de LIMA, Alexandra Furtado; SPAZZIN, Aloísio Oro; GALAFASSI, Daniel; CORRER-SOBRINHO, Lourenço; CARLINI-JÚNIOR, Bruno
Objective This study evaluated the effect of ferrule preparation (Fp) on the fracture resistance of endodontically treated teeth, restored with composite resin cores with or without glass fiber posts. Material and Methods Forty-four bovine teeth were sectioned 19 or 17 mm (2 mm ferrule) from the apex, endodontically treated and assigned to four groups (n = 11): Group 1: Fp and post; Group 2: Fp and without post; Group 3: without Fp and with post; Group 4: without Fp and without post. All specimens were restored with composite resin core and metal crown. Specimens were subjected to fracture resistance testing in a universal testing machine at a crosshead speed of 0.5 mm/min. The data were analyzed by two-way ANOVA and Tukey’s tests (α=0.05). Results The mean fracture resistance values were as follows: Group 1: 573.3 N; Group 2: 552.5 N; Group 3: 275.3 N; Group 4: 258.6 N. Significantly higher fracture resistance was found for the groups with Fp (p<0.001). Conclusion There was no statistically significant interaction between the "Fp" and "post" factors (p = 0.954). The ferrule preparation increased the fracture resistance of endodontically treated teeth. However, the use of glass fiber post showed no significant influence on the fracture resistance. PMID:20835570
Souza-Junior, Eduardo J; Bueno, Vanessa C P S; Dias, Carlos T S; Paulillo, Luís A M S
The aim of this study was to evaluate the influence of eugenol-containing endodontic sealers and luting strategy on the pull-out bond strength of glass fiber posts to dentin. Sixty-four bovine incisors were randomly assigned into two groups of 32 specimens each for obturation procedure with gutta-percha only, or with Pulp Canal Sealer EWT Subsequently, the roots were prepared for the fiber post Reforpost and all specimens of each endodontic sealing procedure were allocated to four groups (n = 8), according to the strategies for post cementation: A) Single Bond 2 and RelyX ARC; B) All Bond 2 and C&B cement; C) All Bond 2 and RelyX ARC; D) Single Bond 2 and C&B Cement. The posts were cemented immediately after the endodontic treatment. The pull-out test was performed at a cross-head speed of 0.5 mm/min in a universal testing machine (EMIC). Data (Kgf) were submitted to a two-way ANOVA and Tukey test (p < or = 0.05). The eugenol-based sealer did not influence the pull-out bond strength of fiber posts regardless of the luting strategy. RelyX ARC showed higher bond strength than C&B Cement when used with Single Bond 2 adhesive system, when the eugenol-based sealer was present. All Bond 2, when associated to all cements studied, promoted similar bond strength, regardless of the eugenol-containing endodontic sealer In conclusion, eugenol-containing sealer did not influence the pull-out bond strength values of the resin luting systems for glass fiber post cementation. The bond system and resin cement association from the same manufacturer had similar bond strength values for dentin.
Sharma, Shweta; Attokaran, George; Singh, Kunwar S.; Jerry, Jeethu J.; Ahmed, Naima; Mitra, Nirban
Aim and Objectives: Use of posts improves the physical properties of endodontically-treated teeth. Different post types are developed such as metal, custom-made, carbon, and quartz. The present study was conducted to evaluate the fracture resistance of glass fiber-reinforced, carbon, and quartz post in endodontically-treated teeth. Materials and Methods: Forty extracted human maxillary incisor teeth were decoronated and endodontically treated and equally divided into 4 groups; control, glass fiber-reinforced, carbon, and quartz posts. No post was used in the control group. Post space was prepared and cemented with different posts and subjected to universal testing machine to check fracture resistance. The data were statistically analyzed using t-test and analysis of variance to compare the mean difference between groups (SPSS version 20, IBM). Results: Quartz type of endodontic post showed good fracture resistance compared to carbon and resin-reinforced post. Least resistance was observed in the control group without post. Conclusion: Quartz, carbon, and glass fiber-reinforced posts show good resistance to fracture, and hence can be used in endodontically-treated teeth to enhance their strength. PMID:27583227
Sonkesriya, Subhash; Olekar, Santosh T; Saravanan, V; Somasunderam, P; Chauhan, Rashmi Singh; Chaurasia, Vishwajit Rampratap
Background: Posts are used to enhance crown buildup in pulpless teeth with destructed crown portion. Different types of post are used in endodontically treated teeth. The aim of the present in vitro study was to evaluate fracture resistance of custom made, metal, glass fiber reinforced and carbon reinforced posts in endodontically treated teeth. Materials and Methods: An in vitro study was carried out on extracted 40 human maxillary central incisor teeth, which was divided into four groups with 10 samples in each group with custom made, metal post, glass fiber reinforced, and carbon reinforced posts. The samples were decoronated at cemento-enamel junction and endodontically treated. Post space was prepared and selected posts were cemented. The composite cores were prepared at the height of 5 mm and samples mounted on acrylic blocks. Later fracture resistance to the compressive force of samples was measured using Universal Testing Machine. Results: The maximum resistance to the compressive force was observed in carbon reinforced and glass fiber reinforced posts compared others which is statistically significant (P > 0.001) and least was seen in custom fabricated post. Conclusion: It is concluded that carbon reinforced fiber post and glass fiber posts showed good fracture resistance compared to custom made and metal posts. PMID:26028904
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
Preethi, GA; Kala, M
Aim: Restoring endodontically treated teeth is one of the major treatments provided by the dental practitioner. Selection and proper use of restorative materials continues to be a source of frustration for many clinicians. There is controversy surrounding the most suitable choice of restorative material and the placement method that will result in the highest probability of successful treatment. This clinical study compares two different varieties of fiber posts and one cast post and core in terms of mobility of crown margin under finger pressure, recurrent caries detected at the crown margin, fracture of the restoration, fracture of the root and periapical and periodontal pathology requiring crown removal over the period of 12months as evaluated by clinical and radiographical examination. Materials and Methods: 30 root canal treated, single rooted maxillary anterior teeth of 25 patients in the age range of 18–60 years where a post retained crown was indicated were selected for the study between January 2007 and August 2007; and prepared in a standard clinical manner. It was divided into 3 groups of 10 teeth in each group. After post space preparation, the Carbon fiber and Glass fiber reinforced posts were cemented with Scotch bond multipurpose plus bonding agent and RelyX adhesive resin cement in the first and second groups respectively. The Cast post and cores were cemented with Zinc Phosphate cement in the third group. Following post- cementation, the preparation was further refined and a rubber base impression was taken for metal-ceramic crowns which was cemented with Zinc Phosphate cement. A baseline periapical radiograph was taken once each crown was cemented. All patients were evaluated after one week (baseline), 3 months, 6 months and one year for following characteristics mobility of crown margin under finger pressure, recurrent caries detected at the crown margin, fracture of the restoration, fracture of the root and periapical and periodontal pathology
Edelhoff, Daniel; Weber, Michael; Spiekermann, Hubertus; Marx, Rudolf
For esthetical and biomechanical reasons root canal posts made of fibre-reinforced composite (FRC) have gained an important role in clinical application. Additionally, in contrast to metal or ceramic posts, FRC-posts offer the option of removal. Prior to adhesive placement of FRC-posts the root canal dentin of the non vital tooth and the post surface have to be preconditioned. Up to now the post preconditioning has to be proceeded in the chair side technique. This leads to an additional time expense in the clinical treatment schedule. Also a certain risk of errors in application during chair side conditioning procedure is of concern. Modern PVD-technologies can help to make the treatment by the manufacturer well in advance of the clinical use more efficient and reliable, as well as saving clinicians valuable chair-time. For this reason the apical surfaces of the posts were intensively cleaned and activated, PVD-layered and coated by a conserving transparent layer. This coating has the meaning to protect the surface against environmental contamination and allows the try-in of the posts without any risk of damage of the preconditioned surface. To prove the stability of the layer system under simulated clinical conditions pull out tests after 180 days'storage in physiological saline solution have been performed.
Wang, Hsuan-Wen; Chang, Yen-Hsiang; Lin, Chun-Li
This study develops a novel anatomical short glass fiber reinforced (anatomical SGFR) post and evaluates the mechanical performance in artificial endodontically treated premolars. An anatomical SGFR fiber post with an oval shape and slot/notch designs was manufactured using an injection-molding machine. The three-point bending test and crown/core restorations using the anatomical SGFR and commercial cylindrical fiber posts under fatigue test were executed to understand the mechanical resistances. The results showed that static and dynamic rotational resistance were found significantly higher in the anatomical SGFR fiber post than in the commercial post. The endurance limitations at 1.2×10(6) cycles were 66.81 and 64.77 N for the anatomical SGFR and commercial fiber posts, respectively. The anatomical SGFR fiber post presented acceptable value of flexural strength and modulus, better fit adaption in the root canal resist torque more efficiency but was not a key issue in the lateral fracture resistance in an endodontically treated premolar.
Bueno, Carlos Eduardo da Silveira; Pelegrine, Rina Andrea; Silveira, Cláudia Fernandes de Magalhães; Bueno, Vanessa Castro Pestana da Silveira; Alves, Vanessa de Oliveira; Cunha, Rodrigo Sanches; Pereira, Gisele Damiana da Silveira; Paulillo, Luis Alexandre Maffei Sartini
Resin-based restorative materials, widely used to cement posts, may be influenced by irrigants used during endodontic chemical-mechanical preparation. This study evaluated the impact of endodontic irrigating solutions and adhesive cement systems on the push-out shear bond strength of glass fiber posts to root dentin. Ninety-six bovine incisors were divided into 12 groups (4 irrigants × 3 resin cements; n = 8). Prepared canals were irrigated with saline solution, 2.5% sodium hypochlorite (NaOCl), 5.25% NaOCl, or 2% chlorhexidine gel, and posts were cemented with RelyX ARC, Panavia F, or RelyX U100. The bond strength was evaluated by means of the push-out test, and results were subjected to analysis of variance. The mean bond strength observed for the combination of 5.25% NaOCl irrigant and RelyX U100 cement was significantly lower (8.82 MPa) than the values found for the other groups (P < 0.05). The other combinations of irrigating solution and resin cement had no adverse effect on the bond strength of the glass fiber posts to dentin.
Wang, Hsuan-Wen; Chang, Yen-Hsiang; Lin, Chun-Li
This study evaluates the fracture resistance in an endodontically treated tooth using circular fiber-reinforced composite (FRC) and innovated anatomical short glass fiber reinforced (SGFR) posts under fatigue testing, monitored using the acoustic emission (AE) technique. An anatomical SGFR fiber post with an oval shape and slot/notch design was manufactured using an injection-molding machine. Crown/core maxillary second premolar restorations were executed using the anatomical SGFR and commercial cylindrical fiber posts under fatigue test to understand the mechanical resistances. The load versus AE signals in the fracture and fatigue tests were recorded to evaluate the restored tooth failure resistance. The static fracture resistance results showed that teeth restored using the anatomical SGFR post presented higher resistance than teeth restored using the commercial FRC post. The fatigue test endurance limitation (1.2×10(6) cycles) was 207.1N for the anatomical SGFR fiber post, higher than the 185.3N found with the commercial FRC post. The average accumulated number of AE signals and corresponding micro cracks for the anatomical SGFR fiber post (153.0 hits and 2.44 cracks) were significantly lower than those for the commercial FRC post (194.7 hits and 4.78 cracks) under 40% of the static maximum resistance fatigue test load (pass 1.2×10(6) cycles). This study concluded that the anatomical SGFR fiber post with surface slot/notch design made using precise injection molding presented superior static fracture resistance and fatigue endurance limitation than those for the commercial FRC post in an endodontically treated premolar.
Memon, Sarfaraz; Mehta, Sonal; Malik, Salim; Nirmal, Narendra; Sharma, Deeksha; Arora, Himanshu
Introduction: From the point of dental practice, the restoration of endodontically treated teeth has become an important aspect as it involves a range of treatment options of variable complexity. Restoring teeth with insufficient coronal tooth structure, it is always indicated to use the post to retain a core for definitive restoration. Fiber post has a modulus of elasticity in analogs to dentin structure, thus reducing the stress areas at the dowel dentin interface. However, the only material that can substantiate all these properties can be none other than dentin itself. Materials and Methodology: Three-dimensional (3D) models of the maxillary central incisor were developed incorporating all the nonlinearities. Continuum 3D elements were used in three dimensions. Maxillary central incisor was laser scanned, duplicated with the help of reverse engineering into STL format, and it was converted into 3D model for finite element analysis (FEA). For the model, fixed boundary conditions were applied at the outer bone, while 100 N static vertical occlusal loads were prescribed at 135° on the loading component of the simulated tooth. The stress distribution was evaluated using dentin and fiber post with prescribed materials, loading and boundary conditions in endontically treated teeth by 3D FEA. Results: The analysis for von Misses stress for dentin post showed that the stress in the dentin post at the cervical area was 127 MPa. The displacement in the dentin post was <0.025 mm. Von Misses stress for the fiber post at the cervical area was approximately 182 MPa and the displacement was <0.035 mm. Conclusion: The FEA results showed that the stress in the cervical area of the dentin was more for fiber post when compared to dentin post, and maximum displacement values were less for dentin post in comparison to fiber post. PMID:27134431
Guo, Jing; Wang, Zhiming; Li, Xuesheng; Sun, Chaoyang; Gao, Erdong
PURPOSE This in-vitro study aimed to evaluate the fracture resistances and failure modes of endodontically treated mandibular premolars restored with endocrowns and conventional post-core retained crowns. MATERIALS AND METHODS Thirty mandibular premolars were assigned into three groups (n=10): GI, intact teeth; GE, teeth with endocrowns; GC, teeth with conventional post-core supported crowns. Except for the teeth in group GI, all specimens were cut to 1.5 mm above the cementoenamel junction and endodontically treated. Both endocrowns and conventional crowns were fabricated from lithium-disilicate blocks using a CEREC 3D CAD/CAM unit. All specimens were subjected to thermocycling and then to 45° oblique compressive load until fracture occurred. The fracture resistance and failure mode of each specimen were recorded. Data were analyzed with one-way ANOVA and LSD Post Hoc Test (α=.05). RESULTS The fracture resistances of GE and GC were significantly lower than that of GI (P<.01), while no significant difference was found between GE and GC (P=.702). As of the failure mode, most of the specimens in GE and GC were unfavorable while a higher occurrence of favorable failure mode was presented in GI. CONCLUSION For the restoration of mandibular premolar, endocrown shows no advantage in fracture resistance when compared with the conventional method. Both of the two methods cannot rehabilitate endodontically treated teeth with the same fracture resistances that intact mandibular premolars have. PMID:28018567
Sharma, Navneet; Singh, Harpal
Statement of problem: Techniques and recommendations for the restoration of endodontically treated teeth have changed from the use of custom cast metal post and core system to glass fiber-reinforced (GFRC) post and composite core system. Has this latest prefabricated glass fiber reinforced post and composite core system increased the fracture resistance of teeth and reduced the incidence of unrestorable root fractures. Purpose: The purpose of this study was to evaluate the incidence of root fracture and mode of failure of endodontically treated teeth restored with two different post and core systems. Material and Methods: Forty maxillary central incisors were randomly divided into two groups. (n=20). All teeth received endodontic treatment. First group was restored with custom cast post and core system. Second group was restored with glass fiber post and composite core system. In Both the groups posts were cemented with adhesive resin cement. Compressive load was applied at an angle of 130 to the long axis of teeth at a cross head speed of 1 mm/min until fracture occurred. Data were analyzed with student “t” test P<.001. Results: The mean value for fracture resistance was (331.4025) N in Group -I Custom cast Ni-Cr post and core and (237.0625) N in Group -II Glass fiber reinforced post and composite core system. Students “t” test shows the significant difference in fracture resistance of two groups. Conclusion: This study showed that the incidence of root fracture was significantly higher in custom cast Ni-Cr post and core system than glass fiber post and composite core system. A more favourable mode of failure was observed in teeth restored with Group II glass fiber post system. Key words:Post-and-core technique, glass fiber post, cast post and-core system, fracture resistance, endodontically treated teeth. PMID:24558556
Azaripour, Adriano; Willershausen, Ines; Kämmerer, Philipp; Willershausen, Brita
Two patients were diagnosed with combined endodontic-periodontal lesions. Endodontic treatment was performed, followed by surgery. In addition, the regeneration process was supported by the application of an enamel matrix derivate alone or in combination with guided bone regeneration techniques. At recall visits after 24 months, the teeth were asymptomatic and marked bone regeneration had occurred in both patients. The successful post-endodontic treatment of combined endodontic-periodontal lesions, using periodontal surgery and as adjunct guided tissue regenerative techniques, is presented. Further, the possibility of saving teeth, even with severely apparent pathology, should be highlighted.
Sarkis-Onofre, Rafael; Pereira-Cenci, Tatiana; Opdam, Niek Johannes; Demarco, Flávio Fernando
The aim of this study was to evaluate if clinical experience, whether in relation to length of practice time and/or level of specialization influences the dentist's preference for using posts to restore endodontically treated teeth. A cross sectional study was carried out using a questionnaire with dentists (n = 276) in Pelotas, southern Brazil. Data were collected regarding clinical experience, post-graduate training, and variables related to restorations (posts/cements and use of rubber dam) for endodontically treated teeth. The data were submitted to a descriptive analysis and associations were tested. The response rate was 68%. Cast metal posts (24.53%), glass fiber posts (20.75%) and resin cement (66.67%) were the most commonly selected materials. In relation to rubber dams, 93.05% of the dentists were found not use them to lute posts. There was a significant association between the level of training of post-graduate dentists and the type of post used (p = 0.027), in that dentists without post-graduate training used cast metal posts more frequently, whereas dentists with post-graduate training reported glass fiber posts as their first choice. The results of the study showed that dentists preferred cast metal posts, glass fiber posts and resin cement. Continuing education influenced the decision of the dentists on their choice of dental posts.
Mohammadi, Zahed; Shalavi, Sousan
Glass ionomer cements (GICs) are biocompatible and have capacities to release fluoride and to bond to dentine, and thus are appropriate for use in endodontics. This paper reviews the composition and properties of different GICs, including their biocompatibility and antibacterial activity, their applications as intraorifice barriers and root canal sealers, and their use in the repair of root perforations, root-end fillings and temporary coronal restorations.
Majori, M; Bedini, R; Altamura, C; Filippini, P; Caiazza, S
Aesthetics is a very important element in dentistry, but requires the support of good mechanical performance. Quartz fiber used in post-endodontic reconstruction is an aesthetic material, although there is little research concerning its mechanical properties. This study evaluated the retentive property of post-endodontic reconstruction, composed of a quartz fiber post. Different thermal stresses were applied in vitro to post-endodontic reconstructions, in order to simulate oral thermal action on post-system dental structure linkage. We chose 30 human extracted teeth, endodontically treated and restored, and then divided them into three groups of 10 teeth. A different treatment was applied to each group before mechanical testing: in the 1st group no treatment was done (controls); in the 2nd group teeth were subjected, in a climatic chamber, to 10 thermo-cycles between 4 degrees C and 58 degrees C; in the 3rd group teeth were stored in a saline solution at 37 degrees C for 48 hr. The teeth then underwent tensile shear stress tests at break point using a computerized electronic dynamometer. After mechanical testing, two teeth from each group were longitudinally half-sectioned, sputter-coated in gold and observed by scanning electron microscopy (SEM). The extracted quartz fiber post of each tooth also underwent SEM observation. Mechanical test results demonstrated that thermal cyclic variations could affect bond stability between dental structures and posts in quartz fiber reconstructions, whereas their bond strength seemed unaffected by humidity increases. Quartz fiber post SEM observation demonstrated a homogeneous structure and a regular fiber disposition. Dental root canal morphology SEM images always showed a different thickness in the cement layer. (Journal of Applied Biomaterials & Biomechanics 2004; 2: 156-61).
Furtos, Gabriel; Baldea, Bogdan; Silaghi-Dumitrescu, Laura
The aim of this study was to analyze the radiopacity and filler content of three experimental glass fiber posts (EGFP) in comparison with other glass/carbon fibers and metal posts from the dental market. Three EGFP were obtained by pultrusion of glass fibers in a polymer matrix based on 2,2-bis[4-(2-hydroxy-3-methacryloyloxypropoxy)-phenyl]propane (bis-GMA) and triethyleneglycol dimethacrylate (TEGDMA) monomers. Using intraoral sensor disks 27 posts, as well as mesiodistal sections of human molar and aluminum step wedges were radiographed for evaluation of radiopacity. The percentage compositions of fillers by weight and volume were investigated by combustion analysis. Two EGFP showed radiopacity higher than enamel. The commercial endodontic posts showed radiopacity as follows: higher than enamel, between enamel and dentin, and lower than dentin. The results showed statistically significant differences (p b 0.05)when evaluatedwith one-way ANOVA statistical analysis. According to combustion analyses, the filler content of the tested posts ranges between 58.84wt.% and 86.02wt.%. The filler content of the tested EGFP ranged between 68.91 wt.% and 79.04 wt.%. EGFP could be an alternative to commercial glass fiber posts. Futureglass fiber posts are recommended to present higher radiopacity than dentin and perhaps ideally similar to or higher than that of enamel, for improved clinical detection. The posts with a lower radiopacity than dentin should be considered insufficiently radiopaque. The radiopacity of some glass fiber posts is not greatly influenced by the amount of filler.
da Costa, Rogério Goulart; de Morais, Eduardo Christiano Caregnatto; Leão, Moira Pedroso; Bindo, Márcio José Fraxino; Campos, Edson Alves; Correr, Gisele Maria
Customized glass fiber posts that is well adjusted into the root canal and have mechanical properties similar to those of dentin may be a suitable treatment for severely compromised endodontically treated teeth. This article reports a 3-year follow up of severely damaged endodontically treated teeth restored with unidirectional fiber glass customized post and core system instead of a conventional fiber post. The fabrication of this glass fiber customized post is a simple technique, providing an increased volume of fibers into the root canal, and an adequate polymerization of the post-core system. Over a three-year period, the treatments demonstrated good clinical and radiographic characteristics, with no fracture or loss of the post and/or crown. This technique can be considered effective, less invasive, and suitable for restore endodontically treated teeth. PMID:21228960
Maceri, Franco; Martignoni, Marco; Vairo, Giuseppe
This paper investigates some mechanical aspects of a new endodontic restoration technique, based on the idea that the root cavity can be more efficiently filled if multiple prefabricated composite posts (PCP) are employed. Multi-post technique increases bearing capacity and durability of endodontically treated teeth, as shown by numerical simulations performed through three-dimensional elastic finite-element static analyses of a lower premolar, constrained by a non-linearly elastic spring system representing the periodontal ligament, under several parafunctional loads. The influence of PCPs' number, material and dimensions is investigated by comparison of the resulting stress fields with those obtained in cases of traditional restorations (cast metal post and cemented single-PCP) and natural tooth, highlighting the advantages of the proposed technique when standard restorative materials are considered. A risk-analysis of root-fracture and interface-failure shows that cast gold-alloy post produces high stress concentrations at post-dentin interface, whereas multi-post solution leads to a behaviour closer to the natural tooth's, exhibiting some advantages with respect to single-PCP restorations. As a matter of fact, whenever PCPs' overall cross-section area increases, multi-post solution induces a significant reduction of stress levels into the residual dentin (and therefore the root-fracture-risk decreases) as well as of the expected polymerization shrinkage effects. Moreover, interfacial stress values in multi-post restorations can be higher than the single-PCP ones when carbon-fibre posts are considered. Nevertheless, the interfacial adhesive/cohesive failure-risk is certainly acceptable if glass-fibre posts are employed.
Chieruzzi, Manila; Rallini, Marco; Pagano, Stefano; Eramo, Stefano; D'Errico, Potito; Torre, Luigi; Kenny, José M
The aim of this study was to investigate the mechanical behavior of a dental system built up with fiber-reinforced composite (FRC) endodontic posts with different types of fibers and two cements (the first one used with a primer, the second one without it). Six FRC posts were used. Each system was characterized in terms of structural efficiency under external applied loads similar to masticatory forces. An oblique force was applied and stiffness and maximum load data were obtained. The same test was used for the dentine. The systems were analyzed by scanning electron microscope (SEM) to investigate the surface of the post and inner surface of root canal after failure. The mechanical tests showed that load values in dental systems depend on the post material and used cement. The highest load (281 ± 59 N) was observed for the conical glass fiber posts in the cement without primer. There was a 50 and 85% increase in the maximum load for two of the conical posts with glass fibers and a 229% increase for the carbon fiber posts in the cement without primer as compared with the cement with primer. Moreover, almost all the studied systems showed fracture resistances higher than the typical masticatory loads. The microscopic analysis underlined the good adhesion of the second cement at the interfaces between dentine and post. The mechanical tests confirmed that the strength of the dental systems subjected to masticatory loads was strictly related to the bond at the interface post/cement and cement/dentine.
Maria, Rahul; Punga, Rohit
Aims: This in vitro study evaluated: a) the retention of stainless steel posts of 1.5 mm diameter which were cemented with Zinc Phosphate cement versus Glass fiber posts with 1.1 mm, 1.3 mm and 1.5 mm diameters which were cemented with resin cement and b) the effect of change in diameter on the retention of Glass fiber posts with 1.1 mm, 1.3 mm and 1.5 mm diameters. Materials and Methods: Sixty extracted mandibular premolar teeth were endodontically treated and randomly assigned to four groups of fifteen teeth each. In Groups I, II and III glass fibre posts with diameters 1.1 mm, 1.3 mm and 1.5 mm were cemented by using resin cement. In Group IV, stainless steel posts with diameter 1.5 mm were cemented by using zinc phosphate cement. The specimens were tested for tensile loading at a cross head speed of 2.0 mm/min, on a universal testing machine. Statistical Analysis Used: One way analysis of variance and Tukey’s (post-hoc) test. Results: Mean tensile strength from highest to lowest was in the order of Group IV, Group II, Group III, Group I. Statistically significant differences were observed between the mean tensile strengths between Groups I and II, Groups I and III, Groups I and IV, Groups II and IV, Groups III and IV, while non significant differences were observed between Groups II and III. Conclusion: Stainless steel posts were more retentive than glass fibre posts. Glass fibre posts with 1.3 mm or 1.5 mm diameters provided significantly greater retention as compared to 1.1 mm diameter posts. PMID:24959506
Rosalem, Cíntia Gonçalves Carvalho; Mattos, Claudia Machado de Almeida; Guerra, Selva Maria Gonçalves
Introduction: A significant number of endodontically treated teeth restored with posts have associated periapical lesions, and several authors have discussed the probable causes of the development of these. Attention has been focused on restorative procedures performed after endodontic treatment and their association with the prognosis of endodontic therapy because a number of root-filled teeth will require post- and core-retained restorations. Purpose: The purpose of this study was to evaluate, by examination of periapical radiographs, whether the placement of intra-radicular posts in endodontically treated teeth may act as a risk factor for development of periapical lesions. Material and Methods: This case-control study analyzed periapical radiographs of 72 endodontically treated teeth with coronal restorations. All radiographs were obtained from a single private practice. Specimens were assigned to 2 groups: Group 1 (control) was composed of teeth without periapical lesions and Group 2 (case) was composed of teeth with periapical lesions. The number of teeth with and without posts in each group was recorded. Three calibrated examiners analyzed the radiographs visually under X4 magnification. Results: In Group 1, 28 (65.1%) out of 43 teeth were restored with posts. In Group 2, 24 (82.8%) out of 29 teeth had intra-radicular posts. The interpretation of chi-square test showed that these percentages were not significantly different (x2=2.687; p=0.101). Odds ratio was 2.571 (0.8158.118), which indicates that there was no statistically significant association between periapical lesions and posts. Conclusion: Intra-radicular posts placed in endodontically treated teeth were not a significant risk factor for development of periapical lesions in the practice where the cohort of patients was treated. PMID:19089134
Amarnath, G S; Swetha, M U; Muddugangadhar, B C; Sonika, Radhika; Garg, Ashu; Rao, T R Poonam
Background: Endodontically treated teeth with posts are more prone to fracture. Hence, the purpose of this study was to investigate the in-vitro fracture resistance of devitalized teeth and mode of failure restored with posts of different materials and different lengths. Materials and Methods: Sixty freshly extracted human mandibular premolars were endodontically treated and then restored with 1 of 2 prefabricated posts: Stainless-steel (SS) and glass-fiber (fiber posts [FP]) with intraradicular lengths of 4, 5 or 10 mm (n = 10). Following core restoration, a static compressive load was applied perpendicular to the long-axis of the teeth. Initial failure of each specimen was recorded in Newton. The mode of failure was also determined radiographically. The data were analyzed using two-way ANOVA and Tukey's post-hoc analysis with Bonferroni adjustment. Results: Analysis indicated significant differences (P < 0.001) among the groups. Among the SS posts, SS/7 (246 N) exhibited the highest failure load and SS/4 (122 N) the lowest. FP/10 (140.5 N) exhibited the highest failure load among the FP and FP/4 (68.5 N) the lowest. SS posts showed post pull out, followed by core fracture while FP showed core debonding, followed by core fracture as the primary mode of failure. Conclusion: Fracture resistance of the teeth proportionately increased with increase in the length of FP while it decreased with that of metal post. SS posts showed greater fracture resistance than FP when 90° load was applied. PMID:26229366
De Ataide, Ida De Noronha; Fernandes, Marina; Lambor, Rajan; Alreja, Dalip
This case report describes a novel technique of restoring endodontically treated teeth. Hidden caries causing irreversible pulpitis in a mandibular molar with Radix Entomolaris (RE) was evident. The intact occlusal surface anatomy was duplicated before preparing an access cavity to replicate the original occlusal surface in the post endodontic restoration using (Computer-Aided Design and Computer-Aided Manufacturing) CAD/CAM technique. This report highlights uniquely designed onlay utilizing the benefits of contemporary materials and advanced technology. PMID:28050515
Luthria, Archana; Srirekha, A; Hegde, Jayshree; Karale, Rupali; Tyagi, Sanjana; Bhaskaran, Sajeev
Aim: The aim of this study was to evaluate the fracture resistance of endodontically treated maxillary premolars with wide mesio-occluso-distal (MOD) cavities restored with either composite resin, or composite resin reinforced with different types of fibres. Materials and Methods: Fifty human maxillary premolars were selected. Five intact teeth served as positive controls. Endodontic therapy was carried out in the remaining forty-five teeth. Standardized MOD cavities were prepared in all the teeth. The teeth were restored with a nanocomposite using an incremental technique. These forty five teeth were randomly divided into three experimental groups (Group A, B and C) (n = 15). The teeth in Group A did not undergo any further procedures. The teeth in Group B and C were reinforced with composite impregnated glass fibre and polyethylene fibre, respectively. Fracture resistance was measured in Newtons (N). Results: The positive controls showed the highest mean fracture resistance (811.90 N), followed by Group B (600.49N), Group A (516.96N) and Group C (514.64N), respectively. One Way analysis of variance (ANOVA) test revealed a statistically significant difference between all the groups (P = 0.001). Post-hoc Tukey test revealed a moderately significant difference (P = 0.034) between Control and Group B, and a strongly significant difference between Control and Group A (P = 0.002), and Control and Group C (P = 0.001). Conclusions: Endodontic therapy and MOD cavity preparation significantly reduced the fracture resistance of endodontically treated maxillary premolars (P = 0.001). No statistically significant difference was found between the experimental groups (Group A, B and C) (P > 0.1). However, the fracture resistance of the composite impregnated glass fibre reinforced group was much higher than the others. PMID:23112487
Atbaei, Adnan; Mortazavi, Nazanin
The purpose of this prospective research was to evaluate the post-endodontic pain-reducing effect of piroxicam (feldene), a non-selective non-steroidal anti-inflammatory drug. Pain following endodontic treatment is often linked to the inflammatory process as well as additional central mechanisms. The effects of intraligamentary injection of piroxicam have not previously been studied. Sixty-five patients with irreversible pulpitis were randomly divided into two groups. The active group received intraligamentary injections totalling 0.4 mL of piroxicam, while the placebo group received the same amount of lidocaine. One-appointment endodontic therapy was performed by a single endodontist. Visual Analogue Scale was used to record pain before treatment and 4, 8, 12, 24 and 48 h postoperatively. The decrease in the intensity of post-treatment pain between the two groups was very significant. Intraligamentary injection of piroxicam can be considered an effective method for reducing post-endodontic pain.
Braga, Neilor Mateus Antunes; Paulino, Silvana Maria; Alfredo, Edson; Sousa-Neto, Manoel Damião; Vansan, Luiz Pascoal
This study evaluated the strength required to remove glass-fiber and metallic cast posts with different lengths. Sixty endodontically treated canines were included and their roots were embedded in acrylic resin after discarding the crowns. Samples were randomly assigned to 3 groups according to the post length (n = 20): I- 6 mm, II - 8 mm and III- 10 mm. Each group was divided into 2 subgroups based on the post material (n = 10): A- glass fiber or B- metallic cast. Post-space was prepared with Fibrekor Post Kit attached to a parallelometer. In subgroup A, prefabricated glass fiber posts from Fibrekor Post Kit were utilized. In metallic post group (subgroup B), an impression of post space was obtained, followed by casting. All posts were luted with Panavia F cement. A universal testing machine determined the force required to dislodge each post. ANOVA analysis indicated significant differences (P < 0.01) among post length. Tukey test showed that posts with 10 mm-length showed higher resistance on removal than posts with 6 mm-length. Posts with 8 mm-length did not exhibit difference when compared to 6 and 10 mm posts. No significant differences (P > 0.05) were observed between the tested post materials. It was concluded that the type of post did not influence the removal resistance and that posts with 10 mm-length required greater force to be dislodged.
Comparative Evaluation of the Reinforcing Effect of Different Post Systems in the Restoration of Endodontically Treated Human Anterior Teeth at Two Different Lengths of Post Space Preparation- An in Vitro Study
Jindal, Sahil; Jindal, Ritu; Gupta, Kanika; Mahajan, Sandeep; Garg, Sunidhi
Objectives: Comparative evaluation of the reinforcing effect of different post systems in the restoration of endodontically treated human anterior teeth at two different lengths of post space preparation- an in vitro study Materials and Methods: 135 extracted human incisors were endodontically treated, out of which 120 teeth were decoronated 2mm above the cementoenamel junction and divided into four experimental groups based on the post system to be used: Glass fiber post (GFP) and stainless steel post (SSP), titanium post (TTP), cast metal post (CMP). Each group was divided into two sub-groups according to the length of post space preparation: 5mm and 10mm. All the samples were restored with metal crowns. The fracture resistance was measured by applying loads at an angle of 135º to the long axis of teeth in an instron universal testing machine. Fracture mode was analyzed for all the samples. Results from the four test groups were compared and analysed using one-way ANOVA test and the Post-hoc Bonferroni test to demonstrate differences between pairs of groups. Results: The results revealed that SSP group at 10mm post space length showed the significantly (“P-value< 0.05”) highest fracture resistance (793.7787 N). Decrease in post length resulted in the decrease in fracture resistance in all the groups reduced to values even lesser than the control (437.8733N). Conclusion: The different post systems used in the study were able to reinforce endodontically treated teeth only at 10mm post space length. PMID:23724211
Post-treatment apical periodontitis may persist due to biological factors as outlined by Nair or when treatment procedures have been ineffective in eliminating the intraradicular infection. This case series reports on the management of five posterior teeth restored with posts where microsurgical techniques were employed utilising the operating microscope, ultrasonics, micro-instrumentation and mineral trioxide aggregate as a root-end filling material. Healing was evident at 12-month review appointments. Microsurgical techniques have significantly improved the outcomes for healing of periapical lesions when compared to traditional approaches to endodontic surgery. Success rates have been shown to be comparable with conventional orthograde treatment.
Diaz-Arnold, A M; Wilcox, L R
A glass ionomer material was evaluated for coronal microleakage in permanent lingual access restorations of endodontically treated anterior teeth. The material was tested as a restoration, placed over a zinc oxide-eugenol base, and as a base with an acid-etched composite resin veneer and a dentinal bonding agent. Restored teeth were thermocycled, immersed in silver nitrate, developed, and sectioned to assess microleakage. Significant coronal leakage was observed with all materials used.
Chieruzzi, Manila; Pagano, Stefano; Cianetti, Stefano; Lombardo, Guido; Kenny, José M; Torre, Luigi
The aim of this work was to evaluate the stress distribution inside endodontically treated teeth restored with different posts (glass fibre, carbon fibre and steel posts) under different loading conditions by using a 3D-finite element analysis. The effect of masticatory and impact forces on teeth with different degrees of bone loss was analysed. The model consists of: dentine, post, cement, gutta-percha, core and crown. Four simulations were conducted with two static forces (170N horizontal and 100N oblique) and two sections constrained: 1mm (alveolar bone position in a normal periodontium) and 6mm (middle of root) below the crown. Von Mises and the principal stresses were evaluated and analysed with a 3-way ANOVA and Tukey test (α=0.05) and the effect of fibre percentage analysed. Significant differences were found among the stress values for all conditions (p<0.05). Impact load was always responsible for the most critical situation especially when the bone loss was more evident. The system with steel posts showed the highest principal stresses at the post-cement interface with horizontal load and top constraints (compressive stress of 121MPa and tensile stress of 115MPa). The use of glass posts provides a more homogeneous behaviour of the system with lower stresses. Higher fibre percentages gave higher stress in the posts. Moreover, larger bone losses are responsible for important increase in stress. Thus, this work demonstrated that periodontal disease has an important role in the success of tooth restoration after endodontic therapy, influencing the choice of post material and depth.
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
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.
SHERFUDHIN, Haneef; HOBEICH, Joseph; CARVALHO, Carlos Augusto; N. ABOUSHELIB, Moustafa; SADIG, Walid; SALAMEH, Ziad
Objective This study investigated the effect of different ferrule heights on endodontically treated premolars. Materials and Methods Fifty sound mandibular first premolars were endodontically treated and then restored with 7-mm fiber post (FRC Postec Plus #1 Ivoclar-Vivadent) luted with self-polymerized resin cement (Multilink, Ivoclar Vivadent) while the coronal section was restored with hybrid composite core build-up material (Tetric Ceram, Ivoclar-Vivadent), which received all-ceramic crown. Different ferrule heights were investigated: 1-mm circumferential ferrule without post and core (group 1 used as control), a circumferential 1-mm ferrule (group 2), non-uniform ferrule 2-mm buccally and 1-mm lingually (group 3), non-uniform ferrule 3-mm buccally and 2-mm lingually (group 4), and finally no ferrule preparation (group 5). The fracture load and failure pattern of the tested groups were investigated by applying axial load to the ceramic crowns (n=10). Data were analyzed statistically by one-way ANOVA and Tukey’s post-hoc test was used for pair-wise comparisons (α=0.05). Results There were no significant differences among the failure load of all tested groups (P<0.780). The control group had the lowest fracture resistance (891.43±202.22 N) and the highest catastrophic failure rate (P<0.05). Compared to the control group, the use of fiber post reduced the percentage of catastrophic failure while increasing the ferrule height did not influence the fracture resistance of the restored specimens. Conclusions Within the limitations of this study, increasing the ferrule length did not influence the fracture resistance of endodontically treated teeth restored with glass ceramic crowns. Insertion of a fiber post could reduce the percentage of catastrophic failure of these restorations under function. PMID:21437466
Chen, Aijie; Feng, Xiaoli; Zhang, Yanli; Liu, Ruoyu; Shao, Longquan
To investigate the stress distribution in a maxillary canine restored with each of four different post systems at different levels of alveolar bone loss. Two-dimensional finite element analysis (FEA) was performed by modeling a severely damaged canine with four different post systems: CAD/CAM zirconia, CAD/CAM glass fiber, cast titanium, and cast gold. A force of 100 N was applied to the crown, and the von Mises stresses were obtained. FEA revealed that the CAD/CAM zirconia post system produced the lowest maximum von Mises stress in the dentin layer at 115.8 MPa, while the CAD/CAM glass fiber post produced the highest stress in the dentin at 518.2 MPa. For a severely damaged anterior tooth, a zirconia post system is the best choice while a cast gold post ranks second. The CAD/CAM glass fiber post is least recommended in terms of stress level in the dentin.
Alkumru, Hasan Necdet; Akalin, Buket
PURPOSE The aim of this study was to determine the fracture resistance and the mode of fracture of endodontically treated teeth restored with different fiber posts and all-ceramic crowns. MATERIALS AND METHODS Two glass fiber reinforced post systems in two different sizes and polyethylene fiber ribbon in two different thicknesses (n=10) were used. The specimens, restored with all-ceramic crowns, were subjected to a compressive load (in N) delivered at a 130-degree angle to the long axis until a fracture could be noted. The results were analyzed statistically with a One-Way ANOVA test (P<.05). RESULTS Statistically significant differences were observed between the mean fracture resistance values of Postec, Snowlight, and Kerr Connect thin specimens (P<.0095). The Postec results (395.70 N) were found to be significantly higher than the others. No statistical difference was observed among the thick specimens (P<.2657). The mean fracture resistance values of the Snowlight thick samples were found to be higher than those of the Snowlight thin samples. The specimens were always fractured around the cemento-enamel junction at the palatinal side. No post fracture was observed for the thin Snowlight and Kerr Connect specimens or for the thick Postec and Kerr Connect specimens. Among the common failure types of the specimens, the worst was observed to be the root fracture failure. The highest post dislodgement failure result (80%) was obtained from the thin Kerr Connect specimen. CONCLUSION In terms of optimizing fracture resistance, the fiber post size selection should be done according to the forces applied to the restored teeth. PMID:27141261
Skupien, Jovito Adiel; Sarkis-Onofre, Rafael; Cenci, Maximiliano Sérgio; Moraes, Rafael Ratto de; Pereira-Cenci, Tatiana
This study aimed to identify factors that can affect the retention of glass fiber posts to intra-radicular dentin based on in vitro studies that compared the bond strength (BS) of GFPs cemented with resin cements. Searches were carried out in PubMed and Scopus until December 2013. Bond strength values and variables as type of tooth, presence of endodontic treatment, pretreatment of the post, type of bonding agent (if present), type of cement and mode of cement application were extracted from the 34 included studies. A linear regression model was used to evaluate the influence of these parameters on BS. The presence of endodontic treatment decreased the BS values in 22.7% considering the pooled data (p = 0.013). For regular cement, cleaning the post increased BS when compared to silane application without cleaning (p = 0.032), considering cleaning as ethanol, air abrasion, or phosphoric acid application. Applying the cement around the post and into root canal decreased the resistance compared to only around the post (p = 0.02) or only into root canal (p = 0.041), on the other hand, no difference was found for self-adhesive resin cement for the same comparisons (p = 0.858 and p = 0.067). Endodontic treatment, method of cement application, and post pretreatment are factors that might significantly affect the retention of glass-fiber posts into root canals mainly when cemented with regular resin cement. Self-adhesive resin cements were found to be less technique-sensitive to luting procedures as compared with regular resin cements.
Kashefinejad, Mohamad; Harandi, Azade; Bijani, Ali
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. PMID:27536323
Manju, M.; Shanthraj, Srinivas L.; Savitha, K. C.; Sethi, Ntasha
Trauma to the anterior teeth affects the esthetic and psychological well-being of the patient. Advancement in the adhesive dentistry has facilitated the restoration of the coronal tooth fractures by minimally invasive procedures when the original tooth fragment is available. Reattachment of fractured fragment offers immediate treatment with improved preponderant aesthetics and restoration of function. Here, we describe a case of complicated fracture of the maxillary left immature permanent central incisor, which was treated endodontically followed by esthetic reattachment of the fractured fragment using the glass fiber post. Functional demands and esthetic considerations of the patient were fully met with this biologic mode of fragment reattachment. PMID:26283849
Alfredo, Edson; de Souza, Emanuel Soares; Marchesan, Melissa Andréia; Paulino, Silvana Maria; Gariba-Silva, Ricardo; Sousa-Neto, Manoel Damião
The present study evaluated, in vitro, the influence of an eugenol-based endodontic sealer (EndoFill) on the adhesion of intra-radicular posts cemented with a resin-based cement (Enforce) ou a zinc phosphate cement. Twenty-four single-rooted maxillary canines were divided into 2 groups (n=12) and obturated with either gutta-percha points plus EndoFill or gutta-percha points alone (no cement). In each group, half of intracanal posts (n=6) were cemented with Enforce resin-based cement and half with zinc phosphate cement. Specimens were submitted to pull-out test in an Instron machine and tensile force was applied at a crosshead speed of 0.5 mm/min until post dislodgement. The maximum forces required for post removal was recorded (N) and means were submitted to statistical analysis by Kruskal-Wallis test (p<0.01). Posts cemented with zinc phosphate cement were significantly more retentive (353.4 N) than those cemented with Enforce (134.9 N) (p<0.01). Regarding the influence of the eugenol-based cement (EndoFill) on post retention, there was statistically significant difference (p<0.01) only between the groups cemented with Enforce, i.e., in the canals filled with EndoFill + guta-percha there was lower bond strength than in the canals filled with gutta-percha points alone (101.5 and 168.2 N, respectively). In conclusion, the zinc-phosphate-based cement showed greater post retention than the resin-based cement. The findings of this study suggest that the eugenol-containing sealer interfered with the adhesive properties of the resin-based cement.
Bosso, Kátia; Gonini Júnior, Alcides; Guiraldo, Ricardo Danil; Berger, Sandrine Bittencourt; Lopes, Murilo Baena
Endodontic posts are necessary to provide adequate retention and support when no sufficient remaining structure is available to retain the core. There are different materials and techniques to construct post-and-core, but there is no consensus about which one promotes better stress distribution on the remaining tooth structure. This study aimed to quantify and evaluate the distribution of stress in the root produced by customized glass fiber posts compared to different endodontic posts. Twenty-five simulated roots from photoelastic resin were made and divided into 5 groups: CPC, cast post-and-core; SP, screw post; CF, carbon fiber post; GF, glass fiber post; and CGF, customized glass fiber post. After cementing CPC and SP posts with zinc phosphate cement, and CF, GF and CGF posts with resin cement, resin cores were made for groups 2-5. Specimens were evaluated with vertical or 45° oblique loading. To analyze the fringes, the root was divided into 6 parts: palatal cervical, palatal middle, palatal apical, vestibular cervical, vestibular middle, and vestibular apical. The formed fringes were photographed and quantified. Data were recorded and subjected to two-way ANOVA and Tukey's test (5%). SP (1.95±0.60) showed higher stress (p<0.05) compared to the others (CPC-0.52±0.74; CF-0.50±0.75, GF-0.23±0.48 and CGF-0.45±0.83). All posts showed high stress in apical third (CPC-1.40±0.65; SP-2.30±0.44, CF-1.80±0.45, GF-1.20±0.45, CGF-1.70±1.03) Low stress was found in cervical third (CPC-0.20±0.45; CF-0.00±0.00, GF-0.00±0.00, CGF-0.00±0.00), except by SP (1.90±0.65), which showed statistical difference (p<0.05). Customized post showed high stress concentration at the root and conventional glass fiber posts showed more favorable biomechanical behavior.
