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Introduction Determining the length of the root canal is one of the key factors that can affect the outcome of endodontic therapy. Incorrectly determined working length results in underfilled or overfilled canal. The aim of this work was to verify the effectiveness of cone-beam computerized tomography (CBCT) and apex locators in determining working length of the root canal. Material and method Endodontic procedure was performed according to established endodontic protocol on 98 teeth. Teeth were divided into two groups: single-rooted and multi-rooted teeth. In both groups, working length was measured with an apex locator (Woodpex III) and CBCT (Planmeca Viso). In multi-rooted teeth, the canals were classified according to their morphological position into the groups Lingvomesial (LM), Buccomesial (BM), Bucodistal (BD), Palatal (P) and Distal (D) canals. Root canal length was determined by a dentist using apex locator at the University of Banja Luka while CBCT analysis was performed by a radiology engineer at the 3DENT radiology center in Banja Luka. Results CBCT odontometry had small deviations from apex locator odontometry. The mean value of the absolute difference between CBCT measurement and apex locator measurement was the smallest in the group of linguomesial canals (0.284 mm), and the largest in the group of distal canals of the lower molars (1.939 mm). Based on the results of the Mann-Whitney U test, it was concluded that there was no statistically significant difference (p > 0.05) in measured length of the root canal between the two methods in all groups of roots of multi-rooted teeth as well as in the group of single-rooted teeth. Conclusion CBCT odontometry is as reliable as apex locator odontometry.

Introduction Exposure to lead (Pb) can have harmful effects on the general state of the body, including oral health. The aim of this study was to examine the prevalence of changes in gingiva and periodontal tissue in adult rats intoxicated with lead acetate by histological analysis. Material and methods The study was conducted on 42 Wistar rats. Intoxication of rats with lead acetate was carried out through drinking water ad libitum. The first group (A1) consisted of 16 rats that received lead-acetate in water at a concentration (1500 ppm) for 14 days, and the second group (A2) consisted of 16 rats that received lead-acetate in water at the same concentration for 30 days. Results Gingivitis and periodontitis in the first group of rats (A1) were observed in 41.7% of cases, and in the second group (A2) in 84% of cases. A statistically significant difference was found between the investigated groups (ch2 = 6.955; p < 0.018). Conclusion Since changes in the gingiva and periodontium have been observed in rats intoxicated with lead for a long period of time, it is necessary to propose a preventive program for patients exposed to lead, which includes dental procedures such as oral hygiene training and regular visits to the dentist.

Introduction Diabetes mellitus (DM) is a state of chronic hyperglycemia that is a predisposing factor to caries, gingivitis, inflammation of periodontium, oral candidiasis, xerostomia and many other diseases of the oral cavity. Inflammation of the supporting tissue of the tooth is a chronic disease that destroys the supporting structure of the tooth, i.e. periodontal ligament and alveolar bone. The aim of this study was to examine using histological analysis the presence of periodontitis and gingivitis in rats with experimentally induced DM that were sacrificed after 14 and 30 days. Material and methods The research was conducted on 42 Wistar rats. DM in experimental animals was induced by the use of Alloxan intraperitoneally. The first group (Exp_14) consisted of 16 rats in which DM was induced and sacrificed after 14 days, the second group (Exp_30) consisted of 16 rats in which DM was induced and they were sacrificed after 30 days, while the control consisted of 10 healthy rats. Results Periodontitis and gingivitis in the first group of rats (Exp_14) were determined in 54.5% of cases, while in the second group (Exp_30) in 88% of cases. In the control group no case of periodontitis and gingivitis was recorded. A highly statistically significant difference was found between the examined groups (Chi-square = 14.685; p < 0.001). Conclusion In the group of rats with experimentally induced DM that were sacrificed after 30 days, a significantly higher incidence of periodontitis and gingivitis was found compared to the group of rats that were sacrificed after 14 days.

