Successful Root Canal Treatment Research Articles

Generative Adversarial Networks (GANs) 2D imaging optimization in image–J for estimation of endodontic filling material measurement: A review

Background: Root canal treatment (RCT) remains the most common clinical intervention in dentistry, treating a wide range of pulp-related conditions and structural tooth injuries. RCT begins by partially removing the crown to access and remove the infected pulp through a meticulous process of cleaning, reshaping, and irrigating the canal. This prepared canal is filled with gutta-percha as the endodontic filling material (EFM), and adhesive cement is used to seal the canal before final restoration with a crown. The success of RCT, however, hinges on accurately measuring and applying the EFM volume within the canal. Current measurement practices using 2D radiographic imaging fall short in accuracy due to operator limitations and the inherent lack of depth and clarity in 2D images, which contribute to high variability in EFM application. CBCT has emerged as a viable alternative, offering comprehensive 3D imaging for a more accurate EFM volume assessment, yet its high radiation levels, cost, and accessibility issues pose challenges. Thus, with increasing demand for safer and cost-effective alternatives, AI-driven enhancements in 2D imaging are being explored to achieve CBCT-level accuracy without its drawbacks, marking a significant step forward in RCT reliability and success rates. Purpose: To explore the potential of GANs and Image–J integration on 2D images for estimation of EFM measurement. Method: A literature review of studies published within the past five years from sources like ResearchGate, ScienceDirect, PubMed, and Google Scholar. Result: This study explores the integration of artificial intelligence, specifically convolutional neural networks (CNN) and generative adversarial networks (GANs), to enhance the accuracy of endodontic filling material (EFM) measurements in root canal treatments (RCT). CNN's structure, comprising multilayered networks with pooling layers, has shown potential in medical imaging by segmenting anatomical details for EFM measurement. However, challenges remain due to CNN's reliance on extensive datasets and its susceptibility to misinterpretation when faced with complex anatomical variations. GANs, combining a generator and discriminator, address these limitations by enabling unsupervised learning, allowing the generation of photorealistic data samples for more precise EFM measurement. This bidirectional learning system refines measurement accuracy through continuous feedback between the generator and discriminator, achieving superior outcomes across parameters like radiopacity, dimensional consistency, classification performance, and sealing ability. Furthermore, the AI model is enhanced by integrating Image-J, a Java-based image analysis software with precise 2D measurement capabilities. Despite its effectiveness in analyzing length and volume, Image-J has limitations due to its dependence on the operator’s interpretation, especially with low-quality 2D images. The combined use of GANs with Image-J allows for automated, detailed border detection of the pulp anatomy, improving measurement accuracy even with complex root canal forms. The results suggest that this integrated AI approach can advance clinical practices by providing precise, rapid, and consistent EFM measurements, potentially overcoming the limitations of traditional 2D radiographic methods and addressing CBCT’s drawbacks in radiation exposure and accessibility. Conclusion: The integration of generative adversarial networks (GANs) with Image-J offers a promising advancement in the measurement of endodontic filling materials (EFM) for root canal treatments based on 2D imaging. GANs enhance Image-J’s measurement precision and accuracy by utilizing bidirectional deep learning, which enables continuous learning and refinement without requiring extensive external inputs. This approach not only improves EFM estimation but also presents a viable alternative to cone-beam computed tomography (CBCT), reducing potential health risks and economic burdens associated with CBCT. The combined GANs and Image-J system thus supports a more accessible, efficient, and precise methodology for EFM assessment in clinical dentistry.

