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Statement of Problem: Gingival irritation is a common side effect of at-home bleaching, but how the design of the bleaching tray affects its occurrence is unclear., Purpose: The purpose of this randomized clinical trial was to determine whether a direct relationship is present between the design of bleaching trays and the risk of gingival irritation during at-home bleaching treatments., Material and Methods: This clinical trial was registered at ClinicalTrials.gov. (NCT06371664). Seventy-two participants were randomly assigned to 2 experimental groups: extended bleaching tray (3 mm) and nonextended bleaching tray (1 mm). Over a period of 3 weeks, participants underwent a nightguard dental bleaching treatment (6 to 8 hours) using 16% carbamide peroxide gel. Gingival irritation was evaluated subjectively by participants daily and objectively by clinicians at each visit. Tooth sensitivity was recorded daily using a 5-point numerical scale. Tooth color measurements were also made with a dental spectrophotometer. The risk of gingival irritation and the risk and intensity of tooth sensitivity were analyzed with the Pearson chi squared test and Fisher exact test. The color analysis was conducted with the Student t test (α=.05)., Results: Subjectively, the risk of gingival irritation was 66.7% in the extended group and 47.2% in the nonextended group, showing no statistically significant difference (P>.05). However, objectively, the risk of gingival irritation was significantly higher in the extended group (88.9%) compared with the nonextended group (63.9%) (P=.01(95% CI 1.06 to 1.83). Tooth sensitivity intensity was significantly higher in the extended tray group (P<.001), although the design did not significantly influence the risk of tooth sensitivity (P>.05). No significant differences were found between groups regarding color change (P>.05)., Conclusions: The use of an extended bleaching tray design increases the risk of gingival irritation and the intensity of tooth sensitivity. Therefore, the nonextended tray is recommended to minimize adverse reactions., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

The aim of this study is to analyze the effects of different endodontic irrigants and adhesive systems on the resin bond strength of fiber post cementation. In total, 144 single-rooted, unrestored human teeth were endodontically treated and randomly divided into 12 groups according to four endodontic irrigants (distilled water as control; EDTA 17%; NaOCl 5%; chlorhexidine digluconate 2%) and three different adhesive/resin cement systems (etch-and-rinse: orthophosphoric acid, Parabond ® A+B/Paracore ® ; self-etch: ParaBond ® Non-Rinse Conditioner, Parabond ® A+B/Paracore ® ; Universal: Clearfil TM Universal Bond/Clearfil TM DC Core Plus). Forty-eight hours after post cementation, ten teeth from each group were cross-sectioned into three discs (cervical, middle and apical regions). Thirty specimens of each group ( n = 30) were submitted to a push-out test at a crosshead speed of 1 mm/min. The remaining two teeth of each group were sectioned in the same manner, and the resin-dentin interface was evaluated using scanning electron microscopy (SEM). The results were statistically analyzed with the ANOVA test and Tukey's test ( p < 0,01). The adhesive protocols and post space region showed no significant effect on bond strength ( p > 0.01). The combination of NaOCl 5% and ClearfilTM Universal Bond reduced the adhesive strength ( p < 0.01). The NaOCl 5%, in relation to other irrigants, significantly decreased the push-out bond strength.

Background: Performing an appropriate Class II direct restoration is a great challenge. The correct selection of the matrix system and the elements used for its stabilization will have a great impact on the result. The aim of this study is to show a new digital method for a predictable selection of the wedge and compare it with the conventional method. Methods: Sixty patients were randomly divided into two groups. In Group 0, the wedge was selected intraoperatively by visual examination, while in Group 1 the wedge was selected preoperatively through the measurement of the cervical embrasure on the bite-wing radiography. The number of wedges used, modifications to them, and tissue damage were registered, along with the quality of the proximal contact and the marginal adaptation. Results: Student's t -test revealed a statistical difference between the number of wedges used, which was higher in Group 0 ( p < 0.05). Pearson Chi-square test showed that tissue damage was statistically higher in Group 0 ( p < 0.05), while there was no statistically significant difference between groups in wedge modifications ( p > 0.05). Group 1 revealed a higher frequency of satisfactory proximal contact and marginal adaptation ( p < 0.05). Conclusions: This new technique reduces wedges waste and tissue damage and provides an adequate interproximal anatomy.

Dens Invaginatus (DI) or dens in dente is an uncommon anomaly which mostly affects permanent lateral incisors, and it is very rare in molars. This article presents the conservative endodontic management of four different cases of DI and a discussion of the endodontic literature for this malformation. Three upper lateral incisors Type II, IIIa and IIIb, and an upper first molar Type II are shown. The most conservative approach possible was carried out. Three of the cases were obturated using the continuous wave technique. In one of the cases, it was possible to treat only the invagination with MTA and preserve the pulp vitality of the main canal. To make a correct diagnosis and to treat in the most conservative way possible, a DI is necessary to know its classification and use tools such as CBCT and magnification., (© 2023 Australian Society of Endodontology Inc.)

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., (© 2021 Australian Society of Endodontology Inc.)