Introduction The aim of this work was to check the average thickness of dentinal wall of the mesio-buccal root of the first lower molar using CBCT axial sections of intact teeth. Material and method In this cross-sectional study, 100 CBCT images of mandibular first molars from the Promax 3Dent radiology center in Banja Luka, Bosnia and Herzegovina were evaluated. A Planmeca Promax3D Max apparatus (Planmeca, Helsinki, Finland) was used, with a field of view (FOV) of 8 × 8 cm and a resolution of 0.1 mm. Analysis was performed using Romexis Viewer software version 3.1.1 (Planmeca, Helsinki, Finland). At an axial thickness of 0.1 mm, transverse sections with a distance of 1 mm were made below the furcation area (at a magnification ×10) at a distance of 1, 2, 3, 4, 5 mm from the furcation. The data were then analyzed by paired t-test. Results The thickness of dentinal wall of the mesio-buccal root of the lower first molar was significantly smaller at 2 mm and 3 mm than when measured at 1, 4 and 5 mm (p < 0.05). There was no significant difference between measurements at 1, 4 and 5 mm below the furcation area (p = 0.001). Conclusion Due to the small thickness of dentinal wall at 2-3 mm below the furcation in the root canal, caution is required when instrumenting mesio-buccal canal of the lower first molar and correct selection of the instrumentation technique in order to avoid transportation or stripping perforation that may lead to root fracture.

Introduction Marginal seal or adequate marginal adaptation of material along the cavity walls should be able to prevent leakage of tissue fluid and consequently bacterial microleakage, terefore, it is considered as significant factor for long term success of endodontic treatment. The aim of this work was to test the marginal microleakage of newly synthesized nanostructured biomaterials based on calcium aluminate, calcium silicate and MTA with a dye penetration test after application the material to the interradicular perforations of extracted teeth. Material and method The study included 48 extracted human maxillary and mandibular molars. Newly synthesized nanostructured materials were tested: material based on calcium aluminate, calcium silicate. Commercial calcium silicate cement (MTA Angelus, Londrina, Brazil) was used as a control material. Marginal microleakage was examined with a dye penetration test six months after application of the material in experimentally prepared interradicular perforations on extracted human molars. Penetration depth measurement was analyzed with a binocular magnifier (Leica DM 500, Leica Byosistems). Results are expressed in millimeters and statistically processed by applying the analysis of variance for repeated measurements with the Sidak test. Results The lowest average penetration (mm) was for MTA (1.40 ± 0.63 mm), and the highest for Ca aluminates (2.10 ± 0.63 mm), while for calcium silicates an average color penetration of 1.73 ± 0, 67mm was recorded. By testing intergroup differences in color penetration between groups, a statistically significant difference between MTA and Ca aluminate was obtained using Sidak's test (t = -0.693; p = 0.036). No statistically significant difference was recorded between MTA and Ca silicate, nor was there a statistically significant difference between Ca aluminate and Ca silicate. Conclusion The lowest marginal microleakage, the best marginal sealing, was recorded with the MTA material. The microleakage of calcium aluminate-based materials was significantly higher compared to calcium silicate and MTA.

Introduction In addition to good biological properties, biomaterials should also possess appropriate physical properties in order to provide stability and longevity at the place of application. The aim of this work was to evaluate physical properties of an experimental nanostructured material based on calcium aluminate (CAL) and calcium silicate (CS). Material and method The research used nanostructured calcium aluminate synthesized by the hydrothermal solgel method from the individual components of calcium aluminate (CaO·Al2 O3 ), calcite (CaCO3 ) and barium sulfate (BaSO4 ) as an X-ray contrast agent and calcium silicate (CS). The prepared material was placed in plastic molds with a diameter of 5 ± 0.1 mm and a height of 2 ± 0.1 mm. After setting time, the materials were left in an incubator at 37°C for 24 hours, and then they were removed from the mold and absorption and solubility of the materials was calculated. MTA (Angelus Londrina, Brazil) was used as a control material. Results The lowest material solubility was recorded with MTA (0.255 mg/mm3 ), followed by calcium silicate (0.267 mg/mm3 ), and the highest with calcium aluminate (0.725 mg/mm3 ). The difference was statistically significant between calcium aluminate and MTA (p = 0.001901) and between calcium aluminate and calcium silicate (p = 0.002550). After 28 days in deionized water, the lowest water sorption was recorded with MTA (0.347 mg/mm3 ), followed by calcium silicate (0.357 mg/mm3 ), and the highest water sorption was measured with calcium aluminate (0.474 mg/mm3 ). Statistically significant differences were observed between calcium aluminate and MTA (p = 0.000283) and between calcium aluminate and calcium silicate (p = 0.001576). Conclusion Material solubility and water absorption of calcium aluminate-based nanostructured material was significantly higher compared to calcium silicate (CS) and MTA.

