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Sample records for multi-visit endodontic treatment

  1. Single Versus Multi-visit Endodontic Treatment of Teeth with Apical Periodontitis: An in vivo Study with 1-year Evaluation

    PubMed Central

    Gill, GS; Bhuyan, AC; Kalita, C; Das, L; Kataki, R; Bhuyan, D

    2016-01-01

    Background: Apical periodontitis (AP) is one of the most prevalent diseases of the teeth. Treatment of AP is based on the removal of the cause, i.e., bacteria from the root canals. Achievement of adequate bacterial eradication in one appointment treatment remains a controversy. Aim: This prospective study was conducted with the objective to compare the periapical healing of teeth with AP treated in (a) single visit versus (b) two visits, either with or without Vitapex as an intracanal medicament. Subjects and Methods: Patients were selected randomly from the Department of Conservative Dentistry and Endodontics. Forty-three patients (81 teeth) met the inclusion criteria, i.e., AP (both symptomatic and asymptomatic) visible radiographically size ≥2 mm × 2 mm, not suffering from any immune-compromising disease, age between 16 and 65 years and tooth not accessed previously. Patients were randomly divided into three groups, i.e., single-visit group (Group 1), multi-visit group without any intracanal medicament (Group 2), and multi-visit group with Vitapex as interim intracanal medicament (Group 3). Comparison was done radiographically using periapical index (PAI). The primary outcome measure was the change in periapical radiolucency after 1 year assessed by PAI scores. The Mann-Whitney U-test was used to evaluate differences between groups at baseline (immediate postoperative) and at the 12-month follow-up evaluation. Change in PAI score for each group from baseline to 12-month follow-up evaluation was tested with the Wilcoxon signed rank test. The secondary outcome measures, proportion of teeth in each group that could be considered improved (decreased PAI score) or healed (PAI <2), were assessed with the Chi-square test. Results: No statistically significant difference in periapical healing was found between three groups. Conclusion: After 1-year evaluation, no difference in periapical healing was found between single-visit treatment and multi-visit treatment

  2. Incidence of post obturation pain following single and multi visit root canal treatment in a teaching hospital of Bangladesh.

    PubMed

    Jabeen, S; Khurshiduzzaman, M

    2014-04-01

    Post obturation pain is the pain of any degree after endodontic treatment. There are different opinions regarding incidence of post obturation pain related to single and multi visit root canal treatment. This prospective study was conducted to evaluate the incidence of post obturation pain in single visit and multi visit root canal treatment and to compare the incidence of pain between the two treatment groups. A total of 120 cases of endodontically involved asymptomatic non vital single rooted teeth were selected for this study. The patients were assigned and divided in to two treatment groups, sixty patients each. In single visit group, all teeth were prepared and filled using the standardized preparation and lateral condensation filling technique. In the multi visit treatment group, at the first appointment, the teeth were prepared, and dressed with calcium hydroxide paste for 7 days. At the second appointment, the teeth were prepared and obturated by using lateral condensation technique. The frequency of post obturation pain was recorded as no pain, slight, moderate and severe pain and evaluated at the day 1 and at the day 7 after obturation. The data were analyzed statistically by using SPSS version-12. P value <0.05 was taken as significant. The study showed that the post obturation pain in the single visit treatment group was more than multi visit treatment group, which is significant (p value <0.044). Out of the 120 patients, 86(71.7%) patients had no pain, 19(15.8%) had slight pain and 15(12.5%) patients had moderate pain at the day 1 after obturation. At the day 7 after obturation, 108(90%) patients had no pain, 9(7.5%) had slight pain and 3(2.5%) patients had moderate pain. No patient noticed severe pain during the follow up period. Older patient had significantly more post obturation pain than the younger patient. There was higher incidence of post obturation pain following the single visit root canal treatment. In multi visit root canal treatment with

  3. Endodontic treatment of molars

    PubMed Central

    Habl, Claudia; Bodenwinkler, Andrea; Stürzlinger, Heidi

    2006-01-01

    Objective Commissioned by the German Institute of Medical Documentation and Information (DIMDI) the Austrian Health Institute (ÖBIG) prepared a HTA report on the long-term effectiveness of endodontic treatment (root canal treatment, RCT) of molars. The focus is to examine factors influencing the outcome of endodontic treatment and showing their impact on long-term results. Additionally, economic aspects of root canal treatment in Germany are discussed. Methodology By performing a systematic literature search in 29 databases (e.g. MEDLINE), the Cochrane Library and by hand searching two peer-reviewed endodontic journals the authors could identify 750 relevant articles, of which finally 18 qualified for assessment. Results The findings show that the most relevant factor influencing the long-term outcome of endodontic treatment is the preoperative status of a tooth. The lowest success rates are reported for molars with a preoperative devital or necrotic pulp and persisting periapical lesions (so called periapical disease). Discussion Even if there is no positive selection of patients and the RCT is performed by a normal dentist rather than an endodontist - a fact which is very common - long-term success rates of more then 90% are possible. The overall success rates for endodontic treatment of molars therefore seem to be similar to those of other tooth-types. Conclusions Especially primary, conventional (i.e. non-surgical) root canal treatment is an effective and efficient therapy for endodontically ill molars, especially if no large periapical lesion persists. Nonetheless, a long term successful endodontic therapy requires a thorough assessment of the pre-operative status of the molar and treatment according to established guidelines. PMID:21289954

  4. Implant treatment planning: endodontic considerations.

    PubMed

    Simonian, Krikor; Frydman, Alon; Verdugo, Fernando; Roges, Rafael; Kar, Kian

    2014-12-01

    Implants are a predictable and effective method for replacing missing teeth. Some clinicians have advocated extraction and replacement of compromised but treatable teeth on the assumption that implants will outperform endodontically and/or periodontally treated teeth. However, evidence shows that conventional therapy is as effective as implant treatment. With data on implants developing complications long term and a lack of predictable treatment for peri-implantitis, retaining and restoring the natural dentition should be the first choice when possible. PMID:25928961

  5. Periostitis ossificans managed with endodontic treatment.

    PubMed

    Kucukyilmaz, Ebru; Sener, Yagmur; Tosun, Gül; Savas, Selcuk

    2015-01-01

    Periostitis ossificans (PO) is a specific type of chronic osteomyelitis. Radiographically, it is characterized by the presence of lamellae of newly formed periosteal bone outside the cortex, giving the characteristic appearance of "onion skin." The most common cause of PO is periapical infection of the mandibular permanent first molar, which occurs primarily in children and young adults. Treatment in these cases is directed toward eliminating the source of the infection, either by extraction of the offending tooth or endodontic therapy. The purpose of this paper is to present a case of PO involving a permanent mandibular first molar managed with endodontic treatment. PMID:25909844

  6. Persistent endodontic infection--re-treatment or surgery?

    PubMed

    Love, Robert M

    2012-04-01

    Management of a tooth with persistent periradicular disease primarily involves management of persistent intraradicular infection. Conventional endodontic re-treatment is the main modality that will manage this condition although endodontic surgery with or without retreatment is a viable option in cases. Case selection involves an appreciation of the disease aetiology and expected outcomes and consideration of patient, tooth and clinician factors. Both conventional endodontic re-treatment and surgery have high long-term success and survival rates and it has been shown that an endodontically treated tooth with persistent periradicular pathology that can be managed by conventional endodontic re-treatment or surgery and restoration has comparable, and potentially more beneficial, outcomes to treatment options involving tooth loss and rehabilitation, such as an implant supported crown. As such endodontic retreatment should be the prime treatment modality unless a tooth has reached a stage where these techniques cannot manage ongoing disease and/or structural integrity. PMID:24783842

  7. Mandibular nerve paresthesia caused by endodontic treatment.

    PubMed

    Gallas-Torreira, M Mercedes; Reboiras-López, M Dolores; García-García, Abel; Gándara-Rey, José

    2003-01-01

    The paresthesias of the inferior dental nerve consists of a complication that can occur after performing various dental procedures such as cystectomies, extraction of impacted teeth, apicoectomies, endodontic treatments, local anesthetic deposition, preprosthetic or implantologic surgery. The possible mechanisms of nervous lesions are mechanical, chemical and thermal. Mechanical injury includes compression, stretching, partial or total resection and laceration. The lesion can cause a discontinuity to the nerve with Wallerian degeneration of the distal and integrated fibers of the covering (axonotmesis) or can cause the total sectioning of the nerve (neurotmesis). Chemical trauma can be due to certain toxic components of the endodontic filling materials (paraformaldehyde, corticoids or eugenol) and irrigating solutions (sodium hypochlorite) or local anesthetics. Thermal injury is a consequence of bone overheating during the execution of surgical techniques. We present a clinical case of paresthesia of the inferior dental nerve after the introduction of a gutta-percha point in the mandibular canal during the performance of a root canal therapy of the inferior first molar. The etiology and the treatment of this endodontic complication are described. PMID:12937392

  8. Antimicrobial peptide-based treatment for endodontic infections--biotechnological innovation in endodontics.

    PubMed

    Lima, Stella Maris de Freitas; de Pádua, Gabriela Martins; Sousa, Maurício Gonçalves da Costa; Freire, Mirna de Souza; Franco, Octávio Luiz; Rezende, Taia Maria Berto

    2015-01-01

    The presence/persistence of microorganisms in the pulp and periapical area corresponds to the maintenance of an exacerbated immune response that leads to the start of periradicular bone resorption and its perpetuation. In endodontic treatment, the available intracanal medications do not have all the desirable properties in the context of endodontic infection and apical periodontitis; they need to include not only strong antimicrobial performance but also an immunomodulatory and reparative activity, without host damage. In addition, there are various levels of resistance to root canal medications. Thus, antimicrobial agents that effectively eliminate resistant species in root canals could potentially improve endodontic treatment. In the emergence of new therapies, an increasing number of studies on antimicrobial peptides (AMPs) have been seen over the past few years. AMPs are defense biomolecules produced in response to infection, and they have a wide spectrum of action against many oral microorganisms. There are some studies that correlate peptides and oral infections, including oral peptides, neuropeptides, and bacterial, fish, bovine and synthetic peptides. So far, there are around 120 published studies correlating endodontic microbiota with AMPs but, according to our knowledge, there are no registered patents in the American patent database. There are a considerable number of AMPs that exhibit excellent antimicrobial activity against endodontic microbiota at a small inhibitory concentration and modulate an exacerbated immune response, down-regulating bone resorption. All these reasons indicate the antimicrobial peptide-based endodontic treatment as an emerging and promising option. PMID:25447423

  9. Endodontic treatment enhances the regenerative potential of teeth with advanced periodontal disease with secondary endodontic involvement

    PubMed Central

    Kwon, Eun-Young; Cho, Yunjung; Lee, Ju-Youn; Kim, Sung-Jo

    2013-01-01

    Purpose The aim of this study was to identify a role for endodontic intervention in enhancing the regenerative potential of the periodontal ligament when combined with periodontal treatment in seriously involved teeth with a secondary endodontic component. Methods Patients who exhibited radiolucency extending to the periapical region, abnormal electric pulp testing values, and deep probing depth derived from primary periodontal disease with secondary endodontic involvement were included. Intentional root canal treatment was applied to those teeth in which the apical lesions were presumed to communicate with those of the periodontal lesion of the teeth that remained vital. In all three selected cases, regenerative periodontal therapy incorporating either bone graft or guided tissue regeneration was instituted 3 months after the endodontic intervention. Results Remarkable enhancement in radiographic density was noticeable around the affected teeth as evidenced by changes in radiopacity. There was a significant reduction in the probing pocket depth and gain in the clinical attachment level. Chewing discomfort gradually disappeared from the commencement of the combined treatment. Conclusions An intentional endodontic intervention may be a worthwhile approach for the sophisticated management of teeth suffering from serious attachment loss and alveolar bone destruction with concomitant secondary endodontic involvement. PMID:23837128

  10. Irrigants in non-surgical endodontic treatment.

    PubMed

    Regan, John D; Fleury, Alex A P

    2006-01-01

    This paper highlights that one of the main goals of root canal treatment is the elimination of microorganisms from the contaminated root canal system. Instrumentation alone will not allow for adequate debridement and disinfection of the complex and diverse root canal system. Chemomechanical debridement is required. The importance of the use of irrigants during non-surgical root canal treatment has frequently been neglected both during instruction of dental students and later in the clinical practice of endodontics. The article highlights 'shape, clean and fill' vs. 'clean, shape and fill' to enable chemomechanical debridement. Our protocol advises mechanical debridement and copious irrigation for a minimum of twenty minutes with 2.5% to 6% solutions of sodium hypochlorite, followed by a rinse with a 17% solution of ethylenediaminetetraacetic acid and a final rinse with 2% chlorhexidine. The canals are dried with high volume aspirators and sterile paper points. PMID:16989370

  11. A Review of Antibacterial Agents in Endodontic Treatment

    PubMed Central

    Rahimi, Saeed; Janani, Maryam; Lotfi, Mehrdad; Shahi, Shahriar; Aghbali, Amirala; Vahid Pakdel, Mahdi; Salem Milani, Amin; Ghasemi, Negin

    2014-01-01

    Microorganisms play a major role in initiation and perpetuation of pulpal and periapical diseases. Therefore, elimination of the microorganisms present in the root canal system is the fundamental objective of endodontic treatment. The use of mechanical debridement, chemical irrigation or other antimicrobial protocols and intra-canal medicaments are critical to attain this goal. The aim of this article was to review the antimicrobial agents and their properties in endodontics. PMID:25031587

  12. Progression of periapical cystic lesion after incomplete endodontic treatment.

    PubMed

    Huh, Jong-Ki; Yang, Dong-Kyu; Jeon, Kug-Jin; Shin, Su-Jung

    2016-05-01

    We report a case of large radicular cyst progression related to endodontic origin to emphasize proper intervention and follow-up for endodontic pathosis. A 25 yr old man presented with an endodontically treated molar with radiolucency. He denied any intervention because of a lack of discomfort. Five years later, the patient returned. The previous periapical lesion had drastically enlarged and involved two adjacent teeth. Cystic lesion removal and apicoectomy were performed on the tooth. Histopathological analysis revealed that the lesion was an inflammatory radicular cyst. The patient did not report any discomfort except for moderate swelling 3 days after the surgical procedure. Although the patient had been asymptomatic, close follow-ups are critical to determine if any periapical lesions persist after root canal treatment. PMID:27200282

  13. Progression of periapical cystic lesion after incomplete endodontic treatment

    PubMed Central

    Yang, Dong-Kyu; Jeon, Kug-Jin

    2016-01-01

    We report a case of large radicular cyst progression related to endodontic origin to emphasize proper intervention and follow-up for endodontic pathosis. A 25 yr old man presented with an endodontically treated molar with radiolucency. He denied any intervention because of a lack of discomfort. Five years later, the patient returned. The previous periapical lesion had drastically enlarged and involved two adjacent teeth. Cystic lesion removal and apicoectomy were performed on the tooth. Histopathological analysis revealed that the lesion was an inflammatory radicular cyst. The patient did not report any discomfort except for moderate swelling 3 days after the surgical procedure. Although the patient had been asymptomatic, close follow-ups are critical to determine if any periapical lesions persist after root canal treatment. PMID:27200282

  14. A systematic review of nonsurgical single-visit versus multiple-visit endodontic treatment

    PubMed Central

    Wong, Amy WY; Zhang, Chengfei; Chu, Chun-hung

    2014-01-01

    Conventional endodontic treatment used to require multiple visits, but some clinicians have suggested that single-visit treatment is superior. Single-visit endodontic treatment and multiple-visit endodontic treatment both have their advantages and disadvantages. This paper is a literature review of the research on nonsurgical single-visit versus multiple-visit endodontic treatment. The PubMed database was searched using the keywords (endodontic treatment OR endodontic therapy OR root canal treatment OR root canal therapy) AND (single-visit OR one-visit OR 1-visit). Review papers, case reports, data studies, and irrelevant reports were excluded, and 47 papers on clinical trials were reviewed. The studies generally had small sample sizes, and the endodontic procedures varied among the studies. Meta-analysis on the selected studies was performed, and the results showed that the postoperative complications of the single-visit and multiple-visit endodontic treatment were similar. Furthermore, neither single-visit endodontic treatment nor multiple-visit treatment had superior results over the other in terms of healing or success rate. Results of limited studies on disinfection of the root canals using low-energy laser photodynamic therapy is inconclusive, and further studies are necessary to show whether laser should be used in endodontic treatment. This review also found that that neither single-visit endodontic treatment nor multiple-visit treatment could guarantee the absence of postoperative pain. Since the study design of many studies displayed significant limitation and the materials and equipment used in endodontic treatment have dramatically changed in recent years, prospective randomized clinical trials are needed to further verify the postoperative pain and success rates of single-visit versus multiple-visit endodontic treatment. PMID:24855389

  15. [Treatment of a fractured endodontical instrument in the root canal].

    PubMed

    Schipper, M; Peters, L B

    2015-12-01

    A 53-year-old woman with continuing pain coming from a lower first molar was diagnosed with apical periodontitis, with a retained fractured instrument in the root canal. There are a variety of treatment options for dealing with a corpus alienum in a root canal. In this case it was decided to treat the tooth endodontically, and leave the fractured instrument fragment in situ. The selection of this treatment option was made on the basis of knowledge of the original diagnosis and the success rates of the various treatment options as described in the relevant literature, weighed against the possible risks and their effects on the prognosis. This suggested that the use of a dental operating microscope has a positive impact on the success rates of endodontic treatment The prognosis for endodontic treatment when a fractured instrument fragment is left within the root canal, as in this case, is not significantly reduced. The presence of preoperative periapical pathology, however, is a more clinically significant prognostic indicator. PMID:26665200

  16. Differential Diagnosis and Treatment Proposal for Acute Endodontic Infection.

    PubMed

    Keine, Kátia Cristina; Kuga, Milton Carlos; Pereira, Kamila Figueiredo; Diniz, Ana Carolina Soares; Tonetto, Mateus Rodrigues; Galoza, Marina Oliveira Gonçalves; Magro, Miriam Graziele; de Barros, Yolanda Benedita Abadia Martins; Bandéca, Matheus Coelho; de Andrade, Marcelo Ferrarezi

    2015-12-01

    The objective of this study was to describe the main lesions that simulate clinically and propose a treatment protocol for acute endodontic infection. Signs and clinical symptoms of periodontal abscess, gingival abscess, odontoma, herpes simplex, pericoronitis, acute pulpitis and necrotizing ulcerative gingivitis/periodontitis (NUG/NUP) were described and compared with acute endodontic infections. A treatment protocol was described by optimizing the procedures in access cavity, microbial decontamination and detoxification of the root canal, apical debridement, intracanal and systemic medication and surgical drainage procedures. The convenience of the use of 5.25% sodium hypochlorite, root canal instrumentation using a crown-down technique, intracanal medication with 2% chlorhexidine or triple antibiotic paste and the convenience of the use of antibiotics, analgesics, and surgical drainage to solve cases of acute dentoalveolar abscess was discussed. PMID:27018033

  17. [Endodontically treated teeth. Success--failure. Endorestorative treatment plan].

    PubMed

    Zabalegui, B

    1990-01-01

    More and more often the general dentist is finding the presence of endodontically treated teeth during his treatment planning procedure. He has to ask himself if the endo-treated tooth functions and will continue to function function successfully, when deciding which final endo-restorative procedure to apply. For this reason the dentist or the endodontist with whom he works should clinically evaluate these teeth, establish a diagnostic criteria of their success or failure and a treatment plan according to the prognosis. The purpose of this article is to offer an organized clinical view of the steps to follow when evaluating an endodontically treated tooth and how to establish a final endo-restorative plan. PMID:2168732

  18. Influence of Endodontic Treatment on Systemic Oxidative Stress

    PubMed Central

    Inchingolo, Francesco; Marrelli, Massimo; Annibali, Susanna; Cristalli, Maria Paola; Dipalma, Gianna; Inchingolo, Alessio Danilo; Palladino, Antonio; Inchingolo, Angelo Michele; Gargari, Marco; Tatullo, Marco

    2014-01-01

    Introduction: An increased production of oxidizing species related to reactive oral diseases, such as chronic apical periodontitis, could have systemic implications such as an increase in cardiovascular morbidity. Based on this consideration, we conducted a prospective study to assess whether subjects affected by chronic periodontitis presented with higher values of oxidative stress than reference values before endodontic treatment, and whether endodontic treatment can reduce the oxidative imbalance and bring it back to normal in these subjects. Materials and methods: The authors recruited 2 groups of patients from private studies and dental clinics: these patients were recruited randomly. The oxidative balance in both patients with chronic apical periodontitis (CAP) and healthy control patients was determined by measuring the oxidant status, using an identification of the reactive oxygen metabolites (d-ROMs) test, while the antioxidant status in these patients was determined using a biological antioxidant potential (BAP) test. Both these tests were carried on plasma samples taken from enrolled patients. Values were measured both before the endodontic treatment of the patients with chronic apical periodontitis, and 30 and 90 days after treatment, and compared to those obtained from healthy control patients. Results: It was found that, on recruitment, the patients with chronic apical periodontitis exhibited significantly higher levels of oxidative stress than control patients, as determined by the d-ROMs and BAP tests. Furthermore, the d-ROMs test values were shown to decrease and the BAP test values to increase over time in patients with chronic apical periodontitis following endodontic therapy. As the levels of oxidative stress in these patients tended to reduce and return to normal by 90 days following treatment. Conclusions: This study has demonstrated a positive association between chronic apical periodontitis and oxidative stress. Subjects affected by chronic

  19. Treatment of a Periodontic-Endodontic Lesion in a Patient with Aggressive Periodontitis

    PubMed Central

    2016-01-01

    Case Description. This case report describes the successful management of a left mandibular first molar with a combined periodontic-endodontic lesion in a 35-year-old Caucasian woman with aggressive periodontitis using a concerted approach including endodontic treatment, periodontal therapy, and a periodontal regenerative procedure using an enamel matrix derivate. In spite of anticipated poor prognosis, the tooth lesion healed. This case report also discusses the rationale behind different treatment interventions. Practical Implication. Periodontic-endodontic lesions can be successfully treated if dental professionals follow a concerted treatment protocol that integrates endodontic and periodontic specialties. General dentists can be the gatekeepers in managing these cases. PMID:27418983

  20. Laser scanning dental probe for endodontic root canal treatment

    NASA Astrophysics Data System (ADS)

    Blank, Molly A. B.; Friedrich, Michal; Hamilton, Jeffrey D.; Lee, Peggy; Berg, Joel; Seibel, Eric J.

    2011-03-01

    Complications that arise during endodontic procedures pose serious threats to the long-term integrity and health of the tooth. Potential complexities of root canals include residual pulpal tissue, cracks, mesial-buccal 2 and accessory canals. In the case of a failed root canal, a successful apicoectomy can be jeopardized by isthmuses, accessory canals, and root microfracture. Confirming diagnosis using a small imaging probe would allow proper treatment and prevent retreatment of endodontic procedures. An ultrathin and flexible laser scanning endoscope of 1.2 to 1.6mm outer diameter was used in vitro to image extracted teeth with varied root configurations. Teeth were opened using a conventional bur and high speed drill. Imaging within the opened access cavity clarified the location of the roots where canal filing would initiate. Although radiographs are commonly used to determine the root canal size, position, and shape, the limited 2D image perspective leaves ambiguity that could be clarified if used in conjunction with a direct visual imaging tool. Direct visualization may avoid difficulties in locating the root canal and reduce the number of radiographs needed. A transillumination imaging device with the separated illumination and light collection functions rendered cracks visible in the prepared teeth that were otherwise indiscernible using reflected visible light. Our work demonstrates that a small diameter endoscope with high spatial resolution may significantly increase the efficiency and success of endodontic procedures.

  1. ANALYSIS OF ENTEROCOCCUS FAECALIS IN SAMPLES FROM TURKISH PATIENTS WITH PRIMARY ENDODONTIC INFECTIONS AND FAILED ENDODONTIC TREATMENT BY REAL-TIME PCR SYBR GREEN METHOD

    PubMed Central

    Ozbek, Selcuk M.; Ozbek, Ahmet; Erdogan, Aziz S.

    2009-01-01

    Objective: The aims of this study were to investigate the presence of Enterococcus faecalis in primary endodontic infections and failed endodontic treatments using real-time PCR and to determine the statistical importance of the presence of E. faecalis in a Turkish population with endodontic infections. Material and Methods: E. faecalis was investigated from 79 microbial samples collected from patients who were treated at the Endodontic Clinic of the Dental School of Atatürk University (Erzurum, Turkey). Microbial samples were taken from 43 patients (Group 1) with failed endodontic treatments and 36 patients (Group 2) with chronic apical periodontitis (primary endodontic infections). DNA was extracted from the samples by using a QIAamp® DNA mini-kit and analyzed with real-time PCR SYBR Green. Results: E. faecalis was detected in 41 out of 79 patients, suggesting that it exists in not less than 61% of all endodontic infections when the proportion test (z= -1.645, endodontic infections in Turkish patients, and is more often associated with failed endodontic treatments than primary endodontic infections. PMID:19936510

  2. Cone beam computed tomography aided diagnosis and treatment of endodontic cases: Critical analysis

    PubMed Central

    Yılmaz, Funda; Kamburoglu, Kıvanç; Yeta, Naz Yakar; Öztan, Meltem Dartar

    2016-01-01

    Although intraoral radiographs still remain the imaging method of choice for the evaluation of endodontic patients, in recent years, the utilization of cone beam computed tomography (CBCT) in endodontics showed a significant jump. This case series presentation shows the importance of CBCT aided diagnosis and treatment of complex endodontic cases such as; root resorption, missed extra canal, fusion, oblique root fracture, non-diagnosed periapical pathology and horizontal root fracture. CBCT may be a useful diagnostic method in several endodontic cases where intraoral radiography and clinical examination alone are unable to provide sufficient information. PMID:27551342

  3. Cone beam computed tomography aided diagnosis and treatment of endodontic cases: Critical analysis.

    PubMed

    Yılmaz, Funda; Kamburoglu, Kıvanç; Yeta, Naz Yakar; Öztan, Meltem Dartar

    2016-07-28

    Although intraoral radiographs still remain the imaging method of choice for the evaluation of endodontic patients, in recent years, the utilization of cone beam computed tomography (CBCT) in endodontics showed a significant jump. This case series presentation shows the importance of CBCT aided diagnosis and treatment of complex endodontic cases such as; root resorption, missed extra canal, fusion, oblique root fracture, non-diagnosed periapical pathology and horizontal root fracture. CBCT may be a useful diagnostic method in several endodontic cases where intraoral radiography and clinical examination alone are unable to provide sufficient information. PMID:27551342

  4. Endodontic treatment in the primary dentition.

    PubMed

    Koshy, Sajeev; Love, Robert M

    2004-08-01

    A number of factors are involved in the development of pulp and periapical disease in primary and permanent teeth, with dental caries being the main factor. Although these factors are similar, the clinical management of a primary or permanent tooth with pulp or periapical disease may be quite different. This is based mainly on the differences between the two types of teeth, with primary tooth longevity, coronal structural integrity, root canal morphology, and root anatomy being important features to be taken into account when treatment planning. This paper reviews some aspects of primary teeth and the various treatment options for the management of pulp and periapical disease. PMID:15378974

  5. [Nonsurgical endodontic treatment of an invaginated canine].

    PubMed

    Fernández Guerrero, F; Miñana Laliga, R; Bullon Fernandez, P

    1989-01-01

    We present a case of a maxillary canine with a dens invaginatus treated successfully. The patient had pain, swelling and a sinus tract coming from the inmature apex of the canine. The canals were enlarged and cleaned and the main canal was filled with Calcium Hydroxide to allow the root development. Seven months later, the patient was asymptomatic and the tooth was obturated with guttapercha. One year later it was confirm the success in the treatment. PMID:2638021

  6. Treatment of combined endodontic: periodontic lesion by sealing of palato-radicular groove using biodentine

    PubMed Central

    Naik, Mayuri; de Ataide, Ida de Noronha; Fernandes, Marina; Lambor, Rajan

    2014-01-01

    Introduction: Palatoradicular groove is a developmental anomaly which is predominantly found in maxillary lateral incisors. It provides a susceptible alcove for the progression of localised periodontal inflammation which can further cause pulpal involvement. This case report describes the successful treatment of a large periodontic – endodontic lesion usingnon surgical endodontic therapy and biodentine for the sealing of the palatoradicular groove. PMID:25506153

  7. Combined Endodontic-Periodontal Treatment of a Palatogingival Groove.

    PubMed

    Castelo-Baz, Pablo; Ramos-Barbosa, Isabel; Martín-Biedma, Benjamín; Dablanca-Blanco, Ana Belén; Varela-Patiño, Purificación; Blanco-Carrión, Juan

    2015-11-01

    A palatogingival groove is a developmental anomaly that predisposes the involved tooth to develop a severe periodontal lesion. These grooves often present a clinical challenge because diagnosis and treatment planning require an interdisciplinary approach. This case report describes the successful management of a right maxillary lateral incisor with a deep palatogingival groove in combination with an extensive periodontal pocket and pulp necrosis of the involved tooth. Collaborative management used a combination of endodontic treatment, periodontal therapy, odontoplasty, and a periodontal regenerative procedure using protein complex derived from enamel matrix (Emdogain; Straumann, Basel, Switzerland). Despite a predicted poor prognosis, the tooth lesion healed. This report also discusses the rationale behind the treatment modalities. PMID:26395912

  8. 3D root canal modeling for advanced endodontic treatment

    NASA Astrophysics Data System (ADS)

    Hong, Shane Y.; Dong, Janet

    2002-06-01

    More than 14 million teeth receive endodontic (root canal) treatment annually. Before a clinician's inspection and diagnosis, destructive access preparation by removing teeth crown and dentin is usually needed. This paper presents a non-invasive method for accessing internal tooth geometry by building 3-D tooth model from 2-D radiographic and endoscopic images to be used for an automatic prescription system of computer-aided treatment procedure planning, and for the root canal preparation by an intelligent micro drilling machine with on-line monitoring. It covers the techniques specific for dental application in the radiographic images acquirement, image enhancement, image segmentation and feature recognition, distance measurement and calibration, merging 2D image into 3D mathematical model representation and display. Included also are the methods to form references for irregular teeth geometry and to do accurately measurement with self-calibration.

  9. Treatment Options: Biological Basis of Regenerative Endodontic Procedures

    PubMed Central

    Hargreaves, Kenneth M.; Diogenes, Anibal; Teixeira, Fabricio B.

    2013-01-01

    Dental trauma occurs frequently in children and often can lead to pulpal necrosis. The occurrence of pulpal necrosis in the permanent but immature tooth represents a challenging clinical situation since the thin and often short roots increase the risk of subsequent fracture. Current approaches for treating the traumatized immature tooth with pulpal necrosis do not reliably achieve the desired clinical outcomes, consisting of healing of apical periodontitis, promotion of continued root development and restoration of the functional competence of pulpal tissue. An optimal approach for treating the immature permanent tooth with a necrotic pulp would be to regenerate functional pulpal tissue. This review summarizes the current literature supporting a biological rationale for considering regenerative endodontic treatment procedures in treating the immature permanent tooth with pulp necrosis. PMID:23439043

  10. Endodontic treatment of the pregnant patient: Knowledge, attitude and practices of dental residents

    PubMed Central

    Ibhawoh, Louis; Enabulele, Joan

    2015-01-01

    Introduction: In order to control serious pulpal pain following odontogenic infections in pregnant women, endodontic treatment may become necessary. The aim of this study was to assess the perception of dentists about rendering endodontic treatment to pregnant women. Materials and Methods: This was a cross-sectional study of resident doctors in the different dental specialties in Nigeria preparing for the various levels of the fellowship examinations of the West Africa College of Surgeons and the National Postgraduate Medical College of Nigeria. Data were collected by the means of a 17-itemed questionnaire which sought information on respondents' demography, their considerations while rendering endodontic treatment to the pregnant patients and their perceptions of the safety of endodontic treatment in pregnancy. The data collected were analyzed using the Statistical Package for Social Science version 21.0. Results: With regards to the safety of endodontic treatment during pregnancy, 91.8% considered it safe, and this was not statistically significant in relation to the specialty or status of the respondent. Majority (77.0%) agreed they would undertake a root canal treatment on a pregnant patient with all respondents in restorative dentistry, prosthodontics, periodontics, and pedodontics in the affirmative while all in oral pathology would refuse to do such (P = 0.0001). Conclusion: Dental residents are aware of the safety of endodontic treatment in pregnant women. However, gaps exist in their knowledge, bringing to the fore, the need for inclusion of pregnancy-specific training in the dental postgraduate curriculum. PMID:26778880

  11. Endodontic Treatment of Hypertaurodontic Mandibular Molar Using Reciprocating Single-file System: A Case Report.

    PubMed

    C do Nascimento, Adriano; A F Marques, André; C Sponchiado-Júnior, Emílio; F R Garcia, Lucas; M A de Carvalho, Fredson

    2016-01-01

    Taurodontism is a developmental tooth disorder characterized by lack of constriction in the cementoenamel junction and consequent vertical stretch of the pulp chamber, accompanied by apical displacement of the pulpal floor. The endodontic treatment of teeth with this type of morpho-anatomical anomaly is challenging. The purpose of this article is to report the successful endodontic treatment of a hypertaurodontic mandibular molar using a reciprocating single-file system. PMID:27320297

  12. [The diagnostic value of oblique technique for periapical radiography and its usefulness in endodontic treatment].

    PubMed

    Mikołajczak, Teresa; Wilk, Grazyna

    2008-01-01

    The applicability of the intraoral X-rays in the oblique projection during the endodontic treatment is described in this study. The rules concerning the positioning of the X-ray tube, intraoral film and the examined tooth, necessary to obtain images in mesial and distal oblique projections are discussed. The usefulness of the aforementioned projections in visualizing the anatomy, anomalies as well as periapical changes of the dental roots and canals during the endodontic treatment is presented. PMID:19839519

  13. [The place of radiography in endodontic treatment carried out in general practice in Dakar].

    PubMed

    Gaye, F; Mbaye, M; Faye, B; Diallo, B

    2002-03-01

    An investigation conducted over dental surgeons of 52 dental offices in Dakar and it's near suburb (40 from private sector and 12 from public and quasi-public) has shown that the use of retro-alveolar radiography during endodontic treatment was not systematic, due to the price of retro-alveolar film, waste of time and relative facility of the endodontic treatment of monoradicular teeth. The preparatory negative is favored (32.70%) particularly by private dental surgeons, who use two retro-alveolar films for endodontic treatment: pre and post operative radiography (30%). The immediate post operator control is executed only in case of post-operator pains by public and quasi-public dental surgeons (16.67%) with one retro-alveolar film on average for the endodontic treatment; at term any radiographic control is done. Three retro-alveolar films per endodontic treatment were exceptionally used (9.61%) and offset incidences (15%) are not much used as well as support-films (angulators). The retro-alveolar radiography is still a reliable guide for a clinical success in endodontic treatment with a minimum of three retro-alveolar films and offset incidences. PMID:12061249

  14. Orthodontic-endodontic treatment planning of traumatized teeth.

    PubMed

    Steiner, D R; West, J D

    1997-03-01

    Occasionally, an orthodontic patient will accidentally traumatize a maxillary anterior tooth before or during orthodontic treatment. In some situations, the trauma will be substantial and avulse the tooth. In other accidents, the tooth may not avulse, but the pulp becomes nonvital. If the pulp is devitalized, and the root has not fully formed, the apex of the root canal may be wide. In this situation, the endodontist may recommend apexification procedures to help close the apex before conventional obturation of the root canal. If the patient is currently undergoing orthodontic movement of the traumatized incisor, what effect will the tooth movement have on the success of the apexification? If the tooth were avulsed, replanted, and then ankylosed, should it be extracted? If so, when should the ankylosed incisor be removed? What effect will further facial growth have on the ankylosed tooth and the potential to achieve a successful esthetic restoration? The answers to these questions are important during the interdisciplinary treatment planning of the patient with traumatized teeth. This article will elucidate the endodontic-orthodontic considerations for patients with traumatized anterior teeth. PMID:9206471

  15. Effect of cryogenic treatment on nickel-titanium endodontic instruments

    PubMed Central

    Kim, J. W.; Griggs, J. A.; Regan, J. D.; Ellis, R. A.; Cai, Z.

    2005-01-01

    Aim To investigate the effects of cryogenic treatment on nickel-titanium endodontic instruments. The null hypothesis was that cryogenic treatment would result in no changes in composition, microhardness or cutting efficiency of nickel-titanium instruments. Methodology Microhardness was measured on 30 nickel-titanium K-files (ISO size 25) using a Vicker’s indenter. Elemental composition was measured on two instruments using X-ray spectroscopy. A nickel-titanium bulk specimen was analysed for crystalline phase composition using X-ray diffraction. Half of the specimens to be used for each analysis were subjected to a cryogenic treatment in liquid nitrogen (−196 °C) for either 3 s (microhardness specimens) or 10 min (other specimens). Cutting efficiency was assessed by recording operator choice using 80 nickel-titanium rotary instruments (ProFile® 20, .06) half of which had been cryogenically treated and had been distributed amongst 14 clinicians. After conditioning by preparing four corresponding canals, each pair of instruments were evaluated for cutting efficiency by a clinician during preparation of one canal system in vitro. A Student’s t-test was used to analyse the microhardness data, and a binomial test was used to analyse the observer choice data. Composition data were analysed qualitatively. Results Cryogenically treated specimens had a significantly higher microhardness than the controls (P < 0.001; β > 0.999). Observers showed a preference for cryogenically treated instruments (61%), but this was not significant (P = 0.21). Both treated and control specimens were composed of 56% Ni, 44% Ti, 0% N (by weight) with a majority in the austenite phase. Conclusions Cryogenic treatment resulted in increased microhardness, but this increase was not detected clinically. There was no measurable change in elemental or crystalline phase composition. PMID:15910471

  16. Comparison of the Success Rate of Endodontic Treatment and Implant Treatment

    PubMed Central

    Elemam, Ranya Faraj; Pretty, Iain

    2011-01-01

    Dentists and patients are facing a perplexity between saving a compromised tooth through endodontic treatment and restoration or by extraction and replacement with an implant. The purpose of this paper was to compare the success rates of these two treatments. Success was measured as the longevity of the tooth or implant. Studies which met strict inclusion criteria to ensure best evidence were included. Searches were performed in Ovid Medline, Pubmed, Scopus database, and the Cochrane Library. Evidence-based groups were formed following the assessment of inclusion/exclusion criteria. The overall success rates for primary endodontic, nonsurgical retreatment, and surgical treatment were (86.02%), (78.2%), and (63.4%), respectively, implants was 90.9%. In conclusion, choice between implant and endodontic therapy cannot be exclusively based on outcome as both treatments differ in the biological process, diagnostic modalities, failure patterns, and patients preferences. More research is required with improved study designs before long-term success rates can be compared. PMID:21991484

  17. [Analysis of the key points in the micro-endodontic treatment].

    PubMed

    Hou, B X

    2016-08-01

    Micro-endodontic treatment refers to the microscope-assisted endodontic treatment techniques. The microscope offers a stereoscopic, enlarged image under great magnification and illumination at a comfortable working position. It will greatly promote the precision and improve the outcomes of endodontic treatment through enhancing the ability to detect the complexity of the root canal system of teeth that probably cannot be seen by the naked eyes, remove the infectious substances in root canal more efficiently, provide a tight root canal obturation and carry out effective retreatment procedures. The requirements of micro-endodontic treatment are different from the conventional root canal therapy carried out without microscope due to the complicated structure of the microscope. In order to make the use of microscope easier, it is of great importance to learn how to adjust the position of the operator and the patient, preset the angle of objective lens and the eyepiece, select the proper magnification and instruments, practice eye-hand cooperation under the microscope, etc. The purpose of this article was to analyze the key points in the applications of the microscope in endodontic treatment by reviewing the literature together with the author's clinical experience. PMID:27511033

  18. Non-linear indices of heart rate variability during endodontic treatment.

    PubMed

    Santana, Milana Drumond Ramos; Pita Neto, Ivo Cavalcante; Martiniano, Eli Carlos; Monteiro, Larissa Raylane Lucas; Ramos, José Lucas Souza; Garner, David M; Valenti, Vitor Engácia; Abreu, Luiz Carlos de

    2016-01-01

    Dental treatment promotes psychosomatic change that can influence the procedure and compromise the general well-being of the patient. In this context, it highlights the importance of evaluating the function of the autonomic nervous system in individuals undergoing endodontic treatment. Thus, this manuscript aimed to analyse cardiac autonomic modulation, through non-linear indices of heart rate variability (HRV) during endodontic treatment. Analysis of 50 subjects of either sex aged between 18 and 40 years diagnosed with irreversible pulp necrosis of lower molars undergoing endodontic treatment was undertaken. We carried out fractal and symbolic analysis of HRV, which was recorded in the first session of the endodontic treatment at four intervals: T1: 0-10 min before the onset of the treatment session; T2: 0-10 min after the application of anaesthesia; T3: throughout the period of treatment; and T4: 0-30 min after the end of the treatment session. There was reduction of α1 in T2 compared to T1 and T4 (p < 0.0001). The α2 index also reduced in T2 compared to T3 (p = 0.0035). There was an increase in the α1/α2 ratio in T4 compared to T2 and T3 (p = 0.0003). It was found that 0V% was significantly lower in T2 (p = 0.002), while 2UV% was significantly higher (p < 0.0001) when compared to other points in time. In conclusion, HRV is reduced during endodontic treatment, and after applying local anaesthetic the parasympathetic component of HRV increases. These data indicate that endodontic treatment acutely overcharges the heart, supporting the stress involved in this situation. PMID:26910016

  19. Cervicofacial emphysema and pneumomediastinum after a high-speed air drill endodontic treatment procedure.

    PubMed

    Durukan, Polat; Salt, Omer; Ozkan, Seda; Durukan, Banu; Kavalci, Cemil

    2012-11-01

    Cervicofacial subcutaneous emphysema is defined as the abnormal introduction of air in the subcutaneous tissues of the head and neck. It is mainly caused by trauma, head and neck surgery, general anesthesia, and coughing or habitual performance of Valsalva maneuver. The occurrence of subcutaneous emphysema after dental treatment is rare, and diffusion of gas into the mediastinum is much rarer, especially when the procedure is a nonsurgical treatment. The most common dental cause of pneumomediastinum is the introduction of air via the air turbine handpiece during surgical extraction of an impacted tooth. Only 6 cases of pneumomediastinum after endodontic treatment have been reported between 1960 and 2008. Pneumothorax is defined clinically as an “accumulation of air or gas between the parietal and visceral pleurae,” and although it is often not a medical emergency, it can result in respiratory distress, tension pneumothorax, shock, circulatory collapse, and even death. Although there are many possible causes of dyspnea during a dental procedure, 1 rare complication is pneumothorax. Although specific closed turbine systems are available for oral surgical procedures, these drills may be used in exodontia to section teeth and facilitate tooth extraction. We report a case of cervical subcutaneous emphysema and pneumomediastinum occurring after an endodontic treatment of right first molar using an air-tribune drill. We present here in a case of massive pneumomediastinum and cervicofacial subcutaneous emphysema that occurred after opening the access cavity for endodontic treatment. We describe its etiologies and guidelines for its prevention during nonsurgical endodontic treatment. PMID:22306391

  20. The Application of Microencapsulation Techniques in the Treatment of Endodontic and Periodontal Disease

    PubMed Central

    Álvarez, Asteria Luzardo; Espinar, Francisco Otero; Méndez, José Blanco

    2011-01-01

    In the treatment of intracanal and periodontal infections, the local application of antibiotics and other therapeutic agents in the root canal or in periodontal pockets may be a promising approach to achieve sustained drug release, high antimicrobial activity and low systemic side effects. Microparticles made from biodegradable polymers have been reported to be an effective means of delivering antibacterial drugs in endodontic and periodontal therapy. The aim of this review article is to assess recent therapeutic strategies in which biocompatible microparticles are used for effective management of periodontal and endodontic diseases. In vitro and in vivo studies that have investigated the biocompatibility or efficacy of certain microparticle formulations and devices are presented. Future directions in the application of microencapsulation techniques in endodontic and periodontal therapies are discussed. PMID:24310596

  1. Endodontic Treatment of a Double-Rooted Maxillary Second Molar with Four Canals: A Case Report

    PubMed Central

    Ashraf, Hengameh; Dianat, Omid; Hajrezai, Reihaneh; Paymanpour, Payam; Azadnia, Sina

    2014-01-01

    A healthy female was referred to Endodontic Department. The referral letter from her dentist expressed that an emergency pulpotomy of tooth #27 had been carried out with probable perforation of the chamber floor which was due to the unusual anatomy of the chamber. Cone-beam computed tomography (CBCT) revealed that the tooth had two mesial and two distal canals. Perforation site was repaired and endodontic treatment was completed. At 24-month follow-up, patient was asymptomatic and clinical and radiographic examinations showed successful outcomes. PMID:25386215

  2. Endodontic treatment of a double-rooted maxillary second molar with four canals: a case report.

    PubMed

    Ashraf, Hengameh; Dianat, Omid; Hajrezai, Reihaneh; Paymanpour, Payam; Azadnia, Sina

    2014-01-01

    A healthy female was referred to Endodontic Department. The referral letter from her dentist expressed that an emergency pulpotomy of tooth #27 had been carried out with probable perforation of the chamber floor which was due to the unusual anatomy of the chamber. Cone-beam computed tomography (CBCT) revealed that the tooth had two mesial and two distal canals. Perforation site was repaired and endodontic treatment was completed. At 24-month follow-up, patient was asymptomatic and clinical and radiographic examinations showed successful outcomes. PMID:25386215

  3. Genetic Variants in Cyclooxygenase- 2 Contribute to Post-treatment Pain among Endodontic Patients

    PubMed Central

    Applebaum, Elizabeth; Nackley, Andrea G.; Bair, Eric; Maixner, William; Khan, Asma A.

    2015-01-01

    Introduction Non-steroidal anti-inflammatory drugs (NSAIDs) have a well-established analgesic efficacy for inflammatory pain. These drugs exert their effect by inhibiting the enzyme cyclooxygenase (COX) and are commonly used for the management of pain following endodontic treatment. There are two distinct isoforms of COX: COX-1, which is constitutively expressed; and COX-2, which is primarily induced by inflammation. Previous studies have shown that functional human genetic variants of the COX-2 gene may explain individual variations in acute pain. The present study extends this work by examining the potential contribution of the two COX isoforms to pain after endodontic treatment. Methods Ninety-four patients treated by endodontic residents at the University of North Carolina School of Dentistry were enrolled into a prospective cohort study. Data on potential predictors of post-treatment pain was collected and all patients submitted saliva samples for genetic analysis. Non-surgical root canal therapy was performed and participants recorded pain levels for five days following. Results In this study, 63% of patients experienced at least mild pain after root canal therapy and 24% experienced moderate to severe pain. Presence of pretreatment pain was correlated with higher post-treatment pain (p=0.01). Elevated heart rate (p=0.02) and higher diastolic blood pressure (p=0.024) were also correlated with decreased post-treatment pain. Finally, we identified genetic variants in COX-2 (haplotype composed of rs2383515 G, rs5277 G, rs5275 T, and rs2206593 A) associated with post-treatment pain following endodontic treatment (p= 0.025). Conclusion Understanding the genetic basis of pain following endodontic treatment will advance its prevention and management. PMID:26081267

  4. [Comprehensive endodontic treatment with the use of depo- and galvanophoresis with copper hydroxide-calcium].

    PubMed

    Rumiantsev, V A; Opeshko, V V; Tubaeva, E A; Stapanian, Z V; Chakhkieva, F D; Kop'ev, D A; Ovcharenko, O S

    2007-01-01

    In the blind and randomized study in cases of routine endodontic treatment of 460 teeth in 372 patients high efficacy of additional use of depo- and galvanophoresis with copper hydroxide-calcium according to the technique modified by the authors. PMID:17828063

  5. Prevalence of apical periodontitis and endodontic treatment in a Kosovar adult population

    PubMed Central

    2011-01-01

    Background Despite numerous studies on the prevalence of apical periodontitis (AP) and endodontic treatment in diverse geographical populations, there are currently no data on the prevalence of these conditions in populations of adults native to Kosovo. Therefore, little is known about how widespread these conditions are, and whether there is any correlation between root canal treatment and AP. The purpose of our research was to address this anomaly by investigating AP and endodontic treatment in an adult Kosovar population based on radiographic examination. Methods The sample used for this study consisted of randomly selected individuals referred to the University Dentistry Clinical Center of Kosovo in the years 2006-2007. Orthopantomographs of 193 patients were evaluated. The periapical status of all teeth (with the exception of third molars) was examined according to Ørstavik's Periapical Index. The quality of the root canal filling was rated as 'adequate' or 'inadequate' based on whether all canals were filled, the depth of fill relative to the radiographic apex and the quality of compaction (absence/presence of voids). Data were analyzed statistically using the Chi-square test and calculation of odds ratios. Results Out of 4131 examined teeth, the prevalence of apical periodontitis (AP) and endodontic treatment was 12.3% and 2.3%, respectively. Of 95 endodontically-treated teeth, 46.3% were associated with AP. The prevalence of AP increased with age. The prevalence in subjects aged over 60 years old (20.2%) was higher than in other age groups. A statistically significant difference was found for the frequency of endodontically-treated teeth associated with AP in the 40-49 year age group (P < 0.001). Of some concern was the discovery that only 30.5% of the endodontically-treated teeth examined met the criteria of an acceptable root canal filling. Inadequately root-filled teeth were associated with an increased AP risk. Conclusions The prevalence of AP and the

  6. [Endodontic re-treatment or apical surgery, is an evidence-based choice possible?].

    PubMed

    de Lange, J

    2016-02-01

    Treatment of a recurrence after an initial endodontic treatment can consist of endodontic re-treatment or apical surgery. The literature reports comparable success rates for these two options. However, randomised controlled trials that are truly comparable to each other are unavailable as a result of which comparison and an informed choice are not really possible. In addition to the treatment outcome, consideration also has to be given to cost-effectiveness and other patient-related factors, such as pain, swelling and medication. Regarding these considerations, too, little reliable information can be found in the literature. Moreover, factors relating to insurance play an important role in the Netherlands, where only apical surgery is covered by the basic healthcare insurance. In conclusion, all of these factors should be carefully considered before proceeding to an individual treatment strategy. PMID:26878715

  7. Effects of endodontic treatment on apparent Young's modulus of human teeth: in vitro study using speckle interferometry

    NASA Astrophysics Data System (ADS)

    González-Peña, Rolando J.; Salvador, Rosario; Cibrián, Rosa M.; Martinez-Celorio, René A.; López, Francisco J.; Sala, Faustino; Paredes, Vanessa

    2012-04-01

    The introduction of new techniques for endodontic procedures requires the analysis of the biomechanical behavior of dental structures. Digital speckle shearing pattern interferometry (DSSPI) is a nondestructive optical measuring technique that allows one to directly quantify deformations in teeth that are subjected to stress. DSSPI technique was applied to measure small deformations caused by flexion in different types of teeth. The test was carried out both before and after endodontic treatment with the ProTaper method in order to evaluate the variation of dental elasticity, taking into the account the type of tooth and the endodontic treatment. The results obtained show that dental elasticity, established by means of the apparent Young's modulus, before and after the endodontic treatment, differs between incisors and premolars. The endodontic process does not affect dental elasticity (p>0.7). Specifically, 57.1% of central incisors and 56.3% of second premolars slightly increase their elasticity after the endodontic process. In turn, 42.9% of central incisors and 43.7% of second premolars slightly decrease elasticity. The endodontic treatment especially affects the ``neutral fibre'' therefore, there is little influence on elasticity by flexion. However, after finishing the process, the channel was restored with material, which can slightly increase tooth elasticity in some cases.

  8. Pregabalin in the treatment of inferior alveolar nerve paraesthesia following overfilling of endodontic sealer

    PubMed Central

    Alonso-Ezpeleta, Oscar; Martín, Pablo J.; López-López, José; Castellanos-Cosano, Lizett; Martín-González, Jenifer; Segura-Egea, Juan J.

    2014-01-01

    A case of orofacial pain and inferior alveolar nerve (IAN) paraesthesia after extrusion of endodontic sealer within the mandibular canal treated with prednisone and pregabalin is described. A 36-year-old woman underwent root canal treatment of the mandibular second right premolar tooth. Post-operative panoramic radiograph revealed the presence of radiopaque canal sealer in the mandibular canal. Damage to IAN consecutive to extrusion of endodontic sealer was diagnosed. Non-surgical management was decided, including: 1 mg/kg/day prednisone 2 times/day, once-daily regimen, and 150 mg/day pregabalin, two doses per day, monitoring the progress with periodic follow-up visits. Six weeks after the incident the signs and symptoms were gone. The complete resolution of paraesthesia and the control of pain achieved suggest that a non-surgical approach, combining prednisone and the GABA analogue pregabalin, is a good option in the management of the IAN damage subsequent to endodontic sealer extrusion. Key words:Endodontics, inferior alveolar nerve, neuropathic pain, orofacial pain, paraesthesia, pregabalin. PMID:24790724

  9. Regenerative Endodontic Treatment: Report of Two Cases with Different Clinical Management and Outcomes

    PubMed Central

    Khoshkhounejad, Mehrfam; Shokouhinejad, Noushin

    2015-01-01

    Endodontic intervention in necrotic immature permanent teeth is usually a clinical challenge. With appropriate case selection, regenerative treatment can be effective, providing a desirable outcome. However, there is still no consensus on the optimal disinfection protocol or the method to achieve predictable clinical outcome. This article presents two cases of regenerative treatment in necrotic immature teeth, using mineral trioxide aggregate (MTA) and BiodentineTM as coronal barriers and different irrigants, which led to different clinical outcomes. PMID:26884781

  10. Regenerative Endodontic Treatment: Report of Two Cases with Different Clinical Management and Outcomes.

    PubMed

    Khoshkhounejad, Mehrfam; Shokouhinejad, Noushin; Pirmoazen, Salma

    2015-06-01

    Endodontic intervention in necrotic immature permanent teeth is usually a clinical challenge. With appropriate case selection, regenerative treatment can be effective, providing a desirable outcome. However, there is still no consensus on the optimal disinfection protocol or the method to achieve predictable clinical outcome. This article presents two cases of regenerative treatment in necrotic immature teeth, using mineral trioxide aggregate (MTA) and Biodentine(TM) as coronal barriers and different irrigants, which led to different clinical outcomes. PMID:26884781

  11. Patients’ Perceptions of Endodontic Treatment as Part of Public Health Services: A Qualitative Study

    PubMed Central

    Melgaço-Costa, José Leonardo Barbosa; Martins, Renata Castro; Ferreira, Efigênia Ferreira; Sobrinho, Antônio Paulino Ribeiro

    2016-01-01

    Evaluations by patients constitute an important part of the process of improving health services. This study examined patients’ perceptions of secondary dental care in three cities in Minas Gerais, Brazil based on the endodontic treatment received. Data were collected using semi-structured interviews (addressing access, treatment and results) and a field diary (direct observations and report of professionals). The interviews were audiotaped, fully transcribed, and analyzed using content analysis. Two principal themes were identified: access to service and quality of service. The difficulties in accessing service were associated with the insufficient number of professionals to meet the high demand for endodontic treatment, problems in referring from primary to secondary care and geographic barriers. Service quality was related to the presence/absence of pain and anxiety that patients experienced, the time and number of sessions required to complete treatment, how patients were treated by dentists, and whether those patients would recommend the service to other patients. Access to endodontic treatment was a problem emphasized by users, and satisfaction with the quality of the service was more related to how patients were treated than to the technical competence of the dentist. PMID:27128932

  12. Patients' Perceptions of Endodontic Treatment as Part of Public Health Services: A Qualitative Study.

    PubMed

    Melgaço-Costa, José Leonardo Barbosa; Martins, Renata Castro; Ferreira, Efigênia Ferreira; Sobrinho, Antônio Paulino Ribeiro

    2016-01-01

    Evaluations by patients constitute an important part of the process of improving health services. This study examined patients' perceptions of secondary dental care in three cities in Minas Gerais, Brazil based on the endodontic treatment received. Data were collected using semi-structured interviews (addressing access, treatment and results) and a field diary (direct observations and report of professionals). The interviews were audiotaped, fully transcribed, and analyzed using content analysis. Two principal themes were identified: access to service and quality of service. The difficulties in accessing service were associated with the insufficient number of professionals to meet the high demand for endodontic treatment, problems in referring from primary to secondary care and geographic barriers. Service quality was related to the presence/absence of pain and anxiety that patients experienced, the time and number of sessions required to complete treatment, how patients were treated by dentists, and whether those patients would recommend the service to other patients. Access to endodontic treatment was a problem emphasized by users, and satisfaction with the quality of the service was more related to how patients were treated than to the technical competence of the dentist. PMID:27128932

  13. Outcome of Endodontic Treatments Made by Postgraduate Students in the Dental Clinic of Bretonneau Hospital

    PubMed Central

    Touboul, Virginie; Germa, Alice; Lasfargues, Jean-Jacques; Bonte, Eric

    2014-01-01

    Objective. The objective of this retrospective study is double: (1) to assess the 1–4 years of outcome of endodontic treatment performed by postgraduate students in endodontics in the Dental Clinic of Bretonneau Hospital and (2) to examine outcome predictors. Method. 363 teeth in 296 patients were treated between 2007 and 2011. 183 patients (224 teeth) were lost during the followup. 113 patients were included in the study (recall: 38%), corresponding to 139 teeth of which 8 were extracted. 131 remaining teeth (36%) were examined clinically and radiographically. Apical periodontitis (AP) was absent (PAI = 1) or present (PAI ≥ 2). Outcome was classified as “healed,” “healing,” or “diseased”. Results. The success rate was 92%. No failure was observed among the 23 initial endodontic treatments. Among the 108 retreated teeth, 80% were “healed” and 11% were “healing.” An association was found between success rate and preoperative signs or symptoms (absent 95% versus present 83%), preoperative root filling density (inadequate 93% versus adequate 57%), but not between preoperative AP status and success. Conclusion. Outcomes in this retrospective study were similar to those previously reported. However, a larger sample size is needed to assess outcome predictors more precisely. PMID:24778652

  14. Diagnosis and treatment of teeth with primary endodontic lesions mimicking periodontal disease: three cases with long-term follow ups

    PubMed Central

    Lim, Jae-Hyung; Lee, Ji-Hyun

    2014-01-01

    A tooth with primary endodontic disease that demonstrates a periodontal defect might be extracted because of misdiagnosis as severe periodontal disease or a vertical root fracture. The aim of this case report was to demonstrate the long-term survival of endodontically treated teeth, which had been initially considered unsavable. With meticulous evaluation including the patient's dental history, clinical and radiographic examinations, teeth with primary endodontic lesions could be differentiated and saved after proper root canal treatment. Pain history, vitality test, and radiographic examinations, as well as a general periodontal condition check with periodontal probing on an affected tooth, might be the key methods to differentiate endodontic pathosis from that of periodontal disease. PMID:24516831

  15. Treatment of an endodontic perforation with a restoration and a root coverage gingival graft.

    PubMed

    Harris, R J

    1995-07-01

    This case report describes the treatment of a perforation on the facial surface of the maxillary right central incisor made during endodontic therapy. Treatment of this highly visible area required a creative approach to therapy. The perforation was repaired with an amalgam restoration. A connective tissue with partial thickness double pedicle graft was used to replace missing periodontal structures, cover the exposed root surface, and obscure from view, as much as possible, the amalgam restoration placed in the perforation. This unconventional therapy is offered as a possible treatment option when few or no other acceptable options exist. PMID:7562357

  16. Curricular Guidelines for Endodontics.

    ERIC Educational Resources Information Center

    Journal of Dental Education, 1981

    1981-01-01

    Guidelines developed by the Section on Endodontics of the American Association of Dental Schools for use by educational institutions as curriculum development aids are provided. Endodontics is that branch of dentistry dealing with diagnosis and treatment of oral conditions that arise as a result of pathoses of dental pulp. (MLW)

  17. [Endodontic treatment of primary teeth. Pulp exposure and pulp necrosis].

    PubMed

    Gruythuysen, R J M

    2005-11-01

    With management of the deep caries in primary teeth we have to take account into the coping strategies of the patient and the state of the development of the dentition. That's why in most cases a root canal treatment of primary incisors or even a pulpotomy is not indicated. Often Intellectual Decision Not To Restore is a good alternative for treatment of deep caries in primary incisors. In deep caries lesions of primary canines and molars preferably minimal invasive techniques as indirect pulp capping are performed. In case of a exposure, the dentist can choose between several types of treatment. Improved techniques have lead to clinical satisfying results of the calcium hydroxide pulpotomy. A partial pulpotomy is if possible the treatment of choice. A resin modified glass ionomer cement is used to cover the pulp wound because it has good sealing properties and it is easy to handle. To limit the burden in young children a root canal treatment in primary teeth is seldom indicated. Overfilling with calcium hydroxide in root canal treatment of primary teeth never causes problems. PMID:16320568

  18. The Impact of Apical Patency in the Success of Endodontic Treatment of Necrotic Teeth with Apical Periodontitis: A Brief Review

    PubMed Central

    Machado, Ricardo; Ferrari, Carlos Henrique; Back, Eduardo; Comparin, Daniel; Tomazinho, Luiz Fernando; Vansan, Luiz Pascoal

    2016-01-01

    Accumulation of soft tissue or dentinal remnants in the apical region is a common event that can cause blockage of root canals. This event can be avoided if apical patency is performed during the root canal shaping procedures. However, there is no consensus on the role of apical patency in relation to the success of endodontic treatment of necrotic teeth with apical periodontitis. Therefore, the purpose of this paper was to conduct a brief review on the role of apical patency in guaranteeing the success of endodontic treatments of necrotic teeth with apical periodontitis considering two other key points; the root canal anatomy and microbiology. PMID:26843880

  19. Dental students' perceptions about the endodontic treatments performed using NiTi rotary instruments and hand stainless steel files.

    PubMed

    Martins, Renata Castro; Seijo, Marília Oliveira Saraiva; Ferreira, Efigênia Ferreira; Paiva, Saul Martins; Ribeiro Sobrinho, Antônio Paulino

    2012-01-01

    This study evaluated the perceptions of Brazilian undergraduate dental students about the endodontic treatments performed using NiTi rotary instruments and hand stainless steel. Data were collected using a questionnaire administered to undergraduate dental students enrolled in endodontic disciplines. The students were divided into 3 groups: G1, students who had treated straight canals with SS hand instruments; G2, students who had treated curved canals with SS hand instruments; and G3, students who had treated both straight and curved canals with NiTi rotary instruments. The number of endodontic treatments performed, types of treated teeth, students' learning, time spent, encountered difficulties, quality of endodontic treatment and characteristics of the employed technique were analyzed. There was a 91.3% rate of return for the questionnaires. Mandibular molars were the most frequently treated teeth, followed by maxillary incisors. The Kruskal-Wallis test showed no differences in learning (p=0.528) or in the characteristics of the technique employed (p=0.560) among the three groups. G3 students performed a greater number of endodontic treatments (p<0.001) in a smaller time (p<0.001) than did G1 and G2 students. Difficulties were reported primarily by students in G2 and G3 compared with G1 (p=0.048). The quality of endodontic treatments differed only between G1 and G2 (p=0.045). The use of NiTi rotary instruments should be included in undergraduate dental curriculum, contributing to the increase of patients assisted and consequently to improve the clinical experience of the students. PMID:23338269

  20. Can Antimicrobial Photodynamic Therapy (aPDT) Enhance the Endodontic Treatment?

    PubMed

    Chiniforush, Nasim; Pourhajibagher, Maryam; Shahabi, Sima; Kosarieh, Emad; Bahador, Abbas

    2016-01-01

    In order to achieve a long-lasting effect, one of the main goals in root canal treatment is to eliminate the endodontic bacteria. Conventional chemomechanical debridement is considered as the basic treatment in root canal therapy, but adjunctive techniques such as antimicrobial photodynamic therapy (aPDT) can also be helpful. The aim of this study was to evaluate reports in the scientific literature that used different photosensitizers (PSs) for bacterial reduction. The literature search was conducted using databases including PubMed, Scopus, and Google Scholar with the keywords "photodynamic therapy," "antimicrobial photodynamic therapy," or "photoactivated disinfection" and "endodontic," "Enterococcus faecalis," or "root canal treatment," from 2000 to 2015. By evaluating different studies, it was concluded that aPDT should be applied in combination with conventional mechanical debridement and irrigants. However, it is also important to note that the success rate is critically dependent on the type of the PS, output power of the laser used, irradiation time, pre-irradiation time, and type of tips used. PMID:27330702

  1. Endodontic treatment of mandibular molar with root dilaceration using Reciproc single-file system

    PubMed Central

    Meireles, Daniely Amorin; Bastos, Mariana Mena Barreto; Marques, André Augusto Franco; Sponchiado, Emílio Carlos

    2013-01-01

    Biomechanical preparation of root canals with accentuated curvature is challenging. New rotatory systems, such as Reciproc, require a shorter period of time to prepare curved canals, and became a viable alternative for endodontic treatment of teeth with root dilaceration. Thus, this study aimed to report a clinical case of endodontic therapy of root with accentuated dilaceration using Reciproc single-file system. Mandibular right second molar was diagnosed as asymptomatic irreversible pulpitis. Pulp chamber access was performed, and glide path was created with #10 K-file (Dentsply Maillefer) and PathFile #13, #16 and #19 (Dentsply Maillefer) up to the temporary working length. The working length measured corresponded to 20 mm in the mesio-buccal and mesio-lingual canals, and 22 mm in the distal canal. The R25 file (VDW GmbH) was used in all the canals for instrumentation and final preparation, followed by filling with Reciproc gutta-percha cones (VDW GmbH) and AH Plus sealer (Dentsply Maillefer), using thermal compaction technique. The case has been receiving follow-up for 6 mon and no painful symptomatology or periapical lesions have been found. Despite the difficulties, the treatment could be performed in a shorter period of time than the conventional methods. PMID:24010084

  2. Cleaning and decompression of inferior alveolar canal to treat dysesthesia and paresthesia following endodontic treatment of a third molar.

    PubMed

    Scala, Rudy; Cucchi, Alessandro; Cappellina, Luca; Ghensi, Paolo

    2014-01-01

    Endodontic overfilling involving the mandibular canal may cause an injury of the inferior alveolar nerve (IAN). We report a case of disabling dysesthesia and paresthesia of a 70-year-old man after endodontic treatment of his mandibular left third molar that caused leakage of root canal filling material into the mandibular canal. After radiographic evaluation, extraction of the third molar and distal osteotomy, a surgical exploration was performed and followed by removal of the material and decompression of the IAN. The patient reported an improvement in sensation and immediate disappearance of dysesthesia already from the first postoperative day. PMID:25099006

  3. The efficacy of low-level laser treatment in reducing pain and swelling after endodontic surgery: a systematic review

    NASA Astrophysics Data System (ADS)

    Moshari, Amirabbas; Vatanpour, Mehdi; Zakershahrak, Mehrsa

    2016-03-01

    Introduction: LLLT in oral cavity believed to reduce pain after endodontic surgery and wisdom tooth removal, to accelerate wound healing and to have an anti-inflammatory and regenerative effect. The aim of this systematic review therefore was to assess the proof available for the efficacy of low-level laser treatment in reducing pain and swelling after endodontic surgery. Methods: The PubMed service of the U.S. National Library of Medicine was searched with applicable search strategies. No language restriction was applied. The last electronic search was accomplished on August 31, 2015. All randomized clinical trials on the efficiency of low-level laser treatment in reducing pain and swelling after endodontic surgery was considered for the Meta-analysis. Quality consideration of the included randomized clinical trials was appraised according to CONSORT guidelines. Results: Only two randomized clinical trials were attained. These studies clarified that laser treatment could reduce pain and swelling, but the results were not significant. Conclusions: Low-level laser therapy can be advantageous for the reduction of postoperative pain but there is no strong confirmation for its efficiency. Its clinical utility and applicability relating to endodontic surgery, Along with the optimal energy dosage and the number of laser treatments needed after surgery, still, demand further research and experiment.

