Coronal Seal Research Articles

The influence of endodontic treatment quality on periapical lesions' architecture in cone-beam computed tomography.

This study assessed the influence of root canal treatment quality on the architecture of periapical lesions. A total of 121 lesions were involved in this research. Two researchers analysed the surface of the lesions, diameters in three planes, volume and sphericity. The quality of root canal treatment was assessed with PESS index. Non-parametric statistical tests: Mann-Whitney and Spearman rank correlation coefficient were used in this research. Connected lesions of multirooted teeth spread in the coronal plane revealed a positive correlation with coronal seal and root canal filling homogenicity, however their spread in the sagittal plane showed a positive correlation only with root canal filling homogenicity. The quality of root canal treatment has an influence on the periapical lesions' architecture.

Comparative Analysis of Coronal Sealing Materials in Endodontics: Exploring Non-Eugenol Zinc Oxide-Based versus Glass-Ionomer Cement Systems.

The proper closure of the access cavity between appointments during endodontic treatment is paramount and relies on temporary fillings. This systematic review evaluates the effectiveness of zinc oxide-based materials and glass-ionomer cement (GIC) as temporary coronal sealers after root canal treatment in extracted human teeth. Three databases were searched to identify randomized clinical trials that examined the sealing properties of various temporary sealing materials using dyes or stains as indicators. A total of seven in vitro studies that fulfilled the eligibility criteria were critically analyzed. These indicated significant variations in the relative sealing ability of the coronal breach of endodontically treated teeth, either by zinc oxide or GIC-based materials. While GIC-based material (e.g., Fuji IX and Fuji II) exhibited superior sealing of single-rooted teeth, zinc oxide-based material (e.g., Cavit, Coltosol, Caviton) also showed promising attributes. Resin-modified GIC formulations displayed enhanced physical properties, yet challenges related to adhesive failure and shrinkage during polymerization were observed. Zinc oxide-based materials have demonstrated superior coronal sealing effectiveness over certain GIC in controlled settings. Their premixed nature ensures consistent application and hygroscopic properties improve cavity sealing. However, the focus on dye penetration tests for microleakage in vitro may not fully represent the risk of bacterial infiltration. Thus, in vivo studies are crucial for validating these findings in clinical contexts.

The Middle Mesial Canal: Combined Endodontic and Restorative Treatment Approach - A Case Report

The management of the middle mesial canal (MMC) in mandibular first molars presents considerable challenges during endodontic treatment due to its complex anatomy. Challenges may arise throughout various stages of treatment, including canal location, instrumentation, and obturation. The inability to identify and shape this canal can lead to endodontic failure and post-treatment apical periodontitis. Therefore, understanding this aberrant root canal anatomy and its clinical implications during the various stages of endodontic treatment is essential for successful management, including the selection of the optimal coronal restoration to enhance the efficacy of the obturation’s coronal seal and to ensure the restoration’s maximal longevity. This case report describes the diagnosis and successful endodontic and restorative management of an MMC in a mandibular first molar.

Nonsurgical endodontic retreatment: A series of four case reports

The primary objective of endodontic treatments or any pulp therapy is to maintain the integrity and health of oral tissues. Endodontic treatments aim to disinfect and shape the root canal system completely and obturate it in 3D to prevent reinfection. Although initial root canal therapy has high success rates, failures can occur. The term ‘retreatment’ denotes a new intervention to retain the tooth in the oral cavity. Nonsurgical endodontic retreatment can preserve previously treated teeth with persistent periapical lesion(s), if the tooth is restorable and periodontally sound, and patient wants to keep it. The clinician and patient should select the treatment with the best long-term outcome. This case series describes endodontically treated teeth that required nonsurgical endodontic retreatment due to inadequate obturation, persistent periradicular lesion and loss of coronal seal.

Effect of Pulp Chamber Access, Instrumentation, Obturation, and Restoration on the Fracture Resistance of Endodontically Treated Canine Teeth in Dogs.

