Search Results (47)

Endodontic irrigant solutions act as crucial pretreatment conditioning agents in dentin biomimetic remineralization, preparing the collagen scaffold for calcium phosphate infiltration and subsequent tooth structure reconstruction. In this study, root dentin discs were exposed for 10 min to five irrigant solutions: sodium hypochlorite (NaClO, 3%), EDTA (17%), citric acid (CA, 10%), chlorhexidine (CHX, 2%), and an innovative experimental formulation containing citric acid (7%) and surfactants. Samples were then aged in Hank’s Balanced Salt Solution (HBSS) at 37 °C for three months to simulate long-term clinical conditions. Physicochemical modifications of the collagen and apatite phases were assessed at each experimental stage using ATR-FTIR spectroscopy, with the A_CaP/A_{Amide I} and A₈₇₀/A_CaP absorbance ratios as markers of the degree of mineralization and apatite carbonate content, respectively. Results indicated that CHX- and EDTA-treated dentin exhibited the highest remineralization after ageing, while NaClO impeded remineralization due to collagen degradation. The experimental irrigant produced the most pronounced demineralization, followed by CA; however, it also facilitated significant remineralization, attributed to citrate–collagen binding and surfactant-enhanced apatite nucleation. NaClO selectively degraded collagen and increased apatite crystallinity; CA inhibited apatite nucleation through adsorbed citrate ions, and CHX and EDTA induced minimal alterations. These findings provide molecular-level evidence linking short-term irrigant effects to the long-term potential for dentin biomineralization, with direct implications for irrigant selection in regenerative endodontic protocols. It should be noted that this study was conducted on dentin discs obtained from a single tooth; all findings should therefore be regarded as preliminary and require confirmation in studies with larger, biologically independent sample sizes. Full article

Odontogenic cutaneous sinus tracts represent an uncommon clinical manifestation of chronic dental infection and are frequently misdiagnosed due to the absence of dental symptoms and their resemblance to dermatologic lesions. This case report describes the nonsurgical endodontic management of a cutaneous sinus tract of dental origin in a 13-year-old patient. The patient presented with a persistent extraoral lesion in the mandibular region, initially evaluated by non-dental specialists. Clinical and radiographic examination revealed a necrotic mandibular first molar associated with a periapical radiolucency and intraoral sinus tract. Nonsurgical root canal treatment was performed using chemomechanical debridement with sodium hypochlorite irrigation and calcium hydroxide as an intracanal medicament. Complete obturation was achieved following resolution of intracanal exudation. No surgical intervention of the cutaneous lesion was undertaken. Progressive healing of the periapical lesion and spontaneous resolution of the extraoral sinus tract were observed over a 6-month follow-up period. This case is noteworthy because it combines a prolonged diagnostic delay, an atypical extraoral manifestation in a child, and successful resolution by nonsurgical endodontic therapy alone without surgical excision of the cutaneous lesion. The 6-month follow-up confirms sustained clinical and radiographic healing, underscoring the importance of early recognition and conservative management in pediatric patients. Early identification and elimination of the dental source can prevent unnecessary surgical procedures and minimize the risk of permanent scarring. Full article

The aim of this systematic review was to assess the influence of different final irrigation protocols and activation methods on the dentinal tubular penetration of calcium silicate-based sealers (CSSs). The review followed the PRISMA 2020 guidelines, and the protocol was registered in the Open Science Framework (OSF; DOI: 10.17605/OSF.IO/5HTVN). A PICOS-based research question was formulated, and a comprehensive literature search was conducted in MEDLINE, Scopus, Embase, Web of Science, and SciELO up to October 2025. After study selection, a qualitative synthesis of methodologies and outcomes was performed, and methodological quality was assessed using the QUIN tool. Twenty-one in vitro studies were included, all of which used single-rooted teeth or single roots. The available evidence suggests that final irrigation protocols may influence CSS penetration, although the magnitude and consistency of this effect varied substantially across studies. Sodium hypochlorite (NaOCl) and 17% EDTA were the most frequently investigated irrigants and were generally associated with improved penetration, but no irrigation protocol or activation technique can currently be considered superior. Current research trends include the evaluation of chelating agents, continuous chelation protocols, and irrigant activation systems such as passive ultrasonic irrigation, sonic activation, laser activation, and XP-Endo Finisher. Future studies should standardize irrigation protocols, activation methods, sealer types, obturation techniques, microscopy-based assessment procedures, and penetration outcome measures, while also including larger samples and more anatomically complex root canal systems. Full article