  4. The Factors Responsible for Endodontic Treatment Failure in the Permanent Dentitions of the Patients Reported to the College of Dentistry, the University of Aljouf, Kingdom of Saudi Arabia

    PubMed Central

    2016-01-01

    Introduction The endodontic failure is a common problem in dentistry. The success of endodontic and re-endodontic treatment depends on many factors. These includes periodontal disease, root fractures, residual necrotic pulp tissue, presence of peri-radicular infection, broken instruments, mechanical perforations, root canal underfillings, root canal overfillings, missed canals or unfilled canals. Aim The present research was aimed at evaluating the different factors responsible for endodontic treatment failure in permanent dentitions of the patients. Materials and Methods In the present in vivo cross-sectional study, 90 patients, who reported in endodontic section of Department of Conservative Dentistry, with post endodontic treatment pain, tenderness to percussion, swelling and sinus tract in their permanent dentitions were considered as endodontic failure cases, and were considered for endodontic re-treatment. The teeth with vertical root fracture and badly broken down unrestorable teeth were excluded from the present study. The study subjects were divided into three groups on the basis of their age. Informed consent was taken from the study subjects and the approval was taken for this study from the college ethical committee. Results The results were obtained as frequencies and percentages after analysing the collected informations by using SPSS version 10 computer soft ware. The majority of the endodontic failures were noted in the age group III (41.11%) and minimum endodontic failures were found in the age group I (24.44%). According to the tooth type, the majority of the endodontic failures were noted in maxillary molars (44.4%), mandibular molars (20%) and maxillary premolars (15.5%). The endodontic treatment performed by the general dental practitioners (GDPs) showed the most failure rate (78.8%). The factors which were most responsible for endodontic failures were underfilled canals (33.3%), unfilled and missed canals (17.7%). Conclusion This study

  5. Coronal microleakage of 3 temporary filling materials used for endodontic treatment: an in vitro study.

    PubMed

    Feliz Matos, Leandro; Rodriguez, Indira De Los Santos; Gonzalez, Mally Luz Rodriguez; Pereyra, Dulce; Monzon Velez, Erick R

    2013-01-01

    Most root canal treatments are performed over multiple appointments. The temporary sealing material used between sessions must have sealing properties capable of preventing microleakage. This study assessed the degree of microleakage of temporary sealing materials according to time spent blocking the access cavity. Endodontic treatments with a standardized protocol were performed on 63 healthy, single-rooted, caries-free human teeth. The teeth were divided randomly into 5 groups. Groups 1-3 were each treated with 1 of 3 sealing materials, while Group 4 and 5 served as positive and negative controls, respectively. Data was obtained and analyzed with nonparametric tests (Kruskal-Wallis and Chi-square). Results indicated statistically significant differences between materials and the degree of microleakage (P = 0.000). All 3 sealing materials allowed microleakage within 48 hours, with glass ionomer cement demonstrating the most microleakage. PMID:24064164

  6. Management of progressive apical root resorption 13 years after dental trauma and primary endodontic treatment.

    PubMed

    Machado, Ricardo; Tomazinho, Luiz Fernando; Magagnin, Roseani; Leal Silva, Emmanuel João Nogueira; Vansan, Luiz Pascoal

    2016-01-01

    Many studies have focused on the search for a restorative material with good sealing properties and biocompatibility for treatment of teeth with open apices and necrotic pulps, which can result from periradicular disease and root resorption. Mineral trioxide aggregate (MTA) has exhibited promising clinical results in retrograde fillings and pulpotomies as well as for treatment of root perforations, root resorptions, incomplete root formations, and pulpal necrosis. This case report describes the management of a progressive apical root resorption in a previously traumatized tooth that had been endodontically treated. Five years of clinical and radiographic follow-up demonstrated the clinical efficacy of MTA in limiting the inflammatory resorptive process and promoting apexification and regeneration of periradicular tissue. PMID:27367638

  7. [Endodontics in motion: new concepts, materials and techniques 2. The use of cone-beam computed tomography in endodontic diagnosis and treatment planning].

    PubMed

    Özok, A R; Metska, M E

    2015-09-01

    Systems for cone-beam computed tomography make a high-quality 3D reconstruction of dentomaxillofacial structures possible, without exposing the patient to excessive doses of radiation. Due to its 3D nature cone-beam computed tomography is superior to conventional dental radiographic imaging methods for many aspects of endodontic diagnosis and treatment planning. There are multiple indications for the use of cone-beam computed tomography scans in endodontics, including detection of periapical lesions or root fractures and the exploration of the root canal anatomy and its deviations. Depending on conditions, a judicious decision will always have to be made with regard to the radiographic technique to be applied. Primary in that respect must be the means by which the most accurate diagnostic image can be achieved with the lowest possible dose of radiation. Making a cone-beam computed tomography scan is justified only when the required diagnostic information cannot be achieved adequately using lower dose conventional dental radiographic imaging techniques. PMID:26397106

  8. Endodontic applications of short pulsed FR Nd:YAG dental laser: treatment of dystrophic calcification: a clinical trial report

    NASA Astrophysics Data System (ADS)

    Gregg, Robert H., II

    1992-06-01

    Formation of dystrophic calcification deposits within the root canal of a tooth, have historically been difficult clinical endodontic complications. Presently, removal of such tissue, mineralized through the deposition of calcareous materials in a root canal (a 'calcified canal'), remains resistant to conventional endodontic techniques. The subsequent treatment primarily involves undesirable surgical procedures and/or loss of the tooth. Described in this clinical trial is a technique using free running (RF) pulsed, Nd:YAG laser energy to ablate hard calcified tissue which obstructed mechanical access of the root canal and root apex--a technique employed after conventional endodontic methods failed. This paper discusses the 'plasma' effect, 'spallation', canal illumination and transillumination using the helium-neon (HeNe) aiming beam. A free running pulsed, FR Nd:YAG dental laser was successfully used at 20 pulses per second and 1.75 watts to photovaporize and photodisrupt enough calcified tissue obstruction, to allow a conventional endodontic file to pass the canal blockage, and access the root apex. This clinical trial achieved the immediate, short term objective of endodontic hard tissue removal via photovaporization and photodisruption. The pulsed FR Nd:YAG dental laser used as described in this clinical report appears to be a very safe and very effective technique; offers a treatment alternative to traditional therapy that suggests high patient acceptance; and is significantly less stressful for the doctor and staff than traditional treatment options. Long-term, controlled scientific and clinical studies are necessary to establish the safety and efficacy of both the helium-neon energy for visualization and the low- watt pulsed FR Nd:YAG energy for photovaporization and photodisruption of hard calcified tissue within the root canal. Research is especially needed to understand the effects of low- watt, pulsed FR, Nd:YAG laser on the activity of osteoclasts and

  9. Diode laser for endodontic treatment: investigations of light distribution and disinfection efficiency

    NASA Astrophysics Data System (ADS)

    Stock, Karl; Graser, Rainer; Udart, Martin; Kienle, Alwin; Hibst, Raimund

    2011-03-01

    Diode lasers are used in dentistry mainly for oral surgery and disinfection of root canals in endodontic treatment. The purpose of this study was to investigate and to improve the laser induced bacteria inactivation in endodontic treatment. An essential prerequisite of the optimization of the irradiation process and device is the knowledge about the determinative factors of bacteria killing: light intensity? light dosis? temperature? In order to find out whether high power NIR laser bacterial killing is caused by a photochemical or a photothermal process we heated bacteria suspensions of E. coli K12 by a water bath and by a diode laser (940 nm) with the same temporal temperature course. Furthermore, bacteria suspensions were irradiated while the temperature was fixed by ice water. Killing of bacteria was measured via fluorescence labeling. In order to optimize the irradiation of the root canal, we designed special fiber tips with radial light emission characteristic by optical ray tracing simulations. Also, we calculated the resulting light distribution in dentin by voxelbased Monte Carlo simulations. Furthermore, we irradiated root canals of extracted human teeth using different fiber tip geometries and measured the resulting light and heat distribution by CCD-camera and thermography. Comparison of killing rates between laser and water based heating shows no significant differences, and irradiation of ice cooled suspensions has no substantial killing effect. Thus, the most important parameter for bacterial killing is the maximum temperature. Irradiation of root canals using fiber tips with radial light emission results in a more defined irradiated area with minor irradiation of the apex and higher intensity and therefore higher temperature increase on root canal surface. In conclusion, our experiments show that at least for E. coli bacteria inactivation by NIR laser irradiation is solely based on a thermal process and that heat distribution in root canal can be

  10. Accidental injury of the inferior alveolar nerve due to the extrusion of calcium hydroxide in endodontic treatment: a case report.

    PubMed

    Shin, Yooseok; Roh, Byoung-Duck; Kim, Yemi; Kim, Taehyeon; Kim, Hyungjun

    2016-02-01

    During clinical endodontic treatment, we often find radiopaque filling material beyond the root apex. Accidental extrusion of calcium hydroxide could cause the injury of inferior alveolar nerve, such as paresthesia or continuous inflammatory response. This case report presents the extrusion of calcium hydroxide and treatment procedures including surgical intervention. A 48 yr old female patient experienced Calcipex II extrusion in to the inferior alveolar canal on left mandibular area during endodontic treatment. After completion of endodontic treatment on left mandibular first molar, surgical intervention was planned under general anesthesia. After cortical bone osteotomy and debridement, neuroma resection and neurorrhaphy was performed, and prognosis was observed. But no improvement in sensory nerve was seen following surgical intervention after 20 mon. A clinician should be aware of extrusion of intracanal medicaments and the possibility of damage on inferior alveolar canal. Injectable type of calcium hydroxide should be applied with care for preventing nerve injury. The alternative delivery method such as lentulo spiral was suggested on the posterior mandibular molar. PMID:26877992

  11. Accidental injury of the inferior alveolar nerve due to the extrusion of calcium hydroxide in endodontic treatment: a case report

    PubMed Central

    2016-01-01

    During clinical endodontic treatment, we often find radiopaque filling material beyond the root apex. Accidental extrusion of calcium hydroxide could cause the injury of inferior alveolar nerve, such as paresthesia or continuous inflammatory response. This case report presents the extrusion of calcium hydroxide and treatment procedures including surgical intervention. A 48 yr old female patient experienced Calcipex II extrusion in to the inferior alveolar canal on left mandibular area during endodontic treatment. After completion of endodontic treatment on left mandibular first molar, surgical intervention was planned under general anesthesia. After cortical bone osteotomy and debridement, neuroma resection and neurorrhaphy was performed, and prognosis was observed. But no improvement in sensory nerve was seen following surgical intervention after 20 mon. A clinician should be aware of extrusion of intracanal medicaments and the possibility of damage on inferior alveolar canal. Injectable type of calcium hydroxide should be applied with care for preventing nerve injury. The alternative delivery method such as lentulo spiral was suggested on the posterior mandibular molar. PMID:26877992

  12. Are more endodontic consultations needed in dental school clinic settings? A study of treatment decisions at one school.

    PubMed

    Aminoshariae, Anita; Tulunoglu, Ibrahim; Demko, Catherine; Galsterer, Mark; Montagnese, Thomas A; Mickel, Andre

    2015-04-01

    With no previous studies of the occurrence of interdisciplinary consultations for tooth extraction in a dental school clinic setting, the aim of this cross-sectional descriptive investigation was to measure and compare the consultation process that occurred among departments at one U.S. dental school for making treatment decisions on tooth extraction. A comprehensive computerized retrieval (Crystal Reports) was used to identify and gather data from patient records from July 1, 2007, to July 1, 2011. Treatment plans and progress notes were analyzed to determine why each tooth had been extracted and which department had recommended the extraction. Results showed that the clinical departments involved in treatment planning decisions were the DMD dental student clinic, Department of Periodontics, and Department of Endodontics. The narrative records of 227 patients who had 516 teeth extracted were examined. About three-fourths (73.26%) of the extracted teeth were extracted based on the recommendation of only one department. Of these extracted teeth, 22.0% (n=114) were previously endodontically treated, and only four were recommended for endodontic consultation prior to extraction. The study found that most extractions were performed without specialty consultations and that the Department of Endodontics was consulted the least of all departments. To foster interdisciplinary collaboration in dental school clinics and help students develop expertise in such collaborations, more specialty consultations are needed for teeth that are treatment planned for extraction in order to preclude needless extraction of potentially salvageable teeth. Doing so will provide benefits for both patient care and students' education. PMID:25838010

  13. Modern Endodontic Principles. Part 8: The Future of Endodontics.

    PubMed

    Roudsari, Reza Vahid; Jawad, Sarra; Taylor, Carly; Darcey, James; Qualtrough, Alison

    2016-06-01

    Although the principles of endodontics have remained unchanged for many decades, root canal treatment has been subject to major changes in the past few years. This paper outlines the cutting-edge advances including the materials and techniques used. CPD/Clinical Relevance: This article provides an overview of bioactive materials and insight into regenerative endodontics, vital pulp therapy and intentional replantation. PMID:27529911

  14. Adverse Reaction of Sodium Hypochlorite during Endodontic Treatment of Primary Teeth

    PubMed Central

    Panse, Amey Manohar; Gawali, Pritesh Namdeo

    2015-01-01

    ABSTRACT Sodium hypochlorite (NaOCl) is the most common and effective intracanal medicament used in root canal treatments, because of its low-cost and a very effective antimicrobial activity against microbiota of infected root canals. Sodium hypochlorite is an effective intracanal irrigant and is used in concentrations ranging from 0.5 to 5.25%. At these concentrations, it is highly hypertonic and strongly alkaline with pH 11 to 13. Despite its safe properties, serious complications can result from inadvertent use due to its cytotoxic features. Most of the complications are the result of accidental extrusion of the solution from the apical foramen or accessory canals or perforations into the periapical area. Although it is an effective solution for disinfection of root canal system, fewer incidence of complications are reported, especially in primary teeth. Present article highlights one of such cases of NaOCl accident and its successful management in a 4-year-old child. How to cite this article: Chaugule VB, Panse AM, Gawali PN. Adverse Reaction of Sodium Hypochlorite during Endo-dontic Treatment of Primary Teeth. Int J Clin Pediatr Dent 2015;8(2):153-156. PMID:26379387

  15. Endodontic treatment of a maxillary first molar with seven root canals confirmed with cone beam computer tomography - case report.

    PubMed

    Martins, Jorge N R

    2014-06-01

    The most common configuration of the maxillary first molar is the presence of three roots and four root canals, although the presence of several other configurations have already been reported. The objective of this work is to present a rare anatomic configuration with seven root canals diagnosed during an endodontic therapy. Endodontic treatment was performed using a dental operating microscope. Exploring the grooves surrounding the main canals with ultrasonic troughing was able expose unexpected root canals. Instrumentation with files of smaller sizes and tapers was performed to prevent root physical weakness. The anatomic configuration was confirmed with a Cone Beam Computer Tomography image analysis which was able to clearly show the presence of seven root canals. An electronic database search was conducted to identify all the published similar cases and the best techniques to approach them are discussed. PMID:25121069

  16. Endodontic Treatment of a Maxillary First Molar with Seven Root Canals Confirmed with Cone Beam Computer Tomography – Case Report

    PubMed Central

    2014-01-01

    The most common configuration of the maxillary first molar is the presence of three roots and four root canals, although the presence of several other configurations have already been reported. The objective of this work is to present a rare anatomic configuration with seven root canals diagnosed during an endodontic therapy. Endodontic treatment was performed using a dental operating microscope. Exploring the grooves surrounding the main canals with ultrasonic troughing was able expose unexpected root canals. Instrumentation with files of smaller sizes and tapers was performed to prevent root physical weakness. The anatomic configuration was confirmed with a Cone Beam Computer Tomography image analysis which was able to clearly show the presence of seven root canals. An electronic database search was conducted to identify all the published similar cases and the best techniques to approach them are discussed. PMID:25121069

  17. Quality-Shaping Factors and Endodontic Treatment amongst General Dental Practitioners with a Focus on Denmark

    PubMed Central

    Demant, Sune; Markvart, Merete; Bjørndal, Lars

    2012-01-01

    There is a gap between the endodontic outcome that can be achieved and the outcome observed on the basis of worldwide general dental practitioner data. The quality of root canal treatment (RCT) is shaped by the dentist's knowledge, attitude, and skills, but it may also be influenced by the patient's demands and degree of satisfaction. The topic has only been sparsely investigated. Although dental health has increased over the years in Denmark, the number of performed root fillings has also increased, probably because the number of tooth extractions have declined and more molar teeth have been treated. Caries appears to be the main cause for performing RCT and a preventive approach by employing stepwise excavation may reduce RCT, but this strategy does not remove the gap. Factors influencing RCT quality could be the status on adoption of nickel-titanium rotary technology, more focus on infection control (rubber dam use, knowledge of factors important for prognosis), as dentists often think that they are good at doing RCT, but often perform inadequately, an alteration of clinician's awareness of their performance in the context of dental practices, seems warranted. Finally, the development of new preventive modalities for pulp and apical inflammation are crucial. PMID:22536241

  18. Root dentin strain and temperature rise during endodontic treatment and post rehabilitation.

    PubMed

    Amade, Euridsse Sulemane; Novais, Veridiana Resende; Roscoe, Marina Guimarães; Azevedo, Fabiane Maria Ferreira; Bicalho, Aline Aredes; Soares, Carlos José

    2013-01-01

    This study investigated the effects of endodontic treatment procedures and different post systems rehabilitation steps on the strain and temperature rise on apical and cervical root dentin regions. Twenty-one extracted human canine teeth had two strain gages attached to the distal root surface and two thermocouples attached to the mesial root surface (cervical and apical). The strain and temperature rise were recorded during the following procedures: root canal preparation, final rinse and drying, root canal filling and canal relief. Then the teeth were divided into three groups (n=7), according to the type of post system: CPC, cast post and core; FGP, fiberglass post; and PSP, prefabricated steel post. Data continued to be recorded during the post space preparation, post modeling (only for CPC), post trying and post cementation. Data were subjected to a two-way ANOVA followed by Tukey's test (α=0.05). The post-space preparation caused the highest temperature rise (4.0-14.9 °C) and the highest strain in the apical region during irrespective of post type. The resin cement light-activation resulted in significant temperature increases in the cervical region for all of the groups. The canal relief and the post-space preparation produced highest temperature rises. The CPC post modeling resulted in higher root strain level similarly the level of post preparation. The PSP resulted in highest strain during post trying and post cementation. PMID:24474355

  19. Learning experience in endodontics: Brazilian students' perceptions.

    PubMed

    Seijo, Marilia O S; Ferreira, Efigênia F; Ribeiro Sobrinho, Antônio P; Paiva, Saul M; Martins, Renata C

    2013-05-01

    Including students' perceptions in the educational process is considered a key component in monitoring the quality of academic programs. This study aimed to evaluate the concept of one's learning experience in endodontic teaching from the perspective of a group of Brazilian students. A total of 126 self-administered, structured questionnaires were distributed to undergraduate dental students enrolled in endodontics courses during the second semester of the 2009 academic year. The questionnaires were administered during final examinations and focused on students' opinions concerning learning during endodontic treatments, time spent during endodontic treatments, difficulties found during endodontic treatments, quality of endodontic treatments performed, characteristics of the technique employed, and suggestions to improve endodontic teaching. Ninety-one percent of the questionnaires were returned for evaluation. The obtained answers were discussed and analyzed, thereby generating quantitative and qualitative data showing students' perceptions of their experiences in endodontics courses. The main points that can affect the teaching of endodontics, according to the undergraduate students, included patients' absences and delays, selection of patients, preclinical and clinical training, difficulties found, type of technique employed, and teachers' orientation during endodontic treatment. The students' perceptions provided valuable information about the development of the course and the teacher-student relationship, together with the added intention of enhancing the teaching of endodontics as well as other courses. PMID:23658412

  20. Preferred Materials and Methods Employed for Endodontic Treatment by Iranian General Practitioners

    PubMed Central

    Raoof, Maryam; Zeini, Negar; Haghani, Jahangir; Sadr, Saeedeh; Mohammadalizadeh, Sakineh

    2015-01-01

    Introduction: The aim of this study was to gather information on the materials and methods employed in root canal treatment (RCT) by general dental practitioners (GDPs) in Iran. Methods and Materials: A questionnaire was distributed among 450 dentists who attended the 53th Iranian Dental Association congress. Participants were asked to consider demographic variables and answer the questions regarding the materials and methods commonly used in RCT. Descriptive statistics were given as absolute frequencies and valid percentages. The chi-square test was used to investigate the influence of gender and the years of professional activity for the employed materials and techniques. Results: The response rate was 84.88%. The results showed that 61.5% of the participants did not perform pulp sensitivity tests prior to RCT. Less than half of the general dental practitioners (47.4%) said that they would trace a sinus tract before starting the treatment. Nearly 16% of practitioners preferred the rubber dam isolation method. Over 36% of the practitioners reported using formocresol for pulpotomy. The combined approach of working length (WL) radiographs and electronic apex locators was used by 35.2% of the practitioners. Most of the respondents used K-file hand instruments for canal preparation and the technique of choice was step-back (43.5%), while 40.1% of respondents used NiTi rotary files, mostly ProTaper and RaCe. The most widely used irrigant was normal saline (61.8%). Calcium hydroxide was the most commonly used inter appointment medicament (84.6%). The most popular obturation technique was cold lateral condensation (81.7%) with 51% using zinc oxide-eugenol-based sealers. Conclusions: The majority of Iranian GDPs who participated in the present survey do not comply with quality guidelines of endodontic treatment. PMID:25834595

  1. Endodontic Epidemiology

    PubMed Central

    Shahravan, Arash; Haghdoost, Ali Akbar

    2014-01-01

    Epidemiology is the study of disease distribution and factors determining or affecting it. Likewise, endodontic epidemiology can be defined as the science of studying the distribution pattern and determinants of pulp and periapical diseases; specially apical periodontitis. Although different study designs have been used in endodontics, researchers must pay more attention to study designs with higher level of evidence such as randomized clinical trials. PMID:24688577

  2. Management of Teeth with Persistent Apical Periodontitis after Root Canal Treatment Using Regenerative Endodontic Therapy.

    PubMed

    Saoud, Tarek Mohamed A; Huang, George T-J; Gibbs, Jennifer L; Sigurdsson, Asgeir; Lin, Louis M

    2015-10-01

    Regenerative endodontic therapy (RET) is currently used to treat immature teeth with necrotic pulp and/or apical periodontitis. However, recently RET has been used to treat mature teeth with necrotic pulp and/or apical periodontitis and resulted in regression of clinical signs and/or symptoms and resolution of apical periodontitis. The purpose of this case report was to describe the potential of using RET to treat 2 mature teeth with persistent apical periodontitis after root canal therapy using RET. Two male patients, one 26-year old and another 12-year old, presented for retreatment of persistent apical periodontitis after root canal treatment of 2 mature teeth (#9 and #19). The gutta-percha fillings in the canals of teeth #9 and #19 were removed with Carvene gutta-percha solvent (Prevest DenPro, Jammu, India) and ProTaper Universal rotary retreatment files (Dentsply Maillefer, Ballaigues, Switzerland). The canals of both teeth were further chemomechanically debrided with rotary retreatment files and copious amounts of sodium hypochlorite irrigation and dressed with Metapaste (Meta Biomed, Chungbuk, Korea). RET was performed on teeth #9 and #19. Periapical bleeding was provoked into the disinfected root canals. The blood clots were covered with mineral trioxide aggregate plugs, and the access cavities were restored with intermediate restorative material. Teeth #9 and #19 showed regression of clinical signs and/or symptoms and healing of apical periodontitis after 13-month and 14-month follow-ups, respectively. Tooth #9 revealed narrowing of the canal space and apical closure by deposition of hard tissue. RET has the potential to be used to retreat teeth with persistent apical periodontitis after root canal therapy. PMID:26279479

  3. Sensitivity of human dental pulp cells to eighteen chemical agents used for endodontic treatments in dentistry.

    PubMed

    Kobayashi, Morio; Tsutsui, Takeo W; Kobayashi, Tomoko; Ohno, Maki; Higo, Yukari; Inaba, Tomohiro; Tsutsui, Takeki

    2013-01-01

    To determine the adverse effects against human dental pulp tissue, the sensitivity of human dental pulp cells (D824 cells) to 18 chemical agents used for endodontic treatments in dentistry was examined. The cytotoxicity, as determined by a decrease in colony-forming ability of cells treated with the chemical agents, increased as the concentration increased. As a quantitative measure of the cytotoxic effect, LC(50), the concentration which induces a 50% lethality, was extrapolated from the concentration-response curves. The rank of the chemical agents according to their cytotoxic effect (LC(50)) was sodium arsenite > formaldehyde > hydrogen peroxide > zinc oxide > thymol ≈ iodoform ≈ eugenol > guaiacol > ethylenediaminetetraacetic acid ≈ iodine > procaine > lidocaine ≈ chloramphenicol ≈ m-cresol > calcium hydroxide ≈ sodium hypochlorite ≈ phenol ≈ p-phenolsulfonic acid. To compare the cytotoxicity and the levels of apoptosis and mRNA expression of five genes related to the function of dental pulp tissue, D824 cells treated with the LC(50) concentrations of chemical agents were assayed by the TUNEL method and quantitative reverse transcription polymerase chain reaction analysis, respectively. The inducibility of apoptotic cells and the level of mRNA expression of the genes varied with the chemical agents, indicating that both effects occurred independent of the rank of cytotoxic effect of the chemical agents. The results not only provide information concerning cytotoxicity of various chemical agents to human dental pulp cells, but also show an insight into the diversity of the pharmacodynamic action of the chemical agents. PMID:22083529

  4. Evaluation of the Factors and Treatment Options of Separated Endodontic Files Among Dentists and Undergraduate Students in Riyadh Area

    PubMed Central

    Pedir, Samah Samir; Mahran, Abeer Hashem; Beshr, Khaled

    2016-01-01

    Introduction Separation of endodontic files during root canal treatment is a common multifactorial problem facing most of dental practitioners both dentists and students that has high impact on treatment and prognosis outcome. Aim To compare the incidence, factors and treatment options of separated endodontic files among dentists and undergraduate students in Riyadh area. Materials and Methods A survery of 35-questionnaire was formulated and e-mailed to all 149 dentists of different dental specialties who are working in different clinical centers in Riyadh area and are attending the 26th Saudi Dental Society International Dental Conference in addition to 130 undergraduate students in different dental colleges in Riyadh. Overall, 118 participants of dentists completed the survey, with response rate of 79% and the same number of students with response rate of 90.7%. Results Total of 57.6% dentists’ faced separated files problem during root canal preparation, while only 7.6% of students faced this problem. 53% of separated endodontic files (SEF) were hand files, 65% stainless steel files, 81% were small size files most common sizes (#15-20) (p <0.0001). Causes of SEF were root Canal anatomy, in 45%. 66% of SEF occurred in curved canals, 98% were in molars in mesiobuccal and mesiolingual canals, (p <0.0001). 44% of SEF were successfully bypassed, 53% were successfully removed from coronal third of root canal, 42% of SEF successfully removed using ultrasonics under visualization of operating microscope. 73% of retained SEF cases showed good prognosis, (p <0.0001). Conclusion SEF is a multifactorial clinical problem that must be either removed, by passed to allow complete cleaning, shaping, disinfection, obturation and effective coronal seal. PMID:27134994

  5. Successful treatment of chronic periapical osteomyelitis in a Parma wallaby (Macropus parma) using comprehensive endodontic therapy with apicoectomy.

    PubMed

    Kilgallon, Conor P; Bicknese, Beth; Fagan, David A

    2010-12-01

    Although necrobacillosis remains a common condition of captive macropods, there have been limited reports of successful treatment modalities by which it can be treated. Comprehensive endodontic therapy with apicoectomy has been used reliably in human and domestic animal dentistry. This report describes a case of periapical osteomyelitis involving a mandibular incisor in a Parma wallaby (Macropus parma) that was successfully treated using these techniques in conjunction with low-level laser therapy at 810 nm, which was used for decontamination of the pulp cavity, anti-inflammatory, and biostimulatory effects. PMID:21370653

  6. Endodontic re-treatment associated with the elimination of amalgam root-end filling through sinus tracts: a report of two cases.

    PubMed

    Soares, Janir Alves; Nunes, Eduardo; Silveira, Frank Ferreira; Santos, Suelleng Maria Cunha; Oliveira, Maiolino Thomaz Fonseca

    2009-08-01

    Two patients presented with complaints of recurrent drainage of purulent exudate from sinus tracts, inflammation and pain after endodontic re-treatment of the maxillary left (Case 1) and right (Case 2) lateral incisors. The periapical lesions persisted after apical curettage, apicectomy and root-end filling with silver amalgam. Radiographic examination exposed the poor quality of the endodontic treatments and the silver amalgam root-end fillings, which were associated with periapical radiolucent areas in both teeth. The sinus tract persisted after root canal cleaning and shaping, followed by a calcium hydroxide root canal dressing. The root-end fillings were periapically dislodged with endodontic K-files, and showed progressive displacement by sinus tracts up to elimination in the oral cavity. Follow ups of 42 and 65 months post procedure revealed clinical disappearance of the symptoms, sinus tracts and exudates, and radiographs revealed that the repair process of the periapical radiolucent areas was quite advanced. PMID:19703076

  7. A new approach to the treatment of true-combined endodontic-periodontic lesions by the guided tissue regeneration technique.

    PubMed

    Tseng, C C; Harn, W M; Chen, Y H; Huang, C C; Yuan, K; Huang, P H

    1996-12-01

    Clinicians often have difficulty in the diagnosis and treatment of the combined endodontal and periodontal (endo-perio) lesion. A case of an endo-perio true-combined lesion on a maxillary premolar was first treated with conventional endodontic therapy. Periodontal surgery was then completed, which included scaling and root planing and apical curettage on the tooth. The facial bony defect was then filled with a decalcified freeze-dried bone allograft mixed with tetracycline powder. A non-resorbable Teflon membrane was then used to cover the bone material and the periodontal flap sutured over this. This combined treatment resulted in minimal probing depth (2 mm), maximal clinical attachment gain (8 mm), as well as radiographic evidence of alveolar bone gain. This case report demonstrates that proper diagnosis, followed by removal of etiological factors and utilizing the guided tissue regeneration technique combined with osseous grafting, will restore health and function to a tooth with severe attachment loss caused by an endo-perio lesion. PMID:9220758

  8. Iatrogenic Damage to the Periodontium Caused by Endodontic Treatment Procedures: An Overview

    PubMed Central

    Bhat, Aishwarya; Sirajuddin, Syed; Prabhu, Sandeep S; Chungkham, Sachidananda; Bilichodmath, Chandrasekhar

    2015-01-01

    The tooth, the pulp tissue within it and its supporting structures should be viewed as one biologic unit. The interrelationship of these structures influences each other during health, function and disease. The interrelationship between periodontal and endodontic diseases has aroused much speculation, confusion and controversy. The endodontium and periodontiumare closely related and disease or damage of one tissue may lead to the involvement of the other. PMID:26312090

  9. Safety Irradiation Parameters of Nd:YAP Laser Beam for Endodontic Treatments: An In Vitro Study

    PubMed Central

    Namour, A.; Geerts, S.; Zeinoun, T.; De Moor, R.; Nammour, S.

    2016-01-01

    Objective. Nd:YAP laser has several potentialities of clinical applications in endodontics. The aim of our study is to determine the safety range of irradiation parameters during endodontic application of Nd:YAP laser that can be used without damaging and overheating the periodontal tissue. Material and Methods. Twenty-seven caries-free single-rooted extracted human teeth were used. Crowns were sectioned to obtain 11 mm root canal length. Temperature increases at root surfaces were measured by a thermocouple during Nd:YAP laser irradiation of root canals at different energy densities. Canal irradiation was accomplished with a circular and retrograde movement from the apex until the cervical part of the canal during 10 seconds with an axial speed of 1 mm/s. Each irradiation was done in a canal irrigated continuously with 2.25% NaOCl solution. Results. Periodontal temperature increase depends on the value of energy density. Means and standard deviations of temperature increases at root surfaces were below 10°C (safe threshold level) when the average energy densities delivered per second were equal to or below 4981 J/cm2 and 9554 J/cm2, respectively, for irradiations using a fiber diameter of 320 μm and 200 μm. Conclusions. Within the limitations of this study and under specific irradiation conditions, Nd:YAP laser beam may be considered harmless for periodontal tissues during endodontic applications. PMID:27376084

  10. Safety Irradiation Parameters of Nd:YAP Laser Beam for Endodontic Treatments: An In Vitro Study.

    PubMed

    Namour, A; Geerts, S; Zeinoun, T; De Moor, R; Nammour, S

    2016-01-01

    Objective. Nd:YAP laser has several potentialities of clinical applications in endodontics. The aim of our study is to determine the safety range of irradiation parameters during endodontic application of Nd:YAP laser that can be used without damaging and overheating the periodontal tissue. Material and Methods. Twenty-seven caries-free single-rooted extracted human teeth were used. Crowns were sectioned to obtain 11 mm root canal length. Temperature increases at root surfaces were measured by a thermocouple during Nd:YAP laser irradiation of root canals at different energy densities. Canal irradiation was accomplished with a circular and retrograde movement from the apex until the cervical part of the canal during 10 seconds with an axial speed of 1 mm/s. Each irradiation was done in a canal irrigated continuously with 2.25% NaOCl solution. Results. Periodontal temperature increase depends on the value of energy density. Means and standard deviations of temperature increases at root surfaces were below 10°C (safe threshold level) when the average energy densities delivered per second were equal to or below 4981 J/cm(2) and 9554 J/cm(2), respectively, for irradiations using a fiber diameter of 320 μm and 200 μm. Conclusions. Within the limitations of this study and under specific irradiation conditions, Nd:YAP laser beam may be considered harmless for periodontal tissues during endodontic applications. PMID:27376084

  11. Endodontic classification.

    PubMed

    Morse, D R; Seltzer, S; Sinai, I; Biron, G

    1977-04-01

    Clinical and histopathologic findings are mixed in current endodontic classifications. A new system, based on symptomatology, may be more useful in clincial practice. The classifications are vital asymptomatic, hypersensitive dentin, inflamed-reversible, inflamed/dengenerating without area-irreversible, inflamed/degenerating with area-irreversible, necrotic without area, and necrotic with area. PMID:265327

  12. Lasers in endodontics: an overview

    NASA Astrophysics Data System (ADS)

    Frentzen, Matthias; Braun, Andreas; Koort, Hans J.

    2002-06-01

    The interest in endodontic use of dental laser systems is increasing. Developing laser technology and a better understanding of laser effects widened the spectrum of possible endodontic indications. Various laser systems including excimer-, argon+-, diode-, Nd:YAG-, Er:YAG- and CO2-lasers are used in pulp diagnosis, treatment of hypersensitivity, pulp capping, sterilization of root canals, root canal shaping and obturation or apicoectomy. With the development of new delivery systems - thin and flexible fibers - for many different wavelengths laser applications in endodontics may increase. Since laser devices are still relatively costly, access to them is limited. Most of the clinical applications are laser assisted procedures such as the removing of pulp remnants and debris or disinfection of infected root canals. The essential question is whether a laser can provide improved treatment over conventional care. To perform laser therapy in endodontics today different laser types with adopted wavelengths and pulse widths are needed, each specific to a particular application. Looking into the future we will need endodontic laser equipment providing optimal laser parameters for different treatment modalities. Nevertheless, the quantity of research reports from the last decade promises a genuine future for lasers in endodontics.

  13. Endodontic Microsurgical Treatment of a Three-rooted Mandibular First Molar with Separate Distolingual Root: Report of One Case.

    PubMed

    Wang, Han Guo; Xu, Ning; Yu, Qing

    2016-01-01

    The separate distolingual (DL) roots of three-rooted mandibular first molars are thought to be too difficult for performing apical surgery. This article represents microsurgical treatment of a three-rooted mandibular first molar with a separate DL root. The procedure includes incision and flap retraction, osteotomy, apicoectomy, retropreparation and retrofilling of the root canal, using micro instruments, ultrasonic retrotips and mineral trioxide aggregate (MTA) under a dental operating microscope. Two mm in length of apical root resection, 2 mm in depth of root canal retropreparation with a personalised ultrasonic retrotip, and 2 mm in length of retrofilling with MTA are the key points for accomplishment of apical surgery on separate DL roots. The case was followed up for 15 months after surgery. Clinical and radiographic examinations revealed complete healing of periapical tissue. Separate DL roots of three-rooted mandibular first molars can be treated by endodontic microsurgery with modifications from standard protocol. PMID:27622221

  14. A comparative study of four coronal obturation materials in endodontic treatment.

    PubMed

    Uranga, A; Blum, J Y; Esber, S; Parahy, E; Prado, C

    1999-03-01

    The aim of this study was to compare, in vitro, the ability of temporary versus permanent materials to seal the access cavity. Eighty human maxillary single-canal teeth were prepared biomechanically and obturated with gutta-percha and an endodontic cement AH Plus, using the warm vertical compaction technique. All access cavities were sealed with 1 of 4 materials (Cavit, Fermit, Tetric, or Dyract). Microleakage was assessed by methylene blue dye penetration. The teeth were submitted to 100 thermocycles, with temperature varying from 0 degree to 55 degrees C. The greatest degree of leakage was observed with the temporary materials (Cavit and Fermit). There was a significant difference (p < 0.05) in leakage between all materials except between Dyract and Tetric. This suggests that it may be more prudent to use a permanent restorative material for provisional restorations to prevent inadequate canal sealing and the resulting risk of fluid penetration. PMID:10321182

  15. Endodontics and the ageing patient.

    PubMed

    Johnstone, M; Parashos, P

    2015-03-01

    Patients are living longer and the rate of edentulism is decreasing. Endodontic treatment is an essential part of maintaining the health and well-being of the elderly. Retention of natural teeth improves the quality of life and the overall health and longevity of ageing patients. Also, teeth that might be otherwise extracted may be strategically valuable to retain a prosthesis, and elderly patients are more likely to have medical complications that may prevent dental extractions from being safely performed. The technical goals of endodontic treatment in the elderly are the same as those for younger patients. However, the pulpo-dentinal complex undergoes calcific changes over time, which may pose challenges for the clinician. The purposes of this review are to discuss age changes in the pulp and the challenges posed by diagnosing, treatment planning and treating the elderly endodontic patient. PMID:25762039

  16. Biofilm in endodontics: A review.

    PubMed

    Jhajharia, Kapil; Parolia, Abhishek; Shetty, K Vikram; Mehta, Lata Kiran

    2015-01-01

    Endodontic disease is a biofilm-mediated infection, and primary aim in the management of endodontic disease is the elimination of bacterial biofilm from the root canal system. The most common endodontic infection is caused by the surface-associated growth of microorganisms. It is important to apply the biofilm concept to endodontic microbiology to understand the pathogenic potential of the root canal microbiota as well as to form the basis for new approaches for disinfection. It is foremost to understand how the biofilm formed by root canal bacteria resists endodontic treatment measures. Bacterial etiology has been confirmed for common oral diseases such as caries and periodontal and endodontic infections. Bacteria causing these diseases are organized in biofilm structures, which are complex microbial communities composed of a great variety of bacteria with different ecological requirements and pathogenic potential. The biofilm community not only gives bacteria effective protection against the host's defense system but also makes them more resistant to a variety of disinfecting agents used as oral hygiene products or in the treatment of infections. Successful treatment of these diseases depends on biofilm removal as well as effective killing of biofilm bacteria. So, the fundamental to maintain oral health and prevent dental caries, gingivitis, and periodontitis is to control the oral biofilms. From these aspects, the formation of biofilms carries particular clinical significance because not only host defense mechanisms but also therapeutic efforts including chemical and mechanical antimicrobial treatment measures have the most difficult task of dealing with organisms that are gathered in a biofilm. The aim of this article was to review the mechanisms of biofilms' formation, their roles in pulpal and periapical pathosis, the different types of biofilms, the factors influencing biofilm formation, the mechanisms of their antimicrobial resistance, techniques to

  17. Biofilm in endodontics: A review

    PubMed Central

    Jhajharia, Kapil; Parolia, Abhishek; Shetty, K Vikram; Mehta, Lata Kiran

    2015-01-01

    Endodontic disease is a biofilm-mediated infection, and primary aim in the management of endodontic disease is the elimination of bacterial biofilm from the root canal system. The most common endodontic infection is caused by the surface-associated growth of microorganisms. It is important to apply the biofilm concept to endodontic microbiology to understand the pathogenic potential of the root canal microbiota as well as to form the basis for new approaches for disinfection. It is foremost to understand how the biofilm formed by root canal bacteria resists endodontic treatment measures. Bacterial etiology has been confirmed for common oral diseases such as caries and periodontal and endodontic infections. Bacteria causing these diseases are organized in biofilm structures, which are complex microbial communities composed of a great variety of bacteria with different ecological requirements and pathogenic potential. The biofilm community not only gives bacteria effective protection against the host's defense system but also makes them more resistant to a variety of disinfecting agents used as oral hygiene products or in the treatment of infections. Successful treatment of these diseases depends on biofilm removal as well as effective killing of biofilm bacteria. So, the fundamental to maintain oral health and prevent dental caries, gingivitis, and periodontitis is to control the oral biofilms. From these aspects, the formation of biofilms carries particular clinical significance because not only host defense mechanisms but also therapeutic efforts including chemical and mechanical antimicrobial treatment measures have the most difficult task of dealing with organisms that are gathered in a biofilm. The aim of this article was to review the mechanisms of biofilms’ formation, their roles in pulpal and periapical pathosis, the different types of biofilms, the factors influencing biofilm formation, the mechanisms of their antimicrobial resistance, techniques to

  18. Three-dimensional imaging modalities in endodontics

    PubMed Central

    Mao, Teresa

    2014-01-01

    Recent research in endodontics has highlighted the need for three-dimensional imaging in the clinical arena as well as in research. Three-dimensional imaging using computed tomography (CT) has been used in endodontics over the past decade. Three types of CT scans have been studied in endodontics, namely cone-beam CT, spiral CT, and peripheral quantitative CT. Contemporary endodontics places an emphasis on the use of cone-beam CT for an accurate diagnosis of parameters that cannot be visualized on a two-dimensional image. This review discusses the role of CT in endodontics, pertaining to its importance in the diagnosis of root canal anatomy, detection of peri-radicular lesions, diagnosis of trauma and resorption, presurgical assessment, and evaluation of the treatment outcome. PMID:25279337

  19. Endodontic treatment of a C-shaped mandibular second premolar with four root canals and three apical foramina: a case report

    PubMed Central

    Bertrand, Thikamphaa

    2016-01-01

    This case report describes a unique C-shaped mandibular second premolar with four canals and three apical foramina and its endodontic management with the aid of cone-beam computer tomography (CBCT). C-shaped root canal morphology with four canals was identified under a dental operating microscope. A CBCT scan was taken to evaluate the aberrant root canal anatomy and devise a better instrumentation strategy based on the anatomy. All canals were instrumented to have a 0.05 taper using 1.0 mm step-back filing with appropriate apical sizes determined from the CBCT scan images and filled using a warm vertical compaction technique. A C-shaped mandibular second premolar with multiple canals is an anatomically rare case for clinicians, yet its endodontic treatment may require a careful instrumentation strategy due to the difficulty in disinfecting the canals in the thin root area without compromising the root structure. PMID:26877993

  20. Diversity of endodontic microbiota revisited.

    PubMed

    Siqueira, J F; Rôças, I N

    2009-11-01

    Although fungi, archaea, and viruses contribute to the microbial diversity in endodontic infections, bacteria are the most common micro-organisms occurring in these infections. Datasets from culture and molecular studies, integrated here for the first time, showed that over 460 unique bacterial taxa belonging to 100 genera and 9 phyla have been identified in different types of endodontic infections. The phyla with the highest species richness were Firmicutes, Bacteroidetes, Actinobacteria, and Proteobacteria. Diversity varies significantly according to the type of infection. Overall, more taxa have been disclosed by molecular studies than by culture. Many cultivable and as-yet-uncultivated phylotypes have emerged as candidate pathogens based on detection in several studies and/or high prevalence. Now that a comprehensive inventory of the endodontic microbial taxa has been established, future research should focus on the association with different disease conditions, functional roles in the community, and susceptibility to antimicrobial treatment procedures. PMID:19828883

  1. [Desmoplastic fibroma. Differential diagnosis of a periapical lesion from endodontic failure].

    PubMed

    Zabalegui, B; Gil, J; Zabalegui, I

    1989-01-01

    Treatment of endodontically involved teeth requires accurate diagnosis of the clinical pulpal condition to determine the primary cause of pathosis. The case presented shows the differential diagnosis between a desmoplastic fibroma and a failure of a misdiagnosed endodontic treatment. The initial direction of treatment should had never been the endodontic therapy but local surgical curettage of the lesion. PMID:2638020

  2. Presence of Candida albicans in Root Canals of Teeth with Apical Periodontitis and Evaluation of their Possible Role in Failure of Endodontic Treatment

    PubMed Central

    Kumar, Jay; Sharma, Rohit; Sharma, Madhurima; Prabhavathi, V; Paul, John; Chowdary, Chava Deepak

    2015-01-01

    Background: Candidal organisms are commensals of the oral cavity and their opportunistic infection depends on the interplay of local and systemic factors. Endodontic treatment failure has been associated with the persistence of microbial flora following therapy in the root canal system, and this includes fungi like Candida, which are resistant to conventional root canal irrigants. Materials and Methods: A total of 20 mandibular molars were included in the study of which 15 were primary randomized controlled trial cases, whereas 5 were retreatment cases. The patient’s saliva, as well as the root canal flora, were examined for the presence of Candida organisms and further confirmed for the presence of Candida albicans. Results: Of the 20 samples comprising the study group, the saliva culture revealed 11 of them to have a colony forming unit (CFU) >400 and 9 of the 20 canals microbiology showed CFU >400. Among the 15 first-time root canal treatment cases, saliva examination these revealed 8 of them to have CFU >400 and the canal microbiology of these showed 6 of them to have CFU >400. Among the retreatment cases, 3 of the 5 cases showed CFU >400 in both the saliva DN canal culture. Conclusion: Candidal contamination of the root canals could be the cause of endodontic treatment failure and thus emphasizes the importance of rubber dam isolation and the use of irrigants with antifungal properties for sufficient duration during treatment. PMID:25859106

  3. Applicability of bacterial cellulose as an alternative to paper points in endodontic treatment.

    PubMed

    Yoshino, Aya; Tabuchi, Mari; Uo, Motohiro; Tatsumi, Hiroto; Hideshima, Katsumi; Kondo, Seiji; Sekine, Joji

    2013-04-01

    Dental root canal treatment is required when dental caries progress to infection of the dental pulp. A major goal of this treatment is to provide complete decontamination of the dental root canal system. However, the morphology of dental root canal systems is complex, and many human dental roots have inaccessible areas. In addition, dental reinfection is fairly common. In conventional treatment, a cotton pellet and paper point made from plant cellulose is used to dry and sterilize the dental root canal. Such sterilization requires a treatment material with high absorbency to remove any residue, the ability to improve the efficacy of intracanal medication and high biocompatibility. Bacterial cellulose (BC) is produced by certain strains of bacteria. In this study, we developed BC in a pointed form and evaluated its applicability as a novel material for dental canal treatment with regard to solution absorption, expansion, tensile strength, drug release and biocompatibility. We found that BC has excellent material and biological characteristics compared with conventional materials, such as paper points (plant cellulose). BC showed noticeably higher absorption and expansion than paper points, and maintained a high tensile strength even when wet. The cumulative release of a model drug was significantly greater from BC than from paper points, and BC showed greater compatibility than paper points. Taken together, BC has great potential for use in dental root canal treatment. PMID:23268234

  4. Advances in endodontics: Potential applications in clinical practice

    PubMed Central

    Kishen, Anil; Peters, Ove A.; Zehnder, Matthias; Diogenes, Anibal R.; Nair, Madhu K.

    2016-01-01

    Contemporary endodontics has seen an unprecedented advance in technology and materials. This article aimed to review some of the challenges and advances in the following sections: (1) endodontic imaging, (2) root canal preparation, (3) root canal disinfection, (4) root canal filling, and (4) regenerative endodontic procedures (REPs). Jointly, these advances are aimed at improving the state of the art and science of root canal treatment. PMID:27217630

  5. Advances in endodontics: Potential applications in clinical practice.

    PubMed

    Kishen, Anil; Peters, Ove A; Zehnder, Matthias; Diogenes, Anibal R; Nair, Madhu K

    2016-01-01

    Contemporary endodontics has seen an unprecedented advance in technology and materials. This article aimed to review some of the challenges and advances in the following sections: (1) endodontic imaging, (2) root canal preparation, (3) root canal disinfection, (4) root canal filling, and (4) regenerative endodontic procedures (REPs). Jointly, these advances are aimed at improving the state of the art and science of root canal treatment. PMID:27217630

  6. Rethinking root canal treatment: understanding the difference between preventing and treating endodontic infection.

    PubMed

    El-Ma'aita, A M; Qualtrough, A J E; Darcey, J; Hunter, M J

    2015-07-10

    Root canal treatment is a frequently performed procedure aimed to address pulpal and peri-radicular disease. It comprises a number of clinical steps regardless of the initial diagnosis. The emphasis of each step varies according to whether there is a vital pulp (non-infected) or if the pulp system contains necrotic, infected tissue and there is peri-apical pathology. This article aims to discuss the differences in performing root canal treatments on teeth with vital and non-vital pulps. The reader should understand the differences between performing a root canal treatment in teeth with vital pulps and those with infected root canal spaces and peri-radicular pathology. PMID:26159976

  7. Regenerative endodontics--Creating new horizons.

    PubMed

    Dhillon, Harnoor; Kaushik, Mamta; Sharma, Roshni

    2016-05-01

    Trauma to the dental pulp, physical or microbiologic, can lead to inflammation of the pulp followed by necrosis. The current treatment modality for such cases is non-surgical root canal treatment. The damaged tissue is extirpated and the root canal system prepared. It is then obturated with an inert material such a gutta percha. In spite of advances in techniques and materials, 10%-15% of the cases may end in failure of treatment. Regenerative endodontics combines principles of endodontics, cell biology, and tissue engineering to provide an ideal treatment for inflamed and necrotic pulp. It utilizes mesenchymal stem cells, growth factors, and organ tissue culture to provide treatment. Potential treatment modalities include induction of blood clot for pulp revascularization, scaffold aided regeneration, and pulp implantation. Although in its infancy, successful treatment of damaged pulp tissue has been performed using principles of regenerative endodontics. This field is dynamic and exciting with the ability to shape the future of endodontics. This article highlights the fundamental concepts, protocol for treatment, and possible avenues for research in regenerative endodontics. PMID:26699211

  8. Clinical evaluation of 3 Mix and Other Mix in non-instrumental endodontic treatment of necrosed primary teeth

    PubMed Central

    Nanda, Rishi; Koul, Monika; Srivastava, Salil; Upadhyay, Vinod; Dwivedi, Rahul

    2014-01-01

    Problem considered The objective was to evaluate and compare the clinical and radiographic efficacy of two different combinations of antibacterial drugs when used in non-instrumental endodontic treatment of necrosed primary teeth. Materials and method Forty teeth were randomly divided into two groups, viz. groups A and B having 20 teeth each. In Group A, 3 Mix (ciprofloxacin, metronidazole, and minocycline) and in Group B, Other Mix (ciprofloxacin, ornidazole, and minocycline) mixed with propylene glycol were used. Medication cavities of Group-A and B were filled with 3 Mix and Other Mix respectively followed by restoration of teeth. Clinical evaluation was done at 3 months whereas, clinical and radiographic evaluation was done at 6 and 12 months, respectively. Results Both the groups showed 100% clinical success whereas, radiographic success rate was 81% with 3 Mix and 92% with Other Mix but, was not statistically significant. Conclusions Both the antibacterial pastes can be used effectively in non instrumental endodontic treatment of necrosed primary teeth and require more clinical trials to prove its efficacy. PMID:25737928

  9. Microleakage in endodontics.

    PubMed

    Muliyar, Sabir; Shameem, K Abdul; Thankachan, Rekha P; Francis, P G; Jayapalan, C S; Hafiz, K A Abdul

    2014-01-01

    A three-dimensional obturation and complete coronal and apical seal is one the important aims of root canal treatment. Since microorganisms may remain in the root canal system after instrumentation, a tight apical seal is desired to prevent bacteria and their by-products from invading the apex. A perfect apical seal is also desired to prevent apical percolation. One of the major objectives of tooth restoration is the protection of exposed dentine against bacteria and their toxins. The interface between the restoration and dental hard tissue is an area of clinical concern as insufficient sealing can result in marginal discoloration, secondary caries, and pulpitis. For that reason, adequate sealing is essential for the optimal clinical performance Prevention of microleakage in endodontically treated teeth is most important for patients who rely on the combined expertise and quality care of dentist/endodontist colleagues. Microleakage is arguably the single most important risk factor for apical periodontitis. PMID:25628496

  10. Microleakage in Endodontics

    PubMed Central

    Muliyar, Sabir; Shameem, K Abdul; Thankachan, Rekha P; Francis, P G; Jayapalan, C S; Hafiz, K A Abdul

    2014-01-01

    A three-dimensional obturation and complete coronal and apical seal is one the important aims of root canal treatment. Since microorganisms may remain in the root canal system after instrumentation, a tight apical seal is desired to prevent bacteria and their by-products from invading the apex. A perfect apical seal is also desired to prevent apical percolation. One of the major objectives of tooth restoration is the protection of exposed dentine against bacteria and their toxins. The interface between the restoration and dental hard tissue is an area of clinical concern as insufficient sealing can result in marginal discoloration, secondary caries, and pulpitis. For that reason, adequate sealing is essential for the optimal clinical performance Prevention of microleakage in endodontically treated teeth is most important for patients who rely on the combined expertise and quality care of dentist/endodontist colleagues. Microleakage is arguably the single most important risk factor for apical periodontitis. PMID:25628496

  11. Postoperative Pain after Endodontic Treatment of Asymptomatic Teeth Using Rotary Instruments: A Randomized Clinical Trial

    PubMed Central

    Shahi, Shahriar; Asghari, Vahideh; Rahimi, Saeed; Lotfi, Mehrdad; Samiei, Mohammad; Yavari, Hamidreza; Shakouie, Sahar; Nezafati, Saeed

    2016-01-01

    Introduction: The aim of the present study was to compare the effect of two different rotary instruments on postoperative pain in teeth with asymptomatic irreversible pulpitis. Methods and Materials: A total of 78 mandibular first and second molars were divided into two groups (n=39) and their root canal preparation was carried out with either RaCe or ProTaper rotary instruments. All the subjects underwent one-visit root canal treatment and the severity of postoperative pain was evaluated using visual analog scale (VAS) at 4-, 12-, 24-, 48- and 72-h and 1-week intervals. In addition, the need for taking analgesics was recorded. Data were analyzed with the repeated-measures ANOVA and the Mann-Whitney U test was used for two-by-two comparison. Statistical significance was set at 0.05. Results: Comparison of mean pain severity between the two groups at various postoperative intervals did not reveal any significant differences (P=0.10). The difference in amount of analgesics taken by each groups was not statistically significant (P=0.25). Conclusion: There were no significant differences in the postoperative pain reported between the two groups; which indicates the clinical acceptability of both systems. PMID:26843876

  12. Post endodontic Aspergillosis in an immunocompetent individual

    PubMed Central

    Urs, Aadithya B.; Nunia, Kalpana; Mohanty, Sujata; Gupta, Shalini

    2015-01-01

    Non-invasive aspergillosis in immunocompetent individuals subsequent to post endodontic treatment can involve the maxillary antrum. An early and accurate diagnosis will aid in prompt and effective treatment. A 35 year old female patient reported with a painful nasomaxillary swelling. Previous records revealed the failure of the endodontic treatment of maxillary left second premolar which was subsequently extracted. Root piece was accidently left behind which resulted in a painful nasomaxillary swelling. The extraction socket was curetted and tissue was sent for histopathological examination, which revealed abundant septate fungal hyphae with numerous spores characteristic of Aspergillus. The patient showed marked improvement in the symptoms with systemic itraconazole at 3 months follow up and complete resolution occurred within 6 months. Inclusion of aspergilloma infections in the differential diagnosis is advocated when patients present with post-endodontic nasomaxillary swelling. Key words:Aspergillosis, fungal sinusitis, post root canal treatment. PMID:26535103

  13. [Theory and practice of minimally invasive endodontics].

    PubMed

    Jiang, H W

    2016-08-01

    The primary goal of modern endodontic therapy is to achieve the long-term retention of a functional tooth by preventing or treating pulpitis or apical periodontitis is. The long-term retention of endodontically treated tooth is correlated with the remaining amount of tooth tissue and the quality of the restoration after root canal filling. In recent years, there has been rapid progress and development in the basic research of endodontic biology, instrument and applied materials, making treatment procedures safer, more accurate, and more efficient. Thus, minimally invasive endodontics(MIE)has received increasing attention at present. MIE aims to preserve the maximum of tooth structure during root canal therapy, and the concept covers the whole process of diagnosis and treatment of teeth. This review article focuses on describing the minimally invasive concepts and operating essentials in endodontics, from diagnosis and treatment planning to the access opening, pulp cavity finishing, root canal cleaning and shaping, 3-dimensional root canal filling and restoration after root canal treatment. PMID:27511034

  14. Endodontic-periodontal microsurgery for combined endodontic-periodontal lesions: An overview

    PubMed Central

    Sharma, Ritu; Hegde, Vivek; Siddharth, M; Hegde, Rashmi; Manchanda, Gunsha; Agarwal, Pratul

    2014-01-01

    Endodontic and periodontal microsurgery has surpassed the success rates for traditional endodontic and periodontal surgical procedures. Excellent healing results are being attributed to both the techniques, when employed, for isolated endodontic or periodontal defects. Combined endodontic-periodontal lesions have been referred to as a true challenge, requiring not only endodontic microsurgical management but also concurrent bone grafting and membrane barriers techniques. The prevention of epithelial downgrowth and regeneration of periodontal cementum, fiber, and bone seals the fate of these cases. Achieving primary closure with submergence of grafts has a positive effect on GTR outcome. New techniques of periodontal microsurgery, such as minimally invasive papilla preserving flaps with passive internal mattress suturing, have managed to obtain 90% primary flap closure over grafted sites. Root surface treatment and conditioning has also shown to be beneficial for GTR. Endodontic microsurgery for the combined lesion has not integrated these advances yet. These advances, along with a recently suggested treatment strategy, are ushering in the level next in management of the combined lesions. This article offers an overview of the combined lesion, the disease, its classification, treatment strategy, regenerative tools, microsurgical recommendations, and outcome studies. PMID:25506135

  15. Undergraduate endodontic education: what are the challenges?

    PubMed

    Qualtrough, A J E

    2014-03-01

    To deliver the knowledge and skills required to equip undergraduate students for practice is a significant responsibility; graduates must be familiar with the diagnosis and treatment of pulpal and periradicular diseases and the preservation and restoration of pulpally compromised teeth. A greater understanding of the microbiological processes involved in endodontics and developments in instruments and materials have transformed our approaches to root canal treatment. Information technology has revolutionised certain aspects of education and has had an effect on endodontic teaching. Dental graduates will be expected to treat an increasingly elderly population and will enter a climate in which remuneration for root canal treatment could have a significant effect on the number of cases treated and the pattern of referral. Teachers of endodontics at the majority of dental schools are taxed by competing demands for time in packed curricula, a lack of availability of natural teeth for classroom exercise and a lack of suitable patients. The debate as to whether endodontics should be a specialist subject in its own right has rumbled on for three decades. Compared with the situation in the 1970s, there are now well defined curricula guidelines to which those involved in teaching can refer and map teaching in their schools against agreed norms. These create the potential for students to graduate with the knowledge and skills at a sound level of competence to carry out endodontic procedures and with a deeply engrained understanding of the need for continuing professional development. PMID:24651348

  16. Endodontic radiography.

    PubMed

    Nixon, P P; Robinson, P B

    1997-05-01

    The ability to take radiographs of good diagnostic quality is an essential prerequisite for successful root canal therapy. However, the operator also has a responsibility to limit the radiation dose to the patient. This article reviews the radiography required for root canal treatment with these criteria in mind. PMID:9515363

  17. Synchronized delivery of Er:YAG-laser pulses into water studied by a laser beam transmission probe for enhanced endodontic treatment

    NASA Astrophysics Data System (ADS)

    Gregorčič, P.; Lukač, N.; Možina, J.; Jezeršek, M.

    2016-04-01

    We examine the effects of the synchronized delivery of multiple Er:YAG-laser pulses during vapor-bubble oscillations into water. For this purpose, we used a laser beam transmission probe that enables monitoring of the bubble's dynamics from a single shot. To overcome the main drawbacks of this technique, we propose and develop an appropriate and robust calibration by simultaneous employment of shadow photography. By using the developed experimental method, we show that the resonance effect is obtained when the second laser pulse is delivered at the end or slightly after the first bubble's collapse. In this case, the resonance effect increases the mechanical energy of the secondary bubble's oscillations and prolongs their duration. The presented laser method for synchronized delivery of Er:YAG-laser pulses during bubble oscillations has great potential for further improvement of laser endodontic treatment, especially upon their safety and efficiency.

  18. Current overview on challenges in regenerative endodontics

    PubMed Central

    Bansal, Ramta; Jain, Aditya; Mittal, Sunandan

    2015-01-01

    Introduction: Regenerative endodontics provides hope of converting the non-vital tooth into vital once again. It focuses on substituting traumatized and pathological pulp with functional pulp tissue. Current regenerative procedures successfully produce root development but still fail to re-establish real pulp tissue and give unpredictable results. There are several drawbacks that need to be addressed to improve the quality and efficiency of the treatment. Aim: The aim of this review article is to discuss major priorities that ought to be dealt before applications of regenerative endodontics flourish the clinical practice. Materials and Methods: A web-based research on MEDLINE was done using filter terms Review, published in the last 10 years and Dental journals. Keywords used for research were “regenerative endodontics,” “dental stem cells,” “growth factor regeneration,” “scaffolds,” and “challenges in regeneration.” This review article screened about 150 articles and then the relevant information was compiled. Results: Inspite of the impressive growth in regenerative endodontic field, there are certain loopholes in the existing treatment protocols that might sometimes result in undesired and unpredictable outcomes. Conclusion: Considerable research and development efforts are required to improve and update existing regenerative endodontic strategies to make it an effective, safe, and biological mode to save teeth. PMID:25657518

  19. [Endodontics in motion: new concepts, materials and techniques 3. The role of irrigants during root canal treatment].

    PubMed

    van der Sluis, L W M

    2015-10-01

    The aims of root canal irrigation are the chemical dissolution or disruption and the mechanical detachment of pulp tissue, dentin debris and smear layer (instrumentation products), microorganisms (planktonic or biofilm) and their products from the root canal wall, their removal out of the root canal system and their chemical dissolution or disruption. Each of the endodontic irrigation systems has its own irrigant flow characteristics, which should fulfill these aims. Without flow (convection), the irrigant would have to be distributed through diffusion. This process is slow and depends on temperature and concentration gradients. On the other hand, convection is a faster and more efficient transport mechanism. During irrigant flow, frictional forces will occur, for example between the irrigant and the root canal wall (wall shear stress). These frictional forces have a mechanical cleaning effect on the root canal wall. These frictional forces are the result of the flow characteristics related to the different irrigation systems. PMID:26465016

  20. Pulsed Nd-YAG laser in endodontics

    NASA Astrophysics Data System (ADS)

    Ragot-Roy, Brigitte; Severin, Claude; Maquin, Michel

    1994-12-01

    The purpose of this study was to establish an operative method in endodontics. The effect of a pulsed Nd:YAG laser on root canal dentin has been examined with a scanning electron microscope. Our first experimentation was to observe the impacts carried out perpendicularly to root canal surface with a 200 micrometers fiber optic in the presence of dye. Secondarily, the optical fiber was used as an endodontic instrument with black dye. The irradiation was performed after root canal preparation (15/100 file or 40/100 file) or directly into the canal. Adverse effects are observed. The results show that laser irradiation on root canal dentin surfaces induces a nonhomogeneous modified dentin layer, melted and resolidified dentin closed partially dentinal tubules. The removal of debris is not efficient enough. The laser treatment seems to be indicated only for endodontic and periapical spaces sterilization after conventional root canal preparation.

  1. Natural Therapeutic Options in Endodontics - A Review

    PubMed Central

    Venkateshbabu, Nagendrababu; Anand, Suresh; Abarajithan, Mohan; Sheriff, Sultan O.; Jacob, Pulikkotil S.; Sonia, Nath

    2016-01-01

    Complete eradication of microbial biofilms and elimination of the smear layer are the key factors during endodontic treatment. Various chemical irrigants have been proposed in the literature for the same. The major setback with these chemical irrigants is that they are not bio-friendly to the dental and peri-radicular tissues. In the recent years, research to use natural products for root canal disinfection has gained importance. The aim of this article is to compile various herbal products that have been used as an irrigants and intracanal medicaments in the field of Endodontics to eradicate the biofilm and remove smear layer. PMID:27386007

  2. Natural Therapeutic Options in Endodontics - A Review.

    PubMed

    Venkateshbabu, Nagendrababu; Anand, Suresh; Abarajithan, Mohan; Sheriff, Sultan O; Jacob, Pulikkotil S; Sonia, Nath

    2016-01-01

    Complete eradication of microbial biofilms and elimination of the smear layer are the key factors during endodontic treatment. Various chemical irrigants have been proposed in the literature for the same. The major setback with these chemical irrigants is that they are not bio-friendly to the dental and peri-radicular tissues. In the recent years, research to use natural products for root canal disinfection has gained importance. The aim of this article is to compile various herbal products that have been used as an irrigants and intracanal medicaments in the field of Endodontics to eradicate the biofilm and remove smear layer. PMID:27386007

  3. Comparison of Endodontic Treatment Results Yielded from Using Normal Saline with IKI Final Rinse or NaOCl Irrigation: A 30-Month Follow-up Study

    PubMed Central

    Abbaszadegan, Abbas; Nabavizadeh, Mohammadreza; Hoseini Yekani, Ameneh; Khayat, Akbar

    2013-01-01

    Introduction The aim of this clinical trial was to evaluate and compare the endodontic treatment results of teeth with apical periodontitis after thirty-month recall with two different irrigation regimen: normal saline followed by Iodine Potassium Iodide (IKI) or sodium hypochlorite (NaOCl) irrigation alone. Materials and Methods Twenty seven patients (30 teeth) who had been included in the first part of our antimicrobial survey were recalled. In previous stage, root canal treatments were performed using either normal saline with IKI final rinse (n = 15) or NaOCl (n = 15) as irrigating solutions. Bacterial samples were taken before and after instrumentation. In this stage, three patients (6 teeth) were excluded from the follow-up schedule since they did not respond to the recall requests. The remaining 24 subjects (12 teeth in each NaOCl and IKI group) were examined clinically and radiologically. Post-operative and follow-up images were coded, blindly evaluated and given a periapical score according to PAI scoring system. The outcome was assessed in two ways; first, the changes in PAI score from base line to the follow-up evaluation in each group were assessed by wilcoxon signed rank test. In addition, Mann-Whitney U test was used to compare the differences between the post-operative and follow-up images of treatment groups. Second, the dichotomous variables as “healed” or “not healed” were compared. Results The Median (Min, Max) PAI scores for NaOCl group and IKI group were both 5 (3, 5) for immediate post-operative radiographs and declined to 1 (1, 2) and 2 (1, 2), respectively. A statistically significant decrease in PAI score from the base line to the follow-up evaluation was seen in both groups (P = 0.002). The decrease in NaOCl group was higher significantly in comparison to IKI group (P = 0.036). One hundred percent of the teeth were healed in both groups (PAI ≤ 2) and no teeth showed any abnormal clinical findings. Conclusion Root canal irrigation

  4. Preclinical endodontic teaching

    PubMed Central

    Narayanaraopeta, Udaya; AlShwaimi, Emad

    2015-01-01

    Objectives: To provide an overview of the general curricula in preclinical endodontic training from 6 established dental schools in Saudi Arabia. Methods: This study was conducted in January 2014 including only schools that had more than 2 groups of student graduates prior to the study. We included 2 dental schools from the Central region, one from Qassim region, one from the Makkah region (west), one from Abha region (south west), and one from the eastern region. An internet-based questionnaire was sent to the course directors of preclinical endodontics department of the 6 schools. The survey comprised 20 questions that examined various aspects of preclinical endodontics. Results: It was demonstrated that a significant number of faculty members had Doctor of Philosophy (PhD) degrees (n=21), Master’s degrees (n=15), and Saudi board certifications (n=8). We determined that the faculty to student ratio varied from 2:1 to 8: 1 among the colleges. The participating dental schools were found to teach the Step Back, as well as the Step Down techniques for root canal preparation. Five of the 6 schools implemented the use of nickel titanium rotary instruments. All dental schools predominantly used radiographs as the means of the working length determination. Conclusion: The curriculum for preclinical endodontics in Saudi Arabia is comparable to that followed in most European countries. A more comprehensive survey is needed that would involve more schools to formulate generalized guidelines for preclinical endodontic training in Saudi Arabia. PMID:25630011

  5. Endodontic treatment of the mandibular first molar with six roots canals - two case reports and literature review.

    PubMed

    Martins, Jorge N R; Anderson, Craig

    2015-04-01

    The most common configuration of the mandibular first molar is the presence of two roots and three root canals. The objective of this work is to present two rare anatomic configurations with six root canals on two mandibular left first molars diagnosed during endodontic therapy. Root canal therapy was performed using a dental operating microscope. Ultrasonic troughing in the grooves in between the mesial root canals and in between the distal root canals was able to show the middle root canals. Large samples population characterization researches and systematic reviews were unable to detect a single case of six root canals configuration in a mandibular first molar in their investigations. Although it is a rare configuration, a six root canal configuration is possible to be found in the mandibular first molar. Three different pulp chamber configurations are possible to be found. Two or three roots may be present and the root configuration more common in the mesial root is the Type 8 and Type 12 for the distal root. Some concepts about the required technique to approach these cases are also debated. PMID:26023651

  6. Endodontic Treatment of the Mandibular First Molar with Six Roots Canals – Two Case Reports and Literature Review

    PubMed Central

    Anderson, Craig

    2015-01-01

    The most common configuration of the mandibular first molar is the presence of two roots and three root canals. The objective of this work is to present two rare anatomic configurations with six root canals on two mandibular left first molars diagnosed during endodontic therapy. Root canal therapy was performed using a dental operating microscope. Ultrasonic troughing in the grooves in between the mesial root canals and in between the distal root canals was able to show the middle root canals. Large samples population characterization researches and systematic reviews were unable to detect a single case of six root canals configuration in a mandibular first molar in their investigations. Although it is a rare configuration, a six root canal configuration is possible to be found in the mandibular first molar. Three different pulp chamber configurations are possible to be found. Two or three roots may be present and the root configuration more common in the mesial root is the Type 8 and Type 12 for the distal root. Some concepts about the required technique to approach these cases are also debated. PMID:26023651

  7. [The application of laser in endodontics].

