Aim: To evaluate dental students’ perception of reflective practice before and after an educational intervention. Second, to investigate how it might be more effectively incorporated into dental education. Materials and methods: A 2-hour session for reflective writing instructions was done as a group discussion and feedback between the instructor and the learners. A template for reflection based on Gibbs’ reflective cycle was used. Fifty-one third-year dental students (academic year 2023–2024) participated in this study. Forty-four students consented and filled out an anonymous pre-session electronic survey. The survey comprised two parts including demographics (two questions) and reflective skills related part (11 questions). Twenty-nine students consented and filled out an anonymous post-session electronic survey. The survey included the same parts as the previous, as well as added opinion-related questions (2 questions). Results: Reflective practice was significantly appreciated among students who thought it was “extremely important” for dental education (n = 22, 75.8%). Moreover, most students (n = 17, 58.6%) believed it should be “completely integrated” into the curriculum. The methods applauded for reflective practice were group discussion (n = 23, 79.3%), reflective writing journal (n = 19, 65.5%), and an online platform (n = 8, 27.6%). There was a statistically significant difference in the evaluation of dental students’ perception of reflective practice before and after the session, favoring progress in reflective skills related to their capacity for self-assessment, reflection-on-action, and peer learning. Pre-session sex disparity was resolved after the session. Conclusion: Dental students’ perception of reflective practice enhanced after the educational intervention, and they favored its integration into the curriculum by organized group discussion. Clinical significance: This study supports the growing consensus that establishing reflective practice is a necessary element of becoming a healthcare professional and the recognition of reflective practice as part of continuous professional development for dental professionals.

Aim: This study assessed how different final irrigation solutions impact the push-out bond strength (PBS) of EndoSequence Bioceramic (BC) and cerafill BC sealers. Methods: Eighty single-root lower premolars were selected and decoronated. The root canals were then cleaned and shaped chemo-mechanically using ProTaper files up to F5, with 5.25% sodium hypochlorite applied between each file for rinsing. Subsequently, the teeth were categorized into four primary groups of 20 each, distinguished by their final irrigation solution. Group A utilized 17% glycolic acid (GA), group B used a 5% apple vinegar solution, group C employed 17% ethylenediamine tetraacetic acid (EDTA), and group D used saline. Each group was further divided into two subgroups of 10 teeth each, based on the type of BC sealer applied—Cerafill BC sealer for subgroup a, and EndoSequence BC sealer for subgroup b. Two dentin disks were then obtained from the middle third of each root (n = 20) and subjected to the PBS test. Upon completion of this test, the dentin disks were scrutinized under a stereomicroscope to determine the mode of failure for each disk. Results: The use of EndoSequence BC sealer in obturation led to the apple vinegar final irrigation group exhibiting significantly higher PBS than the GA and saline solution groups. Furthermore, when implemented with cerafill BC sealer, the EDTA final irrigation solution group displayed the greatest PBS, showing a significant difference compared with the GA and saline solution groups. Conclusion: Apple vinegar solution could be a potential alternative to EDTA as a chelating agent during root canal treatment, though further research is required. Clinical significance: The EDTA and apple vinegar are effective at removing smear layers, which improves sealer penetration and prevents obturation materials dislodgment.

Aim: The aim of this study was to evaluate patient satisfaction based on the model of “care” proposed by Joan Tronto. Materials and methods: A total of 300 patients aged 20−70 years were interviewed using a self-administered questionnaire covering the 4 dimensions of Tronto's care (caring about, taking care of, care giving, and care receiving). The data collected was analyzed using Statistical Package for the social sciences version 19 software. The correlation between the degree of satisfaction and the analyzed parameters was determined using the Chi-square test, with a significance threshold of p = 0.05. Results: A satisfaction rate of 91.7% was determined. It was strongly correlated with attention, listening, quality of information, and sympathy (p = 0.001). The “competence” factor also appeared to correlate strongly with overall patient satisfaction (p < 0.001). Conclusion: The majority of participants were satisfied with the dental care they received. This result shows the importance of ethics in clinical care. Clinical significance: Taking the ethical dimension into account can help in the proper planning of care procedures and increase patient satisfaction.

