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Objective: Since the 1960s, there has been contradictory evidence regarding the association between periodontal pathology and the status of the pulp. The purpose of this study was to evaluate the histopathological changes of pulp tissue with severe periodontal disease, including vertical bone loss involving the major apical foramen, and compared them with the histological pulpal status of teeth with healthy periodontium. Methods: This case-controlled study included 35 intact teeth with severe periodontitis of hopeless prognosis (test group) and 35 teeth without periodontitis extracted for orthodontic reasons (control group). For each tooth, periodontal and endodontic parameters such as probing depth and pulpal vitality were recorded, and the pulp tissue was evaluated histologically. The data were analysed with a significance level of 0.05. Results: Vital pulp was observed in all specimens of both groups (P=1). Pulpal inflammation in the apical portion was observed in 81.71% of the severe periodontitis group, whereas all teeth in the control group demonstrated no signs of pulpal inflammation. Dystrophic calcification and pulp stones were observed in 7.5% of the periodontitis group and 5.7% of the healthy group (P>0.05). Pulp fibrosis was observed in 22.8% of the periodontitis group and 2.8% of the control group (P=0.012). Pulpal necrosis was not noted in either group. In the periodontitis group, internal resorption was present in 22.8% of cases (P=0.005) and external resorption was present in 80% of cases (P

The aim of this study was to evaluate the composition of microbiota of irreversible pulpitis and primary endodontic infections with respect to clinical and radiographic findings by performing cultures and 16s rDNA sequencing in Iranian patients. In this prospective cross-sectional study, samples were collected from 41 root canals for 4 main groups of patients. Bacterial identification was performed by the polymerase chain reaction (PCR) and 16s rDNA sequencing of aerobic and anaerobic cultivable colonies taken from patients’ culture plates. Additionally, the presence of 13 bacterial species and 3 nonbacterial species was also explored using PCR and species-specific primers. Sixteen microbial species, 1 fungus (Candida albicans), and 1 virus (Herpes simplex virus) were discovered and isolated. Species with the highest prevalence were Dialister invisus (68.3%), Porphyromonas gingivalis (58.8%), Streptococcus salivarius (58.5%), and Treponema denticola (56.1%). Lysinibacillus fusiformis (19.1%) was detected in the root canals for the first time. Candida albicans was seen in 11 cases (26.8%). Herpes simplex virus (HSV) was seen in 4 patients (9.8%). Our results suggest that Gram-negative anaerobic oral bacteria are the majority of the microbes in primary endodontic infections. Various combinations of bacterial species were related to different clinical and radiographic conditions. Lysinibacillus fusiformis was detected for the first time in primary endodontic infections. The results of this investigation might help clinicians choose to identify suspected endodontic pathogens in the etiology of each form of pulpal and periradicular diseases to determine the best therapeutic measures.

To evaluate the effect of Er:YAG etching on topography, microstructure, compressive strength, and shear bond strength (SBS) of All-Bond Universal adhesive to mineral trioxide aggregate-Angelus (AMTA) and Biodentine (BD).Sixty cylindrical specimens of each cement (AMTA and BD) in five groups were prepared and stored for 72 h. The control groups were non-etched, and four other groups were acid-etched and laser-etched with a pulse energy of 60, 80, or 100 mJ, followed by compressive strength testing. Surface micromorphology and topography were evaluated. Similar groups were bonded using All-Bond Universal with self-etch and etch-and-rinse (acid-etch) approaches, and laser-etch 60, 80, and 100 mJ, and SBS was tested. Data were analyzed using two-way and one-way ANOVA and the Bonferroni post hoc tests (α = 0.05).BD had a significantly higher compressive strength and SBS (except for laser-etch 100) compared to AMTA, regardless of the etching method (p 0.001). Acid etching and laser etching 100 of both cements and laser etching 80 of BD alone produced a significantly lower compressive strength than that for the other groups. Contrary to BD, for AMTA, all the treatments significantly increased SBS compared to that of the self-etch group.Etching of AMTA was needed for stronger bonding; laser etching with 60 or 80 mJ without compromising compressive strength was recommended. Etching not only did not improve bonding ability of BD, but it also negatively affected the strength of BD.To achieve successful combined calcium silicate cement-resin material restoration, an adequate bond between the materials is mandatory. This might be provided with the ultramild adhesive through laser etching without compromising compressive strength, depending on cement composition and laser energy level used.

