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 investigate the endodontic characteristics of mandibular premolars with dens evaginatus (DE) that require endodontic treatment.

Patients who underwent endodontic treatment were enrolled. The inclusion criteria were patients who underwent root canal treatment in the lower permanent teeth with DE and were followed up for at least 1 year. Preoperative clinical and radiographic variables were obtained. The frequency distribution of the preoperative variables was compared using the χ² or Fisher’s exact tests. The significance of the change in periapical health index (PAI) and root development stages before and after treatment was examined using the Wilcoxon signed-rank test.

A total of 150 teeth of 134 patients with an average age of 15.3 years were included. The percentage distribution comparison of the preoperative variables and obturation techniques revealed significant differences in pulpal and periapical diagnosis, and percussion, and especially regarding age, root development stage, and PAI. Age was the only statistically significant preoperative variable associated with root growth (p < 0.05).

Approximately, 60% of DEs requiring endodontic treatment had immature roots. Age being the most significant predisposing factor, early treatment provides the greatest opportunity for full root development.

This systematic review addressed the question: “What is the prevalence of apical periodontitis in patients prior to hematopoietic cell transplantation?”

A systematic search was conducted in MEDLINE/PubMed, Cochrane Library, Scopus, Web of Science, Embase, and Grey Literature Report. Eligibility criteria were based on the condition, content, and population strategy: the condition was the radiographic prevalence of apical periodontitis, the content comprised patients scheduled for hematopoietic stem cell transplantation, and the population consisted of adult and pediatric patients. The revised Risk of Bias in Nonrandomized Studies of Exposure tool was used to assess the quality of studies. The Grading Recommendations Assessments, Development, and Evaluation (GRADE) tool was used to assess the quality of evidence.

Eight studies were included in this review. The average number of patients with apical periodontitis was 15.65% (range, 2.1%–43.34%). One study was classified as having a very high risk of bias, 1 with a high risk of bias, and 6 with some concern for bias. GRADE analysis showed a very low certainty of evidence. Significant limitations concerning the absence of control over confounding variables were identified.

With the caveat of the very low quality of evidence in the studies reviewed, there was a low to moderate prevalence of apical periodontitis in patients prior to undergoing hematopoietic cell transplantation.

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.

The aim of this study was to compare the color change of the Giomer resin composite (Beautifil-Bulk) by using photographs obtained with a smartphone (iPhone 6S) associated with Adobe Photoshop software (digital method), with the spectrophotometric method (Vita Easyshade) after immersion in different pigment solutions.

Twenty resin composite samples with a diameter of 15.0 mm and thickness of 1.0 mm were confectioned in A2 color (n = 5). Photographs and initial color readings were performed with a smartphone and spectrophotometer, respectively. Then, samples were randomly divided and subjected to cycles of immersion in distilled water (control), açai, Coke, and tomato sauce, 3 times a day, 20 minutes for 7 days. Later, new photographs and color readings were taken.

The analysis (2-way analysis of variance, Holm-Sidak, p < 0.05) demonstrated no statistical difference (p < 0.005) between the methods in all groups. Similar color changes were observed for all pigment solutions when using the spectrophotometric method. For the digital method, all color changes were clinically unacceptable, with distilled water and tomato sauce similar to each other and with statistical differences (p < 0.005) for Coke and açai.

Only the tomato sauce produced a color change above the acceptability threshold using both methods of color assessment. The spectrophotometric and digital methods produce different patterns of color change. According to our results, the spectrophotometric method is more recommended in color change assessment.

This study assessed the reliability of digital color measurements using images of resin composite specimens captured with a cellphone.