Offutt Air Force Base, Looking Glass Airborne Command Post, Hydraulic Fluid Buildings, Northeast of Looking Glass Avenue at southwest side of Project Looking Glass Historic District, Bellevue, Sarpy County, NE
Anjaneyulu, K.; Nivedhitha, Malli Sureshbabu
Introduction: Pain of endodontic origin has been a major concern to the patients and the clinicians for many years. Post-operative pain is associated with inflammation in the periradicular tissues caused by irritants egressing from root canal during treatment. It has been suggested that calcium hydroxide intra-canal medicament has pain-preventive properties because of its anti-microbial or tissue altering effects. Some dispute this and reasoned that calcium hydroxide may initiate or increase pain by inducing or increasing inflammation. Objective: To evaluate the effectiveness of calcium hydroxide in reducing the post-treatment pain when used as an intra-canal medicament Materials and Methods: The following databases were searched: PubMed CENTRAL (until July 2013), MEDLINE, and Cochrane Database of Systematic Reviews. Bibliographies of clinical studies and reviews identified in the electronic search were analyzed for studies published outside the electronically searched journals. The primary outcome measure was to evaluate the post-treatment pain reduction when calcium hydroxide is used as an intra-canal medicament in patients undergoing root canal therapy. Results: The reviews found some clinical evidence that calcium hydroxide is not very effective in reducing post-treatment pain when it is used alone, but its effectiveness can be increased when used in combination with other medicaments like chlorhexidine and camphorated monochlorophenol (CMCP). Conclusion: Even though calcium hydroxide is one of the most widely used intra-canal medicament due to its anti-microbial properties, there is no clear evidence of its effect on the post-treatment pain after the chemo-mechanical root canal preparation. PMID:24944439
de OLIVEIRA, Simone Gomes dias; GOMES, Denise Jornada; COSTA, Marcelo Hissé das Neves; de SOUSA, Ezilmara Rolim; LUND, Rafael Guerra
Objective The aim of this study was to investigate the coronal microleakage of endodontically treated teeth prepared to receive an intracanal post and teeth with an intracanal post but without a prosthetic crown and exposed to contamination by fresh human saliva. Material and Methods A mechanical-chemical preparation following the step-back technique was carried out in 35 extracted single-rooted human teeth. The teeth were randomly divided into five groups: G1=root canals instrumented, obturated, and prepared to receive an intracanal post (N=10); G2=root canals with cemented posts but without coronal sealing (N=10); PC1=positive control root canals instrumented and open (N=5); PC2=positive control 2 root canals without instrumentation and open (N=5); and NC=negative control healthy teeth (N=5). The crowns were removed except for the control group of intact teeth. The root canals were obturated and sterilized with cobalt 60 gamma irradiation and were then adapted in an apparatus using a Brain Heart Infusion (BHI) medium and fresh human saliva for contamination. Microbial growth was indicated by the presence of turbidity in the BHI liquid medium. Results Data were submitted to the Kaplan-Meier Survival Analysis and the Holm-Sidak statistic method, which observed an index of 90% of microleakage in root canals after 24 hours for G1 and 70% of microleakage in samples at the end of 40 days for G2. Conclusion The results show that root canals with an intracanal post but without a prosthetic crown can be recontaminated when exposed to fresh human saliva in a short period. PMID:24212985
Juloski, J.; Fadda, G.M.; Monticelli, F.; Fajó-Pascual, M.; Goracci, C.; Ferrari, M.
The objective of this prospective clinical trial was to investigate the influence of the residual coronal structure of endodontically treated teeth and the type of cement used for luting fiber posts on four-year clinical survival. Two groups (n = 60) were defined, depending on the amount of residual coronal dentin after abutment build-up and final preparation: (1) more than 50% of coronal residual structure; and (2) equal to or less than 50% of coronal residual structure. Within each group, teeth were randomly divided into 2 subgroups (n = 30) according to the material used for luting fiber posts: (A) resin core build-up material, Gradia Core; or (B) self-adhesive universal cement GCem Automix. The rate of success was assessed based on clinical and intra-oral radiographic examinations at the follow-up after 6, 12, 24, 36, and 48 months. The highest 48-month success and survival rates were recorded in group 1A (90% and 100%, respectively), whereas teeth in group 2B exhibited the lowest performance (63.3% success rate, 86.6% survival rate). Cox regression analysis revealed that neither the amount of coronal residual structure nor the luting material significantly influenced the failure risk (p > .05) (ClinicalTrials.gov, NCT01532947). PMID:24646637
González-Lluch, Carmen; Pérez-González, Antonio; Sancho-Bru, Joaquín L; Rodríguez-Cervantes, Pablo-Jesús
Many studies have investigated the effect of different parameters of the endodontically restored tooth on its final strength, using in vitro tests and model simulations. However, the differences in the experimental set-up or modelling conditions and the limited number of parameters studied in each case prevent us from obtaining clear conclusions about the relative importance of each parameter. In this study, a validated 3D biomechanical model of the restored tooth was used for an exhaustive sensitivity analysis. The individual influence of 20 different parameters on the mechanical performance of an endodontic restoration with prefabricated posts was studied. The results bring up the remarkable importance of the loading angle on the final restoration strength. Flexural loads are more critical than compressive or tensile loads. Young's modulus of the post and its length and diameter are the most influential parameters for strength, whereas other parameters such as ferrule geometry or core and crown characteristics are less significant.
Jeaidi, Zaid Al
Objectives: To assess the fracture resistance of endodontically treated teeth with a novel Zirconia (Zr) nano-particle filler containing bulk fill resin composite. Methods: Forty-five freshly extracted maxillary central incisors were endodontically treated using conventional step back preparation and warm lateral condensation filling. Post space preparation was performed using drills compatible for fiber posts (Rely X Fiber Post) on all teeth (n=45), and posts were cemented using self etch resin cement (Rely X Unicem). Samples were equally divided into three groups (n=15) based on the type of core materials, ZirconCore (ZC) MulticCore Flow (MC) and Luxacore Dual (LC). All specimens were mounted in acrylic resin and loads were applied (Universal testing machine) at 130° to the long axis of teeth, at a crosshead speed of 0.5 mm/min until failure. The loads and the site at which the failures occurred were recorded. Data obtained was tabulated and analyzed using a statistical program. The means and standard deviations were compared using ANOVA and Multiple comparisons test. Results: The lowest and highest failure loads were shown by groups LC (18.741±3.02) and MC (25.16±3.30) respectively. Group LC (18.741±3.02) showed significantly lower failure loads compared to groups ZC (23.02±4.21) and MC (25.16±3.30) (p<0.01). However groups ZC (23.02±4.21) and MC (25.16±3.30) showed comparable failure loads (p=0.23). Conclusions: Fracture resistance of endodontically treated teeth restored with Zr filler containing bulk fill composite cores was comparable to teeth restored with conventional Zr free bulk fill composites. Zr filled bulk fill composites are recommended for restoration of endodontically treated teeth as they show comparable fracture resistance to conventional composite materials with less catastrophic failures. PMID:28083048
Mosharraf, Ramin; Zare, Sepideh
Objectives: An important factor that interferes with the bonding between the root canal wall and resin cement is the root canal sealer remnant. There is controversy about the effect of eugenol-containing sealers on the bond strength between resin cements and fiber post. The aim of this study was to evaluate the effect of the type of endodontic sealer on the bond strength of FRC posts cemented with resin cement to the root canal wall. Materials and Methods: In this in vitro study, 20 extracted mandibular first premolars were endodontically treated and divided into two groups according to the endodontic sealer used (n=10): G1: AH26 (Resin based); and G2: Endofill (Eugenol-based). After preparing post space, adhesive resin cement (Panavia F 2.0) was used for cementation of the fiber post to the root canal dentin. Three 3 mm thick slices were obtained from each root. The push-out test was performed with a cross-head speed of 1 mm/minute. Two-way ANOVA and Tukey post hoc tests were used for analyzing data (α=0.05). Results: The two-way ANOVA showed that different root canal sealers (P=0.037) had significant effects on bond strength (BS), but root canal regions (P=0.811) and interaction between root canal sealers and root canal regions (P=0.258) had no significant effects on BS. Maximum and minimum mean values were observed in the AH26 group, the apical region and the Endofill group in the apical region, respectively. Post Hoc Tukey test revealed that there were no significant differences between different root canal regions in both cements (P>0.05). Conclusion: The region of root canal had no effect on the bond strength of cemented fiber posts to the root canal. Eugenol-based sealers (Endofill) significantly reduced the bond strength between fiber posts luted with resin cement to the root canal. PMID:25584058
Singh, S. Vijay; Bhat, Manohar; Gupta, Saurabh; Sharma, Deepak; Satija, Harsha; Sharma, Sumeet
Objective: A three-dimensional (3D) finite element analysis (FEA) on the stress distribution of endodontically treated teeth with titanium alloy post and carbon fiber post with different alveolar bone height. Materials and Methods: The 3D model was fabricated using software to represent an endodontically treated mandibular second premolar with post and restored with a full ceramic crown restoration, which was then analyzed using FEA using FEA ANSYS Workbench V13.0 (ANSYS Inc., Canonsburg, Pennsylvania, U.S.A) software. Results: The FEA showed the maximum stresses of 137.43 Mpa in dentin with alveolar bone height of 4 mm when the titanium post was used, 138.48 Mpa when carbon fiber post was used as compared to 105.91 Mpa in the model with alveolar bone height of 2 mm from the cement enamel junction (CEJ) when the titanium post was used and 107.37 Mpa when the carbon fiber post was used. Conclusions: Stress was observed more in alveolar bone height level of 4 mm from CEJ than 2 mm from CEJ. Stresses in the dentin were almost similar when the carbon fiber post was compared to titanium post. However, stresses in the post and the cement were much higher when titanium post was used as compared to carbon fiber post. PMID:26430375
RIPPE, Marília Pivetta; SANTINI, Manuela Favarin; BIER, Carlos Alexandre Souza; BALDISSARA, Paolo; VALANDRO, Luiz Felipe
Objective To evaluate the impact of the type of root canal preparation, intraradicular post and mechanical cycling on the fracture strength of roots. Material and Methods eighty human single rooted teeth were divided into 8 groups according to the instruments used for root canal preparation (manual or rotary instruments), the type of intraradicular post (fiber posts- FRC and cast post and core- CPC) and the use of mechanical cycling (MC) as follows: Manual and FRC; Manual, FRC and MC; Manual and CPC; Manual, CPC and MC; Rotary and FRC; Rotary, FRC and MC; Rotary and CPC; Rotary, CPC and MC. The filling was performed by lateral compactation. All root canals were prepared for a post with a 10 mm length, using the custom #2 bur of the glass fiber post system. For mechanical cycling, the protocol was applied as follows: an angle of incidence of 45°, 37°C, 88 N, 4 Hz, 2 million pulses. All groups were submitted to fracture strength test in a 45° device with 1 mm/ min cross-head speed until failure occurred. Results The 3-way ANOVA showed that the root canal preparation strategy (p<0.03) and post type (p<0.0001) affected the fracture strength results, while mechanical cycling (p=0.29) did not. Conclusion The root canal preparation strategy only influenced the root fracture strength when restoring with a fiber post and mechanical cycling, so it does not seem to be an important factor in this scenario. PMID:25025556
Zare Jahromi, Maryam; Barekatain, Mehrdad; Ravanbod, Shirin; Ranjbarian, Parisa; Kousehlar, Sara
Statement of the Problem: Endodontic irrigants and medicaments may affect the bond strength of intracanal posts to root dentin. Purpose: The aim of this study was to compare the effect of calcium hydroxide (Ca(OH)2) and 2% chlorhexidine gel (CHX) on bond strength of fiber post cemented with resin cement to root dentin. Materials and Method: This in vitro experimental study was conducted on 36 mandibular premolars. Canals were prepared using the step back technique. After root canal irrigation, the teeth were divided into three groups of 12. Ca(OH)2 paste and CHX gel were used as intracanal medicaments in the first and second groups respectively. No intracanal medicament was used in the third group (control group). Access cavities were then sealed and the teeth were incubated for one week. The root canals were then filled using gutta percha and AH26 sealer and the teeth were incubated for 72 hours. Tooth crowns were then cut at the level of the cementoenamel junction and intracanal posts were placed. The teeth were mounted in auto-polymerizing acrylic resin, and incubated for one week .They were then sectioned into 1.5mm thick slices from their coronal surface using a fully automated cutting machine, and subjected to push-out test until failure. The load at debonding was recorded and data were analyzed using one-way ANOVA, post-hoc test and t-test. The coronal margin of the root was at the level of the surface of acrylic resin in the mold. Results: The mean bond strength was 4.45 MPa in the Ca(OH)2, 2.45 MPa in the CHX and 2.48 MPa in the control group. The difference in this regard was statistically significant among groups (p= 0.04). The Ca(OH)2 group had significant differences with the CHX and control groups (p= 0.03 and p= 0.02, respectively). The difference between the CHX and control groups was not significant (p= 0.974). Conclusion: Based on the results, Ca(OH)2 increased the bond strength of fiber post to root dentin but 2% CHX had no effect on bond
Offutt Air Force Base, Looking Glass Airborne Command Post, Vehicle Refueling Station, Northeast of AGE Storage Facility at far northwest end of Project Looking Glass Historic District, Bellevue, Sarpy County, NE
Crispim da Silveira, Olimpia; Bras da Silva, Rodivan; Dametto, Fabio Roberto; Machado, Claudia Tavares; Souza dos Santos, Alex Jose
Purpose To evaluate the effect of different endodontic irrigating solutions on the micro push-out bond strength of a fiber glass dowel. Material and Methods Seventy 16-mm long root segments of bovine incisors were prepared and randomly assigned to 7 groups (n=10) according to the type of irrigating solution used prior to the cementation of the intra-radicular fiber glass dowels: G1: 5.25% NaOCl + 17% EDTA; G2: 5.25% NaOCl; G3: 17% EDTA; G4: 2% chlorhexidine gel; G5: 70% alcohol; G6: 11.5% polyacrylic acid; and G7: saline (control). After treatment of intracanal dentin, the glass fibre dowels were cemented with self-adhesive resin cement (RelyX Unicem). Six slices with the thickness of 1.00 ± 0.05 mm were obtained from each tooth at the coronal, middle and apical root thirds (2 slices per third) using a low-speed saw. Micro push-out tests were performed at a crosshead speed of 0.5mm/min and the data (MPa) were analyzed statistically by ANOVA and Tukey’s and Dunnett’s tests. Results There were statistically significant differences (p<0.0001) among the irrigating solutions, but no significant difference (p=0.0591) was found among the root thirds. G5 presented the highest bond strength mean of all groups (p<0.0001). The use of 70% alcohol increased the adhesion values by 53% compared to the group control. Conclusion The use of 70% alcohol increased the bond strength of the fiber glass dowel to the dentin walls. However, the push-out bond strength between the dowel and the root dentin was not affected by the root third (coronal, middle and apical). PMID:27688347
Migliau, Guido; Piccoli, Luca; Besharat, Laith Konstantinos; Di Carlo, Stefano; Pompa, Giorgio
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
Verma, Leena; Passi, Sidhi
Aesthetic requirement of severely mutilated primary anterior teeth in the case of early childhood caries has been a challenge to pediatric dentist. Among restorative treatment options, prefabricated crown and biological and resin composite restoration either by means of direct or indirect technique are mentioned in the literature. This paper presents the clinical sequence of rehabilitation of maxillary anterior primary teeth. Endodontic treatment was followed by the placement of a glass fibre-reinforced composite resin post. The crown reconstruction was done with composite restoration. Resin glass fibre post has best properties in elasticity, translucency, adaptability, tenaciousness, and resistance to traction and to impact. Along with ease of application, fiber can be used as an alternative to traditionally used materials in the management of early childhood caries. PMID:22567447
Gulve, Meenal Nitin; Gulve, Nitin Dilip
Background: Scuba diving is one of the fastest growing sports in the world. The objective of this study was to evaluate the effect of pressure variations to which divers are exposed on the pull out strength of glass fiber post luted with different cements. Materials and Methods: In this in vitro study, 120 extracted, single-rooted lower premolars were endodontically treated. They were randomly divided into six groups and restored using the glass fiber post (Ivoclar Vivadent AG) and the following luting agents: Zinc phosphate, conventional glass ionomer, resin reinforced glass ionomer, resin cement with etch-and-rinse adhesive, resin cement with self-etching adhesive, and self-adhesive resin cement. Each group was randomly divided into two equal subgroups, one as a control, and the other to be used experimentally. After 7 days of storage, experimental groups were pressure cycled. The force required to dislodge each post was recorded in Newton (N) on Universal testing machine (Star Testing System) at a crosshead speed of 1 mm/min. Data were statistically analyzed using the ANOVA and Student's t-test (P < 0.001). Results: The pull out strength of posts cemented with zinc phosphate and conventional glass ionomer in pressure cycle group was significantly less than their control group. Although, no significant difference was found between pressure cycle and control group using resin reinforced glass ionomer cement and resin cements. Conclusion: Dentist should consider using resin reinforced glass ionomer or resin cement, for the cementation of glass fiber post, for the patients such as divers, who are likely to be exposed to pressure cycling. PMID:24379861
Jafari Navimipour, Elmira; Ebrahimi Chaharom, Mohammad Esmaeel; Alizadeh Oskoee, Parnian; Mohammadi, Narmin; Bahari, Mahmoud; Firouzmandi, Maryam
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
Irodi, Sujatha; Mehta, Deepak; Subramanya, Shankar; Govindaraju, Vinay Kumar
Introduction The influence of the remaining coronal tooth structure along with intra-radicular esthetic posts increases fracture resistance of fractured teeth especially in the anterior region. The advent of resin based luting cements improves the adhesion of fiber posts. Aim To evaluate the fracture resistance of endodontically treated roots restored with fiber posts using different resin cements – Calibra (etch and rinse), PermaFlo® DC (self-etch primer) and SmartCem2 (self-adhesive). Materials and Methods Extracted human maxillary central incisors having similar dimensions were decoronated at the Cemento-Enamel Junction (CEJ) to create 16mm long specimens and endodontically treated. A total of 45 teeth were divided into three groups with 15 teeth each for cementation of easy fiber posts (size1, 0.8mm diameter). Post spaces were prepared to a depth of 10mm. Group 1 – Caulk 34% phosphoric acid gel, dual cure adhesive Prime and Bond NT followed by luting of post with Calibra cement. Group 2 – Ultra – etch then Primer A and Primer B, and PermaFlo® DC was used to cement the post. Group 3 – SmartCem2 [1:1 ratio] was used to cement the post. The excess lengths of posts were seared and teeth were mounted on acrylic blocks and loaded under compressive force to the long axis of the tooth which increased in periodic pattern of 1mm/min. The value of the force at which each root section gets fractured was noted. The data were statistically analysed using ANOVA and Tukey’s Test. Results The mean fracture load (and SD) were as follows Group 1 – 762.400 (251.490); Group 2 – 662.933 (206.709); Group 3 – 657.800 (57.372). No statistically significant differences were seen among all three Groups, p-value (0.228). Conclusion Posts cemented using self -adhesive resin cement SmartCem2 have highest fracture resistance and bonding efficacy of self-adhesive technique showed reliably better results but was comparable to total–etch and self–etch techniques. PMID
Ramazani, Mohsen; Hamidi, Mahmoud Reza; Moghaddamnia, Ali Akbar; Ramazani, Nahid; Zarenejad, Nafiseh
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
Marcos, Regina Maria Helen-Cot; Kinder, Gustavo Ross; Alfredo, Edson; Quaranta, Tarcisio; Correr, Gisele Maria; Cunha, Leonardo Fernandes da; Gonzaga, Carla Castiglia
The objective of the present study was to evaluate the influence of resin cement thickness on the bond strength of prefabricated and customized glass fiber posts after storage in distilled water. Thirty human uniradicular roots were treated endodontically. The roots were divided into 3 groups: THIN (thin cement layer) - post space preparation with #0.5 drill and cementation of #0.5 post; THICK (thick cement layer) - post space preparation with #1 drill and cementation of #0.5 post; and CUSTOM (customized cement layer) - post space preparation with #1 drill and cementation of a customized post (#0.5 glass fiber posts customized with resin composite). All posts were luted with self-adhesive resin cement. The push-out test was carried out after storage for 24 h and 90 days in distilled water at 37 °C. The data were analyzed with three-way ANOVA and Tukey's test (a=0.05). Bond strengths were significantly higher for CUSTOM (9.37 MPa), than for THIN (7.85 MPa) and THICK (7.07 MPa), which were statistically similar. Considering the thirds, the bond strength varied in the sequence: apical (7.13 MPa) < middle (8.22 MPa) = coronal (8.94 MPa). Bond strength for 24 h storage was significantly higher (8.80 MPa) than for 90-day storage (7.40 MPa). It may be concluded that the thickness of resin cement influenced the bond strength of glass fiber posts. The customized posts presented higher bond strength. Storage in water for 90 days affected negatively the values of bond strength, especially for thick cement layers in the apical third.
Solomon-Sathish, Emmanuel; Venkatalakshmi-Aparna, Potluri; Balagopal, Sunderasan
Background The purpose of this study was to relate the fracture resistance of endodontically treated teeth in relation to post geometry. Material and Methods Forty single rooted mandibular premolars were instrumented by step - back technique and obturated by lateral condensation. Forty teeth were randomly divided into four groups: Reforpost glass fiber X-ray®, RelyX®, Exacto conical® and Parapost Fiber Lux®. The post spaces were prepared using respective drills and luted. The core build up was done and metal crowns were luted. Fracture resistance was determined in universal testing machine. The statistical analysis was done using one way ANOVA and post hoc Tukey Kramer test. Results The teeth restored with Reforpost showed highest fracture resistance followed by Parapost and Exacto conical. The teeth restored with RelyX showed least fracture resistance. The teeth restored with Parapost had less unfavourable fracture followed by exacto conical. Conclusions Parallel design had less number of catastrophic failure and had better fracture resistance. Key words:Fracture resistance, glass fiber post, post geometry, stress. PMID:26855705
Grassi, Felice R.; Pappalettere, Carmine; Di Comite, Mariasevera; Corsalini, Massimo; Mori, Giorgio; Ballini, Andrea; Crincoli, Vito; Pettini, Francesco; Rapone, Biagio; Boccaccio, Antonio
Aims. To investigate how the interfacial shear strength of the dentin - post interface with and without defects changes for different combinations irrigant/sealer. Methods. In forty human decoronated and instrumented teeth, fibreglass posts were inserted. The obtained root segments were randomly assigned to four different groups according to the irrigant adopted and the cement used to seal the root canal. The root segments were processed for metyl-methacrylate embedding. Serial sections were obtained and submitted to histomorphometric analyses in order to observe any defect of adhesion at the dentin - post interface and to measure the defects' dimension. The serial sections were also submitted to micro-push-out test. The measured shear strength values were subjected to statistical analysis by one-way ANOVA. The values of bond strength determined for the defective samples were correlated with the dimension of the defects. Finite element models were built to interpret and corroborate the experimental findings. Results. ANOVA showed that the generic combination irrigant/sealer does not affect the interfacial shear strength values. The bond strength of the samples without defects was averagely twice as large as that of the defective samples. The defects occupying more than 12 % of the total transverse section area of the endodontic cement layer led to a reduction of the bond strength of about 70 %. The predictions of the finite element models were in agreement with the experimental results. Conclusion. Defects occupying less than 2 % of the total transverse section area of the cement layer were shown to be acceptable as they have rather negligible effects on the shear strength values. Technologies/protocols should be developed to minimize the number and the size of the defects. PMID:23055816
Hofmann, N; Just, N; Haller, B; Hugo, B; Klaiber, B
The purpose of the present study was to decide whether composite resin or conventional glass ionomer cement should be preferred as a base material in endodontically treated premolars. Twelve extracted human maxillary premolars were mounted in a universal testing machine at a 35 degrees angle. Cuspal stiffness was determined by applying a load of 75 N to the buccal cusp and recording the displacement of the cusp using inductive displacement transducers. In the same teeth, different cavity preparations and restorations were performed sequentially. Standard MOD cavities were enlarged to allow endodontic access. In addition, the cusps were undermined. Half of the teeth were restored to the level of the previous shallow cavities using conventional glass ionomer cement (Ketac Fil), in the rest of the teeth dentine bonding agent (Syntac) and composite resin (Tetric) were used instead. Finally, composite resin fillings (Tetric) were placed. All restorations were removed and the experiments were repeated twice. For each replication, the assignment of the base materials to the experimental groups was reversed, and ceramic inlays (Empress) were used as final restorations for the last replication. Improvement of cuspal stiffness achieved by conventional glass ionomer bases was very small, whereas composite resin bases increased cuspal stability by more than a factor of two. After placement of the final restorations, however, there was no longer a difference between teeth with different base materials. Nevertheless, composite resin bases might be preferred for two reasons. Firstly, deterioration of adhesive restorations will probably start at the cavosurface margins. The incidence of margin gaps, however, will not only compromise marginal seal but also the stabilizing effect of the restoration. In this situation, the resin base may still stabilize the tooth. Moreover, resin bases may reduce the risk of cusp fracture during the time between cavity preparation and the insertion
de Oliveira Moreira, Paulo E.; Pamplona, Lucianne S.; Nascimento, Gláucia C. R.; Esteves, Renata A.; Pessoa, Oscar F.; Silva, Cecy M.
Objective: We evaluated the effects of internal bleaching on the adhesion of glass-fiber posts (GFPs) luted with different resin cements. Methods: Forty extracted human single-root teeth were endodontically treated and divided into four groups (n=10): G1- conventional resin cement (CRC); G2- self-adhesive resin cement (SARC); G3- bleaching + CRC; and G4- bleaching + SARC. Specimens were sectioned transversally into three slices to perform the push-out test at the coronal, middle and apical regions of the root canals. Data were analyzed using analysis of variance and Tukey's test (p<0.05). Results: The push-out bond strength of GFPs luted with SARC after bleaching (G4) was significantly lower than that of the other groups (p<0.001). We found no statistically significant differences in push-out bond strength among the other groups. Significance: Internal bleaching reduced the adhesion of GFPs luted with SARC. The adhesion of GFPs luted with CRC was not decreased after bleaching. PMID:26962369
Yadav, Rakesh K.; Tikku, A. P.; Chandra, Anil; Wadhwani, K. K.; Ashutosh kr; Singh, Mayank
Endodontic implants were introduced back in 1960. Endodontic implants enjoyed few successes and many failures. Various reasons for failures include improper case selection, improper use of materials and sealers and poor preparation for implants. Proper case selection had given remarkable long-term success. Two different cases are being presented here, which have been treated successfully with endodontic implants and mineral trioxide aggregate Fillapex (Andreaus, Brazil), an MTA based sealer. We suggest that carefully selected cases can give a higher success rate and this method should be considered as one of the treatment modalities. PMID:25298723
Forough Reyhani, Mohammad; Ghasemi, Negin; Rahimi, Saeed; Milani, Amin Salem; Omrani, Elnaz
Introduction: The aim of this in vitro study was to evaluate the effect of MTA-based sealer (MTA Fillapex), eugenol-based sealer (Dorifill) and an epoxy resin sealer (AH Plus) on the bond strength of fiber posts cemented with a self-etch adhesive. Materials and Methods: The root canals of 72 maxillary incisors were prepared using the step-back technique after removing/cutting off the crowns. The samples were randomly divided to 4 groups (n=18). In group 1 (the controls) gutta-percha was used without sealer. In groups 2, 3 and 4, the canals were filled with gutta-percha using AH Plus, Dorifill and MTA Fillapex sealers, respectively, by cold lateral compaction technique. After post space preparation, the fiber posts were cemented in the root canals using self-etch adhesive. Then 1-mm-thick disks were prepared from the coronal thirds of all the root canals and subjected to a push-out test. Data were analyzed using the one-way ANOVA and post hoc Tukey’s tests. Results: The maximum (4.45±0.09 MPa) and minimum (1.02±0.03 MPa) bond strength values were recorded in the control and Dorifill groups, respectively. The mean push-out bond strength values were similar for MTA Fillapex and AH Plus sealers (P>0.05). However these values were significantly higher than that of the Dorifill sealer (P<0.05). Conclusion: Sealer type affected the bond strength of the fiber posts and MTA Fillapex decreased the dislodgment resistant of the fiber post. PMID:27141220
Alandia-Román, Carla Cecilia; Vincenti, Sergio Augusto Freitas; Silami, Francisca Daniele Jardilino; Silveira, Renata Espíndola; Pinto, Gustavo Col Dos Santos; Pires-de-Souza, Fernanda de Carvalho Panzeri
In this study, the influence of different irrigant solutions applied before cementation on the bond strength (BS) of glass fiber posts to root dentin was evaluated. Thirty endodontically treated maxillary canines of similar length were selected and divided into 3 groups (n = 10) according to the irrigant solution used before post cementation: 1% sodium hypochlorite (NaOCl; control), 2% chlorhexidine (CHX), or a 6.5% grape seed extract (GSE) cross-linking agent. After cementation of the posts, the roots were transversely sectioned to create 2 discs (2 mm) for each of the root thirds: coronal, middle, and apical. These discs were submitted to push-out tests (0.5 mm/min) to evaluate the BS between the glass fiber posts and the root dentin. Statistical analysis was performed by a 2-way analysis of variance and a Tukey test (P < 0.05). The failure mode was evaluated in all specimens. Both the CHX and GSE groups presented significantly higher BS values than the control group in all root thirds (P < 0.05). The values of the GSE group were significantly higher than those of the CHX group in all thirds except the apical third (P < 0.05). In the control group, the BS value was highest in the cervical third. There was no significant difference in the BS values between the cervical and middle thirds when CHX was used (P > 0.05); however, the BS value diminished significantly in the apical third (P < 0.05). The highest BS value in the GSE group was found in the middle third. The results showed that the use of either GSE or CHX before adhesive cementation improved the BS of glass fiber posts to root dentin.
Shahravan, Arash; Haghdoost, Ali Akbar
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
HARAGUSHIKU, Gisele Aihara; BACK, Eduardo Donato Eing Engelke; TOMAZINHO, Paulo Henrique; BARATTO, Flares; FURUSE, Adilson Yoshio
Objective This study evaluated the effect of root canal disinfectants on the elimination of bacteria from the root canals, as well as their effect on glass-fiber posts bond strength. Material and Methods Fifty-three endodontically treated root canals had post spaces of 11 mm in length prepared and contaminated with E. faecalis. For CFU/ml analysis, eight teeth were contaminated for 1 h or 30 days (n=4). Teeth were decontaminated with 5% NaOCl, 2% CHX, or distilled water. As control, no decontamination was conducted. After decontamination, sterile paper points were used to collect samples, and CFU/ml were counted. For push-out, three groups were evaluated (n=15): irrigation with 2.5% NaOCl, 2% CHX, or sterile distilled water. A bonding agent was applied to root canal dentin, and a glass-fiber post was cemented with a dual-cured cement. After 24 h, 1-mm-thick slices of the middle portion of root canals were obtained and submitted to the push-out evaluation. Three specimens of each group were evaluated in scanning electron microscopy (SEM). Data were analyzed with one-way ANOVA and Dunnett’s T3 test (α=0.05). Results The number of CFU/ml increased from 1 h to 30 days of contamination in control and sterile distilled water groups. Decontamination with NaOCl was effective only when teeth were contaminated for 1 h. CHX was effective at both contamination times. NaOCl did not influence the bond strength (p>0.05). Higher values were observed with CHX (p<0.05). SEM showed formation of resin tags in all groups. Conclusion CHX showed better results for the irrigation of contaminated root canals both in reducing the bacterial contamination and in improving the glass-fiber post bonding. PMID:26398518
Marques, Eduardo Fernandes; Bueno, Carlos Eduardo da Silveira; Veloso, Heloisa Helena Pinho; Almeida, Gustavo; Pinheiro, Sergio Luiz
This study sought to evaluate how instrumentation techniques and irrigating solutions affected the bond strength of glass fiber posts. For this study, 80 human maxillary central incisors were selected. Endodontic access was obtained, root canal length was measured, and the coronal third was prepared using Gates-Glidden drills. The specimens were embedded in acrylic resin and randomly assigned to 8 groups (n = 10): manual instrumentation only (Group 1), rotary instrumentation only (Group 2), irrigation with 2.5% sodium hypochlorite (NaOCl) (Group 3), irrigation with 2% chlorhexidine (CHX) (Group 4), manual instrumentation and irrigation with 2.5% NaOCl (Group 5), manual instrumentation and irrigation with 2% CHX (Group 6), rotary instrumentation and irrigation with 2.5% NaOCl (Group 7), and rotary instrumentation and irrigation with 2% CHX (Group 8). Specimens in Groups 5-8 also received a 1 minute final rinse with ethylenediaminetetraacetic acid. Canals were filled and the specimens stored for 30 days in distilled water. The restoration material was removed down to the apical 4 mm of the root canal. The glass fiber posts were luted with resin cement and stored for 24 hours at 37°C. Specimens were subjected to a tensile strength test at a constant speed of 1.0 mm/minute and a load of 2,000 kgf. The results were analyzed by analysis of variance and Tukey's test. Irrigation with 2.5% NaOCl reduced the bond strength of fiber posts significantly (P < 0.01), while CHX showed no effect (P > 0.05). It was concluded that irrigation with 2.5% NaOCl has a negative effect on micromechanical retention of glass fiber posts, whether manual or rotary instrumentation is used.
Mannocci, Francesco; Qualtrough, Alison J E; Worthington, Helen V; Watson, Timothy F; Pitt Ford, Thomas R
Prospective clinical studies comparing the results of different types of restorations of endodontically treated teeth are lacking. This study compared the clinical success rate of endodontically treated premolars restored with fiber posts and direct composite to the restorations of premolars using amalgam. Premolars with Class II carious lesions were selected and randomly assigned to one of two experimental groups: (1) restoration with amalgam or (2) restoration with fiber posts and composite. One hundred and nine teeth were included in Group 1 and 110 in Group 2. Patients were recalled after 1, 3 and 5 years. No statistically significant difference was found between the proportion of failed teeth in the two experimental groups. Significant differences were observed between the proportion of root fractures (p=0.029) and caries (p=0.047), with more root fractures and less caries observed in the teeth restored with amalgam at the five-year recall. Within the limits of this study, it can be concluded that restorations with fiber posts and composite were found to be more effective than amalgam in preventing root fractures but less effective in preventing secondary caries.
Muangamphan, Panorjit; Sattapan, Boonrat; Kukiattrakoon, Boonlert; Thammasitboon, Kewalin
Aim: To investigate the fracture resistance of restored endodontically treated teeth (RETT) with fiber posts, cores, and crowns with limited ferrules. Materials and Methods: Sixty maxillary anterior teeth were endodontically treated and decoronated 2 mm above the cemento-enamel junction, and then divided into 6 groups of 10 teeth each; Group circumferential ferrule (2FR), Group ferrule in the labial, mesial, and palatal region (2FR-LaMPa), Group ferrule in the labial, and palatal region (2FR-LaPa), Group 2FR-Pa and 2FR-La respectively, and Group 0FR (no ferrule). All 60 prepared teeth were then restored with quartz fiber posts, resin composite cores, and metal crowns. The specimens were subjected to load until failure occurred. Data were analyzed using one-way analysis of variance and Tukey's tests (α = 0.05). The mode of failure was determined under a stereoscope. Results: A statistical significant difference was found among groups 2FR-LaMPa, 2FR-Pa, 2FR-LaPa, and 2FR from the group 2FR-La, and from the group 0FR (P < 0.01). The predominant mode of failure was an oblique palatal to labial root fracture for the groups with remaining ferrules. Conclusion: For RETT that have incomplete crown ferrules, the location of the ferrules may affect their fracture resistance. PMID:26069401
de Oliveira, Jonas Alves; Pereira, Jefferson Ricardo; Lins do Valle, Accácio; Zogheib, Lucas Villaça
This study evaluated the fracture resistance of endodontically treated teeth restored with prefabricated carbon fiber posts and varying quantities of coronal dentin. Sixty freshly extracted upper canines were randomly divided into groups of 10 teeth each. The specimens were exposed to 250,000 cycles in a controlled chewing simulator. All intact specimens were subjected to a static load (N) in a universal testing machine at 45 degrees to the long axis. Data were analyzed by 1-way analysis of variance and Tukey test (alpha = .05). Significant differences (P < .001) were found among the mean fracture forces of the test groups (positive control, 0 mm,1 mm, 2 mm, 3 mm, and negative control groups: 1022.82 N, 1008.22 N, 1292.52 N, 1289.19 N, 1255.38 N, and 1582.11, respectively). These results suggested that the amount of coronal dentin did not significantly increase the fracture resistance of endodontically treated teeth restored with prefabricated carbon fiber post and composite resin core.
Bitter, Kerstin; Gläser, Christin; Neumann, Konrad; Blunck, Uwe; Frankenberger, Roland
Purpose Restoration of endodontically treated teeth using fiber posts in a one-stage procedure gains more popularity and aims to create a secondary monoblock. Data of detailed analyses of so called “post-and-core-systems” with respect to morphological characteristics of the resin-dentin interface in combination with bond strength measurements of fiber posts luted with these materials are scarce. The present study aimed to analyze four different post-and-core-systems with two different adhesive approaches (self-etch and etch-and-rinse). Materials and Methods Human anterior teeth (n = 80) were endodontically treated and post space preparations and post placement were performed using the following systems: Rebilda Post/Rebilda DC/Futurabond DC (Voco) (RB), Luxapost/Luxacore Z/Luxabond Prebond and Luxabond A+B (DMG) (LC), X Post/Core X Flow/XP Bond and Self Cure Activator (Dentsply DeTrey) (CX), FRC Postec/MultiCore Flow/AdheSE DC (Ivoclar Vivadent) (MC). Adhesive systems and core materials of 10 specimens per group were labeled using fluorescent dyes and resin-dentin interfaces were analyzed using Confocal Laser Scanning Microscopy (CLSM). Bond strengths were evaluated using a push-out test. Data were analyzed using repeated measurement ANOVA and following post-hoc test. Results CLSM analyses revealed significant differences between groups with respect to the factors hybrid layer thickness (p<0.0005) and number of resin tags (p = 0.02; ANOVA). Bond strength was significantly affected by core material (p = 0.001), location inside the root canal (p<0.0005) and incorporation of fluorescent dyes (p = 0.036; ANOVA). CX [7.7 (4.4) MPa] demonstrated significantly lower bond strength compared to LC [14.2 (8.7) MPa] and RB [13.3 (3.7) MPa] (p<0.05; Tukey HSD) but did not differ significantly from MC [11.5 (3.5) MPa]. Conclusion It can be concluded that bond strengths inside the root canal were not affected by the adhesive approach of the post
Lima, Jessica Ferraz Carvalho; Lima, Adriano Fonseca; Humel, Maria Malerba Colombi; Paulillo, Luis Alexandre Maffei Sartini; Marchi, Giselle Maria; Ferraz, Caio Cezar Randi
The aim of this in vitro study was to evaluate the influence of different irrigation protocols on the bond strength, at different root depths, of fiber posts cemented with a self-adhesive cement 24 hours after endodontic treatment. Fifty-six bovine incisor roots were endodontically prepared and separated into 7 groups (n = 8) according to irrigation protocols: group 1, sterile saline (control); group 2, chlorhexidine (CHX) gel 2% and saline; group 3, sodium hypochlorite (NaOCl) 5.25% and saline; group 4, CHX and saline (final irrigation with ethylenediaminetetraacetic acid [EDTA] 17%); group 5, NaOCl and saline (final irrigation with EDTA); group 6, CHX and saline (final irrigation with NaOCl and EDTA); and group 7, NaOCl (final irrigation with CHX and EDTA). No statistically significant difference was found among the groups. Within the limitations of this study, it can be concluded that the different irrigation protocols did not influence the bond strength of self-adhesive resin cement, which presented similar behaviors at the 3 root depths studied.
da Rosa, Ricardo Abreu; Barreto, Mirela Sangoi; da Rosa, Tiago Abreu; Reis, Katia Rodrigues; Kaizer, Osvaldo Bazzan
This study used differential root weakening to evaluate the fracture resistance of bovine teeth restored using glass fiber posts (with or without accessory glass fiber posts). Fifty bovine mandibular incisors were sectioned 14 mm from the apex, fixed in acrylic resin blocks, and divided into 5 groups: healthy roots with a glass fiber post (Group 1), partially weakened teeth with a glass fiber post (Group 2), partially weakened teeth with a glass fiber post and 2 accessory glass fiber posts (Group 3), extensively weakened teeth with a glass fiber post (Group 4), and extensively weakened teeth with a glass fiber post and 5 accessory glass fiber posts (Group 5). Posts were luted with resin cement, cores were prepared using composite resin, and metallic crowns were cemented. The specimens were stored in distilled water at 37°C for more than 72 hours until the fracture resistance test. Specimens were loaded at 135 degrees relative to the long axis of the tooth at a crosshead speed of 0.5 mm/minute in a universal testing machine. All groups predominantly exhibited favorable failure patterns and there were no statistically significant differences between groups (two-way ANOVA, α = 0.05).
Vangala, Amulya; Hegde, Vivek; Sathe, Sucheta; Dixit, Manisha; Jain, Paresh
Aim: To evaluate the effect of different irrigating solutions on postspace treatments on the push-out bond strength of glass fiber posts. Materials and Methods: Thirty mandibular premolar roots were decoronated and endodontically treated. Postspaces were prepared and roots were divided into three groups: In group 1: 2.5% sodium hypochlorite irrigation (control), group 2: 17% ethylenediaminetetraacetic acid (EDTA) with hand activation, group 3: 17% EDTA irrigation with photon-induced photoacoustic streaming (PIPS) has been done to the postspaces. Scanning electron microscope (SEM) analysis has been made for two samples of each group. Fiber posts were then luted with resin cement. Each root was prepared for push-out test. Data have been statistically analyzed. Results: SEM results showed clean postwalls with both group 2 and group 3, whereas group 1 showed adhesion of resin cement to intraradicular dentine. When all groups were compared, the bond strength values are higher with group 2 followed by group 3. Conclusion: Within the limitations of the study, clean postwalls and the highest bond strength values were obtained from 17% EDTA with hand activation and 17% EDTA with PIPS. PMID:26957800
Galhano, Graziela Avila; Valandro, Luiz Felipe; de Melo, Renata Marques; Scotti, Roberto; Bottino, Marco Antonio
This study investigated the flexural strength of eight fiber posts (one carbon fiber, one carbon/quartz fiber, one opaque quartz fiber, two translucent quartz fiber, and three glass fiber posts). Eighty fiber posts were used and divided into eight groups (n = 10): G1: C-POST (Bisco); G2: AESTHETI-POST (Bisco); G3: AESTHETI-PLUS (Bisco); G4: LIGHT-POST (Bisco); G5: D.T. LIGHT-POST (Bisco); G6: PARAPOST WHITE (Coltene); G7: FIBERKOR (Pentron); G8: REFORPOST (Angelus). All of the samples were tested using the three-point bending test. The averages obtained were submitted to the ANOVA and to Tukey's test (p < 0.05). The mean values (MPa) of the groups AESTHETI-POST-carbon/quartz fiber post (Bisco) and AESTHETI-PLUS-quartz fiber post (Bisco) were statistically similar and higher than the mean values of the other groups. The mean values of the groups C-POST-carbon fiber post (Bisco), LIGHT-POST-translucent quartz fiber post (Bisco), D.T. LIGHT-POST-double tapered translucent quartz fiber post (Bisco), PARAPOST WHITE-glass fiber post (Coltene) and FIBREKOR--glass fiber post (Pentron) were similar and higher than the group REFORPOST-glass fiber post (Angelus).
Mehrvarzfar, Payman; Esnashari, Ehsan; Salmanzadeh, Reyhaneh; Fazlyab, Mahta; Fazlyab, Mahyar
Introduction: The aim of this randomized-controlled clinical trial was to assess the effect of intraligamentary (PDL) injection of dexamethasone on onset and severity of post-treatment pain in patients with symptomatic irreversible pulpitis. Methods and Materials: A total number of 60 volunteers were included according to the inclusion criteria and were assigned to three groups (n=20). After administration of local anesthesia and before treatment, group 1 (control) PDL injection was done with syringe containing empty cartridge, while in groups 2 and 3 the PDL injection was done with 0.2 mL of 2% lidocaine or dexamethasone (8 mg/2 mL), respectively. Immediately after endodontic treatment patients were requested to mark their level of pain on a visual analogue scale (VAS) during the next 48 h (on 6, 12, 24 and 48-h intervals). They were also asked to mention whether analgesics were taken and its dosage. Considering the 0-170 markings on the VAS ruler, the level of pain was scored as follows: score 0 (mild pain; 0-56), score 1 (moderate pain; 57-113) and score 3 (severe pain; 114-170). The data were analyzed using the Kruskal-Wallis and the Chi-square tests and the level of significance was set at 0.05. Results: After 6 and 12 h, group 1 and group 3 had the highest and lowest pain values, respectively (P<0.01 and P<0.001 for 6 and 12 h, respectively). However, after 24 and 48 h the difference in the pain was not significant between groups 1 and 2 (P<0.6) but group 3 had lower pain levels (P<0.01 and P<0.8 for 24 and 48 h, respectively). Conclusion: Pretreatment PDL injection of dexamethasone can significantly reduce the post-treatment endodontic pain in patients with symptomatic irreversible pulpitis. PMID:27790253
Carvalho, Ceci Nunes; Freire, Laila Gonzales; Carvalho, Alexandre Pinheiro Lima de; Duarte, Marco Antonio Húngaro; Bauer, José; Gavini, Giulio
This study evaluated pH and release of calcium, sodium and phosphate ions from different medications in human dentin. Fifty premolars were prepared and randomly divided into groups: (CHX) - 2% chlorhexidine gel; (CHX + CH) - CHX + calcium hydroxide PA; (CH) - CH + propylene glycol 600; (NPBG) - experimental niobium phosphate bioactive glass + distilled water; (BG) - bioactive glass (Bio-Gran) + distilled water. The specimens were immersed in deionized water and the pH variations were measured. The quantification of ions in the solutions was made by inductively coupled plasma - atomic emission spectroscopy (ICP/AES) at 10 min, 24 h, 7, 14, 21 and 30 days. The results were analyzed by ANOVA and Tukey`s test, with a significance level of 5%. CH had the highest level of calcium ions release at 30 days, while CHX and BG released more sodium ions. BG, NPBG and CHX released a higher amount of phosphate ions. The pH of CH was significantly higher compared with the other groups. CH favored the greatest increase of pH and calcium ions release. The bioactive glasses released more sodium and phosphate ions and presented an alkaline pH immediately and after 30 days.
