Análise do diâmetro de cones acessórios calibrados por réguas calibradoras / Diameter analysis of accessory cones calibrated by calibrating rulers

O objetivo do presente estudo foi de comparar o diâmetro dos cones acessórios FM EL calibrados por duas réguas calibradoras com seus respectivos diâmetros nominais. Foram calibrados 80 cones de guta percha FM EL (Odous de Deus) utilizando duas réguas calibradoras das seguintes marcas: Prisma e Denco. Os cones foram divididos em 8 grupos (n=10) de acordo com a régua e com o diâmetro em que foram calibrados. Posteriormente, os cones foram fotografados e tiveram seus D0 mensurados através do software ImageJ. Após a realização da análise estatística utilizando-se os testes de Normalidade de Shapiro-Wilk e o teste t Student (Distribuição Normal), obteve-se os seguintes resultados: não houve diferença estatisticamente significativa com o valor de referência na régua prisma nos cones 40, isto é, em todas as outras situações encontrou-se diferença com os valores de referência. Quando foram comparados os valores das medianas e desvio padrão das duas réguas calibradoras também houve diferença estatisticamente significativa (p<0,05) nos cones 25, 35 e 40. Os cones acessórios FM EL (Odous de Deus) calibrados com a régua Denco diferiram dos diâmetros nominais da régua. Assim, deve-se estar atento à exatidão e precisão desses instrumentos a fim de se evitar possíveis erros de mensuração e interpretação capazes de comprometer o êxito da obturação no tratamento endodôntico.

The aim of the present study was to compare the diameter of the FM EL accessory cones calibrated by two calibrating rulers with their respective nominal diameters 80 FM EL gutta percha cones (Odous of God) were calibrated using two calibrating culers of the following brands: Prisma and Denco. The cones were divided in 8 groups (n=10) according to the ruler and the diameter in which they were calibrated. Posteriorly, the cones were photographed and nad their D0 neasured through the software ImageJ. After performing the statistical analysis using the Shapiro- Wilk Normality tests and the Student T test (Normal Distribution), the following results were obtained: there was no stastistically significant difference with the reference value in the prism rule in the cones 40, that is, in all other situations, a difference was found with the reference values. When the median values and standard deviation of the two calibrating rulers were compared, there was also a statistically significant difference (p<0,05) in cones 25, 35 and 40. The FM EL (Odous of God) accessory cones calibrated eita the Denco ruler differed from the nominal diameters of the ruler. Thus, one must pay attention to the accuracy and precision of these instruments in order to avoid possible errors of measurement and interpretation capable of compromising the success of filling in endodontic treatment.

The efficacy of 3 root canal sealers combined with warm gutta-percha vertical compression technique in the treatment of dental pulp disease.

To investigate the efficacy of 3 root canal sealants such as AH Plus, GuttaFlow and iRoot SP combined with warm gutta-percha vertical compression technique in the treatment of dental pulp disease. This was a single-center retrospective study. 180 patients with dental pulp disease were divided into AH Plus group (n = 60), GuttaFlow group (n = 60) and iRoot SP group (n = 60) according to the different treatment methods. Patients in different groups were treated with corresponding root canal sealant combined with warm gutta-percha vertical compression technique. The quality of root canal filling, filling time, filling area ratio, the incidence of pain after operation, serum interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) and efficacy at 6 months after operation were compared among the 3 groups, respectively. The filling time in the GuttaFlow group and the iRoot SP group was significantly shorter than that in the AH Plus group (P < .001). There were significant differences in pain grade (P = .015) and pain rate (P = .016) among the 3 groups, and the pain rate in the GuttaFlow group and the iRoot SP group was significantly lower than that in the AH Plus group (P = .016). The time-point effect, intergroup effect and time-groups effect of serum TNF-α and IL-6 were significantly different (P < .001), and the levels of the 3 groups after treatment were significantly lower than those before treatment (P < .05), and the levels were significantly lower in the GuttaFlow group and the iRoot SP group (P < .05). There were significant differences in efficacy grading and effective rate among the 3 groups (P = .028), and the effective rate of iRoot SP group was significantly higher than that of AH Plus group (P < .05). The iRoot SP or GuttaFlow as root canal sealant combined with warm gutta-percha vertical compression technique in the treatment of dental pulp disease is better than AH Plus, and the former one can shorten the filling time, relieve the postoperative pain and improve the inflammatory response, but the long-term apical sealing effect of iRoot SP is better than GuttaFlow.

