Comparing pre- and postoperative etoricoxib administration versus only postoperative on third molar extraction sequelae and oral health quality of life: a prospective quasi-experimental study.

OBJECTIVES: This study aimed to compare the impact of pre- and postoperative etoricoxib administration versus only postoperative on third molar extraction sequelae and oral health quality of life. MATERIALS AND METHODS: This prospective quasi experimental study involved 56 patients, divided into a study group receiving preemptive etoricoxib 120 mg before surgery and postoperative etoricoxib 120 mg (n = 28), and a control group receiving preemptive placebo before surgery and postoperative etoricoxib 120 mg (n = 28). Follow-up assessments were conducted at 3- and 7-days post-surgery, recording swelling, trismus, and adverse events. Patients rated perceived pain using the visual analog scale (VAS) and completed an oral health-related quality of life (OHRQoL) questionnaire at specified intervals. Statistical analysis employed non-parametric tests (i.e., the Mann-Whitney test, Friedman test, and Wilcoxon sign test) with P < 0.05. RESULTS: Significantly lower VAS scores were reported in the study group throughout the follow-up period (P < 0.05). Pharmacological protocol did not have a significant impact on postoperative edema and trismus (P > 0.05). However, double etoricoxib intake significantly improved postoperative quality of life on day 3 after surgery (P < 0.05). CONCLUSIONS: Pre- and postoperative etoricoxib 120 mg intake in third molar surgery reduced postoperative pain and enhanced postoperative quality of life on day 3 after surgery. Importantly, it was equally effective in managing swelling and trismus compared to exclusive postoperative intake. CLINICAL RELEVANCE: Preemptive etoricoxib use may decrease patient discomfort following impacted mandibular third molar extraction.

Assessment of bone regeneration after maxillary radicular cyst enucleation with or without bone grafting materials: a retrospective cohort study.

OBJECTIVE: The limitations of spontaneous bone healing underscore the necessity for exploring alternative strategies to enhance bone regeneration in maxillary radicular cyst cases. This retrospective study aimed to assess the impact of a bone substitute material (i.e., Bio-Oss) on bone volume regeneration following maxillary radicular cyst enucleation using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: Seventy-three patients with maxillary radicular cysts were divided into two groups: one undergoing guided bone regeneration (GBR) with Bio-Oss and absorbable collagen membrane (n = 35), and the other receiving cyst excision alone (n = 38). Volumetric measurements using Amira software on CBCT scans evaluated bone regeneration, with cystic lesion shrinkage rates calculated. Intergroup comparisons utilized independent sample t-tests (P < 0.05), and linear regression analysis assessed the influence of preoperative cyst volume and group on bone healing. RESULTS: Both groups showed similar success rates in bone formation at the 12-month follow-up, with no significant differences between them (mean (SD), control: 75.16 (19.17) vs. GBR: 82 (20.22), P > 0.05). Linear regression analysis revealed a negative correlation between preoperative cyst volume and bone regeneration in both groups (P < 0.05). CONCLUSION: Bio-Oss may not significantly enhance bone augmentation in maxillary radicular cysts. In addition, preoperative cyst volume negatively affected the shrinkage rate of cystic lesions. CLINICAL RELEVANCE: Clinicians should consider patient-specific factors such as anatomy and lesion size when determining the need for bone substitute materials. Future research could focus on optimizing treatment protocols and alternative regenerative strategies to improve patient outcomes in maxillary cyst cases.

An Experimental Anatomic CBCT Study on the Correlations Between MB1 and MB2 of the Mesio-Vestibular Root of the Upper First Molars.

This experimental anatomic study aimed to investigate the correlations between the mesio-vestibular canal (MB1) and the second mesio-vestibular canal (MB2) of the mesio-vestibular root of the upper sexts using cone-beam computed tomography (CBCT) imaging. A total of 24 extracted maxillary first molars were collected and subjected to CBCT imaging. The presence, location, and morphology of MB1 and MB2 canals were evaluated using axial, coronal, and sagittal CBCT sections. The interrelation between MB1 and MB2 canals was assessed, including their separate canals, merging, and division points. Among the 24 maxillary first molars examined, 86.5% demonstrated the presence of an MB2 canal in addition to MB1. The MB2 and MB1 were confluent in 80% of the cases with a confluent height of 4,16 mm. The mean distance between MB1 and MB2 canals was 1.85 mm. This study provides detailed information on the anatomic correlations between MB1 and MB2 canals of the mesio-vestibular root in the upper sexts using CBCT imaging. The high prevalence of MB2 canals suggests their significance in endodontic procedures and emphasizes the importance of thorough exploration and identification during root canal treatment. The knowledge of the location and morphology of these canals can aid in successful endodontic therapy and enhance treatment outcomes.

