Comparative Evaluation of Microleakage in Endodontically Treated Teeth Using an Alkasite Restorative Material Versus Resin-Modified Glass Ionomer Cement (RMGIC) as an Intraorifice Barrier: A Study Protocol.

Background The most popular approach to treating pulpal and periapical disease is endodontic therapy, but the most common failure after root canal therapy, if not followed by planned rehabilitation of the tooth, is tooth fracture, which may be so severe in some cases needing extraction. Inadequate endodontic restorations increase the risk of fracture and coronal leakage, which can disseminate bacteria and their byproducts and perhaps lead to the failure of root canal therapy. In order to offer protection against masticatory forces along with compressive obturation forces that can lead to vertical root fracture, research has also supported the use of post-endodontic treatment restorative materials with an elastic modulus that is either greater or comparable to the tooth itself for post-endodontic restorations. Restorative materials that can bond to root dentin can be used to create intraorifice barriers, which prevent coronal microleakage and reinforce the radicular dentin. The current in vitro study aims to assess the effects of various intraorifice barriers (an alkasite restorative material versus resin-modified glass ionomer cement) on the sealing ability of the intraorifice barriers following root canal therapy. Methodology In vitro, confocal laser microscopy is used to determine the microleakage of various intraorifice barriers. Conclusion The sealing ability of a post-endodontic restoration is crucial for the overall success of endodontic treatment, and this in vitro study protocol would ultimately help in selecting the appropriate intraorifice barrier.

Perfecting the Craft: Composite Restoration Elevated With the Stamp Technique.

The "stamp technique" for posterior composite restoration placements is a relatively simple method for duplicating occlusal anatomy with near perfection. Due to the sensitivity of proprioceptors in the stomatognathic system to pressure, even slight occlusal disparities resulting from direct restorations can cause discomfort for patients. This discomfort often leads patients to adjust to a new habitual occlusal position, potentially leading to significant long-term craniomandibular issues. It was initially designed to restore Class I cavities and eroded teeth, where the marginal ridge of the tooth remains undamaged. The method is suitable for teeth with preoperative intact anatomy unaffected by carious lesions. The stamp technique aims to deliver a precise and natural-looking restoration with accurate functional occlusion. This case study demonstrates the application of the stamp technique for a straightforward Class I composite restoration, with the goal of quickly replicating the occlusal anatomy by creating a model of the original, unprepared tooth structure within minutes.

Restoration of a Peg Lateral Incisor Using the Putty Index Technique: A Case Report.

The restoration of peg lateral incisors poses considerable aesthetic and functional issues. This case report describes the use of a putty index approach for conservatively restoring peg-shaped maxillary lateral incisors with resin composites. A 21-year-old female patient with good periodontal health and appropriate occlusal interactions had treatment at the Department of Conservative Dentistry and Endodontics. The restoration method included initial impressions, shade selection, etching, bonding, and gradual composite application, followed by curing and polishing. The putty index was used as a reference to accurately recreate the palatal enamel. This approach provides a low-cost, minimally intrusive treatment that maintains natural tooth structure while producing satisfactory aesthetic outcomes. Direct adhesive resin restorations are being highlighted as a feasible option, as technology and bonding techniques progress. This case shows the significance of modifying treatment plans based on patient characteristics and practitioner expertise.

Treating a Case of Class II Caries With Silver Diamine Fluoride: A Newer Approach.

This case report details the comprehensive management of a six-year-old child diagnosed with early childhood caries (ECC), a prevalent condition affecting young children. The patient presented with acute pain in the lower left quadrant of the jaw, specifically involving the deciduous mandibular first molar (tooth D), which exhibited Class II caries. A prompt intervention was necessary to prevent further decaying of the tooth and manage the child's discomfort. The treatment strategy focused on a minimally invasive approach, beginning with the application of silver diamine fluoride (SDF) to arrest the progression of dental caries. SDF is known for its efficacy in halting carious lesions and providing immediate pain relief, making it a suitable option for young patients. Following the stabilization of the carious lesion, a stainless steel crown (SSC) was placed over the affected tooth. This restoration not only preserved the structural integrity of the tooth but also restored the masticatory function and maintained an aesthetic appearance, which is crucial for the child's overall oral health and development. This case highlights the effectiveness of combining SDF treatment with SSC placement in managing ECC, thus providing a durable solution that offers both pain relief and long-term protection against further carious activity. The chosen method underscores the importance of early intervention and the use of child-friendly restorative techniques in pediatric dentistry.

