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Statistical Review Article
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Sample size determination for conducting a pilot study to assess reliability of a questionnaire
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Mohamad Adam Bujang, Evi Diana Omar, Diana Hui Ping Foo, Yoon Khee Hon
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Restor Dent Endod 2024;49(1):e3. Published online January 10, 2024
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DOI: https://doi.org/10.5395/rde.2024.49.e3
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Abstract
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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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Meeting Abstract
Review Articles
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Cone-beam computed tomography in endodontics: from the specific technical considerations of acquisition parameters and interpretation to advanced clinical applications
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Néstor Ríos-Osorio, Sara Quijano-Guauque, Sandra Briñez-Rodríguez, Gustavo Velasco-Flechas, Antonieta Muñoz-Solís, Carlos Chávez, Rafael Fernandez-Grisales
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Restor Dent Endod 2024;49(1):e1. Published online December 11, 2023
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DOI: https://doi.org/10.5395/rde.2024.49.e1
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Abstract
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PubReader
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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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Seethalakshmi Tamizhselvan, Diana Davidson, Srinivasan Manali Ramakrishnan
Journal of Conservative Dentistry and Endodontics.2025; 28(8): 833. CrossRef - IMAGING TECHNIQUES IN ENDODONTIC DIAGNOSIS: A REVIEW OF LITERATURE
Mihaela Salceanu, Anca Melian , Tudor Hamburda , Cristina Antohi , Corina Concita , Claudiu Topoliceanu , Cristian Levente Giuroiu
Romanian Journal of Oral Rehabilitation.2025; 17(1): 705. CrossRef - A Three-rooted Deciduous Second Molar in a 13-year-old Caucasian Female
Daniel Traub, Robert Walsh, Colleen Ahern
International Journal of Medical Case Reports.2025; 4(3): 51. CrossRef - Bildgebung im ZMK-Bereich – aber in welcher Reihenfolge?
Rainer Lutz
Zahnmedizin up2date.2024; 18(04): 297. CrossRef - Cone-beam computed tomography evaluation of shaping ability of kedo-S square and fanta AF™ baby rotary files compared to manual K-files in root canal preparation of primary anterior teeth
Shaimaa S. El-Desouky, Bassem N. El Fahl, Ibrahim A. Kabbash, Shimaa M. Hadwa
Clinical Oral Investigations.2024;[Epub] CrossRef - Analysis of Endodontic Successes and Failures in the Removal of Fractured Endodontic Instruments during Retreatment: A Systematic Review, Meta-Analysis, and Trial Sequential Analysis
Mario Dioguardi, Corrado Dello Russo, Filippo Scarano, Fariba Esperouz, Andrea Ballini, Diego Sovereto, Mario Alovisi, Angelo Martella, Lorenzo Lo Muzio
Healthcare.2024; 12(14): 1390. CrossRef
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12,969
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14
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13
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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
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Karem Paula Pinto, Gabriela Ribeiro da Silva, Cláudio Malizia Alves Ferreira, Luciana Moura Sassone, Emmanuel João Nogueira Leal da Silva
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Restor Dent Endod 2024;49(4):e34. Published online September 6, 2024
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DOI: https://doi.org/10.5395/rde.2024.49.e34
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Abstract
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Supplementary Material
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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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- Indian Association of Conservative Dentistry and Endodontics consensus statement on deep caries management
Deepak Kumar Sharma, R. S. Mohan Kumar, Shishir Singh, Suparna Ganguly Saha, Meenal Nithin Gulve, Dipali Y. Shah, Sathish Abraham, Shruthi Nagaraja, Raksha Bhat
Journal of Conservative Dentistry and Endodontics.2025; 28(8): 714. CrossRef
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Research Articles
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Comparative study of the effectiveness of different bleaching agents on blood-colored extracted teeth and investigation of recoloring after bleaching: an in vitro experimental study
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Gülşen Arslan, Akın Aladağ, Ayşegül Demirbaş, Murat Türkün
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Restor Dent Endod 2025;50(3):e22. Published online July 9, 2025
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DOI: https://doi.org/10.5395/rde.2025.50.e22
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Abstract
PDF
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- Objectives
This study evaluated the efficacy of three distinct bleaching agents over time on blood-stained, devitalized teeth. Furthermore, the recoloring subsequent to bleaching will be monitored.
Methods
The study was conducted on 60 caries-free, unfilled, upper human incisors. The Freccia and Peters blood staining technique was employed, and four groups (n = 15) were identified: control, 35% hydrogen peroxide-treated, 37% carbamide peroxide-treated, and sodium perborate-treated groups. Color differences were measured using ΔE00, ΔWID, L*, a*, and b* values. To investigate tooth discoloration after bleaching, 10 unbleached teeth with three groups of 10 bleached teeth were compared by vine staining. The group of bleached teeth was restored immediately, another group waited one week, and the third group had sodium ascorbate applied and analyzed using one-way analysis of variance tests (p < 0.05).
Results
Among the groups, carbamide peroxide exhibited the most significant whitening during the 6-day bleaching process, followed by hydrogen peroxide and sodium perborate. Subsequent examination of the wine recoloring of post-bleaching samples demonstrated that bleached teeth exhibited a heightened propensity for recoloration in contrast to unbleached teeth. Notably, sodium ascorbate treatments for hydrogen peroxide neutralization and the wait-and-restore approach were not statistically significant in terms of preventing recoloration.
Conclusions
Sodium perborate is less effective and more time-consuming than hydrogen peroxide or carbamide peroxide for bleaching purposes. Carbamide peroxide is the most effective bleaching agent. The sodium ascorbate treatment and the wait-and-restore approach are ineffective in preventing recoloring. Bleached teeth have more discoloration than unbleached teeth.
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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
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Meghana Aditya Vartak, Vibha Rahul Hegde, Sanitra Rahul Hegde, Ushaina Fanibunda
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Restor Dent Endod 2025;50(1):e5. Published online February 17, 2025
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DOI: https://doi.org/10.5395/rde.2025.50.e5
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Abstract
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- 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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- Análise comparativa dos aspectos biomecânicos dos pinos de fibra de vidro e fibra de polietileno (RIBBOND) - revisão de literatura
Ana Kamily da Cunha Silva, Tânia Regina Carvalho de Sá, Livia Duarte Santos Lopes de Carvalho, Lilian Gomes Soares Pires, Marconi Raphael de Siqueira Rego, Matheus Araújo Brito Santos Lopes
RCMOS - Revista Científica Multidisciplinar O Saber.2025;[Epub] CrossRef - Biomimetic Strategies for the Rehabilitation of Compromised Anterior Teeth
Aakansha Puri, M.S. Prathap
Contemporary Clinical Dentistry.2025; 16(3): 218. CrossRef - Clinical outcomes of non-metallic customized post-and-core systems: A systematic review
Jonathan Jun Xian Yuen, Yew Hin Beh, Zhi Kuan Saw, Hock Siang Chua
Journal of Endodontics.2025;[Epub] CrossRef
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Case Report
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Multidisciplinary management of an endo-perio lesion complicated by a cemental tear: a case report
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Nishanth D. Sadhak, Akshaya Pallod, Shreyas Oza
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Restor Dent Endod 2025;50(3):e31. Published online August 22, 2025
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DOI: https://doi.org/10.5395/rde.2025.50.e31
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- Endodontic-periodontal lesions (EPLs) complicated by cemental tears present a diagnostic and therapeutic challenge. This case report describes the successful management of a 66-year-old male patient with a mandibular second molar (#18) exhibiting an EPL complicated by a cemental tear. Clinical examination revealed a draining sinus tract, deep periodontal pockets, and radiographic evidence of a “J-shaped” lesion and a radiopaque cemental fragment. The tooth had previously initiated endodontic treatment. A multidisciplinary approach involving endodontic treatment and surgical removal of the cemental tear was implemented. At 24-month follow-up, clinical and radiographic examination revealed significant improvement in periodontal health, bone regeneration, and resolution of the lesion. This case highlights the importance of considering cemental tears in the differential diagnosis of EPLs and demonstrates the efficacy of a combined endodontic-periodontal approach for achieving predictable outcomes.
Research Articles
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In vitro experimental study comparing continuous and intermittent irrigation protocols: influence of sodium hypochlorite volume and contact time on tissue dissolution
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Alfredo Iandolo, Dina Abdellatif, Davide Mancino, Gwenael Rolin, Camille Coussens, Aurelian Louvrier, Felipe G Belladonna, Edouard Euvrard, Emmanuel João Nogueira Leal da Silva
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Restor Dent Endod 2025;50(4):e36. Published online October 15, 2025
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DOI: https://doi.org/10.5395/rde.2025.50.e36
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Abstract
PDF
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- Objectives
This study aimed to evaluate whether continuous irrigation with larger volumes or allowing sodium hypochlorite (NaOCl) resting time is more critical for pulp tissue dissolution using a controlled artificial root canal system.
Methods
A three-dimensional printed artificial root canal with a lateral canal in the apical third was fabricated. Standardized bovine pulp tissue specimens were inserted, and three irrigation protocols were tested: group A (continuous NaOCl irrigation at 1 mL/min via syringe pump), group B (intermittent NaOCl irrigation with 0.1 mL and a 3-minute resting period), and group C (control, saline irrigation). The time for complete dissolution and the total NaOCl volume were recorded.
