The purpose of this report is to evaluate the applicability of a novel Print and Try technique in the presence of aberrant endodontic anatomies and to achieve a predictable treatment with improved outcome. According to guidelines, cone beam computed tomography (CBCT) is recommended in the presence of complex anatomies. The volumes were utilized to produce a stereo lithographic (STL) file, from which a 3D-plastic tooth model including a hollow root canal system was obtained. The 3D-patient-specific model facilitates the treatment planning and the trial of therapeutic approaches. Using a transparent material, all the treatment steps could be directly visualized. Subsequently, endodontic therapy could be performed in vivo with reduced operating time and with a better overview. Clinicians benefit from the Print and Try technique when facing a complicated root canal system with reduced stress and higher chances of success. In aberrant endodontic anatomies, the use of a transparent 3D plastic model, derived from the CBCT dicom, provides an exact preview of clinical challenges that will be met intra-operatively. A patient centered tailored approach to shaping, cleaning, and filling strategies can be applied.

There is currently no consensus on the optimal post system to provide effective long-term results. We used an engineering approach to investigate the mechanical properties of a sandwich hollow carbon fiber post in synergy with a new bonding technique. We studied two systems - a sandwich fiber hollow post (Techole®, Isasan, Como, Italy) composed of carbon fiber incorporated in a Dpp-MOR resin mix and a traditional non-hollow post (Tech 2000®, Isasan, Como, Italy). A bi-component composite (Clearfil Core®, Kuraray, New York, NY, USA) (2.2 gcm3, 12.3 GPa) and a dual cure composite with lower density and modulus of elasticity (Clearfil DC Core®, Kuraray, New York, NY, USA) (2.0 gcm3, 10.0 GPa) were also used into hollow posts. Results from three-point bending test (n=81), compression test (n=78) and cut test (n=81) were achieved. In the three-point bending test there were significant differences in flexibility/bending when sandwich fiber hollow posts were filled with composite of different modulus of elasticity. Hollow sandwich posts showed also significant (p=0,000) better resistance to compression and cutting than solid posts, independently of the type of composite. Moreover, hollow posts filled plus composite with a modulus of elasticity of 12.3 GPa showed significant (p=0,000) improved resistance parameters rather than hollow posts filled with a composite of 10.0 GPa. The study confirms the favorable mechanical properties of the hollow sandwich fiber post system (Techole®) and the synergistic efficacy when used in combination with the composite Clearfil DC Core® (10.0 GPa) and, especially, Clearfil Core® (12.3 GPa).

Article: Ex-vivo study about antimicrobial effectiveness of phytic acid against Enterococcus faecalis into root canals - Minerva Dental and Oral Science 2022 December;71(6):299-307 - Minerva Medica - Journals

Aim: External cervical resorption (ECR) assessment and its management planning are often difficult. This work proposes a standardized workflow for ECR treatment considering the 3D-classification of the lesion by Patel and assesses its clinical applicability to seven preliminary clinical cases. Summary: ECR cases were detected from medical and dental history, clinical data and a conventional radiography; a Cone Beam Computed Tomography (CBCT) with a small field of view (FOV) was performed too. A both 2D and 3D-classification was applied on each resorption. After studying better the clinical aspect, especially the accessibility of the lesion, the restorability of the tooth was assessed and the approach was decided between external repair, with or without endodontic treatment, or internal repair. Reparative tissue was removed and the defect was managed through new generation composite resins, mineral trioxide aggregate (MTA) or other cements. A pulp capping was performed in one case and a canal treatment in the others. Clinical and radiographic checks assessed both quality and adequacy of the treatments immediately and over time. Key learning points: A standardized workflow could be useful for ECR treatment. CBCT is essential for determination of ECR extension and an appropriate treatment planning. ECR management should be conservative, but should also remove the reparative tissue. ECR management could be performed within one or two appointments. A follow-up is required to evaluate the treatment over time. The main outcome is the survival of the element, the secondary outcomes are the absence of resorption progression, no symptoms and healthy periodontal values.