Explore the vast range of titles available.

[...]case-by-case evaluation is essential, especially since no gold standard protocol currently exists for the management of fractured instruments within root canals [20]. Materials and methods Study design This study aimed to evaluate the effectiveness of a protocol using an Nd: YAP laser (λ: 1340 nm, LOBEL MEDICAL SAS, Les Roches de Condrieu, France) for removing fractured instruments in root canals of teeth with minimal root curvature (less than 15 degrees). An energy-dispersive X-ray (EDX) spectroscopy analysis (JSM 7500F, JEOL, Tokyo, Japan) was conducted to determine the chemical composition of dentinal canal walls after laser-assisted instrument removal. Treatment protocol and laser irradiation parameters Our procedure followed a protocol similar to that used in a previous study [22].

Bioceramics, with excellent bioactivity and biocompatibility, have been widely used in dentistry, particularly in endodontics. Mineral trioxide aggregate (MTA) is the most widely used bioceramic in endodontics. Recently, many new bioceramics have been developed, showing good potential for the treatment of endodontic diseases. This paper reviews the characteristics of bioceramics and their applications in various clinical endodontic situations, including root-end filling, root canal therapy, vital pulp therapy, apexification/regenerative endodontic treatment, perforation repair, and root defect repair. Relevant literature published from 1993 to 2023 was searched by keywords in PubMed and Web of Science. Current evidence supports the predictable outcome of MTA in the treatment of endodontic diseases. Although novel bioceramics such as Biodentine, EndoSequence, and calcium-enriched mixtures have shown promising clinical outcomes, more well-controlled clinical trials are still needed to provide high-level evidence for their application in endodontics. In addition, to better tackle the clinical challenges in endodontics, efforts are needed to improve the bioactivity of bioceramics, particularly to enhance their antimicrobial activity and mechanical properties and reduce their setting time and solubility.

ObjectivesThe aims of the present longitudinal retrospective observational case series study were to investigate the survival and success rates of primary non-surgical endodontic therapy.Materials and methodsPatients with at least one endodontically treated tooth (ETT), with 5 years of follow-up and in compliance with the recall programme of at least 1 time per year in a private practice setting, were recruited. Kaplan-Meier survival analyses were performed considering (a) tooth extraction/survival and (b) endodontic success as the outcome variables. A regression analysis was performed to evaluate prognostic factors associated with tooth survival.ResultsThree hundred twelve patients and 598 teeth were included. The cumulative survival rates showed 97%, 81%, 76% and 68% after 10, 20, 30 and 37 years, respectively. The corresponding values for endodontic success were 93%, 85%, 81% and 81%, respectively.ConclusionsThe study demonstrated high longevity in symptomless function as well as high success rates of ETT. The most significant prognostic factors associated with tooth extraction were the presence of deep (> 6 mm) periodontal pockets, the presence of pre-operative apical radiolucency and the lack of occlusal protection (no use of a night guard).Clinical relevanceThe favourable long-term (> 30 years) prognosis of ETT must encourage clinicians to rely on primary root canal treatment when taking the decision regarding whether a tooth with pulpal and/or periapical diseases should be saved or be extracted and replaced with an implant.

NOABSTRACTLaser-assisted treatment of pathological processes in the hard and soft periodontal tissues is an innovative approach that offers several advantages compared to traditional methods. Root resorption is a pathological process, in which the degradation of the dental structure is observed, often as a result of trauma, infection, or orthodontic treatment. Our aim is to present a case of total periodontitis, with indications for extraction of the causative tooth, treated with a combined endodontic approach and laser-assisted periapical surgery.A 60-year-old female patient, with total periodontitis of tooth 11, sought help for esthetic correction 5 years ago. During the examination, the following were found: discolored upper right central incisor with a fistula, extensive carious defect involving the cervical tissues, marginal recession, root perforation, and a periapical lesion.Laser-assisted surgery, in combination with precisely executed endodontic treatment, increases the success rate in similar clinical cases and can be considered an appropriate treatment option for clinicians.