Results
Complete dissolution occurred in groups A and B, with significant differences in NaOCl volume and time (p < 0.05). In group A, complete dissolution was consistently observed after the 6th irrigation cycle, corresponding to a total NaOCl volume of 6.0 ± 0.66 mL per test. The average time required for complete dissolution in this group was 6 ± 0.66 minutes. In group B, complete dissolution occurred after the 4th cycle, with a total NaOCl volume of 0.4 ± 0.06 mL per test and a mean dissolution time of 12.6 ± 1.8 minutes.
Conclusions
NaOCl volume and exposure time significantly influence pulp tissue dissolution.
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Pattern of endodontic instrument separation and factors affecting its retrieval: a 10-year retrospective observational study in a postgraduate institute
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Velmurugan Natanasabapathy, Aswathi Varghese, Paul Kevin Abishek Karthikeyan, Srinivasan Narasimhan
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Restor Dent Endod 2025;50(1):e7. Published online February 19, 2025
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DOI: https://doi.org/10.5395/rde.2025.50.e7
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Abstract
PDF
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- 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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Citations
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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 - Deep Learning-Based Detection of Separated Root Canal Instruments in Panoramic Radiographs Using a U2-Net Architecture
Nildem İnönü, Umut Aksoy, Dilan Kırmızı, Seçil Aksoy, Nurullah Akkaya, Kaan Orhan
Diagnostics.2025; 15(14): 1744. CrossRef - MANAGEMENT OF INTRACANAL SEPARATED INSTRUMENTS: FACTORS CONTRIBUTING TO ENDODONTIC FILE SEPARATION — A NARRATIVE REVIEW
Tareq Hajaj, Paul Freiman , Serban Talpos Niculescu , Mihai Rominu , Tiberiu Hosszu , Ioana Veja
Romanian Journal of Oral Rehabilitation.2025; 17(2): 993. CrossRef
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Statistical Research Article
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An elaboration on sample size determination for correlations based on effect sizes and confidence interval width: a guide for researchers
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Mohamad Adam Bujang
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Restor Dent Endod 2024;49(2):e21. Published online May 2, 2024
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DOI: https://doi.org/10.5395/rde.2024.49.e21
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Abstract
PDF
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- 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 MethodsSample 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.
ResultsUsing 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.
ConclusionsDetermining 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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Dan Hu, Yue Li, Hua Zhang, Lian-Lian Wang, Wen-Wen Liu, Xin Yang, Ming-Zhao Xiao, Hao-Ling Zhang, Juan Li
World Journal of Gastroenterology.2025;[Epub] CrossRef - Return to work in young and middle-aged colorectal cancer survivors: Factors influencing self-efficacy, fear, resilience, and financial toxicity
Dan Hu, Yue Li, Hua Zhang, Lian-Lian Wang, Wen-Wen Liu, Xin Yang, Ming-Zhao Xiao, Hao-Ling Zhang, Juan Li
World Journal of Gastroenterology.2025;[Epub] CrossRef - Predictive validity of obstacle-crossing test variations in identifying fallers after inpatient rehabilitation for stroke
Prudence Plummer, Megan E. Schliep, Lina Jallad, Ehsan Sinaei, Jody A. Feld, Vicki S. Mercer
Topics in Stroke Rehabilitation.2025; 32(6): 631. CrossRef - Global NDVI-LST Correlation: Temporal and Spatial Patterns from 2000 to 2024
Ehsan Rahimi, Pinliang Dong, Chuleui Jung
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Stine Alpheis, Christopher Sinke, Julian Burek, Tillmann H. C. Krüger, Eckart Altenmüller, Daniel S. Scholz
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Jonas Svanström, Bernice Skytt, Maria Lindberg, Magnus Lindberg
WORK: A Journal of Prevention, Assessment & Rehabilitation.2025; 81(3): 2952. CrossRef - The Dilemma and Wisdom in Translating p Values: A Collaborative Approach to Strengthening Scientific Validity
Mohamad Adam Bujang, Suyan Tian
BioMed Research International.2025;[Epub] CrossRef - Comparison of Condylar Position Discrepancies Assessed Using an Optical Jaw Tracking System and a Conventional Condylar Position Indicator
Joana Silva, Eugénio Martins, Alberto Canabez, Domingo Martin, Conchita Martin
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Research Articles
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Does the use of different root canal sealers and adhesive resin cements impact the bond strength of glass fiber posts?
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Ália Regina Neves de Paula Porto, Rudá França Moreira, Felipe Gonçalves Belladonna, Victor Talarico Leal Vieira, Emmanuel João Nogueira Leal da Silva
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Restor Dent Endod 2025;50(3):e29. Published online August 29, 2025
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DOI: https://doi.org/10.5395/rde.2025.50.e29
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- Objectives
This study aimed to assess the influence of two endodontic sealers on the bond strength of glass fiber posts using conventional and self-adhesive resin cement through a push-out test. Methods: Forty central human incisors were randomly divided into four groups (n = 10) based on sealer (epoxy resin- based or calcium silicate-based) and cement (conventional and self-adhesive resin) types: AH Plus (Dentsply De- Trey)/RelyX ARC (3M ESPE), AH Plus/RelyX U200 (3M ESPE), Bio-C Sealer (Angelus)/RelyX ARC, and Bio-C Sealer/RelyX U200. After canal filling and post cementation, roots were sectioned to obtain one specimen per root third. A pushout test and failure pattern assessment were conducted, with bond strength analyzed using the one-way analysis of variance and Tukey test. Results: AH Plus/RelyX ARC showed the highest bond strength values, with a significant difference in the middle third. The most common failure was mixed (55%), while adhesive failures made up 45%, with 23.5% at the cement/post interface and 21.5% at the cement/dentin interface. Conclusions: AH Plus/RelyX ARC provided the highest bond strength values for glass fiber posts to dentin.
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Concentrated growth factor scaffold-based pulpotomy of permanent molars with symptomatic irreversible pulpitis
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Arthi K. Harith, Vishnupriya Koteeswaran, Dinesh Kowsky, Natanasabapathy Velmurugan, Suresh Nandini
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Restor Dent Endod 2025;50(1):e1. Published online January 17, 2025
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DOI: https://doi.org/10.5395/rde.2025.50.e1
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Abstract
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- 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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Comparison of remineralization in caries-affected dentin using calcium silicate, glass ionomer cement, and resin-modified glass ionomer cement: an in vitro study
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Kwanchanok Youcharoen, Onwara Akkaratham, Papichaya Intajak, Pipop Saikaew, Sirichan Chiaraputt
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Restor Dent Endod 2025;50(4):e37. Published online November 14, 2025
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DOI: https://doi.org/10.5395/rde.2025.50.e37
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Abstract
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- Objectives
This study evaluated the ability of calcium silicate cement (CSC) as a remineralizing agent compared with conventional glass ionomer cement (GIC) and resin-modified GIC (RMGIC) to remineralize artificial caries-affected dentin.
Methods
Twenty-five class V cavities were prepared on extracted human third molars. Twenty teeth underwent artificial caries induction. The remaining five teeth with sound dentin serve as the positive control. The twenty demineralized teeth were subdivided into four groups (n = 5): carious dentin without restoration (negative control [NC]), carious dentin restored with CSC (Biodentine, Septodont), carious dentin restored with GI (Fuji IX, GC Corporation), and carious dentin restored with RMGIC (Fuji II LC, GC Corporation). Following restoration, the specimens were stored in artificial saliva for 7 days. The elastic modulus was evaluated by a nanoindentation test. The mineral composition was analyzed by scanning electron microscopy-energy-dispersive X-ray spectroscopy (SEM-EDX), and the mineral composition at the dentin-material interface.
Results
CSC had a higher modulus of elasticity compared to GI, RMGI, and NC groups (p < 0.05). Higher calcium and phosphorus content was observed under CSC restorations, as indicated by SEM-EDX examination, which may lead to better remineralization.
Conclusions
Compared to GI and RMGI, CSC showed the best remineralization and mechanical reinforcement in caries-affected dentin, indicating CSC for use in minimally invasive restorative dentistry.
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Marginal adaptation of three root-end filling materials in cavities prepared with laser and ultrasonic tips: an in vitro comparative study
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Busra Zengin, Seda Aydemir, Nicholas Paul Chandler
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Restor Dent Endod 2025;50(4):e32. Published online September 9, 2025
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DOI: https://doi.org/10.5395/rde.2025.50.e32
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Abstract
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- Objectives
This study evaluated the marginal adaptation of ProRoot MTA (Dentsply Tulsa Dental), Biodentine (Septodont), and TotalFill BC RRM (FKG) placed in root-end cavities prepared with ultrasonic or Er,Cr:YSGG laser tips, using scanning electron microscopy.
Methods
The canals of 90 extracted maxillary central incisors were prepared and obturated and their roots resected. Six groups of 15 specimens were allocated as follows: ultrasonic + ProRoot MTA, ultrasonic + Biodentine, ultrasonic + TotalFill, laser + ProRoot MTA, laser + Biodentine, and laser + TotalFill. Roots were sectioned longitudinally to expose the filling material. Apical and coronal micrographs were taken, and the greatest distance between dentin and filling material was measured. The total gap area was also calculated using further micrographs.
Results
Cavities prepared with the ultrasonic tips and filled with Biodentine showed significantly greater gap dimensions compared with TotalFill (p < 0.001) and ProRoot MTA (p = 0.007) in the apical region. The ultrasonic group showed significantly higher void values compared to the laser group for ProRoot MTA (p = 0.026), when comparing the total values of void. The Biodentine group was significantly higher than the TotalFill group in root-end cavities prepared with ultrasonic tips (p < 0.001). The Biodentine group was significantly higher than the ProRoot MTA group in root-end cavities prepared with the laser tip (p = 0.002).