Comparison of electronic apex locator and simultaneous working length detection methods with radiological method in terms of postoperative pain

BackgroundPrecise knowledge of the apical construction, which determines the end of the area for canal preparation and filling, is essential for the success of root canal treatment and the management of postoperative pain. For this purpose, devices based on various methods that determine the working length (WL) are used. However, it is still controversial which method provides the most accurate measurements.AimTo investigate the compatibility of the electronic apex locator (EWL) and simultaneous working length determination (SWL) methods in single-root teeth in comparison with the radiographic working length determination (RWL) method and to determine which one produced more effective results in terms of postoperative pain.Materials & methodsOne hundred patients scheduled for root canal treatment (RCT) were randomly assigned to one of the three groups according to the working length measurement method (EWL, SWL or RWL). After WL determination with assigned method, root canals were prepared and then obturated. Age, gender, simplified oral hygiene index (OHI-S), oral and dental examinations and Visual Analogue Scale (VAS) results of all participants were recorded. The incidence and intensity of postoperative pain were rated on a Visual Analogue Scale (VAS) by patients 6, 12, 24, 48 h and 7 days after RCT. The number of analgesic tablets (400 mg Ibuprofen) taken by patients was also recorded. Data were analyzed using the chi-square, One- way ANOVA and Kruskal-Wallis tests. Bland-Altman and Passing-Bablock regression analysis were used as method comparison techniques.ResultsIt was determined that the number of patients receiving analgesia and the total number of analgesia doses were higher in EWL and RWL groups compared to SWL group (p < 0.0001). When the WL values at which the treatment was applied were compared in the patient groups; WL values of EWL group were statistically lower than SWL group (p < 0.01). While there was no difference between the preoperative VAS scores of the groups (p = 0.7590), the postoperative 6th and 12th hour VAS scores of SWL group were lower than those of EWL and RWL groups (p = 0.005 and p = 0.0002, respectively). Again, the VAS scores of SWL group at the 24th and 48th postoperative hours were lower than those of RWL group (p < 0.05). According to the Bland-Altman and Passing-Bablock regression analysis results, although there was no statistically significant difference between the EWL and SWL methods (p = 0.471), the bias value of -0.1190 was well below the acceptable total error (0.1648). Additionally, a strong relationship was found between EWL and SWL methods (r = 0.9698, r2 = 0.9406, p < 0.001). Therefore, statistically these two methods were considered compatible with each other. It was determined that there was a statistically significant bias (0.340, p < 0.0001) between the RWL and SWL methods, exceeding the total error.ConclusionsAs a result, it was determined that the SWL method, which is used to determine working length for the success of endodontic treatment, can be used as an alternative to the EWL method thus producing more effective results in the management of postoperative pain. However, in addition to the method used, the technology of the device developed for this method should not be ignored.Clinical relevancePrecise knowledge of the apical construction, which determines the end of the area for canal preparation and filling, is essential for the success of root canal treatment and the management of postoperative pain. For this purpose, devices based on various methods that determine the working length are used. However, it is still controversial which method provides the most accurate measurements. This study found that the simultaneous working length determination method can be used as an alternative to the electronic working length determination method and produces more effective results in the management of postoperative pain. Another important outcome of this study is that the Total Allowable Error (TEa) for the electronic apex locator method, which is accepted as the reference, has been calculated for the first time. Other methods have been evaluated according to this reference method. This is a first in literature.

Nonsurgical endodontic retreatment of C-shaped maxillary molars: case reports and review of literature

The root canal systems of maxillary first molar (MFM) and maxillary second molar (MSM) variations represent a clinical challenge for endodontists, especially the prevalence of fused C-shaped roots. Having a thorough knowledge of root canal configuration is an extremely important point for a successful root canal treatment to avoid missing extra canals. The aim of this article was to present 2 cases of maxillary molar with an unusual C-shaped configuration diagnosed during root canal retreatment/treatment and conduct a literature review of the MFM and MSM anatomy. Case 1 reports that three separate palatal root canals fused into a C-shaped configuration in the MFM, which with an enamel pearl in the furcation, was classified as Type D and first reported in MFM. Case 2 reflects the fusion of all three buccal canals of the MSM into a C-shaped configuration that finally formed an apical foramen with a supernumerary tooth, and the configuration was Type B. Evaluation at an 18-month and a 9-month recall revealed that two patients were symptom-free after the conduct of a non-surgical retreatment/treatment, and the X-ray revealed normal periapical tissue. In addition, the thickness of the Schneiderian membrane due to odontogenic maxillary sinusitis returns to normal after an effective retreatment in case 1. These reports serve to remind endodontists of the importance and complexity of anatomical variations, which should always be considered when formulating an effective root canal treatment plan. The combined use of cone-beam computerized tomography (CBCT) and a dental operating microscope (DOM) will be profitable to locate and identify extra canals when a periapical radiograph shows signs of an unusual canal morphology.

