Chitosan has been widely investigated and used. However, the literature does not refer to the shelf life of this solution. This study evaluated, through the colorimetric titration technique and an analysis of dentin micro-hardness, the shelf life of 0.2% chitosan solution.

Thirty human canines were sectioned, and specimens were obtained from the second and third slices, from cemento-enamel junction to the apex. A 0.2% chitosan solution was prepared and distributed in 3 identical glass bottles (v1, v2, and v3) and 3 plastic bottles (p1, p2, and p3). At 0, 7, 15, 30, 45, 60, 90, 120, 150, and 180 days, the specimens were immersed in each solution for 5 minutes (n = 3 each). The chelating effect of the solution was assessed by micro-hardness and colorimetric analysis of the dentin specimens. 17% EDTA and distilled water were used as controls. Data were analyzed statistically by two-way and Tukey-Kramer multiple comparison (α = 0.05).

There was no statistically significant difference among the solutions with respect to the study time (p = 0.113) and micro-hardness/time interaction (p = 0.329). Chitosan solutions and EDTA reduced the micro-hardness in a similar manner and differed significantly from the control group (p < 0.001). Chitosan solutions chelated calcium ions throughout the entire experiment.

Regardless of the storage form, chitosan demonstrates a chelating property for a minimum period of 6 months.

This study evaluated the influence of a multi-mode universal adhesive (MUA) containing silane (Single Bond Universal, 3M EPSE) on the bonding of resin cement to lithium disilicate.

Thirty IPS e.max CAD specimens (Ivoclar Vivadent) were fabricated. The surfaces were treated as follows: Group A, adhesive that did not contain silane (ANS, Porcelain Bonding Resin, Bisco); Group B, silane (S) and ANS; Group C, hydrofluoric acid (HF), S, and ANS; Group D, MUA; Group E, HF and MUA. Dual-cure resin cement (NX3, Kerr) was applied and composite resin cylinders of 0.8 mm in diameter were placed on it before light polymerization. Bonded specimens were stored in water for 24 hours or underwent a 10,000 thermocycling process prior to microshear bond strength testing. The data were analyzed using multivariate analysis of variance (p < 0.05).

Bond strength varied significantly among the groups (p < 0.05), except for Groups A and D. Group C showed the highest initial bond strength (27.1 ± 6.9 MPa), followed by Group E, Group B, Group D, and Group A. Thermocycling significantly reduced bond strength in Groups B, C, and E (p < 0.05). Bond strength in Group C was the highest regardless of the storage conditions (p < 0.05).

Surface treatment of lithium disilicate using HF and silane increased the bond strength of resin cement. However, after thermocycling, the silane in MUA did not help achieve durable bond strength between lithium disilicate and resin cement, even when HF was applied.

This study investigated the cleaning ability of ultrasonically activated irrigation (UAI) and a novel activation system with reciprocating motion (EC, EasyClean, Easy Equipamentos Odontológicos) when used with a relatively new chelating agent (QMix, Dentsply). In addition, the effect of QMix solution when used for a shorter (1 minute) and a longer application time (3 minutes) was investigated.

Fifty permanent human teeth were prepared with K3 rotary system and 6% sodium hypochlorite. Samples were randomly assigned to five groups (n = 10) according to the final irrigation protocol: G1, negative control (distilled water); G2, positive control (QMix 1 minute); G3, QMix 1 minute/UAI; G4, QMix 1 minute/EC; G5, QMix 3 minutes. Subsequently the teeth were prepared and three photomicrographs were obtained in each root third of root walls, by scanning electron microscopy. Two blinded and pre-calibrated examiners evaluated the images using a four-category scoring system. Data were statistically analyzed using Kruskal-Wallis and Dunn tests (p < 0.05).

There were differences among groups (p < 0.05). UAI showed better cleaning ability than EC (p < 0.05). There were improvements when QMix was used with auxiliary devices in comparison with conventional irrigation (p < 0.05). Conventional irrigation for 3 minutes presented significantly better results than its use for 1 minute (p < 0.05).

QMix should be used for 1 minute when it is used with UAI, since this final irrigation protocol showed the best performance and also allowed clinical optimization of this procedure.

Periapical lesions, including periapical cyst (PC), periapical granuloma (PG), and periapical abscess (PA), are frequently affected by chemical/physical damage during root canal treatment or severe bacterial infection, and thus, the differential diagnosis of periapical lesions may be difficult due to the presence of severe inflammatory reaction. The aim of this study was to make differential diagnosis among PC, PG, and PA under polarizing microscope.

The collagen birefringence patterns of 319 cases of PC (n = 122), PG (n = 158), and PA (n = 39) obtained using a polarizing microscope were compared. In addition, 6 cases of periodontal fibroma (PF) were used as positive controls.

Collagen birefringence was condensed with a thick, linear band-like pattern in PC, but was short and irregularly scattered in PG, and scarce or absent in PA. PF showed intense collagen birefringence with a short, palisading pattern but no continuous band-like pattern. The linear band-like birefringence in PC was ascribed to pre-existing expansile tensile stress of the cyst wall.

In this study all PCs (n = 122) were distinguishable from PGs and PAs by their characteristic birefringence, despite the absence of lining epithelium (n = 20). Therefore, the authors suggest that the presence of linear band-like collagen birefringence of the cyst wall aids the diagnostic differentiation of PC from PG and PA.

