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Objective: The aim of this study was to evaluate the influence of autoclave sterilization on the resistance to cyclic fatigue of two nickel-titanium (NiTi) endodontic files of identical design and taper, but with different NiTi alloy treatments: the newly introduced heat-treated Race Evo and the electropolished Race files. Materials and methods: Fifteen Race (25/0.06) files and fifteen Race Evo (25/0.06) files (n = 30 in total) were randomly assigned to five sub-groups each consisting of three files of the same NiTi alloy treatment. One group served as a control with files unautoclaved. The four remaining groups were sterilized in a steam sterilizer for 1, 3, 5, and 10 autoclave cycles, respectively. Files then underwent cyclic fatigue testing in a simulated metal canal block. A scanning electron microscope was used to inspect the surface of the fractured instruments. Statistical analysis was conducted using independent t-test and multi-factorial analysis of variance with significance set at a p value of ≤0.05. Results: Both Race Evo and Race files showed no significant difference between the different autoclaving cycles in terms of the number of cycles to fracture (p = 0.232 and p = 0.359). Despite rotating at a higher speed, the number of cycles to fracture of heat-treated Race Evo files was significantly higher than that of Race files (p ≤ 0.0001). Conclusion: Autoclave sterilization has no significant effect on the resistance to cyclic fatigue of heat-treated Race Evo or electropolished Race files. However, Race Evo files showed superior resistance to cyclic fatigue irrespective of autoclaving cycles.

Objectives. The aim of this study was to investigate the influence of exposure to additional preclinical endodontic training on undergraduate students’ technical quality of root canal treatment and overall confidence levels in endodontics. Methods. Technical quality of root canal treatment performed clinically by fifth-year undergraduate students was evaluated and divided into two groups: Group 1, teeth treated by students who had attended both a preclinical endodontic block course and an elective preclinical course. Group 2: teeth treated by students who had not attended the elective preclinical course. All students were also invited to participate in a survey to rate their undergraduate endodontic training and confidence levels performing endodontic treatment. Statistical analysis of data was performed using Person chi-square test, Fisher Freeman Halton exact test, and t-test. A p -value <0.05 was considered statistically significant. Results. There was no significant difference between the two groups in overall obturation quality ( p = 0.619 ). However, more teeth treated by attendees were of adequate obturation length ( p = 0.015 ) and lacked procedural errors ( p = 0.004 ). Significantly more elective course attendees rated their undergraduate endodontic training as adequate ( p = 0.002 ), but there was no significant difference in the level of confidence between the attendees and the non-attendees. Conclusion. Within the limitations of this study, additional preclinical training showed minimal effect on overall quality of root canal treatment performed clinically by undergraduate students and did not enhance their confidence levels; however, it was associated with more satisfaction with their undergraduate endodontic education.

BACKGROUND The use of advanced platelet-rich fibrin (A-PRF) membranes for guided bone and tissue regeneration in through-and-through defects after endodontic surgery was explored in three cases. CASE SUMMARY Herein, three patients presented to the endodontic clinic suffering from apical periodontitis, associated with large bone resorption and related to previously endodontically treated teeth. Periapical surgery was indicated in these cases and the osteotomy site was covered by A-PRF membrane. Cone-beam computed tomography (CBCT) was used to assess the cases before and after the surgery. CONCLUSION Four months post-surgery, the recall CBCT scan showed complete obliteration of the osteotomy with newly formed bone. A-PRF membrane showed promising results and was an advantageous addition to surgical endodontic treatment.

This study was to determine the effectiveness of diode laser (LI) and ultrasonic (UI)‐activated irrigation with or without a surfactant as adjunct techniques during the retreatment of gutta‐percha and tricalcium silicate‐based sealer (BC) sealer. Forty‐two single‐rooted premolars were instrumented and filled with gutta‐percha and BC sealer, then retreated using NiTi retreatment rotary files. Teeth were randomly divided into three equal groups: Control (manual irrigation), UI and LI groups. Each group was subdivided into 2.5% NaOCl irrigant and ChlorCid™️ Surf subgroups. The amount of material removed following UI and LI was significantly greater than that of manual irrigation (p < 0.0001). However, there was no significant difference between the surfactant subgroups, irrespective of irrigation technique (p = 1.00, p = 0.535, p = 0.805). The use of UI and LI adjuncts to NiTi rotary retreatment techniques showed significant improvement in gutta‐percha with BC sealer removal. However, surfactants had no effect on the efficacy.

