Restorative Dentistry & Endodontics最新文献

Objectives: The aim of this study was to demonstrate the impact of a high-power 810-nm diode laser as monotherapy on the clinical and tomographic success of treating teeth with periapical lesions, through a series of 31 cases.

Methods: Teeth with apical lesions underwent endodontic treatment in which a high-power 810-nm diode laser with saline solution was used as monotherapy for disinfection. This type of therapy aimed to replace the traditional irrigation protocol with sodium hypochlorite. This research is the first to assess the clinical success of this alternative treatment, along with tomographic evaluations conducted over periods ranging from 2 to 7 years, analyzed using the periapical index based on cone-beam computed tomography (CBCTPAI). All cases were performed by a single clinician following the same laser protocol, which involved using 1 W of continuous power and four cycles of 20 seconds of laser activation.

Results: All teeth showed no clinical symptoms upon follow-up examination. However, the tomographic evaluation revealed that the success rates for teeth receiving primary treatment were 60% and 80% according to strict and loose criteria, respectively. For teeth requiring retreatment, the success rates were 12.5% and 37.5% using strict and loose criteria, respectively.

Conclusions: The teeth with apical lesions that underwent primary treatment did not present clinical symptoms, but they showed a moderate success rate on tomographic evaluation. However, despite lacking clinical symptoms, teeth with apical lesions that required retreatment had a very low success rate on tomographic evaluation.

Objectives: This study aimed to evaluate the stress distribution in teeth restored with different post materials and bonding conditions using finite element analysis (FEA).

Methods: A two-dimensional FEA model of a maxillary central incisor restored with IPS-Empress-2 crown (Ivoclar Vivadent), composite resin core, and posts were created. The model simulated bonded and non-bonded conditions for both fiber-reinforced composite (FRC) and titanium (Ti) posts. Stress distribution was analyzed using ANSYS 14.0 software under a 100-N load applied at a 45° angle to the long axis of the tooth.

Results: The results revealed that stress concentration was significantly higher in non-bonded posts compared to bonded ones. FRC posts exhibited stress values closer to those of dentin, whereas Ti posts demonstrated higher stress concentration, particularly in non-bonded states, increasing the potential risk of damage to surrounding tissues.

Conclusions: FRC posts, with elastic properties similar to dentin and proper adhesion, minimize stress concentration and potential damage to surrounding tissues. Conversely, materials with higher elastic modulus like Ti, can cause unfavorable stress concentrations if not properly bonded, emphasizing the importance of post adhesion in tooth restoration.

Objectives: This study aimed to evaluate the effect of different surface treatments on the bond strength between new or aged glass ionomers (GI) and resin composites in sandwich restorations.

Methods: A comprehensive search was conducted in three databases to identify studies focusing on the bond strength of new or aged GIs and resin composites in laboratory settings. The selected studies were assessed for potential biases based on predetermined criteria. Additionally, a meta-analysis was performed using three studies.

Results: A total of 29 studies were included, with 24 investigating the bond strength of new GIs and five focusing on GI repair. Three studies were included in the meta-analysis (with a 95% confidence interval) which revealed no significant difference in the mean MPa values of resin-modified glass ionomer (RMGI) treated with phosphoric acid or Er,Cr:YSGG laser before the application of an etch-and-rinse adhesive. Surface treatment was found to be crucial for achieving optimal bonding between GI and resin composite, regardless of the GI's condition.

Conclusions: The combination of mechanical and chemical surface treatments does not significantly affect the bond strength between new RMGI and composite. However, for GI repair, it is recommended to use both treatments to enhance the bond strength.

Objectives: The study aimed to conduct a bibliometric analysis of the GentleWave system (Sonendo, Inc.).

Methods: An electronic search was conducted in June 2024 using the Web of Science Collection database. Two reviewers independently screened publications, extracting data on authorship, publication details, study design, and citation metrics. Statistical analyses were performed in R to assess variable correlations, while the VOSviewer (Visualization of Similarities Viewer) software was used to map author and keyword networks.

