The present study investigated the prevalence of mechanical allodynia (MA) in healthy teeth adjacent and contralateral to endodontically diseased teeth.

This cross-sectional study included 114 patients with symptomatic irreversible pulpitis and apical periodontitis in permanent mandibular first molars who possessed healthy teeth adjacent and contralateral to the endodontically diseased tooth. The mechanical sensitivity of the teeth was determined by percussion testing. The presence or absence of pain on percussion in the teeth adjacent and contralateral to the endodontically diseased tooth and the tooth distal to the contralateral symmetrical tooth was recorded according to coding criteria. The prevalence of MA was computed as a percentage, and binary logistic regression analysis was done. The Fisher exact test and Mann-Whitney U test were used for binary and ordinal data.

Age and sex did not influence the prevalence of MA. An increased prevalence of MA was found in patients with higher levels of spontaneous pain (p < 0.001). The prevalence of allodynia was 57% in teeth adjacent to endodontically diseased teeth and 10.5% in teeth contralateral to endodontically diseased teeth. In addition, on the ipsilateral side, there were more painful sensations distal to the diseased tooth than mesially.

Despite being disease-free, teeth adjacent and contralateral to endodontically diseased teeth exhibited pain on percussion. There was a direct association between the severity of the patient’s pain and the presence of MA.

This study aimed to evaluate the clinical performance of an alkasite restorative material in molars that had undergone root canal treatment.

The research was registered in Brazilian Registry of Clinical Trials. The randomized clinical trial involved 33 patients, each with at least 1 mandibular molar requiring restoration after receiving endodontic treatment. Patients were randomly assigned to receive either bulk-fill resin composite (Tetric N Ceram Bulk Fill, Ivoclar Vivadent) or the alkasite restorative material (Cention N, Ivoclar Vivadent). Upon completion of the restorations, 3 calibrated professionals utilized the United States Public Health Service criteria to assess various factors, including retention, secondary caries, marginal adaptation, restoration color, marginal pigmentation, and anatomical form. Evaluations were conducted at intervals of 7 days, 6 months, and 17 months. Additionally, the assessment encompassed the presence of radiolucent lines adjacent to the restoration, material deficiencies or excess, contact points, and caries recurrence. The data underwent analysis using the Friedman and Mann-Whitney tests (α = 0.05).

After 17 months, the results revealed that the alkasite restorative material exhibited greater wear of anatomical shape compared to the bulk-fill resin composite (p = 0.0189). Furthermore, the alkasite restorative material significantly differed from the natural tooth color in most cases (p = 0.0000). However, no other criteria displayed significant differences between the materials or over time (p > 0.05).

The alkasite restorative material (Cention N) emerges as a viable option for restoring endodontically treated teeth, displaying clinically acceptable alterations after a 17-month evaluation period.

Brazilian Registry of Clinical Trials (ReBEC) Identifier: RBR-97kx5jv

PROSPERO Identifier: CRD42023426021

Previous in vitro studies determined the whitening effects of bleaching products on stained resin composite surfaces. This in vitro study aimed to verify the effectiveness of a whitening system on composite resin previously subjected to pigmentation, specifically examining the depth of whitening effectiveness within the material structure.

A commercially available nano-filled composite resin was used. Specimens were stained using a coffee-based solution and a 10% carbamide peroxide-based gel was employed as the whitening agent. The pigment’s penetration and the effect of the bleaching gel were evaluated by measuring color (CieLab values) from the outer edge to the inner part of the specimens. Color measurements were taken at 14 points, starting from 0.1 mm from the external perimeter up to 3.0 mm.

Analysis of variance tests showed a statistically significant difference between the Control Group (CG), Pigmentation Group, and Whitening Group. The whitening agent was effective up to 1.5 mm in depth, with Whiteness index (W) values not statistically different from those of CG up to 0.5 mm in depth.

Whitening agents on nano-filled resin composite previously pigmented appear effective in restoring the W to values similar to the original, particularly in the superficial layers of the sample.

This study aimed to relate the file fragment length and location in the root canal to the retrieval chances, the clinical time required and the occurrence of secondary fractures.

Sixty clinical cases of fractured instruments were included in this study. They were classified according to the instrument length and the location of the root canal. In each group, the success rate in the instrument retrieval, the clinical time required and the occurrence of secondary fractures were evaluated. The collected data were analyzed using the Kruskal-Wallis test on the basis of a 0.05 significance level.

