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This systematic review evaluated whether using anti-erosive agents as a pretreatment of eroded dentin before bonding with resin composite affects the bond strength. A search was conducted by two reviewers in the PubMed, Embase, Scopus, Web of Science, and Science Direct databases in January 2023. Articles that employed artificially eroded human dentin and performed treatment prior to adhesion with anti-erosive substances were eligible. A validated tool with 12 items regarding in vitro studies was used to assess the risk of bias in the selected articles, obtaining a final score for each study. Four in vitro studies were included in this systematic review. Most studies used the microtensile bond strength test; most failures were adhesive or mixed. No tested substance negatively affected the bond strength to eroded dentin. Sodium fluoride (NaF), tin-containing fluoride (Sn/F) and silver diamine fluoride (Ag(NH₃)₂F) have been proven not to interfere with or improve bond strength to eroded dentin. Esta revisión sistemática evaluó si el uso de agentes antierosivos como tratamiento previo de la dentina erosionada antes de la adhesión de la resina compuesta afecta la resistencia adhesiva. Dos revisores realizaron una búsqueda en las bases de datos PubMed, Embase, Scopus, Web of Science y Science Direct en enero de 2023. Fueron seleccionados los artículos que empleaban dentina humana erosionada artificialmente y realizaban un tratamiento con sustancias antierosivas antes de la adhesión. Se utilizó una herramienta validada con 12 ítems referentes a estudios in vitro para evaluar el riesgo de sesgo en los artículos seleccionados, obteniendo una puntuación final para cada estudio. En esta revisión sistemática se incluyeron cuatro estudios in vitro. La mayoría de los estudios utilizaron la prueba de resistencia de unión por microtracción; la mayoría de las fallas fueron adhesivas o mixtas. Ninguna sustancia evaluada afectó negativamente la resistencia adhesiva a la dentina erosionada. El fluoruro de sodio (NaF), el fluoruro conteniendo estaño (Sn/F) y el fluoruro diamino de plata (Ag(NH₃)₂F) demostraron no interferir o mejorar la resistencia adhesiva a la dentina erosionada.

This study aimed to investigate the impact of the combination of Benzalkonium chloride (BAC) and sodium hypochloride (NaOCl) and its application after ethylenediaminetetraacetic acid (EDTA) in root canal irrigation procedures on the microhardness and mineral content of dentin. Distal roots of mandibular third molars were embedded in auto-polymerizing acrylic resin, sectioned coronally to apically resulting in fifty-four root sections. Thirty sections underwent microhardness evaluation, and twenty-four sections were randomly chosen for mineral analysis. The microhardness assessment comprised three groups: Group 1 (2.5% NaOCl), Group 2 (2.5% NaOCl with 0.084% BAC), and Group 3 (2.5% NaOCl with 0.084 BAC post-17% EDTA). Initial and post-irrigation microhardness values were measured for each group. For mineral analysis, samples were categorized into four groups: distilled water, 2.5% NaOCl, 2.5% NaOCl with 0.084% BAC, and 17% EDTA+2.5% NaOCl with 0.084% BAC. X-ray photoelectron spectroscopy immediately measured magnesium, phosphorus, and calcium mineral contents on dentin surfaces post-irrigation. Results indicated a significant reduction in root dentin microhardness for all solutions (p<0.05). However, no statistically significant difference in the percentage of reduction was observed among the groups (p>0.05). XPS analysis revealed no significant disparity in dentin surface mineral content among the groups (p>0.05). In conclusion, the addition of Benzalkonium chloride to sodium hypochloride, either alone or after EDTA, did not induce a significant alteration in dentin microhardness or mineral content. These findings contribute to a nuanced understanding of dental irrigation protocols and their effects on dentin properties during endodontic procedures.

A successful endodontic treatment requires a combination of satisfactory mechanical instrumentation, adequate irrigation protocols, and three-dimensional obturation of the canal system. Irrigation is considered the most critical procedure to ensure cleaning and disinfection. To date, a large variety of irrigants has been proposed. However, sodium hypochlorite (NaOCl) remains the gold standard. In order to achieve complete cleaning and disinfection, final irrigation with EDTA and ultrasonic devices has been used as an ideal protocol. Most endodontic research focuses on the cleaning and antibacterial properties of the irrigant solutions. Recent evidence demonstrated that the irrigation protocols cause erosion, affecting the radicular dentin ultrastructure. This article aims to describe the clinical features of the present knowledge concerning the effect of irrigation protocols on radicular dentin.