Veterinary studies documenting the effect of endodontic treatment on tooth fracture resistance are scarce. The objective of this ex vivo study was to evaluate the effects of mesial access preparation and restoration, as well as pulp chamber access, instrumentation, obturation, and restoration, on the fracture resistance and characteristics of canine teeth in dogs. Sixty-five dog canine teeth were divided into 4 groups: 1. Standard endodontic treatment through a mesial access only; 2. Treatment as per group 1, adding an incisal access, instrumentation and obturation of the pulp chamber, and restoration of the access; 3. Treatment as per group 2, without pulp chamber obturation or restoration of the incisal access; and 4. Untreated teeth. The fracture resistance and characteristics of each group were documented using axial compression testing, angled 45° disto-occlusal to the long axis of the crown. The maximum force prior to fracture in groups 1, 3, and 4 were not statistically different, demonstrating that restored mesial and incisal accesses with pulp chamber instrumentation did not statistically affect fracture resistance. However, obturated and restored group 2 teeth demonstrated decreased fracture resistance compared to all other groups (P < .001). Additionally, 26.7% of group 1 teeth sustained complicated crown fractures, while 100% of group 2 teeth fractured within the obturation or restorative materials, preventing pulp exposure in these cases. Although the cause and clinical importance of decreased tooth fracture resistance following pulp chamber obturation and restoration remains unknown, it may provide protective value for maintaining a coronal seal in the event of tooth fracture.

Molar root canal treatment performed by undergraduate dental students; an observational study of procedural errors and student perception

BackgroundMolar root canal treatment (RCT) is challenging and requires training and specific skills. Rotary instrumentation (RI) reduces the time needed for instrumentation but may increase the risk of certain procedural errors. The aims of this study were to evaluate the quality of molar RCTs provided by undergraduate students, to compare the prevalence of procedural errors following manual and RI, and to assess the students’ self-perceived confidence to perform molar RCT without supervision and their preference for either manual or RI.MethodsMolar RCTs performed by the final year students were evaluated radiographically according to predefined criteria (Appendix 1). The procedural errors, treatment details, and the students’ self-perceived confidence to perform molar RCT and their preference for either manual or RI were recorded. Descriptive statistics were performed, and the Chi-squared test was used to detect any statistically significant differences.Results60.4% of RCTs were insufficient. RI resulted in more sufficient treatments compared with MI (49% vs. 30.3% respectively. X2: 7.39, p = 0.007), required fewer visits to complete (2.9 vs. 4.6 respectively. X2: 67.23, p < 0.001) and was the preferred technique by 93.1% of students. The most common procedural errors were underextension of the root canal obturation (48.4%), insufficient obturation (45.5%), and improper coronal seal (35.2%) without a significant difference between the two techniques. 26.4% of the participating students reported that they did not feel confident to perform molar RCT without supervision.ConclusionThe quality of molar RCT provided by UG students was generally insufficient. RI partially improved the technical quality of RCT compared with MI. UG students need further endodontic training and experience before they can safely and confidently practise molar RCT.

Role of hermetic coronal seal on the long term success of apexification in immature permanent teeth induced by calcium hydroxide based regenerative materials- A pilot study

: Calcium hydroxide with or without iodoform is commonly used for apexification in immature permanent teeth. Before permanent restoration, temporary restorative material is used for ensuring coronal seal at the tooth orifice. An ideal coronal sealing agent prevents micro-leakage and maintains aseptic root canal environment. : This study aims at assessing the role of coronal seal on the long term success of apexification in immature permanent teeth by calcium hydroxide.: 51 children between the age group of 8-10 years having open apex in permanent upper anterior(s) secondary to trauma were divided into three groups, each receiving calcium hydroxide based material for apexification. Children were evaluated clinically and radiographically and followed up for a period of nine months. Cavit was used as temporary restoration in all three groups. Cases with loss of coronal seal, failure in apexification and clinical flare ups were identified. The data were statistically analyzed by Z-test and Chi-square test.: Presence of good coronal seal was directly related with successful and uneventful apexification. Loss of coronal seal was mostly related with increased evidence of clinical flare up and failure in or delayed apexification. Both the results were found to be statistically significant.: Temporary restorative materials providing meticulous coronal seal is as important as the permanent restoration, for the long term success of apexification.