Conclusions
Under the conditions of this study, it was determined that the root-end cavity preparation technique had an effect on the amount of gaps formed between the dentin and the three filling materials.
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- Marginal Adaptability of Harvard MTA and Biodentine Used as Root-End Filling Material: A Comparative SEM Study
Yaneta Kouzmanova, Ivanka Dimitrova
Materials.2025; 18(19): 4598. CrossRef
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Calcium silicate-based sealers remnants in isthmuses of mesial roots of mandibular molars: an in vitro evaluation
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David Saldanha de Brito Alencar, Ana Cristina Padilha Janini, Lauter Eston Pelepenko, Brenda Fornazaro Moraes, Francisco Haiter Neto, Marco Antonio Hungaro Duarte, Marina Angélica Marciano
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Restor Dent Endod 2025;50(3):e25. Published online July 15, 2025
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DOI: https://doi.org/10.5395/rde.2025.50.e25
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Endodontic retreatment aims to address treatment failure through the removal of root canal filling materials. This in vitro study evaluated the presence of filling material remnants in the mesial root canals, specifically focusing on the isthmuses, of mandibular molars after retreatment.
Methods
One hundred extracted mandibular molar mesial roots with isthmuses were prepared with an R25 file, obturated with one of five calcium silicate-based sealers (BioRoot RCS [Septodont], MTApex [Ultradent Products Inc.], EndoSequence BC Sealer HiFlow [Brasseler USA], Bio-C Sealer [Angelus]) or an epoxy resin-based sealer (AH Plus Jet [Dentsply Maillefer]), all stained with rhodamine B, and stored at 37ºC for 30 days to allow for setting. Retreatment was subsequently performed using R40 and XP-endo Finisher R instruments (FKG Dentaire) with 2.5% sodium hypochlorite irrigation. The presence of remaining filling material was then assessed using confocal microscopy, and setting times were tested per ISO 6876:2012.
Results
AH Plus Jet showed the most remnants at 2 mm and the longest retreatment time. Calcium silicate-based sealers exhibited prolonged setting times under dry conditions, with EndoSequence BC Sealer HiFlow showing a particularly extended setting period.
Conclusions
Despite retreatment, residues remained in all canals and isthmus regions, particularly Bio-C Sealer and AH Plus Jet in apical areas, emphasizing the difficulty of complete removal and the persistence of filling material.
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The influence of bioactive glass (BGS-7) on enamel remineralization: an in vitro study
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Chaeyoung Lee, Eunseon Jeong, Kun-Hwa Sung, Su-Jung Park, Yoorina Choi
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Restor Dent Endod 2025;50(4):e33. Published online October 15, 2025
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DOI: https://doi.org/10.5395/rde.2025.50.e33
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- Objectives
The aim of this study was to compare the remineralizing capacity of bioactive glass (BGS-7, CGBIO) with other agents.
Methods
Twenty caries-free third molars were sectioned and demineralized. Specimens were divided into four groups: (1) control, (2) Clinpro XT varnish (Solventum), (3) 1.23% acidulated phosphate fluoride gel, and (4) a new type of CaO-SiO2-P2O5-B2O3 system of bioactive glass ceramics (BGS-7). Agents were applied and stored in simulated body fluid at 37℃ for 2 weeks. Microhardness was measured using the Vickers hardness testing method. Five specimens per group were analyzed using quantitative light-induced fluorescence (QLF) to assess mineral loss. Field-emission scanning electron microscopy (FE-SEM) and energy-dispersive X-ray spectroscopy (EDS) were used to examine the surface morphology and elemental composition. Data were analyzed using paired t-test and one-way analysis of variance (p < 0.05).
Results
BGS-7 showed the highest microhardness values and the greatest recovery in QLF analysis (p < 0.05). FE-SEM revealed granular precipitates on demineralized enamel in the BGS-7 group. EDS confirmed the presence of newly formed silicon and fluoride layers.
Conclusions
BGS-7 demonstrated superior remineralization capacity compared to other agents, suggesting its potential as an effective remineralizing material.
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How protocol, posts, and experience affect fracture detection in multi-rooted teeth using cone-beam computed tomography: an ex vivo experimental study
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Gleica Dal’ Ongaro Savegnago, Gabriela Marzullo de Abreu, Carolina Baumgratz Spiger, Lucas Machado Maracci, Wislem Miranda de Mello, Gabriela Salatino Liedke
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Restor Dent Endod 2025;50(3):e23. Published online July 24, 2025
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DOI: https://doi.org/10.5395/rde.2025.50.e23
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- Objectives
This study aimed to evaluate the influence of cone-beam computed tomography (CBCT) acquisition protocol, the presence of intraradicular metal post, and examiner experience on the detection of complete root fractures in multi-rooted teeth.
Methods
Twenty human molar teeth filled with gutta-percha were placed into artificial alveoli created in bovine ribs. The sample was divided into two groups based on the presence or absence of intraradicular posts in the distal roots. CBCT scans were obtained using four acquisition protocols with varying voxel sizes (0.28, 0.2, 0.125, and 0.80 mm). Following the creation of controlled fractures using a chisel and hammer, CBCT imaging was repeated, resulting in 160 images. Five examiners assessed the images using OnDemand software (KaVo Dental GmbH). Sensitivity, specificity, and accuracy were calculated for each examiner, CBCT protocol, and post-condition. Statistical comparisons were performed using Cochran’s Q test and McNemar test, and a significance level of 5%.
Results
In teeth without metallic posts, sensitivity, specificity, and accuracy values exceeded 0.70, 0.70, and 0.80, respectively. However, the presence of metallic posts significantly reduced diagnostic performance, particularly in low-resolution protocols evaluated by less-experienced examiners.
Conclusions
CBCT acquisition protocols should be selected based on the presence of metallic posts to optimize root fracture detection in multi-rooted teeth. Examiner experience also plays a critical role in diagnostic accuracy.
Case Report
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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
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Ra’fat Ibrahim Farah, Sanaa Najeh Al-Haj Ali, Abdullah Alharbi, Bandar Alresheedi
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Restor Dent Endod 2024;49(4):e36. Published online October 10, 2024
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DOI: https://doi.org/10.5395/rde.2024.49.e36
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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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Research Article
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Predictive factors in the retrieval of endodontic instruments: the relationship between the fragment length and location
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Ricardo Portigliatti, Eugenia Pilar Consoli Lizzi, Pablo Alejandro Rodríguez
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Restor Dent Endod 2024;49(4):e35. Published online September 9, 2024
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DOI: https://doi.org/10.5395/rde.2024.49.e35
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- 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 MethodsSixty 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.
ResultsThe 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.
ConclusionsIn 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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2,681
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Review Article
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Can carbamide peroxide be as effective as hydrogen peroxide for in-office tooth bleaching and cause less sensitivity? A systematic review
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Patrick Wesley Marques de Boa, Kaiza de Sousa Santos, Francisca Jennifer Duarte de Oliveira, Boniek Castillo Dutra Borges
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Restor Dent Endod 2024;49(2):e14. Published online March 20, 2024
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DOI: https://doi.org/10.5395/rde.2024.49.e14
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This study aimed to answer the question through a systematic review: Can carbamide peroxide be as effective as hydrogen peroxide and cause less in-office bleaching sensitivity? A literature survey was performed in PubMed/MEDLINE, Embase, Scopus, ISI Web of Science, and gray literature. Primary clinical trials that compared the efficacy or the in-office bleaching sensitivity between carbamide and hydrogen peroxides were included. The risk of bias was evaluated using the RoB2. The certainty of the evidence was assessed using the GRADE approach. DPI training significantly improved the mean scores of the dental undergraduates from 7.53 in the pre-DPI-training test to 9.01 in the post-DPI-training test (p < 0.001). After 6 weeks, the mean scores decreased marginally to 8.87 in the retention test (p = 0.563). DPI training increased their confidence level from 5.68 pre-DPI training to 7.09 post-DPI training. The limited evidence suggests that the 37% carbamide peroxide may be similarly effective to the 35% hydrogen peroxide for bleaching teeth in-office and causes less bleaching sensitivity. However, more well-designed split-mouth clinical trials are necessary to strengthen the evidence.
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- Impact of nanostructured additives in tooth bleaching agents on enhancing color change and reducing side effects: a scoping review
Patrick Wesley Marques de Boa, Kaiza de Sousa Santos, Aleph Matthews da Silva Souza, Arnóbio Antônio da Silva-Júnior, Boniek Castillo Dutra Borges
Clinical Oral Investigations.2025;[Epub] CrossRef - Quantitative and Qualitative Assessment of Enamel Surface Roughness Following High-Concentration Peroxide Bleaching: A Comparative In Vitro Study
Mamnoon Ghafir, Nida Mehmood, Leeza Bharati, Shreya Bhukal, Ritika Sethi, Aanchal Chaudhary, Seema Gupta
Cureus.2025;[Epub] CrossRef - Using violet light during in-office tooth bleaching to enhance the efficacy of carbamide peroxide without increasing bleaching sensitivity: a systematic review and meta-analysis
Mariana Silva de Bessa, Kaiza de Sousa Santos, Patrick Wesley Marques de Boa, Francisca Jennifer Duarte de Oliveira, Bárbara Faria de Sá Barbosa, Boniek Castillo Dutra Borges
Lasers in Medical Science.2025;[Epub] CrossRef - Influence of Different Light-Activated Bleaching Gels on Pulp Chamber Temperature: An In Vitro Study
Mandana Karimi, Elmira Ataee, Ladan Ranjbar Omrani, Mahdi Abbasi, Elham Ahmadi
Avicenna Journal of Dental Research.2024; 16(4): 225. CrossRef
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9,341
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4
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Research Article
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Effects of different curing methods on the color stability of composite resins
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Massimo Pisano, Alfredo Iandolo, Dina Abdellatif, Andrea Chiacchio, Marzio Galdi, Stefano Martina
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Restor Dent Endod 2024;49(4):e33. Published online September 5, 2024
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DOI: https://doi.org/10.5395/rde.2024.49.e33
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- 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 MethodsThe 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.
