These changes can affect the external surfaces via micropitting, corrosion, a reduction in cutting capacity, and/or an influence on the resistance to cyclic fatigue or to torsional fatigue. In this study, we examined the modification of the torsional properties of endodontic instruments after hot sterilization, and compared the properties with instruments not subjected to hot sterilization cycles in terms of resistance to torsional fatigue and deflection angle in NiTi and steel instruments. The following work was performed based on the PRISMA indications. Studies were identified through bibliographic research using electronic databases. A total of 725 records were identified in the PubMed and Scopus databases. A total of 685 records remained after exclusion by year of publication (1979 to 2019). With the application of the eligibility criteria (all articles pertaining to the issue of sterilization in endodontics), we found 146 articles, which decreased to 130 articles after elimination of duplications. There were 45 articles that studied the influences of sterilization procedures on the physical and mechanical characteristics of the instruments, and 12 that measured parameters related to resistance to torsional fatigue. Applying the inclusion and exclusion criteria resulted in a total of eight articles for quantitative analysis. The meta-analysis results show a pejorative effect of torsional fatigue for NiTi instruments subjected to heat sterilization compared to the non-sterilized control. Sterilization is a fundamental step in the reuse of endodontic instruments. The sterilization procedure involves disinfection, cleaning, washing, drying, packaging, and sterilization by heat. Heat sterilization can lead to changes in the physical and mechanical properties of dental instruments. These changes can affect the external surfaces via micropitting, corrosion, a reduction in cutting capacity, and/or an influence on the resistance to cyclic fatigue or to torsional fatigue. In this study, we examined the modification of the torsional properties of endodontic instruments after hot sterilization, and compared the properties with instruments not subjected to hot sterilization cycles in terms of resistance to torsional fatigue and deflection angle in NiTi and steel instruments. The following work was performed based on the PRISMA indications. Studies were identified through bibliographic research using electronic databases. A total of 725 records were identified in the PubMed and Scopus databases. A total of 685 records remained after exclusion by year of publication (1979 to 2019). With the application of the eligibility criteria (all articles pertaining to the issue of sterilization in endodontics), we found 146 articles, which decreased to 130 articles after elimination of duplications. There were 45 articles that studied the influences of sterilization procedures on the physical and mechanical characteristics of the instruments, and 12 that measured parameters related to resistance to torsional fatigue. Applying the inclusion and exclusion criteria resulted in a total of eight articles for quantitative analysis. The meta-analysis results show a pejorative effect of torsional fatigue for NiTi instruments subjected to heat sterilization compared to the non-sterilized control.

Endodontic canal disinfection procedures that use sodium hypochlorite, and subsequently, heat sterilization procedures can alter the surface of endodontic instruments, described as corrosion and micropitting. These phenomena can be visualized on the surface of the instruments by SEM and atomic force microscopy analyses. The endodontic instruments used in probing, pre-enlargement, and shaping phases are made of steel alloy or nickel-titanium alloy (NiTi) and are subject to torsional, flexor, and cyclic fatigue; indeed, reuse of these instruments must be done with the knowledge that these instruments are subject to fracture following stress caused during their use. Fracture of the instrument within the canal is an eventuality that can lead to failure of the treatment, and therefore it is important to try to reduce situations that can contribute to the fracture. This review was performed based on the PRISMA protocol. Studies were identified through bibliographic research using electronic databases. A total of 1036 records were identified on the PubMed and Scopus databases. After screening the articles, restricted by year of publication (1979 to 2019), there were 946 records. With the application of the eligibility criteria (all the articles pertaining to the issue of sterilization in endodontics), there were 228 articles. There were 104 articles after eliminating overlaps. There were 50 articles that discussed the influence of sterilization procedures on the surface characteristics of endodontic instruments, and 26 articles that measured parameters on surface alteration. Applying the inclusion and exclusion criteria resulted in a total of eleven articles for quantitative analysis. Four articles were in reference to the primary outcome, eight articles to secondary outcome, and five articles to tertiary outcome. The meta-analysis showed a statistically significant surface alteration effect after five autoclaves and after immersion in the canal irrigants after 10 min.

Objectives The objective of this randomized controlled trial was to assess the influence of use of posts as well as the type of posterior tooth (premolars vs molars) for the treatment with lithium disilicate (LS2) partial crowns. Materials and methods A total of 60 patients were treated with posterior LS2 partial crowns. Two groups (n = 60) were made based on the type of restored tooth: Group 1, premolars and Group 2, molars. The samples of each group were divided into 2 subgroups (n = 30): Subgroup A restored with fiber posts and Subgroup B without them. Clinical and intraoral radiographic examinations were assessed during each recall (6 months and, 1, 2, and 3 years). Kaplan-Meier log-rank test and Cox regression analysis (Pp Results Three subgroups showed 100% of survival while group 2 A exhibited the lowest performance (93.3%). The Cox regression analysis showed that the presence of the post was not a significant factor for survival time (Hazard Ratio HR = 0388; CI95% Confidence Interval for H R = 0,1- to 1,5; pp = 017). Tooth type had an influence on survival time that was at the limit of statistical significance (Hazard Ratio HR = 0123; CI95% Confidence Interval for HR = 0 0015- to 0997; p = 005). Particularly, failure risk was greater for premolars. ‘Post by tooth type’ interactions were not statistically significant (p = 0126). Conclusions over a 3-year observation period, the clinical performance of endodontically treated teeth restored with lithium disilicate partial crowns was not significantly affected by the use of a fiber post and by the type of tooth (premolars or molars).

To evaluate the properties of experimental mineral trioxide aggregate (MTA) resin-modified materials for root-end filling procedures, varying their compositions regarding the addition of hydroxiapatite (HA) or dicalcium phosphate dihydrate, with or without chlorhexidine digluconate. White MTA (Angelus, Londrina, Brazil) was used as a reference material. Degree of conversion (DC) was evaluated by Fourier transformed infrared (FTIr) spectroscopy (n = 5). Flowability (n = 3) and radiopacity (n = 3) were evaluated following ISO 6876:2001 methods. For splitting tensile strength analysis, cylindrical samples (n = 10) were subjected to compressive load using a universal testing machine (Instron Corporation, Norwood, MA). Water sorption and solubility tests were performed according to ISO 4049:2009 methods. Calcium ion release and pH analysis (n = 10) were evaluated using a pH meter (Orion, Watsonville, CA). Cytotoxicity (n = 8) of materials extracts was evaluated as cell viability percentage. Statistical analysis was performed using Kolmogorov-Smirnov for normal distribution and data was subjected to one-way ANOVA and Tukey test (α = 0.05). Addition of chlorhexidine digluconate reduced DC mean values for experimental materials (