Comparative Evaluation of the Efficacy of TheraCal LC, Mineral Trioxide Aggregate, and Biodentine As Direct Pulp Capping Materials in Patients With Pulpal Exposure in Posterior Teeth: A Triple-Blinded Randomized Parallel Group Clinical Trial.

Background The aim was to evaluate and compare the efficacy of TheraCal LC, mineral trioxide aggregate (MTA), and Biodentine as direct pulp capping (DPC) materials in patients with pulpal exposure in the posterior teeth. Methodology A total of 54 samples were assessed for eligibility. Out of this, 12 teeth samples failed to meet the inclusion criteria. Finally, 42 teeth samples were selected which were randomly distributed into three groups (n = 14). Groups A, B, and C received the intervention of MTA, Biodentine, and TheraCal LC, respectively. The assessment was performed clinically to check for postoperative pain, tenderness, and neural sensibility, and the radiographs were used to check the presence of periodontal ligament (PDL) space widening, calcified barrier, and periapical radiolucency at the follow-up of 21 days, three months, and 12 months. The outcomes depended on the clinical and radiographic success rates recorded at 12 months of recall. Results Overall successful outcome of DPC clinically at different periods was 97.61% at three months and 88.09% at 12 months. A Chi-square test was used which showed that the difference was statistically nonsignificant. For groups A, B, and C, the success rate at follow-up came out to be 85.71%, 100%, and 78.57% at 12 months, respectively. The overall radiographic success rate of DPC at different time periods was 83.33% at three months and 88.09% at 12 months. A Chi-square test was used which showed that the difference was statistically nonsignificant. For groups A, B, and C, the success rate at follow-up came out to be 85.71%, 100%, and 78.57% at 12 months, respectively. Conclusion Resin-based calcium-silicate agent (TheraCal LC) showed good efficacy and can be used in practice with the predictability of a good success rate both clinically and radiographically. Thus, TheraCal LC can be utilized as an alternative to MTA or Biodentine in clinical practice, with the predictability of similar successful outcomes in patients with pulpal exposure in the posterior teeth.

Correlation of Pulp Calcification and Cardiovascular Conditions: A Literature Review.

The pathophysiology of calcified dental pulp is considered to be comparable to that of calcified atheroma in the artery. These calcified masses are small nodular which is seen more often in the coronal pulp region than in the radicular pulp. This is generally more common in the elderly population and usually corresponds to increasing age. Calcifications are also found in the brain, breast, arteries, and kidneys. There is a link between pulp calcification and cardiovascular problems. It is commonly assumed that individuals suffering from cardiovascular diseases have a higher risk of calcification in the pulp. The use of radiography as a quick means of detecting cardiovascular disease is possible. The pulp calcification process is usually triggered by the osteoblastic process. The process is identified by the presence of an osteoid matrix, which is built down by odontoblast cells in the pulp's peripheral portions, culminating in the production of tissue that is comparable to dentine. This review will look at pulp calcifications from all angles, including their mechanism, clinical considerations, radiographic features, and management, and also to determine if there is a link between pulp calcification and cardiovascular problems.

Be Smart and Active in Conservative Dentistry and Endodontics.

Numerous aspects of dentistry have been transformed by smart materials. In recent years, there have been advancements in dental materials that exhibit improved biological compatibility. These materials are specifically designed to interact effectively with the fluids found in the oral cavity, including saliva and gingival crevicular fluids. The search for the optimum restorative material results in the development of a more recent generation of dental materials known as smart materials. Smart materials react to stimuli, including stress, temperature, moisture, pH, electric field, and magnetic field, in a regulated way. Some of them are biomimetic and can imitate the dentin and enamel seen in natural teeth. These resources herald the start of a new era in dentistry known as "Smart Dentistry," and they project a promising future in terms of improved dependability and efficiency. These types of diverse materials can pick up and perform definite functionalities regarding adjustments in the nearby surroundings. Based on their capacity for recognition, analysis, and discrimination, these materials might be able to foresee problems in the near future. The superior biocompatibilities of smart materials, which have brought about a new generation of biosmart dentistry, are a crucial component of their utilization in numerous dental applications. We should use any material with intelligence as we progress in innovation and advanced technology. Additionally, we should purposefully incorporate intelligence into existing materials through design. Smart materials have proven advantageous in the field of dentistry, particularly in restorative applications. Various dental products, including smart composites, resin-modified glass ionomer materials, pit, and fissure sealants releasing amorphous calcium phosphate (ACP), smart ceramics, and compomers have all witnessed positive advancements due to the integration of smart materials.

The Good Old Masserann Technique for the Retrieval of a Separated Instrument: An Endodontic Challenge.