To evaluate the treatment outcome of large periapical cystic lesions treated by combining two novel, conservative approaches, \"SealBio\" and \"Surgical Fenestration\". Five cases (4M:1F, age range 14-38 years, mean age 24.5 years) of large periapical cystic lesions, diagnosed on clinical and radiographic examination, were included in the study. After informed consent, endodontic treatment was initiated; chemo-mechanical preparation and intra-canal dressing of calcium hydroxide was given. At the next sitting after one week, further disinfection root canals was done by \"apical clearing\", \"apical foramen widening\" and irrigation. A cotton pellet was kept in the access cavity. After local anaesthesia, full thickness muco-periosteal flap was reflected and the thinned out bone was removed with bone rongers, a small piece of cystic lining was excised and the cystic cavity was copiously flushed with Betadine solution. The remaining cystic lining was gently curetted and the flap was sutured back. \"SealBio\" was performed after gentle irrigation with saline and intentional over instrumentation. A calcium sulphate based cement was pushed in the cervical third of the canal and the access opening was sealed with glass ionomer cement. Patient was prescribed antibiotics and anti-inflammatory drugs for 5 days and sutures were removed after 7 days. Patients were followed up clinically and radiographically at regular intervals. In this pilot study, treatment outcome after combined technique of \"SealBio\" and \"Surgical fenestration\" was found to be highly effective in healing of large periapical cystic lesions. It was simple to perform and very conservative treatment; it required minimal bone removal, obviated the need for complete cyst enucleation, apicectomy and retrograde filling.

This clinical scenario describes a maxillary first molar with four canals that required endodontic treatment. The pulp space morphology of the upper molar is highly intricate. The most notable changes include the existence of lateral and auxiliary canals, two palatal canals of the maxillary molar. A literature search turned up very few case descriptions of maxillary first teeth with four canals. This case illustration details the successful endodontic therapy performed on a maxillary first molar with four canals using intraoral periapical radiograph.

The study examined the current practices of irrigation and activation techniques used by dental professionals in Iraq, focusing on the selection and application of chemical irrigants and adjunct techniques during endodontic therapy. A cross-sectional survey was conducted among 108 participants, including general dental practitioners (GDPs) and endodontic specialists. The survey aimed to capture detailed information about the choice of irrigation solutions, the duration, depth, and pressure of irrigation, and the adjunctive techniques employed, such as ultrasonic and sonic activation. The findings reveal that while sodium hypochlorite remains the most used irrigant, advanced activation methods like passive ultrasonic irrigation (PUI) are underutilized despite their proven benefits. Additionally, most respondents adjust their irrigation protocols depending on canal anatomy, with an emphasis on tailored approaches to achieve optimal disinfection. The study highlights the need for better training and access to modern irrigation tools to improve treatment outcomes.

Objective This systematic review and meta-analysis aimed to evaluate the efficacy of regenerative endodontic procedures compared with conventional root canal treatment procedures in mature permanent teeth with periapical lesions. Methods This systematic review and meta-analysis were conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Randomized controlled trials that were included in the study compared regenerative endodontic procedures with traditional root canal treatment procedures in mature permanent teeth with irreversible pulpitis. The Risk of Bias 2 tool was used for quality assessment, and the certainty of the evidence was evaluated using the GRADE approach. Meta-analysis was performed using the RevMan Web software, using odds ratios for dichotomous outcomes and mean differences for continuous outcomes, with a random-effects model applied. Heterogeneity was assessed using the I2 statistic, and publication bias was evaluated using funnel plots and Egger's test. Results The analysis included five studies encompassing diverse regenerative strategies. Overall, regenerative endodontic procedures demonstrated comparable or superior clinical and radiographic healing outcomes relative to conventional treatments. Notably, certain regenerative approaches showed greater potential for restoring pulp vitality and reducing early postoperative pain. However, the quality of evidence was moderate, constrained by small sample sizes, methodological heterogeneity, and blinding challenges. Conclusion Current evidence suggests that regenerative endodontic procedures are promising alternatives to conventional root canal treatment procedures for mature teeth with periapical lesions. Despite these encouraging findings, further high-quality, multicenter trials with standardized protocols and extended follow-up periods are necessary to confirm the results and establish the long-term benefits and cost-effectiveness of regenerative endodontics.

The main objective of endodontic treatment is to remove vital and necrotic remnants of pulp tissue and microorganisms and their toxic products from the root canal. During chemo-mechanical endodontic preparation, a smear layer is formed on the wall of the canals. Due to an inability to remove all tissue remnants and the smear layer from the root canal by mechanical instrumentation, it is necessary to use irrigation to ensure sufficient cleaning and disinfection of the largest part of the root canalicular system. The most commonly used irrigants are sodium hypochlorite (Na-OCl), ethylenediaminetetraacetic acid (EDTA), citric acid and chlorhexidine (CHX). Recently, the irrigants QMix and MTAD have been introduced to the market. They are a mixture of different components having antimicrobial, organolytic and mineralytic effects on canal detritus and the smear layer. This review article investigates irrigants in terms of the nature of their effect, their efficiency, optimal concentration, and method of use, and the interactions between the irrigants most commonly used in endodontic therapy are discussed, with special emphasis on QMix and MTAD.