Dentin deproteinization strategies are being revisited as adjunctive approaches to reduce technique sensitivity, improve monomer infiltration to mineralized dentin, and enhance the longevity of resin–dentin interfaces. This organized narrative review critically summarizes the chemistry, kinetics, biological considerations, and clinical translatability of agents used for smear-layer deproteinization or post-etching deproteinization. Searches of PubMed/MEDLINE, Scopus, and LILACS up to October 2025 were used to identify evidence on oxidizing irrigants (sodium hypochlorite/hypochlorous acid, calcium hypochlorite, peracetic acid, chlorine dioxide), enzymatic proteolysis treatments (bromelain, papain, trypsin/pepsin, and GAG-targeting enzymes), physical approaches (heat and lasers), and post-oxidizer reducing/antioxidant strategies. Oxidizers provide the fastest and most surface-verified organic removal, but their clinical value is limited by concentration- and time-dependent oxidative carry-over, which interferes with free-radical polymerization. Enzymes offer a more selective route, although their support is driven largely by bond strength and morphological outcomes rather than direct surface-chemical confirmation. Heat remains a proof-of-principle method rather than a clinical option, whereas laser protocols are highly parameter-sensitive. Overall, deproteinization should be interpreted through a combined framework of surface chemistry, adhesive compatibility, aging behavior, biosafety, and chairside feasibility. Current evidence supports cautious, protocol-specific development rather than routine clinical adoption, with priority given to clinically realistic time-dose windows and paired surface/aging outcomes. Full article

Teeth may retain forensic value after chemical exposure, yet the effects of commercially available corrosive agents remain insufficiently characterized. This study evaluated short-term alteration patterns in human teeth exposed to household acidic and alkaline products available on the Romanian market. Five extracted mandibular third molars were analyzed, including four experimental teeth and one control. Each experimental tooth was fully immersed for 48 h in a different agent: hydrochloric acid descaler, sodium hypochlorite bleach, mixed hydrochloric/sulfuric acid descaler, or sodium hydroxide. Morphometric changes, mass, and pH were monitored serially, while stereomicroscopy, SEM-EDX, and hard tissue ground sections were used for structural and compositional assessment. Acid-exposed teeth showed the greatest damage, with major mass loss in the hydrochloric acid and mixed-acid samples, enamel loss, and marked microstructural disruption. The mixed-acid specimen exhibited the most severe collapse and near-complete calcium/phosphorus depletion. Sodium hypochlorite produced mainly superficial and root-level alterations with relative preservation of gross morphology, whereas sodium hydroxide caused minimal dimensional change and a calcium-rich adherent surface deposit. These findings show that household corrosives produce distinct, forensically recognizable dental alteration patterns within 48 h and support an integrated pattern-recognition approach in suspected chemical concealment scenarios. Full article

Objectives: The identification of novel antimicrobial agents for use in root canal treatment may provide opportunities to improve treatment outcomes. This study aimed to assess the antimicrobial efficacy of different molecular weights of chitosan (CS), and how modification with CS may impact on the antimicrobial, physico-mechanical and biological properties of Biodentine™, a calcium-silicate-based material used in endodontics. Methods: C. albicans biofilms were treated with either 3% sodium hypochlorite (NaOCl) or a 0.05% or 0.1% CS solution for 5 min. The growth medium was replenished, and cells were re-incubated for additional 72 h. Regrowth of biofilms was assessed using a colorimetric XTT assay. Additionally, multispecies biofilms were established and the regrowth of biofilms on Biodentine discs were quantified following the addition of 0.5 wt% and 1 wt% of CS powder using qPCR. The physico-mechanical and biological properties of the new composite of Biodentine and CS were also evaluated. Results: Viability readings revealed significant initial biofilm inhibitory effects of CS solutions, followed by significant regrowth after 72 h. Upon the addition of CS to Biodentine, significant reductions in multispecies biofilm regrowth were determined. Notably, the antibiofilm activity of CS was found to be increased as the molecular weight decreased. The addition of powdered CS of low molecular weight showed a reduction in the mechanical properties of Biodentine, whereas no detrimental effects on the other material properties were noted. Conclusions: Chitosan may not be useful as an alternative irrigant to NaOCl. Addition of CS to Biodentine represents a potential means of augmenting the antimicrobial activity of Biodentine against persistent microorganisms following endodontic therapy. Despite the reductions in mechanical properties of the material, the new composite still represents a viable material option when material strength and hardness are not critical. Full article

