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In endodontic practice, preferring the instruments with higher cyclic fatigue resistance would help to minimize the risk of instrument fractures; therefore especially during the preparation of curved canals, instruments with smaller core area and less cross-sectional metal mass, which could lead higher flexibility, can be proposed.

The aim was to evaluate the effects of fiber-reinforced composite restorations and a bulk-fill resin composite on the fracture strength of mandibular premolars treated endodontically. Standard mesio-occluso-distal (MOD) cavities were prepared in 48 mandibular premolars. Following root canal treatment, teeth were assigned to four groups: Group 1, nano-hybrid resin composite; Group 2, polyethylene woven fiber plus nano-hybrid resin composite; Group 3, short fiber-reinforced resin composite plus nano-hybrid resin composite; and Group 4, bulk-fill resin composite plus nano-hybrid resin composite. Then, the teeth were subjected to the fracture toughness test. The data were analyzed statistically using one-way ANOVA, followed by Tukey's post-hoc test. The fiber-reinforced groups had better results than the nano-hybrid and bulk-fill composites (p<0.05), while the bulk-fill and nano-hybrid composite restorations gave similar results (p>0.05). Fiber-reinforcement improved the fracture strength of teeth with large MOD cavities treated endodontically. Bulk-fill composites can be used reliably as well as nano-hybrid composites.

Kaval ME, G€ uneri P, C ß alıs ßkan MK. Regenerative endodontic treatment of perforated internal root resorption: a case report. International Endodontic Journal, 51, 128-137, 2018. Aim To present the regenerative endodontic treatment procedure of a perforated internal root resorption case and its clinical and radiographic findings after 2 years. Summary A 14-year-old female patient was referred complaining of moderate pain associated with her maxillary left lateral incisor. After radiographic examination, a perforated internal resorption lesion in the middle third of tooth 22 was detected. Under local anaesthesia and rubber dam isolation, an access cavity was prepared and the root canal was shaped using K-files under copious irrigation with 1% NaOCl, 17% EDTA and distilled water. At the end of the first and second appointments, calcium hydroxide (CH) paste was placed in the root canal using a lentulo. After 3 months, the CH paste was removed using 1% NaOCl and 17% EDTA solutions and bleeding in the root canal was achieved by placing a size 20 K-file into the periapical tissues. Mineral trioxide aggregate was then placed over the blood clot. The access cavity was restored using glassionomer cement and resin composite. After 2 years, the tooth was asymptomatic and radiographic examination revealed hard tissue formation in the perforated resorption area and remodelling of the root surface. Key learning points• Regenerative endodontic treatment procedures are an alternative approach to treat perforated internal root resorption lesions.• Calcium hydroxide was effective as an intracanal medicament in regenerative endodontic treatment procedures.