    PubMed

    He, W X; Liu, N N; Wang, X L; He, X Y

    2016-08-01

    Since laser was introduced in the field of medicine in 1970's, its application range has continuously expanded. The application of laser in endodontics also increased due to its safety and effectiveness in dental treatments. The majority of the laser application researches in dentistry focused on dentin hypersensitivity, removal of carious tissues, tooth preparations, pulp capping or pulpotomy, and root canal treatment. In this article, we reviewed literature on the effects of laser in the treatments of dental and pulp diseases. PMID:27511037

  8. Management of an Endodontic-Periodontal Lesion in a Maxillary Lateral Incisor with Palatal Radicular Groove: A Case Report

    PubMed Central

    Sooratgar, Aidin; Tabrizizade, Mehdi; Nourelahi, Maryam; Asadi, Yasin; Sooratgar, Hosein

    2016-01-01

    The radicular groove is a developmental anomaly that predisposes the tooth to periodontal break-down. Sometimes the situation becomes more complicated by pulp necrosis and development of a combined endodontic-periodontal lesion which is a diagnostic and treatment challenge for the clinician. This report presents the successful management of an endodontic-periodontal lesion in a maxillary lateral incisor that has a developmental palatal radicular groove using a combination of nonsurgical endodontic therapy and periodontal regenerative techniques. Conclusion: The combination of nonsurgical endodontic and periodontal regenerative treatment is a predictable method in treating combined endodontic-periodontal lesions caused by palato-gingival groove. PMID:27141225

  9. Role of provisional restorations in endodontic therapy

    PubMed Central

    Sivakumar, Jambai Sampathkumar; Suresh Kumar, Beri Narasimiah; Shyamala, Palaniyandi Vadivel

    2013-01-01

    Root-canal treatment can be carried out in single visit in vital, non-infected teeth, eliminating the need for dressing and provisionalization. Many clinical cases with infected canals require dressing with antibacterial medicaments in a multivisit treatment in which effective provisionalization for different periods of time becomes mandatory. Successful root-canal treatment requires effective mechanical and chemical debridement, elimination of bacteria and pulp tissue remnants and proper canal shaping to facilitate effective obturation. Lack of satisfactory temporary restorations during endodontic therapy ranked second amongst the contributing factors in continuing pain after the commencement of treatment. This review aims to provide an overview of the materials used for provisionalization during and immediately after endodontic treatment. PMID:23946564

  10. Ultrasonics in endodontic surgery: a review of the literature.

    PubMed

    De Paolis, Gianfranco; Vincenti, Valentina; Prencipe, Matteo; Milana, Valerio; Plotino, Gianluca

    2010-04-01

    Currently, although ultrasonics (US) is used in dentistry for therapeutic and diagnostic applications as well as for cleaning of instruments before sterilization, its main use is for scaling and root planing of teeth and in root canal therapy, both for orthograde and retrograde therapy. Both in conventional and surgical treatments, US in endodontics has enhanced quality of clinical procedures and represents an important adjunct in the treatment of difficult cases. More precisely it has become increasingly more useful in applications such as gaining access to canal openings, cleaning and shaping, obturation of root canals, removal of intracanal materials and obstructions, and endodontic surgery. This review of the literature aims at presenting the numerous advantages of US in surgical endodontics and emphasizes its application in a modern-day endodontic practice. PMID:22238704

  11. Ultrasonics in endodontic surgery: a review of the literature

    PubMed Central

    De Paolis, Gianfranco; Vincenti, Valentina; Prencipe, Matteo; Milana, Valerio; Plotino, Gianluca

    2010-01-01

    Summary Currently, although ultrasonics (US) is used in dentistry for therapeutic and diagnostic applications as well as for cleaning of instruments before sterilization, its main use is for scaling and root planing of teeth and in root canal therapy, both for orthograde and retrograde therapy. Both in conventional and surgical treatments, US in endodontics has enhanced quality of clinical procedures and represents an important adjunct in the treatment of difficult cases. More precisely it has become increasingly more useful in applications such as gaining access to canal openings, cleaning and shaping, obturation of root canals, removal of intracanal materials and obstructions, and endodontic surgery. This review of the literature aims at presenting the numerous advantages of US in surgical endodontics and emphasizes its application in a modern-day endodontic practice. PMID:22238704

  12. Use of Cone Beam Computed Tomography in Endodontics

    PubMed Central

    Scarfe, William C.; Levin, Martin D.; Gane, David; Farman, Allan G.

    2009-01-01

    Cone Beam Computed Tomography (CBCT) is a diagnostic imaging modality that provides high-quality, accurate three-dimensional (3D) representations of the osseous elements of the maxillofacial skeleton. CBCT systems are available that provide small field of view images at low dose with sufficient spatial resolution for applications in endodontic diagnosis, treatment guidance, and posttreatment evaluation. This article provides a literature review and pictorial demonstration of CBCT as an imaging adjunct for endodontics. PMID:20379362

  13. [Overall digitalization: leading innovation of endodontics in big data era].

    PubMed

    Ling, J Q

    2016-04-01

    In big data era, digital technologies bring great challenges and opportunities to modern stomatology. The applications of digital technologies, such as cone-beam CT(CBCT), computer aided design,(CAD)and computer aided manufacture(CAM), 3D printing and digital approaches for education , provide new concepts and patterns to the treatment and study of endodontic diseases. This review provides an overview of the application and prospect of commonly used digital technologies in the development of endodontics. PMID:27117212

  14. Comparison of Long-term Survival of Implants and Endodontically Treated Teeth

    PubMed Central

    Setzer, F.C.; Kim, S.

    2014-01-01

    The outcomes of both dental implants and endodontically treated teeth have been extensively studied. However, there is still a great controversy over when to keep a natural tooth and when to extract it for a dental implant. This article reviews the benefits and disadvantages of both treatment options and discusses success vs. survival outcomes, as well as the impact of technical advances for modern endodontics and endodontic microsurgery on the long-term prognosis of tooth retention. PMID:24065635

  15. Antimicrobial Activity of Calcium Hydroxide in Endodontics: A Review

    PubMed Central

    Shalavi, S; Yazdizadeh, M

    2012-01-01

    The purpose of endodontic therapy is to preserve the patient's natural teeth without compromising the patient's local or systemic health. Calcium hydroxide has been included in several materials and antimicrobial formulations that are used in several treatment modalities in endodontics, such as inter-appointment intracanal medicaments. The purpose of this article was to review the antimicrobial properties of calcium hydroxide in endodontics. Calcium hydroxide has a high pH (approximately 12.5-12.8) and is classified chemically as a strong base. The lethal effects of calcium hydroxide on bacterial cells are probably due to protein denaturation and damage to DNA and cytoplasmic membranes. Calcium hydroxide has a wide range of antimicrobial activity against common endodontic pathogens but is less effective against Enterococcus faecalis and Candida albicans. Calcium hydroxide is also a valuable anti-endotoxin agent. However, its effect on microbial biofilms is controversial. PMID:23323217

  16. Outcomes of endodontic therapy in general practice

    PubMed Central

    Bernstein, Susan D.; Horowitz, Allan J.; Man, Martin; Wu, Hongyu; Foran, Denise; Vena, Donald A.; Collie, Damon; Matthews, Abigail G.; Curro, Frederick A.; Thompson, Van P.; Craig, Ronald G.

    2014-01-01

    Background The authors undertook a study involving members of a dental practice-based research network to determine the outcome and factors associated with success and failure of endodontic therapy. Methods Members in participating practices (practitioner-investigators [P-Is]) invited the enrollment of all patients seeking treatment in the practice who had undergone primary endodontic therapy and restoration in a permanent tooth three to five years previously. If a patient had more than one tooth so treated, the P-I selected as the index tooth the tooth treated earliest during the three- to five-year period. The authors excluded from the study any teeth that served as abutments for removable partial dentures or overdentures, third molars and teeth undergoing active orthodontic endodontic therapy. The primary outcome was retention of the index tooth. Secondary outcomes, in addition to extraction, that defined failure included clinical or radiographic evidence (or both) of periapical pathosis, endodontic retreatment or pain on percussion. Results P-Is in 64 network practices enrolled 1,312 patients with a mean (standard deviation) time to follow-up of 3.9 (0.6) years. During that period, 3.3 percent of the index teeth were extracted, 2.2 percent underwent retreatment, 3.6 percent had pain on percussion and 10.6 percent had periapical radiolucencies for a combined failure rate of 19.1 percent. The presence of preoperative periapical radiolucency with a diagnosis of either irreversible pulpitis or necrotic pulp was associated with failure after multivariate analysis, as were multiple canals, male sex and Hispanic/Latino ethnicity. Conclusions These results suggest that failure rates for endodontic therapy are higher than previously reported in general practices, according to results of studies based on dental insurance claims data. Clinical Implications The results of this study can help guide the practitioner in deciding the most appropriate course of therapy for

  17. Chlorhexidine in endodontics.

    PubMed

    Gomes, Brenda P F A; Vianna, Morgana E; Zaia, Alexandre A; Almeida, José Flávio A; Souza-Filho, Francisco J; Ferraz, Caio C R

    2013-01-01

    Chemical auxiliary substances (CAS) are essential for a successful disinfection and cleanness of the root canals, being used during the instrumentation and if necessary, as antimicrobial intracanal medicaments. Different CAS have been proposed and used, among which sodium hypochlorite (NaOCl), chlorhexidine (CHX), 17% EDTA, citric acid, MTAD and 37% phosphoric acid solution. CHX has been used in Endodontics as an irrigating substance or intracanal medicament, as it possesses a wide range of antimicrobial activity, substantivity (residual antimicrobial activity), lower cytotoxicity than NaOCl whilst demonstrating efficient clinical performance, lubricating properties, rheological action (present in the gel presentation, keeping the debris in suspension); it inhibits metalloproteinase, is chemically stable, does not stain cloths, it is odorless, water soluble, among other properties. CHX has been recommended as an alternative to NaOCl, especially in cases of open apex, root resorption, foramen enlargement and root perforation, due to its biocompatibility, or in cases of allergy related to bleaching solutions. The aim of this paper is to review CHX's general use in the medical field and in dentistry; its chemical structure, presentation form and storage; mechanism of action; antimicrobial activity including substantivity, effects on biofilms and endotoxins, effects on coronal and apical microbial microleakage; tissue dissolution ability; interaction with endodontic irrigants; effects on dentin bonding, metalloproteinases and collagen fibrils; its use as intracanal medicament and diffusion into the dentinal tubules; its use as disinfectant agent of obturation cones; other uses in the endodontic therapy; and possible adverse effects, cytotoxicity and genotoxicity. PMID:23780357

  18. Chloroform in the endodontic operatory

    SciTech Connect

    McDonald, M.N.; Vire, D.E. )

    1992-06-01

    This article reviews the role chloroform has played in dentistry and describes an occupational health clinical investigation into the possible hazards of chloroform use in the operatory. Due to a Food and Drug Administration ban on drugs and cosmetics containing chloroform, there has been some confusion as to whether the use of chloroform in the practice of dentistry is considered unsafe or has been prohibited. Utilizing common endodontic treatment methods employing chloroform, this study reports no negative health effects to the dentist or assistant and air vapor levels well below Occupational Health and Safety Administration mandated maximum levels. The report concludes that, with careful and controlled use, chloroform can be a useful adjunct in the practice of dentistry. The Food and Drug Administration has no jurisdiction over a dentist's use of chloroform in clinical practice and has not proven that chloroform is a human carcinogen.

  19. Experimental model: dye penetration of extensive interim restorations used during endodontic treatment while under load in a multiple axis chewing simulator.

    PubMed

    Jensen, Arna-Lee; Abbott, Paul V

    2007-10-01

    The purpose of this study was to design an experimental model that allowed extensive endodontic interim restorations to be tested for dye penetration while under simulated masticatory load. Extracted premolar teeth had standardized mesio-occluso-distal cavities prepared, and the root canals were instrumented. A cotton wool pellet was placed in the pulp chamber, and the cavities were restored with Cavit, IRM, Ketac-Fil Plus, Ketac-Silver, or composite resin (Z100). They were subjected to the equivalent of 3 months of clinical load while exposed to methylene blue dye. Results of this study could not support IRM as a suitable interim endodontic restorative material to use in extensive cavities. The dye penetration in the Ketac-Fil Plus and Ketac-Silver specimens was not predictable, and the results suggested Cavit and Z100 composite resin require further investigations as potentially useful materials for this purpose. PMID:17889699

  20. Apical and periapical repair of dogs' teeth with periapical lesions after endodontic treatment with different root canal sealers.

    PubMed

    Leonardo, Mário Roberto; Salgado, Antônio Alberto; da Silva, Léa Assed; Tanomaru Filho, Mário

    2003-01-01

    The aim of this study was to evaluate the apical and periapical repair after root canal treatment of dogs' teeth with pulp necrosis and chronic periapical lesion using different root canal sealers. After periapical lesion induction, forty-four root canals of 3 dogs were submitted to biomechanical preparation using 5.25% sodium hypochlorite as an irrigating solution. A calcium hydroxide dressing (Calen PMCC) was applied for 15 days and the root canals were filled using the lateral condensation technique with gutta-percha points and Sealapex, AH Plus or Sealer Plus for sealing. After 180 days, the animals were sacrificed by anesthetic overdose and the obtained histological sections were stained with hematoxylin-eosin for optical microscopic analysis of the apical and periapical repair. The groups filled with Sealapex and AH Plus had better histological repair (p < 0.05) than the group filled with Sealer Plus, that had unsatisfactory results. PMID:12908063

  1. CBCT Use in Endodontic Diagnosis.

    PubMed

    Beach, David A

    2016-02-01

    Endodontic diagnosis and treatment planning has taken a giant leap forward due to introduction of CBCT in dentistry. While conventional 2-D radiographs remain the most cost-effective and routine method to evaluate a patient’s dentition, their diagnostic potential is limited. The 3-D manipulation of images that CBCT offers provides better insight into diagnostic dilemmas and complicate treatment decisions. Despite the advantages of CBCT imaging, it should be used complimentary to 2-D radiography, not as a replacement. The principle of ALARA (in which patients should be exposed to radiation “as low as reasonably achievable”), still applies to this technology. CBCT should not be used routinely in the absence of clinical signs or symptoms that necessitate a more in-depth view of a tooth and surrounding structures. In other words, if a conventional 2-D radiograph will suffice, then a CBCT pretreatment scan is not necessary. However, if more information is needed to make an accurate diagnosis, a 3-D CBCT image is justified and highly beneficial as shown through several case examples share in this article. PMID:26995838

  2. Root dentine and endodontic instrumentation: cutting edge microscopic imaging.

    PubMed

    Atmeh, Amre R; Watson, Timothy F

    2016-06-01

    Cutting of the dental hard tissues is an integral part of restorative dentistry. Cutting of the root dentine is also needed in preparation prior to endodontic treatment, with significant commercial investment for the development of flexible cutting instruments based around nickel titanium (NiTi) alloys. This paper describes the evolution of endodontic cutting instruments, both in materials used, e.g. the transition from stainless steel to NiTi, and the design of the actual instruments themselves and their method of activation-by hand or motor driven. We have been examining tooth-cutting interactions microscopically for over 25 years using a variety of microscopic techniques; in particular, video-rate confocal microscopy. This has given a unique insight into how many of the procedures that we take for granted are achieved in clinical practice, by showing microscopic video images of the cutting as it occurs within the tooth. This technology has now been extended to allow imaging of the endodontic instrument and the root canal wall for the first time. We are able to image dentine distortion and crack propagation during endodontic filing of the root canal space. We are also able to visualize the often claimed, but seldom seen action of contemporary endodontic instruments. PMID:27274802

  3. Rapid kill-novel endodontic sealer and Enterococcus faecalis.

    PubMed

    Beyth, Nurit; Kesler Shvero, Dana; Zaltsman, Nathan; Houri-Haddad, Yael; Abramovitz, Itzhak; Davidi, Michael Perez; Weiss, Ervin I

    2013-01-01

    With growing concern over bacterial resistance, the identification of new antimicrobial means is paramount. In the oral cavity microorganisms are essential to the development of periradicular diseases and are the major causative factors associated with endodontic treatment failure. As quaternary ammonium compounds have the ability to kill a wide array of bacteria through electrostatic interactions with multiple anionic targets on the bacterial surface, it is likely that they can overcome bacterial resistance. Melding these ideas, we investigated the potency of a novel endodontic sealer in limiting Enterococcus faecalis growth. We used a polyethyleneimine scaffold to synthesize nano-sized particles, optimized for incorporation into an epoxy-based endodontic sealer. The novel endodontic sealer was tested for its antimicrobial efficacy and evaluated for biocompatibility and physical eligibility. Our results show that the novel sealer foundation affixes the nanoparticles, achieving surface bactericidal properties, but at the same time impeding nanoparticle penetration into eukaryotic cells and thereby mitigating a possible toxic effect. Moreover, adequate physical properties are maintained. The nanosized quaternary amine particles interact within minutes with bacteria, triggering cell death across wide pH values. Throughout this study we demonstrate a new antibacterial perspective for endodontic sealers; a novel antibacterial, effective and safe antimicrobial means. PMID:24223159

  4. Antimicrobial comparison on effectiveness of endodontic therapy and endodontic therapy combined with photo-disinfection on patients with periapical lesion: a 6 month follow-up

    NASA Astrophysics Data System (ADS)

    Garcez, Aguinaldo S.; Núñez, Silvia C.; Hamblin, Michael R.; Ribeiro, Martha S.

    2008-03-01

    This study compares the antimicrobial effect of photodynamic therapy (PDT) combined to endodontic treatment with conventional endodontic treatment alone in patients with necrotic pulp and has a 6-month radiographic follow up comparing the healing of periapical lesions. Fifteen patients with periapical lesion and requiring root canal treatment were selected. Microbiological samples were taken after accessing the root canal, conventional manual endodontic therapy (group 1 n=5) and after accessing the canal, endodontic therapy and PDT (group 2 n=10). All the root canals were filled with a calcium hydroxide paste for 1 week. Radiographs were taken after obturation and following 6 months. Endodontic therapy alone presented an 87% reduction in microorganisms while the combination with PDT had a 95% reduction. Radiographic follow up showed 32% higher reduction in the lesion area in PDT group. Results suggest that the use of PDT added to conventional endodontic treatment leads to a further major reduction of microbial load. PDT is an efficient alternative to chemical antimicrobial agents. It is a non-cumulative local treatment, which may be an appropriate approach for the treatment of infections in the oral cavity.

  5. Endodontic therapy averting major surgery and avoiding keloid formation.

    PubMed

    Marano, P D; Korkosz, J A; Rogers, E W

    1978-04-01

    Keloids and mandibular unfavorable fractures are reviewed. A case report of a patient with keloid diathesis, who had a mandibular unfavorable fracture, is presented. A grossly carious, abscessed first molar was in the line of fracture. This tooth was the only erupted tooth present in the proximal fragment. Endodontic therapy and restoration of normal contour enabled the surgeons to treat the fractured mandible by means of simple closed reduction. The endodontic treatment pre-empted a major surgical procedure under general anesthesia and also averted a skin incision which would have subsequently formed a disfiguring keloid. PMID:273853

  6. Veterinary endodontics: an online study guide.

    PubMed

    2008-05-01

    The Editorial Board of the Journal of Endodontics has developed a literature-based study guide of topical areas related to endodontics. This study guide is intended to give the reader a focused review of the essential endodontic literature and does not cite all possible articles related to each topic. Although citing all articles would be comprehensive, it would defeat the idea of a study guide. This section will cover veterinary endodontics. PMID:18457705

  7. Glucocorticoids in endodontics: an online study guide.

    PubMed

    2008-05-01

    The Editorial Board of the Journal of Endodontics has developed a literature-based study guide of topical areas related to endodontics. This study guide is intended to give the reader a focused review of the essential endodontic literature and does not cite all possible articles related to each topic. Although citing all articles would be comprehensive, it would defeat the idea of a study guide. This section will cover the use of glucocorticoids in endodontics. PMID:18457695

  8. Postextraction implant in sites with endodontic infection as an alternative to endodontic retreatment: a review of literature.

    PubMed

    Corbella, Stefano; Taschieri, Silvio; Tsesis, Igor; Del Fabbro, Massimo

    2013-06-01

    The aim of this literature review is to evaluate the outcomes of implants placed after extraction of teeth with infections of endodontic origin. An electronic search was performed through electronic databases (Medline and Embase) using the terms "immediate implant," "post-extractive implants," "endodontic infection," "infected site," and "extraction socket" combined with the use of Boolean operators ("AND" and "OR"). Only articles on human subjects were considered. At least 12 month of mean follow-up was required for inclusion. No restriction was placed regarding study design. Ten studies were included in this review. Survival rates ranged from 92% to 100%. A total of 497 implants were placed in sites with endodontic infection. In nine studies the use of bone substitutes was associated with immediate implant placement. Because of the low number of included studies and the heterogeneity of study design, more well-designed studies are required to assess the relevance of this treatment alternative. PMID:23834016

  9. Student Endodontic Performance with and without Numerical Requirements.

    ERIC Educational Resources Information Center

    Lee, Charles Q.; And Others

    1994-01-01

    A study compared dental student performance in clinical endodontics under two instructional approaches, one in which number of procedures completed by students (n=79) was measured and one (n=84 students) emphasizing total patient care and stricter accounting of clinical treatment time. Results indicated the latter group treated fewer teeth but…

  10. Sickle cell anemia in Brazil: personal, medical and endodontic patterns.

    PubMed

    Ferreira, Shirlene Barbosa Pimentel; Tavares, Warley Luciano Fonseca; Rosa, Marco Aurélio Camargo da; Brito, Luciana Carla Neves de; Vieira, Leda Quércia; Martelli, Hercílio; Ribeiro, Antônio Paulino

    2016-05-20

    Sickle cell anemia (SCA) is the most prevalent genetic disease worldwide. Recurrent vaso-occlusive infarcts predispose SCA patients to infections, which are the primary causes of morbidly and mortality. This study aimed to evaluate the relationship between SCA and endodontic diseases. Personal information, medical data (hematological indices, virologic testing, blood transfusions, medications received, splenectomy) and information on the need for endodontic treatment were obtained from SCA patients who were registered and followed up by the Fundação Hemominas, Minas Gerais, Brazil.These data were compared with the need for root canal treatment in SCA patients. One hundred eight patients comprised the studied population, and the rate of the need for endodontic therapy was 10.2%. Among the medical data, a significant difference was observed for eosinophil (p = 0.045) counts and atypical lymphocyte counts (p = 0.036) when the groups (with and without the need for endodontic treatment) were compared. Statistical relevance was observed when comparing the patients with and without the need for root canal therapy concerned eosinophil counts and atypical lymphocyte counts. The differences in statistical medical data, observed between the groups suggest that both parameters are naturally connected to the stimulation of the immune system that can occur in the presence of root canal infections and that can be harmful to SCA individuals. PMID:27223130

  11. Endodontic applications of cone beam computed tomography.

    PubMed

    McClammy, Thomas V

    2014-07-01

    Cone-beam CT (CBCT) has made a dramatic contribution and has been quickly adopted in endodontics. It is a game changer in research and clinical applications. Although CBCT and its application in implantology is well known, the surgical placement of implants is now a factor in endodontics. This article illustrates unique applications of CBCT in implantology in a specialty endodontic facility. Endodontics creates the foundation for restorative dentistry for a healthy tooth, a well-treated endodontically treated tooth, or a well-placed dental implant. CBCT helps make this possible and predictable. PMID:24993923

  12. Aesthetic posts and cores for metal-free restoration of endodontically treated teeth.

    PubMed

    Quintas, A F; Dinato, J C; Bottino, M A

    2000-01-01

    Utilization of contemporary post and core systems has facilitated the aesthetic restoration of endodontically treated teeth. Light transmission and biocompatibility have been enhanced by the introduction of metal-free post systems. The periodontal and endodontic status, root length, and histological structure of the devitalized teeth must be considered in order to achieve successful restoration following endodontic treatment. This article presents various restorative criteria for the aesthetic placement and buildup of post and core materials, as well as the preservation of maximum coronal and root structure. PMID:11405025

  13. Endodontic surgery: an online study guide.

    PubMed

    2008-05-01

    The Editorial Board of the Journal of Endodontics has developed a literature-based study guide of topical areas related to endodontics. This study guide is intended to give the reader a focused review of the essential endodontic literature and does not cite all possible articles related to each topic. Although citing all articles would be comprehensive, it would defeat the idea of a study guide. This section will cover indications and contraindications, surgical anatomy related to endodontics, flap design, root-end resection, the beveled root surface, root-end preparation techniques, root-end filling materials, endodontic surgical aids, endodontic surgical wound healing, incision and drainage, surgical trephination, intentional replantation, endodontic endosseous implants, submergence of roots, transplantation of teeth, and cystic decompression. PMID:18457709

  14. Argon laser application to endodontics

    NASA Astrophysics Data System (ADS)

    Blankenau, Richard J.; Ludlow, Marvin; Anderson, David

    1993-07-01

    The application of laser technology to endodontics has been studied for some time. At the present time several major problems are being investigated: (1) removal of infected tissues, (2) sterilization of canals, (3) obturation of canals, and (4) preservation of the vitality of supporting tissues. This list is not intended to imply other problems do not exist or have been solved, but it is a starting point. This paper reviews some of the literature that relates to laser applications to endodontics and concludes with some of the findings from our investigation.

  15. Optical coherence tomography for endodontic imaging

    NASA Astrophysics Data System (ADS)

    van Soest, G.; Shemesh, H.; Wu, M.-K.; van der Sluis, L. W. M.; Wesselink, P. R.

    2008-02-01

    In root canal therapy, complications frequently arise as a result of root fracture or imperfect cleaning of fins and invaginations. To date, there is no imaging method for nondestructive in vivo evaluation of the condition of the root canal, during or after treatment. There is a clinical need for a technique to detect defects before they give rise to complications. In this study we evaluate the ability of optical coherence tomography (OCT) to image root canal walls, and its capacity to identify complicating factors in root canal treatment. While the potential of OCT to identify caries has been explored before, endodontic imaging has not been reported. We imaged extracted lower front teeth after endodontic preparation and correlated these images to histological sections. A 3D OCT pullback scan was made with an endoscopic rotating optical fiber probe inside the root canal. All oval canals, uncleaned fins, risk zones, and one perforation that were detected by histology were also imaged by OCT. As an example of an area where OCT has clinical potential, we present a study of vertical root fracture identification with OCT.

  16. Endodontic therapy in a postirradiated child: review of the literature and report of a case.

    PubMed

    Kielbassa, A M; Attin, T; Schaller, H G; Hellwig, E

    1995-06-01

    Exodontia of extremely carious teeth leads to a significant risk of osteoradionecrosis in patients who have undergone radiotherapy. In these patients, endodontic treatment could be an alternative. Successful root canal therapy in a girl who had been irradiated for head and neck neoplasms is reported. The results indicated that use of calcium hydroxide to obturate the root canals is a viable method of postirradiation endodontics in primary teeth. PMID:8602421

  17. The Applications of Cone-Beam Computed Tomography in Endodontics: A Review of Literature

    PubMed Central

    Kiarudi, Amir Hosein; Eghbal, Mohammad Jafar; Safi, Yaser; Aghdasi, Mohammad Mehdi; Fazlyab, Mahta

    2015-01-01

    By producing undistorted three-dimensional images of the area under examination, cone-beam computed tomography (CBCT) systems have met many of the limitations of conventional radiography. These systems produce images with small field of view at low radiation doses with adequate spatial resolution that are suitable for many applications in endodontics from diagnosis to treatment and follow-up. This review article comprehensively assembles all the data from literature regarding the potential applications of CBCT in endodontics. PMID:25598804

  18. A 22-year follow-up of an endodontic implant.

    PubMed

    Wolff, Jan; Sándor, George K; Forouzanfar, Tim; Schulten, Engelbert A J M; Oikarinen, Kyösti S

    2015-10-01

    Root fractures in the middle and apical thirds of the root are treated by repositioning and for approximately 6 weeks of immobilization while those in the cervical third are immobilized for 3 months. Even though the results are good, some root-fractured teeth are lost and replaced by dental implants or fixed partial dentures. One historic but effective treatment option for those root fractures with unfavorable crown to root ratios is an endodontic implant in middle and apical third root fractures. This method offers immediate stable fixation of a crown and its coronal root segment to the underlying alveolar bone. This report documents the long-term survival of a tooth treated with an endodontic implant. A 25-year-old male patient presented following a bicycle accident with a dislocated unfavorable root fracture in the middle third. The crown with the coronal root segment was secured to the bone using a commercially available endodontic implant. The apical part of the root was removed. Although the clinical and radiological follow-up results of the endodontic implant demonstrated a good clinical function and little bone loss, the implant ultimately had to be removed after 22 years of service due to pain and increasing mobility. PMID:25865147

  19. Evidence-based patient education: knowledge transfer to endodontic patients.

    PubMed

    Sorrell, John T; McNeil, Daniel W; Gochenour, Lori L; Jackson, C Russell

    2009-11-01

    Evidence-based treatment is emphasized in oral health care, but there has been less focus on empirically demonstrating the effects of patient education. Attempts to educate patients must be empirically demonstrated in order to provide evidence-based guidance to practitioners and educators. We conducted two studies that assessed information acquisition during five-minute audiovisual films on oral hygiene procedures, endodontic procedures, and fear about pain during root canal therapy. A fifteen-item Dental Knowledge Questionnaire (DKQ), with three subscales each focusing on the content of one of the films, was developed and psychometrically evaluated. Study 1 included 268 undergraduates; study 2 involved 104 endodontic patients. Participants completed the DKQ, viewed one of the three films, and repeated the questionnaire. The effects of information on knowledge were assessed using 3 (film group) X 3 (subscale of the DKQ) X 2 (time) repeated measures ANOVAs. Scores improved in a content-specific fashion relevant to the film viewed among undergraduates, F(4, 263)=211.33, p<.001, partial eta(2)=.62 and endodontic patients, F(4, 99)=87.22, p<.001, partial eta(2)=.63. The results provide evidence for using brief informational film as an efficacious method to increase patient knowledge, at least in the short term. The DKQ is proposed as a tool to assess patient knowledge in the arenas of oral hygiene and endodontics. PMID:19910479

  20. [Developmental radicular groove as a cause of endodontic failure].

    PubMed

    Fabra Campos, H; Millet Part, J

    1989-01-01

    A clinical case of apical injury on an upper lateral incisor with endodontical and surgical failures in its treatment is presented. Extraction of the incisor and its study at the stereoscopic microscope showed the existence of a developmental groove running from the cingulum to the end of the root, establishing a communication between the crevice and the apical part of the tooth. Bacterial infection through the groove could provide an explanation for treatment failure. PMID:2640035

  1. A Successful Endodontic Outcome with Non-Obturated Canals

    PubMed Central

    Asgary, Saeed; Fazlyab, Mahta

    2015-01-01

    This case report represents the outcome of endodontic treatment in an infected mandibular molar with periradicular periodontitis and inherent poor prognosis of root canal treatment due to severe root curvature. The tooth was successfully treated by leaving the mesial root non-obturated, the canal orifices were coronally sealed with calcium enriched mixture cement and a definitive coronal amalgam restoration, was placed at the subsequent visit. PMID:26213546

  2. The effectiveness of endodontic solvents to remove endodontic sealers.

    PubMed

    Hwang, Jae I; Chuang, Augustine H; Sidow, Stephanie J; McNally, Kathleen; Goodin, Jeremy L; McPherson, James C

    2015-03-01

    Dental emergencies negatively affect troop readiness, especially during combat. Endodontic retreatment, when required, is especially challenging when the removal of endodontic sealer is required. In this study, we investigated the effectiveness of synthetic endodontic solvents to remove endodontic sealers. Fifty capillary tubes (2.7 mm ID×22 mm L), each filled to 15 mm with either Roth 801, AH Plus, MetaSEAL, or gutta-percha, were stored at 75% humidity for 14 days at 37°C. Ten capillary tubes containing each sealer were treated with either chloroform, xylene, EndoSolv R, EndoSolv E, or no solvent, and then penetrated with D3 ProTaper Universal Retreatment file on the same day. The time for the file to penetrate the length of each sealer was recorded, and the data statistically analyzed. Roth 801 failed to set and was not tested. The file took 3.4±0.1, 4.8±0.3, 5.7±0.4, 4.5±0.2, and 10.6±1.0 seconds (mean±SD) to penetrate gutta-percha using chloroform, xylene, EndoSolv R, EndoSolv E, or no solvent, respectively, and was performed by one endodontic resident at one sitting. The time for penetration of gutta-percha with any solvent was significantly faster (p≤0.05) than for AH Plus or MetaSEAL.The time for AH Plus ranged from 23.1±1.0 to 81.5±4.5 seconds. The time for MetaSEAL ranged from 97.2±6.1 to >180 seconds. EndoSolv E was the most effective solvent for AH Plus. It took significantly more time to remove MetaSEAL than AH Plus, regardless of the solvent used. Our study indicated that the use of the proper endodontic solvent makes complete removal of a sealer much more effective during retreatment. PMID:25747639

  3. Modern endodontic practice: instruments and techniques.

    PubMed

    Kim, Syngcuk

    2004-01-01

    Like many other dental and medical specialties, endodontics has evolved and changed over the years. The changes that have occurred in the past 10 years, however, have been of great magnitude and profundity. The microscope, ultrasonic units with specially configured tips, superbly accurate microchip computerized apex locators, flexible nickel-titanium files in rotary engines, and greater emphasis on microscopic endodontic surgery have totally changed the way endodontics and endodontic surgery are practiced. Comparing these changes with formocreoszol medication, K-file and radiographic determination of working length are truly dramatic. These changes are bringing the specialty of endodontic practice into the twenty-first century with greater precision, fewer procedural errors, less discomfort to the patient, and faster case completions. Seven key advancements in endodontics were made in the last decade. This article discusses these advancements and their applicability to everyday practice. PMID:15066503

  4. Chlorhexidine gluconate, its properties and applications in endodontics

    PubMed Central

    Mohammadi, Zahed

    2008-01-01

    The major objective in endodontic therapy is to disinfect the entire root canal system. This requires that the pulpal content be eliminated as sources of infection. This goal may be accomplished by mechanical instrumentation and chemical irrigation, in conjunction with medication of the root canal between treatment sessions. Microorganisms and their by-products are considered to be the major cause of pulpal and periradicular pathosis. In order to reduce or eliminate bacteria from the root canal system, various irrigants have been used during treatment. Chlorhexidine is a cationic solution which can be used during treatment. It has a wide range of antimicrobial activity. Furthermore, because of its cationic structure, chlorhexidine has a unique property named substantivity. The purpose of this paper is to review different aspects of chlorhexidine in endodontics. PMID:24265633

  5. Clinical negligence or endodontic mishaps: A surgeons dilemma

    PubMed Central

    Yadav, Rakesh Kumar; Chand, Sharad; Verma, Promila; Chandra, Anil; Tikku, Aseem Prakash; Wadhwani, Kulwinder Kaur

    2012-01-01

    Complications may occur during and after endodontic treatment, which may be due to negligence of the operator. The surgical treatment of a case presenting pain and persistent pus discharge and swelling due to the extrusion of the root canal filling to the base of the nasal floor between left maxillary lateral and canine teeth is presented in this report. First, carelessness was during root canal treatment that was over obturated and second time during extraction in which overextended gutta-percha remained in the bone, caused the complications like pain, persistent pus discharge, and headache. Clinicians should be aware of the fact that endodontic instruments and filling materials (solid or liquid) can be extended in such a degree that can lead to neurological or sinus complications. PMID:23251068

  6. Evaluation of over-etching technique in the endodontically treated tooth restoration

    PubMed Central

    Migliau, Guido; Piccoli, Luca; Besharat, Laith Konstantinos; Di Carlo, Stefano; Pompa, Giorgio

    2015-01-01

    Summary The main purpose of a post-endodontic restoration with posts is to guarantee the retention of the restorative material. The aim of the study was to examine, through the push-out test, how bond strength between the post and the dentin varied with etching time with 37% orthophosphoric acid, before cementation of a glass fiber post. Moreover, it has been examined if over-etching (application time of the acid: 2 minutes) was an effective technique to improve the adhesion to the endodontic substrate, after highlighting the problems of adhesion concerning its anatomical characteristics and the changes after the endodontic treatment. Highest bond strength values were found by etching the substrate for 30 sec., while over-etching didn’t improve bond strength to the endodontic substrate. PMID:26161247

  7. [Control of generalized chronic periodontitis combined with calcium-antagonist-related gingival overgrowth by a complex periodontal-endodontic-prosthodontic treatment. Case report].

    PubMed

    Szánto, Erika; Gera, István

    2011-12-01

    To day a relatively high percentage of elderly population of the industrialized world suffers with different cardiovascular diseases and are on permanent antihypertensive therapy. One of the most frequently used drugs is the calcium channel blockers prescribed against high blood pressure. The most common oral side effect of these drugs is the gingival enlargement that might develop even on otherwise healthy gingiva. The incidence of chronic periodontitis in this age group is also high and the Ca antagonist medication in those individuals might substantially modify the clinical course of periodontal inflammation leading to gingival enlargement and hypertrophic pocket wall. The case presented here is a 52 years old hypertonic woman with a long history of Ca-antagonist therapy and generalized chronic periodontitis combined with gingival hyperplasia. After the change of medication the 1,5 years comprehensive periodontal endodontic and prosthodontic therapy restored patient's periodontal health and provided complex dental rehabilitation. Nevertheless, only regular periodontal supportive therapy could ensure predictable outcome and guarantee long lasting periodontal health. PMID:22308953

  8. Comparative characteristics of endodontic drills.

    PubMed

    Loska, Sonia; Basiaga, Marcin; Pochrząst, Magdalena; Łukomska-Szymańska, Monika; Walke, Witold; Tyrlik-Held, Jadwiga

    2015-01-01

    The work concerns the analysis of influence of the wear process of endodontic instruments on the mechanical and physico-chemical properties of the materials from which they are made. A detailed study of the microstructure, mechanical properties and corrosion resistance in the environment simulating work of the tool was conducted. The research was done for the new Mtwo endodontic files and after six times of use. In addition, the observations with a scanning electron microscope in order to reveal possible damage caused by the impact of a corrosive environment were carried out. The results showed that use of the tool by six times revealed damage at the edges of the blades and may cause a lack of continuity of the cutting line resulting in the uneven distribution of the resistive force which acts on the tool during operation. PMID:26688191

  9. Overview on the Current Antibiotic Containing Agents Used in Endodontics

    PubMed Central

    Bansal, Ramta; Jain, Aditya

    2014-01-01

    Antibiotics are systemically and locally used extensively in endodontics. However, local antibiotic application mode is considered more effective than systemic administration. The local mode enables the dentist to target bacteria in every nook and corner of root canal system, which is otherwise beyond reach if targeted by instrumentation or conventional root canal treatment protocols. Therefore, they are an important adjunct to conventional treatment of root canal. The present study reviews the various antibiotic containing dental agents used in endodontics. A web-based research on MedLine was performed with terms Review Articles published in the last 10 year's dental journals in English for literature researching, extracting, and synthesizing data. Relevant articles were shortlisted. Important cross-reference articles were also reviewed. PMID:25210667

  10. Regenerative Endodontics: A Road Less Travelled

    PubMed Central

    Bansal, Ramta; Mittal, Sunandan; Kumar, Tarun; Kaur, Dilpreet

    2014-01-01

    Although traditional approaches like root canal therapy and apexification procedures have been successful in treating diseased or infected root canals, but these modalities fail to re-establish healthy pulp tissue in treated teeth. Regeneration-based approaches aims to offer high levels of success by replacing diseased or necrotic pulp tissues with healthy pulp tissue to revitalize teeth. The applications of regenerative approaches in dental clinics have potential to dramatically improve patients’ quality of life. This review article offers a detailed overview of present regenerative endodontic approaches aiming to revitalize teeth and also outlines the problems to be dealt before this emerging field contributes to clinical treatment protocols. It conjointly covers the basic trilogy elements of tissue engineering. PMID:25478476

  11. [Irrigants and intracanal medicaments in endodontics].

    PubMed

    Zehnder, Matthias; Lehnert, Birgit; Schönenberger, Kathrin; Waltimo, Tuomas

    2003-01-01

    Modern, biologic root canal therapy should be performed with suitable irrigating solutions and intracanal medicaments. The goal of endodontic treatment is to free the treated tooth from infection and prevent reinfection as thoroughly as possible by means which do not put the organism at risk. In this review of the literature, an evidence-based concept for irrigation and medication of root canal systems is presented. Irrigants and medicaments are discussed with respect to their antimicrobial, tissue-dissolving and endotoxin-decontaminating capacity in relation to their systemic toxicity. Recent findings pertaining to interactions of root canal medicaments and irrigating solutions and their impact on a sound irrigating and medicating concept are discussed. PMID:12956038

  12. Regenerative endodontics: a road less travelled.

    PubMed

    Bansal, Ramta; Jain, Aditya; Mittal, Sunandan; Kumar, Tarun; Kaur, Dilpreet

    2014-10-01

    Although traditional approaches like root canal therapy and apexification procedures have been successful in treating diseased or infected root canals, but these modalities fail to re-establish healthy pulp tissue in treated teeth. Regeneration-based approaches aims to offer high levels of success by replacing diseased or necrotic pulp tissues with healthy pulp tissue to revitalize teeth. The applications of regenerative approaches in dental clinics have potential to dramatically improve patients' quality of life. This review article offers a detailed overview of present regenerative endodontic approaches aiming to revitalize teeth and also outlines the problems to be dealt before this emerging field contributes to clinical treatment protocols. It conjointly covers the basic trilogy elements of tissue engineering. PMID:25478476

  13. Can traumatic occlusion cause endodontic problems? A case report.

    PubMed

    Indramohan, Jamuna; Neelakantan, Prasanna; Subba Rao, C V; Vasudevan, C

    2011-01-01

    Radicular cysts are commonly found odontogenic cysts in the jaws. The lesion is diagnosed mainly in young patients during the second decade of life. In the majority of cases, it is asymptomatic. This paper reports a rare case in which traumatic occlusion was identified as the etiology of a radicular cyst. Endodontic treatment was performed and the traumatic occlusion also was corrected. A six-month follow-up appointment found good healing of the periapical region. PMID:21903554

  14. Imaging Techniques in Endodontics: An Overview

    PubMed Central

    Deepak, B. S.; Subash, T. S.; Narmatha, V. J.; Anamika, T.; Snehil, T. K.; Nandini, D. B.

    2012-01-01

    This review provides an overview of the relevance of imaging techniques such as, computed tomography, cone beam computed tomography, and ultrasound, to endodontic practice. Many limitations of the conventional radiographic techniques have been overcome by the newer methods. Advantages and disadvantages of various imaging techniques in endodontic practice are also discussed. PMID:22530184

  15. Teacher Training in Graduate Endodontic Programs.

    ERIC Educational Resources Information Center

    Burrell, William; Lee, Mickey M.

    1981-01-01

    A national survey of postdoctoral endodontic students on the perceived educational needs of dental faculty indicated that most endodontic students possess very little formal educational training, they perceive a strong need for it, and that they desire more training in evaluation/testing methods. (MLW)

  16. 21 CFR 872.3840 - Endodontic silver point.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Endodontic silver point. 872.3840 Section 872.3840...) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3840 Endodontic silver point. (a) Identification. An endodontic silver point is a device made of silver intended for use during endodontic therapy...

  17. 21 CFR 872.3840 - Endodontic silver point.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Endodontic silver point. 872.3840 Section 872.3840...) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3840 Endodontic silver point. (a) Identification. An endodontic silver point is a device made of silver intended for use during endodontic therapy...

  18. 21 CFR 872.3840 - Endodontic silver point.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Endodontic silver point. 872.3840 Section 872.3840...) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3840 Endodontic silver point. (a) Identification. An endodontic silver point is a device made of silver intended for use during endodontic therapy...

  19. 21 CFR 872.3840 - Endodontic silver point.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Endodontic silver point. 872.3840 Section 872.3840...) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3840 Endodontic silver point. (a) Identification. An endodontic silver point is a device made of silver intended for use during endodontic therapy...

  20. 21 CFR 872.3840 - Endodontic silver point.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Endodontic silver point. 872.3840 Section 872.3840...) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3840 Endodontic silver point. (a) Identification. An endodontic silver point is a device made of silver intended for use during endodontic therapy...

  1. 21 CFR 872.3830 - Endodontic paper point.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Endodontic paper point. 872.3830 Section 872.3830...) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3830 Endodontic paper point. (a) Identification. An endodontic paper point is a device made of paper intended for use during endodontic therapy to...

  2. 21 CFR 872.3830 - Endodontic paper point.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Endodontic paper point. 872.3830 Section 872.3830...) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3830 Endodontic paper point. (a) Identification. An endodontic paper point is a device made of paper intended for use during endodontic therapy to...

  3. 21 CFR 872.3830 - Endodontic paper point.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Endodontic paper point. 872.3830 Section 872.3830...) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3830 Endodontic paper point. (a) Identification. An endodontic paper point is a device made of paper intended for use during endodontic therapy to...

  4. Er:YAG laser for endodontics: efficiency and safety

    NASA Astrophysics Data System (ADS)

    Hibst, Raimund; Stock, Karl; Gall, Robert; Keller, Ulrich

    1997-12-01

    Recently it has been shown that bacterias can be sterilized by Er:YAG laser irradiation. By optical fiber transmission the bactericidal effect can also be used in endodontics. In order to explore potential laser parameters, we further investigated sterilization of caries and measured temperatures in models simulating endodontic treatment. It was found out that the bactericidal effect is cumulative, with single pulses being active. This offers to choose all laser parameters except pulse energy (radiant exposure) from technical, practical or safety considerations. For clinical studies the following parameter set is proposed for efficient and safe application (teeth with a root wall thickness > 1 mm, and prepared up to ISO 50): pulse energy: 50 mJ, repetition rate: 15 Hz, fiber withdrawal velocity: 2 mm/s. With these settings 4 passes must be performed to accumulate the total dose for sterilization.

  5. Diagnosis demystified: CT as diagnostic tool in endodontics

    PubMed Central

    Shruthi, Nagaraja; Sreenivasa Murthy, B V; Sundaresh, K J; Mallikarjuna, Rachappa

    2013-01-01

    Diagnosis in endodontics is usually based on clinical and radiographical presentations, which are only empirical methods. The role of healing profession is to apply knowledge and skills towards maintaining and restoring the patient's health. Recent advances in imaging technologies have added to correct interpretation and diagnosis. CT is proving to be an effective tool in solving endodontic mysteries through its three-dimensional visualisation. CT imaging offers many diagnostic advantages to produce reconstructed images in selected projection and low-contrast resolution far superior to that of all other X-ray imaging modalities. This case report is an endeavour towards effective treatment planning of cases with root fracture, root resorption using spiral CT as an adjuvant diagnostic tool. PMID:23814212

  6. Rotary endodontics in primary teeth – A review

    PubMed Central

    George, Sageena; Anandaraj, S.; Issac, Jyoti S.; John, Sheen A.; Harris, Anoop

    2015-01-01

    Endodontic treatment in primary teeth can be challenging and time consuming, especially during canal preparation, which is considered one of the most important steps in root canal therapy. The conventional instrumentation technique for primary teeth remains the “gold-standard” over hand instrumentation, which makes procedures much more time consuming and adversely affects both clinicians and patients. Recently nickel–titanium (Ni–Ti) rotary files have been developed for use in pediatric endodontics. Using rotary instruments for primary tooth pulpectomies is cost effective and results in fills that are consistently uniform and predictable. This article reviews the use of nickel–titanium rotary files as root canal instrumentation in primary teeth. The pulpectomy technique is described here according to different authors and the advantages and disadvantages of using rotary files are discussed. PMID:26792964

  7. Methyl mercaptan and hydrogen sulfide products stimulate proinflammatory cytokines in patients with necrotic pulp tissue and endodontically treated teeth.

    PubMed

    Jacobi-Gresser, E; Schütt, S; Huesker, K; Von Baehr, V

    2015-01-01

    Bacterial infections of the residual dentin or infected pulp tissue are responsible for most cases of endodontic treatment failures. Persisting microorganisms in necrotic pulp tissue produce sulphur components such as methyl mercaptan and hydrogen sulfide as well as thioether derivatives. Although there is emerging evidence that these sulphur compounds stimulate immune cells and induce the inflammatory cascade, the immunological mechanisms of local and systemic inflammation have not been described. In this retrospective study we evaluated the ex-vivo immune response of peripheral blood mononuclear cells to sulphur compounds in 53 patients with clinical or radiologic endodontic treatment failure, 20 patients with clinical discomfort or radiological findings without previous endodontic treatment and a control group of 31 patients who had received successful endodontic treatment at least five years previously. Patients with endodontic abnormalities showed significantly higher ex-vivo sulphur compound-stimulated interferon-gamma (IFN-γ) and interleukin-10 (IL-10) levels as compared to the control group. The association between ex-vivo-stimulated cytokines and endodontically derived sulphur compounds was further substantiated by the fact that the number of IFN-γ and/or IL-10-positive patients decreased significantly 3-8 months after re-treatment of the root canal or tooth extraction. Furthermore, serum tumor necrosis factor-alpha (TNF-α) levels were higher in patients than in controls, and at the same time, the TNFA -308 G/A polymorphism was associated with endodontic treatment failure in our study population. We conclude that a cellular immune response to sulphur compounds contributes to the inflammatory process observed in relation to endodontic treatment failures. PMID:25864743

  8. Current opinions concerning the restoration of endodontically treated teeth: basic principles

    PubMed Central

    VȦrlan, C; VȦrlan, V; Bodnar, D; Suciu, I

    2009-01-01

    The goal of this general article is to present a survey of the current knowledge about the clinical approach of restoring endodontically treated teeth. The best way to restore teeth after root canal treatment has long been and still is a controversial subject of debate to this day. The clinical approach of restoring endodontically treated teeth needs taking into consideration several issues: aims of coronal restoration, criteria for establishing the various modalities of coronal restoration, clinical solutions of restoring teeth after endodontic treatment, guidelines regarding restorative materials and techniques, possibilities and limits of restoration using direct adhesive materials and techniques. The aims of coronal restoration of endodontically treated teeth are generally considered to be the following ones: to prevent recontamination of the root canal system and / or periapical space, to replace missing hard dental tissues and to restore coronal morphology and functions, to provide the necessary strength for the restoration/tooth complex in order to withstand functional stress and prevent crown and/or root fracture. The criteria for establishing the modalities of coronal restoration for endodontically treated teeth are: amount and quality of remaining hard dental tissues, topography and coronal morphology of the tooth, functional occlusal forces that the restoration/tooth complex has to withstand, restoring requirements in order to include the treated tooth in a comprehensive oral rehabilitation treatment plan, esthetic requirements. PMID:20108535

  9. Clinical Approach of High Technology Techniques for Control and Elimination of Endodontic Microbiota

    PubMed Central

    Chiniforush, Nasim; Pourhajibagher, Maryam; Shahabi, Sima; Bahador, Abbas

    2015-01-01

    The main goal in endodontic treatment is to eradicate or at least reduce intraradicular microbial population to levels that are more compatible with periapical lesions healing process. Since endodontic infections are polymicrobial in nature, intraradicular survival of endodontic microbiota and their pathogenic properties are influenced by a combination of their virulence factors. The purpose of this article is to review the endodontic microbiota and their respective virulence attributes, as well as perform a literature review of the effects of disinfection procedures in the treatment of endodontic infections to gain best practices. Conventional technique for root canal preparation includes mechanical debridement and application of antimicrobial irrigants. Recently, laser irradiation has been used to enhance the results of root canal treatment through its thermal effect. To reduce thermal side effects, laser activated irrigation (LAI) and photon induced photoacoustic streaming (PIPS) were introduced. Antimicrobial photodynamic therapy (aPDT) by photochemical reaction uses light at a specific wavelength to activate a nontoxic photosensitizer (PS) in the presence of oxygen to produce cytotoxic products. Different PSs are used in dentistry including methylene blue (MB), toluidine blue O (TBO), indocyanine green (ICG) and curcumin. Among different options, ICG could be the best choice due to its peak absorption at wavelength of 808 nm, which coincides with the commercial diode laser devices. Also, this wavelength has more penetration depth compared to other wavelengths used in aPDT. PMID:26705458

  10. Treponema diversity in root canals with endodontic failure

    PubMed Central

    Nóbrega, Leticia M. M.; Delboni, Maraisa G.; Martinho, Frederico C.; Zaia, Alexandre A; Ferraz, Caio C. R.; Gomes, Brenda P. F. A.

    2013-01-01

    Objective: This study sought to investigate the prevalence of eight oral Treponemas (Treponema denticola, T. amylovorum, T. maltophilum, T. medium, T. pectinovorum, T. socranskii, T. vicentii and T. lecithinolyticum) in teeth with endodontic treatment failure and periapical lesion. Methods: Samples were taken from 40 root canals presenting endodontic failure and periapical lesion. DNA extraction was performed and Nested-PCR technique was used for the detection of Treponema species using specific primers. Results: Treponemas was detected in 56.5% of the samples analyzed (22/39). Individual root canals yielded a maximum of 6 target Treponema species. T. denticola (30.8%) and T. maltophilum (30.8%) were the most frequently detected species followed by T. medium (20.5%), T. socranskii (20.5%), T. pectinovorum (17.9%) and T. vicentii (17.9%). Positive association was verified between T. denticola and T. maltophilum such as T. medium (P<.05). T. lecithinolyticum was positively associated with intraradicular post (P<.05). Conclusion: The present study revealed that a wide variety of Treponema species plays a role in persistent/secondary infection turning the root canal microbiota even more complex than previously described by endodontic literature. PMID:23408792

  11. The periodontal – endodontic continuum: A review

    PubMed Central

    Sunitha V, Raja; Emmadi, Pamela; Namasivayam, Ambalavanan; Thyegarajan, Ramakrishnan; Rajaraman, Vijayalakshmi

    2008-01-01

    Periodontal therapy deals with many aspects of the supporting structures, including the prevention and repair of lesions of the gingival sulcus. Endodontics deals primarily with disease of the pulp and periapical tissues. The success of both periodontal and endodontic therapy depends on the elimination of both disease processes, whether they exist separately or as a combined lesion. The relationship between periodontal and endodontic disease has been a subject of speculation for many years. This paper aims at presenting a comprehensive review of several aspects of perio-endo lesions. PMID:20142886

  12. Endodontic retreatment: an online study guide.

    PubMed

    2008-05-01

    The Editorial Board of the Journal of Endodontics has developed a literature-based study guide of topical areas related to endodontics. This study guide is intended to give the reader a focused review of the essential endodontic literature and does not cite all possible articles related to each topic. Although citing all articles would be comprehensive, it would defeat the idea of a study guide. This section will cover retreatment rationale, corrosion of silver points, retreatment techniques, removal of posts, and possible complications during retreatment. PMID:18457690

  13. Biomimetic endodontics: the final evolution?

    PubMed

    Clark, David J

    2007-07-01

    We are seeing a gradual evolution by a small but growing number of endodontists and general dentists toward delicate biomimetic, microscope-based shaping. This old-fashioned respect for periradicular dentin is paired with microscopes, ultrasonics, and an appreciation for root morphology. Although no 2 roots are the same, general anatomic patterns allow the microscope-equipped clinician to search for major pulpal regions that will yield a high probability of cleaning and shaping the clinically available pulpal zones. There are complex, anatomically improbable, and clinically impossible areas of pulp that are beyond the reach of even the most gifted hands. Regardless, the clinician has the responsibility to begin each procedure seeking perfection and joyfully finishing with excellence. The shapes that were introduced during the Schilder (crown-down) era have served as a transitional technique to allow the first real 3-dimensional compaction of gutta-percha. Nonetheless, endodontics is in the end a restoratively driven procedure. Large, arbitrary, round shapes create beautiful endodontics but can dramatically weaken the tooth. The shaping philosophy advanced in this treatise allows perfectly adequate shapes to achieve the hydraulics needed for modern obturation. It will require different skills and materials to shape, pack, and restore the exotic architecture of nature. (See Tables 1 to 3.). PMID:17708316

  14. Dimensional changes of endodontic sealers.

    PubMed

    Kazemi, R B; Safavi, K E; Spångberg, L S

    1993-12-01

    The purpose of this study was a long-term comparison of the dimensional changes of endodontic sealers of diverse properties. The sealers were injected as thin layers on the internal walls of glass pipettes 1 mm in diameter. The pipettes were filled with deionized water, and the water meniscus levels were recorded periodically up to 180 days. The water was removed from the pipettes, samples were allowed to dry, and the mass and the volume of the sealers were measured. AH26 and Endo-Fill had an initial expansion followed by a volumetric loss. The two zinc oxide eugenol-based sealers studied started to shrink within hours after mixing; the first volumetric loss for AH26 was recorded during the first 30 days and for Endo-Fill after 30 days. The least dimensional change at any time was observed for Endo-Fill. It was concluded that a significant dimensional change and continued volume loss can occur in some endodontic sealers. PMID:8284084

  15. Identification and Endodontic Management of Middle Mesial Canal in Mandibular Second Molar Using Cone Beam Computed Tomography.

    PubMed

    Paul, Bonny; Dube, Kavita

    2015-01-01

    Endodontic treatments are routinely done with the help of radiographs. However, radiographs represent only a two-dimensional image of an object. Failure to identify aberrant anatomy can lead to endodontic failure. This case report presents the use of three-dimensional imaging with cone beam computed tomography (CBCT) as an adjunct to digital radiography in identification and management of mandibular second molar with three mesial canals. PMID:26664763

  16. Identification and Endodontic Management of Middle Mesial Canal in Mandibular Second Molar Using Cone Beam Computed Tomography

    PubMed Central

    Paul, Bonny; Dube, Kavita

    2015-01-01

    Endodontic treatments are routinely done with the help of radiographs. However, radiographs represent only a two-dimensional image of an object. Failure to identify aberrant anatomy can lead to endodontic failure. This case report presents the use of three-dimensional imaging with cone beam computed tomography (CBCT) as an adjunct to digital radiography in identification and management of mandibular second molar with three mesial canals. PMID:26664763

  17. Iatrogenic Subcutaneous Emphysema of Endodontic Origin – Case Report with Literature Review

    PubMed Central

    Mishra, Lora; Patnaik, Swarnav; Patro, Sangram; Debnath, Nitai; Mishra, Satyaranjan

    2014-01-01

    Surgical emphysema is well known and many case reports have been published on this. Many authors have reported this as a complication post dentoalveolar treatment. Diffusion of air into facial planes and periorbital area during endodontic procedures has been rarely reported. The use of three way air syringe and forceful irrigation of root canal can lead to surgical emphysema of subcutaneous tissue planes in and around the teeth which are involved. This case report highlights one such complication seen during endodontic treatment, discusses aetiology, complications and conservative management of this dental office emergency. PMID:24596796

  18. Postextraction implant in sites with endodontic infection as an alternative to endodontic retreatment: a review of literature.

    PubMed

    Corbella, Stefano; Taschieri, Silvio; Tsesis, Igor; Massimo, Del Fabbro

    2012-05-22

    Abstract Objective: the aim of this literature review was to evaluate the outcomes of implants placed after extraction of teeth with infections of endodontic origin.Study design: an electronic search was performed through electronic databases (Medline and EMBASE) using the terms "immediate implant", "post-extractive implants", "endodontic infection", "infected site", "extraction socket" combined with the use of Boolean operators ("AND" and "OR"). Only articles on human subjects were considered. At least 12 month of mean follow-up was required for inclusion. No restriction was placed regarding study design.Results: Ten studies were included in this review. Survival rates ranged from 92% to 100%. A total of 497 implants were placed in sites with endodontic infection. In nine studies the use of bone substitutes was associated with immediate implant placement.Conclusion: because of the low number of included study and the heterogeneity in study design, more well-designed studies are required in order to assess relevance of this treatment alternative. PMID:22616711

  19. Management of failed periodontal surgical intervention for a furcal lesion with a nonsurgical endodontic approach

    PubMed Central

    Asgary, Saeed

    2014-01-01

    As long as the prognosis of teeth remains a matter of concern, the endodontic-periodontal relationship will be considered a challenge for the clinician. Many etiologic factors, including bacteria, fungi, and viruses, plus other contributing factors, such as trauma, root resorptions/perforations, and dental malformations, play a role in the co-occurrence of endodontic and periodontal lesions. Whatever the cause, a correct diagnosis on which to base the treatment plan is the key to successful maintenance of the tooth. This article reports the successful endodontic management of a furcation lesion in a mandibular molar that was nonresponsive to a previous periodontal surgical graft. The case had presented a diagnostic challenge for the clinicians, and this article reviews the key points that can lead to a correct diagnosis and treatment planning. PMID:24790924

  20. [Ultrasonics in endodontics: mechanism of action].

    PubMed

    Pacheco Plaza, M C; Kessler Nieto, F; Orts Rodríguez, M T; Ruiz de Temiño Malo, P

    1989-01-01

    The present study, first of three dwelling with ultrasonics in endodontic therapy, is a review of the literature about mechanisms involved and appliance of some of the sonic and ultrasonic system. PMID:2700391

  1. Trends in endodontic claims in Italy.

    PubMed

    Pinchi, Vilma; Pradella, Francesco; Gasparetto, Laura; Norelli, Gian-Aristide

    2013-02-01

    According to the scant data available in the literature, endodontic claims are common among dental professional liability cases and the second most common type of claim. This study aimed to describe the characteristics of endodontic claims in Italy and the most frequently disputed errors, and the discussion below includes consideration of ethical and medico-legal aspects thereof. We retrospectively analysed 120 technical reports written on cases of professional malpractice in endodontics in the last 5 years. The complainant patients were males in 22.5% of the cases, while females made up the remaining 77.5%. In the dentist sample, male operators were more often involved in litigation cases (80%) than female operators. The most frequently claimed technical errors were: lack of a complete filling of root canal/s (71.7%), the perforation of tooth structure (12.7%), extrusion of sealing materials beyond the apex of the tooth (9.6%) and the fracture of an endodontic instrument (5.9%). In 1.7% of cases it was found that the expert did not make any errors performing the endodontic therapy. In only very few cases (2.7%) no therapy was considered necessary, while the most common therapeutic solution involved in endodontic misconduct was tooth extraction (53.0%). In many cases the dentist preferred to extract the endodontically undertreated tooth and substitute it prosthetically rather than trying to re-treat it. The discrepancy between the total number of cases examined and those that eventually go to court leads us to believe that the majority of endodontic malpractice cases are resolved in out-of-court settlements. PMID:23410021

  2. Endodontic Management of a Haemophilic Patient- A Clinical Perspective

    PubMed Central

    Dudeja, Krishan Kumar; Lakhanpal, Manisha; Ali, Sartaj

    2014-01-01

    Haemophilia and other bleeding disorders remain an enigma to the dentists world over. They not only challenge the skills of dental specialists but also raise the question of how these individuals should be managed emotionally as well as psychologically. The high incidence of dental problems in haemophiliacs is most likely caused by the fear and apprehension not only on the part of the patients but also dentists of inducing bleeding during treatment which can even be life threatening in certain cases. With proper care, diligence and meticulous treatment planning, there is no dental treatment that cannot be performed in such patients. Mild haemophiliacs can be easily managed and can effectively undergo even surgical endodontics without factor replacement therapies. However, severe haemophilia can pose significant health hazard and needs thorough preparation to meet any exigencies arising during the treatment. This case report describes how one such severely haemophilic patient with pain and swelling in the left submandibular region was managed with nonsurgical endodontic treatment in mandibular molar teeth and also discusses the importance of correct methods of diagnosis and various treatment considerations in such patients. PMID:25177652

  3. Endodontic management of permanent mandibular molars with 6 root canals: report of 3 cases.

    PubMed

    Malhotra, Amit; Ahlawat, Jyoti; Bansal, Chirag; Tahiliani, Divya

    2016-01-01

    Aberrations in the internal dental anatomy present challenges for clinicians performing endodontic therapy. These challenges have been partly resolved in recent years by a more comprehensive knowledge of root canal anatomy as well as advancements in the endodontic armamentarium. The aim of this case series is to describe successful root canal treatment, under magnification, in 3 cases of mandibular first molars with 6 root canals. Two of these teeth had 2 roots (mesial and distal) with 3 canals in each root; the third tooth had 3 root canals located mesially and 3 present distally as well as a radix entomolaris. A distal root with 3 canals is rare; however, it is important to look for such anatomical variations to ensure successful endodontic therapy. PMID:27599288

  4. Using 3-dimensional printing to create presurgical models for endodontic surgery.

    PubMed

    Bahcall, James K

    2014-09-01

    Advances in endodontic surgery--from both a technological and procedural perspective-have been significant over the last 18 years. Although these technologies and procedural enhancements have significantly improved endodontic surgical treatment outcomes, there is still an ongoing challenge of overcoming the limitations of interpreting preoperative 2-dimensional (2-D) radiographic representation of a 3-dimensional (3-D) in vivo surgical field. Cone-beam Computed Tomography (CBCT) has helped to address this issue by providing a 3-D enhancement of the 2-D radiograph. The next logical step to further improve a presurgical case 3-D assessment is to create a surgical model from the CBCT scan. The purpose of this article is to introduce 3-D printing of CBCT scans for creating presurgical models for endodontic surgery. PMID:25197746

  5. [Study of some physical and biological properties of an endodontic sealer composed of calcium hydroxide].

    PubMed

    Birman, E G; Sampaio, J M; Magalhães, J; Sato, E

    1990-01-01

    The authors present a study of the physical and biological properties of a new endodontic cement known as Sealapex. In its composition the presence of calcium hydroxide is introduced in order to induce calcification of the periapical tissue. Our results using glass round cover slips implanted on the subcutaneous tissue of mice indicated a persistent foreign body reaction (60 days). The physical properties studied compared to N-Rickert ciment indicated, a decreased leakage. Adhesivity tests didn't give us significant values. Laboratorial studies and clinical trials are necessary to a complete acceptance of this new ciment in endodontic treatment. PMID:2135327

  6. Antibacterial effects of N-acetylcysteine against endodontic pathogens.

    PubMed

    Moon, Ji-Hoi; Choi, Young-Suk; Lee, Hyeon-Woo; Heo, Jung Sun; Chang, Seok Woo; Lee, Jin-Yong

    2016-04-01

    The success of endodontic treatment depends on the eradication of microorganisms from the root canal system and the prevention of reinfection. The purpose of this investigation was to evaluate the antibacterial and antibiofilm efficacy of N-acetylcysteine (NAC), an antioxidant mucolytic agent, as an intracanal medicament against selected endodontic pathogens. Minimum inhibitory concentrations (MICs) of NAC for Actinomyces naeslundii, Lactobacillus salivarius, Streptococcus mutans, and Enterococcus faecalis were determined using the broth microdilution method. NAC showed antibacterial activity, with MIC values of 0.78-1.56 mg/ml. The effect of NAC on biofilm formation of each bacterium and a multispecies culture consisting of the four bacterial species was assessed by crystal violet staining. NAC significantly inhibited biofilm formation by all the monospecies and multispecies bacteria at minimum concentrations of 0.78-3.13 mg/ml. The efficacy of NAC for biofilm disruption was evaluated by scanning electron microscopy and ATP-bioluminescence quantification using mature multispecies biofilms. Preformed mature multispecies biofilms on saliva-coated hydroxyapatite disks were disrupted within 10 min by treatment with NAC at concentrations of 25 mg/ml or higher. After 24 h of treatment, the viability of mature biofilms was reduced by > 99% compared with the control. Moreover, the biofilm disrupting activity of NAC was significantly higher than that of saturated calcium hydroxide or 2% chlorhexidine solution. Within the limitations of this in vitro study, we conclude that NAC has excellent antibacterial and antibiofilm efficacy against endodontic pathogens and may be used as an alternative intracanal medicament in root canal therapies. PMID:27033208

  7. Relationship between systemic diseases and endodontics: an online study guide.

    PubMed

    2008-05-01

    The Editorial Board of the Journal of Endodontics has developed a literature-based study guide of topical areas related to endodontics. This study guide is intended to give the reader a focused review of the essential endodontic literature and does not cite all possible articles related to each topic. Although citing all articles would be comprehensive, it would defeat the idea of a study guide. This section will cover the relationship between systemic diseases and endodontics. PMID:18457702

  8. Single-visit endodontics: an online study guide.

    PubMed

    2008-05-01

    The Editorial Board of the Journal of Endodontics has developed a literature-based study guide of topical areas related to endodontics. This study guide is intended to give the reader a focused review of the essential endodontic literature and does not cite all possible articles related to each topic. Although citing all articles would be comprehensive, it would defeat the idea of a study guide. This section will cover single visit endodontics. PMID:18457689

  9. Case report: endodontic and surgical treatment of an upper central incisor with external root resorption and radicular cyst following a traumatic tooth avulsion.