ResultsThere 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.
ConclusionsSpectrophotometric 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 - Comparative Evaluation of Direct and Indirect Composite Restorations in Class II Tooth Preparations - An In vivo Study
Akshun Gupta, Garima Arora, Aprajita Mehta, Satish Sane, Siddhi Nevrekar, Apurva Nagrale
Advances in Human Biology.2025; 15(4): 550. CrossRef - Micro- and Nanoplastics and the Oral Cavity: Implications for Oral and Systemic Health, Dental Practice, and the Environment—A Narrative Review
Federica Di Spirito, Veronica Folliero, Maria Pia Di Palo, Giuseppina De Benedetto, Leonardo Aulisio, Stefano Martina, Luca Rinaldi, Gianluigi Franci
Journal of Functional Biomaterials.2025; 16(9): 332. CrossRef
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5,193
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Review Article
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Comparative evaluation of the biological response of conventional and resin modified glass ionomer cement on human cells: a systematic review
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Shishir Singh, Gaurav Kulkarni, R S Mohan Kumar, Romi Jain, Ameya M Lokhande, Teena K Sitlaney, Musharraf H F Ansari, Navin S Agarwal
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Restor Dent Endod 2024;49(4):e41. Published online November 1, 2024
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DOI: https://doi.org/10.5395/rde.2024.49.e41
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This review aimed to evaluate and compare the biological response (biocompatibility and cytotoxicity) of resin modified glass ionomer cement (RMGIC) in contrast to conventional glass ionomer cement (GIC) on human cells. Articles reporting parallel and split-mouth clinical trials, randomized controlled trials, non-randomized controlled trials, prospective studies, and in vitro studies on human permanent teeth that assessed the biological response of GIC and RMGIC were included. The following electronic bibliographic databases were searched using the keywords: MEDLINE/PubMed, EBSCO, Cochrane Central Register of Controlled Trials, and Google Scholar. For the risk of bias MINORS tool and the modified scale of Animal Research: Reporting of In Vivo Experiments and Consolidated Standards of Reporting Trials were used. Initial screening identified 552 studies, of which 9 articles met the inclusion criteria and were included in the study. Different parameters such as odontoblastic changes, inflammatory response, tertiary dentin formation, presence of microorganisms, morphological changes, cell viability, number, and metabolism were used to evaluate the biological response of conventional GIC and RMGICs. Conventional GIC shows lower cytotoxicity compared to RMGIC in vital pulp therapy procedures. Further, in vivo studies and long-term clinical trials are needed to compare these observations for pulp therapy using the 2 test materials.
Trial RegistrationPROSPERO Identifier: CRD42023426021
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- Advanced Platelet-Rich Fibrin Plus Sealed Exclusively with Glass Ionomer Cement: Setting a New Standard for Healing, Aesthetics and Predictive Modelling in Regenerative Endodontics
Dubravka Turjanski, Dragutin Lisjak, Petra Bučević Sojčić, Jelena Valpotić, Tea Borojević Renić, Kristina Goršeta, Domagoj Glavina
Materials.2025; 18(18): 4421. CrossRef - The conventional glass ionomers – A forgotten paradigm
Shishir Singh
Journal of Conservative Dentistry and Endodontics.2024; 27(12): 1201. CrossRef
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Research Articles
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Analysis of thermal profiles on tooth structure and insert during one-piece or adapter-coupled ultrasonic insert use: an in vitro experimental study
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Gabriela Loewen Brotto, Bruno Monguilhott Crozeta, Bruno Marques-da-Silva, Alysson Nunes Diógenes, Emmanuel João Nogueira Leal da Silva, Flávia Sens Fagundes Tomazinho
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Restor Dent Endod 2025;50(3):e24. Published online July 11, 2025
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DOI: https://doi.org/10.5395/rde.2025.50.e24
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- Objectives
This in vitro study aimed to evaluate temperature variation on the external surface of mandibular molars and within ultrasonic inserts when using adapter-coupled versus one-piece inserts.
Methods
Twenty-four extracted human mandibular molars were divided into two groups based on the type of ultrasonic insert used: adapter-coupled and one-piece inserts. Temperature on the external surface of each tooth was measured with a thermocouple probe positioned in the furcation area, capturing data continuously. The temperature of the ultrasonic inserts was monitored in real-time using a thermal imaging camera. Measurements were taken in a controlled environment without cooling for over 120 seconds. Statistical analysis was conducted using analysis of variance (ANOVA) and two-way ANOVA with repeated measures to evaluate temperature variations between groups and over time, with significance set at 5%.
Results
In the external tooth surface temperature measurements, no significant differences were observed between the groups during the initial 15 seconds (p = 0.185) and 30 seconds (p = 0.067). However, significant differences emerged at 60 seconds (p = 0.025), 90 seconds (p = 0.024), and 120 seconds (p = 0.020), with the one-piece insert group demonstrating higher temperatures in the furcation region. Thermal imaging of the inserts revealed a significant difference at all time points (p < 0.001), with adapter-coupled inserts showing greater heating.
Conclusions
The use of ultrasonic inserts leads to a gradual rise in temperature on the external tooth surface. One-piece inserts generated higher temperatures on the tooth, while adapter-coupled inserts exhibited greater heating within the insert.
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Isolating design variables by assessing the impact of cross-section geometry on the mechanical performance of nickel-titanium rotary instruments: a comparative in vitro study
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Anne Rafaella Tenório Vieira, Guilherme Ferreira da Silva, Emmanuel João Nogueira Leal da Silva, Rodrigo Ricci Vivan, João Vitor Oliveira de Amorim, Thaine Oliveira Lima, Raimundo Sales de Oliveira Neto, Marco Antonio Hungaro Duarte, Murilo Priori Alcalde
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Restor Dent Endod 2025;50(3):e28. Published online July 24, 2025
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DOI: https://doi.org/10.5395/rde.2025.50.e28
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This study aimed to assess the effect of cross-section geometry on the mechanical properties of nickel-titanium (NiTi) instruments by comparing two instruments with identical tip size, taper, and thermal treatment but differing in cross-section design.
Methods
One hundred four NiTi rotary instruments, being S-shaped and triangular cross-section, manufactured with Blueish thermal treatment, were tested (n = 52 per group). Differential scanning calorimetry was employed, and the metal mass volume and cross-section area were assessed. The cyclic fatigue, torsional, and bending resistance tests were assessed. Data were analyzed using the Kolmogorov-Smirnov and Student t tests, and the level of significance was set at 5%.
Results
The instruments exhibited similar start and finish temperatures of phase transformation. The S-shaped instruments had significantly lower metal mass volume and cross-sectional area (p < 0.05). S-shaped instruments demonstrated superior cyclic fatigue resistance, greater angular deflection, and lower bending stiffness (p < 0.05).
Conclusions
Cross-section geometry significantly influences the mechanical properties of NiTi rotary instruments.
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Effect of surface treatment on glass ionomers in sandwich restorations: a systematic review and meta-analysis of laboratory studies
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Hoda S. Ismail, Ashraf Ibrahim Ali, Franklin Garcia-Godoy
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Restor Dent Endod 2025;50(2):e13. Published online April 16, 2025
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DOI: https://doi.org/10.5395/rde.2025.50.e13
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- 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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- The impact of alloy treatment on the dynamic cyclic fatigue resistance of triangular base cross-section NiTi endodontic instruments
Rashid El Abed, Amre R. Atmeh, Mohamed Jamal, Anas Al Jadaa, Hamza El-Faraj, Abdel Rahman Bani Amer, Taher Al Omari
Odontology.2025;[Epub] CrossRef
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Does minimally invasive canal preparation provide higher fracture resistance of endodontically treated teeth? A systematic review of in vitro studies
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Sıla Nur Usta, Emmanuel João Nogueira Leal Silva, Seda Falakaloğlu, Mustafa Gündoğar
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Restor Dent Endod 2023;48(4):e34. Published online October 17, 2023
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DOI: https://doi.org/10.5395/rde.2023.48.e34
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This systematic review aimed to investigate whether minimally invasive root canal preparation ensures higher fracture resistance compared to conventional root canal preparation in endodontically treated teeth (ETT). A comprehensive search strategy was conducted on the “PubMed, Web of Science, and Scopus” databases, alongside reference and hand searches, with language restrictions applied. Two independent reviews selected pertinent laboratory studies that explored the effect of minimally invasive root canal preparation on fracture resistance, in comparison to larger preparation counterparts. The quality of the studies was assessed, and the risk of bias was categorized as low, moderate, or high. The electronic search yielded a total of 1,767 articles. After applying eligibility criteria, 8 studies were included. Given the low methodological quality of these studies and the large variability of fracture resistance values, the impact of reduced apical size and/or taper on the fracture resistance of the ETT can be considered uncertain. This systematic review could not reveal sufficient evidence regarding the effect of minimally invasive preparation on increasing fracture resistance of ETT, primarily due to the inherent limitations of the studies and the moderate risk of bias.