Literature review and case study: unveiling the complexities of mandibular second molar with three distal canals

The occurrence of morphological deviations in root canal anatomy is challenging and can influence treatment outcomes. While mandibular second molars typically have 2 roots and 3 canals, a unique case emerged in a 23-year-old Indian male with a symptomatic permanent left mandibular second molar showing three distal, two mesial canals, and two roots. The tooth presented as non-mobile but tender on percussion. The patient was diagnosed with symptomatic irreversible pulpitis with symptomatic apical periodontitis. The presence of mid distal canal was radiographically and visually confirmed with the aid of limited FOV cone-beam computed tomography and the dental operating microscope. Successful nonsurgical root canal treatment with 6-month follow-up has been documented in this case report.

Impact of Tulsi extract on sealer penetration in dentinal tubules as compared to 17% EDTA as the final root canal irrigant (in vitro analysis)

Introduction: Penetration of endodontic sealers into dentinal tubules is essential for ensuring successful root canal treatment by creating a hermetic seal that prevents reinfection. Traditionally, 17% EDTA has been used as the final irrigant for smear layer removal. However, concerns regarding its limited antimicrobial properties and potential for dentin erosion have prompted the exploration of alternative solutions. This in vitro study compared the effectiveness of Tulsi extract with that of 17% EDTA in promoting sealer penetration within the dentinal tubules. Methodology: Thirty extracted single-rooted teeth were randomly divided into three groups: Group 1, 17% EDTA; Group 2, Tulsi extract; and Group 3, saline control. After preparation, the root canals were irrigated with their respective soluti ons, filled with gutta-percha, and sealed with a calcium hydroxide-based sealer. Sealer penetration was analyzed using scanning electron microscopy (SEM) at the 2 mm and 5 mm levels from the root apex. Results: The results showed no significant difference in sealer penetration at 2 mm among all the groups. However, at 5 mm, both EDTA and Tulsi groups exhibited significantly greater sealer penetration than the control group (p &lt; 0.001). No significant difference was observed between the EDTA and Tulsi groups at 5 mm (p = 0.706). Conclusion: Tulsi extract demonstrated similar efficacy to 17% EDTA in facilitating sealer penetration, suggesting its potential as a biocompatible and antimicrobial alternative for root canal irrigation protocols. Further studies are warranted to explore its clinical applications and commercial viability.

PERMANENT MANDIBULAR CANINE WITH TWO ROOTS AND TWO CANALS

Mandibular canines are documented as frequently having one root and one canal in most cases, although around 15% may have two canals and two roots. Thus, anatomic variation exists therefore knowledge and keen observation during root canal can help to identify the less frequent variation morphology of tooth and play a pivotal role in the success of root canal treatment. This case report discusses a mandibular canine with two roots and two canals.

Influence of Direct Coronal Restoration Materials on the Fracture Resistance of Endodontically Treated Premolars: An In Vitro Study.

