Research

11 pages, 30784 KiB

Open AccessArticle

Heat-Induced Changes in the Physical Properties of a New Premixed Calcium Silicate-Containing Root Canal Sealer: An In Vitro Study

by Ryota Ito, Satoshi Watanabe, Akira Kouno, Shinya Yamauchi and Takashi Okiji

Dent. J. 2024, 12(4), 106; https://doi.org/10.3390/dj12040106 - 12 Apr 2024

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Abstract

This study aimed to examine how heating affects the physical properties of a newly developed premixed calcium silicate-containing sealer (AH Plus Bioceramic Sealer; AHB), in comparison with EndoSequence BC Sealer (ES), AH Plus Jet (AH), and Pulp Canal Sealer. The setting time, flow, [...] Read more.

This study aimed to examine how heating affects the physical properties of a newly developed premixed calcium silicate-containing sealer (AH Plus Bioceramic Sealer; AHB), in comparison with EndoSequence BC Sealer (ES), AH Plus Jet (AH), and Pulp Canal Sealer. The setting time, flow, and film thickness were tested with or without heating at 100 °C for 30 or 60 s, in accordance with ISO6876:2012 standards. Ultrastructural and elemental analyses were performed with scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDS). Data were analyzed using one-way analysis of variance (ANOVA) with a Tukey post hoc test (α = 0.05). All sealers exhibited significantly shorter setting time and flow after heating at 100 °C for 30 and 60 s (p < 0.05). After heating, AHB showed a significantly higher film thickness compared to that of the other materials (p < 0.05). None of the tested properties of heat-applied AHB and ES met ISO standards, except the setting time in ES. The SEM/EDS results for AHB and ES were not affected by heating. The detected changes in physical properties can negatively impact the performance of premixed calcium silicate-containing sealers, particularly AHB, when warm vertical compaction is employed. Full article

(This article belongs to the Special Issue Endodontics and Restorative Sciences)

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12 pages, 591 KiB

Open AccessArticle

The Effect of Different Compositions and Concentrations of Etidronate-Containing Irrigants on the Antibacterial Activity of Sodium Hypochlorite against Enterococcus faecalis and Candida albicans

by Nina Novozhilova, Ksenia Babina, Maria Polyakova, Inna Sokhova, Valeria Sherstneva, Alexandr Zaytsev, Irina Makeeva and Anna Mikheikina

Dent. J. 2024, 12(3), 46; https://doi.org/10.3390/dj12030046 - 21 Feb 2024

Viewed by 966

Abstract

We assessed the effect of different compositions and concentrations of two etidronate-containing irrigants on the antibacterial activity of sodium hypochlorite (SH) against Enterococcus faecalis and Candida albicans in vitro. Pure cultures of C. albicans and E. faecalis were isolated from root canal samples. [...] Read more.

We assessed the effect of different compositions and concentrations of two etidronate-containing irrigants on the antibacterial activity of sodium hypochlorite (SH) against Enterococcus faecalis and Candida albicans in vitro. Pure cultures of C. albicans and E. faecalis were isolated from root canal samples. The disc diffusion method was used to compare the antibacterial effect of pure SH and SH mixed with 9%, 15%, and 18% etidronate of two manufactures (dual rinse (DR); IsraDent (ID)) and EDTA. The pH and temperature of the solutions were measured immediately after mixing and within 40 min. The ANOVA revealed a significant influence of the type of irrigating solution on the C. albicans and E. faecalis inhibition zone diameters that ranged from 6.6 to 51.6 mm and from 6.4 to 12.4 mm, respectively. SH with DR 9% exhibited the highest effect against C. albicans. The antifungal activity of the other irrigants was SH = SH + DR15% = SH + DR18% = SH + ID9% > SH + EDTA > SH + ID15% > SH + ID18%. No significant differences in the anti-E. faecalis effect were revealed between the tested solutions except for the mixtures of SH and 15% and 18% ID, which exhibited no antiseptic effect. There was a strong positive correlation between antiseptic activity against both microorganisms and the pH values of the tested solutions. In conclusion, most etidronate formulations did not significantly hamper sodium hypochlorite activity against C. albicans and E. faecalis. The effect was concentration- and manufacturer-dependent. Full article

