Fracture resistance of endodontically treated teeth restored with a bulkfill flowable material and a resin composite

Aim. To determine and compare the fracture resistance of endodontically treated teeth restored with a bulk fill flowable material (SDR) and a traditional resin composite. Methods. Thirty maxillary and 30 mandibular first molars were selected based on similar dimensions. After cleaning, shaping and filling of the root canals and adhesive procedures, specimens were assigned to 3 subgroups for each tooth type (n=10): Group A: control group, including intact teeth; Group B: access cavities were restored with a traditional resin composite (EsthetX; Dentsply-Italy, Rome, Italy); Group C: access cavities were restored with a bulk fill flowable composite (SDR; Dentsply-Italy), except 1.5 mm layer of the occlusal surface that was restored with the same resin composite as Group B. The specimens were subjected to compressive force in a material static-testing machine until fracture occurred, the maximum fracture load of the specimens was measured (N) and the type of fracture was recorded as favorable or unfavorable. Data were statistically analyzed with one-way analysis of variance (ANOVA) and Bonferroni tests (P<0.05). Results. No statistically significant differences were found among groups (P<0.05). Fracture resistance of endodontically treated teeth restored with a traditional resin composite and with a bulk fill flowable composite (SDR) was similar in both maxillary and mandibular molars and showed no significant decrease in fracture resistance compared to intact specimens. Conclusions. No significant difference was observed in the mechanical fracture resistance of endodontically treated molars restored with traditional resin composite restorations compared to bulk fill flowable composite restorations

A Multilocular Radiolucency Presenting at the Apex of a Tooth: Lessons to be Learned

An accurate diagnosis and treatment plan can increase the chances for a timely and effective treatment and better outcomes of our patients. Clinicians can use clinical and radiographic examinations to help them in their everyday practice for making a correct differential diagnosis. Traditionally, a periapical lesion that is treated by non-surgical endodontic therapy is not biopsied. As a result, no histological diagnosis is available prior to endodontic treatment. While this approach is effective in the vast majority of cases, some cases are more complex and may be deceptive, resulting in failed treatment. One such case is presented in this case report. Interdisciplinary consultation and collaboration as a team of the endodontist, radiologist, oral surgeon and histopathologist is very important to be able to make a correct diagnose, treatment plan and to give the best treatment to our patients

Fracture strength of endodontically treated teeth with different access cavity designs

INTRODUCTION: The purpose of this study was to compare in vitro the fracture strength of root-filled and restored teeth with traditional endodontic cavity (TEC), conservative endodontic cavity (CEC), or ultraconservative "ninja" endodontic cavity (NEC) access. METHODS: Extracted human intact maxillary and mandibular premolars and molars were selected and assigned to control (intact teeth), TEC, CEC, or NEC groups (n = 10/group/type). Teeth in the TEC group were prepared following the principles of traditional endodontic cavities. Minimal CECs and NECs were plotted on cone-beam computed tomographic images. Then, teeth were endodontically treated and restored. The 160 specimens were then loaded to fracture in a mechanical material testing machine (LR30 K; Lloyd Instruments Ltd, Fareham, UK). The maximum load at fracture and fracture pattern (restorable or unrestorable) were recorded. Fracture loads were compared statistically, and the data were examined with analysis of variance and the Student-Newman-Keuls test for multiple comparisons. RESULTS: The mean load at fracture for TEC was significantly lower than the one for the CEC, NEC, and control groups for all types of teeth (P .05). Unrestorable fractures were significantly more frequent in the TEC, CEC, and NEC groups than in the control group in each tooth type (P < .05). CONCLUSIONS: Teeth with TEC access showed lower fracture strength than the ones prepared with CEC or NEC. Ultraconservative "ninja" endodontic cavity access did not increase the fracture strength of teeth compared with the ones prepared with CEC. Intact teeth showed more restorable fractures than all the prepared ones