Aim: The objective of this study is to assess the impact of three different surface etching techniques and two composite materials on surface roughness (R_a) and the shear bond strength (SBS) of clear aligner attachments bonded to monolithic zirconia (MZ). Materials and methods: Sixty-six MZ disks were divided into three main groups (n = 22) according to the surface treatment method: group I: hydrofluoric acid (HFA) 9.5%, group II: 50 µm aluminum oxide (Al₂O₃) sandblasting, and group III: Er:Cr:YSGG laser. Each group was then subdivided into two subgroups according to the composite material (n = 11) used for bonding of the attachment, either packable composite Filtek Z350 or composite Filtek Z250. Clear aligner attachments were then bonded to the disks, and measurements of R_a and SBS were taken. Statistical analysis was carried out using the Kruskal−Wallis test and two-way analysis of variance. Results: The HFA groups showed the highest SBS (11.29 ± 2.83 MPa) and R_a (0.82 µm), while the laser groups exhibited the lowest SBS (8.29 ± 2.38 MPa) and R_a (0.634 µm). In Filtek Z350, there was a significant difference observed between the subgroups regarding SBS but not in Filtek Z250 subgroups. Conclusion: The 9.5% HFA provided the highest SBS value in comparison with Er:Cr:YSGG laser and sandblasting (p <0.05). Clinical significance: This study has the potential to benefit both orthodontists and patients by providing insights into techniques that can improve the bond strength and longevity of clear aligner attachments to MZ.

Aim: The aim of this study was to compare and evaluate the phase transformation and effect on the bond strength and fracture toughness of monolithic zirconia after surface treatment with alumina and synthetic diamond particles. Materials and Methods: Forty samples of monolithic sintered zirconia discs (Y-TZP) were divided into two groups of 20 samples each. Group A – air abrasion with alumina particles (n = 20); group B – air abrasion with synthetic diamond particles (n = 20). Pretreatment phase and posttreatment of each zirconia sample from group A and group B were evaluated using an X-ray diffraction machine. The surface roughness of each zirconia sample was evaluated using a profilometer. Composite discs were fabricated and bonded to the air-abraded surface of each zirconia sample from group A and group B using a dual-cured resin cement, respectively. These samples were mounted in an acrylic block to determine the bond strength of zirconia with resin cement using a universal testing machine. This was followed by a fracture toughness test of the samples using a Vickers indentation hardness tester. The results were subjected to statistical analysis using a t-test, and relevant statistical conclusions were drawn. Results: The mean ± SD of monoclinic content in group A (alumina particles) and group B (synthetic diamond particles) was 0.82 ± 0.010% and 0.76 ± 0.015%, respectively. The mean ± SD of surface roughness in group A (alumina particles) and group B (synthetic diamond particles) was 0.507 ± 0.106 and 0.513 ± 0.116 µm, respectively, and the mean ± SD of bond strength in group A (alumina particles) and group B (synthetic diamond particles) was 6.11 ± 1.47 and 6.49 ± 0.83 MPa, respectively. The mean ± SD of fracture toughness in group A (alumina particles) and group B (synthetic diamond particles) was 2.63 ± 0.46 0.5 and 5.70 ± 1.03 MPam^0.5, respectively. p < 0.05 was considered statistically significant. Conclusion: The distribution of mean monoclinic content was significantly higher in zirconia samples abraded by alumina (Group A) as compared to synthetic diamond particles (Group B). The mean surface roughness and bond strength results were statistically insignificant between both groups. The distribution of mean fracture toughness was significantly higher in group B compared to group A. Clinical significance: Synthetic diamond particles for air abrasion of Y-TZP can be a promising alternative to alumina as they cause minimal changes in the structural integrity without compromising the bond strength.