Clinical Approach to Dental Root Canal Filler-Induced Maxillary Sinus Fungal Mass Using Transnasal Endoscopy.

Accidentally extruded root canal filler within the sinuses may induce maxillary sinusitis with fungal mass. The authors describe 2 cases of gutta-percha-induced fungal masses in the left maxillary sinus of 2 women. The lesions were evaluated preoperatively using both computed tomography and magnetic resonance imaging, providing comprehensive insights into the condition. In one patient, the lesion was located such that it could be resected through the middle meatal antrostomy alone. However, the second patient presented with an anteroinferiorly situated lesion that necessitated not only a transnasal approach but also an endoscopic modified medial maxillectomy. Both patients recovered uneventfully after surgery. This case series is the first published report of 2 cases of gutta-percha-induced maxillary sinus fungal masses, with their imaging findings, successfully treated through different routes through transnasal endoscopic surgery. These reports highlight the need for a collaborative approach between dental practitioners and otolaryngologists. In addition to the patient's wishes, surgical interventions must consider the unique characteristics of each case and the potential for collaboration across different medical specialties.

Finite element evaluation of dentin stress changes following different endodontic surgical approaches.

The aim was to compare the effect of different endodontic surgical treatments on the stress distributions in dentin of a simulated first mandibular molar tooth using the finite element analysis method. Three surgical endodontic procedures (apical resection, root amputation, and hemisection) were simulated in a first mandibular molar. Biodentine or mineral-trioxide-aggregate was used to repair the surgery site in apical resection and root amputation models; the remaining root canal spaces were filled with gutta-percha. Access cavities were restored using resin composite. In hemisection model, root canal was filled with gutta-percha, and coronal restoration was finished with a monolithic zirconia crown. A sound tooth model was created as a control model. An oblique force of 300 N angled at 45° to the occlusal plane was simulated. Maximum von Mises stresses were evaluated in dentin near the surgery regions and the entire tooth. Apical resection/Biodentine and apical resection/mineral-trioxide-aggregate models generated maximum von Mises stresses of 39.001 MPa and 39.106 MPa, respectively. The recorded maximum von Mises stresses in root amputation models were 66.491 MPa for root amputation/Biodentine and 73.063 MPa for root amputation/mineral-trioxide-aggregate models. The highest maximum von Mises stress value among all models was observed in the hemisection model, measuring 138.87 MPa. Hemisection induced the highest von Mises stresses in dentin, followed by root amputation and apical resection. In apical resection, Biodentine and mineral-trioxide-aggregate did not show a significant difference in stress distribution. Biodentine in root amputation may lead to lower stresses compared to mineral-trioxide-aggregate.

The effect of voxel and field of view size on the volumetric alteration artifact of high-density materials with 2 cone beam computed tomography devices.

OBJECTIVE: We investigated the influence of voxel and field of view (FOV) sizes on expression of the volumetric alteration artifact (VAA) of 5 high-density materials in 2 cone beam computed tomography (CBCT) devices. STUDY DESIGN: Cylinders of amalgam, cobalt-chromium, gutta-percha, titanium, and zirconium were individually positioned in a polymethyl methacrylate phantom. OP300 Maxio and ProMax 3D Classic CBCT devices were used to acquire images with varying voxel and FOV sizes, totaling 585 scans. Two evaluators segmented the high-density cylinder images to obtain the tomographic volumes. The difference between the tomographic and physical volume of each cylinder (i.e., volumetric alteration) was calculated. Statistical analysis was conducted with multiway ANOVA and the Tukey post hoc test (α = 5%). Evaluator reliability was measured with the intraclass correlation coefficient (ICC). RESULTS: All studied parameters and nearly all interactions influenced the VAA (P < .05). The post hoc test demonstrated less volumetric alteration for the smallest voxel sizes, 61 × 78 mm FOV, and gutta-percha for OP300, and for the smallest voxel sizes, 80 × 80 mm FOV, and gutta-percha and titanium for ProMax 3D (P < .05). The ICC demonstrated perfect reliability (1.00). CONCLUSIONS: Voxel and FOV sizes influenced VAA expression. Using smaller voxel sizes, the 61 × 78 mm FOV for OP300 and the 80 × 80 mm FOV for ProMax 3D, and materials with lower density and lower atomic number reduced VAA expression.

