Objective: To assess the effect of blood contamination and acidic pH on the bioactive surface changes of 2 calcium silicate–based materials used for furcation perforation repair. Methods: Furcation perforation was created in 36 extracted mandibular molars, randomised and equally divided into 3 groups according to the medium used to set the repair material: blood, butyric acid and Hank’s balanced salt solution (HBSS). Each group was subdivided into 2 equal subgroups according to the repair material used: mineral trioxide aggregate (MTA) and EndoSeal MTA. Scanning electron microscopic examination was performed at ×1500 and ×1600 to evaluate the crystalline structure, gap measurements and energy-dispersive X-ray analysis. Data were statistically analysed at a significance level of 0.05. Results: Morphological analysis revealed that blood contamination induced rounded, globular crystal formation in both materials, while acid and HBSS contamination resulted in apatite-like deposits along the cementdentin interface. For gap measurement in blood, both materials achieved superior sealing with no detectable gaps. In acid and HBSS, EndoSeal MTA exhibited significantly smaller gaps compared to MTA in both acidic and HBSS conditions. Elemental analysis indicated that while both materials performed similarly in blood and HBSS, EndoSeal MTA maintained a significantly higher calcium-to-phosphorus ratio than MTA under acidic conditions, suggesting better chemical stability in low-pH environments. Conclusion: Under the tested ex vivo conditions, EndoSeal MTA demonstrated superior marginal adaptation and surface elemental stability compared to MTA when exposed to acidic and HBSS environments, although both materials provided a comparable interfacial adaptation in the presence of blood. These laboratory findings highlight material differences under stress but cannot be directly extrapolated to definitive clinical success or healing potential.
Objectives: This study aims to evaluate i) the antimicrobial and immunomodulatory effects of calcium hydroxide (Ca(OH)2) when combined with nonsteroidal anti-inflammatory drugs (NSAIDs) against Enterococcus faecalis (E. faecalis), and ii) to assess the inflammatory and cytocompatibility responses of this combination in human peripheral blood mononuclear cells (PBMCs). Methods: Three-week-old E. faecalis biofilms were developed on human dentine blocks and subsequently treated for 1 week with Ca(OH)2 alone or combined with 20% ketoprofen (Keto), 20% diclofenac sodium, or gentamicin. Biofilm disruption was assessed using scanning electron microscopy (SEM), while gelatinase (GelE) activity served as a marker of bacterial virulence. Culture supernatants were used to stimulate PBMCs in vitro for 24 hours. The immunomodulatory responses of PBMCs were evaluated using fluorescence microscopy, NucleoCounter NC-202™ cell analysis for live/total cell counts and viability, and ELISA for TNF-α and IL-1β secretion. Results: All medicated groups showed significantly reduced GelE activity compared to untreated controls, with the most substantial suppression observed in the Ca(OH)2 + diclofenac group. While Ca(OH)2 + diclofenac and Ca(OH)2 + gentamicin were most effective in reduceding TNF-α and IL-1β levels, Ca(OH)2 + diclofenac was also associated with the lowest PBMCs viability and highest cell aggregation. Ca(OH)2 + Keto preserved PBMCs viability while maintaining anti-inflammatory and antimicrobial effects. Conclusion: Combining Ca(OH)2 with diclofenac sodium or Keto enhances the antimicrobial and immunomodulatory efficacy of Ca(OH)2 against E. faecalis biofilms. Ca(OH)2 + diclofenac reduced PBMCs viability, suggesting a strong immunosuppressive effect that may be beneficial in dampening excessive inflammation but also raises concerns regarding cytocompatibility and dose optimization. Ca(OH)2 + keto demonstrated a more favourable balance between antimicrobial activity and biocompatibility, supporting its potential as a non-antibiotic adjunct in intracanal medication protocols.
