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(1) Background: Non-surgical endodontic treatment has been shown to be clinically successful; however, clinical long-term data are scarce. This practice-based retrospective clinical investigation evaluated endodontic outcomes over 40 years and identified relevant clinical co-factors. (2) Methods: Two experienced dental practitioners in two different private dental practices treated 174 patients with 245 teeth from 1969 to 1993. After root canal obturation, either a new direct restoration (amalgam, resin composite, or glass-ionomer cement) or the re-cementation of a pre-existing prosthetic restoration or renewal of prosthetic restoration followed. Metal posts (operator A) or metal screws (operator B) were inserted when coronal substance loss was significant. The primary outcome (i.e., tooth survival) was achieved when the endodontically treated tooth was, in situ, painless and had full function at the end of the observation period. A secondary outcome, the impact of different prognostic factors on survival rate, was evaluated. (3) Results: The overall mean survival was 56.1% of all treated teeth after 40 years of clinical service, resulting in an annual failure rate of 1.1%. Most investigated clinical co-factors (jaw, tooth position, intracanal dressings, post/screw placement, and gender) showed no significant influence on survival. (4) Conclusions: Even with materials and techniques from the 1970s and 1980s, successful root canal treatment was achievable. Except for post-endodontic restorations, most of the evaluated factors had no significant influence on the clinical long-term survival of root canal-treated teeth.

Successful bacterial inactivation or elimination is essential for successful outcomes in endodontics. This study investigated the efficacy of a calcium hydroxide paste (Ca(OH)2) as a temporary medical dressing for 1 week after chemomechanical root canal treatment (CMRCT). Microbiological samples from 26 patients were collected after endodontic emergency treatment as follows: (1) removal of the provisional filling material; (2) CMRCT; (3) irrigation with sodium hypochlorite I (3%); (4) medicinal insertion of Ca(OH)2; and (5) irrigation with sodium hypochlorite II (3%). A microbiological examination was carried out after the specimens had been taken from the root canals via saline and sterile paper points. CMRCT resulted in a significant reduction in total bacterial load (TBL) in the root canal (p < 0.05). Additional irrigation (3) resulted in a further significant reduction in TBL (p < 0.05). In contrast, Ca(OH)2 medication did not prevent the bacterial load from returning to the previous level immediately after CMRCT, but did not increase above that level either (p < 0.05). However, the increase in TBL was significant (p < 0.05) in comparison with the disinfection groups (I/II). Administration of Ca(OH)2 for 1 week shows that in combination with an additional disinfection procedure, an increase in TBL must be expected, but not above the level of conditions after CMRCT.

Abstract Background It is still not fully understood what pretreatment is best for achieving maximum tightness for pit and fissure sealings (PFS). Aim This study investigated microleakage of PFS placed after etching with phosphoric acid or after the application of self‐etching primers/adhesives (SEPA). Design 131 third molars were assigned to ten groups. In Hel‐P, Helioseal® was applied after phosphoric acid etching. In the other groups, SEPA were used (Dyr‐AP: Adper™ Prompt™ L‐Pop™, Dyract® Seal; Bea: BeautiSealant Primer and Paste; Hel‐Exp: Experimental primer, Helioseal®; Hel‐Cl: Clearfil™ SE Bond1, Helioseal®). Specimens were stored in distilled water at 37°C (28 days), followed by 3500 thermocycles and staining with 5% methylene blue (M) or 5% silver nitrate (S). After methylene blue staining and sectioning, microleakage was assessed light microscopically. During silver nitrate staining, specimens were dissolved by 32% HCl and remaining PFS were evaluated under a SEM. Results Tightness, percentage of penetrated area, and maximum dye penetration were best for Hel‐P and Hel‐Cl (p