Introduction/Objective. Lead exposure represents one of the most important factors that affect the general health, including oral health and it is associated with enamel and dentin tooth defects. The aim of this paper was to determine expression of the fibronectin in the pulp of rats with experimentally induced diabetes mellitus (DM), after lead exposure, by using immunohistochemical analysis. Methods. The study was conducted on 42 rats of Wistar strain. Intoxication of rats with lead-acetate was done via drinking water ad libitum. The first group (Exp_14) consisted of 16 rats, which received lead in water for 14 days, the second group (Exp_30) consisted of 16 rats which received lead in water for 30 days at the same concentration (1500 ppm), while the control consisted of 10 healthy rats. Groups Exp_14 and Exp_30 were induced into DM, by using the Alloxan intraperitoneally. Pathohistological and immunohistochemical analysis determined fibronectin expression in pulp, odontoblasts, predentin and dentine of the teeth. Results. High diffuse positivity of fibronectin in group Exp_14 was noticed in 63.6% of rats, in group Exp_30 in 24% of rats, while in the control group it was noticed in 50% of rats. There was no statistically significant difference in the expression of fibronectin between the examined groups. Conclusion. Lead intoxication through drinking water, for a period of 14 and 30 days, had effect on the expression of fibronectin in the pulp, odontoblasts, predentin and dentin of the teeth of animals experimentally induced DM.

Introduction/Objective. The aim of this paper was to verify the biocompatibility of the newly synthesized nanostructured material based on calcium aluminate after implantation into the subcutaneous tissue of rats. Methods. The study included 18 rats aged 10–11 weeks, divided into two experimental groups (n = 9). In all animals, incision took place on the back and two pockets of 15 mm in depth were made, in which sterile polyethylene tubes with test materials [calcium aluminate cement (ALBO-CA), calcium silicate cement with the addition of hydroxyapatite (ALBO-CSHA), and mineral trioxide aggregate (MTA) for the control group) were implanted. Six rats of each group were sacrificed in three observational periods (seven, 15, 30 days). Pathohistological analysis included inflammation, bleeding, fibrous capsule, and tissue integrity around the implanted material. Results. After seven days of treatment, ALBO-CA and ALBO-CSHA showed better tissue response compared to MTA, with a statistically significant difference in inflammation intensity (p = 0.2781). The difference in vascular congestion and thickness of the fibrous capsule after implantation of ALBO-CA material compared to MTA was also statistically significant (p = 0.5567). At the end of the 30-day evaluation period, an identical inflammatory response of connective tissue at the site of implanting ALBO-CA, ALBO-CSHA, and MTA (score of 0.7) was recorded. The formation of thick or moderately thick fibrous capsule was found to be the thickest in ALBO-CA (grade 3.7). There were no statistically significant differences between the parameters analyzed after 30 days. Conclusion. Newly synthesized ALBO-CA showed a satisfactory tissue response and confirmed biocompatibility after implantation in subcutaneous tissue of rats.