Eliyas, S; Vere, J; Ali, Z; Harris, I
Non-surgical endodontic retreatment is the treatment of choice for endodontically treated teeth with recurrent or residual disease in the majority of cases. In some cases, surgical endodontic treatment is indicated. Successful micro-surgical endodontic treatment depends on the accuracy of diagnosis, appropriate case selection, the quality of the surgical skills, and the application of the most appropriate haemostatic agents and biomaterials. This article describes the armamentarium and technical procedures involved in performing micro-surgical endodontics to a high standard.
Adanir, Necdet; Belli, Sema
Objectives The purpose of this in vitro study was to evaluate the influence of different post lengths upon root fracture resistance. Methods 78 maxillary central teeth with similar dimensions were mounted in acrylic blocks with artificial silicone periodontal ligaments. Combinations of post lengths of 6 mm (shorter than 1/1 clinical crown length), 9 mm (1/1 clinical crown length), and 12 mm (longer than 1/1 clinical crown length) made up 6 different groups consisting of 13 teeth each. The glass fiber posts (Snowpost) were cemented with Super-Bond C&B and Panavia F luting cement. Composite-resin cores were made with Clearfil PhotoCore. The specimens were tested in a universal test machine. The testing machine applied controlled loads to the core, 2 mm from its incisal edge, on the palatal side at an angle 135 degrees to the long axis of the root. The testing machine was set at a crosshead speed of 5mm per minute. All samples were loaded until failure. Results There was no statistically significant difference between cements (P>.05). Posts shorter than clinical crown length, demonstrated root fracture under significantly lower loading forces (P<.05). Conclusion Usage of posts shorter than clinical crowns should be avoided to eliminate clinical failure. PMID:19212505
Tour Savadkouhi, Sohrab; Fazlyab, Mahta
Tooth discoloration induced by endodontic sealers, is a common finding that impairs aesthetic outcome of endodontic treatment. The aim of the present mini literature review, was to summarize the existing data on discoloration potential of different endodontic sealers. The research covered the article published in PubMed and Google Scholar from 2000 to 2015. The searched keywords included 'tooth discoloration AND endodontic', 'tooth discoloration AND sealer, 'tooth discoloration AND zinc-oxide eugenol sealer', 'tooth discoloration AND Calcium Hydroxide Sealer', 'tooth discoloration AND Glass Ionomer Sealer', 'tooth discoloration AND epoxy-resin Sealer', 'tooth discoloration AND Silicon Based Sealer', 'tooth discoloration AND Bioceramic Sealer' and 'Spectrophotometry'.
Lieblich, Stuart E
Conventional endodontic therapy is successful approximately 80-85% of the time. Many of these failures will occur after one year. The presence of continued pain, drainage, mobility or an increasing size of a radiolucent area are some of the indications to treat the case surgically. Since many of these cases may have had final restorations placed by the dentist, the salvage of these cases is of importance to the patient. Advances in periapical surgery have included the use of ultrasonic root end preparation. With the use of these piezoelectric devices, a more controlled apical preparation can be achieved. Additionally, isthmus areas between canals can be appropriately prepared and sealed. The precision afforded with these devices reduces the chances for a malpositioned fill and a more successful outcome.
Endodontic posts do not increase the strength of the remaining tooth structure in endodontically treated teeth. On the contrary, depending on the post design employed (tapered versus parallel-sided), the root can be weakened relative to the amount of tooth removed during preparation. In many cases, if there has been a high degree of damage to the clinical crown, conservative preparation for an anatomic tapered (biomimetic) post with the incorporation of a ferrule on solid tooth structure is necessary to protect the reaming root structure as well as for the long-term retention of the composite resin core and the definitive restoration. Adhesively luted endodontic posts reinforced with glass or quartz fiber lead to better homogeneous tension distribution when loaded than rigid metal or zirconium oxide ceramic posts. Fiber-reinforced posts also possess advantageous optical properties over metal or metal oxide post systems. The clinician should realize that there are admittedly substantial differences in the mechanical loading capacity of the different fiber-reinforced endodontic posts and should be aware of such differences in order to research and select a suitable post system for use.
Kumar, Lalit; Pal, Bhupinder; Pujari, Prashant
Endodontically treated teeth with excessive loss of tooth structure would require to be restored with post and core to enhance the strength and durability of the tooth and to achieve retention for the restoration. The non-metallic posts have a superior aesthetic quality. Various core build-up materials can be used to build-up cores on the posts placed in endodontically treated teeth. These materials would show variation in their bonding with the non-metallic posts thus affecting the strength and resistance to fracture of the remaining tooth structure. Aims. The aim of the study was to assess the fracture resistance of three composite resin core build-up materials on three prefabricated non-metallic posts, cemented in extracted endodontically treated teeth. Material and Methods. Forty-five freshly extracted maxillary central incisors of approximately of the same size and shape were selected for the study. They were divided randomly into 3 groups of 15 each, depending on the types of non-metallic posts used. Each group was further divided into 3 groups (A, B and C) of 5 samples each depending on three core build-up material used. Student's unpaired 't' test was also used to analyse and compare each group with the other groups individually, and decide whether their comparisons were statistically significant. Results. Luxacore showed the highest fracture resistance among the three core build-up materials with all the three posts systems. Ti-core had intermediate values of fracture resistance and Lumiglass had the least values of fracture resistance.
PEREIRA, Jefferson Ricardo; da ROSA, Ricardo Abreu; SÓ, Marcus Vinícius Reis; AFONSO, Daniele; KUGA, Milton Carlos; HONÓRIO, Heitor Marques; do VALLE, Accácio Lins; VIDOTTI, Hugo Alberto
Objective The purpose of this study was to assess the push-out bond strength of glass fiber posts to root dentin after cementation with glass ionomer (GICs) and resin-modified glass ionomer cements (RMGICs). Material and Methods Fifty human maxillary canines were transversally sectioned at 15 mm from the apex. Canals were prepared with a step back technique until the application of a #55 K-file and filled. Post spaces were prepared and specimens were divided into five groups according to the cement used for post cementation: Luting & Lining Cement; Fuji II LC Improved; RelyX Luting; Ketac Cem; and Ionoseal. After cementation of the glass fiber posts, all roots were stored at 100% humidity until testing. For push-out test, 1-mm thick slices were produced. The push-out test was performed in a universal testing machine at a crosshead speed of 0.5 mm/minute and the values (MPa) were analyzed by Kolmogorov-Smirnov and Levene's tests and by two-way ANOVA and Tukey's post hoc test at a significance level of 5%. Results Fiber posts cemented using Luting & Lining Cement, Fuji II LC Improved, and Ketac Cem presented the highest bond strength to root dentin, followed by RelyX Luting. Ionoseal presented the lowest bond strength values (P>0.05). The post level did not influence the bond strength of fiber posts to root dentin (P=0.148). The major cause of failure was cohesive at the cement for all GICs and RMGICs. Conclusions Except for Ionoseal, all cements provided satisfactory bond strength values. PMID:25004052
Dias, Larissa Lustosa Lima; Giovani, Alessandro Rogério; Sousa, Yara Teresinha Corrêa Silva; Vansan, Luiz Pascoal; Alfredo, Edson; Sousa-Neto, Manoel Damião; Paulino, Silvana Maria
Objective: This study evaluated in vitro the influence of an eugenol-based sealer (EndoFill) on the retention of stainless steel prefabricated posts cemented with zinc phosphate and resin-based (Panavia F) cements after different periods of root canal obturation, using the pull-out test. Material and methods: Sixty upper canines were decoronated and the roots were embedded in resin blocks. The specimens were distributed into 3 groups, according to the period elapsed between canal obturation and post cementation: Group I - immediately; Group II - 72 h and Group III - 4 months. The groups were subdivided according to the type of cement used for post cementation: A - zinc phosphate and B - Panavia F. Following the experimental periods, specimens were subjected to pull- out test in an Instron machine with application of tensile force at a crosshead speed of 0.5 mm/min until post dislodgement. The maximum forces required for post removal were recorded (kN) and means were subjected to statistical analysis by 2-way ANOVA and Tukey-Kramer test (α=0.001) Results: There were statistically significant differences (p<0.01) between the posts cemented with zinc phosphate cement (0.2112 kN) and Panavia F (0.0501 kN). However, no statistically significant differences (p>0.05) were found between the three post cementation periods, regardless of the cement. Conclusions: It was concluded that the eugenol-based sealer influenced the tensile strength of the posts cemented with the resin cement, but had no influence on the time waited between root canal obturation and post space preparation/post cementation. PMID:20027430
Fidel, Sandra Rivera; Sassone, Luciana; Alvares, Gustavo Ribeiro; Guimarães, Rodrigo Prada Sant'anna; Fidel, Rivail Antônio Sérgio
Combined coronal and vertical root fractures are difficult to treat and extraction of the affected tooth is quite often indicated. In anterior teeth, esthetics and function must be reestablished immediately. This case describes the restoration of a fractured upper right central incisor using a glass fiber post and adhesive composite. At the follow-up appointment, 13 months later, clinical and radiographical examinations revealed the glass fiber post and restoration in place, suggesting the efficacy of the treatment in maintaining fractured tooth.
Bilgi, Priyanka Shripad; Shah, Nimisha Chinmay; Patel, Parth Pinakinbhai; Vaid, Deepa S
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
Webber, Mariana Benedetti Ferreira; Michida, Silvia Masae de Araújo; Marson, Fabiano Carlos; de Oliveira, Giovani Corrêa; Silva, Cleverson de Oliveira e
Background: The aim of this study was to evaluate, by means of pull-out test, the bond strength of fiberglass posts when cemented with different lengths in endodontically treated teeth. Materials and Methods: Sixty single-rooted bovine roots were cut in the cementoenamel junction with 21 mm length. They were endodontically treated and randomly divided into three groups (n = 20). Group 1 - Preparation of 2/3 of the remaining roots; Group 2 - Preparation of ½ of the remaining roots and Group 3 - Preparation of ¼ of remaining roots. For all groups it were used posts n = 3 (Exacto, Angelus, Brazil), and cemented with self-etching resin cement (RelyXU200). After cementing posts, the samples were thermocycled (10.000 cycles/5°C and 55°C). The pull-out test was performed on a universal testing machine (EMIC - DL500) and the values obtained were statistically analyzed by analysis of variance (one-factor ANOVA) and multiple comparison test of Tukey, with level of significance of 5%. Results: The mean values ± standard deviation in Newtons (N) were: Group 1 = 120.5 (±42.8) A, Group 2 = 103.1 (±31.2) AB, Group 3 = 41.2 (±22.4) C, P < 0.005. Conclusion: The preparation of ½ of remaining root appears to be a viable alternative when 2/3 of the preparation of the remaining root is not possible, but more results are needed for clinical validation. PMID:25954063
Toman, M; Toksavul, S; Tamaç, E; Sarikanat, M; Karagözoğlu, I
Aim of this study was to assess the influence of chlorhexidine digluconate (CHX) application on bond strength of glass fibre reinforced composite (FRC) posts to root dentine using adhesive luting systems. Forty extracted human mandibular premolars were endodontically treated and root canals were prepared. Teeth were divided into 2 groups according to luting system as SuperBond C&B (etch-and-rinse/chemical cure) and FuturaBond DC (self-etch/ dual cure). Each group was further divided in 2 subgroups (n=10) according to whether CHX was applied or not. Group Futura/CHX: FuturaBond DC + CHX; group Futura: FuturaBond DC; group Super/CHX: Super Bond C&B + CHX; group Super: SuperBond C&B + CHX. Mean and standard deviation (in parenthesis) values of bond strength in MPa were: group Futura/CHX: 8.86 (1.96), group Futura: 7.65 (1.01), group Super/CHX: 17.47(2.93), group Super: 12.41 (3.83). Bond strength values were affected by the type of luting agent and CHX irrigation (p=0.001, two-way ANOVA). There were statistically significant differences among the groups according to one-way ANOVA (p<0.001). Significant differences were observed in bond strength between groups Super/CHX and Super (p=0.023), between groups Futura/CHX and Super/CHX (p<0.001). Application of CHX before luting procedure with etch-and-rinse/chemical cure luting agent of glass FRC post improved long-term bond strength between glass FRC and root dentine.
Comparative evaluation of the effect of different crown ferrule designs on the fracture resistance of endodontically treated mandibular premolars restored with fiber posts, composite cores, and crowns: An ex-vivo study
Dua, Nikita; Kumar, Bhupendra; Arunagiri, D.; Iqbal, Mohammad; Pushpa, S.; Hussain, Juhi
Introduction: In cases of severe hard tissue loss, 2 mm circumferential ferrule is difficult to achieve which leads to incorporation of different ferrule designs. Aim: To compare and evaluate the effect of different crown ferrule designs on the fracture resistance of mandibular premolars restored with fiber posts, composite cores, and crowns. Materials and Methods: Fifty freshly extracted mandibular premolars were endodontically treated and divided into five groups: Group I - 2 mm circumferential ferrule above the cementoenamel junction (CEJ); Group II - 2 mm ferrule on the facial aspect above CEJ; Group III - 2 mm ferrule on the lingual aspect above CEJ; Group IV - 2 mm ferrule on the facial and lingual aspects above CEJ with interproximal concavities, and Group V - no ferrule (control group) and were later restored with fiber posts, composite cores, and crowns. Specimens were mounted on a universal testing machine, and compressive load was applied at a crosshead speed of 1 mm/min until fracture occurred. Results: The results showed that circumferential ferrule produced the highest mean fracture resistance and the least fracture resistance was found in the control group. Conclusion: Circumferential ferrule increases the fracture resistance of endodontically treated teeth restored with bonded post, core, and crown. PMID:27217642
Dabas, V K
In the present study, four restorative materials were used for the restoration of endodontically treated anterior teeth and their strength were compared with that of natural teeth. 100 freshly extracted Maxillary Central Incisors were used. The teeth were restored with Pin-retained amalgam-core buildups, Dowel-post with Glass ionomer-Amalgam alloy combination Cast Core build up. The natural tooth showed the maximum strength. Though some of the restorative materials showed promising results, none of them is able to show strength anywhere near to that of natural tooth.
Journal of Dental Education, 1981
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)
Gulve, Meenal N.
Radicular fractures in permanent teeth are uncommon injuries and account for only 0.5–7% of dental traumas. These fractures commonly result from a horizontal impact and are transverse to oblique in direction. Their incidence is more in the middle third of the root than at the apical and cervical thirds. This paper describes a case of complicated crown fracture of maxillary incisors along with horizontal root fracture at the middle third of maxillary right central and lateral incisor. The fractured root fragments of the upper right central and lateral incisor were united with the help of a glass fiber post after receiving an endodontic treatment. The other two incisors were treated endodontically followed by post endodontic restorations. Eventually the four incisors were restored with porcelain fused to metal crowns. A one-year follow-up revealed a well stabilized assembly of the root fragments and the post. PMID:26904313
Zenobio, Elton Golçalves; Shibli, Jamil Awad
Clinicians often have difficulty with the diagnosis and treatment of root perforation. This paper reports two patients with root perforation treated with periodontal surgery associated with guided tissue regeneration (GTR) and demineralized freeze-dried bone allograft (DFDBA). This combined treatment resulted in minimal probing depths, minimal attachment loss, and radiographic evidence of bone gain after follow-up evaluations that ranged from 2 to 4 years. These case reports show a correct diagnosis and removal of etiologic factors can restore both periodontal and endodontic health.
Ranjkesh, Bahram; Lovschall, Henrik; Erfanparast, Leila; Jafarabadi, Mohammad A; Oskouei, Sina Ghertasi; Isidor, Flemming
ABSTRACT Aim: The aim of this study was to compare the survival of composite resin restorations retained by glass fiber posts or reversed-orientated (upside-down) metal posts in severely decayed primary anterior teeth after 6, 12, and 18 months. Materials and methods: A total of forty-four 3- to 5-year-old children with bilateral severely decayed primary maxillary canines were included. Patients were treated under general anesthesia. After pulpectomy, an intracanal post was seated in the primary maxillary canine on each side: either a glass fiber post or a metallic post in reversed orientation and teeth restored with light-cured composite. Survival rate of each technique was evaluated at predetermined follow-ups and data were analyzed with McNemar’s test (α = 0.05). Results: The difference in survival of restorations retained by two types of posts was not statistically significant in clinical and radiographical evaluations after 6, 12, and 18 months. The survival rate of reversed-orientated metal and glass fiber posts after 18 months was 81.1 and 67.6% respectively (p = 0.14). Conclusion: Reversed-orientated metal post did not show lower clinical survival compared with glass fiber posts in 18-month follow-up. Hence, reversed-orientated metal post can be considered as a potential method to obtain retention for composite restorations in severely decayed primary anterior teeth. How to cite this article: Vafaei A, Ranjkesh B, L0vschall H, Erfanparast L, Jafarabadi MA, Oskouei SG, Isidor F. Survival of Composite Resin Restorations of severely Decayed Primary Anterior Teeth retained by Glass Fiber Posts or Reversed-orientated Metal Posts. Int J Clin Pediatr Dent 2016;9(2):109-113. PMID:27365929
Narayanaraopeta, Udaya; AlShwaimi, Emad
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
Sadighpour, L.; Rezaei, S.; Geramipanah, F.; Mohammadi, M.; Choubchian, S.
Objective: Contradictory results have been reported over microleakage studies of restorative materials and methods. Despite the number of publications on leakage there are few evidences comparing the different microleakage evaluation methods. The purpose of the present study was to compare the clearing technique and longitudinal sectioning in the evaluation of dye penetration along a glass fiber post. Materials and Methods: Fifteen single-rooted human teeth were endontically prepared and obturated with gutta percha points and a resin based sealer (AH26). A glass fiber post (Glassix) was cemented into each post space with a dual polymerizing resin cement (Varilink II) and the composite core (Tetric Ceram) was fabricated. Specimens were immersed in Indian ink solution for 72 hours after completion of 1500 cycles of thermal cycling. Then demineralized, cleared and evaluated for the deepest length of dye penetration using a stereomicroscope. Specimens were then cut longitudinally and the length of penetration was measured again by the same instrument. The mean difference of the penetrated length was analyzed by two methods using the paired t test and an analysis of correlation (α = 0.05). Results: No significant difference was found in the mean microleakage measured by the two methods (P= 0.07). Significant correlation was found between them (P=0.0001, r= 0.9) Conclusion: The clearing technique and longitudinal sectioning showed the same results in microleakage of Glassix post and composite core within the limitation of the present study. PMID:21998786
Madfa, Ahmed A; Al-Hamzi, Mohsen A; Al-Sanabani, Fadhel A; Al-Qudaimi, Nasr H; Yue, Xiao-Guang
This study aimed to analyse and compare the stability of two dental posts cemented with four different luting agents by examining their shear stress transfer through the FEM. Eight three-dimensional finite element models of a maxillary central incisor restored with glass fiber and Ni-Cr alloy cast dental posts. Each dental post was luted with zinc phosphate, Panavia resin, super bond C&B resin and glass ionomer materials. Finite element models were constructed and oblique loading of 100 N was applied. The distribution of shear stress was investigated at posts and cement/dentine interfaces using ABAQUS/CAE software. The peak shear stress for glass fiber post models minimized approximately three to four times of those for Ni-Cr alloy cast post models. There was negligible difference in peak of shear stress when various cements were compared, irrespective of post materials. The shear stress had same trend for all cement materials. This study found that the glass fiber dental post reduced the shear stress concentration at interfacial of post and cement/dentine compared to Ni-Cr alloy cast dental post.
Mortman, Rory E
This article addresses technologic advances in endodontics pertaining to new and emerging technology. Cone-beam computed tomography and optical occurrence tomography are 2 new imaging technologies that can assist the practitioner in the diagnosis of pulpal disease. The self-adjusting file and the Apexum device can be used for instrumentation and bulk debridement of an apical lesion, respectively. Neodymium:yttrium-aluminum-garnet laser, erbium:chromium:yttrium-scandium-gallium-garnet laser, EndoActivator, EndoVac, and light-activated disinfection may assist the practitioner in cleaning the root canal system. Computed tomography-guided surgery shows promise in making endodontic surgery easier, as does mineral trioxide aggregate cement for regenerative endodontic procedures.
Enkel, Bénédicte; Dupas, Cécile; Armengol, Valérie; Akpe Adou, Jonas; Bosco, Julia; Daculsi, Guy; Jean, Alain; Laboux, Olivier; LeGeros, Racquel Z; Weiss, Pierre
Endodontic treatment in dentistry is a delicate procedure and many treatment attempts fail. Despite constant development of new root canal filling techniques, the clinician is confronted with both a complex root canal system and the use of filling materials that are harmful for periapical tissues. This paper evaluates reported studies on biomaterials used in endodontics, including calcium hydroxide, mineral trioxide aggregate, calcium phosphate ceramics and calcium phosphate cements. Special emphasis is made on promising new biomaterials, such as injectable bone substitute and injectable calcium phosphate cements. These materials, which combine biocompatibility, bioactivity and rheological properties, could be good alternatives in endodontics as root canal fillers. They could also be used as drug-delivery vehicles (e.g., for antibiotics and growth factors) or as scaffolds in pulp tissue engineering.
Kumar, Arun; Sabarinathan; Raja, Ramesh
Introduction When restoring an endodontically treated tooth with deficient coronal tooth structure, posts can be used to strengthen the tooth. Recently prefabricated posts are widely used as they exclude the need for complex laboratory procedures making the procedure time saving. But the post-placement can produce stresses that cause root fracture. Different techniques can be used to study the stress distribution due to different posts, but most of them are two-dimensional and difficult to reproduce. Aim The aim of the study was to compare the stress distribution in a maxillary central incisor with Titanium and Glass fiber posts with and without ferrule using the three dimensional finite element analysis. Materials and Methods In this study 3D finite element analysis was used. Four models P1(Endodontically treated maxillary central incisor with a ferrule of coronal dentin and restored with parallel sided prefabricated titanium post and composite resin core), P2 (Endodontically treated maxillary central incisor restored with parallel sided prefabricated Titanium post and composite resin core without a ferrule of coronal dentin), P3 (Endodontically treated maxillary central incisor with a ferrule of coronal dentin and restored with parallel sided prefabricated glass fiber reinforced composite post and composite core), P4 (Endodontically treated maxillary central incisor restored with parallel sided prefabricated glass fiber reinforced composite post and composite core without a ferrule of coronal dentin), were modeled using PRO E software. Then stress analysis was done using ANSYS WORKBENCH 10.0software. A load of 100 N was applied to the models at 2mm from the incisal edge on the palatal surface with an angle of 45o to the long axis of the tooth. Results The results suggested that maximum stresses were seen around posts in order of Titanium post without ferrule followed by Titanium post with ferrule next Glass fiber post without ferrule followed by Glass fiber post
The purpose of this study was to evaluate the bond strength at the post/resin-cement interface with 3 different surface treatments of glass fiber posts and with 2 different luting resin cements. Sixty glass fiber posts (RelyX Fiber Post) were randomly divided into 3 groups (n = 20) and were luted with a dual-polymerizing self-adhesive universal resin cement (RelyX Unicem) and with a dual-polymerizing resin cement (RelyX ARC). This was carried out in association with a dual-polymerizing adhesive (Scotchbond Multi-Purpose Plus) in simulated plexiglass root canals after receiving three different pretreatment procedures. A pull-out test was performed on each sample to measure bond strengths. Data were analyzed with two-way ANOVA. Two samples from each group were processed for SEM observations in order to investigate the morphologic aspect of the post/cement interface. Both resin cements demonstrated significant different bond strength values (P < 0.0001). The surface treatment result was also statistically significant (P = 0.0465). SEM examination showed a modification of the post surface after pretreatment with methyl methacrylate. The dual-polymerizing self-adhesive universal resin cement achieved higher MPa bond strength values. The use of methyl methacrylate as a surface treatment of glass fiber posts provided a significant increase in bond strengths between the posts and both luting materials. PMID:24987418
da Silva, Luciana Mendonça; de Andrade, Andréa Mello; Machuca, Melissa Fernanda Garcia; da Silva, Paulo Maurício Batista; da Silva, Ricardo Virgolino C.; Veronezi, Maria Cecília
This in vitro study evaluated the tensile bond strength of glass fiber posts (Reforpost – Angelus-Brazil) cemented to root dentin with a resin cement (RelyX ARC – 3M/ESPE) associated with two different adhesive systems (Adper Single Bond - 3M/ESPE and Adper Scotchbond Multi Purpose (MP) Plus – 3M/ESPE), using the pull-out test. Twenty single-rooted human teeth with standardized root canals were randomly assigned to 2 groups (n=10): G1- etching with 37% phosphoric acid gel (3M/ESPE) + Adper Single Bond + #1 post (Reforpost – Angelus) + four #1 accessory posts (Reforpin – Angelus) + resin cement; G2- etching with 37% phosphoric acid gel + Adper Scotchbond MP Plus + #1 post + four #1 accessory posts + resin cement. The specimens were stored in distilled water at 37°C for 7 days and submitted to the pull-out test in a universal testing machine (EMIC) at a crosshead speed of 0.5 mm/min. The mean values of bond strength (kgf) and standard deviation were: G1- 29.163 ± 7.123; G2- 37.752 ±13.054. Statistical analysis (Student's t-test; α=0.05 showed no statistically significant difference (p<0.05) between the groups. Adhesive bonding failures between resin cement and root canal dentin surface were observed in both groups, with non-polymerized resin cement in the apical portion of the post space when Single Bond was used (G1). The type of adhesive system employed on the fiber post cementation did not influence the pull-out bond strength. PMID:19089224
Aerts, A.; Velde, B.; Janssens, K.; Dijkman, W.
Although Roman and post-Empire glasses found in Europe are reputed to have a very constant composition and hence source of components, it appears that some 4-5th century and later specimens show evidence of a different source of silica (sand) component. Zirconium and titanium are the discriminating elements. Data presented here for 278 specimens from 1st to 4th century German and Belgian samples indicate a strongly homogeneous Zr and Ti content; N: number of analyzed samples while 62 samples from Maastricht show low Zr-Ti contents from 1st to 3rd century samples while 4-5th century samples show a strong trend of concomitant Ti and Zr increase. If the high values of Zr-Ti represent a new source of silica (sand) the trend from low to high content suggests that a significant amount of low Zr-Ti glass was recycled to form these glass objects. Similar high Ti content can be seen in analysis results reported for other but not all 4-5th century samples found in northern Europe while earlier productions show typical low Ti contents. Although the fusing agent for these glasses seems to have always been natron (a mineral deposit in the Nile delta) from Hellenistic times to the 9th century, a change in the silica source, indicated by variation of the Ti and Zr content, could very well reflect the results of political instability of the 4-5th century exemplified by the fragmentation of the Roman Empire into two parts.
McClannahan, Scott B; Baisden, Michael K; Bowles, Walter R
Determination of the etiology of the patient's chief complaint and a correct diagnosis are paramount prior to a recommendation of endodontic therapy. Reproduction of the patient's chief complaint is critical. If the chief complaint cannot be reproduced, consider consultation with or referral to an endodontist or orofacial pain specialist. The diagnostic terminology presented in this update provides for a more accurate description and communication of the health or pathological conditions of both pulpal and apical tissues. This information is summarized in Table I.
Tour Savadkouhi, Sohrab; Fazlyab, Mahta
Tooth discoloration induced by endodontic sealers, is a common finding that impairs aesthetic outcome of endodontic treatment. The aim of the present mini literature review, was to summarize the existing data on discoloration potential of different endodontic sealers. The research covered the article published in PubMed and Google Scholar from 2000 to 2015. The searched keywords included ‘tooth discoloration AND endodontic’, ‘tooth discoloration AND sealer, ‘tooth discoloration AND zinc-oxide eugenol sealer’, ‘tooth discoloration AND Calcium Hydroxide Sealer’, ‘tooth discoloration AND Glass Ionomer Sealer’, ‘tooth discoloration AND epoxy-resin Sealer’, ‘tooth discoloration AND Silicon Based Sealer’, ‘tooth discoloration AND Bioceramic Sealer’ and ‘Spectrophotometry’. Conclusion: A total number of 44 articles were gained which reduced to 11 after excluding the repetitive items. The available evidence for discoloration potential of endodontic sealers currently available on the market is scarce. However, it can be concluded that all endodontic sealers can potentially stain the tooth structure to different degrees. PMID:27790251
Gomes, Brenda P F A; Vianna, Morgana E; Zaia, Alexandre A; Almeida, José Flávio A; Souza-Filho, Francisco J; Ferraz, Caio C R
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.
Oliveira, Aline S; Ramalho, Elisa S; Spazzin, Aloísio O; Naves, Lucas Z; Moraes, Rafael R
The combined use of silane and solvated bonding agents on the bond strength to glass-fibre posts was investigated. A model Bis-GMA/HEMA adhesive was formulated with no solvent, 30% of ethanol or 80% of acetone. The surfaces of rectangular-shaped posts were silanated or not and one of the agents was applied, except for the control group. Cylinders of resin cement (RelyX ARC, 3M ESPE, Saint Paul, MN, USA) were built-up on the surfaces (n = 20) and submitted to shear testing. All groups showed higher bond strengths when the surfaces were silanated. When no silanization was carried out, the use of bonding agents, either solvated or non-solvated, increased the bond strengths. All groups treated with both silane and bonding agent showed higher bond strengths than the group that was only silanated. Control and ethanol-based adhesives were similar, whereas the acetone-based agent yielded higher bond strengths. Adhesive failures were predominant. Combination of silane and adhesive enhanced the bond to fibre posts.
Frydman, G; Levatovsky, S; Pilo, R
FRC (Fiber-reinforced composite) posts have been used since the beginning of the 90s with the introduction of carbon fiber posts. Fiber posts are widely used to restore endodontically treated teeth that have insufficient coronal tooth structure. Many in vitro and in vivo studies have shown the advantage of using FRC over prefabricated and cast metal post especially indicated in narrow root canals which are prone to vertically root fracture. The most frequent failure of FRC is debonding of a post at the resin cement/dentin interface. Bonding to dentin may be achieved by using etch-and-rinse and self-etch adhesives. The bond strength formed by self-adhesive cements is noticeably lower in comparison to the bond strength formed with resin cements applied in combination with etch-and-rinse adhesives. In an attempt to maximize resin bonding to fiber posts, several surface treatments have been suggested. Sandblasting with alumina particles results in an increased surface roughness and surface area without affecting the integrity of the post as long as it is applied by 50 microm alumina particles at 2.5 bars for maximally 5 seconds at a distance of 30 mm. The efficiency of post salinization is controversial and its contribution to the retention is of minor importance. Hydrofluoric acid has recently been proposed for etching glass fiber posts but this technique produced substantial damage to the glass fibers and affected the integrity of the post. Delayed cementation of fiber post (at least 24h post endodontic treatment) resulted in higher retentive strengths in comparison to immediate cementation and the best results were obtained when the luting agent was brought into the post space with lentulo spirals or specific syringes. The resin cement film thickness also influences the pullout strengths of fiber-reinforced posts .The highest bond strength values were obtained when the cement layer oversized the post spaces but not larger than 0.3 mm. The use of core build
narrow- 37 line excitation F. Optical transitions of Sm3+ in oxide glasses 41 G. Energy transfer from U i+ to Sm3+ in phosphate glass 45 H. Transition...probabilities of europium(III) in zirconium 50 and beryllium fluoride glasses, phosphate glass and pentaphosphate crystals I. Multiphonon relaxation in...in phosphate , borate, germa- nate and tellurite glasses. The level fluorescent lifetime was derived from these rates and from the calculated radiative
Möncke, D; Kamitsos, E I; Palles, D; Limbach, R; Winterstein-Beckmann, A; Honma, T; Yao, Z; Rouxel, T; Wondraczek, L
A series of transition and post-transition metal ion (Mn, Cu, Zn, Pb, Bi) binary borate glasses was studied with special consideration of the cations impact on the borate structure, the cations cross-linking capacity, and more generally, structure-property correlations. Infrared (IR) and Raman spectroscopies were used for the structural characterization. These complementary techniques are sensitive to the short-range order as in the differentiation of tetrahedral and trigonal borate units or regarding the number of non-bridging oxygen ions per unit. Moreover, vibrational spectroscopy is also sensitive to the intermediate-range order and to the presence of superstructural units, such as rings and chains, or the combination of rings. In order to clarify band assignments for the various borate entities, examples are given from pure vitreous B2O3 to meta-, pyro-, ortho-, and even overmodified borate glass compositions. For binary metaborate glasses, the impact of the modifier cation on the borate speciation is shown. High field strength cations such as Zn(2+) enhance the disproportionation of metaborate to polyborate and pyroborate units. Pb(2+) and Bi(3+) induce cluster formation, resulting in PbOn- and BiOn-pseudophases. Both lead and bismuth borate glasses show also a tendency to stabilize very large superstructural units in the form of diborate polyanions. Far-IR spectra reflect on the bonding states of modifier cations in glasses. The frequency of the measured cation-site vibration band was used to obtain the average force constant for the metal-oxygen bonding, FM-O. A linear correlation between glass transition temperature (Tg) and FM-O was shown for the metaborate glass series. The mechanical properties of the glasses also correlate with the force constant FM-O, though for cations of similar force constant the fraction of tetrahedral borate units (N4) strongly affects the thermal and mechanical properties. For paramagnetic Cu- and Mn-borate glasses, N4 was
Möncke, D.; Kamitsos, E. I.; Palles, D.; Limbach, R.; Winterstein-Beckmann, A.; Honma, T.; Yao, Z.; Rouxel, T.; Wondraczek, L.
A series of transition and post-transition metal ion (Mn, Cu, Zn, Pb, Bi) binary borate glasses was studied with special consideration of the cations impact on the borate structure, the cations cross-linking capacity, and more generally, structure-property correlations. Infrared (IR) and Raman spectroscopies were used for the structural characterization. These complementary techniques are sensitive to the short-range order as in the differentiation of tetrahedral and trigonal borate units or regarding the number of non-bridging oxygen ions per unit. Moreover, vibrational spectroscopy is also sensitive to the intermediate-range order and to the presence of superstructural units, such as rings and chains, or the combination of rings. In order to clarify band assignments for the various borate entities, examples are given from pure vitreous B2O3 to meta-, pyro-, ortho-, and even overmodified borate glass compositions. For binary metaborate glasses, the impact of the modifier cation on the borate speciation is shown. High field strength cations such as Zn2+ enhance the disproportionation of metaborate to polyborate and pyroborate units. Pb2+ and Bi3+ induce cluster formation, resulting in PbOn- and BiOn-pseudophases. Both lead and bismuth borate glasses show also a tendency to stabilize very large superstructural units in the form of diborate polyanions. Far-IR spectra reflect on the bonding states of modifier cations in glasses. The frequency of the measured cation-site vibration band was used to obtain the average force constant for the metal-oxygen bonding, FM-O. A linear correlation between glass transition temperature (Tg) and FM-O was shown for the metaborate glass series. The mechanical properties of the glasses also correlate with the force constant FM-O, though for cations of similar force constant the fraction of tetrahedral borate units (N4) strongly affects the thermal and mechanical properties. For paramagnetic Cu- and Mn-borate glasses, N4 was determined
Martin, L R; Gilbert, B; Dickerson, A W
1. Perforations in the floor of the pulp chambers of molars offer an improved prognosis when treated aseptically and quickly. 2. Perforations in the apical third of the root canal, when made with a reamer or file that leaves 2 mm. or less of unfilled root canal space, have a good prognosis. 3. If a perforation, either mechanical or resorptive in etiology, occurs on the lingual surface and requires surgical management, prognosis is poor. 4. Recent advances in the use of calcium hydroxide to treat endodontic perforations show promise.
Pereira, Jefferson Ricardo; de Oliveira, Jonas Alves; do Valle, Accacio Lins; Zogheib, Lucas Villaca; Ferreira, Paulo Martins; Bastos, Luiz Gustavo Cavalcanti
The aim of this study was to evaluate the effect of prefabricated fiber posts on the flexural strength and modulus of elasticity of a composite resin. Thirty bar-shaped specimens measuring 25 x 2.0 x 2.0 mm were made, containing posts that were 1.3 mm in diameter and 20 mm long. Each group contained 10 specimens: Group 1, resin without post; Group 2, resin with carbon fiber post; Group 3, resin with glass fiber post. The samples were immersed in water at 37 degrees C until the three-point loading test was performed at a speed of 1.0 mm/minute. The results were statistically analyzed by ANOVA and Tukey's test (P = 0.05). Both fiber posts were similar in strength and both were stronger than the control. Group 3 obtained a higher mean modulus of elasticity than Groups 1 and 2, which were similar. The results of this study demonstrated that the presence of a fiber post significantly raised flexural strength values and the glass fiber post significantly increased the modulus of elasticity of the evaluated composite resin.
Franco, Ademir; Picoli, Fernando Fortes; Nunes, Fernando Gomes; Estrela, Carlos
Objective of work The present study aims to report a case of successful human identification based on the comparison of ante-mortem and post-mortem records of endodontic treatment. Based on these, the legal value of storing and updating clinical records is highlighted throughout the text. Case report An unknown body was recovered from a traffic accident site. Forensic examination was conducted in order to establish the identity of the victim. Based on the absence of ante-mortem fingerprint registration in the national database, the search for AM data was performed using periapical radiographic records from private dental clinics. A positive dental identification was achieved analyzing evidence of endodontic treatment. Conclusion Dental radiographs play a valuable role as legal tools supporting the criminal demands on the daily forensic practice. Specifically in endodontics, periapical radiographs are essential for a proper treatment. In forensics, these radiographs represent a solid source of ante-mortem data for human identifications. PMID:27688359
Kaushik, Sagar N; Kim, Bogeun; Walma, Alexander M Cruz; Choi, Sung Chul; Wu, Hui; Mao, Jeremy J; Jun, Ho-Wook; Cheon, Kyounga
Regenerative endodontics has been proposed to replace damaged and underdeveloped tooth structures with normal pulp-dentin tissue by providing a natural extracellular matrix (ECM) mimicking environment; stem cells, signaling molecules, and scaffolds. In addition, clinical success of the regenerative endodontic treatments can be evidenced by absence of signs and symptoms; no bony pathology, a disinfected pulp, and the maturation of root dentin in length and thickness. In spite of the various approaches of regenerative endodontics, there are several major challenges that remain to be improved: a) the endodontic root canal is a strong harbor of the endodontic bacterial biofilm and the fundamental etiologic factors of recurrent endodontic diseases, (b) tooth discolorations are caused by antibiotics and filling materials, (c) cervical root fractures are caused by endodontic medicaments, (d) pulp tissue is not vascularized nor innervated, and (e) the dentin matrix is not developed with adequate root thickness and length. Generally, current clinical protocols and recent studies have shown a limited success of the pulp-dentin tissue regeneration. Throughout the various approaches, the construction of biomimetic microenvironments of pulp-dentin tissue is a key concept of the tissue engineering based regenerative endodontics. The biomimetic microenvironments are composed of a synthetic nano-scaled polymeric fiber structure that mimics native pulp ECM and functions as a scaffold of the pulp-dentin tissue complex. They will provide a framework of the pulp ECM, can deliver selective bioactive molecules, and may recruit pluripotent stem cells from the vicinity of the pulp apex. The polymeric nanofibers are produced by methods of self-assembly, electrospinning, and phase separation. In order to be applied to biomedical use, the polymeric nanofibers require biocompatibility, stability, and biodegradability. Therefore, this review focuses on the development and application of the
Hunter, M J
Endodontics is a constantly developing field, with new instruments, preparation techniques and sealants competing with trusted and traditional approaches to tooth restoration. Thus general dental practitioners must question and understand the significance of these developments before adopting new practices. In view of this, the aim of this article, and the associated presentation at the 2013 British Dental Conference & Exhibition, is to provide an overview of endodontic methods and constantly evolving best practice. The presentation will review current preparation techniques, comparing rotary versus reciprocation, and question current trends in restoration of the endodontically treated tooth.
Reis, Kátia Rodrigues; Spyrides, George Miguel; Oliveira, Jonas Alves de; Jnoub, Alexandre Abrão; Dias, Kátia Regina Hostilio Cervantes; Bonfantes, Gerson
This study investigated the effects of the cement type and the water storage time on the push-out bond strength of a glass fiber post. Glass fiber posts (Fibrekor, Jeneric Pentron) were luted to post spaces using a self-cured resin cement (C&B Cement [CB]), a glass ionomer cement (Ketac Cem [KC]) or a resin-modified glass ionomer cement (GC FujiCEM [FC]) according to the manufacturers' instructions. For each luting agent, the specimens were exposed to one of the following water storage times (n=5): 1 day (T1), 7 days (T7), 90 days (T90) and 180 days (T180). Push-out tests were performed after the storage times. Control specimens were not exposed to water storage, but subjected to the push-out test 10 min after post cementation. Data (in MPa) were analyzed by Kruskal-Wallis and Dunn`s test (α=0.05). Cement type and water storage time had a significant effect (p<0.05) on the push-out bond strength. CB showed significantly higher values of retention (p<0.05) than KC and FC, irrespective of the water storage time. Water storage increased significantly the push-out bond strength in T7 and T90, regardless of the cement type (p<0.05). The results showed that fiber posts luted to post spaces with the self-cured resin cement exhibited the best bonding performance throughout the 180-day water storage period. All cements exhibited a tendency to increase the bond strength after 7 and 90 days of water storage, decreasing thereafter.
Frentzen, Matthias; Braun, Andreas; Koort, Hans J.
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.
Muliyar, Sabir; Shameem, K Abdul; Thankachan, Rekha P; Francis, P G; Jayapalan, C S; Hafiz, K A Abdul
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
Wandscher, Vinícius Felipe; Bergoli, César Dalmolin; de Oliveira, Ariele Freitas; Kaizer, Osvaldo Bazzan; Souto Borges, Alexandre Luiz; Limberguer, Inácio da Fontoura; Valandro, Luiz Felipe
This study evaluated the shear stress presented in glass fiber posts with parallel fiber (0°) and different coronal diameters under fatigue, fracture resistance and FEA. 160 glass-fiber posts (N=160) with eight different coronal diameters were used (DT=double tapered, number of the post=coronal diameter and W=Wider - fiber post with coronal diameter wider than the conventional): DT1.4; DT1.8W; DT1.6; DT2W; DT1.8; DT2.2W; DT2; DT2.2. Eighty posts were submitted to mechanical cycling (3×10(6) cycles; inclination: 45°; load: 50N; frequency: 4Hz; temperature: 37°C) to assess the surviving under intermittent loading and other eighty posts were submitted to fracture resistance testing (resistance [N] and shear-stress [MPa] values were obtained). The eight posts types were 3D modeled (Rhinoceros 4.0) and the shear-stress (MPa) evaluated using FEA (Ansys 13.0). One-way ANOVA showed statistically differences to fracture resistance (DT2.2W and DT2.2 showed higher values) and shear stress values (DT1.4 showed lower values). Only the DT1.4 fiber posts failed after mechanical cycling. FEA showed similar values of shear stress between the groups and these values were similar to those obtained by shear stress testing. The failure analysis showed that 95% of specimens failed by shear. Posts with parallel fiber (0°) may suffer fractures when an oblique shear load is applied on the structure; except the thinner group, greater coronal diameters promoted the same shear stresses.
Pereira, Gabriel Kalil Rocha; Lançanova, Mateus; Wandscher, Vinicius Felipe; Kaizer, Osvaldo Bazzan; Limberger, Inácio; Özcan, Mutlu; Valandro, Luiz Felipe
Several rotary instruments have been daily employed on clinic to promote cut aiming to adjust the length of fiber posts to the radicular conduct, but there is no information on the literature about the effects of the different rotary instruments and its impact on the micromorphology of surface and mechanical properties of the glass fiber post. This study aimed the impact of rotary instruments upon fiber-matrix integrity, micromorphology and flexural-strength of glass-fiber posts (GFP). GFP (N=110) were divided into 5 groups: Ctrl: as-received posts, DBc: coarse diamond-bur, DBff: extra-fine diamond-bur, CB: carbide-bur, DD: diamond-disc. Cutting procedures were performed under abundant irrigation. Posts exposed to rotary instruments were then subjected to 2-point inclined loading test (compression 45°) (n=10/group) and 3-point flexural-strength test (n=10/group). Fiber-matrix integrity and micromorphology at the cut surface were analyzed using a SEM (n=2/group). Cutting procedures did not significantly affect the 2-point (51.7±4.3-56.7±5.1 MPa) (p=0.0233) and 3-point flexural-strength (671.5±35.3-709.1±33.1 MPa) (p=0.0968) of the posts (One-way ANOVA and Tukey׳s test). Fiber detachment was observed only at the end point of the cut at the margins of the post. Cut surfaces of the CB group were smoother than those of the other groups. After 3-point flexural strength test, fiber-matrix separation was evident at the tensile side of the post. Rotary instruments tested with simultaneous water-cooling did not affect the resistance of the tested fiber posts but caused disintegration of the fibers from the matrix at the end of the cut, located at the margins.
