Effects of melatonin, proline, and salicylic acid on seedling growth, photosynthetic activity, and leaf nutrients of sorghum under salt stress.

Soil salinization poses a significant challenge to the sustainability and productivity of agriculture worldwide. This issue continues to hinder plant growth, requiring innovative solutions to alleviate salt stress. Moreover, climate change accelerates soil salinization, which may soon spread to previously unaffected agricultural areas. Therefore, the present study evaluated the potential role of different seed priming agents (hydro (H), salicylic acid (SA), proline (P), and melatonin (MEL)) on seedlings and leaf macro and micronutrients of sorghum grown under four (.27, 2.5, 5.0, and 8.0 dS m-1) soil salinity conditions. Soil salinity drastically reduced all the growth parameters of sorghum seedlings, primarily the reduction in growth traits, which was remarkable after 2.5 dS m-1 soil salinity. In addition, plant height, shoot fresh weight, and stomata were reduced by 40.8%, 74.6%, and 36.5%, respectively, at 8.0 dS m-1 compared to .27 dS m-1. SA- and MEL-primed seeds mitigated the harmful effects of soil salinity by reducing Na+ accumulation in the leaves and increasing the K+/Na+ and Ca2+/Na+ ratios and photosynthetic activity under salt stress. However, the Zn2+, Mn2+, and Cu2+ contents of sorghum leaves increased with increasing soil salinity, and these nutrients also improved with seed priming by SA, MEL, and P. Considering all nutrients, MEL-primed sorghum seeds had better macro- and micro-nutrient uptake capacities than the H, SA, and P treatments under high soil salinity conditions. Finally, the present study showed that MEL-induced improvement in salt tolerance in sorghum seedlings was related to enhanced nutritional status, photosynthetic activity, and biomass production in salinized areas.

Spectrophotometric Analysis of Color Stability Induced by Various Calcium Silicate Cements in Full Pulpotomy of Permanent Molars: Theracal PT, Biodentine, and ProRoot MTA.

AIM: The objective of this study was to assess the color stability induced by Theracal PT, Biodentine, and ProRoot MTA in teeth subjected to full pulpotomy, over a span of 6 months. MATERIALS AND METHODS: The study employed a total of 48 freshly extracted intact human third molar teeth. Samples were randomly assigned into four groups (n = 12). All teeth, with the exception of the control group, underwent endodontic access. All materials were mixed in accordance with the manufacturer's guidelines and applied at a thickness of 3 mm at the orifice level before they set. The study groups were negative control (was not prepared), positive control (ProRootMTA), Biodentine, and Theracal PT. Glass ionomer and composite resin material was applied to the cavities. The color measurements were performed using the VITA Easy Shade spectrophotometer. All measurements were repeated 3 times in the determined area on the middle buccal surface of the tooth at baseline that (T0); after access preparation and material placement and setting) and then subsequently at 7 (T1), 30 (T2), 90 (T3), and T4 (180) days later. Data were statistically analyzed by using Kruskal-Wallis H at a confidence level of 95% (P < .05). RESULTS: Compared with the negative control group, Biodentine and Theracal PT showed color stability (ΔE ≤ 3.7). The teeth treated with MTA showed clinically observable discoloration (ΔE ≥ 3.7) at T0, T1, T2, T3, and T4 intervals. At all-time intervals, the MTA group induced more discoloration than Biodentine and Theracal PT (P < .05). CONCLUSIONS: Theracal PT and Biodentine caused least discoloration compared to PMTA even 6 months after its application in teeth undergoing pulpotomy, thereby offering clinicians a reliable alternative for use in the esthetic zone.

Short fiber reinforced composite on fracture strength of immature permanent anterior teeth with simulated regenerative endodontic procedures: an in vitro study.

