Degree in Medicine and Surgery, University of Bologna 1989 Master in Endodontics University of Siena 1998 Clinical Assistant Professor (Endodontic surgery) University of Siena since 2015 Co-Director of Diploma di Micro Endodonzia University of Valencia (Spain) since 2015
Aim: To assess the influence of two different placement techniques and powder/liquid mixing ratio... more Aim: To assess the influence of two different placement techniques and powder/liquid mixing ratio of a bioceramic sealer on the quality of root canal filling by single-cone using a micro-CT analysis. Methods: Thirty-two single-rooted elements with a mesio-distal diameter of 5,00\ub10,50 mm, a buccallingual diameter of 6,50 \ub10,50 mm and a root length of 14,50\ub10,50 mm measured at CEJ level were selected to be included in the study. After creating the coronal access cavity, root canals were scouted with manual files and the working length was acquired. Root canals were shaped with R40 Reciproc Blue and irrigated with NaOCl 5% and EDTA 17% solutions. Prepared samples were randomly assigned into four experimental groups (n=8), according to the sealer placement technique and the powder/liquid mixing ratio: G1, the sealer (BioRoot RCS, Septodont) was mixed in a 1:5 ratio, as suggested by the manufacturer, and carried into the root canal by a dedicated gutta-percha cone up to the working length; G2, sealer placement as group G1, but using 1:6 mixing ratio; G3, the sealer was mixed in a 1:5 ratio and carried into the root canal by a syringe with a cannula (Apexcal, Ivoclar) up to its complete filling, then a dedicated gutta-percha cone was inserted into the canal; G4, sealer placement as group G3, but using 1:6 mixing ratio. All the samples were submitted to micro-CT analysis. Micro-CT scans were acquired after shaping procedures (t0) and after canals obturation (t1) and then compared to evaluate the presence of voids in the gutta-percha, sealer and dentin interfaces. The normality of the distribution and the equality of variance of the microtomographic datasets were tested with a Shapiro-Wilk and Levene test, respectively; the significance of the differences between groups in terms of the formation of voids was ascertained with the Kruskal-Wallis test. The results were considered statistically significant for a p-value < 0.05. Results: Minimal void volumes were observed among groups. G1 performed the best result: total void volumes were 0,253\ub10,175% of the entire canal space. The other experimental groups follow in order of increasing volume: G3 (0,260\ub10,254%), G2 (0,532\ub10,528%), G4 (0,840\ub10,705%), but no statistically significant difference was observed. All groups showed a similar distribution of voids: in the apical and middle third of the root canal the presence of voids was minimal while the greatest void volumes were detected in the coronal third, due to the canal anatomy and the larger amount of sealer. In this canal portion voids were mainly distributed within the sealer. Concerning the sealer viscosity, the more fluid formulation (1:6) showed an increase of void volumes, although without statistical significance. Likewise, no statistically relevant influence was registered regarding the sealer placement technique. Conclusion: All the examined techniques should be considered effective for the clinician. Under the conditions of the present study, the 1:5 powder/liquid mixing ratio should be preferred when associated with both the sealer placement techniques, according to the clinical situation and the operator preferences. When using the low viscosity formulation, the clinician should insert the sealer slowly and in a controlled way, in order to minimize the formation of voids
Journal of biological regulators and homeostatic agents, 2020
An ideal scenario for a tooth in necrosis with immature root would be to continue root developmen... more An ideal scenario for a tooth in necrosis with immature root would be to continue root development after the regeneration of pulp tissue. We report a case, where the regenerative endodontic procedure (REP) was done using biodentine as a scaffold in an immature mandibular molar tooth.
This study aimed to evaluate the precision of the guided endodontic technique applied to calcifie... more This study aimed to evaluate the precision of the guided endodontic technique applied to calcified canals in anterior teeth in relation to demographic and dental variables. The present observational study was conducted during the period 2020–2021. The patients were consecutive referrals at the Department of Endodontics and Conservative Dentistry of the University Hospital of Siena. The guided endodontics protocol was applied using 0.75 mm diameter burs for the lower teeth and 0.90 mm for the upper teeth. The inclusion criteria were as follows: (i) teeth with pulp canal obliteration (PCO) associated with a periapical lesion (periapical index (PAI) ≥ 2); (ii) teeth with PCO that require the placement of a root canal post for the execution of a prosthetic treatment; (iii) teeth in which surgical treatment was not justified. Socio-demographic characteristics of the patients were recorded and related to the drill path accuracy through the guide in the calcified endodontic canal, evaluate...
