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Introduction: Endodontic therapy has been regarded as a safe treatment option with highly promising results in preserving natural teeth. Numerous factors may influence the longevity of endodontically treated teeth (ETT), thus altering their success/survival rate. This study aimed to determine the survival and success rates of endodontically treated premolars and molars with different complex restorative/prosthodontic treatments. Materials and Methods: A total of 190 patients with an ETT were included, who had received final coronal restoration up to 14 days after the temporary one and at least one year prior to the enrollment. The investigator evaluated the quality of endodontic filling, coronal restoration, mobility, and proximal contacts. Data were analyzed with multiple binary logistic regression and the Chi-Square test. Results: The average duration of followup was 28.6±11.9 months. Overall, 89.4% (170/190) of the teeth survived. The overall success rate for the investigated teeth was 70.5% (134/190). Success rates of 100% for crown, 95.7% for post and core crown (PCC), and 94.7% for amalgam build-up with post were achieved. However, the success rates were 75%, 52.5%, and 50% for amalgam build-up, composite build-up, and PCC with crown lengthening, respectively. The Chi-square test revealed that there was a significant difference between the different restorations in terms of success (P<0.001). Multiple binary logistic regression models revealed that coronal leakage (P=0.048), obturation void (P=0.037), obturation length (P=0.020), mobility (P=0.002), type of the restoration (P<0.001), and proximal contact (P<0.001) were significant predictors for success. However, apical lucency, root length, marginal caries, tooth type, and post did not appear to be significant indicators of success (P>0.05). Conclusions: ETT with minimal mobility, exhibiting underfilled obturations without visible voids, and having received crown/PCC/amalgam build-up with a post, along with the presence of both proximal contacts, tend to exhibit a significantly high success rate. [ABSTRACT FROM AUTHOR]

To evaluate the anesthetic efficacy of 4% articaine with 1:100,000 epinephrine via primary intraosseous (IO) injection with the QuickSleeper device vs inferior alveolar nerve block (IANB) for mandibular first molars diagnosed with symptomatic irreversible pulpitis (SIP). Sixty-four patients with a first mandibular molar with SIP were randomly divided into 2 groups: IO (n = 32) and IANB (n = 32). Each received either an IO injection with the 5th generation QuickSleeper device or a conventional IANB with 1.7 mL 4% articaine with 1:100,000 epinephrine. Success was defined as no/mild pain upon the access cavity preparation and initial filing. Injection pain, anesthetic onset, heart rate (HR) change, HR recovery time, and duration of anesthesia were also recorded and analyzed. The success rates were 40.6% for IANB and 81.2% for IO (P <.001). IO exhibited a significantly lower injection pain (P =.027), a shorter onset of action (P <.001), a greater heart rate increase (P <.001), a faster heart rate recovery time (P <.001), and a shorter duration of action (P <.001) vs IANB. Primary IO anesthesia using the fifth generation of the QuickSleeper device was more successful than IANB when using 4% articaine with 1:100,000 epinephrine to anesthetize mandibular first molars with SIP. The QuickSleeper device appeared to be a viable alternative to IANB for mandibular anesthesia. [ABSTRACT FROM AUTHOR]

Objectives The final phase of root canal therapy involves the obturation of the root canal system to prevent bacterial leakage and ensure successful outcomes. However, during this process, there is a risk of sealer extrusion into vital structures such as the mandibular canal, which can lead to sensory changes like paresthesia. Case This report discussed a 40-year-old female case who presented with a crown fracture and a periapical lesion on her endodontically treated mandibular left second molar. During the retreatment, bioceramic sealer was extruded into the mandibular canal. Immediate radiographic evaluation and cone beam computed tomography confirmed the sealer's presence within the sub-branches of the mandibular canal, though the main canal was unaffected. Conservative treatment with ibuprofen and dexamethasone resulted in pain relief and the patient did not experience any neurological deficits such as paresthesia. A 36- month follow-up revealed successful healing of the periapical lesion and absorption of the extruded sealer. Conclusion This case highlighted the importance of precise endodontic techniques to prevent sealer extrusion and demonstrated the potential of conservative management in cases of sealer extrusion into sub-branches of inferior alveolar nerve. [ABSTRACT FROM AUTHOR]

