Background: Endodontic treatment aims to eliminate pulp tissue, microorganisms, and toxins while creating an environment conducive to tissue revitalization and regeneration. Sodium hypochlorite, the gold-standard irrigant, is effective but has significant cytotoxic effects, prompting the need for safer alternatives. This study investigates the cytotoxicity, cell proliferation, adhesion to dentin, and osteogenic differentiation of cells exposed to Dual Rinse HEDP, curcumin, and sodium hypochlorite (2.5%) for 1, 5, and 15 min, focusing on their potential application in revitalization and regenerative endodontic protocols. Methodology: Samples were assigned to groups based on the irrigant used: control, HEDP, curcumin, or sodium hypochlorite (2.5%) for exposure durations of 1, 5, and 15 min. Cytotoxicity was assessed using the MTT assay, with optical density measured at the specified times. Cell proliferation was evaluated via the Trypan blue exclusion test, with viable cells counted using a hemocytometer. Data were presented as mean and standard deviation (SD) values and statistical significance was set at p < 0.05 for all tests. Cell adherence to dentin discs was analyzed using scanning electron microscopy (SEM) after 5-min irrigant exposure. Osteogenic differentiation was assessed through alizarin red staining for calcium deposition and quantitative PCR analysis of BMP-2, TGF-β1, VEGF, and DSPP gene expression. Results: Cell cytotoxicity differed significantly across groups (p < 0.05), with HEDP showing the best results at 1 and 5 min. After 15 min, Group II had the highest value, followed by Group I. HEDP also recorded the highest cell proliferation, followed by curcumin. HEDP exhibited substantial calcium deposition and significantly upregulated BMP-2, TGF-β1, VEGF, and DSPP gene expression, surpassing other materials. Curcumin moderately promoted calcified nodule formation. Osteogenic media also induced significant gene upregulation. Conclusions: Dual Rinse HEDP and curcumin are tissue-friendly. Dual rinse HEDP efficiently increases stem cell adherence to dentin discs and their osteogenic differentiation. So, this irrigant has the potential to be used in regeneration protocols.

Aim Compare efficacy of Dual Rinse HEDP with sodium hypochlorite to sodium hypochlorite in combination with a finishing rinse with 17% EDTA solution to remove the smear layer. Materials and methods Sixteen human maxillary single-rooted, single canalled sound premolars were used. Specimens were distributed into 2 groups and labeled according to irrigation protocol used. Each group consisted of 8 specimens: Group 1 50% NaOCl followed by 17% EDTA. Group 2 The Dual Rinse® HEDP mixed with 50% NaOCl. Roots were prepared for SEM appraisal. The smear layer was assessed and scored. Energy-dispersive X-ray analysis was used to analyze the inorganic chemical structure of the treated dentin of the two tested groups. Data were tabulated and statistically analyzed.Kruskal-Wallis test tailed by Mann-Whitney test compared mean scores between irrigant solutions and root regions groups. Chi-square test compared the frequency distribution of scores between different groups. Results Smear layer was reduced with The Dual Rinse® HEDP group. Groups exhibited a statistically significant difference in mean scores within apical region and no statistically significant difference within coronal and middle regions. Groups showed a statistically significant difference in frequency distribution of scores within coronal and apical regions. A statistically significant difference in scores frequency existed in between the three root regions within NaOCl+EDTA group While no difference was present in between the different regions within Dual Rinse® HEPD group. Energy- dispersive X-ray analysis showed lower peaks of calcium in the Dual Rinse® HEDP. Conclusion The Dual Rinse® HEDP can be used as one step irrigant.

Background: This is a triple-blinded, prospective split-mouth clinical trial. It is important to shed light on the effect of different apical preparation sizes regarding postoperative pain within the same patient with the same pulpal histological status. The aim is to compare and evaluate the severity of postoperative pain following apical enlargement with two different sizes after the IBF using the visual analogue scale. Methods: Fifty “teeth” in 25 patients were assigned into two equal groups (25 per group) using E3 Azure rotary files; Group A was prepared two sizes greater than the Initial binding file (IBF) (the largest K file to bind at the actual working length) mesial canals, which were enlarged to 35#/0.04 and 40#/0.04 for the distal canals. Group B was prepared in three sizes larger than the IBF: 40#/0.04 for mesial canals and 45#/0.04 for the distal canals. On a modified VAS form, patients were questioned to indicate the degree of their pain and assisted in narrating their pain intensity during the following periods: 12, 24, and 72 h, and after a week. VAS data were non-parametric and analyzed using the signed-rank test for intergroup comparisons, Freidman’s test, and the Nemenyi post hoc test for intragroup comparisons. The significance level was set at p < 0.05. Results: showed that regardless of measurement time, enlargement of apical preparation was significantly associated with higher pain scores (p < 0.001). Within both groups, there was a significant reduction of measured pain score with time, with values measured after 12 and 24 h being significantly higher than values measured at other intervals (p < 0.001) and with values measured after three days being significantly higher than 1-week value (p < 0.001). Conclusion: The size of apical preparation had a significant effect on postoperative pain. Trial registration number & date: NCT05847738, 08/05/2023.

Ts were randomly assigned into two equal groups according to rotary system used: Hyflex CM or MPro (n = 25). Both groups were mechanically prepared. Patients were asked to assess their postoperative pain using the numerical rating scale (NRS) at 3, 6, 24, 48, and 72 h after instrumentation. Data were presented as mean, standard deviation, median, and interquartile range values to be statistically analyzed with R statistical analysis software using Friedman’s test followed by Nemenyi post hoc test at different time intervals within each rotary system. Mann–Whitney U test was conducted to compare NRS values between both rotary systems. Results: The intensity of pain postoperatively was low significantly in Hyflex group in all observation periods. MPro group showed a decreasing mean from 3 h to 72 h time intervals. 3 h recorded the highest mean (3.72 ± 1.88). Statistically, there was a significant difference between all intervals except after 48 and 72 h. Hyflex group showed the same. 3 h recorded the highest mean (1.72 ± 1.34). Statistically, there was a significant difference between 3 h and the rest time intervals, but no significant difference was found between the 6, 24, 48, and 72 h. For both groups, there was no significant association between gender and pain and there was no significant correlation between age and pain Conclusion: Both Hyflex and Mpro systems resulted in postoperative pain with a different degree but Hyflex system represented lower postoperative pain intensity when used for mechanical instrumentation of mandibular molars with irreversible pulpitis....

CM Wire Endodontic Files Cyclic Fatigue after Irrigant’s Immersion

Objective: This study aims to assess the impact of bioceramic and resin based sealers on postendodontic pain after endodontic treatment performed in single visit. Methods: In this study, forty patients in need of endodontic therapy were chosen. single visit endodontic treatment was done for the patients but obturated using two different types of sealers: in Group 1: AH Plus sealer was used and in Group 2: EndoSequence BC sealer Hiflow was used. Post endodontic pain was measured for 12,24,48 and 72 hours postoperatively. Results: Both sealer groups’ post-endodontic pain levels did not significantly differ from one another. Conclusions: Both AH Plus and Endosequence BC sealer Hiflow perform similarly in terms of the incidence and severity of postoperative pain in teeth with symptomatic irreversible pulpitis (SIP). Endodontics performed in a single visit can utilise any type of both sealers without worrying about pain following obturation.