Modern Therapeutic Approaches in Endodontics and Restorative Dentistry

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Dentistry".

Deadline for manuscript submissions: 11 August 2024 | Viewed by 10493

Special Issue Editor

Special Issue Information

Dear Colleagues,

In endodontics, the removal of bacterial load from the complex endodontic space is essential to achieving success, which is gained through shaping, 3D cleaning, and the tridimensional obturation of the complex root canal system. In recent years, satisfactory results could be obtained with modern technologies such as an operative microscope, ultrasonic tips, modern rotary files, devices to activate irrigation, and tridimensional obturation techniques. Restorative dentistry is evolving rapidly thanks to new materials and modern adhesive systems that allow new therapeutic approaches guaranteeing the aesthetic-functional rehabilitation of the compromised tooth.

This Special Issue focuses on all the technologies available today to increase the success rate in Endodontics and restorative dentistry.

Dr. Alfredo Iandolo
Guest Editor

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Keywords

  • endodontics
  • root canal treatment
  • cleaning
  • NaOCl
  • endodontic surgery
  • composites, bonding, curing
  • restorative dentistry

Published Papers (6 papers)

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Editorial

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2 pages, 225 KiB  
Editorial
Modern Therapeutic Strategies in Endodontics and Restorative Dentistry
by Alfredo Iandolo
Medicina 2023, 59(2), 333; https://doi.org/10.3390/medicina59020333 - 10 Feb 2023
Viewed by 1518
Abstract
Modern endodontics aims to reduce or eliminate bacterial load inside root canals [...] Full article