Comparison of coronal sealing of flowable composite, resin-modified glass ionomer, and mineral trioxide aggregate in endodontically treated teeth: An in-vitro study

Background: Coronal seal is one of the essential factors that affects the success of endodontic treatment and reinforces the apical seal. The intra-orifice barrier is an efficient alternative approach to decrease coronal leakage in endodontically treated teeth and various materials have been used for this purpose. This study aimed to compare the coronal sealing of flowable composite, resin-modified glass ionomer (RMGI), and mineral trioxide aggregate (MTA) in endodontically treated teeth. Materials and Methods: In this in vitro study, 35 single-canal canine teeth were divided into five groups, including flowable composite, RMGI, MTA, positive control, and negative control groups. The teeth were filled with restorative materials according to the factory's instructions. Afterward, the samples were immersed in 2% methylene blue dye solution for 1 week at 37°C and 100% humidity condition. Finally, the teeth were sectioned longitudinally and dye penetration was measured using a stereomicroscope with ×10. Data were analyzed with Kolmogorov–Smirnov and Kruskal–Wallis tests (α = 0.05). Results: The positive control group showed the highest amount of dye penetration compared to other groups (12.34 ± 0.46). Dye penetration in the MTA group was significantly lower (4.25 ± 0.31) compared to the RMGI group (5.94 ± 0.24) (P = 0.02). Moreover, while the dye penetration in the MTA group was lower than in the flowable composite group (5.65 ± 0.26), the difference was not statistically significant (P = 0.12). Conclusion: MTA reduces the coronal leakage and provides an acceptable coronal seal in endodontically treated teeth, especially compared to RMGI, and therefore, using MTA as an intra-orifice barrier increases the endodontic treatment success rate.

In vitro and in vivo evaluation of iRoot BP Plus as a coronal sealing material for regenerative endodontic procedures

ObjectivesTo investigate in vitro effects of a nanoparticle bioceramic material, iRoot BP Plus, on stem cells from apical papilla (SCAP) and in vivo capacity to induce pulp-dentin complex formation. Materials and methodsThe sealing ability of iRoot BP Plus was measured via scanning electron microscopy (SEM). SCAP were isolated and treated in vitro by iRoot BP Plus conditioned medium, with mineral trioxide aggregate (MTA) conditioned medium and regular medium used as controls, respectively. Cell proliferation was assessed by BrdU labeling and MTT assay and cell migration was evaluated with wound healing and transwell assays. Osteo/odontogenic potential was evaluated by Alizarin red S staining and qPCR. Pulp-dentin complex formation in vivo was assessed by a tooth slice subcutaneous implantation model.ResultsiRoot BP Plus was more tightly bonded with the dentin. There was no difference in SCAP proliferation between iRoot BP Plus and control groups (P > 0.05). iRoot BP Plus had a greater capacity to elevated cell migration (P < 0.05) and osteo/odontogenic marker expression and mineralization nodule formation of SCAP compared with MTA groups (P < 0.05). Furthermore, the new continuous dentine layer and pulp-like tissue was observed in the iRoot BP Plus group in vivo.ConclusionsiRoot BP Plus showed excellent sealing ability, promoted the migration and osteo/odontogenesis of SCAP and induced pulp-dentin complex formation without affecting the cell proliferation, which indicated iRoot BP Plus was a promising coronal sealing material in REPs.Clinical relevanceThe coronal sealing materials play crucial roles for the outcomes of REPs. This study showed that iRoot BP Plus has good coronal sealing and promote pulp-dentin complex formation compared with MTA, providing experimental evidences for the clinical application of iRoot BP Plus as a promising coronal seal material in REPs.