This study aimed to evaluate the color stability of bulk-fill and nanohybrid resin-based composites polished with 3 different, multistep, aluminum-oxide impregnated finishing and polishing disks.

Disk-shaped specimens (8 mm in diameter and 4 mm in thickness) were light-cured between two glass slabs using one nanohybid bulk-fill (Tetric EvoCeram, Ivoclar Vivadent), one micro-hybrid bulk-fill (Quixfil, Dentsply), and two nanohybrid incremental-fill (Filtek Ultimate, 3M ESPE; Herculite XRV Ultra, Kerr) resin-based composites, and aged by thermocycling (between 5 - 55℃, 3,000 cycles). Then, they were divided into subgroups according to the polishing procedure as SwissFlex (Coltène/Whaledent), Optidisc (Kerr), and Praxis TDV (TDV Dental) (n = 12 per subgroup). One surface of each specimen was left unpolished. All specimens were immersed in coffee solution at 37℃. The color differences (ΔE) were measured after 1 and 7 days of storage using a colorimeter based on CIE Lab system. The data were analyzed by univariate ANOVA, Mann-Whitney U test, and Friedmann tests (α = 0.05).

Univariate ANOVA detected significant interactions between polishing procedure and composite resin and polishing procedure and storage time (p < 0.05). Significant color changes were detected after 1 day storage in coffee solution (p < 0.05), except Quixfil/Optidisc which was color-stable after 7 days (p > 0.05). Polishing reduced the discoloration resistance of Tetric EvoCeram/SwissFlex, Tetric EvoCeram/Praxis TDV, Quixfil-SwissFlex, and all Herculite XRV Ultra groups after 7 days storage (p < 0.05).

Discoloration resistance of bulk-fill resin-based composites can be significantly affected by the polishing procedures.

This study compared the effect of hexamethyldisiloxane (HMDSO) and ammonia (NH₃) plasmas on the bond strength of resin cement to fiber posts with conventional treatments.

Sixty-five fiber posts were divided into 5 groups: Control (no surface treatment); H₂O₂ (24% hydrogen peroxide for 1 min); Blasting (blasting with aluminum oxide for 30 sec); NH₃ (NH₃ plasma treatment for 3 min); HMDSO (HMDSO plasma treatment for 15 min). After the treatments, the Ambar adhesive (FGM Dental Products) was applied to the post surface (n = 10). The fiber post was inserted into a silicon matrix that was filled with the conventional resin cement Allcem Core (FGM). Afterwards, the post/cement specimens were cut into discs and subjected to a push-out bond strength (POBS) test. Additionally, 3 posts in each group were evaluated using scanning electron microscopy. The POBS data were analyzed by one-way analysis of variance and the Tukey's honest significant difference post hoc test (α = 0.05).

The Blasting and NH₃ groups showed the highest POBS values. The HMDSO group showed intermediate POBS values, whereas the Control and H₂O₂ groups showed the lowest POBS values.

Blasting and NH₃ plasma treatments were associated with stronger bonding of the conventional resin cement Allcem to fiber posts, in a procedure in which the Ambar adhesive was used.

To compare the fatigue life of Tango-Endo, WaveOne GOLD, and Reciproc NiTi instruments under static model via artificial canals with different angles of curvature.

Reciproc R25, WaveOne GOLD Primary, and Tango-Endo instruments were included in this study (n = 20). All the instruments were rotated in artificial canals which were made of stainless steel with an inner diameter of 1.5 mm, 45°, 60°, and 90° angles of curvatures and a radius of curvature of 5 mm until fracture occurred, and the time to fracture was recorded in seconds using a digital chronometer. The data were analyzed using Kruskal-Wallis and post-hoc Dunn tests were used for the statistical analysis of data in SPSS 21.0 software.

Tango-Endo files were found to have significantly higher values than WaveOne GOLD and Reciproc files in terms of fatigue life (p < 0.05). However, there was no statistically significant difference between fatigue life of Reciproc and WaveOne GOLD files (p > 0.05). It was determined that increasing the angle of curvature of the stainless canals caused significant decreases in fatigue life of all of three files (p < 0.05).

Within the limitations of the present study, the cyclic fatigue life of Tango-Endo in canals having different angles of curvature was statistically higher than Reciproc and WaveOne GOLD.

The aim of this randomized, controlled, prospective clinical study was to evaluate patients' intraoperative discomfort during root canal preparations in which either multi-file rotary (Mtwo) or single-file reciprocating (Reciproc) systems were used.

Fifty-five adult patients, aged between 25 and 69 years old, with irreversible pulpitis or pulp necrosis participated in this study. Either the mesiobuccal or the distobuccal canals for maxillary molars and either the mesiobuccal or the mesiolingual canals for mandibular molars were randomly chosen to be instrumented with Mtwo multi-file rotary or Reciproc single-file reciprocating systems. Immediately after each canal instrumentation under anesthesia, patient discomfort was assessed using a 1 - 10 visual analog scale (VAS), ranging from ‘least possible discomfort’ (1) to ‘greatest possible discomfort’ (10). The Wilcoxon signed-rank test was used to determine significant differences at p< 0.05.

Little intraoperative discomfort was found in all cases. No statistically significant differences in intraoperative discomfort between the 2 systems were found (p = 0.660).

Root canal preparation with multi-file rotary or single-file reciprocating systems had similar and minimal effects on patients' intraoperative discomfort.