Effectiveness of continuous chelation irrigation protocol in endodontics: a scoping review of laboratory studies.

This scoping review aimed to synthesize and explore the current boundaries and limitations of laboratory research on the effectiveness of continuous chelation irrigation protocol in endodontics. This scoping review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews. Literature search was conducted on Pubmed and Scopus to identify all laboratory studies evaluating smear layer and hard-tissue debris removal or, antimicrobial efficacy, or dentine erosion induced by continuous chelation. Two independent reviewers performed the all review steps and the relevant items were recorded. Seventy-seven potentially relevant studies were identified. Finally, 23 laboratory studies met the eligibility criteria for qualitative synthesis. Seven studies focused on the smear layer/debris removal outcome, 10 on antimicrobial activity, and 10 on dentine erosion. In general, the continuous chelation protocol was equally or more effective in the cleanliness of root canals and antimicrobial activity compared with traditional sequential protocol. In addition, etidronate solutions seemed to be milder chelating agents compared to those with EDTA, thus resulting in reduced or no dentine erosion and roughness modification. Yet, the methodological differences among the included studies limit the results' generalizability. The continuous chelation seems to be equally or more effective in all investigated outcomes when compared with the traditional sequential protocol. The methodological variability among the studies and shortcomings in the methods employed limit the generalizability and clinical relevance of the results. Standardized laboratory conditions combined with reliable three-dimensional investigation approaches are necessary to obtain clinically informative findings.

Effects of heating on bioceramic sealers: a scoping review of chemo-physical properties and clinical implications.

This scoping review aims to summarize current research to assess the impact of heating on the chemo-physical properties of bioceramic sealers. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews guidelines, a comprehensive literature search was conducted in April 2024 across PubMed and Scopus databases. Inclusion criteria referred to all study types evaluating the effect of heating temperature on bioceramic sealers' properties, with no language or time restrictions applied. Studies were independently screened by two reviewers, and relevant data were extracted and synthesized qualitatively. Out of 91 initially identified studies, 19 met the eligibility criteria for inclusion in the qualitative synthesis. The selected studies ranged from 2014 to 2024 and comprised laboratory-based investigations. Various bioceramic sealers, including EndoSequence BC Sealer, BioRoot RCS, and TotalFill BC, were analyzed across different heating techniques. The findings revealed divergent responses of bioceramic sealers to heat, with some demonstrating stability while others exhibited alterations in properties such as flow, setting time, and chemical composition. The impact of heat on bioceramic sealers depends on the sealer's composition and laboratory setting. While some sealers are affected significantly, others remain stable. Clinicians should carefully consider these factors when bioceramic sealers are used with warm obturation techniques, but caution is needed as real-world conditions may vary. Integrating laboratory results with clinical evidence is essential for improving treatment efficacy and patient care.

Push-out bond strength and SEM fractographical analysis of hollow fibre posts used with self-adhesive resin cement: a pilot study.

Detachment is the major cause of failure of endodontic fibre posts. Hollow posts have been recently introduced to overcome such issue. The primary aim of this pilot study was to compare the push-out bond strength of hollow posts and traditional solid posts. Eight round-shaped single-canal premolars extracted for periodontal reason were selected as sample and equally randomized into two groups: (i) traditional solid fibre posts-TECH21xop and ii) hollow fibre posts-TECHOLE. A dual-curing self-adhesive cement (new TECHCEM) was used for posts placement. Six horizontal sections-two from each portion of the root (coronal, middle and apical)-were obtained from each sample root, yielding a total of 24 sections for each group. Push-out test was performed on the sections and bond strength values were compared between groups and within each group. Scanning electron microscope (SEM) fractographical analysis was conducted on each section. Additional SEM and EDX analyses were performed on new samples of both posts, to assess fibres density and distribution, and the chemical composition of the fibres and the matrix. Hollow posts showed a significantly higher push-out bond strength (6.36 ± 1.22 MPa) than solid posts (3.64 ± 1.62 MPa). Among the three root portions of the same group, there was no significant difference in bond strength. In both groups, the most frequent type of fracture was a mixed adhesive failure with the cement covering 0 to 50% of the post perimeter. Hollow post fibres appear more similar in size and have a more homogeneous distribution, compared to solid posts. The two post types also have different chemical compositions.