Introduction: One of the most common problems in endodontic treatments is post-treatment pain, and sealers might be one of the factors influencing the degree of pain following root canal therapy. The purpose of this study is to compare pain following endodontic treatment using an AH-26 resin sealer against the Resil experimental sealer in mandibular molars with irreversible pulpitis. Materials and Methods: One hundred patients with irreversible pulpitis in the mandibular first or second molar were randomly divided into two groups (n=50) based on the type of sealer applied. Two postgraduate students with at least five years of experience treated all patients. All patients had a single root canal treatment. Postoperative pain scores and analgesic consumption were assessed after 6, 12, 24, and 48 hours and 3, 4, 5, 6, and 7 days after the treatment. The data were statistically analyzed by Fisher's exact or Chi-Square test (to compare the distribution of qualitative variables in two groups), repeated measures ANOVA (to compare changes in pain intensity over time in two groups), Boneferronie (for pairwise comparisons), Friedman, Wilcoxon and Mann-Whitney tests (for assessment of the changes in pain scores over time). The generalized estimating equations (GEE) were used for assessing time and group effects. Results: There was no significant difference in postoperative pain between groups at any of the time points studied (P>0.05), and also for patient analgesic consumption between groups (P>0.05). Both groups recorded the maximum pain levels in the first 6 hours. For each subsequent day postoperatively, the odds ratio (OR) of not using analgesics was 2.078. Conclusion: Resil and AH-26 perform similarly in terms of the occurrence and intensity of postoperative pain in mandibular molar teeth with irreversible pulpitis. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to evaluate the efficacy of the orifice-level passive ultrasonic activation (OL-PUA) technique in removing debris from the mesial root canals of mandibular molars, besides comparing it with other approaches, including manual dynamic agitation (MDA), EndoActivator, and laser-activated irrigation (LAI). Methods: Ninety mesial roots of mandibular molars were prepared up to 25.06 using the Race rotary system, filled with 3% sodium hypochlorite (NaOCl), and then they were randomly assigned to 5 groups (n = 15) based on the activation protocol: MDA, EndoActivator, OL-PUA, LAI (using a diode laser), and needle irrigation (no activation). Moreover, one group served as the negative control using normal saline as the final irrigant. The roots were decalcified and sectioned into coronal, middle, and apical cross-sections. After histological staining, the remaining debris was assessed with an optical microscope and measured in the canals and isthmuses using histomorphometric analysis. Statistical analyses were performed by using oneway ANOVA and Tukey's HSD post hoc test (P = 0.05). Results: Although less residual debris was observed after OL-PUA/LAI than using the EndoActivator/MDA methods, no significant difference was found between the four activation techniques at any root third (P > 0.05). The OL-PUA/LAI group harbored significantly less remaining debris than the needle-irrigated samples at all root thirds (P < 0.05). Debris accumulation increased from the coronal to the apical root thirds. Conclusion: No statistical difference was detected between the four activation techniques in terms of debris-removal performance, and none of them resulted in completely debris-free canals. Orifice-level PUA proved to be a promising approach with significant efficacy in removing debris compared to control groups. [ABSTRACT FROM AUTHOR]