Introduction Currently, one of the most important ecological issues is exposure to lead in environment, since it is a metal with evident toxic effects on human organism. Hard dental tissues are suitable structures for assessing long-term effects of exposure to toxic metals. The aim of this paper was to determine the concentration of lead in hard dental tissues of a rat with experimentally induced DM using SEM/EDS analysis, after 14 and 30 days of exposing animals to lead. Material and methods The study was conducted in rats of Wistar strains divided into the three groups. The first group consisted of 8 rats (128 molars and premolars of the upper and lower jaws) with experimentally induced DM, taking lead in the course of 14 days at the concentration of 1500 ppm; the second group included 8 rats (128 molars and premolars of the upper and lower jaws) taking lead in the course of 30 days at the concentration of 1500 ppm, while the third control group consisted of 5 healthy rats (80 molars and premolars of the upper and lower jaws). Experimental animals received lead-acetate every day at the concentration of 1500 ppm via water ad libitum. In these animals, diabetes mellitus was induced by Alloxan. The teeth samples were analysed using scanning electron microscopy (SEM). EDS analysis determined the mass fraction of lead and other elements in hard dental tissues. Results No lead was detected in a single tooth layer in the teeth of rats that received lead in drinking water in the course of 14 days. The average values of the mass fraction of lead, calcium, and phosphorus in enamel of teeth of rats receiving lead in the course of 30 days amounted to: lead 0.36%, calcium 15.48%, and phosphorus 10.62%. Lead was registered only in enamel. Conclusion Lead was detected in enamel only in rats receiving lead in the course of 30 days while it was not detected in teeth after the course of 14 days.

Introduction. Bond between composite materials and bleached teeth depends on the change of micro-morphological structure of enamel and dentin after the application of bleaching agent. Bleaching procedure can weaken adhesion of composite materials to hard tissues, where even just a presence of hydrogen peroxide may affect their polymerization. The aim of this study was to determine bond strength of composite materials after internal teeth bleaching using 30% carbamide peroxide. Material and Methods. The study was conducted on 20 extracted, endodontically treated human teeth. After internal teeth bleaching with 30% carbamide peroxide a class V cavity was prepared and restored with Tetric EvoCeram nanocomposite material. Microleakage was determined using dye method (silver nitrate) and measured on the incisal and gingival walls using stereoloupes. Results. Linear dye penetration on the incisal wall (7.25 μm) of bleached teeth was greater than on the incisal wall in non-bleached (control group) teeth (5.75 μm) but with no statistically significant difference. Dye penetration on the gingival wall of bleached teeth (20.00 μm) was greater than on the gingival wall of the control group (14.25 μm). This difference was statistically significant (p

Introduction. Indirect pulp capping is a therapeutic intervention in the treatment of deep carious lesion in order to stimulate odontoblasts to produce tertiary dentin using different biomaterials based mainly on calcium hydroxide. The aim of this study was to assess the effect of hard-setting (Dycal) and a suspension of calcium hydroxide (Calcipulp) in the treatment of deep carious lesion (caries profunda). Materials and Methods. Clinical study included 29 patients of both genders, age 16 to 40, and 45 teeth of different morphological groups with verified caries profunda using clinical and radiographic examination. After the cavity preparation, calcium hydroxide materials (Dycal or Calcipulp) were applied on the pulpal wall and cavities temporarily restored (phosphate cement) for the period of two months. After this period cavities were restored with composite materials and clinically observed during twelve months, with mandatory check-ups after three and six months. Results. Obtained results showed that indirect pulp capping using calcium hydroxide suspension (90.0%) was more successful than hard-setting material (84.0%), but with no statistically significant difference. Conclusion. Suspension and hard-setting calcium hydroxide were equally successful in the treatment of caries profunda.

Introduction. Advance in new nano-composite materials and adhesive systems has provided stronger bond with hard dental tissue as well as possibility for minimal cavity preparation. The aim of this study was to evaluate, using dye method, marginal seal of direct composite veneers placed on intact and abraded anterior teeth and polymerized with classical and soft start light curing technique. Material and Methods. The study was conducted on 40 extracted human anterior teeth. They were extracted for periodontal reasons and divided into two groups: intact teeth (20) and abraded teeth (20). 10 teeth in each group were polymerized with classical and soft start technique. Dye penetration was measured using stereo loupes with micrometer scale and six times magnification. Results. Linear dye penetration on the gingival wall when direct composite veneers were placed in intact teeth and polymerized with classical technique was 2.50 μm, while on the incisal wall it was 0.5 μm. Linear dye penetration on the gingival wall in intact teeth polymerized with soft start technique was 2.25 μm, while on the incisal wall it was 2.0 μm. Average dye penetration of direct composite veneers in abraded teeth polymerized with classical technique on the gingival wall was 3.0 μm while on the incisal wall it was 1.25 μm. Linear dye penetration in abraded teeth polymerized with soft start technique was greater on the gingival wall (3.50 μm) than on the incisal wall (3.25 μm). Conclusion. Smaller microcrack was observed on the incisal wall than on the gingival wall in all teeth regardless of the technique of polymerization used. The least dye penetration was observed in the group of intact teeth polymerized with classical technique of polymerization.