The reference color of cylindrical specimens built-up with the use of resin composite (shades A1, A2, A3, and A4) was measured with a portable spectrophotometer (CIELab). Images of the specimens were obtained individually or pairwise (compared shades in the same photograph) under standardized parameters. The color of the specimens was measured in the images using RGB system and converted to CIELab system using image processing software. Whiteness index (WI_D) and color differences (ΔE₀₀) were calculated for each color measurement method. For the cellphone, the ΔE₀₀ was calculated between the pairs of shades in separate images and in the same image. Data were analyzed using 2-way repeated-measures analysis of variance (α = 0.05). Linear regression models were used to predict the reference ΔE₀₀ values of those calculated using color measured in the images.

Images captured with the cellphone resulted in different WI_D values from the spectrophotometer only for shades A3 and A4. No difference to the reference ΔE₀₀ was observed when individual images were used. In general, a similar ranking of ΔE₀₀ among resin composite shades was observed for all methods. Stronger correlation coefficients with the reference ΔE₀₀ were observed using individual than pairwise images.

This study showed that the use of cellphone images to measure the color difference seems to be a feasible alternative providing outcomes similar to those obtained with the spectrophotometer.

This study investigated the incidence of root dentin defects after the use of different post space preparation (PSP) drills.

Seventy-two bovine incisors were selected and obtained 14-mm-long root sections. Twelve roots served as controls with no intervention (G1). The 60 root canals remaining were instrumented using the crown-down technique with the ProTaper Next system and obturated using the lateral condensation technique. Specimens were randomly distributed into 5 groups (n = 12) according to the operative steps performed: G2, root canal instrumentation and filling (I+F); G3, I+F and PSP with Gates-Glidden drills; G4, I+F and PSP with Largo-Peeso reamers; G5, I+F and PSP with Exacto drill; and G6, I+F and PSP with WhitePost drill. Roots were sectioned at 3, 6, 9, and 12 mm from the apex, and digital images were captured. The presence of root dentin defects was recorded. Data were analyzed by the χ² test, with p < 0.05 considered to indicate statistical significance.

Root dentin defects were observed in 39.6% of the root sections. No defects were observed in G1. G5 had significantly more cracks and craze lines than G1, G2, and G3 (p < 0.05), and more fractures than G1, G2, G3, and G4 (p < 0.05). When all root sections were analyzed together, significantly more defects were observed at the 12-mm level than at the 3-mm level (p < 0.05).

PSP drills caused defects in the root dentin. Gates-Glidden drills caused fewer root defects than Largo-Peeso reamers and Exacto drills.

In this study, we investigated the potential of amoxicillin-loaded polymeric microspheres to be delivered to tooth root infection sites via a bioactive reparative cement.

Amoxicillin-loaded microspheres were synthesized by a spray-dray method and incorporated at 2.5% and 5% into a mineral trioxide aggregate cement clinically used to induce a mineralized barrier at the root tip of young permanent teeth with incomplete root development and necrotic pulp. The formulations were modified in liquid:powder ratios and in composition by the microspheres. The optimized formulations were evaluated in vitro for physical and mechanical eligibility. The morphology of microspheres was observed under scanning electron microscopy.

The optimized cement formulation containing microspheres at 5% exhibited a delayed-release response and maintained its fundamental functional properties. When mixed with amoxicillin-loaded microspheres, the setting times of both test materials significantly increased. The diametral tensile strength of cement containing microspheres at 5% was similar to control. However, phytic acid had no effect on this outcome (p > 0.05). When mixed with modified liquid:powder ratio, the setting time was significantly longer than that original liquid:powder ratio (p < 0.05).

Lack of optimal concentrations of antibiotics at anatomical sites of the dental tissues is a hallmark of recurrent endodontic infections. Therefore, targeting the controlled release of broad-spectrum antibiotics may improve the therapeutic outcomes of current treatments. Overall, these results indicate that the carry of amoxicillin by microspheres could provide an alternative strategy for the local delivery of antibiotics for the management of tooth infections.

This micro-computed tomographic (CT) study aimed to compare the shaping abilities of ProTaper Next (PTN), One Shape (OS), and One Curve (OC) files in 3-dimensionally (3D)-printed mandibular molars.