Interfacial adaptation of NeoMTA Plus, BioRoot RCS and MTA in root-end cavities: A micro-CT study.

AIM: This study aimed to use the micro-computed tomography to evaluate the interfacial adaptation and the presence of gaps of NeoMTA Plus, BioRoot RCS, and MTA in the root-end cavities. METHODOLOGY: Thirty standardized bovine roots measuring 15 mm in length were selected. Chemical-mechanical preparation was performed up to instrument #80 and obturation with the cold lateral compaction technique with cement based on zinc oxide and eugenol. The roots were kept at 37°C for 7 days. Afterward, apicectomy of the apical 3 mm and a root-end filling cavity was performed at 3 mm depth. Micro-computed tomography (micro-CT) was performed to measure the volume of the retroactivity. The roots were divided by stratified randomization into three groups according to the retro-end filling material: NeoMTA Plus, BioRoot RCS, and MTA. A new micro-CT was performed to assess the presence of voids in the root-end filling material and between it and the canal wall. One-way ANOVA and Tukey tests were performed using the BioEstat 4.0 program. RESULTS: There was no difference in the initial volume values of the root-end cavities (p > .05). After the insertion of root-end filling materials, the most significant volumes of voids were observed in the NeoMTA Plus group (p < .05), with no difference for the BioRoot RCS and MTA Angelus groups (p > .05). CONCLUSION: Micro-computed tomography showed that MTA and BioRoot RCS have better interfacial adaptation and presented fewer number of gaps than NeoMTA Plus when used as root-end filling materials. RESEARCH HIGHLIGHTS: Micro-computed tomography evaluation of different root-end fillings materials.

Tratamento de perfuração iatrogênica de furca com técnica de inserção modificada do mta: relato de caso / Iatrogenic furca perforation treatment with modified mta insertion technique: case report

As perfurações endodônticas podem ocorrer patologicamente por lesão cariosa profunda, bem como durante o acesso ou na instrumentação dos canais radiculares, que em sua grande maioria estão relacionadas com a negligência ou desconhecimento das variações anatômicas internas do dente. O presente trabalho descreve um caso clínico de perfuração de furca, onde o tratamento inicial foi baseado na descontaminação e selamento da comunicação com uma técnica de inserção modificada do MTA. Após a anestesia, foi realizado o isolamento absoluto e remoção de tecido infectado presente na câmara pulpar. Feita a limpeza da perfuração utilizando soro fisiológico e modelagem do canal com o instrumento reciprocante, a obturação foi concebida com cone de guta percha e cimento biocerâmico. Em seguida, o MTA foi manipulado, de acordo com recomendações do fabricante usando água destilada na proporção 1:1 e inserido na canaleta de uma régua endodôntica com a espátula de inserção nº1. O material foi removido da canaleta e inserido na perfuração, finalizando o vedamento da mesma. Portanto, concluiu-se que o selamento da perfuração apresentou um resultado satisfatório, tanto clínico como radiográfico, destacado pela proservação de 5 meses, evidenciando discreta formação de trabeculado ósseo na região de furca(AU)

Endodontic perforations can occur pathologically due to a deep carious lesion, as well as during access or instrumentation of root canals, which are mostly related to negligence or ignorance of the internal anatomical variations of the tooth. The present work describes a clinical case of furcation perforation, where the initial treatment was based on decontamination and sealing of the communication with a modified MTA insertion technique. After anesthesia, absolute isolation and removal of infected tissue present in the pulp chamber was performed. After cleaning the perforation using saline solution and modeling the canal with the reciprocating instrument, the filling was designed with a gutta-percha cone and bioceramic cement. Then, the MTA was manipulated, according to the manufacturer's recommendations, using distilled water in a 1:1 ratio and inserted into the groove of an endodontic ruler with the #1 insertion spatula. The material was removed from the channel and inserted into the perforation, finishing its sealing. Therefore, it was concluded that the sealing of the perforation presented a satisfactory result, both clinical and radiographic, highlighted by the 5-month followup, evidencing a slight formation of bone trabeculate in the furcation region(AU)

Effectiveness of Different Rotary Files Systems in Removal of Gutta-percha during Endodontic Retreatment with or without Solvents: A Comparative Study.

