The primary objective of endodontic therapy is to create a biologically acceptable environment within the root canal system that allows for the healing and maintenance of the health of the peri-radicular tissue. Bacteria are one of the main causes of pulp problems, and they have different methods of penetrating and invading the endodontic space such as through carious lesions, traumatic pulp exposures, and fractures. The types of bacteria found range from facultative anaerobes to aerobes, up to the most resistant species able to survive in nutrient-free environments; the bacterial species Enterococcus faecalis belongs to this last group. Enterococcus faecalis is considered one of the main causes of recurring apical periodontal lesions following endodontic treatment, with persistent lesions occurring even after re-treatment. The review presented in this paper was performed in accordance with the PRISMA protocol and covers articles from the related scientific literature that were sourced from PubMed, Scopus, and Google Scholar using the following terms as keywords: “endodontic treatment”, “endodontic bacteria”, “microbial endodontic”, and “endodontic failure”. Only the articles considered most relevant for the purposes of this paper were read in full and taken into consideration for the following review. The results show that Enterococcus faecalis, Actinomycetes, and Propionibacterium propionicum are the species most frequently involved in persistent radicular and extra-radicular infections.

Endodontic treatment consists of different working procedures, such as the isolation of the operating field, pulp chamber access, and cleaning and shaping phases with at last the need of a three-dimensional filling of the canals. Each step requires a series of single-use or sterilizable instruments. We have performed a systematic review of different sterilization and disinfection procedures aiming at drawing up a disinfection and sterilization procedure to be used on endodontic instruments. A search on PubMed and Scopus was carried out using the following keywords: “endodontic sterilization,” “endodontic autoclave,” “decontamination dental bur,” “sterilization dental burs,” and “gutta-percha points sterilization.” Eligible articles were included in the qualitative and quantitative analysis. Results of the meta-analysis showed that the most effective method in sterilization is autoclaving. The qualitative analysis showed that the use of single-use or first-use instruments requires presterilization or sterilization procedures, and for reusable tools, attention must be paid to the removal of debris deposited on the blades, not easy to remove manually.

Obstructive sleep apnea is characterized by a reduced airflow through the upper airways during sleep. Two forms of obstructive sleep apnea are described: the central form and the obstructive form. The obstructive form is related to many factors, such as the craniofacial morphology. To evaluate the correlation between the morphology of the cranial base, of the mandible and the maxilla, and obstructive sleep apnea severity. Eighty-four patients, mean age of 50.4 years old; 73 males and 11 females with obstructive sleep apnea were enrolled in the present study. Patients with high body mass index and comorbidities were excluded. Lateral cephalograms and polysomnography were collected for each patient to evaluate the correlation between craniofacial morphology and obstructive sleep apnea severity. A Spearman’s rho correlation test between cephalometric measurements and obstructive sleep apnea indexes was computed. Statistical significance was set at p < 0.05. Patients with a severe obstructive sleep apnea presented a reduction of sagittal growth of both effective mandibular length and cranio-basal length. The mandibular length was the only variable with a statistical correlation with apnea-hypopnea index. Vertical dimension showed a weak correlation with the severity of obstructive sleep apnea. No correlation with maxillary sagittal dimension was shown. Obstructive sleep apnea severity may be correlated to mandibular and cranial base growth. Facial vertical dimension had no correlation with obstructive sleep apnea severity.

Sterilization is a fundamental step in the reuse of endodontic instruments. The sterilization procedure involves disinfection, cleaning, washing, drying, packaging, and sterilization by heat. Heat sterilization can lead to changes in the physical and mechanical properties of dental instruments. These changes can affect the external surfaces via micropitting, corrosion, a reduction in cutting capacity, and/or an influence on the resistance to cyclic fatigue or to torsional fatigue. In this study, we examined the modification of the torsional properties of endodontic instruments after hot sterilization, and compared the properties with instruments not subjected to hot sterilization cycles in terms of resistance to torsional fatigue and deflection angle in NiTi and steel instruments. The following work was performed based on the PRISMA indications. Studies were identified through bibliographic research using electronic databases. A total of 725 records were identified in the PubMed and Scopus databases. A total of 685 records remained after exclusion by year of publication (1979 to 2019). With the application of the eligibility criteria (all articles pertaining to the issue of sterilization in endodontics), we found 146 articles, which decreased to 130 articles after elimination of duplications. There were 45 articles that studied the influences of sterilization procedures on the physical and mechanical characteristics of the instruments, and 12 that measured parameters related to resistance to torsional fatigue. Applying the inclusion and exclusion criteria resulted in a total of eight articles for quantitative analysis. The meta-analysis results show a pejorative effect of torsional fatigue for NiTi instruments subjected to heat sterilization compared to the non-sterilized control.

The purpose of the present study was to evaluate: (i) maxillary occlusal plane changes after clear aligners therapy with a 3D measurement technique; and (ii) as a secondary outcome, if such changes were correlated to the patient’s 1axilla-mandibular divergence. 3D maxillary models of 32 patients (7 males and 25 females; mean age 22.3 +/− 3.4 year) treated with clear aligners were analyzed. The angle (α) between a reference palatine plane and a maxillary occlusal plane was measured. Five angular cephalometric measurements (NSL/MP; PP-OP; OP-MP; PP-MP; PFH/AFH%) were performed and related to Δα. The subjects were further divided into three groups according to facial divergence. After aligner treatment, Δα increased in hyperdivergent patients and decreased in hypodivergent patients (p < 0.05). Δα showed a significant positive correlation with NSL/MP (rho = 0.44) and negative correlation with PFH/AFH% (rho = −0.53). Aligners treatment produced a counterlockwise rotation of the maxillary occlusal plane, even if this rotation occurs differently depending on divergence.

Aim: The aim of the study was to evaluate the cephalometric effects of the elastodontic appliance (EA) in the management of patients presenting with a skeletal Class II/1 malocclusion. Methods: Twenty Class II patients treated using the EA (Group EA) were compared with 20 Class II untreated children (Group C). Cephalograms were compared at the start (T0) and after 24 months (T1) after which time, skeletal, dental, and aesthetic variables were evaluated. A statistical evaluation was conducted by applying an unpaired t- test for normally distributed variables. Results: From T0 to T1, the EA group showed a significant increase in lower facial height (LFH), in mandibular length (Co-Gn), in the upper incisor and cranial plane angle (1 + SN) and in the distance between a true vertical line (TVL)-soft tissue B (B’) and TVL-soft tissue Pogonion (Pog’) points. From T0 to T1, group C showed a significant decrease in SN-occlusal plane (PO) ( p < 0.01), of SN-mandibular plane (Go-Me) ( p < 0.01) and of total gonial (N-Go-Me) angles ( p < 0.05); a significant reduction of the distance between TVL-upper incisor (1+), TVL-lower lip (Li), and TVL-Pog’ was shown. No statistical differences were observed between the groups in dental and aesthetic outcomes, except for a skeletal increase in LFH ( p < 0.05) and in Co-Gn length ( p < 0.05), which was statistically significant in the EA group. Conclusion: In Class II growing patients, the EA induces minor skeletal effects, compared to untreated control patients.