BACKGROUND Inflammatory external root resorption is one of the possible complications of replanta... more BACKGROUND Inflammatory external root resorption is one of the possible complications of replantation of an avulsed tooth. Several studies have shown that limited FOV CBCT is an efficient diagnostic support and in treatment planning of these cases in paediatric patients because of its high resolution combined with low radiation doses. The recent literature has suggested that Biodentine is an effective material for resolution of inflammatory root resorption. CASE REPORT This article describes the successful therapy of a replanted tooth affected by inflammatory root resorption. In the present case, a CBCT exam was performed to detect the extent of the damage, and the canal was filled with Biodentine in the apical third. At present, the threated tooth is asymptomatic, and the twelve months follow-up examination showed healing of periradicular hard tissues.
The aim of this study was to compare the efficacy of a new generation endodontic irrigant, Tetrac... more The aim of this study was to compare the efficacy of a new generation endodontic irrigant, Tetraclean, to the widely used sodium hypochlorite. Tetraclean combines a powerful detergent effect with a strong antimicrobial efficacy, whereas sodium hypochlorite has several drawbacks and is sometimes ineffective in preventing microbial-mediated endodontic failure. The bactericidal activity of both irrigants against Enterococcus faecalis, the most commonly isolated species from root canals of teeth with post-treatment disease, was assessed i) in vitro, according to the European Standard lines for the evaluation of the bactericidal activity of chemical disinfectants, and ii) with an ex vivo model of extracted and decoronated human teeth, infected with E. faecalis and subsequently irrigated with either of the irrigants. Both irrigants display very similar bactericidal activity against E. faecalis in vitro. However, the ex vivo model shows that only in the teeth irrigated with Tetraclean did ...
The aim of this study was to compare the efficacy of a new generation endodontic irrigant, Tetrac... more The aim of this study was to compare the efficacy of a new generation endodontic irrigant, Tetraclean, to the widely used sodium hypochlorite. Tetraclean combines a powerful detergent effect with a strong antimicrobial efficacy, whereas sodium hypochlorite has several drawbacks and is sometimes ineffective in preventing microbial-mediated endodontic failure. The bactericidal activity of both irrigants against Enterococcus faecalis, the most commonly isolated species from root canals of teeth with post-treatment disease, was assessed i) in vitro, according to the European Standard lines for the evaluation of the bactericidal activity of chemical disinfectants, and ii) with an ex vivo model of extracted and decoronated human teeth, infected with E. faecalis and subsequently irrigated with either of the irrigants. Both irrigants display very similar bactericidal activity against E. faecalis in vitro. However, the ex vivo model shows that only in the teeth irrigated with Tetraclean did ...
Aim: To assess the influence of two different placement techniques and powder/liquid mixing ratio... more Aim: To assess the influence of two different placement techniques and powder/liquid mixing ratio of a bioceramic sealer on the quality of root canal filling by single-cone using a micro-CT analysis. Methods: Thirty-two single-rooted elements with a mesio-distal diameter of 5,00\ub10,50 mm, a buccallingual diameter of 6,50 \ub10,50 mm and a root length of 14,50\ub10,50 mm measured at CEJ level were selected to be included in the study. After creating the coronal access cavity, root canals were scouted with manual files and the working length was acquired. Root canals were shaped with R40 Reciproc Blue and irrigated with NaOCl 5% and EDTA 17% solutions. Prepared samples were randomly assigned into four experimental groups (n=8), according to the sealer placement technique and the powder/liquid mixing ratio: G1, the sealer (BioRoot RCS, Septodont) was mixed in a 1:5 ratio, as suggested by the manufacturer, and carried into the root canal by a dedicated gutta-percha cone up to the working length; G2, sealer placement as group G1, but using 1:6 mixing ratio; G3, the sealer was mixed in a 1:5 ratio and carried into the root canal by a syringe with a cannula (Apexcal, Ivoclar) up to its complete filling, then a dedicated gutta-percha cone was inserted into the canal; G4, sealer placement as group G3, but using 1:6 mixing ratio. All the samples were submitted to micro-CT analysis. Micro-CT scans were acquired after shaping procedures (t0) and after canals obturation (t1) and then compared to evaluate the presence of voids in the gutta-percha, sealer and dentin interfaces. The normality of the distribution and the equality of variance of the microtomographic datasets were tested with a Shapiro-Wilk and Levene test, respectively; the significance of the differences between groups in terms of the formation of voids was ascertained with the Kruskal-Wallis test. The results were considered statistically significant for a p-value < 0.05. Results: Minimal void volumes were observed among groups. G1 performed the best result: total void volumes were 0,253\ub10,175% of the entire canal space. The other experimental groups follow in order of increasing volume: G3 (0,260\ub10,254%), G2 (0,532\ub10,528%), G4 (0,840\ub10,705%), but no statistically significant difference was observed. All groups showed a similar distribution of voids: in the apical and middle third of the root canal the presence of voids was minimal while the greatest void volumes were detected in the coronal third, due to the canal anatomy and the larger amount of sealer. In this canal portion voids were mainly distributed within the sealer. Concerning the sealer viscosity, the more fluid formulation (1:6) showed an increase of void volumes, although without statistical significance. Likewise, no statistically relevant influence was registered regarding the sealer placement technique. Conclusion: All the examined techniques should be considered effective for the clinician. Under the conditions of the present study, the 1:5 powder/liquid mixing ratio should be preferred when associated with both the sealer placement techniques, according to the clinical situation and the operator preferences. When using the low viscosity formulation, the clinician should insert the sealer slowly and in a controlled way, in order to minimize the formation of voids
Journal of biological regulators and homeostatic agents, 2020
An ideal scenario for a tooth in necrosis with immature root would be to continue root developmen... more An ideal scenario for a tooth in necrosis with immature root would be to continue root development after the regeneration of pulp tissue. We report a case, where the regenerative endodontic procedure (REP) was done using biodentine as a scaffold in an immature mandibular molar tooth.