(1) Background: The long-term survival of an endodontically treated tooth depends on a successful root canal treatment as well as an adequate definitive coronal restoration. This study aimed to evaluate the strength of endodontically treated premolars with mesial-occlusal-distal (MOD) cavity preparation restored with different direct coronal restoration materials but from the same manufacturer against fracture. (2) Methods: sixty intact premolars were selected and placed into five groups (n = 12): G1-intact teeth, G2-endodontic treatment and unrestored MOD cavities, G3-endodontic treatment and MOD cavities restored with Tetric PowerFlow and Tetric EvoCeram, G4-endodontic treatment and MOD cavities restored with Multicore Flow and Tetric EvoCeram, and G5-endodontic treatment and MOD cavities restored with Multicore Flow. The specimens were subjected to an axial compression load at a speed of 1.6 mm/min and optically inspected before and after with a stereomicroscope. For each premolars group, the following data were recorded: the compression resistance, the compressive strength, and the maximum force supported. The microstructure of the samples after the compression test was analyzed using scanning electron microscopy (SEM). (3) Results: statistical analysis (ANOVA and Tukey test) showed that there was a statistically significant difference between G1 and the other groups. Even though there was no statistically significant difference between the restored groups, a better mechanical behavior was registered within the G3. (4) Conclusions: this in vitro study indicated that none of the materials used can lead to a higher or at least similar fracture resistance as the intact teeth. The coronal restoration only with nano-hybrid composites may lead to a higher therapeutic benefit for the fracture-susceptible premolars.

Healing of periapical lesion by non-surgical endodontic therapy: A case report

Periapical lesions often arise as a consequence of pulpal diseases, and most inflammatory periapical lesions are initially managed with conservative non-surgical methods. The success of root canal treatment hinges on the thorough cleaning, shaping, and obturation of the root canal system. Calcium hydroxide and triple antibiotic paste (TAP) are preferred intracanal medicaments due to their effective antibacterial properties. This case report details the non-surgical management of a periapical lesion associated with the mandibular central incisors in a 18-year-old female who presented with periodic swelling and pus drainage in the labial sulcus, due to traumatic accident in the that area. The case underscores the effectiveness of using calcium hydroxide and TAP as interappointment endodontic dressings, leading to favorable clinical and radiographic outcomes for managing a periapical radiolucency.

Management Of Large Periapical Lesion With A Noninvasive Approach: A Case Report

Periapical lesions develop as a sequela to pulpal diseases. The majority of inflammatory periapical lesions are initially treated with conservative non-surgical procedures. The success of root canal treatment is based on thorough cleaning, shaping and obturation of the root canal system. Calcium hydroxide and triple antibiotic paste (TAP) are recommended as intracanal medicaments due to its antibacterial properties. This case report describes the non-surgical management of a large cyst-like periapical lesion in relation to the maxillary lateral incisor of a 19-year-old male with the chief complaint of periodic swelling and pus drainage from the palatine region with a history of a traumatic accident in the same area. The present case highlights the use of calcium hydroxide and TAP as an interappointment endodontic dressing for non-surgical management of large periapical radiolucency, which resulted in favourable clinical and radiographic outcomes

Digital precision meets dentin preservation: PriciGuide™ system for guided access opening

Traumatic injuries to maxillary central incisors often necessitate root canal treatment (RCT). However, traditional access cavity preparation can remove significant dentin, compromising tooth strength and long-term prognosis. This article explores the use of the PriciGuide™ system for minimally invasive access cavity preparation in such cases. PriciGuide™ system is a novel, patented system that utilizes a sleeveless guide technique to enhance accuracy and control during access procedures. This article presents a clinical case demonstrating the application of PriciGuide™ system for access cavity preparation in traumatized necrotic maxillary central incisors. The focus is on preserving dentin while achieving optimal access for successful RCT. By showcasing the effectiveness of PriciGuide™ system in this case, this article contributes to the growing body of evidence supporting its role in minimally invasive endodontics. The approach presented has the potential to improve long-term outcomes for patients with not only traumatized necrotic maxillary central incisors but also in teeth having prosthesis that requires RCT and in teeth with calcifications.