Influence of different heat treatments and temperatures on the cyclic fatigue resistance of endodontic instruments with the same design.

OBJECTIVES: To evaluate the influence of different heat treatments and temperatures on the cyclic fatigue resistance of 2Shape instruments (Micro Mega, Besancon, France) with the same design. MATERIALS AND METHODS: A total of 80 2Shape TS1 (#25/.04) and 80 TS2 (#25/.06) files with different heat treatments (no heat-treated, NHT; C-Wire; T-Wire; CM-Wire) were tested at room (25° ± 1 °C) and body (37° ± 1 °C) temperatures in 16-mm stainless steel artificial canal with a curvature of 60° and 5 mm of radius. Files were tested in continuous rotation at 300 rpm using a customized device. Cyclic fatigue resistance was expressed in the number of cyclic to fracture (NCF). The phase transformation temperature of each file was determined by differential scanning calorimetry. Data were statistically analyzed using the two-way ANOVA and the Bonferroni post-hoc test with p < 0.05. RESULTS: All CM-Wire TS1 and TS2 files showed higher NCF than the other groups at both temperatures (p < 0.001). C-Wire TS2 showed higher resistance than NHT and T-Wire TS2 (p < 0.001), with no significant differences between the last two. Body temperature significantly decreased NCF of all tested files (p < 0.05) except for NHT and T-Wire TS1. CONCLUSIONS: Body temperature negatively affected the cyclic fatigue resistance of C-Wire and CM-Wire TS1 and of all TS2 files compared with room temperature. The CM-Wire instruments exhibited the highest cyclic fatigue resistance of all tested files. CLINICAL RELEVANCE: Heat-treated nickel-titanium files can differently perform according to environmental temperature and file dimensions. The CM-Wire 2Shape prototypes displayed the highest flexural resistance in all experimental conditions.

Effectiveness of the platelet-rich fibrin in the control of pain associated with alveolar osteitis: a scoping review.

OBJECTIVES: The aim of this scoping review was to determine the effectiveness of the platelet-rich fibrin in the control of pain associated with alveolar osteitis. MATERIALS AND METHODS: Reporting was based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews. A literature search was conducted in the PubMed and Scopus databases to identify all clinical studies on the application of platelet-rich fibrin in the control of pain caused by alveolar osteitis. Data were extracted independently by two reviewers and qualitatively described. RESULTS: The initial search returned 81 articles, with 49 identified after duplicates removal; of these, 8 were selected according to the inclusion criteria. Three of the eight studies were randomized controlled clinical trials, and four were non-randomized clinical studies, two of which were controlled. One study was case series. In all of these studies, pain control was evaluated using the visual analog scale. Overall, the use of platelet-rich fibrin resulted effective in the control of pain determined by alveolar osteitis. CONCLUSIONS: Within the limits of this scoping review, the application of platelet-rich fibrin in the post-extra-extraction alveolus reduced the pain associated with alveolar osteitis in almost all the included studies. Nevertheless, high-quality randomized trials with adequate sample size are warranted to draw firm conclusions. CLINICAL RELEVANCE: Pain associated with alveolar osteitis causes discomfort to the patient and is challenging to be treated. Use of platelet-rich fibrin could be a promising clinical strategy for pain control in alveolar osteitis if its effectiveness will be confirmed by further high-quality studies.

The effect of different kinematics on apical debris extrusion with a single-file system.

