Vital pulp therapy, including direct pulp capping and partial and full pulpotomy, is primarily indicated for immature or mature permanent teeth with reversible pulpitis. Mature permanent teeth with irreversible pulpitis are frequently treated with root canal therapy. This report presents two cases of full pulpotomy using Biodentine^TM in mature permanent teeth with irreversible pulpitis and acute apical periodontitis. The periapical radiograph illustrated a deep carious lesion extended to the pulp with apical radiolucency lesion or widened periodontal ligament space. Full pulpotomy with a tricalcium silicate-based cement was chosen as the definitive treatment. After decayed tissue excavation under a rubber dam, the exposed pulp tissue was amputated to the level of the canal orifice with a new sterile bur. Biodentine^TM was applied as the pulp capping agent after hemostasis was obtained and for temporary restoration. The clinical signs disappeared quickly after the treatment. After one month, the coronal part of the temporary restoration was removed, and a composite resin was placed over the capping agent as a final restoration. At two-year follow-ups, the teeth were asymptomatic. Radiographs showed healing of the periapical lesion and periodontal ligament. Biodentine^TM full pulpotomy of mature permanent teeth with irreversible pulpitis and apical periodontitis can be an alternative option to root canal therapy.

Objectives: In this study, we aimed to investigate the effects of a mixture of advanced platelet‐rich fibrin (A‐PRF) and xenogenic bone substitute material (XBSM) on the proliferation and migration of human periodontal ligament stem cells (hPDLSCs) based on the in vitro release of growth factors.Material and Methods: The concentrations of platelet‐derived growth factor‐AB (PDGF‐AB) and vascular endothelial growth factor (VEGF) released by the A‐PRF‐XBSM mixture were estimated using enzyme‐linked immunoassay for up to 7 d. The A‐PRF‐XBSM mixture exudate was incubated with hPDLSCs. At Days 1, 3, 5, and 7, cell proliferation and migration were investigated by cell counting and wound‐healing assays.Results: PDGD‐AB and VEGF were released from the A‐PRF‐XBSM mixture exudate for up to 7 days. hPDLSCs were cultured in media with various concentrations of the A‐PRF‐XBSM mixture exudate and exhibited their proliferation and migration ability. Furthermore, the factors released from the 100% A‐PRF‐XBSM mixture exudate had a substantial effect on cell migration, whereas those released from 4% and 20% A‐PRF‐XBSM mixture exudates stimulated hPDLSC proliferation.Conclusions: A‐PRF‐XBSM mixture continuously released growth factors over 7 days and enhanced hPDLSC proliferation and migration. Therefore, A‐PRF in combination with XBSM might provide potential advantages for periodontal tissue regeneration.

Background/Objectives: Glass-hybrid and high-viscosity glass-ionomer systems aim to improve conventional glass-ionomer performance. This in vitro study compared Vickers hardness and microleakage of a coated glass-hybrid system and a coated high-viscosity glass-ionomer system in thermocycled conservative Class II cavities in human maxillary first premolars. Methods: Thirty extracted maxillary first premolars were used in a paired within-tooth design. Two standardized conservative Class II cavities, one mesial and one distal, were prepared in each tooth, and each tooth received both systems: EQUIA Forte HT Fil with EQUIA Forte Coat and GC Gold Label IX EXTRA CAPSULE with GC G-Coat Plus. After restoration and thermocycling, Vickers hardness was measured on restoration cross-sections at occlusal and gingival locations. Microleakage was assessed on sectioned specimens using dye penetration measurements and ordinal infiltration scores. Results: EQUIA Forte HT showed a higher tooth-level mean Vickers hardness than Gold Label IX Extra after thermocycling (95.05 ± 6.58 HV vs. 91.33 ± 7.50 HV), with a mean paired difference of 3.72 HV (95% CI: 0.32 to 7.11; p = 0.033). In the location-dependent analysis, the effect of the restorative system was significant (p = 0.025), whereas testing location and the interaction were not significant. The microleakage index and the distributions of occlusal-wall and gingival-wall ordinal infiltration scores did not differ significantly between the two restorative systems. Conclusions: Under the conditions of this in vitro study, EQUIA Forte HT showed a slight tooth-level hardness advantage over Gold Label IX Extra after thermocycling. Neither system showed a statistically significant advantage in dye-based marginal sealing.