In order to ensure standardization, 3D-printed mandibular molars with a consistent mesiobuccal canal curvature (45°) were used in the present study (n = 18). Specimens were instrumented with the OC, OS, or PTN files. The teeth were scanned pre- and post-instrumentation using micro-CT to detect changes of the canal volume and surface area, as well as to quantify transportation of the canals after instrumentation. Two-way analysis of variance was used for statistical comparisons.

No statistically significant differences were found between the OC and OS groups in the changes of the canal volume and surface area before and after instrumentation (p > 0.05). The OC files showed significantly less transportation than the OS or PTN systems for the apical section (p < 0.05). In a comparison of the systems, similar values were found at the coronal and middle levels, without any significant differences (p > 0.05).

These 3 instrumentation systems showed similar shaping abilities, although the OC file achieved a lesser extent of transportation in the apical zone than the OS and PTN files. All 3 file systems were confirmed to be safe for use in mandibular mesial canals.

To minimize the tooth sensitivity caused by in-office bleaching, many dentists use non-steroidal anti-inflammatory drugs and topical desensitizing gels containing potassium nitrate and sodium fluoride. This study aimed to evaluate the influence of these substances on inflammation and the expression of substance P and calcitonin gene-related peptide in pulp nerve fibers.

Seventy-two rats were divided into 6 groups as follows: GI, control; GII, only dental bleaching; GIII, only ibuprofen; GIV, ibuprofen administered 30 minutes before and after the bleaching treatment and every 12 hours until the analysis; GV, only topical application of a desensitizing agent; and GVI, topical application of a desensitizing agent before dental bleaching. Placebo gel was applied to the upper left jaw and the bleaching agent was applied to the upper right jaw in all groups. Subsequently, the groups were divided into 3 subgroups based on the time of analysis: 0, 24, and 48 hours after bleaching (n = 8). The rats were euthanized and the maxillae were processed and evaluated by histopathological and immunohistochemical analyses. The data were analyzed using the Kruskal-Wallis test, followed by the Dunn test (p < 0.05).

In the bleaching groups, the inflammatory process and expression of neuropeptides decreased over time. The animals in which a desensitizing agent was applied showed better results within 24 hours.

The use of a desensitizing agent had positive effects on inflammation and pain-related neuropeptide expression, minimizing the painful effects of dental bleaching treatment.

Self-adhesive resin cements contain functional monomers that enable them to adhere to the tooth structure without a separate adhesive or etchant. One of the most stable functional monomers used for chemical bonding to calcium in hydroxyapatite is 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP). The aim of this study was to evaluate the influence of the10-MDP concentration on the bond strength and physical properties of self-adhesive resin cements.

We used experimental resin cements containing 3 different concentrations of 10-MDP: 3.3 wt% (RC1), 6.6 wt% (RC2), or 9.9 wt% (RC3). The micro-tensile bond strength of each resin cement to dentin and a hybrid resin block (Estenia C&B, Kuraray Noritake Dental) was measured, and the fractured surface morphology was analyzed. Further, the flexural strength of the resin cements was measured using the three-point bending test. The water sorption and solubility of the cements following 30 days of immersion in water were measured.

The bond strength of RC2 was significantly higher than that of RC1. There was no significant difference between the bond strength of RC2 and that of RC3. The water sorption of RC3 was higher than that of any other cement. There were no significant differences in the three-point bending strength or water solubility among all three types of cements.

Within the limitations of this study, it is suggested that 6.6 wt% 10-MDP showed superior properties than 3.3 wt% or 9.9 wt% 10-MDP in self-adhesive resin cement.

To evaluate the influence of the restorative technique on the mechanical response of endodontically-treated upper premolars with mesio-occluso-distal (MOD) cavity.