The aim of this study was to compare the filling capacity in curved root canal using a new continuous wave of condensation technique (Termo Pack II, Easy Dental Equipments, Brazil) or lateral compaction. The percentage of voids in the filling of mesial root canals of mandibular molars was assessed by micro-computed tomography (micro-CT). Mesial root canals (n=24) of mandibular molars with a degree of curvature between 20° and 40° were prepared using rotary system (ProDesign Logic, Easy, Brazil) up to #35, .05 taper. The root canals were filled by using the continuous wave of condensation system or lateral compaction and AH Plus sealer (n=12). Scanning at 9 µm was performed after preparation and after filling by using micro-CT SkyScan 1176. The volumetric percentage of filling material and voids (total length and in each root canal third) were calculated. Data were analyzed using ANOVA/Tukey and Student’s t tests (α=0.05). Before the filling techniques, the root canals volume after preparation was similar (p>0.05). The root canals filled by the continuous wave of condensation technique presented the lowest percentage of voids, and the greatest percentage of filling material in total length and thirds (cervical, middle and apical) (p<0.05). Both techniques were not able of completely filling the root canals. The continuous wave of condensation technique Termo Pack II promoted better root canal filling in curved root canals, when compared with lateral compaction.

Dental age estimation is very important for individual identification in criminal and civil forensic investigations. One of the methods for age estimation is studying age related changes in pulp volume of teeth. The objective of the current study was to estimate dental age from the pulp volume of five different categories of teeth of a Peruvian sample using cone beam computed tomography (CBCT). Retrospective CBCT records of 231 patients [females (134), males (97), age: 12-60 years]  were included in the study, categorized into five different age groups (12-19, 20-29, 30-39, 40-49, 50-59, 60 years and older). Dental pulp volume of five categories of teeth(upper canines, left upper central incisors, left upper first molars, lower left first premolars, first molars) were analyzed using Romexis® 5.3.3.5 software for each patient. There was a reduction in the pulp volume of upper right and left canine with age. The pulp volume was lowest in people aged 60 years and over. Linear regression analysis of the pulp volume and chronological age showed a coefficient of determination of 30%, suggesting a weak correlation. A weak correlation between dental pulp and age is derived. But, a robust large homogenous sample of teeth in future for different age groups may establish a reliable regression equation.

The aim of this study was to assess the influence of micro-computed tomography (micro-CT) voxel size on evaluation of root canal preparation using rotary heat-treated nickel-titanium files. Curved mesial root canals of mandibular molars were prepared using ProDesign Logic 30/.05 (PDL) or HyFlex EDM 25/.08 (HEDM) (n=12). The specimens were scanned using micro-CT with 5μm of voxel size before and after root canal preparation. Images with sub-resolution of 10 and 20μm voxel sizes were obtained. The percentage of volume increase, debris and uninstrumented root canal surface were analyzed in the different voxel sizes. Data were compared using unpaired Student’s t-test and ANOVA statistical tests (α=0.05). No differences were observed for percentage of volume increase, debris and instrumented surface between the root canals prepared by PDL and HEDM (p>0.05).  Both systems promoted higher percentage of debris in the apical third compared to the middle third (p<0.05). After instrumentation using PDL the percentage of uninstrumented surface was highr in the apical third than middle third only when analysis were performed at 5µm (p<0.05). When comparing the different voxel sizes (5,10 or 20µm), both groups showed different means for the variables, with no significant difference (p>0.05). PDL and HEDM had similar root canal preparation capacity. Micro-CT images using different voxel sizes did not influence the results of volume increase and debris evaluation. However, images at 5µm showed greater accuracy to evaluate the percentage of uninstrumented surfaces.

To determine the accuracy of the Kvaal method in the estimation of dental age through the analysis of digital panoramic radiographs of patients between 20 and 47 years of age who attended the stomatological clinic of the Universidad Científica del Sur, (2018 to 2019), Lima-Perú. 289 digital panoramic radiographs belonging to individuals of both sexes, aged 20 to 47 years were analyzed. Length and width measurements were obtained in the dental and pulp chamber in the upper central incisors. These data were subsequently evaluated by calculating the proportions between the pulp and root length of the upper central incisor by applying the formula of the method of Kvaal et al. to obtain the accuracy of the method in estimating dental age. Applying the formula of Kvaal et al. indicates that the relationship between the width of the pulp and the length of the root has a higher level of significance in relation to others proportions: M mean value of all ratios except T (-0.659) and W-L difference between W and L (-0.643). The coefficient of determination (r²) and standard error of estimation (SEE) using the original Kvaal formula is r²: 0.70, SEE: 4.90 years, then a modified Kvaal formula was proposed for the Peruvian population. The Method of Kvaal et al. has an accuracy of 1.24 in estimating the dental age of individuals, using the upper central incisor in digital panoramic radiographs.