Comprehensive analysis of root canal morphology in maxillary premolars among the Pakistani subpopulation: a CBCT-based study

BackgroundUnderstanding the root canal morphology is essential for the success of root canal treatment. Therefore, this study aimed to evaluate and analyze the root canal configuration of maxillary premolars using Cone Beam Computed Tomography in the Pakistani subpopulation.MethodThis cross-sectional study utilized CBCT scans from two distinct centres: Aga Khan University in Karachi and Jinnah MRI and Body Scans in Lahore. The CBCT images were visualized using GALAXIS version 1.9 (SICAT GmbH and Co. KG, Bonn, Germany), integrated within the Sirona Dental System (D-64625 Bensheim, Germany). The scanning parameters were standardized at 85 kV, 7 mA, with a 15-s exposure time and a voxel size of 0.16 mm. A total of 707 CBCT scans were collected, encompassing 2180 maxillary premolars. Root canal configurations were classified based on (Ahmed et al. Int Endod J. 2017;50(8):761–70). Statistical analyses were performed using SPSS version 26, employing the Chi-square test with a significance level set at p < 0.05.ResultsThe distribution of root canal morphologies varied significantly with age and gender. Among maxillary premolars, 50% exhibited the typical configuration of 2MPMB1 L1 (two roots, single canal in each buccal and lingual root), while 26% of maxillary right second premolars displayed 1MPM1 (one root, one canal). Overall, 1MPM1 accounted for 27.4% of the total cases in the second premolars. There was no statistically significant relationship between age and root canal distribution in either first premolars (p = 0.338) or second premolars (p = 0.833). Regarding gender, a significant difference was observed in the distribution of right maxillary 1st premolars (p = 0.022*), with a higher prevalence among females.ConclusionThis study offers significant insights into the anatomical variations of root canals in maxillary premolars across diverse regional subpopulations in Pakistan. While specific root canal configurations were prevalent, the findings indicate no statistically significant correlation between age and root canal morphology in maxillary premolars. However, a notable gender disparity was observed in the distribution of the right maxillary first premolars.

Intentional Replantation in Combination with Fibroblast Growth Factor-2 Application and Orthodontic Tooth Extrusion for Periodontal Regeneration in the Treatment of Severe Endodontic-Periodontal Lesions.

Endodontic-periodontal lesions are characterized by the involvement of the pulp and periodontal disease in the same tooth. Despite successful root canal treatment, if the majority of bone support has been lost from periodontitis, the tooth may have a poor prognosis. In severe endodontic-periodontal lesions, the periodontal tissue regenerates poorly because of the significant loss of the periodontal ligament and cementum, poor tooth stability, and bone defect morphology unfavorable for bone regeneration. To overcome these difficult situations, in this case, osteotomy of the replantation bed and tooth replantation with horizontal rotation and deep placement were performed. To improve periodontal regeneration, fibroblast growth factor (FGF) 2 was applied to the artificially made periodontal defect. In addition, orthodontic extrusion of the deeply replaced tooth was performed for potential coronal migration of the periodontal tissue. This case presents a unique multidisciplinary method of treating severe endodontic-periodontal lesions using intentional replantation combined with FGF 2 application and orthodontic extrusion.

IN VIVO STUDY EVALUATES EFFECTIVENESS OF ADDING CIPROFLOXACIN TO CALCIUM HYDROXIDE VERSUS SAUSSUREA COSTUS TO CALCIUM HYDROXIDE MEDICATION AGAINST BACTERIAL BIOFILM IN ROOT CANAL TREATMENT

