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Aim: Several factors influence the condition of the periapical tissues associated with root filled teeth. The primary objective of this study was to retrospectively evalu ate the extent and speed of bone healing of large periapical lesions associated with nonsurgical root canal treatment or retreatment. The secondary objective was to analyse the relationship between the time to complete healing when analysed using cone beam computed tomography (CBCT) and other possible predictors that affect healing. Methodology: Seventy-nine patients were treated during the years 2013–2020 with large periapical lesions of endodontic origin (10–15mm) as observed on intraoral periapical radiographs (IOPAR) were included. IOPAR and CBCT were available before treatment and during the follow-up (IOPAR every 6months and CBCT every 12months). The volume of periapical lesions was calculated by OsiriX Lite software. Variables such as initial volume of the lesion, age, gender, type of treatment or type of root canal filling were compared to identify the differences between healed and unhealed lesions. Pearson's Chi-square test was used for categorical variables, the t-test for age and the Wilcoxon test for initial volume of the lesion. The association between time to healing and the variables was assessed using univariate analysis and multivariate analysis. The Wilcoxon test was used to observe the association of heal ing time with categorical variables and the correlation index was measured with the quantitative variables. Results: Of the 79 cases analysed, 60 lesions (76%) were completely healed as verified by CBCT in a mean healing time of 19months, of which 60% healed fully between 12 and 18months. Increase in age of patient and larger initial volume of the lesion were associated with a significantly longer healing time (p<.001). Gender, filling material and type of treatment did not have a significant effect on the healing process (p>.05).

The aim of this study was to evaluate patients’ knowledge and perceptions of the use of systemic antibiotics in the treatment of endodontic infections and to determine the possible contribution of patients to the development of bacterial resistance. Methods: A total of 550 patients were asked to respond to a survey on the perception of systemic antibiotic use in the treatment of endodontic infections and antibiotic resistance during January 2022 and March 2023. A bivariate and multivariate analysis was performed to determine possible correlates in the population regarding antibiotic use in the endodontic world. Results: A total of 514 patients were included in the study, 65.9% of whom were women. While 34.6% of the population studied thought that it was always necessary to take antibiotics prior to endodontics, 49.4% considered that they were necessary after endodontics, regardless of the clinical symptoms. The prevalence of self-medication was 17.3%, and women self-medicate more than men, with significant differences (p < 0.05), although they have a greater knowledge of antibiotic resistance than men (p < 0.05). Forty-four percent of the population expected to take antibiotics when faced with dental pain, mainly women (p < 0.05). Conclusion: The general population is contributing to the serious problem of bacterial resistance. It is necessary to promote educational strategies focused on the correct use of antibiotics in the community. The worst results were found mainly in the population with a low level of education. The level of education was the variable that most influenced the knowledge and aĴitudes of the population, followed by the sex of the participants.

Aim Several factors influence the condition of the periapical tissues associated with root filled teeth. The primary objective of this study was to retrospectively evaluate the extent and speed of bone healing of large periapical lesions associated with nonsurgical root canal treatment or retreatment. The secondary objective was to analyse the relationship between the time to complete healing when analysed using cone beam computed tomography (CBCT) and other possible predictors that affect healing. Methodology Seventy-nine patients were treated during the years 2013–2020 with large periapical lesions of endodontic origin (10–15 mm) as observed on intraoral periapical radiographs (IOPAR) were included. IOPAR and CBCT were available before treatment and during the follow-up (IOPAR every 6 months and CBCT every 12 months). The volume of periapical lesions was calculated by OsiriX Lite software. Variables such as initial volume of the lesion, age, gender, type of treatment or type of root canal filling were compared to identify the differences between healed and unhealed lesions. Pearson's Chi-square test was used for categorical variables, the t-test for age and the Wilcoxon test for initial volume of the lesion. The association between time to healing and the variables was assessed using univariate analysis and multivariate analysis. The Wilcoxon test was used to observe the association of healing time with categorical variables and the correlation index was measured with the quantitative variables. Results Of the 79 cases analysed, 60 lesions (76%) were completely healed as verified by CBCT in a mean healing time of 19 months, of which 60% healed fully between 12 and 18 months. Increase in age of patient and larger initial volume of the lesion were associated with a significantly longer healing time (p < .001). Gender, filling material and type of treatment did not have a significant effect on the healing process (p > .05). Conclusions Clinicians should be aware that

El objetivo de esta tesis fue evaluar la influencia de varios sistemas de instrumentación rotatoria y reciprocante en la generación de microcracks dentinarios tras la preparación de los conductos en raíces rectas y en raíces curvas empleando un método no destructivo y analizando en relación con los métodos más utilizados en la literatura. Se trata de un trabajo ex vivo en el que se seleccionaron dientes extraídos que cumplían con una serie de criterios de inclusión y se les someten a los procedimientos clínicos de preparación. Se emplea un método no invasivo (micro-CT), que nos permite el análisis de la condición previa de las raíces (antes de los procedimientos) y posteriormente el análisis de esas mismas raíces tras el tratamiento. Cuando se analiza con micro-CT, vemos que existen microcracks preexistentes, pero que los sistemas de instrumentación no generan nuevos defectos. Con las limitaciones de este trabajo, se puede concluir que no pueden ser utilizados métodos destructivos para el análisis de defectos en la dentina, y que los procedimientos de instrumentación no generan nuevos microcracks dentinarios.

