
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 (
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 (
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.
Citations

This study aimed to identify and analyze articles on enamel microabrasion for the treatment of white spot lesions. A search was conducted on the Web of Science. The following parameters were recorded and analyzed: number of citations, year, journal, impact factor, study design, theme, country and continent, institution, authors, and keywords. Data was analyzed using VOSviewer software. The initial search resulted in 1,126 documents, of which 94 articles were included. The highest number of citations an article received was 65. The oldest article was published in 1975, and the most recent in 2023. The most frequent study design was case report (
Citations

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 (
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.
Citations

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.
Citations

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 (
The analysis (2-way analysis of variance, Holm-Sidak,
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.
Citations

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 (WID) 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 WID 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.
Citations

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

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
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 (
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.
Citations

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 (
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 (
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.
Citations

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 (
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.
Citations

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.
Citations

Antiresorptive drugs (ARDs), such as bisphosphonates or denosumab, that prevent bone resorption are widely used in patients with osteoporosis or with cancer that has metastasized to the bones. Although osteonecrosis of the jaw (ONJ) is a well-documented complication of ARD use, the benefits ARDs outweigh the complication. Thus, research has focused on finding ways to prevent or reduce the risk of developing ONJ. Dentists, as part of a multi-professional team, have a critical role in preventing ONJ. However, many dentists tend to hesitate to provide dental care to patients with ONJ, or tend to think that it is a problem to be dealt with by oral surgeons. This review gives an overview of ARD-related ONJ and provides the guidelines for dental care in patients taking ARDs to lower the risk of developing ONJ.
Citations

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,
MP showed the highest cusp (
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.
Citations

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 (
The greatest color change (ΔE) was observed at 3 months (
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.
Citations

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 (
In groups NaOCl and NaOCl+EDTA, the calcium (Ca)/phosphorus (P) ratio decreased while the sodium (Na) level increased compared with the other groups (
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.
Citations

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
There were no significant differences among 3 groups in terms of canal volume change (
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.
Citations

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

X-linked hypophosphatemia (XLH) is a hereditary metabolic disease caused by the loss of phosphate through the renal tubules into the urine, and an associated decrease in serum calcium and potassium phosphate. Its dental features include spontaneous dental abscesses that occur in the absence of trauma or dental caries. The aim of this case report was to describe the dental problems of XLH patients and to evaluate limitations in their treatment. A 14 year old male and a 38 year old female with XLH were referred to the Department of Conservative Dentistry for endodontic treatment. The dental findings were periapical abscesses without obvious trauma or caries. Conservative endodontic treatment was performed in teeth with pulp necrosis and abscess. In case 1, the treated teeth showed improvements in bone healing, without clinical symptoms. However, in case 2, the implants and the treated tooth showed hypermobility, and the final restoration was therefore postponed. Early diagnosis, periodic examinations, and communication with the patient's pediatrician are important in the dental management of patients with XLH.
Citations

The aim of this
The crowns of 24 extracted sound human molars were sectioned. Sixty enamel specimens (2 × 3 × 4 mm) were selected and divided into five groups (
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 (
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.
Citations

Tooth transposition is a disorder in which a permanent tooth develops and erupts in the normal position of another permanent tooth. Fusion and gemination are developmental disturbances presenting as the union of teeth. This article reports the nonsurgical retreatment of a very rare case of fused teeth with transposition. A patient was referred for endodontic treatment of her maxillary left first molar in the position of the first premolar, which was adjacent to it on the distobuccal side. Orthopantomography and periapical radiography showed two crowns sharing the same root, with a root canal treatment and an associated periapical lesion. Tooth fusion with transposition of a maxillary molar and a premolar was diagnosed. Nonsurgical endodontic retreatment was performed. At four yr follow-up, the tooth was asymptomatic and the radiolucency around the apical region had decreased, showing the success of our intervention. The diagnosis and treatment of fused teeth require special attention. The canal system should be carefully explored to obtain a full understanding of the anatomy, allowing it to be fully cleaned and obturated. Thermoplastic techniques were useful in obtaining hermetic obturation. A correct anatomical evaluation improves the set of treatment options under consideration, leading to a higher likelihood of esthetically and functionally successful treatment.