To compare the amount of extruded debris caused by different motions using a single-file system. Fifty mandibular first molar teeth were randomized into 5 groups (n = 10) according to the motion tested: Optimize Torque Reverse (OTR), TF Adaptive Motion (TFA), continuous rotation (CR), reciprocation motion (+ 150°, -30°) (REC), and Jeni motion (Jeni). One Curve single file 25/06 (Micro-Mega, Besançon, France) was used in all experimental groups. The root canals were irrigated with 2.5% NaOCl, and the extruded debris were collected at pre-weighted glass vials. The glass vials were kept inside an incubator for one week at 70 °C to dry out the irrigating solution. The extruded debris was quantified by subtracting the pre-instrumentation from the post-instrumentation weight of the glass vials. The time required for each instrumentation procedure was digitally recorded. All data were analyzed statistically with one way ANOVA and post hoc Tukey test (P < 0.05). All the motions extruded apically debris with Jeni mode caused significantly less debris extrusion than TFA, REC, and CR (P < 0.05) while no significant difference emerged with OTR. Preparation time was not significantly different in all groups. Within the limits of the present study, all the kinematics produced apically debris extrusion, with Jeni reporting a similar amount of debris compared with OTR and significantly less than TFA, REC, and CR. Preparation time was similar among the tested kinematics.

Repeatability of dental shade by digital spectrophotometry in current, former, and never smokers.

Cigarette smoking contributes to poor oral health and dental discoloration. Therefore, stopping smoking may translate into measurable amelioration of dental shade indices. We compared dental shade parameters by digital spectrophotometry among current, former, and never smokers and verified their repeatability at 7 and 30 days. Dental shade parameters (CIE L*a*b* and corresponding whiteness index for dentistry-WID) were measured in current, former, and never smokers with a digital spectrophotometer (Vita Easyshade V) on three separate study visits: at baseline (day 0), at day 7, and day 30. Dental shade parameters were analyzed in 18 current, 18 former, and 20 never smokers. The repeatability of shade parameters was consistent in current, former, and never smokers. L*, a*, b*, and WID show significant short and long-term repeatability (p < 0.0001, by regression analyses). The mean (± SD) WID score of 13.42 (± 4.9) in current smokers was significantly lower compared to the WID score of 20.38 (± 5.3) in never smokers (p = 0.001). No significant differences were observed between current and former smokers and between former smokers and former smokers. Dental shade measurements by digital spectrophotometry were highly reproducible and showed that teeth whiteness of current smokers is substantially inferior compared to never smokers. Objective discrimination of dental shade can be a valuable regulatory science endpoint for investigating oral hygiene and dental aesthetics of consumer care products, smoking cessation medications, and tar-free tobacco products (e-cigarettes, heated tobacco products, oral nicotine products) for cigarette substitution.Clinical trial registration: the study was not registered in ClinicalTrials.gov considering that it is a pilot study, parts of a larger project with ID: NCT04649645.

Accuracy of trial restorations from virtual planning: A comparison of two fabrication techniques.

STATEMENT OF PROBLEM: Different technologies have been used to fabricate trial restorations. However, studies investigating the accuracy of trial restorations fabricated with different techniques in comparison with the initial 3-dimensional virtual design are lacking. PURPOSE: The purpose of this clinical study was to evaluate completely digital workflows for managing the esthetic outcome through the production of trial restorations with 2 different technologies: stereolithography apparatus (SLA 3D) and computer-aided design and computer-aided manufacturing (CAD-CAM). The aim was to determine which of them provided trial restorations more similar to those of the 3D virtual design. MATERIAL AND METHODS: Thirty participants who did not meet ideal esthetic proportions for the anterior maxillary teeth were enrolled. For each, 2 intraoral and extraoral frontal photographs and intraoral digital scans were made. The digital images were processed by using the Digital Smile System (DSS) software program to have a smile preview after the treatment. Virtual designs were matched with the surface tessellation language (STL) files from the intraoral scans and edited by exocad DentalCAD to create custom trial restorations using SLA 3D and CAD-CAM technologies. Two independent examiners measured the virtual restorations by using virtual calipers in the software program and then the trial restorations by using digital calipers. The measurements were carried out from the incisal edge to the gingival margin, mesial-distal widths of the central incisors, and the distance from the distal margins of maxillary right and left canines. The trial restorations were evaluated intraorally for fit. The participants approved the definitive treatment outcome after the evaluation. The normality of data was verified with the Shapiro-Wilk test, and the Friedman test for matched groups with the Bonferroni and Dunn tests for multiple comparisons were used (α=.05). RESULTS: Comparing the 3D designs with the printed trial restorations, a significant increase was only found in the mesial-distal width of central incisors (P<.05), while the milled trial restorations showed a significant increase (P<.05) of all measurements except for the maxillary right and left canines. Comparing printed trial restorations with the milled ones, the only significant difference was found in height measures of maxillary right central incisor, with the milled trial restorations exhibiting higher values than the printed ones (P<.05). The printed trial restorations showed good clinical fit, and the milled restorations had poor clinical adaptation. CONCLUSIONS: The accuracy of printed trial restorations was higher than that of milled trial restorations, except for the canine to canine width of maxillary anterior teeth. However, this difference did not compromise the fit of the printed trial restorations. The milled trial restorations had increased dimensions in comparison with the measurements made in 3D designs, and consequently, their clinical fit was compromised. SLA 3D- printing technology provided the best fit.