Introduction. The biggest drawback of composite materials is polymerization contraction and the existence of microcracks, therefore the market is now offering a wide variety of new composite materials. The aim of this study was to evaluate the marginal seal using dye method of class V cavities restored with self-etching flowable composite material Vertise Flow polymerized with different light-curing techniques. Material and Methods. The study was conducted on 60 extracted intact human teeth (30 premolars, 30 molars). Two cavities Class V (3×2×2 mm) were prepared in all teeth. Cavities on buccal surfaces were filled with self-etching flowable composite Vertise Flow (Kerr Dental Products), and on lingual with flowable composite Tetric Flow (Ivoclar Vivadent) using the corresponding adhesive systems. Polymerisation was performed using Bluephase Led flashlight C8 (Ivoclar Vivadent). Microleakage was tested using dye in a silver nitrate solution. Dye penetration was measured using stereo loupes with micrometer scale and six times magnification. Results. Linear dye penetration in intact molars restored using the classical polymerization technique and Vertise Flow composite was 3.41 μm while with Tetric Flow it was 4.23 μm. In intact molars restored using soft-start polymerization technique and Vertise Flow the dye penetration was 1.25 μm while for Tetric Flow it was 4.23 µm. Mean dye penetration in intact molars restored using pulse curing technique and material Vertise Flow was 1.02 μm while for the composite Tetric Flow it was 4.35 μm. In intact premolars restored using conventional curing technique and Vertise Flow dye penetration was 1.14 μm while for Tetric Flow it was 3.90 μm. Dye penetration in intact premolars restored using soft-start polymerization technique and Vertise Flow was 0.75 μm while for Tetric Flow it was 3.15 μm. Using a pulse polymerization technique and Vertise Flow in intact premolars dye penetration was 1.45 μm while for Tetric Flow it was 3.76 μm. Conclusion. Vertise Flow, self-etching flowable composite showed better marginal seal than flowable composite resin Tetric Flow. Smaller microcracks with Vertise Flow were confirmed after applying all three light-curing polymerization techniques.

Objective. The causes of internal posteruptive discoloration of teeth are bleeding, necroses, infections, and endodontic filling materials. The aim of this study was to establish the results of bleaching endodontically treated teeth using walking bleach, in-office, and combined techniques, using 30% carbamide peroxide and 35% hydrogen peroxide, as well as the effect of etiological factors, and the time elapsed after endodontic treatment on the success of bleaching. Materials and Methods. The research involved 30 endodontically treated teeth in healthy patients. Retroalveolar X-rays were taken to check the quality of root canal obturation. Endodontic treatment and obturation were carried out on the discolored non-vital teeth without any previous endodontic treatment. Before bleaching, two millimeters of the filling were removed from the root canal and the very entry into the canal was protected with glass ionomer cement. The teeth were divided into three groups, depending on the bleaching technique: walking bleach technique (10 patients), in-office technique (10 patients), and combined technique (10 patients). The teeth were bleached with 30% carbamide peroxide and 35% hydrogen peroxide. The bleaching procedure was repeated in all the patients three times. The color of all teeth was determined based on the Vita Classic guide before and after bleaching. The Χ2 square and Kruskal−Wallis tests were used to identify differences in teeth bleaching results. Results. A statistically significant difference (p < 0.05) was established between bleaching success and the time elapsed after endodontic treatment. There were no statistically significant differences observed between the bleaching success and etiological factors, bleaching techniques, or bleaching agents. Conclusions. The effectiveness of non-vital tooth bleaching is affected by the time elapsed after endodontic treatment.