Introduction The acute (symptomatic) apical abscess is characterized by pulp necrosis, rapid onset, spontaneous pain, percussion pain, pus formation, and tissue swelling. The etiopathology of acute apical abscesses includes active (lytic) herpesviruses and gram-negative anaerobic bacteria. The present study examined the potential of valacyclovir, an anti-herpesvirus agent, and systemic amoxicillin to manage the pain of acute apical abscesses. Methods Twenty emergency patients with moderate to severe apical abscess pain received randomly either amoxicillin (1 g immediate dose followed by 500 mg, 4 times a day, totally 7 days) + valacyclovir (2 g immediate dose followed by 500 mg, twice a day, totally 3 days) (“valacyclovir” group, 10 patients) OR amoxicillin (1 g immediate dose followed by 500 mg, 4 times a day, totally 7 days) + placebo (“placebo” group, 10 patients). Daily telephone calls during the 6-day follow-up period assessed pain level on a numeric rating scale and analgesic intake. The Mann-Whitney and the Friedman statistical tests analyzed the outcome data. Results At the baseline examination, all 10 valacyclovir and 9 placebo patients exhibited moderate to severe pain and 18 patients needed pain medication. On the first day after baseline, the valacyclovir group showed 2 patients with moderate/severe pain and 1 patient on pain medication, but the placebo group revealed as many as 8 patients with moderate/severe pain and 9 patients on pain medication. The difference in pain level and analgesic usage between the valacyclovir and the placebo group remained statistically significant during the entire post-baseline study period (P Conclusion The present study points to valacyclovir as a promising adjunctive agent in pain control with acute apical abscesses.

Objectives The aim of this investigation was to evaluate the clinical and histological differences in wound healing between beveled and perpendicular vertical releasing incisions in dogs. Material and Methods Four male mongrel dogs were used in this investigation. In each quadrant, a vertical releasing incision was made on either the mesial or the distal aspect of the cuspid teeth of each animal all on the same day. The sites were randomly selected to either receive a beveled incision or a perpendicular incision. A sulcular muco-periosteal flap was raised, reapproximated, and then sutured using 3-0 Vicryl. The animals were evaluated daily for the first week, and then at different time intervals during this investigation. One animal was killed at each time interval of 9, 14, 21, and 28 days after surgery. One animal was killed at each time interval, and a bone block consisting of the cuspid teeth and their surrounding bone and soft tissues was harvested, formalin fixed, and paraffin embedded. Samples were sectioned serially and stained with hematoxylin-eosin. Specimens were evaluated using a microscope with magnification ranging from ×10 to ×400 by a histopathologist. Four indices were used for histologic evaluation. Results At day 9 after surgery, a visible groove was seen in the marginal tissues of both perpendicular and beveled incisions. At day 9, both of the histologic sections showed less organized connective tissue and capillary networks with no significant difference in inflammation. In the 14-day samples, a depression was still present at the perpendicular incision sites, but not in the beveled incision group, where the groove was not visualized at all. In the 21- and 28-day samples, irregular capillary arrangements were seen in the connective tissue of the perpendicular incision groups with completely healed epithelium. There were no statistically significant differences noted histologically between the beveled and perpendicular incision groups noted at 9, 14, 21, or 28 days (P > .05). Conclusion Based on these findings, it appears that clinical and histologic healing of beveled or perpendicular releasing incisions are similar 28 days after surgery.

Regenerative endodontic procedures are undertaken on permanent teeth with necrotic pulps and open apices in an attempt to resolve symptoms, to allow the continued development of the root(s), and to reestablish vitality. The available histologic analysis of these teeth has, in the majority of studies, shown that true regeneration of the pulp-dentin complex is not achieved. A recent investigation using an animal model outlined a procedure wherein pulpal amputation a few millimeters short of the apex followed by evoked bleeding allowed the complete regeneration of the normal pulp-dentin complex in immature vital teeth of ferrets. By implementation of this procedure, we report successful pulp regeneration outcome evidenced by continued root development and a positive response to pulp vitality tests in a maxillary central incisor with an open apex diagnosed with symptomatic irreversible pulpitis.

Figure 2 was incorrect in the original published version of this article. Correct figure in presented here. The original article has been corrected.

There is a need for updating the current treatment modalities for periapical lesions of endodontic origin to reflect the contributions and potential morbidity from herpesvirus infection. Herpesviruses, particularly human cytomegalovirus and Epstein-Barr virus, play an important role in the symptomatic periapical lesion. Indeed, periapical lesions may remain stable and silent until they become symptomatic, possibly triggered by the activation of latent herpesviruses within the lesion itself. Given the potential for grave systemic conditions associated with herpesvirus infection, early detection and treatment decisions for periapical lesions by the dentist may positively affect a patient’s overall health; especially for the immunocompromised patient.