The aim of the present study was to evaluate the effect of short fiber reinforced composite on the fracture strength of anterior immature teeth treated with regenerative endodontic procedures. A total of 120 permanent maxillary central incisors were selected, and root lengths were standardized. Except for the positive control group (n = 20), the root canals were instrumented to simulate immature teeth with incomplete root development, and the regenerative endodontic procedure was performed. Twenty instrumented teeth acted as negative controls (n = 20), and the remaining 80 teeth were randomly divided into 4 groups according to the chosen coronal restoration material: bulk fill, short fiber reinforced composite (SFRC), polyethylene fiber (Ribbond Ultra), and flowable composite resin. Each specimen was then subjected to fracture testing using a universal testing machine (AGS-X, Shimadzu, Japan). The load to fracture was recorded. Data were subjected to statistical analysis using analysis of variance and the Tukey Honestly Significant Difference test. A significant difference was detected between the groups (p < 0.05), with the positive control group showing the highest mean fracture strength. The SFRC group had significantly higher values than the bulk fill, polyethylene fiber, flowable composite resin and negative control groups. In conclusion, SFRC has a relatively high fracture strength compared to other materials used in regenerative endodontic procedures. The use of SFRC enhanced the fracture strength of immature permanent teeth.

The Effects of Calcium Silicate- and Calcium Hydroxide-based Root Canal Sealers on Postoperative Pain: A Randomized Clinical Trial.

INTRODUCTION: This study aimed to compare the postoperative pain level changes resulting from using calcium silicate- (EndoSeal MTA) and calcium hydroxide-based (Sealapex) root canal sealers in mandibular first and second molar teeth with symptomatic apical periodontitis. METHODS: A total of 60 patients with symptomatic apical periodontitis in their lower molar teeth were randomly allocated into 2 groups according to sealer type (n = 30). Demographic data, including gender, age, and smoking habit, and preoperative pain measures were recorded. Root canal treatments were performed in a single visit. Postoperative pain measurements and analgesic intake were measured at 6, 12, 24, and 48 hours and after 3, 5, and 7 days using the visual analog scale. The data were statistically analyzed using a chi-squared test (to compare gender, age, smoking habit, analgesic intake, and sealer extrusion), the Mann-Whitney U test (to compare pain levels), Friedman tests (for the evaluations of the reduction in pain levels over time), and Spearman's correlation test (to analyze the relationships of age, gender, smoking habit factors with postoperative pain) (P = .05). RESULTS: The statistical analysis showed no significant differences between the groups in postoperative pain and analgesic intake at any of the time intervals evaluated (P > .05). CONCLUSIONS: Patients treated with calcium silicate- and calcium hydroxide-based root canal sealers experienced similar postoperative pain and no statistically significant differences were observed in analgesic intake.

The assessment of groundwater quality through the water quality and nitrate pollution indexes in northern Türkiye.

Groundwater is contaminated by anthropogenic factors such as industry, domestic waste, and excessive fertilizers. Groundwater samples, which were obtained from 50 different wells in July 2020, were used in this study. Thirteen hydrochemical properties, including electrical conductivity (EC), pH, total dissolved solids (TDS), total hardness (TH), nitrate NO3-, anions, and cations were analyzed. Also, types of groundwater were investigated via the Piper diagram. The groundwater was also evaluated for irrigation suitability using the sodium percentage (Na%), sodium adsorption ratio (SAR), Kelly's index (KI), residual sodium carbonate (RSC), potential salinity, magnesium hazard (MR), and permeability index (PI). The samples were assessed for drinking the suitability using the water quality index (WQI) and the nitrate pollution index (NPI). Geographic information systems (GIS) were used to create spatial distribution maps of irrigation water quality indices, WQI, and NPI values. The results of major cations varied sodium 28.69-211.80 mg/L, calcium 78.74-258.89 magnesium 27.78-161.30 mg/L, and potasium 0.10-3.57 mg/L. The results from the study area showed that 62.70 of EC, 32.40% of PI, 20.09% of RSC, 51.55% of PS, and 49.36% of MR were inappropriate for irrigation purposes. The NPI data ranged from - 0.75 to 9.65, and 21.06% of the study areas were heavily polluted. The WQI showed that almost 62.90% of the experimental area was categorized as poor, very poor, and inappropriate for drinking water purposes, whereas 37.10% of the areas were categorized as good and excellent.