Research

Jump to: Editorial

11 pages, 794 KiB  
Article
Comparison of Efficacy of Lidocaine and Articaine as Inferior Alveolar Nerve Blocking Agents in Patients with Symptomatic Irreversible Pulpitis: Randomized Controlled Trial
by Sobia Hassan, Alia Ahmed, Warda Saqib, Ayman M. Abulhamael, Syed Rashid Habib and Muhammad Qasim Javed
Medicina 2023, 59(10), 1840; https://doi.org/10.3390/medicina59101840 - 16 Oct 2023
Cited by 1 | Viewed by 1499
Abstract
Background and Objectives: Lidocaine Hydrochloride has been the standard choice for local anesthesia in dentistry and Articaine’s unique structure and growing popularity make it a viable alternative. Due to contradictory results in prior research and a scarcity of trials conducted in the [...] Read more.
Background and Objectives: Lidocaine Hydrochloride has been the standard choice for local anesthesia in dentistry and Articaine’s unique structure and growing popularity make it a viable alternative. Due to contradictory results in prior research and a scarcity of trials conducted in the Pakistani population, this study aims to compare the anesthetic efficacy of Lidocaine with Articaine for inferior alveolar nerve blocks in patients with symptomatic irreversible pulpitis. Materials and Methods: This double-blinded, randomized controlled trial included 152 patients who were selected by consecutive non-probability sampling. The participants included patients who presented with symptomatic irreversible pulpitis in mandibular posterior teeth (molars and premolars) and depicted normal apical tissue radiographically. The patients were equally and randomly divided into two groups. The control group received 2% Lidocaine Hydrochloride injections, and the experiment group received 4% Articaine Hydrochloride injections. Participants scored their pain on the HP-VAS both before and after the administration of anesthesia. A value of 54 mm or less on the scale indicated effective anesthesia. The data obtained were analyzed using SPSS. Chi-square test was applied to analyze data for statistical significance. Results: There was no statistically significant difference in the efficacy of the two anesthetic agents. During access cavity preparation, Lidocaine demonstrated a success rate of 93%, whereas Articaine exhibited a slightly higher success rate of 97%. During initial instrumentation, the success rates for Lidocaine and Articaine were 72% and 71%, respectively. This suggests that both Lidocaine and Articaine were effective in achieving anesthesia during the dental procedure in patients with symptomatic irreversible pulpitis, with Articaine showing a slightly better success rate, although the difference was not statistically significant. Conclusions: The anesthetic efficacy of Articaine is similar to that of lidocaine in subjects with symptomatic irreversible pulpitis. Hence, Articaine can serve as an alternative to Lidocaine for local anesthesia administration in dentistry. Full article
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11 pages, 3561 KiB  
Article
Influence of the Fiber Post Length on the Fracture Strength of Endodontically Treated Teeth
by Adrian-George Marinescu, Osama Abuabboud, Ștefana-Denisa Zimbru, Laura-Elena Cîrligeriu, Bianca-Adina Piț, Ioana-Amalia Borcean, Mihai Paven, Luminița-Maria Nica and Dan Ioan Stoia
Medicina 2023, 59(10), 1797; https://doi.org/10.3390/medicina59101797 - 9 Oct 2023
Cited by 1 | Viewed by 1761
Abstract
Background and Objectives: Although fiber posts are widely used in the restoration of endodontically treated teeth (ETT), their ideal cementation depth into the root canal is still debated in literature. The aim of the present study was to evaluate whether the different intra-radicular [...] Read more.
Background and Objectives: Although fiber posts are widely used in the restoration of endodontically treated teeth (ETT), their ideal cementation depth into the root canal is still debated in literature. The aim of the present study was to evaluate whether the different intra-radicular insertion lengths of the fiber posts influence the fracture strength of ETT. Materials and Methods: A total of 10 permanent human lower incisors with straight roots of similar length and volume extracted for periodontal reason were sectioned 2 mm above the cement–enamel junction (CEJ) to a total length of 18 mm and endodontically treated in the same manner, then randomly divided into two groups of five each (Groups 1 and 2, n = 5). Two sound incisors, with no endodontic treatment, were used as the control group (Group 3, n = 2). After one week of storage in a humid environment, spaces for fiber post no. 1 (Reforpost, Angelus, Londrina, PR, Brazil) were prepared in the first two groups at a depth of 5 mm (Group 1) and 7 mm (Group 2), and the fiber posts were adhesively cemented using self-adhesive resin cement (Maxcem Elite, Kerr GmbH, Herzogenrath, Germany). After 7 days, the samples were vertically positioned and fixed in a self-curing transparent acrylic resin, up to 2 mm below the CEJ level, and mechanically tested in compression after another week of storage using a displacement-controlled testing machine up to each sample’s fracture. The force–displacement curves were recorded for each sample, the means were calculated for each group and a statistical comparative analysis between groups was conducted. Results: Although no statistically significant differences between groups were observed, the highest mean fracture force (N) was recorded in Group 2 (1099.41 ± 481.89) in comparison to Group 1 (985.09 ± 330.28), even when compared to the sound, non-treated teeth (1045.69 ± 146.19). Conclusions: Within the limitations of this in vitro study, teeth where fiber posts were placed deeper into the root canal (7 mm) recorded slightly higher fracture forces in comparison with shorter lengths (5 mm). However, similar biomechanical performances obtained in the mechanical tests showed no statistical differences between the 7 mm and the 5 mm inserted posts. Full article
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18 pages, 8628 KiB  
Article
Effects of Dental Bleaching Agents on the Surface Roughness of Dental Restoration Materials
by Alexandru Dan Popescu, Mihaela Jana Tuculina, Oana Andreea Diaconu, Lelia Mihaela Gheorghiță, Claudiu Nicolicescu, Cristian Niky Cumpătă, Cristiana Petcu, Jaqueline Abdul-Razzak, Ana Maria Rîcă and Ruxandra Voinea-Georgescu
Medicina 2023, 59(6), 1067; https://doi.org/10.3390/medicina59061067 - 1 Jun 2023
Cited by 1 | Viewed by 1959
Abstract
Background and Objectives: This study aimed to evaluate the surface roughness evolution of several finished and polished composites when bleaching materials are applied. The research was conducted on four microhybrid or nanofilled composites that are used in dental restorations. Materials and Methods: For [...] Read more.