Pulp canal obliteration (PCO) in calcified teeth presents a challenge for endodontic treatment, especially when accompanied by discoloration. Guided endodontic access (GEA) has emerged as an advanced method for root canal therapy (RCT) in such cases. This case report describes the successful treatment of a calcified maxillary central incisor with discoloration using GEA. A 32- year-old female with a history of dental trauma presented with discoloration in the left maxillary central incisor that did not respond to external bleaching. Clinical examination revealed a pulpless infected canal with asymptomatic apical periodontitis. Cone-beam computed tomography (CBCT) and intraoral scanning were utilized to create a three dimensional (3D) template, enabling minimally invasive access preparation through the palatal aspect. The RCT was performed in a single visit, followed by tooth whitening using hydrogen peroxide. At 18 months follow-up, the tooth was asymptomatic, and the apical lesion was healed. GEA offers a predictable and conservative approach, preserving tooth structure and providing enhanced long-term prognosis for teeth with calcified canals and discoloration. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to compare the accuracy and agreement between cone-beam computed tomography (CBCT) and micro-computed tomography (micro-CT) in the assessment of canal transportation and centering ratio following root canal instrumentation with rotary files. Material and Methods: Twenty mesiobuccal canals of mandibular molars were prepared using the 2Shape sequential rotary system. CBCT and micro-CT scans were performed before and after instrumentation, and the magnitude of transportation and centering ratio were measured. The acceptable transportation was set at ≤0.15 mm. The accuracy and agreement between CBCT and micro-CT were calculated, and the intra-class correlation coefficient (ICC) and kappa coefficient were determined to assess the agreement between the two modalities. Statistical analyses were performed using repeated measures ANOVA. Results: Transportation was detected by both modalities at all distances from the apex after instrumentation. The agreement between CBCT and micro-CT in assessing canal transportation was observed in 80%, 85%, 75%, and 75% of specimens at 1-, 3-, 5-, and 7-mm from the apex, respectively. The ICC for transportation and centering ratio was much lower than 0.75, indicating poor agreement between the modalities. The kappa coefficient did not show acceptable agreement between the methods. Conclusions: CBCT and micro-CT demonstrated poor agreement in assessing canal transportation and centering ratio. Micro-CT remains the preferred modality for in vitro investigations, while CBCT should be limited to clinical settings. [ABSTRACT FROM AUTHOR]

The superior lateral incisors are primarily affected by the developmental deformity known as dens invaginatus (DI). Oehler's type III DI has the highest complexity rendering a root canal treatment (RCT) an arduous challenge for this type, so early diagnosis and treatment before pulp involvement are important. This report presents two maxillary lateral incisors with type IIIb DI, the left one being associated with a periapical lesion and the right one with normal pulp. A nine-year-old boy was referred to our clinic complaining of mobility of the maxillary left lateral incisor (LLI) associated with gumboil throughout the previous two months. Periapical radiolucency was visible on radiographs, as well as an invagination that crosses the apical foramen from the pulp chamber in both maxillary lateral incisors. The pulp of the main canal of LLI was vital and pseudo canals were necrotized and associated with chronic apical abscess. Based on the condition of the main pulp of maxillary lateral incisors, two separate treatments were carried out. RCT was done only for the pseudo canals in the LLI, while the main root canal was preserved. The right maxillary lateral incisor (RLI) had vital pulp with normal periapical tissue So the invagination was sealed as the tooth was erupting. During the oneyear follow-up period, the development of the root in LLI with a thick root wall and closed apex was observed in the periapical radiograph but pseudo canals became infected and the tooth became symptomatic, therefore retreatment for pseudo canals was carried out. The RLI root was developed and the tooth was clinically asymptomatic, so it didn't need further treatment. Maintaining pulp vitality is crucial for type III Dens invaginated young permanent teeth since it could support root formation and improve long-term prognosis, and in cases with pulp involvement, non-surgical RCT is clinically predictable. [ABSTRACT FROM AUTHOR]

Objective: The management of postoperative endodontic pain (PEP) is essential to contemporary endodontic practice. Diclofenac and ibuprofen (IBU) are two of the most widely-used non-steroidal anti-inflammatory analgesics. However, their comparative data are neither sufficient nor conclusive. This prospective randomised clinical trial aimed to compare the analgesic efficacy of diclofenac potassium (DFK) with IBU on PEP in maxillary and mandibular first molars diagnosed with irreversible pulpitis after single-visit non-surgical root canal treatment. Methods: Sixty-four patients were randomised into two groups of DFK (n=32) and IBU (n=32), using the stratified permuted randomisation method, and 61 participants completed the trial. After root canal treatment, patients randomly received IBU 400 mg every 6 hours (n=31) or DFK 50 mg every 8 hours (n=30) for 24 hours. Patients recorded their pain level on 0-100 mm visual analogue scales (VAS) at 2, 4, 6, 12, and 24 hours after the treatment. Recorded VAS scores and the number of pain-free patients (VAS<5) were compared between the two groups. A generalised linear estimation equation model, Chi-Square test, and Mann-Whitney U test were used to analyse the data. Results: The mean overall PEP score was statistically significantly lower in the DFK group than the IBU group with a p value of 0.030. Pain scores at 2 (p=0.034), 4 (p=0.021), and 24 hours (p=0.042) after the treatment were also significantly lower for DFK than IBU. The number of pain-free patients was also significantly higher in the DFK group at 2-hour (p=0.015) and 4-hour (p=0.048) time points and overall (p=0.013) compared to the IBU group. There was no adverse effect observed in either group. Conclusion: Based on the results, taking multi-dose DFK 50 mg by the clock had better analgesic outcomes than multi-dose IBU 400 mg for PEP management. [ABSTRACT FROM AUTHOR]

