Conservative Management of Mature Permanent Teeth with Carious Pulp Exposure.

Vital pulp therapy (VPT) in mature permanent teeth with carious pulp exposure has been a matter of debate, with root canal therapy being the conventional standard of care. Previously reported negative outcomes for VPT in these teeth were based on data from studies that have used calcium hydroxide in direct pulp capping and partial and full pulpotomy. The introduction of hydraulic calcium silicate-based materials with sealing and bioactive potentials have opened a new era in VPT with more favorable results.

Long-term Pulpal and Restorative Outcomes of Pulpotomy in Mature Permanent Teeth.

Introduction: Pulpotomy in mature permanent cariously exposed teeth preserves the remaining pulp tissues, but long-term outcomes of the pulp and the restoration are unknown. This prospective study examined the immediate and long-term status of the pulp and the restored tooth and identified potential predictors of early and late failures in teeth that were asymptomatic or experiencing only mild symptoms at the time of treatment.

Methods: Pulpotomy was performed using the aseptic technique and a tricalcium silicate cement under local anesthesia.

Restoration of the Root-Filled Tooth.

Root-filled teeth are weakened by loss of strategic tooth structure through restorative procedures and caries, rather than by the endodontic procedures. Therefore, prompt restoration is required to minimise coronal leakage and the risk of tooth fracture. However, restorability should be confirmed before root canal treatment begins, by removing caries and existing restoration to evaluate the residual tooth structure.

Thin and thick layers of resin-based sealer cement bonded to root dentine compared: Adhesive behaviour.

This study aims to evaluate tensile and shear bond strengths of one epoxy (AH) and two methacrylate resin-based sealers (EZ and RS) in thin and thick layers bonded to root dentine. An alignment device was prepared for accurate positioning of 20 root dentine cylinders in a predefined gap of 0.1 or 1 mm.

Critical evaluation of the push-out test for root canal filling materials.

Introduction: The push-out test has been widely used in experimental endodontics but has been criticized on technical grounds particularly because the soft-core material undergoes plastic deformation under load. This study systematically evaluated the technique by comparing push-out strength and load profiles in relation to core material stiffness, canal diameter, punch diameter, sample orientation, and mode of failure.

Methods: Straight palatal roots of 90 maxillary molars were obturated with an epoxy resin-based sealer alone (10 roots) or gutta-percha (70) or epoxy resin (10) cores with a thin layer of sealer cement.

Lesion progression in post-treatment persistent endodontic lesions.

Introduction: Radiographic lesions related to root-filled teeth may persist for long periods after treatment and are considered to indicate failure of initial treatment. Persistent lesions are found in a proportion of cases, but information on lesion progression is lacking. This study examined the incidence of lesion improvement, remaining unchanged, and deterioration among persistent lesions in a group of patients recruited from a university-based clinic and identified potential predictors for lesion progression.

Behavior of resin-based endodontic sealer cements in thin and thick films.

Objectives: For root canal fillings, a thin layer of sealer cement is generally recommended. However, with resin-based sealers, lower bond strength to dentin has been shown in thin layers compared to thick, contrary to typical behavior of adhesive layers between two adherents. The aim of this study was to evaluate tensile and shear bond strength of thin and thick films of three resin-based sealers (one epoxy-based and two methacrylate-based) materials and to investigate corner effects of one methacrylate-based resin sealer.

Revascularization and tissue regeneration of an empty root canal space is enhanced by a direct blood supply and stem cells.

Background: Regenerative endodontics is an innovative treatment concept aiming to regenerate pulp, dentin and root structures. In the diseased or necrotic tooth, the limitation in vascular supply renders successful tissue regeneration/generation in a whole tooth challenging. The aim of this study is to evaluate the ability of vascularized tissue to develop within a pulpless tooth using tissue engineering techniques.

Incidence and impact of painful exacerbations in a cohort with post-treatment persistent endodontic lesions.

Introduction: Painful exacerbations of persistent periapical lesions have unknown incidence and impact on quality of life. This study examined the incidence and impact of painful exacerbations and evaluated potential predictive factors of pain associated with root-filled teeth with persistent lesions after root canal treatment.

Methods: Patients from a university hospital clinic were screened to identify root-filled teeth with periapical lesions at time of treatment and not resolved at least 4 years later.

The incorporation of casein phosphopeptide-amorphous calcium phosphate into a glass ionomer cement.

Objectives: The aim of this study was to measure the effect of incorporating CPP-ACP into an autocure GIC on physical and mechanical properties, ion release and enamel demineralization inhibition.

Methods: Physical and mechanical properties were evaluated using tests specified by the International Organization for Standardization (ISO). Concentrations of fluoride, calcium and inorganic phosphate in deionized water (pH 6.

Effect of hydration on the strain gradients in dental hard tissues after heat and cold application.

Introduction: This study was aimed to investigate the thermal strain gradients on dental hard tissues to localized heat and cold applications, applied to assess the vitality of pulp. The role of hydration on the thermal strain distribution within the enamel, dentin, and dentino-enamel junction (DEJ) was examined by using a digital moiré interferometry.

Methods: Extracted bovine incisors were prepared, and high-frequency diffraction gratings were replicated on one surface.

Impact of a retained instrument on treatment outcome: a systematic review and meta-analysis.

Introduction: Fracture of root canal instruments is one of the most troublesome incidents in endodontic therapy. This systematic review and meta-analysis aim to determine the outcome difference between retained fractured instrument cases and matched conventional treated cases.