Background and objectives: Elimination of root canal bacteria is a perquisite for a successful root canal treatment. This research aims to determine the effectiveness of adding ciprofloxacin versus Saussurea costus extract to calcium hydroxide medicament against bacterial biofilm in root canal treatment in vivo study. Materials and methods: In vivo study on 70 single-rooted human teeth at Sana'a University dental clinics used Saussurea costus extract preparation, including washing, drying, crushing, mixing, centrifugation, drying, and homogenization.The intracanal drug concentration was standardized by mixing 1 g of calcium hydroxide powder with 1 ml of ciprofloxacin or 1 ml of Saussurea costus extract in both groups. Three bacteriological samples were taken before root canal treatment, before Medicaments were placed, and 7 days after, and CFU and bacterial isolation were performed using standard methods. Results: An intragroup analysis showed that all drug groups had a significant decrease in the number of intracanal bacterial cells from S1 to S2 and from S2 to S3 (p&lt;0.0001). When comparing quantitative S1 or S2 data, there was no significant difference between the groups; however, at Sample 3, the Saussurea costus extract calcium hydroxide (34.05±21.8) had considerably higher bacterial counts than the calcium hydroxide + Ciprofloxacin group (11.9±29 CFU). The most isolated bacteria in S1 and S2 were Staphylococcus aureus (58.6%, 51.4%), followed by Klebsiella species (27.1%, 18.6%), Escherichia coli (25.7%, 17.1%), Enterococcus faecalis (22.9%, 15.7%) and Pseudomonas aeruginosa (21.4%, 12.9%). Conclusions: The addition of Ciprofloxacin to calcium hydroxide and Saussurea costus- calcium hydroxide provided further antibacterial effectiveness when used as an intracanal medicament in vivo during root canal treatment. Peer Review History: Received 27 March 2024; Revised 5 May 2024; Accepted 28 June; Available online 15 July 2024 Academic Editor: Essam Mohamed Eissa, Beni-Suef University, Egypt, dressamceutics@yahoo.com Average Peer review marks at initial stage: 6.5/10 Average Peer review marks at publication stage: 7.0/10 Reviewers: Dr. Kingsley C Anukam, University of Benin, Nigeria, kanukam@gmail.com Dr. Liliya Logoyda, Horbachevsky Ternopil State Medical University, Ukraine, logojda@tdmu.edu.ua

An in vitro comparative evaluation of cyclic fatigue resistance of two rotary and two reciprocating file systems.

Root canal instrumentation is one of the important procedures for successful endodontic therapy. Unexpected fracture of files occurs during root canal instrumentation without any visible signs of deformation compromising the success of root canal treatment. The aim of the study was to evaluate and compare cyclic fatigue resistance (CFR) of rotary and reciprocating files in simulated canals with 45°, 60°, and 90° angle of curvature. The study design was an In vitro study. Sixty nickel-titanium files, 30 each of rotary and reciprocating files were selected and divided into four groups (n = 15) of Neoendo Flex, ProTaper Next, WaveOne Gold (WOG), and Reciproc Blue (RPB) files. Each group was further subdivided into three subgroups containing five samples each based on their use in simulated canals with 45°, 60°, and 90° angle of curvature. To simulate root canals with 45°, 60°, and 90° angle of curvature, three artificial canals were designed in a stainless steel metal block. Each file was autoclaved, immersed in 3% sodium hypochlorite (NaOCl), and coated with 17% ethylenediaminetetraacetic acid (EDTA). Each file was tested for CFR using a torque-controlled reduction handpiece by instrumenting in a simulated canal for 10 s until fracture. The cycle of autoclaving, exposure to NaOCl, EDTA, and testing of CFR for 10 s per canal as per groups and subgroups was repeated again and again until the respective file fracture. The time taken to file fracture was recorded using a digital chronometer. The time taken for each file fracture (in minutes) was multiplied by the number of rotations per minute to attain the number of cycles to failure (NCF). The obtained results were subjected to statistical analysis using one-way analysis of variance and independent t-test. One-way ANOVA test showed a statistically significant difference between the four groups, P < 0.001. Independent "t"-test between individual subgroups showed a statistically significant difference, as P < 0.05. WOG and RPB reciprocating file systems showed superior CFR, more especially in canals with abrupt 90° angle of curvature compared to both rotary file systems tested. Among rotary file systems tested, Neoendo Flex showed greater CFR than ProTaper Next.

