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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.
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OBJECTIVE: This bibliometric analysis evaluated the top 100 most-cited articles on the application of quantitative light-induced fluorescence (QLF) technology in caries research. DATA: The following data were collected: title, authors, country, institution, citations count, title and year of article, study design, topic and keywords. Networks among authors and keywords were constructed by VOSviewer software. SOURCES: Scopus database on April 25, 2024. STUDY SELECTION: A global citation score of 4633 (average 46.33 citations) was calculated with publication years ranged from 1999 to 2020. Caries Research emerged as the top contributing journal. Pretty IA was the most prolific author (18 %). United Kingdom had the highest number of most-cited papers (32 %), followed by Netherlands and USA (20 % each). Laboratory studies constituted the predominant study design (45 %), followed by randomized clinical trials (20 %) and non-systematic reviews (11 %). The keywords "dental caries" and "fluorescence" had 81 and 79 occurrences, respectively. The main topic was QLF use for caries detection (45 %). CONCLUSIONS: This paper provides an update summary of the scientific impact of QLF technology application in caries research. QLF has gained increasing attention worldwide, accompanied by a consistent rise in scientific investigations exploring its application in caries research. CLINICAL SIGNIFICANCE: The findings offer valuable insights into the most influential articles in QLF technology for caries assessment, serving as a critical resource for researchers, clinicians, and students. Understanding the trends in this field can aid in informed decision-making and the advancement of evidence-based practices in caries management and prevention.
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Bibliometría , Caries Dental , Fluorescencia Cuantitativa Inducida por la Luz , Humanos , Investigación Dental , FluorescenciaRESUMEN
OBJECTIVES: In comparison to conventional combustible cigarettes, Electronic Nicotine Delivery Systems (ENDS) including both e-cigarettes (ECs) and heated tobacco products (HTPs) significantly reduce exposure to toxic chemical emissions. However, their impact on dental plaque remains unclear. This study measures dental plaque in ENDS (ECs and HTPs) users using quantitative light-induced fluorescence (QLF) technology, comparing them with current, former, and never smokers. METHODS: This cross-sectional study compared dental plaque measurements using QLF technology (Q-ray cam™ Pro) among current smokers (≥10 cigarettes/day), former smokers (quit ≥6 months), never smokers, and exclusive ENDS users (quit ≥6 months). Dental plaque measurements were expressed as ΔR30 (total area of mature dental plaque) and ΔR120 (greater plaque thickness/maturation-calculus). The Simple Oral Hygiene (SOH) score was calculated by the QLF proprietary software. Statistical analyses including ANCOVA was performed by R version (4.2.3) with p < 0.05. RESULTS: A total 30 smokers, 24 former smokers, 29 never smokers, and 53 ENDS users were included. Current smokers had significantly higher ΔR30 and ΔR120 values compared to other groups (p < 0.001). ENDS users showed plaque levels similar to never and former smokers (p > 0.05) but significantly lower than current smokers (p < 0.01). Although ENDS users showed a lower SOH score than smokers, this difference was not statistically significant. Daily toothbrushing and mouthwash usage were significant covariates. CONCLUSION: ENDS users exhibited reduced accumulation of dental plaque and calculus compared with current smokers. CLINICAL SIGNIFICANCE: Exclusive ENDS use could less impact dental plaque accumulation compared to cigarette smoking. Further research is needed to confirm these findings and fully understand ENDS impact on dental plaque formation.
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Placa Dental , Sistemas Electrónicos de Liberación de Nicotina , Humanos , Estudios Transversales , Femenino , Adulto , Masculino , Fluorescencia , Persona de Mediana Edad , Fumadores , Luz , Higiene Bucal , Nicotina/administración & dosificación , Fumar , Índice de Placa Dental , Adulto Joven , Productos de Tabaco/efectos adversosRESUMEN
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.
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Cirugía Asistida por Computador , Humanos , Cirugía Asistida por Computador/métodos , Endodoncia/métodosRESUMEN
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.
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Antibacterianos , Suturas , Humanos , Antibacterianos/uso terapéutico , Antibacterianos/farmacología , Procedimientos Quirúrgicos Orales , Infección de la Herida Quirúrgica/prevención & control , Antiinfecciosos Locales/uso terapéutico , Antiinfecciosos Locales/farmacología , Clorhexidina/uso terapéutico , Clorhexidina/farmacología , Triclosán/farmacología , Triclosán/uso terapéuticoRESUMEN
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.
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Sustitutos de Huesos , Minerales , Quiste Radicular , Humanos , Trasplante Óseo/métodos , Estudios Retrospectivos , Quiste Radicular/cirugía , Sustitutos de Huesos/uso terapéutico , Regeneración ÓseaRESUMEN
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.