    PubMed

    Lux, Hans-Christian; Goetz, Falko; Hellwig, Elmar

    2010-11-01

    In the age group between 6 and 12 years, trauma to the upper incisors happens frequently. In the case of avulsion, a replantation is the state-of-the-art treatment; however, it may lead to several complications, particularly if suitable posttraumatic management is not carried out. External cervical resorptions as well as apical granuloma and cysts due to microbial contamination of the root canal are common complications. In the presented trauma case, a conservative approach was chosen to treat a large cystic lesion combined with cervical and apical resorptions. After initial placement of Ledermix and calcium hydroxide into the root canal, a marsupialization with the temporary insertion of an obturator was performed. The gradual reduction led to a fast recovery of the bony defect and a root canal filling was placed. The 2-year follow-up showed an improved condition. All adjacent teeth remained vital during the course of the treatment. PMID:20692191

  10. Nanoparticle-based endodontic antimicrobial photodynamic therapy

    PubMed Central

    Pagonis, Tom C.; Chen, Judy; Fontana, Carla Raquel; Devalapally, Harikrishna; Ruggiero, Karriann; Song, Xiaoqing; Foschi, Federico; Dunham, Joshua; Skobe, Ziedonis; Yamazaki, Hajime; Kent, Ralph; Tanner, Anne C.R.; Amiji, Mansoor M.; Soukos, Nikolaos S.

    2009-01-01

    Objective To study the in vitro effects of poly(lactic-co-glycolic acid) (PLGA) nanoparticles loaded with the photosensitizer methylene blue (MB) and light against Enterococcus faecalis (ATCC 29212). Materials and Methods The uptake and distribution of nanoparticles in E. faecalis in suspension was investigated by transmission electron microscopy (TEM) after incubation with PLGA complexed with colloidal gold particles for 2.5, 5 and 10 minutes. E. faecalis species were sensitized in planktonic phase and in experimentally infected root canals of human extracted teeth with MB-loaded nanoparticles for 10 minutes followed by exposure to red light at 665 nm. Results The nanoparticles were found to be concentrated mainly on the cell walls of microorganisms at all three time points. The synergism of light and MB-loaded nanoparticles led to approximately 2 and 1 log10 reduction of colony-forming units in planktonic phase and root canals, respectively. In both cases, mean log10 CFU levels were significantly lower than controls and MB-loaded nanoparticles without light. Conclusion The utilization of PLGA nanoparticles encapsulated with photoactive drugs may be a promising adjunct in antimicrobial endodontic treatment. PMID:20113801

  11. Six-month healing success rates after endodontic treatment using the novel GentleWave™ System: The pure prospective multi-center clinical study

    PubMed Central

    Le, Khang T.; Woo, Stacey M.; Rassoulian, Shahriar A.; McLachlan, Kimberly; Abbassi, Farah; Garland, Randy W.

    2016-01-01

    Background This prospective multi-center (PURE) clinical study evaluated healing rates for molars after root canal treatment employing the GentleWave® System (Sonendo, Inc., Laguna Hills, CA). Material and Methods Eighty-nine patients met the inclusion criteria and consented for this clinical study after referral for a root canal treatment. All enrolled patients were treated with the GentleWave System. Five endodontists performed the clinical procedures and follow-up evaluations. Pre-operative, intra-operative, and post-operative data were collected from the consented patients. Each patient was evaluated for clinical signs and symptoms. Two trained, blinded, and independent evaluators scored the subject tooth radiographs for apical periodontitis using the periapical index (PAI). The teeth classified as healing or healed were considered as a success and composed of a cumulative success rate of healing. Statistical analysis was performed by using the Fisher’s exact test, Pearson correlation, and multivariate logistic regression analyses of the pre-operative prognostic factors at 0.05 significance level. Results Seventy-seven patients were evaluated at six months with a follow-up rate of 86.5%. The cumulative success rate of healing was 97.4%. Eleven prognostic factors were identified using bivariate analyses. Using logistic analyses, the two prognostic significant variables that were directly correlated to healing were the pre-operative presence of periapical index (p value=0.016), and single treatment visits (p value=0.024). Conclusions In this six-month PURE clinical study, the cumulative success rate of healing was 97.4% when patients were treated with the GentleWave® System. Key words:Healing rate, root canal treatment, molar, GentleWave™, Sonendo®, Multisonic Ultracleaning™ . PMID:27398180

  12. 21 CFR 872.3890 - Endodontic stabilizing splint.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Endodontic stabilizing splint. 872.3890 Section... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3890 Endodontic stabilizing splint. (a) Identification. An endodontic stabilizing splint is a device made of a material, such as titanium, intended to...

  13. 21 CFR 872.3890 - Endodontic stabilizing splint.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Endodontic stabilizing splint. 872.3890 Section 872.3890 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3890 Endodontic stabilizing splint. (a) Identification. An endodontic stabilizing...

  14. Patient Demonstration Videos in Predoctoral Endodontic Education: Aspects Perceived as Beneficial by Students.

    PubMed

    Edrees, Hadeel Y; Ohlin, Johan; Ahlquist, Michael; Tessma, Mesfin K; Zary, Nabil

    2015-08-01

    The aim of this study was to assess the perceived benefits of video-mediated demonstrations in learning endodontics. Participants in the study were 75 third-year students enrolled in the undergraduate dentistry program at Karolinska Institute, Stockholm, Sweden. After the endodontic preclinical course, the students were introduced to the treatment protocol in the clinic by watching two live patient-demonstrated videos. The first video demonstrated how to communicate with the patient and perform diagnosis and root canal instrumentation. The second video illustrated how to perform bacterial sampling and root canal filling. After the students watched each video, a questionnaire was used to evaluate their opinions about various steps of the endodontic treatment protocol and the benefit of such educational material for their practice. Of the total 75 students, 72 completed the first questionnaire (96% response rate), and 65 completed the second questionnaire (87% response rate). The results showed that the students perceived high value in the video demonstrations related to treatment procedure. A statistically significant difference was observed between the perceived benefits of the first and second sessions in communication and treatment procedure (p<0.001). Further studies are needed to assess improvement in the design and delivery format for video demonstrations to enhance their effectiveness as a teaching modality for endodontics. PMID:26246531

  15. Manual versus mechanical endodontic glidepath.

    PubMed

    West, John

    2011-01-01

    This article, the second in a series of 3 articles on the endodontic Glidepath beginning with the September 2010 issue of Dentistry Today (archived articles can be found at dentistrytoday.com), represents an inquiry into the critical distinctions of the endodontic Glidepath. First, we reviewed the need for a confirmed and reproducible Glidepath as prerequisite to rotary or reciprocal shaping. In order to be safe, before rotary shaping, the dentist must always discover that a Glidepath already exists or that one needs to be created. Second, an emphasis was placed on a "finishing checklist" for Glidepath preparation for safe and successful rotary. The checklist is 2 parts: (1) minimum super loose No. 10 file sized k tunnel is verified; (2) the super loose No. 10 file sized tunnel must run from canal orifice through the canal PT to the RT. In this way, patency is preserved and yet the delicate and often fragile cemental anatomy remains undamaged and unchanged, therefore meeting Schilder's fourth mechanical objective of "keeping the foramen as small as practical." Third, we discussed that the question should not be "manual versus mechanical" but rather "manual, then mechanical." Always measure the existence of a Glidepath with manual before mechanical. The key elements for improving your performance of Glidepath mastery include a clear intention of what needs to be accomplished and yet at the same time, restraint; gentleness; copious irrigation with sodium hypochlorite; curved files; randomness; discovery; expecting the unexpected and surrendering to, honoring, and respecting the delicate anatomical structure called the root canal system. After all, nature has been demonstrating how to make a Glidepath for a long time, but we have not been paying attention. We have been too heavy-handed, we have pushed, we have forced, and we have not always been good stewards of nature's fragile framework. She has been giving us and teaching us the Glidepath answer all along. Listen

  16. Innovations in endodontic filling materials: guttapercha vs Resilon.

    PubMed

    de Souza Filho, Francisco José; Gallina, Giuseppe; Gallottini, Livio; Russo, Riccardo; Cumbo, Enzo Maria

    2012-01-01

    One of the goals of endodontic treatment is to achieve a complete, tridimensional, hermetic sealing of the root canal system to prevent the entry of microorganisms or their products through both the coronal and apical pathways. Gutta-percha is the most widely used material for root canal filling and despite its numerous properties, such as biocompatibility and thermoplasticity, it has however an important limit: the lack of adhesion to the canal walls. Attempts to address this problem have been made over the years by using endodontic cements capable of bonding to canal dentine but their tendency to resorption in time can compromise the quality of treatment. The first step towards a real adhesive endodontic filling(4) is rather recent; in fact, it goes back to 2003 when, on the occasion of the American Dental Association (ADA) Annual Session, Resilon Research LLC introduced a new canal filling adhesive system based on a thermoplastic synthetic resin material called Resilon™. The real innovation of this system is its capacity of creating a core made of Resilon™ bonded to the cement which adheres to dentine walls previously conditioned with a self-etching primer(4) so no changes in the techniques of canal preparation are required. The aim of this study was to evaluate the capacity of two filling materials (gutta-percha and Resilon) to adapt to the canal anatomy, especially on the apical third, using the continuous wave of condensation technique. Our data suggest that in the third apical the gutta-percha best shows rheological properties that are as important as the bond capability. PMID:22632398

  17. Probable biofilm formation in the cheek as a complication of soft tissue filler resulting from improper endodontic treatment of tooth 16.

    PubMed

    Marusza, Wojciech; Mlynarczyk, Grazyna; Olszanski, Romuald; Netsvyetayeva, Irina; Obrowski, Michael; Iannitti, Tommaso; Palmieri, Beniamino

    2012-01-01

    Injectable filling agents offer the promise of a better appearance without surgery and, among them, hyaluronic acid is the most commonly used. Although complications are rare, it is necessary to know the possible side effects and complications in order to be prepared for their management. That is why many researchers have been focusing on the interactions between hyaluronic acid and pathogens, inflammatory mediators, the immune system, and markers of oxidative stress to achieve efficient drug delivery, given that hyaluronic acid has widening applications in the field of nanomedicine. Here we report the case of a 37-year-old female patient who returned to our clinic with an abscess in her left cheek 3 months after a deep injection of 1 mL of stabilized hyaluronic acid in both cheeks. Steroid and antibiotic therapy was initiated without success, and abscess drainage was performed. Extraction of tooth 16 was performed 11 days after insertion of drains into the abscess. Laboratory blood tests showed acute inflammation of presumed bacterial etiology. Microbiological examination of pus was negative. Bacterial cultures were found in the extracted tooth. After antibiotic therapy, a complete reversal of the pathological process was observed. The present report highlights the need to assess periodontal problems prior to any aesthetic facial treatment. Analyses of further case reports and clinical studies are necessary to understand the potential role of hyaluronic acid in the formation of biofilm, and how to avoid this complication, thereby increasing the safety of hyaluronic acid-based procedures. PMID:22619504

  18. Probable biofilm formation in the cheek as a complication of soft tissue filler resulting from improper endodontic treatment of tooth 16

    PubMed Central

    Marusza, Wojciech; Mlynarczyk, Grazyna; Olszanski, Romuald; Netsvyetayeva, Irina; Obrowski, Michael; Iannitti, Tommaso; Palmieri, Beniamino

    2012-01-01

    Injectable filling agents offer the promise of a better appearance without surgery and, among them, hyaluronic acid is the most commonly used. Although complications are rare, it is necessary to know the possible side effects and complications in order to be prepared for their management. That is why many researchers have been focusing on the interactions between hyaluronic acid and pathogens, inflammatory mediators, the immune system, and markers of oxidative stress to achieve efficient drug delivery, given that hyaluronic acid has widening applications in the field of nanomedicine. Here we report the case of a 37-year-old female patient who returned to our clinic with an abscess in her left cheek 3 months after a deep injection of 1 mL of stabilized hyaluronic acid in both cheeks. Steroid and antibiotic therapy was initiated without success, and abscess drainage was performed. Extraction of tooth 16 was performed 11 days after insertion of drains into the abscess. Laboratory blood tests showed acute inflammation of presumed bacterial etiology. Microbiological examination of pus was negative. Bacterial cultures were found in the extracted tooth. After antibiotic therapy, a complete reversal of the pathological process was observed. The present report highlights the need to assess periodontal problems prior to any aesthetic facial treatment. Analyses of further case reports and clinical studies are necessary to understand the potential role of hyaluronic acid in the formation of biofilm, and how to avoid this complication, thereby increasing the safety of hyaluronic acid-based procedures. PMID:22619504

  19. On implementation of an endodontic program.

    PubMed

    Koch, Margaretha

    2013-01-01

    It is widely accepted that the uptake of research findings by practitioners is unpredictable, yet until they are adopted, advances in technology and clinical research cannot improve health outcomes in patients. Despite extensive research there is limited knowledge of the processes by which changes occur and ways of measuring the effectiveness of change of practice. The overall aim of this thesis was to investigate aspects of an educational intervention in clinical endodontic routines and new instrumentation techniques in a Swedish County Public Dental Service. Special reference was made to the establishment of changed behaviour in practice, the process of change, and the clinical effects. Although a high level of competence in root canal treatment procedures is required in general dental practice, a number of Swedish studies have revealed inadequate root-fillings quality and associated periapical inflammation in general populations. It is suggested that the adoption of the nickel-titanium rotary instrumentation (NiTiR) technique would improve the cleaning and shaping of root canals and the quality of the root-filling. However, there is limited knowledge of the effectiveness of the technique when applied in general dental practice. In two of four consecutive studies, the subjects were employees of a county Public Dental Service. The aim was to investigate the rate of adoption of clinical routines and the NiTiR technique: the output, and the qualitative meaning of successful change in clinical practice. In the other two studies the aim was to investigate treatment effect and the cost-effectiveness of root canal treatment in a general population: the outcome. Four hundred employees (dentists, dental assistants, administrative assistants and clinical managers) of a Swedish County Public Dental Service were mandatorily enrolled in an educational and training program over two years. Change of practice was investigated in a post-education survey. The NiTiR technique was

  20. A Survey over the Dentists’ and Endodntists’ Approaches towards the Management of Endodontic Emergencies in Mashhad, Iran

    PubMed Central

    Bidar, Maryam; Gharechahi, Maryam; Soleimani, Tayebeh; Eslami, Neda

    2015-01-01

    Introduction: Pain or swelling caused by various stages of inflammation/infection of the pulp/periradicular area is among endodontic emergencies. Determining the most effective method of emergency treatment is a challenging issue in endodontics. The goal of this study was to determine and compare the level of knowledge in general dentists and endodontists about endodontic emergency treatment plan in Mashhad, Iran in 2012-2013. Methods and Materials: In this cross-sectional descriptive study, 152 questionnaires were distributed among 120 general dentists and 32 endodontists of Mashhad. The questionnaire contained two separate parts. The first part included demographic information and in the second part different treatment protocols were suggested for 12 various conditions of pulp/periapical emergencies, and the participants were asked to choose the correct option(s). To determine the relationship between qualitative variables, the chi-square analysis was used. The level of significance was set at 0.05. Results: There were significant differences between treatment plans presented by general dentists and endodontists about endodontic emergencies, especially in cases of necrotic pulp and subsequent swelling. Conclusion: Level of knowledge of dentists about the indications of incision and drainage, intra-canal medicament, root filing beyond the apical foramen and antibiotic prescription was not enough. These findings highlight the importance of refreshing courses for general dentists to improve their competency in the management of endodontic emergencies. PMID:26523142

  1. Estimated radiation risks associated with endodontic radiography.

    PubMed

    Danforth, R A; Torabinejad, M

    1990-02-01

    Endodontic patients are sometimes concerned about the risks of tumors or cataracts from radiation exposure during root canal therapy. By using established dose and risk information, we calculated the extent of these risks. The chance of getting leukemia from an endodontic x-ray survey using 90 kVp was found to be 1 in 7.69 million, the same as the risk of dying from cancer from smoking 0.94 cigarettes or from an auto accident when driving 3.7 km. Risk of thyroid gland neoplasia was 1 in 667,000 (smoking 11.6 cigarettes, driving 45 km) and risk of salivary gland neoplasia 1 in 1.35 million (smoking 5.4 cigarettes, driving 21.1 km). Use of 70 kVp radiography reduced these risks only slightly. To receive the threshold dose to eyes to produce cataract changes, a patient would have to undergo 10,900 endodontic surveys. PMID:2390963

  2. Bactericidal effect of Nd:YAG laser irradiation in endodontics

    NASA Astrophysics Data System (ADS)

    Aun, Carlos E.; Barberini, Alexandre F.; Camargo, Selma C. C.; Silva Kfouri, Luciana; Lorenzetti Simionato, Maria R.

    1999-05-01

    The success of endodontic therapy is based on the elimination of bacterial colonization from the endodontic system and periapical tissues. Recent studies have been showing the bactericidal effect of laser in root canal treatment. The propose of the study is to evaluate the effect of Nd:YAG laser irradiation in contaminated root canal treatment. The propose of the study is to evaluate the effect of Nd:YAG laser irradiation in contaminated root canals from upper central incisor. For the experiment 12 teeth were selected, respect at the apical third, sterilized, and 10 μm Streptococcus sanguis liquid culture were inoculated in the root canals. The laser test groups were irradiated with Nd:YAG laser at standard setting of 15Hz, 100mj and 1,5 W for 10, 20 and 30 seconds each in slow helicoidal movements from the apex to the top using a 300 micrometers fiber. After the procedure the specimens were placed in Tryptic Soy Agar, the number of colony forming units was evaluated. The experiment showed a significant reduction on viability of Streptococcus sanguis at the respective time of 20 and 30 seconds.

  3. Endodontic management of a fused mandibular second molar and paramolar with the aid of spiral computed tomography: a case report.

    PubMed

    Ballal, Suma; Sachdeva, Gurmeet Singh; Kandaswamy, Deivanayagam

    2007-10-01

    Fusion and gemination are developmental anomalies of the dental hard tissues that might require endodontic and surgical treatment for functional, orthodontic, or esthetic reasons. In this article, we report a rare case of successful endodontic management of unilateral fused mandibular second molar with a paramolar. The rarity with which this entity appears, along with its complex characteristics, often makes it difficult to diagnose and treat. The use of high-end diagnostic imaging modalities such as spiral computed tomography can help the clinician in making a confirmatory diagnosis and determining the treatment plan before undertaking the actual treatment. This case report highlights the usefulness of spiral computed tomography in accurate diagnosis and endodontic management of these unusual cases. PMID:17889700

  4. A technique to salvage endodontically compromised maxillary anterior tooth.

    PubMed

    Comut, Alper; Foran, Denise; Cunningham, Ralph P

    2014-01-01

    A complication of endodontic treatment is over-preparation of the tooth structure in an attempt to access calcified pulp chambers and root canals. This could result in thin root walls that might compromise the long-term prognosis of the tooth. There are various treatment options when such a complication occurs, among them, extraction of the compromised tooth and its replacement with a dental implant. This clinical report describes a nonsurgical, multidisciplinary treatment alternative where a maxillary anterior tooth with a thinned root wall was successfully saved by repairing the damaged root to its original thickness using a composite resin material and subsequently restoring with a cast post and core and a crown. PMID:24654367

  5. Genotoxicity of Endodontic Materials: A Critical Review.

    PubMed

    Mohammadi, Zahed; Shalavi, Sousan; Jafarzadeh, Hamid; Bhandi, Shilpa; Patil, Shankargouda

    2015-08-01

    Genotoxicity is an action on cell's genetic material which may affect its integrity. This includes certain types of radiations and also certain chemical compounds. Genotoxic materials are those with affinity to interact with DNA but render them potentially carcinogenic or mutagenic. This review will address the genotoxicity of endodontic irrigants, medicaments and sealers. PMID:26423507

  6. Regenerative Endodontics in light of the stem cell paradigm

    PubMed Central

    Rosa, Vinicius; Botero, Tatiana M.; Nör, Jacques E.

    2013-01-01

    Stem cells play a critical role in development and in tissue regeneration. The dental pulp contains a small sub-population of stem cells that are involved in the response of the pulp to caries progression. Specifically, stem cells replace odontoblasts that have undergone cell death as a consequence of the cariogenic challenge. Stem cells also secrete factors that have the potential to enhance pulp vascularization and provide the oxygen and nutrients required for the dentinogenic response that is typically observed in teeth with deep caries. However, the same angiogenic factors that are required for dentin regeneration may ultimately contribute to the demise of the pulp by enhancing vascular permeability and interstitial pressure. Recent studies focused on the biology of dental pulp stem cells revealed that the multipotency and angiogenic capacity of these cells could be exploited therapeutically in dental pulp tissue engineering. Collectively, these findings suggest new treatment paradigms in the field of Endodontics. The goal of this review is to discuss the potential impact of dental pulp stem cells to Regenerative Endodontics. PMID:21726222

  7. The influence of endodontic broken stainless steel instruments on the urinary levels of iron.

    PubMed

    Saghiri, Mohammad Ali; Asatourian, Armen; Haraji, Afshin; Ramezani, Golam H; Garcia-Godoy, Franklin; Scarbecz, Mark; Sheibani, Nader

    2014-06-01

    Previous studies on the endodontic broken stainless steel instruments have mainly focused on retrieval of specimens. However, the systemic consequences of the retained separated instruments need an investigation. The current study aimed to evaluate the correlation between broken stainless steel instruments inside the root canal space and the urinary level of iron (Fe) in patients. Sixty near-aged and same-gender patients were selected. Thirty patients in the control group had no endodontic treatment in their history, while the other 30 patients in the endodontic group had broken stainless steel instrument. The urine samples were collected in iron-free containers. All specimens were refrigerated for 1 day and then subjected to Fe level measurement by electrothermal atomic absorption spectrometry. Data were analyzed by Kolmogorov-Smirnov and t tests at P < 0.05. The correlation coefficients of age and sex were also evaluated in relation with Fe levels in the urine. The level of Fe did not show any significant increase in the experimental group (P > 0.05). There was a positive correlation between age and Fe levels of endodontic and control groups. However, the joint effects of age and sex on Fe levels were different for the two groups. The presence of broken stainless steel instruments inside the root canal space did not elevate the level of Fe in the urine of patients. However, this value was positively correlated with the patient age. PMID:24699830

  8. Clinical decision making in restorative dentistry, endodontics, and antibiotic prescription.

    PubMed

    Zadik, Yehuda; Levin, Liran

    2008-01-01

    The purpose of this study was to evaluate the influence of geographic location of graduation (Israel, Eastern Europe, Latin America) on decision making regarding management of dental caries, periapical lesions, and antibiotic prescribing routines. A questionnaire was given to ninety-eight general practitioners regarding demographic and work habits. Photographs of lesions were shown on a screen. Participants reported recommended treatment and whether they would routinely prescribe antibiotics following regular endodontic treatment, retreatment, and impacted third molar surgical extraction in healthy patients. There was a 94 percent (n=92) response rate, of which eighty-five responses were used in the data analysis. Surgical treatment of asymptomatic enamel caries lesions was not recommended by most of the subjects, and surgery was recommended for DEJ caries lesions in low or moderate caries risk patients, both without significant differences between geographic regions of dental school graduation. Israelis had a lower frequency of retreatment in asymptomatic teeth that demonstrated periapical radiolucency with post restoration (without crown) compared to Latin Americans and East Europeans. Most of the participants would not retreat asymptomatic teeth that demonstrated periapical radiolucency with post and crown. After third molar surgery, 46 percent of participants routinely prescribed antibiotics. Significantly more Latin American graduates prescribed antibiotics following endodontic treatment, retreatment, and third molar extractions (p<0.05). Overmedication (antibiotics) and overtreatment (caries) among young practitioners reflect failure of undergraduate education in proper use of antibiotics and management of the carious lesions according to the patient's clinical presentation and caries risk assessment rather than routinely undertaking surgical caries treatment. PMID:18172239

  9. Effect of Premedication with Indomethacin and Ibuprofen on Postoperative Endodontic Pain: A Clinical Trial

    PubMed Central

    Mokhtari, Fatemeh; Yazdi, Kamal; Mahabadi, Amir Mohammad; Modaresi, Seyed Jalil; Hamzeheil, Zeinab

    2016-01-01

    Introduction: Post-endodontic pain is one of the main problems for both patients and dentists. The purpose of this study was to compare the effectiveness of premedication with indomethacin and ibuprofen for management of postoperative endodontic pain. Methods and Materials: In this clinical trial, mandibular molars with irreversible pulpitis were endodontically treated in 66 patients. The medicines were prepared similarly in the form of capsules containing 400 mg ibuprofen (group A), 25 mg indomethacin (group B) and placebo (group C). The patients were given one capsule 1 h before the start of treatment. Patients recorded their pain measured by a visual analogue scale (VAS) at medication time, during treatment and 8, 12 and 24 h after treatment. The data were analyzed using the chi-square, repeated measures ANOVA, paired t-test, Tamhane and Pearson correlation coefficient. Results: Ibuprofen and indomethacin significantly reduced the postoperative pain in comparison with placebo during treatment and 8 h after treatment; however, there were no significant differences between them 12 and 24 h after treatment. Conclusion: Premedication with ibuprofen and indomethacin can effectively control short term post-operative pain; the lower incidence of side effects and greater analgesic power of ibuprofen make it a superior choice. PMID:26843879

  10. Modern Endodontic Planning Part 1: Assessing Complexity and Predicting Success.

    PubMed

    Jawad, Sarra; Taylor, Carly; Roudsari, Reza Vahid; Darcey, James; Qualtrough, Alison

    2015-09-01

    Following a diagnosis of irreversible pulpal disease, periapical disease or failed endodontic therapy, the options for the tooth are extraction or root canal treatment. There is increasing evidence that certain factors may allow the clinician to predict the likely outcome of root canal therapy (RCT) and thus better inform the patient of the possible success rates. Should the patient choose root canal treatment, the clinician must also be able to gauge the potential difficulties that may be encountered and consequently determine whether it is within their competency. CPD/CLINICAL RELEVANCE: Assessing outcomes and complexity of care is an essential part of informed consent. Knowing when to refer is an essential component of best clinical practice. PMID:26630858

  11. Cone beam computed tomography evaluation and endodontic management of permanent mandibular second molar with four roots: A rare case report and literature review

    PubMed Central

    Rajasekhara, Subhashini; Sharath Chandra, SM; Parthasarathy, Late Bharath

    2014-01-01

    The morphological variation in the number of roots and root canals, especially in multi-rooted teeth is a constant challenge for diagnosis and successful endodontic therapy. Knowledge of the most common anatomic characteristics and their possible variations is fundamental. Although, endodontic management of four-rooted mandibular first molars have been observed on a few occasions in the literature, to the best of our knowledge four-rooted mandibular second molars having two mesial and two distal roots have not been reported. This paper highlights endodontic management of mandibular second molar with four roots (two mesial and two distal) with one canal in each root and its cone beam computed tomography (CBCT) evaluation which was primarily done for post treatment assessment for diagnosing post-endodontic complications, at the same time confirmed our radiographic diagnosis of this variation. This also helped us portraying the anatomy of this rare variation. PMID:25125856

  12. Evidenced-based review of clinical studies on endodontic diagnosis.

    PubMed

    2009-08-01

    The practice of endodontics requires excellence in diagnostic skills. The importance of this topic has been underscored by a recent 2008 AAE-sponsored symposium on endodontic diagnosis, which will be highlighted in a special issue of the Journal of Endodontics. In this minireview, we focus on recent clinical studies that emphasize different aspects related to the diagnosis of disorders of the pulp-dentin complex. PMID:19631854

  13. Canal projection using gutta-percha points: A novel technique for pre-endodontic buildup of grossly destructed tooth

    PubMed Central

    Tanikonda, Rambabu

    2016-01-01

    The use of Projector Endodontic Instrument Guidance System (PEIGS) during endodontic treatment of grossly mutilated tooth facilitates projection of canal orifices from the floor of the pulp chamber to the cavosurface, providing direct visualization and access to the projected canals. Alternatives, such as hypodermic needles as sleeves, were tried successfully with similar outcome. The aim of this case report is to describe a simpler, easily available, economical, yet an effective alternative technique to conventional PEIGS during the pre-endodontic management of grossly destructed tooth. These case reports demonstrate the use of greater tapered gutta-percha points that are easily available and more economical than PEIGS for the successful management of a badly destructed tooth. PMID:27099431

  14. Prevalence of Rubber Dam Usage during Endodontic Procedure: A Questionnaire Survey

    PubMed Central

    G, Shashirekha; Maity, Asim Bikash; Panda, Pankaj Kumar

    2014-01-01

    Aim: To determine the prevalence and frequency of rubber dam usage for endodontic procedures among general practitioners, specialized practitioners, undergraduate final year students and Endodontists in the state of Odisha, India. Methodology: A pre-piloted questionnaire was distributed among 737 subjects. Dentists and final year students were surveyed in relation to their prevalence of rubber dam usage. Statistical Analysis Used: Chi-square/ Fisher Exact tests have been used to find the significance of study parameters on categorical scale between two or more groups. Results: Overall response rate was 71%. While about 94% of the subjects knew the use of rubber dam, 30% have used it for root canal cases and 23% use them for all cases of root canal treatment. Use of rubber dam was 15.4% in paediatric patients and 34.4% in adult patients. 68% of subjects received knowledge about rubber dam usage in undergraduate school. 75% felt that rubber dam should be compulsory before endodontic treatment & 90% were willing to gain knowledge through training and continuing dental education programs. Conclusion: Whilst rubber dam is used frequently for root canal treatment than operative treatment, in the present survey there is a low prevalence of its usage during endodontic therapy. This presents quality issues, as well as medico-legal and safety concerns for the professional and patients alike. Greater emphasis should be placed on the advantages of using rubber dam in clinical dentistry at dental school and through continuing dental education for practitioners to update their knowledge. PMID:25121053

  15. [Accidental injection sodium hypochlorite during endodontic therapy. Better understand to better manage].

    PubMed

    Ben Rejeb, H; Douki, N

    2015-09-01

    The high frequency of iatrogenic incidents during endodontic treatment is a source of stress for the practitioner. These incidents may occur during the different steps of a root canal treatment. During irrigation, extrusion of sodium hypochlorite beyond the apex is a rare but impressive accident. Sodium hypochlorite, is the most common irrigant used in modern endodontics, but when it comes in contact with the periapical tissue, it can cause complications ranging from mild discomfort to serious tissue damage such as the hematoma and hemato-emphysema. The aims of this article are to discuss through the presentation of two clinical cases: Etiological and predisposing factors; Signs guiding to suspicion of accidental injection of sodium hypochlorite. In this work, we focused on clinical keys that help the practitioner in better understanding this accident in order to prevent it or to manage it well when it occurs. PMID:26930773

  16. Diversity of Spirochetes in Endodontic Infections ▿

    PubMed Central

    Sakamoto, Mitsuo; Siqueira, José F.; Rôças, Isabela N.; Benno, Yoshimi

    2009-01-01

    The diversity of spirochetes in primary endodontic infections of teeth with chronic apical periodontitis or acute apical abscesses was investigated using 16S rRNA gene clone library analysis. The prevalences of three common cultivable oral Treponema species were also determined using species-specific nested PCR. All detected spirochetes belonged to the genus Treponema. Overall, 28 different taxa were identified from the 431 clones sequenced: 9 cultivable and validly named species, 1 cultivable as-yet-uncharacterized strain, and 18 as-yet-uncultivated phylotypes, 17 of which were novel. The large majority of clones (94%) were from cultivable named species. The numbers of Treponema species/phylotypes per selected positive sample ranged from 2 to 12. Species-specific nested PCR detected T. denticola, T. socranskii, and T. maltophilum in 59 (66%), 33 (37%), and 26 (29%) of the 90 cases of primary endodontic infections, respectively. Clone library analysis revealed diverse Treponema species/phylotypes as part of the microbiota associated with asymptomatic and symptomatic (abscess) endodontic infections. Although several as-yet-uncultivated Treponema phylotypes were disclosed, including novel taxa, cultivable named species were more abundant and frequently detected. PMID:19261792

  17. Diversity of spirochetes in endodontic infections.

    PubMed

    Sakamoto, Mitsuo; Siqueira, José F; Rôças, Isabela N; Benno, Yoshimi

    2009-05-01

    The diversity of spirochetes in primary endodontic infections of teeth with chronic apical periodontitis or acute apical abscesses was investigated using 16S rRNA gene clone library analysis. The prevalences of three common cultivable oral Treponema species were also determined using species-specific nested PCR. All detected spirochetes belonged to the genus Treponema. Overall, 28 different taxa were identified from the 431 clones sequenced: 9 cultivable and validly named species, 1 cultivable as-yet-uncharacterized strain, and 18 as-yet-uncultivated phylotypes, 17 of which were novel. The large majority of clones (94%) were from cultivable named species. The numbers of Treponema species/phylotypes per selected positive sample ranged from 2 to 12. Species-specific nested PCR detected T. denticola, T. socranskii, and T. maltophilum in 59 (66%), 33 (37%), and 26 (29%) of the 90 cases of primary endodontic infections, respectively. Clone library analysis revealed diverse Treponema species/phylotypes as part of the microbiota associated with asymptomatic and symptomatic (abscess) endodontic infections. Although several as-yet-uncultivated Treponema phylotypes were disclosed, including novel taxa, cultivable named species were more abundant and frequently detected. PMID:19261792

  18. Cleaning of endodontic files, Part I: The effect of bioburden on the sterilization of endodontic files.

    PubMed

    Johnson, M A; Primack, P D; Loushine, R J; Craft, D W

    1997-01-01

    Ninety-two new endodontic files were randomly assigned to five groups with varying parameters of contamination, cleaning method, and sterilization (steam or chemical). Files were instrumented in bovine teeth to accumulate debris and a known contaminant, Bacillus stearothermophilus. Positive controls produced growth on both T-soy agar plates and in T-soy broth. Negative controls and experimental files (some with heavy debris) failed to produce growth. The results showed that there was no significant difference between contaminated files that were not cleaned before sterilization and contaminated files that were cleaned before sterilization. Bioburden present on endodontic files does not appear to affect the sterilization process. PMID:9594742

  19. An In Vitro Study on the Effects of Post-Core Design and Ferrule on the Fracture Resistance of Endodontically Treated Maxillary Central Incisors

    PubMed Central

    Sreedevi, S; Sanjeev, R; Raghavan, Rekha; Abraham, Anna; Rajamani, T; Govind, Girish Kumar

    2015-01-01

    Background: Endodontically treated teeth have significantly different physical and mechanical properties compared to vital teeth and are more prone to fracture. The study aims to compare the fracture resistance of endodontically treated teeth with and without post reinforcement, custom cast post-core and prefabricated post with glass ionomer core and to evaluate the ferrule effect on endodontically treated teeth restored with custom cast post-core. Materials and Methods: A total of 40 human maxillary central incisors with similar dimensions devoid of any root caries, restorations, previous endodontic treatment or cracks were selected from a collection of stored extracted teeth. An initial silicone index of each tooth was made. They were treated endodontically and divided into four groups of ten specimens each. Their apical seal was maintained with 4 mm of gutta-percha. Root canal preparation was done and then post core fabrication was done. The prepared specimens were subjected to load testing using a computer coordinated UTM. The fracture load results were then statistically analyzed. One-way ANOVA was followed by paired t-test. Results: 1. Reinforcement of endodontically treated maxillary central incisors with post and core, improved their fracture resistance to be at par with that of endodontically treated maxillary central incisor, with natural crown. 2. The fracture resistance of endodontically treated maxillary central incisors is significantly increased when restored with custom cast post-core and 2 mm ferrule. Conclusion: With 2 mm ferrule, teeth restored with custom cast post-core had a significantly higher fracture resistance than teeth restored with custom cast post-core or prefabricated post and glass ionomer core without ferrule. PMID:26464537

  20. Biocompatibility of dental materials used in contemporary endodontic therapy: a review. Part 2. Root-canal-filling materials.

    PubMed

    Hauman, C H J; Love, R M

    2003-03-01

    Root-canal-filling materials are either placed directly onto vital periapical tissues or may leach through dentine. The tissue response to these materials therefore becomes important and may influence the outcome of endodontic treatment. This paper is a review of the biocompatibility of contemporary orthograde and retrograde root-canal-filling materials. PMID:12657140

  1. The comparison of the effect of endodontic irrigation on cell adherence to root canal dentin.

    PubMed

    Ring, Karla C; Murray, Peter E; Namerow, Kenneth N; Kuttler, Sergio; Garcia-Godoy, Franklin

    2008-12-01

    The purpose of this study was to compare the effect of 10 different endodontic irrigation and chelating treatments on dental pulp stem cell (DPSC) attachment to root canal surfaces. Thirty-eight extracted human nondiseased single-canal teeth were cleaned and shaped using ProTaper and ProFile rotary instrumentation (Tulsa Dentsply, Tulsa, OK). The irrigation treatments investigated were 6% sodium hypochlorite, 2% chlorhexidine gluconate, Aquatine Endodontic Cleanser, and Morinda citrifolia juice. The irrigation treatments were used in conjunction with EDTA or MTAD. The instrumented teeth were immediately placed in cell culture with confluent DPSCs for 1 week. The number of attached DPSCs appeared to be correlated with the cytotoxicity of the root canal irrigating solution (analysis of variance, p < 0.0001). The presence or absence of the smear layer had little influence on DPSC activity (chi-square, p > 0.05). The results suggest that biocompatible irrigants are needed to promote DPSC attachment to root canal dentin, which is essential to accomplish some regenerative endodontic therapies. PMID:19026877

  2. Numerical Study on the Influence of Material Characteristics on Ni-Ti Endodontic Instrument Performance

    NASA Astrophysics Data System (ADS)

    Petrini, Lorenza; Necchi, Silvia; Taschieri, Silvio; Migliavacca, Francesco

    2009-08-01

    Ni-Ti rotary endodontic instruments ( files) are used in dentistry during the endodontic treatment to shape the root canal of the tooth while removing the pulp when infected. Up to now, the studies for evaluating their performances and drawbacks were mainly limited to experimental tests on product flexural and torsional resistance. This work exploits computational analyses for investigating the effects of materials with different mechanical properties on the behavior of rotary endodontic instruments. The aim is to understand the appropriate material choice to reduce the criticality of the treatment in particular clinical conditions. In particular, the interaction between an accurately modeled rotating file and differently shaped root canals during the clinical procedure was studied performing finite element analyses. Strains induced by the treatment on a file made of a “standard” Ni-Ti alloy (characterized by average properties of the pseudoelastic behavior), a “long” Ni-Ti alloy (characterized by wide transformation region), a “super” Ni-Ti alloy (characterized by an extended Hookian behavior without transformation region), and stainless steel were compared. The results accurately show the advantages of the use of Ni-Ti alloy with respect to stainless steel and the better performance of the “long” alloy in all the tested case.

  3. 21 CFR 872.3830 - Endodontic paper point.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Endodontic paper point. 872.3830 Section 872.3830 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3830 Endodontic paper point. (a)...

  4. 21 CFR 872.3830 - Endodontic paper point.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Endodontic paper point. 872.3830 Section 872.3830 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3830 Endodontic paper point. (a)...

  5. 21 CFR 872.6730 - Endodontic dry heat sterilizer.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... dry heat sterilizer shall have an approved PMA or declared completed PDP in effect before being placed... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Endodontic dry heat sterilizer. 872.6730 Section... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Miscellaneous Devices § 872.6730 Endodontic dry heat...

  6. 21 CFR 872.6730 - Endodontic dry heat sterilizer.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... dry heat sterilizer shall have an approved PMA or declared completed PDP in effect before being placed... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Endodontic dry heat sterilizer. 872.6730 Section... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Miscellaneous Devices § 872.6730 Endodontic dry heat...

  7. 21 CFR 872.6730 - Endodontic dry heat sterilizer.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... dry heat sterilizer shall have an approved PMA or declared completed PDP in effect before being placed... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Endodontic dry heat sterilizer. 872.6730 Section... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Miscellaneous Devices § 872.6730 Endodontic dry heat...

  8. 21 CFR 872.3890 - Endodontic stabilizing splint.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Endodontic stabilizing splint. 872.3890 Section 872.3890 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3890 Endodontic stabilizing splint....

  9. Application of lasers in endodontics

    NASA Astrophysics Data System (ADS)

    Ertl, Thomas P.; Benthin, Hartmut; Majaron, Boris; Mueller, Gerhard J.

    1997-12-01

    Root canal treatment is still a problem in dentistry. Very often the conventional treatment fails and several treatment sessions are necessary to save the tooth from root resection or extraction. Application of lasers may help in this situation. Bacteria reduction has been demonstrated both in vitro and clinically and is either based on laser induced thermal effects or by using an ultraviolet light source. Root canal cleansing is possible by Er:YAG/YSGG-Lasers, using the hydrodynamic motion of a fluid filled in the canals. However root canal shaping using lasers is still a problem. Via falsas and fiber breakage are points of research.

  10. Endodontic management of mandibular first molar with seven canals using cone-beam computed tomography

    PubMed Central

    Banode, Ankur Mahesh; Gade, Vandana; Patil, Sanjay; Gade, Jaykumar

    2016-01-01

    The endodontic treatment of a mandibular molar with aberrant canal configuration can be diagnostically and clinically challenging. Successful endodontic therapy thus depends on the clinician's ability to anticipate and look for these aberrant variations. A mandibular first molar with seven canals represents a rare anatomical variant, particularly when four canals are found in distal root. Based on in vitro studies, its incidence is reported to be between 0.2% and 3%. With the advent of cone-beam computed tomography (CBCT) as an adjunctive diagnostic aid, the determination of root canal anatomy in teeth with complex canal configurations has become more precise. The present case report discusses successful nonsurgical management of radix entomolaris along with middle mesial canal and middle distal canal in mandibular first molar with seven canals (four canals in distal and three in mesial) employing CBCT as an adjunctive diagnostic aid to conventional radiography. PMID:27307680

  11. Endodontic management of mandibular first molar with seven canals using cone-beam computed tomography.

    PubMed

    Banode, Ankur Mahesh; Gade, Vandana; Patil, Sanjay; Gade, Jaykumar

    2016-01-01

    The endodontic treatment of a mandibular molar with aberrant canal configuration can be diagnostically and clinically challenging. Successful endodontic therapy thus depends on the clinician's ability to anticipate and look for these aberrant variations. A mandibular first molar with seven canals represents a rare anatomical variant, particularly when four canals are found in distal root. Based on in vitro studies, its incidence is reported to be between 0.2% and 3%. With the advent of cone-beam computed tomography (CBCT) as an adjunctive diagnostic aid, the determination of root canal anatomy in teeth with complex canal configurations has become more precise. The present case report discusses successful nonsurgical management of radix entomolaris along with middle mesial canal and middle distal canal in mandibular first molar with seven canals (four canals in distal and three in mesial) employing CBCT as an adjunctive diagnostic aid to conventional radiography. PMID:27307680

  12. Microbial transformation from normal oral microbiota to acute endodontic infections

    PubMed Central

    2012-01-01

    Background Endodontic infections are a leading cause of oro-facial pain and tooth loss in western countries, and may lead to severe life-threatening infections. These infections are polymicrobial with high bacterial diversity. Understanding the spatial transition of microbiota from normal oral cavities through the infected root canal to the acute periapical abscess can improve our knowledge of the pathogenesis of endodontic infections and lead to more effective treatment. We obtained samples from the oral cavity, infected root canal and periapical abscess of 8 patients (5 with localized and 3 with systemic infections). Microbial populations in these samples were analyzed using next-generation sequencing of 16S rRNA amplicons. Bioinformatics tools and statistical tests with rigorous criteria were used to elucidate the spatial transition of the microbiota from normal to diseased sites. Results On average, 10,000 partial 16S rRNA gene sequences were obtained from each sample. All sequences fell into 11 different bacterial phyla. The microbial diversity in root canal and abscess samples was significantly lower than in the oral samples. Streptococcus was the most abundant genus in oral cavities while Prevotella and Fusobacterium were most abundant in diseased samples. The microbiota community structures of root canal and abscess samples were, however, more similar to each other than to the oral cavity microbiota. Using rigorous criteria and novel bioinformatics tools, we found that Granulicatella adiacens, Eubacterium yurii, Prevotella melaninogenica, Prevotella salivae, Streptococcus mitis, and Atopobium rimae were over-represented in diseased samples. Conclusions We used a novel approach and high-throughput methodologies to characterize the microbiota associated normal and diseased oral sites in the same individuals. PMID:22839737

  13. Properties and applications of calcium hydroxide in endodontics and dental traumatology.

    PubMed

    Mohammadi, Z; Dummer, P M H

    2011-08-01

    Calcium hydroxide has been included within several materials and antimicrobial formulations that are used in a number of treatment modalities in endodontics. These include, inter-appointment intracanal medicaments, pulp-capping agents and root canal sealers. Calcium hydroxide formulations are also used during treatment of root perforations, root fractures and root resorption and have a role in dental traumatology, for example, following tooth avulsion and luxation injuries. The purpose of this paper is to review the properties and clinical applications of calcium hydroxide in endodontics and dental traumatology including its antibacterial activity, antifungal activity, effect on bacterial biofilms, the synergism between calcium hydroxide and other agents, its effects on the properties of dentine, the diffusion of hydroxyl ions through dentine and its toxicity. Pure calcium hydroxide paste has a high pH (approximately 12.5-12.8) and is classified chemically as a strong base. Its main actions are achieved through the ionic dissociation of Ca(2+) and OH(-) ions and their effect on vital tissues, the induction of hard-tissue deposition and the antibacterial properties. The lethal effects of calcium hydroxide on bacterial cells are probably due to protein denaturation and damage to DNA and cytoplasmic membranes. It has a wide range of antimicrobial activity against common endodontic pathogens but is less effective against Enterococcus faecalis and Candida albicans. Calcium hydroxide is also an effective anti-endotoxin agent. However, its effect on microbial biofilms is controversial. PMID:21535021

  14. Review of ultrasonic irrigation in endodontics: increasing action of irrigating solutions

    PubMed Central

    Mozo, Sandra; Llena, Carmen

    2012-01-01

    Introduction: Effective irrigant delivery and agitation are prerequisites for successful endodontic treatment. Ultrasonic irrigation can be performed with or without simultaneous ultrasonic instrumentation. Existing literature reveals that ultrasonic irrigation may have a very positive effect on chemical, biological and physical debridement of the root canal system as investigated in many in vitro studies. Objective: The purpose of this review article was to summarize and discuss the available information concerning ultrasonic irrigation in endodontics. Methods: This article presents an overview of ultrasonic irrigation methods and their debridement efficacy. In this paper the relevant literature on passive ultrasonic irrigation is reviewed. Information from original scientific papers or reviews listed in MEDLINE and Cochrane were included in the review. Results: The use of ultrasound in the irrigation procedure results in improved canal cleanliness, better irrigant transfer to the canal system, soft tissue debridement, and removal of smear layer and bacteria. There are many in vitro studies, but there is a need to standardize protocols, and correlate the clinical efficacy of ultrasonic devices with improved treatment outcomes. Understanding the basis of ultrasonic irrigation is fundamental for clinicians and researchers to improve the design and use of ultrasonic irrigation. Key words:Ultrasonic irrigation, ultrasound, smear layer, endodontics. PMID:22143738

  15. Comparison of Single Visit Post Endodontic Pain Using Mtwo Rotary and Hand K-File Instruments: A Randomized Clinical Trial

    PubMed Central

    Kashefinejad, Mohamad; Harandi, Azade; Bijani, Ali

    2016-01-01

    Objectives: Pain is an unpleasant outcome of endodontic treatment that can be unbearable to patients. Instrumentation techniques may affect the frequency and intensity of post-endodontic pain. This study aimed to compare single visit post endodontic pain using Mtwo (NiTi) rotary and hand K-file instruments. Materials and Methods: In this randomized controlled trial, 60 teeth with symptomatic irreversible pulpitis in 53 patients were selected and randomly assigned into two groups of 30 teeth. In group A, the root canals were prepared with Mtwo (NiTi) rotary instruments. In group B, the root canals were prepared with hand K-file instruments. Pain assessment was implemented using visual analog scale (VAS) at four, eight, 12 and 24 hours after treatment. The acquired data were analyzed using chi-square, Mann-Whitney U and Student’s t-test (P<0.05). Results: Patients treated with rotary instruments experienced significantly less post-endodontic pain than those treated with hand instruments (P<0.001). Conclusions: The use of Mtwo (NiTi) rotary instruments in root canal preparation contributed to lower incidence of postoperative pain than hand K-files.

  16. Evaluation of the retention of endodontic implants.

    PubMed

    Maniatopoulos, C; Pilliar, R M; Smith, D C

    1988-04-01

    The study investigated the retentive strength of endodontic implants measured by forced removal (pull-out or push-out tests) as a function of implant design and cement type. Smooth-tapered, threaded, and an innovative porous-surfaced implant were evaluated. Specimens were cemented in single-rooted human teeth with five different cements: zinc phosphate, polycarboxylate, glass ionomer, silicophosphate, or AH-26. The results indicated superior retention for the threaded and porous-surfaced implants, and stronger retention with glass-ionomer and AH-26 cements. PMID:3162990

  17. [Determination of canal length in endodontics].

    PubMed

    Bogaerts, P; Van Nieuwenhuysen, J P

    2005-01-01

    Although the reliability of the electronic apex locator is agreed upon in the endodontic literature, the general practitioner has difficulties to integrate the device in his daily practice. The authors of this paper conclude that the apex locator should be used to confirm the information obtained from the pre-operatory radiograph (imperatively taken with the parallel technique) and they assert that the data obtained electronically have still to be interpretated. The apex locator can be considered an essential tool as long as its limitations are known. PMID:15943057

  18. Some problems encountered in endodontic radiography.

    PubMed

    Lim, K C; Teo, C S

    1986-07-01

    This retrospective survey highlights some of the problems faced by undergraduate students using the bisecting angle technique in endodontic radiography. The radiographs of maxillary incisors and premolars were observed to suffer from a greater amount of distortion than radiographs of the corresponding mandibular teeth. Further, the presence of rubber dam equipment affected the accuracy of the radiographs, and this was more apparent on the radiographs of the maxillary incisors and premolars compared to the mandibular incisors and premolars. Other problems identified included superimposition, indistinct and missed root apices. Methods to overcome these problems are suggested. PMID:3777839

  19. The sterilization of endodontic hand files.

    PubMed

    Hurtt, C A; Rossman, L E

    1996-06-01

    Several different methods of file sterilization were analyzed to determine the best method of providing complete file sterility, including the metal shaft and plastic handle. Six test groups of 15 files were studied using Bacillus stearothermophilus as the test organism. Groups were "sterilized" by glutaraldehyde immersion, steam autoclaving, and various techniques of salt sterilization. Only proper steam autoclaving reliably produced completely sterile instruments. Salt sterilization and glutaraldehyde solutions may not be adequate sterilization methods for endodontic hand files and should not be relied on to provide completely sterile instruments. PMID:8934994

  20. An innovative approach in microscopic endodontics.

    PubMed

    Mittal, Sunandan; Kumar, Tarun; Sharma, Jyotika; Mittal, Shifali

    2014-05-01

    The introduction of the dental operating microscope was a turning point in the history of dentistry. It triggered a rapid transition from the conventional world of macro-dentistry to the precise, detailed world of micro-dentistry. However, working at these higher-power magnifications brings the clinician into the realm where even slight hand movements are disruptive. Physiologic hand tremor is a problem resulting in difficulty in mouth mirror placement. Hence, in this paper, a new instrument was designed to overcome the drawback of hand tremors during microscopic endodontics. PMID:24944459

  1. Endodontic Management of a Mandibular Incisor Exhibiting Concurrence of Fusion, Talon Cusp and Dens Invaginatus using CBCT as a Diagnostic Aid

    PubMed Central

    Kumar, Varun

    2016-01-01

    Teeth with aberrant anatomy present a challenge to the endodontist. Advanced tools like cone beam computed tomography aid in exploring the details of endodontic architecture in such cases. The aim of this case report is to highlight the advantage of CBCT in endodontic management of teeth with multiple dental anomalies. A mandibular lateral incisor associated with an extraoral sinus tract revealed unusual clinical anatomy. A provisional diagnosis of type III dens in dente was made based on radiographic findings. Considering the complex anatomy, CBCT was advised to get a confirmatory diagnosis. The anatomic details revealed by CBCT differed significantly from the provisional diagnosis. A final diagnosis of concurrence of fusion with a supernumerary tooth, talon cusp and type II dens invaginatus was established and endodontic treatment of the concerned tooth was carried out. Non-surgical endodontic treatment resulted in successful resolution of the sinus tract and healing of the periapical lesion. CBCT, thus proves to be an excellent diagnostic tool for management of teeth with unusual anatomy, paving way for a conservative treatment free of endodontic mishaps. PMID:27042591

  2. Fracture resistance of endodontically treated single rooted premolars restored with Sharonlay: An in vitro study

    PubMed Central

    Sharath Chandra, S. M.; Agrawal, Nishtha; Sujatha, I.; Sivaji, K.

    2016-01-01

    Aims: The aim of this study is to compare in vitro the fracture resistance of the endodontically treated tooth restored with a novel design Sharonlay, with the two component restorative method, i.e., post with separate onlay, and onlay without post. Subjects and Methods: 45 single-rooted mandibular second premolars were taken, and root canal treatment was performed. Teeth were then randomly divided into three groups (n = 15) based on the type of restoration given: Group I - metal onlay with cast post extension (Sharonlay), Group II - metal onlay with prefabricated metal post (Mani post system), Group III - metal onlay over endodontically treated tooth obturated with Gutta-percha (control group). Fracture resistance was checked using the Instron universal testing machine and the fracture patterns were analyzed. Results: According to the values recorded, Group I showed maximum mean fracture resistance followed by Groups II and III. Statistically significant difference was found between Groups I and II and Groups I and III and statistically significant difference was found between Groups II and III. Conclusion: A single unit component Sharonlay, gives higher fracture resistance to a premolar as compared to (a) metal onlay with prefabricated metal post and (b) metal onlay over endodontically treated tooth. PMID:27217643

  3. Finite Element Analysis of a Copper Single Crystal Shape Memory Alloy-Based Endodontic Instruments

    NASA Astrophysics Data System (ADS)

    Vincent, Marin; Thiebaud, Frédéric; Bel Haj Khalifa, Saifeddine; Engels-Deutsch, Marc; Ben Zineb, Tarak

    2015-10-01

    The aim of the present paper is the development of endodontic Cu-based single crystal Shape Memory Alloy (SMA) instruments in order to eliminate the antimicrobial and mechanical deficiencies observed with the conventional Nickel-Titane (NiTi) SMA files. A thermomechanical constitutive law, already developed and implemented in a finite element code by our research group, is adopted for the simulation of the single crystal SMA behavior. The corresponding material parameters were identified starting from experimental results for a tensile test at room temperature. A computer-aided design geometry has been achieved and considered for a finite element structural analysis of the endodontic Cu-based single crystal SMA files. They are meshed with tetrahedral continuum elements to improve the computation time and the accuracy of results. The geometric parameters tested in this study are the length of the active blade, the rod length, the pitch, the taper, the tip diameter, and the rod diameter. For each set of adopted parameters, a finite element model is built and tested in a combined bending-torsion loading in accordance with ISO 3630-1 norm. The numerical analysis based on finite element procedure allowed purposing an optimal geometry suitable for Cu-based single crystal SMA endodontic files. The same analysis was carried out for the classical NiTi SMA files and a comparison was made between the two kinds of files. It showed that Cu-based single crystal SMA files are less stiff than the NiTi files. The Cu-based endodontic files could be used to improve the root canal treatments. However, the finite element analysis brought out the need for further investigation based on experiments.

  4. Antimicrobial action of calcium hydroxide-based endodontic sealers after setting, against E. faecalis biofilm.

    PubMed

    Rezende, Gabriely Cristinni; Massunari, Loiane; Queiroz, India Olinta de Azevedo; Gomes Filho, João Eduardo; Jacinto, Rogério Castilho; Lodi, Carolina Simonetti; Dezan Junior, Elói

    2016-01-01

    Enterococcus faecalis are gram positive bacteria that can mostly resist endodontic therapy, inducing persistent infection in the root canal system. Endodontic sealers with antimicrobial activity may help eliminate residual microorganisms that survive endodontic treatment. The present study aimed at comparing the antimicrobial activity of Acroseal, Sealapex and AH Plus endodontic sealers in an in vitro biofilm model. Bovine dentin specimens (144) were prepared, and twelve blocks for each sealer and each experimental time point (2, 7 and 14 days) were placed and left in contact with plates containing inoculum of E. faecalis (ATCC 51299), to induce biofilm formation. After 14 days, the samples were transferred to another plate with test sealers and kept at 37°C and 5% CO2 for 2, 7 and 14 days. The specimens without sealers were used as a control for each period. The samples were agitated in a sonicator after each experiment. The suspensions were agitated in a vortex mixer, serially diluted in saline, and triple plated onto m-Enterococcus agar. Colonyforming units were counted, and the data were statistically analyzed using ANOVA, Shapiro-Wilk and Kruskal-Wallis one-way tests (p < 0.05) to determine antimicrobial potential. Sealapex showed significant differences at all the experimental time points, in comparison with all the other groups. AH Plus and Acroseal showed antimicrobial activity only on the 14th experimental day. Neither of the sealers tested were able to completely eliminate the biofilm. Sealapex showed the highest antimicrobial activity in all the experimental periods. The antimicrobial activity of all the sealers analyzed increased over time. PMID:26981759

  5. Modern endodontic surgery concepts and practice: a review.

    PubMed

    Kim, Syngcuk; Kratchman, Samuel

    2006-07-01

    Endodontic surgery has now evolved into endodontic microsurgery. By using state-of-the-art equipment, instruments and materials that match biological concepts with clinical practice, we believe that microsurgical approaches produce predictable outcomes in the healing of lesions of endodontic origin. In this review we attempted to provide the most current concepts, techniques, instruments and materials with the aim of demonstrating how far we have come. Our ultimate goal is to assertively teach the future generation of graduate students and also train our colleagues to incorporate these techniques and concepts into everyday practice. PMID:16793466

  6. Restoration of Endodontically Treated Molars Using All Ceramic Endocrowns

    PubMed Central

    Carlos, Roopak Bose; Thomas Nainan, Mohan; Pradhan, Shamina; Roshni Sharma; Benjamin, Shiny; Rose, Rajani

    2013-01-01

    Clinical success of endodontically treated posterior teeth is determined by the postendodontic restoration. Several options have been proposed to restore endodontically treated teeth. Endocrowns represent a conservative and esthetic restorative alternative to full coverage crowns. The preparation consists of a circular equigingival butt-joint margin and central retention cavity into the entire pulp chamber constructing both the crown and the core as a single unit. The case reports discussed here are moderately damaged endodontically treated molars restored using all ceramic endocrowns fabricated using two different systems, namely, CAD/CAM and pressed ceramic. PMID:24455318

  7. Photomechanical investigations on post endodontically rehabilitated teeth.

    PubMed

    Kishen, A; Asundi, A

    2002-04-01

    An investigation of the stress distribution patterns in post-core restored teeth and the behavior of dentin material to fracture propagation was conducted using experimental techniques such as digital photoelasticity (on photoelastic models), mechanical testing and scanning electron microscopy (SEM) (on extracted teeth). Digital photoelastic experiments showed that endodontic post-core restoration resulted in regions of high tensile stress and of stress concentrations in the remaining dentin structure. It was observed from mechanical testing that the fracture resistance in post-core restored teeth is significantly lower (p<0.0001) than that in intact tooth. There was a significant correspondence between the plane of stress concentrations identified in the photoelastic models and in those of the plane of fracture exhibited by the rehabilitated tooth specimens. While the fracture of post-core rehabilitated teeth was consistent, that of control teeth was not as distinct. The SEM highlighted varying dentin response to fracture propagation at the inner core and the outer regions. The fractographs showed brittle and ductile response to fracture propagation in the outer and inner core dentin, respectively. These photomechanical studies highlighted that the stress concentrations, high tensile stress and loss of inner ductile dentin associated with post endodontic rehabilitation diminished their resistance to fracture. PMID:11966313

  8. Endodontic instruments after torsional failure: nanoindentation test.

    PubMed

    Jamleh, Ahmed; Sadr, Alireza; Nomura, Naoyuki; Ebihara, Arata; Yahata, Yoshio; Hanawa, Takao; Tagami, Junji; Suda, Hideaki

    2014-01-01

    This study aimed to evaluate effects of torsional loading on the mechanical properties of endodontic instruments using the nanoindentation technique. ProFile (PF; size 30, taper 04; Dentsply Maillefer, Switzerland) and stainless steel (SS; size 30, taper 02; Mani, Japan) instruments were subjected to torsional test. Nanoindentation was then performed adjacent to the edge of fracture (edge) and at the cutting part beside the shank (shank). Hardness and elastic modulus were measured under 100-mN force on 100 locations at each region, and compared to those obtained from the same regions on new instruments. It showed that PF and SS instruments failed at 559 ± 67 and 596 ± 73 rotation degrees and mean maximum torque of 0.90 ± 0.07 and 0.99 ± 0.05 N-cm, respectively. Hardness and elastic modulus ranged 4.8-6.7 and 118-339 GPa in SS, and 2.7-3.2 and 52-81 GPa in PF. Significant differences between torsion-fractured and new instruments in hardness and elastic modulus were detected in the SS system used. While in PF system, the edge region after torsional fracture had significantly lower hardness and elastic modulus compared to new instruments. The local hardness and modulus of elasticity of endodontic instruments adjacent to the fracture edge are significantly reduced by torsional loading. PMID:24610598

  9. The properties and applications of chlorhexidine in endodontics.

    PubMed

    Mohammadi, Z; Abbott, P V

    2009-04-01

    Microorganisms and their by-products are considered to be the major cause of pulp and periradicular pathosis. Hence, a major objective in root canal treatment is to disinfect the entire root canal system, which requires that all contents of the root canal system be eliminated as possible sources of infection. This goal may be accomplished using mechanical instrumentation and chemical irrigation, in conjunction with medication of the root canal system between treatment sessions. To reduce or eliminate bacteria, various irrigation solutions have been advocated. Chlorhexidine is a cationic molecule, which can be used during treatment. It has a wide range of antimicrobial activity. Its cationic structure provides a unique property named substantivity. The purpose of this paper is to review the structure and mechanism of action of CHX, its antibacterial and antifungal activity, its effect on biofilm, its substantivity (residual antibacterial activity), its tissue solvent ability, its interaction with calcium hydroxide and sodium hypochlorite, its anticollagenolytic activity, its effect on coronal and apical leakage of bacteria, its toxicity and allergenicity and the modulating effect of dentine and root canal components on its antimicrobial activity. A Medline search was performed from 1981 to the end of March 2008 and was limited to English-language papers. The keywords searched on Medline were 'chlorhexidine AND endodontics', 'chlorhexidine AND root canal therapy', 'chlorhexidine AND substantivity' and 'chlorhexidine AND toxicity'. The reference lists of each article were manually checked for additional articles of relevance. PMID:19220510

  10. SEM and microCT validation for en face OCT imagistic evaluation of endodontically treated human teeth

    NASA Astrophysics Data System (ADS)

    Negrutiu, Meda L.; Nica, Luminita; Sinescu, Cosmin; Topala, Florin; Ionita, Ciprian; Bradu, Adrian; Petrescu, Emanuela L.; Pop, Daniela M.; Rominu, Mihai; Podoleanu, Adrian Gh.

    2011-03-01

    Successful root canal treatment is based on diagnosis, treatment planning, knowledge of tooth anatomy, endodontic access cavity design, controlling the infection by thorough cleaning and shaping, methods and materials used in root canal obturation. An endodontic obturation must be a complete, three-dimensional filling of the root canal system, as close as possible to cemento-dentinal junction, without massive overfilling or underfilling. There are several known methods which are used to assess the quality of the endodontic sealing, but most are invasive. These lead to the destruction of the samples and often no conclusion could be drawn in respect to the existence of any microleakage in the investigated areas of interest. Using an time domain en-face OCT system, we have recently demonstrated real time thorough evaluation of quality of root canal fillings. The purpose of this in vitro study was to validate the en face OCT imagistic evaluation of endodontically treated human teeth by using scanning electron microscopy (SEM) and microcomputer tomography (μCT). SEM investigations evidenced the nonlinear aspect of the interface between the endodontic filling material and the root canal walls and materials defects in some samples. The results obtained by μCT revealed also some defects inside the root-canal filling and at the interfaces between the material and the root canal walls. The advantages of the OCT method consist in non-invasiveness and high resolution. In addition, en face OCT investigations permit visualization of the more complex stratified structure at the interface between the filling material and the dental hard tissue.

  11. Rare Root Morphology of a Maxillary Central Incisor Associated With Gingival Hyperplasia: An Endodontic Case Report.

    PubMed

    Monea, Monica; Moldovan, Cosmin

    2016-05-01

    Dilaceration is a developmental disturbance characterized by the angulation of the crown or root of a permanent tooth, which is often related to trauma of primary dentition. We report a case of a dilacerated root in a maxillary central incisor associated with gingival hyperplasia in a patient under fixed orthodontic treatment, a combination of pathological conditions that had never been mentioned before in the scientific literature.A 10-year-old female patient presented to the Department of Odontology and Oral Pathology with tenderness to palpation and bleeding from the oral aspect of the central incisor, alerted by the proliferation of the gingiva. During clinical examination, the palpation performed with a dental probe revealed a carious lesion with dental pulp exposure on the distal aspect of right central incisor and the presence of a sessile mass of inflamed gingival tissue that proliferated inside the defect. On the preoperative radiograph a dilacerated root canal was noted, without periapical bone resorption.The main diagnosis was irreversible pulpitis and gingival hyperplasia and the treatment option was surgical removal of the inflamed tissue with histopathological examination and root canal treatment. Successful endodontic treatment with a good prognosis was recorded.The measurement of the root curvature proved to be extremely helpful in choosing the right endodontic technique and made the treatment easier than expected. An important observation was that, despite the rare clinical and radiographic aspect of this dilacerated tooth, the endodontic treatment proved to be relatively easy to perform and, therefore, the prognosis was considered favorable. PMID:27149498

  12. Cone beam computed tomography in Endodontics - a review.

    PubMed

    Patel, S; Durack, C; Abella, F; Shemesh, H; Roig, M; Lemberg, K

    2015-01-01

    Cone beam computed tomography (CBCT) produces undistorted three-dimensional information of the maxillofacial skeleton, including the teeth and their surrounding tissues with a lower effective radiation dose than computed tomography. The aim of this paper is to: (i) review the current literature on the applications and limitations of CBCT; (ii) make recommendations for the use of CBCT in Endodontics; (iii) highlight areas of further research of CBCT in Endodontics. PMID:24697513

  13. Endodontic Management of Maxillary First Molar with Five Root Canals, Including Two Distobuccal Root Canals: A Case Report.