Objective: This study aimed to assess postoperative pain outcomes and changes in periapical matrix metal-loproteinase-9 (MMP-9) levels following the use of diclofenac sodium (DcS) and calcium hydroxide Ca(OH)2 intracanal medications. Methods: Thirty patients with necrotic single-rooted mandibular premolars were randomly assigned to DcS or Ca(OH)2 intracanal medication groups. Standard 2-visit endodontic treatment was performed. Postoperative pain was recorded following instrumentation and obturation at 6, 12, 24, and 48 hours, and MMP-9 levels were measured after chemo-mechanical preparation and after placement of intracanal medicament for 1 week. Results: Diclofenac sodium demonstrated a significantly lower incidence and intensity of postoperative pain following the first visit compared with Ca(OH)2, particularly at 6, 12, and 24 hours. Both agents significantly decreased inflammatory biomarker levels from post-instrumentation to pre-obturation in necrotic root canals. Despite this reduction, biomarker levels remained elevated in the DcS group relative to the Ca(OH)2 group. Conclusion: Diclofenac sodium used as an intracanal medication significantly reduced postoperative pain compared with Ca(OH)2. Ca(OH)2 demonstrated a greater reduction in MMP-9 levels, although both agents produced a marked decline in biomarker levels from post-instrumentation to pre-obturation in necrotic root canals.
Objective: This study aimed to characterise the topographic distribution of naturally occurring vertical root fracture (VRF) lines in single-canal premolars and to evaluate whether these patterns are associated with regional differences in dentine sclerosis assessed by scanning electron microscopy (SEM). Methods: Twenty-four extracted root-filled single-canal premolars with clinically confirmed natural VRFs were examined. Fracture line localisation was mapped according to the root third and surface direction. In 10 specimens, longitudinal sections were analysed by SEM in the buccolingual and mesiodistal planes across the coronal, middle and apical thirds. Dentine sclerosis was quantified using the sclerosis coefficient (Ks), based on the proportion of dentinal tubule area within standardised SEM images. Results: Fracture sites were most frequently observed in the middle third of the root, particularly on the buccal surface. Scanning electron microscopy analysis showed pronounced directional heterogeneity of dentine sclerosis in the middle third, where Ks values were lower in the buccolingual plane than in the mesiodistal plane, especially near the canal wall. In contrast, apical and external regions showed more uniformly high sclerosis values. Conclusion: This study’s findings showed that in single-canal premolars with naturally occurring VRFs, fracture lines were most frequently observed on the buccal surface and in the middle third of the root. Scanning electron microscopy analysis showed that this region was characterised by the greatest directional heterogeneity in dentine sclerosis, with lower Ks values in the buccolingual than in the mesiodistal plane near the canal wall. Further biomechanical studies, including direct mechanical testing and finite element modelling, are required to determine whether the observed microstructural patterns may contribute to VRF initiation or propagation.
UNLABELLED:The evolution from apexification to regenerative endodontic procedures reflects a paradigm centred on preservation of the apical stem cell niche as a prerequisite for restoration of the pulp-dentine complex. This case series explores the biological premise in 6 immature mandibular second premolars diagnosed with pulp necrosis and chronic apical pathology secondary to fractured Leong's tubercles. Management employed a tissue-preserving regenerative protocol characterised by minimal mechanical instrumentation and metronidazole monotherapy as the sole intracanal antimicrobial agent. Following canal disinfection, controlled apical bleeding was induced to establish an endogenous cell-rich scaffold, and coronal sealing was achieved using bioceramic and adhesive restorative materials. Over follow-up intervals ranging from 9 months to 9.5 years, all teeth demonstrated resolution of periapical pathology, continued root maturation, apical closure and radicular wall reinforcement. Four teeth regained pulp sensibility, suggesting possible neurovascular regeneration. No reinfection or structural compromise was observed. Metronidazole monotherapy was associated with favourable clinical and radiographic outcomes while promoting biologically favourable regenerative outcomes, offering a reproducible, cost-efficient alternative to conventional multi-antibiotic protocols and reinforcing the feasibility of this monotherapy approach in regenerative endodontics.