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Tercer Molar , Diente Impactado , Humanos , Etoricoxib/uso terapéutico , Tercer Molar/cirugía , Trismo/prevención & control , Trismo/etiología , Calidad de Vida , Estudios Prospectivos , Salud Bucal , Extracción Dental/efectos adversos , Dolor Postoperatorio/tratamiento farmacológico , Dolor Postoperatorio/prevención & control , Diente Impactado/cirugía , Edema/etiologíaRESUMEN
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/. â¼; 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.
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Falla de Equipo , Ensayo de Materiales , Preparación del Conducto Radicular , Técnicas In Vitro , Preparación del Conducto Radicular/instrumentación , Instrumentos Dentales , Titanio , Diseño de Equipo , Níquel , Movimiento (Física) , Análisis del Estrés Dental , Humanos , Estrés MecánicoRESUMEN
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.
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OBJECTIVES: To evaluate the fracture strength and linear elongation at break of three-units fixed partial dentures (FPDs) fabricated with traditional and new materials for fixed prosthodontics before and after ageing. METHODS: Sixty models of three-units FPDs were fabricated and cemented onto a Co-Cr model simulating the replacement of a maxillary second premolar. The samples were randomly divided into 3 groups: metal-ceramic (MCR), graphene-doped polymethylmethacrylate (PMMA-GR) and polymethylmethacrylate (PMMA). Half of the samples were directly subjected to fracture test, while the remaining half underwent an ageing process and then a fracture loading test using an electrodynamic testing machine. Fracture load and elongation at break values were taken and statistically analysed. RESULTS: Significant differences were detected between the different materials (p<0.05). All groups showed a reduction of the fracture load and elongation at break values after ageing, but not statistically significant, except for PMMA group (p = 2.012e-19) (p = 3.8e-11). CONCLUSIONS: MCR and PMMA-GR three-units FPDs showed higher fracture strength and lower elongation at break compared to PMMA. MCR and PMMA-GR had higher resistance to ageing processes compared to PMMA. CLINICAL SIGNIFICANCE: PMMA-GR could be considered a material for long-term provisional restorations as its mechanical behaviour and ageing resistance are more like MCR than PMMA.
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Resistencia Flexional , Grafito , Polimetil Metacrilato , Ensayo de Materiales , Cerámica , Dentadura Parcial Fija , Fracaso de la Restauración Dental , Análisis del Estrés Dental , Porcelana DentalRESUMEN
BACKGROUND: Although the detrimental effects of conventional combustible cigarettes on oral health and dental esthetics are well known, there is limited information about the long-term impact of combustion-free nicotine alternatives (C-F NA) such as e-cigarettes or heated tobacco products. OBJECTIVE: This multicenter, prospective, 3-parallel-arm randomized controlled trial will investigate whether switching from combustible cigarettes to C-F NA will lead to measurable improvements in oral health parameters and dental esthetics over 18 months in adult smokers with limited gum disease. METHODS: Regular smokers not intending to quit and without clinical signs of periodontitis will be randomly assigned (1:4 ratio) to either standard of care with brief cessation advice (control group; arm A) or C-F NA use (intervention group; arm B). The study will also include a reference group of never smokers (reference group; arm C). The primary end point is the change in the Modified Gingival Index (MGI) score from baseline between the control arm (arm A) and the intervention arm (arm B) at the 18-month follow-up. In addition, the study will analyze the within- and between-group (arms A, B, and C) changes in MGI assessment, plaque imaging, dental shade quantitation, tooth stain scores, and oral health-related quality of life questionnaires measured at each study time point. All participants will attend a total of 7 clinic visits: screening, enrollment, and randomization (visit 0); baseline visit-day 14 (visit 1); day 90 (visit 2); day 180 (visit 3); day 360 (visit 4); and day 540 (visit 5). This multicenter study will be conducted in 4 dental clinics in 4 countries. The statistical analysis will involve descriptive statistics for continuous and categorical data. Primary end points will undergo tests for normality and, based on distribution, either a 2-sided t test or Mann-Whitney U test. Linear mixed model with random factors center and study arms by center will also be applied. Secondary end points, including MGI assessment and quality of life, will be subjected to similar tests and comparisons. Only if one value of the parameter MGI is missing after day 1, the last available observation will be carried forward. The analysis will be performed on the substituted data. Secondary parameters will not have missing value replacement. RESULTS: Participant recruitment began in October 2021, and enrollment was completed in June 2023. Results will be reported in 2025. CONCLUSIONS: This will be the first study to provide key insights into oral health benefits or risks associated with using C-F NA in smokers who are seeking alternatives to cigarette smoking. TRIAL REGISTRATION: ClinicalTrials.gov NCT04649645; https://clinicaltrials.gov/ct2/show/NCT04649645. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/53222.