Assessment of The Impact of Quality of Canal Obturation, Coronal and Apical Seal on The Healing Of CBCT-Diagnosed Periapical Lesions in Endodontically Treated Teeth in Sri Lanka

Background: Previous literature has investigated the association between the attribute of coronal restoration and root canal obturation with the radiographic periapical status of endodontically treated teeth. Objectives: This study intends to assess the status of periapical lesions/pathology and, the main factors influencing the healing of periapical lesions of root canal-treated teeth clinically and radiographically exploiting CBCT. The quality of coronal restoration, canal obturation, and apical seal were selected to be assessed, as they have a greater impact on healing peri apical pathology. Method: This analysis was conducted at the Department of Restorative Dentistry and the Division of Oral Medicine and Radiology, Faculty of Dental Sciences, University of Peradeniya, Sri Lanka. All the patients who presented between January 2020 and January 2021, had root canal treatment done at least one year prior, were referred for CBCT assessment for some other conditions, and fulfilled the inclusion criteria, were selected. Root canal-treated teeth were recognized by radio-opaque filling material inside the canals in any anterior or posterior teeth. Results: A sum of 50 CBCT reports from 50 patients was encompassed in the dissertation. Median age was 26 (±4) years, with 37.5% of reports belonging to males. Statistical analysis was performed utilizing Statistical Package for Social Sciences (SPSS) version 20.0 software (IBM Corp). Out of fifty patients, 32 had been found to have adequate clinical coronal seal while 31 have been found to have adequate radiographical coronal seal. Further, 31 patients were found to have insufficient obturation and 28 were found to have adequate apical seal. A significant association was observed between periapical healing and adequate coronal restoration in root-filled teeth (p=0.048). However, the association between the healing of the periapical region, and adequate root canal obturation (p=0.09) and adequate apical seal (p=0.777) were found to be non-significant. Conclusion: The most influential factor for the healing of periapical lesions in endodontically treated teeth appears to be adequate coronal restoration, compared to root canal obturation and apical seal, in a cohort of patients in Sri Lanka

Assessment of Periapical Status in Posterior Root Canal-Treated Teeth Using Cone Beam Computed Tomography in the Iranian Population

Background: Periapical radiolucency occurs due to root canal infections. In this respect, effective root canal treatment and appropriate coronal restoration can aid in preventing these lesions. Thus, the present study aimed to assess the periapical status in posterior root canal-treated teeth by cone-beam computed tomography (CBCT) in the Iranian population. Methods: The CBCT images of 210 patients (475 endodontically treated molars and premolars) referred to the Hamadan Dental School (from 2020 to 2022) were evaluated in this observational study. The images were obtained by a NewTom 3G CBCT device (NewTom, Verona, Italy) with an FOV of 6×6 inches at 110 kVp and varying milliampers and exposure times according to the patient’s age and body size. They were observed by two maxillofacial radiologists who recorded the periapical status, coronal seal, and endodontic treatment quality of root canal-treated teeth. The Chi-square test was used for data analysis (P≤0.05). Finally, the periapical lesion was determined, along with its association with gender, type of tooth, endodontic treatment quality, and appropriate restoration. Results: The results revealed no significant association between periapical radiolucency and gender. The prevalence of periapical lesions was higher in males aged 25–50 years, but no significant correlation was found in this regard. There was no significant relationship between tooth type and the presence of periapical lesions, while it had the highest prevalence in maxillary molars. Endodontic treatment quality and coronal restoration showed significant correlations with the presence of periapical radiolucency. Conclusion: There was no significant association between the presence of periapical radiolucency and gender and age. The prevalence of periapical lesions was higher in males. Cases with poor endodontic treatment and poor restoration demonstrated the highest prevalence of periapical lesions.

CAD/CAM Customized Metal Post and Core with Digital Intraoral Impression: A Case Report

Background: Following endodontic treatment, it is crucial to utilize a suitable restorative technique to secure the coronal seal as well as shield remaining dental structure. When two or more walls of a tooth are lost, it becomes necessary to restore it with posts in order to enhance retention and stability of the final restoration. These posts can be categorized as either prefabricated or customized, and can be produced via the CAD-CAM. Purpose: The development of digital dentistry has been aimed at augmenting the accuracy of workflow and expediting the production process. The focus of this case report is the restoration of undamaged teeth that have undergone endodontic treatment. This was done with the assistance of a CAD-CAM post and core system that was milled through digital impression. Patients and Methods: For this particular case, the method employed involved utilizing an intraoral scan for the fabrication of a post and core restoration for inferior premolars that had undergone endodontic treatment. This approach was derived from in vitro experiments which validated the intraoral scanner's capacity to accurately discern post-space up to a depth of 12 mm with the assistance of the scan post. Results: The digital technique allows us to convert the concave surface of the root canal into the convex surface of the post, and realize an anatomical post and core that improves the biomechanics of the endodontically treated tooth reducing the possibility of root fractures. Conclusion: The use of an intraoral digital scanner represents an opportunity for the clinician as it speeds up the production of an anatomical post and core restorations.

