Restorative Dentistry & Endodontics

Celebrating the past 50 years and ushering in a new half-century: Kyung-San Min; Restor Dent Endod 2025;50(1):e11. Published online February 19, 2025; DOI: https://doi.org/10.5395/rde.2025.50.e11

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Concentrated growth factor scaffold-based pulpotomy of permanent molars with symptomatic irreversible pulpitis: Arthi K. Harith, Vishnupriya Koteeswaran, Dinesh Kowsky, Natanasabapathy Velmurugan, Suresh Nandini; Restor Dent Endod 2025;50(1):e1. Published online January 17, 2025; DOI: https://doi.org/10.5395/rde.2025.50.e1

Abstract PDF PubReader ePub: Objectives
Pulpotomy is a minimally invasive procedure that aims to retain the vitality of the radicular pulp by removing the inflamed coronal pulp tissue. This case series presents the successful management of symptomatic irreversible pulpitis by pulpotomy with concentrated growth factor (CGF) scaffolds.
Methods
Six permanent mandibular molars with a diagnosis of symptomatic irreversible pulpitis were included. Under Local anesthesia and rubber dam isolation, caries were excavated using high-speed bur under coolant. Full coronal pulpotomy was done and hemostasis was achieved. CGF membrane was prepared and placed over the radicular pulp and layered with Biodentine (Septodont). Final restoration of type IX glass ionomer cement and bulk fill composite resin was placed. Patients were assessed for various clinical and radiographic parameters at intervals of 1 week and 3, 6, and 12 months. Five patients fulfilled the success criteria at the end of 1 year.
Results
Pulpotomy is considered an alternative treatment modality for root canal treatment in symptomatic irreversible pulpitis aiming at alleviating symptoms and maintaining vitality. CGF scaffold when used as a capping material acts as a reservoir for growth factors with anti-inflammatory properties and enhances healing.
Conclusions
Scaffold-based pulpotomy can be considered a biological approach to healing inflamed pulp.

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Effect of quality of radiographs taken during root canal treatment on technical quality of root canal fillings and endodontic outcome: Jia Min Ng, Yan Yee Lee, Prashanti Chippagiri, Elaheh Ahanin, Abhishek Parolia; Restor Dent Endod 2025;50(1):e3. Published online January 7, 2025; DOI: https://doi.org/10.5395/rde.2025.50.e3

Abstract PDF PubReader ePub: Objectives
This study evaluated the number and quality of working length (WL) and master cone (MC) radiographs taken during root canal treatment by dental undergraduates, and their associations with the technical quality of root canal fillings (TQRCF) and endodontic outcomes (EO).
Methods
A retrospective evaluation of radiographs from 303 root canal-treated teeth in 231 patients was conducted, with 72 patients attending recall visits to assess EO. The chi-square and one-way analysis of variance tests were performed.
Results
A total of 505 WL and 557 MC radiographs were reviewed, with 72.9% and 75% deemed satisfactory, respectively. Satisfactory TQRCF was achieved in 60.4% of cases. Significant associations were found between the extension of the file in WL and gutta-percha in MC radiographs and TQRCF (p = 0.000). Misinterpretation of these radiographs resulted in poor TQRCF. Furthermore, 64.2% of teeth had satisfactory EO. A significant relationship was noted between the quality of MC radiographs and both TQRCF (p = 0.043) and EO (p = 0.003).
Conclusions
Unsatisfactory MC radiographs were linked to poor TQRCF and unfavorable EO. Regular radiographic training is recommended to enhance EO.