OBJECTIVE:Pulp capping materials must possess biocompatibility, odontogenic characteristics, and promote mineralisation. The combination of nano α-tricalcium phosphate (nano α-TCP) with silver nanoparticles (AgNPs) yields these features. The objective of this work was to examine the impact of nano-α-TCP and AgNPs on the odontogenic differentiation and mineralisation of human dental pulp stem cells (hDPSCs). METHODS:Composites of nano α-TCP and AgNPs were produced inside a UDMA/TEGDMA resin matrix, with AgNPs varying from 1% to 10% w/w (weight/weight) The morphology and distribution of nano α-TCP and AgNPs were analysed using scanning electron microscope-energy dispersive X-ray spectroscopy (SEM-EDS). The viability of hDPSCs was assessed with the metabolic activity (MTT) test at 24 and 72 hours. The capacity for odontogenesis was evaluated by DSPP (dentin sialophosphoprotein) and dentin matrix protein-1 (DMP-1) proteins on days 3, 7, 14, and 21, while mineralisation was analysed using Alizarin Red on days 14 and 21. A two-way ANOVA was conducted, followed by Tukey's test (P < .05). RESULTS:Scanning electron microscopy -Energy Dispersive X-ray Spectroscopy (SEM-EDS) demonstrated a porous matrix with a uniform distribution of calcium phosphate (CaP) and silver (Ag) content, aligning with the intended composition; certain formulations approximated the Ca/P ratio of hydroxyapatite. The viability assay of hDPSCs indicated that all treatment groups exceeded 80% after 24 and 72 hours. DSPP levels reached their zenith on day 3, diminished from days 7 to 14, and subsequently rose again on day 21, whereas DMP-1 levels exhibited no consistent pattern of increase or decrease until day 21, signifying the advancement of differentiation. The Alizarin Red assay indicated a notable rise in mineral deposits between days 14 and 21. CONCLUSION:Nano α-tricalcium phosphate and AgNPs resin composites demonstrated cytocompatibility, expression of odontogenic markers, and mineralisation-related activity in hDPSCs under in vitro conditions. These findings support the bioactivity of the tested formulations as an experimental proof of concept; however, in vivo and clinical studies are required before any clinical application can be considered.
OBJECTIVE:This study aimed to investigate the effects of repeated use on the fracture resistance of thermally treated nickel-titanium (NiTi) files with identical S-shaped cross-sections but different kinematics. METHODS:Reciproc Blue (RB; reciprocating, single-file technique) and VDW.Rotate (VR; continuous rotation, multiple-file sequence) were divided into subgroups based on 0, 2, or 4 simulated uses. Each file prepared standardised J-shaped resin canals, with preparation protocols following each manufacturer's recommended clinical sequence. After each usage cycle, files were tested for cyclic fatigue resistance using a custom device simulating each motion at body temperature, and for torsional resistance according to ISO 3630-1. Fractured fragments were examined with a scanning electron microscope. Data were statistically analysed using one way analysis of variance (ANOVA) and Duncan's post hoc tests at a significance level of 95%. RESULTS:Both systems showed increased toughness and distortion angle after 2 uses (P < .05), likely due to stress-induced martensitic (SIM) transformation. RB exhibited higher cyclic fatigue resistance than VR. After 4 uses, mechanical performance declined in both systems (P < .05), while maximum torque remained unchanged (P > .05). Scanning electron microscope (SEM) revealed typical features of cyclic fatigue and torsional fractures, with machining grooves present even in new files. CONCLUSION:Limited repetitive uses of NiTi files can transiently improve torsional and cyclic fatigue resistance. Continuous repetitive use, however, decreases mechanical performance due to fatigue accumulation and microstructural defects. These findings underscore the importance of restricting clinical reuse to preserve the mechanical integrity and safe performance of NiTi rotary instruments.
UNLABELLED:Bioceramic sealers have attracted increasing attention in endodontics due to their potential biological and physicochemical properties, including bioactivity, ion release and possible chemical interaction with dentin. These materials have been suggested to support mineralisation, may contribute to sealing performance and exhibit antimicrobial effects associated with alkaline pH and calcium ion release. Compared with conventional sealers, such as epoxy resin- and zinc oxide-eugenol-based materials, bioceramic sealers may offer certain advantages in terms of biocompatibility and bioactivity; however, their performance appears to vary depending on material composition and experimental conditions. This narrative review aims to provide a comprehensive and critical overview of the chemical and physical properties of bioceramic sealers, with particular emphasis on their bonding mechanisms and biological effects. However, the available evidence is largely derived from in vitro and preclinical studies; therefore, the findings should be interpreted with caution.