Common Temporization of Access Cavity and Pulp Spacers Practiced by Endodontists in Saudi Arabia: A Cross-sectional Study

Background: Temporary restorations are necessary for preventing coronal leakage during and after treatment completion and must provide an effective barrier against salivary contamination of the root canal system. Endodontic spacers also help remove temporary restoration by avoiding the chances of unwanted intact tooth structure loss and perforation on the floor of the pulp chamber and prevent temporary restorative materials entrapment into the root canals resulting in canal blockage. However, the cotton pellet placed between the temporary and the root canal orifice can compromise the coronal seal by the reduction in thickness of temporary restoration. Objective: The primary aim of this investigation was to determine the most common temporary restoration used during and after endodontic treatment. The secondary aim is to know the percent preference for restorations with double seal and the frequency of spacer used. Methods: Four hundred fifty online questionnaires comprising 15 (four demographic questions and eleven questions related to the study objective) were sent to endodontists in Saudi Arabia via WhatsApp and Twitter. Statistical significance was set at P&lt;0.05 when assessed using a chi-square test. Results: About 370 (82.22%) participants completed the survey. Glass ionomer cement (GIC) was most used as a temporary restoration among endodontists for both the anterior (53%) and posterior teeth (49.7%; P=0.001). In double seal, Cavit was most used as the temporary restoration, which was placed below the seal exposed orally 56.2% (P=0.001). GIC was most used as coronal seal material placed over Cavit in 71.9% of the participants (P=0.001). About 56.2% of the endodontists placed cotton pellets between visits but not after obturation (P=0.001). Polytetrafluoroethylene tape instead of cotton pellet was preferred by 30.3% of the participants (P=0.001). Conclusion: Glass ionomer cement (GIC) was most used as a temporary restoration. In double seal, GIC was most used as coronal seal material placed over Cavit. A pulp spacer was found to be the most commonly used between visits but not after obturation.

The impact of pulpotomy on the long-term prognosis and survival of young permanent teeth

This review explores the impact of pulpotomies on the long-term prognosis and survival of primary and young permanent teeth. Pulpotomy is a vital pulp therapy procedure aiming to preserve pulp health and functions. The review covers various vital pulp therapy techniques, including indirect pulp treatment, direct pulp treatment, partial pulpotomy, and full pulpotomy. Apexogenesis, a procedure promoting root end formation, is also discussed. Long-term success in endodontic therapy requires an effective coronal seal to prevent microleakage and bacterial ingress into root canals. The study's methodology involved a comprehensive literature search to gather information on pulpotomy's effects on tooth prognosis and survival. Factors influencing the success of vital pulp therapy, such as the size of the exposure, the state of the pulp, and the choice of capping material, are analyzed. Bacterial contamination is identified as a crucial factor affecting the therapy's prognosis. Strategies to improve pulp healing and treatment outcomes are explored, offering insights into clinical decision-making for pulpotomy procedures.

Fracture Resistance of Endodontically Treated Teeth Restored With Short Fiber Reinforced Composite and a Low Viscosity Bulk Fill Composite in Class II Mesial-Occlusal-Distal Access Cavities: An Ex-vivo Study.