Aim: To assess the root−crown ratio (RCR) of maxillary and mandibular anterior permanent teeth from cone-beam computed tomography (CBCT) acquired from a sample of Yemeni adults. Materials and methods: This was a retrospective radiographic observational cross-sectional study. The study included 233 CBCTs. Root length, crown length, and RCR of all anterior teeth were measured using Ez-3Di software. Factors considered for correlation included gender differences, skeletal classifications (class I, II, and III), overjet (OJ), and overbite (OB). The data were entered and analyzed using the Statistical Package for the Social Sciences software. Significance was set at a value of p < 0.05. Results: Mean RCR of maxillary and mandibular anterior teeth ranged between 1.2 and 1.3 for central incisors, 1.3 and 1.4 for lateral incisors, and 1.5 and 1.6 for canines. The length of roots and crowns was generally greater in males, except for the mean crown length of the left mandibular central incisor. Class III participants exhibited the longest root length for maxillary and mandibular canines, 15.75 and 14.7 mm, respectively, compared with class I and II participants. Participants with increased OJ (>4 mm) showed the lowest root and crown lengths in all canines and lateral incisors while displaying the highest root length in all central incisors. However, no statistically significant variances were observed in root length and the RCR (p > 0.05). Those with a deep bite had the longest roots for maxillary lateral and central incisors and the shortest roots for maxillary canines. In contrast, participants with an open bite displayed the opposite measurements. Conclusions: Gender differences in RCR were insignificant except for the mandibular right central incisor. No significant differences were observed among the three skeletal classes in all study parameters. Furthermore, RCR variations based on OJ and OB were not statistically significant, except for the mandibular left lateral incisor in relation to OB. Clinical significance: Understanding RCR variations supports clinicians in treatment planning, especially in anchorage selection, force application, and predicting treatment outcomes. This knowledge is important for minimizing potential complications and improving treatment effectiveness in various orthodontic cases.

Aim and background: The balance between mechanical properties, esthetics, and therapeutic benefits in restorative materials, especially for high-risk patients, is lacking. Effective comparative study designs are required. This randomized clinical trial evaluated the clinical performance of Alkasite bioactive restorative material vs resin-modified glass ionomer (RMGI) in cervical carious lesions according to United States Public Health Service (USPHS) criteria over 1 year. Materials and methods: Twenty-eight high-risk adult patients with Class V cavities in anterior or premolar teeth were randomly assigned to two groups (n = 14 each). The first group received restorations with an RMGI. In contrast, using a selective etching technique and a universal adhesive, the second group was restored with a bulk-fill alkasite. All materials were applied according to the manufacturer's instructions. The restorations were evaluated at baseline (1 week), after 6 months, and after 12 months using modified USPHS criteria. Data were recorded and statistically analyzed. Results: Regarding the primary outcome of marginal integrity, no statistically significant difference was found between the alkasite and RMGI restorations at any follow-up interval. However, within the RMGI group, a statistically significant change in marginal integrity was observed across different follow-up periods. All secondary outcomes showed no statistically significant differences in either intragroup or intergroup comparisons at the various follow-up intervals, except for anatomic form, where a statistically significant difference was observed within the RMGI group over different follow-up periods. Conclusion: Both restorations have shown similar clinical performance over a year, indicating their effectiveness in cervical restorations. Alkasite restoration can successfully replace RMGI for cervical restorations in patients with a high caries index. Clinical significance: This study addressed the need for restorative materials that balance mechanical strength, esthetics, and therapeutic benefits in high-risk patients. Alkasite restorations are promising alternatives to RMGI. The findings will guide material selection for enhanced functionality, esthetics, and long-term caries prevention. Clinical trial registration number: NCT04716517.

Aim: The present study aimed to evaluate the postoperative nerve function following coronal incisions for facial fractures. Materials and methods: The present study included 30 patients with craniomaxillofacial trauma treated using the bi-temporal/coronal or hemicoronal approach. A preoperative computed tomography (CT) scan of the face with 3D reconstruction was done for all the patients to determine the exact extent of the fractures. All the cases were undertaken with general anesthesia and endotracheal intubation. Under all aseptic conditions, a coronal incision was given, reflection of the flap was done and fracture segments were approached. Reduction and fixation were achieved at the sites and closure was done. Postoperatively, neurological deficits in the zygomaticotemporal, supraorbital, and frontal branches of the facial nerve were closely observed at 1-, 4-, 16-, 24-, and 52-weeks intervals. Results: In all 30 patients, the duration of recovery varied between 16 weeks, 24 weeks, 32 weeks and 52 weeks but at the end of 32–52 weeks all the deficits subsided. There was a marked recovery between 16 and 24 weeks, with a complete resolution of 52 weeks. The study found a significant association between recovery time and nerve healing, highlighting the coronal approach's effectiveness in treating complex facial fractures while preserving nerve integrity. Conclusion: In conclusion, the study found that while patients undergoing craniomaxillofacial reconstruction via the coronal approach initially experienced notable neurological deficits, full nerve function was ultimately restored over time, underscoring a strong correlation between nerve healing and favorable functional outcomes. Clinical significance: The coronal approach not only delivers superior esthetic results but also safeguards neural integrity, minimizing the risk of nerve impairment often associated with traditional methods of fracture management. Coronal incisions provide superior access for precise anatomic reduction and preserve nerve integrity.