This study aimed to evaluate the precision of the guided endodontic technique applied to calcifie... more This study aimed to evaluate the precision of the guided endodontic technique applied to calcified canals in anterior teeth in relation to demographic and dental variables. The present observational study was conducted during the period 2020–2021. The patients were consecutive referrals at the Department of Endodontics and Conservative Dentistry of the University Hospital of Siena. The guided endodontics protocol was applied using 0.75 mm diameter burs for the lower teeth and 0.90 mm for the upper teeth. The inclusion criteria were as follows: (i) teeth with pulp canal obliteration (PCO) associated with a periapical lesion (periapical index (PAI) ≥ 2); (ii) teeth with PCO that require the placement of a root canal post for the execution of a prosthetic treatment; (iii) teeth in which surgical treatment was not justified. Socio-demographic characteristics of the patients were recorded and related to the drill path accuracy through the guide in the calcified endodontic canal, evaluate...
BACKGROUND Inflammatory external root resorption is one of the possible complications of replanta... more BACKGROUND Inflammatory external root resorption is one of the possible complications of replantation of an avulsed tooth. Several studies have shown that limited FOV CBCT is an efficient diagnostic support and in treatment planning of these cases in paediatric patients because of its high resolution combined with low radiation doses. The recent literature has suggested that Biodentine is an effective material for resolution of inflammatory root resorption. CASE REPORT This article describes the successful therapy of a replanted tooth affected by inflammatory root resorption. In the present case, a CBCT exam was performed to detect the extent of the damage, and the canal was filled with Biodentine in the apical third. At present, the threated tooth is asymptomatic, and the twelve months follow-up examination showed healing of periradicular hard tissues.
The aim of this study was to compare the efficacy of a new generation endodontic irrigant, Tetrac... more The aim of this study was to compare the efficacy of a new generation endodontic irrigant, Tetraclean, to the widely used sodium hypochlorite. Tetraclean combines a powerful detergent effect with a strong antimicrobial efficacy, whereas sodium hypochlorite has several drawbacks and is sometimes ineffective in preventing microbial-mediated endodontic failure. The bactericidal activity of both irrigants against Enterococcus faecalis, the most commonly isolated species from root canals of teeth with post-treatment disease, was assessed i) in vitro, according to the European Standard lines for the evaluation of the bactericidal activity of chemical disinfectants, and ii) with an ex vivo model of extracted and decoronated human teeth, infected with E. faecalis and subsequently irrigated with either of the irrigants. Both irrigants display very similar bactericidal activity against E. faecalis in vitro. However, the ex vivo model shows that only in the teeth irrigated with Tetraclean did ...
The aim of this study was to compare the efficacy of a new generation endodontic irrigant, Tetrac... more The aim of this study was to compare the efficacy of a new generation endodontic irrigant, Tetraclean, to the widely used sodium hypochlorite. Tetraclean combines a powerful detergent effect with a strong antimicrobial efficacy, whereas sodium hypochlorite has several drawbacks and is sometimes ineffective in preventing microbial-mediated endodontic failure. The bactericidal activity of both irrigants against Enterococcus faecalis, the most commonly isolated species from root canals of teeth with post-treatment disease, was assessed i) in vitro, according to the European Standard lines for the evaluation of the bactericidal activity of chemical disinfectants, and ii) with an ex vivo model of extracted and decoronated human teeth, infected with E. faecalis and subsequently irrigated with either of the irrigants. Both irrigants display very similar bactericidal activity against E. faecalis in vitro. However, the ex vivo model shows that only in the teeth irrigated with Tetraclean did ...
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