• Imaging Science in Dentistry
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• v.53 no.1
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• pp.77-82
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• 2023

Purpose: This study evaluated anatomical variations in the root canals of the lower premolars and molars in a Brazilian sub-population using cone-beam computed tomography (CBCT). Materials and Methods: In total, 121 CBCT images of patients were selected from a database. All images contained lower first and second premolars and molars on both sides of the arch, fully developed roots, and no treatment, resorption, or calcifications. In each image, the root canals of the lower premolars and molars were evaluated according to the Vertucci classification in On-Demand 3D software in the multiplanar reconstruction with dynamic navigation. Twenty-five percent of the images were re-assessed to analyze intraobserver confidence with the kappa test. Data were statistically evaluated with linear regression to evaluate the correlations of anatomic variations with age and sex, and the Wilcoxon test to analyze the laterality of variations, with a significance level of 5%. Results: The intraobserver agreement (0.94) was excellent. In general, the root canals of lower premolars and molars showed a higher prevalence of type I than other Vertucci classification types, followed by type V in premolars and type II in molars. When the molar roots were evaluated separately, type II was more frequent in mesial roots and type I in distal roots. Although age showed no correlations with the results, sex and laterality showed correlations with tooth 45 and the lower second premolars, respectively. Conclusion: The lower premolars and molars of a Brazilian sub-population showed a wide range of root canal anatomic variations.

• Restorative Dentistry and Endodontics
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• v.48 no.4
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• pp.33.1-33.12
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• 2023

Objectives: This study aimed to evaluate the bleaching efficacy and hydrogen peroxide permeability in the pulp chamber by the at-home bleaching gel in protocols applied on different dental surfaces. Materials and Methods: Forty premolars were randomly into 4 groups: control group no bleaching, only application on the buccal surface (OB), only application on the lingual surface (OL) and application in buccal and lingual surfaces, simultaneously (BL). At-home bleaching gel (White Class 7.5%) was used for the procedure. The bleaching efficacy was evaluated with a digital spectrophotometer (color change in CIELAB [ΔE_ab] and CIEDE 2000 [ΔE₀₀] systems and Whitening Index for Dentistry [ΔWI_D]). The hydrogen peroxide permeability in the pulp chamber (㎍/mL) was assessed using UV-Vis spectrophotometry and data were analyzed for a 1-way analysis of variance and Tukey's test (α = 0.05). Results: All groups submitted to bleaching procedure showed bleaching efficacy when measured with ΔE_ab and ΔE₀₀ (p > 0.05). Therefore, when analyzed by ΔWI_D, a higher bleaching efficacy were observed for the application on the groups OB and BL (p = 0.00003). Similar hydrogen peroxide permeability was found in the pulp chambers of the teeth undergoing different protocols (p > 0.05). Conclusions: The application of bleaching gel exclusively on the OB is sufficient to achieve bleaching efficacy, when compared to BL. Although the OL protocol demonstrated lower bleaching efficacy based on the ΔWI_D values, it may still be of interest and relevant in certain clinical scenarios based on individual needs, requiring clinical trials to better understand its specificities.

• Restorative Dentistry and Endodontics
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• v.44 no.3
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• pp.34.1-34.9
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• 2019

Objectives: Restorative Dentistry and Endodontics (Restor Dent Endod; RDE) is an English-language journal published by the Korean Academy of Conservative Dentistry, and it has been online since 2012 with quarterly publications. The purpose of this paper was to review and analyze the publications in this journal since its inception and over the 7-year period from 2012 to 2018. Materials and Methods: This paper assessed the number, type, and subject of articles published, as well as authorship patterns and article citations of the journal over a 7-year period. The citation indicator for the journal (h-index) was assessed using Google Scholar. Results: The number of articles per issue has remained relatively consistent in the 7 years that were analyzed. An analysis of the article types revealed various categories of review articles. Original research articles accounted for the most articles per volume. Twice as many articles per volume were on endodontic topics than on restorative subjects. Articles published in RDE have been widely cited in Synapse, Crossref, and PubMed Central. A country-wise mapping of authors' institutions revealed significant contributions from authors around the world. With an h-index of 24, RDE ranks third among journals in its specialty. The most cited articles were open lectures on statistics and research articles on recent concepts, technology, and materials. Conclusion: Over the last 7 years, RDE has served as a platform for a large number of manuscripts in the field of restorative dentistry and endodontics.