Methods: The MEDLINE database, EMBASE, Web of Science, and the Cochrane Database were searched.

Comparison of three techniques for preparing oval-shaped root canals.

Introduction: This study compared three techniques for preparing oval-shaped root canals: Anatomic Endodontic Technology (AET), hand instruments (Hedström files; Dentsply Maillefer, Ballaigues, Switzerland), and rotary nickel-titanium (EndoWave; Morita, Osaka, Japan) instruments with regard to cleaning ability and final canal shape.

Methods: Three groups each of 13 extracted human mandibular premolars with oval-shaped canals were used. After canal preparation, teeth were sectioned at three levels (coronal, middle, and apical), photographed to assess cross-sectional canal shape, and processed for histologic evaluation of canal wall planing and the presence of debris.

Effect of glass-ionomer cement lining on postoperative sensitivity in occlusal cavities restored with resin composite--a randomized clinical trial.

This study investigated the ability of a glass-ionomer cement (GIC) lining to reduce postoperative sensitivity in occlusal cavities restored with resin composite. In addition, the effects of a total-etch and self-etch adhesive on postoperative sensitivity were also compared. Patients who had moderate to deep occlusal caries of at least one molar were recruited.

A comparison of techniques for obturating oval-shaped root canals.

This study compared the effectiveness of three obturation techniques for oval-shaped canals. Roots of 42 extracted teeth with oval canals were randomly divided into three groups: (1) ProTaper canal preparation and single cone obturation with matching gutta-percha point; (2) ProTaper preparation plus thermoplastic obturation (Thermafil); (3) Profile .06 taper and matching master cone with lateral condensation.

Effect of dentinal tubules and resin-based endodontic sealers on fracture properties of root dentin.

Objective: To investigate the role of dentinal tubules in the fracture properties of human root dentin and whether resin-filled dentinal tubules can enhance fracture resistance.

Materials And Methods: Crack propagation in human root dentin was investigated in 200 microm thick longitudinal samples and examined by light and scanning electron microscopy. 30 maxillary premolar teeth were prepared for work of fracture (Wf) test at different tubule orientations, one perpendicular and two parallel to dentinal tubules.

Fluid flow after resin-composite restoration in extracted carious teeth.

The aim of this study was to investigate fluid flow in dentin after restoration of carious teeth with resin composite bonded with a total-etching adhesive, with or without glass-ionomer cement lining. The roots of extracted third molars were removed and the crowns were connected to a fluid flow-measuring device. Each carious lesion was stained with caries detector dye and caries was removed using slow-speed burs and spoon excavators.

Cuspal deflection, strain and microleakage of endodontically treated premolar teeth restored with direct resin composites.

Objectives: To measure cuspal deflection and tooth strain, plus marginal leakage and gap formation caused by polymerization shrinkage during direct resin composite restoration of root-filled premolars.

Methods: Thirty-two first and second maxillary premolars were divided into four groups (n=8). Group 1 had standardised mesio-occlusal-distal (MOD) cavities and served as the control group.

Intracanal bisphosphonate does not inhibit replacement resorption associated with delayed replantation of monkey incisors.

Progressive replacement resorption following delayed replantation of avulsed teeth has proved to be an intractable clinical problem. A wide variety of therapeutic approaches have failed to result in the predictable arrest of resorption, with a good long-term prognosis for tooth survival. Bisphosphonates are used in the medical management of a range of bone disorders and topically applied bisphosphonate has been reported to inhibit root resorption in dogs.

Bonding of resin-based sealers to root dentin.

This study compared the microshear bond strength of three resin-based sealers to root dentin and assessed whether sealer cements behave differently in thin and thick films. Extracted maxillary premolars were sectioned buccolingually, and 45 root halves were randomly allocated for microshear bond testing with the three resin sealers in thin and thick films. The microshear bond strength was then calculated in MPa.

Sealing ability of occlusal resin composite restoration using four restorative procedures.

The purpose of this work was to investigate fluid flow after restoration using four restorative procedures. Micro-gap, internal dye leakage, and micropermeability of bonded interfaces were also investigated. Each tooth was mounted, connected to a fluid flow-measuring device, and an occlusal cavity was prepared.

The effect of a resin-based sealer cement on micropunch shear strength of dentin.

Dentinal tubules occupy a substantial proportion of total dentin volume, especially of inner dentin. Resin-based sealer cements are known to penetrate deeply into dentinal tubules, but their ability to influence root strength is controversial. In this study, the contribution of dentinal tubules to shear strength and the influence of a resin-based sealer on shear strength were evaluated.

Flare-ups in endodontics and their relationship to various medicaments.

The purpose of this research is to investigate the frequency of endodontic flare-ups using a visual analogue scale. Definitions of flare-ups vary widely as does their reported frequency. A flare-up was defined as an increase of 20 or more points on the visual analogue scale for a given tooth, within the periods of 4 h and 24 h after the initial treatment appointment.

Thermal stimulation causes tooth deformation: a possible alternative to the hydrodynamic theory?

Objectives: To investigate the relationship between temperature distribution and tooth structure deformation during and after localised application of thermal stimuli used during pulp vitality testing.

Methods: Strains and temperature changes within tooth structures were recorded when three different thermal stimuli, namely heated gutta percha (120-140 degrees C), carbon dioxide dry ice (-72 degrees C) and refrigerant spray (-50 degrees C), were applied to extracted bovine incisors. Each stimulus was applied for 5s on the labial enamel surface in a random order, with a 30-min interval between tests.