OBJECTIVE:Periapical healing is a biologically complex process that extends beyond the resolution of clinical symptoms or radiographic findings. Understanding the molecular events underlying this process may improve diagnostic interpretation and guide therapeutic strategies. To identify and classify molecular biomarkers associated with periapical tissue healing, with emphasis on their roles in inflammatory resolution and tissue regeneration. METHODS:A systematic review was undertaken in accordance with PRISMA 2020 guidelines. Literature searches were performed in PubMed only covering January 2014 to April 2025. From 110 records screened, 60 full texts were assessed and 28 studies met inclusion criteria (clinical and experimental papers reporting molecular markers linked with periapical healing). Data were extracted on study design, intervention and biomarker direction of change. RESULTS:Biomarkers were grouped into 3 overlapping categories: (1) Resolution phase - downregulation of tumour necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and matrix metalloproteinase-9 (MMP-9), along-side upregulation of regulatory and anti-inflammatory molecules including interleukin-10 (IL-10) and fork-head box P3 (FOXP3). (2) Regeneration phase was characterised by increased expression of osteogenic and angiogenic markers such as Runt-related transcription factor 2 (RUNX2), vascular endothelial growth factor A (VEGFA), dentin matrix protein-1 (DMP1) and osteocalcin (OCN). (3) Dual-role markers: Several biomarkers exhibited dual roles, contributing to both immune regulation and tissue regeneration depending on treatment context and healing stage such as FOXP3, osteoprotegerin (OPG) and epidermal growth factor receptor (EGFR) acting across both phases. Conventional endodontic therapy predominantly induced resolution-associated biomarker patterns, whereas regenerative protocols preferentially enhanced osteogenic and angiogenic signalling. CONCLUSIONS:Periapical healing involves overlapping phases of inflammatory resolution and tissue regeneration, each characterised by distinct molecular patterns. A biomarker-based classification may improve understanding of healing dynamics and support a biologically informed definition of endodontic success.
Objective: To investigate the root canal morphology of bifurcated canals in mandibular premolars in a Thai sub-population using micro-computed tomography (micro-CT). Methods: Eighty extracted mandibular premolars with bifurcated canals, comprising 64 mandibular first premolars and 16 mandibular second premolars, were scanned using micro-CT and analysed. Root canal morphology was evaluated in terms of the distance and level of canal separation from the cementoenamel junction (CEJ), direction of canal bifurcation and angles of canal separation and curvature. Results: The mean distance of canal separation from the CEJ was 6.76 ± 2.58 mm in mandibular first premolars and 9.06 ± 3.82 mm in mandibular second premolars. Canal separation predominantly occurred at the middle root level (65.06% in first and 56.25% in second premolars), primarily in the buccolingual direction. The mean angles of canal separation were 11.52° ± 6.43° (buccal) and 25.47° ± 9.94° (lingual) in mandibular first premolars, with a similar pattern in mandibular second premolars. The mean angles of curvature were 16.14° ± 8.26° (buccal) and 25.14° ± 11.47° (lingual) in mandibular first premolars, and 16.90° ± 10.05° (buccal) and 19.20° ± 10.96° (lingual) in mandibular second premolars. Conclusion: In mandibular premolars with bifurcated canals, canal separation most commonly occurs 6-9 mm apical to the CEJ and predominantly at the middle root level in a buccolingual orientation. The buccal canal tends to be straighter, whereas the lingual canal exhibits sharper separation angles and greater curvature.
UNLABELLED:This study aimed to compare the efficacy of 2 retreatment protocols - SClean® file and R1 ClearSonic™ ultrasonic tip - in removing bioceramic (EndoSequence BC Sealer®, CeraSeal®, Kerr®) and epoxy resin-based (AH Plus®) sealers using micro‑CT analysis. One hundred and four extracted single-rooted teeth were divided into 8 groups according to sealer type and cleaning protocol. Residual sealer volume, surface area, and apical permeability were analysed using Mann-Whitney U and Kruskal-Wallis tests (α=0.05). No technique achieved complete removal, with the highest residue in the apical third. SClean® was more effective on bioceramic sealers (P < .05), while R1 ClearSonic™ showed no significant inter-sealer differences. Apical permeability recovery was greatest with bioceramic sealers, reaching 100% for EndoSequence BC Sealer®. In conclusion, bioceramic sealers are more easily eliminated than epoxy resin-based sealers, though complete removal - particularly apically - remains difficult.
