Restorative Dentistry & Endodontics

Sample size determination for conducting a pilot study to assess reliability of a questionnaire: Mohamad Adam Bujang, Evi Diana Omar, Diana Hui Ping Foo, Yoon Khee Hon; Restor Dent Endod 2024;49(1):e3. Published online January 10, 2024; DOI: https://doi.org/10.5395/rde.2024.49.e3

This article is a narrative review that discusses the recommended sample size requirements to design a pilot study to assess the reliability of a questionnaire. A list of various sample size tables that are based on the kappa agreement test, intra-class correlation test and Cronbach’s alpha test has been compiled together. For all calculations, type I error (alpha) was set at a maximum value of 0.05, and power was set at a minimum value of 80.0%. For the kappa agreement test, intra-class correlation test, and Cronbach’s alpha test, the recommended minimum sample size requirement based on the ideal effect sizes shall be at least 15, 22, and 24 subjects respectively. By making allowances for a non-response rate of 20.0%, a minimum sample size of 30 respondents will be sufficient to assess the reliability of the questionnaire. The clear guideline of minimum sample size requirement for the pilot study to assess the reliability of a questionnaire is discussed and this will ease researchers in preparation for the pilot study. This study provides justification for a minimum requirement of a sample size of 30 respondents specifically to test the reliability of a questionnaire.

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Concentrated growth factor scaffold-based pulpotomy of permanent molars with symptomatic irreversible pulpitis: Arthi K. Harith, Vishnupriya Koteeswaran, Dinesh Kowsky, Natanasabapathy Velmurugan, Suresh Nandini; Restor Dent Endod 2025;50(1):e1. Published online January 17, 2025; DOI: https://doi.org/10.5395/rde.2025.50.e1

Abstract PDF PubReader ePub: Objectives
Pulpotomy is a minimally invasive procedure that aims to retain the vitality of the radicular pulp by removing the inflamed coronal pulp tissue. This case series presents the successful management of symptomatic irreversible pulpitis by pulpotomy with concentrated growth factor (CGF) scaffolds.
Methods
Six permanent mandibular molars with a diagnosis of symptomatic irreversible pulpitis were included. Under Local anesthesia and rubber dam isolation, caries were excavated using high-speed bur under coolant. Full coronal pulpotomy was done and hemostasis was achieved. CGF membrane was prepared and placed over the radicular pulp and layered with Biodentine (Septodont). Final restoration of type IX glass ionomer cement and bulk fill composite resin was placed. Patients were assessed for various clinical and radiographic parameters at intervals of 1 week and 3, 6, and 12 months. Five patients fulfilled the success criteria at the end of 1 year.
Results
Pulpotomy is considered an alternative treatment modality for root canal treatment in symptomatic irreversible pulpitis aiming at alleviating symptoms and maintaining vitality. CGF scaffold when used as a capping material acts as a reservoir for growth factors with anti-inflammatory properties and enhances healing.
Conclusions
Scaffold-based pulpotomy can be considered a biological approach to healing inflamed pulp.

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Fracture resistance and failure modes of endodontically-treated permanent teeth restored with Ribbond posts vs other post systems: a systematic review and meta-analysis of in vitro studies: Meghana Aditya Vartak, Vibha Rahul Hegde, Sanitra Rahul Hegde, Ushaina Fanibunda; Restor Dent Endod 2025;50(1):e5. Published online February 17, 2025; DOI: https://doi.org/10.5395/rde.2025.50.e5

Abstract PDF PubReader ePub: Objectives
This systematic review aimed to investigate the fracture resistance and mode of failure of endodontically-treated permanent teeth restored with Ribbond posts (Ribbond, Inc.) compared with endodontically-treated permanent teeth restored with other post systems.
Methods
A comprehensive, systematic literature search was carried out using several electronic databases: MEDLINE/PubMed, Google Scholar, and Cochrane Library. Two separate researchers were appointed to identify the studies meeting the eligibility criteria, and to perform the data extraction, risk of bias, and quality assessment.
Results
Twelve studies were included in the quantitative analysis. Meta-analysis was performed with 11 of the 12 included articles. The meta-analysis showed that Ribbond posts have a fracture strength less than prefabricated metal posts, cast metal posts, and prefabricated fiber posts and greater than custom e-glass fiber posts. Mode of failure analysis revealed that Ribbond posts have the most favorable non-catastrophic fractures.
Conclusions
Although Ribbond posts have lower fracture resistance, their favorable mode of failure makes them potentially the most biomimetic post system.

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Pattern of endodontic instrument separation and factors affecting its retrieval: a 10-year retrospective observational study in a postgraduate institute: Velmurugan Natanasabapathy, Aswathi Varghese, Paul Kevin Abishek Karthikeyan, Srinivasan Narasimhan; Restor Dent Endod 2025;50(1):e7. Published online February 19, 2025; DOI: https://doi.org/10.5395/rde.2025.50.e7

Abstract PDF PubReader ePub

Objectives
This study aimed to assess the pattern of endodontic instrument separation, their retrievability, and factors affecting its retrieval, in a postgraduate institute.
Methods
Cases referred for the management of separated endodontic instruments (SEI) from 2013 to 2023 were considered for this study. Data related to demographics, tooth type, file type, and retrieval were documented in an Excel sheet. Eight prognostic factors assumed to influence the retrieval were analyzed in this study. The secondary aim was to compare the pattern of SEI and retrievability between conventional nickel-titanium files and newer generation heat-treated nickel-titanium files. Retrieval was attempted by a senior endodontist under the dental operating microscope. Various ultrasonic tips and a Broken Tool Removal loop system were used during retrieval. Simple descriptive statistics were performed. Binomial logistic regression was done to identify the effect of the eight prognostic factors on the retrieval outcome.
Results
A total of 190 SEI was reported. SEI occurred more often in posterior teeth than anterior teeth, mandibular arch than maxillary arch, and in larger files than smaller files. Separation occurred more often in the apical third compared to the other levels. Retrieval was attempted in 88 cases and successful in 70 cases (79.5%). The larger taper and apical position of the SEI negatively influenced the retrieval by 1.4 and 8.7 times, respectively.
Conclusions
Retrieval of SEI was successful in the majority of the cases. An increase in taper and apically placed SEI negatively impacted the retrieval. There was no difference in the pattern of separation nor retrievability between conventional nickel-titanium files and newer generation heat-treated nickel-titanium files.

