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Background: To compare the outcomes of conventional access cavity preparation (CONV) versus guided endodontics (GE) for access cavity preparation in anterior teeth with pulp canal calcification (PCC) regarding root canal detection, substance loss, procedural time, and need for additional radiographs. Methods: Extracted, sound human teeth with PCC (n = 108) were matched in pairs, divided into two groups and used to produce 18 models. An independent endodontist and a general dentist performed access cavity preparation under simulated clinical conditions on nine models each (54 teeth). The endodontist used the conventional technique and the general dentist GE. Time needed to access the root canals and the number of additional radiographs were recorded. Pre- and postoperative cone-beam computed tomography scans were obtained to measure substance loss. Statistical significance was tested by examining the overlap of 95% confidence intervals (CIs) between the groups. Results: All root canals were successfully accessed by both methods. There were no significant differences in substance loss (CI: CONV 15.9–29.6 mm3 vs. GE 17.6-27.5mm3) or procedural time (CI: CONV 163.3-248.5 s vs. GE 231.9-326.8 s). However, 31 additional radiographs were required for GE compared to none for CONV. Conclusions: For access cavity preparation in teeth with PCC, both CONV by a specialist and GE by a general dentist produce good results in terms of substance loss and time requirements. [ABSTRACT FROM AUTHOR]

Purpose: This sub-analysis of our multicenter trial was to assess the long-term periodontal health (PH) of teeth, esthetically reshaped by means of direct composite buildups. Materials and Methods: 198 patients who received 667 direct composite buildups on 585 treated teeth (TT) between 01/2001 and 12/2013 were included. PH was assessed for each TT and for an untreated control tooth (CT) by recording the pocket probing depths (PPD), clinical attachment level (CAL), sulcus bleeding index (SBI), and Turesky's modification of the Quigley Hein plaque index (PI). Statistical analysis was performed using the twosample Student's t-test and Mann-Whitney U-test. Regression models were performed to check for associations between PH and patients' age, gender, age of the buildups, enlargement range, jaw, and tooth type. The level of significance was set at a = 0.05. Results: PI scores were significantly (p < 0.001) higher in TT (1.60 ± 0.81) than in CT (1.41 ± 0.81). Differences between TT and CT regarding PPD (TT: 2.14 ± 0.56/CT: 2.18 ± 0.56), CAL (TT: 2.34 ± 1.05/CT: 2.33 ± 0.92), and SBI (TT: 0.41 ± 0.60/CT: 0.41 ± 0.65) were not statistically significant (p > 0.05). The enlargement range of the TT and the tooth type were not associated with PH. Male patients had significantly higher PPDs, CAL, and SBI values than did female patients. CAL and SBI values increased over time for both the TT and CT. CAL, SBI, and PI values were significantly higher in the mandible and the PPD values in the maxilla. Conclusion: Direct composite buildups made for reshaping, change of color or position of teeth did not impair PH in the long term. [ABSTRACT FROM AUTHOR]

Purpose: This case report presents the management of molar incisor hypomineralization (MIH) from the mixed to the permanent dentition stage. Shortly after eruption of hypomineralized teeth, masticatory forces frequently cause rapid enamel breakdown. The MIH Treatment Need Index (MIH-TNI) provides guidelines for the treatment of MIH in relation to how severely the teeth are affected. Clinical considerations: An 11-year-old patient with permanent teeth affected by MIH was referred to us by his orthodontist for conservative dental treatment before planned orthodontic treatment. The restorative treatment varied according to the degree of severity of the affected teeth and included indirect composite resin restorations on teeth #17 (MIH-TNI 4c), #35 (MIH-TNI 4c) and #37 (MIH-TNI 4b), direct composite resin fillings on teeth #26 (MIHTNI 2b), #27 (MIH-TNI 2a) and #16 (MIH-TNI 4c) and fissure sealants on teeth #16, 15, 14, 24, 25, 34, 36, 44, 45, 46 and 47. Orthodontic treatment was already started during the restorative phase with a bite-jumping appliance. With the conclusion of the second phase of mixed dentition at age 12, the orthodontist was able to start fixed orthodontic treatment of the maxillary and mandibular arches with all of the child's permanent teeth adequately restored. Orthodontic treatment was completed at age 14. At present, 6 years after initiation of dental treatment, all teeth are still free of decay. Conclusion: A carefully supervised recall program with early comprehensive care at frequent intervals and adequate, defect-driven restorations depending on how severely the teeth are affected are the basis for a favorable long-term prognosis in patients with MIH. [ABSTRACT FROM AUTHOR]