El objetivo de este trabajo es ayudar a los profesionales a seleccionar el tipo de rotación adecuada para hacer un tratamiento endodóntico, de acuerdo con su nivel de experiencia. Tanto en la fase de glide path como en la preparación completa del conducto, tanto en términos de fractura del instrumento como para el tiempo de preparación. Se instrumentaron un total de 160 conductos curvos. El tiempo de preparación y el número de instrumentos fracturados se registraron y compararon estadísticamente. Se encontró que el uso de movimientos recíprocos permitió a los operadores no expertos evitar la fractura del instrumento durante la fase de glide path, y preparar los conductos radiculares más rápidamente. En el caso de los operadores expertos fueron más rápidos con rotación alterna en la preparación del glide path e igual de efectivos en la instrumentación del conducto con ambos movimientos. En todos los casos rompieron menos instrumentos de rotación alterna y fracturaron menos limas los expertos. Por lo tanto, la experiencia del operador es un factor clave, y en el caso de ser un operador inexperto conviene decantarse por los movimientos alternantes.

Objectives: The objective of this study was to analyze the impact of the abutment width on early marginal bone loss (MBL).Material and Methods: A balanced, randomized, double- blind clinical trial with two parallel experimental arms was conducted without a control group. The arms were “cylindrical” abutment and “concave” abutment. Eighty hexagonal internal connection implants, each with a diameter of 4 × 10 mm, were placed in healed mature bone. The main variable was the peri-implant tissue stability, which was measured as MBL at 8 weeks and 6 months.Results: The final sample consisted of 77 implants that were placed in 25 patients. 38 (49.4%) were placed using the cylindrical abutment, and the other 39 (50.6%) were placed using the concave abutment. The early global MBL of −0.6 ± 0.7 mm in the cy-lindrical abutment group was significantly higher than it was in the concave abutment group, in which the early global MBL was −0.4 ± 0.6 mm (p= .030). The estimated ef-fect size (ES) was negative for the cylindrical abutment (ES = −1.3730, CI −2.5919 to −0.1327; t- value = −2.4893; p= .0139), therefore implying a loss of mean bone level, and it was positive for the concave abutment (ES = 2.8231; CI: 1.4379 to 4.2083; t- value= 4.0957; p= .0002), therefore implying an increase in the average bone level.Conclusions: The concave abutments presented significantly less early MBL at 6 months post- loading than classical cylindrical abutments did

This study intended to help practitioners selecting the appropriate motionaccording to their level of expertise for glide path and complete root canalpreparation of curved canals in terms of instrument fracture and preparationtime. A total of 160 curved root canals (angle>30°, radius<6 mm) were allo-cated randomly to 4 groups: A/B for expert operators and C/D for nonexpertoperators. A/C were shaped with rotary and B/D with reciprocating instru-ments. Preparation time was registered and compared with Kruskal–Wallisnon-parametric test and Dunn’s post hoc test. Instrument separation was alsoregistered and compared with chi-square test. A fractographic analysis was per-formed with scanning electron microscopy. The use of reciprocation motionsallowed nonexpert operators to avoid instrument breakage during glide pathand to prepare root canals faster. Experts were equally effective in rotary/re-ciprocating root canal shaping and faster with rotary motions than nonexpertoperators, who also fractured significantly more rotary instruments.

The aim of this study was to evaluate the efficacy of continuous apical negative ultrasonic irrigation into simulated lateral canals and the apical third in straight and curved root canals. Two simulated lateral canals were created 2, 4 and 6 mm from the working length in 120 single-rooted teeth (6 canals/tooth, n = 360 straight, n = 360 curved). The teeth were randomly divided into 3 experimental groups: positive pressure irrigation (PPI) (n = 20); passive ultrasonic irrigation (PUI) (n = 20); continuous apical negative ultrasonic irrigation (CANUI) (n = 20). 20% Chinese ink was added to a 5% sodium hypochlorite solution and delivered into the root canals. The results showed a significantly higher (P < 0.05) penetration of irrigant into the lateral canals and up to working length in the CANUI group for straight and curved roots. CANUI improves penetration into the lateral canals and up to the working length of the cleared teeth in straight and curved roots.

The aim of this study was to present a new technique for plastic carrier removal in retreatment situations. The gutta-percha technique that uses plastic carrier obturators is one of the most commonly used; however, removing this core is tedious and time-consuming. Two clinical cases were performed by an expert in the field of endodontics, to expose this technique, in which a conical ultrasonic tip with an active point and a Hëdstrom hand file allowed the removal of the plastic carrier quickly and effectively. The use of magnification is indispensable for a predictable success with this method

[Abstract] Background: Nearly two decades have passed since a paradoxical reaction in the orofacial region to some bone modifying agents and other drugs was recognized, namely medication-related osteonecrosis of the jaw (MRONJ). Purpose: The aim of this manuscript was to critically review published data on MRONJ to provide an update on key terminology, concepts, and current trends in terms of prevention and diagnosis. In addition, our objective was to examine and evaluate the therapeutic options available for MRONJ. Methods: The authors perused the most relevant literature relating to MRONJ through a search in textbooks and published articles included in several databases for the years 2003–2021. Results and conclusions: A comprehensive update of the current understanding of these matters was elaborated, addressing these topics and identifying relevant gaps of knowledge. This review describes our updated view of the previous thematic blocks, highlights our current clinical directions, and emphasizes controversial aspects and barriers that may lead to extending the accumulating body of evidence related to this severe treatment sequela.