Samadi, Firoza; Jaiswal, JN; Saha, Sonali
ABSTRACT% Aim: To compare the effect of different chemical solvents on glass fiber reinforced posts and to study the effect of these solvents on the shear bond strength of glass fiber reinforced post to core material. Materials and methods: This study was conducted to evaluate the effect of three chemical solvents, i.e. silane coupling agent, 6% H2O2 and 37% phosphoric acid on the shear bond strength of glass fiber post to a composite resin restorative material. The changes in post surface characteristics after different treatments were also observed, using scanning electron microscopy (SEM) and shear bond strength was analyzed using universal testing machine (UTM). Results: Surface treatment with hydrogen peroxide had greatest impact on the post surface followed by 37% phosphoric acid and silane. On evaluation of the shear bond strength, 6% H2O2 exhibited the maximum shear bond strength followed in descending order by 37% phosphoric acid and silane respectively. Conclusion: The surface treatment of glass fiber post enhances the adhesion between the post and composite resin which is used as core material. Failure of a fiber post and composite resin core often occurs at the junction between the two materials. This failure process requires better characterization. How to cite this article: Sharma A, Samadi F, Jaiswal JN, Saha S. A Comparative Evaluation of Effect of Different Chemical Solvents on the Shear Bond Strength of Glass Fiber Reinforced Post to Core Material. Int J Clin Pediatr Dent 2014;7(3):192-196. PMID:25709300
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.
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 focus on the use of lasers in endodontics.
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.
Modulus GPa Gigapascal GRP Glass Reinforced Plastic HPSEC High Performance Size Exclusion Chromatography min Minute mcal Millicalories mL Milliliter MW...Tpost-cure Post-Cure Temperature Cross-Link Density -iv- 1. INTRODUCTION Reinforced polymeric materials, in particular glass reinforced plastics (GRP’s...properties of glass reinforced plastics , requires that the resin, the reinforcing fibre, the additives (such as fire retardants), and their interaction
Benic, Goran I; Wolleb, Karin; Hämmerle, Christoph H F; Sailer, Irena
The primary aim of this study was to test whether intraradicular posts of different colors induce different amounts of color change of the buccal gingiva. Twentythree patients in need of a post-and-core buildup at one endodontically treated incisor, canine, or premolar were included. Titanium (Ti), zirconia (Zi), and glass fiber (Gf) posts were consecutively inserted in each test tooth. Spectrophotometric color measurement of the buccal gingiva was performed prior to post bed preparation and after insertion of Ti, Zi, and Gf posts. For control purposes, the gingival color at the contralateral vital tooth was assessed. The differences of color components ΔL, Δa, and Δb and the total color difference (ΔE) between different experimental conditions were obtained. ΔE value of 3.7 was considered the threshold value for intraoral color distinction. The gingival thickness at test teeth was measured. No difference occurred with regard to the amount of gingival discoloration induced by different posts. In the majority of cases, posts did not exhibit a visible influence on the color of buccal gingiva. The gingiva at endodontically treated teeth presented a visible discoloration compared to the gingiva at vital teeth. The degree of gingival discoloration at endodontically treated teeth was correlated with the gingival thickness, with more pronounced discolorations in cases of thinner soft tissue.
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
Johnstone, M; Parashos, P
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.
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 present the topical areas of microorganisms involved in primary infection; microorganisms involved with failing endodontics, culturing, bacteremia, and endodontics; leaving teeth open; antibiotics; actinomycosis; sterilization of instruments and sterilization of gutta-percha, microorganisms in periradicular lesions; biofilms; and fungi, viruses, and prions.
Jhajharia, Kapil; Parolia, Abhishek; Shetty, K Vikram; Mehta, Lata Kiran
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
Blankenau, Richard J.; Ludlow, Marvin; Anderson, David
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.
Seijo, Marilia O S; Ferreira, Efigênia F; Ribeiro Sobrinho, Antônio P; Paiva, Saul M; Martins, Renata C
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.
Kumar, K. Vinay; Kiran Kumar, K.S.; Supreetha, S.; Raghu, K.N.; Veerabhadrappa, Anusha Channabasappa; Deepthi, S
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
Memarpour, Mahtab; Abbaszadeh, Maryam
Objectives To determine the retentive strength and failure mode of undercut composite post, glass fiber post and polyethylene fiber post luted with flowable composite resin and resin-cement. Materials and Methods Coronal parts of 120 primary canine teeth were sectioned and specimens were treated endodontically. The teeth were randomly divided into 6 groups (n = 20). Prepared root canals received intracanal retainers with a short composite post, undercut composite post, glass fiber post luted with flowable resin or resin-cement, and polyethylene fiber post luted with flowable resin or resin-cement. After crown reconstruction, samples were tested for retentive strength and failure mode. Statistical analysis was done with one-way ANOVA and Tukey tests (p < 0.05). Results There were statistically significant differences between groups (p = 0.001). Mean bond strength in the undercut group was significantly greater than in the short composite post (p = 0.030), and the glass fiber post (p = 0.001) and the polyethylene fiber post group luted with resin-cement (p = 0.008). However, the differences between the undercut group and the groups with flowable composite as the luting agent were not significant (p = 0.068, p = 0.557). Adhesive failure was more frequent in the fiber post groups. Conclusions Although the composite post with undercutting showed the greatest resistance to dislodgement, fiber posts cemented with flowable composite resin provided acceptable results in terms of retentive strength and fracture mode. PMID:24303356
O’Donnell, J.N.R.; Skrtic, D.
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
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 focus on post space preparation.
Birman, E G; Sampaio, J M; Magalhães, J; Sato, E
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.
Hwang, Jae I; Chuang, Augustine H; Sidow, Stephanie J; McNally, Kathleen; Goodin, Jeremy L; McPherson, James C
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.
Corsalini, Massimo; Pettini, Francesco; Di Venere, Daniela; Ballini, Andrea; Chiatante, Giuseppe; Lamberti, Luciano; Pappalettere, Carmine; Fiorentino, Michele; Uva, Antonio E.; Monno, Giuseppe; Boccaccio, Antonio
Endocanalar posts are necessary to build up and retain coronal restorations but they do not reinforce dental roots. It was observed that the dislodgement of post-retained restorations commonly occurs after several years of function and long-term retention may be influenced by various factors such as temperature changes. Temperature changes, in fact, produce micrometric deformations of post and surrounding tissues/materials that may generate high stress concentrations at the interface thus leading to failure. In this study we present an optical system based on the projection moiré technique that has been utilized to monitor the displacement field of endocanalar glass-fibre posts subjected to temperature changes. Measurements were performed on forty samples and the average displacement values registered at the apical and middle region were determined for six different temperature levels. A total of 480 displacement measurements was hence performed. The values of the standard deviation computed for each of the tested temperatures over the forty samples appear reasonably small which proves the robustness and the reliability of the proposed optical technique. The possible implications for the use of the system in the applicative context were discussed. PMID:27990186
6. Looking glass aircraft in the project looking glass historic district. View to north. - Offutt Air Force Base, Looking Glass Airborne Command Post, Looking Glass Avenue between Comstat Drive & Nightwatch Avenue, Offutt Air Force Base, Bellevue, Sarpy County, NE
Garlock, J A; Pringle, G A; Hicks, M L
Odontogenic keratocysts manifest themselves as radiolucencies that can appear anywhere in the maxilla or mandible, including periradicular areas; they may thus masquerade as lesions of endodontic origin. This retrospective study examined 239 odontogenic keratocysts received by the Oral Pathology Laboratory at Temple University School of Medicine over a 3-year period. Twenty-one (9%) of the cysts received were located periradicularly; of these 21, 12 (57%) were associated with nonvital or endodontically treated teeth and thus mimicked lesions of endodontic origin. Because of its aggressive nature and tendency to recur, the periradicular odontogenic keratocyst should be included in the differential diagnosis of lesions that are refractory to endodontic treatment.
Jha, Padmanabh; Aggarwal, Akarshak
Aim. The aim of this study was to compare the fracture resistance of simulated immature teeth restored with gutta-percha, glass fiber posts (GFP), experimental dentine posts (DP) or Intracanal composite Resin (ICR). Materials and Methods. Fifty maxillary canines were decoronated, standardized and enlarged until, number 5 Peeso reamers were allowed to simulate immature teeth. After placement of 5 mm of MTA, the canals were divided into 5 groups and filled as follows: Group 1: AH Plus + gutta-percha, lateral compaction; Group 2: GFP luted with PARACORE dual cure resin; Group 3: DP luted with PARACORE dual cure resin; Group 4: PARACORE dual cure resin. A standardized core was built in all groups except in Group 5. Each of the specimens was tested for fracture resistance by universal testing machine. Results. The mean fracture resistance were 817 ± 27.753, 1164.6 ± 21.624, 994.4 ± 96.8747, 873.8 ± 105.446 and 493.7 ± 6.945 newtons for Groups 1, 2, 3, 4, and 5 respectively. Independent “t” test revealed statistically significant discrepancies, in the fracture resistance among the 4 groups except Group 1 and Group 4 (P < 0.05). Conclusions. This study suggests that GFP and DP may be preferred for additional reinforcement of immature teeth. PMID:25629086
Eraslan, Öznur; Eraslan, Oğuz; Eskitaşcıoğlu, Gürcan; Belli, Sema
The aim of this finite element method (FEM) study was to test two different restorative techniques used for construction of severely damaged endodontically treated premolar teeth using Finite Element Stress Analysis Method. In this study, four types of three-dimensional (3-D) FEM mathematical models simulating (1) a sound lower single rooted premolar tooth with supporting structures; (2) a root-filled lower premolar tooth without lingual cusp, restored with resin composite; (3) a root-filled lower premolar tooth without lingual cusp restored with resin composite in combination with a polyethylene fiber which is placed circumferentially to help to create a composite lingual wall; (4) a root-filled lower premolar tooth without lingual cusp restored with resin composite in combination with a glass fiber post, were modeled. A 300-N static vertical occlusal load was applied on the node at the center of occlusal surface of the tooth to calculate stress distributions. Solidworks/Cosmosworks structural analysis programs were used for FEM analysis. The analysis of the von Mises stress values revealed that maximum stress concentrations were located at loading areas for all models. Root dentine tissue, lingual cortical bone, and apical bone structures were other stress concentration regions. There were stress concentration differences among the models at root dentine tissue. Although the distribution pattern was similar with composite resin restored tooth model, highest stress values were observed at root dentine in the model restored with post-and-core. Post structure accumulated more stress on its own body. Stress distribution patterns of sound tooth and fiber-reinforced restoration models were found as similar. The present study showed that the use of post material increased the stress values at root dentine structure while reinforcing the restoration with a fiber decreases stress transmission. Fiber-reinforced restoration provided stress distributions similar to sound
Deepak, B. S.; Subash, T. S.; Narmatha, V. J.; Anamika, T.; Snehil, T. K.; Nandini, D. B.
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
Burrell, William; Lee, Mickey M.
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)
... 21 Food and Drugs 8 2011-04-01 2011-04-01 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...
... 21 Food and Drugs 8 2010-04-01 2010-04-01 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...
... 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...
... 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...
... 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...
... 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...
... 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...
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
Mao, Teresa; Neelakantan, Prasanna
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.
He, Ling; Zhong, Juan; Gong, Qimei; Cheng, Bin; Kim, Sahng G; Ling, Junqi; Mao, Jeremy J
Apical revascularization (AR) and platelet-rich plasma have been used to restore dental pulp vitality in infected immature permanent teeth. Two regenerative therapies are cell transplantation and cell homing. This article updates and benchmarks these therapies with cell homing. A case report concluded that AR increased root length; however, quantitative and statistical assessments disproved this. Regenerative endodontic therapies require prospective clinical trials demonstrating safety and efficacy. These therapies are intrinsically susceptible to procedural and patient variations. Cell homing uses novel molecules that drive therapeutic efficacy, and may be less sensitive to procedural and patient variations.
Mishra, Lora; Patnaik, Swarnav; Patro, Sangram; Debnath, Nitai; Mishra, Satyaranjan
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.
LAZARI, Priscilla Cardoso; de OLIVEIRA, Rodrigo Caldeira Nunes; ANCHIETA, Rodolfo Bruniera; de ALMEIDA, Erika Oliveira; FREITAS JUNIOR, Amilcar Chagas; KINA, Sidney; ROCHA, Eduardo Passos
Objective The aim of the present study was to analyze the influence of root canal and glass fiber post diameters on the biomechanical behavior of the dentin/cement/post interface of a root-filled tooth using 3D finite element analysis. Material and Methods Six models were built using micro-CT imaging data and SolidWorks 2007 software, varying the root canal (C) and the glass fiber post (P) diameters: C1P1-C=1 mm and P=1 mm; C2P1-C=2 mm and P=1 mm; C2P2-C=2 mm and P=2 mm; C3P1-C=3 mm and P=1 mm; C3P2-C=3 mm and P=2 mm; and C3P3-C=3 mm and P=3 mm. The numerical analysis was conducted with ANSYS Workbench 10.0. An oblique force (180 N at 45º) was applied to the palatal surface of the central incisor. The periodontal ligament surface was constrained on the three axes (x=y=z=0). Maximum principal stress (σmax) values were evaluated for the root dentin, cement layer, and glass fiber post. Results: The most evident stress was observed in the glass fiber post at C3P1 (323 MPa), and the maximum stress in the cement layer occurred at C1P1 (43.2 MPa). The stress on the root dentin was almost constant in all models with a peak in tension at C2P1 (64.5 MPa). Conclusion The greatest discrepancy between root canal and post diameters is favorable for stress concentration at the post surface. The dentin remaining after the various root canal preparations did not increase the stress levels on the root. PMID:24473716
In the follow study, we have developed a detailed understanding of the chemical and mechanical microscopic interactions that occur during polishing affecting the resulting surface microroughness of the workpiece. Through targeted experiments and modeling, the quantitative relationships of many important polishing parameters & characteristics affecting surface microroughness have been determined. These behaviors and phenomena have been described by a number of models including: (a) the Ensemble Hertzian Multi Gap (EHMG) model used to predict the removal rate and roughness at atomic force microscope (AFM) scale lengths as a function of various polishing parameters, (b) the Island Distribution Gap (IDG) model used to predict the roughness at larger scale lengths, (c) the Deraguin-Verwey-Landau-Overbeek (DLVO) 3-body electrostatic colloidal model used to predict the interaction of slurry particles at the interface and roughness behavior as a function of pH, and (d) a diffusion/chemical reaction rate model of the incorporation of impurities species into the polishing surface layer (called the Bielby layer). Based on this improved understanding, novel strategies to polish the workpiece have been developed simultaneously leading to both ultrasmooth surfaces and high material removal rates. Some of these strategies include: (a) use of narrow PSD slurries, (b) a novel diamond conditioning recipe of the lap to increase the active contact area between the workpiece and lap without destroying its surface figure, (c) proper control of pH for a given glass type to allow for a uniform distribution of slurry particles at the interface, and (d) increase in applied load just up to the transition between molecular to plastic removal regime for a single slurry particle. These techniques have been incorporated into a previously developed finishing process called Convergent Polishing leading to not just economical finishing process with improved surface figure control, but also
Idris, Mohamed; Sakkir, Nasil; KJ, Nandakishore; Kini, Annapurna
Aberrations in the root canal anatomy are a commonly occurring phenomenon. Although the mandibular second molar is commonly a bi-rooted tooth with an uncomplicated endodontic anatomy, variations have to be considered every time endodontic therapy is performed. This case report describes the non-surgical endodontic retreatment performed on a mandibular second molar with four seperate roots and canals. ProTaper Universal rotary nickel-titanium instruments (Dentsply Maillefer, Ballaigues, Switzerland) for treatment and retreatment were used to remove the old gutta percha and to clean and shape all root canals, followed by the complete obturation of root canal system. Post-operative CBCT scan was taken to confirm the quality of the performed treatment. PMID:24783160
Kumar, Narender; Aggarwal, Vivek; Singla, Mamta; Gupta, Ridhima
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
Cstf3 everse OFd neeO a 1 d IIeif by locLETEa WE~~ CLJANIATO OF TH)S PAITIE OFh~ Iat NOVnteSred) EVALUATION OF DEBRIDEMENT TECHNIQUES FOR ENDODONTIC ...INSTRUMENTS *RONALD 0. SEGALL, DMD **CARLOS E. del RIO, DDS ***JOHN M. BRADY, DDS, MSPH ****WILLIAM A. AYER, DDS, PhD :f*MAJ, DC Endodontic Resident, US... Endodontic Residency, US Army Institute of Dental Research, Walter Reed Army Medical Center, Washington, DC 20012 ***COL, DC Chief, Dept. of Biophysics
Winter, G B
One of the most difficult problems met with in endodontic therapy for children is the traumatized anterior tooth whose root is still incomplete. In cases where the pulp is vital, treatment by pulp capping or pulpotomy is directed to preserving the vitality of the radicular pulp to ensure completion of root formation. Calcium hydroxide remains the material of choice in both forms of treatment. Once root formation is complete, removal of the pulp residue and filling of the root canal may be performed as a preliminary to restoration by means of a post retained crown. Where the pulp is non vital, attempts to fill the funnel shaped apical part of the canal, whether from a coronal approach or by open operation for retrograde filling, have proved unsatisfactory. Many workers have shown however that a number of root filling materials and root dressings are capable of inducing either continued root growth or a closure of the apical region by a calcific scar. A detailed survey of 34 teeth treated by this method has been made and the important principles which appear to influence the success of the technique are enumerated.
Trindade, Alessandra Cesar; De Figueiredo, José Antônio Poli; Steier, Liviu; Weber, João Batista Blessmann
Recently, several in vitro and in vivo studies demonstrated promising results about the use of photodynamic therapy during root canal system disinfection. However, there is no consensus on a standard protocol for its incorporation during root canal treatment. The purpose of this study was to summarize the results of research on photodynamic therapy in endodontics published in peer-reviewed journals. A review of pertinent literature was conducted using the PubMed database, and data obtained were categorized into sections in terms of relevant topics. Studies conducted in recent years highlighted the antimicrobial potential of photodynamic therapy in endodontics. However, most of these studies were not able to confirm a significant improvement in root canal disinfection for photodynamic therapy as a substitute for current disinfection methods. Its indication as an excellent adjunct to conventional endodontic therapy is well documented, however. Data suggest the need for protocol adjustments or new photosensitizer formulations to enhance photodynamic therapy predictability in endodontics.
Rajeswari, Kalaiselvam; Kandaswamy, Deivanayagam; Karthick, Soundararajan
Successful endodontic practice requires complete knowledge about the various medical conditions and appropriateness in planning treatment as per the need with effective safety measures. This review focuses on a number of systemic complications encountered in endodontic practice and directions to be followed for avoiding potential complications. A detailed PubMed search was carried out using specific keywords, and 25 articles were referred for finalizing the content. PMID:27829742
Milani, Amin Salem; Froughreyhani, Mohammad; Mohammadi, Hosein; Tabegh, Fatemeh Ghasemi; Pournaghiazar, Fatemeh
This study was designed to investigate the fracture strength of endodontically treated teeth temporarily restored with some commonly used interim materials. Of 90 extracted maxillary premolars used in this study, 15 were left intact as the positive control. Endodontic treatment was performed on the remaining 75 teeth. The endodontically treated teeth were then randomly assigned to 5 groups (n = 15). One group was not restored and served as the negative control. In the remaining 4 experimental groups, the teeth were restored with a temporary cement: Zonalin, IRM, Coltosol, or Fuji II LC resin-modified glass ionomer (RMGI). The fracture strengths of all teeth were measured with a universal testing machine. The fracture strength of teeth restored with RMGI was significantly greater than that of other groups (P < 0.001), including intact teeth (P = 0.025). The fracture strength of teeth restored with other temporary materials was significantly lower than that of intact teeth (P < 0.05) but not significantly different from that of the negative control. From a structural resistance standpoint, RMGI may be the best choice for short-term temporary restoration of endodontically treated teeth. Other types of temporary restorative material had no reinforcing effect on tooth structure.
Silva, Rhonan Ferreira; Franco, Ademir; Mendes, Solon Diego Santos Carvalho; Picoli, Fernando Fortes; Nunes, Fernando Gomes; Estrela, Carlos
Endodontics is a special branch of dentistry constantly guided by imaging examinations. From a forensic scope, endodontics plays a valuable role providing solid antemortem (AM) radiographic evidence for comparison with postmortem findings in human identifications. This study illustrates the interface between endodontics and forensic odontology describing three cases of human identification based on radiographic endodontic records. From 2009 to 2012, three unknown male victims of murder were examined in a local Brazilian medico-legal institute to retrieve identity and potential cause of death. Specifically, when asked for AM data, a relative of the three victims provided periapical radiographs of endodontic treatments. Based on that, forensic dentists reproduced the same imaging acquisition techniques obtaining similar periapical radiographs, enabling a comparative dental identification. All the victims were positively identified based on patterns of dental morphology and treatment intervention. This study draws the attention of general and forensic dentists highlight the importance of properly recording dental treatments and searching for evidence in AM endodontic data, respectively.
Silva, Rhonan Ferreira; Franco, Ademir; Mendes, Solon Diego Santos Carvalho; Picoli, Fernando Fortes; Nunes, Fernando Gomes; Estrela, Carlos
Endodontics is a special branch of dentistry constantly guided by imaging examinations. From a forensic scope, endodontics plays a valuable role providing solid antemortem (AM) radiographic evidence for comparison with postmortem findings in human identifications. This study illustrates the interface between endodontics and forensic odontology describing three cases of human identification based on radiographic endodontic records. From 2009 to 2012, three unknown male victims of murder were examined in a local Brazilian medico-legal institute to retrieve identity and potential cause of death. Specifically, when asked for AM data, a relative of the three victims provided periapical radiographs of endodontic treatments. Based on that, forensic dentists reproduced the same imaging acquisition techniques obtaining similar periapical radiographs, enabling a comparative dental identification. All the victims were positively identified based on patterns of dental morphology and treatment intervention. This study draws the attention of general and forensic dentists highlight the importance of properly recording dental treatments and searching for evidence in AM endodontic data, respectively. PMID:28123272
McDonald, M.N.; Vire, D.E. )
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.
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
Maresca, Cristina; Barrero, Carlos; Duggan, Dereck; Platin, Enrique; Rivera, Eric; Hannum, Wallace; Petrola, Frank
Blended learning (BL) is the integration of classroom learning with an online environment. The purpose of this study was to determine whether dental students who experienced BL in a preclinical endodontic course demonstrated better manual skills, conceptual knowledge, and learning experience compared to those experiencing traditional learning. All eighty-one students (100 percent) in a preclinical endodontics course agreed to participate and were assigned to either the traditional or BL group. A root canal procedure was used to determine the level of manual skills gained by each group. Pre- and post-intervention quizzes were given to all students to evaluate conceptual knowledge gained, and the students' perspectives on the methods were evaluated with a survey. The BL group scored better than the traditional group on the manual skills exercise at a statistically significant level (p=0.0067). There were no differences in the post-intervention quiz scores between the two groups, and the students' opinions were positive regarding BL. With BL, the students were able to learn and demonstrate dental skills at a high level.
Rajasekhara, Subhashini; Sharath Chandra, SM; Parthasarathy, Late Bharath
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
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
Elnaghy, Amr M; Elsaka, Shaymaa E
This study evaluated the effect of different surface treatments on the flexural properties and adhesion of glass fiber post to self-adhesive luting agent and radicular dentin. Seventy-five single-rooted human teeth were prepared to receive a glass fiber post (Reblida). The posts were divided into five groups according to the surface treatment: Gr C (control; no treatment), Gr S (silanization for 60 s), Gr AP (airborne-particle abrasion), Gr HF (etching with 9 % hydrofluoric acid for 1 min), and Gr M10 (etching with CH2Cl2 for 10 min). Dual-cure self-adhesive luting agent (Rely X Unicem) was applied to each group for testing the adhesion using micropush-out test. Failure types were examined with stereomicroscope and surface morphology of the posts was characterized using a scanning electron microscopy (SEM). Flexural properties of posts were assessed using a three-point bending test. Data were analyzed using ANOVA and Tukey's HSD test. Statistical significance was set at the 0.05 probability level. Groups treated with M10 showed significantly higher bond strength than those obtained with other surface treatments (P < 0.05). In general, improvements in bond strength (MPa) were found in the following order: M10 > C > S > AP > HF. Most failure modes were adhesive type of failures between dentin and luting agent (48.2%). SEM analysis revealed that the fiber post surfaces were modified after surface treatments. The surface treatments did not compromise the flexural properties of fiber posts. Application of M10 to the fiber post surfaces enhanced the adhesion to self-adhesive luting agent and radicular dentin.
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.
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.
Yu, Conrad M.
A glass-silicon column that can operate in temperature variations between room temperature and about 450.degree. C. The glass-silicon column includes large area glass, such as a thin Corning 7740 boron-silicate glass bonded to a silicon wafer, with an electrode embedded in or mounted on glass of the column, and with a self alignment silicon post/glass hole structure. The glass/silicon components are bonded, for example be anodic bonding. In one embodiment, the column includes two outer layers of silicon each bonded to an inner layer of glass, with an electrode imbedded between the layers of glass, and with at least one self alignment hole and post arrangement. The electrode functions as a column heater, and one glass/silicon component is provided with a number of flow channels adjacent the bonded surfaces.
... 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...
... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Endodontic dry heat sterilizer. 872.6730 Section... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Miscellaneous Devices § 872.6730 Endodontic dry heat sterilizer. (a) Identification. An endodontic dry heat sterilizer is a device intended to sterilize...
... 21 Food and Drugs 8 2010-04-01 2010-04-01 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...
Siqueira, José F
Overwhelming evidence indicates that periradicular diseases are infectious disorders. The question now is no longer whether microorganisms are involved in the pathogenesis of such diseases, but which specific microbial species are. The list of microorganisms involved in periradicular diseases keeps expanding and has the potential to become increasingly more accurate during the next few years. Molecular methods have contributed significantly to the knowledge about the microbial species involved. Undoubtedly, a great deal of additional research is needed to define the specific role played by suspected endodontic pathogens in the etiology of each form of periradicular disease and to determine the best therapeutic measures for the pathogen's eradication. In addition, there is an emergent need to define markers that permit the clinician to know when he or she should conclude the treatment and to predict the outcome of the treatment. Although endodontic procedures and some acute endodontic infections can cause bacteremia, there is no clear evidence that microorganisms from the root canal can cause diseases in remote sites of the body. However, there is a risk in some compromised individuals, and prophylactic measures should be taken. Prescription of systemic antibiotics in endodontic therapy is rarely necessary. Because of the emergence of bacterial resistance against most known antibiotics, their use in endodontics should be highly limited and restricted to a few cases.
Bansal, Ramta; Jain, Aditya; Mittal, Sunandan
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
Dhillon, Harnoor; Kaushik, Mamta; Sharma, Roshni
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.
Jiang, H W
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.
Simon, Stéphane R J; Tomson, Phillip L; Berdal, Ariane
Recent advances in biotechnology and translational research have made it possible to provide treatment modalities that protect the vital pulp, allow manipulation of reactionary and reparative dentinogenesis, and, more recently, permit revascularization of an infected root canal space. These approaches are referred to as regenerative procedures. The method currently used to determine the origin of the tissue secreted during the repair/regeneration process is largely based on the identification of cellular markers (usually proteins) left by cells that were responsible for this tissue production. The presence of these proteins in conjunction with other indicators of cellular behavior (especially biomineralization) and analysis of the structure of the newly generated tissue allow conclusions to be made of how it was formed. Thus far, it has not been possible to truly establish the biological mechanism controlling tertiary dentinogenesis. This article considers current therapeutic techniques to treat the dentin-pulp complex and contextualize them in terms of reparative and regenerative processes. Although it may be considered a semantic argument rather than a biological one, the definitions of regeneration and repair are explored to clarify our position in this era of regenerative endodontics.
Beach, David A
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.
PURPOSE Post surface conditioning is necessary to expose the glass fibers to enable bonding between fiber post and resin cement. The purpose of the present study was to evaluate the effect of different surface conditioning on tensile bond strength (TBS) of a glass fiber reinforced post to resin cement. MATERIALS AND METHODS In this in vitro study, 40 extracted single canal central incisors were endodontically treated and post spaces were prepared. The teeth were divided into four groups according to the methods of post surface treatment (n=10): 1) Silanization after etching with 20% H2O2, 2) Silanization after airborne-particle abrasion, 3) Silanization, and 4) No conditioning (Control). Adhesive resin cement (Panavia F 2.0) was used for cementation of the fiber posts to the root canal dentin. Three slices of 3 mm thick were obtained from each root. A universal testing machine was used with a cross-head speed of 1 mm/minute for performing the push-out tests. Two-way ANOVA and Tukey post hoc tests were used for analyzing data (α=0.05). RESULTS It is revealed that different surface treatments and root dentin regions had significant effects on TBS, but the interaction between surface treatments and root canal regions had no significant effect on TBS. There was significant difference among H2O2 + Silane Group and other three groups. CONCLUSION There were significant differences among the mean TBS values of different surface treatments. Application of hydrogen peroxide before silanization increased the bond strength between resin cements and fiber posts. The mean TBS mean values was significantly greater in the coronal region of root canal than the middle and apical thirds. PMID:23755337
Alonso-Ezpeleta, Oscar; Martín, Pablo J.; López-López, José; Castellanos-Cosano, Lizett; Martín-González, Jenifer; Segura-Egea, Juan J.
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
Uzunoglu, Emel; Turker, Sevinc Aktemur
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
Alonso-Ezpeleta, Oscar; Martín, Pablo J; López-López, José; Castellanos-Cosano, Lizett; Martín-González, Jenifer; Segura-Egea, Juan J
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.
Garcia, F; Sanromán, F; Llorens, M P
A total of 44 experimental endodontic treatments were performed in incisors of eight horses of different ages. Four different endodontic pastes were used: Cloropercha, AH26 De Trey, Eugenol-Endometasone, and Universal N2. Gutta-percha points were also included in the last two treatments. Access to the pulp cavity of incisors was gained through their vestibular and occlusal faces. Holes drilled in vestibular faces were sealed with composite and those drilled in occlusal faces were sealed with Amalgama. Animals were observed during eighteen months at least after endodontics. Radiographic controls were done just after surgery and before slaughtering. Treated incisors and alveoli were studied histopathologically. During the experiment all animals were in good condition. They ate apparently without trouble, and neither clinical nor radiological signs were present.
Ragot-Roy, Brigitte; Severin, Claude; Maquin, Michel
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.
Durack, Conor; Patel, Shanon
Cone beam computed tomography (CBCT) is a contemporary, radiological imaging system designed specifically for use on the maxillo-facial skeleton. The system overcomes many of the limitations of conventional radiography by producing undistorted, three-dimensional images of the area under examination. These properties make this form of imaging particularly suitable for use in endodontics. The clinician can obtain an enhanced appreciation of the anatomy being assessed, leading to an improvement in the detection of endodontic disease and resulting in more effective treatment planning. In addition, CBCT operates with a significantly lower effective radiation dose when compared with conventional computed tomography (CT). The purpose of this paper is to review the current literature relating to the limitations and potential applications of CBCT in endodontic practice.
Rezaei Dastjerdi, Maryam; Amirian Chaijan, Kamran
Objectives To determine and compare the fracture resistance of endodontically treated maxillary central incisors restored with different posts and cores. Materials and Methods Forty-eight upper central incisors were randomly divided into four groups: cast post and core (group 1), fiber-reinforced composite (FRC) post and composite core (group 2), composite post and core (group 3), and controls (group 4). Mesio-distal and bucco-lingual dimensions at 7 and 14 mm from the apex were compared to ensure standardization among the groups. Twelve teeth were prepared for crown restoration (group 4). Teeth in other groups were endodontically treated, decoronated at 14 mm from the apex, and prepared for posts and cores. Resin-based materials were used for cementation in groups 1 and 2. In group 3, composite was used directly to fill the post space and for core build-up. All samples were restored by standard metal crowns using glass ionomer cement, mounted at 135° vertical angle, subjected to thermomechanical aging, and then fractured using a universal testing machine. Kruskal-Wallis and Mann-Whitney U tests were used to analyze the data. Results Fracture resistance of the groups was as follows: Control (group 4) > cast post and core (group 1) > fiber post and composite core (group 2) > composite post and core (group 3). All samples in groups 2 and 3 fractured in restorable patterns, whereas most (58%) in group 1 were non-restorable. Conclusions Within the limitations of this study, FRC posts showed acceptable fracture resistance with favorable fracture patterns for reconstruction of upper central incisors. PMID:26295027
Kinaia, Bassam Michael; Chogle, Sami M A; Kinaia, Atheel M; Goodis, Harold E
Periodontal and endodontic diseases are inflammatory responses leading to periodontal and pulpal tissue loss. Regenerative therapies aim to restore the lost structures to vitality and function. Various materials and treatments methods have been used such as bone grafts, guided tissue regeneration, enamel matrix derivatives, growth and differentiation factors, and stem cells. Although the current materials and methods demonstrated adequate clinical results, true and complete biological tissue regeneration is not yet attainable. The current article reviews chronologically the materials and methods used in periodontal and endodontic regeneration highlighting their clinical success and shortcomings, and discussing future directions in regenerative therapy.
Venkateshbabu, Nagendrababu; Anand, Suresh; Abarajithan, Mohan; Sheriff, Sultan O.; Jacob, Pulikkotil S.; Sonia, Nath
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
Chen, Aijie; Feng, Xiaoli; Zhang, Yanli; Liu, Ruoyu; Shao, Longquan
To investigate the stress distribution of a severely damaged maxillary anterior tooth restored with a computer-aided design/computer-aided manufacturing (CAD/CAM) glass-fiber post system. Twelve models were fabricated with different alveolar bone levels and cervical dentin wall thicknesses and studied using a two-dimensional finite element method. A force of 100 N was applied to the lingual surface of the crown at 45 degrees, and the maximum von Mises stress was calculated. A higher stress level was observed in the dentin than in the post and crown. With the reduction of dentin thickness, the maximum von Mises stress in the dentin increased slightly to a peak at a thickness of 1.5 mm, followed by a slight decrease at a thickness of 1.0 mm. However, the relative ratio (RR) values did not show a large difference (RR > 80%). Meanwhile, a large difference in RR values was observed with a change in bone level (RR < 80%). When using a CAD/CAM glass-fiber post system, the maximal von Mises stress was significantly affected by the bone level, rather than by the dentin thickness. Moreover, this system may be applied to the treatment of a maxillary anterior tooth with a bone level of only 2/3.
Sharma, Ritu; Hegde, Vivek; Siddharth, M; Hegde, Rashmi; Manchanda, Gunsha; Agarwal, Pratul
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
Sadaf, Durre; Ahmad, Muhammad Zubair
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
Marques-da-Silva, Bruno; Baratto-Filho, Flares; Abuabara, Allan; Moura, Paula; Losso, Estela M; Moro, Alexandre
This article describe a rare case of multiple taurodontism involving all molars in a 17-year-old male. Volumetric cone-beam computed tomography was used to investigate internal and external root morphology, including that of a maxillary first molar which required endodontic treatment and retreatment. Medical history was not contributory; however, Klinefelter syndrome was the diagnostic hypothesis in this case.
Moraes, A P; Sarkis-Onofre, R; Moraes, R R; Cenci, M S; Soares, C J; Pereira-Cenci, T
The role of silanes in the bonding of resin luting agents to glass-fiber posts (GFPs) is a controversial topic, and the question still remains whether post silanization is able to improve the retention of GFPs luted into root canals. Thus, this study was designed to determine whether evidence exists to justify silanization of GFPs before cementation to increase their retention into root canals. In vitro studies that evaluated the retention of GFPs cemented into root canals or artificial substrates and that used silane coupling agents for pretreatment of the post were selected. Searches were carried out in PubMed and Scopus databases with no publication year or language limits. The last search was carried out in August 2014. Two distinct data analyses were carried out: 1) control group (no post pretreatment) vs silane only and 2) post pretreatment + silane vs silane only. Pooled-effect estimates were obtained by comparing the difference between each bond strength mean value and were expressed as the weighted mean difference between groups (p≤0.05). A total of 178 articles were found, and 23 were included in the review. The results were affected by the substrate into which the GFPs were luted (teeth or artificial devices). The analysis between control group and silane only for studies that used artificial devices favored the use of silane (p<0.0001), but considering studies that used teeth as substrate, no significant difference was observed (p=0.35). The analysis between silane only and pretreatment + silane did not show a significant difference between groups when artificial devices were used (p=0.71), whereas the analysis favored the use of post pretreatment + silane over silane (p<0.00001) only when the GFPs were luted into teeth. In conclusion, this review indicates that silanization improves the retention of GFPs luted into root canals provided that selective surface pretreatments are applied to the post before silanization.
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.
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
Sharath Chandra, Siddapur Mathada
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
Schmitd, Ligia Buloto; Lima, Tatiana de Castro; Chinellato, Luiz Eduardo Montenegro; Bramante, Clóvis Monteiro; Garcia, Roberto Brandão; de Moraes, Ivaldo Gomes; Bernardineli, Norberti
The aims of this study were to evaluate the quality of indirect digitized radiographic images taken during endodontic procedures and to compare the measurements recorded with this technique to those obtained from conventional radiographs. Two-hundred conventional periapical radiographs taken at the undergraduate Endodontics Clinic of the Dental School of Bauru were digitized. The conventional and indirect digitized images were compared by three examiners as to the quality and accuracy of the measurements recorded during endodontic treatment, in canal length determination, gutta-percha adaptation, lateral condensation and final obturation. The conventional radiographs were observed on a film viewer, surrounded by a dark card, and measured with magnifying glass and a millimeter ruler; the indirect digitized images were evaluated on the Digora® for Windows software, with free utilization of the bright/contrast tool. Unlike the conventional radiographic images, all indirect digitized images were considered as having a high quality. The distance between the filling material and the root apex was 0.117 mm larger, on average, for the Digora® system (p<0.01). The measurements achieved by the investigated radiographic methods were clinically similar and they are thus equivalent. Changes in brightness and contrast of the images using Digora® software improved the diagnosis. PMID:19089211
Mokhtari, Fatemeh; Yazdi, Kamal; Mahabadi, Amir Mohammad; Modaresi, Seyed Jalil; Hamzeheil, Zeinab
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
This case report presents surgical endodontic management outcomes of maxillary incisors that were infected via the lateral canals. Two cases are presented in which endodontically-treated maxillary central incisors had sustained lateral canal infections. A surgical endodontic treatment was performed on both teeth. Flap elevation revealed vertical bone destruction along the root surface and infected lateral canals, and microscopy revealed that the lateral canals were the origin of the lesions. After the infected lateral canals were surgically managed, both teeth were asymptomatic and labial fistulas were resolved. There were no clinical or radiographic signs of surgical endodontic management failure at follow-up visits. This case report highlights the clinical significance and surgical endodontic management of infected lateral canal of maxillary incisor. It is important to be aware of root canal anatomy variability in maxillary incisors. Maxillary central incisors infected via the lateral canal can be successfully managed by surgical endodontic treatment. PMID:25671217
Grande da Cruz, Fernanda Zander; Grande, Christiana Zander; Roderjan, Douglas Augusto; Galvão Arrais, César Augusto; Bührer Samra, Adriana Postiglione; Calixto, Abraham Lincoln
Objective To evaluate the effects of etch-and-rinse and self-etching adhesive systems on Vickers hardness (VHN) uniformity of dual-cured resin cements after fiber post cementation. Methods: Fifty glass fiber posts were cemented into bovine roots using the following cementing systems: Prime&Bond 2.1 Dual Cure and Enforce with light-activation (PBDC-LCEN); Prime&Bond 2.1 and Enforce with light-activation (PB-CLEN); Prime&Bond 2.1 Dual Cure and Enforce without light exposure (PBDC-SCEN); ED Primer and Panavia 21 (ED-SCPN); and Clearfil SE Bond and Panavia 21 (CF-SCPN). The roots were stored in distilled water for 72 h and transversely sectioned into thirds (coronal, medium, and apical). The VHN values of the resin cement layers were measured close to the post and to the dentin wall on the transversely sectioned flat surfaces. The results were analyzed by three-way repeated measures analysis of variance (ANOVA) and Tukey’s post-hoc test (pre-set alpha of 5%). Results: Most resin cements presented higher VHN values near the post than near the dentin wall. The ED-SCPN group showed the highest VHN values regardless of the root third, while the self-cured group PBDC-SCEN exhibited the lowest values. The resin cements from the light-activated groups PBDC-LCEN and PB-LCEN showed lower VHN values at the apical third than at the coronal third. The VHN values were not influenced by the root third in self-cured groups PBDC-SCEN, ED-SCPN, and ED-SCPN. Conclusion: Depending on the product, bonding agents might promote changes in hardness uniformity of resin cements after post cementation. PMID:22904652
Baldea, Bogdan; Canjau, Silvana; Popescu, Dragos; Tudor, Anca; Todea, Carmen
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.
1 A NAVAL POSTGRADUATE DENTAL SCHOOL ANALYSIS OF INITIAL ENDODONTIC TREATMENT by Rodney V. Scott LCDR, DC, USN...A thesis submitted to the Faculty of the Endodontics Graduate Program Naval Postgraduate Dental School Uniformed Services...Clinical Research A Naval Postgraduate Dental School Analysis of Initial Endodontic Treatment Rodney V. Scott, DDS
Kishen, Anil; Peters, Ove A.; Zehnder, Matthias; Diogenes, Anibal R.; Nair, Madhu K.
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
REPORT DATE 13. REPORT TYPE AND DATES COVERED 1 1993 I THESIS /QiiJJ ~fiJj yyy_ 4. TITLE AND SUBTITLE S. FUNDING NUMBERS Interpretation of Endodontic...radiographic interpretations. Oral Surg Oral Med Oral Pathol 1974;38:287-93. I ii Thesis accepted by the faculty of the Department of Endodontics...appreciation to those who assisted me in my endodontic education as well as with this research project and thesis . I want to acknowledge the support of
Seifi, Safoura; Fouroghi, Ramin
Central Giant Cell Granulomas (CGCGs) may manifest as radiolucencies anywhere in the mandible or maxilla. In rare cases, it can appear as a localized periradicular area and mimic an endodontic lesion. This case report presents an uncommon location of CGCG which was not accurately diagnosed nor timely treated. Periodic follow ups of periapical radiolucencies after RCT are necessary. Dentists should include CGCG in differential diagnosis of lesions that are refractory to endodontic treatment. [Iranian Endodontic Journal 2009;4(4):158-60].
Cho, Yong-Wook; Kim, Euiseong
Nowadays, oral anticoagulants are commonly prescribed to numerous patients for preventing cardiovascular accident such as thromboembolism. An important side effect of anticoagulant is anti-hemostasis. In a major surgery, the oral anticoagulant therapy (OAT) regimen must be changed before the surgery for proper post-operative bleeding control. However, in a minor dental surgery and endodontic surgery, the necessity for changing or discontinuing the OAT is open to debate. In this study, risks of the consequences were weighed and analyzed. In patients who stop the OAT, the occurrence of thromboembolic complication is rare but the result is fatal. In patients who continuing the OAT, post-operative bleeding can be controlled well with the local hemostatic measures. In the endodontic surgery, there are almost no studies about this issue. The intra-operative bleeding control is particularly important in the endodontic surgery because of its delicate and sensitive procedures such as inspection of resected root surface using dental microscope and retrograde filling. Further studies are necessary about this issue in the viewpoint of endodontic surgery.
Nowadays, oral anticoagulants are commonly prescribed to numerous patients for preventing cardiovascular accident such as thromboembolism. An important side effect of anticoagulant is anti-hemostasis. In a major surgery, the oral anticoagulant therapy (OAT) regimen must be changed before the surgery for proper post-operative bleeding control. However, in a minor dental surgery and endodontic surgery, the necessity for changing or discontinuing the OAT is open to debate. In this study, risks of the consequences were weighed and analyzed. In patients who stop the OAT, the occurrence of thromboembolic complication is rare but the result is fatal. In patients who continuing the OAT, post-operative bleeding can be controlled well with the local hemostatic measures. In the endodontic surgery, there are almost no studies about this issue. The intra-operative bleeding control is particularly important in the endodontic surgery because of its delicate and sensitive procedures such as inspection of resected root surface using dental microscope and retrograde filling. Further studies are necessary about this issue in the viewpoint of endodontic surgery. PMID:24010076
Mao, Jeremy J; Kim, Sahng G; Zhou, Jian; Ye, Ling; Cho, Shoko; Suzuki, Takahiro; Fu, Susan Y; Yang, Rujing; Zhou, Xuedong
Regenerative endodontics has encountered substantial challenges toward clinical translation. The adoption by the American Dental Association of evoked pulp bleeding in immature permanent teeth is an important step for regenerative endodontics. However, there is no regenerative therapy for most endodontic diseases. Simple recapitulation of cell therapy and tissue engineering strategies that are under development for other organ systems has not led to clinical translation in regeneration endodontics. Recent work using novel biomaterial scaffolds and growth factors that orchestrate the homing of host endogenous cells represents a departure from traditional cell transplantation approaches and may accelerate clinical translation.
Freedman, G A
The dilemma that confronts the practitioner in the area of post-endodontic rehabilitation is a positive one. The variety of products and techniques available offer practical solutions to most restorative problems. Patients have benefited [figure: see text] from recent developments in post-and-core technology, and continue to reap the benefits of research and development. The ideal system of products for the endodontic-restorative continuum includes: an esthetic resin fiber post a composite core an automixed resin luting cement current techniques that combine the automixed resin luting cement and composite core into the same component.
Plascencia, Hugo; Díaz, Mariana; Cholico, Patricia; del Real, Monserrat; Márquez-de Alba, Salvador
The modern surgical endodontic treatment is a safe and predictable procedure with high success rate. However, several factors can retard or impede the proper healing process. Use of a high speed handpiece during hard tissues management (osteotomy and apical resection) can potentially be one of these factors. Formation of metallic debris from the surgical diamond burs, production of necrotic local tissue due to overheating and the direct liberation of air from conventional handpiece into the working area are potential irritants able to delay the tissue healing. The aim of the present article is to report the histopathological findings of the trans-operational accidental contamination with oil in the surgical area during an endodontic surgery. PMID:27790269
Bansal, Rashmi; Bansal, Rajesh
Scientific advances in the creation of restorative biomaterials, in vitro cell culture technology, tissue grafting, tissue engineering, molecular biology and the human genome project provide the basis for the introduction of new technologies into dentistry. Non-vital infected teeth have long been treated with root canal therapy (for mature root apex) and apexification (for immature root apex), or doomed to extraction. Although successful, current treatments fail to re-establish healthy pulp tissue in these teeth. But, what if the non-vital tooth could be made vital once again? That is the hope offered by regenerative endodontics, an emerging field focused on replacing traumatized and diseased pulp with functional pulp tissue. Restoration of vitality of non-vital tooth is based on tissue engineering and revascularization procedures. The purpose of this article is to review these biological procedures and the hurdles that must be overcome to develop regenerative endodontic procedures.