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Citations
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- Impact of conservative versus conventional instrumentation on the release of inflammatory mediators and post‐operative pain in mandibular molars with asymptomatic irreversible pulpitis: A randomized clinical trial
Sıla Nur Usta, Ana Arias, Emre Avcı, Emmanuel João Nogueira Leal Silva
International Endodontic Journal.2025; 58(6): 862. CrossRef - Mapping risk of bias criteria in systematic reviews of in vitro endodontic studies: an umbrella review
Rafaella Rodrigues da Gama, Lucas Peixoto de Araújo, Evandro Piva, Leandro Perello Duro, Adriana Fernandes da Silva, Wellington Luiz de Oliveira da Rosa
Evidence-Based Dentistry.2025;[Epub] CrossRef - Micro‐computed tomography evaluation of minimally invasive root canal preparation in 3D‐printed C‐shaped canal
Nutcha Supavititpattana, Siriwan Suebnukarn, Panupat Phumpatrakom, Kamon Budsaba
Australian Endodontic Journal.2024; 50(3): 621. CrossRef - Ex vivo investigation on the effect of minimally invasive endodontic treatment on vertical root fracture resistance and crack formation
Andreas Rathke, Henry Frehse, Maria Bechtold
Scientific Reports.2024;[Epub] CrossRef
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3,694
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Effect of endodontic sealer on postoperative pain: a network meta-analysis
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Cynthia Maria Chaves Monteiro, Ana Cristina Rodrigues Martins, Alessandra Reis, Juliana Larocca de Geus
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Restor Dent Endod 2023;48(1):e5. Published online December 29, 2022
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DOI: https://doi.org/10.5395/rde.2023.48.e5
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This systematic review and network meta-analysis aimed to answer the following focused research question: “Does the type of endodontic sealer affect the postoperative pain in patients who received endodontic treatment?” Different databases and grey literature were surveyed. Only one randomized controlled trial were included. The risk of bias in the studies was evaluated by using the Cochrane Collaboration’s tool. A random-effects meta-analysis was conducted to compare the risk and intensity of postoperative pain. The quality of the body of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation approach. Out of 11,601 studies, 15 remained for qualitative analyses and 12 for meta-analysis. Seven studies were classified at high risk of bias, and 8 studies raised some concerns. No significant differences between the endodontic materials were observed in the direct comparisons, both in risk and in intensity of postoperative pain (pairwise comparisons with 2 studies: I2 = 0%; p > 0.05 and 8 studies: I2 = 23%; p > 0.05, respectively). The certainty of the evidence was graded as low or moderate. There was no difference in the risk and intensity of postoperative pain after filling with different endodontic sealers. Further systematic reviews should be conducted.
Trial RegistrationPROSPERO Identifier: CRD42020215314
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- Effect of occlusal reduction on post-operative pain of symptomatic and asymptomatic molar teeth
Aysenur Kamacı Esen, Fatma Furuncuoğlu, Fatima Betul Basturk, Muhammet Nuri Taşcıoğlu, Masoud Parirokh
Acta Odontologica Scandinavica.2025; 84: 371. CrossRef - An Observational Study on Pain Occurrence After Root Canal Treatment: Role of Operator Experience When Using a Bioceramic Sealer
Mihai Merfea, Ioana Sofia Pop-Ciutrila, Mindra Eugenia Badea, Ada Gabriela Delean, Oana Cimponeriu, Razvan Corneliu Pop, Maria Peter, Iulia Clara Badea, Sanda Ileana Cimpean
Journal of Clinical Medicine.2025; 14(13): 4558. CrossRef - Assessment of Postoperative Pain After Single‐ or Multiple‐Visit Endodontic Therapy and Its Molecular Aspects: A Randomised Controlled Study
Larissa Nunes Rosa Bedene, Denise Piotto Leonardi, Joana Santana Couto, Bruno Marques‐da‐Silva, Marilisa Carneiro Leão Gabardo, João Arnando Brancher, Flávia Sens Fagundes Tomazinho
Australian Endodontic Journal.2025;[Epub] CrossRef - Clinical and Radiographic Outcomes of Root Canal Obturation with Hydraulic Condensation and Tricalcium Silicate Bioceramic Sealer: A 12-Month Observational Study on Periapical Healing
Kostadin Zhekov, Vesela Stefanova
Journal of Functional Biomaterials.2025; 16(11): 412. CrossRef - Comparative evaluation of postoperative pain and periapical healing after root canal treatment using three different endodontic sealers: A randomized controlled clinical trial
Ruchika Pandey, Nitin Kararia, Deepak Kumar Sharma, Vishal Rathod, Anand Vilas Bansod, Dhaval Desai
Journal of Conservative Dentistry and Endodontics.2024; 27(9): 962. CrossRef - Effect of bioceramic-based and resin-based sealers on postoperative discomfort following root canal therapy: a systematic review and meta-analysis
Mansi Supare, Ajinkya M. Pawar, Kashmira Sawant, Dian Agustin Wahjuningrum, Suraj Arora, Firas Elmsmari, Mohmed Isaqali Karobari, Bhagyashree Thakur
PeerJ.2024; 12: e18198. CrossRef - Comparative Evaluation of Incidences of Post Operative Pain in Patient Treated in Single Visit Root Canal Treatment by Using Different Sealers: - An in-Vivo Study
Sadashiv Daokar, Aishwarya Ranjalkar, Kalpana Pawar, Komal Potfode, Dhanashri Padwal, Sana Khan
International Journal of Innovative Science and Research Technology (IJISRT).2024; : 2743. CrossRef
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Case Report
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An unusual case of dens invaginatus on a mandibular second molar: a case report
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Davide Mancino, Dina Abdellatif, Alfredo Iandolo, Fabien Bornert, Youssef Haïkel
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Restor Dent Endod 2025;50(1):e2. Published online January 8, 2025
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DOI: https://doi.org/10.5395/rde.2025.50.e2
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- 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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Citations
Citations to this article as recorded by

- Type IIIb dens invaginatus in a maxillary second molar and its microscopic anatomical features: a case report
Mingming Li, Zhiwu Wu, Shaoying Duan, Yuling Zuo
BMC Oral Health.2025;[Epub] CrossRef
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Review Article
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Disinfectant effectiveness of chlorhexidine gel compared to sodium hypochlorite: a systematic review with meta-analysis
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Theodoro Weissheimer, Karem Paula Pinto, Emmanuel João Nogueira Leal da Silva, Lina Naomi Hashizume, Ricardo Abreu da Rosa, Marcus Vinicius Reis Só
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Restor Dent Endod 2023;48(4):e37. Published online October 26, 2023
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DOI: https://doi.org/10.5395/rde.2023.48.e37
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Abstract
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Supplementary Material
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This study aimed to compare the disinfectant ability of chlorhexidine (CHX) gel and sodium hypochlorite (NaOCl). Systematic searches were conducted from inception until December 8th, 2022 (MEDLINE/PubMed, Cochrane Library, Web of Science, Scopus, Embase, and Grey Literature databases). Only randomized clinical trials were included. The revised Cochrane risk of bias tools for randomized trials were used to assess the quality of studies. Meta-analyses were performed. The overall quality of evidence was assessed through the Grading of Recommendations Assessment, Development, and Evaluation tool. Six studies were included. Five had a low risk of bias and 1 had some concerns. Three studies assessed bacterial reduction. Two were included in the meta-analysis for bacterial reduction (mean difference, 75.03 [confidence interval, CI, −271.15, 421.22], p = 0.67; I2 = 74%); and 3 in the meta-analysis for cultivable bacteria after chemomechanical preparation (odds ratio, 1.03 [CI, 0.20, 5.31], P = 0.98; I2 = 49%). Five studies assessed endotoxin reduction. Three were included in a meta-analysis (mean difference, 20.59 [CI, −36.41, 77.59], p = 0.48; I2 = 74%). There seems to be no difference in the disinfectant ability of CHX gel and NaOCl, but further research is necessary.
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Citations
Citations to this article as recorded by

- Bactericidal Effects of Ultraviolet-C Light-Emitting Diode Prototype Device Through Thin Optical Fiber
Mi-Jeong Jeon, Yu-Sung Choi, Deog-Gyu Seo
Applied Sciences.2025; 15(8): 4504. CrossRef - Effectiveness of Irrigation Protocols in Endodontic Therapy: An Umbrella Review
Manuel J. Orozco-Gallego, Eliana L. Pineda-Vélez, Wilder J. Rojas-Gutiérrez, Martha L. Rincón-Rodríguez, Andrés A. Agudelo-Suárez
Dentistry Journal.2025; 13(6): 273. CrossRef - In Vitro Evaluation of Disinfectants on Gutta-Percha Cones: Antimicrobial Efficacy Against Enterococcus faecalis and Candida albicans
Tringa Kelmendi, Donika Bajrami Shabani, Aida Meto, Hani Ounsi
Journal of Clinical Medicine.2025; 14(19): 6846. CrossRef - Preparing porcine lens to mimic human lens capsule
Yajing Pei, Shaofeng Han, Mingfeng Lu, Yang Yang, Ke Ma
Journal of Cataract & Refractive Surgery.2024; 50(9): 963. CrossRef - Comparative Evaluation of Disinfection Protocols for Dental Impressions in Prosthodontics
Subhash Sonkesriya, Ghanshyam Gaur, Akanksha Maheshwari, Arun Kumar Ashahiya, Simran Kaur Aulakh, Amit Kumar, Bhumika Kamal Badiyani
Cureus.2024;[Epub] CrossRef
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5,106
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Research Articles
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The clinical success of ART restorations and Hall technique in primary molars: a randomized 18-month follow-up study
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Esra Oz, Zuhal Kırzıoglu, Canan Kale
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Restor Dent Endod 2023;48(2):e19. Published online May 1, 2023
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DOI: https://doi.org/10.5395/rde.2023.48.e19
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- Objectives
The aim of the study was to evaluate the clinical and radiographic success of the Hall technique (HT) and atraumatic restorative treatment (ART) restorations using high-viscosity glass-ionomer cement for the management of occlusal carious lesions in primary molars.