Background and Objectives: This study aimed to evaluate the surface roughness evolution of several finished and polished composites when bleaching materials are applied. The research was conducted on four microhybrid or nanofilled composites that are used in dental restorations. Materials and Methods: For each composite type, 5 samples were selected for control, 5 samples were subjected to the bleaching protocol “office bleach” with 40% hydrogen peroxide, and 5 other samples were subjected to the “home bleach” protocol with 16% carbamide peroxide, resulting in a total number of 60 samples. The surfaces of all the samples were tested for roughness, and the values of the most relevant parameter (Ra), were collected. Comparisons between composites and samples were performed using one-way ANOVA (in Statistical Package for Social Sciences). Results: After the bleaching protocol with 40% hydrogen peroxide gel, it was found that the roughness of the group increased considerably compared to the control group, so the highest roughness was found at GC Gradia direct anterior group, and the lowest value was registered for the 3M ESPE Valux Plus group. Following the bleaching protocol with 16% carbamide peroxide (home bleach), it was noted that the sample surfaces were not as affected. In this case, the lowest roughness was found at 3M ESPE Valux Plus group, and the highest roughness was registered for the GC G-aenial anterior group. Following the interpretation of the results, all four types of dental composites tested showed significant surface roughness differences between the groups subjected to bleaching protocols and those kept as control (p < 0.05). Conclusions: The surfaces of the samples were affected by the bleaching protocols by increasing the roughness compared to the control samples. Full article
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8 pages, 538 KiB  
Article
Long-Term Chromatic Durability of White Spot Lesions through Employment of Infiltration Resin Treatment
by Francesco Puleio, Federica Di Spirito, Giuseppe Lo Giudice, Giuseppe Pantaleo, David Rizzo and Roberto Lo Giudice
Medicina 2023, 59(4), 749; https://doi.org/10.3390/medicina59040749 - 12 Apr 2023
Cited by 2 | Viewed by 1310
Abstract
Background and Objectives: White spot lesions (WSLs) denote regions of subsurface demineralization on the enamel that manifest as opaque and milky-white regions. Treatment for WSLs is essential for both clinical and aesthetic reasons. Resin infiltration has been identified as the most efficacious [...] Read more.
Background and Objectives: White spot lesions (WSLs) denote regions of subsurface demineralization on the enamel that manifest as opaque and milky-white regions. Treatment for WSLs is essential for both clinical and aesthetic reasons. Resin infiltration has been identified as the most efficacious solution for alleviating WSLs, but studies with long-term monitoring are scarce. The aim of this clinical study is to assess the color change stability of the lesion after four years of implementing the resin infiltration technique. Materials and Methods: Forty non-cavity and unrestored white spot lesions (WSLs) were treated with the resin infiltration technique. The color of the WSLs and adjacent healthy enamel (SAE) was assessed using a spectrophotometer at T0 (baseline), T1 (after treatment), T2 (1 year after) and T3 (4 years after). The Wilcoxon test was utilized to determine the significance of the variation of color (ΔE) between WSLs and SAE over the observed time periods. Results: When comparing the color difference ΔE (WSLs-SAE) at T0-T1, the Wilcoxon test demonstarated a statistically significant difference (p < 0.05). For ΔE (WSLs-SAE) at T1-T2 and T1-T3, the color variation was not statistically significant (p = 0.305 and p = 0.337). Conclusions: The study’s findings indicate that the resin infiltration technique is an effective solution for resolving the appearance of WSLs, and the results have demonstrated stability for a minimum of four years. Full article
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12 pages, 6609 KiB  
Article
Efficacy of Smear Layer Removal at the Apical One-Third of the Root Using Different Protocols of Erbium-Doped Yttrium Aluminium Garnet (Er:YAG) Laser
by Amel Yousif Habshi, Nausheen Aga, Khadija Yousif Habshi, Muna Eisa Mohamed Hassan, Ziaullah Choudhry, Muhammad Adeel Ahmed, Azeem Ul Yaqin Syed and Rizwan Jouhar
Medicina 2023, 59(3), 433; https://doi.org/10.3390/medicina59030433 - 22 Feb 2023
Cited by 2 | Viewed by 1565
Abstract
Background and Objectives: Smear layer forms during cleaning and shaping can obstruct the entry of both irrigant and sealant into the dentinal tubules, resulting in the accumulation of the bacteria and their byproducts. To ensure effective adhesion and better periapical healing, it is [...] Read more.
Background and Objectives: Smear layer forms during cleaning and shaping can obstruct the entry of both irrigant and sealant into the dentinal tubules, resulting in the accumulation of the bacteria and their byproducts. To ensure effective adhesion and better periapical healing, it is strongly advised to remove the smear layer before proceeding with root canal obturation. This study was designed to compare the efficiency of laser-activated irrigation (LAI) in removing the smear layer and debriding the most apical third of the root canal. Materials and Methods: Sixty-five extracted human teeth with straight single roots were randomly and equally divided into four laser and one control groups. Root canals in all samples were shaped using prime size TruNatomy rotary files. During preparation, each canal was irrigated with 3 mL of 3% NaOCl and 3 mL of 17% EDTA alternately, followed by the irrigation with 10 mL of distilled water to avoid the prolonged effect of EDTA and NaOCl solutions. Final irrigation of 5 mL of 17% EDTA of the root canal was done to eliminate the smear layer and was subsequently activated by an endodontic ultrasonic tip for 20 s three times (control group), a flat-end laser tip (test groups 1 and 3) or a taper-end laser tip (test groups 2 and 4) for two cycles. The time of each cycle activation was 10 s (groups 1 and 2) or 20 s (groups 3 and 4) in which the Er:YAG laser of 2940 nm was used. The laser operating parameters were 15 Hz and 50 μs pulse duration. The samples were then split longitudinally and subjected to scanning electron microscopy (SEM). Results: The remaining smear layer at the apical part of the root canals was statistically significant between the control group and the laser groups 1 (p = 0.040) and 2 (p = 0.000). Within the laser groups, the exposed tubules count was greater in the laser with the flat tip as compared with the tapered tip (Laser 1 > Laser 2 and Laser 3 > Laser 4). Finally, no significant differences in the count of debris between the laser groups and control group were observed, except for laser 4 (p < 0.05), which had the highest count of debris. Conclusion: LAI to remove debris and smear layer at the apical third of the root canal is inferior to the current ultrasonic technique. However, when using the Er:YAG LAI, it is recommended to use a flat tip design for 10 s for two cycles to ensure maximum debridement of the apical dentin surface. Full article
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