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Fracture resistance and failure modes of endodontically-treated permanent teeth restored with Ribbond posts vs other post systems: a systematic review and meta-analysis of in vitro studies: Meghana Aditya Vartak, Vibha Rahul Hegde, Sanitra Rahul Hegde, Ushaina Fanibunda; Restor Dent Endod 2025;50(1):e5. Published online February 17, 2025; DOI: https://doi.org/10.5395/rde.2025.50.e5

Abstract PDF PubReader ePub: Objectives
This systematic review aimed to investigate the fracture resistance and mode of failure of endodontically-treated permanent teeth restored with Ribbond posts (Ribbond, Inc.) compared with endodontically-treated permanent teeth restored with other post systems.
Methods
A comprehensive, systematic literature search was carried out using several electronic databases: MEDLINE/PubMed, Google Scholar, and Cochrane Library. Two separate researchers were appointed to identify the studies meeting the eligibility criteria, and to perform the data extraction, risk of bias, and quality assessment.
Results
Twelve studies were included in the quantitative analysis. Meta-analysis was performed with 11 of the 12 included articles. The meta-analysis showed that Ribbond posts have a fracture strength less than prefabricated metal posts, cast metal posts, and prefabricated fiber posts and greater than custom e-glass fiber posts. Mode of failure analysis revealed that Ribbond posts have the most favorable non-catastrophic fractures.
Conclusions
Although Ribbond posts have lower fracture resistance, their favorable mode of failure makes them potentially the most biomimetic post system.

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Surface properties and susceptibility to staining of a resin composite after brushing with different whitening toothpastes: Aline da Silva Barros, Carolina Meneghin Barbosa, Renata Siqueira Scatolin, Waldemir Francisco Vieira Junior, Laura Nobre Ferraz; Restor Dent Endod 2025;50(1):e6. Published online February 26, 2025; DOI: https://doi.org/10.5395/rde.2025.50.e6

Abstract PDF PubReader ePub: Objectives
This study investigated the effects of different whitening toothpaste (WT) on the surface properties and staining susceptibility of a resin composite.
Methods
Cylindrical samples were prepared with a micro-hybrid resin composite and were randomized into groups according to the toothpaste (n = 12): distilled water (DW), regular toothpaste (RT), WT with silica + pyrophosphate (WT-S/P), WT with pentaphosphate and pyrophosphate (WT-P/P), WT with hydrogen peroxide and pyrophosphate (WT-HP/P) and WT with charcoal and pyrophosphate (WT-Ch/P). The samples were brushed for 825 cycles in an automatic brushing machine, simulating 30 days of brushing. After that, an immersion in coffee (10 mL/sample) was performed for 30 minutes for 30 days. The analyses of color, surface microhardness (SMH), and surface roughness (Ra) were performed at the initial time, after brushing with toothpaste and after immersion in coffee. The ΔL*, Δa*, Δb*, ΔEab, Δand E00 values were calculated comparing after toothpaste with initial time and after coffee with after toothpaste. Data were analyzed using a mixed linear model for repeated measures (SMH), Kruskal-Wallis, Dunn, Friedman, and Nemenyi tests, with α = 0.05.
Results
For ΔL*, the WT-Ch/P group had the lowest values and differed from the other groups comparing the after toothpaste with the initial time interval (p < 0.001). The WT-Ch/P group had the lowest SMH values in after-toothpaste time (p < 0.001). In after-toothpaste time and after coffee time, the WT-S/P group had the highest Ra values and differed from the groups except the WT-Ch/P group (p < 0.001).
Conclusions
The toothpaste composition affects the surface characteristics and susceptibility to staining of the resin composite. The charcoal-based toothpaste had the worst performance for the color analyses and SMH.

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Pattern of endodontic instrument separation and factors affecting its retrieval: a 10-year retrospective observational study in a postgraduate institute: Velmurugan Natanasabapathy, Aswathi Varghese, Paul Kevin Abishek Karthikeyan, Srinivasan Narasimhan; Restor Dent Endod 2025;50(1):e7. Published online February 19, 2025; DOI: https://doi.org/10.5395/rde.2025.50.e7