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Effectiveness of microscope-assisted root canal treatment in permanent posterior teeth: A retrospective cohort study
Ya-Ching Chang, Ting-Ya Wang
Journal of Dentistry.2025; 157: 105771. CrossRef

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Guided endodontics, precision and predictability: a case series of mineralized anterior teeth with follow-up cone-beam computed tomography: Rafael Fernández-Grisales, Wilder Javier Rojas-Gutierrez, Pamela Mejía, Carolina Berruecos-Orozco, Néstor Ríos-Osorio; Restor Dent Endod 2025;50(1):e4. Published online January 6, 2025; DOI: https://doi.org/10.5395/rde.2025.50.e4

Abstract PDF PubReader ePub: Pulp chamber and root canal obliteration (PCO/RCO) presents a challenge for clinicians when nonsurgical endodontic treatment is indicated. Guided endodontics (GE) aims to precisely locate the root canal (RC) system while preserving as much pericervical dentin as possible. GE involves integrating cone-beam computed tomography (CBCT) of the affected tooth with a digital impression of the maxillary/mandibular arch, allowing for careful planning of the drilling path to the RC system through a three-dimensional (3D) static guide. This article reports four cases of teeth with PCO/RCO, accompanied by additional diagnoses of internal and external root resorption and horizontal tooth fracture, all successfully treated with GE. These cases highlight the clinical and radiographic success of GE treatments using CBCT, establishing this technique as a predictable approach for managing mineralized teeth.

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Success rate of direct pulp capping on permanent teeth using bioactive materials: a systematic review and meta-analysis of randomized clinical trials: Karem Paula Pinto, Gabriela Ribeiro da Silva, Cláudio Malizia Alves Ferreira, Luciana Moura Sassone, Emmanuel João Nogueira Leal da Silva; Restor Dent Endod 2024;49(4):e34. Published online September 6, 2024; DOI: https://doi.org/10.5395/rde.2024.49.e34

Abstract PDF Supplementary Material PubReader ePub: This systematic review and meta-analysis aimed to evaluate the success rate of direct pulp capping (DPC) on permanent teeth, comparing the use of MTA with calcium hydroxide and calcium silicate-based cements. A systematic search was carried out in 4 databases until July 2023. The selection was based on PICOS criteria and only randomized clinical trials were included. The risk of bias was assessed using RoB-2 tool, and meta-analyses were performed using RevMan 5.3 software. The overall quality of evidence was determined using the GRADE tool. Thirteen studies were included. Meta-analyses indicated significantly higher success rate for DPC using MTA compared to calcium hydroxide, while no significant difference was observed between MTA and Biodentine, showing a success rate from 80% to 100% even after 3 years of follow-up. Five studies were classified as having high risk of bias and the GRADE assessment revealed low certainty of evidence. DPC is highly effective for permanent teeth when using MTA or Biodentine. There is a need for future well-designed randomized clinical trials to evaluate the efficacy of DPC using newer bioceramic materials.

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Cone-beam computed tomography in endodontics: from the specific technical considerations of acquisition parameters and interpretation to advanced clinical applications: Néstor Ríos-Osorio, Sara Quijano-Guauque, Sandra Briñez-Rodríguez, Gustavo Velasco-Flechas, Antonieta Muñoz-Solís, Carlos Chávez, Rafael Fernandez-Grisales; Restor Dent Endod 2024;49(1):e1. Published online December 11, 2023; DOI: https://doi.org/10.5395/rde.2024.49.e1

Abstract PDF PubReader ePub

The implementation of imaging methods that enable sensitive and specific observation of anatomical structures has been a constant in the evolution of endodontic therapy. Cone-beam computed tomography (CBCT) enables 3-dimensional (3D) spatial anatomical navigation in the 3 volumetric planes (sagittal, coronal and axial) which translates into great accuracy for the identification of endodontic pathologies/conditions. CBCT interpretation consists of 2 main components: (i) the generation of specific tasks of the image and (ii) the subsequent interpretation report. A systematic and reproducible method to review CBCT scans can improve the accuracy of the interpretation process, translating into greater precision in terms of diagnosis and planning of endodontic clinical procedures. MEDLINE (PubMed), Web of Science, Google Scholar, Embase and Scopus were searched from inception to March 2023. This narrative review addresses the theoretical concepts, elements of interpretation and applications of the CBCT scan in endodontics. In addition, the contents and rationale for reporting 3D endodontic imaging are discussed.

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Surgical management of maxillary sinusitis of endodontic origin after reestablishing maxillary sinus floor healing through a nonsurgical approach: a case report: Eun-Sook Kang, Min-Kyeong Kim, Mi-Kyung Yu, Kyung-San Min; Restor Dent Endod 2025;50(2):e12. Published online April 8, 2025; DOI: https://doi.org/10.5395/rde.2025.50.e12

Abstract PDF PubReader ePub: When root canal infections breach the maxillary sinus floor (MSF), maxillary sinusitis of endodontic origin (MSEO) can result. This case illustrates the surgical management of MSEO following the nonsurgical reestablishment of the MSF. A 55-year-old woman presented with left facial pain and was diagnosed with MSEO originating from the left upper first molar. Despite undergoing nonsurgical root canal treatment, there was no evidence of bony healing after 6 months. However, cone-beam computed tomographic (CBCT) scans revealed the reestablishment of MSF. Subsequently, surgical intervention was carried out using a dental operating microscope. Two years after surgery, CBCT images indicated that the mucosal edema had resolved, and the MSF was well reestablished. Preserving the MSF is crucial for the success of endodontic surgery. When MSEO is present, the integrity of the MSF must be assessed to determine appropriate treatment options.

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An elaboration on sample size determination for correlations based on effect sizes and confidence interval width: a guide for researchers: Mohamad Adam Bujang; Restor Dent Endod 2024;49(2):e21. Published online May 2, 2024; DOI: https://doi.org/10.5395/rde.2024.49.e21

Abstract PDF PubReader ePub

Objectives

This paper aims to serve as a useful guide for sample size determination for various correlation analyses that are based on effect sizes and confidence interval width.

Materials and Methods

Sample size determinations are calculated for Pearson’s correlation, Spearman’s rank correlation, and Kendall’s Tau-b correlation. Examples of sample size statements and their justification are also included.

Results

Using the same effect sizes, there are differences between the sample size determination of the 3 statistical tests. Based on an empirical calculation, a minimum sample size of 149 is usually adequate for performing both parametric and non-parametric correlation analysis to determine at least a moderate to an excellent degree of correlation with acceptable confidence interval width.