Objectives In endodontics, mineral trioxide aggregate (MTA) and calcium-enriched mixture (CEM cement) are commonly used bioceramic materials. Regenerative endodontics often involves the use of double or triple antibiotic pastes (DAP or TAP), which are effective but may cause discoloration. This study aims to examine the effectiveness of internal bleaching in addressing discoloration caused by 4 different materials. Methods This in vitro study was conducted on 40 single-rooted anterior and premolar human teeth that did not have caries, restorations, obvious discoloration, or fractures and were extracted due to periodontal disease or orthodontic treatment. The teeth were randomly assigned to 4 groups (n=10). After root canal instrumentation, the baseline color of the specimens was measured using a spectrophotometer. After applying the aforementioned materials in the canals, access cavities were sealed with glass ionomer (GI), and the color of the specimens was measured again after 1 month to calculate color change (∆E). Internal bleaching was performed with 35% hydrogen peroxide 3 times within 3 weeks, and values were calculated at each time point. Data were analyzed using paired t-tests and 1-way analysis of variance (ANOVA). Results Clinically noticeable discoloration (∆E>3.7) occurred in the MTA Angelus (∆E=4.88) and TAP (∆E=17.3) groups. The ∆E of the TAP group was significantly higher than that of all other groups (P<0.05). The discoloration was borderline detectable in the CEM group (∆E=3.89) and clinically undetectable in the DAP group (∆E=2.02). Discoloration significantly improved after 3 rounds of bleaching in the TAP group (P<0.05), as well as after 2 rounds of bleaching in the MTA (P<0.05) and CEM (P<0.05) groups. In all groups, ∆E increased after each round of bleaching. Conclusion The CEM cement may yield better results with lower discoloration compared to MTA and exhibit a more favorable response to internal bleaching. For canal disinfection using antibiotic paste, DAP is a good alternative to TAP. [ABSTRACT FROM AUTHOR]

Introduction: Nano-technology applied for the local delivery of different agents and/or drugs has made its path to endodontics. In the current study, the antibacterial efficacy of biopolymer-coated ceramic microparticles loaded with a modified combination of triple antibiotics, i.e. Penicillin G, Metronidazole and Ciprofloxacin (PMC), was evaluated against two strains of Enterococcus faecalis (E.faecalis); a standard clinical strain obtained from previously root-filled teeth with persistent periapical lesions, and compared to the most common antimicrobials used in endodontics. Methods and Materials: After synthesis of the polymer-coated microparticles loaded with antibiotics, the 21-day release of antibiotics were evaluated and a stock solution was produced using the maximum released amount of drugs and distilled water. The antibacterial activity of PMC, triple antibiotic paste (TAP), calcium hydroxide (CH), chlorhexidine (CHX) and sodium hypochlorite (NaOCl) against two bacterial strains was determined using "Minimum Inhibitory Concentration" and "Agar Diffusion Test". Additionally, "Microtiter Plate Assay" was performed to assess anti-biofilm properties. Results: Minimum inhibitory concentration values reported for TAP and PMC were 1/256. PMC showed the maximum diameter of growth inhibition in both strains (33 mm and 35 mm), while CH had the minimum diameters (13 mm and 13 mm). Based on microtiter plate assay, TAP showed higher biofilm formation than PMC. Biofilm formation was higher in the standard strain for PMC; however, NaOCl, CHX and CH completely inhibited biofilm formation. Conclusions: Based on the findings of the present study, it could be concluded that PMC and TAP were the most effective medicaments against E.faecalis in its planktonic form; however, none could inhibit its biofilm formation. Further studies using larger sample size and "Confocal Scanning Laser Microscopy" are recommended. [ABSTRACT FROM AUTHOR]