(This article belongs to the Special Issue Endodontics and Restorative Sciences)

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16 pages, 3769 KiB

Open AccessFeature PaperArticle

Decision Making in the Restoration of Endodontically Treated Teeth: Effect of Biomimetic Dentistry Training

by Paridhi Kimble, Sandra Stuhr, Neville McDonald, Akshaya Venugopalan, Marcia S. Campos and Bruno Cavalcanti

Dent. J. 2023, 11(7), 159; https://doi.org/10.3390/dj11070159 - 26 Jun 2023

Cited by 1 | Viewed by 2567

Abstract

The restoration of endodontically treated teeth (ETT) is challenging as these teeth often present with structural deficiencies. Currently, there is no consensus regarding the final restoration choice. Historically, the full coverage crown was the universally selected treatment for endodontically treated teeth. With advances [...] Read more.

The restoration of endodontically treated teeth (ETT) is challenging as these teeth often present with structural deficiencies. Currently, there is no consensus regarding the final restoration choice. Historically, the full coverage crown was the universally selected treatment for endodontically treated teeth. With advances in adhesive and biomimetic dentistry, more minimally invasive treatment modalities have become a viable option. With this study, we aim to understand the restorative decision of the general dentist with or without additional training in biomimetic dentistry. Seventy-eight general dentists, with or without biomimetic training, were surveyed to determine their restorative preferences on five extracted posterior teeth, categorized according to volumetric loss of tooth structure, as indicated by the number of missing walls, the isthmus width, the presence or absence of marginal ridges, and cusps. CAD/CAM reconstructions were made with the teeth to analyze the volume of tooth loss and compare these with the survey results. Data were compared using the chi-squared test and Fisher’s exact test. The frequency of responses recommending a crown and the volume of tooth loss were correlated using the Pearson test (p < 0.05). For all five teeth, survey responses showed a statistically significant difference in the restorative decision of full coverage versus alternative restorations, with biomimetic dentists selecting a direct restoration or inlay/onlay in lieu of a full coverage crown (n = 63, p < 0.05). The age of the participant did not have a significant impact on the restorative decision making process for these teeth. The biomimetic trained dentists showed a greater tendency to select a crown option only when the volume of tooth loss was greatest, otherwise their restorative decisions tended towards the conservative treatment options. This study also demonstrates a novel method of digitally developing a volume of tooth loss to compare against the visual interpretation of the volume of tooth loss. Full article

(This article belongs to the Special Issue Endodontics and Restorative Sciences)

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9 pages, 1236 KiB

Open AccessArticle

Evaluation of Dentinal Thickness and Remaining Dentine Volume around Root Canals Using Cone-Beam Computed Tomography Scanning

by Svetlana Razumova, Anzhela Brago, Haydar Barakat, Dimitriy Serebrov, Zoya Guryeva, Gleb S. Parshin and Vasiliy I. Troitskiy

Dent. J. 2023, 11(5), 124; https://doi.org/10.3390/dj11050124 - 04 May 2023

Cited by 1 | Viewed by 1916

Abstract

Background: The remaining dentinal thickness is a significant factor to deal with when planning post-endodontic treatment. Aim: To assess the changes in the root canal dentinal thickness of intact and endodontically treated teeth using CBCT scans in the coronal, middle, and apical third [...] Read more.