Abstract PDF PubReader ePub: Objectives
This study aimed to assess the pattern of endodontic instrument separation, their retrievability, and factors affecting its retrieval, in a postgraduate institute.
Methods
Cases referred for the management of separated endodontic instruments (SEI) from 2013 to 2023 were considered for this study. Data related to demographics, tooth type, file type, and retrieval were documented in an Excel sheet. Eight prognostic factors assumed to influence the retrieval were analyzed in this study. The secondary aim was to compare the pattern of SEI and retrievability between conventional nickel-titanium files and newer generation heat-treated nickel-titanium files. Retrieval was attempted by a senior endodontist under the dental operating microscope. Various ultrasonic tips and a Broken Tool Removal loop system were used during retrieval. Simple descriptive statistics were performed. Binomial logistic regression was done to identify the effect of the eight prognostic factors on the retrieval outcome.
Results
A total of 190 SEI was reported. SEI occurred more often in posterior teeth than anterior teeth, mandibular arch than maxillary arch, and in larger files than smaller files. Separation occurred more often in the apical third compared to the other levels. Retrieval was attempted in 88 cases and successful in 70 cases (79.5%). The larger taper and apical position of the SEI negatively influenced the retrieval by 1.4 and 8.7 times, respectively.
Conclusions
Retrieval of SEI was successful in the majority of the cases. An increase in taper and apically placed SEI negatively impacted the retrieval. There was no difference in the pattern of separation nor retrievability between conventional nickel-titanium files and newer generation heat-treated nickel-titanium files.

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Success rates comparison of endodontic microsurgery and single implants with comprehensive and explicit criteria: a systematic review and meta-analysis: Min Jung Ko, Ju Hyun Park, Na Rae Lee, Joon-Ho Yoon, Young-Taek Kim, Sin-Yeon Cho; Restor Dent Endod 2025;50(1):e8. Published online February 19, 2025; DOI: https://doi.org/10.5395/rde.2025.50.e8

Abstract PDF Supplementary Material PubReader ePub: Objectives
While the success criteria of endodontic microsurgery (EMS) have been consistently defined and widely accepted, the success criteria of dental implants are outdated and focus only on the implant fixture and surrounding bone. This study aimed to evaluate the outcomes of EMS and single implants (SIs) with explicit criteria.
Methods
We searched for articles published from January 2010 to February 2022 and discussed them and consulted with a clinical advisory committee composed of four dental specialists and one epidemiologist during article selection and data extraction.
Results
Twenty-two EMS studies and six SI studies were included in the meta-analysis. Teeth treated using EMS had a pooled success rate of 89% (90% at <5-year follow-up and 80% at ≥5-year follow-up) and the pooled success rate of SI was 78%.
Conclusions
The success rates of the two procedures with similar follow-up periods were comparable. Subgroup analysis found no other variable that significantly influenced study heterogeneity. Considering the treatment sequence and the similar success rates, it would be advantageous to consider EMS, rather than implants, first in a situation where both procedures are applicable.

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Shaping ability and cyclic fatigue resistance between Genius ProFlex, ZenFlex, and TruNatomy rotary systems: an experimental study: Raimundo Sales de Oliveira Neto, Murilo Priori Alcalde, Pedro Cesar Gomes Titato, Pedro Henrique Souza Calefi, Carlos Alberto Spironelli Ramos, Guilherme Ferreira da Silva, Rodrigo Ricci Vivan, Marco Antonio Hungaro Duarte; Restor Dent Endod 2025;50(1):e9. Published online February 13, 2025; DOI: https://doi.org/10.5395/rde.2025.50.e9

Abstract PDF PubReader ePub: Objectives
The aim of this study was to investigate the efficacy of three newly introduced rotary endodontic systems: Genius ProFlex (Medidenta), TruNatomy (Dentsply Maillefer), and ZenFlex (Kerr).
Methods
Forty-five mandibular molars with root canal curvatures <5° were utilized. Micro-computed tomography scans were performed pre- and post-preparation to assess apical transportation, centralization, percentage of dentin wear, and canal volume alterations. Eight instruments of each diameter underwent cyclic fatigue testing.
Results
The percentage of dentin wear on mesial and distal walls showed no significant differences among ZenFlex, TruNatomy, and Genius ProFlex at 1, 2, 3, and 4 mm from the apical foramen and root canal orifice (p > 0.05). Centering ability varied in the mesiolingual canal (p < 0.05). No notable differences were observed in transportation (p > 0.05). Genius ProFlex demonstrated lower volumetric changes (p < 0.05). There were significant differences in cyclic fatigue, with higher values for Genius ProFlex and lower values for TruNatomy (p < 0.05).
Conclusions
The three nickel-titanium rotary instruments are safe and efficient for root canal preparation, with Genius ProFlex exhibiting superior cyclic fatigue resistance.