Conclusions

Determining data assumption(s) is one of the challenges to offering a valid technique to estimate the required sample size for correlation analyses. Sample size tables are provided and these will help researchers to estimate a minimum sample size requirement based on correlation analyses.

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Maria Czarnobilska, Małgorzata Bulanda, Ewa Czarnobilska, Wojciech Dyga, Marcel Mazur
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Xinyi Wang, Sven Anders, Zhiqian Jiang, Marcia Bruce, Dominica Gidrewicz, Margaret Marcon, Justine M. Turner, Diana R. Mager
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Effect of quality of radiographs taken during root canal treatment on technical quality of root canal fillings and endodontic outcome: Jia Min Ng, Yan Yee Lee, Prashanti Chippagiri, Elaheh Ahanin, Abhishek Parolia; Restor Dent Endod 2025;50(1):e3. Published online January 7, 2025; DOI: https://doi.org/10.5395/rde.2025.50.e3

Abstract PDF PubReader ePub: Objectives
This study evaluated the number and quality of working length (WL) and master cone (MC) radiographs taken during root canal treatment by dental undergraduates, and their associations with the technical quality of root canal fillings (TQRCF) and endodontic outcomes (EO).
Methods
A retrospective evaluation of radiographs from 303 root canal-treated teeth in 231 patients was conducted, with 72 patients attending recall visits to assess EO. The chi-square and one-way analysis of variance tests were performed.
Results
A total of 505 WL and 557 MC radiographs were reviewed, with 72.9% and 75% deemed satisfactory, respectively. Satisfactory TQRCF was achieved in 60.4% of cases. Significant associations were found between the extension of the file in WL and gutta-percha in MC radiographs and TQRCF (p = 0.000). Misinterpretation of these radiographs resulted in poor TQRCF. Furthermore, 64.2% of teeth had satisfactory EO. A significant relationship was noted between the quality of MC radiographs and both TQRCF (p = 0.043) and EO (p = 0.003).
Conclusions
Unsatisfactory MC radiographs were linked to poor TQRCF and unfavorable EO. Regular radiographic training is recommended to enhance EO.

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Shaping ability and cyclic fatigue resistance between Genius ProFlex, ZenFlex, and TruNatomy rotary systems: an experimental study: Raimundo Sales de Oliveira Neto, Murilo Priori Alcalde, Pedro Cesar Gomes Titato, Pedro Henrique Souza Calefi, Carlos Alberto Spironelli Ramos, Guilherme Ferreira da Silva, Rodrigo Ricci Vivan, Marco Antonio Hungaro Duarte; Restor Dent Endod 2025;50(1):e9. Published online February 13, 2025; DOI: https://doi.org/10.5395/rde.2025.50.e9

Abstract PDF PubReader ePub: Objectives
The aim of this study was to investigate the efficacy of three newly introduced rotary endodontic systems: Genius ProFlex (Medidenta), TruNatomy (Dentsply Maillefer), and ZenFlex (Kerr).
Methods
Forty-five mandibular molars with root canal curvatures <5° were utilized. Micro-computed tomography scans were performed pre- and post-preparation to assess apical transportation, centralization, percentage of dentin wear, and canal volume alterations. Eight instruments of each diameter underwent cyclic fatigue testing.
Results
The percentage of dentin wear on mesial and distal walls showed no significant differences among ZenFlex, TruNatomy, and Genius ProFlex at 1, 2, 3, and 4 mm from the apical foramen and root canal orifice (p > 0.05). Centering ability varied in the mesiolingual canal (p < 0.05). No notable differences were observed in transportation (p > 0.05). Genius ProFlex demonstrated lower volumetric changes (p < 0.05). There were significant differences in cyclic fatigue, with higher values for Genius ProFlex and lower values for TruNatomy (p < 0.05).
Conclusions
The three nickel-titanium rotary instruments are safe and efficient for root canal preparation, with Genius ProFlex exhibiting superior cyclic fatigue resistance.

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Surface properties and susceptibility to staining of a resin composite after brushing with different whitening toothpastes: Aline da Silva Barros, Carolina Meneghin Barbosa, Renata Siqueira Scatolin, Waldemir Francisco Vieira Junior, Laura Nobre Ferraz; Restor Dent Endod 2025;50(1):e6. Published online February 26, 2025; DOI: https://doi.org/10.5395/rde.2025.50.e6

Abstract PDF PubReader ePub: Objectives
This study investigated the effects of different whitening toothpaste (WT) on the surface properties and staining susceptibility of a resin composite.
Methods
Cylindrical samples were prepared with a micro-hybrid resin composite and were randomized into groups according to the toothpaste (n = 12): distilled water (DW), regular toothpaste (RT), WT with silica + pyrophosphate (WT-S/P), WT with pentaphosphate and pyrophosphate (WT-P/P), WT with hydrogen peroxide and pyrophosphate (WT-HP/P) and WT with charcoal and pyrophosphate (WT-Ch/P). The samples were brushed for 825 cycles in an automatic brushing machine, simulating 30 days of brushing. After that, an immersion in coffee (10 mL/sample) was performed for 30 minutes for 30 days. The analyses of color, surface microhardness (SMH), and surface roughness (Ra) were performed at the initial time, after brushing with toothpaste and after immersion in coffee. The ΔL*, Δa*, Δb*, ΔEab, Δand E00 values were calculated comparing after toothpaste with initial time and after coffee with after toothpaste. Data were analyzed using a mixed linear model for repeated measures (SMH), Kruskal-Wallis, Dunn, Friedman, and Nemenyi tests, with α = 0.05.
Results
For ΔL*, the WT-Ch/P group had the lowest values and differed from the other groups comparing the after toothpaste with the initial time interval (p < 0.001). The WT-Ch/P group had the lowest SMH values in after-toothpaste time (p < 0.001). In after-toothpaste time and after coffee time, the WT-S/P group had the highest Ra values and differed from the groups except the WT-Ch/P group (p < 0.001).
Conclusions
The toothpaste composition affects the surface characteristics and susceptibility to staining of the resin composite. The charcoal-based toothpaste had the worst performance for the color analyses and SMH.

