The aim of the present study was to compare the effect of chitosan nanoparticle, QMix, and 17% EDTA on the penetrability of a calcium silicate-based sealer into dentinal tubules using a confocal laser scanning microscope (CLSM). Sixty mandibular premolar teeth were selected and randomly divided into three groups (n = 20) before root canal preparation according to the solution used in the final rinse protocol: chitosan, QMix, and EDTA groups. Twenty teeth of each group were filled with a TotalFill BC sealers' single gutta-percha cone and with 0.1% rhodamine B. The specimens were horizontally sectioned at 3 and 5 mm from the apex, and the slices were analyzed in CLSM (4×). Total percentage and maximum depth of sealer penetration were measured using confocal laser scanning microscopy with using Image J analysis software. Dentinal tubule's penetration depth, percentage, and area were measured using imaging software. Kruskal-Wallis test was used for statistical analysis. The level of significance was set at 5%. Results of Kruskal-Wallis analysis showed that there was a significant difference in the percentage and depth of sealer penetration among all groups at 3 and 5 mm level sections (P < 0.05). Within the groups, the minimum sealer penetration depth was recorded for chitosan nanoparticle group. Greater depth of sealer penetration was recorded at 5 mm as compared to 3 mm in all the groups. Within the limitation of the present study, it can be concluded that QMix and EDTA promoted sealer penetration superior to that achieved by chitosan nanoparticle.

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Background: Titanium-prepared platelet rich fibrin (T-PRF) is an autologous hemo-component with a high concentration of platelets that also incorporates leukocytes, and growth factors into the dense fibrin matrix and can be used as a healing biomaterial. This study assesses the adjunctive use of T-PRF in intrabony defects (IBDs) with open flap debridement (OFD) in comparison with guided tissue regeneration (GTR) as a gold standard and OFD alone as a control. Material and Methods: A total of 45 patients (15 per group) were randomized as either T-PRF (test group), GTR (test group), or OFD alone (control group) sites. Probing depth (PD), clinical attachment level (CAL), and IBD were recorded. The radiographic depth of IBD was also measured. Primary outcomes assessed were changes in PD, CAL, and radiographic IBD that were assessed at the beginning and nine months later. Results: The PRF and GTR group showed significant improvement in clinical parameters compared with the OFD alone (control group) at nine months. While there were no significant differences in PD and CAL between test groups (T-PRF and GTR groups), the significant difference was found in radiographic IBD depth. Conclusion: T-PRF may give similar successful results as GTR in the treatment of IBDs with endo-perio lesions.

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This study investigated the relationship between chronological age and pulp tooth area ratio (PTR) in maxillary central teeth using cone‐beam computed tomography (CBCT) images in the Turkish population. The sample consisted of CBCT images of 120 male and female subjects between 14 and 75 years old. The PTR of the maxillary central teeth was calculated using inVivo 5 software (Anatomage, San Jose, CA). Data were analyzed with independent t‐test and Pearson's rank correlation test. There was a significant negative correlation between chronological age and PTR (r = −0.615). The results showed that the PTR of maxillary central teeth is a reliable method for age estimation in the Turkish population.

AimThis single‐centre retrospective case–control study evaluated fractal dimension (FD) changes in radiographs of periapical lesions using a fractal analysis in healthy individuals and type 2 diabetes mellitus (DM) patients following root canal treatment.MethodologyThe study data consisted of two groups: the DM group which contained a total of 46 mandibular molar teeth in 37 patients with no systemic disease other than type 2 DM, and the control group which contained a total of 52 mandibular molar teeth in 41 patients without systemic disease. Periapical radiographs were obtained prior to root canal treatment and 1 year post‐treatment. Fractal analysis was performed by selecting a region of interest on the periapical radiographs. For both groups, the FD changes in lesion area were calculated and compared. In addition, periapical status was evaluated using the periapical index (PAI) scores on periapical radiographs for both groups. Data were analysed using dependent‐sample t‐test, independent‐sample t‐test, Wilcoxon signed‐rank test and Mann–Whitney U‐test.ResultsIn both groups, FD values were increased significantly 1 year post‐treatment as compared with those prior to treatment (P < 0.05). The time‐dependent increase in FD was significantly greater in the control group (P < 0.05). Time‐dependent increases in FD did not differ between genders (P > 0.05). There was a significant decrease in PAI scores in both type 2 DM and control groups depending on time (P < 0.05). No significant difference was found between the groups in terms of time‐related decreasesin PAI scores (P > 0.05).ConclusionAn increase in the FD of the periapical lesion area was observed 1 year after root canal treatment. DM had a negative effect on FD increase.

The purpose of this study was to evaluate and compare the effect of Reciproc Blue (RPCB), XP‐endo Shaper (XPS), and WaveOne Gold (WOG) single‐files on dentinal microcrack formation using micro‐computed tomography (micro‐CT). Twenty‐four mesial roots (24 mesio‐buccal and 24 mesio‐lingual canals) of mandibular molar teeth were prepared using RPCB, XPS, and WOG files (n = 8/each group). The samples were scanned with micro‐CT in the pre‐ and post‐preparation. Then, before preparation and after preparation cross‐sectional images of the teeth were evaluated to detect the presence of microcracks. For each group, the number of microcracks was calculated as a percentage rate. The data were statistically analyzed using McNemar at 5% significance level (p < .05). Dentinal microcracks were observed in 25.99% (2,103 of 7,813), 31.99% (2,482 of 7,758), and 36.66% (2,836 of 7,731) of cross‐sectional images of the XPS, WOG, and RPCB groups, respectively. In all the groups, all the dentinal microcracks seen in the post‐treatment cross‐sectional images were present in the corresponding pre‐treatment images. Within the limitations of this study, the XPS, WOG, and RPCB files did not cause new dentinal microcrack formation or propagation of existing dentinal microcracks.

The objective of this study was to evaluate and compare the cytotoxicity and genotoxicity on human fibroblast cell lines of sodium hypochlorite (NaOCl), chitosan and propolis as root canal irrigating solutions. Human fibroblast cells were exposed to chitosan, propolis and NaOCl for 4 and 24 h. Cell viability was assessed by 2,3-bis-(2methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide, and oxidative DNA damage was assessed by determination of 8-hydroxydeoxyguanosine (8-OHdG) level with an ELISA kit. The data of cell cytotoxicity were analysed statistically using a test of one-way analysis of variance at a significance level of p < 0.05. In the NaOCI group, the 8-OHdG level was higher than in the chitosan group, but there was no statistical difference when compared with the other groups (p < 0.05). It was determined that the irrigation solutions were cytotoxic, depending on the dose and time. NaOCl was the most toxic solution after both 4and 24 h of exposure (p < 0.05). Chitosan and propolis may be alternatives to NaOCl for irrigation solutions, because they are both less toxic and produce less oxidative DNA damage.