Comparative Evaluation of Sealing Ability of Mineral Trioxide Aggregate and Biodentine Used for Root Furcation Perforation Repair – A Systematic Review"

Introduction: During endodontic operations, furcation perforations are a serious complication that might jeopardize periodontal health and the affected tooth\u27s long-term prognosis. To stop microbial leaking and encourage periodontal repair, these perforations must be properly sealed. Because of its sealing capabilities and biocompatibility, Mineral Trioxide Aggregate (MTA) has long been regarded as the gold standard for furcation healing. A more recent calcium silicate-based substance called biodentine has gained attention as a possible substitute because of its advantageous physical characteristics and bioactivity. Objectives: The aim of the present systematic review is to evaluate and compare the sealing ability of Mineral Trioxide Aggregate and Biodentine when used for the repair of root furcation perforations. Methods: A comprehensive electronic search was carried out across databases such as PubMed, Scopus, and Google Scholar. The included studies compared the sealing capabilities of MTA and Biodentine in the repair of furcation perforations by in vitro or ex vivo experimental investigations. Two reviewers independently carried out the data extraction and quality assessment in accordance with PRISMA criteria. Results:The majority of the included research evaluated the effectiveness of sealing using spectrophotometric, fluid filtration, dye penetration, or bacterial leakage techniques. Although MTA and Biodentine both showed adequate sealing capabilities, a number of studies found that Biodentine performed better or on par with MTA in terms of marginal adaption and decreased leakage. Conclusions: Root furcation holes can be successfully repaired using both mineral trioxide aggregate and biodentine. Although MTA is still often used, Biodentine seems to provide a similar sealing capacity combined with benefits like quicker setting time and better handling. To confirm these results and encourage evidence-based material selection in clinical practice, more standardized clinical and in vivo research is advised

Accuracy of the integrated electronic apex locator in locating simulated perforation under various irrigating solutions in an in vitro study

Aim: This study’s objective was to assess the accuracy of the integrated apex locator in identifying artificial root canal perforations in the presence of saline, chlorhexidine, sodium hypochlorite, QMix, and MTAD. Methods: The root canals of 60 single-rooted extracted human teeth were perforated artificially at a point 10 mm away from the root apex. After measuring the actual lengths up to the perforation point, the teeth were then put within an alginate mould for measurements using an integrated apex locator. Using a #20 K-file in the presence of NaCl, CHX, MTAD, NaOCl, and QMix, an electronic apex locator was used to measure the perforations electronically in accordance with the manufacturer’s instructions. Between the measurements, each canal was dried with paper points after being irrigated with distilled water. The accuracy of all the readings was calculated at ± 0.5 mm. Statistical analyses were performed using the Z-test. Results: In comparison to the MTAD, NaOCl, and Qmix, saline and chlorhexidine scored more readings in the ± 0.5 mm range of the perforation site, and the difference was statistically significant. Conclusion: The most precise electronic measurements of artificial perforation were obtained in the presence of chlorhexidine or saline

Effect of Heat on Surface Changes and Fracture Resistance of NiTi Rotary files: A systematic Review on Implications in Endodontic Practice.

Introduction: NiTi rotary files are not immune to challenges, particularly during clinical use. One of the major concerns associated with their application is the generation of heat during root canal preparation. Objectives: The objectives of this review encompass a thorough assessment of alterations in surface       characteristics, such as roughness and topography, of NiTi rotary files following heat exposure. Methods: This systematic review was conducted following a predetermined protocol, which was registered on the Open Science Framework (OSF) to ensure transparency and accountability in the review process. The research question was formulated using the PICO framework. A comprehensive literature search was conducted to identify relevant studies from various information sources. The following databases were systematically searched, screnner. All the data collected was then extracted. Results: All the data was then extracted and this review concluded that autoclave sterilization of newer rotary endodontic instruments could increase resistance to cyclic fatigue but the difference observed are not that significant pertaining to all the limitations of this review. Conclusions: In conclusion, the findings of this systematic review highlight the significant impact of autoclave heat on the surface roughness and fracture resistance of NiTi rotary files. The alterations in surface characteristics and mechanical properties induced by autoclave exposure can influence the files\u27 clinical performance and lifespan

Effects of Glide Path Preparation on Apical Debris Extrusion in Root Canal Treatment: A Systematic Review