Bullous scabies, the light shed on etiopathogenesis and treatment: report of five paediatric cases.

Introduction: Bullous scabies (BS) is an infrequent and atypical presentation of scabies, with a predilection for elderly males. The mechanism of BS is not fully understood; superinfection, friction due to pruritus, autoeczemation, direct injury from mite's lytic enzymes, cross-reactivity of scabies protein with basal membrane zone antigens are considered to be possible reasons. Aim: To define clinical features of paediatric BS cases, which is an extremely rare subtype of scabies. Material and methods: This is a retrospective study of paediatric BS cases seen at two tertiary care centres. Previously described bacterial culture, antibiogram and follow-up records were investigated retrospectively. Confirmed scabies cases, according to the "International Alliance for the Control of Scabies (IACS)" with bullae were included. All cases were treated with 10% sulfur ointment for 3 consecutive days, two cycles. Households of cases were also treated simultaneously. Systemic antibiotics were added to patients with elevated acute phase reactants according to the antibiogram results. Informed consent was obtained from patients' parents. Results: Five BS cases were included. Three cases were male, two cases were female. Four cases had staphylococcus aureus, one had group-A beta haemolytic streptococcus positive bullae culture. All cases achieved a rapid complete resolution of symptoms after topical 10% sulfur ointment. Conclusions: Paediatric BS is an extremely rare entity of scabies. Bacterial superinfection plays a key role in bullae formation. 10% sulfur ointment is a highly effective treatment option for paediatric BS.

Micronutrient Deficiencies and Digital Computerized Phototrichogram Analysis in Telogen Effluvium: a Retrospective Correlation Study in a Tertiary Medical Center.

INTRODUCTION: Telogen effluvium (TE) is a common form of non-scarring alopecia that may manifest as acute or chronic hair shedding. Several studies evaluated a possible relationship between various vitamin and mineral deficiencies and TE, but it is still a controversial topic. OBJECTIVES: This study aimed to investigate the status of vitamin and mineral deficiencies in patients diagnosed with TE and to evaluate their correlation with anagen hair ratios (AHR) calculated with an automated digital phototrichogram (ADCP). METHODS: Electronic records of 973 TE patients were retrospectively analyzed. Demographic, clinical data, parameters such as ferritin, vitamin B12 (Vit-B12), vitamin D (Vit-D), folic acid, zinc and hemoglobin (HGB) serum levels were evaluated. Anagen to telogen hair ratios were also assessed in forty-two patients via ADCP. RESULTS: The rates of anemia, low ferritin level, and Vit-B12, folate, Vit-D, and zinc deficiencies were 11.9% (N = 109), 44% (N = 332), 1.5% (N = 13), 2.5% (N = 14), 87% (N = 51), and 4.5% (N = 2), respectively. A positive correlation was found between HGB levels and AHR in female patients (Spearman rank, r = 0.417, P = 0.008). No statistically significant relationship was found between ferritin, Vit-B12, folate, zinc serum levels and AHR. The relationship between Vit-D and AHR could not be assessed due to the insufficient number of patients with Vit-D data. CONCLUSIONS: HGB value is the only marker that is positively correlated with the AHR of patients with TE. Ordering HGB can be used as an initial test for managing TE patients cost-effectively.

Palladium complexes containing NNN pincer type ligands and their activities in Suzuki-Miyaura cross coupling reaction.

