Background. Infantile hemangiomas may have unexpected behavior. Initial regression (spontaneously or drug-induced) may be followed by unexplained recurrences. At this moment, there are no well-established criteria to predict infantile hemangioma reccurrences. Methods. We compared the VEGF pathway gene expression profile for one case of involuting infantile hemangioma versus one case of recurrent proliferative infantile hemangioma using TaqMan Array. Results. We found ten genes upregulated for both involuting and recurrent proliferative hemangiomas: ACTB, KRAS, MAP2K1, HRAS, NOS3, BAD, HSPB1, HPRT1, GUSB, and CASP9. Thirteen genes were downregulated for both involuting and proliferative hemangiomas: FIGF, ACTG1, GRB2, MAPKAPK2, ACTG2, MAP2K2, MAPK3, HSP90AA1, MAP2K6, NRAS, ACTA1, KDR, and MAPK1. Three genes showed divergent expression between proliferating and involuting hemangiomas. Proliferating hemangioma had MAPK14 and AKT1 gene upregulation and ACTA2 downregulation. Involuting infantile hemangioma was characterized by ACTA2 upregulation and AKT1 and MAPK14 downregulation. Conclusions. Three genes, AKT1, p38/MAPK14, and ACTA2, were found to have divergent expression in proliferating and involuting infantile hemangiomas. Excepting AKT1, which was mentioned in the last ISSVA classification (strictly related to Proteus Syndrome), none of the other genes were reported. An accurate gene expression profile mapping of infantile hemangiomas together with a gene expression-based hemangioma classification is stringently needed.

Background and Objectives: Although fiber posts are widely used in the restoration of endodontically treated teeth (ETT), their ideal cementation depth into the root canal is still debated in literature. The aim of the present study was to evaluate whether the different intra-radicular insertion lengths of the fiber posts influence the fracture strength of ETT. Materials and Methods: A total of 10 permanent human lower incisors with straight roots of similar length and volume extracted for periodontal reason were sectioned 2 mm above the cement–enamel junction (CEJ) to a total length of 18 mm and endodontically treated in the same manner, then randomly divided into two groups of five each (Groups 1 and 2, n = 5). Two sound incisors, with no endodontic treatment, were used as the control group (Group 3, n = 2). After one week of storage in a humid environment, spaces for fiber post no. 1 (Reforpost, Angelus, Londrina, PR, Brazil) were prepared in the first two groups at a depth of 5 mm (Group 1) and 7 mm (Group 2), and the fiber posts were adhesively cemented using self-adhesive resin cement (Maxcem Elite, Kerr GmbH, Herzogenrath, Germany). After 7 days, the samples were vertically positioned and fixed in a self-curing transparent acrylic resin, up to 2 mm below the CEJ level, and mechanically tested in compression after another week of storage using a displacement-controlled testing machine up to each sample’s fracture. The force–displacement curves were recorded for each sample, the means were calculated for each group and a statistical comparative analysis between groups was conducted. Results: Although no statistically significant differences between groups were observed, the highest mean fracture force (N) was recorded in Group 2 (1099.41 ± 481.89) in comparison to Group 1 (985.09 ± 330.28), even when compared to the sound, non-treated teeth (1045.69 ± 146.19). Conclusions: Within the limitations of this in vitro study, teeth where fiber posts were placed deeper into the root canal (7 mm) recorded slightly higher fracture forces in comparison with shorter lengths (5 mm). However, similar biomechanical performances obtained in the mechanical tests showed no statistical differences between the 7 mm and the 5 mm inserted posts.

The aim of the study was to determine the marginal and internal adaptation after curing of different composite resin restorations, using a nondestructive X-ray micro-computed tomography (micro-CT). Forty previously extracted human molars, kept in 10% formalin to preserve the bonding capabilities of the tooth structures, were divided into four groups based on the composite system used and different light-curing times. Class II (vertical slot) cavities were prepared on one proximal side and restored with dental composite using a Tofflemire matrix, with a bulk-fill composite resin (Venus Bulk Fill, Heraeus Kulzer) and a universal posterior composite (G-ænial Posterior, GC). A curing lamp (Kerr Demi Ultra) was used with different curing times. Micro-CT scanning was performed by using Nikon XTH 225ST to reveal any defects in adaptation or gaps at the tooth restoration interface. The 3D images of the adaptation around the restorations were reconstructed using VG Studio Max 2.2 and myVGL 2.2.6 64-bit software. All samples from the G-ænial group showed marginal and internal gaps, with G-ænial Posterior having higher polymerization shrinkage and marginal gap values. In the Venus Bulk Fill group, there were fewer restorations with internal and external gap formation. Micro-CT is a three-dimensional imaging technique that can nondestructively detect adaptation around the resin composite restorations at every level of the sample.