Introduction: This study compared the cleaning effectiveness of NeoNiTi, 2Shape and Revo_S rotary instruments. Materials and Methods: Fifty mandibular molar mesial roots were selected with an angle of curvature less than 20 degrees divided into three groups (n=15). Five samples were selected as negative control group. In all three systems, the final file was 25, 6%. The score of debris and smear layer in three thirds (coronal, middle and apical) of the root canal walls were evaluated using scanning electron microscopic (SEM) magnification. The data were analyzed using the Kruskal Wallis and Mann Whitney U tests for intergroup comparison (P≤0.05) and Freidman and Wilcoxon signed-rank test was employed for intragroup comparison (P≤0.05). Results: Residual debris of the 2Shape system in the apical region was significantly higher than the other two systems (P=0.039). Revo_S and 2Shape groups had significantly higher quantities of debris in the apical than the coronal region (P=0.029 and P=0.02, respectively). In the 2Shape group, the amount of mid-region debris was significantly higher (P=0.005) than the coronal. In inter-group comparison there was no significant difference in residual smear layer between the systems. In intra-group comparison in all three systems, the amount of smear layer in the coronal third was significantly higher than in the other two areas. (P=0.017, P<0.001 and P=0.032, respectively). Conclusion: 2Shape left the highest amount of debris in the apical region. The amount of debris in Revo_S and 2Shape groups in the apical region was significantly higher than in the coronal. The amount of smear layer in all three groups in the coronal area was higher than the middle and apical areas. [ABSTRACT FROM AUTHOR]

Objectives Children frequently encounter dental problems related to traumatic dental injuries (TDIs). This study aimed to investigate TDIs among children aged 7-13 years, who were admitted to the Tehran School of Dentistry in Tehran, Iran. Methods This retrospective study was performed on 70 patients with 129 TDIs. Information, such as age at the time of the accident, gender, cause and type of TDI, the interval between the accident and the emergency care, and treatment, was gathered from the patients’ records. During the follow-up session, the pulp sensibility, probing, and percussion tests were conducted. The collected data was statistically analyzed using Fisher’s exact test and Chi-square test. The significance level was set at P<0.05. Results A total of 129 TDIs were reported during 2018-2021. Maxillary central incisors (80.62%) were the most commonly involved teeth, followed by maxillary lateral incisors (17.82%) and mandibular lateral incisors (1.55%). Falls were the main contributor to TDIs (31.78%). The most frequent TDIs involved enamel-dentin fractures without pulp involvement (37.20%) and subluxation (19.37%), followed by enamel-dentin fractures exposing the pulp (10.85%), avulsion (10.85%), infraction (4.65%), lateral luxation (3.87%), intrusion (3.87%), and extrusion (3.10%). Splinting (26.61%) and restoration (23.74%) were the most frequent treatments. The average pu-wollof period was 2-3 years, with a survival rate of 67%. Conclusion It appears that a significant number of parents are unaware of the necessity of immediate treatment and regular followup after TDIs, which can result in a high rate of treatment failure. [ABSTRACT FROM AUTHOR]

Background: Conflicting findings on the potency of antibiotic pastes versus calcium hydroxide (CH) have been evident in the literature. Aims: To compare the antibacterial efficacy of single antibiotic paste (SAP), double antibiotic paste (DAP), triple antibiotic paste (TAP), and modified TAP (mTAP) with CH on bacterial biofilms. Methods: PubMed, Scopus, and Embase were comprehensively searched until August 23, 2021. The study protocol was registered in the PROSPERO. Ex vivo studies performed on Enterococcus faecalis or polymicrobial biofilms incubated on human/bovine dentin were selected. The quality of the studies was assessed using a customized quality assessment tool. Standardized mean difference (SMD) with a 95% confidence interval (CI) was calculated for the meta-analysis. Meta-regression models were used to identify the sources of heterogeneity and to compare the efficacy of pastes. Results: The qualitative and quantitative synthesis included 40 and 23 papers, respectively, out of 1421 search results. TAP (SMD = −3.82; CI, −5.44 to −2.21; P < 0.001) and SAPs (SMD = −2.38; CI, −2.81 to − 1.94; P < 0.001) had significantly higher antibacterial efficacy compared to the CH on E. faecalis biofilm. However, no significant difference was found between the efficacy of DAP (SMD = −2.74; CI, −5.56–0.07; P = 0.06) or mTAP (SMD = −0.28; CI, −0.82–0.26; P = 0.31) and CH. Meta-regression model on E. faecalis showed that SAPs have similar efficacy compared to TAP and significantly better efficacy than DAP. On dual‑species (SMD = 0.15; CI, −1.00–1.29; P = 0.80) or multi‑species (SMD = 0.23; CI, −0.08–0.55; P = 0.15) biofilms, DAP and CH had similar efficacy. Conclusions: Ex vivo evidence showed that antibiotic pastes were either superior or equal to CH. The studied SAPs had considerably higher or similar antibacterial effectiveness compared to DAP, CH, and TAP. Hence, combined antibiotic therapy was not necessarily required for root canal disinfection ex vivo. [ABSTRACT FROM AUTHOR]