Clinical utility index for root canal sealers.

BACKGROUND: Effective endodontic treatment requires the use of a root canal sealer with optimal properties to ensure a hermetic seal, prevent reinfection, and promote healing. Despite the availability of various sealers, a standardized evaluation system still needs to be improved. OBJECTIVES: To develop a Clinical Utility Index (CUI) that systematically evaluates and ranks root canal sealers based on their sealing ability, antimicrobial efficacy, flow rate, and solubility. METHODS: The CUI was developed through a structured process involving expert identification, panel discussions, and the establishment of scoring criteria. Five sealers were evaluated (Sealers A, B, C, D, and E). Mean values for the core properties were calculated, and sealers were ranked accordingly. The total CUI for each sealer was computed based on the assigned scores for each property. RESULTS: Sealer B achieved the highest CUI at 95%, demonstrating superior performance across all core properties. Sealer C followed with a CUI of 80%, while Sealer A ranked third with 60%. Sealers D and E showed the lowest performance, with CUIs of 30% and 35%, respectively, highlighting deficiencies in multiple properties. DISCUSSION: The CUI provides a comprehensive evaluation framework for root canal sealers, facilitating informed decision-making by practitioners. Sealer B's high CUI underscores the importance of balancing sealing ability, antimicrobial effect, flow rate, and solubility. The results align with existing literature emphasizing the critical role of these properties in endodontic success. CONCLUSION: The CUI offers a robust and balanced method for evaluating root canal sealers, aiding in selecting the most suitable sealer based on empirical data. Future research should refine the index and validate its applicability in diverse clinical scenarios to enhance endodontic treatment outcomes.

Evaluation of the physical properties of bromelain-modified biodentine for direct pulp capping.

BACKGROUND: This study aims to evaluate the compressive strength, solubility, radiopacity, and flow of Bromelain (BR)-modified Biodentine (BD) for direct pulp capping (DPC). This is suggested to determine the impact of BR on the physical properties of BD. METHODS: Eighty samples were prepared according to the ISO and ADA specifications and evaluated for compressive strength, solubility, radiopacity, and flow. The compressive strength was evaluated at 24 h and 21 days via a universal testing machine. The solubility was determined by weight loss after 24-hours immersion in deionized water. Radiopacity was assessed via X-ray with aluminum step-wedges, and flow was measured by the diameter of the discs under a standard weight. Independent sample t-tests were used to statistically assess the data. A significance level of 5% was considered. RESULTS: The compressive strength was 41.08 ± 1.84 MPa for BD and 40.92 ± 1.80 MPa for BR + BD after 24 h, and 88.93 ± 3.39 MPa for BD and 87.92 ± 3.76 MPa for BR + BD after 21 days, with no significant differences. Solubility was slightly greater in the BR + BD (2.75 ± 0.10%) compared to BD (2.62 ± 0.25%), but not significantly different. The radiopacity was similar between BD (2.82 ± 0.11 mm) and BR + BD (2.73 ± 0.10 mm). BR + BD resulted in significantly greater flow (9.99 ± 0.18 mm) than did BD (9.65 ± 0.27 mm) (p ≤ 0.05). CONCLUSION: BR-modified BD maintains BD's physical properties, with improved flow, making it a promising DPC agent that warrants further study.

From Decay to Delight: A Case Report on Esthetic Rehabilitation in Early Childhood Caries.