Objective: This study evaluated the effects of alternative self-etch application modes on resin-dentin microtensile bond strength (µTBS) of three commercially available “no wait” concept universal adhesives. Materials and methods: In this study extracted impacted non-carious human third molars were used. The flat surfaces were prepared in mid-coronal dentin and prepared with a 600-grit SiC paper. The three universal adhesives that were used are as follows: Clearfil Universal Bond Quick (CUQ, Kuraray Noritake, Japan), G-Premio Bond (GPB, GC Corp, Japan), and a self-curing universal adhesive “Tokuyama Universal Bond” (TUB; Tokuyama Dental, Japan). The following three different application procedures were used for the dentin surfaces: the adhesives were applied and immediately subjected to air-dry; the adhesives were applied followed by a 10-second wait; or the adhesives were rubbed for 10 seconds. Then composite resin was applied to the dentin surface and light cured. After storage in 37°C distilled water for 24 h, all the bonded teeth were cut into 1mm² sections using a low-speed diamond saw (Micracut 125 Low Speed Precision Cutter, Metkon, Bursa, Turkey) under running water (n=15). The sections were subjected to a tensile force at a crosshead speed of 1mm/min in a testing apparatus (Microtensile Tester, Bisco, IL, USA) and µTBS values were measured. Data were analyzed using the Kruskal-Wallis test and Mann-Whitney U test. Failure modes were analyzed under a stereomicroscope. Results: Prolonged application time significantly affected the µTBS (p<0.005). A significant increase of µTBS on active application was observed for CUQ and GPB. The TUB with an active application had a significantly lower µTBS value compared with the other adhesives. Conclusions: Prolonged application time caused significant improvement of bond strength in all adhesives. The active application is effective at increasing the dentin bond strength except for TUB.

ABSTRACT Saliva and external agents containing different concentrations of sodium fluoride (NaF) promote the dental remineralization process. However, these resources may not be sufficient to counteract the multiple factors involved in the process of dental caries, especially in high-risk patients. There are alternatives that have been extensively researched, such as casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) which provides essential ions, like phosphate and calcium, acting as an adjuvant in the remineralization process. Manufacturers of CPP-ACP-based products also suggest that it can produce desensitizing effects. This nanocomplex has been used experimentally with some dental cements and adhesive systems, but it is important to clarify the effects of this procedure, and the remineralizing/desensitizing advantages it offers. The objective of this topic review was to present the state of the art on CPP-ACP nanocomplex. In terms of dental caries prevention, this remineralizing option is not better than NaF. CPP-ACP provides a dental desensitizing action, but it is temporary, similar or less effective than other alternatives such as potassium nitrate or NaF. The experimental incorporation of CPP-ACP into dental cements should be controlled for not to compromise the physico-chemical properties of the material. The use of dental products based on this nanocomplex as dental surface pretreatment may decrease the bond strength of adhesive materials, but this effect is material dependent.

The purpose of this preliminary study is to evaluate the push-out bond strength (PBS) of experimental dentin posts (EDPs) obtained from human and bovine teeth sterilized by autoclaving and gamma radiation. Eighty-four mandibulary premolars were obturated and divided into three post groups: the glass fiber group (Fb) human EDP group (Hm) and the bovine EDP group (Bv). Three subgroups (n=12) were obtained for each EDP groups according to the sterilization methods; no sterilization (Cnt), steam autoclaving (Aut), and gamma radiation (Rad) a total dose of 25 kGy. All posts were cemented to root canals using a dual cured resin cement (Panavia SA). After the micro slices (1mm in thickness) were obtained of each subgroup, PBS test was performed. Data were analyzed using two-way ANOVA and Tukey’s multiple comparison tests (α=.05). The post type and sterilization method was significantly effective on the PBS values according to the ANOVA (P<.001). No sterilization apllied EDP groups showed significantly higher PBS values than the sterilized groups (P<.001). Bv_Cnt (9.42 ±1.31) showed significantly lower PBS values than both Fb (12.36 ±1.54) and Hm_Cnt (11.06 ±1.38) groups (P<.001). Both steam autoclaving and gamma radiation affect the PBS values and fracture modes of EDPs negatively. The bovine EDPs are not as effective as human EDPs with regard to the PBS to the root dentin.