Sivakumar, Jambai Sampathkumar; Suresh Kumar, Beri Narasimiah; Shyamala, Palaniyandi Vadivel
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
He, W X; Liu, N N; Wang, X L; He, X Y
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.
Frisk, Fredrik; Hakeberg, Magnus; Ahlqwist, Margareta; Bengtsson, Calle
This cross-sectional study was designed to explore a possible association between endodontic disease variables and coronary heart disease (CHD). Dental infections are hypothesized to be linked to atherosclerosis and could be a cause of vascular changes crucial for the development of CHD. Most studies have focused on periodontal disease. To our knowledge, no one has specifically studied endodontic variables as risk factors for the development of CHD. In 1992-93, a representative sample (n = 1056) of women in Göteborg, Sweden, aged between 38 and 84 years, took part in a combined dental and medical survey. The dependent variable was CHD, i.e. subjects with angina pectoris and/or a history of myocardial infarction (n = 106). The independent variables were number of root-filled teeth (RF), number of teeth with periapical radiolucencies (PA), tooth loss (TL), age, life situation, marital status, smoking, alcohol habits, body mass index, waist-hip ratio, serum cholesterol and triglyceride concentrations, hypertension and diabetes. The multivariate logistic regression analysis did not prove the endodontic variables to be predictive of CHD. Only age and tooth loss were significantly associated with CHD, with OR = 1.07 (CI = 1.03-1.12) and OR = 2.70 (CI = 1.49-4.87), respectively. The bivariate logistic regression analysis showed a positive significant association between subjects with RF = 2 and CHD, but for PA the bivariate analysis did not support an association with CHD. This cross-sectional study did not reveal a significant association between endodontically treated teeth and CHD nor between teeth with periapical disease and CHD.
Prado, Natália Araújo Silva; Ferreira, Reinaldo de Souza; Maurício, Marcos Henrique de Pinho; Paciornik, Sidnei; de Miranda, Mauro Sayão
The present study evaluated the influence of the cement film thickness on the push-out bond strength of glass fiber posts in the cervical, medium, and apical thirds of root canal spaces. Thirty roots were randomly divided into three groups, according to the fiber post system's drills: (G1) #2; (G2) #3; (G3) #4. The posts were cemented using a self-adhesive cement, and a small amount of powdered Rhodamine B was used as a stain. Images of both sides of each slice were obtained before and after the push-out test. To determine the cement thickness, a macro routine was developed using the software KS 400. The data were analyzed statistically using Kruskal-Wallis and Dunn's test. G2 (14.62 ± 5.15 MPa) showed statistically higher bond strength values than G1 (10.04 ± 5.13 MPa) and G3 (7.68 ± 6.14 MPa). All groups presented higher bond strength values in the apical third. The bur diameter significantly influenced the results of the shear bond strength for the push-out test. The slight increase in the cement thickness allowed an increase in the values of shear bond strength when compared to very thin or very thick cement films. PMID:27143971
Vijay, Rajakumar; Indira, R
Aim: To evaluate the bacterial microleakage across remaining Gutta-percha in teeth prepared for post space with and without the use of an intracanal glass ionomer barrier. Materials and Methods: Forty freshly extracted intact human mandibular premolars with single canal were instrumented, obturated with Gutta-percha and AH plus sealer and post spaces were created. Teeth were assigned into experimental groups as follows: Group I – 3 mm of Gutta-percha, Group II – 4 mm of Gutta-percha, Group III – 3 mm of Gutta-percha with 1 mm of Vitrebond as barrier, Group IV – 4 mm of Gutta-percha with 1mm of Vitrebond as barrier. The roots were suspended in Rogosa SL broth and 50 μl of lyophilized Lactobacilli Casei was inoculated as the microbial marker. The mean days taken for the broth to turn turbid were tabulated. The values were statistically analyzed using one way ANOVA and Tukey's HSD test. Results: At the end of 64 days, the mean and standard deviation of the number of days for the broth to turn turbid was: Group I – 20.50, (SD - 3.96). Group II – 25.43, (SD - 4.83), Group III – 38.63, (SD - 9.36), and Group IV – 53.50, (SD - 11.15) Conclusion: Vitrebond could be used as an intracanal barrier to provide a superior coronal seal in teeth requiring post and core. PMID:20617069
Diogenes, Anibal R; Ruparel, Nikita B; Teixeira, Fabricio B; Hargreaves, Kenneth M
The endodontic management of permanent immature teeth is fraught with challenges. Although treatment modalities for vital pulp therapy in these teeth provide long-term favorable outcome, the outcomes from the treatment of pulp necrosis and apical periodontitis are significantly less predictable. Immature teeth diagnosed with pulp necrosis have been traditionally treated with apexification or apexogenesis approaches. Unfortunately, these treatments provide little to no benefit in promoting continued root development. Regenerative endodontic procedures have emerged as an important alternative in treating teeth with otherwise questionable long-term prognosis because of thin, fragile dentinal walls and a lack of immunocompetency. These procedures rely heavily on root canal chemical disinfection of the root canal system. Traditionally, irrigants and medicaments have been chosen for their maximum antimicrobial effect without consideration for their effects on stem cells and the dentinal microenvironment. Translational research has been crucial to provide evidence for treatment modifications that aim to increase favorable outcome while steering away from common pitfalls in the currently used protocols. In this review, recent advances learned from translational research related to disinfection in regenerative endodontics are presented and discussed.
Alves, Flávio R; Coutinho, Mariana S; Gonçalves, Lucio S
Paresthesia is a neurosensitivity disorder caused by injury to the neural tissue. It is characterized by a burning or twinging sensation or by partial loss of local sensitivity. Paresthesia related to endodontic treatment can occur because of extravasation of filling material or the intracanal dressing, as a consequence of periapical surgery or because of periapical infection. A literature review of paresthesia in endodontics was undertaken, with a view to identifying and discussing the most commonly affected nerves, the diagnostic process and the treatment options. Among reported cases, the most commonly affected nerves were those passing through the jaw: the inferior alveolar nerve, the mental nerve and the lingual nerve. To diagnose paresthesia, the endodontist must carry out a complete medical history, panoramic and periapical radiography, and (in some cases) computed tomography, as well as mechanoceptive and nociceptive tests. To date, no specific treatment for endodontic-related paresthesia has been described in the literature, since the problem may be related to a variety of causes.
Deniz Arısu, Hacer; Üçtaşlı, Mine Betül; Okay, Tufan Can
PURPOSE Over the past years, the adhesion of fiber posts luted with simplified adhesive systems has been a matter of great interest. The aim of this study was to assess the post retentive potential of a self-adhesive resin cement using different adhesive systems to compare the push-out bond strengths of fiber posts. MATERIALS AND METHODS The post spaces of 56 mandibular premolar roots were prepared and divided into 4 experimental groups and further divided into 2 subgroups according to testing time (n=7). The fiber posts (Rely X Fiber Post) were luted with a self-adhesive resin cement (RelyX Unicem) and one of the following adhesive systems: no adhesive, a total-etch adhesive resin (Single Bond), a two-step self-etch adhesive resin (Clearfil SE Bond) and a one-step self-etch adhesive resin (Clearfil S3 Bond). Each root was cut horizontally, and 1.5 mm thick six root segments were prepared. Push-out tests were performed after one week or three months (0.5 mm/min). Statistical analysis were performed with three-way ANOVA (α=.05). RESULTS Cervical root segments showed higher bond strength values than middle segments. Adhesive application increased the bond strength. For one week group, the total-etch adhesive resin Single Bond showed higher bond strength than the self-adhesive resin cement RelyX Unicem applied without adhesive resin at middle region. For 3 months group, the two-step self-etch adhesive resin Clearfil SE Bond showed the highest bond strength for both regions. Regarding the time considered, Clearfil SE Bond 3 months group showed higher bond strength values than one week group. CONCLUSION Using the adhesive resins in combination with the self-adhesive resin cement improves the bond strengths. The bond strength values of two-step self-etch adhesive resin Clearfil SE Bond improved as time passes. PMID:24049572
5. Head-on view of looking glass aircraft. View to southwest. - Offutt Air Force Base, Looking Glass Airborne Command Post, Looking Glass Aircraft, On Operational Apron covering northeast half of Project Looking Glass Historic District, Bellevue, Sarpy County, NE
3. General view showing rear of looking glass aircraft. View to north. - Offutt Air Force Base, Looking Glass Airborne Command Post, Looking Glass Aircraft, On Operational Apron covering northeast half of Project Looking Glass Historic District, Bellevue, Sarpy County, NE
4. View showing underside of wing, looking glass aircraft. View to north. - Offutt Air Force Base, Looking Glass Airborne Command Post, Looking Glass Aircraft, On Operational Apron covering northeast half of Project Looking Glass Historic District, Bellevue, Sarpy County, NE
Objectives The aim of this study was to determine the knowledge, current approaches, techniques and practices for the restoration of endodontically treated teeth (ETT) among general dental practitioners and specialists in north of Saudi Arabia. Methodology A standard questionnaire based survey containing 16 multiple choice questions about techniques and treatment methods, frequency of post, type of post, choice of luting cement, core material, reason of failure of endodontic treatment was distributed by hand and through email among 255 general dentists and specialists. The data were processed by using SPSS statistical software. Results The majority of clinicians (54%) believed that post reinforces the remaining tooth structure and reduces fracture probability. The ferrule effect was considered an important factor in increasing fracture resistance of the ETT (72%). The preferred technique for restoring ETT was core material along with 1–2 mm of ferule (41%) followed by prefabricated post and core build up (25%). On the basis of post material, the most common was metal (43%) followed by fiber post (41%). 2/3rd length of the root canal for the post length (67%), 4–5mm apical seal of gutta percha after post placement (47%) and for the post diameter, 1/3rd of root diameter (51%) was agreed by most of the participants. Composite resin (61%) was the most popular material for core foundation followed by amalgam (23%). Conclusion The surveyed practitioners had a sound knowledge of the techniques and materials for restoring ETT with the exception that post reinforces the remaining tooth structure and reduces fracture probability. PMID:25901132
Gopikrishna, Velayutham; Sibi, Swamy; Archana, Durvasulu; Pradeep Kumar, Angabakkam Rajasekaran; Narayanan, Lakshmi
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
Saraf, Hrushikesh P.; Nikhade, Pradnya P.; Chandak, Manoj G.
Ingestion of the endodontic instrument during root canal treatment is rare but can result in serious complications. The present paper reports a case in which endodontic file was accidentally swallowed by the patient undergoing root canal therapy, which entered digestive tract and passed uneventfully. PMID:22577586
Wilcox, L R; Diaz-Arnold, A
Forty-six intact extracted human anterior teeth were treated endodontically with laterally condensed gutta-percha and sealer. The teeth were restored with a base of either zinc phosphate or temporary stopping and a permanent restoration of either acid etched composite resin with GLUMA as the dentin bonding agent or with Ketac-Fil glass ionomer. The teeth were thermocycled, coated with nail varnish (except for the access), immersed in silver nitrate, developed, and sectioned longitudinally. The linear dye penetration was measured. All restorations permitted leakage into the base. All groups had specimens which leaked into the gutta-percha. There was a tendency for the glass ionomer/zinc phosphate group to leak least, but there were no statistically significant differences among the groups.
Gupta, Ruchi; Rai, Rochna
Aim: To ascertain the adoption of new endodontic technology in general dental practice in India in 2011. Methodology: A postal questionnaire survey comprising 26 questions was sent to 700 general dental practitioners. The questions covered professional activity, root canal preparation and instrumentation, choice of irrigants and intracanal medicaments, choice of obturation techniques and other aspects of endodontics. The data were analyzed using descriptive statistics and the Chi-square (χ2) test at 0.05 level of significance. Results: The overall response rate was 88%. The results showed that rubber dams were used by 27% of dental practitioners in India. The most widely used irrigant was sodium hypochlorite, which was used by 33% of the respondents. Thirty nine percent of the practitioners were still incorporating only hand files during the cleaning and shaping phase of treatment. The technique of choice was both step back and crown down (35%). Calcium hydroxide was found to be the most frequently used (62%) intracanal medicament. Lateral condensation with guttapercha (61%) was the most common method used for obturation. Majority used zinc oxide eugenol as a sealer (55%). The post obturation restoration was done mostly by composite material (46%). Most of the respondents placed crowns after root canal treatment. Digital radiography was reported as being used by 17% of the respondents. There was no difference between males and females with respect to the incorporation of new technologies in dentistry. They had been incorporated significantly more by respondents who held postgraduate qualifications and had professional activities of <5 years. Conclusion: The results indicated that new endodontic technology and materials are slowly being incorporated in clinical practice of endodontics in India. This survey shows the importance of continuing dental education for practitioners to update their knowledge. PMID:24392420
Moosavi, Horieh; Manari, Fatemeh
Background Endodontically treated teeth are widely considered to be more susceptible to fracture than vital teeth. Obturation procedures and post placement have been a main cause of vertical root fracture. Material and Methods Forty-eight human premolars with standardized weakened roots were endodontically treated and allocated to four experimental groups (n=12). After root canal treatment, in group 1, fiber posts #1 were cemented in root canals using Estelite Core Quick, and the crowns were restored with resin composite. For group 2 and 3, the roots and crowns were restored using a light-cured and self-cured adhesive and resin composites respectively. In group 4, it was used the Panavia F 2.0 resin cement and resin composite for corono-radicular reconstruction. In group 5, the teeth remained untouched. After 24 hours storage and 1000 thermocycles, samples were loaded at a cross head speed of 1 mm per minute. Results A significant difference was observed in fracture resistance among groups 4 and 5 compared to other groups. Conclusions Root reconstruction with fiber post and Panavia resin cement, and crown building using light-cured resin composite resulted in increased fracture resistance equal to that of intact teeth. Key words:Fracture resistance, fiber post, resin cement, resin composite. PMID:28298991
Topcu, Fulya Toksoy; Erdemir, Ugur; Sahinkesen, Gunes; Mumcu, Emre; Yildiz, Esra; Uslan, Ibrahim
The aim of this study was to evaluate the regional push-out bond strengths for two fiber-reinforced post types using three different dentin bonding agents. Sixty single-rooted extracted human first premolar teeth were sectioned below the cemento-enamel junction, and the roots were endodontically treated. Following standardized post space preparations, the roots were divided into two fiber-post groups (Glassix and Carbopost), and further divided into three subgroups of 10 specimens each for the bonding systems self-etching dentin bonding agents (Clearfil SE Bond and Optibond all-in-one), and total-etching dentin bonding agent (XP Bond). A dual-cure resin luting cement (Maxcem) was then placed in the post spaces and posts were then seated into the root canals polymerized through the cervical portion. The roots were then cut into 3-mm thick sections. Push-out tests were performed at a crosshead speed of 0.5 mm/min. The data were analyzed with multivariate ANOVA (alpha = 0.05). The morphology of interface between different dentin bonding agents from the cervical sections were analyzed with SEM. Glass fiber-reinforced posts demonstrated significantly higher push-out bond strengths than carbon fiber-reinforced posts (p < 0.001). Bond strength values decreased significantly from the cervical to the apical root canal regions (p < 0.001). Self-etching dentin adhesive Clearfil SE Bond and total-etching dentin adhesive XP Bond demonstrated similar bond strengths values and this was significantly higher compared with the Optibond all-in-one in cervical root canal region. In conclusion, in all root segments, the glass fiber-reinforced posts provided significantly increased post retention than the carbon fiber-reinforced posts, regardless of the adhesive used.
Ellis, Devon S.
Owing to their corrosion resistance and superior strength to weight ratio, there has been, over the past two decades, increased interest in the use of fiber-reinforced polymer (FRP) reinforcing bars in reinforced concrete structural members. The mechanical behavior of FRP reinforcement differs from that of steel reinforcement. For example, FRP reinforcement exhibit a linear stress-strain behavior until the bar ruptures and the strength, stiffness and bond properties of FRP reinforcement are affected more adversely by elevated temperatures. All structures are subject to the risk of damage by fire and fires continue to be a significant cause of damage to structures. Many structures do not collapse after being exposed to fire. The safety of the structure for any future use is dependent on the ability to accurately estimate the post-fire load capacity of the structure. Assuming that the changes, due to fire exposure, in the mechanical behavior of the GFRP reinforcing bar and concrete, and the bond between the reinforcing bar and the concrete are understood, an analytical procedure for estimating the post-fire strength of GFRP reinforced concrete flexural elements can be developed. This thesis investigates the changes in: a) tensile properties and bond of GFRP bars; and b) the flexural behavior of GFRP reinforced concrete beams flexural after being exposed to elevated temperatures up to 400°C and cooled to ambient temperature. To this end, twelve tensile tests, twelve pullout bond tests and ten four-point beam tests were performed. The data from the tests were used to formulate analytical procedures for evaluating the post-fire strength of GFRP reinforced concrete beams. The procedure produced conservative results when compared with the experimental data. In general, the residual tensile strength and modulus of elasticity of GFRP bars decrease as the exposure temperature increases. The loss in properties is however, smaller than that observed by other researchers when
Thomas, Anchu Rachel; Elavarasu, Premkumar; Venkatesh, Vijay
Vascular anomalies are localized defects in the vasculature that may or may not be present at birth. There are many types of vascular anomalies with different aetiology and clinical picture and, therefore, require the combined expertise of medical, radiological, and surgical specialities for its diagnosis and management. The term “haemangioma” is used as a common generic label to incorporate all types of vascular malformations. In this report, we describe a case of two maxillary premolars, requiring endodontic therapy, in close proximity to a haemangioma. The challenges encountered in the diagnosis and management of the case are discussed.
Patel, Shyam; Chander, Subhash; Ahluwalia, Amrit Singh
Over the past few decades, the free radicals and antioxidants have attracted tremendous importance in the field of dentistry. Depending on the level of free radicals in the body, they can either be harmful or helpful. Antioxidants are the substances that interact with and stabilize free radicals thereby protecting cells from the damage caused by free radicals. The indigenous antioxidants may be useful in preventing the harmful effects of oxidative stress. The present article presents a review on the free radicals formation, their role in disease pathogenesis, antioxidants and their potential role in endodontics. PMID:26155593
Shay, B; Moshonov, J
Root canal shaping is one of the key stages of endodontic treatment, when performed properly, it is a predictive factor for the outcome of the treatment. It is critical for an adequate disinfection, which is more effective at the completion of a proper shaping procedure. The introduction of NiTi instruments into endodontic greatly improved the root canal shaping and decreased the time required for a full mechanical preparation. Over the last 2 decades, numerous attempts have been made to further improve the procedure with a wide range of rotary NiTi endodontic file systems. All these systems require several subsequent files. Recently, three different concepts of single-file systems have been introduced: 1. The single file reciprocating working motion: it consists of a reciprocating counterclockwise and a clockwise motion. This reciprocal motion reduces torsional loads thus, allows safer instrumentation with less working time. 2. Single-file instrumentation using full 360 degrees rotational movement to be used in a full clockwise rotation. Some of these files also have an Anti Breakage Control (ABC) which protects from catastrophic procedural malfunction by unwinding of these file before breakage. 3. The Self-Adjusting File (SAF) which is a thin-walled, pointed cylinder, hollow nickel-titanium endodontic file that is elastically compressible into a root canal that has been previously negotiated using a #20 hand file and can widened inside it, facilitating removal of debris and dentin from the canal wall. The file conforms to the canal shape and permits irrigant flow through the file. The SAF works in a combined vibrating and partial rotational motions, and circumferentially simultaneously enlarging and irrigating the canal. The objectives of these new approaches is to reduce the working time and cost and improve safety of the shaping procedure, and suggest to have a lower procedural errors incidents. Few studies, conducted in the recent years, using these new
Lee, Bin-Na; Moon, Jong-Wook; Chang, Hoon-Sang; Hwang, In-Nam; Oh, Won-Mann
Traditionally, apexification has been used to treat immature permanent teeth that have lost pulp vitality. This technique promotes the formation of an apical barrier to close the open apex so that the filling materials can be confined to the root canal. Because tissue regeneration cannot be achieved with apexification, a new technique called regenerative endodontic treatment was presented recently to treat immature permanent teeth. Regenerative endodontic treatment is a treatment procedure designed to replace damaged pulp tissue with viable tissue which restores the normal function of the pulp-dentin structure. After regenerative endodontic treatment, continued root development and hard tissue deposition on the dentinal wall can occur under ideal circumstances. However, it is difficult to predict the result of regenerative endodontic treatment. Therefore, the purpose of this study was to summarize multiple factors effects on the result of regenerative endodontic treatment in order to achieve more predictable results. In this study, we investigated the features of regenerative endodontic treatment in comparison with those of other pulp treatment procedures and analyzed the factors that have an effect on regenerative endodontic treatment. PMID:26295020
Objectives The aim of the present study was to determine radiographically the different reasons and problems of endodontic treatment failure. Methods The periapical radiographs of 100 patients with one hundred teeth (130 root canals) were examined to identify the problems and failures of endodontic treatment. The various reasons of failure that is under filling, poor filling, over filling and presence of procedural errors were recorded for each root filled canal. Chi square test was used to determine statistical significance between different parameters. Results Under fillings were found in 46.9% of the root canals. The percentage of poor fillings and over fillings were 28.5% and 13% respectively. Separated instruments and strip perforations were present in 4% and 3% of the teeth, while the presence of furcal perforation and coronal leakage was observed in one case each (1%).Endodontic problems and failures were most commonly observed in molars compare to anterior and premolar teeth. Mesiobuccal, mesiolingual and distobuccal root canals were the most frequently canals with endodontic problems and failures. The relationship between mesiobuccal, mesiolingual and distal canals in mandibular molars and mesiobuccal, distobuccal and palatal canals in maxillary molars in terms of endodontic failures were statistically significant by chi square analysis (P≤0.05). Conclusion The most common cause of endodontic treatment failure was under filling followed by poor filling and over filling and first molar was the most frequently involved tooth with endodontic problems and failures. PMID:26309429
Salaria, Sanjeev Kumar; Kamra, Shilpa; Ghuman, Simrat Kaur; Sharma, Garima
Radicular cyst (RC) is the most common odontogenic cyst of inflammatory origin affecting the jaws; involves the roots of the carious or traumatic non-vital tooth. Different therapeutic modalities, such as nonsurgical endodontic therapy or surgical enucleation with primary closure, decompression etc., were proposed for the management of such lesions. Presenting a case of a 28-year-old otherwise healthy male patient who reported with pain and swelling with respect to tooth #41, 31. Diagnosis of infected RC at a rare location was established on the basis of clinical, radiographical and fine needle aspiration cytological examination. Looking after the clinical characteristics, origin, extension, size of cystic lesion and patient cooperation; nonsurgical endodontic therapy utilizing Bhasker's hypothesis was opted. One year post-operative result suggested that nonsurgical endodontic therapy along with minimally invasive treatment utilizing Bhasker's hypothesis is an effective tool to transform infected radicular cystic lesion to healthy periapical periodontal tissue. PMID:27994430
Değer, Yalçın; Adigüzel, Özkan; Özer, Senem Yiğit; Kaya, Sadullah; Polat, Zelal Seyfioğlu; Bozyel, Bejna
Background The mouth is exposed to thermal irritation from hot and cold food and drinks. Thermal changes in the oral cavity produce expansions and contractions in tooth structures and restorative materials. The aim of this study was to investigate the effect of temperature and stress distribution on 2 different post systems using the 3-dimensional (3D) finite element method. Material/Methods The 3D finite element model shows a labio-lingual cross-sectional view of the endodontically treated upper right central incisor and supporting periodontal ligament with bone structures. Stainless steel and glass fiber post systems with different physical and thermal properties were modelled in the tooth restored with composite core and ceramic crown. We placed 100 N static vertical occlusal loading onto the center of the incisal surface of the tooth. Thermal loads of 0°C and 65°C were applied on the model for 5 s. Temperature and thermal stresses were determined on the labio-lingual section of the model at 6 different points. Results The distribution of stress, including thermal stress values, was calculated using 3D finite element analysis. The stainless steel post system produced more temperature and thermal stresses on the restorative materials, tooth structures, and posts than did the glass fiber reinforced composite posts. Conclusions Thermal changes generated stresses in the restorative materials, tooth, and supporting structures. PMID:26615495
Gathani, Kinjal M.; Raghavendra, Srinidhi Surya
Root canal therapy has enabled us to save numerous teeth over the years. The most desired outcome of endodontic treatment would be when diseased or nonvital pulp is replaced with healthy pulp tissue that would revitalize the teeth through regenerative endodontics. ‘A search was conducted using the Pubmed and MEDLINE databases for articles with the criteria ‘Platelet rich plasma’, ‘Platelet rich fibrin’, ‘Stem cells’, ‘Natural and artificial scaffolds’ from 1982–2015’. Tissues are organized as three-dimensional structures, and appropriate scaffolding is necessary to provide a spatially correct position of cell location and regulate differentiation, proliferation, or metabolism of the stem cells. Extracellular matrix molecules control the differentiation of stem cells, and an appropriate scaffold might selectively bind and localize cells, contain growth factors, and undergo biodegradation over time. Different scaffolds facilitate the regeneration of different tissues. To ensure a successful regenerative procedure, it is essential to have a thorough and precise knowledge about the suitable scaffold for the required tissue. This article gives a review on the different scaffolds providing an insight into the new developmental approaches on the horizon. PMID:27857762
van Soest, G.; Shemesh, H.; Wu, M.-K.; van der Sluis, L. W. M.; Wesselink, P. R.
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.
Jamleh, Ahmed; Sadr, Alireza; Nomura, Naoyuki; Ebihara, Arata; Yahata, Yoshio; Hanawa, Takao; Tagami, Junji; Suda, Hideaki
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.
Moradi, Saeed; Naghavi, Neda
INTRODUCTION: Many patients suffer from mild, moderate or severe pain during or after root canal therapy. Theoretically, post-operative pain control can be achieved by using long-acting local anesthetics. The aim of this study was to evaluate the efficacy of a long acting anesthesia, bupivacaine, on preventing post-operative pain associated with endodontic treatment, and to compare it with lidocaine. MATERIALS AND METHODS: This study was a double blind and randomized clinical trial on 30 patients' anterior maxillary teeth. The patients were divided into two groups of fifteen. One group was administered lidocanine (2% with 1:100000 epinephrine) local anesthesia and the other group was given bupivacaine (0.5% without epinephrine). The pain in patients were compared using the visual analogue scale (VAS) at definite times i.e. before treatment, during treatment and 2,4,6,8,10,12,24,36 and 48 hours after operation. Data were analyzed using One-way ANOVA tests. RESULTS: Bupivacaine significantly decreased postoperative pain compared to lidocaine. Postoperative pain was directly related to preoperative pain. Women reported more pain, though significant difference in postoperative pain report was not found between different ages. CONCLUSION: In conclusion, a single dose of bupivacaine 0.5% used in infiltration anesthesia could be more effective in reduction or prevention of post-operative endodontic pain compared with lidocaine. PMID:24778680
Carlos, Roopak Bose; Thomas Nainan, Mohan; Pradhan, Shamina; Roshni Sharma; Benjamin, Shiny; Rose, Rajani
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
Liu, Chang; Liu, Hong; Qian, Yue-Tong; Zhu, Song; Zhao, Su-Qian
In this study, we evaluate the influence of post surface pre-treatments on the bond strength of four different cements to glass fiber posts. Eighty extracted human maxillary central incisors and canines were endodontically treated and standardized post spaces were prepared. Four post pre-treatments were tested: (i) no pre-treatment (NS, control), (ii) sandblasting (SA), (iii) silanization (SI) and (iv) sandblasting followed by silanization (SS). Per pre-treatment, four dual-cure resin cements were used for luting posts: DMG LUXACORE Smartmix Dual, Multilink Automix, RelyX Unicem and Panavia F2.0. All the specimens were subjected to micro push-out test. Two-way analysis of variance and Tukey post hoc tests were performed (α=0.05) to analyze the data. Bond strength was significantly affected by the type of resin cement, and bond strengths of RelyX Unicem and Panavia F2.0 to the fiber posts were significantly higher than the other cement groups. Sandblasting significantly increased the bond strength of DMG group to the fiber posts. PMID:24177170
Kazemi, R B; Safavi, K E; Spångberg, L S
The purpose of this study was to assess the marginal stability and permeability of a new interim restorative endodontic material, Tempit (Centrix Inc., Milford, Conn.), and to compare the findings with the results of two commonly used restorative endodontic materials, Cavit (Premier Dental Products Co., Philadelphia, Pa.) and IRM (Intermediate Restorative Material Capsules, The Caulk Co., Division of Dentsply International Inc., Milford, Del.) This study was performed in several steps. First, the endodontic access cavities were prepared and restored on 80 extracted mandibular molars. The samples were exposed to methylene blue dye solution for 6 days, thermocycled, and sectioned; the dye penetration and diffusion were measured along the margins and into the body of the materials. The second experiment was a special study performed in standardized glass tubes to better evaluate the marginal and body dye penetration into the materials by increasing the length of the fillings. To eliminate the possibility of hygroscopic setting mechanisms of materials, samples were first allowed to set under water before dye was introduced. Cavit and Tempit showed a substantial amount of dye diffusion into the body of the materials. Cavit exhibited the best sealing ability at all times. The marginal and body dye penetration were significantly different for the Tempit material in all experiments than Cavit (p < 0.001). IRM demonstrated the least body penetration of all three materials (p < 0.001) but had a substantial marginal leakage not significantly different from the results of the Tempit material (p = 0.6 and p = 0.1).(ABSTRACT TRUNCATED AT 250 WORDS)
Good, Melissa; El, Karim Ikhlas A; Hussey, David L
Endodontic lubricants, irrigants and medicaments help prepare and disinfect root canal systems (RCS) but primary and secondary cases involve different microbes and therefore it is unlikely that one protocol will be effective for both case types. Each individual 'solution' or sequence of'solutions' could play a significant role in each case type, but there are no detailed published guidelines in existence. To help inform clinical practice it was decided to undertake a literature review followed by a UK and Republic of Ireland wide audit on current endodontic'solution' usage within dental schools. The literature review was undertaken under the following headings: pre-op oral rinse; file lubricants; root canal irrigants and intracanal medicaments and provides an evidence base for protocol development for both primary and retreatment cases.The audit project and the protocols developed from the findings of both the literature review and audit will be presented in Part 2.
Šmit, Ž.; Milavec, T.; Fajfar, H.; Rehren, Th.; Lankton, J. W.; Gratuze, B.
The combined PIXE-PIGE method was used for the analysis of 43 glass fragments from the archaeological site Tonovcov grad in western Slovenia, with 10 of these additionally being analysed by LA-ICP-MS. The glass objects were attributed to the Late Antique production of the 4th-7th c. AD, with two examples of early Roman glass and three glass beads, one of them presumably of oriental origin. The analysis showed typical natron-type glass, produced in the Levantine region around the river Belus, and a few examples of HIMT glass, which could be recognized also in several other recycled objects. Only one glass bead, found in Early Medieval context, was made of the ash of halophytic plants.
Corbella, Stefano; Taschieri, Silvio; Elkabbany, Ahmed; Del Fabbro, Massimo; von Arx, Thomas
Endodontic surgery aims at the resolution of a periapical inflammatory process by surgical access followed by enucleation of the lesion and root-end filling to curb any potentially noxious agent within the physical confines of the affected root. Guided bone regeneration could be associated to endodontic surgery aiming to enhance periradicular tissue regeneration. The objective of this paper was to review the scientific literature about guided bone regeneration in endodontic surgery, evaluating the effects on periapical lesion healing process. The included articles are classified considering the anatomical characteristics of the lesion. Fourteen articles were included in the review after abstract and title selection. Eight articles were on studies on lesions affecting only the periapical region (three about through-and-through lesions) while six were about the treatment of apico-marginal lesions. On the basis of the currently available literature, there is a low scientific evidence of a benefit related. to the use of guided bone regeneration procedure in endodontic surgery.
Shalavi, S; Yazdizadeh, M
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
Caplan, D J; Chasen, J B; Krall, E A; Cai, J; Kang, S; Garcia, R I; Offenbacher, S; Beck, J D
A paucity of epidemiologic research exists regarding systemic health consequences of endodontic disease. This study evaluated whether incident radiographically evident lesions of endodontic origin were related to development of coronary heart disease (CHD) among 708 male participants in the VA Dental Longitudinal Study. At baseline and every three years for up to 32 years, participants (who were not VA patients) received complete medical and dental examinations, including full-mouth radiographs. Cox regression models estimated the relationship between incident lesions of endodontic origin and time to CHD diagnosis. Among those < or = 40 years old, incident lesions of endodontic origin were significantly associated with time to CHD diagnosis (p < 0.05), after adjustment for covariates of interest, with hazard ratios decreasing as age increased. Among those > 40 years old, no statistically significant association was observed. These findings are consistent with research that suggests relationships between chronic periodontal inflammation and the development of CHD, especially among younger men.
Torabinejad, M.; Danforth, R.; Andrews, K.; Chan, C.
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.
Ling, J Q
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.
Patel, S; Durack, C; Abella, F; Shemesh, H; Roig, M; Lemberg, K
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.
Rahimi, Saeed; Janani, Maryam; Lotfi, Mehrdad; Shahi, Shahriar; Aghbali, Amirala; Vahid Pakdel, Mahdi; Salem Milani, Amin; Ghasemi, Negin
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
Rocha, Maria José de Carvalho; Cardoso, Mariane
The present study aimed to verify the factors that interfere with the success of endodontic treatment of traumatized primary teeth as well as to determine the success level of the proposed treatment, through survival analysis. The research was conducted through the analysis of dental traumatism records and attached radiological exams of patients assisted by the Assistance Program for the Traumatized Patient at UFSC (Universidade Federal de Santa Catarina). Fifty-one dental records of patients aged between 10 and 60 months were analyzed. These patients had their traumatized teeth endodontically treated (n = 51), according to the indications of the UFSC protocol. In order to evaluate possible interference factors affecting the success of the endodontic treatment, the following items were analyzed: age of the child at the beginning of the endodontic treatment (over or below 36 months), trauma type (mild or severe) pathological root resorption type (replacement or inflammatory), localization of the pathological root resorption (in the apical third or in the middle third), bone resorption (absent or present), alteration of the soft tissue (absent or present), condition of the pulp tissue (vitality or necrosis) and trauma recurrence (absent or present). Through the chi-squared test (chi(2) = 9.594, P < 0.05) and survival analysis, it was verified that trauma recurrence in the same tooth is a factor that interferes in the success of endodontic treatment. It was also observed, through survival analysis, that levels of success of endodontic treatments are stabilized in the 19th month. A period of 48 months of follow up was observed. It was also verified that most failures occurred between the 7th and 12th months counting from the beginning of the endodontic treatment. It was concluded that endodontic treatment of traumatized primary teeth, performed according to the UFSC protocol, enables the maintenance of the traumatized tooth in acceptable conditions in the buccal cavity
Slutzky-Goldberg, Iris; Slutzky, Hagay; Gorfil, Colin; Smidt, Ami
Coronal restorations and posts can positively influence the long-term prognosis of teeth following root canal therapy. Final sealing the canal by placing an appropriate post and core will minimize leakage of oral fluids and bacteria into the periradicular area and is recommended as soon as possible after completion of root canal filling. Glass ionomer or MTA placed over the residual root canal filling after post space preparation may be effective to prevent bacterial leakage. A ferrule of 1-2 mm of tooth tissue coronal to the finish line of the crown significantly improves the fracture resistance of the tooth and is more important than the type of the material the core and post are made of. PMID:20309408
Bohora, Aarti; Kokate, Sharad
Aims and Objectives: The principal goal of endodontics is the prevention of periapical infection. Acute and chronic apical periodontitis occur due to the persistence of pathogenic microorganisms such as Enterococcus faecalis and Candida albicans harboring the root canal systems of the teeth. The concept of the use of probiotics in addressing endodontic disease is new and has not been studied adequately. On the basis of the success of probiotics in periodontal treatment, this preliminary work was performed (a) to evaluate the antibacterial efficacy of probiotics against common endodontic pathogens, i.e. E. faecalis and C. albicans, and (b) to evaluate the potential use of probiotic therapy as an additive in endodontic treatment procedures. Materials and Methods: Two commercial probiotics were selected and evaluated based upon the numbers and concentration of organisms. Pathogenic test organisms were C. albicans (ATCC 10231) and E. faecalis (ATCC 29212). Phase 1 of the study was conducted by agar cup method test to evaluate the antibacterial activity of the selected probiotics against E. faecalis and C. albicans by measuring zones of inhibition (ZOI) in mm. Microorganisms from probiotic samples were isolated following manufacturer's instructions. Pathogenic organisms were set to a 0.1 McFarland standard challenge. Circular wells of 8 mm diameter were punched in each of the poured plates. Appropriately diluted test samples were added to the above-punched wells. The volume of the solution added to each well was 100 μl. The plates were incubated in an upright position at 37°C for 24 hours under aerobic conditions. Post incubation, ZOI was measured (mm). Phase 2 was conducted by mixing 9 ml of 30% poloxamer 407 and de Man, Rogosa and Sharpe (MRS) broth in a test tube with 500 μl of either E. faecalis or C. albicans set at an optical density (OD) of 0.252, together with 500 μl of test probiotic strain, set at a respective OD. Samples were then incubated at 37°C for
Palit Madhu Chanda; Hegde, K Sundeep; Bhat, Sham S; Sargod, Sharan S; Mantha, Somasundar; Chattopadhyay, Sayan
Root canal revascularization attempts to make necrotic tooth alive by the use of certain simple clinical protocols. Earlier apexification was the treatment of choice for treating and preserving immature permanent teeth that have lost pulp vitality. This procedure promoted the formation of apical barrier to seal the root canal of immature teeth and nonvital filling materials contained within root canal space. However with the success of root canal revascularization to regenerate the pulp dentin complex of necrotic immature tooth has made us to rethink if apexification is at the beginning of its end. The objective of this review is to discuss the new concepts of tissue engineering in endodontics and the clinical steps of root canal revascularization.
Bansal, Ramta; Mittal, Sunandan; Kumar, Tarun; Kaur, Dilpreet
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
Bansal, Ramta; Jain, Aditya; Mittal, Sunandan; Kumar, Tarun; Kaur, Dilpreet
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.
Hansen, M G
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.
Zehnder, Matthias; Lehnert, Birgit; Schönenberger, Kathrin; Waltimo, Tuomas
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.
Dimitriu, Bogdan; Vârlan, Constantin; Suciu, Ioana; Vârlan, Virginia; Bodnar, Dana
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.
Vascular supply is the most accurate marker of pulp vitality. Tests for assessing vascular supply that rely on the passage of light through a tooth have been considered as possible methods for detecting pulp vitality. Laser Doppler flowmetry (LDF), which is a noninvasive, objective, painless, semi-quantitative method, has been shown to be reliable for measuring pulpal blood flow. The relevant literature on LDF in the context of endodontics up to March 2008 was reviewed using PubMed and MEDLINE database searches. This search identified papers published between June 1983 and March 2008. Laser light is transmitted to the pulp by means of a fibre optic probe. Scattered light from moving red blood cells will be frequency-shifted whilst that from the static tissue remains unshifted. The reflected light, composed of Doppler-shifted and unshifted light, is returned by afferent fibres and a signal is produced. This technique has been successfully employed for estimating pulpal vitality in adults and children, differential diagnosis of apical radiolucencies (on the basis of pulp vitality), examining the reactions to pharmacological agents or electrical and thermal stimulation, and monitoring of pulpal responses to orthodontic procedures and traumatic injuries. Assessments may be highly susceptible to environmental and technique-related factors. Nonpulpal signals, principally from periodontal blood flow, may contaminate the signal. Because this test produces no noxious stimuli, apprehensive or distressed patients accept it more readily than current methods of pulp vitality assessment. A review of the literature and a discussion of the application of this system in endodontics are presented.
Saha, Suparna Ganguly; Bhardwaj, Anuj; Dubey, Sandeep; Saha, Mainak; Kala, Shubham; Jain, Sohini; Narwani, Shweta
Introduction A definitive diagnosis is of primary importance before initiating any endodontic treatment; yet, there are occasions when the dental professional is unable to accurately reproduce the patient’s chief complaint, as it can pose a dilemma and may require consideration of multiple variables in order to reach an accurate diagnosis. So to overcome this problem, a methodical approach in providing endodontic treatment should be implemented which includes diagnosis, definitive dental treatment and adjunctive drug therapy, known as the “3D” strategy. Aim The purpose of this study was to evaluate the possible "masking" effect of these analgesics on endodontic diagnosis using a novel bite force sensor device. Materials and Methods A total of 90 patients with endodontic pain were selected and they were given either a placebo or 400 mg ibuprofen (brufen) or 50mg diclofenac sodium (voveron). Both patients and operators were completely blinded to the drugs administered. Bite force tolerance values were noted before and one hour after administration of medication using the self designed bite force sensor. Results The pre- and post-bite force tolerance values were tabulated for both contralateral and affected tooth. For the affected tooth, there was statistically significant difference between pre- and post-bite force tolerance values in Group I (i.e., ibuprofen) and Group II (i.e., diclofenac sodium) (p<0.05) with no significant difference observed in Group III (placebo). Conclusion The easily available over the counter self administered analgesics in addition to providing symptomatic relief to patients suffering from symptomatic apical periodontitis may also cloud the definitive diagnosis of the clinician, thus jeopardising the treatment plan. The self designed bite force sensor was effective in arriving at a definitive diagnosis in teeth with chronic irreversible pulpitis with symptomatic apical periodontitis, where the allodynia has been camouflaged by the use
Feliz Matos, Leandro; Rodriguez, Indira De Los Santos; Gonzalez, Mally Luz Rodriguez; Pereyra, Dulce; Monzon Velez, Erick R
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.
Efficiency of SumsinoPae Four Types of Endodontic Files and Reamers Submber oaper S. PERFORMING ORG. REPORT NUMBER 7AUTHOR(s) S. CONTRACT OR GRANT NUMBER...an reveree aide Ii neceeary end Identify by block number) Comparative efficiency of endodontic files; endodontic instrumentation; instrumentation...sections of bovine bone. Each canal was instrumented to a size 80 using four types of endodontic instruments: Hedstrom S files; K-files; reamers; and the
perforations along 15,16 the shaft as suggested by Goldman et al. 3. A prototype endodontic needle made by cutting off the pointed tip of a standard 26-gauge...different types of irrigating needles in the removal of contamination in vitro from the root canals of forty endodontically treated single-rooted...TYPES OF NEEDLES IN IRRIGATING ENDODONTICALLY TREATED TEETH E. Drobotij, DDS, MS Resident, Endodontics Dept. of Dentistry - PO Box 59 Madigan Army
Zabalegui, B; Gil, J; Zabalegui, I
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.
Atmeh, Amre R; Watson, Timothy F
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.
Zaltsman, Nathan; Houri-Haddad, Yael; Abramovitz, Itzhak; Davidi, Michael Perez; Weiss, Ervin I.
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
Kim, Sahng G.; Zhou, Jian; Ye, Ling; Cho, Shoko; Suzuki, Takahiro; Fu, Susan Y.; Yang, Rujing; Zhou, Xuedong; Mao, Jeremy J.
SYNOPSIS Despite a great deal of enthusiasm and effort, regenerative endodontics has encountered substantial challenges towards clinical translation. Recent adoption by the American Dental Association (ADA) of evoked pulp bleeding in immature permanent teeth is an important step for regenerative endodontics. However, there is no regenerative therapy for the majority of endodontic diseases. Simple recapitulation of cell therapy and tissue engineering strategies that are under development for other organ systems has not led to clinical translation in regeneration endodontics. Dental pulp stem cells may appear to be a priori choice for dental pulp regeneration. However, dental pulp stem cells may not be available in a patient who is in need of pulp regeneration. Even if dental pulp stem cells are available autologously or perhaps allogeneically, one must address a multitude of scientific, regulatory and commercialization barriers, and unless these issues are resolved, transplantation of dental pulp stem cells will remain a scientific exercise, rather than a clinical reality. Recent work using novel biomaterial scaffolds and growth factors that orchestrate the homing of host endogenous cells represents a departure from traditional cell transplantation approaches and may accelerate clinical translation. Given the functions and scale of dental pulp and dentin, regenerative endodontics is poised to become one of the early biological solutions in regenerative dental medicine. PMID:22835543
JITARU, STEFAN; HODISAN, IOANA; TIMIS, LUCIA; LUCIAN, ANAMARIA; BUD, MARIUS
Background and aim Bioceramics are ceramic compounds obtained both in situ and in vivo, by various chemical processes. Bioceramics exhibit excellent biocompatibility due to their similarity with biological materials, like hydroxyapatite. Bioceramics and multi-substituted hydroxyapatite or similar compounds have the ability to induce a regenerative response in the organism. The aim of this paper is to make a literature review on the main bioceramic materials currently used in endodontics and on their specific characteristics. Methods We conducted a search in the international databases (PubMed), to identify publications in the last 10 years, using the following key words: “bioceramics endodontics”, “bioceramic endodontic cement”, “bioceramic sealer” and “direct pulp capping bioceramic”. Results Commonly used endodontic sealers (e.g., containing zinc oxide, calcium hydroxide and a resin) have a long tradition in scientific research and clinical use in endodontics. For specific cases, like root resorptions, perforations, apexification, and retrograde fillings, new biocompatible materials were developed in order to improve the clinical outcome: ProRooT MTA (Dentsply Company, Germany); Biodentine (Septodont, France); Endosequence BC sealer (Brassler, SUA); Bioaggregate (IBC, Canada); Generex A (Dentsply Tulsa Dental Specialties, USA). Conclusion The studies are generally in favor of bioceramic materials even if there are not many products available on the market for endodontic use. As more products are launched and more research is performed regarding these materials, we will provide more reliable data on clinical outcome. PMID:27857514
Shah, Preetam; Gugwad, Sachin C; Bhat, Chetan; Lodaya, Rahul
Endodontic treatment makes the tooth brittle due to loss of bulk of tooth structure, decrease in the moisture content of dentin and dentin elasticity. The following study was carried out to evaluate the effect of endodontic treatment on the fracture resistance of the tooth and reinforcing ability of three different core materials. The following study comprised of sample size of 30 deciduous second molars divided into control group (6) and test group (24). Access opening was done in 24 and 18th teeth with access opening were restored with three different core materials namely IRM (6), silver amalgam (6), GIC (6). All the 30 were subjected to fracture test using UTM (Universal testing machine)- Instron 95. Result showed a drastic reduction in the fracture resistance of the tooth on access opening (1/3rd) and out of the three core materials glass ionomer was shown to be the best core material giving the highest fracture registrance followed by silver amalgam and IRM.
