Resin infiltration of trauma-induced enamel cracks - a proof-of-concept.

Objectives: The aim of this in-vitro study was to investigate the masking efficacy of adhesively sealed enamel cracks with resin infiltration compared with the use of a universal adhesive.

Methods: Enamel cracks were induced on the labial surfaces of bovine teeth using a pendulum impact tester. Specimens were treated adhesively by resin infiltration with ICON (DMG) or Scotchbond Universal Plus (3M).

Understanding dental pulp inflammation: from signaling to structure.

The pulp is a unique tissue within each tooth that is susceptible to painful inflammation, known as pulpitis, triggered by microbial invasion from carious lesions or trauma that affect many individuals. The host response involves complex immunological processes for pathogen defense and dentin apposition at the site of infection. The interplay of signaling between the immune and non-immune cells via cytokines, chemokines, neuropeptides, proteases, and reactive nitrogen and oxygen species leads to tissue reactions and structural changes in the pulp that escalate beyond a certain threshold to irreversible tissue damage.

The impact of cone beam CT on outcomes associated with endodontic access cavity preparation: a controlled human analogue study using 3D-printed first maxillary molars.

Objectives: To identify if supplemental preoperative cone beam CT (CBCT) imaging could improve outcomes related to endodontic access cavity preparation, using 3D-printed maxillary first molars (M1Ms) in a rigorously simulated, controlled human analogue study.

Methods: Eighteen operators with 3 experience-levels took part in 2 simulated clinical sessions, 1 with and 1 without the availability of CBCT imaging, in a randomized order and with an intervening 8-week washout period. Operators attempted the location of all 4 root canals in each of 3 custom-made M1Ms (2 non-complex and 1 complex mesiobuccal [MB] canal anatomy).

Direct Composite Restorations on Permanent Teeth in the Anterior and Posterior Region - An Evidence-Based Clinical Practice Guideline - Part 2: Recommendations for Composite Processing.

Purpose: Part 2 of this German S3 clinical practice guideline provides recommendations for the process of manufacturing composite restorations. It covers key aspects like caries removal, field isolation, matrix and adhesive techniques, as well as light curing and polishing. The outcomes of interest include survival rates and restoration quality.

Developing the Benchmark: Establishing a Gold Standard for the Evaluation of AI Caries Diagnostics.

: The aim of this study was to establish a histology-based gold standard for the evaluation of artificial intelligence (AI)-based caries detection systems on proximal surfaces in bitewing images. : Extracted human teeth were used to simulate intraoral situations, including caries-free teeth, teeth with artificially created defects and teeth with natural proximal caries. All 153 simulations were radiographed from seven angles, resulting in 1071 in vitro bitewing images.

Evaluation of baghdadite (CaZrSiO) cements for the application as novel endodontic filling materials.

Objectives: Baghdadite (CaZrSiO) cements of various composition have been investigated in this study regarding an application as endodontic filling materials.

Methods: Cements were either obtained by mixing mechanically activated baghdadite powder with water (maBag) or by subsequently substituting the ß-tricalcium phosphate (ß-TCP) component in a brushite forming calcium phosphate cement. The cements were analyzed for their mechanical performance, injectability, radiopacity, phase composition and antimicrobial properties.

Long-term performance of ceramic in/-onlays vs. cast gold partial crowns - a retrospective clinical study.

Objectives: To assess the long-term clinical performance of ceramic in-/onlays (CIOs) and cast gold partial crowns (CGPCs) in posterior teeth in terms of success, survival, complications (biological, technical) and quality.

Material And Methods: In a retrospective study, a total of 325 patients were recorded after up to 24.8 years (mean 13.

Removal of fiber posts using conventional versus guided endodontics: a comparative study of dentin loss and complications.

Objectives: To compare the efficacy of fiber post removal using conventional (CONV) versus guided endodontics (GE) in terms of dentin loss, residual resin material, procedural errors, and working time in vitro.

Material And Methods: Ninety human central incisors were root-filled and scanned by micro-computed tomography (CT), then restored with fiber posts and composite. Twenty-four sets of teeth with up to four human maxillary central incisors were fabricated and divided into three groups: conventional post removal by a general dentist (CG) or endodontology specialist (CS) and guided endodontics (GE) by a general dentist, yielding 30 teeth per operator and group.

