Background: One of the ideal properties of a root canal sealer is to have a good sealing ability, especially at the apical third of the root. Objective: To evaluate the comparison of the apical leakage between obturation using bioceramic sealer (BS) and polydimethylsiloxane sealer (PS). Materials and Methods: Thirty-six mandibular premolars were equally divided into two groups and were obturated with single cone technique. The sealers used for Group I and Group II were BS and PS respectively. After obturation, the samples were incubated (37˚C, 24 h), sealed with two coats of nail polish except for 2 mm from the apex, submerged in the Indian ink for 7 days, decalcified, dehydrated, and made transparent according to Robertson technique. Dye penetration was evaluated under stereomicroscope. Samples without dye penetration were given score 0, dye penetration ≤ 0.5 mm were given score 1, 0.51 -1 mm were given score 2, and >1 mm were given score 3. Result: The largest proportion distribution in BS group was at the score 1 (55.6%), whereas in PS group was at the score 2 (44.4%). Conclusion: Bioceramic sealer showed similar apical leakage to polydimethylsiloxane sealer. Clinical Relevance: Based on this study, bioceramic sealer can be recommended to be used as sealer with low level of apical leakage as well as polydimethylsiloxane sealer.

Broken files affect cleaning, shaping, and filling processes of the root canal, thereby causing maintenance failure. Objective. This report explains how to remove broken files using ultrasonic instruments and endodontic micro forceps. Case Report. A 25-year-old female patient had incomplete root canal treatment at the lower right first molar 1 week ago. There were radiolucency in the bifurcation and apical root and the presence of broken files in the 1/3 coronal mesiolingual root. The retrieval started by making a staging platform with an ET20 ultrasonic tip. Endodontic micro forceps were used including a screw wedge that works by clamping the file fragments through a mechanical lock and pulling them to the coronal. Conclusion. It is possible to successfully remove broken files from the root canal using ultrasonic instruments and endodontic micro forceps.

Objective: The main objective of endodontic treatment is to remove microorganisms from the root canal space and prevents reinfection. Deep penetration of the dentinal tubule is advantageous because it increases the contact area between the root canal filling material and dentin, thereby increasing the sealing quality of the entire root canal system. Bioceramic sealers are biocompatible, nontoxic, non-shrinking, hydrophilic, and stable, do not expand during setting, and can form hydroxyapatite, which then forms chemical bonds with dentin to compare the abilities of three types of bioceramic-based sealers to penetrate the dentinal tubules.Methods: Obturation used three types of bioceramic sealers. Group 1 (calcium phosphate silicate), Group 2 (a mixture of tricalcium silicate and resin), and Group 3 (pure tricalcium silicate) were observed using a scanning electron microscope and measurement of the penetration distance with ImageJ.Results: The bioceramic sealers had statistically significant differences in penetration distance into dentinal tubules (p’s<0.001). The mean penetration value of Group 1 (calcium phosphate silicate) was 115.99 μm, Group 2 (a mixture of tricalcium silicate and resin) was 209.28 μm, and Group 3 (pure tricalcium silicate) was 84.07 μm.Conclusion: Although all three bioceramic sealers penetrated the dentinal tubules, they exhibited differences in their penetration capabilities. Group 2 had the deepest penetration, likely due to the resin content.

Objective: To discover the ideal concentration of Advanced Platelet Rich Fibrin (A-PRF) as modification of PRF, for human Dental Pulp Stem Cells (hDPSCs) differentiation. Material and Methods: hDPSCs were devided into five experimental groups: Group I (control group) consist of hDPSCs cultured in 10% FBS, Group II consist of hDPSCs cultured in 1% A-PRF, Group III consist of hDPSCs cultured in 5% A-PRF, Group IV consist of hDPSCs cultured in 10% A-PRF and Group V consist of hDPSCs cultured in 25% A-APRF. All group have been observed for 7 and 14 days and each group had three biological replicates (triplo). Formation of the mineralized nodules was detected after 7 days by Alizarin red-based assay and Dentin Sialophosphoprotein (DSPP) expression after 7 and 14 days quantified by ELISA reader. Statistical analysis was proven with Kruskal-Wallis and post hoc Mann-Whitney test. Results: The differentiation of hDPSCs in all A-PRF groups was significantly different on day-7 (p<0.05) compare to control group (Group I). There were no significant differences between all groups on day-14 (p>0.05). Significantly differences between Group II (1% A-PRF) and Group I (control), Group II (1% A-PRF) and Group III (5% A-PRF), also Group II (1% A-PRF) and Group V (25% A-PRF) was found from post hoc test analysis. Conclusion: The ideal conditioned media concentration for differentiation of human dental pulp stem cells was on 1% up to 5% A-PRF group.

Objective: Carboxymethyl chitosan/amorphous calcium phosphate (CMC/ACP) can replace the role of dentine matrix protein 1. Guided tissueremineralization (GTR) is a method of extrafibrillar and intrafibrillar collagen remineralization. This study analyzed the ability of CMC/ACP to achieveintrafibrillar and extrafibrillar remineralization on demineralized dentin.Methods: We divided 12 demineralized occlusal cavities into four groups: 7 days control group, 14 days control group, 7 days CMC/ACP group, and14 days CMC/ACP group. In the control group, the cavities were directly filled with temporary restoration material, while the cavities of the CMC/ACPgroups first underwent application of CMC/ACP and were then filled with temporary restoration material. All samples were stored in a 37°C shakingincubator. 12 samples were analyzed by energy-dispersive X-ray (EDX) spectroscopy and four were analyzed by transmission electron microscope(TEM).Results: From day 7 to day 14, there was a significant increase in calcium and phosphate levels within the CMC/APC groups. The phosphate levelswere much lower than the calcium or minerals formed on the 7th day, in the form of hydroxyapatite. TEM analysis shows that the CMC/ACP groupexhibited more intrafibrillar and extrafibrillar remineralization.Conclusion: CMC/ACP can improve the GTR process.

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Objective This study aimed to analyze, evaluate, and characterize novel cement-based carboxymethyl chitosan/amorphous calcium phosphate (CMC/ACP). Materials and Methods The three cement groups studied were gypsum (Gyp), and CMC/ACP—gypsum cement-based 5% (5% CAG) and 10% (10% CAG). The groups were characterized using Fourier-transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), setting time, and scanning electron microscopy (SEM) data. The characterization results were analyzed qualitatively, but the data for setting time were analyzed using SPSS (p < 0.05). Statistical Analysis Data were statistically analyzed. One-way analysis of variance was used to compare numerical (parametric) data between more than two separate groups followed by post hoc Tukey. Results FTIR showed phosphate groups indicate the presence of calcium phosphate in the form of amorphous (ACP) in the CMC/ACP, CMC/ACP post-milled powder, and CMC/ACP cement-based (5% CAG and 10% CAG). XRD showed no difference in the diffraction spectra among the Gyp, 5% CAG, and 10% CAG groups. SEM images revealed that the CMC/ACP cement-based groups (5% CAG and 10% CAG) showed CMC/ACP cluster filled with hollow spaces between the gypsum crystals and aggregations surrounding the gypsum crystals. The CMC/ACP showed envelopes and attached to the crystalline structures of the gypsum. Setting times of 5% CAG and 10% CAG showed significant differences compared with Gyp (p < 0.05). Conclusion The result of our study showed that CMC/ACP cement-based (5% CAG and 10% CAG) demonstrated amorphous characteristic, which can stabilize calcium ions and phosphate group (ACP). In addition, the modification of gypsum using CMC/ACP as cement-based extended the time of setting.

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