Background: The remaining dentinal thickness is a significant factor to deal with when planning post-endodontic treatment. Aim: To assess the changes in the root canal dentinal thickness of intact and endodontically treated teeth using CBCT scans in the coronal, middle, and apical third of the root canal. Material and methods: Three hundred CBCT scans for three age groups were analyzed to study the dentinal thickness pre- and post-endodontic treatment. The dentinal thickness (DT) was measured along the buccal, mesial, distal, and lingual/palatal walls from the inner surface of the root canal to the outer surface in mm. Statistical analysis was set at 0.05. Results: The results of this study showed that the buccal, palatal, distal, and mesial dentinal thickness in intact and endodontically treated teeth is different. The differences were statistically significant when comparing the parameters of “healthy” and “treated” teeth (p < 0.05). There were no statistically significant differences in indicators associated with age (p > 0.05). In the coronal third of the root canal, the least amount of dentin tissue lost was 4.2% for mandibular canines. Conclusions: The dentinal thickness in the coronal and middle third of the root decreases significantly more than the apical third. The most loss of dentine volume was among molar teeth, and the remaining dentinal thickness was less than 1 mm, which would increase the risk of complication while preparing the canal for a post. Full article

(This article belongs to the Special Issue Endodontics and Restorative Sciences)

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17 pages, 6127 KiB

Open AccessArticle

Synthesis and Characterization of Zirconia–Silica PMMA Nanocomposite for Endodontic Implants

by Puji Widodo, Wawan Mulyawan, Nina Djustiana and I. Made Joni

Dent. J. 2023, 11(3), 57; https://doi.org/10.3390/dj11030057 - 22 Feb 2023

Cited by 3 | Viewed by 1784

Abstract

This study aimed to enhance the mechanical properties of PMMA composites by introducing various types of fillers, including ZrO₂, SiO₂, and a mixture of ZrO₂-SiO₂ nanoparticles, which were prepared as prototypes for an endodontic implant. The [...] Read more.

This study aimed to enhance the mechanical properties of PMMA composites by introducing various types of fillers, including ZrO₂, SiO₂, and a mixture of ZrO₂-SiO₂ nanoparticles, which were prepared as prototypes for an endodontic implant. The ZrO₂, SiO₂, and mixed ZrO₂-SiO₂ nanoparticles were synthesized using the sol–gel method and the precursors Tetraethyl Orthosilicate, Zirconium Oxychloride, and a mixture of both precursors, respectively. Before polymerization, the as-synthesized powders were subjected to the bead milling process to obtain a well-dispersed suspension. Two scenarios for the fillers were implemented in the preparation of the PMMA composite: a mixture of ZrO₂/SiO₂ and ZrO₂-SiO₂ mixed with two different types of silane: (3-Mercaptopropyl) trimethoxysilane (MPTS) and 3-(Trimethoxysilyl) Propyl Methacrylate (TMSPMA). The observation of the characteristics of all of the investigated fillers included the use of a particle-size analyzer (PSA), a Zeta-potential analyzer, FTIR, XRF, XRD, and SEM. The mechanical properties of the MMA composites, as prepared under various scenarios, were observed in terms of their flexural strength, diametrical tensile strength (DTS), and modulus of elasticity (ME). These levels of performance were compared with a PMMA-only polymer. Each sample was measured five times for flexural strength, DTS, and ME. The results showed that the best PMMA composite was SiO₂/ZrO₂/TMSPMA, as revealed by measurements of the flexural strength, DTS, and ME corresponding to 152.7 ± 13.0 MPa, 51.2 ± 0.6 MPa, and 9272.8 ± 2481.4 MPa, which are close to the mechanical properties of dentin. The viability of these PMMA composites, as measured up to day 7, was 93.61%, indicating that they are nontoxic biomaterials. Therefore, it was concluded that the PMMA composite created with SiO₂/ZrO₂/TMSPMA can be considered to be an acceptable endodontic implant. Full article

(This article belongs to the Special Issue Endodontics and Restorative Sciences)

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13 pages, 1662 KiB

Open AccessArticle

Can the Concentration of Citric Acid Affect Its Cytotoxicity and Antimicrobial Activity?