PbO nanoparticles were explored as a highly efficient, simple, cheap, and recyclable catalyst for the fast synthesis of 1H-pyrazolo[1,2-b]phthalazine-5,10-dione derivatives by means of a one-pot three-component reaction of phthalhydrazide, aromatic aldehyde, and malononitrile under solvent-free conditions at 80 °C. Furthermore, nanosized PbO was prepared by the two conventional methods of planetary ball milling and dispersion of commercial PbO in n-octane, and their catalytic performances were compared with the commercial bulk PbO. The prepared nano-PbO via ball milling was described by SEM, TEM, XRD, EDX, and FT-IR spectroscopy. The present protocol conveyed major proficiencies such as the use of a reasonable and readily available catalyst, simple work-up and purification of products by nonchromatographic strategy, low reaction times, and enhanced yields under relatively environmental benign conditions. The heterogeneous catalyst was appropriately recyclable and could be reused for several times without loss of activity.

This study compared the antibacterial effect of 2% clindamycin and 2% and 100% concentration of triple antibiotic paste (TAP) on an Enterococcus faecalis biofilm. Dentinal tubules of 100 root specimens were infected and randomly assigned to five groups. A total of 1000 mg mL-1 of TAP, 20 mg mL-1 of TAP and clindamycin, calcium hydroxide or methylcellulose (control) were placed in the root canal for 1 week. After treatment, dentine shavings were collected from 200 and 400 μm dentine depth and the number of colony-forming units (CFU) per mg was determined. Reduction in viable bacteria in first three groups was significantly better than calcium hydroxide and control groups. However, the antimicrobial effectiveness among these three groups was not significantly different from each other. There was no significant difference between data at 200 and 400 μm in all groups except the Ca(OH)2 group. The antibiofilm effect of clindamycin was comparable with TAP, so it may be used instead of TAP.

Introduction The susceptibility of endodontically treated teeth (ETT) to fracture is mainly associated with the loss of tooth structure. This study evaluated the effect of the access cavity design and taper preparation of root canals on ETT fracture resistance of maxillary molars. Methods For tapering assessment, 30 sound distobuccal roots of maxillary molars were randomly assigned to 1 of 3 groups (n = 10): a .04 taper, a .06 taper, or a .08 taper. Endodontic canal preparations were performed using the Twisted Files rotary system (Kerr Co, Glendora, CA). In addition, 48 intact maxillary first and second molars were randomly assigned to 1 of 3 groups (n = 16) for cavity preparation approaches: intact teeth, traditional access cavity (TAC), or conservative access cavity (CAC). Fracture resistance was tested using a universal testing machine. For statistical analysis, the level of significance was P ≤ .05. Results The .04 taper instrumentation had the highest fracture resistance (259.61 ± 52.06), and the .08 taper had the lowest (168.43 ± 59.63). The .04 and .06 groups did not differ significantly (P > .05); however, these groups differed significantly from the .08 group (P ≤ .05). Regarding the cavity preparation approaches, the 3 groups of intact teeth, CAC, and TAC showed fracture resistance mean values of 2118.85 ± 336.97, 1705.69 ± 591.51, and 1471.11 ± 435.34, respectively, with no significant difference between the CAC and TAC groups (P > .05). Conclusions Increasing the taper of the root canal preparation can reduce fracture resistance. Moreover, access cavity preparation can reduce resistance; however, CAC in comparison with TAC had no significant impact.

The oxidation of thiocyanate to polythiocyanic acid by peroxydisulfate was carried out in an aqueous solution at room temperature. The primary step is the decomposition of peroxydisulfate into sulfate-free radicals. At room temperature in the presence of peroxydisulfate as a oxidizing agent, HSCN polymerizes to (HSCN)n. The oxidation of thiocyanate in an aqueous solution is often complicated, but here we obtained the polythiocyanic acid as a major product. The products were characterized by elemental analysis, IR, UV- visible, H-NMR spectroscopy, and X-ray powder diffraction.

Introduction: Root canal preparation techniques may cause postoperative pain. The aim of the present study was to compare the intensity of postoperative pain after endodontic treatment using hand files, single file rotary (OneShape), and single file reciprocating (Reciproc) systems. Methods and Materials: In this single-blind, parallel-grouped randomized clinical trial a total of 150 healthy patients aged between 20 to 50 years old were diagnosed with symptomatic irreversible pulpitis of one maxillary or mandibular molars. The teeth were randomly assigned to three groups according to the root canal instrumentation technique: hand files (control), OneShape and Reciproc. Treatment was performed in a single visit by an endodontist. The severity of the postoperative pain was assessed by the visual analogue scale (VAS) after 6, 12, 24, 48 and 72 h. Data were analyzed using the Kruskal-Wallis and Mann-Whitney U tests. Results: The patients in control group reported significantly higher mean postoperative pain intensity at 12, 24, 48, and 72 h compared to the patients in the two other groups (P0.05). Conclusion: The instrumentation kinematics (single-file reciprocating or single-file rotary) had no impact on intensity of postoperative pain.