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Straightforward replication of digital wax-up design into direct composite resin restorations in adolescents using a custom 3-dimensionally printed index: Ra’fat Ibrahim Farah, Sanaa Najeh Al-Haj Ali, Abdullah Alharbi, Bandar Alresheedi; Restor Dent Endod 2024;49(4):e36. Published online October 10, 2024; DOI: https://doi.org/10.5395/rde.2024.49.e36

Abstract PDF PubReader ePub

This case report introduces a straightforward, noninvasive approach for the esthetic rehabilitation of malformed anterior teeth in adolescents using direct composite restorations. The universal composite resin restorations are applied within a transparent 3-dimensionally printed rigid-resin index, which is individually customized from a digital wax-up. Compared to other methods, this technique streamlines the restoration process, significantly reducing chairside time while enhancing the predictability, accuracy, and patient acceptance of the aesthetic outcome.

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Diastema closure and esthetic rehabilitation with peg-shaped laterals: A case series
Afsana Ansari, Dipika Yadav
The Saint's International Dental Journal.2024; 8(2): 48. CrossRef

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Effects of different curing methods on the color stability of composite resins: Massimo Pisano, Alfredo Iandolo, Dina Abdellatif, Andrea Chiacchio, Marzio Galdi, Stefano Martina; Restor Dent Endod 2024;49(4):e33. Published online September 5, 2024; DOI: https://doi.org/10.5395/rde.2024.49.e33

Abstract PDF PubReader ePub

Objectives

The aim of this study was to compare the effects of different polymerization strategies and the effectiveness of finishing and polishing procedures of composite resins on color stability.

Materials and Methods

The samples were divided into 4 main groups according to the polymerization strategy, and all groups except the control group received surface treatment. Each group was subsequently divided into 3 subgroups respectively: Kuraray Clearfil Majesty ES-2 Classic, Premium and Universal. Approximately 24 hours after preparation of the samples, they were immersed for 7 days in a coffee solution. A first color measurement was performed after the preparation of the samples, the second measurement was performed after 7 days in the coffee solution. All measurements were carried out using a dental spectrophotometer to assess the CIE L* a* b* color parameters.

Results

There was a statistically significant difference between ΔE values for different procedures (p = 0.003); in particular, the differences were found only between the groups that received surface treatment and the control group. In addition, a statistically significant difference was observed between the values of ΔE for different composites in the different procedure groups.

Conclusions

Spectrophotometric analysis showed that the additional photopolymerization and oxygen inhibition procedures did not yield better results in relation to color stability. In addition, finishing and polishing provided better color stability compared to not performing these procedures.

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Abrasiveness and Bleaching Level of Toothpastes on Composite Resins: A Quantitative Analysis Using a Novel Brushing Simulator
Simge Meseli, Elif Alkan, Bora Korkut, Ozlem Kanar, Dilek Tagtekin
Applied Sciences.2025; 15(5): 2314. CrossRef

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An unusual case of dens invaginatus on a mandibular second molar: a case report: Davide Mancino, Dina Abdellatif, Alfredo Iandolo, Fabien Bornert, Youssef Haïkel; Restor Dent Endod 2025;50(1):e2. Published online January 8, 2025; DOI: https://doi.org/10.5395/rde.2025.50.e2

Abstract PDF PubReader ePub: The present case report describes the endodontic treatment of a type III B dens invaginatus (DI) in a three-rooted mandibular second molar since the invagination invades the root and extends apically. Clinical and cone-beam computed tomography examination of the mandibular second molar showed a broadened coronal morphology, DI, a third root, periapical radiolucency, and compression of a distal root canal by the invagination, which developed an atypical semilunar shape. The tooth was diagnosed with pulpal necrosis, symptomatic apical, and peri-invagination periodontitis. Consequently, three-dimensional virtual reconstruction was conducted to improve anatomical interpretation and case planning and accelerate the intraoperative phase by reducing operator stress and minimizing intraoperative variables. The present case report aims to raise awareness of the existence of DI on the mandibular second molar.

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Evaluation of the effects of different file systems and apical functions of integrated endodontic motors on debris extrusion: an ex vivo experimental study: Sıla Nur Usta, Antonio Magan-Fernandez, Cumhur Aydın; Restor Dent Endod 2025;50(2):e14. Published online April 14, 2025; DOI: https://doi.org/10.5395/rde.2025.50.e14

Abstract PDF PubReader ePub: Objectives
This study aimed to evaluate the effects of two different file systems operated with three apical functions of an endodontic motor integrated with an electronic apex locator on debris extrusion.
Methods
Sixty single-rooted teeth were prepared and divided into two main groups and three subgroups based on the file system (OneShape [Micro-Mega SA] and WaveOne [Dentsply Maillefer]) and apical function of the endodontic motor used (auto apical stop [AAS], auto apical reverse [AAR], and auto apical slowdown [ASD]). The teeth were mounted in pre-weighed glass tubes filled with 0.9% sodium chloride to complete the circuit with the apex locator. Files were advanced until the respective apical function (stop, reverse, or slowdown) was activated. The extruded debris was collected, dried, and weighed by subtracting pre-weighed values from post-weighed values. Preparation time was also recorded. Statistical analyses were performed to compare the groups.
Results
OneShape was associated with significantly less debris extrusion compared to WaveOne, regardless of the apical function (p < 0.05). The ASD function resulted in the least debris extrusion compared to AAS and AAR (p < 0.05). Preparation time was significantly longer in the ASD function (p < 0.05), while no differences were observed between the file systems (p > 0.05).
Conclusions
The OneShape file system and the ASD function produced the least amount of apical debris. While the ASD function requires more preparation time, its potential to minimize debris extrusion suggests it may reduce postoperative symptoms.

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Effect of surface treatment on glass ionomers in sandwich restorations: a systematic review and meta-analysis of laboratory studies: Hoda S. Ismail, Ashraf Ibrahim Ali, Franklin Garcia-Godoy; Restor Dent Endod 2025;50(2):e13. Published online April 16, 2025; DOI: https://doi.org/10.5395/rde.2025.50.e13

Abstract PDF PubReader ePub: Objectives
This study aimed to evaluate the effect of different surface treatments on the bond strength between new or aged glass ionomers (GI) and resin composites in sandwich restorations.
Methods
A comprehensive search was conducted in three databases to identify studies focusing on the bond strength of new or aged GIs and resin composites in laboratory settings. The selected studies were assessed for potential biases based on predetermined criteria. Additionally, a meta-analysis was performed using three studies.
Results
A total of 29 studies were included, with 24 investigating the bond strength of new GIs and five focusing on GI repair. Three studies were included in the meta-analysis (with a 95% confidence interval) which revealed no significant difference in the mean MPa values of resin-modified glass ionomer (RMGI) treated with phosphoric acid or Er,Cr:YSGG laser before the application of an etch-and-rinse adhesive. Surface treatment was found to be crucial for achieving optimal bonding between GI and resin composite, regardless of the GI’s condition.
Conclusions
The combination of mechanical and chemical surface treatments does not significantly affect the bond strength between new RMGI and composite. However, for GI repair, it is recommended to use both treatments to enhance the bond strength.