Instrument separation is one of the most upsetting endodontic errors, and it can occur at any time during root canal surgery. A broken file causes a metallic restriction in the root canal and makes it difficult to clean and shape the instrument effectively, thereby making the prognosis questionable. Hence, such a fragment should be properly retrieved when it becomes difficult to bypass it. A variety of techniques and tools are utilized for instrument recovery; however, most of them are expensive, difficult to master, and technique-sensitive. One such tool for orthograde removal of intracanal metallic obstacles is the Masserann kit. We discuss a case involving file removal from the maxillary premolar by using the Masserann technique.

Comparative Evaluation of the Effect of Six Different Low-Surface-Tension Vehicles on the Penetration of Modified Triple Antibiotic Paste in Dentinal Tubules: An In Vitro Study.

Background Modified triple antibiotic paste (MTAP) helps in the elimination of microorganisms which is imperative for the success of endodontic therapy. The intracanal medicament powders must be mixed with vehicles for better handling and penetration in the root canals. The purpose of this study is to compare the effect of six low-surface-tension vehicles on the penetration of MTAP in dentinal tubules. Methodology The root apices of 60 single-rooted human mandibular premolars were resected to obtain 12mm length. After biomechanical preparation, intracanal medicaments were prepared by mixing with the six vehicles (Group 1- Bupivacaine, Group 2- Sodium ether lauryl sulfate, Group 3- Neosporin H, Group 4- Chlorhexidine gluconate, Group 5- Chitosan, and Group 6- Polyethylene glycol) with MTAP and Rhodamine B dye. Middle and apical transverse sections were scanned under a confocal laser scanning microscope. The data were statistically analyzed using the one-way ANOVA test and the level of significance was p<0.05. Results The maximum depth of penetration was seen in Group 2 (MTAP with sodium ether lauryl sulfate) followed by Group 5 (MTAP with chitosan), Group 4 (MTAP with chlorhexidine gluconate), Group 1 (MTAP with bupivacaine), and Group 6 (MTAP with polyethylene glycol), and the least penetration by Group 3 (MTAP with Neosporin H). The depth of penetration in the middle level was in the order of Group 2 followed by Group 4, Group 5, Group 3, Group 6, and Group 1. The depth of penetration in the apical level was in the order of Group 2 followed by Group 5, Group 1, Group 4, Group 6, and Group 3. The overall depth of penetration was significantly higher at the middle level than at the apical level. Conclusion Group sodium ether lauryl sulfate showed the maximum depth of penetration in both the middle and apical areas. The least depth of penetration in the middle area was seen in group bupivacaine and the apical area by group Neosporin H.

Beyond Tradition: Non-surgical Endodontics and Vital Pulp Therapy as a Dynamic Combination.

Symptomatic irreversible pulpitis and apical periodontitis in mature permanent teeth present challenges in their management. Traditional treatment approaches, such as root canal therapy or tooth extraction, may compromise tooth structure and oral function. This review article explores the combination of non-surgical endodontic treatment and vital pulp therapy as an alternative approach for these conditions. The purpose is to examine this combined approach's effectiveness, benefits, challenges, and limitations. The objectives include reviewing the literature, evaluating clinical outcomes, discussing potential benefits, and providing recommendations for clinical practice. The combination approach aims to preserve tooth structure, promote healing, and reduce postoperative complications. The article discusses the rationale for combining the two techniques, presents evidence supporting their efficacy, and outlines the techniques and protocols involved. Clinical outcomes, case studies, potential challenges, and comparative analysis with traditional approaches are also explored. Future directions and research recommendations highlight areas for further investigation, innovations, and the development of clinical guidelines. In conclusion, the combination of non-surgical endodontic treatment and vital pulp therapy offers a valuable strategy for managing mature permanent mandibular molars with symptomatic irreversible pulpitis and apical periodontitis. Further research and advancements are needed to refine the treatment protocol and expand the evidence base, and clinicians should stay updated to provide optimal care and improve patient outcomes.

Anterior Matrix Systems for Composite Restorations: A Review.

In the field of restorative dentistry, composite resins have emerged as the most utilized materials. They revolutionized the cosmetic approach to anterior tooth treatment since their introduction to dental practice. In cases where one or more of the tooth's walls are absent, matrices are employed to assist in the creation of the proper anatomic contour and proximal contacts without the occurrence of gingival overhangs. Matrices come in a variety of designs suitable for various therapeutic conditions. Depending on the level of tooth destruction, they might range from a simple metal or plastic strip to a circumferential ring of metal surrounding the entire crown. Although the handling characteristics of modern composites have significantly improved, dentists still encounter challenges with the development of good interproximal contact and proper anatomical contour. The utilization of an anterior matrix system can be paramount in achieving these objectives.

Understanding the Complexities of Cast Post Retention: A Comprehensive Review of Influential Factors.