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OBJECTIVES: The aim of this study is to determine the cyclic fatigue resistance of Mtwo Minimal in static and dynamic tests, with different amplitudes of pecking movements, at intracanal temperature. MATERIALS AND METHODS: Two hundred new 25-mm Mtwo Minimal rotary files (#10/0.035, #17.5/0.045, #25/0.05, #40/0.03, #45/0.03) were tested in static and dynamic cyclic fatigue tests at 35°C (±1°C). An artificial stainless-steel canal was used. In the dynamic mode, axial movements were set at 1 and 3 mm. The number of cycles to fracture (NCF) was recorded and statistically analyzed by one-way analysis of variance (p < 0.05). RESULTS: The 3-mm dynamic test showed significantly increased NCF than the other tests for the #10/0.035, #17.5/0.045, and #25/0.05 files (p < 0.05). The #40/0.03 and #45/0.03 files showed no significant differences in all the tests (p > 0.05). CONCLUSION: Mtwo Minimal showed higher cyclic fatigue resistance in the dynamic test than the static test, except for the larger instruments. The 3-mm pecking amplitude increased the cyclic fatigue resistance of the smaller instruments.
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Níquel , Titanio , AleacionesRESUMEN
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.
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Antiinfecciosos , Capa de Barro Dentinario , Humanos , Quelantes/farmacología , Antiinfecciosos/farmacología , Atención Odontológica , Revisiones Sistemáticas como AsuntoRESUMEN
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.
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Recubrimiento Dental Adhesivo , Técnica de Perno Muñón , Cementos de Resina/química , Proyectos Piloto , Ensayo de Materiales , Análisis del Estrés Dental , Dentina , VidrioRESUMEN
OBJECTIVES: To determine the validity and reliability of novel digitalized tools for dental plaque detection and explore the benefits and limitations connected to their use. DATA: Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews. All human clinical studies comparing dental plaque detection using digitalized systems against a standard reference were included. SOURCES: PubMed and Scopus were screened from 01 January 2013 to 28 September 2023. Bibliographies of primary studies and principal peer-reviewed scientific journals were manually searched. STUDY SELECTION: The initial search identified 576 articles, with a total of 13 included in the review, published between 2015 and 2023. Most of the studies included (77 %) were cross-sectional with three being prospective. Digital devices captured 2D and 3D images via cameras and intra-oral scanners, respectively. The Turesky's modified plaque index was the most frequent clinical index. Correlation with clinical examination was moderate to strong, with good to excellent intra- and inter-system agreement. CONCLUSIONS: Within the limitations of this scoping review, image analysis-based plaque detection systems demonstrated good correlations with clinical plaque indices, using both 2D and 3D imaging systems. Whilst digital plaque detection devices offer advantages in terms of procedural standardization and reproducibility, they also have limitations, therefore currently, their application should be underpinned by a comprehensive clinical examination. CLINICAL SIGNIFICANCE: Digital plaque detection tools, that provide standardized measurements and store acquired images, facilitate more informed feedback to patients. This objective analysis may enhance clinician confidence in their utility for clinical trials and other applications.
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Placa Dental , Humanos , Reproducibilidad de los Resultados , Placa Dental/diagnóstico , Estudios Prospectivos , Índice de Placa Dental , Imagenología TridimensionalRESUMEN
The aim of the study was to evaluate the impact of kinematics and irrigation protocols on the extrusion of apical debris during removal of different obturation techniques. A total of 144 single-rooted teeth were instrumented and obturated with Thermafil+AH Plus, Thermafil+AH Plus Bioceramic and single gutta-percha cone+AH Plus Bioceramic. Samples were divided according to the retreatment kinematics: continuous rotation or Jeni motion. Each sub-group was subjected to conventional irrigation or irrigation activated by EDDY. Extruded debris was collected in Eppendorf tubes, weighted and retreatment time was digitally recorded. Data were analysed with two-way ANOVA (p < 0.05). Debris extrusion was not significantly different between all groups. EDDY activation system and CanalPro Jeni required significantly longer time compared with other groups to remove Thermafil+AH Plus and single cone+AH Plus Bioceramic. Within current limitations, obturation technique, irrigation protocol and kinematics tested had no influence on apical extrusion debris, while they significantly impacted the retreatment time.
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Gutapercha , Materiales de Obturación del Conducto Radicular , Preparación del Conducto Radicular/métodos , Obturación del Conducto Radicular/métodos , Fenómenos Biomecánicos , Cavidad Pulpar , RetratamientoRESUMEN
The aim of this study was to compare the cyclic fatigue resistance of nickel-titanium instruments inside single and double-curved canals at different temperatures. 160 HyFlex EDM #20.05 (HEDM), VDW.ROTATE #20.05 and #25.06, Mtwo #25.06 were randomised (n = 10) for the dynamic cyclic fatigue tests according to the curvature (i.e. single and double) at 20° ± 1°C and 35° ± 1°C. The number of cycles to fracture (NCF) was analysed by two-way ANOVA with p < 0.05. Fatigue resistance of all instruments significantly decreased at body temperature in single and double curvatures, except for HEDM in double curvature. The NCF was significantly lower in double curvature than single at both temperatures for all files, except for VDW.ROTATE #20.05 at 35° ± 1°C. Within the study limitations, temperature significantly impaired cyclic fatigue resistance of all files except HEDM #20.05 in double curvature. Similarly, double curvature had a detrimental effect on cyclic fatigue resistance of all files except for VDW.ROTATE #20.05 at body temperature.