Materials and MethodsThis randomized clinical study observed 40 children (aged 5–6 years). For each child, one tooth was treated with HT and one with ART. The primary outcome measures for HT restorations were successful, minor, and major failure rates. Clinical evaluations of ART restorations were performed according to the modified United States Public Health Service criteria during 18-month follow-up. McNemar test was used for statistical analysis.
ResultsThirty of 40 (75%) participants returned for 18 months of follow-up. In the clinical evaluations of teeth that were treated with HT, the patients did not have complaints of pain or other symptoms, all crowns remained in the oral cavity, the gums were healthy, and the teeth were functional in all evaluations. At the end of the 18-month follow-up, the surface texture and marginal integrity criteria of ART restorations were recorded as 26.7% and 33.3%, respectively. In the radiographic evaluation of 30 patients treated with ART and HT, all restorations were considered successful.
ConclusionsThe 18-month clinical and radiographic results after treatments applied to single-surface cavities in anxious children showed that both treatment methods were successful.
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Citations
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- Success rate of Hall Technique for restoring carious primary molars - systematic review and meta-analysis
Tamara Kerber Tedesco, Nicola Patricia Innes, Claudia Lopez Gallegos, Gabriela Seabra Silva, Thais Gimenez, Mariana Minatel Braga, Mariana Pinheiro Araujo, Jayakumar Jayaraman, Waraf Al-yaseen, Daniela Prócida Raggio
Evidence-Based Dentistry.2025; 26(1): 65. CrossRef - Effectiveness of Dental Restorative Materials in the Atraumatic Treatment of Carious Primary Teeth in Pediatric Dentistry: A Systematic Review
Gianna Dipalma, Angelo Michele Inchingolo, Lucia Casamassima, Paola Nardelli, Danilo Ciccarese, Paolo De Sena, Francesco Inchingolo, Andrea Palermo, Marco Severino, Cinzia Maria Norma Maspero, Alessio Danilo Inchingolo
Children.2025; 12(4): 511. CrossRef - Clinical, radiographic, and microhardness evaluation of caries in primary molars managed with modified Hall technique
Eman El Sayed El Bedewy, Nahed A.A. Abohamila, Shereen A. M. Ali, Shimaa M.M. Hadwa
Tanta Dental Journal.2025; 22(1): 133. CrossRef - Pain Perception During Minimally Invasive Caries Removal in Children: A Randomized Clinical Trial Comparing Chemo-Mechanical Caries Removal
Dhirja Goel, Neha Awasthi, Yanina Singh, Sukhdeep Singh, Nenung Yirang
Journal of International Society of Preventive and Community Dentistry.2025; 15(4): 348. CrossRef - Clinical and histological evaluation of hall technique with and without silver diamine fluoride in the treatment of carious primary molars
Marwa M.A.Z. Abd-Elhaleium, Fatma A.-A. El-Hendawy, Lamis A. El-Ghareb, Sara Y. AboAli
Tanta Dental Journal.2025; 22(2): 351. CrossRef - Comparative success of minimally invasive treatments for cavitated caries in primary teeth: a network meta-analysis
Rasoul Sahebalam, Mahsa Ghorbani, Alireza Sarraf Shirazi, Motahareh Khosrojerdi, Mana Mowji
BMC Oral Health.2025;[Epub] 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
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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
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Restor Dent Endod 2025;50(2):e16. Published online May 12, 2025
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DOI: https://doi.org/10.5395/rde.2025.50.e16
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- 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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Evaluation of the effects of different file systems and apical functions of integrated endodontic motors on debris extrusion: an ex vivo experimental study
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Sıla Nur Usta, Antonio Magan-Fernandez, Cumhur Aydın
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Restor Dent Endod 2025;50(2):e14. Published online April 14, 2025
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DOI: https://doi.org/10.5395/rde.2025.50.e14
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- 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.
Case Reports
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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
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Eun-Sook Kang, Min-Kyeong Kim, Mi-Kyung Yu, Kyung-San Min
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Restor Dent Endod 2025;50(2):e12. Published online April 8, 2025
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DOI: https://doi.org/10.5395/rde.2025.50.e12
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- 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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Guided endodontics, precision and predictability: a case series of mineralized anterior teeth with follow-up cone-beam computed tomography
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Rafael Fernández-Grisales, Wilder Javier Rojas-Gutierrez, Pamela Mejía, Carolina Berruecos-Orozco, Néstor Ríos-Osorio
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Restor Dent Endod 2025;50(1):e4. Published online January 6, 2025
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DOI: https://doi.org/10.5395/rde.2025.50.e4
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- 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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A 48-month clinical performance of hybrid ceramic fragment restorations manufactured in CAD/CAM in non-carious cervical lesions: case report
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Michael Willian Favoreto, Gabriel David Cochinski, Eveline Claudia Martini, Thalita de Paris Matos, Matheus Coelho Bandeca, Alessandro Dourado Loguercio
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Restor Dent Endod 2024;49(3):e32. Published online August 5, 2024
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DOI: https://doi.org/10.5395/rde.2024.49.e32
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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.
Research Article
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Single-session associative protocol for dentin hypersensitivity management: a 1-year randomized, blinded clinical study
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Thayna Carolina Zeni, Poliana Maria de Faveri Cardoso, Rafael da Silva Vanolli, Márcio José Mendonça, Julio Katuhide Ueda, Veridiana Camilotti
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Restor Dent Endod 2024;49(2):e15. Published online March 20, 2024
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DOI: https://doi.org/10.5395/rde.2024.49.e15
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- Objectives
This study aimed to establish a single-session associative protocol for non-restorative management of dentin hypersensitivity (DH).
Materials and MethodsTwenty-four individuals with DH and a minimum sensitivity level of 4 on the visual analog scale (VAS) were selected. The study was conducted in a split-mouth design, with each participant (n = 20) having at least 1 affected tooth in all quadrants. The management protocols consisted of control group: universal adhesive, Neural Desensitizing Protocol group: 5% potassium nitrate, Mixed Desensitizing Protocol (PAM) group: 5% sodium fluoride and 5% potassium nitrate, Remineralizing Desensitizing Protocol (PDR) group: surface-partially reacted glass technology photopolymerizable varnish. Evaluations were performed immediately after application, at 1 week, 1 month, 2 months, and 12 months using the VAS sensitivity test.
ResultsThe scores were subjected to statistical analysis using the Friedman test (p < 0.05), Durbin-Conover test (p < 0.05), and Wilcoxon test (p < 0.05). At the 12-month evaluation, all groups showed statistically significant differences compared to the initial assessment. For the evaluation after 12 months, there was a statistically significant difference between the PAM group, the control group, and the PDR group.
ConclusionsIt can be concluded that all groups were effective in controlling DH, but there were significant results in the control group and PDR group. The clinical relevance of this study is to demonstrate that the application of single-session desensitizing protocols can be effective in controlling DH for up to 12 months.
