Introducción: la remoción completa de materiales de obturación y dentina contaminada del conducto radicular durante el retratamiento endodóntico puede influir en la aparición de agudización endodóntica. Objetivo: establecer la frecuencia de agudización endodóntica posterior al retratamiento endodóntico de dientes anterosuperiores con diferente longitud de obturación apical. Material y métodos: se eligieron 33 casos con fracaso endodóntico para este estudio. Según la longitud apical de la obturación inicial, los sujetos se dividieron en dos grupos: el grupo A (n = 23) fueron casos obturados entre 0.0 y 2.0 mm al ápice radiográfico (AR) y el grupo B (n = 10) casos obturados entre 2.1 y 6 mm cortos al AR. Las obturaciones con gutapercha se eliminaron con instrumentos ProTaper retreatment D1 a D3 (Dentsply-Sirona, Ballaigues, Switzerland) más cloroformo. Posteriormente los conductos radiculares se instrumentaron con limas K-flexofile. Los casos reinstrumentados fueron obturados con gutapercha (Higyenic, Coltene Whaledent) y Sealapex (Kerr Sybronendo, WA) durante la misma cita. Los pacientes tomaron 400 mg de ibuprofeno cada ocho horas durante 72 horas y registraron el dolor postoperatorio a las ocho, 24, 48 y 72 horas. Se definió como agudización la aparición de dolor severo y/o inflamación (dolor en escala Heft-Parker a partir de 114 mm). Se determinaron porcentajes de casos positivos a la palpación y percusión a las 72 horas en ambos grupos. Resultados: dos pacientes presentaron agudización (6%), ambos en el grupo A. El dolor postoperatorio fue de 21.2% en los pacientes del grupo A a las ocho horas y 9.1% a las 48 horas. No se encontraron diferencias estadísticamente significativas en la presencia de agudización entre grupos (p > 0.05). Conclusiones: la agudización de casos de retratamiento endodóntico es de 6%. La longitud de obturación de casos indicados para retratamiento endodóntico no influye en la frecuencia de agudización postoperatoria.

Background/Objectives: Edentulism is a prevalent chronic condition among older adults, and conventional complete dentures remain the standard of care. However, their fabrication often involves multiple clinical sessions and operator-dependent steps that may compromise fit and comfort. Digital workflows using CAD/CAM technologies have emerged as viable alternatives, offering improved efficiency, precision, and patient-centered outcomes. This case report aims to present a fully digital workflow for maxillary complete dentures and describe clinical efficiency and patient-reported outcomes. Case Presentation: A 73-year-old edentulous male patient underwent maxillary rehabilitation using a fully digital workflow. The protocol included intraoral scanning; the design and 3D printing of a custom tray with occlusal rims; border-molded functional impressions; virtual articulation; and CAD/CAM fabrication. A digitally designed Try-In denture was 3D printed for clinical evaluation, followed by adjustments. The definitive prosthesis was milled from high-performance PMMA discs using a five-axis milling machine. The workflow reduced the number of appointments and laboratory steps. At six-month follow-up, the patient reported high satisfaction with esthetics, retention, phonetics, and masticatory performance. No significant post-delivery adjustments were required. Conclusions: This case demonstrates that fully digital workflows for maxillary complete dentures are clinically viable, providing excellent precision, patient satisfaction, and time efficiency compared to conventional methods. The reproducible protocol described may support the broader integration of CAD/CAM technologies in edentulous rehabilitation.

Background/Objectives: Lithium disilicate (LD) veneers are widely used for minimally invasive anterior rehabilitation because of their favorable optical and mechanical properties. Fully digital workflows have been proposed as alternatives to conventional milling. These approaches combine computer-aided design and manufacturing (CAD/CAM) with 3D-printed burn-out patterns and subsequent heat pressing of LD ingots. However, clinical documentation of multi-unit anterior cases fabricated exclusively through this additive-plus-pressing route remains scarce. This case report aims to describe a fully digital additive-plus-pressing workflow for four maxillary anterior LD veneers and to report 48-month clinical outcomes. Case Presentation: A 52-year-old female presented with esthetic concerns involving the maxillary central and lateral incisors (teeth 11, 12, 21, and 22). After clinical and radiographic evaluation, a minimally invasive veneer-based rehabilitation was planned. Preparations were performed under magnification, and immediate dentin sealing was applied. Digital impressions were obtained with an intraoral scanner, and veneers were designed using CAD software(Exocad DentalDB 3.0 Galway (Exocad GmbH, Darmstadt, Germany). Castable resin patterns were 3D-printed, invested, and heat-pressed using LD ingots, followed by finishing and glazing. Adhesive cementation was performed under rubber dam isolation after hydrofluoric acid etching and silanization of the intaglio surfaces and conditioning of the tooth substrates according to the adhesive protocol, using a dual-cure resin cement. At the 48-month follow-up, all veneers remained intact, with clinically acceptable marginal adaptation, stable color and surface gloss, and no signs of secondary caries or marginal discoloration. The patient reported sustained esthetic satisfaction and comfortable function without postoperative sensitivity. Conclusions: This single-patient report suggests that a fully digital additive-plus-pressing workflow may be clinically viable for high-demand anterior LD veneers, providing favorable medium-term esthetics and patient-centered outcomes with no technical or biological complications. The reproducible protocol described may facilitate the integration of 3D printing and heat pressing into digital veneer rehabilitation and supports further controlled clinical investigations.

