Objective Dental anxiety is a significant barrier for patients seeking oral healthcare and can be influenced by biological, psychological, and demographic factors. This study aimed to investigate how different phases of the menstrual cycle affect dental anxiety in women immediately before undergoing root canal treatment, using both psychometric scales and physiological indicators. Gender-based comparisons were also included for contextual understanding. Methods An analytical cross-sectional study was conducted with 259 participants (aged 18–50 years, 191 women) requiring root canal treatment. Women were categorized into menstrual, proliferative, and secretory phases based on self-reported cycle data. The Severity of anxiety were assessed using the Modified Dental Anxiety Scale (MDAS) and the State-Trait Anxiety Inventory (STAI), alongside physiological measures such as blood pressure and oxygen saturation. In addition to Kruskal-Wallis and Chi-squared tests, multiple linear regression analyses were performed to adjust for potential confounders, including age, education, preoperative pain, and physiological parameters. Results Women in the menstrual and secretory phases reported significantly higher MDAS and STAI-T scores compared to men (p < 0.001). Regarding the STAI-S, scores in all three menstrual phases were significantly higher than those of men (p = 0.001). Multiple regression analysis confirmed that these associations remained significant after adjustment for potential confounders, while age, education, preoperative pain, and physiological parameters showed no significant effects. Physiological parameters, including blood pressure and oxygen saturation, showed no significant variations across groups (p > 0.05). A strong positive correlation was observed between MDAS and both STAI-S and STAI-T scores. Conclusion Women in the menstrual and secretory phases reported higher levels of dental anxiety compared to men, but no significant differences were observed in physiological markers. These findings suggest that estrogen reduction during certain phases of the menstrual cycle may increase anxiety and highlight the potential clinical value of individualized anxiety management during these phases.

Objective: This study aimed to compare the artifact expression of different hydraulic calcium silicate-based root canal sealers using standardized cone-beam computed tomography (CBCT) imaging parameters.Methods: A polymethylmethacrylate (PMMA) model with a standardized cylindrical cavity (0.5 × 0.5 cm) was used. The cavity was filled with AH Plus, AH Plus Bioceramic, NeoSealer Flo, Bio-C Sealer, MTA Cem S, or Bioserra, following manufacturers’ instructions. After setting, each material within the PMMA phantom was scanned using CBCT (Planmeca ProMax 3D Classic; Planmeca, Finland) at 90 kVp, 3.6 mA, 0.2 mm voxel size, and 8×8 cm FOV. The empty phantom served as the control. Each group was scanned three times. Around each material, eight regions of interest (ROIs) were defined. The standard deviation (SD) of gray values within the ROIs was calculated to assess artifact presence. Statistical analysis was performed using the Kruskal–Wallis test with post hoc Bonferroni correction (p = .05).Results: The control group showed significantly lower SD values than all sealer groups (p < .001). AH Plus Bioceramic, NeoSealer Flo, Bio-C Sealer, and MTA Cem S had similar SD values to AH Plus. However, Bioserra exhibited significantly higher SD values compared to AH Plus, AH Plus Bioceramic, and Bio-C Sealer (p < .001).Conclusions: All bioceramic sealers generated artifacts on CBCT. Among them, Bioserra resulted in more pronounced artifacts. These findings suggest that bioceramic sealers may complicate CBCT interpretation, emphasizing the importance of material selection in clinical imaging.