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 (
Instrumentation systems significantly influenced canal transportation (
PTG system produced overall less canal transportation in the curved portion when compared to PTU system.
Citations

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.
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 (
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.
Citations

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.
Citations

Traumatic dental injury can result in avulsion of anterior teeth. In young patients, it is a challenge to the dental professional because after replantation, late complications such as ankylosis require tooth extraction. Although prosthetic and orthodontic treatment, and implant placement have been described as the options for intervention, autogenous tooth transplantation could be an effective procedure in growing patients if there is a suitable donor tooth available. This case presents the treatment of a patient who suffered a traumatic injury at 9 years old with avulsion of tooth 21, which had been replanted, and intrusion of tooth 11. Both teeth ankylosed; thus they were removed and autotransplantation of premolars was carried out. After transplantation, the tooth underwent root canal treatment because of pulpal necrosis. Orthodontic treatment began 3 months after transplantation and during 7 years' follow-up the aesthetics and function were maintained without signs of resorption.
Citations

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 (
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 (
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.
Citations

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

In dentistry, the term 'fusion' is used to describe a developmental disorder of dental hard tissues. In the permanent dentition, fusion of a normal tooth and a supernumerary tooth usually involves the incisors or canines. However, a few cases of fusion involving premolars have also been reported to date. We present a rare case in which fusion of the maxillary left second premolar and a supernumerary tooth in a 13-year-old girl was diagnosed using cone beam computed tomography (CBCT, Alphard-3030, Asahi Roentgen Ind. Co., Ltd.). The tooth was bicuspidized after routine nonsurgical root canal treatment, and the separated teeth underwent appropriate restoration procedures. The second premolar and supernumerary tooth remained asymptomatic without any signs of inflammation after a follow-up period of 9 years. Identification of anatomical anomalies is important for treatment in cases involving fusion with supernumerary tooth, and therefore the microscopic examinations and CBCT are essential for the diagnosis. Fused teeth can be effectively managed by the comprehensive treatment which includes both endodontic and periodontal procedures.
Citations

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 (
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 (
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.
Citations

This case report demonstrates an unnecessary endodontic treatment of teeth with florid cemento-osseous dysplasia (FCOD) due to a misdiagnosis as periapical pathosis and emphasizes the importance of correct diagnosis to avoid unnecessary treatment. A 30-year-old woman was referred to our institution for apicoectomies of the mandibular left canine and both the lateral incisors. The periapical lesions associated with these teeth had failed to resolve after root canal treatment over a 3-year period. Radiographic examinations revealed multiple lesions on the right canine, the second premolar, and both first molars as well as the anterior region of the mandible. Based on clinical, radiographic and histological evaluations, the patient condition was diagnosed as FCOD. The patient has been monitored for 2 years. To avoid unnecessary invasive treatment, accurate diagnosis is essential before treatment is carried out in managing FCOD.
Citations

This study was performed to evaluate the effect of blood contamination on the compressive strength (CS) of Root MTA (RMTA) modified with Calcium chloride (CaCl2) and Disodium hydrogen phosphate (Na2HPO4) as setting accelerators over time.
A total of 110 cylindrical specimens of RMTA were divided into 6 experimental groups as follows: Group1, RMTA; Group 2, RMTA modified with CaCl2 (RMTA-C); Group 3, RMTA modified with Na2HPO4 (RMTA-N); Group 4, RMTA contaminated with blood; Group 5, RMTA-C contaminated with blood; Group 6, RMTA-N contaminated with blood. The CS of specimens in all groups was evaluated after 3 hr, 24 hr, and 1 wk. In the modified groups (groups 2, 3, 5, and 6) the CS of five specimens per group was also evaluated after 1 hr.
Blood contamination significantly reduced the CS of all materials at all time intervals (
Blood contamination decreased the CS of both original and accelerated RMTA.
Citations

The autogenous tooth transplantation is an alternative treatment replacing a missing tooth when a suitable donor tooth is available. It is also a successful treatment option to save significant amount of time and cost comparing implants or conventional prosthetics. These cases, which required single tooth extraction due to deep caries and severe periodontal disease, could have good results by transplanting non-functional but sound donor tooth to the extraction site.
Citations

In most retrospective studies, the clinical performance of restorations had not been considered in survival analysis. This study investigated the effect of including the clinically unacceptable cases according to modified United States Public Health Service (USPHS) criteria into the failed data on the survival analysis of direct restorations as to the longevity and prognostic variables.
Nine hundred and sixty-seven direct restorations were evaluated. The data of 204 retreated restorations were collected from the records, and clinical performance of 763 restorations in function was evaluated according to modified USPHS criteria by two observers. The longevity and prognostic variables of the restorations were compared with a factor of involving clinically unacceptable cases into the failures using Kaplan-Meier survival analysis and Cox proportional hazard model.
The median survival times of amalgam, composite resin and glass ionomer were 11.8, 11.0 and 6.8 years, respectively. Glass ionomer showed significantly lower longevity than composite resin and amalgam. When clinically unacceptable restorations were included into the failure, the median survival times of them decreased to 8.9, 9.7 and 6.4 years, respectively.
After considering the clinical performance, composite resin was the only material that showed a difference in the longevity (
Citations