Aim: The study aims to assess the long-term clinical outcomes and biocompatibility of resin-modified glass ionomer cement and light-curable tricalcium silicate cement in preserving pulp vitality and preventing further carious progression in deep carious lesions. Materials and methods: A total of 46 participants with deep carious lesions and reversible pulpitis were selected and divided into two groups (n = 23): Group I was treated with resin-modified glass ionomer cement (RMGIC) and group II was treated with TheraCal LC (a light-curable tricalcium silicate cement). Once the indirect pulp capping (IPC) material was placed on the pulpal/axial walls, the cavity was temporized using intermediate restorative material, while the permanent restoration was done at 3rd-week recall period. Clinical and radiographic assessments were evaluated at intervals of 24 hours, 3 weeks, 3 months, and 6 months. Data were recorded and statistically analyzed. Results: The mean visual analog scale (VAS) scores for the RMGIC group were 20.21, 12.90, 1.33, 0.00, and 0.00 at baseline, 24 hours, 3 weeks, 3 months, and 6 months, respectively, while the TheraCal LC group showed mean scores of 12.60, 5.95, 2.58, 1.50, and 0.00 at the same intervals. The Mann−Whitney U-test revealed no significant difference in VAS scores between the two groups at any time point (p > 0.05). Intragroup comparisons using the Friedman test indicated statistically significant reductions in VAS scores over time within both groups (p < 0.001). At the 6-month follow-up, there were no significant differences between the groups regarding pain on palpation, swelling, percussion, or mobility (p > 0.05 for all comparisons using the Chi-square test). All teeth in the RMGIC group remained vital at the end of the study, while the vitality rate in the TheraCal LC group was 81%. Conclusion: The study concluded that both RMGIC and TheraCal LC are effective as IPC materials for deep carious lesions with reversible pulpitis, though RMGIC showed a slight advantage in maintaining pulp vitality, reducing symptoms, and minimizing periapical changes over time. Clinical significance: The clinical significance of this study is to offer evidence-based guidance for dental practitioners in choosing suitable materials for IPC in cases of deep carious lesions with reversible pulpitis. This research aims to support clinicians in making informed decisions that promote optimal patient care and improve the success and longevity of restorative treatments.

Aim: The tenet of the study is to evaluate the efficacy of low-level laser therapy (LLLT) as an adjunct to surgical periodontal therapy [open flap debridement (OFD)] on clinical parameters, gingival crevicular fluid (GCF) alkaline phosphatase (ALP) levels in GCF and wound healing. Materials and methods: Thirty subjects afflicted with chronic periodontitis showing evidence of horizontal bone loss on the radiograph, pocket probing depth (PPD) between 4 and 7 mm, and ≥20 natural teeth present in the oral cavity were included in the study. In every patient, OFD+LLLT was done in one quadrant and OFD in another was performed. The clinical parameters were assessed at baseline, 3 and 6 months visits while the GCF sample was collected at baseline visit and 6 months recall. Wound healing indices were recorded 1-week post-op surgery for each group. Results: The results showed an evident improvement in all the clinical parameters [pocket probing depth, gingival index (GI), plaque index (PI), and CAL] from baseline–6 months values; however, no statistically significant difference was seen on the intergroup comparison. Wound healing was statistically significantly superior in the OFD + LLLT group in comparison to the OFD group, indicating a positive effect of lasers on healing. Gingival crevicular fluid ALP levels in the two groups decreased after 6 months and a statistically significant reduction in the laser group indicated an anti-inflammatory effect. Conclusion: The results clearly indicated the efficacy of lasers in terms of acceleration of wound healing and control of inflammation. Clinical significance: Lasers as an adjunct to surgical periodontal therapy evidently have an anti-inflammatory effect (decrease in GCF ALP levels) as well as accelerate the wound healing process.