Forty-eight premolars received MOD preparation (4 groups, n = 12) with different restorative techniques: glass ionomer cement + composite resin (the GIC group), a metallic post + composite resin (the MP group), a fiberglass post + composite resin (the FGP group), or no endodontic treatment + restoration with composite resin (the CR group). Cusp strain and load-bearing capacity were evaluated. One-way analysis of variance and the Tukey test were used with α = 5%. Finite element analysis (FEA) was used to calculate displacement and tensile stress for the teeth and restorations.

MP showed the highest cusp (p = 0.027) deflection (24.28 ± 5.09 µm/µm), followed by FGP (20.61 ± 5.05 µm/µm), CR (17.72 ± 6.32 µm/µm), and GIC (17.62 ± 7.00 µm/µm). For load-bearing, CR (38.89 ± 3.24 N) showed the highest, followed by GIC (37.51 ± 6.69 N), FGP (29.80 ± 10.03 N), and MP (18.41 ± 4.15 N) (p = 0.001) value. FEA showed similar behavior in the restorations in all groups, while MP showed the highest stress concentration in the tooth and post.

There is no mechanical advantage in using intraradicular posts for endodontically-treated premolars requiring MOD restoration. Filling the pulp chamber with GIC and restoring the tooth with only CR showed the most promising results for cusp deflection, failure load, and stress distribution.

The objective of this study was to assess coronal discoloration induced by the following intracanal medicaments: calcium hydroxide (CH), a mixture of CH paste and chlorhexidine gel (CH/CHX), and triple antibiotic paste (3Mix).

Seventy extracted single-canal teeth were selected. Access cavities were prepared and each canal was instrumented with a rotary ProTaper system. The specimens were randomly assigned to CH, CH/CHX, and 3Mix paste experimental groups (n = 20 each) or a control group (n = 10). Each experimental group was randomly divided into 2 subgroups (A and B). In subgroup A, medicaments were only applied to the root canals, while in subgroup B, the root canals were completely filled with medicaments and a cotton pellet dipped in medicament was also placed in the pulp chamber. Spectrophotometric readings were obtained from the mid-buccal surface of the tooth crowns immediately after placing the medicaments (T1) and at 1 week (T2), 1 month (T3), and 3 months (T4) after filling. The ∆E was then calculated. Data were analyzed using 2-way analysis of variance (ANOVA), 3-way ANOVA, and the Scheffé post hoc test.

The greatest color change (ΔE) was observed at 3 months (p < 0.0001) and in 3Mix subgroup B (p = 0.0057). No significant color change occurred in the CH (p = 0.7865) or CH/CHX (p = 0.1367) groups over time, but the 3Mix group showed a significant ΔE (p = 0.0164).

Intracanal medicaments may induce tooth discoloration. Use of 3Mix must be short and it must be carefully applied only to the root canals; the access cavity should be thoroughly cleaned afterwards.

This study aimed to introduce the use of laser-induced breakdown spectroscopy (LIBS) for evaluation of the mineral content of root canal dentin, and to assess whether a correlation exists between LIBS and scanning electron microscopy/energy dispersive spectroscopy (SEM/EDS) methods by comparing the effects of irrigation solutions on the mineral content change of root canal dentin.

Forty teeth with a single root canal were decoronated and longitudinally sectioned to expose the canals. The root halves were divided into 4 groups (n = 10) according to the solution applied: group NaOCl, 5.25% sodium hypochlorite (NaOCl) for 1 hour; group EDTA, 17% ethylenediaminetetraacetic acid (EDTA) for 2 minutes; group NaOCl+EDTA, 5.25% NaOCl for 1 hour and 17% EDTA for 2 minutes; a control group. Each root half belonging to the same root was evaluated for mineral content with either LIBS or SEM/EDS methods. The data were analyzed statistically.

In groups NaOCl and NaOCl+EDTA, the calcium (Ca)/phosphorus (P) ratio decreased while the sodium (Na) level increased compared with the other groups (p < 0.05). The magnesium (Mg) level changes were not significant among the groups. A significant positive correlation was found between the results of LIBS and SEM/EDS analyses (r = 0.84, p < 0.001).