Background/Objectives: Glass-hybrid and high-viscosity glass ionomer systems were developed to address limitations of conventional glass ionomer cements. This in vitro study compared post-thermocycling Vickers hardness and microleakage of a coated glass-hybrid system and a coated high-viscosity glass ionomer system in conservative Class II cavities. Methods: Thirty extracted human maxillary first premolars each received both systems in standardized mesio-occlusal and disto-occlusal cavities, enabling paired within-tooth comparisons. Following thermocycling and methylene blue immersion, Vickers hardness was measured on polished restoration cross-sections at occlusal and gingival locations. Microleakage was quantified using a continuous microleakage index and ordinal dye penetration scores. Results: The EQUIA Forte HT system had a higher tooth-level mean Vickers hardness than the Gold Label IX Extra system (95.05 ± 6.58 HV vs. 91.33 ± 7.50 HV), with a mean paired difference of 3.72 HV (95% CI, 0.32 to 7.11; p = 0.033; Cohen’s d_z = 0.41, 95% CI, 0.03 to 0.78). The location-specific mixed model also showed an effect of restorative system (p = 0.025), whereas neither testing location nor the system × location interaction was significant. No significant between-system difference was detected for the microleakage index or for either ordinal dye penetration score. Conclusions: Within the limitations of this in vitro study, the EQUIA Forte HT system had a modestly higher post-thermocycling tooth-level mean Vickers hardness than the Gold Label IX Extra system, although the clinical relevance of the difference remains uncertain. No between-system differences were detected in dye penetration outcomes.

Introduction: Zinc citrate trihydrate (ZCT) has antibacterial and anti‐inflammatory properties and is widely used in oral‐care products. However, evidence regarding its effectiveness in orthodontic patients remains limited. This study aimed to evaluate the effects of a toothpaste containing 2% ZCT on gingival inflammation, plaque accumulation, and plaque‐associated bacterial load in patients wearing fixed orthodontic appliances. Methods: A randomized controlled clinical trial was conducted among 102 patients with plaque‐induced gingivitis undergoing fixed orthodontic treatment. Participants were randomly assigned to use either a toothpaste containing 2% ZCT (test group) or a conventional toothpaste without ZCT (control group). The gingival index (GI) and Modified Quigley–Hein Plaque Index (MQHPI) were recorded at baseline, after 1 week, and after 4 weeks. Supragingival plaque samples were collected at baseline and after 4 weeks and analyzed using real‐time polymerase chain reaction to quantify selected plaque‐associated bacterial species. Linear mixed‐effects models were used to evaluate the effects of time, treatment, and their interaction on GI and MQHPI. Results: Exploratory time‐specific comparisons at 4 weeks showed lower GI and MQHPI and lower loads of Fusobacterium nucleatum (Fn), Tannerella forsythia (Tf), and Solobacterium moorei (Sm) in the ZCT group. However, the longitudinal mixed‐effects analyses showed no significant treatment‐by‐time interaction for either the clinical outcomes or the quantitatively assessable bacterial species. Conclusions: Both groups showed clinical improvement over time. However, the longitudinal analyses did not demonstrate an additional clinical or microbiological effect attributable to the 2% ZCT toothpaste during the 4‐week study period.

Background: Vital pulp therapy (VPT) in mature permanent teeth with irreversible pulpitis represents a paradigm shift toward preserving pulp vitality. Advanced platelet‐rich fibrin plus (A‐PRF ⁺ ) is a bioactive scaffold capable of releasing high concentrations of growth factors; however, its concentration‐dependent effects on inflamed pulp‐derived stem cells remain unclear. This study aimed to evaluate the concentration‐dependent effects of A‐PRF ⁺ and identify a biologically favorable concentration range for supporting the functional activity of dental pulp stem cells isolated from teeth with irreversible pulpitis. Methods: IP‐DPSCs were isolated from inflamed pulp tissues and characterized by flow cytometry and trilineage differentiation assays. A‐PRF ⁺ was prepared using the low‐speed centrifugation concept (LSCC). Cells were exposed to sequential dilutions of A‐PRF ⁺ extracts (100%, 50%, and 25%). Cell metabolic activity was assessed using the MTT assay. Cell migration was evaluated using a scratch assay, and wound closure rates were quantified with ImageJ software. Statistical analysis was performed using one‐way or two‐way ANOVA with appropriate post‐hoc tests. Results: Flow‐cytometric analysis showed high expression of MSC‐associated markers (CD44, CD73, and CD90) and negligible expression of hematopoietic markers, while differentiation along osteogenic, chondrogenic, and adipogenic lineages was observed following induction culture. A‐PRF ⁺ exhibited a biphasic concentration‐dependent effect. The 25% extract significantly enhanced cell migration, achieving a wound closure rate of 27.09 ± 4.03%, compared with 13.16 ± 4.50% in the 100% extract group ( p = 0.013). Undiluted A‐PRF ⁺ showed inhibitory effects on both migration and metabolic activity. Conclusion: A‐PRF ⁺ exerted concentration‐dependent effects on IP‐DPSCs, with diluted preparations supporting greater migration and metabolic activity than undiluted extracts. These findings suggest the existence of a biologically favorable concentration range for A‐PRF ⁺ and provide a rationale for further investigation of concentration optimization in regenerative endodontic applications.