No abstract

Dynamic viscosity increased with sodium hypochlorite and surfactant concentration but decreased with temperature. Under clinical conditions, all viscosities measured led to laminar flow. The transition between laminar and turbulent flow may be reached by modifying different parameters at the same time: increasing flow rate and temperature whilst decreasing irrigant viscosity by adding surfactants with a high value of critical micellar concentration.

Objectives: To gain insight on the current clinical usage of Bioceramic root canal sealers (BRCS) by general dental practitioners (GDPs) and endodontic practitioners (EPs) and to determine if BRCS clinical application is in accordance with the best available evidence.Material and methods: An online questionnaire of 18 questions addressing BRCS was proposed to 2335 dentists via a web-based educational forum. Participants were asked about socio-demographic data, clinical practice with BRCS and their motivation for using BRCS. Statistical analysis (Chisquared test or Fisher's exact test) were applied, as appropriate, to assess the association between the variable categories (p-value<0.05). Results:The response rate was 28.91%. Among respondents, 94.8% knew BRCS (EPs more than GDPs, p<0.05) and 51.70% were using BRCS. The primary reason for using BRCS was their believe of its improved properties (87.7%). Among BRCS users, single cone technique (SCT) was the most employed obturation method (63.3%) which was more applied by GDPs (p<0.05); EPs utilized more of the thermoplasticized obturation techniques (p<0.05). A proportion of 38.4% of BRCS users indicated the usage of SCT with BRCS regardless of the root canal anatomy (GDPs more than EPs p<0.05) and 55.6% considered that BRCS may influence their ability to re-establish apical patency during retreatment (GDPs more than EPs p<0.05). Conclusions:This study highlights wide variation in the clinical use of BRCS which is not in accordance with the current literature.Clinical relevance: This inconsistency among EPs and GDPs on BRCS clinical application requires further clarifications to better standardize their use and improve their future evaluation.

No abstract

No abstract

Objectives To assess related studies and discuss the clinical implications of endodontic access cavity (AC) designs. Materials and methods A systematic review of studies comparing the fracture resistance and/or endodontic outcomes between different AC designs was conducted in two electronic search databases (PubMed and Web of Science) following the PRISMA guidelines. Study selection, data extraction, and quality assessment were performed. Meta-analyses were undertaken for fracture resistance and root canal detection, with the level of significance set at 0.05 (P = 0.05). Results A total of 33 articles were included in this systematic review. The global evaluation of the risk of bias in the included studies was assessed as moderate, and the level of evidence was rated as low. Four types of AC designs were categorized: traditional (TradAC), conservative (ConsAC), ultraconservative (UltraAC), and truss (TrussAC). Their impact on fracture resistance, cleaning/disinfection, procedural errors, root canal detection, treatment time, apical debris extrusion, and root canal filling was discussed. Meta-analysis showed that compared to TradAC, (i) there is a significant higher fracture resistance of teeth with ConsAC, TrussAC, or ConsAC/TrussAC when all marginal ridges are preserved (P < 0.05), (ii) there is no significant effect of the type of AC on the fracture resistance of teeth when one or two marginal ridges are lost (P > 0.05), and (iii) there is a significantly higher risk of undetected canals with ConsAC if not assisted by dental operating microscope and ultrasonic troughing (P < 0.05). Conclusions Decreasing the AC extent does not necessarily present mechanical and biological advantages especially when one or more surfaces of the tooth structure are lost. To date, the evidence available does not support the application of Trus-sAC. UltraAC might be applied in limited occasions. Clinical relevance Maintaining the extent of AC design as small as practical without jeopardizing the root canal treatment quality remains a pragmatic recommendation. Different criteria can guide the practitioner for the optimal extent of AC outline form which varies from case to case.

These findings highlight the need for educational improvement regarding pain and anxiety in emergency conditions, especially concerning the assessment methods and continuity in the control of pain. Emergency dental care appears to be a very suitable field for contextual learning.

No abstract