AIM: The purpose of the present study was to compare the efficacy of three different file systems in removing gutta-percha during endodontic retreatment with or without solvents. MATERIALS AND METHODS: The current study used 120 freshly extracted, single-rooted human mandibular premolars extracted for orthodontic procedures. The canal was prepared utilizing the step-back technique and obturation was done. The samples were allocated into three experimental groups at random, group I: Hedstrom Files, group II: D-RaCe rotary system, and group III: Mtwo retreatment files system. The three groups were again split into two subgroups of 20 samples each, i.e., with solvent and without solvent. Then, a stereomicroscope with a magnification of × 20 was used to examine the samples. The amount of GP and sealer left was measured in three sections: At apical third (1 mm above the apex), middle third (8 mm from the apex), and coronal third (2 mm below the cementoenamel junction). The obtained data were analyzed using parametric Analysis of Variance (ANOVA). p-values less than 0.05 were considered significant. RESULTS: The overall least debris on the dentinal surface was found in the middle third with/without solvent. The D-RaCe rotary system was 1.24 ± 0.11 and 1.44 ± 0.14, Mtwo retreatment files system was 1.38 ± 0.17 and 1.72 ± 0.09 and Hedstrom files was 2.08 ± 0.21 and 2.18 ± 0.16 respectively and A significant difference was found between the three different file system groups (p < 0.001). CONCLUSION: The current study concluded that, when combined with a solvent, the D-RaCe rotary retreatment system is more effective than the Mtwo rotary retreatment system and Hedstrom Files in removing gutta-percha and sealant from root canal walls. CLINICAL SIGNIFICANCE: When it comes to treating chronic infections, non-surgical retreatment is a more cautious method than periapical surgery. Retreatment should be performed efficiently and with appropriate instruments to ensure effective treatment.

Efficiency and complications in root canal retreatment using nickel titanium rotary file with continuous rotation, reciprocating, or adaptive motion in curved root canals: a laboratory investigation.

BACKGROUND: It is currently unknown whether rotary file motion affects the best outcome of root canal retreatment. This experimental study compared the efficacy, efficiency, and complications of single-use NiTi rotary files using continuous rotation, reciprocating, and adaptive motions in root canal filling removal in curved root canals. Reciproc blue R25 was used with reciprocating motion (RB), VDW.ROTATE retreatment files with continuous rotation (VR), and ProTaper NEXT X2 with continuous rotation (PTNc) or adaptive motion (PTNa). METHODS: Forty mesial root canals of extracted mandibular first and second molars with an angle of curvature between 20°-40° and a radius of curvature between 5 and 10 mm were collected. The specimens were instrumented and obturated with gutta-percha and AH Plus sealer using the continuous wave of condensation technique. The specimens were randomly divided into 4 retreatment groups (n = 10), RB, VR, PTNc, and PTNa. The percentage of root canal filling removal in each group was analyzed using Micro-Computed Tomography (µCT). The motor running time, total time, root canal complication, and instrument complication were recorded and statistically analyzed (p-value < 0.05). RESULTS: The pre-operative root canal curvature and root canal filling volume were comparable among groups. The percentage of root canal filling removal from the whole canal in the PTNc, RB, PTNa, and VR group was 98%, 96%, 95%, and 93%, respectively. A significant difference was observed between the PTNc and VR groups for the whole canal and the apical-third part. The motor running time and total time were significantly different between the groups. Instrument fracture was observed at 40% in the VR and 20% in the PTNa group, but none in the RB and PTNc groups. CONCLUSIONS: The ProTaper NEXT X2 with continuous rotation and RB files can be used with high efficacy and efficiency in curved root canal retreatment. Continuous rotation is more efficacious and efficient than adaptive motion when using the NiTi rotary file. Single file retreatment can be used in small canals with high efficacy, cost-effectiveness, and less time consumption.

Clinical applications of calcium silicate-based materials: a narrative review.

Calcium silicate-based materials are hydrophilic materials with biocompatibility and bioactivity properties. Despite many advantages, they might present some problems related to discolouration, setting time, manipulation and solubility depending on the composition of the product and the type of clinical application. Calcium silicate-based materials can be evaluated under two types according to their intended use: calcium silicate-based cements (CSCs) and calcium silicate-based sealers (CSSs). CSCs can be used in many endodontic procedures including perforation repair, resorption repair, apical barriers, guided endodontic repair, vital pulp treatment, endodontic surgery, root fractures and root canal filling as a core obturation material. CSSs are available for use with gutta-percha to obturate root canals using cold and warm techniques, including the sealer-based obturation technique. The purpose of this review is to evaluate the available literature on CSCs and CSSs and to provide up-to-date information and recommendations for their clinical applications.

