Beliz Ozel

Aim: To evaluate changes in undergraduate dental students' self‐perceived competence and post‐training self‐efficacy in endodontic access cavity preparation following implementation of a revised preclinical course incorporating haptic virtual reality simulation (HVRS) prior to training on extracted human teeth (NT). Methodology: This prospective cohort study was conducted during the 2025–2026 academic year at ACTA. All fourth‐year undergraduate dental students enrolled in the preclinical endodontics course completed a baseline questionnaire assessing self‐perceived competence before HVRS training, using the Simodont dental trainer, during which students performed access cavity preparations on six virtual tooth types. Subsequently, students performed complete root canal treatments on NT mounted in simulated clinical conditions. Self‐perceived competence was reassessed after completion of the training sequence, together with students' perceptions of both training modalities. Self‐efficacy was measured at the end of the training using an adapted Endodontic General Self‐Efficacy Scale. Pre‐post differences in self‐perceived competence were analysed using the Wilcoxon signed‐rank test and correlations using Spearman's rank correlation coefficient, with Benjamini‐Hochberg correction for multiple comparisons. Statistical significance was set at p < 0.05. Results: The response rate was 100% ( n = 86). Self‐perceived competence scores increased significantly from a median of 17 (IQR 15–19) at baseline to 22 (IQR 20–24) after completion of the combined training sequence (Z = −7.47, p < 0.001, r = 0.81). The mean post‐training self‐efficacy score was 28.4 ± 4.1. Both training modalities were rated positively, although NT training was perceived as more effective than HVRS (median 4 vs. 3; Z = −7.62, p < 0.001, r = 0.82), with 84.9% of students favouring NT and none favouring HVRS. Self‐efficacy showed a moderate positive correlation with post‐training self‐perceived competence ( ρ = 0.62, 95% CI 0.48–0.74, p < 0.001). Conclusions: A preclinical curriculum where HVRS was combined with training on extracted human teeth was associated with significant improvements in students' self‐perceived competence and fair levels of post‐training self‐efficacy in endodontic access cavity preparation. The students stated that both HVRS and training on NT contributed to their skills development in preparing endodontic access. The combination may have a cumulative effect on the students' preparedness for clinical training.

In this study, we aimed to compare the effectiveness of various chelating agents, ethilenediaminetetraacetic acid (EDTA), citric acid (CA), and etidronic acid (HEDP) mixed in two different forms, in removing the smear layer and promoting the penetration of an endodontic sealer into the dentinal tubules of extracted single-rooted teeth. The study used 75 teeth divided into five groups: 17% EDTA, 10% CA, 9% HEDP + NaOCl, 9% HEDP + distilled water (DW), and a control (DW) group. Scanning electron microscopy was used to assess smear layer removal and confocal laser microscopy was used to evaluate tubular sealer penetration at different depths from the apical tip. Sealer penetration was highest with 17% EDTA and 10% CA as compared with the other agents (pp = 0.020). For the middle third, EDTA, CA, and HEDP + NaOCl groups were significantly higher than those of the DW group (p<0.001). Cervical-level values were significantly higher than apical-level values for HEDP + NaOCl, HEDP + DW, and DW (p<0.001). Smear layer removal was lower with 9% HEDP + DW than with 17% EDTA and 10% CA at all depths (pp = 0.015) in middle depth. Within the limitations of this study, highest values were seen in EDTA and CA in terms of sealer penetration and smear layer removal. In the light of these findings, the use of strong chelating agents highlights better clinical efficiency than dual-rinse or single HEDP irrigation.

Familial Mediterranean fever (FMF) is a genetic condition that may cause loss of bone mineral density (BMD) due to chronic inflammation. Previously, fractal dimension (FD) analysis values of mandibular cortical bone were shown to be lower in osteoporosis. Therefore, FD might be considered as an auxiliary tool to refer patients for dual-energy x-ray absorptiometry (DXA), which is the gold standard for BMD measurement. The purpose of this cross-sectional retrospective study was to evaluate trabecular and cortical microarchitecture of the mandible with FD analysis on panoramic radiographs in a subpopulation of FMF. Also, the effect of colchicine use was investigated. Forty-three FMF patients, aged between 10.8 and 71.2 years, and age- and gender-matched control group consisting of patients, who had no systemic diseases, were included. Demographic information such as age and gender, and colchicine use were recorded. In terms of age, the patients were classified as <30 and 30< years. On each panoramic radiographs five regions of interest were selected on the mandible as: 1- premolar, 2- molar, 3- angular, 4- condylar, and 5- basal cortical bone regions on right (R) and left (L) sides. Statistical significance was accepted at p<0.05 level. Intra- and inter-observer agreements demonstrated good to excellent consistency. In FMF patients, L3 and L4 values were higher, whereas L5 values were lower (p0.05), whereas in control group R3 and L4 values were higher in the 30< age group (p0.05). FMF disease might be a candidate for referral to DXA examination based on decreased bone density in the mandibular cortex detected by FD measurements on routine panoramic radiographs. Further studies are warranted to ascertain this relationship.

Introduction. Calcium silicate‐based cements (CSCs) are frequently used in various endodontic procedures such as perforation repair, vital pulp therapy, regenerative treatments, or apexification. One of their areas of use, treatment of perforations, can be challenging in clinical practice. Selection of stable, durable, and compatible material with structural and biological alterations is a must in such situations. Aim. This study aimed to compare the dislocation resistance of various calcium‐silicate‐containing materials used in endodontic treatment exposed to various environmental conditions in a push‐out study model. Methods. Selected ninety‐six human mandibular premolars with single root canals were cut from the middle portion to obtain dentin slices of 2 mm thickness (n = 192). Then, the canal lumen was enlarged by using #4Gates‐Glidden drills. Specimens for each repair material (MTA, Angelus, Endosequence RRM (ERRM), Biodentine, BioMTA) were placed in shaped lumens, wrapped in pieces of gauze, and randomly divided into four groups (n = 48) according to the storage time and media: group A: 4 days in phosphate‐buffered saline (PBS), group B: 4 days in acetic acid (pH = 4.4), group C: 34 days in PBS, and group D: 4 days in acetic acid (pH = 4.4) followed by exposure to PBS for 30 days. A universal testing machine measured the dislodgement resistance followed by scanning electron microscopy imaging to evaluate the material‐dentin interface. Results. ERRM showed the highest dislocation resistance in all test groups (p < 0.05). The greatest bonding strength was observed (13,54 ± 5,56 MPa) after exposure to 34 days in PBS (pH = 7.2). The values for ERRM decreased in contact with acetic acid (pH = 4.4) and increased when placed in PBS (p > 0.05). Conclusion. All repair materials showed a higher dislocation resistance when stored in PBS regardless of storage time. However, the improved pH of the surrounding media was not successful in reversing the deteriorating effect caused by lower pH in relation to dislocation resistance in all tested materials except for ERRM.