Aim: The purpose of this study was to evaluate a degradable nanogel-based scaffold with antibacterial content. Methods: This nanogel design consisted of the cross-linker, polyethyleneglycol (PEG 4600) with 3-dimensional network. This polymer degrades over time ( 30 days), delivering a controlled release of antibiotic. Amoxicillin was added to the scaffold with 25 wt% (n=26). Nanogel-scaffold only and amoxicillin only were used as controls. Agar diffusion test against E. faecalis was performed at eight time intervals (days 1, 3, 5, 7, 10, 14, 21, 30). One-Way ANOVA was used to compare the antibacterial properties of experimental groups at the eight different times. Results: The antibacterial properties for experimental plates, at the different times, were not significantly different (F=.624, p=.74). Based on the profile, the scaffold-only group showed a smaller inhibition zone compared to the two other groups. The antibacterial profiles for the experimental group and the antibiotic-only group were similar. Conclusion: This particular scaffold presented antibacterial properties. Findings suggest that nanogel-modified scaffolds may have potential use for drug-delivery in endodontics..
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.
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
Bottino, M C; Kamocki, K; Yassen, G H; Platt, J A; Vail, M M; Ehrlich, Y; Spolnik, K J; Gregory, R L
Here we report the synthesis, materials characterization, antimicrobial capacity, and cytocompatibility of novel antibiotic-containing scaffolds. Metronidazole (MET) or Ciprofloxacin/(CIP) was mixed with a polydioxanone (PDS)polymer solution at 5 and 25 wt% and processed into fibers. PDS fibers served as a control. Scanning electron microscopy (SEM), Fourier-transform infrared spectroscopy (FTIR), tensile testing, and high-performance liquid chromatography (HPLC) were used to assess fiber morphology, chemical structure, mechanical properties, and drug release, respectively. Antimicrobial properties were evaluated against those of Porphyromonas gingivalis/Pg and Enterococcus faecalis/Ef. Cytotoxicity was assessed in human dental pulp stem cells (hDPSCs). Statistics were performed, and significance was set at the 5% level. SEM imaging revealed a submicron fiber diameter. FTIR confirmed antibiotic incorporation. The tensile values of hydrated 25 wt% CIP scaffold were significantly lower than those of all other groups. Analysis of HPLC data confirmed gradual, sustained drug release from the scaffolds over 48 hrs. CIP-containing scaffolds significantly (p < .00001) inhibited biofilm growth of both bacteria. Conversely, MET-containing scaffolds inhibited only Pg growth. Agar diffusion confirmed the antimicrobial properties against specific bacteria for the antibiotic-containing scaffolds. Only the 25 wt% CIP-containing scaffolds were cytotoxic. Collectively, this study suggests that polymer-based antibiotic-containing electrospun scaffolds could function as a biologically safe antimicrobial drug delivery system for regenerative endodontics.
The essential role of microorganisms in the initiation and perpetuation of pulp and periapical pathosis has been well documented. The major objective in endodontic therapy is to disinfect the entire root canal system. Considering the complex anatomy of the root canal system, complete elimination of bacteria by cleaning the root canal with instrumentation alone is unlikely. Therefore, an appropriate antimicrobial irrigant is needed to decrease the microbial load, especially in necrotic and retreatment cases. Another important issue in endodontics is the smear layer. Although there is no general consensus on removal of the smear layer, it seems that removing it enhances the sealing ability of the root canal filling. MTAD is an endodontic irrigant with both antibacterial and smear layer removal abilities. The aim of this paper is to review these different aspects of MTAD.
Millstein, Charles B
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.
Endodontics is the branch of dentistry which deals with dental pulp pathology and treatment of root canals. There has been noted a significant improvement in this discipline recently, which has made a substantial increase in therapeutical efficiency and made dentists' work easier. It was possible due to dynamic development of new material technologies and clinical procedures. Aim of this paper was to present the current state of knowledge in endodontics. The most important achievements were especially stressed. Among the most important for development of present endodontics there are: new methods of canal length estimation, modem methods of visualization, nickel titanium rotary instrumentation, numerous gutta-percha obturation systems and also more biocompatible obturation materials.
Gutmann, James L; Gutmann, Marylou S
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.
Nobuhara, W K; del Rio, C E
Biopsy reports from 150 periradicular tissue specimens obtained from teeth refractory to nonsurgical endodontic therapy were reviewed. The specimens were submitted by postdoctoral dental students in the Department of Endodontics, and the biopsy reports were prepared by oral pathologists at the University of Texas Health Science Center at San Antonio. The study found that 59.3% of the periradicular lesions were granulomas, 22% cysts, 12% scars, and 6.7% other pathoses. The majority (56%) of endodontically treated cases which failed to heal were recognized within 2 yr after the completion of therapy. The most common location for surgical retreatment was the anterior maxilla, followed by the posterior maxilla, the posterior mandible, and the anterior mandible. The periapical granuloma was the predominant pathosis at each location.
Comparison of the effect of shear bond strength with silane and other three chemical presurface treatments of a glass fiber-reinforced post on adhesion with a resin-based luting agent: An in vitro study
Belwalkar, Vaibhavi Ramkrishna; Gade, Jaykumar; Mankar, Nikhil Purushottam
Background: Loss of retention has been cited to be the most common cause of the failure of postretained restoration with irreversible consequences when materials with different compositions are in intimate contact at the post/adhesive interface. With this background, a study was conducted to improve the adhesion at the resin phase of fiber posts using silane and other chemical pretreatments. Materials and Methods: Hundred glass fiber-reinforced posts were tested with 4 different protocols (n = 25) using silane as a control (Group A) and other three experimental groups, namely, Group B-20% potassium permanganate, Group C-4% hydrofluoric acid, and Group D-10% hydrogen peroxide were pretreated on the postsurface followed by silanization. These specimens were bonded with dual-polymerizing resin-based luting agent, which were then loaded at the crosshead speed of 1 mm/min to record the shear bond strength at the post/adhesive interface. The data were analyzed using one-way ANOVA test for multiple group comparisons and the post hoc Bonferroni test for pairwise comparisons (P < 0.05). Results: Group B showed more influence on the shear bond strength when compared to other protocols, respectively (P < 0.001). Conclusion: Alone silanization as a surface treatment did not improve the bond strength. Combination of chemical presurface treatments followed by silanization significantly enhanced the bond strength at the post/adhesive interface. PMID:27307666
Jungermann, Gretchen B.; Burns, Krystal; Nandakumar, Renu; Tolba, Mostafa; Venezia, Richard A.; Fouad, Ashraf F.
Introduction The presence of antibiotic resistance genes in endodontic microorganisms may render the infection resistant to common antibiotics. The aims of this project were to identify selected antibiotics resistance genes in primary and persistent endodontic infections and determine the effectiveness of contemporary endodontic procedures in eliminating bacteria with these genes. Methods In patients undergoing primary endodontic treatment or retreatment, the root canals were aseptically accessed and sampled prior to endodontic procedures as well as following contemporary chemomechanical preparation and medication with calcium hydroxide. Identification of the following antibiotics resistance genes was performed using PCR: blaTEM−1, cfxA, blaZ, tetM, tetW, tetQ, vanA, vanD, and vanE. Limited phenotypic identification and antibiotic susceptibility verification was also performed. Results Overall, there were 45 specimens available for analysis: 30 from primary and 15 from persistent endodontic infections. In preoperative specimens, only blaTEM-1 was significantly more prevalent in primary vs. persistent infections (p=0.04). Following contemporary treatment procedures, there was an overall reduction in prevalence of these genes (p<0.001). blaTEM-1 and tetW were significantly reduced (p<0.05), cfxA, blaZ and tetQ were eliminated, but there was no change in tetM. No specimens contained vanA, vanD, or vanE. Antibiotic susceptibility testing showed significant differences among the antibiotics (p<0.001) and general concordance with the gene findings. Conclusions blaTEM-1 was more prevalent in primary than persistent infections. Vancomycin resistance was not present. The genes identified were reduced with treatment except for tetM. Genetic testing may be useful as a screening tool for antibiotic resistance. PMID:21924178
Wang, Lin; Xie, Xianju; Weir, Michael D; Fouad, Ashraf F; Zhao, Liang; Xu, Hockin H K
The objectives of this study were to: (1) develop a new bioactive dental bonding agent with nanoparticles of amorphous calcium phosphate and dimethylaminohexadecyl methacrylate for tooth root caries restorations and endodontic applications, and (2) investigate biofilm inhibition by the bioactive bonding agent against eight species of periodontal and endodontic pathogens for the first time. Bonding agent was formulated with 5 % of dimethylaminohexadecyl methacrylate. Nanoparticles of amorphous calcium phosphate at 30 wt% was mixed into adhesive. Eight species of biofilms were grown on resins: Porphyromonas gingivalis, Prevotella intermedia, Prevotella nigrescens, Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, Parvimonas micra, Enterococcus faecalis, Enterococcus faecium. Colony-forming units, live/dead assay, biomass, metabolic activity and polysaccharide of biofilms were determined. The results showed that adding dimethylaminohexadecyl methacrylate and nanoparticles of amorphous calcium phosphate into bonding agent did not decrease dentin bond strength (P > 0.1). Adding dimethylaminohexadecyl methacrylate reduced the colony-forming units of all eight species of biofilms by nearly three orders of magnitude. The killing efficacy of dimethylaminohexadecyl methacrylate resin was: P. gingivalis > A. actinomycetemcomitans > P. intermedia > P. nigrescens > F. nucleatum > P. micra > E. faecalis > E. faecium. Dimethylaminohexadecyl methacrylate resin had much less biomass, metabolic activity and polysaccharide of biofilms than those without dimethylaminohexadecyl methacrylate (P < 0.05). In conclusion, a novel dental adhesive was developed for root caries and endodontic applications, showing potent inhibition of biofilms of eight species of periodontal and endodontic pathogens, and reducing colony-forming units by three orders of magnitude. The bioactive adhesive is promising for tooth root restorations to provide
Bahcall, James; Xie, Qian
Local anesthesia is one of the most important drugs given to patients who undergo endodontic treatment. Yet, clinicians often do not view local anesthetic agents as drugs and, therefore, struggle clinically to consistently achieve profound pulpal anesthesia. To improve the clinical effects of local anesthesia for endodontic treatment, in conjunction with selecting the correct type of local anesthesia, clinicians need to thoroughly understand how the local anesthetic process works and how to objectively test for clinical signs of pulpal anesthesia and integrate supplemental anesthesia when appropriate.
Research into regenerative dentistry has added impetus onto the field of molecular biology. It can be documented as a prototype shift in the therapeutic armamentarium for dental disease. Regenerative endodontic procedures are widely being added to the current armamentarium of pulp therapy procedures. The regenerative potential of platelets has been deliberated. A new family of platelet concentrates called the platelet rich fibrin (PRF) has been recently used by several investigators and has shown application in diverse disciplines of dentistry. This paper is intended to add light on the various prospects of PRF and clinical insights to regenerative endodontic therapy. PMID:24516822
Goodis, Harold E; Kinaia, Bassam Michael; Kinaia, Atheel M; Chogle, Sami M A
The work performed by researchers in regenerative endodontics and tissue engineering over the last decades has been superb; however, many questions remain to be answered. The basic biologic mechanisms must be elucidated that will allow the development of dental pulp and dentin in situ. Stress must be placed on the many questions that will lead to the design of effective, safe treatment options and therapies. This article discusses those questions, the answers to which may become the future of regenerative endodontics. The future remains bright, but proper support and patience are required.
Yatsuhashi, Takaaki; Nakagawa, Kan-Ichi; Matsumoto, Miho; Kasahara, Masataka; Igarashi, Tomoko; Ichinohe, Tatsuya; Kaneko, Yuzuru
We experienced two cases of inferior alveolar nerve paresthesia caused by root canal medicaments, which were successfully relieved by microscopic endodontic treatment. In the first case, the paresthesia might have been attributable to infiltration of calcium hydroxide into the mandibular canal through the root canals of the mandibular left second molar tooth. In the second case, the paresthesia might have been attributable to infiltration of paraformaldehyde through the root canals of the mandibular right second molar tooth. The paresthesia was relieved in both cases by repetitive microscopic endodontic irrigation using physiological saline solution in combination with oral vitamin B12 and adenosine triphosphate.
Brow, R.K.; Kovacic, L.; Chambers, R.S.
Hernetic glass sealing technologies developed for weapons component applications can be utilized for the design and manufacture of fuel cells. Design and processing of of a seal are optimized through an integrated approach based on glass composition research, finite element analysis, and sealing process definition. Glass sealing procedures are selected to accommodate the limits imposed by glass composition and predicted calculations.
Mumcu, Emre; Erdemir, Ugur; Topcu, Fulya Toksoy
By means of a micro push-out test, this study compared the bond strengths of two types of fiber-reinforced posts cemented with luting cements based on two currently available adhesive approaches as well as evaluated their failure modes. Sixty extracted single-rooted human maxillary central incisor and canine teeth were sectioned below the cementoenamel junction, and the roots were endodontically treated. Following standardized post space preparation, the roots were divided into two fiber post groups and then further into three subgroups of 10 specimens each according to the luting cements. A push-out test was performed to measure regional bond strengths, and the fracture modes were evaluated using a stereomicroscope. At the root section, there were no statistically significant differences (p>0.05) in push-out bond strength among the tested luting cements. Nevertheless, the push-out bond strength values of glass fiber-reinforced posts were higher than those of carbon fiber-reinforced posts, irrespective of the adhesive approach used. On failure mode, the predominant failure mode was adhesive failure between dentin and the luting cement.
Khoroushi, Maryam; Mazaheri, Hamid; Tarighi, Pardis; Samimi, Pouran
Objectives Hydrogen peroxide (H2O2) surface treatment of fiber posts has been reported to increase bond strength of fiber posts to resin cements. However, residual oxygen radicals might jeopardize the bonding procedure. This study examined the effect of three antioxidant agents on the bond strength of fiber posts to conventional and self-adhesive resin cements. Materials and Methods Post spaces were prepared in forty human maxillary second premolars. Posts were divided into five groups of 8 each: G1 (control), no pre-treatment; G2, 10% H2O2 pre-treatment; G3, G4 and G5. After H2O2 application, Hesperidin (HES), Sodium Ascorbate (SA) or Rosmarinic acid (RA) was applied on each group respectively. In each group four posts were cemented with Duo-Link conventional resin cement and the others with self-adhesive BisCem cement. Push-out test was performed and data were analyzed using 2-way ANOVA and tukey's post-hoc test (α = 0.05). Results There was a statistically significant interaction between the cement type and post surface treatment on push-out bond strength of fiber posts (p < 0.001, F = 16). Also it was shown that different posts' surface treatments significantly affect the push-out bond strength of fiber posts (p = 0.001). H2O2 treated posts (G2) and control posts (G1) cemented with Duo-link showed the highest (15.96 ± 5.07MPa) and lowest bond strengths (6.79 ± 3.94) respectively. Conclusions It was concluded that H2O2 surface treatment might enhance the bond strength of fiber posts cemented with conventional resin cements. The effect of antioxidants as post's surface treatment agents depends on the characteristics of resin cements used for bonding procedure. PMID:25383350
Parekh, Bandish; Irani, Rukshin S.; Sathe, Sucheta; Hegde, Vivek
Background: Microbial contamination of the pulp space is one of the major factors associated with endodontic failure. Thus, in addition to a three dimentional apical filling a coronal seal for root canal fillings has been recommended. Aim: The present study was conducted to evaluate and compare the intra-orifice sealing ability of three experimental materials after obturation of the root canal system. Materials and Methods: Fourty single rooted mandibular premolars were decoronated, cleaned, shaped and obturated. Gutta-percha was removed to the depth of 3.5 mm from the orifice with a heated plugger. Ten specimens each were sealed with Light Cure Glass Ionomer Cement (LCGIC), Flowable Composite (Tetric N-Flow), and Light Cure Glass Ionomer Cement with Flowable Composite in Sandwich Technique along with a positive control respectively and roots submerged in Rhodamine-B dye in vacuum for one week. Specimens were longitudinally sectioned and leakage measured using a 10X stereomicroscope and graded for depth of leakage. Results: According to the results of the present study LC GIC + Tetric N Flow demonstrated significantly better seal (P < 0.01) than LC GIC. However there was no statistically significant difference in leakage (P > 0.01) between Tetric N-Flow and LCGIC+Tetric N-Flow groups. Conclusion: In the current study LCGIC+Tetric N-Flow was found to be superior over other experimental materials as intra-orifice barriers. PMID:24944446
Lee, Charles Q.; And Others
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…
Fouad, Ashraf F.; Burleson, Joseph A.
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…
... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Endodontic dry heat sterilizer. 872.6730 Section 872.6730 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... of completion of a PDP is required to be filed with the Food and Drug Administration on or...
... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Endodontic paper point. 872.3830 Section 872.3830 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED..., or apply medication to, the root canal of a tooth. (b) Classification. Class I (general...
... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Endodontic stabilizing splint. 872.3890 Section 872.3890 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... inserted through the root canal into the upper or lower jaw bone to stabilize a tooth. (b)...
... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Endodontic paper point. 872.3830 Section 872.3830 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED..., or apply medication to, the root canal of a tooth. (b) Classification. Class I (general...
... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Endodontic stabilizing splint. 872.3890 Section 872.3890 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... inserted through the root canal into the upper or lower jaw bone to stabilize a tooth. (b)...
... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Endodontic paper point. 872.3830 Section 872.3830 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED..., or apply medication to, the root canal of a tooth. (b) Classification. Class I (general...
... 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... inserted through the root canal into the upper or lower jaw bone to stabilize a tooth. (b)...
Navarro, G; Mateos, M; Navarro, J L; Canalda, C
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.
Morse, D R
Paresthesia is a condition that involves perverted sensations of pain, touch, or temperature. It has a variety of possible causes. This article presents a literature review and case reports of endodontically related inferior alveolar nerve and mental foramen paresthesia. Nondrug prevention methods and the dental uses of dexamethasone are also discussed.
Kadam, Ajay; Pujar, Madhu; Patil, Chetan
Introduction: The concept of using a “post” for the restoration of teeth has been practiced to restore the endodontically treated tooth. Metallic posts have been commonly used, but their delirious effects have led to the development of fiber-reinforced materials that have overcome the limitations of metallic posts. The use of glass and quartz fibers was proposed as an alternative to the dark color of carbon fiber posts as far as esthetics was concerned. “Debonding” is the most common failure in fiber-reinforced composite type of posts. This study was aimed to compare the push-out bond strength of a self-adhesive dual-cured luting agent (RelyX U100) with a total etch resin luting agent (Variolink II) used to cement two different FRC posts. Materials and Methods: Eighty human maxillary anterior single-rooted teeth were decoronated, endodontically treated, post space prepared and divided into four groups (n = 20); Group I: D.T. light post (RTD) and Variolink II (Ivoclare vivadent), Group II: D.T. light post (RTD) and RelyX U100 (3M ESPE), Group III: Glassix post (Nordin) and Variolink II (Ivoclare vivadent) and Group IV: Glassix post (Nordin) and RelyX U100 (3M ESPE). Each root was sectioned to get slices of 2 ± 0.05-mm thickness. Push-out tests were performed using a triaxial loading frame. To express bond strength in megapascals (Mpa), load value recorded in Newton (N) was divided by the area of the bonded interface. After testing the push-out strengths, the samples were analyzed under a stereomicroscope. Results: The mean values of the push-out bond strength show that Group I and Group III had significantly higher values than Group II and Group IV. The most common mode of failure observed was adhesive between dentin and luting material and between post and luting material. Conclusions: The mean push-out bond strengths were higher for Groups I and III where Variolink II resin cement was used for luting the fiber post, which is based on the total etch
Woodmansey, Karl; Beck, Lynn G; Rodriguez, Tobias E
Few recent surveys have examined the contemporary landscape of predoctoral endodontic education in the United States and Canada, but anecdotal reports suggest that current dental students have difficulty obtaining adequate clinical endodontic experiences. The aims of this study were to quantify the clinical endodontic experiences of current U.S. and Canadian dental students, to explore the issues surrounding their clinical endodontic competence, and to ask more broadly if current graduating dentists are competent to perform endodontic procedures. In August 2014, a hyperlink to a web-based survey with 27 questions was emailed to the 67 predoctoral endodontic directors of U.S. and Canadian dental schools using a list provided by the American Association of Endodontists. Out of these 67 possible participants, 40 responded, for a response rate of 60%. The findings were varied. The average 2014 graduate completed 5.9 (± 2.4) root canal treatments on live patients, and 69% of the respondents voiced concern regarding a shortage of patient experiences. A majority (59%) of the respondents reported thinking that the supply of endodontic patients has decreased and that students have an inadequate supply of endodontic patients. This study found that a clear majority of predoctoral endodontics directors perceived a shortage of patient experiences for their students although, in reality, the number of completed clinical cases appeared to be unchanged since 1975. In addition, 36% of the respondents reported feeling that their 2014 graduates were not competent to perform molar endodontic treatment in their practices.
Wong, Amy WY; Zhang, Chengfei; Chu, Chun-hung
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
Gomes, Brenda P F A; Jacinto, Rogério C; Pinheiro, Ericka T; Sousa, Ezilmara L R; Zaia, Alexandre A; Ferraz, Caio C R; Souza-Filho, Francisco J
The aim of this study was to investigate the presence of strict anaerobes such as Filifactor alocis, Tannerella forsythia, and Treponema denticola in primary and secondary root-infected canals with periapical lesions by molecular analysis and the association of these species with specific endodontic signs and symptoms. Microbial samples were taken from 100 root canals, 50 with necrotic pulp tissues (NPT, primary infection), and 50 with failed endodontic treatment (FET, secondary infection). DNA was extracted from the samples, which were analyzed for the presence of three endodontic pathogens using species-specific primers and PCR. F. alocis were isolated from 23 canals with NPT and 12 canals with FET; T. forsythia from 12 canals with NPT and three canals with FET; T. denticola from 19 canals with NPT and 12 canals with TEP. Suggested associations were found between primary infection and the presence of F. alocis and T. forsythia (both p < 0.05). In particular, associations were found between: pain and F. alocis; swelling and F. alocis; tenderness to percussion and T. forsythia; mobility and T. forsythia and T. denticola; wet canals and F. alocis, T. forsythia, and T. denticola; purulent exsudate and F. alocis, T. forsythia and T. denticola; abscess and F. alocis, T. forsythia, and T. denticola (all p < 0.05). The findings of this study indicated that F. alocis, T. forsythia, and T. denticola seem to be associated with endodontic signs and symptoms. Additionally, F. alocis and T. forsythia were detected more frequently in teeth with necrotic pulp than in teeth with failing endodontic treatment.
Sharma, Sarang; Srivastava, Dhirendra; Sood, Vishal; Yadav, Priya
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
Setzer, F.C.; Kim, S.
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
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 carbon dioxide laser beam, and checking for their viability by standard microbiologic...techniques. It was found that 100% of the spores were killed by the carbon dioxide laser. This holds promise as an effective method of sterilizing endodontic instruments in the future. (Author)
the manuscript. DISCLAIMERS The statements, opinions, and advertisements in the Journal of Endodontics are solely those of the individual authors...I RD-Ai26 872 RESIN ADAPTATION OF RADICULAR DENTIN TUBULES AFTER / I ENDODONTIC INSTRUMENTATION AND ACID ETCHING(U) WALTER I REED ARMY INST OF...Adaptation to Radicular Dentin Tubules SbisoofpeAfter Endodontic Instrumentation and Acid Etching 1982-1983 6. PERFORMING ORG. REPORTNUMBER -, AUTHOR(a) S
Dalmijn, W.L.; Houwelingen, J.A. van
Glass recycling in the Netherlands has grown from 10,000 to 300,000 tonnes per annum. The various advantages and problems of the glass cycle with reference to the state of the art in the Netherlands is given. Special attention is given to new technologies for the automated sorting of cullet with detection systems. In Western Europe the recycling of glass has become a success story. Because of this, the percentage of glass cullet used in glass furnaces has increased. To meet the quality demands of the glass industry, automated sorting for the removal of stones, non-ferrous metals and other impurities had to be developed and incorporated in glass recycling plants. In Holland, Germany and other countries, the amount of glass collected has reached a level that color-sorting becomes necessary to avoid market saturation with mixed cullet. Recently, two systems for color-sorting have been developed and tested for the separation of bottles and cullet in the size range of 20--50 mm. With the increased capacity of the new glass recycling plants, 120,000--200,000 tpy, the quality systems have also to be improved and automated. These quality control systems are based on the automated sorting technology developed earlier for the glass recycling plants. The data obtained are automatically processed and printed. The sampling system and its relation to the theory of Gy will be described. Results of both developments in glass recycling plants will be described.
Several NASA technologies have played part in growth and cost containment of studio glass art, among them a foam type insulation developed to meet a need for lightweight material that would reduce flame spread in aircraft fire. Foam comes in several forms and is widely used by glass artists, chiefly as an insulator for the various types of ovens used in glass working. Another Spinoff is alumina crucibles to contain molten glass. Before alumina crucibles were used, glass tanks were made of firebrick which tended to erode under high temperatures and cause impurities; this not only improved quality but made the process more cost effective. One more NASA technology that found its way into glass art working is a material known as graphite board, a special form of graphite originally developed for rocket motor applications. This graphite is used to exact compound angles and creates molds for poured glass artworks of dramatic design.
Yılmaz, Funda; Kamburoglu, Kıvanç; Yeta, Naz Yakar; Öztan, Meltem Dartar
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
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
MESTIERI, Leticia Boldrin; GOMES-CORNÉLIO, Ana Lívia; RODRIGUES, Elisandra Márcia; SALLES, Loise Pedrosa; BOSSO-MARTELO, Roberta; GUERREIRO-TANOMARU, Juliane Maria; TANOMARU, Mário
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
Geeta, I.B.; Galagali, Girish; Kulkarni, Sangeeta; Suran, Pushpa; Noushin, Faizal
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
Bansal, Ramta; Jain, Aditya
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
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
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
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.
Hibst, Raimund; Stock, Karl; Gall, Robert; Keller, Ulrich
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.
Makkar, Sameer; Gupta, Pranav
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
George, Sageena; Anandaraj, S.; Issac, Jyoti S.; John, Sheen A.; Harris, Anoop
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
Simsek, Neslihan; Keles, Ali; Ocak, Mevlut Sinan
The term taurodontism is derived from the Latin word tauros, for “bull,” and the Greek term odus, for “tooth,” or “bull tooth.” Taurodontism is a morpho-anatomical developmental anomaly, which is seen infrequently in teeth only. It is characterized by a deficiency in the constriction at the cement-enamel junction, with lengthened pulp chambers and apical displacement of the pulpal floor. This gives the tooth a quadrilateral or cylindrical look. This report presents a case of multiple bilateral taurodontism and the successful endodontic treatment of the tooth that had hypertaurodontism. A male patient was referred to the endodontic clinic with decayed left maxillary first molar. Hypertaurodontism was confirmed after clinical and radiographic examination. Panaromic X-rays revealed that all of the patient's molar teeth were taurodontic. Taurodontism offers challenges to the practitioner during shaping and disinfection and at the time of filling the root canals. PMID:24082583
Shruthi, Nagaraja; Murthy, B V Sreenivasa; Sundaresh, K J; Mallikarjuna, Rachappa
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.
Endodontic procedures are challenging and technically demanding. In the UK standards of treatment have been shown to have fallen short of acceptable guidelines, laying many dentists open to litigation on questions of clinical negligence by patients who understand and know what should be considered as current best practice in this area. Failure to communicate with patients about the procedure and not obtaining consent for treatment is a key area of complaint, as is inadequate record keeping. When treatment is undertaken within the framework of accepted guidelines it would be very difficult for a patient to open a claim for clinical negligence should a failure occur. This article looks at potential dento-legal problems in endodontics and how, through compliance with best practice, they may be avoided.
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.
thesis submitted to the Faculty of the Endodontics Graduate Program Naval Postgraduate Dental School Uniformed Services University of the Health...Sciences in partial fulfillment of the requirements for the degree of Master of Science in Oral Biology June 2012 Naval Postgraduate Dental ...Biology at the June 2012 graduation. Thesis Committee: P"trigV:;;;’i~: CAPT, DC, USN Associate Dean, Graduate Dental Program Navy Medicine
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.
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
Yildirim, Ayhan; Lübbers, Heinz-Theo; Yildirim, Vedat
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.
Yildirim, Ayhan; Lübbers, Heinz-Theo; Yildirim, Vedat
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.
Asgary, Saeed; Fazlyab, Mahta
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
Fabra Campos, H; Millet Part, J
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.
Weinberg, M. C.
Research efforts span three general areas of glass science: glass refining, gel-derived glasses, and nucleation and crystallization of glasses. Gas bubbles which are present in a glass product are defects which may render the glass totally useless for the end application. For example, optical glasses, laser host glasses, and a variety of other specialty glasses must be prepared virtually defect free to be employable. Since a major mechanism of bubble removal, buoyant rise, is virtually inoperative in microgravity, glass fining will be especially difficult in space. On the other hand, the suppression of buoyant rise and the ability to perform containerless melting experiments in space allows the opportunity to carry out several unique bubble experiments in space. Gas bubble dissolution studies may be performed at elevated temperatures for large bubbles with negligible bubble motion. Also, bubble nucleation studies may be performed without the disturbing feature of heterogeneous bubble nucleation at the platinum walls. Ground based research efforts are being performed in support of these potential flight experiments.
1. General view of looking glass aircraft in the project looking glass historic district. View to southeast. - Offutt Air Force Base, Looking Glass Airborne Command Post, Looking Glass Avenue between Comstat Drive & Nightwatch Avenue, Offutt Air Force Base, Bellevue, Sarpy County, NE
4. General view of looking glass aircraft in the project looking glass historic district. View to west. - Offutt Air Force Base, Looking Glass Airborne Command Post, Looking Glass Avenue between Comstat Drive & Nightwatch Avenue, Offutt Air Force Base, Bellevue, Sarpy County, NE
2. General view of looking glass aircraft in the project looking glass historic district. View to south. - Offutt Air Force Base, Looking Glass Airborne Command Post, Looking Glass Avenue between Comstat Drive & Nightwatch Avenue, Offutt Air Force Base, Bellevue, Sarpy County, NE
5. General view of looking glass aircraft in the project looking glass historic district. View to north. - Offutt Air Force Base, Looking Glass Airborne Command Post, Looking Glass Avenue between Comstat Drive & Nightwatch Avenue, Offutt Air Force Base, Bellevue, Sarpy County, NE
2. Looking glass aircraft with open main entry door and cockpit hatch. View to south. - Offutt Air Force Base, Looking Glass Airborne Command Post, Looking Glass Aircraft, On Operational Apron covering northeast half of Project Looking Glass Historic District, Bellevue, Sarpy County, NE
3. General view of looking glass aircraft in the project looking glass historic district. View to west. - Offutt Air Force Base, Looking Glass Airborne Command Post, Looking Glass Avenue between Comstat Drive & Nightwatch Avenue, Offutt Air Force Base, Bellevue, Sarpy County, NE
Kala, M.; Banthia, Priyank; Banthia, Ruchi
The vitality of dentin-pulp complex is fundamental to the life of tooth and is a priority for targeting clinical management strategies. Loss of the tooth, jawbone or both, due to periodontal disease, dental caries, trauma or some genetic disorders, affects not only basic mouth functions but aesthetic appearance and quality of life. One novel approach to restore tooth structure is based on biology: regenerative endodontic procedure by application of tissue engineering. Regenerative endodontics is an exciting new concept that seeks to apply the advances in tissue engineering to the regeneration of the pulp-dentin complex. The basic logic behind this approach is that patient-specific tissue-derived cell populations can be used to functionally replace integral tooth tissues. The development of such ‘test tube teeth’ requires precise regulation of the regenerative events in order to achieve proper tooth size and shape, as well as the development of new technologies to facilitate these processes. This article provides an extensive review of literature on the concept of tissue engineering and its application in endodontics, providing an insight into the new developmental approaches on the horizon. Key words:Regenerative, tissue engineering, stem cells, scaffold. PMID:24558528
Jang, Youngjune; Kim, Hyeon; Roh, Byoung-Duck
Appropriate use of local hemostatic agent is one of the important factors on the prognosis of endodontic microsurgery. However, most investigations to date focus on the hemostatic efficacy of the agents, whereas their biologic characteristics have not received enough attention. The purpose of this paper was to review the biologic response of local hemostatic agents, and to provide clinical guidelines on their use during endodontic microsurgery. Electronic database (PUBMED) was screened to search related studies from 1980 to 2013, and 8 clinical studies and 18 animal studies were identified. Among the materials used in these studies, most widely-investigated and used materials, epinephrine, ferric sulfate (FS) and calcium sulfate (CS), were thoroughly discussed. Influence of these materials on local tissue and systemic condition, such as inflammatory and foreign body reaction, local ischemia, dyspigmentation, delayed or enhanced bone and soft tissue healing, and potential cardiovascular complications were assessed. Additionally, biological property of their carrier materials, cotton pellet and absorbable collagen, were also discussed. Clinicians should be aware of the biologic properties of local hemostatic agents and their carrier materials, and should pay attention to the potential complications when using them in endodontic microsurgery. PMID:24790919
Pai, S F; Yang, S F; Sue, W L; Chueh, L H; Rivera, E M
Occlusal endodontic access preparations are occasionally made in teeth without removing the original restoration. However, microleakage between restorative materials that are placed at different times has not been extensively studied. Therefore, our objective was to compare microleakage at three areas: between an access opening restorative material and the cavity wall; between an additional material placed later to patch a secondary opening in the first restorative material and the original restorative material itself; and between the secondarily placed material and the cavity wall. Standard endodontic access preparations were made in 120 noncarious, nonrestored crowns of extracted human molars. These teeth were divided into six experimental groups. Another four molars were controls. The endodontic access cavities were restored with either IRM or amalgam as the primary restorative material. After 14 days, half of the primary restorations was removed, and this defect was filled with a secondary restorative material: IRM, Caviton, or a double seal of Caviton and IRM. Microleakage was measured linearly as the extent of basic fuchsin dye penetration under a stereomicroscope after thermal cycling (5 degrees and 55 degrees C for 100 cycles) and tooth sectioning. Wilcoxon signed-rank test was used for statistical analysis. Results indicated significantly less microleakage between primary and secondary restorative materials placed at different times than microleakage between primary temporary restorative materials and the access cavity wall, regardless of the type of primary restorative material used (IRM or amalgam).
Bouillaguet, Serge; Wataha, John C; Tay, Franklin R; Brackett, Martha G; Lockwood, Petra E
The objective of this study was to evaluate the cytotoxicity of three endodontic sealers (AH Plus/Maillefer-Dentsply, Epiphany/Pentron, GuttaFlow, Coltene-Whaledent). Materials were mixed according to the manufacturer instructions and packed into Teflon molds (10 x 1 mm). For cytotoxicity testing (MTT method), the specimens were placed in contact with cultured cells, then evaluated at two subsequent time points (24 or 72 h). In addition to testing the mixed materials, 5 microl of primer liquid (GuttaFlow and Epiphany) and resin solvents (HEMA, ethanol, sterile water, or acetone) were added directly in culture for 24 and 72 h. The results showed that most materials pose significant cytotoxic risks and that cytotoxicity generally increased with time. At 72 h, GuttaFlow became significantly less toxic than AH Plus, Epiphany sealer, and Resilon. The current results support the need to continue to develop better endodontic sealers that combine the excellent sealing and bonding properties of resins with acceptable biological properties for endodontic applications.
Al-Fouzan, Khalid S.
The interrelationship between periodontal and endodontic disease has always aroused confusion, queries, and controversy. Differentiating between a periodontal and an endodontic problem can be difficult. A symptomatic tooth may have pain of periodontal and/or pulpal origin. The nature of that pain is often the first clue in determining the etiology of such a problem. Radiographic and clinical evaluation can help clarify the nature of the problem. In some cases, the influence of pulpal pathology may cause the periodontal involvement and vice versa. The simultaneous existence of pulpal problems and inflammatory periodontal disease can complicate diagnosis and treatment planning. An endo-perio lesion can have a varied pathogenesis which ranges from simple to relatively complex one. The differential diagnosis of endodontic and periodontal diseases can sometimes be difficult, but it is of vital importance to make a correct diagnosis for providing the appropriate treatment. This paper aims to discuss a modified clinical classification to be considered for accurately diagnosing and treating endo-perio lesion. PMID:24829580
Friedlander, Lara; Anderson, Vivienne
The teaching of advanced endodontic courses at the predoctoral level is common, but it can be difficult to assess teaching effectiveness. Advanced modules placed later in the dental curriculum provide the opportunity to introduce a new topic, revisit and reinforce concepts learned previously, and instill the notion of lifelong learning. At any level, the introduction of new techniques to novices must be based on recognition of their prior knowledge and experience and their need for explicit direction, stepwise instruction, and comprehensive feedback. Assessment of students' performance should not only provide insights into what they know and can do, but also steer them towards desired outcomes. In addition, assessment can provide valuable feedback on teaching effectiveness. In this article, we describe a module piloted for inclusion in the University of Otago (New Zealand) fourth-year dental curriculum. This involved the use of tapered hand and rotary nickel-titanium files for root canal preparation and was taught through a didactic program (lectures and problem-based learning seminars) and a series of preclinical hands-on sessions. Findings from formative and summative assessments as well as student, peer, and self-evaluation indicated that the objectives of the module were met and that it was effective in both providing students with the basic skills for using this type of instrumentation and increasing their understanding and enthusiasm for endodontics. We conclude by discussing curriculum changes resulting from our module evaluation, directions for future research, and suggestions for teaching advanced endodontic techniques.
Schipper, M; Peters, L B
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.
Okano, T.; Wiebe, J.D.; Webber, R.L.; Wagner, R.F.
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.
Blank, Molly A. B.; Friedrich, Michal; Hamilton, Jeffrey D.; Lee, Peggy; Berg, Joel; Seibel, Eric J.
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.
Carracedo-Sánchez, M.; Sarrionandia, F.; Arostegui, J.; Errandonea-Martin, J.; Gil-Ibarguchi, J. I.
We present the results of a petrographic and geochemical study carried out on a layer of achnelithic tephra outcropping at the base of the volcanic cone of Las Herrerías (Miocene-Quaternary volcanic region of Campo de Calatrava, Spain). The tephra, with a composition of nephelinite and ash (< 1 mm) to coarse lapilli (ca. 1 cm) in size, is made of intact isolated achneliths (mostly elongated and spheroidal, including Pele's tears), achnelith fragments and rare welded achneliths. The achneliths at Las Herrerías were generated in a gas-rich fire fountain that fragmented the magma into micro- to nanometre particles. The low viscosity of the nephelinitic blebs (< 1235 Pa.s) inside the hottest (ca. 900 °C), inner zone of the fountain allowed the development of the characteristic fluidal shapes of these pyroclasts and their welding above the glass transition temperature (533-669 °C). The sideromelane glass of the achneliths, also nephelinitic in composition, is variably altered to palagonite. The palagonitization was isovolumetric and took place in a near closed system at the achnelith scale. Palagonitization involved depletion in the concentration (g/cm3) of all major elements and notable increase in H2O content. The elements liberated by this process formed smectite with an average structural formula comprised between those of beidellite and nontronite end terms: (Na0.01K0.03Ca0.18) (Mg0.22Fe0.16)2 + (Fe0.48Al1.02)3 + (Ti0.18)4 + (Si3.58Al0.42) O10(OH)2. The degree of palagonitization in each achnelith was likely related to the amount of water incorporated by individual clasts at the moment of their deposition in a volcanic maar lake. Afterwards, there was no more water circulation through the achnelithic tephra, which was sealed from water by overlying hydrovolcanic tuff deposits. It was this isolation that made possible the preservation of glass to the present day.
Madarati, Ahmad; Rekab, Mohammad Salem; Watts, David Christopher; Qualtrough, Alison
The aim of this in vitro study was to compare parametrically the coronal seal ability over different periods of times of four restorative materials used to seal the pulpal access cavity after endodontic treatment. One hundred and thirty-five mandibular premolars were divided randomly into three time groups (1, 2 and 4 weeks), each of which was in turn divided into four subgroups. Each subgroup was restored using one of four restorative materials: Coltosol, glass ionomer cement (GIC), zinc phosphate (ZP) cement, or intermediate restorative material (IRM) cement. The root canals were prepared using the crown-down technique, and obturated using lateral condensation. Following placement of the restorative material, the samples were incubated in distilled water at 37 degrees C and were subjected to 50 thermocycles (0 +/- 4, 56 +/- 4C). After immersing in (2%) methylene blue dye for 24 h, teeth were longitudinally sectioned and examined under a stereomicroscope. The results showed that Coltosol and GIC cement were significantly superior in sealing ability to ZP and IRM cements (P < 0.05). There was no significant difference between GIC cement and Coltosol. Both Coltosol and GIC after 1 week were significantly better than 4 weeks. There was no significant difference in the seal ability at different time periods when ZP and IRM cements were used.
Sandoval, Victor A.; And Others
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)
Mendel, Robert W.; Scheetz, James P.
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.…
Nicolai, P; Mensi, M; Marsili, F; Piccioni, M; Salgarello, S; Gilberti, E; Apostoli, P
The objective of this study was to demonstrate the correlation between endodontic treatment on maxillary teeth and fungus ball with inductively coupled plasma mass spectrometry measurement of zinc and other metals (barium, lead and copper) in fungus ball samples. Samples of normal maxillary mucosa were used as comparison. Metal concentration was also measured in several endodontic materials. A significant difference was found between the concentration of zinc and copper in fungus ball compared to normal mucosa. Metal distribution was more similar in fungus ball and in the endodontic materials tested than normal mucosa. The similar metal concentration in the endodontic materials and fungus ball suggests that endodontic materials play a role in the pathogenesis of fungus ball. Endodontic materials accidentally pushed into the maxillary sinus during endodontic treatments may play a crucial role. Dentists should be as careful as possible when treating maxillary teeth to avoid perforating the maxillary sinus floor; the use of zinc-free endodontic materials, as zinc is a metal that plays a pivotal role in fungus growth, should be encouraged.
Ling, J Q
In order to promote the use of dental operating microscope in endodontics, Society of Cariology and Endodontology of Chinese Stomatological Association formulated these guidelines, after extensive consultation with related authorities and careful reference to the available published materials and literatures. It is hoped that these guidelines will be useful for dental practitioners embarking on microscopic endodontics.
Parčina, Ivana; Amižić
The primary function of an endodontic post is to provide retention for the core and enable full sealing of the coronal portion of the root canal. Traditionally used metal posts do not meet the requirements of modern dental medicine due to some fairly significant drawbacks such as color, corrosion potential, non-adhesive bonding and high modulus of elasticity which can lead to root fracture. Recently, esthetic ceramic and fiber reinforced posts have been manufactured in order to avoid such imperfections. Since much attention has been devoted to the esthetic aspects of dental medicine, the use of these posts with composite/ceramic cores is very common in restorative dentistry and it is actually becoming a standard. This is due to the fact that, apart from being an esthetically pleasing material, they are also biocompatible, have good physical properties and the capacity of adhesive bonding to tooth tissue and core buildup. Nonetheless, a good clinician should know how to spot the difference between them in order to select and use the appropriate post system in each specific situation. PMID:27789912
Kemaloglu, Hande; Emin Kaval, Mehmet; Turkun, Murat; Micoogullari Kurt, Seniha
The aim was to evaluate the effects of fiber-reinforced composite restorations and a bulk-fill resin composite on the fracture strength of mandibular premolars treated endodontically. Standard mesio-occluso-distal (MOD) cavities were prepared in 48 mandibular premolars. Following root canal treatment, teeth were assigned to four groups: Group 1, nano-hybrid resin composite; Group 2, polyethylene woven fiber plus nano-hybrid resin composite; Group 3, short fiber-reinforced resin composite plus nano-hybrid resin composite; and Group 4, bulk-fill resin composite plus nano-hybrid resin composite. Then, the teeth were subjected to the fracture toughness test. The data were analyzed statistically using one-way ANOVA, followed by Tukey's post-hoc test. The fiber-reinforced groups had better results than the nano-hybrid and bulk-fill composites (p<0.05), while the bulk-fill and nano-hybrid composite restorations gave similar results (p>0.05). Fiber-reinforcement improved the fracture strength of teeth with large MOD cavities treated endodontically. Bulk-fill composites can be used reliably as well as nano-hybrid composites.
Wang, Szu-Ko; Lin, Ting-Chun; Jian, Sheng-Rui; Juang, Jenh-Yih; Jang, Jason S.-C.; Tseng, Jiun-Yi
In this study, the effects of post-annealing on the structure, surface morphology and nanomechanical properties of ZnO thin films doped with a nominal concentration of 3 at.% Ga (ZnO:Ga) are investigated using X-ray diffraction (XRD), atomic force microscopy (AFM) and scanning electron microscopy (SEM) and nanoindentation techniques. The ZnO:Ga thin films were deposited on the glass substrates at room temperature by radio frequency magnetron sputtering. Results revealed that the as-deposited ZnO:Ga thin films were polycrystalline albeit the low deposition temperature. Post-annealing carried out at 300, 400 and 500 °C, respectively, has resulted in progressive increase in both the average grain size and the surface roughness of the ZnO:Ga thin film, in addition to the improved thin films crystallinity. Moreover, the hardness and Young's modulus of ZnO:Ga thin films are measured by a Berkovich nanoindenter operated with the continuous contact stiffness measurements (CSM) option. The hardness and Young's modulus of ZnO:Ga thin films increased as the annealing temperature increased from 300 to 500 °C, with the best results being obtained at 500 °C.
Ashraf, Hengameh; Paymanpour, Payam; Bidabadi, Maryam Mojtahed; Hajrezai, Reihaneh
Long-term success of endodontic treatment is strictly dependent on proper shaping and cleaning of the root canal system followed by obturation of entire prepared space. Anatomical variations should be considered during radiographic and clinical evaluation as parts of endodontic treatment. A mandibular premolar with three canals is quite rare and such a tooth requires special canal preparation and obturation techniques. An astute clinician should identify different canal configurations and treat them endodontically well, because presence of an untreated canal could be a reason for failure of endodontic treatment. This paper describes the conventional orthograde endodontic therapy on an unusual mandibular first premolar with three root canals.