Treatment with NaOCl for 1 hour altered the mineral content of dentin, while EDTA application for 2 minutes had no effect on the elemental composition. The LIBS method proved to be reliable while providing data for the elemental composition of root canal dentin.

The aim of this study was to compare root canal volume change and canal transportation by Vortex Blue (VB; Dentsply Tulsa Dental Specialties), ProTaper Next (PTN; Dentsply Maillefer), and ProTaper Universal (PTU; Dentsply Maillefer) nickel-titanium rotary files in curved root canals.

Thirty canals with 20°–45° of curvature from extracted human molars were used. Root canal instrumentation was performed with VB, PTN, and PTU files up to #30.06, X3, and F3, respectively. Changes in root canal volume before and after the instrumentation, and the amount and direction of canal transportation at 1, 3, and 5 mm from the root apex were measured by using micro-computed tomography. Data of canal volume change were statistically analyzed using one-way analysis of variance and Tukey test, while data of amount and direction of transportation were analyzed using Kruskal-Wallis and Mann-Whitney U test.

There were no significant differences among 3 groups in terms of canal volume change (p > 0.05). For the amount of transportation, PTN showed significantly less transportation than PTU at 3 mm level (p = 0.005). VB files showed no significant difference in canal transportation at all 3 levels with either PTN or PTU files. Also, VB files showed unique inward transportation tendency in the apical area.

Other than PTN produced less amount of transportation than PTU at 3 mm level, all 3 file systems showed similar level of canal volume change and transportation, and VB file system could prepare the curved canals without significant shaping errors.

The aim of this study was to investigate the ability of the fluorescence-aided caries excavation (FACE) device to detect residual caries by comparing conventional methods in vivo.

A total of 301 females and 202 males with carious teeth participated in this study. The cavity preparations were done by grade 4 (Group 1, 154 teeth), grade 5 (Group 2, 176 teeth), and postgraduate (Group 3, 173 teeth) students. After caries excavation using a handpiece and hand instruments, the presence of residual caries was evaluated by 2 investigators who were previously calibrated for visual-tactile assessment with and without magnifying glasses and trained in the use of a FACE device. The tooth number, cavity type, and presence or absence of residual caries were recorded. The data were analyzed using the Chi-square test, the Fisher's Exact test, or the McNemar test as appropriate. Kappa statistics was used for calibration. In all tests, the level of significance was set at p = 0.05.

Almost half of the cavities prepared were Class II (Class I, 20.9%; Class II, 48.9%; Class III, 20.1%; Class IV, 3.4%; Class V, 6.8%). Higher numbers of cavities left with caries were observed in Groups 1 and 2 than in Group 3 for all examination methods. Significant differences were found between visual inspection with or without magnifying glasses and inspection with a FACE device for all groups (p < 0.001). More residual caries were detected through inspection with a FACE device (46.5%) than through either visual inspection (31.8%) or inspection with a magnifying glass (37.6%).

Within the limitations of this study, the FACE device may be an effective method for the detection of residual caries.

The aim of this in vitro study was to evaluate the effect of incorporating three different nanobiomaterials into bleaching material on microhardness of bleached enamel.

The crowns of 24 extracted sound human molars were sectioned. Sixty enamel specimens (2 × 3 × 4 mm) were selected and divided into five groups (n = 12): Group 1 received no bleaching procedure (control); Group 2 underwent bleaching with a 40% hydrogen peroxide (HP) gel; Groups 3, 4, and 5 were bleached with a 40% HP gel modified by incorporation of bioactive glass (BAG), amorphous calcium phosphate (ACP) and hydroxyapatite (HA), respectively. The enamel microhardness was evaluated. The differences in Knoop microhardness data of each group were analyzed by one-way ANOVA, followed by post hoc Tukey tests.

Significant differences were observed between the study groups. The enamel microhardness changes in Groups 1, 3, 4, and 5 were significantly lower than that of Group 2 (p < 0.001).