Introduction. Coronal leakage is detrimental to the long-term success of root canal treatment (RCT). While much emphasis is being placed on the quality of the final restoration, little attention is given to the temporary restoration placed in between root canal treatment appointments. The aim of this study was to survey temporization techniques practiced in Saudi Arabia and the frequency of observing temporary material breakdown or complete loss. Materials and Methods. An online questionnaire was distributed among general dentists, dental specialists, and clinical trainees in undergraduate and postgraduate dental programs. The sample size was estimated at 370 participants. Data were analyzed using descriptive statistics and chi-square tests. Results. The total number of participants who met the inclusion criteria was 525. The majority of them (94.6%) were practicing two-visit RCT. The most common temporization materials were Cavit (50.3%) followed by glass ionomer cement (32%). The majority (72.6%) of participants claimed they allow a thickness of 2-3 mm for temporary restorations. Many participants (60.4%) used a spacer material during temporization, and the cotton pellet was the most common spacer material. Temporary restoration breakdown or complete loss was a common observation. Although the duration between the two RCT visits was 2 weeks or less for 83.6% of participants, only 19.6% of participants claimed that they rarely observed temporization breakdown. Conclusion. Two-visit RCT is commonly practiced in Saudi Arabia, and endodontists performed significantly more single-visit procedures. Temporization practices may lack uniformity; however, clinicians were more likely to use calcium sulfate-derived material for two weeks or less. They allow for 2-3 mm thickness restoration and use a cotton pellet as a spacer. According to their clinical observation, temporary material breakdown or complete loss was frequent. This mandates further attention in research and education.

Background Identify the objectives and the instructional design of undergraduate endodontics in dental schools in Saudi Arabia. Methods The online questionnaire was developed from an original survey conducted in the United Kingdom. The questionnaire was modified for purpose of the study and the region of interest. Then it was directed and emailed to the undergraduate endodontic program directors in twenty-six dental schools in Saudi Arabia. The results were analyzed using descriptive statistics and the Chi-square and Fisher’s exact tests. Results The response rate was 96.15%. The number of credit hours for preclinical endodontic courses was up to four credit hours (84%). Students were clinically trained to do vital pulp therapies (92%), root canal treatment (100%), and root canal retreatment (68%). The majority of dental schools define the minimum clinical requirements (92%). Practical and clinical competency exams were used to evaluate students' performance (92% and 84% respectively). The students were trained to treat cases of minimal (52%) to moderate complexity (48%). Endodontic treatment consent and difficulty assessment form were used by 32% and 60% of dental schools respectively. There was no significant difference in the instructional design between public and private dental schools (P > 0.05). Conclusion The endodontic undergraduate objectives were to graduate competent clinicians who acquired basic science of endodontics and who know their limitations as it is necessary for a safe general dental practice. The use of endodontic treatment consent and case difficulty assessment should be wisely considered in clinical training.

In this study, we evaluate the surface roughness (SR) of three thermally treated nickel-titanium rotary instruments (i.e., TruNatomy [TN], ProTaper Gold [PTG], and EdgeTaper Platinum [ETP]) after impact testing with multiple autoclave sterilization cycles using scanning electron microscopy (SEM). Overall, 60 thermally treated files were sourced (i.e., 20 TN, 20 ETP, and 20 PTG files), and each group was divided into four equal subgroups of five files (n = 5). An unsterilized group was assigned as the pre-autoclaving group (Cycle 0), and the other three groups underwent various autoclave sterilization cycles (Cycles 1, 5, and 10). The roughness average (Ra), root mean square (Rq), and average maximum peak-to-valley height (Rz) values were evaluated using SEM and ImageJ software. The Shapiro–Wilk test, one-way analysis of variance, and post-hoc Tukey test were used to analyze the data. The statistical significance level was set at p < 0.05 . Before autoclaving, all instruments showed debris and SR but with no statistically significant differences existing between the groups. SR values decreased after one autoclaving cycle for all instruments. After five autoclave cycles, the Rz value of ETP was statistically higher compared with PTG and TN. After 10 autoclave cycles, the Ra and Rq values of TN were statistically higher compared with ETP and PTG. These results suggest that multiple autoclaving sterilization cycles influence the SR of TN, PTG, and ETP, with ETP showing higher levels of surface irregularities than PTG and TN.