Implications of root, pulp chamber, and canal anatomy on pulpotomy and revitalization procedures.

Objectives: This review aims to discuss the implications of anatomy of the root, pulp chamber, and canals on pulpotomy and revitalization procedures (RPs) as treatment alternatives to root canal treatment procedures.

Methods: This narrative review was undertaken to address two main questions - why remove vital pulp tissue in teeth with complex canal anatomy when it can be preserved? And why replace the necrotic pulp in teeth with mature roots with a synthetic material when we can revitalize? This review also aims to discuss anatomical challenges with pulpotomy and revitalization procedures.

Results: Maintaining the vitality of the pulp via partial or full pulpotomy procedures avoids the multiple potential challenges faced by clinicians during root canal treatment.

Guided endodontics versus conventional access cavity preparation: an ex vivo comparative study of substance loss.

Background: To compare the outcomes of conventional access cavity preparation (CONV) versus guided endodontics (GE) for access cavity preparation in anterior teeth with pulp canal calcification (PCC) regarding root canal detection, substance loss, procedural time, and need for additional radiographs.

Methods: Extracted, sound human teeth with PCC (n = 108) were matched in pairs, divided into two groups and used to produce 18 models. An independent endodontist and a general dentist performed access cavity preparation under simulated clinical conditions on nine models each (54 teeth).

Treatment of pulpal and apical disease: The European Society of Endodontology (ESE) S3-level clinical practice guideline.

Background: The ESE previously published quality guidelines for endodontic treatment in 2006; however, there have been significant changes since not only in clinical endodontics but also in consensus and guideline development processes. In the development of the inaugural S3-level clinical practice guidelines (CPG), a comprehensive systematic and methodologically robust guideline consultation process was followed in order to produce evidence-based recommendations for the management of patients presenting with pulpal and apical disease.

Aim: To develop an S3-level CPG for the treatment of pulpal and apical disease, focusing on diagnosis and the implementation of the treatment approaches required to manage patients presenting with pulpitis and apical periodontitis (AP) with the ultimate goal of preventing tooth loss.

Forced Orthodontic Extrusion to Restore the Unrestorable: A Proof of Concept.

The purpose of this clinical study was to assess the feasibility of forced orthodontic extrusion with the Tissue Master Concept to retain subgingivally fractured teeth as abutments for which extraction and replacement would be equal treatment opportunities. Participants were recruited from a group of consecutive patients in need of prosthodontic rehabilitation. In total, 36 deeply destroyed teeth in 31 patients underwent forced orthodontic extrusion with forces exceeding 50 g to reestablish biologic width and ensure a 2-mm dentin-ferrule design prior to single-crown restoration.

Endodontic Outcome of Root Canal Treatment Using Different Obturation Techniques: A Clinical Study.

Objective: To evaluate the clinical outcome of root canal treatment by obturation technique, root canal filling quality, and tooth- and patient-related variables.

Methods: This clinical study investigated the endodontic outcome of 114 teeth treated between the years 2009 and 2012. Three different obturation methods were used: (1) adhesive obturation using the continuous wave of condensation technique with Resilon (CWR), (2) matching-taper single-cone technique with gutta-percha and AH Plus (SCGP), and (3) matching-taper single-cone technique with gutta-percha and GuttaFlow (SCGF).

ESE position statement on root resorption.

This Position Statement on root resorption represents the consensus of an expert committee convened by the European Society of Endodontology (ESE). The statement is based on current clinical and scientific evidence as well as the expertise of the committee. The aim is to provide clinicians with authoritative information on the aetiology, histopathology, clinical presentation and recommendations for the management of root resorption.

Root Maturation of an Immature Dens Invaginatus Despite Unsuccessful Revitalization Procedure: A Case Report and Recommendations for Educational Purposes.

Background: The clinical management of teeth with complex dens invaginatus (DI) malformations and apical periodontitis may be challenging due to the lack of routine. The aim of this case report is to describe the endodontic treatment of an immature tooth with DI and to discuss strategies for preclinical training for teeth with such malformations.

Case Report: A 9-year-old male presented with an immature maxillary incisor with DI (Oehlers Type II) and apical periodontitis which was diagnosed by cone beam computed tomography (CBCT).