Introduction: This study investigated the amount of debris and smear layer remaining followed chemomechanical preparation using three systems: ProTaper Universal, reciprocating SafeSider, and hand K-Flexofiles with scanning election microscope (SEM). Materials and Methods: Sixty-five mandibular molars with mesiobuccal canal curvature (25 to 40") were extracted and divided into one control group (n=5), and three experimental groups (n=20) according to the preparation method; K-Flexofile, ProTaper Universal and SafeSider instruments. All canals were irrigated with 3 ml of 5.25% sodium hypochlorite solution and 3 mL of 17% EDTA. Subsequently, the canals were irrigated with 5 ml of normal saline. Then the teeth were examined under the scanning electron microscope (SEM). Kruskal-Wallis, Dunn-Q Bonferroni, and Friedman tests were used for statistical analysis of results. Results: To assess the accumulation of debris, statistically significant differences were observed only in the coronal area among ProTaper Universal, SafeSider, K-Flexofile, and the control group. (P=0.029). To evaluate the residual smear layer amount, statistically significant differences were observed only in the coronal and middle areas, following the preparation of the canals using ProTaper Universal, SafeSider, and hand K-Flexofiles and control groups (P=0.019). Conclusions: Based on the present in vitro study, we can declare that the canals were utterly cleaned of debris and smear layer in none of the groups. Manual Flexofile and ProTaper Universal groups result in cleaner canal walls than reciprocal SafeSider, in the coronal and middle thirds. [ABSTRACT FROM AUTHOR]

Objectives Different root canal filling materials show different clinical and radiographic success rates. Since there is controversy on the best root canal filling material in primary dentition, the aim of this study was to summarize information about root canal filling materials for primary teeth in terms of biocompatibility, cytotoxicity, resorption rate, and survival rate. Methods By searching online databases, studies that addressed biocompatibility, cytotoxicity, resorption, and survival rates of different root filling materials in primary teeth from 1985 to 2020 were evaluated and the required data were extracted. The results were tabulated and compared. Results Due to methodological discrepancies, different studies show different and sometimes inconsistent results, which make it hard to reach a final conclusion; but it seems that Vitapex and Maisto's paste are more biocompatible and have a good survival rate. Zinc oxide eugenol (ZOE) and calcium hydroxide have lower cytotoxicity among different filling materials. However, due to low resorption rate, ZOE can affect permanent successors. Conclusion Based on the unique characteristics of each patient, different filling materials may be used for a clinically optimal dental treatment. [ABSTRACT FROM AUTHOR]

Objectives Establishment of effective communication between the clinician and patient is essential in order to increase patients' satisfaction and achieve better treatment outcomes. These skills have been less investigated among dental students. The current study assessed the attitude of 5th semester dental students towards communication skills learning at Shahid Beheshti University of Medical Sciences in Iran during 2017-2018. Methods In this quasi-experimental study, 40 dental students filled out the Communication Skills Attitude Scale (CSAS) with three domains of needs, operation, and application as self-declaration at two time point points before and after passing the course of “dentist-patient communication skills. Data were analyzed using paired t-test, independent t-test, and Wilcoxon signed rank test. Results A significant positive change occurred in students' attitude in general (P<0.001). An improvement in their attitude was observed in domains of needs (P<0.001), operation (P=0.002), and application (P<0.001) after passing the course in comparison with baseline. After passing the course, male students showed a significant positive attitude in domains of needs (P<0.001), operation (P=0.011), and application (P<0.003). But the only positive change in female students' attitude was observed in the domain of application (P=0.004). The positive attitude change in males was significantly higher than that in females in all domains (P=0.023). A significant positive change was observed in the attitude of 21- year-old students in comparison with other age groups (P=0.002). Conclusion The results showed positive change in both male and female students' attitude after passing the academic course of dentist-patient communication skills. [ABSTRACT FROM AUTHOR]