Background and Objectives: Recognizing the significance of a hermetic apical seal for successful root canal treatment, the present investigation aimed to evaluate two sealing materials through an in vitro analysis, as well as to ascertain the clinical outcomes of patients treated with these two sealers in an in vivo setting. Materials and Methods: For the in vitro part of the study, two control groups of thirty monoradicular teeth were obturated with two sealers. Then, the sealers’ performance was tested based on a predefined protocol. Group A included 30 patients treated with an epoxy oligomer resin-based sealer (Adseal, MetaBiomed), while Group S comprised 30 patients treated with a polymeric calcium salicylate-based sealer (Sealapex, Kerr). Samples were sectioned and evaluated under the microscope to determine the sealer’s tightness by measuring the dye penetration into the root canal filling. For the in vivo part, a prospective study was designed to include 60 patients with chronic apical periodontitis in two endodontic treatment groups, using the same two sealers. Results: The in vitro analysis found that dye penetration in Group A was 0.82 mm (±0.428), while in Group S, the dye penetration was statistically significantly deeper, being 1.23 mm (±0.353). In the in vivo part of the study, the periapical index (PAI) significantly decreased 6 months after endodontic treatment, with 80.0% of patients in Group A having a PAI score of 2 compared to only 56.7% in Group S (p-value = 0.018). Similarly, tooth mobility scores significantly decreased after treatment, but with no difference between groups. The marginal bone loss decreased significantly more in the Adseal group compared to the Sealapex group (23.3% vs. 50.0%, p-value = 0.032). At the same time, 40.0% of patients in Group S had failed tooth healing compared to only 13.3% in Group A (p-value = 0.048). Conclusions: The in vitro study showed that Adseal had a better sealing capacity and a lower degree of dye penetration compared to Sealapex. However, on clinical evaluation in the in vivo study, both patient groups exhibited significant improvements in periapical index, tooth mobility scores, and pain reduction following endodontic treatment. Nevertheless, patients treated with Adseal showed a significantly greater improvement in PAI values, tooth mobility, and teeth healing after treatment. Overall, Adseal, as an endodontic sealer, may provide better sealing capabilities and enhanced clinical outcomes in the treatment of chronic apical periodontitis.

Background/Objectives: This study investigates the temperature changes on the external root surface during root canal preparation using different rotary systems and assesses the impact of irrigation temperatures. Methods: Sixty extracted human maxillary incisors were divided into four groups based on the rotary system used: ProTaper Next (Dentsply Sirona, Ballaigues, Switzerland), Reciproc Blue (VDW GmbH, Munich, Germany), WaveOne Gold (Dentsply Sirona, Ballaigues, Switzerland), and TruNatomy (Dentsply Sirona, Ballaigues, Switzerland). These systems differ in cutting efficiency and design. Temperature measurements during instrumentation and irrigation were recorded using a FLIR E60bx thermal camera (Teledyne FLIR LLC, Hudson, NH, USA). Irrigations were conducted with sodium hypochlorite at room temperature and heated to 60 °C. Results: The ProTaper Next group exhibited the highest average temperature increase during instrumentation (5.2 °C), followed by WaveOne Gold (4.3 °C), Reciproc Blue (3.7 °C), and TruNatomy (2.8 °C). During irrigation with heated sodium hypochlorite, temperature rises recorded were 6.8 °C for ProTaper Next, 5.9 °C for WaveOne Gold, 5.2 °C for Reciproc Blue, and 4.1 °C for TruNatomy. Statistical analysis revealed a significant negative correlation between dentin thickness and temperature rise, with r-values ranging from −0.62 to −0.87 across the groups. No significant correlation was found between canal diameter and temperature change, indicating that the canal’s size does not influence the thermal impact as much as the properties of the rotary system and irrigation temperature. Conclusions: Different rotary systems produce varying levels of temperature increases on the external root surface, influenced significantly by the thickness of the dentin and the temperature of the irrigation solution. These variations necessitate careful selection of instrumentation and irrigation protocols to minimize potential thermal damage to surrounding periodontal tissues.

Background and Objectives: Odontogenic infections (OIs) can lead to severe complications, especially in elderly patients due to age-related physiological changes and comorbidities. This study aims to evaluate the predictive accuracy of inflammatory scores—APACHE II, CURB-65, SOFA, and NEWS2—in determining the severity of odontogenic infections among elderly patients (>70 years) compared to younger patients (<70 years). Materials and Methods: A retrospective cohort study was conducted on patients diagnosed with an OI at the Maxillofacial Surgery Department between January 2018 and January 2024. Patients were divided into two groups: elderly patients (>70 years, n = 49) and younger patients (<70 years, n = 64). The Symptom Severity score (SS) of odontogenic infections was calculated for all patients. Inflammatory scores—APACHE II, CURB-65, SOFA, and NEWS2—were assessed at admission and correlated with infection severity. Additional subgroup analyses were performed based on comorbidities and infection sites. Results: Elderly patients exhibited significantly higher SS scores (mean 12.47 ± 2.93) compared to younger patients (mean 7.82 ± 2.17, p < 0.001). APACHE II, CURB-65, SOFA and NEWS2 scores were significantly elevated in the elderly group (all p < 0.001). The SOFA score demonstrated the highest predictive accuracy for severe OIs in elderly patients, with an area under the curve (AUC) of 0.89 (95% CI: 0.82–0.95). Subgroup analyses revealed that comorbidities such as diabetes mellitus and cardiovascular disease significantly influenced infection severity (p < 0.05). Conclusions: Inflammatory scores, particularly SOFA, are effective in predicting the severity of odontogenic infections in elderly patients. The integration of these scores into clinical practice may enhance early identification of high-risk patients and improve management strategies.