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Publication rate of abstracts presented in ConsEuro meetings held between 2003 and 2019: a bibliometric analysis: Esra Cengiz-Yanardag, Ayse Tugba Erturk-Avunduk, Izgen Karakaya; Restor Dent Endod 2025;50(1):e10. Published online February 19, 2025; DOI: https://doi.org/10.5395/rde.2025.50.e10

Abstract PDF PubReader ePub: Objectives
This study aimed to assess the publication rates of abstracts presented at the ConsEuro Congress using a web-scraping method and to analyze factors correlated with these publication rates.
Methods
Abstracts presented at eight ConsEuro meetings held between 2003 and 2019 were evaluated for subspecialty, study design, number of authors, and the country of the principal investigator’s institution. For abstracts confirmed as subsequently published using a web-scraping method, the following data were recorded: time to publication, the journal of publication, impact factor, quartile, index status, Scientific Journal Ranking of the journal at the year of publication, and changes in the number of authors after publication.
Results
Out of 1,426 abstracts presented, 478 were published in peer-reviewed journals, yielding a publication rate of 33.5%. The median time to publication was 12 months. The leading journal in terms of publication rate was Clinical Oral Investigations. There was no statistically significant difference in publication rates across years. Abstracts related to laser therapy, caries, and dental materials had significantly higher publication rates compared to other subspecialties. Animal, basic, and clinical research studies were more likely to be published. Both study design and subspecialty influenced publication rates, which decreased over time.
Conclusions
A considerable amount of scientific data and preliminary results presented at conferences, which could contribute to scientific knowledge, are overlooked due to low publication rates. The findings of this study may encourage ConsEuro participants to submit well-planned and rigorous studies that are more likely to complete the full publication process.

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An unusual case of dens invaginatus on a mandibular second molar: a case report: Davide Mancino, Dina Abdellatif, Alfredo Iandolo, Fabien Bornert, Youssef Haïkel; Restor Dent Endod 2025;50(1):e2. Published online January 8, 2025; DOI: https://doi.org/10.5395/rde.2025.50.e2

Abstract PDF PubReader ePub: The present case report describes the endodontic treatment of a type III B dens invaginatus (DI) in a three-rooted mandibular second molar since the invagination invades the root and extends apically. Clinical and cone-beam computed tomography examination of the mandibular second molar showed a broadened coronal morphology, DI, a third root, periapical radiolucency, and compression of a distal root canal by the invagination, which developed an atypical semilunar shape. The tooth was diagnosed with pulpal necrosis, symptomatic apical, and peri-invagination periodontitis. Consequently, three-dimensional virtual reconstruction was conducted to improve anatomical interpretation and case planning and accelerate the intraoperative phase by reducing operator stress and minimizing intraoperative variables. The present case report aims to raise awareness of the existence of DI on the mandibular second molar.

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Guided endodontics, precision and predictability: a case series of mineralized anterior teeth with follow-up cone-beam computed tomography: Rafael Fernández-Grisales, Wilder Javier Rojas-Gutierrez, Pamela Mejía, Carolina Berruecos-Orozco, Néstor Ríos-Osorio; Restor Dent Endod 2025;50(1):e4. Published online January 6, 2025; DOI: https://doi.org/10.5395/rde.2025.50.e4

Abstract PDF PubReader ePub: Pulp chamber and root canal obliteration (PCO/RCO) presents a challenge for clinicians when nonsurgical endodontic treatment is indicated. Guided endodontics (GE) aims to precisely locate the root canal (RC) system while preserving as much pericervical dentin as possible. GE involves integrating cone-beam computed tomography (CBCT) of the affected tooth with a digital impression of the maxillary/mandibular arch, allowing for careful planning of the drilling path to the RC system through a three-dimensional (3D) static guide. This article reports four cases of teeth with PCO/RCO, accompanied by additional diagnoses of internal and external root resorption and horizontal tooth fracture, all successfully treated with GE. These cases highlight the clinical and radiographic success of GE treatments using CBCT, establishing this technique as a predictable approach for managing mineralized teeth.

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