This comprehensive review delves into the intricate landscape of cast post retention in restorative dentistry, encompassing historical perspectives, contemporary techniques, and future directions. Examining factors ranging from tooth-related considerations to prosthesis-related dynamics, the review provides a detailed analysis of clinical techniques, including step-by-step procedures, common challenges, and innovative advancements. Technological breakthroughs, such as digital impressions, computer-aided design and computer-aided manufacturing (CAD/CAM) technology, three-dimensional (3D) printing, and finite element analysis, are explored for their transformative impact on precision and customization. The discussion extends to the promising future of cast post retention, emphasising emerging materials, the integration of artificial intelligence in treatment planning, and patient-specific approaches. Implications for clinical practice underscore the importance of individualised treatment planning and the adoption of advanced technologies. Recommendations for future research advocate for comprehensive long-term clinical studies, investigations into AI-driven treatment planning, and a focus on patient outcomes and satisfaction. This review consolidates existing knowledge and anticipates a future marked by enhanced precision, individualised care, and improved long-term success in cast post-retained restorations.

The Comparative Evaluation of Postoperative Pain After the Use of WaveOne Gold and TruNatomy Filing Systems in a Tooth With Irreversible Pulpitis: An Observational Study.

Introduction The present study aimed to clinically compare the incidence of postoperative pain after the endodontic treatment of posterior teeth using the WaveOne Gold (WOG) and TruNatomy (Dentsply Maillefer, Ballaigues, Switzerland) filing systems. The study gives a better understanding of the association of postoperative pain and filing systems used. The patients were selected in such a manner that they have a similar diagnosis before the initiation of treatment. It also helps to understand if the postoperative pain is dependent or independent of the filing system used. Methods In the study, 32 vital teeth with irreversible pulpitis with no periapical lesion were selected for the study. The patients were divided into two groups (n=16) according to the instrumentation system used (WaveOne Gold group and TruNatomy group). The treatments were performed in a single session. The participants were asked to rate the intensity of postoperative pain on a visual analog scale (VAS) (no pain, mild pain, moderate pain, and severe pain) after 24 hours, 72 hours, and seven days; the tests of significance used are Friedman test or Mann-Whitney test. Results The incidence of postoperative pain is comparatively less in WaveOne Gold group after 24 and 72 hours compared with those in the TruNatomy group. No postoperative pain is experienced after seven days by the participants of both groups. Conclusions Postoperative pain is expected more after the preparation of the root canal system with the TruNatomy as compared to WaveOne Gold.

Management of Ellis Class-IV Fractured Tooth With an Open Apex: A Case Report.

Dental professionals face difficulty in managing "immature non-vital teeth with an open apex." It is considered to be challenging because, in this situation, root canal filling material should be confined within the boundaries of the root canal without extruding peri-apically. Apexification tries to create a hard tissue barrier that will cause the open apex to close, allowing root filling to be compacted. The current case report describes the application of mineral trioxide aggregate (MTA) to create an apical plug in an open apex, as MTA is considered a versatile material for apexification, which was followed by the reinforcing of the weekend root using glass fiber post and core build-up to manage the Ellis class IV fracture.

A Case Report on the Rehabilitation of Severely Worn Teeth Using a Custom-Made Cast Post.

Posts have been suggested to strengthen weak endodontically treated teeth against intra-oral forces by transmitting torquing forces within the radicular dentin to supportive tissue along their roots. The case studies that follow show how an interdisciplinary approach was used to use complete veneer crowns after custom cast posts to repair severely damaged treated teeth and restore their appearance and functionality. Coordinated prosthetic and endodontic treatments with careful consideration of the patient's expectations and requirements were crucial for a positive result and patient satisfaction. For a very long period, a cast metal post and core were used to provide the foundation restoration for a prosthetic crown. The cast post and core system has the benefit that the core is a natural extension of the post. It is intended for the post to keep the core restoration, which rebuilds the destroyed coronal structure. In this article, cast post and core and porcelain fused to metal restorations for injured maxillary central incisors are discussed.

Hemisection: A Different Approach From Extraction.

Hemisection is the sectioning of teeth with multiple roots, the removal of the damaged root and its associated crown piece, and the preservation of the healthy root (with crown). When periodontal, resorption, perforation, or caries damage is limited to one root and the other root is still largely healthy, this treatment option may be taken into account. The right case selection is the most important component in determining the long-term success in such cases. This case report details the hemisection of a mandibular molar with root caries, followed by appropriate restoration.

Accidental ingestion of endodontic file: a case report.

Ingestion of the endodontic instrument during root canal treatment is rare but can result in serious complications. The present paper reports a case in which endodontic file was accidentally swallowed by the patient undergoing root canal therapy, which entered digestive tract and passed uneventfully.