Assessing the efficacy of various irrigation solutions in dissolving organic tissue

For successful root canal treatment, adequate chemomechanical instrumentation to eliminate microorganisms and pulp tissue is crucial. This study aims to assess the organic tissue dissolving activity of various irrigation solutions on bovine tooth pulp tissue. 40 extracted bovine mandibular anterior teeth (n = 10) were used for the study. Bovine pulp pieces (25 ± 5 mg) were placed in 1.5 ml Eppendorf tubes. Each tooth pulp sample was then covered with 1.5 ml of different irrigation solutions, dividing them into four groups: Group 1 with freshly prepared 5% Boric acid, Group 2 with 5% NaOCl, Group 3 with Irritrol, and Group 4 with Saline. Samples were left at room temperature for 30 min, then dried and reweighed. The efficacy of tissue dissolution ranked from highest to lowest was found to be NaOCl, Boric Acid, Irritrol, and saline (p < 0.05). It was observed that the decrease in the NaOCl group was greater than the decrease in the Irritrol and saline groups, and the decrease in the Boric acid group was significantly greater than the decrease in the saline group (p < 0.05). It also emphasizes the need for future studies to further investigate the effects of Irritrol and Boric Acid on tissue dissolution.

Comparison of Practice and Knowledge on Endodontic Retreatment amongst the General Practitioners and Endodontists: A Survey

Abstract Introduction: Endodontic retreatment differs from initial root canal treatment. Various factors govern the success of root canal treatment, and failure to achieve any of these may lead to the failure of the therapy. Retreatment decisions differ amongst general practitioners and specialists and are dependent on several factors including educational background, work experience, knowledge and economic resources. A survey was conducted to compare the practice and knowledge regarding endodontic retreatment cases amongst general practitioners and endodontists. Materials and Methods: A questionnaire was constructed with questions based on common practice and knowledge of endodontic retreatment and was distributed to general practitioners and endodontists through electronic means and personal mail. Data were analysed using the Chi-square test. P &lt; 0.05 was considered statistically significant. Results: The results showed that there was no statistical difference in the responses by general dentists and specialists (endodontists). Conclusions: Within the limitations of this survey, it can be concluded that both the general practitioners and specialists (endodontists) have adequate knowledge and follow similar protocols when treating retreatment cases with minor differences in their approach.

Comparative Analysis of Various Irrigation Solutions in Root Canal Treatment.

"Root canal treatment (RCT)" is essential in preserving natural dentition by eliminating infection within the root canal system. Irrigation solutions play a crucial role in achieving successful RCT outcomes by facilitating disinfection and debris removal. An in vitro experimental design was employed to evaluate the irrigation solutions. Antimicrobial efficacy was assessed using agar diffusion assays against Enterococcus faecalis and Candida albicans. Tissue dissolution ability was evaluated by measuring the weight loss of dentin specimens. Cytotoxicity was assessed using cell viability assays with human periodontal ligament fibroblasts. NaOCl demonstrated the highest antimicrobial efficacy, while EDTA exhibited superior tissue dissolution ability. CHX and QMix displayed lower cytotoxicity compared to NaOCl and EDTA. The choice of irrigation solution in RCT should consider factors such as antimicrobial efficacy, tissue dissolution ability, and cytotoxicity. NaOCl remains effective but has high cytotoxicity, whereas CHX and QMix offer alternatives with lower cytotoxicity. EDTA is effective in tissue dissolution but should be used cautiously due to cytotoxic potential. Clinicians should weigh the benefits and limitations of each solution for optimal treatment outcomes.

Overview of Interim and Temporary Restorations of Teeth During Endodontic Treatment.

