Experimental investigation and finite element analysis on the durability of root-filled teeth treated with multisonic irrigation.

Objective: This study compared the fracture load, stress distribution, and survival probability under cyclic loading of extensively restored teeth treated with multisonic irrigation with those treated with conventional instrumentation, with or without a post.

Methods: Mesial-occlusal-distal cavities were prepared in 30 human mandibular premolars. The teeth were randomly divided into 3 groups of 10 based on the endodontic and restorative procedures: (1) Root canal treatment (RCT) followed by resin composite restoration (control group), (2) RCT followed by a glass fiber post restoration (conventional group), and (3) minimal instrumentation plus multisonic irrigation followed by resin composite restoration (GW group).

Maxillary Dental Anatomy and Physiology: Endodontic and Periodontal.

The maxillary sinus floor is formed by the alveolar process of the maxilla. Frequently, the roots of maxillary molars and premolars may protrude into the sinus cavity, with only a thin membrane separating them. Endodontic infections are characterized by mixed biofilms of anaerobic and proteolytic bacteria that can infect the root canal space and accessory anatomy of those teeth producing apical periodontitis.

An In Vitro Evaluation of the Antimicrobial Efficacy of a Novel Irrigant Using Next-Generation Sequencing.

Introduction: To evaluate the antimicrobial activity of Triton irrigation versus 4% sodium hypochlorite (NaOCl) utilizing a direct contact test and an extracted tooth model.

Methods: In the first experiment, a direct contact test was conducted to compare bacterial DNA removal and microbial diversity changes following irrigation with 4% NaOCl or Triton. Hydroxyapatite and dentin discs were inoculated with subgingival human-derived dental plaque for 2 weeks utilizing the Center for Disease Control biofilm reactor and subsequently challenged with the root canal irrigants for 5 minutes.

Anatomical complexities affecting root canal preparation: a narrative review.

A fundamental aspect of the Endodontic field is the knowledge of root canal anatomy. Using a variety of techniques, the internal and external anatomy of teeth have been extensively investigated throughout the past century. Recent improvements in three-dimensional computed tomography have enabled more detailed evaluations of root canal morphology in both clinical and laboratory settings.

The effect of ultrasonic and multisonic irrigation on root canal microbial communities: An ex vivo study.

Aim: To analyse the effect of ultrasonic irrigant activation (UIA) and the GentleWave (GW) multisonic irrigation (GW) with minimal instrumentation on the root canal microbial diversity in an ex vivo model that used extracted molars with a history of pulp necrosis.

Methodology: Twenty-three mandibular molars were prepared ex vivo for collection of superficial (surface control), pre-treatment and post-treatment samples 24 h after extraction. Samples were divided into two groups: UIA using 6% NaOCl (n = 11) and GW group (n = 12).

Load capacity and fracture modes of instrumented tooth roots under axial compression.

Objective: To investigate the influences of root canal instrumentation on the load capacity and fracture modes of tooth roots under axial compression by performing mechanical tests and finite element analysis (FEA).

Methods: Thirty bovine incisor roots were trimmed into cylinders of 5.0 mm diameter.

Exploring the root canal microbiome in previously treated teeth: A comparative study of diversity and metabolic pathways across two geographical locations.

Aim: To analyse and compare the root canal microbiome present in root-filled teeth of two different geographical populations, and to study their functional potential using a next-generation sequencing approach.

Methodology: Sequencing data obtained from surgical specimens from previously treated teeth with periapical bone loss from Spain and USA were included in the study. Taxa were classified using SILVA v.

The root canal microbiome diversity and function. A whole-metagenome shotgun analysis.

Aim: To evaluate the root canal microbiome composition and bacterial functional capability in cases of primary and secondary apical periodontitis utilizing whole-metagenome shotgun sequencing.

Methodology: Twenty-two samples from patients with primary root canal infections, and 18 samples obtained from previously treated teeth currently diagnosed with apical periodontitis were analysed with whole-metagenome shotgun sequencing at a depth of 20 M reads. Taxonomic and functional gene annotations were made using MetaPhlAn3 and HUMAnN3 software.

Taxonomic abundance in primary and secondary root canal infections.

Aim: To evaluate the root canal microbiome composition in cases of primary and secondary apical periodontitis.

Methodology: Thirty-nine samples from patients with primary root canal infections obtained before root canal treatment, and 40 samples obtained during root-end resection procedures from previously filled cases with apical periodontitis were evaluated using 16S rRNA next-generation sequencing analysis (NGS). Demographic and clinical factors included age, sex, infection type, percussion sensitivity, and presence of pain.

Minimal Detectable Width of Tooth Fractures Using Magnetic Resonance Imaging and Method to Measure.

Introduction: Vertical root fracture (VRF) in root canal-treated (RCT) teeth is a common cause of pain, bone resorption, and tooth loss. VRF is also difficult to diagnose and measure. Magnetic resonance imaging (MRI) has the potential to identify VRF due to beneficial partial volume averaging, without using ionizing radiation.

Multispecies biofilm removal by a multisonic irrigation system in mandibular molars.