by Luciano Giardino, Luigi Generali, Paolo Savadori, Mirela Cesar Barros, Leticia Lobo de Melo Simas, Jolanta Pytko-Polończyk, Wojciech Wilkoński, Vasudev Ballal and Flaviana Bombarda de Andrade

Dent. J. 2022, 10(8), 148; https://doi.org/10.3390/dj10080148 - 09 Aug 2022

Cited by 2 | Viewed by 2480

Abstract

Background: There has been no unanimity concerning the ideal concentration of citric acid for safe use in clinical practice. This study evaluated the cytotoxicity and the antibacterial activity in infected dentinal tubules of 10% and 1% citric acid (CA) solutions. Methods: The cytotoxicity [...] Read more.

Background: There has been no unanimity concerning the ideal concentration of citric acid for safe use in clinical practice. This study evaluated the cytotoxicity and the antibacterial activity in infected dentinal tubules of 10% and 1% citric acid (CA) solutions. Methods: The cytotoxicity of CA solutions in DMEM (diluted 1/10, 1/100) was assessed in L-929 fibroblasts. A broth macrodilution method (MIC and MBC) was used to assess CA antibacterial concentration. The antimicrobial activity of CA solutions was also evaluated after their final rinse inside root canals in previously Enterococcus faecalis-contaminated dentinal tubules. Ten infected dentine samples were rinsed for 5 min with 5% NaOCl and subsequently with 1% citric acid for 3 min. Another 10 were rinsed with 5% NaOCl and 10% citric acid for 3 min; the remaining four specimens were utilized as positive controls. Two uncontaminated specimens were used as negative controls. After LIVE/DEAD BacLight staining, the samples were assessed using CLSM to analyze the percentage of residual live and dead cells. Results: Both undiluted and diluted CA solutions showed severe toxicity; no changes from normal morphology were displayed when diluted 1/100. The MIC and MBC of CA were 6.25 mg/mL and 12.50 mg/mL, respectively. CA solutions demonstrated significantly low levels of bacterial counts than the positive control group, reporting a value of 9.3% for the 10% solution versus the 1% solution (35.2%). Conclusions: Despite its valuable antimicrobial properties, the cytotoxic effects of citric acid should be considered during endodontic treatment. Full article

(This article belongs to the Special Issue Endodontics and Restorative Sciences)

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Review

Jump to: Research, Other

15 pages, 489 KiB

Open AccessReview

Irrigation in Endodontics: Polyhexanide Is a Promising Antibacterial Polymer in Root Canal Treatment

by Zurab Khabadze, Yulia Generalova, Alena Kulikova, Irina Podoprigora, Saida Abdulkerimova, Yusup Bakaev, Mariya Makeeva, Marina Dashtieva, Mariya Balashova, Fakhri Gadzhiev, Oleg Mordanov, Adam Umarov, Haddad Tarik, Andrei Zoryan, Amina Karnaeva and Yakup Rakhmanov

Dent. J. 2023, 11(3), 65; https://doi.org/10.3390/dj11030065 - 01 Mar 2023

Viewed by 2392

Abstract

Background:chronic apical periodontitis is a common pathology in dentistry, especially in endodontics. It is necessary to systematize data concerning commonly used irrigation solutions. The development of new protocols for endodontic treatment is a very promising direction. The use of a polyhexanide-based antiseptic can [...] Read more.

Background:chronic apical periodontitis is a common pathology in dentistry, especially in endodontics. It is necessary to systematize data concerning commonly used irrigation solutions. The development of new protocols for endodontic treatment is a very promising direction. The use of a polyhexanide-based antiseptic can positively affect the results of endodontic treatment. Methods: the review was carried out involving the search for English language research and meta-analyses in the Google Scholar and PubMed databases. Results: the number of literary sources that were identified during the literature review is 180. After excluding publications that did not match the search criteria, the total number of articles included in the systematic review was determined to be 68. Conclusions: polyhexanide is a promising solution for infected root canal irrigation. The antibacterial activity of this substance is suitable for the elimination of pathogens responsible for the appearance of apical periodontitis. Full article