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Predictive factors in the retrieval of endodontic instruments: the relationship between the fragment length and location: Ricardo Portigliatti, Eugenia Pilar Consoli Lizzi, Pablo Alejandro Rodríguez; Restor Dent Endod 2024;49(4):e35. Published online September 9, 2024; DOI: https://doi.org/10.5395/rde.2024.49.e35

Abstract PDF PubReader ePub

Objectives

This study aimed to relate the file fragment length and location in the root canal to the retrieval chances, the clinical time required and the occurrence of secondary fractures.

Materials and Methods

Sixty clinical cases of fractured instruments were included in this study. They were classified according to the instrument length and the location of the root canal. In each group, the success rate in the instrument retrieval, the clinical time required and the occurrence of secondary fractures were evaluated. The collected data were analyzed using the Kruskal-Wallis test on the basis of a 0.05 significance level.

Results

The fragment length showed no significant influence on the assessed variables (p > 0.05). The root third where the instrument was located resulted in an increased clinical time, with statistically significant differences (p < 0.05). However, the procedure success rate and the occurrence of secondary fractures showed no association with these variables.

Conclusions

In accordance with the findings of this study, the fractured fragment length did not influence any of the variables assessed, but it is suggested to focus on the fragment location inside the root canal to decide the retrieval of a fractured instrument.

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Neodymium-Doped Yttrium Aluminum Perovskite (Nd:YAP) Laser in the Elimination of Endodontic Nickel-Titanium Files Fractured in Rooted Canals (Part 2: Teeth With Significant Root Curvature)
Amaury Namour, Marwan El Mobadder, Clément Cerfontaine, Patrick Matamba, Lucia Misoaga, Delphine Magnin , Praveen Arany, Samir Nammour
Cureus.2025;[Epub] CrossRef

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Physical-mechanical, chemical and biological properties of graphene-reinforced glass ionomer cements: Tatiane Ramos dos Santos Jordão, Laura Soares Viana Fernandes, Karla Lorene de França Leite, Adílis Alexandria, Emmanuel João Nogueira Leal Silva, Lucianne Cople Maia, Tatiana Kelly da Silva Fidalgo; Restor Dent Endod 2024;49(4):e37. Published online October 10, 2024; DOI: https://doi.org/10.5395/rde.2024.49.e37

Abstract PDF PubReader ePub: Objectives
This study aimed to evaluate the physical-mechanical, chemical, and biological properties of graphene-reinforced glass ionomer cements (GICs).
Materials and Methods
Different proportions of graphene powder were incorporated into 2 high-viscosity self-curing GIC, Ketac Molar (G_Ketac) and Fuji IX (G_Fuji), in 4 different concentrations: 0.5%, 1%, 2%, and 5%. The control groups included the GICs without graphene. Experiments were performed to analyze linear (Ra) and volumetric roughness (Sa), antimicrobial activity, radiopacity, fluoride release, microhardness, solubility, and water sorption. Data were analyzed using Kruskal-Wallis, Mann-Whitney, Wilcoxon, analysis of variance, and Tukey’s test (p ≤ 0.05).
Results
The G_Ketac 0% and G_Fuji0% groups presented higher Ra (4.05 and 2.72) and Sa (4.76 and 5.16), respectively. No inhibition zone was observed, and the incorporation of graphene reduced radiopacity. Moreover, there was no influence on the solubility and water sorption after 21 days. A greater fluoride release was observed in the period of 7 days for most of the groups. After 21 days, G_Ketac 5%, 2%, and 1% presented higher releasing than 0% and 0.5% (p ≤ 0.05).
Conclusions
The graphene incorporation improved the microhardness of GICs in lower concentrations. Graphene incorporation to GICs modified some physical-mechanical, and chemical, but not affected biological properties.

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Influence of disinfecting solutions on the surface topography of gutta-percha cones: a systematic review of in vitro studies: Lora Mishra, Gathani Dash, Naomi Ranjan Singh, Manoj Kumar, Saurav Panda, Franck Diemer, Monika Lukomska-Szymanska, Barbara Lapinska, Abdul Samad Khan; Restor Dent Endod 2024;49(4):e42. Published online November 1, 2024; DOI: https://doi.org/10.5395/rde.2024.49.e42

Abstract PDF Supplementary Material PubReader ePub: The surface integrity of gutta-percha cones is a crucial factor in the success of endodontic procedures. Disinfecting solutions play a pivotal role in sterilizing gutta-percha cones, but their influence on gutta-percha surface topography remains a subject of concern. This systematic review aimed to present a qualitative synthesis of available laboratory studies assessing the influence of disinfecting solutions on the surface topography of gutta-percha and offers insights into the implications for clinical practice. The present review followed PRISMA 2020 guidelines. An advanced database search was performed in PubMed, Google Scholar, Embase, Scopus, LILAC, non-indexed citations and reference lists of eligible studies in May 2024. Laboratory studies, in English language, were considered for inclusion. The quality (risk of bias) of the included studies was assessed using parameters for in vitro studies. A total of 28 studies were included in the qualitative synthesis. Based on the included in vitro studies, surface deposits and alterations in the physical properties of gutta-percha cones were observed after the disinfection protocol. A comprehensive review of the available literature indicates that the choice of disinfecting solution, its concentration, and immersion time significantly affect the surface topography of gutta-percha cones.