Five new NNN pincer-type ligands and their palladium complexes were successfully synthesised and characterised by FT-IR, 1H NMR, 13C NMR, and UV-vis analyses. TEM analysis was used to observe the morphological character of the black residues obtained from the fourth cycle of the reusability test. Furthermore, suitable crystals of the N2,N6-bis(2-tert-butylphenyl)pyridine-2,6-dicarboxamide and its palladium complex were elucidated with the X-ray single crystal diffraction method. Both the ligand and its palladium complex crystallise in a monoclinic system with space group P21/c for the H2L4 and C2/c for the palladium complex. The structure of the pincer ligand and its palladium complex were stabilised by intramolecular and intermolecular C-H⋅⋅⋅O, C-H⋅⋅⋅N, and N-H⋅⋅⋅N contacts. A Suzuki-Miyaura cross-coupling reaction between aryl halides and phenylboronic acid was used to assess the catalytic abilities of the palladium pincer complexes. All of the prepared complexes exhibited considerable catalytic activity. However, complexes 4 (Acetonitrile-N2,N6-bis(2-tert-butylphenyl)pyridine-2,6-dicarboxamidopalladium(II)) and 5 (Acetonitrile-N2,N6-bis(2-nitrophenyl)pyridine-2,6-dicarboxamidopalladium(II)) provided almost 100% conversion with nearly 100% yield in the reaction between 4-bromotoluene and phenylboronic acid. Furthermore, these active complexes catalysed the reaction of the sterically hindered and deactivated substrates (1-Bromo-4-izobutylbenzene and 2-bromo-6-methoxynaphthalene) with phenylboronic acid, and complete conversion and yields up to 100% were achieved in a short time with the 2-bromo-6-methoxynaphthalene.

Rare variant of dens invaginatus with accessory root and labial talon cusp in maxillary lateral incisor-Case report.

Dens invaginatus (DI) often causes dysmorphic changes in both the crown and root. This case report presents a complicated type 3a DI in a maxillary lateral incisor with labial talon cusp and root bifurcation. Although lingual talon cusp is common in maxillary lateral incisor, labial talon cusp is rare. An auxiliary palatal root in maxillary lateral incisor is also unusual. No such case involving all three variations has been described in the literature. The DI was classified as type B4 according to Schulze and Brand, as it involved division of pulp and root. DI was managed by orthograde MTA, radisectomy and periodontal regeneration was done for the palatal root. Labial talon associated with DI and can lead to early periodontal/pulpal involvement. Type 3 DI can affect the root with marked dilatation and division. Additional palatal root should be carefully detected in type 3a DI and managed with the aid of CBCT.

The efficiency of different irrigation activation techniques in the removal of calcium silicate-based endodontic sealer from artificially created groove.

This study evaluated the removal of a calcium silicate-based sealer (EndoSeal MTA) with needle irrigation (NI), passive ultrasonic irrigation (PUI), XP-endo Finisher (XPF) and EDDY. A total of 56 human mandibular premolars were instrumented up to size 40.04 taper. The roots were separated longitudinally, and grooves were prepared with an ultrasonic tip at one-half of each root canal. The grooves were covered with EndoSeal MTA and re-attached roots were investigated based on the activation techniques applied. The results showed that significantly more material (p < 0.05) was removed in the EDDY group compared to the NI, PUI and XPF groups in the apical region. In the coronal region, no significant difference was observed between EDDY, XPF and PUI (p > 0.05), whereas all the latter were significantly more effective than NI (p < 0.05). These findings show that the removal of EndoSeal MTA can be more effective with EDDY compared to XPF, PUI and NI in the apical region.

Efficiency of Endosonic Blue, Eddy, Ultra X and Endoactivator in the removal of calcium hydroxide paste from root canals.

We investigated the efficiency of Endosonic Blue, EDDY, Ultra X and EndoActivator in removing calcium hydroxide from artificially created apical grooves in root canal walls. In Materials and Methods: A total of 60 single-root maxillary central incisors, root canals were created and the roots were divided into two longitudinal parts. In the most suitable root piece, artificial grooves were created in the apical section and filled with calcium hydroxide. Calcium hydroxide in the grooves was removed using EDDY, Ultra X, Endosonic Blue or EndoActivator, and the remnants in the grooves were examined under a stereomicroscope. EDDY and Ultra X removed significantly more calcium hydroxide than Endosonic Blue and EndoActivator. The performance of EDDY and Ultra X or Endosonic Blue and EndoActivator was comparable. Therefore, EDDY and Ultra X are more effective than Endosonic Blue and EndoActivator in removing calcium hydroxide from apical grooves in root canal walls. No technique could achieve complete calcium hydroxide removal.