Background: Streptococcus mutans is a major component of dental plaque, contributing to cariogenic biofilm formation and inducing dental caries. Attempts have recently been made to use postbiotic mediators (PMs) to prevent dental caries. This research evaluated the antimicrobial/antibiofilm activity of PMs derived from Lactobacillus rhamnosus GG (LGG) and Lactobacillus reuteri (LR) against S. mutans in vitro. Methods: PMs were obtained from the Lactobacilli supernatants. The minimum inhibitory concentration, minimum bactericidal concentration, antibiofilm potential, and metabolic activity of PMs against S. mutans were evaluated using CFU/mL, scanning electron microscopy, and XTT (2,3-bis-(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide) reduction assay. The expression of gtfB gene as one of the most important genes involved in S. mutans biofilm formation was also measured using qRT-PCR. Results: CFU score was reduced by both PMs, but the reduction was only significant in LGG (p = 0.02). Both PMs caused a significant decrease in the metabolic activity of S. mutans compared with the controls (p ≤ 0.002). S. mutans treated with LGG PMs exhibited more destructive effects than LR PMs (p > 0.05). S. mutans gtfB gene expression was significantly downregulated when treated with the PMs obtained from both LGG and LR (p = 0.01 for both). Conclusions: We showed that PMs isolated from two Lactobacillus strains inhibited S. mutans biofilm, metabolic activity, and gtfB gene expression. Therefore, these derivatives may be a suitable biofilm-destruction agent against S. mutants. However, the oral environment is a complex ecosystem that needs further investigation.

Successful root canal treatment depends on the adequate elimination of pathogenic bacteria. This study evaluated the effectiveness of a novel 445-nm semiconductor laser in reducing bacteria after chemomechanical root canal treatment. Microbiological specimens from 57 patients were collected after emergency endodontic treatment, in the following sequence: 1, removal of the temporary filling material; 2, chemomechanical treatment; 3, rinsing with sodium hypochlorite (3%) along with one of three adjuvant protocols (n = 19 in each group). The adjuvant procedures were: (a) sodium hypochlorite rinsing alone (3%); (b) laser irradiation; (c) combined sodium hypochlorite rinsing and laser irradiation. The diode laser was set to 0.59 W in continuous-wave mode (CW) for 4 × 10 s. After the flooding of the root canal with saline, specimens were collected using paper points and analyzed microbiologically. Statistically significant reductions in the bacterial load were observed in all three groups (p < 0.05): 80.5% with sodium hypochlorite rinsing alone and 58.2% with laser therapy. Both results were lower than with the combination of sodium hypochlorite rinsing and 445-nm laser irradiation, at 92.7% (p < 0.05). Additional disinfection of the root canal can thus be achieved with 445-nm laser irradiation after conventional chemical disinfection with sodium hypochlorite solution.

PURPOSE: Restoration of endodontically treated teeth using fiber posts in a one-stage procedure gains more popularity and aims to create a secondary monoblock. Data of detailed analyses of so called "post-and-core-systems" with respect to morphological characteristics of the resin-dentin interface in combination with bond strength measurements of fiber posts luted with these materials are scarce. The present study aimed to analyze four different post-and-core-systems with two different adhesive approaches (self-etch and etch-and-rinse). MATERIALS AND METHODS: Human anterior teeth (n = 80) were endodontically treated and post space preparations and post placement were performed using the following systems: Rebilda Post/Rebilda DC/Futurabond DC (Voco) (RB), Luxapost/Luxacore Z/Luxabond Prebond and Luxabond A+B (DMG) (LC), X Post/Core X Flow/XP Bond and Self Cure Activator (Dentsply DeTrey) (CX), FRC Postec/MultiCore Flow/AdheSE DC (Ivoclar Vivadent) (MC). Adhesive systems and core materials of 10 specimens per group were labeled using fluorescent dyes and resin-dentin interfaces were analyzed using Confocal Laser Scanning Microscopy (CLSM). Bond strengths were evaluated using a push-out test. Data were analyzed using repeated measurement ANOVA and following post-hoc test. RESULTS: CLSM analyses revealed significant differences between groups with respect to the factors hybrid layer thickness (p