Introduction: Using a glide path preparation with nickel-titanium rotary files or hand files helps prevent fracture of instruments and maintains the original anatomy of a root canal. Using glide path file systems during root canal treatment causes extrusion of intra-canal debris into peri radicular tissues, which could result in unfavorable outcomes. Objectives: The goal of this systematic review was to look into the effects of glide path preparation on the extrusion of apical debris. Methods: In this systematic review, we analyze various glide path preparation techniques and their impact on apical debris extrusion. We followed PRISMA guidelines, conducted a thorough literature search, and included 13 relevant studies. Results: The original total of 169 articles was reduced to 13 after the keywords, extra filters, and inclusion, and exclusion criteria were applied. It was discovered that the majority of studies that used glide path files showed a statistically significant lesser extrusion of debris. Conclusions: In conclusion, this review underscores the importance of glide path preparation in root canal procedures. Using a glide path file during root canal preparation diminishes debris extrusion and improves clinical prognosis

Analyzing the Effectiveness of Different Methods for Instrument Retrieval: A Comprehensive Systematic Review

Introduction: The rate of success of retrieval of instruments that have been fractured differs because it depends upon several variables, such as the visibility of the broken instrument, the size of the broken instrument relative to the canal\u27s curvature, and the methods used in every instance. The separation of endodontic instruments in the intracanal area can hinder shaping and cleaning processes in the canal and could negatively affect the procedure results. This descriptive analysis of distinct instruments set out to  (1) look over the research concerning treatment options, influences aspects, and complications. (2) propose the best method for the management of these instruments.. Methods: Research was conducted through peer-reviewed journals in PubMed, Lialac, Ebsco, ProQuest, open gray, and J gate to locate experiments and clinical studies and reviews, by utilizing the key phrases Instruments, Files obstructions, fractured or broken instruments, separation removal, retrieval treatment, bypassing, as well as problems with or without the endodontic canal or root canal. Results:. The results show an absence of evidence at a higher level about properly managing separate instruments. The conventional conservative treatment includes eliminating or avoiding the fracture or filling the root canal system to an extent that is coronal to the fragment. The surgical procedure is an option. This is influenced by several aspects and could be linked with issues. Based on recent clinical research an approach to decision-making for treatment is recommended. Conclusions: This comprehensive review provides insights from laboratory studies that examine the correlation between the curvature of root canals and the specific location where instrument fractures occur, offering valuable insights into their impact on overall treatment success. Significantly, the ultrasonic approach demonstrated the most favorable outcomes. It underscores the importance of anchoring clinical practice in rigorously conducted clinical trial

Stereomicroscopic Evaluation of Dentinal Microcracks After Instrumentation of Curved Canal with Rotary Files in Two Motions

Objective: This study aimed to examine the effects of three distinct file systems with two motion types—rotary and reciprocation—on the development of dentinal microcracks after root canal preparation using a stereomicroscope. Methods: Sixty mandibular molars with a curvature of 30° were decoronated and divided into three groups (Vortex Blue, Mtwo, and ProTaper Next) and two subgroups (rotary and reciprocating motions). The samples were then instrumented with the files, dyed with 1% methylene blue dye, and sectioned horizontally at 3, 6, and 9 mm from the root apex. The dentinal microcracks were inspected using a stereomicroscope at 40× magnification. One-way analysis of variance and post hoc Tukey tests were used to perform statistical analysis. Results: Crack formation was statistically significant at the 6-mm and 9-mm levels from the root apex in both motions (p \u3c 0.05). Among all the file system, Vortex Blue caused the highest dentinal microcracks in both motions at 6 mm from the root apex. Conclusion: The reciprocating motion resulted in fewer dentinal microcracks than the rotary motion. All file systems caused significant dentinal microcracks at the curvature of the root canal during both motions. Dentinal microcrack formation was not significant at the root apex

Effect Of Heat on Surface Changes And Fracture Resistance of NiTi Rotary Files : A Systematic Review on Implications in Endodontic practice

Systemic revie

Working length determination: comparative analysis of integrated & electronic apex locator in various irrigating solutions

