Vertical root fractures are the most common cause of tooth loss. These fractures have a multifactorial etiology. They lead to advanced periodontal breakdown with deep periodontal pockets and vertical bone defects. Clinical signs and symptoms are often elusive in nature and may be difficult to detect. In this review, the etiology, diagnosis, prevention and management of vertical root fractures is discussed.

This paper reviews the history, clinical success and concerns regarding the safety of formocresol as a primary molar pulpotomy medicament. The alternatives to formocresol are discussed and their advantages and disadvantages are evaluated.

Aim: The aim of this in vitro study was to compare the effect of three different post systems cemented with different systems on root fracture. Materials and Methods: Seventy-five extracted human maxillary canines with single and straight roots were used in this study. After the crowns were removed, root canals were prepared with Reciproc R50 files. Smear layer of roots were removed using 17% Ethylenediaminetetraacetic acid (EDTA) followed by 5.25% NaOCl and distilled water. All the root canals were filled with cold lateral compaction technique using AH Plus root canal sealer and gutta-percha. Samples were stored at 37°C and 100% humidity for 1 week and then post space was prepared using fiber post drills. The roots were then randomly divided into five groups according to the luting cements and post systems: negative control, positive control, glass fiber post [Unicore^® (Ultradent, Salt Lake City UT, USA)] + composite core [Grandio SO (Voco GmbH, Cuxhave, Germany)], glass fiber post [Unicore^® ] + Rebilda^® post-core system, individual cast post core. A load was applied on the crowns of all teeth at 135° to their long axis until fracture occurred. Data were analyzed using one-way analysis of variance (ANOVA) and post-hoc Tukey tests. Results: There was statistically significant difference between the groups. According to the post-hoc Tukey test, cast post core (1949.35 + 316 N) showed statistically significantly higher fracture resistance than all the groups except Unicore^® + Rebilda^® post-core systems (1722.48 + 144.0 N). Conclusion: Fiber post core system which is an alternative to cast post core systems increased the fracture resistance of the canines with root canal treatment. While irrepairable catastrophic fractures might be seen in cast post-core systems, separations between composite resin core, and root interfaces might be seen in teeth restored with fiber post-core systems.

Purpose: The aim of this study was to assess micro-tensile bond strength values to dentin of four different one-step self-etching adhesive systems in vitro in a comparative manner. Materials and Methods: In the present study, 20 caries-free human molar teeth were used. Occlusal surfaces were removed to achieve a uniform dentin surface under water cooling by using a low-speed diamond saw. The dentin surfaces obtained were abraded for one minute by using 600-grit silicon carbide papers. Then, the teeth were randomly assigned into four groups (n = 5). For restoration of teeth prepared, four different one-step self-etching adhesive systems, including Clearfil S ³ Bond Plus, Clearfil S ³ Bond, Xeno V Bond and Adper Easy Bond were used according to manufacturer's instructions. A 4 mm thick of composite resin crown (ClearfilAP-X) was applied to surfaces pre-treated with bonding agent. Samples were stored in distilled water at 37°C for 24 hours until micro-tensile bond strength tests were performed. Statistical analyses were performed by using one-way ANOVA and post-hoc Tukey tests (α =0.05). Fracture surfaces were evaluated using a stereomicroscope. Results: Significant differences were observed in bond strength to dentin among one-step self-etching adhesive systems (P < 0.05). The highest bond strength was achieved by Clearfil S ³ Bond Plus system (P < 0.05). No significant difference was observed in bond strength among other groups (P > 0.05). Conclusion: There were differences between bond strength values of tested one-step self-etch adhesives. Clearfil S ³ Bond Plus exhibited higher values.

Context : Advances in composite restorative materials have positioned them as credible alternatives to dental amalgam. However, polymerization shrinkage and the resultant microleakage remain major obstacles in the successful use of these materials. Aims: The aim of this study was to investigate the effects of placement technique on microleakage of Quixfil^® composite restorations bonded with Xeno III^® bonding agent Settings and Design : In vitro study. Materials and Methods : Thirty-four cylindrical cavities measuring 5 mm in diameter and 3 mm in depth were prepared on the buccal aspect of extracted human teeth. The apices of all the teeth were sealed and the teeth randomly assigned into the bulk and the incremental groups for restoration. Restorations were polished and two layers of nail varnish applied on all tooth surfaces except a rim of 1 mm around the restorations. The teeth were thermo-cycled and stained with 2% methylene blue dye. The restorations were sectioned and examined under light microscopy. Dye penetration on the tooth-restoration interface was scored on an ordinal scale of 0 to 4. Statistical Analysis Used : Pair-wise comparison of the two placement groups was done using the Wilcoxon Signed Ranks Test. Results : No statistically significant difference was observed in the microleakage of the two study groups (P value > 0.05). Conclusions : There is no statistically significant difference in the microleakage of the bulk and the incremental Quixfil restorations. It is feasible to place Quixfil restorations in layers of up to 3 mm in depth.

Objectives: The purpose of this study was to evaluate the effect of fiber by using different techniques on fracture resistance of endodontically treated molars with mesio-occlusal-distal (MOD) cavities. Materials and Methods: Forty extracted human molars were randomly assigned to four groups (n = 10). Teeth in Groups 2-4 received root canal treatment and a MOD cavity preparation. Group 1 served as control. Group 2 was restored with composite resin. In Group 3, the fiber was inserted into the cavities in buccal to lingual direction by coating the occlusal one-third of the buccal wall to the occlusal one-third of the lingual wall, and lastly, the teeth were restored with composite resin. In Group 4, the flowable resin was coated inside the cavities with the fiber, as Group 3 was before restoring teeth with composite resin. Compressive loading of the teeth was performed at a cross-head speed of 0.5 mm/min. Data were analyzed using one-way ANOVA and Tukey post-hoc tests. Results: Fracture resistance values of all the groups were compared; the differences between Groups 2 and 3 or Groups 2 and 4 were found to be statistically significant. Conclusions: As a result, use of the fiber under composite resin with a flowable resin increased fracture strength to MOD cavities.

The aim of this paper is to describe vital teeth bleaching employing a combination of techniques: In-office and at-home. We applied a 35% hydrogen peroxide with a pen applicator for the in-office process and 16% carbamide peroxide for in-home bleaching. We have concluded that, in-office bleaching in combination with take-home bleaching using hydrogen peroxide is an excellent option for esthetic and conservative treatment of teeth that have been chromatically altered.

Vertical root fracture (VRF) may occur because of root canal treatment or extensive restoration. A 42-year-old woman applied to our clinic with complaint of pain on her left mandibular second premolar tooth. Radiologic examination by panoramic radiograph indicated that the teeth had a root canal treatment and there was a radiolucency through the mesial area of the root. This data was considered that there might be a root fracture, which cannot be detected on panoramic radiograph. Thus, the condition was told to the patient and after her permission, it was decided to take a CBCT image for definite diagnosis. The tooth was scheduled for extraction and socket preservation. A new CBCT image was taken from the extracted teeth with much more dosage to observe the fracture line every aspect. Also, the tooth was sent to the histology department for histologic investigation. The CBCT image demonstrated hardly visible VRF at the coronal, mid-root and apical levels in the axial views. Fracture line that extends through the long axis of the tooth was seen obviously on CBCT image which was taken after extraction and histologically with different zoom in (×25, ×40, ×100, ×200, and ×400). Different stages of endodontic treatment may cause VRFs. Symptoms of VRF are often not obvious, because of this diagnosis may be difficult for dentists. CBCT images could be helpful to evaluate VRFs which cannot diagnose.