Efficiency of reciprocating systems reciprocated at different angles in removing root-canals fillings with an MTA-type sealer: an Ex-vivo study.

BACKGROUND: There have been no reports on the impact of different reciprocating angles on retreatment performance of reciprocating files. This ex-vivo study compared the efficiency of three reciprocating systems in removing MTA-type sealer-based filling materials and investigated the influence of different reciprocating angles on their retreatment ability. METHODS: 140 root-canals were instrumented to a 35 apical size and filled with an MTA-type sealer and gutta-percha cones. Samples were scanned by micro-computed-tomography and the root-canals fillings volumes were measured. Samples were divided into 7 groups according to the reciprocating angles at which the WaveOne-Gold (WOG), Reciproc-Blue (RB) and R-Motion (RM) systems were reciprocated to remove the root-canals' fillings. The WOG-150/30, WOG-90/30, RB-150/30, RB-90/30, RM-150/30 and RM-90/30 groups in which the systems were reciprocated at 150/30 and 90/30 (counterclockwise/clockwise) angles. In the RB-270/30 group the RB system was reciprocated at 270/30 angles. Samples were re-scanned and the remaining filling materials' (RFMs) volumes were measured. The percentage of the RFMs volume and its mean value for each group were calculated and data were statistically analysed at 0.05 significance level. RESULTS: The WOG system resulted in less RFMs (2.24%) when reciprocated at 90/30 angles compared to that resulted from the 150/30 angles (4.96%) [P = 0.002]. The RB system reciprocated at 90/30 angles resulted in less RFMs (2.67%) compared to that resulted from the 270/30 angles (6.64%) [P = 0.001]. The RFMs after using RM system reciprocated at 90/30 (6.02%) and 150/30 (7.61%) were greater than those of WOG (2.24 and 4.96%) and RB (2.67 and 4.34%) reciprocated at the same angles (P < 0.05). The longest time required to remove the filling materials was recorded with the RB-270/30 group (6.06 min) [P = 0.00]. The times required when the WOG, RB and RM files reciprocated at 90/30 angles (3.59, 3 and 3.05 mins, respectively) were shorter than those when files were reciprocated at 150/30 angles (5.25, 4.98 and 3.67 min, respectively) [P < 0.05]. CONCLUSIONS: The WOG and RB systems removed more MTA-type sealer-based root-canals fillings than the RM system. Lower counterclockwise reciprocating angles improve the retreatment ability of reciprocating systems, especially the WOG system and can reduce the time required for retreatment procedures.

Digitally programmed (CAD) offset values for prototyped occlusal splints (CAM): assessment of appliance-fitting using surface-based superimposition and deviation analysis.

AIM: Limited data are available on the fitting properties of prototyped occlusal appliances. The aim of the present study was to assess the fitting of prototyped splints digitally designed with different offset values and generated with two different biocompatible resins. MATERIALS AND METHODS: Ten dental digital models were included, and occlusal splints were designed with different offset values (0.0, 0.05, 0.10, 0.15, 0.20, and 0.25 mm). Each splint was 3D printed using two different biocompatible resins, and the gap between the splint and the teeth was recorded by placing impression material. A specific 3D technology was used to assess the gap volume between the splint and the teeth and to calculate the Euclidean distance between the surface points of two digital models, with and without the gap volume. RESULTS: The splints with a 0.20-mm offset value showed smaller gap volume and deviation analysis values compared with those with offset values of 0.15 and 0.25 mm (P < 0.05). These results were consistent with both types of biocompatible resins used. For each offset value tested, the gap volume and deviation value analysis did not significantly differ between the splints printed with the two different resins. CONCLUSION: According to the present findings, the 0.20-mm offset value would be the best choice when digitally designing occlusal appliances.