OBJECTIVE:This in vitro study evaluated the shear bond strength (SBS) between 4 hydraulic calcium silicate-based cements (HCSCs) and 3 intermediate layer materials used in vital pulp therapy (VPT). METHODS:Two hundred forty specimens were divided into 12 groups and prepared using combinations of HCSCs (mineral trioxide aggregate [MTA], Biodentine, NeoPutty, MTA vital pulp therapy [MTAvpt]) and 3 intermediate layer materials (self-adhesive flowable composite [SAFC], resin-modified glass ionomer [RMGI], and flowable composite [FC]). SBS was measured using a universal testing machine, and failure modes were evaluated under stereomicroscopy. Data were analyzed using two-way ANOVA and Tukey's test with an α=0.05. RESULTS:SBS was affected by HCSC (P < .001), intermediate layer material (P < .001), and their interaction (P=.016). Biodentine exhibited the highest mean SBS (17.24 ± 12.09 MPa), followed by MTAvpt (12.59 ± 10.22 MPa), MTA (11.04 ± 9.80 MPa), and NeoPutty (9.84 ± 10.60 MPa). For intermediate layer materials, SAFC demonstrated the highest mean SBS (21.17 ± 10.88 MPa), significantly greater than FC (13.41 ± 9.07 MPa), and RMGI (3.45 ± 2.52 MPa). The combination Biodentine-SAFC yielded the highest mean SBS value, while groups with RMGI showed the lowest SBS values, with predominantly adhesive failures. CONCLUSION:Under the conditions of this in vitro study, bond strength between HCSCs and intermediate materials varied according to both material types. SAFC and, in some cases, FC exhibited higher initial adhesion to the tested HCSCs, while RMGI showed consistently low SBS.
OBJECTIVE:In cases of failed root canal treatment, rotary NiTi files enhance retreatment efficiency by facilitating effective removal of root canal filling materials while minimising procedural errors and preserving canal anatomy. To compare the efficiency of ProTaper Ultimate (PTUL) and ProTaper Gold (PTG) in the retreatment of root canals previously obturated with AH Plus or TotalFill Bioceramic sealer. METHODS:Sixty extracted single-rooted teeth were prepared using the Reciproc R40 and then divided into 4 groups (n = 15) according to the sealer used; AH Plus or TotalFill Bioceramic, and the retreatment file system, PTUL or PTG. The retreatment time was recorded, and the percentage of the residual filling material was assessed using a stereomicroscope. Statistical analysis was performed at a significance level of P < .05. RESULTS:A significant interaction was observed between sealer type and retreatment file system for both retreatment time and the percentage of remaining filling material (P < .05). Overall, retreatment of TotalFill Bioceramic was significantly faster than AH Plus. Within the AH Plus groups, the PTG system was significantly faster than PTUL, whereas no time difference was noted between files for the TotalFill groups. Regarding filling material removal, the PTUL was significantly more effective at removing TotalFill Bioceramic compared to PTG, which left the highest amount of residual filling material. Conversely, both file systems demonstrated statistically similar efficacy in removing the AH Plus sealer. CONCLUSION:The optimal retreatment file system is heavily sealer-dependent; PTUL maximises the removal of TotalFill Bioceramic, whereas PTG expedites the removal of AH Plus without compromising cleanliness.