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Instrumentos Dentales , Níquel , Titanio , Temperatura Corporal , Aleaciones Dentales , Diseño de Equipo , Falla de Equipo , Ensayo de Materiales , Preparación del Conducto Radicular , Resistencia FlexionalRESUMEN
INTRODUCTION: This laboratory study aimed to evaluate the accumulated hard tissue debris (AHTD) and shaping performance following root canal instrumentation with a novel stainless steel rotary system (Gentlefile; MedicNRG, Kibbutz Afikim, Israel) compared with two single-file nickel-titanium instruments of different kinematics through micro-computed tomography (micro-CT) analysis. METHODS: Thirty isthmus-containing mesial roots of human mandibular molars with a curvature of 15°-35° were scanned with micro-CT at an isotropic resolution of 12 µm and randomly assigned to three groups (n = 10) according to the instruments used for canal preparation: Gentlefile (GF; #23/.04), One Curve (OC; #25/.06; Micro-Mega, Besancon, France), and Reciproc Blue R25 (RB; #25/.08; VDW, Munich, Germany). The AHTD, unprepared canal surface area, volume changes, surface area changes, and transportation were evaluated by comparing preoperative and postoperative micro-CT images. In addition, the time required for canal preparation was recorded. Data were statistically analyzed using the one-way analysis of variance (ANOVA) test or the Kruskal-Wallis test at a significance level of 5%. RESULTS: No significant differences were observed in the percentage of AHTD or in the unprepared canal surface area between the three groups (P > .05). The RB group demonstrated a significantly greater percentage increase in volume and surface area than the GF group (P < .05). The GF and OC groups showed significantly less transportation at 3 mm from the apex than the RB group (P < .001). The OC group required significantly less time for instrumentation than the RB and GF groups (P < .05). CONCLUSIONS: Instrumentation with GF (#23/.04), OC, and RB yielded similar levels of AHTD and unprepared surface area in isthmus-containing curved canals. GF achieved this with less dentin removal and apical transportation, at the expense of a longer preparation time.
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Cavidad Pulpar , Preparación del Conducto Radicular , Humanos , Cavidad Pulpar/diagnóstico por imagen , Cavidad Pulpar/cirugía , Microtomografía por Rayos X , Raíz del Diente , Diente Molar/diagnóstico por imagen , Diente Molar/cirugía , Diseño de EquipoRESUMEN
This paper investigates the influence of cavity configuration and post-endodontic restoration on the fracture resistance, failure mode and stress distribution of premolars by using a method of fracture failure test and finite elements analysis (FEA) coupled to Weibull analysis (WA). One hundred premolars were divided into one control group (Gcontr) (n = 10) and three experimental groups, according to the post-endodontic restoration (n = 30), G1, restored using composite, G2, restored using single fiber post and G3, restored using multifilament fiberglass posts (m-FGP) without post-space preparation. Each experimental group was divided into three subgroups according to the type of coronal cavity configuration (n = 10): G1O, G2O, and G3O with occlusal (O) cavity configuration; G1MO, G2MO, and G3MO with mesio-occlusal (MO); and G1MOD, G2MOD, and G3MOD with mesio-occluso-distal (MOD). After thermomechanical aging, all the specimens were tested under compression load, and failure mode was determined. FEA and WA supplemented destructive tests. Data were statistically analyzed. Irrespective of residual tooth substance, G1 and G2 exhibited lower fracture resistance than Gcontr (p < 0.05), whereas G3 showed no difference compared to Gcontr (p > 0.05). Regarding the type of restoration, no difference was highlighted between G1O and G2O, G1MO and G2MO, or G1MOD and G2MOD (p > 0.05), whereas G3O, G3MO, and G3MOD exhibit higher fracture resistance (p < 0.05) than G1O and G2O, G1MO and G2MO, and G1MOD and G2MOD, respectively. Regarding cavity configuration: in G1 and G2, G1O and G2O exhibited higher fracture resistance than G1MOD and G2MOD, respectively (p < 0.05). In G3, there was no difference among G3O, G3MO and G3MOD (p > 0.05). No difference was found among the different groups and subgroups regarding the failure mode. After aging, premolars restored with multifilament fiberglass posts demonstrated fracture resistance values comparable to those of an intact tooth, irrespective of the different type of cavity configuration.
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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.