Results: The search yielded 47 records, with 32 studies included. Publications spanned 2014 to 2024. The Journal of Endodontics published the highest number of studies (n = 15), and the International Endodontic Journal had the highest impact factor (5.4). The University of British Columbia and Sonendo, Inc. were the most frequent affiliations. Among the 32 articles, 28 were in vitro studies, primarily focusing on microbiology (n = 9). A total of 95 authors were identified, with Haapasalo and Shen being the most cited (n = 229). The articles accumulated 495 citations, demonstrating a strong positive correlation between the number of studies and citation counts (r = 0.98).

Conclusions: The analysis highlights a predominance of in vitro studies. Geographic concentration in the United States and Canada limits diversity, while the strong correlation between study numbers and citations suggests that increased publication volume enhances visibility.

The present case report describes the endodontic treatment of a type III B dens invaginatus (DI) in a three-rooted mandibular second molar since the invagination invades the root and extends apically. Clinical and cone-beam computed tomography examination of the mandibular second molar showed a broadened coronal morphology, DI, a third root, periapical radiolucency, and compression of a distal root canal by the invagination, which developed an atypical semilunar shape. The tooth was diagnosed with pulpal necrosis, symptomatic apical, and peri-invagination periodontitis. Consequently, three-dimensional virtual reconstruction was conducted to improve anatomical interpretation and case planning and accelerate the intraoperative phase by reducing operator stress and minimizing intraoperative variables. The present case report aims to raise awareness of the existence of DI on the mandibular second molar.

Objectives: While the success criteria of endodontic microsurgery (EMS) have been consistently defined and widely accepted, the success criteria of dental implants are outdated and focus only on the implant fixture and surrounding bone. This study aimed to evaluate the outcomes of EMS and single implants (SIs) with explicit criteria.

Methods: We searched for articles published from January 2010 to February 2022 and discussed them and consulted with a clinical advisory committee composed of four dental specialists and one epidemiologist during article selection and data extraction.

Results: Twenty-two EMS studies and six SI studies were included in the meta-analysis. Teeth treated using EMS had a pooled success rate of 89% (90% at <5-year follow-up and 80% at ≥5-year follow-up) and the pooled success rate of SI was 78%.

Conclusions: The success rates of the two procedures with similar follow-up periods were comparable. Subgroup analysis found no other variable that significantly influenced study heterogeneity. Considering the treatment sequence and the similar success rates, it would be advantageous to consider EMS, rather than implants, first in a situation where both procedures are applicable.

Objectives: : Pulpotomy is a minimally invasive procedure that aims to retain the vitality of the radicular pulp by removing the inflamed coronal pulp tissue. This case series presents the successful management of symptomatic irreversible pulpitis by pulpotomy with concentrated growth factor (CGF) scaffolds.

Methods: Six permanent mandibular molars with a diagnosis of symptomatic irreversible pulpitis were included. Under Local anesthesia and rubber dam isolation, caries were excavated using high-speed bur under coolant. Full coronal pulpotomy was done and hemostasis was achieved. CGF membrane was prepared and placed over the radicular pulp and layered with Biodentine (Septodont). Final restoration of type IX glass ionomer cement and bulk fill composite resin was placed. Patients were assessed for various clinical and radiographic parameters at intervals of 1 week and 3, 6, and 12 months. Five patients fulfilled the success criteria at the end of 1 year.

Results: Pulpotomy is considered an alternative treatment modality for root canal treatment in symptomatic irreversible pulpitis aiming at alleviating symptoms and maintaining vitality. CGF scaffold when used as a capping material acts as a reservoir for growth factors with anti-inflammatory properties and enhances healing.

Conclusions: Scaffold-based pulpotomy can be considered a biological approach to healing inflamed pulp.

Objectives: This study aimed to assess the pattern of endodontic instrument separation, their retrievability, and factors affecting its retrieval, in a postgraduate institute.

