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 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.

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 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 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

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 evaluated the effect of serum calcium, parathyroid hormone (PTH), vitamin D, and uric acid levels on pulp stone formation.

Patients who were admitted to the Muğla Sıtkı Koçman University, Faculty of Dentistry, Department of Oral and Maxillofacial Radiology for dental complaints were registered. Among these patients, individuals who had routine biochemical tests at the same period in the Outpatient Clinics of Muğla Sıtkı Koçman University Training and Research Hospital were included in the study. The patients with at least 1 pulp stone on panoramic radiographs recorded as the “pulp stone group” while patients without any pulp stones were the “control group”. Demographic data and serum levels of calcium, PTH, vitamin D, and uric acid were retrospectively evaluated in both groups. Student t-test or Mann-Whitney U test was used to evaluate the differences between the groups.

Among 151 patients, dental pulp stone was detected in 53.6% of patients, and 82.7% of these patients were female. Female sex and pulp stone formation were significantly associated (p = 0.001). The mean age of the pulp stone group was 43.9, while it was 39.9 in the control group, without any significant correlation between age and pulp stone (p > 0.05). Similarly, there were no significant differences in serum levels of PTH, vitamin D, uric acid and calcium between groups (p > 0.05).

According to the present study, the effect of dental factors rather than systemic factors should be considered primarily in pulp stone formation.

This study aimed to evaluate the impact of substrate color and interface distance on the color adjustment of 2 single-shade composites, Vittra APS Unique and Charisma Diamond One.

Dual disc-shaped specimens were created using Vittra APS Unique or Charisma Diamond One as the center composite, surrounded by shaded composites (A1 or A3). Color measurements were taken with a spectrophotometer against a gray background, recording the color coordinates in the CIELAB color space. Illumination with a light-correcting device and image acquisition using a polarizing filter-equipped cell phone were performed on specimens over the same background. Image processing software was used to measure the color coordinates in the center and periphery of the inner composite and in the outer composite. The color data were then converted to CIELAB coordinates and adjusted using data from the spectrophotometer. Color differences (ΔE₀₀) between the center/periphery of single-shade and outer composites were calculated, along with color changes in single-shade composites caused by different outer composites. Color differences for the inner composites surrounded by A1 and A3 were also calculated. Data were analyzed using repeated-measures analysis of variance (α = 0.05).

The results showed that color discrepancies were lowest near the interface and when the outer composite was whiter (A1). Additionally, Charisma Diamond One exhibited better color adjustment ability than Vittra APS Unique.

Color discrepancies between the investigated single-shade composites diminished towards the interface with the surrounding composite, particularly when the latter exhibited a lighter shade.

This study aimed to present the results and analyses of clinical trials, including updates on the different functions of root canal sealers.

In June 2023, we performed a comprehensive search of ClinicalTrials.gov to identify interventional clinical trials pertaining to root canal sealers. In total, 23 clinical trials conducted up to June 2023 were included in this study.

Approximately half of the trials (11 out of 23) were completed, while none were terminated or withdrawn. Each included trial had a minimum of 10 participants, with 11 trials having more than 100 participants. None of the assessed trials provided outcomes, and the majority (17 out of 23) lacked associated publications. In terms of geographic distribution, the USA and Canada did not contribute to any root canal sealer trials.

This study highlights the lack of diversity in trial locations, the absence of reported results, and a scarcity of clinical trials examining the physicochemical properties of different sealers. Most published trials primarily focused on assessing the post-operative pain effect of these sealers, but no significant difference was found regarding post-operative pain control.

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.

The aim of this study was to examine the use of hand or rotary files by pre-graduation (fourth- and fifth-year) and postgraduate students in endodontic treatments and to determine the incidence of file fracture and the management of cases with broken instruments.

A total of 2,168 teeth undergoing primary endodontic treatment were included in this study. It was determined that 79 of these teeth resulted in broken tools. In the case of broken tools, the education level of the treating clinician, the tooth that was being treated, the canal and fracture level, the curvature of the tooth and the management of the broken instrument were recorded. Periapical radiographs of the patients were used to calculate curvature following the Schneider method.

There was no significant difference in the incidence of broken tools according to education level (p > 0.05). The incidence of file fracture in molar teeth (73.4%) was higher than in other teeth (p < 0.05). More files were broken in the mandibular molar MB canal (20.25%) and in the apical third of the canals (72.1%). The risk of instrument fracture was high in teeth with moderate (44.3%) and severe (38%) curvature canals. The management of apically broken (80%) files mostly involved lefting (p < 0.05).

There was no statistically significant difference between fourth-year students, fifth-year students and postgraduate students in terms of instrument fracture.

This study tested the hypothesis that cryotherapy duration influences lipopolysaccharide (LPS)-induced inflammation in a rat model.