Early childhood caries (ECC) continues to be a major global dental health concern for young children. This case report examines a young patient's transformation from decay to delight via comprehensive esthetic treatment. ECC in a four-year-old child resulted in significant dental caries and poor esthetics. In addition to space maintenance and orthodontic examination, essential treatments included dental extractions, stainless steel crowns, and composite restorations. The result showed that the child's smile and self-esteem had been successfully restored, as well as their oral health and function. This case emphasizes the value of early intervention, multidisciplinary teamwork, and individualized treatment plans in the management of early childhood caries and the restoration of pediatric patients' oral health.

Breakthrough in the Development of Endodontic Irrigants.

The three main components of endodontic success are three-dimensional obturation, pulp space sterilization, and biomechanical preparation. Instrumentation techniques are insufficient to accomplish complete disinfection of the pulp space. It is essential to use additional tools, such as endodontic irrigants. This review article aims to provide a general overview of the different root canal irrigants and their clinical uses. Endodontic treatment focuses more on removing infectious material from the root canal system to facilitate the healing of an existing periapical lesion or to prevent the periradicular tissues from being infected. It is important to note that instrumentation alone can reach every part of the root canal wall. Therefore, the irrigation procedure is a crucial aspect of endodontic therapy. Irrigation requires the application of various irrigants, like sodium and chlorhexidine, to get rid of debris, bacteria, and tissue leftovers. The accomplishment of root canal treatments counts heavily on the thoroughness of irrigation, contributing to optimal canal shaping and disinfection. Modern root canal irrigation systems incorporate syringes, needles, and advanced delivery mechanisms, including sonic and ultrasonic devices. These inventions aim to enhance the mechanical action of irrigants, reaching intricate canal anatomy more efficiently. Understanding the dynamics of root canal irrigation and staying abreast of technological advancements are essential for clinicians to achieve improved treatment outcomes in endodontic procedures.

A Case of Bilateral Dens Invaginatus Treated Using the Prophylactic Approach.

Dens invaginatus (DI) is a rare developmental defect in dentistry that results from invagination of the enamel organ into the dental papilla during tooth formation. However, such morphology presents cases that challenge treatment and diagnosis because of the morphology of the canal. The present study reports a case of DI in a 12-year-old boy showing a very unusual clinical and radiographic appearance of maxillary lateral incisors. The flowable composite was used to seal the invagination, and an etchant and a bonding agent were used as part of the preventative or prophylactic clinical therapy that was implemented in this instance. This offers a secure and efficient substitute therapy. This method has the potential to yield the greatest results for patients by combining expertise from endodontics and restorative dentistry.

The Management of a C1-Shaped Canal Configuration in a Mandibular Second Molar.

The mandibular second molar has one unique feature regarding internal anatomy: it tends to have a C-shaped configuration in many cases. In mandibular second molar teeth, it is a variance of racial predilection that is frequently observed. During negotiation, debridement, and obturation, the physician is frequently faced with difficulties due to the complexity inherent in this diversity of canal morphology. This case report describes the management of such canal variation, which requires a thorough knowledge of internal anatomy combined with detailed investigations and the operator's skill in cleaning and shaping the canal for better prognostic outcomes.

Anterior Maxillary Mesiodens Extraction in a Young Adult Male: A Case Report.

Mesiodens are classified as supernumerary teeth located in the maxilla, specifically in the palatal region between the central incisors. The prevalence of this condition varies between 0.15% and 1.9% among individuals. The presence of mesiodens can potentially affect the normal growth and development of teeth, leading to delayed eruption of permanent teeth, displacement or rotation of adjacent teeth, root resorption, and infectious pulpitis. This report discusses the case of a 14-year-old male patient who presented with a palatally placed mesiodens, which was completely erupted in the oral cavity. The patient underwent extraction for the removal of the mesiodens, and the procedure was successful with no complications reported during or after surgery. Early identification and surgical removal of mesiodens are crucial to preventing potential orthodontic and functional complications. This case highlights the importance of regular dental checkups for diagnosing supernumerary teeth. Timely intervention can lead to favorable outcomes, as demonstrated in this patient.