(This article belongs to the Special Issue Endodontics and Restorative Sciences)

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16 pages, 851 KiB

Open AccessReview

Effect of Endodontic Irrigating Solutions on Radicular Dentine Structure and Matrix Metalloproteinases—A Comprehensive Review

by Abayomi Omokeji Baruwa, Jorge N. R. Martins, Tatjana Maravic, Claudia Mazzitelli, Annalisa Mazzoni and António Ginjeira

Dent. J. 2022, 10(12), 219; https://doi.org/10.3390/dj10120219 - 23 Nov 2022

Cited by 4 | Viewed by 2759

Abstract

Irrigating solutions play an important role in the eradication of intracanal microbes and debris dissolution during endodontic treatment. Different combinations of solutions and protocols have been advocated, with sodium hypochlorite (NaOCl), ethylenediamine tetra acetic acid (EDTA), and chlorhexidine (CHX) remaining the most widely [...] Read more.

Irrigating solutions play an important role in the eradication of intracanal microbes and debris dissolution during endodontic treatment. Different combinations of solutions and protocols have been advocated, with sodium hypochlorite (NaOCl), ethylenediamine tetra acetic acid (EDTA), and chlorhexidine (CHX) remaining the most widely used ones by many clinicians. Although these solutions provide efficient inorganic dissolution and antimicrobial capacity, their use has also been reported to cause undesired effects on root dentin composition and mechanical and biomechanical properties, such as microhardness, surface roughness, bond strength, and matrix metalloproteinase (MMP) activity. Several corroborating studies attribute these changes in mechanical properties of dentine to the use of irrigating solutions, and there are limited reports on how the solutions affect the expression of MMPs, which may be a correlating link to understanding the role of these enzymes in dentin collagen and changes in the mechanical properties of dentin. Hence, using the basis of several studies from the literature, the objective is to comprehensively review the influence of individual and combined irrigating solutions on root dentine structure and the activity of the MMPs. Full article

(This article belongs to the Special Issue Endodontics and Restorative Sciences)

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Other

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10 pages, 3388 KiB

Open AccessCase Report

Partial Ceramic Veneer Technique for Challenging Esthetic Frontal Restorative Procedures

by Gustavo Marotto Caetano, Cilea Slomp, Jonas Pereira Andrade, Ana Maria Spohr and Marcel Ferreira Kunrath

Dent. J. 2023, 11(4), 101; https://doi.org/10.3390/dj11040101 - 11 Apr 2023

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Abstract

Frontal darkened teeth have shown to be one of the most challenging treatments for esthetic dentistry in recent years. This case report, along with a 30-month follow-up, describes the application of a partial ceramic veneer, restricted to the mid-cervical third region, made in [...] Read more.

Frontal darkened teeth have shown to be one of the most challenging treatments for esthetic dentistry in recent years. This case report, along with a 30-month follow-up, describes the application of a partial ceramic veneer, restricted to the mid-cervical third region, made in the upper left central incisor darkened by trauma. The procedure consisted of maintenance of the entire incisal face, as well as esthetic and morphological rehabilitation of the smile line with veneers and ultra-thin partial ceramic veneers. The planning process was thoroughly elaborated by photographs, study models, a virtual smile designed, diagnostic waxing, and reproduction in the patient’s mouth through mock-up. Following, dental home bleaching, esthetic gingival contouring, and minimally invasive tooth preparation were performed. Two types of glass ceramics (lithium disilicate and feldspathic) were used in different regions due to the peculiar characteristics of resistance, finishing, and polishing. According to the present case report, preparing a cervical partial ceramic veneer is an innovative, viable, and safe approach to maintaining the incisal portion of the tooth preserved and setting a detailed tooth morphology/color. The application of partial ceramic veneer provides incisal edge preservation and simplifies the reproduction of the adjacent tooth characteristics, avoiding multiple esthetic appointments. Full article

