This study aimed to evaluate the effects of 5% lidocaine and 2.5% lidocaine/2.5% prilocaine topical anesthetic on pain during needle insertion and infiltration injection in the labial mucosa of anterior maxillary teeth, and to assess the relationship between patients’ anxiety and pain scores.

The Modified Dental Anxiety Scale questionnaire was applied and recorded. Patients were randomly divided into 4 groups (n = 30), as follows: G1 group: 5% lidocaine and placebo for 1 minute, G2 group: 2.5% lidocaine/2.5% prilocaine and placebo for 1 minute, G3 group: 5% lidocaine and placebo for 3 minutes, and G4 group: 2.5% lidocaine/2.5% prilocaine and placebo for 3 minutes. Before the application of topical anesthesia, one side was randomly selected as the topical anesthesia and the contralateral side as the placebo. The pain levels were measured with Visual Analog Scale (VAS) immediately after needle insertion and injection and were compared. The correlation between anxiety and pain scores was analyzed.

Administration of 5% lidocaine for 1 minute had significantly higher pain scores for both insertion and infiltration injection than the other groups (p < 0.05). There was a significant moderate positive correlation between dental anxiety and the injection-induced VAS pain score in the placebo side in all groups (p < 0.05).

Topical anesthetics significantly reduced the pain caused by both needle insertion and injection pain in comparison to the placebo side. The pain scores of patients with dental anxiety were lower on the topical anesthesia compared to the placebo side.

Thai Clinical Trials Registry Identifier: TCTR20201217002

This systematic review and meta-analysis aimed to assess the association of cigarette smoking with the prevalence of post-endodontic apical periodontitis in humans.

We searched through PubMed/Medline, Web of Science, and Scopus from inception to December 2020. Risk of bias was performed by using the Newcastle-Ottawa Scale for cross-sectional, cohort, and case-control studies. We performed the statistical analysis in Review Manager 5.3 (RevMan 5.3).

6 studies met the inclusion criteria for qualitative and quantitative synthesis. Statistical analysis of these studies suggests that there were no differences in the prevalence of post endodontic apical periodontitis (AP) when comparing non-smokers vs smoker subjects regarding patients (odds ratio [OR], 0.68; 95% confidence interval [CI], 0.31–1.49; I2 = 58%) and teeth (OR, 1.71; 95% CI, 0.99–2.93; I2 = 72%).

Our findings suggest that there was no association between cigarette smoking and post-endodontic apical periodontitis, as we did not find statistical differences in the prevalence of post-endodontic AP when comparing non-smokers vs smoker subjects. Therefore, smoking should not be considered a risk factor associated with endodontic failure.

Metalloproteinase-inhibiting agents, such as chitosan, can prevent collagen degradation in demineralized dental substrates, thereby improving the adhesive interface. This study evaluated the bond strength (BS) and chemical and morphological characterization of the adhesive interface after applying chitosan solution to demineralized dentin.

The 80 third molars were selected. Forty teeth underwent caries induction using the pH cycling method. The teeth were divided according to the treatment: distilled water (control) and 2.5% chitosan solution. The surfaces were restored using adhesive and composite resins. Half of the specimens in each group were aged, and the other half underwent immediate analyses. The teeth were sectioned and underwent the microtensile bond strength test (µTBS), and chemical and morphological analyses using energy-dispersive spectroscopy and scanning electron microscopy, respectively. Data analysis was performed using 3-way analysis of variance.

For µTBS, sound dentin was superior to demineralized dentin (p < 0.001), chitosan-treated specimens had higher bond strength than the untreated ones (p < 0.001), and those that underwent immediate analysis had higher values than the aged specimens (p = 0.019). No significant differences were observed in the chemical or morphological compositions.

Chitosan treatment improved bond strength both immediately and after aging, even in demineralized dentin.

This study aimed to investigate the anti-erosive/abrasive effect of resin infiltration of previous deproteinized dentin.

Dentin slabs were randomly assigned to 3 groups (n = 15): Control (no deproteinization; no resin infiltrant applied), RI (no deproteinization; resin infiltrant applied), and DRI (deproteinization; resin infiltrant applied). After undergoing the assigned treatment, all slabs were subjected to an in vitro cycling model for 5 days. The specimens were immersed in citric acid (0.05 M, pH = 3.75; 60 seconds; 3 times/day) and brushed (150 strokes). Between the challenges, the specimens were exposed to a remineralizing solution (60 minutes). The morphological alterations were analyzed by mechanical profilometry (µm) and scanning electron microscopy (SEM). Data were submitted to one-way analysis of variance (ANOVA) and Tukey tests (p < 0.05).

Control and RI groups presented mineral wear and did not significantly differ from each other (p = 0.063). DRI maintained a protective layer preserving the dentin (p < 0.001). After erosive/abrasive cycles, it was observed that in group RI, only 25% of the slabs partially evidenced the presence of the infiltrating, while, in the DRI group, 80% of the slabs presented the treated surface entirely covered by a resin-component layer protecting the dentin surface as observed in SEM images.

The removal of the organic content allows the resin infiltrant to efficiently protect the dentin surface against erosive/abrasive lesions.

This study aimed to evaluate the effectiveness of final irrigation with cold saline solution after endodontic treatment compared with saline solution at room temperature against postoperative pain following endodontic treatment.

A broad search was performed in the PubMed, Web of Science, Scopus, Cochrane Library, Virtual Health Library (LILACS), and Grey Literature databases. Two independent reviewers performed data extraction, risk of bias using the Cochrane methodology, and certainty of evidence using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach.