Aim: This study aims to clinically evaluate whether the local administration of vitamin D3 enhances postorthodontic tooth stability over a period of 3 months immediately after debonding. Materials and methods: Patients aged 15–30 years with dental malocclusion and moderate crowding in the lower arch (Little's irregularity score of 4–6) were selected and randomly split into the experimental and the control groups. After complete alignment and leveling, vitamin D3 injection was delivered to the experimental group and the control group was given a placebo injection with 0.9% normal saline mixed with 2% lignocaine. Fourteen days after the injection, the lower archwires were removed from the control and experimental groups. Results: Relapse was significantly higher in control than in the experimental group at all-time intervals. Statistically significant values of relapse were observed at T2 and T3 intervals between the two groups, with greater relapse in the control group than in the experimental group. Inter-canine width, arch perimeter, and intermolar width showed mild changes over 3-month period, but there were no significant differences between the two groups. Conclusion: Relapse was seen in both the control and the experimental in the first 4 weeks of the study. Still, the control group showed a greater relapse rate in the following 8th week and 12th week when compared to the experimental group.

Aim: The present study was undertaken to analyze the facial features in class III patients by measuring the facial frontal (linear) parameters and profile (angular) parameters and correlate them with parents to determine the inheritance of facial features. Materials and methods: The sample consisted of 40 class III patients aged between 9 and 18 years based on skeletal ANB angle (less than 0 degrees) and Angle's class III classification. Frontal and profile photographs of the subjects and parents were taken in a standardized position according to ABO guidelines. The photographs were analyzed using custom-made software for measuring various frontal (linear) and profile (angular) parameters to check for the degree of resemblance of facial features with parents by determining mean value, standard deviation and by applying Student's t-test. The level of significance was set at 5% (p < 0.05). Results: The common facial frontal (linear) parameters in sons and daughters which showed close mean inheritance (p < 0.005) with father were: 1. Al-Me/Ex-Al(R), 2. Al-Me/Ex-Al (L), 3. Al-Me/Ch-Me(R), 4. Al-Me/Ch-Me (L), 5. Ch-Me/Al-Ch(R), and 6. Ch-Me/Al-Ch(L). The common facial profile (angular) parameters in sons and daughters which showed close mean inheritance (p < 0.005) with mother were: 1. nasolabial angle (Cm-Sn-Ls), 2. nasofacial angle (G-Pog/N-Nd), 3. total convexity except nose (G-Sn-Pog), 4. upper lip projection angle (N-Pog/N-Ls), 5. lower lip projection angle (N-Pog/N-Li), and 6. Sn-Po-Gn. The only linear parameter which showed close mean inheritance with mother in both sons and daughters was: 1. ChR-ChL/AIR-AIL (p = 0.0001). Conclusion: Facial frontal (linear) parameters showed close inheritance with father in sons and daughters, while profile (angular) parameters showed close inheritance with mother in sons and daughters. The linear vertical parameters have more inheritance in daughters than sons, while angular parameters have more inheritance in sons as compared to daughters. Overall, facial inheritance from father is more dominant in class III sons and daughters. Clinical significance: The results of this study simplify the orthodontic treatment planning in subjects having class III malocclusion in terms of predicting the course of facial growth from parents. Such prediction can guide in forecasting the treatment outcome in complex malocclusion like class III. The results of this study revealed various parameters which are less heritable, having lesser genetic component, and mostly influenced by environment which can be modified through orthodontics and Dentofacial Orthopedics, thereby having lesser chances of relapse. The results of this study can also be utilized in the field of plastic surgery and forensic science.

Aim: To perform a scientometric mapping of the flipped classroom (FC) in dental education through an analysis of geospatial dynamics, emerging patterns, and collaborative networks. Materials and methods: A comprehensive search of the Web of Science database (Core Collection) was conducted on September 1, 2024, using specific terms related to innovative teaching methodologies and dental education. Articles published between January 2005 and September 2024, indexed in Web of Science, and published in English were included. The collected data included article title, authors, year of publication, journal, keywords, and number of citations. Data analysis was conducted using CiteSpace and Bibliometrix to identify publication patterns, emerging trends, and collaborative networks. Results: Between 2005 and 2024, 306 documents from 94 sources were analyzed, with an annual growth rate of 20.2%. The average age of the documents was 6.19 years, with an average of 12.47 citations per document and 7,469 references. In total, 701 authors’ keywords were identified. A total of 1,183 authors participated, of whom 19 published single-authored papers, resulting in 20 single-authored papers. The average number of coauthors per paper was 4.39, with 18.63% international coauthorships. The main clusters identified were “Flipped Classroom”, “COVID-19”, and “Curriculum Reform”. The years 2019 and 2020 contained the highest number of co-citations, highlighting authors such as Gianoni-Capenakas and Iyer. The three-dimensional structure of the landscape view graph revealed densely connected areas, indicating consolidated research themes. Conclusion: The results of this study have demonstrated a significant evolution in educational methodologies in dentistry, with an increasing focus on the FC and other educational technologies. The high concentration of publications in key journals and the predominance of authors with a single publication underline the importance of fostering collaborative networks and the dissemination of innovative practices. These findings require alignment with the conclusion mentioned in the main manuscript, as the overall conclusion is very broad and needs to be more specific to reflect the detailed results of the study. Clinical significance: This study mapping the FC in dental education is clinically significant because it has a chance to influence the very nature of teaching methodologies. The study treats geospatial dynamics, emerging patterns, and collaborative networks and has highlighted the further incursion of innovative educational practices. The findings show that continued research and collaboration are needed to further optimize and develop these methodologies for the benefit of both educators and learners in the field of dentistry.