Although several methods including composite resin restoration and microabrasion have been used for management of white spot lesion, tooth jewelry can be considered as another noninvasive option. This case report describes the management of white spot lesions by using tooth jewelry. This report also highlights the patients' preference for tooth jewelry as an esthetic concern.
Citations

Traumatic injuries of the face often involve root fractures especially in anterior teeth. The prognosis and the treatment of the root fracture depend on the extent of the fracture line, general health and patient compliance. This case report outlines a new conservative trial treatment modality to stabilize the maxillary central incisors with horizontal root fracture on the cervical to middle third by fabricating canine guidance to remove loading on the traumatized maxillary central incisors during eccentric movements and thus inducing spontaneous healing of the fractured line between the fragments. Radiographs after thirty months showed adequate healing with no signs of pathological changes including root resorption, ankylosis or displacement. Long term follow-up revealed that vitality, stability and aesthetics were maintained and the patient was satisfied with the outcome.
Citations

The maintenance of the healthy periodontal ligament cells of the root surface of donor tooth and intimate surface contact between the donor tooth and the recipient bone are the key factors for successful tooth transplantation. In order to achieve these purposes, a duplicated donor tooth model can be utilized to reduce the extra-oral time using the computer-aided rapid prototyping (CARP) technique.
Briefly, a three-dimensional digital imaging and communication in medicine (DICOM) image with the real dimensions of the donor tooth was obtained from a computed tomography (CT), and a life-sized resin tooth model was fabricated. Dimensional errors between real tooth, 3D CT image model and CARP model were calculated. And extra-oral time was recorded during the autotransplantation of the teeth.
The average extra-oral time was 7 min 25 sec with the range of immediate to 25 min in cases which extra-oral root canal treatments were not performed while it was 9 min 15 sec when extra-oral root canal treatments were performed. The average radiographic distance between the root surface and the alveolar bone was 1.17 mm and 1.35 mm at mesial cervix and apex; they were 0.98 mm and 1.26 mm at the distal cervix and apex. When the dimensional errors between real tooth, 3D CT image model and CARP model were measured in cadavers, the average of absolute error was 0.291 mm between real teeth and CARP model.
These data indicate that CARP may be of value in minimizing the extra-oral time and the gap between the donor tooth and the recipient alveolar bone in tooth transplantation.
Citations

The purpose of this study was to determine the effect of resin infiltration technique on color and surface hardness of white spot lesion (WSL) with various degrees of demineralization.
Ten human upper premolars were cut and divided into quarters with a 3 × 4 mm window on the enamel surface. Each specimens were separated into four groups (
Resin infiltration induced color changes and increased the hardness of demineralized enamel. After resin infiltration, there was no difference in color change (Δ
There was no difference in the effect of resin infiltration on color and hardness among groups with different extents of demineralization.
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This study analyzed the difference in color caused by different thickness in enamel layer of composite resins when applied with single and layering placement technique, and evaluated if the results agreed with the shade guide from the manufacturers to verify reliability of the color matching process of the manufacturers.
For single composite resin samples, 6 mm diameter and 4 mm thickness cylindrical samples were fabricated using Ceram-X mono (DENTSPLY DeTrey) and CIE L*a*b* values were measured with spectrophotometer. Same process was done for layering composite resin samples, making 3 dentinal shade samples, 4 mm thickness, for each shade using Ceram-X duo (DENTSPLY DeTrey) and enamel shade resins were layered in 2 mm thickness and CIE L*a*b* values were measured. These samples were ground to 0.2 mm thickness each time, and CIE L*a*b* values were measured to 1 mm thickness of enamel shade resin.
Color difference (ΔE*) between single and layering composite resin was 1.37 minimum and 10.53 maximum when layering thicknesses were between 1 mm and 2 mm and 6 out of 10 same shade groups suggested by manufacturer showed remarkable color difference at any thickness (ΔE* > 3.3).
When using Ceram-X mono and duo for composite resin restoration, following the manufacturer's instructions for choosing the shade is not appropriate, and more accurate information for Ceram-X duo is needed on the variation and expression of the shades depending on the thickness of the enamel.
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Proximal caries or coronal defect in posterior teeth may result in the loss of proximal space and drifting of neighboring teeth, which makes restoration difficult. Inability to restore proper contours and to align tooth axis properly are commonly encountered problems when planning tooth restoration. Moreover, tilted teeth aggravate periodontal tissue breakdown, such as pseudo-pocket, and angular osseous defect. The purpose of this case presentation is to describe a simple technique for inducing minor tooth movement with orthodontic separating ring and provisional restoration modification. This method was used to create crown placement space on mesially tilted molar. This method is easy, simple and efficient technique which could be used in interproximal space gaining in selected situation.
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The clinical diagnosis of ankylosis can be made only when the affected tooth gives positive evidence of an inability to move. The inability to move is demonstrated either as a failure of the tooth to move with normal vertical dental alveolar growth or a failure of the tooth to move when the tooth is subjected to an orthodontic force system. This case report describes the autotransplantation of an ankylosed maxillary canine.