• Restorative Dentistry and Endodontics
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• v.45 no.3
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• pp.34.1-34.7
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• 2020

Objectives: This study evaluated by using micro-computed tomography (micro-CT) the filling ability and sealer apical extrusion promoted by a new Sealer Injection System (SIS; Angelus) with side openings needle, in comparison with the conventional injection system, associated with a new ready-to-use calcium silicate-based sealer (Bio-C Sealer). Materials and Methods: Acrylic resin models containing a main curved artificial canal and 3 simulated lateral canals in apical, middle and cervical thirds were used. The main root canals were prepared using a rotary system up to size 35.05. The canals were filled with Bio-C sealer by using a single cone technique and the conventional delivery system or SIS. Samples were scanned in micro-CT. The percentage of voids throughout the entire extension of the main root canal and in each third of the lateral canals, besides the apical extrusion of the sealer was calculated. Data were submitted to t-test (p < 0.05). Results: There was no difference between both systems in the main root canals filling. Although the volume percentage of voids was similar in the apical and middle thirds of lateral canals, SIS had the greatest filling ability of the cervical third lateral canal. Moreover, the conventional system showed the highest apical extrusion of the sealer. Conclusions: The conventional and SIS obturation systems had an appropriate filling ability of the main root canal. SIS had the best filling of the cervical third of the lateral canals, besides lower sealer apical extrusion, suggesting its clinical indication.

• Restorative Dentistry and Endodontics
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• v.46 no.4
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• pp.56.1-56.11
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• 2021

Objectives: This study evaluated 2 nickel-titanium rotary systems and a complementary protocol with an ultrasonic tip and a small-diameter instrument in flattened root canals. Materials and Methods: Thirty-two human maxillary second premolars with flattened canals (buccolingual diameter ≥4 times larger than the mesiodistal diameter) at 9 mm from the radiographic apex were selected. The root canals were prepared by ProDesign Logic (PDL) 30/0.01 and 30/0.05 or Hyflex EDM (HEDM) 10/0.05 and 25/0.08 (n = 16), followed by application of the Flatsonic ultrasonic tip in the cervical and middle thirds and a PDL 25/0.03 file in the apical third (FPDL). The teeth were scanned using micro-computed tomography before and after the procedures. The percentage of volume increase, debris, and uninstrumented surface area were analyzed using the Kruskal-Wallis, Dunn, Wilcoxon, analysis of variance/Tukey, and paired and unpaired t-tests (α = 0.05). Results: No significant difference was found in the volume increase and uninstrumented surface area between PDL and HEDM (p > 0.05). PDL had a higher percentage of debris than HEDM in the middle and apical thirds (p < 0.05). The FPDL protocol resulted in less debris and uninstrumented surface area for PDL and HEDM (p < 0.05). This protocol, with HEDM, reduced debris in the middle and apical thirds and uninstrumented surface area in the apical third (p < 0.05). Conclusions: High percentages of debris and uninstrumented surface area were observed after preparation of flattened root canals. The HEDM, Flatsonic tip, and 25/0.03 instrument protocol enhanced cleaning in flattened root canals.

• Restorative Dentistry and Endodontics
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• v.47 no.2
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• pp.21.1-21.11
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• 2022

Objectives: This study aimed to investigate the bonding effects of cleaning protocols on dentin impregnated with endodontic sealer residues using ethanol (E) or xylol (X). The effects of dentin acid etching immediately (I) or 7 days (P) after cleaning were also evaluated. For bonding to dentin, universal adhesive (Scotchbond Universal; 3M ESPE) was used. The persistence of sealer residues, hybrid layer formation and microshear bond strength were the performed analysis. Materials and Methods: One hundred and twenty bovine dentin specimens were allocated into 4 groups (n = 10): G1 (E+I); G2 (X+I); G3 (E+P); and G4 (X+P). The persistence of sealer residues was evaluated by SEM. Confocal laser scanning microscopy images were taken to measure the formed hybrid layer using the Image J program. For microshear bond strength, 4 resin composite cylinders were placed over the dentin after the cleaning protocols. ANOVA followed by Tukey test and Kruskal-Wallis followed by Dunn test were used for parametric and non-parametric data, respectively (α = 5%). Results: G2 and G4 groups showed a lower persistence of residues (p < 0.05) and thicker hybrid layer than the other groups (p < 0.05). No bond strength differences among all groups were observed (p > 0.05). Conclusions: Dentin cleaning using xylol, regardless of the time-point of acid etching, provided lower persistence of residues over the surface and thicker hybrid layer. However, the bond strength of the universal adhesive system in etch-and-rinse strategy was not influenced by the cleaning protocols or time-point of acid etching.

• Restorative Dentistry and Endodontics
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• v.49 no.2
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• pp.15.1-15.11
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• 2024

Objectives: This study aimed to establish a single-session associative protocol for nonrestorative management of dentin hypersensitivity (DH). Materials and Methods: Twenty-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. Results: The 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. Conclusions: It 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.