Root filling quality and bond strength of endodontic sealers to human and bovine dentin / Qualidade da obturação e resistência de união de cimentos endodônticos à dentina humana e bovina

Objetivo: Este estudo teve como objetivo comparar a qualidade da obturação e a resistência de união de dois cimentos endodônticos, AH Plus e Bio-C Sealer, em dentes humanos e bovinos. Métodos: Os canais radiculares de 60 dentes unirradiculares [30 humanos (H) e 30 bovinos (B)] foram preparados e obturados por condensação lateral da guta-percha e AH Plus (grupos AP-H e AP-B) ou Bio-C Sealer (grupos BC-H e BC-B). Seis fatias de 1,5 mm de espessura foram obtidas de cada raiz. Os espécimes foram observados em estereomicroscópio para avaliar a qualidade da obturação, considerando possíveis espaços vazios no material obturador. Posteriormente, as fatias radiculares foram avaliadas em termos de resistência de união por push-out e modo de falha. Os dados foram analisados pelos testes de Mann-Whitney e coeficientes de correlação de Spearman (α=5%). Resultados: A qualidade de obturação fornecida por AP e BC foi semelhante em ambos os substratos de dentina. No entanto, ao comparar dentes humanos e bovinos, os escores de espaços vazios foram maiores nas amostras bovinas, para ambos os cimentos. AP teve maior resistência de união à dentina humana e bovina do que BC. No entanto, não houve diferença significativa na resistência de união entre os substratos dentinários, para ambos os cimentos testados. Além disso, houve uma correlação positiva e moderada entre os valores de resistência de união de dentes humanos e bovinos. O modo de falha misto foi o mais prevalente. Conclusão: AP e BC fornecem qualidade de obturação semelhante, mas o primeiro apresenta maiores valores de resistência de união à dentina humana e bovina. A utilização de dentes bovinos como substitutos de amostras humanas parece ser adequada em estudos relacionados à resistência de união, mas não naqueles que testam a qualidade da obturação endodôntica.(AU)

Objective: This study aimed to compare the filling quality and bond strength of two endodontic sealers, AH Plus and Bio-C Sealer, in human and bovine teeth. Methods: The root canals of 60 [30 human (H) and 30 bovine (B)] single-rooted teeth were prepared and filled by lateral condensation of gutta-percha and AH Plus (groups AP-H and AP-B) or Bio-C Sealer (groups BC-H and BC-B). Six 1.5-mm-thick slices were obtained from each root. The specimens were observed under a stereomicroscope to assess filling quality, considering possible voids within the filling material. Subsequently, root slices were evaluated in terms of push-out bond strength and failure mode. Data were analyzed by Mann-Whitney tests and Spearman correlation coefficients (α=5%). Results: The filling quality provided by AP and BC was similar in both dentin substrates. However, when comparing human and bovine teeth, void scores were greater in the bovine samples, for both sealers. AP had higher bond strength to human and bovine dentin than BC. However, there was no significant difference in bond strength between dentin substrates, for both sealers tested. Also, there was a positive and moderate correlation between the bond strength values of human and bovine teeth. The mixed failure mode was the most prevalent. Conclusion: AP and BC provide similar filling quality, but the first presents higher bond strength values to human and bovine dentin. The use of bovine teeth as substitutes for human samples seems adequate in studies related to bond strength, but not in those testing root canal filling quality.(AU)

Quantitative evaluation of artifact expression in conebeam computed tomography of mesoporous calcium silicate nanoparticles as a promising root canal sealer.

OBJECTIVES: We aimed to quantitatively compare the area and volume of artifacts in cone beam computed tomography produced by mesoporous calcium silicate nanoparticles (MCSNs), AH Plus sealer, and iRoot SP sealer when used as root canal sealers. METHODS: We prepared 40 single-rooted mandibular premolars and divided them into an MCSN sealer group, an AH Plus sealer group, an iRoot SP sealer group, and a no-sealer (control) group. We filled the canals with gutta-percha using the single-cone method and subjected them to conebeam computed tomography before and after the placement of root fillings using the same exposure parameters. We evaluated the images to quantify the areas of hyperdense and hypodense artifacts and non-affected teeth and reconstructed 3-dimensional image models of the materials to study volume distortion artifacts. RESULTS: The MCSN sealer group produced a significantly smaller hyperdense and volume distortion artifacts than the AH Plus and iRoot SP groups (P < .01), but the area and volume of hypodense artifacts did not differ significantly among the groups (P > .05). CONCLUSIONS: When used as a root canal sealer, MCSNs generate a significantly smaller area and volume of hyperdense artifacts than AH Plus and iRoot SP sealers. By significantly reducing the generation of high-density artifacts, MCSNs may facilitate the evaluation of root canal filling quality and the diagnosis of root canal abnormalities.