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Introduction: In endodontic education, there is a need for thorough training prior to students embarking on clinical treatment. The aim of this study was to use three‐dimensional printing technology to create a new model and to compare its suitability for training purposes with resin blocks and extracted teeth. Materials and Methods: Multi‐jet‐modelling (MJM) produced the 3D model replicating a common difficulty in root‐canal morphology. An evaluation study comprising 88 students was run in the sixth semester (summer 2018 and winter 2018/2019). A new questionnaire assessed students' perception of training models and educational environment. Welch's t‐test analysed significant differences. Results: The most pronounced differences between models were noted when rating material hardness, radiopacity, root‐canal configuration and suitability for practising. Students estimated their learning outcome as greater with 3D‐printed teeth compared to resin blocks. Three‐dimensionally printed teeth received significantly lower ratings with regard to enthusiasm, the learning of fine motor skills and spatial awareness, when compared to human teeth (p ≤.001). However, 3D‐printed teeth were appreciated for additional benefits, such as their cleanliness, availability and standardisation of training opportunities with complex root‐canal configurations. Conclusion: Students preferred extracted human teeth to 3D‐printed teeth with respect to their physical characteristics and training experience. However, educational advantages may compensate for the shortcomings. The new questionnaire proved both adequate and accurate to assess the models and educational environment in endodontic training. The new 3D‐printed teeth enhanced the learning opportunities. [ABSTRACT FROM AUTHOR]

Distinguishing composite remnants from tooth structure after trauma splint removal can be challenging. This study aimed to compare the Fluorescence-aided Identification Technique (FIT) with conventional light illumination (CONV) in terms of accuracy and time required for the detection of composite remnants after trauma splint removal. Ten bovine tooth models containing anterior teeth from 12 to 22 with composite remnants after trauma splint removal were used. These models were examined by 10 students and 10 general dentists. Each examiner assessed the 10 models using CONV or FIT three times with an interval of 2 weeks each using a prototype fluorescence-inducing headlamp with a spectral bandwidth of (405 ± 7) nm for FIT and a dental unit lamp for CONV. The examiners charted the location of identified composite remnants, and the procedure time needed for each method was recorded. Statistical analysis was performed with R 3.2.2 software with a significance level of α = 5%. FIT was more accurate and less time-consuming than CONV (p < 0.001). There were no significant differences between dentists and students concerning accuracy (CONV: p = 0.26; FIT: p = 0.73). Students performed FIT significantly faster than the dentists (p < 0.001). FIT is a quick and reliable method of identifying composite remnants after trauma splint removal. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to assess the effectiveness of an intracanal composite anchorage to replace conventionally cemented titanium or bonded glass fibre posts. Materials and methods: Post space preparation was performed up to depths of 6 mm (groups 1 and 2) and 3 mm (group 3) in root filled mandibular premolars. In group 1, titanium posts were cemented with zinc phosphate cement. Glass fibre posts were adhesively cemented in group 2 using a dual-cure composite resin. In group 3, intracanal anchorage was solely performed with a dual-cure composite. All teeth were restored with standardised direct composite crowns without a ferrule. After thermo-mechanical loading, static load was applied until failure. Fracture patterns were assessed, and a microscopic analysis was performed to analyse the occurrence of additional cracks. Results: Group 2 revealed a significantly higher median fracture value (408 N) than groups 1 and 3, while no difference was detected between group 1 (290 N) and group 3 (234 N) ( p = .1417). In group 3, the more favourable fracture patterns were observed. However, the majority of teeth within this fracture category revealed additional minor cracks of the root. Conclusions: Within the limitations of this study, adhesive intracanal anchorage to a depth of 3 mm with resin composite only has the same fracture resistance as titanium posts conventionally cemented to a depth of 6 mm. Even teeth with repairable main fractures exhibited additional dentinal cracks on the root. Clinical relevance: Additional dentinal root cracks in the teeth with repairable main fractures may considerably impair their longevity. [ABSTRACT FROM AUTHOR]