Innovative Pulp Preservation: The Use of Platelet-Rich Fibrin (PRF) and Mineral Trioxide Aggregate (MTA) in Treating Dental Pulp Exposure.

The dental pulp, essential for tooth vitality, often becomes inflamed when exposed due to caries, fractures, or dislodged restorations. Untreated inflammation can lead to pulpal death, necessitating vital pulp therapies (VPTs) such as pulp capping and pulpotomy. Recent trends favor partial caries removal to avoid overtreatment and preserve pulp health. This shift is illustrated through two cases of young female patients with dislodged restorations and deep caries. Both underwent direct pulp capping using platelet-rich fibrin (PRF) and mineral trioxide aggregate (MTA), followed by composite restorations. These cases underscore the importance of biocompatible materials like MTA and PRF in maintaining pulp vitality and promoting dental tissue repair.

Pin-Retained Amalgam: An Intricate Restorative Case Study.

Amalgam has made dental restorations more manageable, especially in difficult cases, due to its strength, durability, and relatively low cost. There can be pros and cons of each dental material depending on which class of cases it is applied or not applied for, depending on the patient's need, and, of course, the dentist's choice. These materials are used frequently for their hardness and durability and are ideal for extensive restoration procedures. On the other hand, composite resins are considered to be more aesthetic for the profitable areas where esthetics are more important. In contrast, glass ionomer cement is considered to be ideal for low-stress-bearing areas. The following case report of pin-retained amalgam restoration presents an example of its application in practical situations and the factors that must be considered to justify the use of this material against others. This paper explains various factors in considering pin-retained amalgam restorations and the procedure for a better and positive outcome.

Preserving Vitality: A Case Report of Partial Pulpotomy in Dental Practice.

This paper aims to evaluate the outcomes of a partial pulpotomy with mineral trioxide aggregate (MTA) in a maxillary first premolar with reversible pulpitis symptoms and signs. An intraoral periapical radiograph revealed a deep pulp-involving carious lesion without any indications of a periapical lesion, no history of night pain, and no tooth tenderness when percussion was applied. Caries removal is done using a round bur, 2-3 mm of inflamed pulp from the crown portion was removed, and bleeding was controlled within four minutes using 2.5% sodium hypochlorite, over which MTA was placed. After the setting of MTA, resin-modified glass ionomer cement was placed over it, and the tooth was restored using composite. The patient was asymptomatic in six months and one-year follow-up with no periapical changes and showed dentin bridge formation. Careful case selection, a precise selection of biomimetic material, and long-term follow-up validate the success of the treatment.

Anatomical Variations in Mandibular Molars: Focus on Midmesial Canals.

Endodontic therapy focuses on the root canal system to treat infected or damaged pulp tissue within the tooth, ultimately preserving the tooth and restoring its function. The root canal space should be cleaned with the use of proper instruments and chemical disinfectants to eradicate infected pulpal tissue and its remnants. The failure of endodontic therapy is attributed to a lack of understanding of the differences in anatomy among teeth, as evidenced by research. Canals are identified, and endodontic treatment is facilitated by the use of dental operating microscopes. Therefore, to achieve a favorable endodontic result, it is imperative to use all available methods to identify additional aberrant root canals. Failure to detect and adequately treat the midmesial canal (MMC) can lead to persistent infection, treatment failure, and the need for retreatment. This case underscores the importance of meticulous assessment and advanced techniques in treating complex canal configurations, ultimately leading to favorable outcomes in endodontic therapy. The MMC, a challenging anatomical feature, was located through careful clinical and radiographic examination. Advanced techniques, including ultrasonic activation and meticulous instrumentation, were employed to navigate and clean the canal effectively. Sodium hypochlorite irrigation and passive ultrasonic activation were utilized for thorough disinfection. The MMC was sealed with biocompatible materials, ensuring comprehensive obturation of the root canal system.

Hemisection: A Paradigm Shift in Prolonging Tooth Viability.

