Current and Emerging Innovations in Minimally Invasive Caries and Endodontic Treatments

Deep carious lesions frequently lead to pulpal exposure and require subsequent root canal treatment in order to save the tooth. Unfortunately, this treatment is often unsuccessful in the long term with periapical disease as the result. New insights into the biological processes associated with pulpal healing and innovations in biocompatible capping agents have led to new treatment strategies, which can keep teeth vital and functional for longer. Dentine is a bioactive substance that releases growth factors when demineralised by carious processes, which has a positive effect on the regeneration of the pulp. Controlling caries in cavitated carious lesions should be attempted using methods which are aimed at biofilm removal and control. Only when cavitated carious dentine lesions are either non-cleansable, or can no longer be sealed, are restorative interventions indicated. Carious tissue is removed purely to create conditions suitable for long-lasting restoration. Bacterially contaminated or demineralised tissue close to the pulp does not need to be removed. To ascertain the state of the pulp, the symptoms observed are critical in determining the most appropriate treatment modality and often with only partial removal of inflamed pulp tissue, the remainder of the pulp can heal. The evidence and, therefore, these recommendations support minimally invasive carious lesion management in conjunction with less invasive endodontic treatment to preserve tooth tissue and maintain pulp viability and function in the long term.</p

Effect of Endodontic Chelating Solutions on The Bond Strength of Endodontic Sealers

The purpose of this in vitro study was to evaluate the effect of various chelating solutions on the radicular push-out bond strength of calcium silicate-based and resin-based root canal sealers. Root canals of freshly-extracted single-rooted teeth (n = 80) were instrumented by using rotary instruments. The specimens were randomly divided into 4 groups according to the chelating solutions being tested: (1) 17% ethylenediaminetetraacetic acid (EDTA); (2) 9% etidronic acid; (3) 1% peracetic acid (PAA); and (4) distilled water (control). In each group, the roots were further assigned into 2 subgroups according to the sealer used: (1) an epoxy resin-based sealer (AH Plus) and (2) a calcium silicate-based sealer (iRoot SP). Four 1 mm-thick sections were obtained from the coronal aspect of each root (n = 40 slices/group). Push-out bond strength test was performed at a crosshead speed of 1 mm/min., and the bond strength data were analyzed statistically with two-way analysis of variance (ANOVA) with Bonferroni's post hoc test (p 0.05). iRoot SP showed higher resistance to dislocation than AH Plus. Final irrigation with 17% EDTA, 9% Etidronic acid, and 1% PAA did not improve the bond strength of AH Plus and iRoot SP to radicular dentin.Wo