[Extrusion after anterior tooth trauma - Magnet and Benexextrusion, two case presentations].

Anterior tooth trauma with crown-root fractures represent a major challenge in the dental practice. In order to be able to treat deeply fractured teeth, a sufficient amount of coronal tooth structure is required. In this article, we would like to present two options for tooth extrusion.

Quality of CAD-CAM inlays placed on aged resin-based composite restorations used as deep margin elevation: a laboratory study.

Objectives: To assess the impact of the age of resin-based composite (RBC) restorations used for deep margin elevation (DME) on the marginal quality and fracture resistance of inlays.

Materials And Methods: Permanent human molars with direct RBC restorations, involving the mesial, occlusal, and distal surface (MOD), were allocated to four groups (each n = 12). Half of the teeth underwent thermomechanical loading including 240,000 occlusal load cycles and 534 thermal cycles (TML, 5 °C/55 °C; 49 N, 1.

Influence of the Scalpel Finishing Technique on Marginal Gap Formation in Class II Resin Composite Restorations.

Objectives: Modern adhesives and composites allow the restoration of deep defects. In such cases, the matrix technique is particularly challenging, and excess composite is a common problem. Removing such overhangs with a scalpel has already been described as a substance preserving or selective finishing technique.

Traumatized teeth: clinical practice guideline for the interim management of teeth with various poor prognosis scenarios in growing patients.

Objectives: Many treatment options accepted for unsalvageable traumatized teeth in adults would seem contraindicated in children and adolescents. Instead, growing patients need interim restorative measures, thus extensively preserving their local bone and soft tissue structures and, ideally, preparing the involved site for later definitive restoration while they transform to skeletal maturity. This narrative topic review addresses the interim management in case of very deep intra-extra-alveolar fractures, extensive infection-related root resorption, tooth ankylosis, and anterior tooth loss in growing patients, and seeks to empower the clinician to select the appropriate treatment approach.

Guided Endodontics: Three-dimensional Planning and Template-aided Preparation of Endodontic Access Cavities.

Pulp canal obliterations (PCO) are often a consequence of dental trauma, such as luxation injuries. Even though dentin apposition is a sign of vital pulp, pulpitis or apical periodontitis may develop in the long term. Root canal treatment of teeth with severe PCO and pulpal or periapical pathosis is challenging for general practitioners and even for well-equipped endodontic specialists.

Dynamic Navigation in Endodontics: Guided Access Cavity Preparation by Means of a Miniaturized Navigation System.

In the case of teeth with pulp canal calcification (PCC) and apical pathology or pulpitis, root canal treatment can be very challenging. PCC are common sequelae of dental trauma but can also occur with stimuli such as caries, bruxism, or after placing a restoration. In order to access the root canal as minimally invasive as possible in case of a necessary root canal treatment, dynamic navigation has recently been introduced in endodontics in addition to static navigation.

Influence of Matrix Type on Marginal Gap Formation of Deep Class II Bulk-Fill Composite Restorations.

Background: To test the hypothesis that transparent matrices result in more continuous margins of bulk-fill composite (BFC) restorations than metal matrices. Methods: Forty standardized MOD cavities in human molars with cervical margins in enamel and dentin were created and randomly assigned to four restorative treatment protocols: conventional nanohybrid composite (NANO) restoration (Tetric EvoCeram, Ivoclar Vivadent, Schaan, Liechtenstein) with a metal matrix (NANO-METAL) versus transparent matrix (NANO-TRANS), and bulk-fill composite restoration (Tetric EvoCeram Bulk Fill, Ivoclar Vivadent, Schaan, Liechtenstein) with a metal matrix (BFC-METAL) versus transparent matrix (BFC-TRANS). After artificial aging (2500 thermal cycles), marginal quality was evaluated by scanning electron microscopy using the replica technique.

Present status and future directions: Surgical extrusion, intentional replantation and tooth autotransplantation.

Surgical extrusion, intentional replantation and tooth autotransplantation procedures are important treatment options that clinicians may consider performing in their day-to-day clinical practice. Despite compromised teeth are generally considered for extraction, clinicians must be aware that these cases could be suitable for management by these alternative predictable treatment options. Surgical extrusion, intentional replantation or tooth autotransplantation have similar treatment protocols which includes atraumatic tooth extraction, visualisation of the root portion and replantation.