Ashraf, Hengameh; Paymanpour, Payam; Bidabadi, Maryam Mojtahed; Hajrezai, Reihaneh
Long-term success of endodontic treatment is strictly dependent on proper shaping and cleaning of the root canal system followed by obturation of entire prepared space. Anatomical variations should be considered during radiographic and clinical evaluation as parts of endodontic treatment. A mandibular premolar with three canals is quite rare and such a tooth requires special canal preparation and obturation techniques. An astute clinician should identify different canal configurations and treat them endodontically well, because presence of an untreated canal could be a reason for failure of endodontic treatment. This paper describes the conventional orthograde endodontic therapy on an unusual mandibular first premolar with three root canals. PMID:24383015
Sooratgar, Aidin; Tabrizizade, Mehdi; Nourelahi, Maryam; Asadi, Yasin; Sooratgar, Hosein
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
Stewart, Carol M; Vertucci, Frank J; Bates, Robert E
In an attempt to improve performance of University of Florida College of Dentistry (UFCD) graduates on the endodontic section of the Florida Dental Licensure Examination, a retrospective analysis was conducted for classes graduating between 1996 and 2003 to assess potential relationships between passing and failing performance and three factors with potential impact on "first attempt" pass rates. The three factors were clinical endodontic experience, performance on the senior mock board examination, and dialogue with representatives of the licensure examination, which resulted in modification of the endodontic section of the licensure exam. Using ANOVA, we found no differences in performance on the endodontic section of the senior mock board exam between graduates who passed the endodontic section of the dental licensure exam and those who failed this section. Furthermore, no differences were found in the mean number of clinical endodontic experiences (number of teeth treated) between graduates who passed the endodontic section of the licensure exam and those who failed. However, in 2003 following dialogue between representatives of the Florida Board of Dentistry and endodontic faculty from the two dental schools in Florida, a significant difference in senior mock board endodontic scores (p>0.05) and a significant difference in performance on the endodontic section of the licensure exam scores (p>0.005) was observed for the 2003 graduates when compared to the 2002 graduates. The mean mock board scores and the mean state board endodontic section scores were higher for the 2003 graduates. In addition, the UFCD failure rate on the endodontic section of the state board exam dropped from 34 percent in 2002 to 6 percent in 2003. The primary factors believed responsible for these improvements were a direct result of dialogue between dental school faculty and state board representatives. They include a greater appreciation by the UFCD faculty for the performance criteria
Contents: Fibrous glass fillers Binders used in the glass plastic industry Method of manufacturing glass plastics and glass plastic articles Properties of fiberglass Primary areas for use of glass fibre reinforced plastics
Fogel, H M; Pashley, D H
The permeability of human radicular dentin was measured as a hydraulic conductance before and after treatment with K files and before and after subsequent treatment of the endodontic smear layer with NaOCl, 50% citric acid, or 3% monopotassium-monohydrogen oxalate. Filing reduced dentin permeability 25 to 49%, respectively, depending upon whether outer or inner root dentin was filed. The permeability of these smear layers was unaffected by 5% NaOCl but increased many times after treatment with 50% citric acid for 2 min. Oxalate treatment lowered root dentin permeability to levels below that produced by creation of smear layers due to the production of a crystalline precipitate.
Effective removal of gutta-percha (GP) in endodontic retreatment is a significant factor in creating successful outcomes from failed procedures. Ideally, gutta-percha removal must be efficient, not predispose the tooth to subsequent failure through iatrogenic events, and clean the existing canals so that subsequent irrigants can effectively and biomechanically cleanse the root canal system. All things being equal, it is recommended that GP be removed without solvents in the coronal two-thirds of canals as much as possible and with solvents in the apical third. Rotary nickel titanium files and the SystemB heat source (SybronEndo, Orange, CA) are significant adjuncts in effective GP removal.
Shadmehr, Elham; Shekarchizade, Neda
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
Shadmehr, Elham; Shekarchizade, Neda
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.
Bolhuis, Peter; de Gee, Anton; Feilzer, Albert
Clinical studies have shown that endodontically treated teeth restored with short posts or deficient ferrules show a high failure risk. This study. evaluated the influence of fatigue loading on the quality of the cement layer between prefabricated quartz coated carbon fiber posts with restricted length and the root canal wall in maxillary pre-molars. Two adhesive resin composite cements, chemical-cured Panavia 21 (Group 1) and dual-cured RelyX-ARC (Group 2), and one resin-modified glass-ionomer cement, chemical-cured RelyX (Group 3), delta were selected for this study. Post- and-core restorations were made on single-rooted human maxillary premolars from which the coronal sections were removed at the level of the proximal cemento-enamel junction (CEJ). Following endodontic treatment, a post-and-core restoration with 6-mm post length was prepared for each tooth. The posts were directly cemented into the root canal and, after applying an adhesive (Clearfil Photo Bond), they were built up with a core build-up composite (Clearfil Photo Core). For each group (n=8), half of the specimens were exposed to fatigue loading (10(6) load cycles) almost perpendicular to the axial axis (85 degrees), while the other half were used as the control. Three parallel, transverse root sections, 1.5-mm thick, were cut from each specimen at the apical, medial and coronal location. These sections were examined by Scanning Electron Microscopy (SEM) to evaluate the integrity of the cement layer, while the retention strength of the cemented post sections was determined with the push-out test. The multivariate results of MANOVA showed that the condition main effect (fatigue or control) was not significant (p=0.059); the two other main effects, type of cement and section location, were significant (p=0.001 and p=0.008). For both the push-out strength and SEM evaluation of the cement layer integrity, the results significantly improved from RelyX to RelyX-ARC to Panavia 21 and also from apical to
This document describes a demonstration for making tempered glass using minimal equipment. The demonstration is intended for a typical student of materials science, at the high school level or above. (JL)
Jivoinovici, R; Suciu, Ileana; Gheorghiu, I; Suciu, Ioana
Damage of pulp tissue usually begins in the coronal pulp. Its mistreatment or its lack of on time detection determines the progressive inclusion of the whole endodontic space in its evolution, opening the way of its expansion in the surrounding tissues of the tooth, and on the marginal apical tissue. Aim. The goal of this study was to highlight that the primary endodontic lesions with secondary periodontal implication healed and bone repair was obtained due to a proper disinfection and an adequate sealing of the endodontic system. In primary endodontic lesion with secondary periodontal involvement, endodontic treatment is required in the first stage followed by specific periodontal treatment. The prognosis is good if an appropriate endodontic approach is chosen, depending on the stage of the periodontal disease and the treatment response. The identification of the etiological factors is the most important to establish the appropriate treatment. In all clinical cases selected in this article, the healing tendency was noticed after an adequate disinfection and sealing of the endodontic system. PMID:28255382
Tao, L; Anderson, R W; Pashley, D H
The purpose of this study was to quantitate the sequential effects of endodontic procedures on the permeability of human root dentin in vitro. Forty single-rooted teeth were used. Both the crown and the apical 2 mm of the root were removed. The hydraulic conductance of the root before and after various endodontic procedures was measured using a fluid filtration method. Measurements were also made of dentin thickness, intracanal diameter changes, and changes in intracanal surface area. The results showed that instrumentation by K files alone or in combination with Gates Glidden drills did not alter radicular dentin permeability when the cementum remained intact. After removing the cementum, the creation of a smear layer and smear plugs on the canal surface tended to offset the expected increase in dentin permeability created by increasing the intracanal surface area and decreasing root dentin thickness. EDTA treatment inside the instrumented canal to remove the smear layer did not increase permeability significantly. The use of K files followed by Gates Glidden drills tended to remove more cervical dentin, increased the intracanal surface area, and increased the hydraulic conductance of root dentin more than the use of K files alone.
Kaptan, R. F.; Haznedaroglu, F.; Kayahan, M. B.; Basturk, F. B.
Objectives. The aim of this study was to gather information about the quality and quantity of root canal treatments carried out by general dental practitioners in Turkey. Methods. Questionnaires were given to 1400 dentists who attended the 16th National Congress organized by the Turkish Dental Association. The participants were asked to answer 34 multiple-choice questions. The questions were subdivided into 3 main topics; general information; general approach to endodontic treatment; and cleaning, shaping, and obturation of root canals. The statistical analysis was carried out by an χ2-test to compare the means at a significance level of P < 0.05. Results. The response rate for this study was 43%. There was a wide variation in the number of root canal treatments completed per month. Nearly 92% of practitioners stated that they never used rubber dam. The most commonly used working length determination technique was radiographic evaluation (P < 0.05). Sodium hypochlorite was the irrigant of choice with varying concentrations and AH Plus was the sealer of choice (P < 0.05). Resin composite was the most frequently used material for final restorations. Conclusions. Endodontic procedures in general practice in Turkey have differences from widely acknowledged quality guidelines. Despite the introduction of new instruments and techniques, most of the general practitioners chose conventional methods. PMID:23251103
Moezizadeh, Maryam; Mokhtari, Nastaran
Purpose: To determine the fatigue resistance and failure mode of endodontically treated premolars using direct composite resin restorations. Materials and Methods: Eighty-four human premolars were divided into seven groups of 12, prepared as follows: Intact teeth used in Group 1 as control, the second group covers the endodontically treated teeth, restored with direct onlays using Z250 composite resin, the next two groups (i.e. 3,4) were similar to the second group, but subjected to 1 and 2 million fatigue load cycles, respectively. Groups 5, 6, 7 were similar to groups 2, 3, 4, however, in these groups Tetric Ceram was used as the restorative material. All specimens were loaded using a Universal Testing Machine until fracture occurred. One-way Anova andTukey's HSD tests were used to analyze the data of onlay groups. Results: All specimens withstood the masticating simulation. The mean fracture strength for Goups 1 to 7 was: 1276.92, 1373.47, 1269/70, 486/35, 484/12, 1130/49, 1113/79 Newton, respectively. No statistically significant differences were found between the groups in fracture strength and failure mode. Conclusions: No statistically significant differences in fracture strength were found between sound teeth and composite onlays that were subjected to 1 and 2 million fatigue load cycles. PMID:22025833
Aun, Carlos E.; Barberini, Alexandre F.; Camargo, Selma C. C.; Silva Kfouri, Luciana; Lorenzetti Simionato, Maria R.
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.
Elham, Farokh Gisour; Sedigheh, Zarmehi
Aim: The current clinical practice of endodontics involves utilization of a variety of new technological advances and materials. Technologies available for use in endodontic offices today include battery or electric motors using NiTi rotary file systems, new generation of electronic apex locators (EALs), improved digital radiographic sensors, surgical microscopes, and ultrasonic units. The aim of this study was to determine the prevalence and use of newer technologies among Iranian dental practitioners. Materials and methods: The population under study included the dental practitioners participating in the 49th and 50th Congress of Dentistry, who were selected with a simple sampling method. Data was collected by questionnaires which were completed by the participants in an anonymous manner. The contingency table and chi-squared test were used for data analysis by SPSS 13.5 software. Results: A total of 700 dental practitioners participated in the study; NiTi rotary systems were used by 50.1%; electronic apex locators were often employed by 46.3%; 21.7% reported that ultrasonic units were often used. Only 1.1% frequently used surgical microscopes. Males and females differed with respect to the use of newer technologies (P<0.05). Conclusion: Based on the results of the present study, it seems necessary for dentists to take part in continuing dental education programs related to the newer technologies to improve their knowledge and practice. PMID:22833772
Haapasalo, Markus; Qian, Wei; Portenier, Isabelle; Waltimo, Tuomas
Successful treatment of apical periodontitis is dependent on the elimination of the infective microflora from the necrotic root canal system. Antimicrobial irrigating solutions and other locally used disinfecting agents and medicaments have a key role in the eradication of the microbes. While most if not all presently used disinfecting agents rapidly kill even the resistant microbes when tested in vitro in a test tube, the effectiveness of the same agents is clearly weaker in the in vivo conditions. Recent studies have given valuable information about the interaction of endodontic disinfecting agents with dentin and other compounds present in the necrotic root canal. As a result of such interactions the antimicrobial effectiveness of several of our key disinfectants may be weakened, or even eliminated under certain circumstances. Different disinfectants show different sensitivity to the action by the various potential inactivators, such as dentin, serum proteins, hydroxyapatite, collagen derived from different sources, and microbial biomass. This review is a summary of our present knowledge of the mostly negative interactions between endodontic disinfecting agents and the various compounds present in the root canal environment.
Fioretti, F; Mendoza-Palomares, C; Avoaka-Boni, M C; Ramaroson, J; Bahi, S; Richert, L; Granier, F; Benkirane-Jessel, N; Haikel, Y
The vitality of the pulp is so fundamental to the functional life of the tooth that new strategies are required to avoid the removal of the whole pulp following irreversible pulpitis and to regenerate the lost endodontic tissues. Nano-odontology would provide suitable solutions for pulp tissue conservative and regenerative approaches. In our group, we have shown that when covalently coupled to Poly-Glutamic Acid (PGA) the incorporation of an anti-inflammatory hormone (melanocortin, a-MSH) into the multilayered films Poly-L-Lysine (PLL)/PGA increases the anti-inflammatory reaction of pulp fibroblasts and macrophages stimulated by LPS (Lipo-Polysaccharides). Recently, usual linear PLL polymers have been chemically grafted for making new Dendrigraft polymers (DGLG4) whose higher branching ratios can give useful properties. The objective is to use nanostructured assemblies containing DGLG4 and PGA-alpha-MSH to design a new nanomaterial. These nanostructured assemblies (DGLG4-PGA-alpha-MSH)n constitute a thick reservoir of the anti-inflammatory peptide and promote adhesion and proliferation of pulp fibroblast on the biomaterial surface. These nanostructured films could be adapted for an endodontic regeneration application to target pulp connective tissue regeneration. Firstly, the crucial reduction of inflammation could be helpful by using PGA-alpha-MSH and secondly the initiation of the regeneration of the connective tissue will be promoted by the whole nanostructured film of which allows pulp cells colonisation.
Martins, Jorge N. R.; da Costa, Rui Pereira; Anderson, Craig; Quaresma, Sérgio André; Corte-Real, Luís S. M.; Monroe, Adam D.
Dens invaginatus may be seen as a developmental malformation. It is characterized by an invagination of the enamel and dentin, creating a lumen inside the affected tooth, which may extend as deep as the apical foramen. Oehlers Type IIIb is considered the most challenging clinical conditions. The purpose of this study is to discuss the nonsurgical endodontic management of vital and necrotic dens invaginatus Type IIIb cases. Due to the complex anatomical consideration of dens invaginatus Type IIIb, endodontic treatment is extremely technique sensitive. A conservative approach was used in a vital case to treat the invaginated lumen only, to preserve the vitality of the pulp, and a more invasive approach was used in a necrotic case to debride the lumen and necrotic pulp for proper disinfection of the root canal system. Although different, all the approaches were successful. The clinical signs and symptoms were resolved. The vital case remains vital after 19 months, and the recall radiographs were able to show satisfactory periapical healing both in vital and necrotic cases. Due to the highly complex anatomy of dens invaginatus Type IIIb, the decision of preserving the pulp vitality may not be related only to pulpal diagnosis but also to the technical requirements of the treatment. Although very technically sensitive, it may be possible to treat the invaginated lumen exclusively, while preserving the vitality of the pulp. Necrotic cases may require a more aggressive approach to achieve a favorable prognosis. PMID:28042276
Marchesan, Melissa Andréia; Barros, Felipe; Porto, Saulo; Zaitter, Suellen; Brugnera, Aldo, Jr.; Sousa-Neto, Manoel D.
This study evaluated ex vivo the influence of the number of gel/LED-laser applications/activations on cervical microleakage of two different barrier materials used for protection during whitening of endodontically treated teeth. Eighty-four canines were instrumented and obturated with epoxy resin sealer. The seal was removed 2 mm beyond the cemento-enamel junction for barrier placement and the teeth were divided into two groups of 40 teeth each: G1, zinc phosphate cement; G2, glass ionomer cement. The two groups were subdivided into 4 subgroups (n=10 each): I) no gel or LED-laser application; II) one gel application and two LED-laser activations; III) two gel applications and four LED-laser activations; IV) three gel applications and six LED-laser activations. The teeth were immersed in India ink for 7 days, decalcified and cleared. Cervical microleakage was quantified with a measurement microscope. Statistical analysis showed that zinc phosphate caused significantly lower microleakage than glass ionomer cement (presented microleakage in all subgroups). However, after two (p<0.01) and three (p<0.001) applications of gel, there was statistially significant microleakage in zinc phosphate barriers. Based on the present results, it can be concluded that cervical barriers with zinc phosphate cement show less cervical microleakage and that two or more applications/activations of gel/LED-laser significantly increase microleakage.
Arslan, Hakan; Topcuoglu, Huseyin S; Aladag, Halit
Tenoxicam is an effective analgesic and anti-inflammatory agent for symptomatic treatment of various conditions. The purpose of this study was to evaluate clinically the effectiveness of prophylactic tenoxicam and prophylactic ibuprofen in reducing post-endodontic pain compared with placebo. A total of 48 patients consented to a double-blind, single dose, prophylactic oral administration of 20 mg of tenoxicam, 200 mg of ibuprofen, or a placebo before root canal treatment. The root canal treatment was performed in one visit. The patients registered their degree of discomfort on a 100-mm visual analog scale, immediately postoperative, and 6, 12, 24, 48 and 72 h after initiation of root canal treatment. The two-way ANOVA test and Tukey HSD post hoc test showed that in the 6-h period, both 20 mg of tenoxicam and 200 mg of ibuprofen provided significantly better pain relief than the placebo. Prophylactic administration of a single dose of 20 mg tenoxicam or 200 mg ibuprofen before RCT provides an effective reduction at 6 h (P < 0.05). Because of the advantages of tenoxicam, it may be useful as a prophylactic analgesic when post-endodontic pain is anticipated.
Cohenca, Nestor; Shemesh, Hagay
The use of cone beam computed tomography (CBCT) in endodontics has been extensively reported in the literature. Compared with the traditional spiral computed tomography, limited field of view (FOV) CBCT results in a fraction of the effective absorbed dose of radiation. The purpose of this manuscript is to review the application and advantages associated with advanced endodontic problems and complications, while reducing radiation exposure during complex endodontic procedures. The benefits of the added diagnostic information provided by intraoperative CBCT images in select cases justify the risk associated with the limited level of radiation exposure.
Gupta, Abhishek; Musani, Smita; Dugal, Ramandeep; Jain, Nikhil; Railkar, Bhargavi; Mootha, Ajay
The aim of this study was to evaluate the use of bonded partial restorations compared with full-coverage porcelain-fused-to-metal (PFM) crowns as a viable treatment option for endodontically treated posterior teeth. Forty-five recently extracted maxillary first premolars were collected, endodontically treated, and mounted in acrylic blocks. The specimens were randomly divided into three groups and prepared to receive their respective restorations. The teeth in group 1 received full-coverage porcelain-fused-to-metal crowns. The teeth in group 2 received bonded partial restorations made from pressed ceramics (lithium disilicate) involving a functional cusp (palatal). Finally, group 3 received bonded partial restorations made from pressed ceramics involving the buccal cusp and keeping a functional cusp (palatal) intact. All group 1 restorations were cemented using glass ionomer cement. Restorations in groups 2 and 3 were bonded using a dual-cured resin cement. All specimens were subjected to an aging process and tested for shear bond strength using a universal loading machine. The mean force applied in Newtons to cause failure for group I was 674.90 ± 94.16 N, for group 2, 463.46 ± 61.11 N, and for group 3, 849.33 ± 68.92 N. P values obtained using one-way analysis of variance showed a highly significant difference between groups 2 and 3 (P = .001), groups 1 and 2 (P = .001), and groups 1 and 3 (P = .001). The fracture modes observed in all groups involved restorations and tooth fracture. This in vitro study suggests that endodontically treated posterior teeth with intact functional cusps can be restored with bonded partial porcelain restorations. However, if the loss of tooth structure involves the functional cusp, full-coverage PFM crowns are the treatment of choice.
Hasan, Muhammad; Umer, Fahad
The objective of root canal treatment is to perform complete debridement of the root canals and subsequent obturation to facilitate healing of periapical pathosis. However, this process becomes complicated with the presence of additional root canal systems. The purpose of the present article is to report successful non-surgical retreatment of a mandibular first molar with five canals. This case report discusses the clinical management of a previously root filled mandibular firstmolar with two missed canal systems; distolingual and an additional mesial canal known as the middle mesial canal. The post-treatment radiographs show successful obturation to length in all canals. The middle mesial canal was found to be associated with mesiolingual canal and categorised as confluent. The configuration of canals in the mesial root was type XV, based on the classification given by Sert and Bayirli. This case report highlights the importance of knowledge and its application in the management of abnormal anatomic variants which play a crucial role in the success of endodontic retreatment. PMID:24654237
Silveira, Adriana M Vieira; Lopes, Hélio P; Siqueira, José F; Macedo, Sérgio B; Consolaro, Alberto
The number of appointments necessary to treat infected root canals is one of the most controversial issues in endodontics. This study evaluated, in dogs, the response of the periradicular tissues to the endodontic treatment of infected root canals performed in a single visit or in two visits, using different interappointment dressings. Periradicular lesions were induced by inoculating Enterococcus faecalis in the root canals. After confirming that a periradicular lesion developed, the root canals were treated within one or two visits, using either ozonized oil or calcium hydroxide in camphorated paramonochlorophenol (CMCP) as an intracanal medication. After 6 months, the animals were sacrificed and the specimens were processed for histological and histobacteriological analysis. The root canals treated in a single visit showed a success rate of 46%. When a calcium hydroxide/CMCP-based interappointment intracanal medication was used, 74% of the cases were categorized as success. In cases where ozonized oil was used as the intracanal medication, a success rate of 77% was observed. These results of the present study demonstrated that the two-visit treatment offered a higher success rate compared to one-visit therapy. In addition, ozonized oil may potentially be used as an intracanal medication.
Kolzenburg, S.; Russell, J. K.; Kennedy, L. A.
Natural silicate glasses are an essential component of many volcanic rock types including coherent and pyroclastic rocks; they span a wide range of compositions, occur in diverse environments, and form under a variety of pressure-temperature conditions. In subsurface volcanic environments (e.g., conduits and feeders), melts intersect the thermodynamically defined glass transition temperature to form glasses at elevated confining pressures and under differential stresses. We present a series of room temperature experiments designed to explore the fundamental mechanical and fragmentation behavior of natural (obsidian) and synthetic glasses (Pyrex™) under confining pressures of 0.1-100 MPa. In each experiment, glass cores are driven to brittle failure under compressive triaxial stress. Analysis of the load-displacement response curves is used to quantify the storage of energy in samples prior to failure, the (brittle) release of elastic energy at failure, and the residual energy stored in the post-failure material. We then establish a relationship between the energy density within the sample at failure and the grain-size distributions (D-values) of the experimental products. The relationship between D-values and energy density for compressive fragmentation is significantly different from relationships established by previous workers for decompressive fragmentation. Compressive fragmentation is found to have lower fragmentation efficiency than fragmentation through decompression (i.e., a smaller change in D-value with increasing energy density). We further show that the stress storage capacity of natural glasses can be enhanced (approaching synthetic glasses) through heat treatment.
Del Fabbro, Massimo; Samaranayake, Lakshman P; Lolato, Alessandra; Weinstein, Tommaso; Taschieri, Silvio
The present study aimed at reviewing the literature on extraradicular infections of endodontically treated teeth, summarizing the main hypotheses on etiopathogenesis and describing the most suitable techniques to identify the composition of pathogenic extraradicular microorganisms. Medline database was searched using the keywords "Apical biofilm," "extraradicular infection," "secondary endodontic lesion," "endodontic retreatment," "biofilm" either alone or combined with AND. A further hand search was performed on the main endodontic journals. The most frequent bacterial species identified in different studies and with different techniques may vary considerably. Although the presence of some species of microorganisms seems to be determinant, the true origin of extraradicular infection is still undetermined. The literature analysis showed marked differences in methodology, materials, aims, and techniques adopted, which led to highly heterogeneous outcomes. The picture emerging from this review is that extraradicular infection is likely a multifactorial disease that requires further systematic investigation using standardized techniques.
González-Martín, Maribel; Torres-Lagares, Daniel; Gutiérrez-Pérez, José Luis; Segura-Egea, Juan José
The present study describes a case of endodontic sealer (AH Plus) penetration within and along the mandibular canal from the periapical zone of a lower second molar after endodontic treatment. The clinical manifestations comprised anesthesia of the left side of the lower lip, paresthesia and anesthesia of the gums in the third quadrant, and paresthesia and anesthesia of the left mental nerve, appearing immediately after endodontic treatment. The paresthesia and anesthesia of the lip and gums were seen to decrease, but the mental nerve paresthesia and anesthesia persisted after 3.5 years. This case illustrates the need to expend great care with all endodontic techniques when performing nonsurgical root canal therapy, especially when the root apices are in close proximity to vital anatomic structures such as the inferior alveolar canal.
View showing rear of looking glass aircraft on operational apron with nose dock hangar in background. View to northeast - Offutt Air Force Base, Looking Glass Airborne Command Post, Operational & Hangar Access Aprons, Spanning length of northeast half of Project Looking Glass Historic District, Bellevue, Sarpy County, NE
Kiarudi, Amir Hosein; Eghbal, Mohammad Jafar; Safi, Yaser; Aghdasi, Mohammad Mehdi; Fazlyab, Mahta
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
Evans, G E; Bishop, K; Renton, T
This is the first of a series of articles, which will summarise new or updated clinical guidelines produced by the Clinical Standards Committee of the Faculty of Dental Surgery, Royal College of Surgeons of England (FDSRCS). Important developments for the dental profession from a number of clinical guidelines will be presented, commencing with the Guidelines for surgical endodontics. The impact of recent evidence relating to the outcome of surgical endodontics and techniques such as cone beam computed tomography and microsurgical techniques are considered.
Mikołajczak, Teresa; Wilk, Grazyna
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.
Froes, Fabiana Gama Benevides; Miranda, Aguida Maria Menezes Aguiar; Abad, Ernani da Costa; Riche, Fernanda Nehme; Pires, Fábio Ramôa
The aim of this report was to present a case of endodontic sealer extrusion into the mandibular canal in a 42-year-old woman. The patient was referred to the Endodontology and Stomatology Clinics, School of Dentistry, Estácio de Sá University, complaining of 5-day duration intense spontaneous pain and paraesthesia, both arising after an endodontic intervention. Conventional radiographs and computed tomography of the mandible showed the presence of radiopacities inside the right mandibular canal. History and these radiographs confirmed extrusion of endodontic sealer. Treatment included an anti-inflammatory drug, completion of endodontic treatment and follow up. The patient reported gradual improvement, becoming asymptomatic after 2 months. Radiographs 30 months after initial examination revealed partial resorption of the foreign material. In conclusion, iatrogenic extrusion of endodontic materials should be included in differential diagnosis of endodontic pain and can sometimes be managed through non-surgical interventions in some cases.
Murray, Peter E; Garcia-Godoy, Franklin; Hargreaves, Kenneth M
Millions of teeth are saved each year by root canal therapy. Although current treatment modalities offer high levels of success for many conditions, an ideal form of therapy might consist of regenerative approaches in which diseased or necrotic pulp tissues are removed and replaced with healthy pulp tissue to revitalize teeth. Researchers are working toward this objective. Regenerative endodontics is the creation and delivery of tissues to replace diseased, missing, and traumatized pulp. This review provides an overview of regenerative endodontics and its goals, and describes possible techniques that will allow regenerative endodontics to become a reality. These potential approaches include root-canal revascularization, postnatal (adult) stem cell therapy, pulp implant, scaffold implant, three-dimensional cell printing, injectable scaffolds, and gene therapy. These regenerative endodontic techniques will possibly involve some combination of disinfection or debridement of infected root canal systems with apical enlargement to permit revascularization and use of adult stem cells, scaffolds, and growth factors. Although the challenges of introducing endodontic tissue engineering therapies are substantial, the potential benefits to patients and the profession are equally ground breaking. Patient demand is staggering both in scope and cost, because tissue engineering therapy offers the possibility of restoring natural function instead of surgical placement of an artificial prosthesis. By providing an overview of the methodological issues required to develop potential regenerative endodontic therapies, we hope to present a call for action to develop these therapies for clinical use.
Colicchia, Giuseppe; Hopf, Martin; Wiesner, Hartmut; Zollman, Dean
Eye aberrations are commonly corrected by lenses that restore vision by altering rays before they pass through the cornea. Some modern promoters claim that pinhole glasses are better than conventional lenses in correcting all kinds of refractive defects such as myopia (nearsighted), hyperopia (farsighted), astigmatisms, and presbyopia. Do pinhole…
Pumarola-Suñé, J; Solá-Vicens, L; Sentís-Vilalta, J; Canalda-Sahli, C; Brau-Aguadé, E
A comparative study of the absorbency properties of different endodontic paper points has been conducted. Twenty standardized absorbent paper points, size 30, from 13 bands (Dentaline, Zipperer, Kerr, Diadent, Roeko novo, Roeko color, Maillefer, P.D., Schein, Spectrapoint, Proclinic, Euronda, and Alpro) of 12 manufacturers were tested. Each dry paper point was weighted using an electronic laboratory balance. A length of 16 mm from the tip was then lowered in distilled water for 5 s, the paper point was weighted again, and the difference between both measurements was taken as the value of the fluid absorbed. Diadent, Kerr, and Dentalite showed significantly higher absorbencies (p < 0.05) than standardized paper points of the remaining brands. The study demonstrates a wide variation in the absorbency properties of this dental accessory.
Hargreaves, Kenneth M.; Diogenes, Anibal; Teixeira, Fabricio B.
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
Verhaagen, Bram; Lea, Simon C; de Bruin, Gerrit J; van der Sluis, Luc W M; Walmsley, A Damien; Versluis, Michel
During a root canal treatment, an antimicrobial fluid is injected into the root canal to eradicate all bacteria from the root canal system. Agitation of the fluid using an ultrasonically vibrating miniature file results in a significant improvement in the cleaning efficacy over conventional syringe irrigation. Numerical analysis of the oscillation characteristics of the file, modeled as a tapered, driven rod, shows a sinusoidal wave pattern with an increase in amplitude and decrease in wavelength toward the free end of the file. Measurements of the file oscillation with a scanning laser vibrometer show good agreement with the numerical simulation. The numerical model of endodontic file oscillation has the potential for predicting the oscillation pattern and fracture likeliness of various file types and the acoustic streaming they induce during passive ultrasonic irrigation.
Potts, T V; Petrou, A
Photopolymerizing resins were exposed to three different wavelengths of light emanating from the argon laser. It was determined that the most efficient wavelengths for photopolymerization of camphorquinone-activated resins were at 477 and 488 nm. The 514.5-nm wavelength was relatively ineffective in activating polymerization. Four camphorquinone-activated resins were placed in the root canals of teeth and tested for polymerization depth using a 488-nm wavelength laser beam coupled to an optical fiber 200 microns in diameter. In regard to polymerization depth, these materials ranked as follows: Genesis greater than Prisma-Fil greater than Prisma Microfine greater than Prisma VLC Dycal. Alterations in the positions of the optical fiber and the surface of the resin in the canal made only minor differences in polymerization depth of the samples. The results indicate that an argon laser coupled to an optical fiber could become a useful modality in endodontic therapy.
Guerreiro-Tanomaru, Juliane Maria; Morgental, Renata Dornelles; Faria-Junior, Norberto Batista; Berbert, Fábio Luis Camargo Vilela; Tanomaru-Filho, Mário
This study evaluated the in vitro antibacterial activity of conventional and experimental endodontic irrigants against Enterococcus faecalis. The following substances were evaluated by direct contact test: 2.5% sodium hypochlorite (NaOCl); 2% chlorhexidine (CHX); 1% peracetic acid. After different contact periods (30 s, 1, 3, and 10 min), a neutralizing agent was applied. Serial 10-fold dilutions were prepared and plated onto tryptic soy agar (TSA) and the number of colony-forming units per milliliter (CFU/mL) was determined. Sterile saline was used as a negative control. Both 2.5% NaOCl and 2% CHX eliminated E. faecalis after 30 s of contact. Peracetic acid reduced the bacterial counts by 86% after 3 min and completely eliminated E. faecalis after 10 min. These results allow us to conclude that 1% peracetic acid is effective against E. faecalis, despite its slower action compared with 2.5% NaOCl and 2% CHX.
Perković, Ivana; Romić, Martina Knežević; Perić, Marina
Objectives to compare the level of anxiety reported by patients and assessed by dentists. Also, the expected and actual pain during the treatment perceived by the patient and dentist were assessed. Methods sixty six endodontic patients filled in two questionnaires, prior to and after the treatment, so did their therapists. The first set of questions for patients was regarding demographics, the frequency of dental visits, the level of anxiety and expectations about the level of pain. Before the treatment, dentists estimated the level of patients' anxiety and the expected intensity of pain. After the treatment, the patients evaluated the level of experienced pain and dentists' empathy during the treatment, while dentists reassessed the intensity of patients' pain.The data were statistically analysed by t-test for paired samples and by Spearmans's Rho correlation coefficient at level of significance set at 0.05. Results Patients' expectation of pain intensity was higher than the actual pain during the treatment (t-test=3.540, p=0.001). There was no difference in the level of pain which dentists expected and their perception of pain during the procedure. There was a statistically significant correlation between the patients' level of anxiety and recognition of it by dentists (Spearman Rho=0.460, p<0.001). A higher level of anxiety increased the expected intensity of pain (Spearman Rho=0.401, p=0.001). Actual intensity of pain was not significantly associated with dental anxiety (Spearman Rho=0.080, p=0.524). Conclusion Since the level of dental anxiety was associated with the increased intensity of expected pain, a vicious cycle of pain and anxiety may be terminated by giving positive information to the patient before and during endodontic procedures. PMID:27688374
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
Gambarini, Gianluca; Plotino, Gianluca; Sannino, GianPaolo; Grande, Nicola Maria; Giansiracusa, Alessio; Piasecki, Lucila; da Silva Neto, Ulisses Xavier; Al-Sudani, Dina; Testarelli, Luca
Endodontic glide path is the creation of a smooth patency from canal orifice to apex, which can be performed manually or with small tapered NiTi rotary instruments. The use of stainless steel (SS) hand K-files inserted in a reciprocating handpiece can be a possible alternative to create a mechanical glide path. The aim of this study was to compare the cyclic fatigue resistance between SS K-files used in a reciprocating motion and NiTi rotary instruments in artificial curved canals. Ten SS size 15 K-files used with the M4 handpiece (SybronEndo, Glendora, CA, USA) and ten PathFiles (Maillefer-Dentsply, Ballaigues, CH, Switzerland) NiTi rotary instruments size 16, 0.02 taper were tested for resistance to cyclic fatigue. The time to fracture inside an artificial curved canal was recorded for each instrument. Data were analyzed by one-way ANOVA and Tukey HSD test. Mean time (and SD) to failure was 464 s (±40.4) for the Group PF (NiTi rotary PathFile), and 1049 s (±24.8) for the Group M4 (SS K-files reciprocating) with a statistically significant difference between the two groups (p = 0.033). The SS 15 K-files used with the M4 handpiece showed a significant greater resistance to cyclic fatigue when compared to the NiTi rotary PathFiles. Therefore, the use of small size SS files in a reciprocating motion might be a rational choice for the creation of a mechanical endodontic glide path in curved root canals.
Gluskin, Alan H; Ahmed, Irfan; Herrero, Dale B
Use of a post system for the rehabilitation of endodontically treated teeth requires traditional planning for the function of the restoration as well as a structural and aesthetic strategy for novel technologies in ceramic and composite dentistry. Contemporary material options have greatly expanded the clinician's ability to rehabilitate the coronoradicular complex. Transilluminating posts, bondable fabrics, and high-technology ceramics create exciting possibilities in post and core design. The use of bondable materials allows the practitioner to unify the structure and morphology of root systems to provide creative solutions to challenges heretofore unmet.
Swarupa, CH; Sajjan, Girija S; Sashi Kanth, YV
Objective: To compare the efficacy of an integrated apex locator and an apex locator and endodontic motor assembly in maintaining the working length when operated under autoreverse mode. Study Design: Thirty distobuccal roots of intact maxillary first molars were taken and access cavities were prepared. The teeth were divided into Group I: Prepared with TCM Endo V and Group II: Prepared with ProPex and NSK assembly. The instrumentation was ended in ProTaper F3 file, which was cemented in the canal. The roots were sectioned, observed under a stereomicroscope and the distance from instrument tip to the apical foramen was measured. Results: Mean difference in the deviation of two groups was 0.075 mm, P = 0.34 (>0.05) which was statistically insignificant when assessed with unpaired t-test. Conclusion: The assembly of ProPex-NSK Endo-mate DT and the apex locating endomotor TCM Endo V Nouvag are clinically acceptable. PMID:24082578
Lahor-Soler, Eduard; Brunet-Llobet, Lluís; Farré, Magí; Pumarola, Josep
Background Endodontic microleakage or microfiltration refers to the percolation of fluids and micro-organisms at the interface of the obturation material and the walls of the root canal system. The aim of this in vitro study was to compare apical microfiltration of Resilon root canal filling by employing three different final irrigant solutions. Material and Methods 128 single-rooted teeth were employed. The crowns were sectioned horizontally at the cemento-enamel junction and instrumented with 5.25% sodium hypochlorite (NaOCl) and 17% EDTA gel to obtain an instrumented 040 apical caliber. An intermediate irrigation was performed with distilled water. The roots were then randomly assigned to three experimental groups with three different final irrigants: (A) 20% citric acid (CA); (B) 2% chlorhexidine digluconate (CHX); and (C) 5.25% NaOCl, plus two control groups (positive and negative). They were then dried, obturated with RealSeal™, and cleared by Robertson’s technique. Apical microleakage was measured by the dye penetration method and assessed with a 4.5x stereomicroscope. Data were statistically analyzed by one way ANOVA and post hoc analysis for multiple comparisons. Results Mean and standard deviations for apical microleakage were: 2% CHX (0.24 mm ± 0.22), 20% CA (0.25 mm ± 0.20), and 5.25% NaOCl (0.87 mm ± 0.32). Significant differences were reported among the group irrigated with NaOCl, CHX and CA (P<0.001). Conclusions A higher rate of apical microleakage was observed when the final irrigation was performed with NaOCl whilst lower rates were reported for CHX and CA. Key words:Apical filtration, endodontic irrigation, resin-based sealers, adhesion, root canal filling. PMID:26155335
Vinothkumar, Thilla S; Rubin, Mohamed I; Balaji, Lakshmi; Kandaswamy, Deivanayagam
Context: Sodium hypochlorite is the most commonly used irrigant but it has disadvantage like high cytotoxicity. So there is a need to find an alternative to 5.25% Sodium hypochlorite against microorganism Enterococcus faecalis and Candida albicans. Literature has shown that these 5 extracts namely Terminalia chebula, Myristica frangrans, Aloe barbadensis, Curcuma longa and Azadaricta indica has good properties which can be used as a potential endodontic irrigant. Aims: To evaluate the antimicrobial efficacy of various herbal extracts namely Curcuma longa (CL), Azadiracta indica (AI), Aloe barbadensis (AV), Myristica fragrans (MF) and Terminalia chebula (TC) as endodontic irrigant against Enterococcus faecalis and Candida albicans using real-time quantitative polymerase chain reaction (qPCR). Materials and Methods: Eighty-four teeth were extracted and suspended with Enterococcus faecalis and Candida albicans. A preliminary study was first performed to determine the minimum inhibitory concentration of extracts. The irrigating groups were divided into five herbal groups and 2 control groups. After irrigating the teeth the remaining microbial load was determined using qPCR. Statistical Analysis Used: Statistical analysis was performed using Oneway Anova/Kruskal-Wallis test with post-hoc Tukey's HSD and was statistically significant (P < 0.05). Results: It was shown that Neem was highly efficient to 5.25% NaOCl in reducing Enterococcus faecalis and Candida albicans within the root canals when compared with other extracts. Conclusions: Neem leaf extract has a significant antimicrobial efficacy against Enterococcus faecalis and Candida albicans compared to 5.25% sodium hypochlorite. PMID:23716972
Aktan, Ali Murat; Yildirim, Cihan; Karataşlıoğlu, Emrah; Çiftçi, Mehmet Ertuğrul; Aksoy, Fatih
An accurate determination of the working length is indispensable for successful endodontic treatment. The aim of this study was to determine the influence of the voxel size and resolution of CBCT on measuring root canal working length. Thirty extracted single-rooted permanent teeth were used for this study. The working lengths of the teeth were determined by a researcher inserted a K-file into each canal until the tip became visible through the major foramen. The file was withdrawn until its tip was seen at the level of the coronal-most border of the major foramen under. The rubber stop was adjusted to the occlusal reference and the distance from the stop to the false tip was measured with digital calipers and recorded as the actual working length. The CBCT images were obtained with a Planmeca ProMax 3D Mid (Planmeca, Helsinki, Finland) using four sets of settings: from voxel size 0.5mm to voxel size 1.0mm. These measurements were compared with actual lengths (as a control group) using Analysis of Variance and the Dunnett Post Hoc Test. The Pearson correlation coefficient (r) and 95% confidence intervals were calculated to compare all measurement methods. The significance level was set at P<0.05. No significant difference was found among CBCT groups and working length. A highest correlation was found between the actual length and smallest voxel size and highest CBCT measurements (r=0.94). CBCT imaging can be used endodontic working length measurement and the smallest voxel size and highest resolution yielded more accurate results.
This document serves as a manual for a workshop on commercial glass melting and associated air emission issues. Areas covered include: An overview of the glass industry; Furnace design and construction practices; Melting furnace operation; Energy input methods and controls; Air legislation and regulations; Soda lime emission mechanisms; and, Post furnace emission controls. Supporting papers are also included.