Association between periodontitis and glycosylated haemoglobin before diabetes onset: a cross-sectional study.

OBJECTIVES: The aim of the present cross-sectional study was to investigate the association between serum glycosylated haemoglobin (HbA1c) levels and periodontal status in patients with periodontitis (CP) and periodontally healthy controls. Furthermore, the objectives were to determine if the periodontitis influenced the serum HbA1c levels. MATERIALS AND METHODS: A total of 93 patients with CP and 95 periodontally healthy subjects were enrolled in the present study using a cross-sectional design. At baseline, patients were examined and characterized on a regular basis for blood serum parameters and non-fasting blood samples levels. In all patients, a full periodontal examination was performed and clinical attachment loss (CAL) was the primary outcome variable chosen. The spearman correlation, a stepwise multivariable linear regression, and Jonckheere-Terpstra tests were applied in order to assess the relationship between HbA1c levels and periodontitis. RESULTS: Patients in the CP group presented a significantly higher median serum level of HbA1c [40.9 (31.2; 45.6) mmol/mol)] compared to patients in the healthy control group [35.3 (29.6; 38.6) mmol/mol)] (p < 0.001). HbA1c levels were negatively correlated with the number of teeth and positively correlated with C-reactive protein levels and all periodontal parameters (p < 0.001). Moreover, there was a significant decrease in the number of teeth when HbA1c levels increased (P-trend < 0.001), while there was a significant increase in periodontal parameters (CAL, p = 0.002); PD, p = 0.008; BOP, p < 0.001) when levels of HbA1c increased. CONCLUSIONS: Patients with CP and undiagnosed diabetes presented significantly higher serum levels of HbA1c compared to periodontally healthy controls. Moreover, the presence of periodontitis was positively correlated with serum HbA1c levels before diabetes onset. CLINICAL RELEVANCE: HbA1c levels were positively correlated with the severity of periodontitis before diabetes onset.

Root fillings with a matched-taper single cone and two calcium silicate-based sealers: an analysis of voids using micro-computed tomography.

OBJECTIVES: To compare the percentage of voids in matched-taper single-cone fillings with GuttaFlow Bioseal or BioRoot RCS root canal sealers, using micro-computed tomography. MATERIALS AND METHODS: Forty-eight single-rooted mandibular premolars were prepared using rotary files and randomly allocated into 2 groups (n = 24), wherein the canals were filled with a matched-taper single gutta-percha cone and one of the two sealers: Group 1, GuttaFlow Bioseal and Group 2, BioRoot RCS. The specimens were scanned with micro-CT before and after root canal filling. A specialized software was used to calculate the voids volume percentage (V%) in the filling for the whole root canal, root canal thirds, and the last millimeter from the apex. Data were statistically analyzed by ANOVA and Tukey tests (p < 0.05). RESULTS: Root canals filled with GuttaFlow Bioseal had significantly less V% than those filled with BioRoot RCS in all the root-thirds (p < 0.05) except at the apical 1 mm (p > 0.05). Comparing the root-thirds, GuttaFlow Bioseal showed similar V% in all regions (p > 0.05), while BioRoot RCS group had significantly greater V% in the coronal third compared with the other thirds (p < 0.05). CONCLUSIONS: Root canals filled with a matched-taper single cone and GuttaFlow Bioseal had significant less voids than those with BioRoot RCS, except at the apical 1 mm. CLINICAL RELEVANCE: Voids in root fillings have been reported to have a negative impact on root canal treatment. This study highlights the percentage of voids in root fillings composed of a single cone of gutta-percha with two types of calcium silicate-based bioceramic sealers.

Long-term sealing ability of 3 endodontic obturation techniques.