Background Teeth undergoing endodontic therapy are prone to structural weakening and increased risk of fractures. The absence of marginal ridges and pericervical dentin further compromises the fracture resistance. The choice of the post-endodontic coronal seal is crucial for the effectiveness of endodontic therapy. Aim and Objectives This study compared the fracture resistance and fracture modes of endodontically treated teeth (ETT) with mesial-occlusal-distal(MOD) cavities restored with two different posterior composite resins: e-glass fiber reinforced composite (FRC) (everX Posterior) and flowable bulk fill composite (SDR Flow+). Materials and Methods Sixty human maxillary first bicuspids were divided into four groups: Group PC- positive control (intact teeth), Group NC- negative control (unrestored endodontically treated teeth), Group EXP- samples restored with everX Posterior and nano-hybrid composite, and Group SDR- samples restored with SDR Flow+ and nano-hybrid composite. The NC, EXP, and Smart Dentin Replacement (SDR) samples underwent endodontic procedures and MOD cavity preparation. The samples from EXP and SDR groups were restored with composite resins as post-endodontic coronal seals. The fracture resistance was evaluated using a Universal Testing Machine (UTM), and fracture modes were examined under a dental operating microscope (DOM) at 6x magnification. Statistical tests were performed using One-way ANOVA and Tukeys' post hoc tests. Results The mean fracture resistance of the experimental groups was as follows: PC- 880.1 ± 209.3 N; NC- 238.1 ± 15.4 N; EXP- 766.1 ± 50.2 N; SDR- 540.8 ± 49.4 N. The highest fracture resistance values were observed in the PC group, whereas the NC group showed the least. The EXP group exhibited significantly higher fracture resistance than the SDR group. Adhesive failure was observed in most samples in the EXP group, whereas samples in the SDR group showed more cohesive failures. Favorable fractures were more prevalent in samples restored with EverX posterior. Conclusion The study findings suggest that everX Posterior can enhance the fracture resistance of structurally compromised ETT. Samples restored with everX Posterior showed a favorable mode of fracture, which can be restored. Applying FRCs can contribute to the longevity and success of endodontic treatment by reinforcing the weakened tooth structure and preventing fractures.

Follow-up of Non-Surgical Endodontic Treatment of Permanent Mandibular First Molars with Middle Mesial Root Canals –Four Clinical Case Series Report with a Mini Literature Review

Introduction: Root canal treatment’s long-term favorable prognosis is dependent on a good pulpal-periapical diagnosis and periodontium health, clear preoperative radiographs, an adequate understanding of complex root canal anatomy and endodontic pathology, proper treatment protocol that involves careful examination of root anatomy, identifying unusual root canal anatomy, access modification, negotiation of all the canals, complete debridement by shaping and chemical disinfection of all the portals of entry and exit within the root canal system, hermetic three- dimensional obturation of root canal space with an inert filling material followed by a fluid-tight tooth coronal seal. Clinicians are challenged with aberrations in the root canal anatomy of permanent mandibular molars especially when this anatomy is difficult to visualize from radiographs. The presence of a middle mesial root canal in permanent mandibular molars has been reported. Extensive exploration of the groove between mesiobuccal and mesiolingual orifices in mandibular permanent molars may reveal the presence of additional middle mesial canal orifice. Objectives: This clinical case series discusses the Follow-up of non-surgical endodontic management of four mandibular permanent first molars with an additional Middle Mesial (MM) canal in the mesial root. A mini literature review of this anatomical anomaly is also presented. Materials and Methods: The four mandibular molars with middle mesial canal endodontic cases done at Endodontics Clinic, Primary Health Care Corporation (PHCC), Qatar by the author in the year 2021 were reviewed with follow-up in the year 2023, address the endodontic management from identification of additional canals to complete obturation and follow up. Results: Clinical follow-up post endodontic treatment demonstrated that the treated molars with extra canals were asymptomatic with no sensitivity to percussion or palpation, no swelling or tooth mobility, and normal periodontal ....

Attitude and practice of regenerative endodontic procedures among endodontists and paediatric dentists: A multinational survey from 13 countries.