    PubMed

    Sinha, Dakshita Joy; Sinha, Ashish Amit; Prakash, Prem; Jaiswal, Natasha

    2016-01-01

    Multiple canals in the root are part of the normal morphology of the tooth. A canal may sometimes be overlooked, however, and this may lead to failure of treatment. The first step in successful endodontic treatment, therefore, is gaining access to the pulp chamber and locating all the canals. In order to achieve this goal, practitioners need to be familiar with all possible variations in root canal morphology, and should thoroughly explore roots to ensure that all canals are identified, debrided, and obturated. Here, we report the diagnosis, treatment planning, and endodontic management of a maxillary first molar with five root canals, including two distobuccal root canals, in a 22-year-old woman. PMID:26961335

  14. Application of cone beam volumetric tomography in endodontics.

    PubMed

    Tyndall, D A; Kohltfarber, H

    2012-11-01

    In a 2008 article on cone beam volumetric tomography (CBVT) and dentoalveolar applications, Tyndall and Rathore wrote: "It is in the area of endodontic applications that the literature has proved most fruitful to date." This statement is even truer today than in 2008. A review of the literature has demonstrated that, in many cases, CBVT is more efficacious than traditional forms of 2-D imaging. Endodontic applications of CBVT include the diagnosis of periapical lesions due to pulpal inflammation, identification, and localization of internal and external resorption, the detection of vertical root fractures, the visualization of accessory canals, and elucidation of the causes of non-healing endodontically treated teeth. Prior to 2008, most published articles on CBVT applications in endodontics were either case reports or in vitro studies. Since that time more well designed clinically related scholarly activity has been published. This article attempts to survey the field of CBVT applications in endodontics and provide the readers with an overview of what has been found. The authors hope that this knowledge will form a foundation for appropriate clinical decision making with specific reference to selection criteria for the endodontic applications of CBVT. PMID:23487892

  15. Application of cone beam volumetric tomography in endodontics.

    PubMed

    Tyndall, Donald A; Kohltfarber, H

    2012-03-01

    In a 2008 article on cone beam volumetric tomography (CBVT) and dentoalveolar applications, Tyndall and Rathore wrote: 'It is in the area of endodontic applications that the literature has proved most fruitful to date.' This statement is even truer today than in 2008. A review of the literature has demonstrated that, in many cases, CBVT is more efficacious than traditional forms of 2-D imaging. Endodontic applications of CBVT include the diagnosis of periapical lesions due to pulpal inflammation, identification and localization of internal and external resorption, the detection of vertical root fractures, the visualization of accessory canals, and elucidation of the causes of non-healing endodontically treated teeth. Prior to 2008, most published articles on CBVT applications in endodontics were either case reports or in vitro studies. Since that time more well designed clinically related scholarly activity has been published. This article attempts to survey the field of CBVT applications in endodontics and provide the readers with an overview of what has been found. The authors hope that this knowledge will form a foundation for appropriate clinical decision making with specific reference to selection criteria for the endodontic applications of CBVT. PMID:22376099

  16. Intracanal use of a corticosteroid solution as an endodontic anodyne.

    PubMed

    Moskow, A; Morse, D R; Krasner, P; Furst, M L

    1984-11-01

    In fifty consecutive clinical patients with endodontically involved teeth that responded with vital pulp test readings, a corticosteroid solution and a saline placebo were alternately used as an intracanal anodyne. The patients subjectively rated their pain on a scale of 0 to 100 as "none," "mild," "moderate," and "severe" (0 = none, 1 to 33 = mild, 34 to 66 = moderate, 67 and above = severe). The ratings were done before the first treatment and then at 24, 48, and 72 hours after treatment. Corticosteroid-treated and placebo-treated cases were not significantly different in terms of type of teeth treated, clinical pulpal diagnosis, and preoperative patient evaluation of pain. The results showed a decreased subjective report of pain for the corticosteroid cases as compared to the controls through the three posttreatment time periods (p less than 0.10). A statistically significant decreased incidence of pain was reported for the corticosteroid cases as compared to the control at the 24-hour time period (p less than 0.05). No clinical indication of infection was noted in either the corticosteroid or saline control cases. PMID:6595622

  17. Current considerations concerning endodontically treated teeth: alteration of hard dental tissues and biomechanical properties following endodontic therapy.

    PubMed

    Dimitriu, Bogdan; Vârlan, Constantin; Suciu, Ioana; Vârlan, Virginia; Bodnar, Dana

    2009-01-01

    The aim of this general article is to present an overview of the current knowledge about composition and structural changes and also about specific biomechanical alterations related to vitality loss or endodontic therapy. For a long time, these issues have been controversially approached from a clinical standpoint and are therefore still confusing for many practitioners. Vitality loss or endodontic procedures seem to induce only negligible changes in hard dental tissue moisture. Physico-chemical properties of dentin can be modified by some of the endodontic chemical products used for chemo-mechanical debridement. On the other hand, tooth biomechanical behavior is affected, since tooth strength is reduced proportionally to coronal tissue loss, due to either pre-existent carious/non-carious lesions or cavity acces preparation, besides restorative procedures. The related literature shows the lack of accepted clinical standards and consensus regarding the optimal way of approaching the specific tooth biomechanics following endodontic therapy. PMID:20108492

  18. Relative efficiency of solvents used in endodontics.

    PubMed

    Hansen, M G

    1998-01-01

    A root canal model was used to test the relative efficiency of various commonly used endodontic solvents including eucalyptol, eucalyptus oil, orange oil, chloroform, and xylene to dissolve or soften gutta-percha and several different types of sealers (Proco-Sol, AH26, and Sealapex). There was no significant difference in the ability of the solvents to dissolve gutta-percha and the zinc oxide-eugenol-based sealer Proco-Sol. The resin-based sealer, AH26, was only dissolved in chloroform and took considerable time (> 30 min). The calcium hydroxide-based sealer, Sealapex, could not be tested because it was found not to set at all unless in contact with air. All of the solvents for both Proco-Sol and gutta-percha produced clinically acceptable dissolving times. PMID:9487865

  19. Antibacterial activity of Pinus elliottii against anaerobic bacteria present in primary endodontic infections.

    PubMed

    Caetano da Silva, Sandro Donizete; Mendes de Souza, Maria Gorete; Oliveira Cardoso, Miguel Jorge; da Silva Moraes, Thais; Ambrósio, Sérgio Ricardo; Sola Veneziani, Rodrigo Cássio; Martins, Carlos Henrique G

    2014-12-01

    Endodontic infections have a polymicrobial nature, but anaerobic bacteria prevail among the infectious microbes. Considering that it is easy to eliminate planktonic bacteria, biofilm-forming bacteria still challenge clinicians during the fight against endodontic diseases. The chemical constituents of the oleoresin of Pinus elliottii, a plant belonging to the family Pinaceae, stand out in the search for biologically active compounds based on natural products with potential application in the treatment of endodontic infections. Indeed, plant oleoresins are an abundant natural source of diterpenes that display significant and well-defined biological activities as well as potential antimicrobial action. In this context, this study aimed to (1) evaluate the in vitro antibacterial activity of the oleoresin, fractions, and subfractions of P. elliottii as well as the action of dehydroabietic acid against 11 anaerobic bacteria that cause endodontic infection in both their planktonic and biofilm forms and (2) assess the in vitro antibiofilm activity of dehydroabietic acid against the same group of bacteria. The broth microdilution technique helped to determine the minimum inhibitory concentration (MIC) of the oleoresin and fractions. This same technique aided determination of the MIC values of nine subfractions of Fraction 1, the most active fraction. The MIC, minimum bactericidal concentration, and antibiofilm activity of dehydroabietic acid against the tested anaerobic bacteria were also examined. The oleoresin and fractions, especially fraction PE1, afforded promising MIC values, which ranged from 0.4 to 50 μg/mL. Concerning the nine evaluated subfractions, PE1.3 and PE1.4 furnished the most noteworthy MIC values, between 6.2 and 100 μg/mL. Dehydroabietic acid displayed antibacterial activity, with MIC values lying from 6.2 to 50 μg/mL, as well as bactericidal effect for all the investigated bacteria, except for Prevotella nigrescens. Assessment of the antibiofilm

  20. Evaluation of meloxicam (A cox-2 inhibitor) for management of postoperative endodontic pain: a double-blind placebo-controlled study.

    PubMed

    Nekoofar, Mohammad Hosein; Sadeghipanah, Marzieh; Dehpour, Ahmad Reza

    2003-10-01

    Successful management of endodontic pain represents a continuing challenge. The purpose of this randomized, double-blind, placebo-controlled, parallel-group trial was to compare the pain reducing effect of oral preparations of meloxicam, piroxicam, and placebo in endodontic emergency patients. A total of 51 patients who presented to the Tehran University endodontic clinic and one private dental clinic were invited to participate. Patients were asked to evaluate their pretreatment pain with a visual-analog scale. After root canal therapy they were randomly assigned to one of three groups: meloxicam, piroxicam, or placebo. Each patient was sent home with a visual-analog scale to fill out at 8 and 24 h after completion of therapy. The results of this study showed no significant differences between efficacy of meloxicam, piroxicam, and placebo, but a significant effect of the time factor in reducing postoperative pain in all treatment groups was observed. PMID:14606784

  1. Nonsurgical endodontic retreatment of fused teeth with transposition: a case report

    PubMed Central

    Noites, Rita Brandão; Martins, Miguel André Duarte; Paulo, Manuel Pedro da Fonseca

    2016-01-01

    Tooth transposition is a disorder in which a permanent tooth develops and erupts in the normal position of another permanent tooth. Fusion and gemination are developmental disturbances presenting as the union of teeth. This article reports the nonsurgical retreatment of a very rare case of fused teeth with transposition. A patient was referred for endodontic treatment of her maxillary left first molar in the position of the first premolar, which was adjacent to it on the distobuccal side. Orthopantomography and periapical radiography showed two crowns sharing the same root, with a root canal treatment and an associated periapical lesion. Tooth fusion with transposition of a maxillary molar and a premolar was diagnosed. Nonsurgical endodontic retreatment was performed. At four yr follow-up, the tooth was asymptomatic and the radiolucency around the apical region had decreased, showing the success of our intervention. The diagnosis and treatment of fused teeth require special attention. The canal system should be carefully explored to obtain a full understanding of the anatomy, allowing it to be fully cleaned and obturated. Thermoplastic techniques were useful in obtaining hermetic obturation. A correct anatomical evaluation improves the set of treatment options under consideration, leading to a higher likelihood of esthetically and functionally successful treatment. PMID:27200284

  2. Nonsurgical endodontic retreatment of fused teeth with transposition: a case report.

    PubMed

    Cardoso, Miguel Agostinho Beco Pinto; Noites, Rita Brandão; Martins, Miguel André Duarte; Paulo, Manuel Pedro da Fonseca

    2016-05-01

    Tooth transposition is a disorder in which a permanent tooth develops and erupts in the normal position of another permanent tooth. Fusion and gemination are developmental disturbances presenting as the union of teeth. This article reports the nonsurgical retreatment of a very rare case of fused teeth with transposition. A patient was referred for endodontic treatment of her maxillary left first molar in the position of the first premolar, which was adjacent to it on the distobuccal side. Orthopantomography and periapical radiography showed two crowns sharing the same root, with a root canal treatment and an associated periapical lesion. Tooth fusion with transposition of a maxillary molar and a premolar was diagnosed. Nonsurgical endodontic retreatment was performed. At four yr follow-up, the tooth was asymptomatic and the radiolucency around the apical region had decreased, showing the success of our intervention. The diagnosis and treatment of fused teeth require special attention. The canal system should be carefully explored to obtain a full understanding of the anatomy, allowing it to be fully cleaned and obturated. Thermoplastic techniques were useful in obtaining hermetic obturation. A correct anatomical evaluation improves the set of treatment options under consideration, leading to a higher likelihood of esthetically and functionally successful treatment. PMID:27200284

  3. PCR-Based Identification of Bacteria Associated with Endodontic Infections

    PubMed Central

    Fouad, Ashraf F.; Barry, Jody; Caimano, Melissa; Clawson, Michael; Zhu, Qiang; Carver, Rachaele; Hazlett, Karsten; Radolf, Justin D.

    2002-01-01

    PCR primers that target the bacterial 16S rRNA genes (or the tuf gene for the genus Enterococcus) were used to identify 10 putative bacterial pathogens in root canals with necrotic pulp. In addition, the associations of these microorganisms with symptoms and a history of diabetes mellitus were investigated. Microbial samples from the root canals of 24 teeth with necrotic pulp were included in the study. PCR with universal bacterial primers identified bacterial DNA in 22 specimens; the remaining 2 specimens were from intact teeth that had been traumatized 6 months prior to treatment. PCR with specific primers showed that preoperative symptoms were significantly associated with the presence of Streptococcus spp. (P < 0.001 by chi-square analysis). There was also a nonsignificant trend for symptoms to be associated with Fusobacterium nucleatum and Porphyromonas gingivalis (odds ratio, >2) and for diabetes mellitus to be associated with P. gingivalis and Porphyromonas endodontalis (odds ratio, >2). Cloning and sequencing of the universal PCR product in one specimen revealed the presence of an organism related to the genus Olsenella, which has not previously been described in endodontic infections. PMID:12202557

  4. Acoustic streaming induced by an ultrasonically oscillating endodontic file.

    PubMed

    Verhaagen, B; Boutsioukis, C; van der Sluis, L W M; Versluis, M

    2014-04-01

    Ultrasonically activated irrigation is an advanced dental technique for irrigation of the root canal system during a root canal treatment. The basic cleaning mechanism is a result of acoustic streaming induced by an oscillating file, leading to mixing of the irrigant and pressure and shear stresses on the walls of the root canal. Here the induced acoustic streaming, pressure, and shear stress are investigated in a two-dimensional cross-section of the root canal, using a combination of theory, numerical predictions, and experimental validation through high-speed particle tracking velocimetry. Acoustic streaming theory describes very well the flow induced by an ultrasonically oscillating endodontic file. It consists of an oscillatory component, which is dominant near the file, and a steady component, or jet, along the axis of oscillation. The importance of the oscillatory component for both the pressure and the shear stress is apparent, as it is two to three orders of magnitude higher than the steady component. A confinement affects the formation of the steady jets; meanwhile the oscillatory velocities and associated pressure and shear stress are increased. Previous work considering only the steady component of the flow therefore, underestimated the hydrodynamic effects induced by ultrasonic files. PMID:25234972

  5. Techniques for immediate core buildup of endodontically treated teeth.

    PubMed

    Smidt, Ami; Venezia, Eyal

    2003-04-01

    Access to the pulp chamber for endodontic treatment is indicated inter alia as a result of extensive caries, trauma to the tooth causing fracture or loss of vitality, requiring restoration of the missing tooth structure. Different approaches and materials are described in the literature for foundation restorations, either with a cast post and core or immediately, with a chairside post-and-core system. This article briefly reviews the current data regarding the microbiologic, prosthetic, mechanical, and periodontal aspects while emphasizing the immediate approach using amalgam, resin composites, and glass ionomers. Factors affecting retention of the post are presented to guide the clinician in selecting a suitable post-and-core system to preserve optimal root structure and prevent root fracture. Three clinical cases are presented in which tooth structure was restored using different techniques: in the first two, provisional acrylic resin shells, one custom made and the other prefabricated, were used to house an amalgam coronal-radicular dowel core, where in the third case, a copper band was used for a composite post-and-core system. All cases emphasize the ease of production and short chairtime in the stages of crown fabrication. PMID:12731611

  6. SHARONLAY - A new onlay design for endodontically treated premolar.

    PubMed

    Sharath Chandra, Siddapur Mathada

    2015-01-01

    Root-canal-treated teeth are structurally compromised as a result of loss of tooth structure due to caries, iatrogenic cavity preparation, and dehydration. Given that a direct relationship exists between the amount of remaining tooth structure and the ability to resist occlusal forces, it is vital to provide a restoration allowing cuspal coverage as soon as possible following completion of the root canal treatment. A decision to provide a full crown or an onlay depends on the remaining tooth structure; if the cuspal width to length ratio is 1:2 or more, an onlay can be placed. When the ratio is less than 1:2, a full crown has to be planned. In single-rooted teeth requiring post-endodontic restoration cast post and core or a prefabricated post can provide resistance to fracture with comparable results. However, in case of premolars contradictory to the practice of providing only cuspal coverage through Onlays, it would in addition require cervical reinforcement also to counter horizontal forces acting in cervical region. A new onlay design SHARONLAY patented design with I.P. no 1956475 dated 27/04/2010 with a post extending into the radicular portion of the premolar providing the required reinforcement in a conservative manner and protecting it against both vertical and horizontal forces is proposed herewith. PMID:25829701

  7. Clinical decision-making after endodontic instrument fracture.

    PubMed

    McGuigan, M B; Louca, C; Duncan, H F

    2013-04-01

    When a file fractures during root canal treatment there are several treatment options available to the clinician. The definitive management should be based on a thorough knowledge of the success rates of each treatment option, balanced against potential risks of removal or file retention. Although integration of modern techniques into endodontic practice has improved the clinician's ability to remove fractured files, removal may not always be possible or even desirable. The aim of the third and final review in this series was to analyse the literature with regard to the management of fractured files. Analysis of the literature demonstrated that the presence of a fractured instrument need not reduce the prognosis if the case is well treated and there is no evidence of apical disease. Therefore, in cases without apical disease removal of the file may not be necessary and retention or bypass should be considered. If apical disease is present, file fracture significantly reduces prognosis indicating a greater need to attempt file removal or bypass. A plethora of different methods have been employed to remove fractured instruments and although successful, these techniques usually require the use of the operating microscope and specialist care. Removal of a fractured file is not without considerable risk, particularly in the apical regions of the root canal, therefore, leaving the fragment in situ should be considered if referral is not possible. Finally, it is imperative that the patient is informed (accompanied by appropriate record keeping) if instrument fracture occurs during treatment or if a fractured file is discovered during a routine radiographic examination. PMID:23619858

  8. Endodontic management of maxillary first molar with type I canal configuration- a rare case report.

    PubMed

    Desai, Niranjan; Jadhav, Ganesh Ranganath; Raghavendra, Srinidhi Surya; Mittal, Priya; Patil, Gururaj

    2015-04-01

    Thorough knowledge about the root canal variations is essential for the predictable endodontic treatment outcome. The root and root canal anatomy of maxillary first molar varies greatly. A Pub-med literature search about single rooted single canalled maxillary first molar was done to know its details such as incidence, diagnostic method used, age, sex and ethnic background of patient. This article presented report of a single rooted single canalled maxillary first molar in a 27-year-old healthy Asian female. PMID:26023655

  9. The Management of a Persistent Periapical Lesion Caused by an Apicomarginal Defect, Associated with a Root End Fracture in an Endodontically Treated Tooth: A Clinical Report

    PubMed Central

    S., Shruthi; Patel, Punit Vaibhav; Kumar, Sheela

    2012-01-01

    This is a case report of the presentation and the management of an apicomarginal defect which was associated with a root end fracture in an endodontically treated tooth. In spite of a successful Root Canal Treatment (RCT), if the fractured root end is left intact, considering inadverdent ankylosis or resorption, it may progress to the development of a bony dehiscence. PMID:23285470

  10. Metaproteome analysis of endodontic infections in association with different clinical conditions.

    PubMed

    Provenzano, José Claudio; Siqueira, José F; Rôças, Isabela N; Domingues, Romênia R; Paes Leme, Adriana F; Silva, Márcia R S

    2013-01-01

    Analysis of the metaproteome of microbial communities is important to provide an insight of community physiology and pathogenicity. This study evaluated the metaproteome of endodontic infections associated with acute apical abscesses and asymptomatic apical periodontitis lesions. Proteins persisting or expressed after root canal treatment were also evaluated. Finally, human proteins associated with these infections were identified. Samples were taken from root canals of teeth with asymptomatic apical periodontitis before and after chemomechanical treatment using either NaOCl or chlorhexidine as the irrigant. Samples from abscesses were taken by aspiration of the purulent exudate. Clinical samples were processed for analysis of the exoproteome by using two complementary mass spectrometry platforms: nanoflow liquid chromatography coupled with linear ion trap quadrupole Velos Orbitrap and liquid chromatography-quadrupole time-of-flight. A total of 308 proteins of microbial origin were identified. The number of proteins in abscesses was higher than in asymptomatic cases. In canals irrigated with chlorhexidine, the number of identified proteins decreased substantially, while in the NaOCl group the number of proteins increased. The large majority of microbial proteins found in endodontic samples were related to metabolic and housekeeping processes, including protein synthesis, energy metabolism and DNA processes. Moreover, several other proteins related to pathogenicity and resistance/survival were found, including proteins involved with adhesion, biofilm formation and antibiotic resistance, stress proteins, exotoxins, invasins, proteases and endopeptidases (mostly in abscesses), and an archaeal protein linked to methane production. The majority of human proteins detected were related to cellular processes and metabolism, as well as immune defense. Interrogation of the metaproteome of endodontic microbial communities provides information on the physiology and

  11. Metaproteome Analysis of Endodontic Infections in Association with Different Clinical Conditions

    PubMed Central

    Provenzano, José Claudio; Siqueira, José F.; Rôças, Isabela N.; Domingues, Romênia R.; Paes Leme, Adriana F.; Silva, Márcia R. S.

    2013-01-01

    Analysis of the metaproteome of microbial communities is important to provide an insight of community physiology and pathogenicity. This study evaluated the metaproteome of endodontic infections associated with acute apical abscesses and asymptomatic apical periodontitis lesions. Proteins persisting or expressed after root canal treatment were also evaluated. Finally, human proteins associated with these infections were identified. Samples were taken from root canals of teeth with asymptomatic apical periodontitis before and after chemomechanical treatment using either NaOCl or chlorhexidine as the irrigant. Samples from abscesses were taken by aspiration of the purulent exudate. Clinical samples were processed for analysis of the exoproteome by using two complementary mass spectrometry platforms: nanoflow liquid chromatography coupled with linear ion trap quadrupole Velos Orbitrap and liquid chromatography-quadrupole time-of-flight. A total of 308 proteins of microbial origin were identified. The number of proteins in abscesses was higher than in asymptomatic cases. In canals irrigated with chlorhexidine, the number of identified proteins decreased substantially, while in the NaOCl group the number of proteins increased. The large majority of microbial proteins found in endodontic samples were related to metabolic and housekeeping processes, including protein synthesis, energy metabolism and DNA processes. Moreover, several other proteins related to pathogenicity and resistance/survival were found, including proteins involved with adhesion, biofilm formation and antibiotic resistance, stress proteins, exotoxins, invasins, proteases and endopeptidases (mostly in abscesses), and an archaeal protein linked to methane production. The majority of human proteins detected were related to cellular processes and metabolism, as well as immune defense. Interrogation of the metaproteome of endodontic microbial communities provides information on the physiology and

  12. Interdisciplinary approach to endodontic therapy for uncooperative children in a dental school environment.

    PubMed

    Soares, Flavio; Britto, Leandro R; Vertucci, Frank J; Guelmann, Marcio

    2006-12-01

    The aim of this study was to describe an interdisciplinary approach for endodontic therapy of behavior-challenging children and to report the efficacy of sedation techniques for these procedures. Sedation records of thirty-two patients who received root canal treatment were reviewed. Age at treatment in months, gender, year of treatment, tooth type, status of root maturation (open or closed apex), etiological factor(s), sedation protocol, and outcome were the variables analyzed. The collected information was entered into a computerized flowchart and the data analyzed using descriptive statistics. Midazolam in combination with meperidine or hydroxyzine were the most common protocols used (46 percent and 40 percent of the cases, respectively). Only two (6 percent) treatments were aborted due to uncontrolled behavior during sedation. We conclude that cooperation between pediatric dentists and endodontists is fundamental to achieving success when providing root canal treatment for uncooperative child patients. PMID:17170328

  13. Viscosity of endodontic irrigants: Influence of temperature

    PubMed Central

    Poggio, Claudio; Ceci, Matteo; Beltrami, Riccardo; Colombo, Marco; Dagna, Alberto

    2015-01-01

    Background: The aim of this study was to assess the influence of temperature on the viscosity of different endodontic irrigants. Materials and Methods: The measurements of viscosity of 3% hydrogen peroxide, 0.9% sodium chloride, aqueous solution of 0.2% chlorhexidine (CHX) and 0.2% cetrimide, 5% sodium hypochlorite (NaOCl) and 17% ethylenediaminetetraacetic acid (EDTA) at different temperatures (22°C, 30°C, 40°C, 50°C and 60°C) were obtained using Mohr balance and Ostwald viscometer. The Shapiro-Wilk test and Mann-Whitney U-tests were used for the statistical analysis. (α = 0.05). Results: No significant differences were recorded at each temperature among 3% hydrogen peroxide, 0.9% sodium chloride and aqueous solution of 0.2% CHX and 0.2% cetrimide. 5% NaOCl and 17% EDTA showed the higher values. Viscosity statistically decreased with increasing temperature. Conclusion: Within the limitations of this study, 5% NaOCl and 17% EDTA are significantly viscous at room temperature and their viscosity reduces with elevating temperature. PMID:26604955

  14. Cytotoxicity, histopathological, microbiological and clinical aspects of an endodontic iodoform-based paste used in pediatric dentistry: a review.

    PubMed

    Cerqueira, Daniella Ferraz; Mello-Moura, Anna Carolina Volpi; Santos, Elaine Marcílio; Guedes-Pinto, Antonio Carlos

    2008-01-01

    This review aims at describing and comparing materials commonly used in root canal therapy, the cytotoxicity, histopathological, microbiological and clinical aspects ofa iodoform-based paste (Guedes-Pinto Paste-GPP) used in endodontic treatment of primary teeth. GPP has shown excellent biocompatibility to pulp fibroblasts and mild inflammatory reactions, having been well-tolerated by the periapical and connective tissues. Moreover, GPP bactericidal and bacteriostatic effects against many oral microorganisms were also demonstrated. Regarding clinical trials, the GPP technique has achieved success rates when considering clinical and radiographic examinations. In the face of all the above mentioned results, this paper would like to propose the use of this endodontic material as a root canal filling for primary teeth. PMID:18389674

  15. Antimicrobial activity of herbal medicines (tulsi extract, neem extract) and chlorhexidine against Enterococcus faecalis in Endodontics: An in vitro study

    PubMed Central

    Chandrappa, Pradeep Muttagadur; Dupper, Akash; Tripathi, Pragya; Arroju, Ramakrishna; Sharma, Preeti; Sulochana, Konthoujam

    2015-01-01

    Background: Successful endodontic treatment depends on effective disinfection and complete sealing of root canal. Various medicaments are advised for disinfecting root canal, such as herbal and non-herbal medicaments. This study was done to assess the antimicrobial activity of herbal medicines (neem extract, tulsi extract) and chlorhexidine against Enterococcus faecalis in Endodontics. Materials and Methods: Agar diffusion method was used to evaluate the antimicrobial action of different medicines. Sixty samples were segregated into four groups with 15 samples in each: Group I: chlorhexidine 2%, Group II: neem extract, Group III: tulsi extract, and Group IV: distilled water. The inhibition zones against E. faecalis were recorded and statistically assessed using one-way analysis of variance (ANOVA) test (P < 0.05). Results: Significant antibacterial effect against E. faecalis was observed with chlorhexidine followed by neem extract and tulsi extract. Conclusion: Herbal medicines seemed to be effective against E. faecalis compared to 2% chlorhexidine gluconate. PMID:26942123

  16. Historical perspectives on the evolution of surgical procedures in endodontics.

    PubMed

    Gutmann, James L; Gutmann, Marylou S

    2010-01-01

    The historical pathway to current surgical endodontic procedures and their applications has been tortuous and tumultuous. Influenced heavily in their development by the European sector, these surgical procedures faced many challenges over the decades. Fortunately for today's practitioners, influential members of the oral surgery community, and a few staunch believers in retaining devitalized teeth, persisted in their investigation of and search for improved procedures that had predictable outcomes. Many so-called "revolutionary" or newer techniques practiced today are but a re-emergence of surgical concepts that were lost in the archives of time. With the advent of evidence-based endodontics, these procedures are now supported extensively by science and by the integration of science into materials usage, technique applications and outcomes research. However, in many respects, this story is just beginning, as the "roots" of surgical endodontics are explored. PMID:20491369

  17. A century of endodontics: from Philadelphia to Boston.

    PubMed

    Millstein, Charles B

    2010-01-01

    While Dr. Grossman was in Rostock with a letter of introduction from Dr. Prinz, he visited several distinguished dentists in Berlin. One was the aged Dr. Otto Walkoff, who, with the help of a physicist while in Wurzberg, was the first dentist to capture the image of a tooth soon after the discovery of radiology by Roentgen in 1895. At his home, Dr. Walkoff passed the X-ray tube head that had taken the historic film to Dr. Grossman, who then held this treasured artifact in his hands. This transfer of culture from Germany to the United States marked the beginning of modern endodontics. Similarly, when Dr. Goldman gave Dr. Schilder his backing by sending him to study under Dr. Grossman at the University of Pennsylvania, the progress of endodontic excellence moved forward, ensuring a Century of Endodontics. PMID:20806701

  18. [Evaluation of radiation risk associated with endodontic radiography].

    PubMed

    Danforth, R A; Torabainejad, M

    1991-01-01

    Endodontic patients are sometimes concerned about the risks of tumors or cataracts from radiation exposure during root canal therapy. By using established dose and risk information, we calculated the extent of these risks. The chance of getting leukemia from an endodontic x-ray survey using 90 kVp was found to be 1 in 7.69 million, the same as the risk of dying from cancer from smoking 0.94 cigarettes or from an auto accident when driving 3.7 km. Risk of thyroid gland neoplasia was 1 in 667,000 (smoking 11.6 cigarettes, driving 45 km) and risk of salivary gland neoplasia 1 in 1.35 million (smoking 5.4 cigarettes, driving 21.1 km). Use of 70 kVp radiography reduced these risks only slightly. To receive the threshold dose to eyes to produce cataract changes, a patient would have to undergo 10,900 endodontic surveys. PMID:1782436

  19. Cone Beam CT use in the pre-prosthetic evaluation of endodontically treated of the rear maxilla

    PubMed Central

    GARGARI, M.; OTTRIA, L.; NEZZO, M.; NERONI, L.; FANUCCI, E.

    2012-01-01

    SUMMARY With our study we wanted to compare the diagnostic accuracy of conventional radiography (orthopanoramic and intraoral radiography) and Cone Beam CT (CBCT) for the diagnosis of periapical lesions on the posterior elements of the upper maxilla endodontically treated. The images were analyzed by a radiologist and an endodontist whose interpretation of radiological examinations is unique. Were examined 34 molars (23 first molars and 13 second molars) with a total of 102 roots. The CBCT detected a significantly higher number of lesions (43%, p <0.001) compared to conventional radiography. Our results demonstrate that the CBCT can be inserted into the diagnostic routine for the evaluation of all pre-prosthetic posterior elements of the upper jaw endodontically treated in addition to the diagnostic techniques 2D, especially when in the treatment plan is provided the realization of an abutment. The CBCT, which has reduction of cost and absorption of radiation with respect to the conventional CT, is also very useful even when there is a need to perform a surgical treatment-endodontic (apicectomy) of a lesion diagnosed with 2D techniques. PMID:23285405

  20. Evaluation of three different rotary systems during endodontic retreatment - Analysis by scanning electron microscopy

    PubMed Central

    Vidal, Flávia-Teixeira; Nunes, Eduardo; Horta, Martinho-Campolina-Rebello; Freitas, Maria-Rita-Lopes-da Silva

    2016-01-01

    Background Endodontic therapy is considered a series of important and interdependent steps, and failure of any of these steps may compromise the treatment outcome. This study aimed to evaluate the effectiveness of three different rotary systems in removing obturation materials during endodontic retreatment using scanning electron microscopy (SEM) analysis. Material and Methods Thirty-six endodontically treated teeth were selected and divided into 3 groups of 10 and 1 control group with 6 dental elements. The groups were divided according to the rotary system used for removing gutta-percha, as follows: G1: ProTaper system; G2: K3 system; G3: Mtwo system; and G4: Control group. Thereafter, the roots were split and the sections were observed under SEM, for analysis and counting of clear dentinal tubules, creating the variable “degree of dentinal tubule patency” (0: intensely clear; 1: moderately clear; 2: slightly clear; 3: completely blocked). The data were subjected to the Friedman and Kruskal-Wallis statistical tests. Results No differences were observed in the “degree of dentinal tubule patency” neither between the root thirds (to each evaluated group) nor between the groups (to each evaluated third). Nevertheless, when the three root thirds were grouped (providing evaluation of all root extension), the “degree of dentinal tubule patency” was lower in G1 than in G3 (p<0.05), but showed no differences neither between G1 and G2 nor G2 and G3. Conclusions No technique was able to completely remove the canal obturation material, despite G1 having shown better results, although without significant difference to G2 Key words:Scanning electron microscopy, NiTi, retreatment. PMID:27034750

  1. Rehabilitation of endodontically treated teeth using the radiopaque fiber post.

    PubMed

    Brown, Philip L; Hicks, Norman L

    2003-04-01

    Metallic posts fall short of satisfying contemporary guidelines for ideal post/core rehabilitation. Along with technological improvements in adhesive resins, cements, and composite restoratives, the evolution of fiber-reinforced posts allows the rehabilitation of endodontically treated teeth with greater esthetics and virtually no predisposition to root fracture. At least one fiber post system now complies with all of the ideal post characteristics described in the endodontic text. This article describes the potential for displacement of metal posts by low-modulus fiber posts, the differences between them, and the development and placement of a radiopaque, translucent, double-tapered fiber post. PMID:12769029

  2. Absorbed radiation by various tissues during simulated endodontic radiography.

    PubMed

    Torabinejad, M; Danforth, R; Andrews, K; Chan, C

    1989-06-01

    The amount of absorbed radiation by various organs was determined by placing lithium fluoride thermoluminescent chip dosimeters at selected anatomical sites in and on a human-like X-ray phantom and exposing them to radiation at 70- and 90-kV X-ray peaks during simulated endodontic radiography. The mean exposure dose was determined for each anatomical site. The results show that endodontic X-ray doses received by patients are low when compared with other radiographic procedures. PMID:2592879

  3. Antibacterial efficacy and drug-induced tooth discolouration of antibiotic combinations for endodontic regenerative procedures.

    PubMed

    Mandras, N; Roana, J; Allizond, V; Pasqualini, D; Crosasso, P; Burlando, M; Banche, G; Denisova, T; Berutti, E; Cuffini, A M

    2013-01-01

    Elimination of microbial contamination from the root canal system is a precondition for successful root canal treatment. Teeth with immature root development, necrotic pulps and apical periodontitis present multiple challenges for successful treatment. Disinfection is achieved by irrigation followed by the placement of an intracanal medicament. A mixture of ciprofloxacin, metronidazole and minocycline (3-MIX S) has been shown to be very effective in eliminating endodontic pathogens in vitro and in vivo. Among the components of the mixture, minocycline can induce tooth discolouration after long-term oral use. Therefore, the elimination of minocycline from the above-mentioned combination has been suggested to prevent the occasion of this undesirable effect. The aim of this study was to investigate the potential antimicrobial efficacy of alternative antibiotic combinations [3-MIX C (clarithromycin); 3-MIX F (fosfomycin)] against bacteria from infected root canals. An additional objective was to evaluate their discolouration potential as possible alternatives to minocycline-based intracanal medicaments. Our in vitro results clearly demonstrated that 3-MIX C and 3-MIX F had a greater antimicrobial activity than 3-MIX S, underlying that clarithromycin still had a higher capacity to kill endodontic pathogens in vitro compared to fosfomycin. Both 3-MIX C and 3-MIX F were able to avoid the permanent staining effect of the crown. PMID:23755774

  4. Mental nerve paresthesia secondary to initiation of endodontic therapy: a case report

    PubMed Central

    Alam, Sharique; Zia, Afaf; Khan, Masood Hasan; Kumar, Ashok

    2014-01-01

    Whenever endodontic therapy is performed on mandibular posterior teeth, damage to the inferior alveolar nerve or any of its branches is possible. Acute periapical infection in mandibular posterior teeth may also sometimes disturb the normal functioning of the inferior alveolar nerve. The most common clinical manifestation of these insults is the paresthesia of the inferior alveolar nerve or mental nerve paresthesia. Paresthesia usually manifests as burning, prickling, tingling, numbness, itching or any deviation from normal sensation. Altered sensation and pain in the involved areas may interfere with speaking, eating, drinking, shaving, tooth brushing and other events of social interaction which will have a disturbing impact on the patient. Paresthesia can be short term, long term or even permanent. The duration of the paresthesia depends upon the extent of the nerve damage or persistence of the etiology. Permanent paresthesia is the result of nerve trunk laceration or actual total nerve damage. Paresthesia must be treated as soon as diagnosed to have better treatment outcomes. The present paper describes a case of mental nerve paresthesia arising after the start of the endodontic therapy in left mandibular first molar which was managed successfully by conservative treatment. PMID:25110646

  5. Fracture resistance of endodontically treated teeth restored with ceramic inlays and different base materials.

    PubMed

    Saridag, Serkan; Sari, Tugrul; Ozyesil, Atilla Gokhan; Ari Aydinbelge, Hale

    2015-01-01

    This study evaluated the fracture resistance of endodontically treated teeth restored with different base materials and mesioocclusal-distal (MOD) ceramic inlays. Fifty mandibular molars were assigned into five groups (n=10 per group). Group1 (control) comprised intact molar teeth without any treatment. Teeth in other groups were subjected to root canal treatment and restored with MOD ceramic inlays on different base materials. In Group 2, base material was zinc phosphate cement; Group 3's was glass ionomer cement; Group 4's was composite resin, and Group 5's was composite resin reinforced with fiber. Finally, a continuous occlusal load was applied until fracture occurred. Mean fracture resistance of Group 1 (3,027 N) was significantly higher than the other groups (890, 1,070, 1,670, 1,226 N respectively). Fracture resistance of Group 4 was statistically comparable with Group 5 and significantly higher than Groups 2 and 3 (p<0.05; Tukey's HSD). Use of different base materials under ceramic inlay restorations could affect the fracture resistance of endodontically treated teeth. PMID:25740162

  6. Endodontic Procedural Errors: Frequency, Type of Error, and the Most Frequently Treated Tooth

    PubMed Central

    Yousuf, Waqas; Khan, Moiz; Mehdi, Hasan

    2015-01-01

    Introduction. The aim of this study is to determine the most common endodontically treated tooth and the most common error produced during treatment and to note the association of particular errors with particular teeth. Material and Methods. Periapical radiographs were taken of all the included teeth and were stored and assessed using DIGORA Optime. Teeth in each group were evaluated for presence or absence of procedural errors (i.e., overfill, underfill, ledge formation, perforations, apical transportation, and/or instrument separation) and the most frequent tooth to undergo endodontic treatment was also noted. Results. A total of 1748 root canal treated teeth were assessed, out of which 574 (32.8%) contained a procedural error. Out of these 397 (22.7%) were overfilled, 155 (8.9%) were underfilled, 16 (0.9%) had instrument separation, and 7 (0.4%) had apical transportation. The most frequently treated tooth was right permanent mandibular first molar (11.3%). The least commonly treated teeth were the permanent mandibular third molars (0.1%). Conclusion. Practitioners should show greater care to maintain accuracy of the working length throughout the procedure, as errors in length accounted for the vast majority of errors and special care should be taken when working on molars. PMID:26347779

  7. Endodontic Procedural Errors: Frequency, Type of Error, and the Most Frequently Treated Tooth.

    PubMed

    Yousuf, Waqas; Khan, Moiz; Mehdi, Hasan

    2015-01-01

    Introduction. The aim of this study is to determine the most common endodontically treated tooth and the most common error produced during treatment and to note the association of particular errors with particular teeth. Material and Methods. Periapical radiographs were taken of all the included teeth and were stored and assessed using DIGORA Optime. Teeth in each group were evaluated for presence or absence of procedural errors (i.e., overfill, underfill, ledge formation, perforations, apical transportation, and/or instrument separation) and the most frequent tooth to undergo endodontic treatment was also noted. Results. A total of 1748 root canal treated teeth were assessed, out of which 574 (32.8%) contained a procedural error. Out of these 397 (22.7%) were overfilled, 155 (8.9%) were underfilled, 16 (0.9%) had instrument separation, and 7 (0.4%) had apical transportation. The most frequently treated tooth was right permanent mandibular first molar (11.3%). The least commonly treated teeth were the permanent mandibular third molars (0.1%). Conclusion. Practitioners should show greater care to maintain accuracy of the working length throughout the procedure, as errors in length accounted for the vast majority of errors and special care should be taken when working on molars. PMID:26347779

  8. [The role of the traditional radiological methods in conservative therapy and endodontics].

    PubMed

    Bianchi, S D; Lojacono, A

    1996-12-01

    The traditional radiographic examinations used in restorative dentistry and endodontics are: intraoral radiograph performed in the beta-wing or the paralleling technique, the partial extraoral radiograph (rotational narrow beam), the panoramic radiography and the periapical radiographs with the bisecting technique which is particularly suitable for visualization of the apex. Radiology is a valuable diagnostic means to evaluate the extension of primary caries, to identify secondary and interproximal initial decays and if required let the therapist measure the biological width. Several factors influence the radiographic interpretation of caries: cervical burnout, mach band effect, internal and external resorption, restorative materials for fillings and sub-bases, abrasions and/or erosions. Radiology allows the diagnosis of developmental and acquired abnormalities of the teeth which can have an influence on the treatment itself. Examples are: variations in the shape of the crown and root, dens in dente, enamel hypoplasia, dentinogenesis imperfecta. Radiograms are of major importance in the evaluation of restorative dentistry results: precision of the margins, congruous contact points, fractures. Moreover, it provides the endodontic procedures with useful diagnostic data and permits the measurements during the treatment, supplying the immediate and long term checks too. PMID:9026703

  9. Healing of a large periapical lesion using triple antibiotic paste and intracanal aspiration in nonsurgical endodontic retreatment

    PubMed Central

    Dhillon, Jaidev Singh; Amita; Saini, Suresh Kumar; Bedi, Harmandeep Singh; Ratol, Sukhmilap Singh; Gill, Bobbin

    2014-01-01

    A patient with a large periapical lesion in relation to the maxillary right central and lateral incisors is presented here. During the conservative root canal treatment, aspiration of the fluid was done through the root canal, followed by placement of triple antibiotic paste for two weeks. Complete periapical healing was observed at the 24-month recall. This report confirms that for treatment of a large periapical lesion it is not always necessary to do surgical treatment and even cyst-like periapical lesions heal following conservative endodontic therapy. PMID:25565747

  10. Rapid Quantification of Bacteria in Infected Root Canals Using Fluorescence Reagents and a Membrane Filter: A Pilot Study on Its Clinical Application to the Evaluation of the Outcomes of Endodontic Treatment

    PubMed Central

    Sato, Takuichi; Yamaki, Keiko; Ishida, Naoko; Shoji, Megumi; Sato, Emika; Abiko, Yuki; Hashimoto, Kazuhiro; Takeuchi, Yasuhisa; Matsuyama, Junko; Shimauchi, Hidetoshi; Takahashi, Nobuhiro

    2012-01-01

    Objective. The bacterial examination has been performed during the course of the root canal treatment. In the present pilot study, the new developed method, using fluorescence reagents and a membrane filter, was applied to the detection and quantification of bacteria in infected root canals, in order to evaluate the outcomes of the treatment. Methods. Six infected root canals with periapical lesions from 5 subjects were included. Informed consent was obtained from all subjects (age ranges, 23–79 years). Samples from infected root canals were collected at the beginning of the treatment (termed #25 First), the end of the first day of treatment (termed #55 First), and the next appointment day (termed #55 Second). Then, the bacterial count (CFU) was measured using fluorescence reagents (4′,6′-diamidino-2-phenylindole and propidium iodide) and the polycarbonate membrane filter by Bioplorer. Results. The mean ± SD of CFU in the sample of “#25 First” was (1.0 ± 1.4) × 105. As the root canal treatment progressed, the CFU decreased as 7.9 × 103 (#55 First) and 4.3 × 102 (#55 Second). Conclusion. In the present pilot study, rapid detection and quantification of bacteria in infected root canals were found to be successfully performed using fluorescence reagents and a membrane filter (Bioplorer analysis). PMID:22693506

  11. Current perspectives of bio-ceramic technology in endodontics: calcium enriched mixture cement - review of its composition, properties and applications.

    PubMed

    Utneja, Shivani; Nawal, Ruchika Roongta; Talwar, Sangeeta; Verma, Mahesh

    2015-02-01

    Advancements in bio-ceramic technology has revolutionised endodontic material science by enhancing the treatment outcome for patients. This class of dental materials conciliates excellent biocompatibility with high osseoconductivity that render them ideal for endodontic care. Few recently introduced bio-ceramic materials have shown considerable clinical success over their early generations in terms of good handling characteristics. Calcium enriched mixture (CEM) cement, Endosequence sealer, and root repair materials, Biodentine and BioAggregate are the new classes of bio-ceramic materials. The aim of this literature review is to present investigations regarding properties and applications of CEM cement in endodontics. A review of the existing literature was performed by using electronic and hand searching methods for CEM cement from January 2006 to December 2013. CEM cement has a different chemical composition from that of mineral trioxide aggregate (MTA) but has similar clinical applications. It combines the biocompatibility of MTA with more efficient characteristics, such as significantly shorter setting time, good handling characteristics, no staining of tooth and effective seal against bacterial leakage. PMID:25671207

  12. Current perspectives of bio-ceramic technology in endodontics: calcium enriched mixture cement - review of its composition, properties and applications

    PubMed Central

    Nawal, Ruchika Roongta; Talwar, Sangeeta; Verma, Mahesh

    2015-01-01

    Advancements in bio-ceramic technology has revolutionised endodontic material science by enhancing the treatment outcome for patients. This class of dental materials conciliates excellent biocompatibility with high osseoconductivity that render them ideal for endodontic care. Few recently introduced bio-ceramic materials have shown considerable clinical success over their early generations in terms of good handling characteristics. Calcium enriched mixture (CEM) cement, Endosequence sealer, and root repair materials, Biodentine and BioAggregate are the new classes of bio-ceramic materials. The aim of this literature review is to present investigations regarding properties and applications of CEM cement in endodontics. A review of the existing literature was performed by using electronic and hand searching methods for CEM cement from January 2006 to December 2013. CEM cement has a different chemical composition from that of mineral trioxide aggregate (MTA) but has similar clinical applications. It combines the biocompatibility of MTA with more efficient characteristics, such as significantly shorter setting time, good handling characteristics, no staining of tooth and effective seal against bacterial leakage. PMID:25671207

  13. Interpreting finite element results for brittle materials in endodontic restorations

    PubMed Central

    2011-01-01

    Background Finite element simulation has been used in last years for analysing the biomechanical performance of post-core restorations in endodontics, but results of these simulations have been interpreted in most of the works using von Mises stress criterion. However, the validity of this failure criterion for brittle materials, which are present in these restorations, is questionable. The objective of the paper is to analyse how finite element results for brittle materials of endodontic restorations should be interpreted to obtain correct conclusions about the possible failure in the restoration. Methods Different failure criteria (Von Mises, Rankine, Coulomb-Mohr, Modified Mohr and Christensen) and material strength data (diametral tensile strength and flexural strength) were considered in the study. Three finite element models (FEM) were developed to simulate an endodontic restoration and two typical material tests: diametral tensile test and flexural test. Results Results showed that the Christensen criterion predicts similar results as the Von Mises criterion for ductile components, while it predicts similar results to all other criteria for brittle components. The different criteria predict different failure points for the diametral tensile test, all of them under multi-axial stress states. All criteria except Von Mises predict failure for flexural test at the same point of the specimen, with this point under uniaxial tensile stress. Conclusions From the results it is concluded that the Christensen criterion is recommended for FEM result interpretation in endodontic restorations and that the flexural test is recommended to estimate tensile strength instead of the diametral tensile test. PMID:21635759

  14. [Scanning electron microscope study of chemically disinfected endodontic files].

    PubMed

    Navarro, G; Mateos, M; Navarro, J L; Canalda, C

    1991-01-01

    Forty stainless steel endodontic files were observed at scanning electron microscopy after being subjected to ten disinfection cycles of 10 minutes each one, immersed in different chemical disinfectants. Corrosion was not observed on the surface of the files in circumstances that this study was made. PMID:1659857

  15. Effectiveness of an Endodontic Diagnosis Computer Simulation Program.

    ERIC Educational Resources Information Center

    Fouad, Ashraf F.; Burleson, Joseph A.

    1997-01-01

    Effectiveness of a computer simulation to teach endodontic diagnosis was assessed using three groups (n=34,32,24) of dental students. All were lectured on diagnosis, pathology, and radiographic interpretation. One group then used the simulation, another had a seminar on the same material, and the third group had no further instruction. Results…

  16. Biofilm biomass disruption by natural substances with potential for endodontic use.

    PubMed

    Alves, Flávio Rodrigues Ferreira; Silva, Marlei Gomes; Rôças, Isabela Neves; Siqueira, José Freitas

    2013-01-01

    This study evaluated the in vitro effects of four natural substances on the biomass of bacterial biofilms to assess their potential use as root canal irrigants. The following substances and their combinations were tested: 0.2% farnesol; 5% xylitol; 20% xylitol; 0.2% farnesol and 5% xylitol; 0.2% farnesol, 5% xylitol, and 0.1% lactoferrin; 5% xylitol and 0.1% lactoferrin; and 20 mM salicylic acid. The crystal violet assay was used to evaluate the effects of these substances on the biomass of biofilms formed by Enterococcus faecalis and Staphylococcus epidermidis. All substances except for 20 mM salicylic acid and 20% xylitol reduced biofilm mass when compared to controls. The combination of farnesol and xylitol was the most effective agent against E. faecalis ATCC 29212 (p < 0.05). Farnesol combined with xylitol and lactoferrin was the most effective against biofilms of the endodontic strain of E. faecalis MB35 (p < 0.05). Similarly, combinations involving farnesol, xylitol, and lactoferrin reduced the biomass of S. epidermidis biofilms. In general, farnesol, xylitol, and lactoferrin or farnesol and xylitol reduced biofilm biomass most effectively. Therefore, it was concluded that combinations of antibiofilm substances have potential use in endodontic treatment to combat biofilms. PMID:23306623

  17. Reconstruction of endodontically treated posterior teeth--with or without post? Guidelines for the dental practitioner.

    PubMed

    Zarow, Maciej; Devoto, Walter; Saracinelli, Monalds

    2009-01-01

    The clinical concepts regarding the restoration of root canal treated teeth are not clear today and often based on conjecture due to a lack of sound empirical data. The diversity of published opinions is confusing and may lead to less-than-optimal treatment selections. There is also emerging debate whether or not a post is necessary. The purpose of the present article is to organize this topic in evidence-based principles and provide dental practitioners with clear guidelines about restorative therapy for premolar and molar teeth. Two clinical reports are presented, to exemplify the different clinical situations. The first case highlights a conservative restoration of an endodontically treated molar, maintaining an adequate quantity of healthy residual tissue and only covering the cusp with restoration material, which was not sustained by healthy dentin. In the second case, the fact that the premolar was so badly damaged by carious pathology meant that it was necessary to use a pin to anchor the composite material, and the cusp was covered completely. Based on the two presented clinical reports and a literature review, the concept of fiber post application is explained. Searches by hand and MEDLINE were employed to identify peer-reviewed articles on reconstruction of endodontically treated posterior teeth. A total of 70 articles published between 1967 and 2008 were reviewed. PMID:20111757

  18. Effect of nitric oxide inhibitor and donor substances on the inflammatory process caused by endodontic irrigants

    PubMed Central

    de BRITO, Luciana Malheiro; CARREIRA, Cláudia de Moura; RALDI, Denise Pontes; LAGE-MARQUES, José Luiz; HABITANTE, Sandra Márcia; SAAD, Wilson Abraão

    2011-01-01

    Nitric oxide (NO) has been considered a key molecule in inflammation Objective The aim of this study was to evaluate the effect of treatment with L-NAME and sodium nitroprussiate, substances that inhibit and release NO, respectively, on tissue tolerance to endodontic irrigants. Material and Methods The vital dye exudation method was used in a rat subcutaneous tissue model. Injections of 2% Evans blue were administered intravenously into the dorsal penial vein of 14 male rats (200-300 g). The NO inhibitor and donor substances were injected into the subcutaneous tissue in the dorsal region, forming two groups of animals: G1 was inoculated with L-NAME and G2 with sodium nitroprussiate. Both groups received injections of the test endodontic irrigants: acetic acid, 15% citric acid, 17% EDTA-T and saline (control). After 30 min, analysis of the extravasated dye was performed by light absorption spectrophotometry (620 nm). Results There was statistically significant difference (p<0.05) between groups 1 and 2 for all irrigants. L-NAME produced a less intense inflammatory reaction and nitroprussiate intensified this process. Conclusion Independently of the administration of NO inhibitors and donors, EDTA-T produced the highest irritating potential in vital tissue among the tested irrigating solutions. PMID:21552711

  19. Epigenetic modulation of dental pulp stem cells: implications for regenerative endodontics.

    PubMed

    Duncan, H F; Smith, A J; Fleming, G J P; Cooper, P R

    2016-05-01

    Dental pulp stem cells (DPSCs) offer significant potential for use in regenerative endodontics, and therefore, identifying cellular regulators that control stem cell fate is critical to devising novel treatment strategies. Stem cell lineage commitment and differentiation are regulated by an intricate range of host and environmental factors of which epigenetic influence is considered vital. Epigenetic modification of DNA and DNA-associated histone proteins has been demonstrated to control cell phenotype and regulate the renewal and pluripotency of stem cell populations. The activities of the nuclear enzymes, histone deacetylases, are increasingly being recognized as potential targets for pharmacologically inducing stem cell differentiation and dedifferentiation. Depending on cell maturity and niche in vitro, low concentration histone deacetylase inhibitor (HDACi) application can promote dedifferentiation of several post-natal and mouse embryonic stem cell populations and conversely increase differentiation and accelerate mineralization in DPSC populations, whilst animal studies have shown an HDACi-induced increase in stem cell marker expression during organ regeneration. Notably, both HDAC and DNA methyltransferase inhibitors have also been demonstrated to dramatically increase the reprogramming of somatic cells to induced pluripotent stem cells (iPSCs) for use in regenerative therapeutic procedures. As the regulation of cell fate will likely remain the subject of intense future research activity, this review aims to describe the current knowledge relating to stem cell epigenetic modification, focusing on the role of HDACi on alteration of DPSC phenotype, whilst presenting the potential for therapeutic application as part of regenerative endodontic regimens. PMID:26011759

  20. In vitro evaluation of the antimicrobial efficacy of chitosan and other endodontic irrigants against Enterococcus faecalis.

    PubMed

    Shenoi, Pratima R; Morey, Elakshi S; Makade, Chetana S; Gunwal, Mohit K; Khode, Rajiv T; Wanmali, Sunay S

    2016-01-01

    The success of endodontic treatment is directly enhanced by elimination of microorganisms in infected root canals. Recently, chitosan, a natural, nontoxic biopolymer, has been introduced as an irrigant that has the capacity to remove the smear layer. The antimicrobial properties of chitosan as an endodontic irrigant have not yet been explored. The purpose of this study was to compare the antimicrobial efficacy of BioPure MTAD, 0.2% chitosan, 1% chitosan, 2% chlorhexidine gluconate, and 3% sodium hypochlorite (NaOCl) against Enterococcus faecalis, which is frequently isolated from persistent root canal infections. The agar well diffusion method was used to measure the antimicrobial activities of these irrigants. Saline was used as a negative control. The order of effectiveness was determined by the measurement of inhibition zones. Data were analyzed using 1-way analysis of variance and the Duncan multiple range test. BioPure MTAD had a significantly larger mean inhibition zone against E faecalis than the other irrigants (P < 0.001). Although 0.2% chitosan did not show any inhibition zones, 1% chitosan was as effective as 3% NaOCl (P = 0.352), and both irrigants showed significantly greater effectivity than 2% chlorhexidine (P < 0.001). Thus, 1% chitosan can be an effective natural antimicrobial substitute for synthetic irrigants. PMID:27599284

  1. The Prophylactic Effects of Zintoma and Ibuprofen on Post-endodontic Pain of Molars with Irreversible Pulpitis: A Randomized Clinical Trial

    PubMed Central

    Ramazani, Mohsen; Hamidi, Mahmoud Reza; Moghaddamnia, Ali Akbar; Ramazani, Nahid; Zarenejad, Nafiseh

    2013-01-01

    Introduction Post endodontic pain is often linked to the inflammatory process as well as additional central mechanisms. The purpose of the present double-blind randomized clinical trial study was to compare the prophylactic effects of a derivative of Zingiber Officinale, Zintoma, and Ibuprofen on post endodontic pain of molars with irreversible pulpitis. Materials and Methods The post endodontic pain of 72 enrolled patients suffering from irreversible pulpitis was assessed after prophylactic use of 400 mg Ibuprofen, 2 gr Zintoma and placebo. Using the Heft-Parker Visual Analogue Scale, the patients recorded their perceived pain before taking the medicament (baseline), immediately after and also at 4, 8, 12, 24, 48, and 72 h post one-visit endodontic treatment. The statistical analysis was done using Kruskal-Wallis, Mann-Whitney, and Freedman tests (P<0.05). Results At all times, there was significant difference between the Ibuprofen and Zintoma (P<0.05) and also between the Ibuprofen and placebo (P<0.05). However, there was no significant difference between Zintoma and the placebo in any of time intervals (P>0.05). No side effects were observed. Conclusion The obtained results of the trial revealed that prophylactic use of 2 gr Zintoma is not an effective pain relieving agent. PMID:23922575

  2. Endodontic retreatment. Aspects of decision making and clinical outcome.

    PubMed

    Kvist, T

    2001-01-01

    Epidemiological surveys have reported that 25%-35% of root filled teeth are associated with periapical radiolucencies. Descriptive studies have demonstrated that clinicians' decision making regarding such teeth are subject to substantial variation. A coherent model to explain the observed variation has not been produced. In the present thesis a "Praxis Concept theory" was proposed. The theory suggests that dentists perceive periapical lesions of varying sizes as different stages on a continuous health scale. Interindividual variations can then be regarded as the result of the choice of different cut-off points on the continuum for prescribing retreatment. In the present study experiments among novice and expert decision makers gave evidence in favour of the theory. Data also suggested that the choice of retreatment criterion is affected by values, costs of retreatment and technical quality of original treatment. From a prescriptive point of view, the presence of a persistent periapical radiolucency has often been used as a criterion of endodontic "failure" and as an indication for endodontic retreatment. As an alternative decision strategy, the use of decision analysis has been proposed. Logical display of decision alternatives, values of probabilities, utility values (U-values) of the different outcomes and calculation of optimal decision strategy are features of this theory. The implementation of this approach is impeded by the uncertainty of outcome probabilities and lack of investigations concerning U-values. U-values of two periapical health states in root filled teeth (with and without a periapical lesion respectively) were investigated in a group of 82 dental students and among 16 Swedish endodontists. Two methods were used to elicit U-values: Standard gamble and Visual Analogue Scale. Large interindividual variation for both health states were recorded. The difference in U-values between the two health states was found to be statistically significant

  3. Accidental Ingestion and Uneventful Retrieval of an Endodontic File in a 4 Year Old Child: A Case Report.

    PubMed

    Bondarde, Prashant; Naik, Anishri; Patil, Sudha; Shah, Parth H

    2015-01-01

    The majority of foreign body ingestions occur in the pediatric population, with a peak incidence between the ages of 6 months and 6 years. Safety during dental treatment of children cannot be overemphasized. Uncooperative, mentally and physically handicapped children are more prone to ingestion or aspiration of dental instruments than other populations. In any event, it is recommended that dental practitioners examine their instrument before use, as a safeguard against any slippage, breakage. Treatment with any endodontic device requires the use of proper isolation such as rubber dam. PMID:26668487

  4. Use of the carbon dioxide laser in sterilization of endodontic reamers.

    PubMed

    Hooks, T W; Adrian, J C; Gross, A; Bernier, W E

    1980-03-01

    The object of this study was to test a new method of sterilizing endodontic instruments by using a carbon dioxide laser system. This was done by contaminating endodontic reamers with spores, exposing them to a CO2 laser beam, and checking for their viability by standard microbiologic techniques. It was found that 100 percent of the spores were killed by the CO2 laser. This holds promise as an effective method of sterilizing endodontic instruments in the future. PMID:6766545

  5. Mechanical behavior of deep cryogenically treated martensitic shape memory nickel–titanium rotary endodontic instruments

    PubMed Central

    Vinothkumar, Thilla Sekar; Kandaswamy, Deivanayagam; Prabhakaran, Gopalakrishnan; Rajadurai, Arunachalam

    2016-01-01

    Objectives: The aim of this study was to investigate the role of deep cryogenic treatment (DCT) on the cyclic fatigue resistance and cutting efficiency of martensitic shape memory (SM) nickel–titanium (NiTi) rotary endodontic instruments. Materials and Methods: Seventy-five HyFlex® CM instruments were randomly divided into three groups of 25 each and subjected to different DCT (–185° C) conditions based on soaking time: DCT 24 group: 24 h, DCT 6 group: 6 h, and control group. Each group was randomly subdivided for evaluation of cyclic fatigue resistance in custom-made artificial canals (n = 15) and cutting efficiency in plexiglass simulators (n = 10). The cyclic fatigue resistance was measured by calculating the number of cycles to failure (NCF) and cutting efficiency was measured using the loss of weight method. Results: Increase in NCF of instruments in DCT 24 group was highly significant (P < 0.01; Tukey's honest significant difference). There was no difference in weight loss of plexiglass simulators in all the groups (P > 0.05; one-way analysis of variance). In conclusion, deep dry cryogenic treatment with 24 h soaking time significantly increases the cyclic fatigue resistance without affecting the cutting efficiency of SM NiTi endodontic instruments. Materials and Methods: Seventy-five HyFlex® CM instruments were randomly divided into three groups of 25 each and subjected to different DCT (–185° C) conditions based on soaking time: DCT 24 group: 24 h, DCT 6 group: 6 h, and control group. Each group was randomly subdivided for evaluation of cyclic fatigue resistance in custom-made artificial canals (n = 15) and cutting efficiency in plexiglass simulators (n = 10). The cyclic fatigue resistance was measured by calculating the number of cycles to failure (NCF) and cutting efficiency was measured using the loss of weight method. Results: Increase in NCF of instruments in DCT 24 group was highly significant (P < 0.01; Tukey's honest significant difference

  6. Fracture resistance of endodontically treated teeth restored with indirect composite inlay and onlay restorations – An in vitro study

    PubMed Central

    Alshiddi, Ibraheem F.; Aljinbaz, Amjad

    2015-01-01

    Objective The purpose of this in vitro study was to evaluate and compare the fracture resistance and fracture mode of extensive indirect inlay and onlay composite resin restorations performed for endodontically treated premolars. Materials and methods A total of 55 extracted maxillary premolars were randomly divided into four groups. The first group (n = 15) remained untreated to serve as a positive control; the second group (n = 15) was endodontically treated with inlay cavities prepared and restored with indirect composite inlay restorations; the third group (n = 15) was also endodontically treated with onlay cavities prepared and restored with indirect composite onlay restorations; and the fourth group (n = 10) was endodontically treated with mesio-occlusodistal (MOD) cavities prepared and left unrestored to serve as negative controls. Dual cure indirect composite resin was used to fabricate the inlay and onlay restorations performed for the second and third groups, respectively. All teeth were subjected to compressive axial loading test using a metal ball (6 mm in diameter) in a universal testing machine (Instron 1195) with a cross-head speed of 0.5 mm/min until a fracture occurred. Statistical analysis of fracture resistance and fracture mode were performed with analysis of variance (ANOVA) (α = 0.05) and Kruskal–Wallis (α = 0.05) tests, respectively. Results For the four treatment groups, the mean fracture resistance values were 1326.9 N, 1500.1 N, 1006.1 N, and 702.7 N, respectively. Statistical analyses showed no significant differences between the mean fracture resistance of the intact tooth group and the inlay restoration group (p > 0.05), while significant differences were observed between the mean fracture resistance of all the other groups (p < 0.05). The Kruskal–Wallis test showed statistically significant differences between the fracture modes of the four groups. Conclusion Within the limitations of this study

  7. Pressure Alteration Techniques in Endodontics- A Review of Literature

    PubMed Central

    Makkar, Sameer; Gupta, Pranav

    2015-01-01

    The triad of biomechanical preparation, pulp space sterilization and three-dimensional obturation is the hallmark of endodontic success. Complete disinfection of the pulp space cannot be achieved with most sophisticated instrumentation techniques. The role of irrigants in obtaining this goal cannot be underestimated. Optimal irrigation is based on the combined use of two or several irrigating solutions, in a specific sequence. Today’s irrigation armamentarium presents a diverse variety of tools and techniques that can assist the practitioner in reducing bacteria and debris within the canal system. However, currently there is no universally accepted standard irrigation technique. The aim of this article is to review armamentarium and various irrigants in endodontic practice. PMID:25954716

  8. A Natural Meliorate: Revolutionary Tissue Engineering in Endodontics

    PubMed Central

    Geeta, I.B.; Galagali, Girish; Kulkarni, Sangeeta; Suran, Pushpa; Noushin, Faizal

    2013-01-01

    Platelet-Rich Fibrin (PRF) was first described by Choukroun et al., (2001). It has been referred to as a second-generation platelet concentrate, which has been shown to have several advantages over traditionally prepared platelet-rich plasma. PRF has a physiologic architecture that is very favourable to the healing process, obtained due to the slow polymerization process. The development of platelet concentrate as bioactive surgical additives that are applied locally to promote wound healing stems from the use of fibrin adhesive. Developments in the field of tissue engineering have made the generation of artificial substitutes in several areas of medicine. Various clinical applications in endodontics include Periapical surgeries, Revascularisationprocedures, Regenerative pulpotomy, Perforation repair. This article aims to discuss the various applications of PRF in the field of Endodontics with few case reports. PMID:24392430

  9. Removal of fiber posts from endodontically treated teeth.

    PubMed

    de Rijk, W G

    2000-05-01

    The removal of posts from endodontically treated teeth can be a major obstacle in the retreatment of teeth that have recurrent pathology, often leading to extraction of a tooth that could have been saved with endodontic retreatment. The use of a fiber post offers the advantages of a suitable elastic modulus and good bonding between post and cement, but also the advantage of easy removal, if so indicated by clinical findings. A special removal kit for fiber posts has been developed, and its use is illustrated, and described. The removal procedure can be completed in a very short time, usually less than 5 min. The tooth can then be restored with the same type and size of fiber post as was in the tooth prior to removal. Removal kits are found to be for single use only. PMID:11763867

  10. Endodontic surgery failure: SEM analysis of root-end filling.

    PubMed

    Taschieri, Silvio; Bettach, Raphael; Lolato, Alessandra; Moneghini, Laura; Fabbro, Massimo Del

    2011-09-01

    This study investigated the quality of root-end filling in cases of periapical lesions persisting after endodontic surgery. Ten patients requiring extraction of an endodontically treated tooth were included. The root-ends of extracted teeth were examined by scanning electron microscopy. Defects at the interface between the root-end filling and cavity margin were classified as ideal, imperfect (some marginal disruption) or inadequate (continuous marginal disruption involving >30% of the interface). Four cases were scored as imperfect, and six were scored as inadequate. A defective apical seal could favour continuous leakage of surviving bacteria and their by-products from the infected root canal system to periapical tissues, thereby sustaining inflammation. PMID:21959669

  11. Endodontic pathology leading to implant failure--a case report.

    PubMed

    Sussman, H I

    1997-01-01

    This case report documents both the placement of a single implant into an alveolar ridge site and the failure of the implant due to bacterial contamination from an endodontic lesion. After placement of the fixture using osteotomes, the adjacent bicuspid developed periapical pathology following prior crown preparation. This root-end inflammatory process proceeded to involve the mesial surface of the implant. Although endodontic therapy on the devitalized tooth was performed within one week, an osteitis developed around the implant. One month after placement, the fixture had to be removed to prevent additional sequela. The osteotomy site appeared to heal uneventfully, allowing for the placement of a tooth-supported, fixed, partial prosthesis. PMID:9477848

  12. Castable glass ceramic crowns and their reaction to endodontic therapy.

    PubMed

    Cohen, B D; Wallace, J A

    1991-07-01

    The purpose of this investigation was to determine how castable glass (Dicor) crowns would react to both cold testing and endodontic access intervention. Full crown preparations were made on six extracted maxillary teeth. The teeth were then forwarded to Dentsply International, York, Pa. Six castable glass crowns were fabricated to fit these teeth and returned to us. Subsequently the teeth were dried and the crowns were cemented. Scanning electron micrographs of the cemented crowns were made, and endodontic access openings were drilled. The teeth were also cold tested with standard methods. The teeth were then again subjected to scanning electron microscopy to determine any changes the crowns might have undergone. One crown cracked around the gingival collar as scanning electron microscopy was performed. The other crowns did not exhibit any problems such as cracking or crazing from either the access openings or the cold testing. PMID:1891229

  13. [Endodontic filling points with gutta percha - requirements, composition and properties].

