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The scaffolds used in regenerative endodontic therapy (RET) provide structural support for cells so that they can adhere to the scaffolds and also are crucial for cellular proliferation and differentiation. The objective of this network meta-analysis was to compare effects of different intracanal scaffolds on success outcomes of RET.PubMed/Medline, EMBASE, Cochrane, CINAHL, Scopus, and Web of Science databases were searched. Studies evaluating and/or comparing clinical and/or radiographic success of RET using different scaffolds with a minimum of 12 months follow-up were included. The Cochrane Collaboration risk of bias (ROB) tool and appropriate tools from Joanna Brigg's Institute were used for the assessment of ROB. A network meta-analysis was performed to compare the primary outcome (clinical success) and other success outcomes (root maturation, and pulpal sensibility) using different scaffolds.Twenty-seven studies fulfilled the desired inclusion criteria of which 25 had a low ROB whereas two had a moderate ROB. Clinical success of RET using platelet-rich plasma (PRP), blood clot (BC), and platelet-rich fibrin (PRF) scaffolds ranged between 91.66%-100%, 84.61-100%, and 77-100% respectively. The different scaffolds did not show any statistically significant difference in clinical success (PRF versus BC [p=1.000], PRP versus BC [p=1.000], and PRF versus PRP [p=0.999]), apical root closure (PRF versus BC [p=1.000], PRP versus BC [p=0.835], PRF versus PRP[p=0.956]), and pulp sensibility (PRF versus BC[p=0.980], PRP versus BC [p=0.520], and PRF versus PRP, p=0.990]).The intracanal scaffolds used during RET did not result in significant differences in regard to clinical success, root maturation, and pulpal sensibility.

The management of traumatic dental injury aims at functional and esthetic rehabilitation. After luxation injury, a displaced tooth must be replaced into its normal position as soon as possible. Incorrect tooth repositioning can cause discomfort to the patient and compromise the outcome. This report documents a novel digital technology-based approach for the management of teeth following luxation injury with displacement. A 25-year-old female reported 2 days after traumatic dental injury to her maxillary right central incisor tooth #8. After clinical and radiographic examination, a diagnosis of lateral luxation of tooth #8 was made. The preoperative high-resolution cone-beam computed tomography (CBCT) image data set confirmed palatal luxation of tooth #8 with fractured and displaced labial cortical plate. The CBCT data were imported into a medical image processing software program, and a segmentation tool was used to segment the fractured cortical plate, luxated tooth, and alveolar process. The socket is reconstructed by realigning fractured cortical bone over the alveolar process and repositioning the tooth in the virtual planning software. A three-dimensional (3D) guiding template was designed over the repositioned tooth and adjacent teeth and printed. This 3D printed guide was used for the repositioning of luxated tooth #8 and stabilizing it during the splinting procedure. This technique of using CBCT and 3D guide for repositioning is an objective, precise, and predictable approach. The 3D printed model of the dental arch after virtual tooth alignment can be used by the dentist to determine the exact splint length and contour before splinting.

This retrospective study analyzed the 12-month pulp sensibility (cold and electric) test response after mineral trioxide aggregate (MTA) full pulpotomy in mature permanent teeth with symptomatic irreversible pulpitis.The records of 120 subjects from 3 completed and 1 ongoing clinical study on MTA full pulpotomy were retrieved. Ninety-six first and second mandibular molar teeth with a diagnosis of symptomatic irreversible pulpitis that underwent a single-visit MTA full pulpotomy and had completed a 12-month clinical, radiographic, and pulp sensibility (cold and electric) test follow-up were included. The data were analyzed using the Fisher exact test, the Pearson chi-square test, and the McNemar test. The significance level was predetermined at P .05.A higher percentage of teeth (94.7%) responded to the electric pulp test in comparison with the cold test (13.5%) (P .05). Sex-based responses to the electric pulp test (P .05) and the cold test were similar (P .05). The age-based response was similar for the electric pulp test (P .05) but was significant for the cold test (P .05). The tooth quadrant (left and right), the tooth (mandibular first and second molar), and the location of restoration (proximal or occlusal) did not influence the response of either the electric pulp test (P .05) or the cold test (P .05). At the 1-year follow-up, all the teeth that were classified as clinically and radiographically successful responded to the electric pulp test; however, only 13 teeth responded to the cold test (P = .00).The majority (94.7%) of the teeth that underwent MTA full pulpotomy responded to the electric pulp test at a 1-year time interval.

Introduction This prospective study evaluated the outcome of a combination of nonsurgical endodontic (NSET) and vital pulp therapy (VPT) for the management of mature permanent mandibular molar teeth with symptomatic irreversible pulpitis (SIP) and apical periodontitis (AP). Methods Institutional ethical clearance was obtained. Mandibular molar teeth (N = 60) with a definitive diagnosis of SIP and AP with a radiographic periapical index score (PAI) of ≥3 in either 1 of the roots (mesial or distal) were included. Block randomization was used for allocation. In the NSET group (n = 30), single-visit NSET was performed using a standardized operating protocol. In the NSET-VPT group (n = 30), subsequent to full pulpotomy, at the root orifice where a vital pulp was observed (as determined by the arrest of pulpal bleed upon application of a 2.5% sodium hypochlorite pressure pack), a mineral trioxide aggregate radicular barrier was placed, and it was covered with light-cured resin-modified glass ionomer cement. NSET was performed in the root exhibiting a PAI score ≥3. The tooth was permanently restored. Postoperative pain was assessed at 24, 48, and 72 hours. Teeth were followed up clinically and radiographically at 12 months. The presence/absence of symptoms and the change in PAI scores were noted. The data were statistically analyzed. Results The success rate was 90% in the NSET group and 93.3% in the NSET-VPT group. According to an intergroup comparison between the proportion of teeth healed and nonhealed (radiographic), there was no significant difference (P > .05). Conclusions The combination of NSET and VPT is a viable biologically based minimally invasive treatment option for multirooted mandibular teeth with SIP and AP.

The aim of this cone-beam computed tomographic study was to evaluate the association between the mesiobuccal root canal configuration (RCC), interorifice distance (IOD), and the corresponding root length of a permanent maxillary first molar tooth.One hundred cone-beam computed tomographic scans obtained from the computerized data bank of the institute were studied. The IOD between the first mesiobuccal and second mesiobuccal canal was measured in the axial section where the second mesiobuccal canal was first visualized. The root length was measured from the cementoenamel junction to the root apex in the coronal and sagittal section. The associations of these parameters with the RCC (based on Vertucci's classification) were evaluated.The predominant RCC was observed to be Vertucci type II (89%). The mean root length with this configuration was 11.19 ± 1.35 mm. In type IV RCC, the mean root length was 9.13 ± 0.52 mm. A statistically significant association was established between the root length and RCC (P.05). In roots with type II and type IV RCC, the mean IOD was 2.58 ± 0.04 mm and 2.62 ± 0.1 mm, respectively. No statistically significant relation was established between the IOD and the type of RCC (P.05).The length of the mesiobuccal root is an important anatomic parameter for predicting the type of RCC in the permanent maxillary first molar tooth.