Intentional replantation for the retreatment of mandibular second molar: a case report.

When the use of root canal retreatment and apical surgery experiences difficulty in treating endodontic diseases, intentional replantation is an optional clinical technique used to retain the tooth. A 28-year-old female complained of chewing discomfort at the mandibular second molar after undergoing root canal treatment 3 month ago. History record and radiographic examination revealed that a C-shaped root canal system was filled with gutta-percha in the mandibular second molar. A radiolucency area existed at the root furcal area with a thin canal wall in the distal and mesial roots. Intentional replantation was used to treat this tooth. The clinical and radiographic results showed that intentional replantation and nano-biomaterial application facilitated infection control, tooth retention, and periodontal tissue regeneration.

Effect of different retreatment files using different kinematics on the release of inflammatory mediators in root canal retreatment of single-rooted teeth: a randomized clinical trial.

OBJECTIVES: This randomized clinical trial aimed to evaluate the effect of two rotaries (ProTaper Universal Retreatment (PTUR)), D-Race (DR) + XP-Endo Finisher R (XPFR) and one reciprocating (Reciproc Blue (RB) retreatment techniques on the release of neuropeptides (Substance P, calcitonin gene-related peptide (CGRP)), and cytokines (IL-6 and IL-10) in periapical fluid in root canal retreatment of single-rooted teeth. MATERIALS AND METHODS: In this randomized clinical trial (ClinicalTrials.gov ID: NCT05039502), seventy-five patients scheduled for retreatment were randomly divided into 3 groups according to the file system used to remove root canal filling materials (n = 25): PTUR, RB, and DR + XPFR. After reshaping and disinfection of the root canals, periapical fluid samples were taken, and the levels of Substance P, CGRP, IL-6, and IL-10 were measured by enzyme-linked immunosorbent assay (ELISA) test. Data were analyzed using the Kruskal-Wallis and chi-square tests. The level of significance was set as p = 0. 05. RESULTS: All the allocated participants received the intervention and were analyzed. There was no statistically significant difference among groups in terms of gender, age, tooth localization, and the distribution of analgesic use after treatment (p values 0.799, 0.095, 0.637, 1.000, respectively). No statistically significant difference was found in terms of the levels of Substance P, CGRP, and IL-10 among groups (p > .05), except IL-6. CONCLUSIONS: PTUR, RB, and DR + XPFR files have comparable results in the expression of inflammatory mediators. CLINICAL RELEVANCE: Retreatment files powered with rotary or reciprocating motion produced similar neuropeptide and cytokine levels in patients.

Impact of photodynamic therapy on the marginal adaptation of Biodentine used as root-end filling material.

BACKGROUND: The marginal adaptation of root-end filling materials and the effective antibacterial control in a surgical site are crucial for the successful outcome of endodontic surgery. OBJECTIVE: This study aimed to evaluate the effect of retrograde application of photodynamic therapy on the marginal adaptation of Biodentine used as a root-end filling material. METHODS: Twenty single-rooted anterior teeth were selected, instrumented and obturated with gutta-percha and AH Plus. The apical 3 mm of the roots were resected and root-end cavities were prepared with an ultrasonic retro-tip. The teeth were randomly divided into two groups (n = 10). In the first group, photodynamic therapy (PDT) was applied in the retrograde cavity prior to the root-end filling. In the second group retro cavity was filled without PDT. All specimens were obturated with Biodentine and afterwards sectioned longitudinally. The gap width at the material-dentin interface was measured using a scanning electron microscope. The results were statistically analyzed. RESULTS: The produced gap width by Biodentine/PDT was 3.85 µm versus 2.68 µm in the Biodentine control group with significant differences in-between. CONCLUSION: Under the conditions of this study, PDT has a negative effect on the marginal adaptation of Biodentine used as root-end filling material.