    PubMed

    Yildirim, Ayhan; Lübbers, Heinz-Theo; Yildirim, Vedat

    2016-01-01

    Gutta-percha is a tough plastic substance from the latex of several Malaysian trees of the sapodilla family that resembles rubber but contains more resin. It is especially used as insulation and in dentistry. Gutta-percha endodontic filling points were found to contain approximately 20% gutta-percha (matrix), 66% zinc oxide (filler), 11% heavy metal sulphates (radiopacifier), and 3% waxes and/or resins (plasticiser). The mechanical properties were indicative of a partially crystalline viscoelastic polymeric material. PMID:26797818

  14. [Endodontic filling with gutta-percha- requirements, formation and characteristics].

    PubMed

    Yildirim, Ayhan; Lübbers, Heinz-Theo; Yildirim, Vedat

    2016-01-01

    Gutta-percha is a tough plastic substance from the latex of several Malaysian trees of the sapodilla family that resembles rubber but contains more resin. It is especially used as insulation and in dentistry. Gutta-percha endodontic filling points were found to contain approximately 20% gutta-percha (matrix), 66% zinc oxide (filler), 11% heavy metal sulphates (radiopacifier), and 3% waxes and/or resins (plasticiser). The mechanical properties were indicative of a partially crystalline viscoelastic polymeric material. PMID:26915930

  15. Oral microbiota species in acute apical endodontic abscesses

    PubMed Central

    George, Noelle; Flamiatos, Erin; Kawasaki, Kellie; Kim, Namgu; Carriere, Charles; Phan, Brian; Joseph, Raphael; Strauss, Shay; Kohli, Richie; Choi, Dongseok; Craig Baumgartner, J.; Sedgley, Christine; Maier, Tom; Machida, Curtis A.

    2016-01-01

    Background and objectives Acute apical abscesses are serious endodontic diseases resulting from pulpal infection with opportunistic oral microorganisms. The objective of this study was to identify and compare the oral microbiota in patients (N=18) exhibiting acute apical abscesses, originating from the demographic region in Portland, Oregon. The study hypothesis is that abscesses obtained from this demographic region may contain unique microorganisms not identified in specimens from other regions. Design Endodontic abscesses were sampled from patients at the Oregon Health & Science University (OHSU) School of Dentistry. DNA from abscess specimens was subjected to polymerase chain reaction amplification using 16S rRNA gene-specific primers and Cy3-dCTP labeling. Labeled DNA was then applied to microbial microarrays (280 species) generated by the Human Oral Microbial Identification Microarray Laboratory (Forsyth Institute, Cambridge, MA). Results The most prevalent microorganisms, found across multiple abscess specimens, include Fusobacterium nucleatum, Parvimonas micra, Megasphaera species clone CS025, Prevotella multisaccharivorax, Atopobium rimae, and Porphyromonas endodontalis. The most abundant microorganisms, found in highest numbers within individual abscesses, include F. nucleatum, P. micra, Streptococcus Cluster III, Solobacterium moorei, Streptococcus constellatus, and Porphyromonas endodontalis. Strong bacterial associations were identified between Prevotella multisaccharivorax, Acidaminococcaceae species clone DM071, Megasphaera species clone CS025, Actinomyces species clone EP053, and Streptococcus cristatus (all with Spearman coefficients >0.9). Conclusions Cultivable and uncultivable bacterial species have been identified in endodontic abscesses obtained from the Portland, Oregon demographic region, and taxa identifications correlated well with other published studies, with the exception of Treponema and Streptococcus cristae, which were not commonly

  16. Effective exposure level and diagnostic performance in endodontic radiography

    SciTech Connect

    Okano, T.; Wiebe, J.D.; Webber, R.L.; Wagner, R.F.

    1983-05-01

    Image quality is limited by the information capacity of the image-forming system and can be computed from three parameters: contrast, resolution, and noise. These parameters can be combined to yield a single measure which determines the maximum amount of information obtainable from any x-ray system and is called the noise-equivalent number of quanta (NEQ) per unit area. The effects of image quality, expressed as noise-equivalent number of quanta (NEQ) per unit area, on the radiographic performance by dentists reading the position of an endodontic file in a root canal were studied. Three different speed films were used in conjunction with a fixed screen. Components of variance associated with the position of the tooth apex and the tip of an endodontic file in a root canal were compared for the effect of different NEQs and observers. Results show that the standard deviation in locating a file tip and tooth apex may be a linear function of log NEQ. These findings indicate that a significant reduction in exposure would have a relatively small effect on the precision of endodontic distance measurements.

  17. Effective exposure level and diagnostic performance in endodontic radiography.

    PubMed

    Okano, T; Wiebe, J D; Webber, R L; Wagner, R F

    1983-05-01

    Image quality is limited by the information capacity of the image-forming system and can be computed from three parameters: contrast, resolution, and noise. These parameters can be combined to yield a single measure which determines the maximum amount of information obtainable from any x-ray system and is called the noise-equivalent number of quanta (NEQ) per unit area. The effects of image quality, expressed as noise-equivalent number of quanta (NEQ) per unit area, on the radiographic performance by dentists reading the position of an endodontic file in a root canal were studied. Three different speed films were used in conjunction with a fixed screen. NEQ values ranged between 0.64 x 10(4) and 14.3 x 10(4) per square millimeter. Components of variance associated with the position of the tooth apex and the tip of an endodontic file in a root canal were compared for the effect of different NEQs and observers. Results show that the standard deviation in locating a file tip and tooth apex may be a linear function of log NEQ. The estimated standard deviation associated with changes in NEQ was found to be relatively small compared to that observed among dentists. These findings indicate that a significant reduction in exposure would have a relatively small effect on the precision of endodontic distance measurements. PMID:6575345

  18. A comparison between xeroradiography and conventional radiography in the diagnosis of endodontic lesions.

    PubMed

    Barkhordar, R A; Kempler, D

    1988-10-01

    Detection of periapical bone pathosis is an important part of the diagnostic process in dentistry. Xeroradiographs and E-speed films were taken to evaluate and to compare the diagnostic value for the radiographic interpretation of periapical lesions. Thirty-four patients undergoing endodontic treatment were chosen. Simultaneous exposures of the radiographic film and the xeroradiographic plates were made. The samples were viewed and categorized by the examiners using the following scores: 0 = unacceptably poor, 1 = poor but diagnostic, 2 = adequate for diagnostic information, and 3 = optimal for diagnostic information. A paired sample t test was performed on the result of the evaluation by the two examiners, and both showed that there were no significant difference at p less than 0.05 between xeroradiography and conventional radiography. A two-sample t test was performed on the means of the two examiner's evaluation, and there was no significant difference at p less than 0.05 between the means. PMID:3186224

  19. Endodontic therapy of a mandibular canine tooth with irreversible pulpitis secondary to dentigerous cyst.

    PubMed

    MacGee, Scott

    2014-01-01

    Dentigerous cysts are uncommon, yet are being reported with increasing frequency in the veterinary literature. Dentigerous cysts are a type of benign odontogenic cyst associated with impacted teeth, most commonly the mandibular first premolar tooth. Significant bone destruction can occur secondary to the expansion of a dentigerous cyst. The expanding cyst can lead to pathology of neighboring teeth, which can include external root resorption or pulpitis. Intraoral dental radiographs are imperative to properly assess the presence and extent of a dentigerous cyst, as well as the status of the neighboring teeth. This case report describes treatment for dentigerous cyst including cyst lining curettage, mandibular bone regeneration, and endodontic therapy for a canine tooth with irreversible pulpitis. PMID:24902411

  20. Bleaching teeth treated endodontically: long-term evaluation of a case series.

    PubMed

    Amato, Massimo; Scaravilli, Maria Serena; Farella, Mauro; Riccitiello, Francesco

    2006-04-01

    The chromatic stability of nonvital discolored teeth, subjected to the combined intracoronal bleaching technique and to endodontic treatment, was evaluated at a distance of 16 yr (1989-2005). The series comprised 50 patients (age range 7-30 yr) selected from among those attending the Dental Clinic at "Federico II" University, Naples, between 1987 and 1989. After 16 yr, only 35 cases could be evaluated: in 22 of these cases (62.9%) the color had remained stable and was similar to that of adjacent teeth, indicating a successful outcome of the combined bleaching technique. There were 13 cases (37.1%) classified as failures because of marked color relapse. Radiology showed none of the cases re-examined to have undergone internal or external root resorption. These results confirm the validity of the combined intracoronal bleaching technique in terms of efficacy, rapid esthetic result, and safety. PMID:16554217

  1. Primary extranodal B-cell non-Hodgkin lymphoma mimicking an endodontic lesion: report of 2 cases.

    PubMed

    Wong, Gordon B; Spadafora, Silvana; Barbon, Nick; Caputo, Michael

    2013-01-01

    Intrabony oral non-Hodgkin lymphoma (NHL) is rare. We report 2 cases of NHL of the maxilla that initially presented as apical abscesses in endodontically treated teeth. Radiographic findings were nondescript, but tissue biopsy revealed diffuse large B-cell NHL in both instances. No other sites of disease were found. Both patients were treated by chemotherapy and radiation with good results. As primary NHL of the maxilla can mimic a dental inflammatory lesion, tissue biopsy is mandatory in cases where symptoms do not resolve after specific treatment. PMID:24059491

  2. [Endodontic treatment of a periapical lesion causing root separation].

    PubMed

    Canalda Sahli, C

    1990-01-01

    A case is presented of a periapical lesion of a rather large size, which produced an important separation of two inferior incisor roots. The root canal was treated, with calcium hydroxide overextending the apex. Clinic and radiographic control after two years complete reparation of the periapex. PMID:2168734

  3. Comparison of Riboflavin and Toluidine Blue O as Photosensitizers for Photoactivated Disinfection on Endodontic and Periodontal Pathogens In Vitro.

    PubMed

    Nielsen, Henrik Krarup; Garcia, Javier; Væth, Michael; Schlafer, Sebastian

    2015-01-01

    Photoactivated disinfection has a strong local antimicrobial effect. In the field of dentistry it is an emerging adjunct to mechanical debridement during endodontic and periodontal treatment. In the present study, we investigate the effect of photoactivated disinfection using riboflavin as a photosensitizer and blue LED light for activation, and compare it to photoactivated disinfection with the widely used combination of toluidine blue O and red light. Riboflavin is highly biocompatible and can be activated with LED lamps at hand in the dental office. To date, no reports are available on the antimicrobial effect of photoactivated disinfection using riboflavin/blue light on oral microorganisms. Planktonic cultures of eight organisms frequently isolated from periodontal and/or endodontic lesions (Aggregatibacter actinomycetemcomitans, Candida albicans, Enterococcus faecalis, Escherischia coli, Lactobacillus paracasei, Porphyromonas gingivalis, Prevotella intermedia and Propionibacterium acnes) were subjected to photoactivated disinfection with riboflavin/blue light and toluidine blue O/red light, and survival rates were determined by CFU counts. Within the limited irradiation time of one minute, photoactivated disinfection with riboflavin/blue light only resulted in minor reductions in CFU counts, whereas full kills were achieved for all organisms when using toluidine blue O/red light. The black pigmented anaerobes P. gingivalis and P. intermedia were eradicated completely by riboflavin/blue light, but also by blue light treatment alone, suggesting that endogenous chromophores acted as photosensitizers in these bacteria. On the basis of our results, riboflavin cannot be recommended as a photosensitizer used for photoactivated disinfection of periodontal or endodontic infections. PMID:26469348

  4. Comparison of Riboflavin and Toluidine Blue O as Photosensitizers for Photoactivated Disinfection on Endodontic and Periodontal Pathogens In Vitro

    PubMed Central

    Nielsen, Henrik Krarup; Garcia, Javier; Væth, Michael; Schlafer, Sebastian

    2015-01-01

    Photoactivated disinfection has a strong local antimicrobial effect. In the field of dentistry it is an emerging adjunct to mechanical debridement during endodontic and periodontal treatment. In the present study, we investigate the effect of photoactivated disinfection using riboflavin as a photosensitizer and blue LED light for activation, and compare it to photoactivated disinfection with the widely used combination of toluidine blue O and red light. Riboflavin is highly biocompatible and can be activated with LED lamps at hand in the dental office. To date, no reports are available on the antimicrobial effect of photoactivated disinfection using riboflavin/blue light on oral microorganisms. Planktonic cultures of eight organisms frequently isolated from periodontal and/or endodontic lesions (Aggregatibacter actinomycetemcomitans, Candida albicans, Enterococcus faecalis, Escherischia coli, Lactobacillus paracasei, Porphyromonas gingivalis, Prevotella intermedia and Propionibacterium acnes) were subjected to photoactivated disinfection with riboflavin/blue light and toluidine blue O/red light, and survival rates were determined by CFU counts. Within the limited irradiation time of one minute, photoactivated disinfection with riboflavin/blue light only resulted in minor reductions in CFU counts, whereas full kills were achieved for all organisms when using toluidine blue O/red light. The black pigmented anaerobes P. gingivalis and P. intermedia were eradicated completely by riboflavin/blue light, but also by blue light treatment alone, suggesting that endogenous chromophores acted as photosensitizers in these bacteria. On the basis of our results, riboflavin cannot be recommended as a photosensitizer used for photoactivated disinfection of periodontal or endodontic infections. PMID:26469348

  5. The effect of endodontic regeneration medicaments on mechanical properties of radicular dentin

    NASA Astrophysics Data System (ADS)

    Yassen, Ghaeth H.

    Endodontic regeneration treatment of necrotic immature teeth has gained popularity in recent years. The approach suggests a biological alternative to induce a continuous root development. In this project, three in vitro experiments were conducted to investigate the effect of three medicaments used in endodontic regeneration on mechanical properties and chemical structure of radicular dentin. In the first experiment, we investigated longitudinally the effect of medicaments on the indentation properties of the root canal surface of immature teeth using a novel BioDent reference point indenter. A significant difference in the majority of indentation parameters between all groups was found after one-week and one-month application of medicaments (p double antibiotic paste (DAP) > control > calcium hydroxide [Ca(OH)2]. The four-week exposure of dentin to TAP and DAP caused 43% and 31% increase in total indentation distance outcome, respectively. In the second experiment, we investigated longitudinally the effect of medicaments on the chemical structure of immature radicular dentin by measuring the phosphate/amide I ratios of dentin using Attenuated Total Reflection Fourier Transform Infrared Spectroscopy. Phosphate/amide I ratios were significantly different between the four groups after one week, two weeks and four week application of medicaments (p untreated dentin > DAP-treated dentin > TAP-treated dentin. In the third experiment, we investigated longitudinally the effect of medicaments on root fracture resistance and microhardness of radicular dentin. For the microhardness, the two-way interaction between group and time was significant (p<0.001). TAP and DAP caused a significant and continuous decrease in dentin microhardness after one and three month application, respectively. The three-month intracanal application of Ca(OH)2 significantly increased the microhardness of root dentin. The time factor had a significant effect on fracture resistance (p<0.001). All

  6. A Comparison of Four Simulation and Instructional Methods for Endodontic Review.

    ERIC Educational Resources Information Center

    Sandoval, Victor A.; And Others

    1987-01-01

    The effects of four different endodontic self-instructional review formats (slide-tape, latent-image simulation, computer text simulation, and computer-assisted video interactive simulation) on senior clinical endodontic performance are compared. Student evaluations, as well as comparative developmental expenditures, are discussed. (Author/MLW)

  7. Characteristics of Predoctoral Endodontic Education in the United States and Canada.

    ERIC Educational Resources Information Center

    Mendel, Robert W.; Scheetz, James P.

    1981-01-01

    A survey to assess the current state of predoctoral endodontic education programs in U.S. and Canadian dental schools is discussed. The investigation focused on faculty characteristics, the learning climate for endodontics, and problems of administration. Current learning conditions were compared with the desirability of these conditions.…

  8. Endodontic retreatment. 1: Indications and case selection.

    PubMed

    Chong, B S; Pitt Ford, T R

    1996-10-01

    Conventional root canal treatment, despite having a reportedly high success rate may not invariably lead to the desired healing response in clinical practice because of shortcomings in the treatment. This is the first of two articles on this subject, and will cover indications and case selection for root canal retreatment. Part 2 will discuss methods of retreatment. PMID:9452622

  9. Cuspal deflection in molars in relation to endodontic and restorative procedures.

    PubMed

    Panitvisai, P; Messer, H H

    1995-02-01

    The extent of cuspal flexure following endodontic and restorative procedures has important consequences for potential fracture. This study was undertaken to determine the extent to which cusps of molars are weakened by progressively larger restorative preparations and endodontic access. Cuspal flexure of 13 extracted, intact human mandibular molars was measured under controlled occlusal loading. A ramped load of 100 N was applied to the mesial cusps via a steel sphere, using a closed-loop servohydraulic testing machine. Lateral cuspal displacement was recorded by linear measuring devices (direct current differential transformers) accurate to 1 micron. Increasingly extensive MO or MOD cavity preparations followed by endodontic access were cut in each tooth. Cuspal deflection increased with increasing cavity size and was greatest following endodontic access. Cuspal deflections of more than 10 microns were observed. These findings reinforce the importance of cuspal coverage to minimize the danger of marginal leakage and cuspal fracture in endodontically treated teeth. PMID:7714437

  10. Biocompatibility and bioactivity of calcium silicate-based endodontic sealers in human dental pulp cells

    PubMed Central

    MESTIERI, Leticia Boldrin; GOMES-CORNÉLIO, Ana Lívia; RODRIGUES, Elisandra Márcia; SALLES, Loise Pedrosa; BOSSO-MARTELO, Roberta; GUERREIRO-TANOMARU, Juliane Maria; TANOMARU, Mário

    2015-01-01

    Mineral Trioxide Aggregate (MTA) is a calcium silicate-based material. New sealers have been developed based on calcium silicate as MTA Fillapex and MTA Plus. Objective The aim of this study was to evaluate biocompatibility and bioactivity of these two calcium silicate-based sealers in culture of human dental pulp cells (hDPCs). Material and Methods The cells were isolated from third molars extracted from a 16-year-old patient. Pulp tissue was sectioned into fragments with approximately 1 mm3 and kept in supplemented medium to obtain hDPCs adherent cultures. Cell characterization assays were performed to prove the osteogenic potential. The evaluated materials were: MTA Plus (MTAP); MTA Fillapex (MTAF) and FillCanal (FC). Biocompatibility was evaluated with MTT and Neutral Red (NR) assays, after hDPCs exposure for 24 h to different dilutions of each sealer extract (1:2, 1:3 and 1:4). Unexposed cells were the positive control (CT). Bioactivity was assessed by alkaline phosphatase (ALP) enzymatic assay in cells exposed for one and three days to sealer extracts (1:4 dilution). All data were analyzed by ANOVA and Tukey post-test (p≤0.05%). Results MTT and NR results showed suitable cell viability rates for MTAP at all dilutions (90-135%). Cells exposed to MTAF and FC (1:2 and 1:4 dilutions) showed significant low viability rate when compared to CT in MTT. The NR results demonstrated cell viability for all materials tested. In MTAP group, the cells ALP activity was similar to CT in one and three days of exposure to the material. MTAF and FC groups demonstrated a decrease in ALP activity when compared to CT at both periods of cell exposure. Conclusions The hDPCs were suitable for the evaluation of new endodontic materials in vitro. MTAP may be considered a promising material for endodontic treatments. PMID:26537716

  11. Treatment of a Maxillary First Molar with Two Palatal Roots

    PubMed Central

    Asghari, Vahideh; Rahimi, Saeed; Ghasemi, Negin; Talebzadeh, Bita; Norlouoni, Ahmad

    2015-01-01

    Thorough knowledge of the morphology and internal anatomy of the root canal system is essential, because it determines the successful outcome of endodontic treatment. The main goal of endodontic treatment is to prevent apical periodontitis and/or to promote the healing of periapical lesion. Presence of two canals or roots on the palatal side of the first maxillary molar has rarely been reported. This case report presents a maxillary first molar with two separate palatal roots. PMID:26523146

  12. Endodontic applications of a short pulsed FR Nd:YAG dental laser: photovaporization of extruded pulpal tissue following traumatic fractures of two maxillary central incisors--a clinical trial repor

    NASA Astrophysics Data System (ADS)

    Gregg, Robert H., II

    1992-06-01

    Historically, many techniques have been attempted in the search for a satisfactory and consistent treatment of inflamed, painful, hyperemic pulpal tissue. Present techniques attempting to achieve profound local anesthesia in such tissue, have not been satisfactory. Local anesthesia techniques acceptable to the patient with painful hyperemic pulpal tissue, has eluded previous technology. The subsequent treatment of hyperemic tissue without sufficient anesthesia primarily involves undesirable invasive mechanical/surgical procedures. Described in this clinical trial is a technique using free running (FR) pulsed, Nd:YAG laser energy to ablate soft tooth pulpal tissue--a technique employed after conventional endodontic methods failed. A free running pulsed, FR Nd:YAG dental laser was successfully used at 20 pulses per second and 1.25 watts to photovaporize endodontic pulpal tissue (pulpectomy) to allow a conventional endodontic file to extirpate the remaining soft tissue remnants and access the root apex. Also described in this paper is the 'hot-tip' effect of contact fiber laser surgery. This clinical trial achieved the immediate, short term objective of endodontic soft tissue removal via photovaporization, without pain reported by the patient. The pulsed FR Nd:YAG dental laser used as described in this clinical report appears to be a very safe and very effective technique; offers a treatment alternative to traditional therapy that suggests high patient acceptance; and is significantly less stressful for the doctor and staff than traditional treatment options. Long-term, controlled scientific and clinical studies are necessary to establish the safety and efficacy of both the helium-neon energy for visualization and the low-watt pulsed FR Nd:YAG energy for photovaporization of soft endodontic pulpal tissue within the root canal. Research is especially needed to understand the effects of a low-watt, pulsed FR, Nd:YAG laser on the activity of osteoclasts and odontoclasts

  13. Endodontic and periodontal management of a severely affected maxillary lateral incisor having combined mucosal fenestration and palatogingival groove

    PubMed Central

    Sharma, Sarang; Srivastava, Dhirendra; Sood, Vishal; Yadav, Priya

    2015-01-01

    Mucosal fenestrations, wherein the tooth root apices are clinically discernible in the oral cavity subsequent to loss of overlying alveolar bone and mucosa, are rare pathologic entities. Palato gingival grooves- anatomic aberrations are also infrequent occurrences that notoriously predispose to periodontal pathologies of varying extent. Both conditions independently are known to popularly affect maxillary lateral incisors. Coexistent fenestration defect and palato gingival groove in the same tooth is extremely rare and undoubtedly is a perfect combination to precipitate severe endodontic-periodontal consequences. In this report, a 34-year-old patient presented to the dental department with complaint of esthetics in relation to exposed root of right maxillary lateral incisor. On closer inspection, a palato gingival groove in addition to fenestration defect was evident on the root surface along with a periodontal pocket of >5 mm. An interdisciplinary treatment was instituted which included endodontic treatment followed by root end resection, osseous bone graft placement and guided tissue regeneration procedures for repair of mucosal fenestration defect. Debridement of the palatal pocket, with saucerization of the groove and restoration with glass ionomer cement were simultaneously employed to correct the palatal defect. PMID:26229283

  14. Antimicrobial effect of Rosa damascena extract on selected endodontic pathogens.

    PubMed

    Shokouhinejad, Noushin; Emaneini, Mohammad; Aligholi, Marziyeh; Jabalameli, Fereshteh

    2010-02-01

    The purpose of this study was to compare the antimicrobial activity of a plant-derived extract (2 percent Rosa damascena extract) with 5.25 percent sodium hypochlorite (NaOCl) and 2 percent chlorhexidine (CHX) on selected endodontic pathogens. The minimum inhibitory concentrations (MICs) of 2 percent rose extract and 2 percent CHX for test microorganisms, except F. nucleatum, were lower than that of 5.25 percent NaOCl. All solutions were able to kill all test microorganisms after one minute. PMID:20232691

  15. Endodontic periapical lesion-induced mental nerve paresthesia

    PubMed Central

    Shadmehr, Elham; Shekarchizade, Neda

    2015-01-01

    Paresthesia is a burning or prickling sensation or partial numbness, resulting from neural injury. The symptoms can vary from mild neurosensory dysfunction to total loss of sensation in the innervated area. Only a few cases have described apical periodontitis to be the etiological factor of impaired sensation in the area innervated by the inferior alveolar and mental nerves. The aim of the present paper is to report a case of periapical lesion-induced paresthesia in the innervation area of the mental nerve, which was successfully treated with endodontic retreatment. PMID:25878687

  16. Endodontic periapical lesion-induced mental nerve paresthesia.

    PubMed

    Shadmehr, Elham; Shekarchizade, Neda

    2015-01-01

    Paresthesia is a burning or prickling sensation or partial numbness, resulting from neural injury. The symptoms can vary from mild neurosensory dysfunction to total loss of sensation in the innervated area. Only a few cases have described apical periodontitis to be the etiological factor of impaired sensation in the area innervated by the inferior alveolar and mental nerves. The aim of the present paper is to report a case of periapical lesion-induced paresthesia in the innervation area of the mental nerve, which was successfully treated with endodontic retreatment. PMID:25878687

  17. [Physico-chemical properties of 4 endodontic sealing cements].

    PubMed

    Halimi, P; Camps, J; Roche, M; Proust, J P

    1990-12-01

    Four endodontic sealers were compared with two series of tests, in thin layer and in 10 mm long and 5 mm diameter rods. Under these conditions, the Pulp Canal Sealer showed the best ability to present a thin layer and the same flow than the Cortisomol. Its setting time was 15 minutes. Forty-eight hours later, the Sealite showed a very good tightness compared to the other sealers. At 30 days, the Pulp Canal Sealer and the OZn-Eugénol were the tightest ones. Less water was absorbed with the Cortisomal and the Sealite. Is there, for these sealers, any correlation between water-absorbtion and tightness? PMID:2077577

  18. Influence of Ultrasonic Irrigation and Chloroform on Cleanliness of Dentinal Tubules During Endodontic Retreatment-An Invitro SEM Study

    PubMed Central

    Singhal, Anurag; Gurtu, Anuraag; Vinayak, Vineet

    2015-01-01

    Background Ultrasonic irrigation has been proved for its remarkable cleaning efficiency in the field of endodontics. But its role in endodontic re-treatment has been understated. There is not much data available to understand the effect of ultrasonic irrigation for the evaluation of cleanliness of dentinal tubules when it is used with or without chloroform, a gutta percha solvent during endodontic retreatment. Aim To compare the influence of ultrasonic irrigation with syringe irrigation on cleanliness of dentinal tubules after gutta perch removal for endodontic retreatment with or without the use of chloroform a gutta percha solvent using scanning electron microscope (SEM). Materials and Methods Freshly extracted 45 human mandibular premolar teeth for periodontal and orthodontic reasons were taken and were occlusally adjusted to a working length of 19 mm. The root canals of all teeth were prepared chemo mechanically to a master apical file size 40 and were divided in various groups. In Group 1 (n = 5; control group), the canals remained unfilled. In Groups 2 and 3 (n = 20 each), the canals were filled using lateral compaction with gutta-percha and AH plus sealer, removal of root fillings was undertaken after 2 weeks using Gates Glidden drills and H files without chloroform in Group 2 and with chloroform in group 3. The specimen of Group 2 and 3 were further divided into two subgroups I and II (n=10). In subgroup I, irrigation was done using side vented needles and sodium hypochlorite. In subgroup II irrigation was done using passive ultrasonic irrigation with sodium hypochlorite. Thereafter, the roots were split and the sections were observed under SEM. The number of occluded dentinal tubules /total number of dentinal tubules were calculated for the coronal, middle and apical third of each root half. Statistical analysis was performed using one-way ANOVA followed by Tukey’s test using standardized technique. Result Results indicated that the cleanest dentinal

  19. Proteomic analysis of endodontic infections by liquid chromatography–tandem mass spectrometry

    PubMed Central

    Nandakumar, R.; Madayiputhiya, N.; Fouad, A.F.

    2009-01-01

    Introduction Endodontic infections are very prevalent and have a polymicrobial etiology characterized by complex interrelationships between endodontic microorganisms and the host defenses. Proteomic analysis of endodontic infections can provide global insights into the invasion, pathogenicity mechanisms, and multifactorial interactions existing between root canal bacteria and the host in the initiation and progression of apical periodontitis. The purpose of this study was to apply proteomic techniques such as liquid chromatography–tandem mass spectrometry (LC–MS/MS) for the identification of proteins of bacterial origin present in endodontic infections. Methods Endodontic specimens were aseptically obtained from seven patients with root canal infections. Protein mixtures were subjected to tryptic in-solution digestion and analysed by reverse-phase nano-LC–MS/MS followed by a database search. Results Proteins, mainly of cell wall or membrane origin, from endodontic bacteria especially Enterococcus faecalis, Enterococcus faecium, Porphyromonas gingivalis, Fusobacterium nucleatum, and Treponema denticola were identified from all the samples tested. Identified proteins included adhesins, autolysins, proteases, virulence factors, and antibiotic-resistance proteins. Conclusions LC–MS/MS offers a sensitive analytical platform to study the disease processes in the root canal environment. The array of proteins expressed in endodontic infections reflects the complex microbial presence and highlights the bacterial species involved in the inflammatory process. PMID:19572900

  20. Hypohidrotic Ectodermal Dysplasia: Prosthetic and Endodontic Management

    PubMed Central

    Jain, Sandhya; Kumar, Alok; Rahangdale, Tripty

    2010-01-01

    Individuals affected by ectodermal dysplasia syndromes have abnormalities of the glands, tooth buds, hair follicles, and nail development. Oral finding in ectodermal dysplasia patient are significant and can include multiple abnormalities of the dentition such as anodontia, hy-podontia or malformed and widely spaced peg like teeth, loss of occlusal vertical dimension, protuberant lips and lack of normal alveolar ridge development. This clinical report describes a combined surgical, pedodontic, and prosthodontic approach for the treatment of a patient with hypohidrotic ectodermal dysplasia.

  1. RNA Interference-Mediated Silencing of Atp6i Prevents Both Periapical Bone Erosion and Inflammation in the Mouse Model of Endodontic Disease

    PubMed Central

    Ma, Junqing; Zhang, Lijie; Tucker, Byron; Zhu, Guochun; Sasaki, Hajime; Hao, Liang; Wang, Lin; Ci, Hongliang; Jiang, Hongbing; Stashenko, Philip

    2013-01-01

    Dental caries is one of the most prevalent infectious diseases in the United States, affecting approximately 80% of children and the majority of adults. Dental caries may lead to endodontic disease, where the bacterial infection progresses to the root canal system of the tooth, leading to periapical inflammation, bone erosion, severe pain, and tooth loss. Periapical inflammation may also exacerbate inflammation in other parts of the body. Although conventional clinical therapies for this disease are successful in approximately 80% of cases, there is still an urgent need for increased efficacy of treatment. In this study, we applied a novel gene-therapeutic approach using recombinant adeno-associated virus (AAV)-mediated Atp6i RNA interference (RNAi) knockdown of Atp6i/TIRC7 gene expression to simultaneously target periapical bone resorption and periapical inflammation. We found that Atp6i inhibition impaired osteoclast function in vitro and in vivo and decreased the number of T cells in the periapical lesion. Notably, AAV-mediated Atp6i/TIRC7 knockdown gene therapy reduced bacterial infection-stimulated bone resorption by 80% in the mouse model of endodontic disease. Importantly, Atp6i+/− mice with haploinsufficiency of Atp6i exhibited protection similar to that in mice with bacterial infection-stimulated bone erosion and periapical inflammation, which confirms the potential therapeutic effect of AAV-small hairpin RNA (shRNA)-Atp6i/TIRC7. Our results demonstrate that AAV-mediated Atp6i/TIRC7 knockdown in periapical tissues can inhibit endodontic disease development, bone resorption, and inflammation, indicating for the first time that this potential gene therapy may significantly improve the health of those who suffer from endodontic disease. PMID:23166162

  2. RNA interference-mediated silencing of Atp6i prevents both periapical bone erosion and inflammation in the mouse model of endodontic disease.

    PubMed

    Ma, Junqing; Chen, Wei; Zhang, Lijie; Tucker, Byron; Zhu, Guochun; Sasaki, Hajime; Hao, Liang; Wang, Lin; Ci, Hongliang; Jiang, Hongbing; Stashenko, Philip; Li, Yi-Ping

    2013-04-01

    Dental caries is one of the most prevalent infectious diseases in the United States, affecting approximately 80% of children and the majority of adults. Dental caries may lead to endodontic disease, where the bacterial infection progresses to the root canal system of the tooth, leading to periapical inflammation, bone erosion, severe pain, and tooth loss. Periapical inflammation may also exacerbate inflammation in other parts of the body. Although conventional clinical therapies for this disease are successful in approximately 80% of cases, there is still an urgent need for increased efficacy of treatment. In this study, we applied a novel gene-therapeutic approach using recombinant adeno-associated virus (AAV)-mediated Atp6i RNA interference (RNAi) knockdown of Atp6i/TIRC7 gene expression to simultaneously target periapical bone resorption and periapical inflammation. We found that Atp6i inhibition impaired osteoclast function in vitro and in vivo and decreased the number of T cells in the periapical lesion. Notably, AAV-mediated Atp6i/TIRC7 knockdown gene therapy reduced bacterial infection-stimulated bone resorption by 80% in the mouse model of endodontic disease. Importantly, Atp6i(+/-) mice with haploinsufficiency of Atp6i exhibited protection similar to that in mice with bacterial infection-stimulated bone erosion and periapical inflammation, which confirms the potential therapeutic effect of AAV-small hairpin RNA (shRNA)-Atp6i/TIRC7. Our results demonstrate that AAV-mediated Atp6i/TIRC7 knockdown in periapical tissues can inhibit endodontic disease development, bone resorption, and inflammation, indicating for the first time that this potential gene therapy may significantly improve the health of those who suffer from endodontic disease. PMID:23166162

  3. Nonsurgical Endodontic Management of a Molar-Incisor Malformation-affected Mandibular First Molar: A Case Report.

    PubMed

    Yue, Wonyoung; Kim, Euiseong

    2016-04-01

    A molar-incisor malformation (MIM) is a newly reported type of dental anomaly that involves a characteristic root malformation in permanent first molars and deciduous second molars and a crown defect in permanent central incisors. This case report describes a nonsurgical root canal treatment of a MIM-affected molar by aid of a reformatted axial view of the tooth cone-beam computed tomography (CBCT). A MIM-affected molar has calcified canal orifices and a few immature accessory furcal canals. Conventional root canal treatment with the aid of CBCT followed by resin restoration was performed on the tooth. The malformed roots of MIM teeth generally make it difficult to apply conventional endodontic treatment; however, it was possible to do with the aid of the reformatted axial view of the CBCT. PMID:26706790

  4. Implant Placement in Failed Endodontic Sites: A Review.

    PubMed

    Flanagan, Dennis

    2016-04-01

    Dental implants may fail to osseointegrate in sites of endodontic failure. This may occur as a result colonization by various anaerobic and facultative bacterial species. If an implant is placed in a site where vegetative bacteria are residing, the implant may fail to integrate if a bacterial colonization proceeds coronally. If the implant apical cortical bone is thin or if there is an apical fenestration, the colonization may proceed through the thin or nonexistent bone through the covering mucosa, relieving inflammatory pressure to create an apical (retrograde) peri-implantitis. Enterococcus faecalis may be the prime culprit in these types of implant failures. After thorough debridement, the implant may be immediately placed after extraction of an endodontically failed tooth, and the patient treated with an appropriate antibiotic. Alternatively waiting for postextraction healing and subsequent implant placement can be done. Nevertheless, either way may allow for the formation of bacterial vegetative forms or biofilms. The implant surface may be colonized when the surface is exposed to the bacteria. Thorough debridement is crucial. Nonetheless, organisms may persist. Randomized controlled trials are needed to elucidate this issue. PMID:26550925

  5. The effect of temperature on rheological properties of endodontic sealers

    PubMed Central

    Rai, Roshni U.; Singbal, Kiran P.; Parekh, Vaishali

    2016-01-01

    Aim: The purpose of this study was to investigate temperature-dependent rheological properties of three endodontic sealers MTA Fillapex (Angelus, Brazil), AH Plus (Dentsply, Germany), and EndoREZ (Ultradent, USA). Materials and Methods: Five samples of each group of endodontic sealers (n = 30) were freshly mixed and placed on the plate of a rheometer (MCR 301, AntonPaar, Physica) and examined at 25°C and 37°C temperature, respectively. Rheological properties of the sealers were calculated according to the loss modulus (G″), storage modulus (G′), loss factor (Tan δ), and complex viscosity (η*) using dynamic oscillatory shear tests. Results: Statistical analysis (Wilcoxon signed-rank test) demonstrated that MTA Fillapex exhibited higher loss modulus (G″ > G′) and a crossover region. AH Plus and EndoREZ had a higher storage modulus (G′ > G″) at both temperatures. Loss factor (Tan δ) of MTA Fillapex was the highest compared to AH Plus, followed by EndoREZ. With a temperature change from 25°C to 37°C, MTA Fillapex exhibited a decrease while AH Plus exhibited an increase and, EndoREZ exhibited the least change, in complex viscosity (η*). Conclusions: EndoREZ exhibited better rheological properties compared to the other two test sealers. PMID:27099414

  6. Aetiology, incidence and morphology of the C-shaped root canal system and its impact on clinical endodontics.

    PubMed

    Kato, A; Ziegler, A; Higuchi, N; Nakata, K; Nakamura, H; Ohno, N

    2014-11-01

    The C-shaped root canal constitutes an unusual root morphology that can be found primarily in mandibular second permanent molars. Due to the complexity of their structure, C-shaped root canal systems may complicate endodontic interventions. A thorough understanding of root canal morphology is therefore imperative for proper diagnosis and successful treatment. This review aims to summarize current knowledge regarding C-shaped roots and root canals, from basic morphology to advanced endodontic procedures. To this end, a systematic search was conducted using the MEDLINE, BIOSIS, Cochrane Library, EMBASE, Google Scholar, Web of Science, PLoS and BioMed Central databases, and many rarely cited articles were included. Furthermore, four interactive 3D models of extracted teeth are introduced that will allow for a better understanding of the complex C-shaped root canal morphology. In addition, the present publication includes an embedded best-practice video showing an exemplary root canal procedure on a tooth with a pronounced C-shaped root canal. The survey of this unusual structure concludes with a number of suggestions concerning future research efforts. PMID:24483229

  7. Aetiology, incidence and morphology of the C-shaped root canal system and its impact on clinical endodontics

    PubMed Central

    Kato, A; Ziegler, A; Higuchi, N; Nakata, K; Nakamura, H; Ohno, N

    2014-01-01

    The C-shaped root canal constitutes an unusual root morphology that can be found primarily in mandibular second permanent molars. Due to the complexity of their structure, C-shaped root canal systems may complicate endodontic interventions. A thorough understanding of root canal morphology is therefore imperative for proper diagnosis and successful treatment. This review aims to summarize current knowledge regarding C-shaped roots and root canals, from basic morphology to advanced endodontic procedures. To this end, a systematic search was conducted using the MEDLINE, BIOSIS, Cochrane Library, EMBASE, Google Scholar, Web of Science, PLoS and BioMed Central databases, and many rarely cited articles were included. Furthermore, four interactive 3D models of extracted teeth are introduced that will allow for a better understanding of the complex C-shaped root canal morphology. In addition, the present publication includes an embedded best-practice video showing an exemplary root canal procedure on a tooth with a pronounced C-shaped root canal. The survey of this unusual structure concludes with a number of suggestions concerning future research efforts. PMID:24483229

  8. Comparison of fracture resistance and failure pattern of endodontically treated premolars with different esthetic onlay systems: An in vitro study

    PubMed Central

    Mynampati, Praffulla; Babu, Mandava Ramesh; Saraswathi, Devabhaktuni Disha; Kumar, Janga Ravi; Gudugunta, Leneena; Gaddam, Divya

    2015-01-01

    Aim: To compare the fracture resistance and modes of failures of three different aesthetic MOD onlays on endodontically treated premolars. Materials and Methods: Forty sound maxillary premolars were selected of which 10 untreated teeth were taken as control (Group I). The other thirty premolars were subjected to standardized MOD onlay preparations and root canal treatments and divided into 3 equal groups. Onlays were prepared in Group II- Indirect composite, Group III- Lithium Disilicate ceramic and Group IV- Full Zirconia. All onlays were cemented using Multilink Automix. All the 40 samples were subjected to fracture resistance testing on Universal testing machine. Also fractured specimens were observed under stereo-microscope for modes of failure. Results: Group IV presented the highest fracture resistance. Groups II and III presented no significant difference in fracture resistance from each other (P > 0.05). Group II and Group III showed significantly lower fracture resistance values than Group I. Coming to modes of failure, only Group IV had showed no cracks in any of the restorations. Conclusion: Full Zirconia MOD onlays increased the fracture resistance of endodontically treated premolars to a significantly higher level than the sound teeth. PMID:25829694

  9. Representative survey on the reprocessing of endodontic instruments in Germany.

    PubMed

    Sonntag, D; Martin, E; Raab, W H M

    2016-05-13

    Aim The aim of the study was to review the implementation of hygiene guidelines for the reprocessing of endodontic files in a representative survey and to determine the time needed for the procedure.Methods A questionnaire with nine items was sent to 4,000 German dentists. In addition to obtaining personal information, it asked for the total time required for the reprocessing of instruments and contained specific questions about the cleaning procedure in order to assess whether the requirements of the German Federal Ministry of Health, as defined by the Robert Koch Institute, were complied with. Approval by the Ethics Committee was obtained. The data were analysed statistically using the Chi-square test and Cramer's V as a measurement of effect size.Results The response rate was 29.4% (n = 1,177/4,000). On 59 questionnaires, answers to several questions were missing; 1,118 questionnaires (28.0%) could be included in the evaluation. With effect sizes between 0.12 and 0.21, the survey could be classified as statistically representative of German dentists in terms of age and gender. The guidelines were adhered to by 31.7% (n = 354/1118) of respondents, while 68.3% (n = 764/1118) adhered to them either not fully, or not at all (P < 0.001). There were no significant differences in adherence to guidelines between younger (up to 44 years) and older (45 years and above) dentists (P = 0.31) or between women and men (P = 0.194). The reported time for cleaning a patient-related instrument set was more than nine minutes for 68.1% of respondents, not including the time needed for sterilisation; 5% of respondents treated files as single-use instruments.Conclusions The guidelines of the German Federal Ministry of Health for cleaning, disinfecting and sterilising endodontic files are widely disregarded in Germany. The designation and use of endodontic files as single-use instruments should be considered. PMID:27173705

  10. Root canal treatment of a maxillary first premolar with three roots

    PubMed Central

    Mathew, Josey; Devadathan, Aravindan; Syriac, Gibi; Shamini, Sai

    2015-01-01

    Successful root canal treatment needs a thorough knowledge of both internal and external anatomy of a tooth. Variations in root canal anatomy constitute an impressive challenge to the successful completion of endodontic treatment. Undetected extra roots and canals are a major reason for failed root canal treatment. Three separate roots in a maxillary first premolar have a very low incidence of 0.5–6%. Three rooted premolars are anatomically similar to molars and are sometimes called “small molars or radiculous molars.” This article explains the diagnosis and endodontic management of a three rooted maxillary premolar with separate canals in each root highlighting that statistics may indicate a low incidence of abnormal variations in root canal morphology of a tooth, but aberrant anatomy is a possibility in any tooth. Hence, modern diagnostics like cone beam computed tomography, and endodontic operating microscope may have to be used more for predictable endodontic treatment. PMID:26538958

  11. [Resistance to fracture of direct restorations with cuspal coverage in endodontically treated upper bicuspids].

    PubMed

    Takahashi, C U; De Cara, A A; Contin, I

    2001-01-01

    Endodontically treated teeth are considered more susceptible to fracture because of the loss of tooth structure. The aim of this study was to evaluate the increase of resistance to fracture of upper bicuspids that underwent endodontic access and were restored with composite resin, with cuspal coverage. Forty extracted human maxillary premolars were divided in 4 groups: I--intact teeth; II--teeth with endodontic access and MOD preparation, restored with composite resin, without cuspal coverage; III--teeth with endodontic access, MOD preparation and occlusal reduction, restored with composite resin, with cuspal coverage; IV--teeth with endodontic access and MOD preparation, without any restoration. The test specimens were submitted to compression test up to their fracture. The test of Turkey and the ANOVA analysis were used to compare and test the results. The teeth from group III (with cuspal coverage) presented with significantly greater resistance to fracture, when compared with those from groups II (restored without cuspal coverage) and IV (not restored). The composite restoration with cuspal coverage can be considered an alternative for endodontically treated premolars. PMID:11705272

  12. Immediate endodontic access cavity sealing: fundamentals of a new restorative technique.

    PubMed

    De Rose, Luca; Krejci, I; Bortolotto, T

    2015-09-01

    Endodontic access cavity sealing is conventionally performed after endodontic irrigation, referred to as delayed endodontic sealing (DES). Evidence shows that endodontic irrigation with NaOCl decreases dentinal bond quality and could cause coronal leakage. Access cavity sealing before endodontic irrigation is a new restorative approach, referred to as immediate endodontic sealing (IES). The primary aim of this in vitro study was to investigate whether IES improved internal adaptation. The secondary aim was to investigate the influence of the viscosity of the composite used to seal the dentine, on the internal adaptation in both IES and DES groups. Third molars (n= 40) with fully developed apices were used. The teeth were prepared into standard Class II MO cavities, and divided in 4 groups according to the approach, and composite viscosity was used for sealing. Group 1: IES + low viscosity composite; group 2: IES + high viscosity composite; group 3: DES + low viscosity composite; and group 4: DES + high viscosity composite. Samples were then sectioned axially for observation using scanning electron microscopy. Outcome was evaluated by determining the internal adaptation of the samples, which was judged based on the percentage of a continuous margin at the tooth-composite interface. The results were analyzed using a two-way analysis of variance and Mann-Whitney test. IES groups exhibited significantly greater internal adaptation (p = 0.000) as compared with DES groups. Composite viscosity did not significantly affect internal adaptation in either IES or DES groups (p > 0.005). PMID:25183493

  13. The use of calcium hydroxide, antibiotics and biocides as antimicrobial medicaments in endodontics.

    PubMed

    Athanassiadis, B; Abbott, P V; Walsh, L J

    2007-03-01

    Bacteria have been implicated in the pathogenesis and progression of pulp and periapical diseases. The primary aim of endodontic treatment is to remove as many bacteria as possible from the root canal system and then to create an environment in which any remaining organisms cannot survive. This can only be achieved through the use of a combination of aseptic treatment techniques, chemomechanical preparation of the root canal, antimicrobial irrigating solutions and intracanal medicaments. The choice of which intracanal medicament to use is dependent on having an accurate diagnosis of the condition being treated, as well as a thorough knowledge of the type of organisms likely to be involved and their mechanisms of growth and survival. Since the disease is likely to have been caused by the presence of bacteria within the root canal, the use of an antimicrobial agent is essential. Many medicaments have been used in an attempt to achieve the above aims but no single preparation has been found to be completely predictable or effective. Commonly used medicaments include calcium hydroxide, antibiotics, non-phenolic biocides, phenolic biocides and iodine compounds. Each has advantages and disadvantages, and further research is required to determine which is best suited for root canal infections. PMID:17546863

  14. General Dental Practitioners’ Concept towards Using Radiography and Apex-Locators in Endodontics

    PubMed Central

    Raoof, Maryam; Heidaripour, Maryam; Shahravan, Arash; Haghani, Jahangir; Afkham, Arash; Razifar, Mahsa; Mohammadizadeh, Sakineh

    2014-01-01

    Introduction: Despite being the gold standard as well as a routine technique in endodontics, radiographic working length (WL) determination owns many drawbacks. Electronic apex-locators (EALs) are recommended to complement radiographies. The aim of this study was to evaluate the perceptions of Iranian general dental practitioners (GDPs) towards using radiography and EAL. Methods and Materials: Three hundred and ninety one GDPs attending the 53th Iranian Dental Association Congress completed a questionnaire focusing on the use of radiography and EALs during the various stages of root canal treatment. The data was analyzed with the chi-square test with the level of significance set at 0.05. The results were then calculated as frequencies and percentages. Results: More than half of the GDPs reported using radiographs as the sole method for WL determination. A total of 30.4% of the practitioners were using the combined approach during root canal therapy of a single-rooted tooth, while 38.9% used this method in multi-rooted teeth. Approximately half of the respondents would not order follow-up radiographies after root canal treatment. Conclusion: Radiography continues to be the most common method for WL determination in Iran. PMID:25386209

  15. An evaluation of sterilization of endodontic instruments in artificial sponges.

    PubMed

    Vélez, A E; Thomas, D D; del Río, C E

    1998-01-01

    The ability to sterilize endodontic files inserted into synthetic sponges was tested. Sponges were subjected to 5 cycles of either dry heat (Driclave) or steam under pressure (autoclave) sterilization. Sterilization was corroborated by microbiological tests. The sponges and files were pre-sterilized separately using steam under pressure. One hundred eighty files contaminated with Bacillus stearothermophilus spores (experimental and positive control) and 60 noncontaminated files (negative control), were inserted into 60 sponges. After each cycle, each file and a portion of sponge surrounding the file were transferred aseptically to tubes containing trypticase soy broth culture medium for bacteriological analysis. None of the tubes containing files and portions of sponges that were subjected to autoclave grew Bacillus stearothermophilus spores. Two of 60 (3.33%) of the tubes that were subjected to sterilization by Driclave demonstrated bacterial growth. Although the sponges tolerated the dry heat cycles well physically, sterilization was achieved in only 96.67% of the cases. PMID:9487869

  16. Antimicrobial activity of diterpenes from Viguiera arenaria against endodontic bacteria.

    PubMed

    Carvalho, Tatiane C; Simão, Marília R; Ambrósio, Sérgio R; Furtado, Niege A J C; Veneziani, Rodrigo C S; Heleno, Vladimir C G; Da Costa, Fernando B; Gomes, Brenda P F A; Souza, Maria Gorete M; Borges dos Reis, Erika; Martins, Carlos H G

    2011-01-01

    Six pimarane-type diterpenes isolated from Viguiera arenaria Baker and two semi-synthetic derivatives were evaluated in vitro against a panel of representative microorganisms responsible for dental root canal infections. The microdilution method was used for the determination of the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) against Porphyromonas gingivalis, Prevotella nigrescens, Prevotella intermedia, Prevotella buccae, Fusobacterium nucleatum, Bacteroides fragilis, Actinomyces naeslundii, Actinomyces viscosus, Peptostreptococcus micros, Enterococcus faecalis and Aggregatibacter actinomycetemcomitans. The compounds ent-pimara-8(14),15-dien-19-oic acid, its sodium salt and ent-8(14),15-pimaradien-3β-ol were the most active, displaying MIC values ranging from 1 to 10 μg mL-1. The results also allow us to conclude that minor structural differences among these diterpenes significantly influence their antimicrobial activity, bringing new perspectives to the discovery of new chemicals for use as a complement to instrumental endodontic procedures. PMID:21233793

  17. Factors Associated with Postoperative Pain in Endodontic Therapy

    PubMed Central

    Sadaf, Durre; Ahmad, Muhammad Zubair

    2014-01-01

    Objective: To assess postoperative pain in endodontic therapy and its association with clinical factors such as gender, age, tooth type, pulpal diagnosis, and preoperative pain, length of obturation and sealer extrusion. Study Design: Cross-Sectional study. Place and Duration of Study: Dental section of the Aga khan university hospital, Karachi, Pakistan from January to December 2009. Methodology: One hundred and forty patients (140) requiring endodontic therapy for molar and premolar teeth were included in this study. Local Anesthesia (2% Lidocain with 1:80,000 Epinephrine) was administered. The tooth was isolated with rubber dam. Access cavity was prepared with the help of round carbide No. 2 bur. Canal preparation was completed using crown-down technique. Access was sealed with sterile dry cotton pallet and restored temporarily with double layer of Glass ionomer cement and Cavit. After one week patients were recalled and access was re-opened, obturation was done using cold lateral condensation technique. Ca(OH)2 based sealer was used. Postoperative radiographs were taken. Patients were recalled after 24 hours and postobturation pain was recorded using Visual analogue scale (VAS).Data was obtained on a structured Performa. χ2 test was used for statistical analysis. Results: Pain was present in 42.9% of patients. Females more frequently experienced pain (65%) than males (35%). Preoperative pain was found to be significantly associated with postoperative pain (p value < 0.001). Obturation length was not found to be significantly associated with postoperative pain (p value 1.0). Sealer extrusion was not found to be significantly associated with postoperative (P value 0.547). PMID:25598754

  18. Diagnosis and Endodontic Management of Fused Mandibular Second Molar and Paramolar with Concrescent Supernumerary Tooth Using Cone-beam CT and 3-D Printing Technology: A Case Report.

    PubMed

    Kato, Hiroshi; Kamio, Takashi

    2015-01-01

    Supernumerary teeth in the molar area are classified as paramolars or distomolars based on location. They occur frequently in the maxilla, but only rarely in the mandible. These teeth are frequently fused with adjacent teeth. When this occurs, the pulp cavities may also be connected. This makes diagnosis and planning of endodontic treatment extremely difficult. Here we report a case of a mandibular second molar fused with a paramolar, necessitating dental pulp treatment. Intraoral and panoramic radiographs were obtained for an evaluation and diagnosis. Although the images revealed a supernumerary tooth-like structure between the posterior area of the mandibular second molar and mandibular third molar, it was difficult to confirm the morphology of the tooth root apical area. Subsequent cone-beam computed tomography (CBCT) revealed that the supernumerary tooth-like structure was concrescent with the root apical area of the mandibular second molar. Based on these findings, the diagnosis was a fused mandibular second molar and paramolar with a concrescent supernumerary tooth. A 3-dimensional (3-D) printer was used to produce models based on the CBCT data to aid in treatment planning and explanation of the proposed procedures to the patient. These models allowed the complicated morphology involved to be clearly viewed, which facilitated a more precise diagnosis and better treatment planning than would otherwise have been possible. These technologies were useful in obtaining informed consent from the patient, promoting 3-D morphological understanding, and facilitating simulation of endodontic treatment. PMID:26370578

  19. Comparative anti-microbial efficacy of Azadirachta indica irrigant with standard endodontic irrigants: A preliminary study

    PubMed Central

    Dutta, Arindam; Kundabala, Mala

    2014-01-01

    Objective: The anti-microbial efficacy of 2.5% sodium hypochlorite (SHC) and 0.2% chlorhexidine gluconate were compared with an experimental irrigant formulated from the Neem tree, Azadirachta indica A. Juss. Materials and Methods: A sample of 36 single rooted anterior teeth with periapical radiolucency and absence of response to vitality tests that required root canal treatment were selected for this study. The test irrigants and their combinations were assigned to five different groups and saline served as the control. Access cavities were prepared using an aseptic technique and samples collected for both anaerobic culture and Gram stained smears, followed by irrigation and sample collection again. The number of organisms were expressed in colony forming units/ml after 72 h of incubation; the smears were analyzed for their microbial loads and tissue clearance and assessed as per defined criteria. Results: Our results found the maximum reduction in microbial loads, when analyzed by culture method, with a combination of SHC and the experimental neem irrigant. Maximum tissue clearance on the Gram Stained smears was also found with the same combination. Conclusion: Neem irrigant has anti-microbial efficacy and can be considered for endodontic use. PMID:24778508

  20. Fibre reinforcement in a structurally compromised endodontically treated molar: a case report.

    PubMed

    Soares, Renita; de Ataide, Ida de Noronha; Fernandes, Marina; Lambor, Rajan

    2016-05-01

    The reconstruction of structurally compromised posterior teeth is a rather challenging procedure. The tendency of endodontically treated teeth (ETT) to fracture is considerably higher than vital teeth. Although posts and core build-ups followed by conventional crowns have been generally employed for the purpose of reconstruction, this procedure entails sacrificing a considerable amount of residual sound enamel and dentin. This has drawn the attention of researchers to fibre reinforcement. Fibre-reinforced composite (FRC), designed to replace dentin, enables the biomimetic restoration of teeth. Besides improving the strength of the restoration, the incorporation of glass fibres into composite resins leads to favorable fracture patterns because the fibre layer acts as a stress breaker and stops crack propagation. The following case report presents a technique for reinforcing a badly broken-down ETT with biomimetic materials and FRC. The proper utilization of FRC in structurally compromised teeth can be considered to be an economical and practical measure that may obviate the use of extensive prosthetic treatment. PMID:27200283

  1. Fibre reinforcement in a structurally compromised endodontically treated molar: a case report

    PubMed Central

    de Ataide, Ida de Noronha; Fernandes, Marina; Lambor, Rajan

    2016-01-01

    The reconstruction of structurally compromised posterior teeth is a rather challenging procedure. The tendency of endodontically treated teeth (ETT) to fracture is considerably higher than vital teeth. Although posts and core build-ups followed by conventional crowns have been generally employed for the purpose of reconstruction, this procedure entails sacrificing a considerable amount of residual sound enamel and dentin. This has drawn the attention of researchers to fibre reinforcement. Fibre-reinforced composite (FRC), designed to replace dentin, enables the biomimetic restoration of teeth. Besides improving the strength of the restoration, the incorporation of glass fibres into composite resins leads to favorable fracture patterns because the fibre layer acts as a stress breaker and stops crack propagation. The following case report presents a technique for reinforcing a badly broken-down ETT with biomimetic materials and FRC. The proper utilization of FRC in structurally compromised teeth can be considered to be an economical and practical measure that may obviate the use of extensive prosthetic treatment. PMID:27200283

  2. A small molecule, odanacatib, inhibits inflammation and bone loss caused by endodontic disease.

    PubMed

    Hao, Liang; Chen, Wei; McConnell, Matthew; Zhu, Zheng; Li, Sheng; Reddy, Michael; Eleazer, Paul D; Wang, Min; Li, Yi-Ping

    2015-04-01

    Periapical disease, an inflammatory disease mainly caused by dental caries, is one of the most prevalent infectious diseases of humans, affecting both children and adults. The infection travels through the root, leading to inflammation, bone destruction, and severe pain for the patient. Therefore, the development of a new class of anti-periapical disease therapies is necessary and critical for treatment and prevention. A small molecule, odanacatib (ODN), which is a cathepsin K (Ctsk) inhibitor, was investigated to determine its ability to treat this disease in a mouse model of periapical disease. While Ctsk was originally found in osteoclasts as an osteoclast-specific lysosomal protease, we were surprised to find that ODN can suppress the bacterium-induced immune response as well as bone destruction in the lesion area. X rays and microcomputed tomography (micro-CT) showed that ODN treatment had significant bone protection effects at different time points. Immunohistochemical and immunofluorescent staining show that ODN treatment dramatically decreased F4/80+ macrophages and CD3+ T cells in the lesion areas 42 days after infection. Consistent with these findings, quantitative real-time PCR (qRT-PCR) and enzyme-linked immunosorbent assay (ELISA) analysis showed low levels of proinflammatory mRNAs (for tumor necrosis factor alpha, interleukin 6, and interleukin 23α) and corresponding cytokine expression in the ODN-treated disease group. The levels of mRNA for Toll-like receptors 4, 5, and 9 also largely decreased in the ODN-treated disease group. Our results demonstrated that ODN can inhibit endodontic disease development, bone erosion, and immune response. These results indicate that application of this small molecule offers a new opportunity to design effective therapies that could prevent periapical inflammation and revolutionize current treatment options. PMID:25583522

  3. A Small Molecule, Odanacatib, Inhibits Inflammation and Bone Loss Caused by Endodontic Disease

    PubMed Central

    Hao, Liang; McConnell, Matthew; Zhu, Zheng; Li, Sheng; Reddy, Michael; Eleazer, Paul D.; Li, Yi-Ping

    2015-01-01

    Periapical disease, an inflammatory disease mainly caused by dental caries, is one of the most prevalent infectious diseases of humans, affecting both children and adults. The infection travels through the root, leading to inflammation, bone destruction, and severe pain for the patient. Therefore, the development of a new class of anti-periapical disease therapies is necessary and critical for treatment and prevention. A small molecule, odanacatib (ODN), which is a cathepsin K (Ctsk) inhibitor, was investigated to determine its ability to treat this disease in a mouse model of periapical disease. While Ctsk was originally found in osteoclasts as an osteoclast-specific lysosomal protease, we were surprised to find that ODN can suppress the bacterium-induced immune response as well as bone destruction in the lesion area. X rays and microcomputed tomography (micro-CT) showed that ODN treatment had significant bone protection effects at different time points. Immunohistochemical and immunofluorescent staining show that ODN treatment dramatically decreased F4/80+ macrophages and CD3+ T cells in the lesion areas 42 days after infection. Consistent with these findings, quantitative real-time PCR (qRT-PCR) and enzyme-linked immunosorbent assay (ELISA) analysis showed low levels of proinflammatory mRNAs (for tumor necrosis factor alpha, interleukin 6, and interleukin 23α) and corresponding cytokine expression in the ODN-treated disease group. The levels of mRNA for Toll-like receptors 4, 5, and 9 also largely decreased in the ODN-treated disease group. Our results demonstrated that ODN can inhibit endodontic disease development, bone erosion, and immune response. These results indicate that application of this small molecule offers a new opportunity to design effective therapies that could prevent periapical inflammation and revolutionize current treatment options. PMID:25583522

  4. Causes and management of post-treatment apical periodontitis.

    PubMed

    Siqueira, J F; Rôças, I N; Ricucci, D; Hülsmann, M

    2014-03-01

    Endodontic treatment failure is usually characterised by the presence of post-treatment apical periodontitis, which may be persistent, emergent or recurrent. The major aetiology of post-treatment disease is persistent intraradicular infection, but in some cases a secondary intraradicular infection due to coronal leakage or an extraradicular infection may be the cause of failure. Understanding the causes of endodontic treatment failure is of paramount importance for the proper management of this condition. Teeth with post-treatment apical periodontitis can be managed by either nonsurgical endodontic retreatment or periradicular surgery, both of which have very high chances of restoring the health of the periradicular tissues and maintaining the tooth function in the oral cavity. This review article focuses on the aetiological factors of post-treatment apical periodontitis and discusses the indications and basics of the procedures for optimal clinical management of this condition. PMID:24651336

  5. The effect of amount of lost tooth structure and restorative technique on fracture resistance of endodontically treated premolars

    PubMed Central

    Bassir, Mahshid Mohammadi; Labibzadeh, Akram; Mollaverdi, Fatemeh

    2013-01-01

    Aim: Endodontic treatment generally reduces the fracture resistance of teeth. The purpose of this study was to evaluate the fracture resistance and the mode of fracture of endodontically treated human premolars with different amounts of remaining tooth structure. Materials and Methods: Seventy non-carious human premolars were randomly assigned into 7 groups. Group 1 (ST) did not receive any preparation. The teeth in groups 2-7 received root canal treatment and different preparations. Group 2 (MO-NF): Mesio-occlusal preparation without filling; Group 3 (MOD-NF): Mesio-occluso-distal preparation without filling; Group 4 (MO-F): Mesio-occlusal preparation with direct composite restoration (Z250); Group 5 (MOD-F): Mesio-occluso-distal preparation with direct composite restoration (Z250); Group 6 (CC-D): Mesio-occluso-distal preparation with cusp reduction and direct composite restoration (Z250); Group 7 (CC-InD): Mesio-occluso-distal preparation with cusp reduction and indirect composite restoration (Gradia GC). The fracture resistance (N) was assessed under compressive load in a universal testing machine (Zwick) perpendicular to the occlusal surface at a cross-head speed of 1 mm/min, and the mode of fracture was assessed under stereomicroscope. Statistical analysis: Data was analyzed by Kruskal – Wallis and Mann – Whitney tests and the mode of fracture was analyzed by Chi-square test (P < 0.05). Results: Statistical analysis showed that MO and MOD cavity preparations significantly reduced the fracture resistance of sound teeth. Direct composite restorations can improve the fracture resistance, and Groups 7 and 6 presented the highest fracture resistance values. Conclusions: Teeth with adhesive restorations showed significantly higher fracture resistance values as compared with the non-restored ones. PMID:24082569

  6. The Sensitivity of Endodontic Enterococcus spp. Strains to Geranium Essential Oil.

    PubMed

    Łysakowska, Monika E; Sienkiewicz, Monika; Banaszek, Katarzyna; Sokołowski, Jerzy

    2015-01-01

    Enterococci are able to survive endodontic procedures and contribute to the failure of endodontic therapy. Thus, it is essential to identify novel ways of eradicating them from infected root canals. One such approach may be the use of antimicrobials such as plant essential oils. Enterococcal strains were isolated from endodontically treated teeth by standard microbiological methods. Susceptibility to antibiotics was evaluated by the disc-diffusion method. The minimal inhibitory concentration (MIC) of geranium essential oil was investigated by microdilution in 96-well microplates in Mueller Hinton Broth II. Biofilm eradication concentrations were checked in dentin tests. Geranium essential oil inhibited enterococcal strains at concentrations ranging from 1.8-4.5 mg/mL. No correlation was shown between resistance to antibiotics and the MICs of the test antimicrobials. The MICs of the test oil were lower than those found to show cytotoxic effects on the HMEC-1 cell line. Geranium essential oil eradicated enterococcal biofilm at concentrations of 150 mg/mL. Geranium essential oil inhibits the growth of endodontic enterococcal species at lower concentrations than those required to reach IC50 against the HMEC-1 cell line, and is effective against bacteria protected in biofilm at higher concentrations. In addition, bacteria do not develop resistance to essential oils. Hence, geranium essential oil represents a possible alternative to other antimicrobials during endodontic procedures. PMID:26703546

  7. Pathological evaluation for sterilization of routinely used prosthodontic and endodontic instruments

    PubMed Central

    Kumar, K. Vinay; Kiran Kumar, K.S.; Supreetha, S.; Raghu, K.N.; Veerabhadrappa, Anusha Channabasappa; Deepthi, S

    2015-01-01

    Background: In daily practice of dentistry, we use same instruments on many patients. Before use, all instruments must be cleaned, disinfected, and sterilized to prevent any contamination. Pre-cleaning and sterilization of some devices can be difficult because of their small size and complex architecture. Dental burs and endodontic files are such instruments. Dental burs come in a variety of shapes and sizes, all with highly complex and detailed surface features. Aim: To determine the effectiveness of various disinfectants and sterilization techniques for disinfection and resterilization of dental burs and endodontic files. Materials and Methods: The materials used for the study were dental burs and endodontic files. Disinfectants used were Quitanet plus, glutaraldehyde, glass-bead sterilizer, and autoclave. The sterility of used dental burs and endodontic files was analyzed. Burs and files that had been used were pre-cleaned, resterilized, and then tested for various pathogens. Each item was transferred by sterile technique into Todd-Hewitt broth, incubated at 37°C for 72 h, and observed for bacterial growth. Results: The present study shows that the endodontic files and burs sterilized by autoclaving and glutaraldehyde showed complete sterilization. Burs and files immersed in glutaraldehyde (2.4%) for 12 h showed complete sterilization, whereas Quitanet plus solution and glass-bead sterilizer showed incomplete sterilization. Conclusion: The present study results indicate that autoclaving and glutaraldehyde (2.4%) showed complete sterilization. Other methods cannot be relied upon for sterilization. PMID:26236684

  8. Integrated treatment of multiple subgingival fractures.

    PubMed

    Cheshire, P D

    1991-08-01

    With careful planning an apparently "hopeless case" can be treated successfully and conservatively. The case report of an 18 year old male requiring a combined periodontic, endodontic and prosthodontic approach is presented. With emphasis on treatment planning and emergency cover in the new dental contract, the approach to the treatment plan is discussed. PMID:1813937

  9. A Rare Case of Type III Dens Invaginatus in a Mandibular Second Premolar and Its Nonsurgical Endodontic Management by Using Cone-beam Computed Tomography: A Case Report.