Objectives Canine teeth are supposed to have one single root canal, but they may have some anatomical variations. This study aimed to investigate the morphology of root canals of maxillary and mandibular canines regarding gender and age in an Iranian population using cone-beam computed tomography (CBCT). Methods Using CBCT images, 126 maxillary and 125 mandibular canines were evaluated. Root anatomy was assessed regarding root length, root curvature, number of roots and canals, and pattern of root canal system. The data were analyzed by the Kruskal Wallis and Mann-Whitney tests and multinomial regression model. Results The mean root length of male patients was significantly higher than females (p=0.0001). The most frequent root curvatures were towards the distal and buccal. Mandibular teeth (p=0.020) and females (p=0.012) had higher frequency of root curvature. All maxillary canines had one root; whereas 1.6% of mandibular canines had two roots. High prevalence of two canals was reported (34.9% of maxillary and 18.4% of mandibular canines). The most prevalent canal patterns included type I (65.1%) followed by type III (34.9%) in maxillary canines and types I (81.6%), III (16.8%) and V (1.6%) in mandibular canines. Higher frequency of type III canal configuration was reported in maxillary teeth (p=0.001) and male patients (p=0.008). No significant difference was found in any parameter between different age groups (p>0.05). Conclusion A high percentage of type III canal configuration in canine teeth especially maxillary canines and male patients was reported. Mandibular teeth and females had higher frequency of root curvature. [ABSTRACT FROM AUTHOR]

This study compared the antibacterial effect of 2% clindamycin and 2% and 100% concentration of triple antibiotic paste (TAP) on an Enterococcus faecalis biofilm. Dentinal tubules of 100 root specimens were infected and randomly assigned to five groups. A total of 1000 mg mL−1 of TAP, 20 mg mL−1 of TAP and clindamycin, calcium hydroxide or methylcellulose (control) were placed in the root canal for 1 week. After treatment, dentine shavings were collected from 200 and 400 μm dentine depth and the number of colony‐forming units (CFU) per mg was determined. Reduction in viable bacteria in first three groups was significantly better than calcium hydroxide and control groups. However, the antimicrobial effectiveness among these three groups was not significantly different from each other. There was no significant difference between data at 200 and 400 μm in all groups except the Ca(OH)2 group. The antibiofilm effect of clindamycin was comparable with TAP, so it may be used instead of TAP. [ABSTRACT FROM AUTHOR]

Objective: A systematic review and meta-analysis were conducted to determine whether there are postoperative pain differences resulting from rotary and reciprocation engine-driven instrumentation motions in non-surgical endodontic treatment or retreatment at 12, 24, and 48 hours., Methods: Four electronic databases (PubMed, Embase, Cochrane Library, and Scopus) were searched to identify randomised controlled trials that compared the effects of rotary and reciprocating instrumentation motions on postoperative pain. Two authors independently screened the search results, extracted the data, and assessed the quality using the Cochrane risk of bias tool. Due to numerous variables across studies, the random effect inverse variance method for meta-analysis was applied. When significant heterogeneity among studies was present, the random effects multi-variable meta-regression analysis was performed to determine the source of heterogeneity., Results: At all time intervals, the incidence of postoperative pain was higher in the reciprocating instrumentation group, but was not statistically significant. There was no significant difference in the analgesic intake between groups. Meta-regression analysis determined study population sizes as a significant heterogeneous factor, while significance was not observed for preoperative pain or the pulpal diagnosis., Conclusion: There was no difference in postoperative pain at 12, 24, and 48 hours after non-surgical root canal treatment and retreatment, using reciprocating or rotary instrumentation motions.