Background/Objectives: The objective of this study was to investigate current endodontic practice patterns and the adoption of newer technologies among dentists, endodontic specialists, and postgraduate students in Spain and Latin America. Methods: A cross-sectional survey was conducted using a structured 30-item questionnaire covering demographics, training, technology adoption (NiTi instrumentation, magnification, CBCT, irrigation adjuncts, bioceramic sealers), obturation techniques, irrigant selection, and clinical procedures. The survey was distributed through a professional Instagram account and WhatsApp groups of dentists, specialists, and postgraduate students. Participation was voluntary, anonymous, and restricted to qualified professionals. Data were collected via Google Forms, cleaned, and grouped into Spain, Mexico, Venezuela, Colombia, Southern Cone & Andes (Argentina, Chile, Peru, Ecuador, Bolivia), and other countries. Descriptive statistics were calculated, and intergroup comparisons were performed using Chi-square or Fisher’s exact tests with Bonferroni correction (p < 0.05). Multiple regression analyses were performed. Results: A total of 1358 valid responses were analyzed, distributed as follows: Spain (219), Mexico (353), Venezuela (162), Colombia (108), Southern Cone & Andes (260), and other countries (256). Most respondents (62.8%) had ≤10 years of experience, and 61.2% reported postgraduate training. Loupes (55.4%) were the most frequent magnification system, followed by microscopes (18.6%). Sodium hypochlorite (98.3%) was the irrigant of choice, commonly used with EDTA (83.5%) and, to a lesser extent, chlorhexidine (33.4%). Sonic (83.2%) and ultrasonic (52.9%) activation were frequent. Bioceramic sealers were used by 18.9%, while calcium hydroxide medication was applied by 37.4%. Specialists and master-level clinicians showed greater use of rotary NiTi systems, CBCT, magnification, and bioceramic sealers, whereas general practitioners relied more on manual instrumentation and single-cone obturation. Success was mainly verified by combined clinical and radiographic evaluation (86.7%). Spain demonstrated higher adoption of microscopes, warm vertical compaction, and CBCT. Conclusions: Core practices such as sodium hypochlorite irrigation and rubber dam use were widespread, while advanced technologies and irrigant protocols varied with training level and region. Continuous education remains essential to promote evidence-based practice and reduce disparities in endodontic innovation. Full article

The selective separation of copper sulfide ore from iron sulfide minerals has always been a technical problem that urgently needs to be solved. This study conducted a process mineralogy research on a copper–tin polymetallic ore in Yunnan. The research results showed that the ore sample contained 0.33% copper, and the oxidation rate of copper was 16.48%. The distribution rate of copper in its independent minerals was only 58.30%. The copper content in oxidized copper and hematite/limonite was relatively high, making it difficult to achieve a high flotation recovery rate. The priority flotation process was applied to the flotation process of this copper mine. The final copper flotation scheme determined was that the grinding fineness of −0.074 mm was 55%, “two roughing, one scavenging, and three cleaning”. This was followed by the re-grinding of the coarse concentrate, with the collector being ML-8:Z-200 = 2:1, the dosage being 60 g/t, and calcium hypochlorite as the copper–sulfur separation inhibitor. Finally, a copper concentrate product with a copper grade of 16.83% and a recovery rate of 54.31% was obtained. At this time, the silver grade was 388.55 g/t, achieving efficient recovery of the copper ore. The comprehensive utilization of multi-metallic copper sulfide in the processing plant has high practical significance. Full article

This study evaluated the efficacy of various cleaning protocols on two nickel–titanium (NiTi) file systems—RaCe EVO(RE) and EdgeFile X7(EE)—using scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDX). Eighty-four NiTi files (42RE, 42EE) were divided into seven groups (n = 12), including a group with unused, sterilized files and a group of used files without cleaning. The remaining files were subjected to simulated clinical use, followed by different cleaning methods, such as soaking in sodium hypochlorite (NaOCl), ethanol wiping (with or without magnification), enzymatic spray, and enzymatic solution. SEM images were imported into ImageJ to quantify surface changes, while EDX assessed elemental composition. The p-value was set to ≤0.05 for significance. Apart from the unused files, calcium and phosphorus—indicators of dentin debris—were present in all groups, especially those cleaned with enzymatic spray (p ≤ 0.0001). Their percentage in RE files soaked in NaOCl or wiped with ethanol was statistically lower than the positive control (p ≤ 0.0001). Post-use, all files showed significantly higher surface asymmetry in Groups 2 and 6 (p = 0.001). Cleaning efficacy depends on the type of NiTi file. RE files responded well to both wiping and soaking, while EE required soaking for effective debris removal. Enzymatic spray was ineffective. Full article