Within the limitations of this study, it can be concluded that incorporation of each one of the three tested biomaterials as remineralizing agents might be effective in decreasing enamel microhardness changes subsequent to in-office bleaching.

The purpose of this study was to assess the ability of ProTaper Gold (PTG, Dentsply Maillefer) in maintaining the original profile of root canal anatomy. For that, ProTaper Universal (PTU, Dentsply Maillefer) was used as reference techniques for comparison.

Twenty simulated curved canals manufactured in clear resin blocks were randomly assigned to 2 groups (n = 10) according to the system used for canal instrumentation: PTU and PTG groups, upto F2 files (25/0.08). Color stereomicroscopic images from each block were taken exactly at the same position before and after instrumentation. All image processing and data analysis were performed with an open source program (FIJI). Evaluation of canal transportation was obtained for two independent canal regions: straight and curved levels. Student's t test was used with a cut-off for significance set at α = 5%.

Instrumentation systems significantly influenced canal transportation (p < 0.0001). A significant interaction between instrumentation system and root canal level (p < 0.0001) was found. PTU and PTG systems produced similar canal transportation at the straight part, while PTG system resulted in lower canal transportation than PTU system at the curved part. Canal transportation was higher at the curved canal portion (p < 0.0001).

PTG system produced overall less canal transportation in the curved portion when compared to PTU system.

The goal of this study was to compare the density of gutta-percha root fillings obturated with the following techniques: cold lateral (CL) compaction, ultrasonic lateral (UL) compaction, and warm vertical (WV) compaction.

Thirty-three extracted mandibular first molars, with two separate mesial canals in each, were selected. After instrumentation, the canals were stratified into three groups based on canal length and curvature, and underwent obturation with one of the techniques. No sealer was used in order to avoid masking any voids. The teeth were imaged pre- and post-obturation using micro-computed tomography. The reconstructed three-dimensional images were analyzed volumetrically to determine the amount of gutta-percha present in every 2 mm segment of the canal. P values < 0.05 were considered to indicate statistical significance.

The overall mean volume fraction of gutta-percha was 68.51 ± 6.75% for CL, 86.56 ± 5.00% for UL, and 88.91 ± 5.16% for WV. Significant differences were found between CL and UL and between CL and WV (p < 0.05), but not between UL and WV (p = 0.526). The gutta-percha density of the roots treated with WV and UL increased towards the coronal aspect, but this trend was not noted in the CL group.

WV compaction and UL compaction produced a significantly denser gutta-percha root filling than CL compaction. The density of gutta-percha was observed to increase towards the coronal aspect when the former two techniques were used.

The aim of this study was to investigate the expression of 7 different sirtuin genes (SIRT1-SIRT7) in human dental pulp cells (HDPCs), and to determine the role of SIRTs in the odontoblastic differentiation potential of HDPCs.

HDPCs were isolated from freshly extracted third molar teeth of healthy patients and cultulred in odontoblastic differentiation inducing media. Osteocalcin (OCN) and dentin sialophosphoprotein (DSPP) expression was analyzed to evaluate the odontoblastic differentiation of HDPCs by reverse transcription-polymerase chain reaction (RT-PCR), while alizarin red staining was used for the mineralization assay. To investigate the expression of SIRTs during odontoblastic differentiation of HDPCs, real time PCR was also performed with RT-PCR.

During the culture of HDPCs in the differentiation inducing media, OCN, and DSPP mRNA expressions were increased. Mineralized nodule formation was also increased in the 14 days culture. All seven SIRT genes were expressed during the odontogenic induction period. SIRT4 expression was increased in a time-dependent manner.

Our study identified the expression of seven different SIRT genes in HDPCs, and revealed that SIRT4 could exert an influence on the odontoblast differentiation process. Further studies are needed to determine the effects of other SIRTs on the odontogenic potential of HDPCs.