Background: This systematic review and meta-analysis aimed to determine whether reciprocating file systems reduce postoperative pain more effectively than rotary file systems. Materials and methods: This review followed the preferred reporting items for systematic review guidelines to ensure rigorous and transparent reporting. The databases searched included MEDLINE, Cochrane Library, and Google Scholar, targeting articles published in English between January 2000 and April 2024. Randomized controlled trials involving children aged 4–12 years requiring pulpectomy, comparing reciprocating file systems with rotary systems. Outcomes included quality of obturation, instrumentation time, and postoperative pain. The participants, settings, interventions, comparators, outcome measures, study designs, statistical analyses, results, and all other relevant data were meticulously and accurately extracted from all included studies. Data extraction was performed and recorded in Excel sheets, with separate documentation maintained for each primary outcome. Results: Out of 279 studies initially identified, 272 were excluded due to duplication, non-English language, or not meeting criteria. Seven studies that met the necessary criteria were included in the systematic review. Among them are five comparisons for instrumentation time, four for postoperative pain, and two comparisons for quality of obturation. Results of the meta-analysis showed that instrumentation time was lower in the rotary file systems than in reciprocating file systems. Postoperative visual analogue scale (VAS) scores after 6 hours and 24 hours were almost similar among both file systems. Conclusion: Given the limitations of this review, it can be said that the postoperative pain scores were comparable between reciprocating and rotary file systems. The root canal preparation time was significantly shorter with the reciprocating system compared to the rotary system. Clinical significance: In pediatric dentistry, behavior management plays a vital role in successful treatment. Therefore, opting for the correct file system is fundamental and helps in minimizing pain and instrumentation time, thereby enhancing the overall patient experience.

Aim: Bioceramic sealers are being used as obturation materials as they are known for hard tissue induction and facilitating periapical healing. Based on some in vitro studies, one can hypothesize that mineral trioxide aggregate (MTA) and biodentine used as the sole obturating material could reinforce the tooth and provide a better sealability than an MTA/biodentine apical plug with gutta-percha obturation. However, there are not many high-quality studies regarding outcomes of complete MTA/biodentine obturations compared with traditional obturation methods. The aim of this review is to organize findings of clinical outcomes and the quality of complete obturation of root canals from various in vitro studies and to identify the gaps in research done in this area. Methods: The preferred reporting items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews guidelines were followed to conduct a thorough literature search in June 2024 across PubMed, Google Scholar, Scopus, Science Direct, and Scielo. The research question was formulated using PICO: population: permanent dentition in adults or children; intervention: orthograde monoblock obturation; comparator: traditional orthograde root canal filling methods; outcome: success defined by asymptomatic, functional tooth, and radiographic evidence of healing. Results: Out of 511 initially identified studies, 474 studies did not meet initial eligibility criteria for inclusion, and only 37 studies were selected. After full-text scrutiny, only 23 were subjected to qualitative assessment. Conclusion: The findings of the data concluded that complete obturation with MTA and biodentine could be a viable alternative to an apical plug followed by gutta-percha obturation or bioceramic sealer with gutta-percha obturation. The lack of randomized controlled trials and long-term retrospective studies precludes clinicians from utilizing this technique. Clinical significance: Bioceramic materials can be used for complete obturation of canals, both in primary and retreatment cases, bringing about periapical healing and regeneration of tissues. They are found to reinforce and improve the strength of radicular structure on account of the monoblock effect.