    PubMed

    Agrawal, Pritesh Kisanlal; Wankhade, Jyoti; Warhadpande, Manjusha

    2016-04-01

    Invaginated teeth present technical difficulties in clinical management because of their abnormal anatomic configuration. Endodontic clinical management of type III dens invaginatus can be greatly enhanced by newer techniques and materials such as cone-beam computed tomography (CBCT), mineral trioxide aggregate, and platelet-rich fibrin. This case report presents a 13-year-old male patient with type III dens invaginatus (DI) in left mandibular second premolar with history of recurrent swelling. Pulp testing revealed no response with the tooth. Dens invaginatus type III with an immature apex and periapical lesion was seen on radiograph. The case was diagnosed as Oehlers type III DI with pulp necrosis and chronic apical abscess. The treatment was planned and performed by using CBCT imaging. CBCT was performed to see the canal anatomy and to know the size of periapical lesion. Root canal treatment was completed in 2 visits. Calcium hydroxide dressing was placed in the first visit. In the second visit MTA was used for apexification in the main canal, and warm vertical compaction technique with gutta-percha was used in the invaginated canal. At the 2-year reevaluation, the patient was asymptomatic, and his tooth had remained functional since the treatment was completed. Radiographic assessment of the tooth showed significant osseous healing of the preoperative lesion. Three-dimensional imaging is a valuable tool for endodontic management of teeth with complex internal anatomy. PMID:26874642

  10. Evolution of the role of phototherapy during endodontic decontamination

    PubMed Central

    Muhammad, Omid Heidar; Rocca, Jean-Paul; Fornaini, Carlo

    2015-01-01

    A microbe free root canal space before obturation leads to higher success rate and conventional chemo-mechanical debridement might not achieve this goal completely. First trials of laser in dentistry started from surgical intervention on caries and bones of oral cavity and extended to prepare cavities and even shaping root canals. Afterward lasers were implicated soon into direct debridement of root canal space. Anyhow failure of laser to remove debris totally from root canal space is demonstrated recently, additionally it might lead to damages to surrounding tissues or inorganic material of root canal if be used without precaution. Nowadays the theory of light assisted protocols became another start point for laser in endodontics. Laser has been introduced as an adjuvant to conventional debridement of root canals. We used Medline search engine to collect scientific publications to edit this review article in purpose of revealing the evolution of laser position from an ultimate cleaning methodology to an adjuvant to conventional root canal disinfection protocols. PMID:26877593

  11. Sound levels in conservative dentistry and endodontics clinic

    PubMed Central

    Dutta, Arindam; Mala, Kundabala; Acharya, Shashi Rashmi

    2013-01-01

    Aim: To evaluate the sound levels generated in dental clinics of conservative dentistry and endodontics. Material and Methods: A decibel-meter with digital readout was used to measure sound levels at different time intervals at the chairside and at the center of the clinic. Minimum and maximum readings during a 3 min interval were recorded. Results: In the post-graduate (PG) clinic, there was significant difference in noise levels between the chairside (66-81 dB[A]) and the center of the clinic (66-67 dB[A]) at certain times. In the under graduate (UG) clinic, noise levels with suction and either high/slow speed handpieces (67-80 dB[A]) were significantly higher than the center of clinic. Suction alone in the UG clinic (63-75 dB[A]) was significantly quieter than in the PG clinic (69-79 dB[A]). Conclusions: (1) Mean sound levels in the working clinics ranged from 63.0 dB[A] to 81.5 dB[A]. These are within the recommended range for dental equipment. (2) With suction and either low/high speed handpiece combination, the PG clinic was significantly noisier than the UG clinic at several time periods. PMID:23716962

  12. Accuracy of endodontic microleakage results: autoradiographic vs. volumetric measurements.

    PubMed

    Ximénez-Fyvie, L A; Ximénez-García, C; Carter-Bartlett, P M; Collado-Webber, F J

    1996-06-01

    The correlation between autoradiographic and volumetric leakage measurements was evaluated. Seventy-two anterior teeth with a single canal were selected and divided into three groups of 24. Group 1 served as control (no obturation), group 2 was obturated with gutta-percha only, and group 3 was obturated with gutta-percha and endodontic sealer. Samples were placed in a vertical position in 48-well cell culture plates and immersed in 1 ml of [14C]urea for 14 days. One-mm-thick horizontal serial sections were cut with a diamond disk cooled with liquid-nitrogen gas. Linear penetration was recorded by five independent evaluators from autoradiographs. Volumetric results were based on counts per minute registered in a liquid scintillation spectrometer. Pearson's correlation coefficient test was used to determine the lineal correlation between both methods of evaluation. No acceptable correlation values were found in any of the three groups (group 1, r = 0.34; group 2, r = 0.23; group 3, r = 0.20). Our results indicate that there is no correlation between linear and volumetric measurements of leakage. PMID:8934988

  13. Differential scanning calorimetric studies of nickel titanium rotary endodontic instruments.

    PubMed

    Brantley, W A; Svec, T A; Iijima, M; Powers, J M; Grentzer, T H

    2002-08-01

    Differential scanning calorimetric (DSC) analyses were performed between -130 degrees and 100 degrees C on specimens prepared from nickel-titanium (NiTi) rotary endodontic instruments: ProFile (n = 5), Lightspeed (n = 4), and Quantec (n = 3). The ProFile and Lightspeed instruments were in the as-received condition, whereas the Quantec instruments were randomly selected from a dental clinic and had unknown history. The DSC plots showed that the ProFile and Lightspeed instruments analyzed had the superelastic NiTi property, with an austenite-finish (Af) temperature of approximately 25 degrees C. Differences in DSC plots for the ProFile instruments and the starting wire blanks (n = 2) were attributed to the manufacturing process. The phase transformation behavior when the specimens were heated and cooled between -130 degrees and 100 degrees C, the temperature ranges for the phase transformations, and the resulting enthalpy changes were similar to those previously reported for nickel-titanium orthodontic wires having superelastic characteristics or shape memory behavior in the oral environment. The experiments demonstrated that DSC is a powerful tool for materials characterization of these rotary instruments, providing direct information not readily available from other analytical techniques about the NiTi phases present, which are fundamentally responsible for their clinical behavior. PMID:12184415

  14. Evolution of the role of phototherapy during endodontic decontamination.

    PubMed

    Muhammad, Omid Heidar; Rocca, Jean-Paul; Fornaini, Carlo; Medioni, Etienne

    2015-12-30

    A microbe free root canal space before obturation leads to higher success rate and conventional chemo-mechanical debridement might not achieve this goal completely. First trials of laser in dentistry started from surgical intervention on caries and bones of oral cavity and extended to prepare cavities and even shaping root canals. Afterward lasers were implicated soon into direct debridement of root canal space. Anyhow failure of laser to remove debris totally from root canal space is demonstrated recently, additionally it might lead to damages to surrounding tissues or inorganic material of root canal if be used without precaution. Nowadays the theory of light assisted protocols became another start point for laser in endodontics. Laser has been introduced as an adjuvant to conventional debridement of root canals. We used Medline search engine to collect scientific publications to edit this review article in purpose of revealing the evolution of laser position from an ultimate cleaning methodology to an adjuvant to conventional root canal disinfection protocols. PMID:26877593

  15. The use of a radiopaque contrast medium in endodontic radiography.

    PubMed

    Shearer, A C; Wasti, F; Wilson, N H

    1996-03-01

    A series of in vitro studies were carried out to investigate the use and application of a radiopaque contrast medium in conventional periapical dental radiography for the diagnosis and evaluation of root canal systems. The water-soluble radiopaque contrast medium was introduced into the root canals of 30 first permanent maxillary and 30 first permanent mandibular molar teeth. The radiographic images of these teeth with and without radiopaque contrast medium in the root canal systems were compared and contrasted. Further comparisons were made with the same teeth rendered transparent. The results indicate that by standardizing the diagnostic criteria the inter-examiner reliability was in good agreement; it was independent of the radiographic technique used. The validity of the radiographs was enhanced by the use of the radiopaque contrast medium. The results confirm that, with the use of a radiopaque contrast medium, images of root canal systems are easier to read and interpret than plain radiographic images of root canal systems. The use of radiopaque contrast medium in endodontic radiography may be a valuable aid in the diagnosis and evaluation of root canal systems. This system would complement rather than replace plain radiography. PMID:9206431

  16. Biocompatibility of two experimental scaffolds for regenerative endodontics

    PubMed Central

    Setzer, Frank C.; Trope, Martin; Karabucak, Bekir

    2016-01-01

    Objectives The biocompatibility of two experimental scaffolds for potential use in revascularization or pulp regeneration was evaluated. Materials and Methods One resilient lyophilized collagen scaffold (COLL), releasing metronidazole and clindamycin, was compared to an experimental injectable poly(lactic-co-glycolic) acid scaffold (PLGA), releasing clindamycin. Human dental pulp stem cells (hDPSCs) were seeded at densities of 1.0 × 104, 2.5 × 104, and 5.0 × 104. The cells were investigated by light microscopy (cell morphology), MTT assay (cell proliferation) and a cytokine (IL-8) ELISA test (biocompatibility). Results Under microscope, the morphology of cells coincubated for 7 days with the scaffolds appeared healthy with COLL. Cells in contact with PLGA showed signs of degeneration and apoptosis. MTT assay showed that at 5.0 × 104 hDPSCs, COLL demonstrated significantly higher cell proliferation rates than cells in media only (control, p < 0.01) or cells co-incubated with PLGA (p < 0.01). In ELISA test, no significant differences were observed between cells with media only and COLL at 1, 3, and 6 days. Cells incubated with PLGA expressed significantly higher IL-8 than the control at all time points (p < 0.01) and compared to COLL after 1 and 3 days (p < 0.01). Conclusions The COLL showed superior biocompatibility and thus may be suitable for endodontic regeneration purposes. PMID:27200277

  17. In vitro longitudinal assessment of coronal discoloration from endodontic sealers.

    PubMed

    Parsons, J R; Walton, R E; Ricks-Williamson, L

    2001-11-01

    A major cause of tooth discoloration may be sealer remnants in the chamber. The objective of this study was to evaluate, longitudinally, coronal discoloration from four sealers. Extracted premolars were sectioned in the coronal third of the root. The chamber contents were removed and instrumentation was via the canal. The following sealers were bulk introduced into the chamber: AH26, Kerr Pulp Canal Sealer, Roths 801 (nonstaining), and Sealapex. The apical access was sealed with white sticky wax. Teeth were maintained in a moist environment at 37 degrees C. Initial (immediate pretreatment) digital images of the teeth were made for base line comparison. Subsequent images were at 1-, 3-, 9-, and 12-month intervals. Then images were mixed and descriptively evaluated blindly by trained evaluators. Discoloration was induced by the four sealers, with slight to moderate visible changes that increased through 12 months. There was slightly more discoloration with AH26 and Kerr Pulp Canal Sealer. In conclusion discoloration induced by the endodontic sealers produced slight to moderate and generally progressive discoloration over 12 months. PMID:11716085

  18. Large-scale Clinical Endodontic Research in The National Dental Practice-Based Research Network: Study Overview and Methods

    PubMed Central

    Nixdorf, Donald R.; Law, Alan S.; Look, John O.; Rindal, D. Brad; Durand, Emily U.; Kang, Wenjun; Agee, Bonita S.; Fellows, Jeffrey L.; Gordan, Valeria V.; Gilbert, Gregg H.

    2013-01-01

    Introduction This paper reports on the feasibility of conducting a large-scale endodontic prospective cohort study in The National Dental Practice-Based Research Network. This study was designed to measure pain and burden associated with initial orthograde root canal therapy (RCT) and to explore potential prognostic factors for pain outcomes. The main objectives of this first report in a series are to describe the project’s feasibility and methods and the demographics of the sample obtained. Methods Sixty-two dentist practitioner-investigators (46 generalists, 16 endodontists) in five geographical areas were certified within the network and trained regarding the standardized study protocol. Enrollment and baseline data collection occurred over 6 months, with post-obturation follow-up for another 6 months. Patients and dentists completed questionnaires before and immediately after treatment visits. Patients also completed questionnaires at 1 week, 3 months, and 6 months after obturation. Results Enrollment exceeded target expectations, with 708 eligible patient-participants. Questionnaire return rates were good, ranging between 90% to 100%. Patient demographics were typical of persons who receive RCT in the United States: mean age 48 years (SD 13 years), with most being female (59%), college-educated (81%), white non-Hispanic (86%), and having dental insurance (81%). The tooth types being treated were also typical: 61% molars, 28% premolars, and 11% anteriors, with maxillary teeth being predominant (59%). Conclusions This study demonstrates the feasibility of conducting large-scale endodontic prospective cohort studies in the network. Patients were rapidly recruited, with high levels of compliance in data collection. PMID:23063220

  19. Searching for Helicobacter pylori and Chlamydia pneumoniae in primary endodontic infections

    PubMed Central

    Rôças, Isabela N.; Siqueira, José F.

    2012-01-01

    Objectives: The purpose of this study was to search samples from primary endodontic infections for the presence of two common human bacterial pathogens - Helicobacter pylori and Chlamydia pneumoniae. Methods: Genomic DNA isolated from samples taken from 25 root canals of teeth with asymptomatic (chronic) apical periodontitis and 25 aspirates from acute apical abscess was initially amplified by the multiple displacement amplification approach and then used as template in species-specific polymerase chain reaction (PCR) for detection of H. pylori and C. pneumoniae. Results: All clinical samples were positive for the presence of bacterial DNA. However, no clinical sample was positive for either H. pylori or C. pneumoniae. Conclusions: Neither H. pylori nor C. pneumoniae were found in samples from primary endodontic infections. These findings suggest that these species are not candidate endodontic pathogens and that the necrotic root canal does not serve as a reservoir for these human pathogens in healthy patients. PMID:22509118

  20. Stimulation of proinflammatory cytokines by volatile sulfur compounds in endodontically treated teeth

    PubMed Central

    Lechner, Johann; von Baehr, Volker

    2015-01-01

    Persistent microorganisms in endodontically treated teeth produce volatile sulfur compounds (VSC) such as methyl mercaptan, hydrogen sulfide, and thioether. In this retrospective study, we evaluated the ex vivo immune response of peripheral blood mononuclear cells to sulfur compounds in 354 patients with systemic diseases. These systemic findings are correlated with semiquantitative values of a VSC indicator applied directly on endodontically treated teeth. Data elucidate the role of VSC in patients with immunologic diseases and the role of a semiquantitative chairside test, like the VSC indicator presented here, in correlation to IFNg and IL-10 sensitization in peripheral blood mononuclear cells. The association between ex vivo-stimulated cytokines and endodontically derived sulfur components is supported by the fact that the number of interferon gamma- and/or interleukin-10-positive sensitized patients declined significantly 3–8 months after extraction of the corresponding teeth. PMID:25792853

  1. Effect of various endodontic solutions on punch out strength of Resilon under cyclic loading

    PubMed Central

    Kumar, Narender; Aggarwal, Vivek; Singla, Mamta; Gupta, Ridhima

    2011-01-01

    Background: Before obturation, various endodontic solutions are used as a final rinse. These solutions might affect the bond strength of Resilon-Epiphany system. The aim of this study was to evaluate the effect of NaOCl (5.25%), chlorhexidine CHX (2%), EDTA solution (17%), and BioPure MTAD on push out bond strength of Resilon-Epiphany system. Materials and Methods: Seventy-five human premolar roots were prepared and divided on the basis of final endodontic solution rinse. The canals were obturated with Resilon-Epiphany system. All samples were restored using a fiber post system and indirect composite crown. The samples received 150 000 cycles of mechanical loading. Push out bond strength was performed in the apical third of root having Resilon obturation. Results and Conclusions: Different endodontic solutions tested, did not affected the push out bond strength of Resilon-Epiphany obturation system. PMID:22144804

  2. Endodontic retreatment of an autotransplanted lower first premolar: a case report.

    PubMed

    Koshy, Sajeev; Love, Robert Matthew

    2003-08-01

    A 24-year-old female with no contributory medical history had been treated by orthodontic alignment and transplantation of the lower left first premolar to the upper left first premolar site to correct for congenitally missing upper premolars. Subsequently, the transplanted premolar was treated by conventional endodontics and apical surgery for persistent periapical periodontitis over a span of 12 years. A combination of conventional endodontic retreatment and periapical surgery resulted in periapical healing. This case outlines the need for careful preoperative case assessment. PMID:12848718

  3. Fracture resistance exhibited by endodontically treated and retreated teeth shaped by ProTaper NEXT versus WaveOne: An in vitro study

    PubMed Central

    Khalap, Neha Deepak; Hegde, Vibha; Kokate, Sharad

    2015-01-01

    Aim: To compare the fracture resistance exhibited by teeth after primary endodontic treatment and retreatment. Materials and Methods: One hundred freshly extracted human teeth were selected. 20 samples served as control (untreated). Eighty experimental samples were divided into two groups (n = 40) for instrumentation using rotary Protaper NEXT (PTN) or reciprocating WaveOne (WO) files and obturated using warm lateral compaction. Half of the samples (n = 20) from each group were subjected to a load. The remaining half were subjected to retreatment using Protaper universal retreatment files (RFs) followed by a file larger than the master apical file used in groups 1 and 2 and reobturated. Group A: Control, Group B: PTN + obturation, Group C: WO + obturation, Group D: RF + PTN + obturation and Group E: RF + WO + obturation. The retreatment specimens were also subjected to load and the readings acquired were statistically analyzed. Result: When compared between the groups, control group exhibited the highest fracture resistance (P < 0.01). When multiple tests were performed, Group E exhibited significantly less fracture resistance (P < 0.01). Conclusion: Endodontic treatment and retreatment both results in lowering the fracture resistance of a tooth. PMID:26752838

  4. Amputation of an Extra-root with an Endodontic Lesion in an Invaginated Vital Maxillary Lateral Incisor: A Rare Case with Seven-year Follow-up

    PubMed Central

    Çalışkan, Mehmet Kemal; Asgary, Saeed; Tekin, Uğur; Güneri, Pelin

    2016-01-01

    The developmental abnormality of tooth resulting from the infolding of enamel/dentin into the root is called dens invaginatus. Management of such cases is usually challenging due to the morphological complexity of root canal system. This report presents a rare treatment protocol of a clinical case of Oehler’s type III dens invaginatus combined with an endodontic lesion in a vital maxillary lateral incisor. Access to the endodontic lesion located between the central and lateral incisors was achieved by reflection of a full mucoperiosteal flap. Granulomatous tissue as well as aberrant root was removed and the surface of the root and adjacent coronal region were reshaped. Three years later, the patient was orthodontically treated. Seven years after completion of surgical/orthodontic management, the tooth remained asymptomatic and functional with normal periodontium/vital pulp. Radiographically, the healing of the lesion was observed. Actually, vitality of the invaginated tooth and communication between the invagination and the root canal were the most important factors in determining such minimally invasive treatment protocol. Depending on the anatomy of the root canal system, surgical amputation of an invaginated root can be performed to achieve a successful outcome in Oehler’s type III dens invaginatus cases, even though it is associated with apical periodontitis. PMID:27141224

  5. Amputation of an Extra-root with an Endodontic Lesion in an Invaginated Vital Maxillary Lateral Incisor: A Rare Case with Seven-year Follow-up.

    PubMed

    Çalışkan, Mehmet Kemal; Asgary, Saeed; Tekin, Uğur; Güneri, Pelin

    2016-01-01

    The developmental abnormality of tooth resulting from the infolding of enamel/dentin into the root is called dens invaginatus. Management of such cases is usually challenging due to the morphological complexity of root canal system. This report presents a rare treatment protocol of a clinical case of Oehler's type III dens invaginatus combined with an endodontic lesion in a vital maxillary lateral incisor. Access to the endodontic lesion located between the central and lateral incisors was achieved by reflection of a full mucoperiosteal flap. Granulomatous tissue as well as aberrant root was removed and the surface of the root and adjacent coronal region were reshaped. Three years later, the patient was orthodontically treated. Seven years after completion of surgical/orthodontic management, the tooth remained asymptomatic and functional with normal periodontium/vital pulp. Radiographically, the healing of the lesion was observed. Actually, vitality of the invaginated tooth and communication between the invagination and the root canal were the most important factors in determining such minimally invasive treatment protocol. Depending on the anatomy of the root canal system, surgical amputation of an invaginated root can be performed to achieve a successful outcome in Oehler's type III dens invaginatus cases, even though it is associated with apical periodontitis. PMID:27141224

  6. In vitro study on the softening of gutta-percha cones in endodontic retreatment.

    PubMed

    Pécora, J D; Spanó, J C; Barbin, E L

    1993-01-01

    Softening time of gutta-percha cones was studied in vitro using five chemical solvents: xylol, chloroform, turpentine, eucalyptol, and orange oil. An apparatus which reproduces the penetration force of an endodontic file was used on the sectioned roots of previously filled teeth. The most rapid chemical solvent of gutta-percha cones was chloroform and the slowest was eucalyptol. PMID:8180484

  7. Endodontic management of a hypertaurodontic tooth associated with 48, XXYY syndrome: A review and case report

    PubMed Central

    Krishnamoorthy, Sridevi; Gopikrishna, Velayutham

    2015-01-01

    Taurodontism is a developmental anomaly of a tooth characterized by large pulp chamber and short roots. Patients with multiple taurodontic teeth are associated with the probability of a systemic syndrome or chromosomal anomaly. This is the first reported incidence of the endodontic management of a hyper taurodontic mandibular second molar in a patient diagnosed with 48, XXYY syndrome. PMID:26069418

  8. Impact of different file systems on the amount of apically extruded debris during endodontic retreatment

    PubMed Central

    Uzunoglu, Emel; Turker, Sevinc Aktemur

    2016-01-01

    Objective: The goal of present study was to determine the effect of different nickel–titanium file systems on the amount of apically extruded debris during endodontic retreatment: D-RaCe retreatment systems, EdgeFile XR retreatment rotary files, and Reciproc R40. Materials and Methods: Thirty-six single-rooted prepared mandibular premolar teeth were filled with Gutta-percha and AH Plus sealer. The teeth were then randomly assigned into three groups (n = 12) for retreatment. The endodontic retreatment was performed as follows: D-RaCe, EdgeFile XR, Reciproc 40. Debris extruded apically during the retreatment was collected into preweighed Eppendorf tubes. An incubator was used to store tubes at 70° C for 5 days. The initial weight was subtracted from final weight of the Eppendorf tubes to calculate the weight of the dry extruded debris for each group. The data obtained were evaluated using Welch analysis of variance and Games-Howell post-hoc tests (P < 0.05). Results: All files resulted in apical extrusion of debris. Reciproc caused significantly less debris extrusion compared to D-RaCe and EdgeFile XR (P < 0.05). Conclusions: The findings revealed that during endodontic retreatment, number, and taper of files might have an influence on the amount of apically extruded debris during endodontic retreatment. PMID:27095898

  9. Indexing of Iranian Publications in Well-known Endodontic Textbooks: A Scientometric Analysis

    PubMed Central

    Kakooei, Sina; Mostafavi, Mahshid; Parirokh, Masoud; Asgary, Saeed

    2016-01-01

    Introduction: Quoting an article in well-known textbooks is held as a credit for that paper. The numbers of Iranian publications mentioned in endodontic textbooks have increased during recent years. The aim of this investigation was to evaluate the number of Iranian articles quoted in eminent endodontic textbooks. Methods and Materials: Three known textbooks (Ingle’s Endodontics, Seltzer and Bender’s Dental Pulp and Cohen’s Pathways of the Pulp) were chosen and all the editions of the textbooks since 2000 were investigated for quoted Iranian publications. Only Iranian authors with affiliations from a domestic university were chosen. All references at the end of each chapter were read by hand searching, and results were noted. The trend and percentage of Iranian publications in different editions of the textbooks were also calculated. The number of citations of these publications in Google Scholar and Scopus databases were also obtained. Results: The number of Iranian publications in all well-known textbooks have notably increased since 2000. The number and percentage of Iranian publications in the latest edition of Cohen’s Pathways of the Pulp was higher compared to other textbooks as well as the previous edition of the same text. Conclusion: Number and percentage of Iranian publications in the field of endodontics in all three textbooks have remarkably increased since 2000. PMID:27471523

  10. Propionibacterium acnes and Staphylococcus epidermidis Isolated from Refractory Endodontic Lesions Are Opportunistic Pathogens▿ †

    PubMed Central

    Niazi, Sadia A.; Clarke, Douglas; Do, Thuy; Gilbert, Steven C.; Mannocci, Francesco; Beighton, David

    2010-01-01

    The predominant cultivable microbiota from 20 refractory endodontic lesions (9 with abscesses and 11 without abscesses) were determined, and Propionibacterium acnes and Staphylococcus epidermidis were among the most predominant organisms. The number of species identified from lesions with abscesses (14.1 ± 2.6) was significantly greater (P < 0.001) than the number from lesions without abscesses (7.4 ± 5.9). Comparison of perioral isolates using repetitive extragenic palindromic PCR of the same species from the same subjects demonstrated that the endodontic and skin populations were significantly different. The P. acnes isolates were typed on the basis of recA gene sequence comparison, and only three types (types I, II, and III) were identified among 125 isolates examined. However, we found that type I (type IA and IB) isolates were primarily isolated from the skin, while types II and III were significantly more likely to be isolated from the endodontic lesions (P < 10−10). We found that the robustness of the recA phylotypes was not strong by comparing the partial gene sequences of six putative virulence determinants, PAmce, PAp60, PA-25957, PA-5541, PA-21293, and PA-4687. The resulting neighbor-joining trees were incongruent, and significant (phi test; P = 2.2 × 10−7) evidence of recombination was demonstrated, with significant phylogenetic heterogeneity being apparent within the clusters. P. acnes and S. epidermidis isolated from refractory endodontic infections, with or without periapical abscesses, are likely to be nosocomial infections. PMID:20739494

  11. The effect of cone beam CT (CBCT) on therapeutic decision-making in endodontics

    PubMed Central

    Knutsson, K; Flygare, L

    2014-01-01

    Objectives: The aim was to assess to what extent cone beam CT (CBCT) used in accordance with current European Commission guidelines in a normal clinical setting has an impact on therapeutic decisions in a population referred for endodontic problems. Methods: The study includes data of consecutively examined patients collected from October 2011 to December 2012. From 2 different endodontic specialist clinics, 57 patients were referred for a CBCT examination using criteria in accordance with current European guidelines. The CBCT examinations were performed using similar equipment and standardized among clinics. After a thorough clinical examination, but before CBCT, the examiner made a preliminary therapy plan which was recorded. After the CBCT examination, the same examiner made a new therapy plan. Therapy plans both before and after the CBCT examination were plotted for 53 patients and 81 teeth. As four patients had incomplete protocols, they were not included in the final analysis. Results: 4% of the patients referred to endodontic clinics during the study period were examined with CBCT. The most frequent reason for referral to CBCT examination was to differentiate pathology from normal anatomy, this was the case in 24 patients (45% of the cases). The primary outcome was therapy plan changes that could be attributed to CBCT examination. There were changes in 28 patients (53%). Conclusions: CBCT has a significant impact on therapeutic decision efficacy in endodontics when used in concordance with the current European Commission guidelines. PMID:24766060

  12. Morphological and chemical changes in dentin after using endodontic agents: Fourier transform Raman spectroscopy, energy-dispersive x-ray fluorescence spectrometry, and scanning electron microscopy study

    NASA Astrophysics Data System (ADS)

    Pascon, Fernanda Miori; Kantovitz, Kamila Rosamilia; Soares, Luís Eduardo Silva; Santo, Ana Maria do Espírito; Martin, Airton Abraha~o.; Puppin-Rontani, Regina Maria

    2012-07-01

    We examine the morphological and chemical changes in the pulp chamber dentin after using endodontic agents by scanning electron microscopy (SEM), Fourier transform Raman spectroscopy (FT-Raman), and micro energy-dispersive x-ray fluorescence spectrometry (μEDXRF). Thirty teeth were sectioned exposing the pulp chamber and divided by six groups (n=5): NT-no treatment; CHX-2% chlorhexidine; CHXE-2% chlorhexidine+17% EDTA E-17% EDTA; SH5-5.25% NaOCl; SH5E-5.25% NaOCl+17% EDTA. The inorganic and organic content was analyzed by FT-Raman. μEDXRF examined calcium (Ca) and phosphorus (P) content as well as Ca/P ratio. Impressions of specimens were evaluated by SEM. Data were submitted to Kruskal-Wallis and Dunn tests (p<0.05). Differences were observed among groups for the 960 cm-1 peak. Ca and P content differences were significant (SH5>NT=SH5E>CHX>E>CHXE). CHXE and E presented the highest Ca/P ratio values compared to the other groups (p<0.05). The SEM images in the EDTA-treated groups had the highest number of open tubules. Erosion in the tubules was observed in CHX and SH5E groups. Endodontic agents change the inorganic and organic content of pulp chamber dentin. NaOCl used alone, or in association with EDTA, was the most effective agent considering chemical and morphological approaches.

  13. Cytotoxicity of a novel nano-silver particle endodontic irrigant

    PubMed Central

    Chan, Eric LK; Zhang, Chengfei; Cheung, Gary SP

    2015-01-01

    Purpose The aim of this study was to evaluate the cytotoxic effect of a novel nano-silver particle (25.2±6.5 nm) endodontic irrigant (0.2 mM) and compare it with 3% sodium hypochlorite. Materials and methods Two cell types, mouse fibroblast National Institutes of Health 3T3 (NIH 3T3) and primary human periodontal ligament stem cell (hPDLSCs) were used in a test for the effect of direct and indirect (by separating the agent and cell with a layer of agar) exposure to the two solutions. In the direct exposure experiment, ten groups of cell cultures were exposed to one dilution (3:1, 2:1, 1:1, 1:2, 1:3, 1:4, 1:5, 1:6 or 1:7) of a nano-silver irrigant for 48 hours; the concentration-response function was estimated by determining the number of viable cells in each group by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. The 50% lethal dose of the testing irrigant for NIH3T3 and hPDLSCs were estimated. In the second part of the experiment, a modified agar overlaying technique was applied. Twelve culture wells (6-well plate) were divided into three groups (n=4). The cell lysis zone (cytotoxic range) created by the stock nano-silver solution, 3% sodium hypochlorite, and an isotonic phosphate buffering saline (control) was measured by two double blinded observers (Kappa score =100%). The cytotoxic score of specific irrigant was derived by modified Sjögren’s method. Results The 50% lethal doses of the testing nano silver irrigant for NIH 3T3 and hPDLSCs after 48 hours of direct exposure were 0.58 and 0.608 dilution of stock solution, respectively. The cytotoxic scores of nano-silver irrigant and control (phosphate buffered saline) on NIH 3T3 were 0.25 (95% confidence interval [CI] =0 to 1.04) and 0 (95% CI =0 to 0); and on hPDLSCs were 0.13 (95% CI =0 to 0.52) and 0.25 (95% CI =0 to 1.04), respectively. Toxicity of the test and control group on both mouse fibroblasts (P>0.05) and hPDLSCs (P=1.00) was not statistically different. Conclusion Our

  14. Fracture Resistance of Endodontically-treated Maxillary Premolars Restored with Composite Resin along with Glass Fiber Insertion in Different Positions

    PubMed Central

    Jafari Navimipour, Elmira; Ebrahimi Chaharom, Mohammad Esmaeel; Alizadeh Oskoee, Parnian; Mohammadi, Narmin; Bahari, Mahmoud; Firouzmandi, Maryam

    2012-01-01

    Background and aims The aim was to evaluate the effect of three methods of fiber insertion on fracture resistance of root-filled maxillary premolars in vitro. Materials and methods Sixty extracted human maxillary premolars received endodontic treatment followed by preparation of mesioocclusodistal (MOD) cavities, with gingival cavosurface margin 1.5 mm coronal to the cementoenamel junction (CEJ). Subsequently, the samples were randomly divided into four groups: no-fiber group; occlusal fiber group (fiber was placed in the occlusal third); circumferential fiber group (fiber was placed circumferentially in the cervical third); and dual-fiber group (occlusal and circumferential fibers). Subsequent to restoring with composite resin and thermocycling, a compressive force was applied until fracture. Data was analyzed using one-way ANOVA and Tukey test at significance levels of P < 0.05 and P < 0.02, respectively. Results Fiber placement significantly increased fracture resistance. Fracture resistance in the dual-fiber group was significantly higher than that in the circumferential fiber group (P < 0.007); however, there were no significant differences between the dual-fiber and occlusal fiber groups (P = 0.706). The highest favorable fracture rate was observed in the circumferential fiber group (60%). Conclusion Composite resin restoration along with glass fiber in the occlusal and gingival thirds can be an acceptable treatment option for restoring root-filled upper premolars. PMID:23277858

  15. Assessment of endodontically treated teeth by using different radiographic methods: an ex vivo comparison between CBCT and other radiographic techniques

    PubMed Central

    Demiralp, Kemal Özgür; Güngör, Kahraman; Yüksel, Selcen; Demiralp, Gokcen; Üçok, Özlem

    2012-01-01

    Purpose To compare different radiographic methods for assessing endodontically treated teeth. Materials and Methods Root canal treatments were applied in 120 extracted mandibular teeth, which were divided into four groups: (1) ideal root canal treatment (60 teeth), (2) insufficient lateral condensation (20 teeth), (3) root canals filled short of the apex (20 teeth), (4) overfilled root canal treatment (20 teeth). The teeth were imaged using intraoral film, panoramic film, digital intraoral systems (CCD and PSP), CCD obtained with portable X-ray source, digital panoramic, and CBCT images obtained at 0.3 mm3 and 0.2 mm3 voxel size. Images were evaluated separately by three observers, twice. Kappa coefficients were calculated. The percentage of correct readings obtained from each modality was calculated and compared using a t-test (p<0.05). Results The intra-observer kappa for each observer ranged between 0.327 and 0.849. The inter-observer kappa for each observer for both readings ranged between 0.312 and 0.749. For the ideal root canal treatment group, CBCT with 0.2 mm3 voxel images revealed the best results. For insufficient lateral condensation, the best readings were found with periapical film followed by CCD and PSP. The assessment of teeth with root canals filled short of the apex showed the highest percentage of correct readings by CBCT and CCD. For the overfilled canal treatment group, PSP images and conventional periapical film radiographs had the best scores. Conclusion CBCT was found to be successful in the assessment of teeth with ideal root canal treatment and teeth with canals filled short of the apex. PMID:23071962

  16. Morphological analysis of tissue reaction caused by a new endodontic paste in subcutaneous tissue of rats

    PubMed Central

    Marques, André AF; Sponchiado, Emilio C; Garcia, Lucas FR; Garrido, Angela DB; França, Suzelei C; Lia, Raphael CC

    2011-01-01

    Aim: To assess the biocompatibility of an experimental endodontic paste based on the ethyl acetate fraction of Pothomorphe umbellata + calcium hydroxide, using propylene glycol as vehicle, in connective tissue of rats. Materials and Methods: Fifteen rats had four polyethylene tubes implanted in their backs, with each one containing the experimental paste. The tube side was considered the control group. After 7, 21, and 42 days, animals were euthanized. Results: Intense inflammatory reaction was noticed after 7 days for experimental paste and it was moderate for control group. At 21 days, the inflammatory reaction was moderate for experimental paste and discrete for control group; and at 42 days, it was discrete for experimental paste and control group. Statistical analysis (Dunn's test, P < 0.01) demonstrated significant difference between the fibrous capsule area at 7 and 42 days (P > 0.01) for experimental paste. Conclusions: Experimental endodontic paste presented satisfactory tissue reaction in the connective tissue of rats. PMID:22025840

  17. Use of a new retrograde filling material (Biodentine) for endodontic surgery: two case reports.

    PubMed

    Caron, Grégory; Azérad, Jean; Faure, Marie-Odile; Machtou, Pierre; Boucher, Yves

    2014-12-01

    Mineral trioxide aggregate (MTA) is considered at the present time as the gold standard for root-end filling in endodontic surgery. However, this biocompatible material presents several drawbacks such as a long setting time and handling difficulties. The aim of this article is to present a new commercialized calcium silicate-based material named Biodentine with physical improved properties compared to MTA in a clinical application. Two endodontic microsurgeries were performed by using specific armamentarium (microsurgical instrumentation, ultrasonic tips) under high-power magnification with an operatory microscope. Biodentine was used as a root-end filling in order to seal the root canal system. The two cases were considered completely healed at 1 year and were followed for one more year. The 2-year follow-up consolidated the previous observation with absence of clinical symptoms and radiographic evidence of regeneration of the periapical tissues. PMID:24810806

  18. Survival time of endodontically treated teeth: a 7-year retrospective clinical study

    NASA Astrophysics Data System (ADS)

    Baldea, Bogdan; Canjau, Silvana; Popescu, Dragos; Tudor, Anca; Todea, Carmen

    2014-01-01

    The aim of this retrospective clinical study was to examine the survival time of endodontically treated teeth (ETT) and the factors that may influence the failure risk, over a period of up to 7 years. The files of 67 patients that received metal free post and core restorations using a standardized technique were analyzed. The survival probability was assessed using Kaplan-Meyer analysis and Log Rank (Matel-Cox). Cox regression was used to assess the risk of failure and to identify possible covariates. The average survival time of the ETT was 6.6 Years. The cumulative failure rate was 5.82% for all type of the restored endodontically treated teeth. The main failure type was encountered in the cervical area of the teeth, and due to the extensive hard tissue loss, the teeth were extracted.

  19. A Review of the Properties and Applications of Ozone in Endodontics: An Update

    PubMed Central

    Mohammadi, Zahed; Shalavi, Sousan; Soltani, Mohammad Karim; Asgary, Saeed

    2013-01-01

    Ozone is a triatomic molecule consisting of three oxygen atoms. It is applied to oral tissues in the forms of ozonated water, ozonated olive oil and oxygen/ozone gas. This paper presents a brief review on the chemistry of ozone as well as its medical and dental applications focusing on its use in endodontics. Ozone’s antimicrobial activity, its effect on dentin bonding, toxicity and contra-indications are also reviewed. PMID:23717326

  20. Pathogenic Bacterial Species Associated with Endodontic Infection Evade Innate Immune Control by Disabling Neutrophils

    PubMed Central

    Matsui, Aritsune; Jin, Jun-O; Johnston, Christopher D.; Yamazaki, Hajime; Houri-Haddad, Yael

    2014-01-01

    Endodontic infections, in which oral bacteria access the tooth pulp chamber, are common and do not resolve once established. To investigate the effects of these infections on the innate immune response, we established a mouse subcutaneous chamber model, where a mixture of four oral pathogens commonly associated with these infections (endodontic pathogens [EP]), i.e., Fusobacterium nucleatum, Streptococcus intermedius, Parvimonas micra, and Prevotella intermedia, was inoculated into subcutaneously implanted titanium chambers. Cells that infiltrated the chamber after these infections were primarily neutrophils; however, these neutrophils were unable to control the infection. Infection with a nonpathogenic oral bacterial species, Streptococcus mitis, resulted in well-controlled infection, with bacterial numbers reduced by 4 to 5 log units after 7 days. Propidium iodide (PI) staining of the chamber neutrophils identified three distinct populations: neutrophils from EP-infected chambers were intermediate in PI staining, while cells in chambers from mice infected with S. mitis were PI positive (apoptotic) or negative (live). Strikingly, neutrophils from EP-infected chambers were severely impaired in their ability to phagocytose and to generate reactive oxygen species in vitro after removal from the chamber compared to cells from S. mitis-infected chambers. The mechanism of neutrophil impairment was necrotic cell death as determined by morphological analyses. P. intermedia alone could induce a similar neutrophil phenotype. We conclude that the endodontic pathogens, particularly P. intermedia, can efficiently disable and kill infiltrating neutrophils, allowing these infections to become established. These results can help explain the persistence of endodontic infections and demonstrate a new virulence mechanism associated with P. intermedia. PMID:25024367

  1. Development and Evaluation of an Endodontic Simulation Model for Dental Students.

    PubMed

    Wolgin, Michael; Wiedemann, Paul; Frank, Wilhelm; Wrbas, Karl-Thomas; Kielbassa, Andrej M

    2015-11-01

    The aims of this study were to develop an endodontic simulation model able to implement the electronic method of working length determination (electronic apex locators, EALs) in a dental school, to evaluate the practicality of this tool for dental students, and to compare the accuracy of working length measurements achieved by the EAL and the radiographic method. A new simulation model was constructed by embedding extracted human teeth in a self-cured resin, along with a conductive medium. After radiographic and electronic working length determinations, root canal instrumentation was performed by students at a dental school in Austria according to the working lengths obtained from the EAL. Subsequently, root apices (n=44) were longitudinally sectioned using a diamond coated bur. Measurements of the distance between the anatomical root apex (ARA) and the apical constriction (AC) as well as between ARA and the ascertained apical point of endodontic instrumentation were performed using digital photography and a 3D computer-assisted design software. The distance between ARA and the radiologic (ARA-R) or electrometric (ARA-EL) readings of the apical point of endodontic instrumentation was compared with the actual distance ARA-AC. The accuracy of both methods was determined. The difference between the actual distance ARA-AC and the targeted radiological distance was statistically significant (p=0.0001), as was the measured distance between ARA-R and ARA-EL (p=0.016). The electronic method seems to be more precisely referring to the AC (R(2)=0.0198) than the radiographic method (R(2)=0.0019). These results suggest that the endodontic simulation model described in this study can be successfully used in preclinical dental education. PMID:26522643

  2. Retrieval of a broken endodontic instrument using cyanoacrylate adhesive. Case report.

    PubMed

    Coutinho Filho, T; Krebs, R L; Berlinck, T C; Galindo, R G

    1998-01-01

    The purpose of this work is to report a clinical case of removal of a fractured endodontic instrument in the root canal of a maxillary molar, when part of this fragment extended through the apical foramen. In the present case, many methods were tried without satisfactory results. Therefore, an alternative device utilizing cyanoacrylate adhesive was tested with success. This method proved to be practical, and the advantages it offers should make it a useful device in the dentist's office. PMID:9835806

  3. Endodontic complications in teeth with vital pulps restored with composite resins: a systematic review.

    PubMed

    Dawson, V S; Amjad, S; Fransson, H

    2015-07-01

    Composite resin is used extensively for restoration of teeth with vital pulps. Although cell culture studies have disclosed harmful effects on pulpal cells, any untoward clinical effects, manifest as adverse pulpal responses, have yet to be determined. This study comprises a systematic review, designed to address the question of whether the risk of endodontic complications is greater with composite resin restorations than with other restorative materials, such as amalgam. The study methodology involved (i) formulation of the research question, (ii) construction and conduct of an extensive literature search with (iii) interpretation and assessment of the retrieved literature. A search of the medical database PubMed was complemented with a search of the Controlled Trials Register (CENTRAL). The initial search yielded 1043 publications, the abstracts of which were read independently by the authors. After additional searches, 10 studies were included in the review. In all the included studies, the level of evidence was assessed as low. No conclusions could therefore be drawn. The included studies reported few, if any, endodontic complications. Little or no differences emerged between teeth restored with composite resins and those restored with amalgam. To determine whether composite resin restorations of teeth with vital pulps are associated with an increased risk for development of endodontic complications such as apical periodontitis, further evidence is needed, from well-constructed studies with a large number of participants. PMID:25100025

  4. Potential of calcium to scaffold an endodontic biofilm, thus protecting the micro-organisms from disinfection.

    PubMed

    van der Waal, Suzette V; van der Sluis, Lucas W M

    2012-07-01

    Biofilms in the root canal of a tooth (endodontic biofilm) can induce and sustain apical periodontitis which is an oral inflammatory disease. Still, little is known about the composition of the endodontic biofilm. Studies on biofilms in root canals focus on the identification of the microbial species, but the majority of the biofilm consists of matrix material. Environmental aspects determine the structure of the biofilm and extracellular matrix. Calcium is involved in biofilm formation and activity at three levels. Firstly in cell-environment; calcium may 'condition' the surfaces of support and bacterial cells. Secondly, in cell-cell interaction; calcium plays a role in build up of biofilm structures. Typically, calcium ions act as 'cation bridges' between polysaccharides originating from different cells. Thirdly, within cells, calcium is required for certain biochemical reactions in bacteria and some bacterial physiological activities. Because calcium is present in the root canal, it could play a significant role in the organization of the biofilm. Chelators, already used in endodontics to remove the smear layer by disintegration of the structural cohesion calcium bonds, could weaken the biofilm matrix by removing calcium from the extracellular matrix thus disturbing its coherence. Subsequently, this disruption could increase the efficacy of disinfecting agents. PMID:22537407

  5. Use of ultrasound, color Doppler imaging and radiography to monitor periapical healing after endodontic surgery.

    PubMed

    Tikku, Aseem P; Kumar, Sunil; Loomba, Kapil; Chandra, Anil; Verma, Promila; Aggarwal, Renu

    2010-09-01

    This study evaluated the effectiveness of ultrasound, color Doppler imaging and conventional radiography in monitoring the post-surgical healing of periapical lesions of endodontic origin. Fifteen patients who underwent periapical surgery for endodontic pathology were randomly selected. In all patients, periapical lesions were evaluated preoperatively using ultrasound, color Doppler imaging and conventional radiography, to analyze characteristics such as size, shape and dimensions. On radiographic evaluation, dimensions were measured in the superoinferior and mesiodistal direction using image-analysis software. Ultrasound evaluation was used to measure the changes in shape and dimensions on the anteroposterior, superoinferior, and mesiodistal planes. Color Doppler imaging was used to detect the blood-flow velocity. Postoperative healing was monitored in all patients at 1 week and 6 months by using ultrasound and color Doppler imaging, together with conventional radiography. The findings were then analyzed to evaluate the effectiveness of the 3 imaging techniques. At 6 months, ultrasound and color Doppler imaging were significantly better than conventional radiography in detecting changes in the healing of hard tissue at the surgical site (P < 0.004). This study demonstrates that ultrasound and color Doppler imaging have the potential to supplement conventional radiography in monitoring the post-surgical healing of periapical lesions of endodontic origin. PMID:20881334

  6. Effect of Contrast Inversion Enhancement on the Accuracy of Endodontic File Length Determination in Digital Radiography

    PubMed Central

    Farhadi, Nastaran; Mehdizadeh, Mojdeh

    2015-01-01

    Objective The aim of this ex vivo study was to evaluate the accuracy of endodontic file length measurement on digital periapical radiographs after application of contrast inversion digital enhancement. Materials and Methods Forty single-rooted single-canal mature permanent human teeth with canals measuring 20-24 mm in length were used in this study. ISO #08 K-files were placed in the root canals of the teeth. The file lengths were measured with a digital caliper as the gold standard. Standard periapical digital images were obtained with the Digora storage phosphor plates and Digora Optime scanner as the original images. The contrast inversion option of Scanora software program version 5.1 was used to produce enhanced images. Three radiologists and three endodontists measured file lengths on the original and enhanced images. The measurements were compared using repeated measures ANOVA and Bonferroni tests (α=0.05). Results There were significant differences between the measurement accuracy of the original and enhanced images (p<0.05). The enhanced images exhibited longer measurements compared to the original images. However, the two sets of digital radiographs provided significantly longer measurements compared to the gold standard (p<0.05). Conclusion The contrast inversion tool of Scanora software program decreases measurement accuracy of the length of small endodontic files on digital periapical radiographs. It is suggested that contrast inversion should not be used in determining the lengths of small endodontic files. PMID:26155552

  7. Radiological Evaluation of Penetration of the Irrigant according to Three Endodontic Irrigation Techniques

    PubMed Central

    Benkiran, Imane; El Ouazzani, Amal

    2016-01-01

    Introduction. This experimental study is to compare radiographs based on the penetration depth of the irrigant following three final irrigation techniques. Material and Method. A sample of sixty teeth with single roots were prepared with stainless steel K files followed by mechanized Ni-Ti files iRace® under irrigation with 2.5% sodium hypochlorite. Radiopaque solution was utilized to measure the penetration depth of the irrigant. Three irrigation techniques were performed during this study: (i) passive irrigation, (ii) manually activated irrigation, and (iii) passive irrigation with an endodontic needle CANAL CLEAN®. Radiographs were performed to measure the length of irrigant penetration in each technique. Results. In comparison, passive irrigation with a conventional syringe showed infiltration of the irrigant by an average of 0.682 ± 0.105, whereas the manually activated irrigation technique indicated an average of 0.876 ± 0.066 infiltration. Irrigation with an endodontic syringe showed an average infiltration of 0.910 ± 0.043. The results revealed highly significant difference between the three irrigation techniques (α = 5%). Conclusion. Adding manual activation to the irrigant improved the result by 20%. This study indicates that passive irrigation with an endodontic needle has proved to be the most effective irrigation technique of the canal system. PMID:27433162

  8. The influence of endodontic infection on periodontal status in mandibular molars.

    PubMed

    Jansson, L E; Ehnevid, H

    1998-12-01

    The purpose of the study was to investigate the influence of an endodontic infection on periodontal probing depth and presence of furcation involvement in periodontally-involved mandibular molars. All first and second mandibular molars in 100 patients were selected if at least one was root-filled or had a possible periapical radiolucency. The sample consisted of patients from a referral population at a periodontal clinic which represented an adult population with a mean age between 50 and 60 years. For mandibular molars with periapical destruction at both roots, mean periodontal probing depth was significantly greater compared to teeth without periapical destruction. Horizontal furcation depths > or =3 mm were significantly more frequent at mandibular molars with periapical destruction. It is suggested that a root canal infection in periodontitis-involved molars may potentiate periodontitis progression by spreading of endodontic pathogens through patent accessory canals and dentinal tubules. In conclusion, an endodontic infection in mandibular molars was found to be associated with additional attachment loss in the furcation area, and may thus be considered to be one of several risk factors influencing the prognosis of molars in periodontitis-prone patients. PMID:9926769

  9. An in vivo assessment of the influence of needle gauges on endodontic irrigation flow rate

    PubMed Central

    Gopikrishna, Velayutham; Sibi, Swamy; Archana, Durvasulu; Pradeep Kumar, Angabakkam Rajasekaran; Narayanan, Lakshmi

    2016-01-01

    Aim: The aim of this clinical study was to assess the influence of irrigation needle gauge on endodontic irrigation flow rates. Settings and Design: In vivo assessment. Materials and Methods: Five specialist endodontists performed intracanal irrigation procedures on 50 mesiobuccal canal of mandibular first molars using three different irrigation needle gauges. Data of time taken for irrigation was recorded by an irrigation testing system and analyzed using independent sample “T” test and one-way analysis of variance (ANOVA) test. The level of significance was set at P < 0.05. Statistical Analysis Used: The following tests were used for the statistical analysis: Independent sample “T” test, one-way ANOVA test, and post hoc multiple comparison was carried out using Tukey's honest significant difference (HSD) test using Statistical Package for the Social Sciences (SPSS) version 16 for Windows. Results: The average flow rate of 26 gauge was 0.27 mLs−1, of 27 gauge was 0.19 mLs−1, and of 30 gauge was 0.09 mls−1. There was statistical significance among the gauges (P < 0.001). 26 gauge had highest flow rate when compared with other groups followed by 27 gauge and 30 gauge respectively. The operator variability for flow rate of three endodontic irrigation needle gauges (26 gauge, 27 gauge, and 30 gauge) was found to be not significant. Conclusions: Needle gauge has significant influence on endodontic irrigation flow rate. PMID:27099430

  10. Effect of restorative procedures on the strength of endodontically treated molars.

    PubMed

    Linn, J; Messer, H H

    1994-10-01

    Endodontically treated molar teeth are considered susceptible to fracture because of loss of tooth bulk. This study evaluated the significance of retaining intact marginal ridges and selective cusp coverage in preserving tooth stiffness during restoration. Strain gauges were bonded to four cusps of 36 intact extracted human lower molars. Teeth were loaded mesially and distally in a closed-loop servohydraulic system to measure stiffness. Endodontic access was followed by mesio-occlusal or mesio-occluso-distal preparation. Teeth were restored with either amalgam (no overlay), amalgam overlay, or gold overlay with partial or complete cusp coverage. Relative stiffness was calculated for all test conditions. Preserving a marginal ridge in molars did not fully conserve the strength of adjacent cusps; selective cusp coverage reinforced only the capped cusps; full occlusal coverage with gold or amalgam strengthened all cusps, but gold did so more consistently. It is more important to cover cusps than to preserve tooth structure (including a marginal ridge) in endodontically treated molar teeth. PMID:7714419

  11. SUSCEPTIBILITY OF STRICT AND FACULTATIVE ANAEROBES ISOLATED FROM ENDODONTIC INFECTIONS TO METRONIDAZOLE AND β-LACTAMS

    PubMed Central

    Gaetti-Jardim, Elerson; Landucci, Luís Fernando; Lins, Samira Âmbar; Vieira, Evanice Menezes Marçal; de Oliveira, Sérgio Ricardo

    2007-01-01

    Endodontic infections are mixed aerobic-anaerobic infections and several microbial groups associated to these pathologies are also involved in orofacial infections. The goal of this study was to evaluate the susceptibility of microorganisms isolated from endodontic infections to β-lactams and metronidazole and verify the production of β-lactamases. Clinical specimens were collected from 58 endodontic infections of 52 patients. The microorganisms were isolated in selective and non-selective culture media, under anaerobiosis and aerobiosis, and identified using biochemical methods. In the susceptibility tests, it was used an agar dilution method, and Wilkins-Chalgren agar enriched with blood, hemin and menadione for the anaerobes, while Mueller- Hinton agar was employed for the facultative anaerobes. The production of β-lactamases was evaluated through the biological and chromogenic cephalosporin methods. All tested isolates were sensitive to imipenem and 99.3% to amoxicillin/clavulanate association, while 16.1% showed resistance to amoxicillin and penicillin G, and 4.89% to cefoxitin. Resistance to metronidazole was just found in facultative anaerobes. Production of β-lactamases was detected in 18.2% of the isolates and presented a correlation with resistance to β-lactams. PMID:19089195

  12. Premixed calcium silicate cement for endodontic applications: injectability, setting time and radiopacity.

    PubMed

    Persson, Cecilia; Engqvist, Håkan

    2011-01-01

    Calcium silicate-based materials (also called MTA) are increasingly being used in endodontic applications. However, the handling properties of MTA are not optimal when it comes to injectability and cohesion. Premixing the cements using glycerol avoids these issues. However, there is a lack of data on the effect of common cement variables on important properties of premixed cements for endodontic applications. In this study, the effects of liquid-to-powder ratio, amount of radiopacifier and amount of calcium sulfate (added to control the setting time) were screened using a statistical model. In the second part of the study, the liquid-to-powder ratio was optimized for cements containing three different amounts of radiopacifier. Finally, the effect of using glycerol rather than water was evaluated in terms of radiopacity. The setting time was found to increase with the amount of radiopacifier when the liquid-to-powder ratio was fixed. This was likely due to the higher density of the radiopacifier in comparison to the calcium silicate, which gave a higher liquid-to-powder ratio in terms of volume. Using glycerol rather than water to mix the cements led to a decrease in radiopacity of the cement. In conclusion, we were able to produce premixed calcium silicate cements with acceptable properties for use in endodontic applications. PMID:23507729

  13. [Treatment of Baume class IV pulp diseases with calcium hydroxide: a clinical experimental study in Dakar].

    PubMed

    Gaye, F; Mbaye, M; Diop-Thiaw, F; Ndiaye, D

    2001-09-01

    The calcium hydroxide used as intracanalar temporary medication in modern endodontics, is the aim of this clinical and radiographic appraisal of endodontic treatment during two sessions (HESS J. C. and all. 1990); on 22 mature permanent teeth with peri apical lesion. In this second Dakar serial study, the mediate disinfection during 6 weeks in average, was followed by a root canal filling for: 11 mono-radicular teeth by compactage of gutta percha, adjusted monocone for 11 pluri-radicular teeth; and so by definitive coronal restoration. The direct magistral preparations used in this study are not expensive, but simple and efficient; our endodontic processing (pre-treatment and treatment) end up at clinical silence and radiographic apical healing in 90.91% of cases after 9 months for 66.67% of root canal filling located at the safety apical limit. PMID:11813684

  14. Fracture resistance of endodontically treated maxillary central incisors with varying ferrule heights and configurations: In vitro study

    PubMed Central

    Singh, Smita; Thareja, Prerna

    2014-01-01

    Objective: The objective of this study is to determine the best ferrule configuration of endodontically treated teeth. Materials and Methods: A total of 40 freshly extracted maxillary central incisors were collected. Teeth were allocated into following four groups of each having 10 teeth. Group 1 teeth restored with crowns (CRN), Group 2 endodontically treated teeth restored with crowns (RCT and CRN), Group 3 endodontically treated teeth restored with cast dowel cores and crowns incorporating uniform 2 mm ferrule (2 FRL), Group 4 endodontically treated teeth restored with cast dowel cores and crowns incorporating uniform 1 mm ferrule (1 FRL). Crown preparation was performed with varying ferrule heights, crowns were cemented with resin modified glass ionomer cement and were kept in 100% humidity for 3 days, all specimens were loaded to failure in a universal testing machine at 0.5 mm/min. Results were obtained in the form of kilo Newton and Newton. Result: The statistical analysis applied was an analysis of variance to detect the presence of group differences. Pair wise comparisons between the groups were analyzed with the Tukey Kramer significant difference test for multiple comparisons. Conclusion: Ferrule had a significant role in the fracture resistance of custom cast post core restored teeth. Endodontically treated maxillary central incisors with a uniform 2 mm ferrule were more fracture resistant than those with a uniform 1 mm ferrule. PMID:24778504

  15. Conventional Treatment of Maxillary Incisor Type III Dens Invaginatus with Periapical Lesion: A Case Report

    PubMed Central

    Borges, Álvaro Henrique; Semenoff Segundo, Alex; Nadalin, Michele Regina; Pedro, Fábio Luís Miranda; da Cruz Filho, Antônio Miranda; Sousa-Neto, Manoel Damião

    2011-01-01

    Dens invaginatus is a developmental dental anomaly clinically characterized by a palatine furrow that can be limited to the coronal pulp or may extend to the radicular apex. The purpose of this paper was to present a clinical case of type III dens invaginatus, identified on the maxillary right central incisor in anterior periapical radiographs, in which the tooth was submitted to conventional endodontic treatment. The results obtained after five years of clinical and radiographic followup demonstrated that conventional endodontic treatment is a clinically viable alternative in cases of type III dens invaginatus. PMID:21991460

  16. An "XL" endodontics intervention for dental students required to repeat the course: changing frustration to improved grades and attitudes.

    PubMed

    Alcota, Marcela; Fuenzalida, Alejandra; Barrientos, Claudia; Garrido, Mauricio; Ruiz de Gauna, Pilar; González, Fermín E

    2015-04-01

    Given the psychological and financial costs involved with failing a clinical course, especially in developing countries, an alternative educational method was tested with students who had to repeat the year-long endodontic course at the University of Chile Faculty of Dentistry. The objectives of the intervention were to deepen theoretical knowledge and practical experiences, as well as to reinforce personal confidence in an endodontic clinical setting for students who failed the regular endodontic course. The aim of this study was to evaluate the success of this new model of educational intervention. In the study, 28 students who had failed the endodontic course repeated it with an alternative teaching method. The students attended patients immediately following practical competence exams, and they had access to simulated models that used rotary instruments and access cavities and had emergency care practice. Feedback sessions were held after each clinical session. Final grades were compared with those of other students who repeated the course without the intervention from 2007 to 2009. A survey was administered to understand the causes of initial failure and their opinions of the intervention. Students who participated in the alternative course did significantly better than their counterparts from previous years who did not receive the intervention (5.7±0.3 vs. 5.4±0.2; p<0.05). Their overall perception of the intervention was positive, and the main cause for previous course failure was personal insecurity and slow clinical care performance (54.2% of the students). The intervention course not only improved grades but also generated interest in endodontics, a contrasting perspective to the frustration students usually express after repeating the course. The results of this study support the introduction of similar interventions in endodontics and perhaps other courses. PMID:25838011

  17. Comparative Evaluation of Advanced and Conventional Diagnostic Aids for Endodontic Management of Periapical Lesions, An in Vivo Study

    PubMed Central

    Singh, Smita; Arora, Saurabh; Sandhu, Amneet Kaur; Dhingra, Ravneet

    2015-01-01

    Aim: To evaluate efficacy of Colour Doppler ultrasonography (CDUSG), direct digital radiography (DDR) and conventional radiography (CR) in diagnosis of periapical lesions and to clinically correlate treatment plan of periapical diseases. Materials and Methods: Thirty patients which were diagnosed with periapical lesions in anterior region by using both conventional and digital radiography were examined using colour doppler ultrasound imaging at the site of lesion. The images of each lesion were analysed by two endodontists and by an expert oral radiologist. A tentative differential diagnosis was agreed upon, based on certain principles discussed in article, then a diagnosis between cyst, granuloma and mixed lesions was made. Periapical lesions diagnosed as mixed lesions by colour doppler ultrasonography (CDUSG) were treated non-surgically whereas other periapical lesions were treated surgically. Tissues obtained during endodontic surgery were processed and examined for histopathological findings, and compared with the diagnosis made by ultrasound images. Statistical analysis was done with Chi-Square test and using one-way-Anova. Results: The periapical lesions which were diagnosed as granuloma by ultrasonographic findings, was confirmed by the results of histopathological examination in all 16 surgically treated cases. The lesions in rest of the 14 cases which showed vascularity and were diagnosed as mixed lesions by ultrasonography, were treated non-surgically and had a favourable prognosis. Conclusion: CR and DDR facilitate diagnosis of the presence of periapical disease, but do not provide and information of its nature. CDUSG imaging facilitates accurate information on the pathological nature of the lesion and hence can lead to predictable treatment planning. PMID:25738075

  18. Cone Beam Computed Tomography Assisted Endodontic Management of a Rare Case of Mandibular First Premolar with Three Roots.

    PubMed

    Balakasireddy, K; Kumar, K Pavan; John, Gijo; Gagan, C

    2015-06-01

    Understanding the morphological anatomy of the root and root canal systems of the teeth increases the success rate of endodontic therapy. Advanced diagnostic imaging techniques like cone beam computed tomography (CBCT) are an essential aid in understanding the anatomy of teeth especially in mandibular premolars. Most commonly mandibular first and second premolars have a single root and a single canal. However, multiple root and canals have also been reported. The present case report discusses endodontic management of a three rooted mandibular first premolar using CBCT. PMID:26124611

  19. Uncultivated Phylotypes and Newly Named Species Associated with Primary and Persistent Endodontic Infections

    PubMed Central

    Siqueira, J. F.; Rôças, I. N.