The fragment length showed no significant influence on the assessed variables (p > 0.05). The root third where the instrument was located resulted in an increased clinical time, with statistically significant differences (p < 0.05). However, the procedure success rate and the occurrence of secondary fractures showed no association with these variables.

In accordance with the findings of this study, the fractured fragment length did not influence any of the variables assessed, but it is suggested to focus on the fragment location inside the root canal to decide the retrieval of a fractured instrument.

The aim of this study was to compare the effects of different polymerization strategies and the effectiveness of finishing and polishing procedures of composite resins on color stability.

The samples were divided into 4 main groups according to the polymerization strategy, and all groups except the control group received surface treatment. Each group was subsequently divided into 3 subgroups respectively: Kuraray Clearfil Majesty ES-2 Classic, Premium and Universal. Approximately 24 hours after preparation of the samples, they were immersed for 7 days in a coffee solution. A first color measurement was performed after the preparation of the samples, the second measurement was performed after 7 days in the coffee solution. All measurements were carried out using a dental spectrophotometer to assess the CIE L* a* b* color parameters.

There was a statistically significant difference between ΔE values for different procedures (p = 0.003); in particular, the differences were found only between the groups that received surface treatment and the control group. In addition, a statistically significant difference was observed between the values of ΔE for different composites in the different procedure groups.

Spectrophotometric analysis showed that the additional photopolymerization and oxygen inhibition procedures did not yield better results in relation to color stability. In addition, finishing and polishing provided better color stability compared to not performing these procedures.

This paper aims to serve as a useful guide for sample size determination for various correlation analyses that are based on effect sizes and confidence interval width.

Sample size determinations are calculated for Pearson’s correlation, Spearman’s rank correlation, and Kendall’s Tau-b correlation. Examples of sample size statements and their justification are also included.

Using the same effect sizes, there are differences between the sample size determination of the 3 statistical tests. Based on an empirical calculation, a minimum sample size of 149 is usually adequate for performing both parametric and non-parametric correlation analysis to determine at least a moderate to an excellent degree of correlation with acceptable confidence interval width.

Determining data assumption(s) is one of the challenges to offering a valid technique to estimate the required sample size for correlation analyses. Sample size tables are provided and these will help researchers to estimate a minimum sample size requirement based on correlation analyses.

This study aimed to evaluate the physical-mechanical, chemical, and biological properties of graphene-reinforced glass ionomer cements (GICs).

Different proportions of graphene powder were incorporated into 2 high-viscosity self-curing GIC, Ketac Molar (G_Ketac) and Fuji IX (G_Fuji), in 4 different concentrations: 0.5%, 1%, 2%, and 5%. The control groups included the GICs without graphene. Experiments were performed to analyze linear (Ra) and volumetric roughness (Sa), antimicrobial activity, radiopacity, fluoride release, microhardness, solubility, and water sorption. Data were analyzed using Kruskal-Wallis, Mann-Whitney, Wilcoxon, analysis of variance, and Tukey’s test (p ≤ 0.05).

The G_Ketac 0% and G_Fuji0% groups presented higher Ra (4.05 and 2.72) and Sa (4.76 and 5.16), respectively. No inhibition zone was observed, and the incorporation of graphene reduced radiopacity. Moreover, there was no influence on the solubility and water sorption after 21 days. A greater fluoride release was observed in the period of 7 days for most of the groups. After 21 days, G_Ketac 5%, 2%, and 1% presented higher releasing than 0% and 0.5% (p ≤ 0.05).

The graphene incorporation improved the microhardness of GICs in lower concentrations. Graphene incorporation to GICs modified some physical-mechanical, and chemical, but not affected biological properties.

The aim of the current study was to evaluate the effect of polishing systems and surface sealant on the color stability and whiteness index of single-shade resin composites after staining and bleaching.

Three single-shade (Omnichroma, Charisma Diamond One, Zenchroma) and one multi-shade (Filtek Z250) materials were tested. From each resin composite, 40 specimens were prepared. The specimens were divided into 4 subgroups (n = 10) according to the surface treatments: 1-step polishing, 1-step + Biscover LV, 2-step polishing, and 2-step polishing + Biscover LV. Color differences (ΔE₀₀) were calculated after being immersed in the coffee solution for 12 days. After the staining, the specimens were immersed in a whitening mouthrinse (Crest-3D White) for 12 hours. Whiteness index differences (∆WI_D = WI_D after staining − WI_D after bleaching) values were recorded. The generalized linear model was used for analysis (p < 0.05).