Regenerative endodontics (RET) refers to biologically based procedures that aim to restore damaged tooth structures and reinstate the pulp-dentine complex to its normal physiological state. The purpose of this study was to examine the attitudes and practices of endodontists and paediatric dentists regarding RET. A survey was conducted among endodontists and paediatric dentists from 13 countries. A number of factors were evaluated, including frequency of RET application, followed guidelines, disinfection techniques, intracanal medication type, scaffold type, preferred coronal seal material, and follow-up period. Among the 1394 respondents, 853 (61.2%) and 541 (38.8%) were endodontists and paediatric dentists, respectively. Almost half (43%) of participants have not performed RET yet. The American Association of Endodontics guideline (47.3%) was selected as the primary source for the clinical protocol. The most frequently selected irrigant solution was 1.5%-3% NaOCl at the first (26.1%) and second (13.6%) sessions. A blood clot (68.7%) and MTA (61.9%) were the most frequently selected scaffold type and coronal barrier. Most participants preferred a 6-month follow-up period. According to this survey, deviations exist from current RET guidelines regarding all aspects evaluated. Standardizing clinical protocols and adhering to available guidelines would help to ensure more predictable outcomes.

Biological considerations of dental materials as orifice barriers for restoring root-filled teeth.

There is ample published literature regarding the technical aspects of restoring root-filled teeth, but little concerning the biological impacts, consequences, and criteria for the selection of direct restorative materials following endodontic treatment. The provision of an effective coronal seal in addition to a sound root filling is known to be important in the prevention of root canal infection. This review seeks to explore the evidence concerning the selection of dental materials in the restoration of root-filled teeth, specifically with a close examination of the properties of commonly used materials as orifice barriers. © 2023 Australian Dental Association.

Vital pulp therapy for permanent teeth with diagnosis of irreversible pulpitis: biological basis and outcome.

Root canal treatment (RCT) has been considered the conventional standard for the management of teeth with carious pulp exposure, particularly in mature teeth presenting with symptoms. Following a better understanding of the histopathology of deep carious lesions, the histology of the cariously exposed pulp and the healing potential of the inflamed pulp, vital pulp therapy (VPT) is increasingly adopted around the world for the management of permanent teeth with clinical signs and symptoms indicative of irreversible pulpitis. Furthermore, VPT became a recognized treatment modality by the European Society of Endodontology (ESE) and the American Association of Endodontists (AAE) by virtue of its high success rates reported in outcome studies using contemporary hydraulic calcium silicate-based cements. However, proper case selection, strict asepsis, capping materials and good coronal seal are mandatory for success. The aim of this paper is to review the biological basis for VPT in symptomatic teeth with carious pulp exposure and to report on the outcome of pulpotomy in teeth with clinical diagnosis of irreversible pulpitis.

Comparative Evaluation of Different Intra-orifice Barriers on the Microleakage of Endodontically Treated Roots Obturated with Gutta-percha “An In-vitro Study”

Aim: To comparatively evaluate various Intra-Orifice barriers (IOB) namely; Cention N (Ivoclar Vivadent), Biodentine (Septodont), Light Cured GIC (GC Gold Label 2LC) and Tetric N Flow (Ivoclar Vivadent) for their effects on the microleakage of endodontically treated teeth.&#x0D; Study Design: In-vitro study.&#x0D; Place of Study: Department of Endodontics and conservative dentistry, Himachal dental college, Sundarnagar, Himachal Pradesh.&#x0D; Materials and Methods: Seventy-five mandibular premolars were decoronated to a standardized length, prepared and obturated with Gutta-Percha and AH Plus sealer. Except for control specimens, the coronal 3-mm gutta-percha was removed and filled with different Intra-orifice barrier materials. The specimens (75) were divided into five groups (n = 15) on the basis of the Intra-Orifice barrier material used. Group 1: Control, Group 2: Cention N, Group 3: Biodentine, Group 4: Light Cured GIC, Group 5: Tetric N Flow. In experimental groups, 3 mm of coronal gutta-percha was removed and replaced with the study material. Samples were submerged in 2% methylene blue dye in vacuum for one week. Specimens were longitudinally sectioned and leakage measured using a 50X stereomicroscope and graded for depth of leakage.&#x0D; Results: In the present study microleakage of roots were significantly affected by the type of Intra-Orifice barrier used and the following pattern was observed: Tetric N Flow &gt; Biodentine &gt;Light Cured GIC &gt; Cention N&gt;Control.&#x0D; Conclusion: The present study concluded that Intra-Orifice barrier placement provides better coronal seal, prevents microleakage, and enhance the longevity of postobturation restorations, Tetric N Flow proved to be the best followed by Biodentine, Light Cured GIC and Control group.