Effects of negative pressure wound therapy on an axial congested rabbit skin flap model without any bare surface.

One of the most important problems encountered in reconstructive surgery is partial or total flap loss, and venous congestion is the most common reason. It should be solved as early as possible. The purpose of this study is to investigate the effects of Negative pressure wound therapy (NPWT) on an ideal congested rabbit skin flap model without any open wound. The current study included 28 female, adult, New Zealand albino rabbits. Animals were divided into four groups according to the duration of NPWT to be applied. An axial pattern ideal congested skin flap was designed on the posterior surface of the ear. After surgical intervention on the right ears, we applied NPWT treatment for 2, 4, 6 and 8 days. The left ears were followed without any treatment. Samples were taken for edema, congestion and neo-angiogenesis examination. There was no significant difference between the NPWT applied group and control group in the 2nd, 4th, 6th, and 8th days for edema and neo-angiogenesis and no differences in the 2nd, 6th, and 8th days for congestion. NPWT group had a higher flap survival rate than the control group but without a significant difference. This study used an ideal congested rabbit skin flap model imitating venous congestion. Our findings illustrate that NPWT treatment does not have a significant effect on the congested skin flap model we utilized where a closed system was created maintaining a skin barrier without a bare surface of the flap. Level of Evidence: Level I, experimental study.

Removal of Calcium Hydroxide Pastes Containing N-Methyl-2-Pyrrolidone, Local Anaesthesia, Glycerine, and Methylcellulose from Artificial Radicular Grooves: An In-vitro Study.

OBJECTIVE: To compare the removal of calcium hydroxide (CaOH) pastes containing N-Methyl-2-pyrrolidone (NMP), lidocaine, glycerine, methylcellulose, or water from artificially created grooves. METHODS: In this study, 115 human single-rooted maxillary incisors with single and straight root canals were prepared using a rotary file up to size 40/.04 and split longitudinally. A longitudinal groove was created from 2 to 5 mm from the apex and filled with CaOH combined with different vehicles. The specimens were divided among 5 experimental groups according to the vehicle as follows: distilled water, lidocaine, glycerine, methylcellulose, and NMP. The two halves were re-attached, and the canals were flushed with 10 ml of 17% EDTA for 60 seconds. The residual amount of CaOH was scored using a stereomicroscope at 8× magnification. Statistical significance was set at P<0.05. RESULTS: The NMP-based group exhibited significantly less residual medicament compared to the distilled water (P<0.05), while there were no statistically significant differences among the methylcellulose-, lidocaine-, and glycerine-based groups and distilled water (P>0.05). CONCLUSION: The vehicle is an important factor in the successful removal of CaOH medicament from the root canals. Within the limitations of the present study, the NMP-based CaOH medicament exhibited better removal efficacy than the distilled water. However, the cleaning success of the methylcellulose-, lidocaine-, and glycerine-based groups was similar to that of distilled water.

Efficacy of EDDY, ultrasonic activation, XP-endo Finisher and needle irrigation on the removal of mTAP from artificially created grooves in root canals.

This study analysed the effect of needle irrigation (NI), passive ultrasonic irrigation (PUI), EDDY and the use of the XP-endo Finisher (XPF) on the removal of modified triple antibiotic paste (mTAP) from artificially created grooves in root canals. Forty-eight maxillary incisors were prepared up to size 50, with a standard groove on one surface of the root canal wall and filled with mTAP. Re-attached roots were analysed based on the activation techniques applied for 180 s with 5 ml 3% sodium hypochlorite. The results showed that EDDY was more effective at removing mTAP than PUI, XPF and needle irrigation (P < 0.05), whereas XPF and PUI were significantly more effective than needle irrigation. (P < 0.05). No significant difference in mTAP removal was observed between XPF and PUI (P > 0.05). These findings suggest that the removal of mTAP can be more efficiently achieved with EDDY than with XPF, PUI or NI.

Assessments of Ground Reaction Force and Range of Motion in Terms of Fatigue during the Body Weight Squat.