The lowest and highest ΔE₀₀ values were found for Zenchroma and Charisma Diamond One respectively. Sealed groups indicated higher ΔE₀₀ values than nonsealed groups with significant differences (p = 0.008). The lowest and highest ΔWI_D values were found for Zenchroma and Charisma Diamond One respectively. Sealed groups indicated lower ΔWI_D values than nonsealed groups with significant differences (p = 0.022).

The use of surface sealant increased the discoloration and showed less whiteness change in resin materials. When the 1-step was compared with the 2-step polishing, the effects on the color stability and whiteness index values of the resin materials were similar.

This study aimed to develop whitening mouth rinses formulated with industrial mushrooms and compare them with over-the-counter whitening mouth rinses.

Formulations with black shimeji mushrooms, mushroom substrates, and mushroom stalks were developed. Bovine enamel/dentin samples were divided into 7 groups (n = 10): Colgate Luminous White, Listerine Whitening Extreme (LWE), Listerine Cool Mint (LC), mushroom extract rinse (MEC), mushroom substrate rinse (MSB), mushroom stalk rinse (MTC), and artificial saliva. Samples were stained with black tea for 6 days, and then were immersed in 100 mL of each mouth rinse twice daily for 14 days. Color parameters (CIELAB [ΔE*], CIEDE2000 [ΔE₀₀], whiteness index for dentistry [ΔWI_D]) and microhardness (Knoop hardness number [KHN]) were analyzed at T₁ (initial), T₂ (24 hours), and T₃ (7 days). Mouth rinse pH was measured, and enamel was examined using a scanning electron microscope. Data were analyzed using generalized linear models, and KHN with the generalized linear mixed model for repeated measures (p ≤ 0.05).

ΔE* was higher in LW and MSB groups. No significant differences were found for ΔE₀₀ (p = 0.0982) and ΔWI_D (p = 0.2536). Experimental mouth rinses did not promote enamel whitening based on ΔE₀₀ and ΔWI_D. LWE and LC reduced KHN and had a more acidic pH, while MEC had higher KHN at T2. MEC, MSB, and MTC had alkaline pH, not altering the tooth surface.

Black shimeji mushrooms are promising for mouth rinse development due to their alkaline pH and non-altering effect on surface microhardness.

This study aimed to comparatively assess the histological response of the pulp toward alendronate and Biodentine in a direct pulp capping procedure.

Twenty-four anterior teeth from 6 New Zealand rabbits were used in this study. Firstly, all rabbits were anesthetized according to their weight. Class V cavities were prepared on the buccal surfaces of anterior teeth. A pin-point exposure of the pulp was then made using a small, sterile round carbide bur and bleeding was arrested with a saline-soaked, sterile cotton pellet. The teeth under study were divided into 2 groups (n = 12). The intentionally exposed pulp was capped with alendronate (Group 1) and Biodentine (Group 2), correspondingly. After 30 days, all rabbits were euthanized; the teeth under study were extracted and taken up for histological analysis.

Biodentine showed an intact, very dense dentin bridge formation with a uniform odontoblast (OD) layer pattern and mild or absent inflammatory response whereas specimens capped with alendronate demonstrated a dense dentin bridge formation with non-uniform OD layer pattern and mild to moderate inflammatory response.

Biodentine showed more biocompatibility than alendronate. However, alendronate can initiate reparative dentin formation and may be used as an alternative pulp capping agent.

This study aimed to evaluate the color stability and solubility of Biodentine and NeoPutty in contact with different irrigation solutions.

Biodentine and NeoPutty were set in cylindrical molds with 7 mm diameter and 1.5 mm high and immersed in distilled water, 17% ethylenediaminetetraacetic acid (EDTA), 2% chlorhexidine (CHX), 9% 1-hydroxyethylidene 1,1-diphosphonate (HEDP), and 5% sodium hypochlorite (NaOCl) solutions for 24 hours. The color change was measured with a spectrophotometer. The solubility values were calculated as the mass loss was expressed as a percentage of the original mass using an analytical balance with 10⁻⁴ g accuracy. Data were analyzed with Kruskal-Wallis followed by Mann-Whitney U tests, and 2-way analysis of variance test followed by Bonferroni corrections for pairwise comparisons for solubility and color stability with a 5% significance threshold, respectively.