The aim of this study was to evaluate the various NiTi rotary instruments regarding their ability to provide a circular apical preparation.
50 single canal roots were selected, cut at the cementodentinal junction and the coronal 1/3 of the canals was flared using Gates Glidden burs. Samples were randomly divided into 5 experimental groups of 10 each. In group I, GT files, Profile 04 and Quantec #9 and #10 files were used. In Group II Lightspeed was used instead of Quantec. In Group III, Orifice shaper, Profile .06 series and Lightspeed were used. In Group IV, Quantec #9 and #10 files were used instead of Lightspeed. In Group V, the GT file and the Profile .04 series were used to prepare the entire canal length. All tooth samples were cut at 1 mm, 3 mm and 5 mm from the apex and were examined under the microscope.
Groups II and III (Lightspeed) showed a more circular preparation in the apical 1mm samples than the groups that used Quantec (Group I & IV) or GT files and Profile .04 series.(Group V)(
Lightspeed showed circular preparation at apical 1 mm more frequently than other instruments used in this study. However only 35% of samples showed circularity even in the Lightspeed Group which were enlarged 3 ISO size from the initial apical binding file (IAF) size. So it must be considered that enlarging 3 ISO size isn't enough to make round preparation.

In clinic, esthetic restoration of a defective natural tooth with composite resin is challenging procedure and needs complete understanding of the color of tooth itself and materials used. The optical characteristics of the composites are different because the chemical compositions and microstructures are not same.
This review provided basic knowledge of the color and the color measurement devices, and analyze the color of the natural tooth. Further, the accuracy of the shade tab, color of the composite resins before and after curing, effect of the water, food and bleaching agent, and translucency, opalescence, and fluorescence effects were evaluated.
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The purpose of this study was to determine the optimal master apical file size with minimal transportation and optimal efficiency in removing infected dentin. We evaluated the transportation of the canal center and the change in untouched areas after sequential preparation with a #25 to #40 file using 3 different instruments: stainless steel K-type (SS K-file) hand file, ProFile and LightSpeed using microcomputed tomography (MCT).
Thirty extracted human mandibular molars with separated orifices and apical foramens on mesial canals were used. Teeth were randomly divided into three groups: SS K-file, Profile, LightSpeed and the root canals were instrumented using corresponding instruments from #20 to #40. All teeth were scanned with MCT before and after instrumentation. Cross section images were used to evaluate canal transportation and untouched area at 1- , 2- , 3- , and 5- mm level from the apex. Data were statistically analyzed according to' repeated nested design'and Mann-Whitney test (
In SS K-file group, canal transportation was significantly increased over #30 instrument. In the ProFile group, canal transportation was significantly increased after preparation with the #40 instrument at the 1- and 2- mm levels. LightSpeed group showed better centering ability than ProFile group after preparation with the #40 instrument at the 1 and 2 mm levels.
SS K-file, Profile, and LightSpeed showed differences in the degree of apical transportation depending on the size of the master apical file.
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The aim of this study was to investigate levels of matrix metalloproteinase-8 (MMP-8) and substance P (SP) in root canal exudates during root canal treatment (RCT) of nonvital, painful teeth.
Patients scheduled for nonsurgical RCT were prospectively selected; the study was performed after obtaining informed consent from the patients and was approved by the Institutional Review Board for Clinical Research of Gangnam Severance Hospital, Yonsei University (3-2008-0118). Canal exudates samples were collected using sterilized paper points from teeth scheduled for RCT across three different time periods. MMP-8 and SP levels were measured using enzyme-linked immunosorbent assay (ELISA). Data were analyzed using a mixed model analysis and the Pearson correlation analysis (
MMP-8 and SP levels in GCF were decreased during RCT (
This study demonstrated that periradicular inflammation endodontic origin can elevate SP and MMP-8 levels in root canal exudates. Interestingly, SP level of canal exudates showed a possibility of being used as an indicator of pain due to periapical pathosis.