Trial RegistrationBrazilian Clinical Trials Registry Identifier: RBR-4r63d7s
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Citations
Citations to this article as recorded by

- In vivo and in situ evaluation of innovative approaches in dentin hypersensitivity treatment
Heba Abd El-Fattah Mohamed, Dina Ezzeldin Mohamed, Elhassan Hassanein, Heba El-din Salah El-din Hamza
BMC Oral Health.2025;[Epub] CrossRef - Publication trends and scientific profile of clinical trials on universal adhesives in dentistry: A metrics-based review
Aurélio de Oliveira Rocha, Lucas Menezes dos Anjos, Michael Willian Favoreto, Michely Cristina Goebel, Bruno Henriques, Alessandra Reis, Alessandro D. Loguercio, Mariane Cardoso
Journal of Dentistry.2025; 161: 105965. CrossRef - EVALUATION OF PUSH-OUT BOND STRENGTH OF GLASS FIBER POSTS USING DIFFERENT LUTING CEMENTS
Jannah Mohammed, Maha Agha
BULLETIN OF STOMATOLOGY AND MAXILLOFACIAL SURGERY.2025; : 274. CrossRef - EVALUATION OF PUSH-OUT BOND STRENGTH OF GLASS FIBER POSTS USING DIFFERENT LUTING CEMENTS
Jannah Mohammed, Jannah Mohammed
BULLETIN OF STOMATOLOGY AND MAXILLOFACIAL SURGERY.2025; : 274. CrossRef - CLINICAL AND BEHAVIORAL DETERMINANTS OF DENTIN SENSITIVITY AMONG DENTAL STUDENTS: AN INSTITUTIONAL CROSS-SECTIONAL STUDY
Giuseppe Eliseo ALLOCCA, Alexandrina MUNTEAN , Cristian Doru OLTEANU , Sorana Maria BUCUR
Medicine and Materials.2025; 5(2): 73. CrossRef - Desensitizing efficacy of a universal dentin adhesive containing mesoporous bioactive glass on dentin hypersensitivity: a randomized clinical trial with a split-mouth model
Hyun-Jung Kim, Soram Oh, Jiyoung Kwon, Kyoung-Kyu Choi, Ji-Hyun Jang, Duck-Su Kim
Scientific Reports.2024;[Epub] CrossRef
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Case Report
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Garre’s osteomyelitis of the mandible managed by nonsurgical re-endodontic treatment
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Heegyun Kim, Jiyoung Kwon, Hyun-Jung Kim, Soram Oh, Duck-Su Kim, Ji-Hyun Jang
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Restor Dent Endod 2024;49(2):e13. Published online March 18, 2024
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DOI: https://doi.org/10.5395/rde.2024.49.e13
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Chronic osteomyelitis with proliferative periostitis, known as Garre’s osteomyelitis, is a type of osteomyelitis characterized by a distinctive gross thickening of the periosteum of bones. Peripheral reactive bone formation can be caused by mild irritation or infection. Garre’s osteomyelitis is usually diagnosed in children and young adults, and the mandible is more affected than the maxilla. The following is a case report of a 12-year-old female patient with Garre’s osteomyelitis of the mandible due to an infection of a root canal-treated tooth. Without surgical intervention, the patient’s symptoms were relieved through nonsurgical root canal re-treatment with long-term calcium hydroxide placement. A cone-beam computed tomography image obtained 6 months after treatment completion displayed complete healing of the periapical lesion and resolution of the peripheral reactive buccal bone. Due to the clinical features of Garre's osteomyelitis, which is characterized by thickening of the periosteum, it can be mistaken for other diseases such as fibrous dysplasia. It is important to correctly diagnose Garre's osteomyelitis based on its distinctive clinical features to avoid unnecessary surgical intervention, and it can lead to minimally invasive treatment options.
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- Focal osteomyelitis with proliferative periostitis
Zarah Yakoob
South African Dental Journal.2025; 79(09): 508. CrossRef
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Research Articles
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Success rates comparison of endodontic microsurgery and single implants with comprehensive and explicit criteria: a systematic review and meta-analysis
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Min Jung Ko, Ju Hyun Park, Na Rae Lee, Joon-Ho Yoon, Young-Taek Kim, Sin-Yeon Cho
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Restor Dent Endod 2025;50(1):e8. Published online February 19, 2025
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DOI: https://doi.org/10.5395/rde.2025.50.e8
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Supplementary Material
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- 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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Citations
Citations to this article as recorded by

- Surgical Management of a Separated Instrument and Radicular Cyst: A Nine-Month Cone Beam Computed Tomography (CBCT) Follow-up
Dipti Chauhan, Hemant Yadav, Anshu Minocha, Vishal Sharma
Cureus.2025;[Epub] CrossRef
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7,288
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Effect of quality of radiographs taken during root canal treatment on technical quality of root canal fillings and endodontic outcome
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Jia Min Ng, Yan Yee Lee, Prashanti Chippagiri, Elaheh Ahanin, Abhishek Parolia
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Restor Dent Endod 2025;50(1):e3. Published online January 7, 2025
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DOI: https://doi.org/10.5395/rde.2025.50.e3
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Abstract
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- 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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Citations
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- Assessment of radiographic errors and repetition rates in undergraduate endodontic education: a retrospective clinical study
Marwa Ameen, Abdul Rahman Saleh, Dunia Alhadi, Manal Almaslamani
The Saudi Dental Journal.2025;[Epub] CrossRef - Application of Periapical Radiography in Root Canal Treatment: A Literature Review
Jennifer Lois Violita Malau, Keizha Allysia Nabila, Widiani Harrista, Regina Amara Ginting, Tassa Kusuma Arya Putri, Jatu Rachel Keshena
Acta Odontologica Indonesia.2025; 1(2): 49. CrossRef
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Review Article
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Influence of disinfecting solutions on the surface topography of gutta-percha cones: a systematic review of in vitro studies
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Lora Mishra, Gathani Dash, Naomi Ranjan Singh, Manoj Kumar, Saurav Panda, Franck Diemer, Monika Lukomska-Szymanska, Barbara Lapinska, Abdul Samad Khan
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Restor Dent Endod 2024;49(4):e42. Published online November 1, 2024
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DOI: https://doi.org/10.5395/rde.2024.49.e42
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Abstract
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Supplementary Material
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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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Citations
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- In Vitro Evaluation of Disinfectants on Gutta-Percha Cones: Antimicrobial Efficacy Against Enterococcus faecalis and Candida albicans
Tringa Kelmendi, Donika Bajrami Shabani, Aida Meto, Hani Ounsi
Journal of Clinical Medicine.2025; 14(19): 6846. CrossRef
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Research Articles
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Nanoleakage of apical sealing using a calcium silicate-based sealer according to canal drying methods
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Yoon-Joo Lee, Kyung-Mo Cho, Se-Hee Park, Yoon Lee, Jin-Woo Kim
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Restor Dent Endod 2024;49(2):e20. Published online April 19, 2024
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DOI: https://doi.org/10.5395/rde.2024.49.e20
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This study investigated the nanoleakage of root canal obturations using calcium silicate-based sealer according to different drying methods.
Materials and MethodsFifty-two extracted mandibular premolars with a single root canal and straight root were selected for this study. After canal preparation with a nickel-titanium rotary file system, the specimens were randomly divided into 4 groups according to canal drying methods (1: complete drying, 2: blot drying/distilled water, 3: blot drying/NaOCl, 4: aspiration only). The root canals were obturated using a single-cone filling technique with a calcium silicate–based sealer. Nanoleakage was evaluated using a nanoflow device after 24 hours, 1 week, and 1 month. Data were collected twice per second at the nanoscale and measured in nanoliters per second. Data were statistically analyzed using the Kruskal-Wallis and Mann–Whitney U-tests (p < 0.05).
ResultsThe mean flow rate measured after 24 hours showed the highest value among the time periods in all groups. However, the difference in the flow rate between 1 week and 1 month was not significant. The mean flow rate of the complete drying group was the highest at all time points. After 1 month, the mean flow rate in the blot drying group and the aspiration group was not significantly different.
ConclusionsWithin the limitations of this study, the canal drying method had a significant effect on leakage and sealing ability in root canal obturations using a calcium silicate-based sealer. Thus, a proper drying procedure is critical in endodontic treatment.
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Effects of a relined fiberglass post with conventional and self-adhesive resin cement
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Wilton Lima dos Santos Junior, Marina Rodrigues Santi, Rodrigo Barros Esteves Lins, Luís Roberto Marcondes Martins
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Restor Dent Endod 2024;49(2):e18. Published online March 27, 2024
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DOI: https://doi.org/10.5395/rde.2024.49.e18
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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 MethodsTwo 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).
ResultsFor 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.
ConclusionsMechanical 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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Prevalence of apical periodontitis and quality of root canal treatment in an adult Kuwaiti sub-population: a cross-sectional study
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Abdulrahman A. Alhailaa, Saad A Al-Nazhan, Mazen A Aldosimani
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Restor Dent Endod 2024;49(2):e16. Published online March 22, 2024
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DOI: https://doi.org/10.5395/rde.2024.49.e16
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This cross-sectional study evaluated the prevalence of apical periodontitis (AP) and the technical quality of root canal fillings in an adult Kuwaiti subpopulation using cone-beam computed tomography (CBCT) images.
Materials and MethodsTwo experienced examiners analyzed 250 CBCT images obtained from Kuwaiti patients aged 15–65 years who attended government dental specialist clinics between January 2019 and September 2020. The assessment followed the radiographic scoring criteria proposed by De Moor for periapical status and the technical quality of root canal filling. Chi-square and Fisher’s exact tests were used for statistical analysis, with significance level set at p < 0.05.
ResultsAmong the 2,762 examined teeth, 191 (6.91%) exhibited radiographic signs of AP, and 176 (6.37%) had undergone root canal filling. AP prevalence in root canal-treated teeth was 32.38%, with a significant difference between males and females. Most of the endodontically treated teeth exhibited adequate root canal filling (71.5%).
ConclusionsThe study demonstrated a comparable prevalence of AP and satisfactory execution of root canal treatment compared to similar studies in different countries.
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- A Retrospective Study of CBCT-Based Detection of Endodontic Failures and Periapical Lesions in a Romanian Cohort
Oana Andreea Diaconu, Lelia Mihaela Gheorghiță, Anca Gabriela Gheorghe, Mihaela Jana Țuculină, Maria Cristina Munteanu, Cătălina Alexandra Iacov, Virginia Maria Rădulescu, Mihaela Ionescu, Adina Andreea Mirea, Carina Alexandra Bănică
Journal of Clinical Medicine.2025; 14(18): 6364. CrossRef
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Analysis of temperature change during polymerization according to resin thickness: an in vitro experimental study
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Kkot-Byeol Bae, Eun-Young Noh, Young-Tae Cho, Bin-Na Lee, Hoon-Sang Chang, Yun-Chan Hwang, Won-Mann Oh, In-Nam Hwang
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Restor Dent Endod 2025;50(4):e34. Published online November 12, 2025
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DOI: https://doi.org/10.5395/rde.2025.50.e34
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This study aimed to analyze the temperature changes during the light curing of conventional flowable composite resin and bulk-fill composite resin of various thicknesses using an infrared thermographic camera.