Six Wistar rats (Rattus norvegicus albinus) were used. Five sites were selected per animal and divided into 5 groups: a negative control group (NC), 2 positive control groups (PC1 and PC2), and 2 experimental groups (E1 and E2). Cryotherapy was applied for 1 minute (E1) or 5 minutes (E2). An acute inflammatory response was induced in the PC and E groups via subcutaneous administration of 0.5 mL/kg. In the PC2 group, a catheter was inserted without additional treatment. For the E1 and E2 groups, 2.5°C saline solution was administered through the implanted catheters for 1 and 5 minutes, respectively. The rats were sacrificed, and samples were obtained and processed for histological analysis, specifically examining the presence of polymorphonuclear neutrophils and hemorrhage. The χ² test was used to compare the presence of acute inflammation across groups. Dependent variables were compared using the linear-by-linear association test.

Inflammation and hemorrhage varied significantly among the groups (p = 0.001). A significantly higher degree of acute inflammation was detected (p = 0.0002) in the PC and E1 samples than in the E2 group, in which cryotherapy was administered for 5 minutes. The PC and E1 groups also exhibited significantly greater numbers of neutrophils (p = 0.007), which were essentially absent in both the NC and E2 groups.

Cryotherapy administration for 5 minutes reduced the acute inflammation associated with LPS and catheter implantation.

This study was conducted to evaluate and compare the tip and taper compatibility of accessory gutta-percha points (AGPs) with various rotary and reciprocating instruments.

Using a profile analyzer, tip and taper measurements were taken of 10 AGPs of each of the 14 models available from Odous de Deus and the 4 models available from Dentsply-Maillefer. Diameter measurements were taken at 1-mm intervals, from 3 mm from the tip (D3) to 16 mm.

Based on the mean values obtained, 3-dimensional (3D) models of the AGPs were drawn in Autodesk Fusion 360 and superimposed on 3D models of each instrument selected (Mtwo, Reciproc, RaCe, K3, and ProDesign Logic) to determine the compatibility between the instrument and the AGP. Data corresponding to the tips and tapers of the various AGPs, as well as the tip and taper differences between the AGPs and the instruments, were analyzed using descriptive statistics. The tapers of the AGPs were subject to the American National Standards Institute/American Dental Association No. 57 standard. The Odous de Deus extra-long medium and extra-long extra-medium AGPs were shown to be compatible with Mtwo, K3, and ProDesign Logic instruments with taper 0.06 and tip sizes 25 and 30, while the Dentsply fine and fine medium cones were compatible with Mtwo, RaCe, and K3 instruments with conicity of 0.04 and tip sizes 35 and 40.

Both the Odous de Deus and Dentsply commercial brands included 2 AGP models with tip (D3) and taper compatibility with Mtwo, RaCe, K3, and/or Prodesign Logic instruments.

The aim of the study was to evaluate the clinical and radiographic success of the Hall technique (HT) and atraumatic restorative treatment (ART) restorations using high-viscosity glass-ionomer cement for the management of occlusal carious lesions in primary molars.

This randomized clinical study observed 40 children (aged 5–6 years). For each child, one tooth was treated with HT and one with ART. The primary outcome measures for HT restorations were successful, minor, and major failure rates. Clinical evaluations of ART restorations were performed according to the modified United States Public Health Service criteria during 18-month follow-up. McNemar test was used for statistical analysis.

Thirty of 40 (75%) participants returned for 18 months of follow-up. In the clinical evaluations of teeth that were treated with HT, the patients did not have complaints of pain or other symptoms, all crowns remained in the oral cavity, the gums were healthy, and the teeth were functional in all evaluations. At the end of the 18-month follow-up, the surface texture and marginal integrity criteria of ART restorations were recorded as 26.7% and 33.3%, respectively. In the radiographic evaluation of 30 patients treated with ART and HT, all restorations were considered successful.

The 18-month clinical and radiographic results after treatments applied to single-surface cavities in anxious children showed that both treatment methods were successful.

This study aimed to evaluate the surrounding and underlying shades’ effect on the color adjustment potential (CAP) of a single-shade composite used in a thin layer.

Cylinder specimens (1.0 mm thick) were built with the Vittra APS Unique composite, surrounded (dual specimens) or not (simple specimens) by a control composite (shade A1, A2, or A3). Simple specimens were also built only with the control composites. Each specimen’s color was measured against white and black backgrounds or the simple control specimens with a spectrophotometer (CIELAB system). The whiteness index for dentistry (WI_D) and translucency parameters (TP₀₀) were calculated for simple specimens. Differences (ΔE₀₀) in color between the simple/dual specimens and the controls were calculated. The CAP was calculated based on the ratios between data from simple and dual specimens.

The Vittra APS Unique composite showed higher WI_D and TP₀₀ values than the controls. The highest values of ΔE₀₀ were observed among simple specimens. The color measurements of Vittra APS Unique (simple or dual) against the control specimens presented the lowest color differences. Only surrounding the single-shade composite with a shaded composite barely impacted the ΔE₀₀. The highest CAP values were obtained using a shaded composite under simple or dual specimens.

The CAP of Vittra APS Unique was strongly affected by the underlying shade, while surrounding this composite with a shaded one barely affected its color adjustment.

PROSPERO Identifier: CRD42020215314

This study aimed to assess the impact of a glide-path on the shaping ability of 2 single-file instruments and to compare the centering ability, maintenance of original canal curvatures and area of instrumentation in simulated S-shaped root canals.