This in vitro study sought to evaluate the sealing ability of 3 root canal obturator systems after immersion in simulated body fluid for 1 year. The coronal sections of 30 single-rooted teeth were removed at the cementoenamel junction at 12 mm (±1 mm), and roots were instrumented with nickel titanium instruments. Specimens were divided into 3 groups (n = 10) according to the obturation manufacturer-specified system and immersed in simulated body fluid. A digital fluid flow-meter was used to detect the flow rate at 1 week, 1 month, and 12 months after immersion. This study demonstrated that the tested endodontic obturation systems were unable to keep their sealing ability stable during the first year. At 12 months, all root filling systems showed increased flow rates (P < 0.0001).

The Role of Pecking Motion Depths in Dynamic Cyclic Fatigue Resistance: In Vitro Study.

OBJECTIVE: This is the first study evaluating the impact of different pecking motion depths on dynamic cyclic fatigue resistance of different endodontic instruments. METHODS: Four nickel-titanium systems (Hyflex EDM OneFile 25/. ∼; Rotate 25/0.6; Mtwo 25/0.6; Reciproc Blue R25) were tested. Forty instruments from each group were subjected to 4 different pecking movements to evaluate their cyclic fatigue resistance. The distances for the pecking motion were 3-mm forward and backward, 1-mm (3-mm forward and 2-mm backward), 2-mm (4-mm forward and 2-mm backward), and 3-mm (5-mm forward and 2-mm backward). Speeds were 100 and 200 mm/min for the descending and ascending motion, respectively. The times to fracture (TtF) in seconds were recorded for each instrument. Data were statistically analysed by using 2-way ANOVA and Bonferroni multiple comparison post hoc test (P < .05). RESULTS: All instruments had a significant increase in cyclic fatigue resistance during the forward dynamic motion compared with the axial continuous. Overall, the heat-treated instruments reported higher fatigue strength than the untreated files (P < .05). Reciproc Blue and Hyflex EDM showed higher TtF in the forward movements of 1-/2-mm and 2-mm (P < .05), respectively while Mtwo 25.06 and Rotate 25.06 in the forward movement of 3-mm (P < .05). CONCLUSIONS: Within the limits of this in vitro study, the pecking motion depths had varying impacts on the cyclic fatigue resistance of instruments. Reciproc Blue and Hyflex EDM performed significantly better with pecking motions of 1-and 2-mm. Improving endodontic instrument durability through specific pecking depths has the potential for improving clinical performance and reducing instrument failures.

Antimicrobial Activity of Antibacterial Sutures in Oral Surgery: A Scoping Review.

OBJECTIVE: The aim of this scoping review was to explore and synthesise the current evidence on the antimicrobial activity of antibacterial suture materials used in oral surgery. METHODS: The review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews. A bibliographic search was carried out in the PubMed and Scopus databases to retrieve all human clinical studies that investigated the antimicrobial efficacy of antibacterial-coated sutures used in oral surgery. Included studies were screened and extracted independently by 2 examiners. Data were tabulated and qualitatively described. RESULTS: The search initially returned 150 articles and resulted in 5 included studies after the duplicates' removal and the full-text screening. Selected studies were published from 2014 to 2019. Three studies (60%) were randomised clinical trials, whilst the remaining studies did not report information on randomisation. The antimicrobial agents for coated sutures included triclosan and chlorhexidine. In almost all the studies, antibacterial-coated sutures exhibited lower bacterial retention compared to those without coating. CONCLUSIONS: Within limitations, the antimicrobial-coated sutures employed in oral surgery exhibited good results in terms of their microbicidal activity when compared with sutures that were not coated. Considering the high variability and confounding factors identified in the included studies, more high-quality research is needed to confirm these results. Antimicrobial-coated sutures could represent a promising and clinically valid strategy to reduce microbial colonisation in oral surgery. The reduced bacterial adherence is likely to improve the clinical success of the surgical procedures. Yet, the cost-benefit ratio of antimicrobial-coated sutures should be assessed in larger clinical trials to confirm their efficacy over conventional noncoated sutures.

Evaluation of the accuracy of digital impressions with different scanning strategies: An in vitro study.