Methods
Flowable composite resin (G-aenial Flo, GC Co.) and bulk-fill composite resin (SDR, Dentsply Caulk) were used. Specimens with thicknesses from 0.5 mm to 5.0 mm were prepared. The infrared thermographic camera measured the temperature changes at the maximum temperature rise point during light curing. The data were analyzed for maximum temperature, time to peak temperature, and temperature rise patterns.
Results
For G-aenial Flo, the maximum temperature tended to decrease with increasing thickness, whereas for SDR, the maximum temperature decreased up to 2.0 mm and then remained relatively consistent from 2.0 mm to 5.0 mm. At thicknesses of 1.5 mm or less, both resins showed a rapid temperature increase within the first 5 seconds, followed by a reduced rate of increase up to 80 seconds. At thicknesses of 2.0 mm or greater, the temperature peaked and then gradually decreased. Across all thicknesses, SDR was observed to reach peak temperature more rapidly than G-aenial Flo.
Conclusions
Observable differences in polymerization dynamics were identified between the two resin types, particularly at greater thicknesses. Although no statistical analysis was performed, these descriptive findings suggest that infrared thermographic cameras may be useful for indirectly assessing polymerization dynamics during resin polymerization.
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Structural and morphological characterization of silver nanoparticles intruded mineral trioxide aggregate admixture as a chair-side restorative medicament: an in vitro experimental study
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H. Murali Rao, Rajkumar Krishnan, Chitra Shivalingam, Ramya Ramadoss
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Restor Dent Endod 2025;50(3):e30. Published online August 8, 2025
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DOI: https://doi.org/10.5395/rde.2025.50.e30
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The aim of this study was to create a rapid admixture of mineral trioxide aggregate (MTA) and silver nanoparticles (AgNPs) for chairside use in clinical settings to remediate the challenges associated with root canal treatment and pulp capping.
Methods
Synthesized AgNPs at ratios of 10 and 25% were added to commercially available MTA to create an admixture. The admixture was subjected to structural and morphological assessment using X-ray diffraction analysis (XRD), Fourier transform infrared (FT-IR) analysis, Raman spectroscopy, and scanning electron microscopy. Antioxidant activity was measured using the hydroxyl radical scavenging assay. A significance level of 0.05 was applied to determine statistical differences.
Results
The addition of AgNPs decreased the carbonate peak intensity in XRD and FT-IR. The rod-like morphology of MTA was changed to a flake-like morphology with the addition of AgNPs. Antibacterial efficacy enhanced proportionally with the augmentation of AgNPs concentration.
Conclusions
The creation of rapid admixture of MTA and AgNPs during chairside use in clinical settings can deliver beneficial characteristics of enhanced morphological features favoring mineralization and profound antibacterial effects to overcome the challenges associated with root canal treatment and pulp capping.
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Stress distribution of restorations in external cervical root resorption under occlusal and traumatic loads: a finite element analysis
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Padmapriya Ramanujam, Paul Kevin Abishek Karthikeyan, Vignesh Srinivasan, Selvakarthikeyan Ulaganathan, Velmurugan Natanasabapathy, Nandini Suresh
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Restor Dent Endod 2025;50(2):e21. Published online May 21, 2025
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DOI: https://doi.org/10.5395/rde.2025.50.e21
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This study analyzed the stress distribution in a maxillary central incisor with external cervical resorptive defect restored with different restorative materials under normal masticatory and traumatic loading conditions using finite element analysis.
Methods
Cone-beam computed tomography of an extracted intact incisor and created resorptive models (Patel’s 3D classification-2Bd and 2Bp) in the maxillary central incisor was performed for finite element models. The 2Bd models were restored either with glass ionomer cement (GIC)/Biodentine (Septodont) or a combination of both with composite resin. 2Bp models were restored externally with a combination technique and internally with root canal treatment. The other model was external restoration with GIC and internal with fiber post. Two masticatory loads were applied at 45˚ to the palatal aspect, and two traumatic loads were applied at 90˚ to the buccal aspect. Maximum von Mises stresses were calculated, and stress distribution patterns were studied.
Results
In 2Bd models, all restorative strategies decreased stress considerably, similar to the control model under all loads. In 2Bp models, the dentin component showed maximum stress at the deepest portion of the resorptive defect, which transfers into the adjacent pulp space. In 2Bp defects, a multilayered restoration externally and root canal treatment internally provides better stress distribution compared to the placement of a fiber post.
Conclusions
Increase in load, proportionally increased von Mises stress, despite the direction or angulation of the load. Multilayered restoration is preferred for 2Bd defects, and using an internal approach of root canal treatment is suggested to restore 2Bp defects.
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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
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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
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Restor Dent Endod 2025;50(2):e20. Published online May 21, 2025
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DOI: https://doi.org/10.5395/rde.2025.50.e20
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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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Comparison of YouTube, TikTok, and Instagram as digital sources for obtaining information about pulp therapy in primary and permanent teeth
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Hüseyin Gürkan Güneç, Emine Kaya, Dila Nur Okumuş, Merve Gül Erence
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Restor Dent Endod 2025;50(3):e26. Published online July 24, 2025
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DOI: https://doi.org/10.5395/rde.2025.50.e26
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This study aimed to compare the content, educational quality, and dependability of videos on Instagram, TikTok, and YouTube about pulp therapy (PT) in pediatric dentistry and endodontics.
Methods
Three popular video sites, Instagram (Meta Platforms, Inc.,), TikTok (ByteDance Ltd.), and YouTube (Google LLC), were searched for PT content to analyze for compliance with the American Association of Endodontists and American Academy of Pediatric Dentistry guidelines for clinical endodontists and pediatric dentists. The searched hashtags were #pulpaltherapy, #pulpaltreatment, #pulptherapy, and #pulptreatment. The classification of 158 English-language videos was based on several variables: communication quality, duration, likes and dislikes, views, source, treatment, and genre. The videos were evaluated using a usefulness score and the Global Quality Scale (GQS), Video Information and Quality Index (VIQI), Journal of the American Medical Association (JAMA) score, and modified DISCERN score to rate their quality and reliability. The majority of the videos were published by healthcare professionals, dental clinics, and universities.
Results
Significant relationships existed between video length, source of upload, usefulness score, tooth type, pulp status, and VIQI, JAMA, GQS, and DISCERN scores for all three platforms (p<0 .05). A statistically significant relationship existed of YouTube, TikTok, and Instagram with the number of views, number of months since upload, view rates, comments and likes (p< 0.05).
Conclusions
TikTok and Instagram reel videos provided high- to moderate-quality information about PT, especially in children, but YouTube may provide more reliable information than other social media tools.
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- New Technologies and Materials in Oral Health and Dental Care of Pediatric Dentistry
Giuseppe Minervini
Children.2025; 12(10): 1310. CrossRef
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Phase transformation temperatures influence the reduction ratio of fatigue resistance of nickel-titanium reciprocating files at body temperature: an in vitro experimental study
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Walid Nehme, Alfred Naaman, Lola Pedèches, Sylvie Lê, Marie Georgelin-Gurgel, Sang Won Kwak, Hyeon-Cheol Kim, Franck Diemer
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Restor Dent Endod 2025;50(4):e35. Published online November 5, 2025
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DOI: https://doi.org/10.5395/rde.2025.50.e35
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The objective of this study was to evaluate the effects of transformational temperatures on the cyclic fatigue resistance at body temperature of reciprocating file systems: R motion (RM), Procodile Q (PQ), and Reciproc Blue.
Methods
Resistance test was done in a custom-made device at room (20°C ± 1°C) and body (37°C ± 1°C) temperatures within a 60° angle of curvature and 5 mm radius of the artificial canal. The time to fracture (TTF) was recorded. The scanning electron microscope observation and differential scanning calorimetry analyses were performed. Two-way analysis of variance and Tukey post-hoc comparison were applied at a significance level of 0.05.
Results
The results showed a significant influence of temperature on instrumental breakage, regardless of the file systems (p < 0.05). The TTF is significantly decreased at body temperature (p < 0.05). PQ showed the longest TTF in both temperature conditions (p < 0.05). RM demonstrated a significantly higher TTF reduction ratio compared to the other files (p < 0.05).
Conclusions
Within the limitations of this study, the heat-treated files with reciprocating kinetics may have different reduction ratios of the fatigue resistance of the file systems under different temperature conditions. This characteristic is an important point of consideration when clinicians select the file system to reduce potential file fracture.
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Physical-mechanical, chemical and biological properties of graphene-reinforced glass ionomer cements
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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
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Restor Dent Endod 2024;49(4):e37. Published online October 10, 2024
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DOI: https://doi.org/10.5395/rde.2024.49.e37
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This study aimed to evaluate the physical-mechanical, chemical, and biological properties of graphene-reinforced glass ionomer cements (GICs).
Materials and MethodsDifferent proportions of graphene powder were incorporated into 2 high-viscosity self-curing GIC, Ketac Molar (GKetac) and Fuji IX (GFuji), 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).
ResultsThe GKetac 0% and GFuji0% 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, GKetac 5%, 2%, and 1% presented higher releasing than 0% and 0.5% (p ≤ 0.05).
ConclusionsThe 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.