Restorative Dentistry & Endodontics最新文献

Objectives: This study aimed to evaluate whether the agitation protocols using ultrasonic inserts or the XP-endo Finisher R file improved the removal of two different endodontic sealer remnants and the bond strength of fiberglass posts to dentin.

Methods: Seventy-two human teeth were selected. The canals were prepared with Reciproc 50 and Easy ProDesign 30/.10 and root filled according to the endodontic sealer groups: AH Plus or EndoSequence BC Sealer HiFlow. The samples were kept at 37ºC and 95% humidity for 28 days. During the post space preparation, the obturation was removed with Largo burs, and the groups were divided according to the irrigant agitation protocols (n = 12): no agitation, agitation with R1-Clearsonic associated with E1-Irrisonic ultrasonic inserts, or agitation with XP-endo Finisher R file. The fiberglass posts were cemented with RelyX ARC. The roots were sectioned into slices and submitted to the push-out test. Micro-computed tomography analysis was used to check the effectiveness of irrigating solution agitation in the elimination of remnants.

Results: The cleaning protocols with agitation were more effective in increasing the bond strength of posts to dentin for both sealer groups compared to non-agitation (p < 0.05). There was no difference between the same cleaning protocols for the different sealers. Among the different thirds, there was no statistical difference for the same sealer in the different cleaning protocols (p > 0.05).

Conclusions: Both agitation protocols effectively clean root-filled canals sealed with resin-based and calcium silicate-based sealers during fiberglass post space preparation. These protocols result in improved bond strength compared to non-agitation methods.

Objectives: This study aimed to evaluate the effects of two different file systems operated with three apical functions of an endodontic motor integrated with an electronic apex locator on debris extrusion.

Methods: Sixty single-rooted teeth were prepared and divided into two main groups and three subgroups based on the file system (OneShape [Micro-Mega SA] and WaveOne [Dentsply Maillefer]) and apical function of the endodontic motor used (auto apical stop [AAS], auto apical reverse [AAR], and auto apical slowdown [ASD]). The teeth were mounted in pre-weighed glass tubes filled with 0.9% sodium chloride to complete the circuit with the apex locator. Files were advanced until the respective apical function (stop, reverse, or slowdown) was activated. The extruded debris was collected, dried, and weighed by subtracting pre-weighed values from post-weighed values. Preparation time was also recorded. Statistical analyses were performed to compare the groups.

Results: OneShape was associated with significantly less debris extrusion compared to WaveOne, regardless of the apical function (p < 0.05). The ASD function resulted in the least debris extrusion compared to AAS and AAR (p < 0.05). Preparation time was significantly longer in the ASD function (p < 0.05), while no differences were observed between the file systems (p > 0.05).

Conclusions: The OneShape file system and the ASD function produced the least amount of apical debris. While the ASD function requires more preparation time, its potential to minimize debris extrusion suggests it may reduce postoperative symptoms.

Objectives: The study aimed to evaluate the effect of limonene extract (LE) on push-out bond strength (BS) to root dentin in endodontically treated teeth.

Methods: Single-rooted teeth were selected and instrumented using the reciprocating technique, then divided into three groups based on the final irrigating solution: 2.5% sodium hypochlorite (NaOCl), 17% ethylenediaminetetraacetic acid (EDTA), and 5% LE. The roots were further divided (n = 12) and obturated using the single-cone technique with epoxy resin-based (ERB) or bioceramic sealer (Bio-C). After 3 days, the roots were sectioned into 2-mm slices, obtaining two slices from each root third. Push-out BS testing was conducted at 0.5 mm/min, followed by failure pattern and adhesive interface analysis using scanning electron microscopy. Push-out BS data were analyzed by three-way analysis of variance and Tukey post-hoc test (p < 0.05).

Results: ERB showed higher BS when irrigated with EDTA (5.0 ± 2.3 MPa) compared to NaOCl (1.8 ± 1.1 MPa) (p = 0.0005), particularly in the cervical third. LE yielded intermediate values without significant differences from the other irrigants (3.5 ± 1.9 MPa) (p > 0.05). For Bio-C, the highest BS was observed in the apical third, especially with LE (9.4 ± 5.0 MPa), differing from other thirds and final irrigating solutions (p < 0.05). Mixed failure patterns were most prevalent, regardless of the irrigant solutions.

Conclusions: The combination of LE with Bio-C demonstrated superior BS in the apical third, suggesting its potential as a final irrigating solution in endodontic treatments.

Objectives: This study analyzed the stress distribution in a maxillary central incisor with external cervical resorptive defect restored with different restorative materials under normal masticatory and traumatic loading conditions using finite element analysis.

Methods: Cone-beam computed tomography of an extracted intact incisor and created resorptive models (Patel's 3D classification-2Bd and 2Bp) in the maxillary central incisor was performed for finite element models. The 2Bd models were restored either with glass ionomer cement (GIC)/Biodentine (Septodont) or a combination of both with composite resin. 2Bp models were restored externally with a combination technique and internally with root canal treatment. The other model was external restoration with GIC and internal with fiber post. Two masticatory loads were applied at 45˚ to the palatal aspect, and two traumatic loads were applied at 90˚ to the buccal aspect. Maximum von Mises stresses were calculated, and stress distribution patterns were studied.

Results: In 2Bd models, all restorative strategies decreased stress considerably, similar to the control model under all loads. In 2Bp models, the dentin component showed maximum stress at the deepest portion of the resorptive defect, which transfers into the adjacent pulp space. In 2Bp defects, a multilayered restoration externally and root canal treatment internally provides better stress distribution compared to the placement of a fiber post.

Conclusions: Increase in load, proportionally increased von Mises stress, despite the direction or angulation of the load. Multilayered restoration is preferred for 2Bd defects, and using an internal approach of root canal treatment is suggested to restore 2Bp defects.

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.