OBJECTIVE:This study aimed to assess the shaping ability of 2 preparation systems with similar designs but different heat treatments during the progressive enlargement of severely curved mesiobuccal and mesiolingual canals in mandibular molars. METHODS:Twenty-two mandibular molars with mesial canals curved >25º were scanned, pair-matched and divided into 2 groups (n=11) for preparation using austenitic (Genius) or martensitic (Genius Proflex) heat-treated instruments. Phase transformation temperatures of the instruments were determined via differential scanning calorimetry. Mesiobuccal and mesiolingual canals were first instrumented with a 17/.05 file and then sequentially enlarged using instruments sized 25/.04-40/.04, with scans taken after each enlargement step. Pre- and postoperative datasets were analysed for volume, surface area, unprepared canal areas, removed dentine volume, transportation and dentine thickness reduction. Statistical analyses included Student's t-test, Generalized Linear Model (GLM) multivariate model and independent t-tests (significance: P < .05). RESULTS:Genius displayed an austenitic structure, while Genius Proflex exhibited an R-phase structure at both 20ºC and 36ºC. Instrument size increase (P=.001) and heat treatment (P < .001) significantly affected shaping outcomes without interaction effects (P=.882). Size increases impacted canal volume (P=.023), unprepared areas (P=.005), removed dentine (P < .001) and dentine thickness reduction (P < .001), but not surface area (P=.390). Heat treatment significantly influenced unprepared canal areas (P < .001). Martensitic instruments caused less transportation (P < .05) and preserved more distal dentine (P < .001) compared to austenitic instruments. CONCLUSIONS:In severely curved mesial canals of mandibular molars, martensitic instruments result in fewer unprepared areas, reduced transportation and better dentine preservation at the distal root canal wall compared with austenitic instruments.
OBJECTIVE:This study evaluated tooth discolouration potential of triple antibiotic paste (TAP) containing either minocycline or cefuroxime, Ledermix and Odontopaste using spectrophotometric analysis. METHODS:Sixty extracted human maxillary central incisors were standardised to 17 mm in length. After canal preparation with ProTaper Next to F5, specimens were randomly allocated to 6 groups (n=10). (Group A-F) Ledermix, TAP with minocycline, TAP with cefuroxime, Odontopaste, positive control (blood) and negative control (saline). Medicaments were placed via apical access to preserve crown integrity. Colour measurements were recorded using a spectrophotometer (Vita Easyshade Advance) at baseline, 3 days, 1 week, 2 weeks and 12 weeks. Specimens were stored at 37°C in darkness between the measurements. Colour changes (ΔE) were calculated using CIE Lab* formula. Data were analysed using two-way analysis of variance (ANOVA) with Bonferroni post-hoc tests (α=0.05). RESULTS:All experimental groups showed significant discolouration at 12 weeks (P < .05), exceeding the clinically perceptible threshold (ΔE > 3.7). Triple antibiotic paste with minocycline demonstrated the highest discolouration (ΔE=22.86 ± 9.99), followed by Ledermix (ΔE=19.11 ± 11.26) and TAP with cefuroxime (ΔE=18.72 ± 8.37), with no significant difference between the latter 2 (P > .05). Odontopaste showed the least discolouration (ΔE=10.06 ± 5.10). All medicaments exhibited progressive, time-dependent discolouration (P < .05). CONCLUSION:All tested antibiotic-containing medicaments caused clinically perceptible tooth discolouration. Triple antibiotic paste containing cefuroxime showed numerically lower discolouration than minocycline containing TAP, although both exceeded clinically acceptable thresholds and were not significantly different from Ledermix (P > .05). Odontopaste exhibited the lowest discolouration among the tested medicaments (ΔE=10.06), yet still exceeded the clinically acceptable limit.
OBJECTIVE:This study aimed to evaluate aseptic practices during non-surgical root canal treatment across general dental practitioners (GDPs), postgraduate endodontic residents (ERs) and specialist endodontists (SEs). METHODS:A descriptive, cross-sectional survey was conducted online between September 2024 and January 2025. Sixteen closed-ended questions assessed adherence to asepsis, focusing on dental dam, gloves, endodontic files, examination instruments and obturation supplies. Responses were analysed by professional group using chi-square tests, with post-hoc z-tests when relevant. Given the exploratory nature of the study, p-values < 0.05 were interpreted descriptively. RESULTS:A total of 815 participants completed the survey (SEs: 49.1%, GDPs: 36.4%, ERs: 14.5%). Systematic dental dam use was highest among SEs (97.2%) and lowest among GDPs (78.1%, p < 0.001). Disinfection of the dental dam after placement and before obturation was inconsistent, though SEs reported greater adherence. Glove changes and replacement of examination instruments were inconsistently performed, especially prior to obturation. Precurving files with gloves was reported by 54.4% of respondents. Gutta-percha disinfection prior to obturation was less frequent among GDPs than SEs and ERs (p < 0.001). Overall, SEs demonstrated better adherence to aseptic practices, though no group achieved complete compliance. CONCLUSION:Aseptic practices during non-surgical root canal treatment remain variable, with critical steps often neglected, even among specialists. Clearer guidelines and consistent education are needed, emphasising asepsis throughout treatment. Effective measures are simple, cost-effective and readily implementable in daily practice.