(This article belongs to the Special Issue Endodontics and Restorative Sciences)

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10 pages, 3467 KiB

Open AccessBrief Report

In Vivo Assessment of the Calcium Salt-Forming Ability of a New Calcium Silicate-Based Intracanal Medicament: Bio-C Temp

by Naoki Edanami, Razi Saifullah Ibn Belal, Shoji Takenaka, Kunihiko Yoshiba, Rosa Edith Baldeon Gutierrez, Shintaro Takahara, Nagako Yoshiba, Naoto Ohkura and Yuichiro Noiri

Dent. J. 2023, 11(4), 91; https://doi.org/10.3390/dj11040091 - 30 Mar 2023

Cited by 3 | Viewed by 1784

Abstract

Calcium salt precipitation induced by intracanal medicaments contributes to the formation of apical hard tissue during apexification. This study compared the calcium salt-forming ability of a new calcium silicate-based intracanal medicament (Bio-C Temp) with that of two commercial calcium hydroxide pastes (Calcipex Plane [...] Read more.

Calcium salt precipitation induced by intracanal medicaments contributes to the formation of apical hard tissue during apexification. This study compared the calcium salt-forming ability of a new calcium silicate-based intracanal medicament (Bio-C Temp) with that of two commercial calcium hydroxide pastes (Calcipex Plane II and Vitapex) in a rat subcutaneous implantation model. Polytetrafluoroethylene tubes containing each of the three materials were subcutaneously implanted in 4-week-old male Wistar rats. After 28 days, the composition and amount of calcium salts formed at the material–tissue interface were assessed using micro-Raman spectroscopy, X-ray diffraction, and elemental mapping. The tested materials produced white precipitates that had Raman spectra with peaks corresponding to hydroxyapatite and calcite. X-ray diffraction detected hydroxyapatite formation on Calcipex Plane II and Vitapex implants, as well as calcite formation on all three materials. Elemental mapping revealed that Bio-C Temp generated significantly smaller calcium- and phosphorus-rich calcified regions within the subcutaneous connective tissue than Vitapex. These results indicate that Bio-C Temp produced less calcium salt in rat subcutaneous tissue than Vitapex, although all materials formed hydroxyapatite and calcite in rat subcutaneous tissue. Bio-C Temp could be less effective than Vitapex in promoting apical hard tissue formation during apexification. Full article

(This article belongs to the Special Issue Endodontics and Restorative Sciences)

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8 pages, 2702 KiB

Open AccessCase Report

Tunnel Fenestration of the Mandibula after Unsuccessful Post Traumatic Treatment: A Case Report of the One Year Follow-Up

by Peter Gillner, Richard Mosch and Constantin von See

Dent. J. 2023, 11(2), 37; https://doi.org/10.3390/dj11020037 - 02 Feb 2023

Viewed by 2085

Abstract

Particularly severe cases with tunneled defects are rarely reported and are described only in a few case reports. This case report describes the treatment of a tunnel fenestration in the lower central jaw after unsuccessful endodontic treatment following trauma of incisors 31 and [...] Read more.

Particularly severe cases with tunneled defects are rarely reported and are described only in a few case reports. This case report describes the treatment of a tunnel fenestration in the lower central jaw after unsuccessful endodontic treatment following trauma of incisors 31 and 41 over the course of six years, which led to the development of an internal granuloma and a radicular cyst in the lower jaw. The patient presented with a 2.67 cm³ radicular cyst displacing the surrounding tissue at regio 31 and 41, which resulted in a tunnel-like bony defect. Endodontic treatment and periapical root tip resection on teeth 31 and 41 with cystectomy, and with a 12 month follow-up, were successful in the healing of the bone defect. The preserved teeth received lithium disilicate crowns for definite restoration one year postoperatively. This treatment can be an option for the therapy of large cysts. Full article

(This article belongs to the Special Issue Endodontics and Restorative Sciences)

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