Aim: The aim of the study was to assess biofilm removal efficacy of GentleWave System and passive ultrasonic irrigation (PUI).

Methodology: Twenty-two human mandibular molars with Vertucci's type II configuration in the mesial root were selected. Teeth were autoclaved, inoculated with dental plaque and incubated in a CDC biofilm reactor for two weeks.

Present status and future directions of intracanal medicaments.

Two fundamental goals of endodontic treatment are to prevent or treat apical periodontitis. From a predictive perspective, several variables can affect the outcome of root canal treatment. Some of these variables depend on intraoperative factors, which include irrigation technique, size of the apical preparation, use of intracanal medicaments or the number of appointments necessary to complete the treatment.

PRESS and Piezo Microsurgery (Bony Lid): A 7-Year Evolution in a Residency Program Part 1: Surgeon-defined Site Location.

Introduction: Treatment of a failing endodontic procedure via microsurgical revision presents better outcomes due, in part, to the integration of the surgical operating microscope (SOM) and cone-beam computed tomography (CBCT) into clinical practice. But challenges still remain with respect to the operational locations and the techniques required to address them. Posterior sites, with substantial cortical plate thicknesses and sensitive anatomy, present the dichotomy of visualization versus postsurgical regeneration of bone.

A critical analysis of research methods and experimental models to study the load capacity and clinical behaviour of the root filled teeth.

The prognosis of root-filled teeth depends not only on a successful root canal treatment but also on the restorative prognosis. This critical review discusses the advantages and limitations of various methodologies used to assess the load capacity or clinical survivability of root-filled teeth and restorations. These methods include static loading, cyclic loading, finite element analysis and randomized clinical trials.

PRESS and Piezo Microsurgery (Bony Lid): A 7-Year Evolution in a Residency Program-Part 2: PRESS-Defined Site Location.

Introduction: Treatment of a failing endodontic procedure via microsurgical revision presents better outcomes due, in part, to the integration of the surgical operating microscope and cone-beam computed tomography into clinical practice. However, challenges still remain with respect to the operational locations and the techniques required to address them. Posterior sites, with substantial cortical plate thicknesses and sensitive anatomy, present the dichotomy of visualization versus postsurgical regeneration of bone.

In vitro efficacy of a non-instrumentation technique to remove intracanal multispecies biofilm.

Aim: The aim of this study was to assess the efficacy of a non-instrumentation technique to disinfect root canals infected by a human dental plaque-derived multispecies biofilm.

Methodology: Twenty-two mandibular incisors were accessed, autoclaved and inoculated with dental plaque. The Center for Disease Control biofilm reactor was used to promote contamination of the root canal space.

Present status and future directions: Management of curved and calcified root canals.

Root canal curvature and calcification introduce factors that increase the risk of procedural accidents during root canal treatment. The inability to achieve patency to the apical third, asymmetrical dentine removal leading to transportation, perforation, and instrument fracture inside the curved trajectories are some of the procedural problems that might jeopardize the management of intraradicular infection and result in poor treatment outcomes. In fact, curved and constricted canals introduce such complexity that total instrumentation concepts and specially designed instruments have been developed to deal with the challenge.

Fatigue analysis of restored teeth longitudinally cracked under cyclic loading.

Objective: To investigate the fatigue behavior of restored teeth, in particular the mechanisms of longitudinal dentinal cracking under cyclic mechanical loading, using finite element analysis (FEA) and the stress-life (S-N) approach.

Methods: Ten root-filled premolars restored with resin composites were subjected to step-stress cyclic loading to produce longitudinal cracks. Fracture loads and number of cycles completed at each load level were recorded.

Accuracy of radiographic pixel linear analysis in detecting bone loss in periodontal disease: Study in diabetic rats.

Introduction: Periodontitis, a complex infectious disease that may lead to irreversible loss of periodontium, is considered a predisposing agent for developing insulin resistance due to the release of inflammatory mediators, showing a bilateral relationship with diabetes mellitus. The investigation of periodontal disease requires a clinical approach and complete intraoral radiographs, even with increasing concerns about radiation exposure. Thus, this study assesses pixel linear analysis accuracy using digital radiography via Digora® in detecting alveolar bone destruction in diabetic rats with periodontal disease.

Efficacy of four local anaesthesia protocols for mandibular first molars with symptomatic irreversible pulpitis: A randomized clinical trial.

Aim: To examine the efficacy rate of four anaesthetic protocols in mandibular first molars with symptomatic irreversible pulpitis (SIP).

Methodology: One hundred and sixty patients with a diagnosis of SIP were included in this randomized clinical trial. Patients were randomly allocated into four treatment groups (N = 40) according to the administered technique: Group 1 (IANB): standard inferior alveolar nerve block (IANB) injection; Group 2 (IANB + IO): standard IANB followed by a supplemental intraosseous infusion (IO) injection; Group 3 (IANB + PDL): standard IANB followed by a supplemental periodontal ligament (PDL) injection; Group 4 (IANB + BI): standard IANB followed by a supplemental buccal infiltration.