OBJECTIVES: To evaluate the effects of three different scanning strategies on the trueness and precision of optical impressions obtained with four intraoral scanners (IOSs). METHODS: The reference maxillary dental arch model was fabricated using Telio CAD, and the relative reference digital reference cast was obtained using a computer numerical control machine and an optical scanner (E4, 3Shape, Copenhagen, Denmark). Test scans were performed with four different IOSs (TRIOS3, MEDIT i700, CS 3600, and iTero Element 5D) by an experienced operator and three different scanning strategies (S1: manufacturer-recommended, S2: optimal per previous literature, and S3: experimental). The scan duration was recorded for each scan. All scans were converted to standard tessellation language format and imported into Geomagic Control X. The accuracy was measured by absolute deviation/distance between aligned surfaces. for comparison with the reference cast using Initial Alignment and Best Fit Alignment functions. Data of trueness and precision of each IOS and scan duration were statistically compared using analysis of variance for repeated measures and Bonferroni post-hoc test (p<.05). RESULTS: Scans obtained with MEDIT i700 and CS 3600 showed higher trueness with S3 (p<.05). Scans obtained with TRIOS 3, MEDIT i700, and CS 3600 were more precise with S3, whereas those with iTero Element 5D were more precise with S2 (p<.05). Statistically significant differences were found in scan duration between different scan strategies for all IOSs. RESULTS: No significant differences in trueness were found among strategies (S1: 9.98 µm, S2: 11.93 µm, S3: 8.84 µm; p=0.388) in Trios 3 and iTero Element 5D (S1: 12.24µm, S2: 11.53µm, S3: 10.71µm; p= p=0.279). Scanning strategy S3 with MEDIT i700 achieved greater trueness (7.33 µm) than S2 (16.33 µm, p<.05), while no significant difference was noted between S1 (10.44 µm) and S3 (p=0.291). S3 showed the highest trueness (16.28 µm) compared to S2 (24.05 µm) and S1 (24.78 µm, p<.001) for CS 3600, with no difference between S1 and S2 (p=0.457). Trios 3 had higher precision with S2 (22.46 µm) than S3 (31.69 µm, p<.05), and no significant differences between S1 (25.67 µm) and S2/S3 (p>.05). MEDIT i700 with S3 (29.52 µm) was more precise than both S1 (39.52 µm) and S2 (46.24 µm) (p<.001) with no difference between the last two (p=0.302). S2 yielded the highest precision (44.93 µm) compared to S3 (61.81 µm) and S1 (76.53 µm) (p<.001) for CS 3600, with S3 more precise than S1 (p<.001). Similarly, iTero Element 5D showed S2 as the most precise (30.19 µm) compared to S3 (42.80 µm) and S1 (44.45 µm) (p<.05), with no difference between S1 and S3 (p=0.472). Scan durations were shorter for S3 and S1 compared to S2 in Trios 3 (p<.001), and S3 was faster than S1 and S2 for MEDIT i700 (p<.001). CS 3600 scans with S1 were quicker than S2 and S3 (p<.001). For iTero Element 5D, no significant differences were found between S1 and S3 (p=0.511), but S2 was slower than both (p<.001). CONCLUSIONS: Scanning strategies significantly affect the accuracy and scan duration of optical impressions. Overall, scans obtained with S3 showed the best combination of trueness, precision, and scan duration with MEDIT i700. Specifically, S3 provided the best trueness with both the MEDIT i700 and the CS 3600 while the S2 strategy demonstrated the highest precision for most scanners. Overall, the S1 and S3 strategies resulted faster than S2 among the devices evaluated. CLINICAL SIGNIFICANCE: The study's results suggest that the experimental scan strategy may optimize the use of intraoral scanners in clinical practice, potentially leading to more accurate and time-efficient dental impressions.

Advancements in guided surgical endodontics: A scoping review of case report and case series and research implications.

This scoping review examined current case series and reports on guided surgical endodontic applications in order to provide a critical platform for future research. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews guidelines were followed. A search on PubMed and Scopus yielded 611 articles, with 17 case reports and 1 series meeting inclusion criteria. Overall, guided surgery addressed anatomical complexities, with 15 articles employing static protocols and 3 dynamic. Results showed minimal iatrogenic errors and reduced chair time, with no postoperative issues reported. Within the cases described, guided endodontic surgery exhibited satisfactory results in management of anatomical complex cases. Cost-effectiveness, the need for adequate follow-up, procedure's reproducibility and accuracy, and objective measurement of the reduction in operative times and iatrogenic errors are some of the limitations in the current reports that need to be considered for planning of future experimental and cohort studies.