Biodentine exhibited higher color changes compared to the NeoPutty contact with all solutions except distilled water (p < 0.05). Both hydraulic cements (HCs) showed higher discoloration values immersion in CHX followed by NaOCl. No statistically significant difference was found between Biodentine and NeoPutty regardless of irrigation solution in terms of solubility (p > 0.05). Solubility values were lower in the distilled water group compared to EDTA and CHX (p < 0.05).

Tested HCs showed solubility and color changes at various rates. NeoPutty could be an appropriate material in aesthetic areas. The usage of HEDP as an irrigant solution can be considered suitable for various endodontic treatments due to its relatively lower solubility and discoloration values.

This scientometric and bibliometric analysis explored scientific publications related to hydraulic calcium silicate-based (HCSB) sealers used in endodontology, aiming to describe basic bibliometric indicators and analyze current research trends.

A comprehensive search was conducted in Web of Science and Scopus using specific HCSB sealer and general endodontic-related terms. Basic research parameters were collected, including publication year, authorship, countries, institutions, journals, level of evidence, study design and topic of interest, title terms, author keywords, citation counts, and density.

In total, 498 articles published in 136 journals were retrieved for the period 2008–2023. Brazil was the leading country, and the universities of Bologna in Italy and Sao Paolo in Brazil were represented equally as leading institutions. The most frequently occurring keywords were “calcium silicate,” “root canal sealer MTA-Fillapex,” and “biocompatibility,” while title terms such as “calcium,” “sealers,” “root,” “canal,” “silicate based,” and “endodontic” occurred most often. According to the thematic map analysis, “solubility” appeared as a basic theme of concentrated research interest, and “single-cone technique” was identified as an emerging, inadequately developed theme. The co-occurrence analysis revealed 4 major clusters centered on sealers’ biological and physicochemical properties, obturation techniques, retreatability, and adhesion.

This analysis presents bibliographic features and outlines changing trends in HCSB sealer research. The research output is dominated by basic science articles scrutinizing the biological and specific physicochemical properties of commonly used HCSB sealers. Future research needs to be guided by studies with a high level of evidence that utilize innovative, sophisticated technologies.

This study evaluated the effect of ProTaper Next (PTN), ProTaper Universal Retreatment (PTR) and hybrid instrumentation (HI) for canal filling removal on the fracture resistance (FR), mode of failure (MoF), and filling removal time.

Ninety-six, mandibular premolars were decoronated and randomly divided into 6 groups (n = 16), as follows: sound (S), untreated canals; prepared teeth (P), canals only prepared to ProTaper Universal finishing instrument (F4); endodontically-treated (ET), prepared and obturated canals using the single-cone technique; and groups PTN, PTR, and HI where filling was removed using PTN, PTR, or HI respectively. FR under vertical loading; MoF and time were assessed. Data were analyzed (Significance level [α] = 0.05).

There was a significant difference in FR among all groups (p < 0.001) (HI < P < PTN < S < ET < PTR). HI showed lower FR than S, ET and PTR, and P showed lower FR than PTR (p < 0.05). For experimental groups, there was a significant difference between every group pair (p < 0.05) No significant difference was found regarding MoF distribution (p > 0.05). HI required the highest filling removal time, while PTR required the least (p < 0.05 between every group pair).

The effect of filling removal on FR may depend on the filling removal technique/system used. PTR could be faster and protect against fracture followed by PTN; HI could adversely affect FR. FR may be associated with filling removal time.

This study was conducted to evaluate the mechanical properties of relined and non-relined fiberglass posts when cemented to root canal dentin using a conventional dual-cure resin cement or a self-adhesive resin cement.

Two types of resin cements were utilized: conventional and self-adhesive. Additionally, 2 cementation protocols were employed, involving relined and non-relined fiberglass posts. In total, 72 bovine incisors were cemented and subjected to push-out bond strength testing (n = 10) followed by failure mode analysis. The cross-sectional microhardness (n = 5) was assessed along the root canal, and interface analyses (n = 3) were conducted using scanning electron microscopy (SEM). Data from the push-out bond strength and cross-sectional microhardness tests were analyzed via 3-way analysis of variance and the Bonferroni post-hoc test (α = 0.05).

For non-relined fiberglass posts, conventional resin cement exhibited higher push-out bond strength than self-adhesive cement. Relined fiberglass posts yielded comparable results between the resin cements. Type II failure was the most common failure mode for both resin cements, regardless of cementation protocol. The use of relined fiberglass posts improved the cross-sectional microhardness values for both cements. SEM images revealed voids and bubbles in the incisors with non-relined fiberglass posts.