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Color stability and solubility of Biodentine and NeoPutty in contact with different irrigation solutions: Sıla Nur Usta, Cangül Keskin; Restor Dent Endod 2024;49(3):e25. Published online June 19, 2024; DOI: https://doi.org/10.5395/rde.2024.49.e25

Abstract PDF PubReader ePub: Objectives
This study aimed to evaluate the color stability and solubility of Biodentine and NeoPutty in contact with different irrigation solutions.
Materials and Methods
Biodentine and NeoPutty were set in cylindrical molds with 7 mm diameter and 1.5 mm high and immersed in distilled water, 17% ethylenediaminetetraacetic acid (EDTA), 2% chlorhexidine (CHX), 9% 1-hydroxyethylidene 1,1-diphosphonate (HEDP), and 5% sodium hypochlorite (NaOCl) solutions for 24 hours. The color change was measured with a spectrophotometer. The solubility values were calculated as the mass loss was expressed as a percentage of the original mass using an analytical balance with 10⁻⁴ g accuracy. Data were analyzed with Kruskal-Wallis followed by Mann-Whitney U tests, and 2-way analysis of variance test followed by Bonferroni corrections for pairwise comparisons for solubility and color stability with a 5% significance threshold, respectively.
Results
Biodentine exhibited higher color changes compared to the NeoPutty contact with all solutions except distilled water (p < 0.05). Both hydraulic cements (HCs) showed higher discoloration values immersion in CHX followed by NaOCl. No statistically significant difference was found between Biodentine and NeoPutty regardless of irrigation solution in terms of solubility (p > 0.05). Solubility values were lower in the distilled water group compared to EDTA and CHX (p < 0.05).
Conclusions
Tested HCs showed solubility and color changes at various rates. NeoPutty could be an appropriate material in aesthetic areas. The usage of HEDP as an irrigant solution can be considered suitable for various endodontic treatments due to its relatively lower solubility and discoloration values.

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Success rates comparison of endodontic microsurgery and single implants with comprehensive and explicit criteria: a systematic review and meta-analysis: Min Jung Ko, Ju Hyun Park, Na Rae Lee, Joon-Ho Yoon, Young-Taek Kim, Sin-Yeon Cho; Restor Dent Endod 2025;50(1):e8. Published online February 19, 2025; DOI: https://doi.org/10.5395/rde.2025.50.e8

Abstract PDF Supplementary Material PubReader ePub: Objectives
While the success criteria of endodontic microsurgery (EMS) have been consistently defined and widely accepted, the success criteria of dental implants are outdated and focus only on the implant fixture and surrounding bone. This study aimed to evaluate the outcomes of EMS and single implants (SIs) with explicit criteria.
Methods
We searched for articles published from January 2010 to February 2022 and discussed them and consulted with a clinical advisory committee composed of four dental specialists and one epidemiologist during article selection and data extraction.
Results
Twenty-two EMS studies and six SI studies were included in the meta-analysis. Teeth treated using EMS had a pooled success rate of 89% (90% at <5-year follow-up and 80% at ≥5-year follow-up) and the pooled success rate of SI was 78%.
Conclusions
The success rates of the two procedures with similar follow-up periods were comparable. Subgroup analysis found no other variable that significantly influenced study heterogeneity. Considering the treatment sequence and the similar success rates, it would be advantageous to consider EMS, rather than implants, first in a situation where both procedures are applicable.

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Cleaning protocols to enhance bond strength of fiberglass posts on root canals filled with bioceramic sealer: an in vitro comparative study: Thiago Bessa Marconato Antunes, Juliana Delatorre Bronzato, Joice Graciani, Ana Cristina Padilha Janini, Rocharles Cavalcante Fontenele, Francisco Haiter Neto, Brenda Paula Figueiredo de Almeida Gomes, Marina Angélica Marciano da Silva; Restor Dent Endod 2025;50(2):e20. Published online May 21, 2025; DOI: https://doi.org/10.5395/rde.2025.50.e20

Abstract PDF PubReader ePub: Objectives
This study aimed to evaluate whether the agitation protocols using ultrasonic inserts or the XP-endo Finisher R file improved the removal of two different endodontic sealer remnants and the bond strength of fiberglass posts to dentin.
Methods
Seventy-two human teeth were selected. The canals were prepared with Reciproc 50 and Easy ProDesign 30/.10 and root filled according to the endodontic sealer groups: AH Plus or EndoSequence BC Sealer HiFlow. The samples were kept at 37ºC and 95% humidity for 28 days. During the post space preparation, the obturation was removed with Largo burs, and the groups were divided according to the irrigant agitation protocols (n = 12): no agitation, agitation with R1-Clearsonic associated with E1-Irrisonic ultrasonic inserts, or agitation with XP-endo Finisher R file. The fiberglass posts were cemented with RelyX ARC. The roots were sectioned into slices and submitted to the push-out test. Micro-computed tomography analysis was used to check the effectiveness of irrigating solution agitation in the elimination of remnants.
Results
The cleaning protocols with agitation were more effective in increasing the bond strength of posts to dentin for both sealer groups compared to non-agitation (p < 0.05). There was no difference between the same cleaning protocols for the different sealers. Among the different thirds, there was no statistical difference for the same sealer in the different cleaning protocols (p > 0.05).
Conclusions
Both agitation protocols effectively clean root-filled canals sealed with resin-based and calcium silicate-based sealers during fiberglass post space preparation. These protocols result in improved bond strength compared to non-agitation methods.

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A global overview of enamel microabrasion for white spot lesions: a bibliometric review: Aurélio de Oliveira Rocha, Karina Cardoso, Michely Cristina Goebel, Pablo Silveira Santos, Lucas Menezes dos Anjos, Juliana Silva Ribeiro, Carla Miranda Santana, Mariane Cardoso; Restor Dent Endod 2024;49(3):e29. Published online July 11, 2024; DOI: https://doi.org/10.5395/rde.2024.49.e29

Abstract PDF Supplementary Material PubReader ePub

This study aimed to identify and analyze articles on enamel microabrasion for the treatment of white spot lesions. A search was conducted on the Web of Science. The following parameters were recorded and analyzed: number of citations, year, journal, impact factor, study design, theme, country and continent, institution, authors, and keywords. Data was analyzed using VOSviewer software. The initial search resulted in 1,126 documents, of which 94 articles were included. The highest number of citations an article received was 65. The oldest article was published in 1975, and the most recent in 2023. The most frequent study design was case report (n = 42). Regarding the themes, it was observed that the main objective of the studies was to evaluate the clinical performance of enamel microabrasion (n = 75), primarily using Opalustre (Ultradent Products Inc., South Jordan, UT, USA) (n = 37) for treating white stains caused by dental fluorosis (n = 41). Most articles originated from Latin America (n = 31), mainly from Brazil (n = 26). The most frequent author was Sundfeld RH (n = 10). This study reveals research trends in the field of enamel microabrasion. The publications were mainly case reports/series using Opalustre for the removal of fluorosis stains.