OBJECTIVES:This study aimed to evaluate the antimicrobial capacity and efficacy in disaggregation, elimination, and inhibition of biofilm formation of HybenX. METHODS:To develop a biofilm elimination model, dentin of radicular human teeth was incubated with E. faecalis American Type Culture Collection (ATCC) 29212 at 37°C with nutritional restriction for 14 days. After incubation, the samples were treated for 1 minute with HybenX, and as controls, chlorhexidine 2%, ethylenediaminetetraacetic acid 17%, and sodium hypochlorite (NaOCl) 5.25% were used. In the inhibition model, samples were pretreated with treatments and incubated. The presence or absence of microorganisms in the dentin was verified using scanning electron microscopy, and bacterial viability and biovolume were determined by confocal laser microscopy with live/dead staining. The 3D images were analysed using IMARIS 8.0 (Oxford Instruments Group, United Kingdom) software. All experiments were performed in triplicate as independent experiments and compared using ANOVA with post hoc Tukey's test at a significance level of P < .05. RESULTS:Biofilm removal and inhibition of formation were observed after HybenX treatment. HybenX showed a significant disaggregation and elimination of biofilm (P < .001), drastically affecting the biovolume, surpassed by NaOCl, which presented a total elimination; it also demonstrated a low bactericidal effect, allowing bacterial viability of 79%. Likewise, it showed a high capacity to inhibit the formation of biofilm, allowing a minimum biovolume similar to NaOCl (P = .01). HybenX eliminates and inhibits biofilm formation; however, it allows the persistence of viable bacteria. CONCLUSION:HybenX effectively eliminates and inhibits biofilm formation; however, it does not prevent the persistence of viable bacteria.
OBJECTIVE:To evaluate the effect of Nano-NeoMTA2 on human dental pulp stem cells (hDPSCs) differentiation and proliferation potential compared to nanohydroxyapatite. METHODS:After the preparation and characterization of the nanoparticles of NeoMTA2 and hydroxyapatite, the nanoparticles were mixed prior to application. The mixed nanoparticles were added to hDPSCs harvested from third molar teeth immediately upon extraction, in addition to a negative and positive control group. Alkaline phosphatase and dentin matrix protein were used as measures for the odontogenic differentiation potential of the hDPSCs. Human DPSC count and viability of Trypan Blue and [3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide] assay were used as a measure of the proliferation potential. RESULTS:Nano-NeoMTA2 demonstrated significantly greater induction of hDPSC proliferation and odontogenic differentiation than nanohydroxyapatite. CONCLUSIONS:Both tested nano-biomaterials induce DPSC odontogenic differentiation and proliferation. Nano-NeoMTA2 stimulates odontogenic differentiation and proliferation of hDPSCs and warrants further investigation as a potential scaffold or direct pulp-capping material.
UNLABELLED:The study evaluated the efficiency of 3 types of irrigation needles in removing debris during the preparation of mesial canals in mandibular molars with Vertucci Class 2 configuration and type 3 isthmus. Thirty samples were analysed using Micro-computed tomography (Micro-CT) and divided into 3 groups based on the needle type: Group OA (open-tip Navitip needle), Group CFSL (closed-tip needle with single lateral opening) and Group CFSLD (closed-tip needle with double lateral openings). Biomechanical preparation was carried out with Logic 30.03 files and 5.25% sodium hypochlorite, followed by final irrigation with 17% EDTA and saline solution. Micro-CT scans quantified residual debris in the main canal and isthmus. Open-tip needles were significantly more effective in cleaning the isthmus region than closed-tip needles (P=.007), although no differences among needle types were observed in the main canals (P=.717). The study concludes that needle design impacts debris-removal efficiency in root canal systems.
