The aim of the this study was to quantitatively evaluate in three-dimensional (3D), the porosity degree of three improved silicate-based endodontic repair cements (iRoot BP Plus®, Biodentine®, and Ceramicrete) compared to a gold-standard calcium silicate bioactive cement (Pro Root® MTA). From each tested cement, four samples were prepared by a single operator following the manufacturer's instructions in terms of proportion, time, and mixing method, using cylindrical plastic split-ring moulds. The moulds were lubricated and the mixed cements were inserted with the aid of a cement spatula. The samples were scanned using a compact micro-CT device (Skyscan 1174, Bruker micro-CT, Kontich, Belgium) and the projection images were reconstructed into cross-sectional slices (NRecon v.1.6.9, Bruker micro-CT). From the stack of images, 3D models were rendered and the porosity parameters of each tested material were obtained after threshold definition by comparison with standard porosity values of Biodentine®. No statistically significant differences in the porosity parameters among the different materials were seen. Regarding total porosity, iRoot BP Plus® showed a higher percentage of total porosity (9.58%), followed by Biodentine® (7.09%), Pro Root® MTA (6.63%), and Ceramicrete (5.91%). Regarding closed porosity, Biodentine® presented a slight increase in these numbers compared to the other sealers. No significant difference in porosity between iRoot BP Plus®, Biodentine®, and Ceramicrete were seen. In addition, no significant difference in porosity between the new calcium silicate-containing repair cements and the gold-standard MTA were found.

This in vivo study aimed to evaluate the influence of contact points on the approximal caries detection in primary molars, by comparing the performance of the DIAGNOdent pen and visual-tactile examination after tooth separation to bitewing radiography (BW). A total of 112 children were examined and 33 children were selected. In three periods (a, b, and c), 209 approximal surfaces were examined: (a) examiner 1 performed visual-tactile examination using the Nyvad criteria (EX1); examiner 2 used DIAGNOdent pen (LF1) and took BW; (b) 1 week later, after tooth separation, examiner 1 performed the second visual-tactile examination (EX2) and examiner 2 used DIAGNOdent again (LF2); (c) after tooth exfoliation, surfaces were directly examined using DIAGNOdent (LF3). Teeth were examined by computed microtomography as a reference standard. Analyses were based on diagnostic thresholds: D1: D₀ = health, D₁-D₄ = disease; D2: D₀, D₁ = health, D₂-D₄ = disease; D3: D₀-D₂ = health, D₃, D₄ = disease. At D1, the highest sensitivity/specificity were observed for EX1 (1.00)/LF3 (0.68), respectively. At D2, the highest sensitivity/specificity were observed for LF3 (0.69)/BW (1.00), respectively. At D3, the highest sensitivity/specificity were observed for LF3 (0.78)/EX1, EX2 and BW (1.00). EX1 showed higher accuracy values than LF1, and EX2 showed similar values to LF2. We concluded that the visual-tactile examination showed better results in detecting sound surfaces and approximal caries lesions without tooth separation. However, the effectiveness of approximal caries lesion detection of both methods was increased by the absence of contact points. Therefore, regardless of the method of detection, orthodontic separating elastics should be used as a complementary tool for the diagnosis of approximal noncavitated lesions in primary molars.

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