• Restorative Dentistry and Endodontics
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• v.40 no.4
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• pp.255-261
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• 2015

Objectives: The aim of this study was to evaluate the effect of three different drinks on the color parameters of four different restorative materials. Materials and Methods: Three different composites (Filtek Ultimate Universal Restorative, Filtek Ultimate Flowable, and Filtek Silorane, 3M ESPE) and a polyacid-modified composite resin material (Dyract XP, Dentsply DeTrey GmbH) were evaluated. Eighty-four disc-shaped specimens of 8 mm in diameter and 2 mm in thickness were prepared (n = 21 each). Color coordinates ($L^*a^*b^*$, ${\Delta}L^*$, ${\Delta}a^*$, ${\Delta}b^*$, and ${\Delta}E^*$) were measured using a $V{\dot{I}}TA$ Easyshade Compact ($V{\dot{I}}TA$ Zahnfabrik) after 24 hr of storage (baseline) and after 30 day of storage in three different beverages of black tea, Coca cola, or water (control) (n = 7). In each beverage, the specimens were stored three times a day, one hr each, for 30 day. The color changes (${\Delta}E$) were calculated and were analyzed by Kruskal-Wallis and Dunn multiple comparison test. Results: The color difference (${\Delta}E^*$) of the resin materials ranged between 1.31 and 15.28 after 30 day of immersion in the staining solutions. Dyract XP in Coca cola ($15.28{\pm}2.61$) and black tea ($12.22{\pm}2.73$) showed the highest mean ${\Delta}E^*$ value after 30 day, followed by Filtek Ultimate Universal Restorative ($5.99{\pm}1.25$) and Filtek Ultimate Flowable ($4.71{\pm}1.40$) in black tea (p < 0.05). Conclusions: The compomers displayed unacceptable color changes at the end of 30 day in all beverages. Among resin composites, the silorane based composite exhibited relatively good color stability than the others. Filtek Ultimate Universal Restorative and Filtek Flowable showed similar color changes in all beverages.

• Restorative Dentistry and Endodontics
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• v.43 no.2
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• pp.23.1-23.9
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• 2018

Objectives: This study evaluated the effect of ultrasonic agitation of mineral trioxide aggregate (MTA), calcium silicate-based cement (CSC), and Sealer 26 (S26) on adaptation at the cement/dentin interface and push-out bond strength. Materials and Methods: Sixty maxillary canines were divided into 6 groups (n = 10): MTA, S26, and CSC, with or without ultrasonic activation (US). After obturation, the apical portions of the teeth were sectioned, and retrograde cavities were prepared and filled with cement by hand condensation. In the US groups, the cement was activated for 60 seconds: 30 seconds in the mesio-distal direction and 30 seconds in the buccal-lingual direction, using a mini Irrisonic insert coupled with the ultrasound transducer. After the materials set, 1.5-mm thick sections were obtained from the apexes. The presence of gaps and the bond between cement and dentin were analyzed using low-vacuum scanning electron microscopy. Push-out bond strength was measured using a universal testing machine. Results: Ultrasonic agitation increased the interfacial adaptation of the cements. The S26 US group showed a higher adaptation value than MTA (p < 0.05). US improved the push-out bond strength for all the cements (p < 0.05). Conclusions: The US of retrograde filling cements enhanced the bond to the dentin wall of the root-end filling materials tested.

• Restorative Dentistry and Endodontics
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• v.44 no.3
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• pp.27.1-27.12
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• 2019

This case report describes a technique in which endodontic treatment and permanent indirect restoration were completed in the same clinical appointment with the aid of a computer-aided design/computer-aided manufacturing (CAD/CAM) system. Two patients were diagnosed with irreversible pulpitis of the mandibular first molar. After access preparation, root canals were located, irrigation was performed until bleeding ceased, and the coronal tooth structure was prepared for indirect restoration. Then, utilizing an interim 3-mm build-up of the endodontic access cavity, a hemi-arch digital scan was performed with an intraoral scanner. Subsequent to digital scanning, restoration design was performed simultaneously with the endodontic procedure. The root canals were shaped using the Race system under irrigation with 2.5% sodium hypochlorite followed by root canal filling. The pulp chamber was subsequently filled with a 3-mm-thick composite resin restoration mimicking the interim build-up previously utilized to facilitate block milling in the CAD/CAM system. Clinical try-in of the permanent onlay restoration was followed by acid etching, application of a 5th generation adhesive, and cementation of the indirect restoration. Once the restoration was cemented, rubber dam isolation was removed, followed by occlusal adjustment and polishing. After 2 years of follow-up, the restorations were esthetically and functionally satisfactory, without complications.