Stormwater pollution from residual chlorine after outdoor disinfection with sodium hypochlorite is an increasing environmental challenge due to its potential negative impact on aquatic ecosystems. Even at low concentrations, residual chlorine can disrupt the stability of water ecosystems. In this regard, stormwater treatment requires innovative and green solutions such as green infrastructure (rain gardens) using the plant phytoremediation technique to reduce the amount of residual chlorine. This study explores the interactions between residual chlorine retained by plants in a rain garden and different microelements. Selected plants were analyzed via spectroscopy, and possible interactions with elements such as chlorine (Cl), phosphorus (P), zinc (Zn), iron (Fe), calcium (Ca), potassium (K), nickel (Ni), silicon (Si), manganese (Mn), magnesium (Mg), chromium (Cr), and cadmium (Cd) were determined using Python-based analysis. Chlorine presented significant positive correlations with cadmium (0.39–0.53) and potassium (0.51–0.55), while negative correlations were found between silicon and chlorine (−0.48–−0.54) and chlorine and iron (−0.45–−0.51). The correlations between chlorine and microelements suggest both common uptake mechanisms and mutual interactions. These results provide a better understanding of the behavior of chlorine in rain gardens and its interactions with other materials, which is especially valuable for designing green infrastructure. This research can help to develop sustainable solutions that reduce environmental pollution and strengthen urban adaptation to climate change. Full article

Background/Objectives: Pain after root canal treatment is a common concern that can greatly affect a patient’s quality of life. Identifying the factors contributing to this pain and focusing on those supported by high-quality research can lead to more effective pain management. This narrative review aims to analyze all available systematic reviews on this topic to determine what has been proven to help decrease pain following the root canal procedure. Methods: A comprehensive literature search was conducted across Scopus and Google Scholar from January 2000 to January 2024, using defined MeSH terms. This yielded 51 systematic reviews, of which 45 specifically investigated factors reducing postoperative pain related to root canal treatment. Results: Eleven factors were identified in the literature, with only eight factors supported by low- to moderate-quality evidence to reduce postoperative pain related to root canal treatment. These eight factors include (1) laser therapy, (2) nonsteroidal anti-inflammatory drugs (especially when combined with acetaminophen) and corticosteroids, (3) ultrasonic irrigation and low concentrations of sodium hypochlorite, (4) cryotherapy, (5) specific combinations of intracanal medicaments (notably calcium hydroxide with chlorhexidine), (6) bioceramic sealers, (7) rotary instrumentation, and (8) apical patency. Conclusions: The insights gained from this narrative review highlight several important factors that reduce postoperative pain related to root canal treatment. Nevertheless, the observed variability in the quality of the evidence calls attention to the necessity for further high-quality research. Full article

Recent studies on utilizing biological functions of natural substances that mimic the mesoscopic structures (nanoparticles of about 50 to 500 nm) found in plant growth points and coral skeletons have been reported. After the calcium hydrogen carbonate contained in materials derived from plants and coral are separated, the crystals of the mesoscopic structure can be reformed by applying a high voltage under a specific set of conditions. A suspension of these mesoscopic crystals in water (CAC-717) can be used as an effective disinfectant. CAC-717 exhibits universal virucidal activity against both enveloped and non-enveloped viruses as well as bactericidal and anti-prion activity. Moreover, in comparison to sodium hypochlorite, the potency of CAC-717 as a disinfectant is less susceptible to organic substances such as albumin. The disinfection activity of CAC-717 is maintained for at least 6 years and 4 months after storage at room temperature. CAC-717 is non-irritating and harmless to humans and animals, making it a promising biosafe disinfectant. This review explores the disinfection activity of CAC-717 as well as the potential and future uses of this material. Full article