Clinical usability of vasundhara's transit for gutta-percha (V transit GP) - A questionnaire-based survey.

Context: The lack of a suitable armamentarium to aid in the disinfection and handling of gutta-percha (GP) cones during obturation has been a common challenge amongst dentists. Aims: This study assessed the clinical usability of 'Vasundhara's (V) Transit GP' through a questionnaire-based survey. Settings and Design: This questionnaire-based study was conducted in Davanagere, Karnataka, in February 2021 for 4 months. Methods and Material: The design was 3D printed using a heat-resistant polypropylene material and named 'Vasundhara's Transit for Gutta Percha (V Transit GP)'. Eighteen postgraduate students participated in the study. Fourteen cases were done by each student, seven without and seven with the use of 'V Transit GP'. The GP cones, before obturation, were transferred to their respective canal slots containing 5.25% sodium hypochlorite for one minute and then transferred to their respective distilled water slots. The cones were dried with sterile gauze and taken for obturation. At the end of the procedure, a questionnaire was handed out, the responses were recorded, and the results were tabulated and analysed using Statistical Package for the Social Sciences (SPSS) version 22.0 software. Results: The results showed that without the use of 'V Transit GP', 84.2% of the dentists felt that the disinfection and handling of GP cones were difficult, whereas with the use of 'V Transit GP', 94.2% of the participants found it to be extremely easy. Conclusions: 'V Transit GP' proved to be an extremely efficient and user-friendly equipment for easy handling and disinfection of GP cones during obturation.

Sealing ability in vitro study and biocompatibility in vivo animal study of different bioceramic based sealers.

INTRODUCTION: The effectiveness of root canal therapy in endodontic practice is largely determined by providing a compact fluid-tight closure at the apex of the root canal, which inhibits irritant entry and buildup, which leads to a biological breakdown of the attachment mechanism and failure. During obturation, along with gutta-percha, root canal sealers are employed to fill voids and seal root canals. Root canal sealers come in a variety of shapes and sizes, each with its own set. AIM: Evaluation of sealing ability in vitro study by using scanning electron microscopy (SEM) and biocompatibility in vivo animals study of BioRoot RCS and meta Biomed bio_ceramic sealer (CeraSeal RCS) and compared the findings with that of Zinc oxide eugenol (ZOE) sealer as control. MATERIALS AND METHODS: This study utilized two bio_ceramic sealers (BioRoot RCS and meta Biomed bio_ceramic sealer (CeraSeal RCS) and compared the findings with that of ZOE sealer as control. Biocompatibility was determined by examining histopathological biopsy specimens collected from rabbits. Each rabbit had four dentin tubes implanted into the subcutaneous tissues, one for BioRoot RCS, one for CeraSeal RCS, and one for ZOE RCS, with the fourth tube being empty haematoxylin and eosin were used to stain histological sections, and a light microscope was used to evaluate them. Extracted human single canal premolars were used to evaluate the sealing ability. The root canals were divided into three sections (coronal, middle, and apical). SEM was used to assess the adhesion quality at the sealer-dentin interface. RESULTS: BioRoot and CeraSeal sealers have excellent sealing adaptation and biocompatibility, as well as rapid tissue recovery, while ZOE sealers have a slower recovery of inflammatory reaction results when compared to bio_root and ceraSeal sealers, as well as a less sealing adaptation than the two other bio_ceramic sealers. CONCLUSION: In general, the two bioceramic sealers tested were biocompatible and capable of sealing or adhesion. While ZOE had less adherence ability and less biocompatibility.

Clinical Efficacy of Treatment of Endodontic-Periodontal Lesions: A Systematic Scoping Review of Experimental Studies.

BACKGROUND: In this review, we evaluated the clinical efficacy of interventions used for the treatment of endo-perio lesions (EPL). METHODS: A systematic scoping review of clinical trials was developed. RESULTS: Seven clinical trials were studied. In at least one study group of six of the seven evaluated trials, endodontic and periodontal treatments were performed simultaneously. All trials showed improvement in probing depth in the studied groups; nevertheless, the experimental groups of five studies demonstrated a statistically significant reduction in this parameter. An increase in clinical attachment level was also reported (p < 0.05). Most trials reported an increase in the filling of the bone defect following therapy (p < 0.05). Mechanical periodontal therapy implemented simultaneously with endodontic therapy demonstrated efficacy in the treatment of concurrent EPL without communication. Endodontic treatment and immediate periodontal surgery did not affect the result of the management of combined EPL with apical communication. The use of diode laser, the management of platelet-rich fibrin (PRF) and titanium-prepared PRF, and the implementation of bone grafts plus endodontic treatment with mineral-trioxide or gutta-percha seems to be an adequate strategy in patients with EPL. CONCLUSIONS: The treatment of EPL using simultaneous endodontic and periodontal therapies seems to be an acceptable treatment alternative.