Mechanical properties were impacted by the cementation protocol. Relined fiberglass posts presented the highest push-out bond strength and cross-sectional microhardness values, regardless of the resin cement used (conventional dual-cure or self-adhesive). Conversely, for non-relined fiberglass posts, the conventional dual-cure resin cement yielded superior results to the self-adhesive resin cement.

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

The purpose of this study was to evaluate the effect of Dental Practicality Index (DPI) training using an online video on the treatment planning decisions and confidence level of dental undergraduates (DUs).

Ninety-four DUs were shown 15 clinical case scenarios and asked to decide on treatment plans based on 4 treatment options. The most appropriate treatment plan had been decided by a consensus panel of experienced dentists. DUs then underwent DPI training using an online video. In a post-DPI-training test, DUs were shown the same clinical case scenarios and asked to assign the best treatment option. After 6 weeks, DUs were retested to assess their knowledge retention. In all 3 tests, DUs completed the confidence level scale questionnaire. Data were analyzed using the related-samples Wilcoxon signed rank test and the independent-samples Mann-Whitney U test with the level of significance set at p < 0.05.

DPI training significantly improved the mean scores of the DUs from 7.53 in the pre-DPI-training test to 9.01 in the post-DPI-training test (p < 0.001). After 6 weeks, the mean scores decreased marginally to 8.87 in the retention test (p = 0.563). DPI training increased their confidence level from 5.68 pre-DPI training to 7.09 post-DPI training.

Training DUs using DPI with an online video improved their decision-making and confidence level in treatment planning.

This study evaluated the bleaching efficacy of different in-office protocols associated with violet light emitting diode (V-LED), and measured the pulpal temperature rise caused by V-LED with or without gel application.

Bovine incisors were distributed in 4 groups (n = 10): VL – V-LED; HP – 35% hydrogen peroxide (control); HYB – hybrid protocol, V-LED applied without gel for 10 irradiation cycles followed by V-LED applied with gel for another 10 irradiation cycles; and HPVL – gel and V-LED applied for 20 irradiation cycles. Three bleaching sessions were performed with 7-day intervals. Bleaching efficacy was evaluated with ΔEab*, ΔE₀₀ and ΔWI_D. Data were recorded at baseline, 7, 14, 21 and 70 days. For pulpal temperature rise, thermocouples were placed inside the pulp chamber of human incisors. To determine intrapulpal temperature, the teeth were irradiated with V-LED with or without application of bleaching gel. Color difference data were analyzed by 2-way repeated measures ANOVA and Tukey’s test. Pulpal temperature was analyzed by t-test (α = 5%).

VL exhibited lower color (ΔEab* and ΔE₀₀) and whiteness changes (ΔWI_D) than the other groups. HPVL presented higher color change values than HYB. HYB and HPVL showed not different ΔWI_D values; and HP showed the highest whiteness changes at all times. There were significant differences comparing ΔT with gel (8.9°C) and without gel application (7.2°C).

HPLV was more efficient than HYB. The 2 protocols with VL showed similar results to control. Gel application combined with VL promoted higher pulpal temperature than to the no gel group.

This study aimed to investigate the frequency and type of endodontic procedural errors in cases indicated for retreatment through cone-beam computed tomography (CBCT) analysis.

The sample consisted of 96 CBCT scans, encompassing 122 permanent teeth with fully formed roots. Errors included perforation, instrument fracture, canal transportation, missed canals, and inadequate apical limit of filling. Additionally, potential risk factors were analyzed and subjected to statistical modeling.

The most frequent procedural error observed was the inadequate apical limit of filling, followed by canal transportation, perforation, missed canal, and instrument fracture. Statistically significant associations were identified between various procedural errors and specific factors. These include canal transportation and root canal wall, with the buccal wall being the most commonly affected; missed canal and tooth type, particularly the palatine and second mesiobuccal canal canals; inadequate apical limit of filling and root curvature, showing a higher deviation to the mesial direction in severely curved canals; inadequate apical limit of filling and the presence of calcifications, with underfilling being the most frequent; canal transportation and periapical lesion, notably with deviation to the buccal direction; and the direction of perforation and periapical lesion, most frequently occurring to buccal direction.

CBCT emerges as a valuable tool in identifying procedural errors and associated factors, crucial for their prevention and management.