Background: Metallic and metal oxide nanoparticles are increasingly explored as antimicrobial biomaterials in endodontics due to their multi-target mechanisms of action, largely mediated by metal ion release (e.g., Ag⁺, Cu⁺). However, bacterial metal resistance systems, particularly efflux-related proteins, may influence their antimicrobial performance. This study aimed to analyze the prevalence and distribution of metal resistance-associated proteins in bacteria involved in endodontic infections using a bioinformatic approach. Methods: An in silico, cross-sectional bioinformatic analysis was conducted using publicly available genomes from the Bacterial and Viral Bioinformatics Resource Center (BV-BRC). Bacterial species associated with acute apical abscess (AAA), symptomatic apical periodontitis (SAP), asymptomatic apical periodontitis (AAP), and post-treatment apical periodontitis (PTAP) were included. The presence of selected metal resistance-related proteins (CutC, CopA, CzcA, CusA, SilA, P-type ATPase, and PA3920) was assessed using a binary presence/absence framework. Prevalence, group comparisons (Fisher’s exact test), and co-occurrence patterns (Phi coefficient) were analyzed. Results: Metal resistance-associated proteins were widely distributed across all infection types, with prevalence ranging from 70.0% to 82.9% and no significant differences between groups (p > 0.05). CutC was the most prevalent protein, followed by CopA and CzcA, whereas SilA and PA3920 were not detected. Correlation analysis revealed consistent co-occurrence patterns among key taxa, including Porphyromonas gingivalis, Fusobacterium nucleatum, and Prevotella spp. Conclusions: Metal resistance-related proteins are broadly distributed in endodontic microbiota, indicating a conserved genetic capacity for metal tolerance. These findings suggest that microbial resistance determinants may influence, but do not directly determine, the antimicrobial performance of nanoparticle-based biomaterials. This study provides a hypothesis-generating, bioinformatic framework to support the design and optimization of antimicrobial biomaterials, highlighting the need for experimental validation and integration of phenotypic and biofilm-based analyses.

Background/Objectives: Residual EDTA may persist after smear-layer removal and after the application of contact sealers during setting. This in vitro study compared the effect of 1 min of pre-setting surface contact with 17% EDTA (vs. distilled water) on a calcium silicate-based sealer (AH Plus Bioceramic Sealer) and an epoxy resin-based sealer (AH Plus). Methods: Discs were prepared (N = 108) in a 2 × 2 design (n = 27/group); per group; n = 12 were used for solubility followed by eluate pH using the same specimens/eluates after 24 h immersion in distilled water; n = 12 were used to test Vickers microhardness on an independent set after setting; and n = 3 were used for SEM/EDS. Results: Data were analyzed at α = 0.05 using Kruskal–Wallis tests followed by Bonferroni-adjusted pairwise Mann–Whitney U tests for solubility and eluate pH, and one-way ANOVA was performed followed by Tukey’s post hoc test to assess the microhardness. Solubility differed among groups (p < 0.001) and was higher for the bioceramic sealer than for the resin sealer; pre-setting EDTA exposure increased solubility for the AH Plus Bioceramic Sealer (0.86 ± 0.08% to 1.30 ± 0.16%) and decreased solubility for AH Plus (0.34 ± 0.04% to 0.22 ± 0.03%) (p < 0.05). The eluate pH also differed among groups (p = 0.001) and was higher for the bioceramic sealer (≈11.7) than for the resin sealer (≈8.7–9.3), with no within-material differences (p = 0.999 and p = 0.851). Microhardness differed among groups (p < 0.001) and was higher for AH Plus (239.70–246.92 HV) than for AH Plus Bioceramic (131.72–170.83 HV); EDTA reduced microhardness only for the bioceramic sealer (p < 0.001), with no significant change for AH Plus (p = 0.475). Descriptive SEM/EDS findings suggested increased surface irregularities and lower surface Ca for AH Plus Bioceramic after EDTA exposure (12.68 to 7.31 wt%). Conclusions: Pre-setting EDTA contact therefore produced material-dependent changes in early properties and adverse surface-related effects in the calcium silicate-based sealer, supporting thorough chelator removal before obturation.

Introducción: los instrumentos endodóncicos usados retienen debris dentinario, lo que representa un riesgo biológico que afecta su esterilización. Objetivo: evaluar con la técnica de espectroscopia de plasmas inducida por láser (LIBS) la limpieza de instrumentos endodóncicos de NiTi tratados con láser Nd:Yag. Material y métodos: se evaluaron instrumentos ProTaper Next X2 (Dentsply Maillefer®, Ballaigues, Switzerland) y WaveOne Gold Primary (Dentsply Maillefer®, Ballaigues, Switzerland) bajo microscopio estereoscópi- co (20X) en dos etapas: 1) instrumentos usados, 2) instrumentos limpiados con ultrasonido o con láser Nd:Yag. En ambas etapas se registró la presencia y extensión de debris dentinario teñido con so- lución Van Gieson. Posteriormente, se analizó con técnica LIBS los elementos contenidos en el debris dentinario en instrumentos NiTi usados y tratados con diferentes métodos de limpieza. Resultados: la técnica láser Nd:Yag presentó mayor capacidad de limpieza (p < 0.0001). El análisis LIBS no mostró espectros de elementos conte- nidos en el debris biológico en los instrumentos tratados con ambos métodos. Conclusiones: el láser Nd:Yag es un método eficaz para la limpieza de instrumentos NiTi que elimina de su superficie los elementos contenidos en el debris dentinario.