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Impact of microabrasion and a remineralizing agent before in-office bleaching on hydrogen peroxide permeability, color alteration, and enamel morphology
Michael Willian Favoreto, Leticia Condolo, Camila Mendes Camargo, Rafael Rodrigues Lima, Karol Carrillo, Abraham Lincoln Calixto, Alessandra Reis, Alessandro D. Loguercio
Journal of Dentistry.2025; 156: 105655. CrossRef
Micro- and Macroabrasion in the Esthetic Zone: A Narrative Review and Case Study
Jose Villalobos-Tinoco, Carlos A. Jurado, Silvia Rojas-Rueda, Nechama S. Citrin, Staley Colvert, Jose Luis Gutierrez-Quintero, Salwa Mekled
Dentistry Journal.2025; 13(5): 183. CrossRef

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The effect of limonene extract on the adhesion of different endodontic cements to root dentin: an in vitro experimental study: Nayara Lima Ferraz Aguiar, Eduardo José Soares, Guilherme Nilson Alves dos Santos, Anna Luísa Araújo Pimenta, Laryssa Karla Romano, Ricardo Gariba Silva, Fernanda de Carvalho Panzeri; Restor Dent Endod 2025;50(2):e16. Published online May 12, 2025; DOI: https://doi.org/10.5395/rde.2025.50.e16

Abstract PDF PubReader ePub: Objectives
The study aimed to evaluate the effect of limonene extract (LE) on push-out bond strength (BS) to root dentin in endodontically treated teeth.
Methods
Single-rooted teeth were selected and instrumented using the reciprocating technique, then divided into three groups based on the final irrigating solution: 2.5% sodium hypochlorite (NaOCl), 17% ethylenediaminetetraacetic acid (EDTA), and 5% LE. The roots were further divided (n = 12) and obturated using the single-cone technique with epoxy resin-based (ERB) or bioceramic sealer (Bio-C). After 3 days, the roots were sectioned into 2-mm slices, obtaining two slices from each root third. Push-out BS testing was conducted at 0.5 mm/min, followed by failure pattern and adhesive interface analysis using scanning electron microscopy. Push-out BS data were analyzed by three-way analysis of variance and Tukey post-hoc test (p < 0.05).
Results
ERB showed higher BS when irrigated with EDTA (5.0 ± 2.3 MPa) compared to NaOCl (1.8 ± 1.1 MPa) (p = 0.0005), particularly in the cervical third. LE yielded intermediate values without significant differences from the other irrigants (3.5 ± 1.9 MPa) (p > 0.05). For Bio-C, the highest BS was observed in the apical third, especially with LE (9.4 ± 5.0 MPa), differing from other thirds and final irrigating solutions (p < 0.05). Mixed failure patterns were most prevalent, regardless of the irrigant solutions.
Conclusions
The combination of LE with Bio-C demonstrated superior BS in the apical third, suggesting its potential as a final irrigating solution in endodontic treatments.

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A 48-month clinical performance of hybrid ceramic fragment restorations manufactured in CAD/CAM in non-carious cervical lesions: case report: Michael Willian Favoreto, Gabriel David Cochinski, Eveline Claudia Martini, Thalita de Paris Matos, Matheus Coelho Bandeca, Alessandro Dourado Loguercio; Restor Dent Endod 2024;49(3):e32. Published online August 5, 2024; DOI: https://doi.org/10.5395/rde.2024.49.e32

Abstract PDF PubReader ePub: From the restorative perspective, various methods are available to prevent the progression of non-carious cervical lesions. Direct, semi-direct, and indirect composite resin techniques and indirect ceramic restorations are commonly recommended. In this context, semi-direct and indirect restoration approaches are increasingly favored, particularly as digital dentistry becomes more prevalent. To illustrate this, we present a case report demonstrating the efficacy of hybrid ceramic fragments fabricated using computer-aided design (CAD)/computer-aided manufacturing (CAM) technology and cemented with resin cement in treating non-carious cervical lesions over a 48-month follow-up period. A 24-year-old male patient sought treatment for aesthetic concerns and dentin hypersensitivity in the cervical region of the lower premolar teeth. Clinical examination confirmed the presence of two non-carious cervical lesions in the buccal region of teeth #44 and #45. The treatment plan involved indirect restoration using CAD/CAM-fabricated hybrid ceramic fragments as a restorative material. After 48 months, the hybrid ceramic material exhibited excellent adaptation and durability provided by the CAD/CAM system. This case underscores the effectiveness of hybrid ceramic fragments in restoring non-carious cervical lesions, highlighting their long-term stability and clinical success.

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Effects of a relined fiberglass post with conventional and self-adhesive resin cement: Wilton Lima dos Santos Junior, Marina Rodrigues Santi, Rodrigo Barros Esteves Lins, Luís Roberto Marcondes Martins; Restor Dent Endod 2024;49(2):e18. Published online March 27, 2024; DOI: https://doi.org/10.5395/rde.2024.49.e18

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Objectives

This study was conducted to evaluate the mechanical properties of relined and non-relined fiberglass posts when cemented to root canal dentin using a conventional dual-cure resin cement or a self-adhesive resin cement.

Materials and Methods

Two types of resin cements were utilized: conventional and self-adhesive. Additionally, 2 cementation protocols were employed, involving relined and non-relined fiberglass posts. In total, 72 bovine incisors were cemented and subjected to push-out bond strength testing (n = 10) followed by failure mode analysis. The cross-sectional microhardness (n = 5) was assessed along the root canal, and interface analyses (n = 3) were conducted using scanning electron microscopy (SEM). Data from the push-out bond strength and cross-sectional microhardness tests were analyzed via 3-way analysis of variance and the Bonferroni post-hoc test (α = 0.05).

Results

For non-relined fiberglass posts, conventional resin cement exhibited higher push-out bond strength than self-adhesive cement. Relined fiberglass posts yielded comparable results between the resin cements. Type II failure was the most common failure mode for both resin cements, regardless of cementation protocol. The use of relined fiberglass posts improved the cross-sectional microhardness values for both cements. SEM images revealed voids and bubbles in the incisors with non-relined fiberglass posts.

Conclusions

Mechanical properties were impacted by the cementation protocol. Relined fiberglass posts presented the highest push-out bond strength and cross-sectional microhardness values, regardless of the resin cement used (conventional dual-cure or self-adhesive). Conversely, for non-relined fiberglass posts, the conventional dual-cure resin cement yielded superior results to the self-adhesive resin cement.