To determine the effect of the spectral output of single and dual-peak light emitting diode (LED) curing lights on the microhardness and color stability of commercial resin composites formulated with camphorquinone and alternative photoinitiators in combination.
Three light-polymerized resin composites (Z100 (3M ESPE), Tetric Ceram (Ivoclar Vivadent) and Aelite LS Posterior (Bisco)) with different photoinitiator systems were used. The resin composites were packed into a Teflon mold (8 mm diameter and 2 mm thickness) on a cover glass. After packing the composites, they were light cured with single-peak and dual-peak LEDs. The Knoop microhardness (KHN) and color difference (ΔE) for 30 days were measured. The data was analyzed statistically using a student's
All resin composites showed improved microhardness when a third-generation dual-peak LED light was used. The color stability was also higher for all resin composites with dual-peak LEDs. However, there was a significant difference only for Aelite LS Posterior.
The dual-peak LEDs have a beneficial effect on the microhardness and color stability of resin composites formulated with a combination of camphorquinone and alternative photoinitiators.
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This case report compared the effectiveness of resin infiltration technique (Icon, DMG) with microabrasion (Opalustre, Ultradent Products, Inc.) in management of white spot lesions. It demonstrates that although neither microabrasion nor resin infiltration technique can remove white spot lesions completely, resin infiltration technique seems to be more effective than microabrasion. Therefore resin infiltration technique can be chosen preferentially for management of white spot lesions and caution should be taken for case selection.
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The purpose of this study is to compare the apical transportation and working length change in curved root canals created in resin blocks, using 3 geometrically different types of Ni-Ti files, K3, NRT, and Profile.
The curvature of 30 resin blocks was measured by Schneider technique and each groups of Ni-Ti files were allocated with 10 resin blocks at random. The canals were shaped with Ni-Ti files by Crown-down technique. It was analyzed by Double radiograph superimposition method (Backman CA 1992), and for the accuracy and consistency, specially designed jig, digital X-ray, and CAD/CAM software for measurement of apical transportation were used. The amount of apical transportation was measured at 0, 1, 3, 5 mm from 'apical foramen - 0.5 mm' area, and the alteration of the working length before and after canal shaping was also measured. For statistics, Kruskal-Wallis One Way Analysis was used.
There was no significant difference between the groups in the amount of working length change and apical transportation at 0, 1, and 3 mm area (
As a result of this study, the 3 geometrically different Ni-Ti files showed no significant difference in apical transportation and working length change and maintained the original root canal shape.
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The aim of this paper is to discuss the mechanical and geometric features of Nickel-titanium (NiTi) rotary files and its clinical effects. NiTi rotary files have been introduced to the markets with their own geometries and claims that they have better ability for the root canal shaping than their competitors. The contents of this paper include the (possible) interrelationship between the geometries of NiTi file (eg. tip, taper, helical angle, etc) and clinical performance of the files as follows;
- Fracture modes of NiTi rotary files - Non-cutting guiding tip and glide path - Taper and clinical effects - Cross-sectional area and clinical effects - Heat treatments and surface characteristics - Screw-in effect and preservation of root dentin integrity - Designs for reducing screw-in effect
Based on the reviewed contents, clinicians may have an advice to use various brands of NiTi rotary instruments regarding their advantages which would fit for clinical situation.
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This study investigated the effect of infection control barrier thickness on power density, wavelength, and light diffusion of light curing units.
Infection control barrier (Cleanwrap) in one-fold, two-fold, four-fold, and eight-fold, and a halogen light curing unit (Optilux 360) and a light emitting diode (LED) light curing unit (Elipar FreeLight 2) were used in this study. Power density of light curing units with infection control barriers covering the fiberoptic bundle was measured with a hand held dental radiometer (Cure Rite). Wavelength of light curing units fixed on a custom made optical breadboard was measured with a portable spectroradiometer (CS-1000). Light diffusion of light curing units was photographed with DSLR (Nikon D70s) as above.
Power density decreased significantly as the layer thickness of the infection control barrier increased, except the one-fold and two-fold in halogen light curing unit. Especially, when the barrier was four-fold and more in the halogen light curing unit, the decrease of power density was more prominent. The wavelength of light curing units was not affected by the barriers and almost no change was detected in the peak wavelength. Light diffusion of LED light curing unit was not affected by barriers, however, halogen light curing unit showed decrease in light diffusion angle when the barrier was four-fold and statistically different decrease when the barrier was eight-fold (
It could be assumed that the infection control barriers should be used as two-fold rather than one-fold to prevent tearing of the barriers and subsequent cross contamination between the patients.
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