Splitting a molar means removing or separating the root and the accompanying crown portion. Hemisection of a damaged tooth aids in preserving the tooth structure and the existing alveolar bone surrounding the preserved root while also enabling the installation of a fixed prosthesis. This case report defines hemisection as an effective modality for preserving carious mandibular first molars with periodontal and periapical pathology.

The Management of Open Apex Using a Bioactive Material: A Case Report.

The management of teeth with open apices poses unique challenges in endodontics, requiring effective strategies to promote continued root development and maintain pulp vitality. This abstract explores the utilization of bioactive materials in the treatment of open apices, specifically focusing on their role in achieving optimal outcomes. Bioactive materials, such as Biodentine (Septodont, Saint-Maur-des-Fossés, France), have gained prominence for their favourable physiochemical properties, biocompatibility, and ability to stimulate dentinogenesis. The application of a bioactive material as an apical plug not only addresses immediate concerns but also contributes to long-term health and stability. This abstract reviews relevant literature, discusses clinical cases, and emphasizes the importance of tailoring treatment plans to the individual characteristics of open apex cases. The findings underscore the promising role of bioactive materials in reshaping the landscape of endodontic interventions for teeth with open apices, highlighting their potential to enhance both clinical and radiographic success.

Diving Deep: Exploring Dual Palatal Canals in the Upper Second Molar.

Dental anatomy exhibits considerable variation with the presence of additional canals being a common occurrence. The upper second molar typically presents with three canals and three roots; however, variations such as the existence of an extra canal or a root can pose challenges during endodontic treatment. Maxillary molar is characterized by an additional canal located within the palatal root, often exhibiting complex configurations and variations in morphology. Access refinement is critical to gaining adequate visibility and facilitating instrumentation. Meticulous exploration of the pulp chamber floor and careful examination of radiographs from different angles are essential for accurate diagnosis. Careful negotiation and cleaning of the extra canal with appropriate files and irrigants are essential to remove pulp tissue and debris effectively. Furthermore, obturation of the canal space with biocompatible materials is crucial to ensure a three-dimensional seal and prevent bacterial ingress. Clinically, the inability to detect and treat the extra palatal canal can lead to persistent infection, incomplete debridement, and compromised treatment outcomes. This case report delves into the significance of this anatomical variation, diagnostic modalities, and effective management strategies.

Metamorphosing Smiles Through Esthetic Vital Bleaching: A Twin Case Report.

Patients have been recently observed to have undergone a noticeable increase in the concern over tooth discoloration making it a common cosmetic issue. This cumulative number of visits to dental experts is in search of ways to whiten their teeth because they desire to improve their looks. Often, the desire for a brighter smile is associated with health and beauty perceptions. Thus, patients tend to go after what they think is the perfect form of an unflawed grin. Diverse treatment modalities exist for tooth discolorations, such as composite laminate and veneers, porcelain veneers, and partial crowns. Amongst these options, bleaching, therefore, appears to be a conservative manner of dealing with teeth discoloration. This twin case report shows that discoloration can be managed best through bleaching using McInnes solution, resulting in good outcomes. Using McInnes solution instead makes bleaching an affordable and conservative technique for removing stains.

Perfecting Posterior Dental Simulacrum: Unveiling the Stamp Technique for Tooth Restoration.

Dentistry is currently undergoing a phase where the pursuit of excellence has become continuous, and there is a rising demand for aesthetic standards, especially in the posterior region of the oral cavity. The "stamp technique" introduces a novel, straightforward method to restore carious teeth with unaltered occlusal structures using composite restoration. It effectively replicates the natural occlusal anatomy with remarkable precision. This method applies to preoperative carious teeth with preserved anatomy, minimally affected by carious lesions. Essentially, it involves creating an occlusal matrix from an undamaged occlusal surface of the tooth, aiming to achieve an accurate restoration resembling the natural tooth. This facilitates the restoration of the tooth's natural contour and contact, ensuring precise functional occlusion. This procedure offers increased efficiency, requires less time while maintaining high accuracy, and reduces the time needed for finishing and polishing.