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Push-Out Bond Strength of Different Luting Cements Following Post Space Irrigation with 2% Chitosan: An In Vitro Study
Shimaa Rifaat, Ahmed Rahoma, Hind Muneer Alharbi, Sawsan Jamal Kazim, Shrouq Ali Aljuaid, Basmah Omar Alakloby, Faraz A. Farooqi, Noha Taymour
Prosthesis.2025; 7(1): 18. CrossRef

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Effect of different storage media on elemental analysis and microhardness of cervical cavity margins restored with a bioactive material: Hoda Saleh Ismail, Brian Ray Morrow, Ashraf Ibrahim Ali, Rabab Elsayed Elaraby Mehesen, Salah Hasab Mahmoud, Franklin Garcia-Godoy; Restor Dent Endod 2024;49(1):e6. Published online January 17, 2024; DOI: https://doi.org/10.5395/rde.2024.49.e6

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Objectives

This study aimed to investigate the elemental analysis and microhardness of a bioactive material (Activa) and marginal tooth structure after storage in different media.

Materials and Methods

Fifteen teeth received cervical restorations with occlusal enamel and gingival dentin margins using the tested material bonded with a universal adhesive, 5 of them on the 4 axial surfaces and the other 10 on only the 2 proximal surfaces. The first 5 teeth were sectioned into 4 restorations each, then stored in 4 different media; deionized water, Dulbecco's phosphate buffered saline (DPBS), Tris buffer, and saliva. The storage period for deionized water was 24 hours while it was 3 months for the other media. Each part was analyzed by scanning electron microscopy-energy dispersive spectroscopy (SEM-EDS) analysis for different substrates/distances and the wt% of calcium, phosphorus, silica, and fluoride were calculated. The other 10 teeth were sectioned across the restoration, stored in either Tris buffer or saliva for 24 hours or 3 months, and were evaluated for microhardness of different substrates/areas. Data were analyzed using analysis of variance and Tukey’s post hoc test.

Results

Enamel and dentin interfaces in the DPBS group exhibited a significant increase in calcium and phosphorus wt%. Both silica and fluoride significantly increased in tooth structure up to a distance of 75 μm in the 3-month-media groups than the immediate group. Storage media did not affect the microhardness values.

Conclusions

SEM-EDS analysis suggests an ion movement between Activa and tooth structure through a universal adhesive while stored in DPBS.

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Influence of curing mode and aging on the bonding performance of universal adhesives in coronal and root dentin
Hoda Saleh Ismail, Ashraf Ibrahim Ali, Mohamed Elshirbeny Elawsya
BMC Oral Health.2024;[Epub] CrossRef

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Impact of the use of high-power 810-nm diode laser as monotherapy on the clinical and tomographic success of the treatment of teeth with periapical lesions: an observational clinical study: Fabricio Hinojosa Pedraza, Abel Victor Isidro Teves-Cordova, Murilo Priori Alcalde, Marco Antonio Hungaro Duarte; Restor Dent Endod 2025;50(2):e15. Published online May 15, 2025; DOI: https://doi.org/10.5395/rde.2025.50.e15

Abstract PDF PubReader ePub: Objectives
The aim of this study was to demonstrate the impact of a high-power 810-nm diode laser as monotherapy on the clinical and tomographic success of treating teeth with periapical lesions, through a series of 31 cases.
Methods
Teeth with apical lesions underwent endodontic treatment in which a high-power 810-nm diode laser with saline solution was used as monotherapy for disinfection. This type of therapy aimed to replace the traditional irrigation protocol with sodium hypochlorite. This research is the first to assess the clinical success of this alternative treatment, along with tomographic evaluations conducted over periods ranging from 2 to 7 years, analyzed using the periapical index based on cone-beam computed tomography (CBCTPAI). All cases were performed by a single clinician following the same laser protocol, which involved using 1 W of continuous power and four cycles of 20 seconds of laser activation.
Results
All teeth showed no clinical symptoms upon follow-up examination. However, the tomographic evaluation revealed that the success rates for teeth receiving primary treatment were 60% and 80% according to strict and loose criteria, respectively. For teeth requiring retreatment, the success rates were 12.5% and 37.5% using strict and loose criteria, respectively.
Conclusions
The teeth with apical lesions that underwent primary treatment did not present clinical symptoms, but they showed a moderate success rate on tomographic evaluation. However, despite lacking clinical symptoms, teeth with apical lesions that required retreatment had a very low success rate on tomographic evaluation.

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Alkasite restorative material for endodontically treated teeth: a randomized controlled pilot study: Davi Ariel Nobuo Bepu, Renata Siqueira Scatolin, Natalia Saud Junqueira Franco, Luiza Pejon Sanchez, Aline Evangelista Souza-Gabriel, Silmara Aparecida Milori Corona; Restor Dent Endod 2024;49(3):e24. Published online June 11, 2024; DOI: https://doi.org/10.5395/rde.2024.49.e24

Abstract PDF PubReader ePub: Objectives
This study aimed to evaluate the clinical performance of an alkasite restorative material in molars that had undergone root canal treatment.
Materials and Methods
The research was registered in Brazilian Registry of Clinical Trials. The randomized clinical trial involved 33 patients, each with at least 1 mandibular molar requiring restoration after receiving endodontic treatment. Patients were randomly assigned to receive either bulk-fill resin composite (Tetric N Ceram Bulk Fill, Ivoclar Vivadent) or the alkasite restorative material (Cention N, Ivoclar Vivadent). Upon completion of the restorations, 3 calibrated professionals utilized the United States Public Health Service criteria to assess various factors, including retention, secondary caries, marginal adaptation, restoration color, marginal pigmentation, and anatomical form. Evaluations were conducted at intervals of 7 days, 6 months, and 17 months. Additionally, the assessment encompassed the presence of radiolucent lines adjacent to the restoration, material deficiencies or excess, contact points, and caries recurrence. The data underwent analysis using the Friedman and Mann-Whitney tests (α = 0.05).
Results
After 17 months, the results revealed that the alkasite restorative material exhibited greater wear of anatomical shape compared to the bulk-fill resin composite (p = 0.0189). Furthermore, the alkasite restorative material significantly differed from the natural tooth color in most cases (p = 0.0000). However, no other criteria displayed significant differences between the materials or over time (p > 0.05).
Conclusions
The alkasite restorative material (Cention N) emerges as a viable option for restoring endodontically treated teeth, displaying clinically acceptable alterations after a 17-month evaluation period.
Trial Registration
Brazilian Registry of Clinical Trials (ReBEC) Identifier: RBR-97kx5jv

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