Eight studies were included in qualitative synthesis. Intracanal cryotherapy favored the reduction of postoperative pain in the systematic review. Four studies were included in meta-analyses. The meta-analysis showed that intracanal cryotherapy reduced postoperative pain in teeth with symptomatic apical periodontitis (SAP) at 24 hours. There was no association between intracanal cryotherapy and control (room temperature) groups in teeth with normal periapical tissue with respect to postoperative pain at 24 hours and 48 hours.

Intracanal cryotherapy was effective in reducing postoperative pain after endodontic treatment in teeth with SAP.

This study aimed to evaluate in vitro the effects of the self-adhesive resin cements RelyX U200 (3M ESPE) and seT PP (SDI Limited) on murine macrophages and the interference of the photoactivation.

Cell viability assays, cell adherence, yeast phagocytosis of Saccharomyces boulardii and production of reactive oxygen species (ROS) were performed in the presence of capillaries containing the respective self-adhesive cement when photoactivated or not.

After long periods of contact, both types of cements, when not photoactivated, are more cytotoxic for macrophages. The seT PP cement when only chemically activated seems to interfere more negatively in the process of phagocytosis of yeasts S. boulardii. Both types of cements interfere in the cell adhesion process, independent of photoactivation. None of the types of cements tested was able to induce the production of ROS.

Our results highlight the great importance of the photoactivation of self-adhesive resin cements in the dental clinic, since RelyX U200, when photoactivated, presented the best results within the evaluated parameters.

This study aimed to evaluate the influence of inorganic composition and filler particle morphology on the mechanical properties of different self-adhesive resin cements (SARCs).

Three SARCs including RelyX Unicem-2 (RUN), Maxcem Elite (MAX), and Calibra Universal (CAL) were tested. Rectangular bar-shaped specimens were prepared for flexural strength (FS) and flexural modulus (FM) and determined by a 3-point bending test. The Knoop microhardness (KHN) and top/bottom microhardness ratio (%KHN) were conducted on the top and bottom faces of disc-shaped samples. Sorption (Wsp) and solubility (Wsl) were evaluated after 24 hours of water immersion. Filler morphology was analyzed by scanning electron microscopy and X-ray energy dispersive spectroscopy (EDS). FS, FM, %KHN, Wsp, Wsl, and EDS results were submitted to 1-way analysis of variance and Tukey’s post-hoc test, and KHN also to paired t-test (α = 0.05).

SARC-CAL presented the highest FS value, and SARC-RUN presented the highest FM. SARC-MAX and RUN showed the lowest Wsp and Wsl values. KHN values decreased from top to bottom and the SARCs did not differ statistically. Also, all resin cements presented carbon, aluminum, and silica in their composition. SARC-MAX and RUN showed irregular and splintered particles while CAL presented small and regular size particles.

A higher mechanical strength can be achieved by a reduced spread in grit size and the filler morphology can influence the KHN, as well as photoinitiators in the composition. Wsp and Wsl can be correlated with ions diffusion of inorganic particles.

This study aimed to analyze the proximity of maxillary molar roots to their overlying cortical bone surfaces and the maxillary sinus.

Cone-beam computed tomographic images of 151 patients with completely erupted upper molars that had 3 separate roots were studied. The following distances were measured: from the root apex to the cortical plate and maxillary sinus floor, and from the apical 3-mm level of the root to the cortical plate. Differences between groups were analyzed with 1-way analysis of variance and the Scheffé post hoc test, the significance of differences between cone-beam computed tomography views with the paired t-test, and the significance of differences among age groups with linear regression analysis. The significance level was set at p < 0.05.

The mesiobuccal and distobuccal root apexes of maxillary second molars were more distant from the buccal cortical plate than the maxillary first molars (p < 0.05). The apical 3-mm level of the mesiobuccal root of the first molar was closer to the buccal cortical bone than the second molar (p < 0.05). In the maxillary first molars, the thickness of the buccal cortical bone decreased in all roots with age (p < 0.05). In all root apexes of both molars, the difference in the vertical level between the maxillary sinus floor and the root apex increased with age (p < 0.05).

Awareness of the anatomical profile of maxillary molar apices in relation to the cortical bones and maxillary sinus will be beneficial for apical surgery.

This study aimed to evaluate the success rate of endodontic treatments performed by undergraduate students and the factors associated with the outcome.

A follow-up of 3 to 8 years after root canal filling was carried out in 91 patients. At the follow-up visits, medical and dental history questionnaires were applied along with clinical and radiographic examinations. Data collected in the clinical exam included: the presence of pain, swelling, sinus tract, mobility, tenderness to palpation and percussion, periodontal probing profile, and type/quality of coronal restoration. Postoperative and follow-up radiographs were digitalized and analyzed by 2 trained and calibrated examiners to assess periapical healing. The treatment outcome was based on strict clinical and radiographic criteria and classified as success (absence of any clinical and radiographic sign of apical periodontitis) or failure (other combination). Logistic regression was used to investigate the impact of clinical and radiographic variables on endodontic treatment outcomes at a 5% significance level.

The success rate of endodontic treatments was 60.7%. The only risk factor significantly associated with failure was the presence of a periapical lesion on the postoperative radiograph (odds ratio, 3.35; 95% confidence interval, 1.17–9.54).

The success rate of endodontic treatments performed by undergraduate students was low and was jeopardized by the presence of a periapical lesion on the postoperative radiograph.