For several decades, recurring outbreaks of human gastrointestinal infections associated with contaminated sprouts have posed an enduring challenge, highlighting the necessity of controlling the etiological agents on contaminated sprout seeds. This study investigated the efficacy of calcium hypochlorite and peroxyacetic acid treatments in inactivating the cells of four enterohemorrhagic Escherichia coli (EHEC) isolates—viz. E. coli O157:H7 K4492, F4546, and H1730, as well as E. coli O104:H4 BAA-2326—on alfalfa seeds and sprouts. The 2–3 log CFU/g of EHEC cells inoculated to sprout seeds became undetectable (≤1.40 log CFU/g) after treatment with the two sanitizers, even with the enrichment steps. Sprouts grown from calcium hypochlorite- and peroxyacetic acid-treated seeds had mean EHEC populations that were 4.54–4.60 log CFU/g and 1.25–1.52 log CFU/g lower, respectively, compared to those on sprouts grown from the untreated control seeds. Significantly (p ≤ 0.05) different from one another, the mean populations of the four EHEC isolates on harvested sprout samples were in the descending order of E. coli O157:H7 K4492, F4546, H1730, and E. coli O104:H4 BAA-2326. The results suggest that both sanitizing treatments effectively suppressed EHEC growth on alfalfa seeds and sprouts, but their effectiveness was bacterial-isolate-dependent. Full article

Background: Adhesion within endodontic obturation material and root canal walls improves the efficacy of the endodontic treatment by establishing a barrier that inhibits reinfection and entombs residual bacteria. This study evaluates the push-out bond strength (POBS) of calcium silicate sealers compared to an epoxy-resin-based sealer. Methods: A total of 36 extracted mono-radicular teeth were prepared with Pro Taper Ultimate and irrigated with 5.25% sodium hypochlorite and 17% EDTA. The specimens were randomly split into three groups (n = 12) according to the endodontic sealer and filling technique used as follows: Ah Plus with the continuous wave condensation technique (CWC), Ah Bioceramic (Ah Bio) with the single-cone technique, and Total Fill Hi-Flow (FKG Hi-Flow) with the CWC technique. The material was allowed to set for 4 weeks, and afterwards, the roots were placed in acrylic resin and sectioned into 1 mm transverse slices. A POBS test was conducted using a universal testing machine, and the mode of bond failure was assessed at 4× magnification using a stereomicroscope. Six specimens from each group were selected for SEM-EDX examination to evaluate dentinal tubule penetration. The data were analysed using analysis of variance and Tukey and Bonferroni post hoc tests. Results: The POBS tests revealed higher values for Ah Plus in comparison to both calcium silicate sealers (p < 0.001), while FKG Hi-Flow showed superior results to Ah Bio (p < 0.001). The cohesive mode of failure was prevalent in all three groups. Conclusions: In conclusion, the resin-based sealer showed higher bond strength and better dentinal tubule penetration than the two calcium silicate sealers tested, while FKG Hi-Flow outperformed AH Bio. Full article

The aim of this study was to evaluate the effects of mechanized final irrigation protocols (XPE, XP-Endo Finisher; XPC, XP-Clean; and ECL, Easy Clean) compared to PUI (passive ultrasonic irrigation) on the debris incidence and open dentinal tubules, and their effects on the adhesion interface after 48 h and 6 months. One hundred twenty maxillary central incisors were submitted to chemical–mechanical preparation using a rotary instrument and 2.5% sodium hypochlorite. Specimens were distributed in 4 groups (n = 30) in accordance with the mechanized final irrigation protocol: XPE, XPC, ECL, or PUI. Forty specimens (n = 10/group) were submitted to SEM analysis to evaluate the residue incidence and dentin open tubules. The other specimens were obturated using Bio-C Sealer and submitted to push-out bond strength and adhesive failure mode evaluations in the cervical, middle, and apical thirds after 48 h or 6 months (n = 10/group). Only in the apical third, ECL presented the highest residue incidence and fewer open dentinal tubules when compared to the XPE, XPC, and PUI groups (p < 0.05). In the cervical and middle root thirds, no significant differences were observed regardless of the group evaluated (p > 0.05). After 48 h, ECL resulted in the lowest bond strength only in the apical third (p < 0.05), while the XPE, XPC, and PUI groups remained similar in the cervical and middle thirds (p > 0.05). At 6 months, all groups showed lower bond strength values regardless of the root third evaluated, but ECL showed the lowest bond strength in the apical and middle root thirds when compared to the other groups (p < 0.05). The ECL protocol did not provide adequate residue removal on the apical radicular third and negatively affected the longevity of endodontic obturation using a calcium silicate-based sealer. Full article