Introduction: Working length (WL) determination is one of the crucial steps in endodontic treatment. Conventional Apex locators (EAL) are consistently employed nowadays for WL determination. Apart from the EAL, Integrated apex locators (IAL) have also come into the market that aim to reduce the number of steps.   Objectives: The objective of this in vitro study was to compare and evaluate the accuracy of Eighteeth E-Connect S (IAL) and Root ZX Mini (EAL) in two different irrigating solutions. Methodology: Thirty freshly extracted, single-rooted teeth were taken. The teeth were then individually mounted on an alginate mould. The measurements of the mounted samples of both the groups were taken accordingly based on the irrigating solutions. WL determination was done one by one with both Conventional Apex locator & Integrated apex locator, respectively in 3% sodium hypochlorite (NaOCl) and 2% Chlorhexidine (CHX). Statistical analysis was performed using One Way ANOVA test. Results: The test results showed that there was no statistically significant difference between EAL & IAL in both groups when compared with the actual WL.Conclusion: Both ALs were equally effective in determining WL at ±0.5mm from the apex in the presence of irrigating solutions, i.e., NaOCl and CHX. &nbsp

Working length determination: Comparative analysis of integrated & electronic apex locator in various irrigating solutions

Introduction: Working length (WL) determination is one of the crucial steps in endodontic treatment. Conventional Apex locators (EAL) are consistently employed nowadays for WL determination. Apart from the EAL, Integrated apex locators (IAL) have also come into the market that aim to reduce the number of steps. Objectives: The objective of this in vitro study was to compare and evaluate the accuracy of Eighteeth E-Connect S (IAL) and Root ZX Mini (EAL) in two different irrigating solutions. Methodology: Thirty freshly extracted, single-rooted teeth were taken. The teeth were then individually mounted on an alginate mould. The measurements of the mounted samples of both the groups were taken accordingly based on the irrigating solutions. WL determination was done one by one with both Conventional Apex locator & Integrated apex locator, respectively in 3% sodium hypochlorite (NaOCl) and 2% Chlorhexidine (CHX). Statistical analysis was performed using One Way ANOVA test. Results: The test results showed that there was no statistically significant difference between EAL & IAL in both groups when compared with the actual WL. Conclusion: Both ALs were equally effective in determining WL at ±0.5mm from the apex in the presence of irrigating solutions, i.e., NaOCl and CHX

Comparative Cone Beam Computed Tomographic Evaluation of Conventional and Conservative Endodontic Access Cavity Designs on Pericervical Dentin Thickness and Fracture Resistance of Teeth: An In-vitro Study

Introduction: The concept of ‘extension for prevention’ accelerates treatment processes but eliminates precious dentin at the pericervical area, resulting in biomechanically weakened tooth structure after endodontic treatment. Pericervical Dentin (PCD) is a new paradigm for endodontic success supports the idea that the amount of residual tooth structure is closely associated with long-term retention of the tooth and resistance to fracturing. Aim: To determine the impact of two endodontic access cavity designs and biomechanical preparation on the pericervical dentin thickness using 3D Cone Beam Computed Tomographic (CBCT) visualisation technique and fracture resistance of the maxillary anterior teeth under compressive load using universal testing machine. Materials and Methods: The in-vitro study was conducted in the Department of Conservative Dentistry and Endodontics at Karnavati School of Dentistry, Gandhinagar, Gujarat, India, from October 2020 to March 2021. Study was carried out on the 30 single rooted freshly extracted maxillary central incisors and were randomly divided into two groups of conventional and conservative access preparation groups (n=15). Group 1 was conventional group, samples were accessed using endo access bur #1. Group 2 was conservative group, samples were accessed using CK micro-endodontic bur under a dental operating microscope. Cleaning and shaping was done using 17% Ethylenediamine Tetraacetic Acid (EDTA) as lubricant and 4% Hyflex CM rotary file system. The CBCT scans were taken preoperatively, following access cavity preparation and postobturation to evaluate the amount of pericervical dentin loss in mesial, lingual, facial and distal surfaces of the teeth at the levels of 1 mm to 4 mm above and below Cementoenamel Junction (CEJ). The samples were then loaded to fracture in the Universal Testing Machine, and the data were analysed using Independent sample t-test using Statistical Package for Social Sciences (SPSS) software version 20.0. Results: In comparison to the group 2, group 1 led to an increase in substantial tooth structure loss in the pericervical region. Among all surfaces, pericervical dentin loss was more pronounced on the lingual surface in the group 1 than in the group 2 (p-value &lt;0.001). Higher fracture resistance was observed in group 2 (1136.75 N) compared to group 1 (687.22 N) under compressive load (p-value &lt;0.001). Conclusion: Incisal cavity design is a less invasive method of accessing maxillary central incisors that preserves pericervical dentin. Under compressive load, pericervical dentin conservation provided greater fracture resistance in the conservative group than in the conventional group.</jats:p