Evaluation of the Antibacterial Effect of Xylene, Chloroform, Eucalyptol, and Orange Oil on Enterococcus faecalis in Nonsurgical Root Canal Retreatment: An Ex Vivo Study.

Objectives: The present ex vivo study is aimed at evaluating the antibacterial efficacy of chloroform, eucalyptol, orange oil, and xylene against E. faecalis biofilm during nonsurgical root canal retreatment. Materials and Methods: Eighty single-rooted teeth were instrumented. The samples were autoclaved, infected with E. faecalis for 4 weeks, and obturated with gutta-percha. Then the teeth were randomly assigned to 4 groups (n = 20): (1) chloroform, (2) eucalyptol, (3) orange oil, and (4) xylene. In all of the groups, gutta-percha removal was conducted according to the same protocol although the solvent used in each group was different. Bacterial samples were collected after gutta-percha removal and following additional apical enlargement. Intergroup and intragroup analyses were conducted using one-way ANOVA combined with the post hoc Tukey test and the paired-sample t-test, respectively. Statistical significance was set to 0.05. Results: All of the groups showed more than 99% bacterial load reduction. The least bacterial load after gutta-percha removal was observed in the chloroform group (p < 0.001). The orange oil group showed a significantly lower bacterial load compared to the eucalyptol group (p = 0.001), while it was not different from the xylene group (p = 0.953). The xylene group also had a significantly lower bacterial load compared with the eucalyptol group (p = 0.017). After apical enlargement, the chloroform group had a significantly lower bacterial load compared to the other groups. The comparison of bacterial load values before and after apical enlargement in the chloroform and eucalyptol groups showed a statistically significant difference (p choloroform = 0.011, p eucalyptol = 0.001). Conclusion: Chloroform was the most effective solvent in terms of antimicrobial activity against E. faecalis followed by orange oil and xylene, which were not significantly different though, and eucalyptol. All of the solvents showed more than 99% bacterial load reduction. Chloroform and xylene revealed to be associated with favorable antibiofilm activity among the examined solvents.

Quality of root canal treatment performed by undergraduate students using nickel-titanium reciprocating versus hand instruments.

PURPOSE: To compare the technical quality of root canal treatment (RCT) depending on the incidence of procedural errors performed by undergraduate students using nickel-titanium reciprocating and conventional hand instrumentation techniques, and to assess the impact of case difficulty and localization of the teeth (maxillary or mandibular molars). METHODS: Dental records and periapical radiographs of molars that were treated with either hand or reciprocating WaveOne (WO) instruments were evaluated retrospectively. The technical quality of RCTs, the incidence of ledge formation, perforation, instrument fracture, overinstrumentation, underfilling, overfilling, inadequate root canal filling, and the effects of case difficulty and tooth localization were compared using the chi-square test with a significance of 5% (α = 0.05). RESULTS: While overinstrumentation was more frequent in the WO group (247 teeth), the incidence of inadequate root canal fillings was higher in the hand instrumentation group (245 teeth) (p < 0.01). No significant difference was observed in the incidence of other procedural errors (p > 0.05). The number of teeth with acceptable technical quality in preparation and obturation was 172 (69.6%) in the WO group, whereas it was 142 (58%) in the hand instrumentation group, presenting a significant difference between the instrumentation techniques (p < 0.01). Higher technical quality rates were observed with WO instrumentation in the high difficulty category and in maxillary teeth (p < 0.01). CONCLUSION: Higher technical quality in preparation and obturation can be achieved with WO reciprocating instruments and file-matched greater tapered gutta-percha cones. No significant difference was observed between the groups in the incidence of procedural errors except for overinstrumentation and insufficient root canal filling. WO instrumentation and obturation with file-matched greater tapered gutta-percha cones provided better technical quality in the high difficulty category and in maxillary teeth.