    2005-01-01

    Endodontic infections have been traditionally studied by culture methods, but recent reports showing that over 50% of the oral microbiota is still uncultivable (B. J. Paster et al., J. Bacteriol. 183:3770-3783, 2001) raise the possibility that many endodontic pathogens remain unknown. This study intended to investigate the prevalence of several uncultivated oral phylotypes, as well as newly named species in primary or persistent endodontic infections associated with chronic periradicular diseases. Samples were taken from the root canals of 21 untreated teeth and 22 root-filled teeth, all of them with radiographic evidence of periradicular bone destruction. Genomic DNA was isolated directly from each sample, and 16S rRNA gene-based nested or heminested PCR assays were used to determine the presence of 13 species or phylotypes of bacteria. Species-specific primers had already been validated in the literature or were developed by aligning closely related 16S rRNA gene sequences. Species specificity for each primer pair was confirmed by running PCRs against a panel of several oral bacteria and by sequencing DNA from representative positive samples. All species or phylotypes were detected in at least one case of primary infections. The most prevalent species or phylotypes found in primary infections were Dialister invisus (81%), Synergistes oral clone BA121 (33%), and Olsenella uli (33%). Of the target bacteria, only these three species were detected in persistent infections. Detection of uncultivated phylotypes and newly named species in infected root canals suggests that there are previously unrecognized bacteria that may play a role in the pathogenesis of periradicular diseases. PMID:16000454

  20. The effect of surface tension reduction on the clinical performance of sodium hypochlorite in endodontics.

    PubMed

    Rossi-Fedele, G; Prichard, J W; Steier, L; de Figueiredo, J A P

    2013-06-01

    Sodium hypochlorite (NaOCl) is recommended as an endodontic irrigant in view of its broad antimicrobial and tissue dissolution capacities. To enhance its penetration into inaccessible areas of root canals and to improve its overall effect, the addition of surface-active agents has been suggested. The aim of this investigation was to review the effect of the reduction of the surface tension on the performance of NaOCl in endodontics. A search was performed in the Medline electronic database (articles published up to 28 July 2012, in English) with the search terms and combinations as follows: 'sodium hypochlorite AND surface tension or interfacial force or interfacial tension or surface-active agent or amphiphilic agent or surface active agent or surfactant or tenside or detergent'. The purpose of this search was to identify publications that compared NaOCl alone and NaOCl modified with the addition of a surface-active agent in endodontics. A hand search of articles published online ('in-press' and 'early view'), and appearing in the reference list of the articles included, was further performed, using the same search criteria as the electronic search. The search identified 302 publications, of which 11 fulfilled the inclusion/exclusion criteria of the review. The evidence available suggests that surface-active agents improve the penetration of NaOCl in the main canal and have no effect on its pulp tissue dissolution ability. There are, however, insufficient data to enable a sound conclusion to be drawn regarding the effect of modifying NaOCl's surface tension on lubrication, antimicrobial and smear layer or debris removal abilities. PMID:23186034

  1. A new device to test cutting efficiency of mechanical endodontic instruments

    PubMed Central

    Rubini, Alessio Giansiracusa; Plotino, Gianluca; Al-Sudani, Dina; Grande, Nicola M.; Putorti, Ermanno; Sonnino, GianPaolo; Cotti, Elisabetta; Testarelli, Luca; Gambarini, Gianluca

    2014-01-01

    Background The purpose of the present study was to introduce a new device specifically designed to evaluate the cutting efficiency of mechanically driven endodontic instruments. Material/Methods Twenty new Reciproc R25 (VDW, Munich, Germany) files were used to be investigated in the new device developed to test the cutting ability of endodontic instruments. The device consists of a main frame to which a mobile plastic support for the hand-piece is connected and a stainless-steel block containing a Plexiglas block against which the cutting efficiency of the instruments was tested. The length of the block cut in 1 minute was measured in a computerized program with a precision of 0.1mm. The instruments were activated by using a torque-controlled motor (Silver Reciproc; VDW, Munich, Germany) in a reciprocating movement by the “Reciproc ALL” program (Group 1) and in counter-clockwise rotation at 300 rpm (Group 2). Mean and standard deviations of each group were calculated and data were statistically analyzed with a one-way ANOVA test (P<0.05). Results Reciproc in reciprocation (Group 1) mean cut in the Plexiglas block was 8.6 mm (SD=0.6 mm), while Reciproc in rotation mean cut was 8.9 mm (SD=0.7 mm). There was no statistically significant difference between the 2 groups investigated (P>0.05). Conclusions The cutting testing device evaluated in the present study was reliable and easy to use and may be effectively used to test cutting efficiency of both rotary and reciprocating mechanical endodontic instruments. PMID:24603777

  2. Fracture resistance of endodontically treated teeth restored with a bulkfill flowable material and a resin composite

    PubMed Central

    Isufi, Almira; Plotino, Gianluca; Grande, Nicola Maria; Ioppolo, Pietro; Testarelli, Luca; Bedini, Rossella; Al-Sudani, Dina; Gambarini, Gianluca

    2016-01-01

    Summary Aim To determine and compare the fracture resistance of endodontically treated teeth restored with a bulk fill flowable material (SDR) and a traditional resin composite. Methods Thirty maxillary and 30 mandibular first molars were selected based on similar dimensions. After cleaning, shaping and filling of the root canals and adhesive procedures, specimens were assigned to 3 subgroups for each tooth type (n=10): Group A: control group, including intact teeth; Group B: access cavities were restored with a traditional resin composite (EsthetX; Dentsply-Italy, Rome, Italy); Group C: access cavities were restored with a bulk fill flowable composite (SDR; Dentsply-Italy), except 1.5 mm layer of the occlusal surface that was restored with the same resin composite as Group B. The specimens were subjected to compressive force in a material static-testing machine until fracture occurred, the maximum fracture load of the specimens was measured (N) and the type of fracture was recorded as favorable or unfavorable. Data were statistically analyzed with one-way analysis of variance (ANOVA) and Bonferroni tests (P<0.05). Results No statistically significant differences were found among groups (P<0.05). Fracture resistance of endodontically treated teeth restored with a traditional resin composite and with a bulk fill flowable composite (SDR) was similar in both maxillary and mandibular molars and showed no significant decrease in fracture resistance compared to intact specimens. Conclusions No significant difference was observed in the mechanical fracture resistance of endodontically treated molars restored with traditional resin composite restorations compared to bulk fill flowable composite restorations. PMID:27486505

  3. Efficacy of Different Techniques for Removing Debris from Endodontic Files Prior to Sterilization

    PubMed Central

    Nosouhian, Saeid; Bajoghli, Farshad; Sabouhi, Mahmoud; Barati, Masoud; Davoudi, Amin; Sharifipour, Maryam

    2015-01-01

    Background: Dental instruments, like endodontic files, are hardly disinfected. The aim of this study was to evaluate the efficacy of mechanical, chemical, and ultrasonic (in combinations or separately) techniques for removing debris from files, prior to sterilization. Materials and Methods: Totally, 90 new endodontic files with size of 15, 25, and 40 (30 files of each one) were sterilized and one files of each one kept as negative control (NC) group. The rest of files (29 files of each size) were divided into five groups after endodontic therapies and prior to autoclaving: (Positive control [PC]: Without interventions, A: Cleaned with scouring sponge soaked in chlorhexidine 0.2%, B: Stored in Micro 10 enzyme, C: Subjected to Micro 10 enzyme in both conventional and ultrasonic way for 15 min, D: Decontaminated by Micro 10 enzyme with ultrasonic). Finally, the samples were observed under a metallographic microscope, and the data were analyzed by Tuckey, paired t-test, two-way ANOVA tests using SPSS software version 15 at a significant level of 0.05. Results: Significant differences were observed in heads of the files among groups C and PC (P = 0.02), and high amount of debris were seen in the shafts of groups A and D (P < 0.001). The amount of remaining debris were significant in the shafts of sizes 15 (P < 0.001) and 25 (P = 0.01). Conclusion: Using Micro 10 in both ultrasonic and conventional methods were acceptable for removing debris from the files. Furthermore, higher amounts of debris were found in the shafts and heads of files with lower sizes (15 and 25). PMID:26464538

  4. European Society of Endodontology position statement: the use of CBCT in endodontics.

    PubMed

    Patel, S; Durack, C; Abella, F; Roig, M; Shemesh, H; Lambrechts, P; Lemberg, K

    2014-06-01

    This Position Statement represents a consensus of an expert committee convened by the European Society of Endodontology (ESE) on the use of Cone Beam Computed Tomography (CBCT). The statement is based on the current scientific evidence, and provides the clinician with evidence-based criteria on when to use CBCT in Endodontics. Given the dynamic and changing nature of research, development of new devices and clinical practice relating to CBCT, this Position Statement will be updated within 3 years, or before that time should new evidence become available. PMID:24815882

  5. Enhancement of NiTi superelastic endodontic instruments by TiO2 coating.

    PubMed

    Aun, Diego Pinheiro; Peixoto, Isabella Faria da Cunha; Houmard, Manuel; Buono, Vicente Tadeu Lopes

    2016-11-01

    Rotary nickel-titanium (NiTi) endodontic instruments were coated with a nanometric flexible TiO2 layer through dip-coating sol-gel. Control groups and coated samples of superelastic NiTi instruments model RaCe 25/0.06 (0.25mm tip-diameter, 6% conicity) were comparatively investigated with respect to the cutting efficiency, fatigue life, and corrosion resistance. Results showed an improvement in cutting efficiency for the coated samples and a high resistance to corrosion in NaClO. The coated instruments showed a better performance in fatigue life after corrosion. PMID:27524067

  6. Localized osteomyelitis secondary to endodontic-implant pathosis. A case report.

    PubMed

    Sussman, H I; Moss, S S

    1993-04-01

    This case report documents the placement of a single implant fixture in an incisor extraction socket, with the adjacent lateral incisor developing periapical pathosis within 2 weeks. This root-end inflammatory process proceeded to communicate with the surface of the implant fixture. Although endodontic therapy was performed within one week on the devitalized tooth, and extensive osteomyelitis developed around the implant. Three weeks after placement, the fixture had to be removed. The osteotomy site appeared to be healing uneventfully during the one month follow-up period. Seven possible causes for this occurrence are discussed. PMID:8483094

  7. Endodontic Considerations in Three-canalled Premolars: A Practical Update.

    PubMed

    Mohammadi, Zahed; Shalavi, Sousan; Giardino, Luciano; Asgary, Saeed

    2016-01-01

    The most difficult clinical considertions in orthograde root canal treatment are generally related to the anatomy of the teeth. Three-canalled maxillary and mandibular premolars (mini-molars) have been reported in several studies. The purpose of this paper was to review various aspects of three-canalled premolars including incidence, clinical and radiographic diagnosis, racial predisposition, access cavity preparation, instrumentation and obturation. PMID:27141223

  8. Endodontic Considerations in Three-canalled Premolars: A Practical Update

    PubMed Central

    Mohammadi, Zahed; Shalavi, Sousan; Giardino, Luciano; Asgary, Saeed

    2016-01-01

    The most difficult clinical considertions in orthograde root canal treatment are generally related to the anatomy of the teeth. Three-canalled maxillary and mandibular premolars (mini-molars) have been reported in several studies. The purpose of this paper was to review various aspects of three-canalled premolars including incidence, clinical and radiographic diagnosis, racial predisposition, access cavity preparation, instrumentation and obturation. PMID:27141223

  9. Fracture Strength of Endodontically Treated Teeth Restored with Casting Post and Core and Glass-Fiber with Composite Core

    PubMed Central

    Saatian, Sedigheh

    2006-01-01

    INTRODUCTION: Prefabricated metal and ceramic posts can be used with different kinds of core materials as an alternative to the conventional casting post and cores. It is unclear how these post and core systems can withstand different kind of forces in the mouth. The purpose of this study was to compare the fracture strength of endodontically treated, crowned maxillary incisors restored with casting post and cores and glass- fiber post with composite core and to evaluate their mode of fractures. MATERIALS AND METHODS: Thirty caries free, human maxillary central incisors with incisoapical length of 23 ± 1 mm were divided into two groups. After root canal treatment procedures and decronation of teeth 2mm above cementoenamel junction, Grope 1 was restored with glass- fiber posts and composite cores and group 2 received casting post and cores. Teeth were prepared with a circumferential shoulder including a 1-2 mm ferrule and 0.5 mm bevel; all posts were cemented with an adhesive resin and teeth were restored with complete coverage crowns. Loads were applied at an angle of 135 degrees using a universal testing machine. Compression force was applied until the specimens fractured. RESULTS: The median fracture strengths of groups 1 and 2 were 459 and 686 respectively (p<0.5). In group I, all fractures occurred in incisal third of roots. In groups II, 40% of fractures were in apical third and middle of roots. CONCLUSION: Within the limitation of this study, the results suggested that glass fiber with composite cores can be used as an alternative to cast posts and cores in anterior teeth when creating 2mm ferrule effect was possible in normal occlusion. Clinical trial is required to verify these in vitro results. PMID:24470803

  10. Patient-Centered Endodontic Outcomes: A Narrative Review

    PubMed Central

    Hamedy, Reza; Shakiba, Bita; Fayazi, Sara; Pak, Jacklyn G; White, Shane N

    2013-01-01

    Introduction Root canal treatment (RCT) success criteria inform us of the path to bony healing and of prognostic factors, but tell little about how the patient perceives, feels, or values RCT. Patients choose, undergo, and pay for RCT, they live with the result, and inform their community. The purpose of this narrative review was to appraise patient-centered outcomes of initial non-surgical RCT and nonsurgical retreatment, in adults. Materials and Methods Patient-centered RCT outcome themes were identified in the extant literature: quality of life, satisfaction, anxiety, fear, pain, tooth survival and cost. Narrative review was applied because the disparate themes and data were unsuited to systematic review or meta-analysis. Results Application of the Oral Health Impact Profile (OHIP) demonstrated that disease of pulpal origin affects quality of life with moderate severity, primarily through physical pain and psychological discomfort, and that RCT results in broad improvement of quality of life. Satisfaction with RCT is extremely high, but cost is the primary reason for dissatisfaction. Anxiety and fear affect RCT patients, profoundly influencing their behaviors, including treatment avoidance, and their pain experience. Fear of pain is “fair” to “very much” prior to RCT. Pain is widely feared, disliked, and remembered; however, disease of pulpal origin generally produces moderate, but not severe pain. RCT causes a dramatic decrease in pain prevalence and severity over the week following treatment. Survival rates of teeth after RCT are very high; complication rates are low. Cost is a barrier to RCT, but initial costs, lifetime costs, cost effectiveness, cost utility, and cost benefit all compare extremely well to the alternatives involving replacement using implants or fixed prostheses. Conclusion Dentists must strive to reduce anxiety, fear, experienced and remembered pain, and to accurately inform and educate their patients with respect to technical

  11. The effect of chloroform, orange oil and eucalyptol on root canal transportation in endodontic retreatment.

    PubMed

    Karataş, Ertuğrul; Kol, Elif; Bayrakdar, İbrahim Şevki; Arslan, Hakan

    2016-04-01

    The purpose of the present study was to assess the effect of solvents on root canal transportation in endodontic retreatment. Sixty extracted human permanent mandibular first molars with curved root canals were selected. All of the root canals were prepared using Twisted File Adaptive instruments (SybronEndo, Orange, CA, USA) and filled with gutta-percha and AH Plus sealer (Dentsply DeTrey, Konstanz, Germany) using the cold lateral compaction technique. The teeth were assigned to four retreatment groups as follows (n = 15): eucalyptol, chloroform, orange oil and control. The canals were scanned using cone-beam computed tomography scanning before and after instrumentation. The chloroform group showed a significantly higher mean transportation value than the orange oil and control groups at the 3 and 5 mm levels (P = 0.011 and P = 0.003, respectively). There was no significant difference among the orange oil, eucalyptol and control groups in terms of canal transportation (P > 0.61). The chloroform led to more canal transportation than the eucalyptol and orange oil during endodontic retreatment. PMID:26420757

  12. Antibiofilm and antibacterial activities of farnesol and xylitol as potential endodontic irrigants.

    PubMed

    Alves, Flávio R F; Neves, Mônica A S; Silva, Marlei G; Rôças, Isabela N; Siqueira, José F

    2013-01-01

    This study investigated the antibiofilm and antibacterial effects of farnesol and xylitol in a series of experiments in order to evaluate their potential use as root canal irrigants. The following substances were tested: 0.2% farnesol; 5% and 20% xylitol; 0.2% farnesol plus 20% xylitol; and saline (control). For comparison with an established endodontic irrigant, 2.5% NaOCl was included in each test. Three experiments were conducted: the crystal violet assay, to evaluate the effects on the biofilm biomass; the dentin disinfection test, to evaluate the effects on bacterial viability in biofilms; and the root canal disinfection test, to simulate the use in the root canal environment. Farnesol was the most effective substance in reducing the biofilm biomass, followed by 20% xylitol. All substances affected bacterial viability in biofilms; farnesol showed the best results followed by the farnesol/xylitol combination. Irrigation with all substances significantly reduced the bacterial load (p<0.001), but only the farnesol/xylitol combination was significantly more effective than saline (p=0.02). NaOCl was more effective than any other substance tested in the three experiments (p<0.001). The findings demonstrated that farnesol affected both the biofilm biomass and the viability of cells in the biofilm, while 20% xylitol affected only the biofilm biomass. Although not more effective than NaOCl, the combination of these two antibiofilm substances has potential to be used in endodontics in certain situations. PMID:23969910

  13. The effect of a multimedia interactive tutorial on learning endodontic problem-solving.

    PubMed

    Plasschaert, A J; Cailleteau, J G; Verdonschot, E H

    1997-05-01

    New technology may create additional opportunities for learning in dental education. One of these new features is a multimedia approach, courseware combining sound, text, stills and video with interactive learning. A multimedia program was developed to train dental students and dental practitioners in decision making and problem solving in endodontics. This study compared the effects of the multimedia program with a more traditional approach consisting of written information, without interaction. 28, 4th-year dental students at the University of Kentucky in Lexington, KY, USA were randomly assigned to the multimedia or the text-based groups. They were given a written pre-test using 2 cases of dental pain and were instructed to study independently using either the multimedia program (group A) or the written information (group B). No restrictions were imposed on the amount of time to be invested, and the total study time was recorded for each student. 3 weeks after the pre-test, the students completed the post-test. A total of 18 students completed both the pre-test and the post-test and their scores were included in the final data. Statistical analysis of the average scores using paired t-tests revealed no significant difference between the performance of the students in either group, indicating that the multimedia approach to learning endodontic problem solving may successfully replace traditional learning strategies. PMID:9567903

  14. Successful clinical and organisational change in endodontic practice: a qualitative study.

    PubMed

    Koch, M; Englander, M; Tegelberg, Å; Wolf, E

    2014-08-01

    The aim of this study was to explicate and describe the qualitative meaning of successful clinical and organizational change in endodontic practice, following a comprehensive implementation program, including the integration of the nickel-titanium-rotary-technique. After an educational intervention in the Public Dental Service in a Swedish county, thematic in-depth interviews were conducted, with special reference to the participants' experience of the successful change. Interviews with four participants, were purposively selected on the basis of occupation (dentist, dental assistant, receptionist, clinical manager), for a phenomenological human scientific analysis. Four constituents were identified as necessary for the invariant, general structure of the phenomenon: 1) disclosed motivation, 2) allowance for individual learning processes, 3) continuous professional collaboration, and 4) a facilitating educator. The perceived requirements for achieving successful clinical and organizational change in endodontic practice were clinical relevance, an atmosphere which facilitated discussion and allowance for individual learning patterns. The qualities required in the educator were acknowledged competence with respect to scientific knowledge and clinical expertise, as well as familiarity with conditions at the dental clinics. The results indicate a complex interelationship among various aspects of the successful change process. PMID:24118746

  15. Radiopacity measurements of three endodontic sealers using digital x-rays

    NASA Astrophysics Data System (ADS)

    Chisnoiu, R.; Moldovan, M.; Pǎstrav, O.; Delean, A.; Prodan, D.; Boboia, S.; Prejmerean, V.; Chisnoiu, A.

    2015-12-01

    The aim of this experimental study was to assess the radiopacity of three endodontic sealers: a self-curing epoxy resin - AH Plus, a dual cure urethane dimethacrylate resin - RealSeal and a new dual cure endodontic hydroxyapatite based filling material developed in collaboration with "Raluca Ripan" Institute for Research in Chemistry from Cluj-Napoca. Material and methods: Five specimens, 10 mm diameter and 1 mm thickness, were digital x-rayed simultaneously with an aluminum step-wedge, varying from 1 to 12 mm thickness, according to ISO 6876:2012 standards. The radiopacity was determined by digital processing of the images, using specially designed software. Four different areas were selected for each specimen, according to quadrants of the sealer disks. Statistical analysis using ANOVA test was performed. Results: AH Plus sealer showed the highest radiopacity, the differences being statistically significant comparing to the others two tested sealers (p<0.05). Real Seal presented intermediate radiopacity values and the new experimental sealer radiopacity showed the lowest values (p>0.05). Conclusions: All tested materials were above the minimum radiopacity level recommended by the ISO 6876:2012. Acknowledgements: This work was funded by: the Romanian Ministry of Education and Research, National Project PN-II-PT-PCCA-2011-3.2-1275, no: 165/2012.

  16. Photo-activated disinfection of the root canal: a new role for lasers in endodontics.

    PubMed

    Lee, Michael T; Bird, Philip S; Walsh, Laurence J

    2004-12-01

    Because micro-organisms play a crucial role in the development of pulpal and periapical disease, the prognosis of endodontic therapy is intimately related to the presence of bacteria within the root canal system. Micro-organisms may persist in the apical region of the root canal system despite chemomechanical preparation. The usefulness of Class IV lasers (such as Nd:YAG, diode, KTP and Er:YAG) for photo-thermal disinfection of the root canal has been demonstrated in numerous studies. An alternative approach to microbial killing in the root canal system by laser light involves the use of low-power lasers to drive a photochemical reaction that produces reactive oxygen species, a technique termed photo-activated disinfection (PAD). By using exogenous photosensitisers such as tolonium chloride, killing of all types of bacteria can be achieved. In vitro studies of PAD have demonstrated its ability to kill photosensitised oral bacteria (such as E. faecalis), and more recently microbial killing in vivo in the root canal system has been demonstrated. While PAD can be undertaken as part of the routine disinfection of the root canal system, it also has potential use for eradicating persistent endodontic infections for which conventional methods have been unsuccessful. PMID:15633797

  17. Ion release and pH of a new endodontic cement, MTA and Portland cement

    PubMed Central

    Amini Ghazvini, Sara; Abdo Tabrizi, Maryam; Kobarfard, Farzad; Akbarzadeh Baghban, Alireza; Asgary, Saeed

    2009-01-01

    INTRODUCTION: This in vitro study measured and compared pH and phosphate and calcium ions release of a new endodontic material (CEM cement), mineral trioxide aggregate (MTA), and Portland cement (PC) using UV-visible technique, atomic absorption spectrophotometry methods, and pH meter, respectively. MATERIALS AND METHODS: Each material was placed in a plastic tube (n=10) and immersed in a glass flask containing deionized water. Half of the samples were tested for determining pH and released ions after 1h, 3h, 24h, 48h, 7d and 28d. Remaining samples (n=5), were evaluated after 28d. Data was analyzed using one way ANOVA and Tukey tests. RESULTS: Results indicated that all materials were highly alkaline and released calcium and low concentration of phosphate ions in all the time intervals. CEM cement released considerably higher concentration of phosphate during the first hour (P<0.05). CONCLUSION: This novel endodontic cement promoted alkaline pH in a similar manner to MTA and released calcium and phosphate. These conditions can stimulate the calcification process and explain the basic physico-chemical mechanisms of hard tissue regeneration of CEM cement. PMID:23940490

  18. Sealing capacity in vitro of thermoplasticized gutta-percha with a solid core endodontic filling technique.

    PubMed

    Valli, K S; Rafeek, R N; Walker, R T

    1998-04-01

    This study assessed the sealing capacity of two endodontic gutta-percha filling techniques. Thirty-four single-rooted fully developed teeth were endodontically accessed, instrumented and randomly divided into two experimental groups (n = 12) and two control groups (n = 5). In Group A, root canals were obturated using a solid core thermoplastic technique (Densfil), in Group B and Group C (negative control) canals were obturated with laterally condensed gutta-percha, and in Group D (positive control) canals were left unobturated. AH-26 was used as the sealer. Two days later, the teeth were conventionally prepared for testing apical and coronal leakage, immersed in india ink for 5 days and subsequently cleared. The linear coronal and apical extent of dye penetration was measured under a light dissecting microscope. The mean apical leakage for Group A was 1.39 mm, and for Group B 2.76 mm, whereas the mean coronal leakage for Group A was 2.87 mm, and for Group B 4.03 mm. The differences between the groups were not statistically significant (P > 0.05). PMID:9558517

  19. Comparison of the effectiveness of sterilizing endodontic files by 4 different methods: an in vitro study.

    PubMed

    Venkatasubramanian, R; Das, U M; Bhatnagar, S

    2010-01-01

    Sterilization is the best method to counter the threats of microorganisms. The purpose of sterilization in the field of health care is to prevent the spread of infectious diseases. In dentistry, it primarily relates to processing reusable instruments to prevent cross-infection. The aim of this study was to investigate the efficacy of 4 methods of sterilizing endodontic instruments: Autoclaving, carbon dioxide laser sterilization, chemical sterilization (with glutaraldehyde) and glass-bead sterilization. The endodontic file was sterilized by 4 different methods after contaminating it with bacillus stearothermophillus and then checked for sterility by incubating after putting it in test tubes containing thioglycollate medium. The study showed that the files sterilized by autoclave and lasers were completely sterile. Those sterilized by glass bead were 90% sterile and those with glutaraldehyde were 80% sterile. The study concluded that autoclave or laser could be used as a method of sterilization in clinical practice and in advanced clinics; laser can be used also as a chair side method of sterilization. PMID:20215664

  20. Vibrational investigation of calcium-silicate cements for endodontics in simulated body fluids

    NASA Astrophysics Data System (ADS)

    Taddei, Paola; Modena, Enrico; Tinti, Anna; Siboni, Francesco; Prati, Carlo; Gandolfi, Maria Giovanna

    2011-05-01

    Calcium-silicate MTA (Mineral Trioxide Aggregate) cements have been recently developed for oral and endodontic surgery. This study was aimed at investigating commercial (White ProRoot MTA, White and Grey MTA-Angelus) and experimental (wTC-Bi) accelerated calcium-silicate cements with regards to composition, hydration products and bioactivity upon incubation for 1-28 days at 37 °C, in Dulbecco's Phosphate Buffered Saline (DPBS). Deposits on the surface of the cements and the composition changes during incubation were investigated by micro-Raman and ATR/FT-IR spectroscopy, and pH measurements. Vibrational techniques disclosed significant differences in composition among the unhydrated cements, which significantly affected the bioactivity as well as pH, and hydration products of the cements. After one day in DPBS, all the cements were covered by a more or less homogeneous layer of B-type carbonated apatite. The experimental cement maintained a high bioactivity, only slightly lower than the other cements and appears a valid alternative to commercial cements, in view of its adequate setting time properties. The bioactivity represents an essential property to favour bone healing and makes the calcium-silicate cements the gold standard materials for root-apical endodontic surgery.

  1. Microbiology and management of endodontic infections in children.

    PubMed

    Brook, Itzhak

    2003-01-01

    The first step in the origination of caries is the formation of a dental plaque. Dental caries can lead to destruction of enamel and dentin resulting in bacterial invasion of the pulp. Invasion of the pulp and the periapical areas can promote the development of dento-alveolar abscess and spread of the infection to other anatomical areas. Several oral acid producing aerobic and anaerobic bacteria, including Streptococcus mutans, Lactobacillus acidophilus, and Actinomyces viscosus, are capable of initiating the carious lesion. The organisms that predominate in pulpitis and dento-alveolar abscess are Prevotella, Porphyromonas, Fusobacterium, and Peptostreptococcus spp. Treatment of caries involves removal of all affected tooth structure and proper replacement with a restorative material. Once pulpitis has developed the infected tissue should be removed and root canal therapy instituted, or the tooth should be extracted. Extraction, root canal therapy and/or drainage of pus usually are indicated for an abscess. Antimicrobial therapy supplementing the dental care should be considered, especially when local or systemic spread of the infection is suspected. Penicillin or amoxicillin are generally effective against most of the aerobic and anaerobic bacteria recovered. The patient whose oral cavity may harbor penicillin-resistant organisms should be considered for treatment with drugs effective against these organisms. These agents include amoxicillin-clavulanate, clindamycin or the combination of metronidazole plus amoxicillin or a macrolide. PMID:14604136

  2. Effect of endodontic irrigation and dressing procedures on the shear bond strength of composite to coronal dentin.

    PubMed

    Abo-Hamar, Sahar E

    2013-01-01

    This study aimed to evaluate the effects of three sodium hypochlorite (NaOCl)-endodontic irrigation procedures used alone or in combinations with two intermediate dressing materials on bond strengths of two adhesive composite systems to coronal dentin. Surfaces were treated with NaOCl or NaOCl-Glyde-File-Prep (H2O2 and EDTA) with or without chlorhexidine (CHX) as a final rinse. Intermediate dressing materials of calcium hydroxide (Ca(OH)2) and sodium perborate (SP) were combined with surface treatments. Surface treatment groups (n = 10/group) included (1) distilled water (control), (2) 5.25% NaOCl (30 min), (3) NaOCl/Glyde (30 min), (4) NaOCl/Glyde (30 min) + CHX (2 min), (5) NaOCl/Glyde (30 min) + Ca(OH)2 (5 days) + CHX (2 min), and (6) NaOCl/Glyde (30 min) + SP (9 days) + CHX (2 min). For each surface treatment group, dentin shear bond strengths of two different composite systems (Excite/Tetric Flow Chroma, [EX/TFC], and Clearfil Protect Bond/Protect Liner F [PB/PLF]) were evaluated. Median shear bond strengths (EX/TFC, PB/PLF) for each surface treatment group in MPa were (1) 21, 18; (2) 26, 18; (3) 21, 17; (4) 22, 16; (5) 17, 11; and (6) 14, 11, respectively. NaOCl significantly increased the bond strength of EX/TFC (p < 0.05), but did not significantly affect that of PB/PLF. The use of NaOCl/Glyde with CHX did not significantly affect EX/TFC (p > 0.05), whereas it significantly decreased PB/PLF (p < 0.05). Ca(OH)2 and SP significantly decreased the bond strengths of both adhesive systems (p < 0.05). Adhesion to coronal dentin is dependent upon the irrigation regimen and the type of adhesive. PMID:25685402

  3. Effect of endodontic irrigation and dressing procedures on the shear bond strength of composite to coronal dentin

    PubMed Central

    Abo-Hamar, Sahar E.

    2012-01-01

    This study aimed to evaluate the effects of three sodium hypochlorite (NaOCl)-endodontic irrigation procedures used alone or in combinations with two intermediate dressing materials on bond strengths of two adhesive composite systems to coronal dentin. Surfaces were treated with NaOCl or NaOCl–Glyde-File-Prep (H2O2 and EDTA) with or without chlorhexidine (CHX) as a final rinse. Intermediate dressing materials of calcium hydroxide (Ca(OH)2) and sodium perborate (SP) were combined with surface treatments. Surface treatment groups (n = 10/group) included (1) distilled water (control), (2) 5.25% NaOCl (30 min), (3) NaOCl/Glyde (30 min), (4) NaOCl/Glyde (30 min) + CHX (2 min), (5) NaOCl/Glyde (30 min) + Ca(OH)2 (5 days) + CHX (2 min), and (6) NaOCl/Glyde (30 min) + SP (9 days) + CHX (2 min). For each surface treatment group, dentin shear bond strengths of two different composite systems (Excite/Tetric Flow Chroma, [EX/TFC], and Clearfil Protect Bond/Protect Liner F [PB/PLF]) were evaluated. Median shear bond strengths (EX/TFC, PB/PLF) for each surface treatment group in MPa were (1) 21, 18; (2) 26, 18; (3) 21, 17; (4) 22, 16; (5) 17, 11; and (6) 14, 11, respectively. NaOCl significantly increased the bond strength of EX/TFC (p < 0.05), but did not significantly affect that of PB/PLF. The use of NaOCl/Glyde with CHX did not significantly affect EX/TFC (p > 0.05), whereas it significantly decreased PB/PLF (p < 0.05). Ca(OH)2 and SP significantly decreased the bond strengths of both adhesive systems (p < 0.05). Adhesion to coronal dentin is dependent upon the irrigation regimen and the type of adhesive. PMID:25685402

  4. Reasons for Apical Surgery Treatment in an Underserved New York City Population.

    PubMed

    Hasselgren, Gunnar; Patel, Pratik; Alhassany, Hashim; Kunzel, Carol

    2016-04-01

    Endodontic retreatment often involves remaking restorations. The total cost may steer the treatment towards surgery. The aim of this study was to retrospectively record the reasons for performing apical surgery in an economically deprived patient population. The clinical reasons (59%) for apical surgery were most common, but the nonclinical (financial) reasons (41%) emerged as a major cause. The finding that 41% of the apicoectomies were performed because of nonclinical constraints is a high figure and may not reflect the situation generally. Still, economic factors potentially play a major role in the selection of surgical versus nonsurgical endodontic retreatment. PMID:27348949

  5. A model for the teaching of clinical techniques in root canal treatment.

    PubMed

    Nattress, B R; Manogue, M; Carmichael, F

    1997-09-01

    A practical model to aid the understanding and practice of endodontic techniques is described. The model uses extracted teeth mounted in light-cured acrylic resin and set in a preformed model tray. Before mounting, the root surfaces of teeth are dipped in wax to simulate the periodontal ligament space. This model allows endodontic techniques to be practised in the operative technique classroom in a way that simulates the clinical situation and enables radiographs of good diagnostic quality to be taken during treatment. Subsequently, teeth can be reset to allow restoration of the root-filled tooth. PMID:9477825

  6. Application of Low level Lasers in Dentistry (Endodontic)

    PubMed Central

    Asnaashari, Mohammad; Safavi, Nassimeh

    2013-01-01

    Low level lasers, cold or soft lasers: These lasers do not produce thermal effects on tissues and induce photoreactions in cells through light stimulation which is called photobiostimulation. Power of these lasers is usually under 250mW. The main point differentiating low level lasers and high power ones is the activation of photochemical reactions without heat formation. The most important factor to achieve this light characteristic in lasers is not their power, but their power density for each surfa ceunit (i.e cm2). Density lower than 670mW/cm2, can induce the stimulatory effects of low level lasers without thermal effects. Low level lasers (therapeutic) used today as treatment adjunctive devices in medicine and dentistry. Numerous studies have been performed on the applications of low level lasers in patient pain reduction. Mechanisms of pain reduction with therapeutic lasers and their application are expressed, and the studies realized in this field are presented. PMID:25606308

  7. Influence of endodontic sealer composition and time of fiber post cementation on sealer adhesiveness to bovine root dentin.

    PubMed

    Rosa, Ricardo Abreu da; Barreto, Mirela Sangoi; Moraes, Rafael do Amaral; Broch, Juliana; Bier, Carlos Alexandre Souza; Só, Marcus Vinícius Reis; Kaizer, Osvaldo Bazzan; Valandro, Luiz Felipe

    2013-01-01

    This study aimed to assess the influence of the type of endodontic sealer (salicylate resin-based sealer vs. two endodontic sealers) and the time of fiber post cementation after root filling on the post adhesion to bovine root dentin. Sixty bovine roots were assigned to six groups (n=10), considering an experimental design with two factors (factorial 3x2): endodontic sealer factor in three levels [epoxy resin-based sealer (AH Plus), eugenol-based sealer (Endofill), and salicylate resin-based sealer plus mineral trioxide aggregate - MTA (MTA Fillapex)] and time for post cementation factor in two levels (immediate post cementation or 15 days after root canal filling). After post cementation, 2-mm-thick slices were produced and submitted to push-out test. The failure modes were analyzed under a 40× stereomicroscope and scored as: adhesive at cement/dentin interface; adhesive at cement/post interface; cement cohesive; post cohesive; dentin cohesive; or mixed. Data were analyzed using two-way ANOVA and Tukey's post-hoc tests (α=0.05). When the fiber posts were cemented immediately after the root canal filling, the bond strengths were similar, independent of the endodontic sealer type. However, after 15 days, the epoxy resin-based sealer presented higher bond strength than the other sealers (p<0.05). Comparison between each sealer in different experimental times did not reveal any differences. The main failure type was adhesive at dentin/cement interface (89.4%). The time elapsed between the root canal filling and post cementation has no influence on post/root dentin adhesion. On the contrary, the type of endodontic sealer can influence the adhesion between fiber posts and root dentin. PMID:23969913

  8. Heat generation on root surfaces after KTP:NdYAG use in endodontic treatment

    NASA Astrophysics Data System (ADS)

    Nammour, S.; Kowalyk, Kenneth; Valici, Ch.; Guillaume, Patrick

    1997-05-01

    The canals of 30 recently extracted human teeth were filled with a photosensitizer. A series of 5 shots, separated by a resting time of 1 second also, was delivered by means of the KTP:YAG fiber tip. The temperature increases were measured on the topical point of the root surfaces by the use of a thermocouple. For laser settings, the rises were always below the safety threshold of 7 C. We conclude that the KTP:NdYAG laser can be harmless for periodontal tissues under some conditions.

  9. [Current perspectives on endodontic treatment of teeth with chronic periapical lesions].

    PubMed

    Canalda Sahli, C

    1990-01-01

    The author study in this article histopathological aspects of periapical lesions, intra-granulomatous epithelial proliferation phenomenon as pathogenic mechanism of microscopic cystic cavities formation, diagnostic problems of them all, as well as the most actual therapeutic perspectives. PMID:1964067

  10. Antimicrobial activity of a temporary sealant used in endodontic treatment: An in vitro study

    PubMed Central

    Domingos, Helena Baruffaldi; Gonçalves, Lucio Souza; de Uzeda, Milton

    2015-01-01

    Objective: The present study is aimed to evaluate the antimicrobial action of Coltosol® in direct contact with human saliva. Materials and Methods: Twelve different individuals were selected. Saliva samples were evaluated at four different time periods: Baseline 1 (T1-initial control), T2 (2 h), T4 (24 h after contact with a standardized sample of a coronary sealer) and baseline 2 (T3-final control). Seeded plates were incubated at 37°C in a bacterial incubator for a period of 48–72 h. After the incubation period, the colony forming units were counted, and the results compared. Results: Differences were statistically significant. There was an inhibition of bacterial growth after the first 2 h of contact and an increase in the number of bacteria after 24 h of direct contact between the material and the saliva. Coltosol® presented bacterial growth inhibition in direct contact with saliva. This inhibitory effect tended to decrease over time, as shown by the two periods when the material was in contact with different samples of saliva. Conclusions: The antimicrobial activity of the material is an important feature; however, other physical and chemical properties of the coronary temporary sealer should be considered. PMID:26430372

  11. Outcomes of Endodontic Therapy Comparing Conventional Sodium Hypochlorite Irrigation with Passive Ultrasonic Irrigation Using Sodium Hypochlorite and Ethylenediaminetetraacetate. A Retrospective Analysis

    PubMed Central

    Hertel, Moritz; Sommer, Katja; Kostka, Eckehard; Imiolczyk, Sandra Maria; Ballout, Husam; Preissner, Saskia

    2016-01-01

    The aim of the present study was to investigate the clinical outcomes of two different standardized endodontic irrigation protocols. It was assumed that the additional use of ethylenediaminetetraacetate (EDTA) and passive ultrasonic irrigation (PUI) would result in an increased rate of absence of symptoms and remission based on the periapical index (PAI) compared to passive irrigation using only sodium hypochlorite (NaOCl). Data and radiographs from 199 teeth retrieved from the institutional endodontic database were analyzed retrospectively. In 106 teeth irrigation was performed using only NaOCl (protocol 1). Ninety-three teeth were irrigated using NaOCl and EDTA (protocol 2). Chlorhexidine (CHX) was additionally used in revision treatments in both groups. All irrigants in group 2 were activated by PUI. Mean follow-up periods were: protocol 1 = 9.2 ± 4.4 and protocol 2 = 6.6 ± 2.5 months (p < 0.0001 (chi-square test). The frequencies of the PAImasterpoint and PAIfollow-up scores did not differ significantly between teeth, which received either protocol 1 or 2 (p = 0.555 and 0.138). Statistical analysis revealed no significant association between treatment success (absence of clinical symptoms and PAIfollow-up = I or PAImasterpoint > PAIfollow-up > I) and the applied protocol (success rates: protocol 1 = 72.6% vs. protocol 2 = 82.8%; p = 0.203). Furthermore, the frequency of extractions did not differ significantly between the two protocols (p = 0.102). No association was found between follow-up time and treatment success (p = 0.888). The hypothesis was not confirmed. Even though the obtained success rate was higher after supplementing the irrigation protocol with EDTA and PUI, no significance was recorded. Hence, protocol 2 was not superior to protocol 1 regarding therapy success, at least within the limited follow-up period. It may be cautiously concluded that sufficient mechanical debridement combined with passive NaOCl irrigation results in comparably high

  12. Outcomes of Endodontic Therapy Comparing Conventional Sodium Hypochlorite Irrigation with Passive Ultrasonic Irrigation Using Sodium Hypochlorite and Ethylenediaminetetraacetate. A Retrospective Analysis.

    PubMed

    Hertel, Moritz; Sommer, Katja; Kostka, Eckehard; Imiolczyk, Sandra Maria; Ballout, Husam; Preissner, Saskia

    2016-01-01

    The aim of the present study was to investigate the clinical outcomes of two different standardized endodontic irrigation protocols. It was assumed that the additional use of ethylenediaminetetraacetate (EDTA) and passive ultrasonic irrigation (PUI) would result in an increased rate of absence of symptoms and remission based on the periapical index (PAI) compared to passive irrigation using only sodium hypochlorite (NaOCl). Data and radiographs from 199 teeth retrieved from the institutional endodontic database were analyzed retrospectively. In 106 teeth irrigation was performed using only NaOCl (protocol 1). Ninety-three teeth were irrigated using NaOCl and EDTA (protocol 2). Chlorhexidine (CHX) was additionally used in revision treatments in both groups. All irrigants in group 2 were activated by PUI. Mean follow-up periods were: protocol 1 = 9.2 ± 4.4 and protocol 2 = 6.6 ± 2.5 months (p < 0.0001 (chi-square test). The frequencies of the PAImasterpoint and PAIfollow-up scores did not differ significantly between teeth, which received either protocol 1 or 2 (p = 0.555 and 0.138). Statistical analysis revealed no significant association between treatment success (absence of clinical symptoms and PAIfollow-up = I or PAImasterpoint > PAIfollow-up > I) and the applied protocol (success rates: protocol 1 = 72.6% vs. protocol 2 = 82.8%; p = 0.203). Furthermore, the frequency of extractions did not differ significantly between the two protocols (p = 0.102). No association was found between follow-up time and treatment success (p = 0.888). The hypothesis was not confirmed. Even though the obtained success rate was higher after supplementing the irrigation protocol with EDTA and PUI, no significance was recorded. Hence, protocol 2 was not superior to protocol 1 regarding therapy success, at least within the limited follow-up period. It may be cautiously concluded that sufficient mechanical debridement combined with passive NaOCl irrigation results in comparably high

  13. Tissue damage after sodium hypochlorite extrusion during root canal treatment.

    PubMed

    de Sermeño, Ruth Fuentes; da Silva, Léa Assed Bezerra; Herrera, Henry; Herrera, Helen; Silva, Raquel Assed Bezerra; Leonardo, Mário Roberto

    2009-07-01

    Sodium hypochlorite solution is toxic to vital tissues, causing severe effects if extruded during endodontic treatment. This paper presents a report on the tissue damage related to inadvertent extrusion of concentrated sodium hypochlorite solution during root canal treatment. A 65-year-old woman was referred with moderate pain, ecchymosis, and severe swelling of the right side of the face. These symptoms appeared immediately after a root canal treatment of the maxillary right canine, which had been started 21 hours earlier. It was diagnosed as air emphysema related to sodium hypochlorite solution extravasation during the endodontic treatment. To avoid this, an initial radiograph should be taken to determine the correct canal working length and confirm root canal integrity. PMID:19442541

  14. Interdisciplinary Treatment of a Fused Lower Premolar with Supernumerary Tooth

    PubMed Central

    Gadimli, Cengiz; Sari, Zafer

    2011-01-01

    The objective of this report is to describe combined orthodontic and endodontic treatment of a fused mandibular premolar with supernumerary tooth. The patient was a 15 year old girl seeking orthodontic treatment for the correction of maxillary and mandibular crowding. Cephalometric examination revealed skeletally Class I relationship. The panoramic radiograph showed a fused tooth with two separate pulp chambers and two separate root canals connecting in apical third. After the endodontic treatment of the fused teeth, the stripping of the supernumerary tooth was performed to establish a Class I canine relationship and to correct midline deviation. At the end of the treatment, the crowding was resolved and positive overjet and overbite was achieved. PMID:21769280

  15. Evaluation of pigmented intraorifice barriers in endodontically treated teeth.

    PubMed

    Wolcott, J F; Hicks, M L; Himel, V T

    1999-09-01

    The purpose of this study was to evaluate the effectiveness of three pigmented glass ionomer cements used as intraorifice barriers to prevent coronal microleakage. One hundred ten extracted mandibular human premolars were divided into four experimental groups of 25 teeth each and two control groups of 5 teeth each. The experimental teeth were instrumented and obturated using thermoplasticized gutta-percha and AH26 sealer. Group 1 teeth received no further treatment. Teeth in groups 2 through 4 had 1 of 3 pigmented glass ionomers (Vitrebond, GC America, and Ketac-Bond) placed as an intraorifice barrier. Positive control teeth were instrumented but not obturated. The negative control teeth were instrumented, obturated, and externally sealed with epoxy resin. The coronal 3 mm of each root was sealed into the lumen of an 18-mm segment of latex surgical tubing. After the apparatus was sterilized, 2.0 ml of a 24 h growth of Proteus vulgaris in trypticase soy broth (TSB) was placed in the coronal reservoir of the tooth. The inoculated apparatus was placed into a presterilized test tube containing 1.5 ml of TSB and incubated for 90 days at 37 degrees C. The TSB in the lower reservoir was observed daily for turbidity, which would indicate leakage along the full length of the obturated root canal. To determine if differences in microbial leakage occurred among the four experimental groups, Pearson's chi 2 and Fisher's exact tests were performed. The confidence level was set at 95%. The positive and negative controls validated the microbial testing method. The teeth without an intraorifice barrier leaked significantly more than teeth with Vitrebond intraorifice barriers (p < 0.05). The difference in leakage among the experimental glass ionomer barriers was not significant (p > 0.05). PMID:10687533

  16. Treatment

    MedlinePlus

    ... Prevention Treatment 2003 U.S. Outbreak African Rodent Importation Ban For Clinicians Clinical Recognition Specimen Collection Treatment Smallpox ... Examining Animals with Suspected Monkeypox African Rodent Importation Ban Resources Related Links Poxvirus Molluscum Contagiosum Orf Virus ( ...

  17. Acute dental pain, Part II: Diagnosis and emergency treatment.

    PubMed

    Antonelli, J R

    1990-09-01

    Part II of this two-part series differentiates and explores endodontic-related emergencies with reversible and irreversible pulpitis. Indications and contra-indications for vital pulp therapy are explained, and treatment is outlined. The inflammatory process involved in irreversible pulpal disease is summarized, and the clinical signs, symptoms, and treatment of irreversible pulpitis (with and without acute periradicular involvement, with pulp necrosis, and acute periradicular abscess with and without cellulitis) are discussed. PMID:2097056

  18. Correlation between cyclic fatigue and the bending properties of nickel titanium endodontic instruments.

    PubMed

    Piao, Jindan; Miyara, Kana; Ebihara, Arata; Nomura, Naoyuki; Hanawa, Takao; Suda, Hideaki

    2014-01-01

    The effects of cyclic fatigue on bending properties of NiTi endodontic instruments were investigated. Sixteen Profiles(®) were divided into two groups (A, and B). The sequence of cantilever bending test and cyclic fatigue test was alternated repeatedly until file separation occurred. In the cyclic fatigue test, the instrument curvature was 19° in group A and 38° in group B. Fractographic examination was performed to determine fracture patterns. In group A, there were significant differences between the bending load values measured before the cyclic fatigue test and the last cantilever bending test before instrument fracture at each deflection (p<0.05). Fractographic examination showed the specific patterns of cyclic fatigue fracture. The stress required to induce martensitic transformation might be reduced due to the softening behavior caused by the cyclic fatigue under the relaxation condition of the superelasticity range (group A). The SEM images were able to display specific patterns indicating cyclic fatigue fracture. PMID:25087661

  19. An agar diffusion study comparing the antimicrobial activity of Nanoseal with some other endodontic sealers.

    PubMed

    Aal-Saraj, Ali Burak; Ariffin, Zaihan; Masudi, Sam'an Malik

    2012-08-01

    The aim of this study was to evaluate the antimicrobial activity of a new experimental nano-hydroxyapatite epoxy resin-based sealer (Nanoseal) with several other commercially available sealers; AH26, Tubliseal, Sealapex and Roekoseal against Enterococcus faecalis, Pseudomonas aeruginosa, Streptococcus mutans, Streptococcus sobrinus and Escherichia coli for up to 7 days. Agar diffusion was used in this study. Fifty Muller-Hinton agar plates were prepared and divided into five experimental groups (n = 10), for each micro-organism. Another 10 agar plates were used as positive and negative controls. Endodontic sealers were tested against each micro-organism. Inhibition zones produced were recorded. The results of this study showed that all test materials exhibited inhibition zones towards the tested micro-organisms for 7 days except for Roekoseal, which showed no inhibition zones. Nanoseal and AH26 exhibited similar zones of inhibition. Significant difference was found between Nanoseal and the other tested sealers (P < 0.001). PMID:22827817

  20. Effects of Dissolving Solutions on the Accuracy of an Electronic Apex Locator-Integrated Endodontic Handpiece

    PubMed Central

    Ustun, Yakup; Uzun, Ozgur; Er, Ozgur; Maden, Murat; Yalpı, Fatma; Canakci, Burhan Can

    2013-01-01

    The effects of three dissolving agents on the accuracy of an electronic apex locator- (EAL-) integrated endodontic handpiece during retreatment procedures were evaluated. The true lengths (TLs) of 56 extracted incisor teeth were determined visually. Twenty teeth were filled with gutta-percha and a resin-based sealer (group A), 20 with gutta-percha and a zinc oxide/eugenol-based sealer (group B), and 16 roots were used as the control group (group C). All roots were prepared to TL. Guttasolv, Resosolv, and Endosolv E were used as the dissolving solutions. Two evaluations of the handpiece were performed: the apical accuracy during the auto reverse function (ARL) and the apex locator function (EL) alone. The ARL function of the handpiece gave acceptable results. There were significant differences between the EL mode measurements and the TL (P < 0.05). In these comparisons, Tri Auto ZX EL mode measurements were significantly shorter than those of the TL. PMID:24379743

  1. Role of Ozone Therapy in Minimal Intervention Dentistry and Endodontics - A Review

    PubMed Central

    A, Shilpa Reddy; Reddy, Narender; Dinapadu, Sainath; Reddy, Manoranjan; Pasari, Srikanth

    2013-01-01

    Ozone has been successfully used in medical field since many years owing to its oxidizing property making it an excellent antimicrobial agent. Moreover its potent anti-inflammatory property along with favorable cellular and humoral immune response made ozone an effective therapeutic agent. Also its ability to arrest and reverse carious lesions in a predictable way opened up a new chapter in minimal intervention dentistry. Furthermore its efficacy in curbing resistant poly microbial root canal flora appears very promising. This article is based on information through valid textbooks, peer reviews, journals and medline/pubmed search. How to cite this article: Reddy S A, Reddy N, Dinapadu S, Reddy M, Pasari S. Role of Ozone Therapy in Minimal Intervention Dentistry and Endodontics - A Review. J Int Oral Health 2013; 5(3):102-108. PMID:24155611

  2. Comparative efficiency of final endodontic cleansing procedures in removing a radioactive albumin from root canal systems

    SciTech Connect

    Cecic, P.A.; Peters, D.D.; Grower, M.F.

    1984-09-01

    Fifty-six teeth were initially instrumented, with the use of seven irrigants or irrigant combinations, and filled with radioactive albumin. The study then showed the relative ability of three final endodontic procedures (copious reirrigation with saline solution, drying with paper points, and reassuring patency of the canal with the final instrument) to remove the albumin. Even after copious irrigation, each additional procedure removed statistically significant amounts of albumin. Alternating an organic solvent and an inorganic solvent did appear to leave the canal system in the optimal condition for final cleansing procedures. The study then correlated the relative efficiency of irrigation alone versus instrumentation plus irrigation in removing the remaining albumin from the canal systems. Reinstrumentation plus copious irrigation removed significantly more albumin than copious irrigation alone.

  3. Fatigue resistance of engine-driven rotary nickel-titanium endodontic instruments.

    PubMed

    Chaves Craveiro de Melo, Marta; Guiomar de Azevedo Bahia, Maria; Lopes Buono, Vicente Tadeu

    2002-11-01

    A comparative study of the fatigue resistance of engine-driven nickel-titanium endodontic instruments was performed, aiming to access the influence of the cutting flute design and of the size of the files that reach the working length in curved canal shaping. Geometrical conditions similar to those found in practice were used. Series 29 #5 ProFile, together with #6 and #8 Quantec instruments, were tested in artificial canals with a 45-degree angle of curvature and 5-mm radius of curvature. It was observed that the size of the instrument, which determines the maximum strain amplitude during cyclic deformation, is the most important factor controlling fatigue resistance. The effect of heat sterilization on the fatigue resistance of the instruments was also examined. The results obtained indicate that the application of five sterilization procedures in dry heat increases the average number of cycles to failure of unused instruments by approximately 70%. PMID:12470021

  4. Persistent infection by Staphylococcus epidermidis in endodontic flare-up: a case report.

    PubMed

    Gonçalves, Simone Helena Ferreira; de Vasconcelos, Rafaela Andrade; Cavalcanti, Bruno das Neves; Camargo, Carlos Henrique Ribeiro

    2016-01-01

    Endodontic flare-ups are challenging situations and may result from selective growth of specific bacterial species; microbial cultures and antibiograms should be used to allow faster, successful management of refractory lesions. A 47-year-old man reported pain on percussion after uncomplicated retreatment of the maxillary left canine for prosthetic purposes. In the following days, pain dramatically increased, leading to removal of the filling and use of intracanal medication. After many unsuccessful attempts to resolve the problem, a microbial culture of the root canal detected the presence of Staphylococcus epidermidis. An antibiogram determined the best drug combination to control this infection: tetracycline (oxytetracycline hydrochloride, 500 mg orally) plus third-generation cephalosporin (ceftriaxone, 1 g intramuscularly). Once the infection was controlled, the root canal was obturated. There was a reduction in the area of radiolucency, and the patient reported no pain at a 2-year follow-up. PMID:26943096

  5. Influence of Surface Morphology on the Torsion Fracture of NiTi Endodontic Instruments

    NASA Astrophysics Data System (ADS)

    Elias, Carlos; Lopes, Helio; Vieira, Victor; Souza, Leticia; Vieira, Márcia

    2014-07-01

    This study analyzed the influences of manufacturing process (twisting and machining) and surface finishing on the angular distortion, maximum torque, and toughness of two NiTi endodontic instruments (Race—FKG Dentaire and TF—Twisted Files, SybronEndo). Statistical analysis of results showed that TF instruments (twisted) had higher distortion angle ( p < 0.05) and lower maximum torque to fracture ( p < 0.05) than Race instruments (machined). SEM analysis of fractured instruments showed a surface morphology characteristic of ductile fracture, with plastic deformation in the helical shafts. The results suggest that both instruments are equally suitable for clinical applications. This study is purely scientific as it evaluates only some material properties, and is not intended to endorse a commercial product.

  6. Dentin ablation-rate measurements in endodontics witj HF and CO2 laser radiation

    NASA Astrophysics Data System (ADS)

    Makropoulou, Mersini I.; Serafetinides, Alexander A.; Khabbaz, Marouan; Sykaras, Sotirios; Tsikrikas, G. N.

    1996-01-01

    Recent studies focused on the ability of the laser light to enlarge the root canal during the endodontic therapy. The aim of this research is the experimental and theoretical study of the ablation rate of two infrared laser wavelengths on dentin. Thirty freshly extracted human teeth were longitudinally sectioned at thicknesses ranged from 0.5 to 2 mm, and irradiated on the root canal dentin. The measured ablation rates in dentinal wall of the root canal showed that the HF laser at 2.9 micrometer can more effectively penetrate into the tissue, whereas the carbon dioxide laser at 10.6 micrometer leads to high thermal damage of the ablation crater surroundings.

  7. [Endodontics in motion: new concepts, materials and techniques 1. Hydraulic Calcium Silicate Cements].

    PubMed

    Moinzadeh, A T; Jongsma, L; de Groot-Kuin, D; Cristescu, R; Neirynck, N; Camilleri, J

    2015-01-01

    Hydraulic Calcium Silicate Cements (HCSCs) constitute a group of materials that have become increasingly popular in endodontics since the introduction of Mineral Trioxide Aggregate (MTA) in the 1990s. MTA is Portland cement to which bismuth oxide has been added to increase its radiopacity. The most important property of MTA is its capacity to set in water or a humid environment. However, MTA also has important limitations, for example, it's difficult to work with and can discolour teeth. Recently, numerous products based on HCSC chemistry, which can be considered as modifications of MTA intended to reduce its limitations, have become available on the market. Despite their potential advantages, all of these materials have their own specific limitations that are currently insufficiently known and investigated. PMID:26210543

  8. An Update on the Management of Endodontic Biofilms Using Root Canal Irrigants and Medicaments

    PubMed Central

    Mohammadi, Zahed; Soltani, Mohammad Karim; Shalavi, Sousan

    2014-01-01

    Microbial biofilm is defined as a sessile multicellular microbial community characterized by cells that are firmly attached to a surface and enmeshed in a self-produced matrix of extracellular polymeric substances. Biofilms play a very important role in pulp and periradicular pathosis. The aim of this article was to review the role of endodontic biofilms and the effects of root canal irrigants, medicaments as well as lasers on biofilms A Medline search was performed on the English articles published from 1982 to 2013 and was limited to papers published in English. The searched keywords were “Biofilms AND endodontics”, “Biofilms AND sodium hypochlorite”, "Biofilms AND chlorhexidine", "Biofilms AND MTAD", "Biofilms AND calcium hydroxide", “Biofilms AND ozone”, “Biofilms AND lasers” and "Biofilms AND nanoparticles". The reference list of each article was manually searched to find other suitable sources of information. PMID:24688576

  9. Evaluation of cytotoxicity, antimicrobial activity and physicochemical properties of a calcium aluminate-based endodontic material

    PubMed Central

    SILVA, Emmanuel João Nogueira Leal; HERRERA, Daniel Rodrigo; ROSA, Tiago Pereira; DUQUE, Thais Mageste; JACINTO, Rogério Castilho; GOMES, Brenda Paula Figueiredo de Almeida; ZAIA, Alexandre Augusto

    2014-01-01

    A calcium aluminate-based endodontic material, EndoBinder, has been developed in order to reduce MTA negative characteristics, preserving its biological properties and clinical applications. Objectives The aim of this study was to evaluate the cytotoxicity, antimicrobial activity, pH, solubility and water sorption of EndoBinder and to compare them with those of white MTA (WMTA). Material and Methods Cytotoxicity was assessed through a multiparametric analysis employing 3T3 cells. Antimicrobial activity against Enterococcus faecalis (ATCC 29212), Staphylococcus aureus. (ATCC 25923) and Candida albicans (ATCC 10556) was determined by the agar diffusion method. pH was measured at periods of 3, 24, 72 and 168 hours. Solubility and water sorption evaluation were performed following ISO requirements. Data were statistically analyzed by ANOVA and Tukey`s test with a significance level of 5%. Results EndoBinder and WMTA were non-cytotoxic in all tested periods and with the different cell viability parameters. There was no statistical differences between both materials (P>.05). All tested materials were inhibitory by direct contact against all microbial strains tested. EndoBinder and WMTA presented alkaline pH in all tested times with higher values of pH for WMTA (P<.05). Both materials showed values complying with the solubility minimum requirements. However, EndoBinder showed lower solubility than WMTA (P<.05). No statistical differences were observed regarding water sorption (P>.05). Conclusion Under these experimental conditions, we concluded that the calcium aluminate-based endodontic material EndoBinder demonstrated suitable biological and physicochemical properties, so it can be suggested as a material of choice in root resorption, perforations and root-end filling. PMID:24626250

  10. Degree of vinyl conversion, polymerization shrinkage and stress development in experimental endodontic composite

    PubMed Central

    O’Donnell, J.N.R.; Skrtic, D.

    2010-01-01

    This study explores degree of vinyl conversion (DVC), polymerization shrinkage (PS) and shrinkage stress (PSS) of the experimental amorphous calcium phosphate (ACP) composites intended for use as an endodontic sealer. Light-cure (LC), chemical cure (CC) or dual-cure (DC; combined light and chemical cure) resins comprised urethane dimethacrylate (UDMA), 2-hydroxyethyl methacrylate (HEMA), methacryloyloxyethyl phthalate (MEP) and a high molecular mass oligomeric co-monomer, poly(ethyleneglycol)-extended UDMA (PEG-U) (designated UPHM resin). To fabricate composites, a mass fraction of 60 % UPHM resin was blended with a mass fraction of 40 % as-made (am-ACP) or ground ACP (g-ACP). DVC values of copolymer (unfilled UPHM resin) and composite specimens were determined by infrared spectroscopy. Glass-filled composites were used as controls. PS and PSS of composites were determined by dilatometry and tensometry, respectively. LC copolymers attained extraordinary high DVC values at 24 h post-cure (95.7 %), compared to CC (52 %) and DC (79.3 %) copolymer specimens. While the DVC values of LC and DC am-ACP composites were reduced between 5 and 10 %, DVC values of DC g-ACP composites increased almost 8 % compared to the corresponding copolymers. High DVC attained in LC composites was, expectedly, accompanied with high PS values (on average 7 vol%). However, PSS developed in LC and especially DC composites did not exceed PSS values seen in other UDMA-based composites. Based on this initial evaluation, it is concluded that, DC, g-ACP filled UPHM composite shows promise as an endodontic sealer. However, further physicochemical evaluations, including water sorption, mechanical stability and ion release as well as a leachability studies need to be performed before this experimental material is tested for cellular responses and, eventually recommended for clinical utility. PMID:20411033

  11. Evaluation of Contact Friction in Fracture of Rotationally Bent Nitinol Endodontic Files

    NASA Astrophysics Data System (ADS)

    Haimed, Tariq Abu

    2011-12-01

    The high flexibility of rotary Nitinol (Ni-Ti) files has helped clinicians perform root canal treatments with fewer technical errors than seen with stainless steel files. However, intracanal file fracture can occur, compromising the outcome of the treatment. Ni-Ti file fracture incidence is roughly around 4% amongst specialists and higher amongst general practitioners. Therefore, eliminating or reducing this problem should improve patient care. The aim of this project was to isolate and examine the role of friction between files and the canal walls of the glass tube model, and bending-related maximum strain amplitudes, on Ni-Ti file lifetimes-tofracture in the presence of different irrigant solutions and file coatings. A specifically designed device was used to test over 300 electropolished EndoSequenceRTM Ni-Ti files for number of cycles to failure (NCF) in smooth, bent glass tube models at 45 and 60 degrees during dry, coated and liquid-lubricated rotation at 600rpm. Fractured files were examined under Scanning Electron Microscopy (SEM) afterwards. Four different file sizes 25.04, 25.06, 35.04, 35.06 (diameter in mm/taper %) and six surface modification conditions were used independently. These conditions included, three solutions; (1) a surfactant-based solution, Surface-Active-Displacement-Solution (SADS), (2) a mouth wash proven to remove biofilms, Delmopinol 1%(DEL), and (3) Bleach 6% (vol.%), the most common antibacterial endodontic irrigant solution. The conditions also included two low-friction silane-based coating groups, 3-Hepta-fluoroisopropyl-propoxymethyl-dichlorosilane (3-HEPT) and Octadecyltrichlorosilane (ODS), in addition to an as-received file control group (Dry). The coefficient of friction (CF) between the file and the canal walls for each condition was measured as well as the surface tension of the irrigant solutions and the critical surface tension of the coated and uncoated files by contact angle measurements. The radius of curvature and

  12. The guided tissue regeneration principle in endodontic surgery: one-year postoperative results of large periapical lesions.

    PubMed

    Pecora, G; Kim, S; Celletti, R; Davarpanah, M

    1995-01-01

    Twenty patients with large endodontic lesions, which failed to respond to conventional endodontic therapy, were selected for this study. The lesions had a radiographic diameter of at least 10 mm, were removed by periradicular surgery, before retrofilling the apices with either super EBA or dessicated zinc oxide-eugenol. In 10 test sites large e-PTFE membranes (Gortex) were placed to cover the lesions, while at the control sites the lesions were not covered before resuturing. Radio-graphic analysis of the lesions at 3, 6, 9 and 12 months revealed that lesions covered with the membranes healed quicker than the control lesions, and that the quality and quantity of the regenerated bone was superior when membranes were used. Results of the study indicate that guided tissue regeneration (GTR) principles can be effectively applied to the healing of large periapical lesions, especially in through-and-through lesions. PMID:7642328

  13. Endodontic disease of the mandibular first molar tooth secondary to caudal crossbite in a young Shetland sheepdog.

    PubMed

    Brine, E J

    1999-03-01

    A six month-old intact female Shetland sheepdog was referred to the University of Illinois Veterinary Dental Clinic with a left-sided mandibular deviation and a thickened left ventral mandible in the region of the first molar tooth. On oral examination, left caudal crossbite was diagnosed. Dental radiographs revealed endodontic disease of the mandibular first molar tooth involved in the crossbite. Because of the difficulty of treating caudal crossbite and the potential of a pathological mandibular fracture, the endodontically affected tooth was extracted. Ten months following the extraction, mandibular deviation and alveolar bone lysis were resolved, but alveolar ridge resorption was present. The abnormal occlusal relationship caused by the caudal crossbite may have led to movement of the tooth, resorption of the tooth alveolus, and irreversible pulpal damage. Although not employed in this case, use of alveolar ridge preservation techniques can prevent mandibular bone loss after extractions. PMID:10863516

  14. Use of Multiple-Displacement Amplification and Checkerboard DNA-DNA Hybridization To Examine the Microbiota of Endodontic Infections▿

    PubMed Central

    Brito, L. C. N.; Teles, F. R.; Teles, R. P.; França, E. C.; Ribeiro-Sobrinho, A. P.; Haffajee, A. D.; Socransky, S. S.

    2007-01-01

    Multiple-displacement amplification (MDA) has been used to uniformly amplify bacterial genomes present in small samples, providing abundant targets for molecular analysis. The purpose of this investigation was to combine MDA and checkerboard DNA-DNA hybridization to examine the microbiota of endodontic infections. Sixty-six samples were collected from teeth with endodontic infections. Nonamplified and amplified samples were analyzed by checkerboard DNA-DNA hybridization for levels and proportions of 77 bacterial taxa. Counts, percentages of DNA probe counts, and percentages of teeth colonized for each species in amplified and nonamplified samples were computed. Significance of differences for each species between amplified and nonamplified samples was sought with Wilcoxon signed-rank test and adjusted for multiple comparisons. The amount of DNA in the samples ranged from 6.80 (± 5.2) ng before to 6.26 (± 1.73) μg after MDA. Seventy of the 77 DNA probes hybridized with one or more of the nonamplified samples. All probes hybridized with at least one sample after amplification. Most commonly detected species at levels of >104 in both amplified and nonamplified samples were Prevotella tannerae and Acinetobacter baumannii at frequencies between 89 and 100% of samples. The mean number of species at counts of >104 in amplified samples was 51.2 ± 2.2 and in nonamplified samples was 14.5 ± 1.7. The endodontic microbiota was far more complex than previously shown, although microbial profiles at teeth with or without periradicular lesions did not differ significantly. Species commonly detected in endodontic samples included P. tannerae, Prevotella oris, and A. baumannii. PMID:17634304

  15. An adventurous habit of bottle-cap opening resulting in an endodontic-periodontal lesion: a case report.

    PubMed

    Ponnaiyan, Deepa; Bhat, K Mahalinga; Bhat, G Subraya

    2009-06-01

    An unusual case of an endodontic-periodontal lesion in a 29-year-old man resulting from a habit of opening beer bottle (metal) caps using his mandibular left molar is reported. The patient had been a chronic alcoholic with several emotional problems and was unaware of the injurious nature of his habit. Thus, the importance of a detailed case history and assessment of psychosocial aspects for an accurate diagnosis of such conditions is highlighted. PMID:19587884

  16. Biocompatibility of dental materials used in contemporary endodontic therapy: a review. Part 1. Intracanal drugs and substances.

    PubMed

    Hauman, C H J; Love, R M

    2003-02-01

    Irrigation solutions and intracanal medicaments are used within the root canal to clean and aid in disinfecting the dentinal walls. Although these materials are intended to be contained within the root canal, they invariably contact the periapical tissues, either through inadvertent extrusion through the apex or leaching. This paper is a review on the methodology involved in biocompatibility testing followed by a discussion on biocompatibility of contemporary intracanal drugs and substances used in endodontics. PMID:12657150

  17. Cone beam CT scans with and without artefact reduction in root fracture detection of endodontically treated teeth

    PubMed Central

    Bechara, B; Alex McMahan, C; Moore, WS; Noujeim, M; Teixeira, FB; Geha, H

    2013-01-01

    Objectives: Cone beam CT (CBCT) is used widely to depict root fracture (RF) in endodontically treated teeth. Beam hardening and other artefacts due to gutta-percha may increase the time of the diagnosis and result in an incorrect diagnosis. Two CBCT machines, ProMax® (Planmeca, Helsinki, Finland) and Master 3D® (Vatech, Hwaseong, Republic of Korea), have the option of applying an artefact reduction (AR) algorithm. The aim of this study was to determine whether using an AR algorithm in two CBCT machines enhances the accuracy of detecting RFs in endodontically treated teeth. Methods: 66 roots were collected and decoronated. All roots were treated endodontically using the same technique with gutta-percha and zinc oxide cement. One-half of the roots were randomly selected and fractured using a nail that was tapped gently with a hammer until complete fracture resulted in two root fragments; the two root fragments were glued together with one layer of methyl methacrylate. The roots were placed randomly in eight prepared beef rib fragments. Results: The highest accuracy was obtained when the ProMax was used without AR. The lowest accuracy was obtained with the Master 3D when used with AR. For both machines, accuracy was significantly higher without AR than with AR. Both with and without AR, the ProMax machine was significantly more accurate than the Master 3D machine. The same rank ordering was obtained for both sensitivity and specificity. Conclusions: For both machines, AR decreased the accuracy of RF detection in endodontically treated teeth. The highest accuracy was obtained when using the ProMax without AR. PMID:23520395

  18. Role of ultrasound and color doppler in diagnosis of periapical lesions of endodontic origin at varying bone thickness

    PubMed Central

    Tikku, Aseem P; Bharti, Ramesh; Sharma, Neha; Chandra, Anil; Kumar, Ashutosh; Kumar, Sunil

    2016-01-01

    Aims: To access the role of ultrasound and color doppler in diagnosing periapical lesions of maxilla and mandible. Settings and Design: This study was conducted in the Department of Conservative Dentistry and Endodontics (Faculty of Dental Sciences), Department of Radiotherapy, and Department of Pathology. Materials and Methods: The study group comprised 30 patients with periapical lesions of endodontic origin in maxilla and mandible requiring endodontic surgery. After thorough clinical and radiographic examination patients were subjected to ultrasound and color doppler examination, where the lesions were assessed for their contents as to cystic or solid. Following which periapical surgery was done and the pathological tissue obtained was subjected to histopathological examination. The results of the ultrasound examination were correlated with histopathological features. The diagnostic validity of ultrasound was assessed by calculating the sensitivity, specificity, positive predictive value, and negative predictive value. Statistical Analysis Used: The statistical analysis was done using statistical package for social sciences (SPSS) version 15.0 statistical analysis software. The values were represented in number (%). Results: Within the limitations of the current study it can be stated that although ultrasound may not establish the definitive diagnosis, it can facilitate the differential diagnosis between cystic and solid granulomatous lesions. However, this technique may have a limited role in detecting periapical lesions present in the region with thick overlying cortical bone. Conclusion: Ultrasound can routinely be recommended as a complimentary method for the diagnosis of periapical lesions of endodontic origin. However, this technique may have a limited role in detecting periapical lesions present in the region with thick overlying cortical bone. PMID:27099421

  19. Frequency, microbial interactions, and antimicrobial susceptibility of Fusobacterium nucleatum and Fusobacterium necrophorum isolated from primary endodontic infections.

    PubMed

    Jacinto, Rogério C; Montagner, Francisco; Signoretti, Fernanda G C; Almeida, Geovania C; Gomes, Brenda P F A

    2008-12-01

    This study assessed the prevalence and microbial interactions of Fusobacterium nucleatum and Fusobacterium necrophorum in primary endodontic infections from a Brazilian population and their antimicrobial susceptibility to some antibiotics by the E-test. One hundred ten samples from infected teeth with periapical pathologies were analyzed by culture methods. Five hundred eighty individual strains were isolated; 81.4% were strict anaerobes. F. nucleatum was found in 38 root canals and was associated with Porphyromonas gingivalis, Prevotella spp., and Eubacterium spp. F. necrophorum was found in 20 root canals and was associated with Peptostreptococcus prevotii. The simultaneous presence of F. nucleatum and F. necrophorum was not related to endodontic symptoms (p > 0.05). They were 100% susceptible to amoxicillin, amoxicillin/clavulanate, and cephaclor. Fusobacterium spp. is frequently isolated from primary-infected root canals of teeth with periapical pathologies. Amoxicillin is a useful antibiotic against F. nucleatum and F. necrophorum in endodontic infections and has been prescribed as the first choice in Brazil. PMID:19026872

  20. Comparison of fracture resistance of endodontically treated teeth restored with nanohybrid, silorane, and fiber reinforced composite: An in vitro study

    PubMed Central

    Bilgi, Priyanka Shripad; Shah, Nimisha Chinmay; Patel, Parth Pinakinbhai; Vaid, Deepa S

    2016-01-01

    Background: The present study was undertaken to evaluate the most suitable restorative for badly mutilated endodontically treated teeth. Aims: To evaluate and compare the fracture resistance of endodontically treated premolars restored with conventional nanohybrid, silorane composite with glass fibers and newer fiber-reinforced composite in mesio-occluso-distal (MOD) cavities. Materials and Methods: Sixty extracted human maxillary premolars were selected. Fifteen intact teeth served as positive controls (Group 1). Endodontic therapy was done in the remaining 45 teeth. MOD cavities were prepared in all the teeth with standardized dimensions and were randomly divided into three groups (Group 2 - nanohybrid + glass fibers, Group 3 - silorane + glass fibers, and Group 4 – fiber-reinforced composite). Restorations were done for all groups. Fracture resistance was measured by Instron universal testing machine. Statistical Analysis Used: One-way anova test and Tukey's post hoc test. Results: Highest fracture resistance was shown by intact teeth group followed by fiber-reinforced composite, nanohybrid, and silorane, respectively. Statistically Significant difference was revealed by anova test (P < 0.0001) and Tukey's post hoc test (P < 0.0001). Conclusions: Among the experimental groups, fiber-reinforced composite showed the highest fracture resistance. Statistically significant difference was observed for all the groups. PMID:27563188