Forty simulated S-shaped root canals were used and were prepared with One Curve (group OC), One G and OC (group GOC), Reciproc Blue (group RB) and R-Pilot and RB (group PRB) and scanned before and after instrumentation. The images were analyzed using AutoCAD. After superimposing the samples, 4 levels (D1, D2, D3, and D4) and 2 angles (Δ1 and Δ2) were established to evaluate the centering ability and modification of the canal curvatures. Then, the area of instrumentation (ΔA) was measured. The data were analyzed using 2-way analysis of variance and Tukey's test for multiple comparisons (p < 0.05).

Regarding the centering ability in the apical part (D3, D4), the use of the glide-path yielded better results than the single-file groups. Among the groups at D4, OC showed the worst results (p < 0.05). The OC system removed less material (ΔA) than the RB system, and for Δ1, OC yielded a worse result than RB (p < 0.05).

The glide-path improved the centering ability in the apical part of the simulated S-shaped canals. The RB system showed a better centering ability in the apical part and major respect of the canal curvatures compared with OC system.

This study evaluated the dentinal penetration depth of 2.5% sodium hypochlorite (NaOCl) in root canals with and without preparation and different irrigant activation protocols.

Sixty-three bovine mandibular incisors were randomly allocated to 6 groups (n = 10): G1, preparation + conventional needle irrigation (CNI); G2, preparation + passive ultrasonic irrigation (PUI); G3, preparation + Odous Clean (OC); G4, no preparation + CNI; G5, no preparation + PUI; G6, no preparation + OC; and CG (negative control; n = 3). Samples were filled with crystal violet for 72 hours. Irrigant activation was performed. Samples were sectioned perpendicularly along the long axis, 3 mm and 7 mm from the apex. Images of the root thirds of each block were captured with a stereomicroscope and analyzed with an image analysis software. One-way analysis of variance, followed by the Tukey post hoc test, and the Student’s t-test were used for data analysis, with a significance level of 5%.

The NaOCl penetration depth was similar when preparation was performed, regardless of the method of irrigation activation (p > 0.05). In the groups without preparation, G6 showed greater NaOCl penetration depth (p < 0.05). The groups without preparation had a greater NaOCl penetration depth than those with preparation (p = 0.0019).

The NaOCl penetration depth was similar in groups with root canal preparation. Without root canal preparation, OC allowed deeper NaOCl penetration. The groups without preparation had greater NaOCl penetration than those undergoing root canal preparation.

This study compared the clinical and radiological outcomes of regenerative endodontic procedures (REPs) using blood clots (BCs), platelet-rich plasma (PRP), and platelet-rich fibrin (PRF) through intraoral periapical radiography (IOPAR) and cone-beam computed tomography (CBCT).

Forty-five single-rooted necrotic teeth with periapical pathology were randomly allocated to receive BC, PRP, or PRF as an individual scaffold. Outcomes were evaluated in 35 teeth in 23 patients with a follow-up period of 12–24 months through qualitative IOPAR scoring and quantitative CBCT measurements. Healing of periapical lesions and in immature teeth, changes in the apical foramen diameter (AFD), root wall thickness (RWT), and root length (RL) were assessed. A p value less than 0.05 was considered to indicate statistical significance.

All teeth were asymptomatic except 1 in the PRP group. Periapical lesion healing was seen in all except 2 teeth in the BC group and 3 in the PRP group. Both IOPAR and CBCT revealed no significant differences in bone healing or changes in AFD, RWT, and RL among the 3 groups. A positive pulp sensibility response to the cold test was seen in 2 teeth in the BC group, but none to the electric pulp test. Intracanal calcification (ICC) was evident in more teeth in the BC group than in the PRP and PRF groups, and was also significantly higher in immature teeth.

Our results revealed that BC, PRP, and PRF have similar potential as scaffolds in REPs, and ICC may be a concern for long-term outcomes.

This study aimed to investigate the influence of different obturation techniques compared to cold lateral compaction on the success rate of primary non-surgical endodontic treatments.

Systematic searches were performed for studies published up to May 17^th, 2022 in MEDLINE/PubMed, Cochrane Library, Web of Science, Scopus, EMBASE, and Grey Literature Reports. Randomized clinical trials and nonrandomized (nonrandomized clinical trials, prospective or retrospective) studies that evaluated the success rate of primary non-surgical endodontic treatments obturated with the cold lateral compaction (control) and other obturation techniques were included. The revised Cochrane risk of bias tools for randomized trials (RoB 2) and nonrandomized studies of interventions (ROBINS-I) were used to evaluate the risk of bias. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool was used to evaluate the certainty of evidence.

Eleven studies (4 randomized clinical trials (RCTs), 4 prospective, and 3 retrospectives) were included. Two RCTs were classified as having some concerns risk of bias and 2 as a low risk of bias. Two nonrandomized studies were classified as having a critical risk of bias and 5 as having a moderate risk of bias. The GRADE analysis demonstrated a very low to moderate certainty of evidence.

This systematic review generally evidenced no differences in the success rate of primary non-surgical endodontic treatments when the cold lateral compaction technique and other obturation techniques are performed. Further well-designed studies are still necessary.