Methods: Cases referred for the management of separated endodontic instruments (SEI) from 2013 to 2023 were considered for this study. Data related to demographics, tooth type, file type, and retrieval were documented in an Excel sheet. Eight prognostic factors assumed to influence the retrieval were analyzed in this study. The secondary aim was to compare the pattern of SEI and retrievability between conventional nickel-titanium files and newer generation heat-treated nickel-titanium files. Retrieval was attempted by a senior endodontist under the dental operating microscope. Various ultrasonic tips and a Broken Tool Removal loop system were used during retrieval. Simple descriptive statistics were performed. Binomial logistic regression was done to identify the effect of the eight prognostic factors on the retrieval outcome.

Results: A total of 190 SEI was reported. SEI occurred more often in posterior teeth than anterior teeth, mandibular arch than maxillary arch, and in larger files than smaller files. Separation occurred more often in the apical third compared to the other levels. Retrieval was attempted in 88 cases and successful in 70 cases (79.5%). The larger taper and apical position of the SEI negatively influenced the retrieval by 1.4 and 8.7 times, respectively.

Conclusions: Retrieval of SEI was successful in the majority of the cases. An increase in taper and apically placed SEI negatively impacted the retrieval. There was no difference in the pattern of separation nor retrievability between conventional nickel-titanium files and newer generation heat-treated nickel-titanium files.

Objectives: The aim of this study was to investigate the efficacy of three newly introduced rotary endodontic systems: Genius ProFlex (Medidenta), TruNatomy (Dentsply Maillefer), and ZenFlex (Kerr).

Methods: Forty-five mandibular molars with root canal curvatures <5° were utilized. Micro-computed tomography scans were performed pre- and post-preparation to assess apical transportation, centralization, percentage of dentin wear, and canal volume alterations. Eight instruments of each diameter underwent cyclic fatigue testing.

Results: The percentage of dentin wear on mesial and distal walls showed no significant differences among ZenFlex, TruNatomy, and Genius ProFlex at 1, 2, 3, and 4 mm from the apical foramen and root canal orifice (p > 0.05). Centering ability varied in the mesiolingual canal (p < 0.05). No notable differences were observed in transportation (p > 0.05). Genius ProFlex demonstrated lower volumetric changes (p < 0.05). There were significant differences in cyclic fatigue, with higher values for Genius ProFlex and lower values for TruNatomy (p < 0.05).

Conclusions: The three nickel-titanium rotary instruments are safe and efficient for root canal preparation, with Genius ProFlex exhibiting superior cyclic fatigue resistance.

Objectives: This study investigated the effects of different whitening toothpaste (WT) on the surface properties and staining susceptibility of a resin composite.

Methods: Cylindrical samples were prepared with a micro-hybrid resin composite and were randomized into groups according to the toothpaste (n = 12): distilled water (DW), regular toothpaste (RT), WT with silica + pyrophosphate (WT-S/P), WT with pentaphosphate and pyrophosphate (WT-P/P), WT with hydrogen peroxide and pyrophosphate (WT-HP/P) and WT with charcoal and pyrophosphate (WT-Ch/P). The samples were brushed for 825 cycles in an automatic brushing machine, simulating 30 days of brushing. After that, an immersion in coffee (10 mL/sample) was performed for 30 minutes for 30 days. The analyses of color, surface microhardness (SMH), and surface roughness (Ra) were performed at the initial time, after brushing with toothpaste and after immersion in coffee. The ΔL*, Δa*, Δb*, ΔEab, Δand E00 values were calculated comparing after toothpaste with initial time and after coffee with after toothpaste. Data were analyzed using a mixed linear model for repeated measures (SMH), Kruskal-Wallis, Dunn, Friedman, and Nemenyi tests, with α = 0.05.

Results: For ΔL*, the WT-Ch/P group had the lowest values and differed from the other groups comparing the after toothpaste with the initial time interval (p < 0.001). The WT-Ch/P group had the lowest SMH values in after-toothpaste time (p < 0.001). In after-toothpaste time and after coffee time, the WT-S/P group had the highest Ra values and differed from the groups except the WT-Ch/P group (p < 0.001).

Conclusions: The toothpaste composition affects the surface characteristics and susceptibility to staining of the resin composite. The charcoal-based toothpaste had the worst performance for the color analyses and SMH.