Root canal treatment of vital, non-infected teeth can often be completed in a single visit, negating the necessity for dressing and provisionalization. Conversely, cases involving infected canals typically demand multiple visits, during which antibacterial medicaments are applied, making effective provisionalization crucial for varying durations. The key components of a successful root canal treatment include adequate canal shape to promote efficient obturation, thorough chemical and mechanical debridement, and complete removal of pulp tissue remnants and bacteria. The primary cause of pain following the initiation of endodontic treatments is often attributed to inadequate debridement or incomplete removal of the pulp tissue, closely followed by insufficient temporary restorations. This review aims to comprehensively overview provisionalization materials used during and immediately after endodontic procedures.

Comparison of push-out bond strength and apical microleakage of different calcium silicate-based cements after using EDTA, chitosan and phytic acid irrigations.

This research was aimed to evaluate push-out bond strength and apical-microleakage after application of three different calcium silicate-based cements with irrigation solutions on simulated immature teeth. 40 maxillary permanent canine teeth were used for push-out bond strength test, and 120 maxillary permanent incisors were used for microleakage evaluation. 120 root slices were divided into four main groups (EDTA, Chitosan, Phytic acid, and Saline) and immersed these solutiouns according to irrigation procedures. Each irrigation group was divided into 3 subgroups (Biodentine, MTA Repair HP, and NeoPUTTY). The prepared teeth were divided into four groups according to irrigation procedure for microleakage test. EDTA irrigation with Biodentine group showed highest push-out bond strength value and saline group with Neoputty showed the lowest push-out bond strength value. The highest microleakage value was seen in saline group with MTA Repair HP, while the lowest microleakage value was observed chitosan with Biodentine group. Chitosan and phytic acid solutions can be recommended as an alternative irrigation solution to 17% EDTA in single-session apexification treatment, since they are non-toxic, naturally occurring materials, effectively remove the smear layer, and have a positive effect on bond strength and apical leakage. RESEARCH HIGHLIGHTS: One of the factors affecting the long-term success of root canal treatment is a hermetic seal. Non-hermetic or inadequate filling triggers a chronic inflammatory reaction in periapical tissues, causing fluids to enter the spaces and negatively affecting the success of the treatment. Therefore, this study will help clinicians choose the right biomaterial and irrigation solution that will affect the success of root canal treatment.

To Compare and Evaluate the Fracture Resistance of Three Post Endodontic Restorations Including Silver Amalgam, Dual Cure Composite Resin and Fibre Reinforced Composite Resin

Background: Endodontically treated teeth are thought to be more prone to fracture. The last stage in a successful root canal treatment is to restore root canal-treated teeth with a permanent, definitive postendodontic restoration. Dehydration, dentin loss during endodontic procedures, and the elimination of significant anatomic elements like cusps, ridges, and the pulp chamber's arched roof—all of which contribute significantly to the normal tooth's support—are the causes of the fracture of endodontically treated teeth. Consequently, intracoronal strengthening is necessary to prevent tooth fracture, especially in the posterior teeth where compressive stresses brought on by occlusal forces can cause tooth fractures.1 Since core materials typically replace a significant portion of the tooth structure and must withstand multidirectional masticatory forces,their compressive strength is crucial.2  Aim: The purpose of this study was to compare the compressive strengths of three direct post enododontic restorations.  Material and Methods: There are thirty extracted maxillary premolars chosen. After receiving root canal therapy, the teeth were divided randomly into three groups for immediate post-endodontic restorations: (i) silver amalgam (ii)Fiber-reinforced composite resin (iii) dual cure glass- reinforced composite resin . After that, a Universal Testing Machine was used to apply compressive stress on the teeth.  Statistical Analysis: Fracture loads will be compared statistically, and the data will be analysed using version 21.0 of SPSS software, analysis of variance and the Post-hoc test for multiple comparisons.  Result and Conclusion: Within the limits of the study, it showed that the post hoc tests reveal that the mean difference of compressive load strength is significant between all the groups, Amalgam has highest load strength followed by Fiber reinforced composite. Dual cure composite has lowest compressive load strength.