The purpose of this study was to analyse in detail body weight squat (BWS)' fatigue effect on the range of motions (ROM) of the hip, knee, ankle and ground reaction forces (GRF). Twenty male recreational athletes (24.0 ± 3.1 years, 178.85 ± 7.12 cm and 78.7 ± 11.45 kg) participated in this study. BWS were performed on four load cell platforms until the participants failed to continue. Participants performed 73 ± 27 repetitions and the duration to complete of the repetitions was 140.72 ± 62.28 s during the BWS exercise. The forefoot and hindfoot of the feet were on two load cells, thus, there were two under each foot. All of the data collected was divided into three sections for analysis (24 ± 9 repetitions for each). In terms of GRF of the fore feet and hind feet, significant differences and medium to large effect size were found between each section (p = 0.006~0.040, ES = 0.693~0.492). No significant differences were found between right and left leg in all sections. Significant differences were found in the ROM of the hip between the sections of first-third (p = 0.044, ES = 0.482) and second-third (p = 0.034, ES = 0.510), the ROM of the knee first-third (p = 0.014, ES = 0.602) and second-third (p = 0.005, ES = 0.701) and for the ROM of the ankle first-second (p = 0.045, ES = 0.479). As a result, end-of-exercise fatigue caused an increase in the ROM of the hip, knee and ankle. Thus, it is observed that fatigue induced increased ROM, also increases the GRF towards the forefeet.

Postoperative Pain After the use of Sodium Hypochlorite gel and Solution Forms: A Randomized Clinical Study.

OBJECTIVE: The present study aimed to compare the effect of sodium hypochlorite (NaOCl) gel and solution forms on postoperative pain level. METHODS: Fifty-two patients were divided into two groups according to the root canal irrigation solution. In the NaOCl solution group, the root canals were irrigated with 2 mL of 5.25% NaOCl between each pecking motion. In the NaOCl gel group, 5.25% NaOCl gel was used according to the manufacturer's instructions. The root canal treatments were completed and the participants were given instructions to record postoperative pain levels on 24, 48, and 72 hours and 1 week after treatment using VAS. RESULTS: Intergroup analyses revealed that the NaOCl gel group resulted in significantly less postoperative pain than the NaOCl solution group on day 1. CONCLUSION: It can be concluded that using NaOCl gel during root canal preparation results in less postoperative on day 1 when compared with the NaOCl solution.

Comparison of Ischemic Preconditioning and Systemic Piracetam for Prevention of Ischemia-Reperfusion Injury in Musculocutaneous Flaps.

BACKGROUND: Ischemia-reperfusion injury plays an important role in flap failure. Ischemic preconditioning technique is the only proven method for preventing ischemia-reperfusion injury, but it is not used widely in daily practice because of difficulties such as prolonging the operation time, need for surgical experience, and increasing the risk of complications. This study has been performed with the assumption that piracetam may be a simple and inexpensive alternative to the preconditioning technique due to its antioxidant, antiaggregant, rheological, anti-inflammatory, antiapoptotic, cytoprotective, and immune modulating effects. METHODS: Thirty-two rats were divided into four groups and latissimus dorsi musculocutaneous flaps were raised. No extra procedure was applied, and no treatment was given to the control group. Four hours of ischemia was created by clamping the thoracodorsal pedicle in the second group. The animals in the third group were treated with 10 minutes of ischemia and reperfusion periods as a preconditioning procedure before the 4 hours of ischemia. Animals in the fourth group received systemic piracetam 30 minutes before and 6 days after reperfusion. Nitric oxide and myeloperoxidase levels in serum and tissue, acute inflammatory cell response, and vascular proliferation in tissue were examined at the postoperative 24th hour and 10th day. RESULTS: Myeloperoxidase activity in both preconditioning and piracetam groups, was significantly lower than the ischemia-reperfusion group. Acute inflammatory cell response was similarly decreased in both preconditioning and piracetam groups compared with ischemia-reperfusion group. Tissue measurements of nitric oxide were also significantly higher in both preconditioning and piracetam groups than in the ischemia-reperfusion group. However, vascular proliferation increased in the preconditioning group, while it did not show any significant change in the piracetam group. CONCLUSION: This study shows that systemic piracetam treatment provides protection against ischemia-reperfusion injury in musculocutaneous flaps and can offer a simple and inexpensive alternative to the preconditioning technique.