Glide path preparation is recommended to reduce torsional failure of nickel-titanium (NiTi) rotary instruments and to prevent root canal transportation. This study evaluated whether the repetitive insertions of G-files to the working length maintain the apical size as well as provide sufficient lumen as a glide path for subsequent instrumentation.

The G-file system (Micro-Mega) composed of G1 and G2 files for glide path preparation was used with the J-shaped, simulated resin canals. After inserting a G1 file twice, a G2 file was inserted to the working length 1, 4, 7, or 10 times for four each experimental group, respectively (n = 10). Then the canals were cleaned by copious irrigation, and lubricated with a separating gel medium. Canal replicas were made using silicone impression material, and the diameter of the replicas was measured at working length (D0) and 1 mm level (D1) under a scanning electron microscope. Data was analysed by one-way ANOVA and post-hoc tests (p = 0.05).

The diameter at D0 level did not show any significant difference between the 1, 2, 4, and 10 times of repetitive pecking insertions of G2 files at working length. However, 10 times of pecking motion with G2 file resulted in significantly larger canal diameter at D1 (p < 0.05).

Under the limitations of this study, the repetitive insertion of a G2 file up to 10 times at working length created an adequate lumen for subsequent apical shaping with other rotary files bigger than International Organization for Standardization (ISO) size 20, without apical transportation at D0 level.

This study aimed to compare the accuracy of conventional intraoral (CI) radiography, photostimulable phosphor (PSP) radiography, cone beam computed tomography (CBCT) and multidetector computed tomography (MDCT) for detection of strip and root perforations in endodontically treated teeth.

Mesial and distal roots of 72 recently extracted molar were endodontically prepared. Perforations were created in 0.2, 0.3, or 0.4 mm diameter around the furcation of 48 roots (strip perforation) and at the external surface of 48 roots (root perforation); 48 roots were not perforated (control group). After root obturation, intraoral radiography, CBCT and MDCT were taken. Discontinuity in the root structure was interpreted as perforation. Two observers examined the images. Data were analyzed using Stata software and Chi-square test.

The sensitivity and specificity of CI, PSP, CBCT and MDCT in detection of strip perforations were 81.25% and 93.75%, 85.42% and 91.67%, 97.92% and 85.42%, and 72.92% and 87.50%, respectively. For diagnosis of root perforation, the sensitivity and specificity were 87.50% and 93.75%, 89.58% and 91.67%, 97.92% and 85.42%, and 81.25% and 87.50%, respectively. For detection of strip perforation, the difference between CBCT and all other methods including CI, PSP and MDCT was significant (p < 0.05). For detection of root perforation, only the difference between CBCT and MDCT was significant, and for all the other methods no statistically significant difference was observed.

If it is not possible to diagnose the root perforations by periapical radiographs, CBCT is the best radiographic technique while MDCT is not recommended.

The aim of this study was to assess the influence of operator experience level on the lifespan of the WaveOne Primary file (Dentsply Maillefer, Ballaigues, Switzerland) in extracted teeth.

Moderately curved canals of extracted maxillary and mandibular molars were randomly distributed into 2 groups: experienced and inexperienced operators. Ten files were allocated to each group (n = 10). Each canal was prepared until the working length was reached, and the same file was used to prepare additional canals until it separated. The number of canals prepared before file separation was recorded. The fragment length of each file was measured, and the location of the fragment in the canal was determined. Data were statistically analysed using the independent 2-sample t-test.

The 2 operators prepared a total of 324 moderately curved canals of maxillary and mandibular molars. There was no significant intergroup difference in the mean number of canals prepared (p = 0.27). The average lifespan of the WaveOne Primary file was 17.1 and 15.3 canals, and the longest lifespan was 25 and 20 canals, when used by experienced and inexperienced operators, respectively. There were no statistically significant intergroup differences in separated fragment length and location.

Within the limitations of this study, operator experience level appears to have no effect on the lifespan of the WaveOne Primary file in preparation of moderately curved canals. Single teeth with multiple canals can be prepared safely even by a novice operator by using a single file.