Effect of calcium hydroxide mixed with lidocaine hydrochloride on postoperative pain in teeth with irreversible pulpitis and symptomatic apical periodontitis: a preliminary randomized controlled prospective clinical trial.

OBJECTIVES: To investigate the effect of calcium hydroxide mixed with lidocaine HCl on postoperative spontaneous pain. MATERIALS AND METHODS: Sixty patients having irreversible pulpitis and symptomatic apical periodontitis with a preoperative spontaneous pain and percussion pain which was more than 50 on a visual analogue scale (100 mm VAS) were included in this study. After the preparation of the root canals, the patients were randomly distributed into two groups according to the calcium hydroxide vehicle, control group (mixed with saline) and calcium hydroxide mixed with lidocaine HCl (n = 30). Postoperative spontaneous pain scores were recorded by a VAS every day for a week. Data were analysed using one-way analysis of variance, chi-squared test and Mann-Whitney U tests (p = 0.05). RESULTS: The calcium hydroxide mixed with lidocaine HCl group resulted in significantly less pain compared with the calcium hydroxide mixed with saline group during days 1 to 4 (p < 0.05). There were no significant differences between the groups in terms of postoperative percussion pain levels (p > 0.05). CONCLUSION: Within the limitations of this study, it can be concluded that the calcium hydroxide mixed with lidocaine HCl can be beneficial in reducing postoperative pain in teeth with irreversible pulpitis and symptomatic apical periodontitis. CLINICAL RELEVANCE: The calcium hydroxide mixed with lidocaine HCl can be beneficial in reducing postoperative pain in teeth with irreversible pulpitis and symptomatic apical periodontitis. CLINICAL REGISTRATION NUMBER: TCTR20181121003.

Effectiveness of the static-guided endodontic technique for accessing the root canal through MTA and its effect on fracture strength.

OBJECTIVES: (1) To evaluate the effectiveness of the static-guided (SG) endodontics technique for accessing the root canal through the mineral trioxide aggregate (MTA) and (2) to evaluate the effect of this technique on the fracture strength of teeth. MATERIALS AND METHODS: Thirty mandibular premolars were used in the present study. After standard coronal access cavity preparation, root canals were prepared up to size #80 to simulate an immature root apex. White MTA was placed approximately 3 mm below the cementoenamel junction (CEJ), as placed in regenerative endodontic procedures. After the MTA had set, the cavity was restored with a resin composite material. The teeth were randomly divided into two groups (n = 15). In the control group, the composite resin and MTA were removed without any guide. In the SG-access group, a cone beam computed tomography (CBCT) scan was performed, 3D-printed guides were designed and fabricated, and then the composite resin and MTA were removed with a guide. One inexperienced operator performed the removal of the composite resin and MTA in all groups. Pre- and post-operative periapical radiographs were taken. The mishaps and time to penetration to root canal were recorded. After that, the root canals were filled, and the access cavities were restored. The samples were subjected to a fracture strength test. Data were analyzed using Mann-Whitney U, independent samples of T test, and chi-square tests at 95% confidence level (P = 0.05). RESULTS: There were significant differences between the control and SG-access groups in terms of mishaps and time to penetration to the root canal through the MTA barrier (P < 0.05). The SG-access group required the shorter time as compared with the control group. Mishaps did not occur in the SG-access group. The SG-access group exhibited the significantly preserved fracture resistance of the teeth as compared with the control group (P < 0.05). Non-restorable failure occurred more frequently in the control group than in the SG-access group. CONCLUSIONS: Within the limitations of the present study, the SG endodontic technique yielded favorable results with respect to time, mishaps, and fracture strength. CLINICAL RELEVANCE: The static-guided endodontics technique may provide advantages to the clinician for MTA removal.