Li20-B203 and Na20-B203 or Te02 . These glasses exhibit for the first time, electrochromic and photochromic behaviour and have potential for use in...the complete spectral distribution of the absorption at levels of 10- cm- I for the first time. In the past, it was only possible to measure low...distribution of the absorption at levels at 10 -cm it was possible, for the first time, to identify extrinsic impurities in highly transparent solids. This
Patil, Shruti Arun; Kulkarni, Sudhindra; Thakur, Srinath; Naik, Balaram
Context: The crown lengthening procedure (CLP) is routinely carried out to correct gingival levels and achieve esthetic contours and adequate crown lengths for restorative purposes. Though the short-term outcomes have been found to be stable, long-term results are not much reported. Aims: To evaluate the long-term stability of the marginal bone levels, gingival levels, and the status of the teeth, which underwent endodontic therapy, followed by CLP and final restorations. Settings and Design: Institutional setting, long-term case series. Materials and Methods: Case records of the patients who underwent CLP and endodontic therapy for corrections of the supra-erupted teeth to regain the lost interocclusal spaces were retrieved, and the cases with complete set of the clinical and radiographs were taken. All the cases were recalled and bone levels on the radiographs, bleeding on probing, probing pocket depths, and changes in the soft tissue margins were evaluated. Statistical Analysis Used: Descriptive analysis. Results: A total of 25 teeth had undergone CLP and endodontic therapy and final restorations for a minimum of 24 months. The mean post-restorative duration was 50.8 ± 22.48 months (range 24–96 months). All the teeth were functional and asymptomatic with 100% survival. Interdental bone loss of 1 mm, probing pockets of 5 mm, and 1 mm buccal recession were observed in 16% of the sites. The amount of interocclusal space regained was adequate to restore the missing teeth in the opposing arch. Conclusions: The CLP is a predictive procedure for correction of supra-erupted teeth. The survival of the teeth that underwent the procedure in the present study was 100% over 24–96 months. PMID:27041850
Khan, Sheeba; Inamdar, Mohammed Nasir K; Munaga, Swapna; Ali, Syed Akbar; Rawtiya, Manjusha; Ahmad, Ezaz
Background: As per many studies endodontically treated teeth are widely considered to be more susceptible to fracture than vital teeth. Obturation strains and post placement have been a major cause of vertical root fracture. Present study was conducted to compare in vitro fracture resistance after filling with either Gutta-percha or Resilon by lateral condensation techniques in root canals. This study evaluated a new thermoplastic synthetic polymer based on polyester, which contains bioactive and radiopaque filler, Resilon performs every way as Gutta-percha except that it allows the bonding agent to attach to the resin core and the dentin wall thus forming a monoblock. Materials and Methods: In the present study 90 freshly extracted single-rooted human mandibular premolar teeth endodontically treated, were cut at the cemento-enamel junction, and were randomly divided into three groups of 30 each as teeth of Group A (Control) received no obturation, Group B teeth were obturated using Gutta-percha/AH26, and Group C teeth were obturated using Resilon/Epiphany obturating kit. Each specimen were mounted in acrylic in a polyvinyl ring and then tested for fracture resistance with the help of an universal testing machine. A compressive force was applied until the root is fractured. The data were subjected to analysis of variance for comparing mean difference of fracture resistance among three groups. Multiple comparisons among these groups were carried out by non-parametric Kruskal–Wallis analysis. A p value of <0.0001 was considered a statistically significant difference. Results: The results obtain after analysis showed no significant differences in the fracture resistance between the two tested groups of endodontic sealers. Conclusion: Within the limitation of the present in-vitro study, Resilon/Epiphany sealer performs better than Gutta-percha/AH 26 sealer with lateral condensation technique. PMID:26668476
Mincik, Jozef; Timkova, Silvia; Urban, Renata
The aim of this study is to compare the effect of various restorative materials on fracture resistance in maxillary premolars. Premolars (n = 64) with no restorations or cracks were selected. MOD cavities were prepared considering the buccolingual width to be equal to half of the intercuspal distance. The specimens were randomly divided into 8 groups, 8 specimens each: group A intact teeth, group B unfilled cavity, group C composite made by oblique layering technique, group D composite with 2 mm cusp coverage, group E bulk-filled posterior composite, group F glass-ionomer, group G amalgam, and group H composite with proximal boxes. The specimens were subjected to an axial compression load with the mean values of fracture resistance in group A: 1289 N, group B: 181.75 N, group C: 445.38 N, group D: 645.88 N, group E: 355.13 N, group F: 352.00 N, group G: 191.38 N, and group H: 572.00 N. There was no significant difference between groups B and G, between C and D, E, and F, and between group D and H. All other measurements were statistically significant. We conclude that composite restoration with cusp coverage is the most ideal nonprosthetic solution for endodontically treated teeth. Cusp coverage increases the fracture resistance compared to the conventional cavity design. PMID:27656212
Faria-E-Silva, André Luís; Pedrosa, Celso de Freitas; Menezes, Murilo de Sousa; da Silveira, Daniele Machado; Martins, Luís Roberto Marcondes
One of the clinically relevant problems dentists face when restoring endodontically treated teeth is the mismatch between fiber post and post space diameters, which results in an excessively thick resin cement layer. Fiber post relining appears as a solution for this problem. Objectives: The aim of this study was to evaluate the effect of fiber post relining with composite resin on push-out bond strength. Material and Methods: Twenty bovine incisors were selected to assess post retention. The crowns were removed below the cementoenamel junction and the root canals were treated endodontically and flared with diamond burs. The roots were allocated into two groups (n=10): G1: fiber posts without relining and G2: fiber posts relined with composite resin. The posts were cemented with a dual-cured resin cement and the specimens were sectioned transversally. Three 1.5-mm thick slabs were obtained per root and identified as cervical, medium and apical thirds. The push-out test was performed at a crosshead speed of 0.5 mm/min until post dislodgement occurred. The failure mode of fractured specimens was analyzed under scanning electron microscopy. Data were analyzed by split-plot ANOVA and post-hoc Tukey's test at a pre-set alpha of 0.05. Results: Relined fiber posts presented higher retention values than non-relined post in all thirds. No statistically significant differences (p>0.05) were found among thirds for relined posts. All failures occurred at the interface between resin cement and root dentin. Conclusions: Relining with composite resin seems to be an effective method to improve the retention of fiber posts to flared root canals. PMID:20027434
Yadav, Hemant Kumar; Yadav, Rakesh Kumar; Chandra, Anil; Thakkar, Rahul Rameshbhai
Objective: The objective of this study was to evaluate the dissolution effectiveness of eucalyptus oil, orange oil, xylene, and distilled water on three different endodontic sealers. Materials and Methods: About 240 samples of root canal sealers (eighty for each sealer) were prepared and divided into four groups of 20 each for immersion in different organic solvents. Each group was further subdivided into two subgroups (n = 10) for 2 and 10 min of immersion time. The mean percentage of weight loss was determined for each sealer in each solvent at both time periods. Data were statistically analyzed by two factor analysis of variance and significance of mean difference was obtained by Tukey's post hoc test (P < 0.05). Results: The lowest level of solubility was observed for Adseal followed by Apexit Plus and Endomethasone N at both time periods in all solvents. Apexit Plus showed no significant (P > 0.05) difference in its dissolution in all the organic solvents except distilled water at both the time periods. The solubility profile of Endomethasone N and Adseal did not differ significantly among eucalyptus oil, orange oil, and xylene at 2 min and between eucalyptus oil and orange oil at 10 min. However, at 10 min, Endomethasone N and Adseal showed a more pronounced solubility in xylene as compared to both eucalyptus oil and orange oil. Conclusions: In general, xylene was the most effective in dissolving root canal sealers than other organic solvents. Essential oils (eucalyptus oil and orange oil) were found similar in their ability to dissolve Apexit Plus and Endomethasone N. PMID:27563181
Tavanafar, Saeid; Karimpour, Azadeh; Karimpour, Hamideh; Mohammed Saleh, Abdulrahman; Hamed Saeed, Musab
Statement of the Problem Vertical root fractures are catastrophic events that often result in tooth extraction. Many contributing factor are associated with increasing incidence of vertical root fracture. Root canal preparation is one of the predisposing factors which can increase the root susceptibility to vertical fracture. Purpose The aim of this study was to compare the effects of three different instrumentation techniques on vertical root fracture resistance of endodontically treated teeth. Materials and Methods In this study, 120 freshly extracted mandibular premolar teeth of similar dimensions were decoronated and randomly divided into control (n=30), nickel-titanium hand K-file (HF, n=30), BioRaCe rotary file (BR, n=30), and WaveOne reciprocating single-file (WO, n=30) groups. After cleaning and shaping the root canals, AH26 was used as canal sealer, and obturation was completed using the continuous wave technique. The root canals were embedded vertically in standardised autopolymerising acrylic resin blocks, and subjected to a vertical load to cause vertical root fracture. The forces required to induce fractures were measured using a universal testing machine. ANOVA and Tukey’s post-hoc test were used to analyse the data. Results All experimental groups showed statistically significant reductions in fracture resistance as compared with the control group. There was a statistically significant difference between the HF and BR groups. The WO group did not differ significantly from the HF group or the BR group. Conclusion All three instrumentation techniques caused weakening of the structure of the roots, and rendered them susceptible to fracture under lesser load than unprepared roots. The fracture resistance of roots prepared with the single-file reciprocating technique was similar to that of those prepared with NiTi hand and rotary instrumentation techniques. PMID:26106635
Alzraikat, Hanan; Taha, Nessrin Ahmad; Hassouneh, Layla
The aim of this study is to evaluate the solubility of a Mineral Trioxide Aggregate sealer (MTA-Fillapex) compared with five other sealers, calcium hydroxide (Sealapex), resin (Realseal), zinc oxide-eugenol (Tubli-Seal), and two epoxy resins (AH-26 and AH-Plus), in chloroform and eucalyptoil in static and ultrasonic environments. Samples of each sealer were prepared (n = 180) and then divided into 12 groups that were immersed in solvents for 5 and 10 min in static and ultrasonic environments. The mean weight loss was determined, and the values were compared using Student's t-test, One-way ANOVA, and Tukey's HSD post-hoc test (p < 0.05). In chloroform, MTA-Fillapex, AH-26, and Sealapex displayed moderate solubility with no significant difference in dissolution (p = 0.125); however, their dissolution was significantly lower than that of AH-Plus (p < 0.001), which was almost fully dissolved after 10 minutes. Realseal was significantly less soluble than all sealers (p < 0.001). In eucalyptoil, MTA-Fillapex showed low solubility, as all of the sealers did, but Tubli-Seal was significantly more soluble than other sealers (p < 0.001). Using ultrasonic activation resulted in a significantly higher dissolution rate in chloroform for all sealers except MTA-Fillapex after 10 min (p = 0.226). In eucalyptoil, ultrasonic activation significantly increased the dissolution rate of all sealers except MTA-Fillapex after 5 and 10 min, Sealapex at 10 min, and AH-Plus at 5 min (p > 0.05). In conclusion, MTA-Fillapex was not sufficiently dissolved in either solvent. Ultrasonic activation had limited effectiveness on MTA-Fillapex dissolution, whereas it significantly increased the efficiency of solvents in dissolving a number of endodontic sealers.
Mendes, Fausto Medeiros; De Benedetto, Monique Saveriano; del Conte Zardetto, Cristina Giovannetti; Wanderley, Marcia Turolla; Correa, Maria Salete Nahás Pires
A case report describing a technique for the restoration of endodontically treated primary maxillary incisors with resin composite short posts and celluloid strip crowns in a 3-year-old boy is presented. The technique offers the advantages of using one restorative material, improving esthetics, and reducing chairtime and costs.
Chiniforush, Nasim; Pourhajibagher, Maryam; Shahabi, Sima; Bahador, Abbas
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
Łysakowska, Monika E; Sienkiewicz, Monika; Banaszek, Katarzyna; Sokołowski, Jerzy
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.
Muhammad, Omid Heidar; Rocca, Jean-Paul; Fornaini, Carlo
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
Setzer, Frank C.; Trope, Martin; Karabucak, Bekir
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
Parsons, J R; Walton, R E; Ricks-Williamson, L
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.
Pina-Vaz, Cidália; Rocha, Rita; Carvalho, Manuel Fontes; Gonçalves, Acácio
Objectives. The aim of this study was to determine whether irrigation with sodium hypochlorite, chlorhexidine, and ozone gas, alone or in combination, were effective against Enterococcus faecalis and Candida albicans; these are microorganisms frequently isolated from teeth with periapical lesions resistant to endodontic treatment. Material and Methods. 220 single root teeth, recently extracted, were inoculated with Candida albicans and Enterococcus faecalis. The formulations tested were sodium hypochlorite at 1, 3, and 5% chlorhexidine at 0.2% and 2% and ozone gas applied for different periods of time. The combination of sodium hypochlorite at 5% and chlorhexidine at 2%, with gaseous ozone, were also assessed. For the most active treatments the mechanism of action was assessed through flow cytometry. Results. Sodium hypochlorite, chlorhexidine, and gaseous ozone alone were ineffective in completely eliminating the microorganisms. The association of chlorhexidine at 2% followed by ozone gas for 24 seconds promoted the complete elimination of Candida albicans and Enterococcus faecalis. Flow cytometry shows that ozone and chlorhexidine act differently, which could explain its synergic activity. Conclusions. This new disinfection protocol, combining irrigation with chlorhexidine at 2% and ozone gas for 24 seconds, may be advantageous when treating infected root canals. PMID:24982899
Barón, Marta; Forner, Leopoldo; Palomares, María; González-García, Cristina; Salmerón-Sánchez, Manuel
Objective: To study nanostructural dentinal changes produced by endodontic irrigants. Study Design: Experimental study. Nanoindentations were performed on peritubular (PD) and intertubular dentine (ID) with an atomic force microscopy. Stiffness and adhesion force were determined before and after application of 5.25% sodium hypochlorite (NaOCl) and 17% ethylenediaminetetraacetic acid (EDTA). Normalized differences before and after treatment for stiffness and adhesion forces were calculated. A paired T-test was used to compare stiffnes and adhesion force before and after irrigants application. Results: After treatment with EDTA there was a 29.80% reduction in stiffness in ID and a 63.53% reduction in PD. Adhesion force was reduced by 21.22% and 8.21% respectively. After treatment with 5.25% NaOCI stiffness was reduced by 2.49% in ID and increased by 15.01% in PD. Adhesion force increased by 25.11% and 23.97% respectively. Conclusions: 17% EDTA reduced stiffness and adhesion force in ID and PD. Treatment with NaOCI at 5.25% had no significant effect on stiffness but did affect adhesion force in ID and PD. Key words:Atomic force microscope, stiffness, adhesion force, peritubular dentine, intertubular dentine. PMID:23524430
Nóbrega, Letícia Maria Menezes; Montagner, Francisco; Ribeiro, Adriana Costa; Mayer, Márcia Alves Pinto; Gomes, Brenda Paula Figueiredo de Almeida
The aim of this study was to explore the bacterial diversity of 10 root canals with acute apical abscess using clonal analysis. Samples were collected from 10 patients and submitted to bacterial DNA isolation, 16S rRNA gene amplification, cloning, and sequencing. A bacterial genomic library was constructed and bacterial diversity was estimated. The mean number of taxa per canal was 15, ranging from 11 to 21. A total of 689 clones were analyzed and 76 phylotypes identified, of which 47 (61.84%) were different species and 29 (38.15%) were taxa reported as yet-uncultivable or as yet-uncharacterized species. Prevotella spp., Fusobacterium nucleatum, Filifactor alocis, and Peptostreptococcus stomatis were the most frequently detected species, followed by Dialister invisus, Phocaeicola abscessus, the uncharacterized Lachnospiraceae oral clone, Porphyromonas spp., and Parvimonas micra. Eight phyla were detected and the most frequently identified taxa belonged to the phylum Firmicutes (43.5%), followed by Bacteroidetes (22.5%) and Proteobacteria (13.2%). No species was detected in all studied samples and some species were identified in only one case. It was concluded that acute primary endodontic infection is characterized by wide bacterial diversity and a high intersubject variability was observed. Anaerobic Gram-negative bacteria belonging to the phylum Firmicutes, followed by Bacteroidetes, were the most frequently detected microorganisms.
Tronstad, L; Barnett, F; Cervone, F
It has recently been found that bacteria are able to survive and maintain an infectious disease process in periapical lesions of nonvital teeth. The purpose of this study was to examine the surfaces of root tips removed during surgical-endodontic treatment for the presence of microorganisms. A full thickness flap was reflected under strict surgical asepsis and the periapical lesions were enucleated and removed. About 2-3 mm of the root was cut off, rinsed in sterile saline and placed in 10% neutral-buffered formalin. Upon fixation, the root tips were dehydrated, air-dried and given an electrically conducting coat of gold in a vacuum evaporator. The root tips were then studied in a Jeol, JSM-U3 scanning electron microscope, usually operated at 20 kV. The root surfaces were covered with soft tissue, except at the apex of the roots, where a continuous, smooth and structureless coating was seen, apparently adjacent to the apical foramen. At higher magnification a variety of bacterial forms were recognized in the smooth coating. A bacterial plaque was observed in irregularities of the surfaces between fiber bundles and cells and in crypts and holes. The bacteria were held together by an extracellular material and the plaque was dominated by cocci and rods. Fibrillar forms were recognized as well, often with cocci attached to their surfaces.
Sunde, Pia Titterud; Olsen, Ingar; Debelian, Gilberto J; Tronstad, Leif
The periapical microbiota of 36 teeth with refractory apical periodontitis was investigated. None of the teeth had responded to conventional endodontic or long-term (> 6 months), calcium-hydroxide treatment. Eight patients had received antibiotics systemically. After anaerobic culture, a total of 148 microbial strains were detected among 67 microbial species. One of the 36 lesions was culture-negative. Approximately half (51.0%) of the bacterial strains were anaerobic. Gram-positive species constituted 79.5% of the flora. Facultative organisms, such as Staphylococcus, Enterococcus, Enterobacter, Pseudomonas, Stenotrophomonas, Sphingomonas, Bacillus, or Candida species were recovered from 27 of the lesions (75%). Sulfur granules were found in 9 lesions (25%). In these granules Actinomyces israelii, A. viscosus, A. naeslundii, and A. meyeri were identified. Other bacterial species, both gram-positive and gram-negative, were detected in the granules as well. Two sulfur granules did not contain Actinomyces. Scanning electron microscopy demonstrated rod- and spirochete-like cells in the granules, and transmission electron microscopy revealed organisms with copious amounts of extracellular material. Outer membrane vesicles were also seen. Some of the granules were calcified. This study demonstrated a wide variety of microorganisms, particularly gram-positive ones, in the periapical lesions of teeth with refractory apical periodontitis.
Mistry, Kunjal S.; Sanghvi, Zarna; Parmar, Girish; Shah, Samir
Objective: To check the antimicrobial activity of Azadirachta indica (Neem), Ocimum sanctum (Tulsi), Mimusops elelngi (Bakul), Tinospora cardifolia (Giloy) and Chlorhexidine Gluconate (CHX) on common endodontic pathogens like Streptococcus mutans, Enterococcus faecalis and staphylococcus aureus. Materials and Methods: The agar diffusion test was used to check the antimicrobial activity of the Methanolic extracts of the medicinal plants along with CHX. Six different concentrations of the tested agents were used for the study. The values of Zone of Inhibition were tabulated according to the concentration of the tested agent and data was statistically analyzed using ANOVA and Bonferroni post- hoc tests. The Minimum Inhibitory Concentration (MIC) and Minimum Bactericidal Concentrations (MBC) values were also recorded. Results: All the plants extracts showed considerable antimicrobial activity against selected endodontic pathogens. At 3mg. concentration, O.sanctum was the most effective against S. mutans, M. elengi showed highest zone of inhibition against E.faecalis, whereas CHX was the most effective agent against S.aureus. CHX was also the most consistent of all the medicaments testes, showing inhibitory effect against all the tree pathogens at all the selected concentrations. Conclusions: The Methanolic extract of A.Indica, O.sanctum, M. Elengi, T.cardifolia and Chlorhexidine Gluconate has considerable antimicrobial activity against S. mutans, E. faecalis and S. aureus. PMID:24966766
Warnsinck, C J; Shemesh, H
Periapical laesions are a frequently occurring phenomenon, in both untreated teeth and teeth which have undergone endodontic treatment. Various factors have been found to positively influence the effectiveness of endodontic treatment, which is defined by a lack of clinical symptoms and also the absence or shrinkage of the periapical laesion. The chance of a painful exacerbation of a persistent periapical laesion is small, even if the area of the laesion has expanded, which happens in approximately 50% of the cases. The survival of endodontically treated teeth with a periapical laesion is 87% after 10 years. Restorative reasons frequently are the main reason for extraction and the presence of a periapical laesion is seldom the reason for losing a tooth. The influence of the periapical laesion on general health is still unclear.
Álvarez, Asteria Luzardo; Espinar, Francisco Otero; Méndez, José Blanco
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
Asgary, Saeed; Fazlyab, Mahta
Missing of mandibular second premolar is one of the most common types of tooth agenesis. In such cases, maintenance of the primary second molar, if possible at all, can prevent many treatment procedures in future. The present case report represents the endodontic management of a necrotic left mandibular primary second molar that had developed an abscess. Considering the missing of the permanent successor, the tooth was disinfected during endodontic preparation and the root canal system was filled with calcium-enriched mixture (CEM) cement in the same session. After 12 months of regular follow-up, not only the tooth was functional and symptom-free, but also healing of the inter-radicular bone lesion and re-establishment of the lamina dura was indicative of treatment success. Further trials are suggested to confirm CEM biomaterial use for management of infected primary molars associated with endodontic lesion. PMID:28179938
Al-Tammami, Musaed Fahad
A revascularization procedure was shown to be the best alternative therapy for immature teeth with necrotic pulp and apical infection. A 12 year old female with a history of trauma to her upper central incisor and a sinus tract was referred for endodontic treatment. She was an active orthodontic patient and had undergone regenerative endodontic treatment for the past 2 years. Clinical examination revealed no response to sensibility, percussion, and palpation tests. The preoperative radiograph showed an open apex and apical rarefaction. The case was diagnosed as previously treated tooth with asymptomatic apical periodontitis. Regenerative endodontic retreatment was performed, and the case was followed for 3 years. Clinical, radiographic, and cone-beam computed tomography follow-up examination revealed an asymptomatic tooth, with evidence of periapical healing and root maturation. PMID:28194367
Lechner, Johann; von Baehr, Volker
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
Ciobanu, Ionela Elisabeta; Rusu, Darian; Stratul, Stefan-Ioan; Didilescu, Andreea Cristina; Cristache, Corina Marilena
Root canal stripping is defined as an oblong, vertical perforation that appears especially in the middle section of curved root canals during endodontic treatments with nickel-titanium (Ni-Ti) instruments. Its occurrence may drastically affect the outcome of the treatment, transforming a common otherwise efficient endodontic procedure into a complication such as tooth extraction. In order to discuss the ethical and legal consequences, two cases of dental strip perforations are herewith presented. Due to the existence of risk factors for dental strip perforation, experience of the clinician and the use of magnification and modern imagistic methods (CBCT) may avoid or reduce the frequency of this type of accidents. Under correct working circumstances, dental stripping should not be regarded as a malpractice but as a procedural accident. However, the patient must always be informed, before and during the endodontic procedure, about the event and the possible complications that may occur.
Ciobanu, Ionela Elisabeta; Rusu, Darian; Didilescu, Andreea Cristina
Root canal stripping is defined as an oblong, vertical perforation that appears especially in the middle section of curved root canals during endodontic treatments with nickel-titanium (Ni-Ti) instruments. Its occurrence may drastically affect the outcome of the treatment, transforming a common otherwise efficient endodontic procedure into a complication such as tooth extraction. In order to discuss the ethical and legal consequences, two cases of dental strip perforations are herewith presented. Due to the existence of risk factors for dental strip perforation, experience of the clinician and the use of magnification and modern imagistic methods (CBCT) may avoid or reduce the frequency of this type of accidents. Under correct working circumstances, dental stripping should not be regarded as a malpractice but as a procedural accident. However, the patient must always be informed, before and during the endodontic procedure, about the event and the possible complications that may occur. PMID:27672458
GlassForm is a software tool for generating preliminary waste glass formulas for a given waste stream. The software is useful because it reduces the number of verification melts required to develop a suitable additive composition. The software includes property models that calculate glass properties of interest from the chemical composition of the waste glass. The software includes property models for glass viscosity, electrical conductivity, glass transition temperature, and leach resistance as measured by the 7-day product consistency test (PCT).
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
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.
Yasuda, Yoshiyuki; Kamaguchi, Arihide; Saito, Takashi
The purpose of this study was to compare the antimicrobial activities of a new resin-based SuperBond (SB) Sealer and five other sealers/cements against endodontic pathogens. The antimicrobial activities of SB Sealer, Sealapex, AH plus, Roeko Seal Automix, Canals N, and ProRoot mineral trioxide aggregate (MTA) were examined using a double-layered method. The microorganisms Staphylococcus aureus, Enterococcus faecalis, Candida albicans, Streptococcus mutans, and Streptococcus sanguinis were used. Live microorganisms were stained using triphenyltetrazolium chloride, and the zones of inhibition of microorganism growth were measured. The antimicrobial activity of SB Sealer was significantly lower than that of the other sealers, except for Pro Root MTA, against S. aureus, C. albicans, S. mutans, and S. sanguinis, but no activity against E. faecalis was detected. On the other hand, AH plus exhibited the highest antimicrobial activity. Pro Root MTA showed no antimicrobial activity against any of the microorganisms tested. SB Sealer offered no antimicrobial advantage over the other sealers tested except for Pro Root MTA.
This book presents information on the following topics: a look at the history of glass strength; atomistic theory of fracture; surface chemistry in relation to the strength and fracture of silicate glasses; high-speed photographic investigations of the dynamic localized loading of some oxide glasses; a correction for measurements of contact area using Newton's rings; envionmentally enhanced crack growth; fatigue in glass; behavior of flaws in fused silica fibers; fracture toughness of chalcogenide glasses and glass-ceramics; fracture analysis of glass surfaces; and fracture mechanics parameters for glasses - a compilation and correlation.
KRUGER AA; HRMA PR
In glass processing situations involving glass crystallization, various crystalline forms nucleate, grow, and dissolve, typically in a nonuniform temperature field of molten glass subjected to convection. Nuclear waste glasses are remarkable examples of multicomponent vitrified mixtures involving partial crystallization. In the glass melter, crystals form and dissolve during batch-to-glass conversion, melter processing, and product cooling. Crystals often agglomerate and sink, and they may settle at the melter bottom. Within the body of cooling glass, multiple phases crystallize in a non-uniform time-dependent temperature field. Self-organizing periodic distribution (the Liesegnang effect) is common. Various crystallization phenomena that occur in glass making are reviewed.
Ashraf, Hengameh; Dianat, Omid; Hajrezai, Reihaneh; Paymanpour, Payam; Azadnia, Sina
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
Mali, Rohini; Lele, Priya; Vishakha
The use of guided tissue regeneration (GTR) has become a standard of care in Periodontology. GTR using membrane barriers and/or bone grafting materials has also been used in periapical surgery. However, the application of the GTR principle, particularly in communicating endodontic-periodontal lesions with loss of the buccal cortical plate, is a very challenging task, with very few reported human clinical studies. An interdisciplinary approach, combining endodontic and periodontal (surgical) procedures can save a tooth in the long run that has been defined as hopeless at the preliminary stage of treatment.
Ashraf, Hengameh; Dianat, Omid; Hajrezai, Reihaneh; Paymanpour, Payam; Azadnia, Sina
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.
Gutmann, James L; Endo, Cert
Originally, Clark's rule was used to identify the position of unerupted or supernumerary teeth (a concept known as oral localization) prior to orthodontic tooth movement or surgical removal. However, the versatility of this rule's principles and concepts are also highly applicable to endodontic diagnosis and treatment. While contemporarily known by many different names, such as the "buccal object rule" and the "cone beam-shift technique," the importance of this rule in endodontics was not recognized in the literature until late in the 20th century, despite historical evidence demonstrating its incorporation into root canal procedures almost 100 years ago.
Tinker Air Force Base, Oklahoma City, OK AND ADDRESS(ES) 8. PERFORMING ORGANIZATION REPORT NUMBER Keesler Air Force Base, Biloxi, MS...Endodontic Journal, doi:10.1111/j.1365- 2591.2011.01958.x 45, 156–161, 2012 doi:10.1111/j.1365-2591.2011.01958.x Wiley Blackwell Publishing, 111 River...Bergeron2 & M. J. Mayerchak3 1Department of Endodontics, Tinker Air Force Base, Oklahoma City, OK; 2Keesler Air Force Base, Biloxi, MS; and 3Private Practice
Moshari, Amirabbas; Vatanpour, Mehdi; EsnaAshari, Ehsan; Zakershahrak, Mehrsa; Jalali Ara, Afsoon
Long-term success of endodontic treatment is dependent on adequate and appropriate cleaning and shaping of the root canal along with proper and correct obturation of the entire prepared space. This article aims to report an exceptional non-surgical and orthograde endodontic treatment of maxillary right central incisor with an extensive radiolucent lesion in a 17-year-old male. Six and 20-month follow-ups showed significant changes, including bone formation and periapical healing within the lesion. The patient was asymptomatic. After 20 months, complete radiographic and clinical healing of the periapical lesion was observed. PMID:28179937
Silberman, Adrian; Heilborn, Carlos; Cohenca, Nestor
Endodontic treatment of third molars often becomes part of comprehensive treatment plans, as it represents a more conservative and less invasive approach than its therapeutic alternatives. The frequency of anatomic variations in mandibular molars, particularly root canal configuration, requires 2 periapical radiographs from different angles. Upon reading and interpretation of the radiographs, the clinician should consider the anatomy and level of difficulty of the endodontic procedure and refer the patient to an endodontist, if deemed necessary. The present article discusses the successful treatment and preservation of a mandibular third molar with 5 root canals, as well as methods for its clinical management.
Mahesh, R; Prasad, Vishnu; Menon, Padma A.
Dental management of children with attention-deficit hyperactivity disorder (ADHD) often requires the need for pharmacological behavior management techniques such as the use of sedation. The purpose of this article is to describe a clinical case involving accidental aspiration of an Endodontic instrument during root canal therapy under sedation. To our knowledge, this is the first case report of aspiration of an Endodontic instrument and should serve to heighten the awareness with regard to aspiration during dental procedures under sedation. It also emphasizes the need for proper isolation techniques in patients treated under sedation, thereby preventing such complications. PMID:24883031
Bless, S.; Tolman, J.
Strength of glass and glass ceramic was measured with a bar impact technique. High-speed movies show regions of tensile and compressive failure. The borosilicate glass had a compressive strength of at least 2.2 GPa, and the glass ceramic at least 4 GPa. However, the BSG was much stronger in tension than GC. In ballistic tests, the BSG was the superior armor.
Gleason, B.; Wachtel, P.; Musgraves, J. D.; Steinkopf, R.; Eberhardt, R.; Richardson, K.
Five chalcogenide glasses in the GeAsSe ternary glass system were melted, fabricated into flats, and molded between planar, uncoated, binderless WC molds using a laboratory-scale precision glass molding machine. The five glasses originate at the binary arsenic triselenide (As40Se60) and are modified by replacing As with Se in 5 mol% increments, or by locking the As:Se ratio and adding Ge, also in 5 mol% increments. The glasses are separated into two groups, one for the Ge-free compositions and the other for the Ge-containing compositions. This effort analyzes the differences between the Ge-containing and the Ge-free glasses on the post-molded glass and mold surface behavior, as well as the mold lifetime. Fabrication features, such as scratch and/or dig marks were present on the glass and mold surfaces prior to the PGM process. White light interferometry analysis of the surfaces shows an overall reduction in the RMS roughness of the glass after molding, and an increase of the roughness of the molds, after 15 molding cycles. After molding, the quantity of observable defects, primarily deposits and dig marks are increased for both the glass and mold surfaces. Deposits found on the WC molds and glasses were analyzed using Electron Dispersive X-ray Spectroscopy (EDS) and showed no evidence of being due to material transfer between the WC molds and the glass constituents. In general the main observable difference in the analysis of the two post molded sets, despite the changes in chemistry, is the quantity of molding induced defects near the edge of the GeAsSe samples.
Naas, Haitem M M; Dashti, Mohammad Hossein; Hashemian, Roxana; Hifeda, Nedda Y
The post-and-core pattern duplication technique is a simple, cost-effective, and accurate method of ensuring the reproducibility of a cast post and core. An acrylic resin pattern is fabricated for an endodontically treated tooth. The post portion of the pattern is duplicated with a polyvinyl siloxane impression material in the lower compartment of a container. The core portion is then duplicated with a polyether impression material in the upper compartment. After the original pattern has been retrieved, the duplicate resin pattern is fabricated in the provided space. This technique will improve efficiency if damage or loss of the pattern or the actual cast post and core occurs.
Kim, J. W.; Griggs, J. A.; Regan, J. D.; Ellis, R. A.; Cai, Z.
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
Albuquerque, M.T.P.; Valera, M.C.; Nakashima, M.; Nör, J.E.; Bottino, M.C.
Stemming from in vitro and in vivo pre-clinical and human models, tissue-engineering-based strategies continue to demonstrate great potential for the regeneration of the pulp-dentin complex, particularly in necrotic, immature permanent teeth. Nanofibrous scaffolds, which closely resemble the native extracellular matrix, have been successfully synthesized by various techniques, including but not limited to electrospinning. A common goal in scaffold synthesis has been the notion of promoting cell guidance through the careful design and use of a collection of biochemical and physical cues capable of governing and stimulating specific events at the cellular and tissue levels. The latest advances in processing technologies allow for the fabrication of scaffolds where selected bioactive molecules can be delivered locally, thus increasing the possibilities for clinical success. Though electrospun scaffolds have not yet been tested in vivo in either human or animal pulpless models in immature permanent teeth, recent studies have highlighted their regenerative potential both from an in vitro and in vivo (i.e., subcutaneous model) standpoint. Possible applications for these bioactive scaffolds continue to evolve, with significant prospects related to the regeneration of both dentin and pulp tissue and, more recently, to root canal disinfection. Nonetheless, no single implantable scaffold can consistently guide the coordinated growth and development of the multiple tissue types involved in the functional regeneration of the pulp-dentin complex. The purpose of this review is to provide a comprehensive perspective on the latest discoveries related to the use of scaffolds and/or stem cells in regenerative endodontics. The authors focused this review on bioactive nanofibrous scaffolds, injectable scaffolds and stem cells, and pre-clinical findings using stem-cell-based strategies. These topics are discussed in detail in an attempt to provide future direction and to shed light on
Albuquerque, M T P; Valera, M C; Nakashima, M; Nör, J E; Bottino, M C
Stemming from in vitro and in vivo pre-clinical and human models, tissue-engineering-based strategies continue to demonstrate great potential for the regeneration of the pulp-dentin complex, particularly in necrotic, immature permanent teeth. Nanofibrous scaffolds, which closely resemble the native extracellular matrix, have been successfully synthesized by various techniques, including but not limited to electrospinning. A common goal in scaffold synthesis has been the notion of promoting cell guidance through the careful design and use of a collection of biochemical and physical cues capable of governing and stimulating specific events at the cellular and tissue levels. The latest advances in processing technologies allow for the fabrication of scaffolds where selected bioactive molecules can be delivered locally, thus increasing the possibilities for clinical success. Though electrospun scaffolds have not yet been tested in vivo in either human or animal pulpless models in immature permanent teeth, recent studies have highlighted their regenerative potential both from an in vitro and in vivo (i.e., subcutaneous model) standpoint. Possible applications for these bioactive scaffolds continue to evolve, with significant prospects related to the regeneration of both dentin and pulp tissue and, more recently, to root canal disinfection. Nonetheless, no single implantable scaffold can consistently guide the coordinated growth and development of the multiple tissue types involved in the functional regeneration of the pulp-dentin complex. The purpose of this review is to provide a comprehensive perspective on the latest discoveries related to the use of scaffolds and/or stem cells in regenerative endodontics. The authors focused this review on bioactive nanofibrous scaffolds, injectable scaffolds and stem cells, and pre-clinical findings using stem-cell-based strategies. These topics are discussed in detail in an attempt to provide future direction and to shed light on
Kolb, Doris; Kolb, Kenneth E.
Presents a detailed discussion on the chemistry of glass. Topics discussed include: natural glass, early history, modern glass composition, raw materials for glass melting, chemically modified glasses, modern glass forming, glass ceramics, and new developments in glass research. (BT)
Gutmann, J L; Rakusin, H
The treatment of fractured teeth poses significant problems for the practitioner. However, once the treatment planning decision has been made to attempt to retain the tooth, various practical regimens are available to effect this goal. This paper addresses the specific use of glass ionomer in the restorative management of incompletely, vertically fractured molar teeth integrated with specific root canal treatment techniques.
González-Peña, Rolando J.; Salvador, Rosario; Cibrián, Rosa M.; Martinez-Celorio, René A.; López, Francisco J.; Sala, Faustino; Paredes, Vanessa
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.
Although the intrinsic strength of silicon dioxide glass is of the order of 10 to the 6th power lb/sq in, the practical strength is roughly two orders of magnitude below this theoretical limit, and depends almost entirely on the surface condition of the glass, that is, the number and size of flaws and the residual surface compression (temper) in the glass. Glass parts always fail in tension when these flaws grow under sustained loading to some critical size. Research associated with glass encapsulated crystalline-Si photovoltaic (PV) modules has greatly expanded our knowledge of glass breaking strength and developed sizeable data base for commercially available glass types. A detailed design algorithm is developed for thickness sizing of rectangular glass plates subject to pressure loads. Additional studies examine the strength of glass under impact loading conditions such as that caused by hail. Although the fundamentals of glass breakage are directly applicable to thin film modules, the fracture strength of typical numerical glass must be replaced with data that reflect the high temperature tin oxide processing, laser scribing, and edge processing peculiar to thin film modules. The fundamentals of glass breakage applicable to thin film modules and preliminary fracture strength data for a variety of 1 ft square glass specimens representing preprocessed and post processed sheets from current amorphous-Si module manufacturers are presented.
Quinn, Daniel B.; Rosenberg, Brian J.
We present an analytical treatment of the acoustics of liquid-filled wine glasses, or "glass harps." The solution is generalized such that under certain assumptions it reduces to previous glass harp models, but also leads to a proposed musical instrument, the "inverted glass harp," in which an empty glass is submerged in a liquid-filled basin. The versatility of the solution demonstrates that all glass harps are governed by a family of solutions to Laplace's equation around a vibrating disk. Tonal analyses of recordings for a sample glass are offered as confirmation of the scaling predictions.
Dikbas, Idil; Tanalp, Jale
Intraradicular posts are useful adjuncts in the restoration of endodontically treated teeth. These systems have undergone a significant evolution in recent years, and fiber-reinforced systems have started to be incorporated into routine clinical care more frequently. Despite the high number of laboratory studies pertaining to the characteristics of fiber posts, clinical studies evaluating their general success rates are rather limited. Since clinical investigations are reliable means to achieve information about the general behavior pattern of materials or techniques, assessment of this data will be beneficial to have a better understanding of fiber-reinforced intraradicular post systems. The purpose of this paper was to make a summary of clinical studies regarding various fiber posts. A PubMed search was conducted and articles dating back to 1990 were retrieved. The paper provides an overview of clinical studies on fiber posts specifically in the last decade as well as commentary analysis.
Krishnamoorthy, Sridevi; Gopikrishna, Velayutham
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
Jaikrishnan, S; Kottoor, Jojo; Mathew, Joy; Kumar, Sanjana Ravi; George, Saira; Hari, Krishna
This case report describes a patient with unusual tooth morphology involving the bilateral presence of 6 maxillary and mandibular first and second molars with a single root and a single canal. The article also discusses the endodontic management of a single-rooted maxillary molar and the use of cone beam computed tomography for evaluation and diagnosis of these anatomical variations.
A necrotic immature mandibular, canine tooth in a two year-old, male, intact Chow Chow was endodontically treated. This tooth had an open apex, wide root canal, thin dentinal walls, and there was periapical bone resorption. An apexification procedure was used to induce apical closure by calcified tissue formation, with resolution of the periapical inflammation.
Martiniano, Eli Carlos; Monteiro, Larissa Raylane Lucas; Valenti, Vitor E.; Sorpreso, Isabel Cristina Esposito; de Abreu, Luiz Carlos
We aimed to evaluate the acute effect of musical auditory stimulation on heart rate autonomic regulation during endodontic treatment. The study included 50 subjects from either gender between 18 and 40 years old, diagnosed with irreversible pulpitis or pulp necrosis of the upper front teeth and endodontic treatment indication. HRV was recorded 10 minutes before (T1), during (T2), and immediately (T3 and T4) after endodontic treatment. The volunteers were randomly divided into two equal groups: exposed to music (during T2, T3, and T4) or not. We found no difference regarding salivary cortisol and anxiety score. In the group with musical stimulation heart rate decreased in T3 compared to T1 and mean RR interval increased in T2 and T3 compared to T1. SDNN and TINN indices decreased in T3 compared to T4, the RMSSD and SD1 increased in T4 compared to T1, the SD2 increased compared to T3, and LF (low frequency band) increased in T4 compared to T1 and T3. In the control group, only RMSSD and SD1 increased in T3 compared to T1. Musical auditory stimulation enhanced heart rate autonomic modulation during endodontic treatment. PMID:28182118
Pécora, J D; Spanó, J C; Barbin, E L
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.
Edrees, Hadeel Y; Ohlin, Johan; Ahlquist, Michael; Tessma, Mesfin K; Zary, Nabil
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.
Iqbal, Azhar; Qureshi, Beenish; Sghaireen, Mohd G.; AL-Omiri, Mahmoud K.
The objective of this study was to collect information regarding methods, materials, and attitudes employed during the endodontic treatment by dentists in north of Saudi Arabia. A questionnaire was designed and distributed among 300 dentists in north of Saudi Arabia to collect the data about the standard protocols of endodontic treatment. The collected data was analyzed by using the SPSS 10 computer software. Out of a total of 300 surveyed dentists, the 66% response rate showed that this study was true representation of the endodontic treatment performed by the dentists in north of Saudi Arabia. 152 (76%) were general dentists and 48 (24%) were endodontists. 18 (9%) were using rubber dam as the method of isolation during endodontic treatment. 173 (86.5%) were using only measurement radiographs for working length determination and 27 (13.5%) were using both electronic apex locator and measurement radiographs. 95 (47.5%) of the respondents were using standardized technique and 25 (12.5%) were using step-down as a root canal preparation technique. 127 (63.5%) of the respondents were using lateral condensation technique, with gutta percha points for root canal obturation. PMID:24944823
Kakooei, Sina; Mostafavi, Mahshid; Parirokh, Masoud; Asgary, Saeed
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
Saghiri, Mohammad Ali; Asatourian, Armen; Haraji, Afshin; Ramezani, Golam H; Garcia-Godoy, Franklin; Scarbecz, Mark; Sheibani, Nader
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.
Tomazinho, Luiz Fernando; Avila-Campos, Mario J
Black-pigmented anaerobic rods such as Prevotella spp. and Porphyromonas spp. are involved in the etiology and perpetuation of endodontic infections. The aim of this study was to evaluate the prevalence of these species in chronic endodontic infections by using culture and polymerase chain reaction (PCR) techniques. Samples of 100 patients with root canals displaying chronic endodontic infections were obtained by sterilized paper points. Bacterial identification was performed by using culture and PCR techniques. By culture, in 33% of the samples, P. intermedia-P. nigrescens (75.8%), P. gingivalis (27.3%), and P. endodontalis (9.1%) were identified, and by PCR 60% of the samples harbored P. nigrescens (43.3%), P. gingivalis (43.3%), P. intermedia (31.7%), and P. endodontalis (23.3%). The presence of these black-pigmented anaerobic rods alone or in association in chronic endodontic infections seems to be frequent. PCR is a very sensitive technique for detecting DNA from bacterial cells. Culturing is only able to reveal living bacteria and is less sensitive for the identification of low numbers of bacterial cells.
Santana, Milana Drumond Ramos; Martiniano, Eli Carlos; Monteiro, Larissa Raylane Lucas; Valenti, Vitor E; Garner, David M; Sorpreso, Isabel Cristina Esposito; de Abreu, Luiz Carlos
We aimed to evaluate the acute effect of musical auditory stimulation on heart rate autonomic regulation during endodontic treatment. The study included 50 subjects from either gender between 18 and 40 years old, diagnosed with irreversible pulpitis or pulp necrosis of the upper front teeth and endodontic treatment indication. HRV was recorded 10 minutes before (T1), during (T2), and immediately (T3 and T4) after endodontic treatment. The volunteers were randomly divided into two equal groups: exposed to music (during T2, T3, and T4) or not. We found no difference regarding salivary cortisol and anxiety score. In the group with musical stimulation heart rate decreased in T3 compared to T1 and mean RR interval increased in T2 and T3 compared to T1. SDNN and TINN indices decreased in T3 compared to T4, the RMSSD and SD1 increased in T4 compared to T1, the SD2 increased compared to T3, and LF (low frequency band) increased in T4 compared to T1 and T3. In the control group, only RMSSD and SD1 increased in T3 compared to T1. Musical auditory stimulation enhanced heart rate autonomic modulation during endodontic treatment.
Paresthesia is a burning or prickling sensation or partial numbness resulting from neural injury. Paresthesia resulting from periapical pathosis or various stages of root canal treatment is of great importance in the field of endodontics. The purpose of this paper is to review paresthesia caused by periapical lesions, local anesthesia, cleaning, shaping and obturation.
Madhuri, G. Vijaya; Varri, Sujana; Bolla, Nagesh; Mandava, Pragna; Akkala, Lakshmi Swathi; Shaik, Jaheer
Aim: To compare the bond strength of four different endodontic sealers to root dentin through push-out test design. Materials and Methods: Forty single-rooted teeth with completely formed apices were selected. Teeth were decoronated, and working length was determined. Instrumentation and irrigation were performed. The teeth were divided into four groups based upon the sealer used. Group 1: Bioceramic sealer (Endosequence), Group 2: Mineral trioxide aggregate (MTA) based sealer (MTA Fill apex), Group 3: Epoxy resin based sealer (MM-Seal), and Group 4: Dual cure resin-based sealer (Hybrid Root Seal). Manipulation and application of the sealer was done as per the manufacturer instructions. All the teeth were obturated using 6% gutta-percha. After obturation, each tooth was prepared for push-out test with root slices of 2 mm thickness using universal testing machine. Results: The highest bond strength was found in Group 1 (Endosequence) (P < 0.05) compared to other groups. The lowest bond strength was found in Group 2 (MTA Fill apex). Statistical analysis is done by two-way ANOVA and Newman-Keuls multiple post hoc. Conclusion: The push-out bond strength of Bioceramic sealer was highest followed by resin-based sealer and lowest bond strength was observed in MTA-based sealer. PMID:27656067
Jadhav, Ganesh Ranganath; Mittal, Priya; Kulkarni, Anish; Syed, Shibli; Bagul, Ravikiran; Elahi, Saina; Kalra, Dheeraj
Background: The purpose of this study was to evaluate the canal cleaning ability of three novel endodontic rotary instruments and compare with ProTaper files as a control in apical third of root canals under scanning electron microscopy (SEM). Materials and Methods: Eighty freshly extracted mandibular premolars were selected according to inclusion criteria. Buccal cusp tips were ground to ensure having a flat coronal reference point with a total tooth length of 16 mm for all samples. Teeth were divided equally into four groups: Group I (ProTaper group), Group II (ProTaper next group), Group III (variable taper group), and Group IV (self-adjusting file [SAF] group). Using SEM, the dentinal surfaces were observed and rated at apical thirds with a magnification of ×1000 for the presence/absence of smear layer and debris. Descriptive analysis was performed, and analysis of variance with Bonferroni post hoc test was carried out for comparison between the groups, at a significance level of 0.05. Results: There was statistically significant difference between Group II and Group IV for debris (P = 0.047) and smear layer (P = 0.037). Conclusion: In apical third of root canal, SAF showed statistically significant canal cleaning ability due to combined effect of continuous streaming irrigation with effectively replacing the irrigant from the apical portion of the root canal, irrigants activation through the creation of turbulence, and its self-adapting design to root canal anatomy with a scrubbing motion on the canal walls. PMID:28182065
Gesi, A; Magnolfi, S; Goracci, C; Ferrari, M
The purpose of this study was to evaluate the time needed to remove several types of fiber posts using two different bur kits. Estimates refer to the time needed to pass the fiber post until arriving at the gutta-percha. Sixty extracted anterior teeth were treated endodontically. A post space with a standard depth of 10 mm was prepared in each root canal. The sample was randomly divided into 3 groups of 20 specimens each. Three different types of posts were cemented: group 1, Conic 6% tapered fiber posts (Ghimas); group 2, FRC Poster fiber posts (Ivoclar-Vivadent); and group 3, Composipost carbon fiber posts (RTD). To remove the post, for half of each group's specimens the burs from the RTD fiber posts removal kit were used (subgroup A). From the other half of the teeth in each group (subgroup B), posts were removed by using a diamond bur and a Largo bur. Composipost carbon fiber posts (group 3) took significantly less time to remove than the other two types of posts (p < 0.05). For the bur kits, the procedure involving the use of a diamond and a Largo bur (subgroup B) was significantly faster (p < 0.05). The interaction between the type of post and the type of bur kit used was not significant (p > 0.05).
Nayak, Moksha; Babshet, Medha
Background The prevalence of apical periodontitis in diabetes mellitus patients is high. The altered immunity in diabetes affects the healing process of periapical tissue. Single visit endodontic treatment has shown to increase the periapical healing rate with better patient compliance. Hence the present study aims at evaluating the clinical and radiographic healing outcome of single visit endodontic treatment, in type 2 diabetes mellitus patients with periapical disease. Material and Methods Eighty patients with periapical disease were divided into 2 groups of 40 each: Group I, Control subjects and Group II, Type 2 diabetics. Glycosylated hemoglobin levels were assessed preoperatively and at follow up intervals in diabetics. Pre-operative assessment of periapical status was done using CPDR (Clinical periapical diagnosis of root), QLDR (Qualitative radiographic diagnosis of tooth) and QTDR (Quantitative radiographic diagnosis of tooth) criteria. Postoperative healing was evaluated following single-visit endodontic treatment by Strindberg criteria. Results Group 2 subjects had chronic and exacerbating lesions with significantly larger lesions (p=0.029). 100 % clinical healing outcome in diabetic group was seen in two months. Group 2 showed 85% success in one year on radiographic evaluation. Poor controlled diabetics showed failure compared to fair and good controlled. Conclusions Type 2 diabetics had chronic and larger sized lesions when compared to control subjects. The periapical lesions in patients with poor diabetic control showed failure. The clinical and radiographic healing outcome of single visit endodontic therapy was delayed in diabetic patients. Key words:Apical periodontitis, diabetes mellitus type 2, endodontics, periapical lesion, strindberg criteria. PMID:27957260
Eliyas, S; Briggs, P; Gallagher, J E
Objective To explore the experiences of primary care dentists following training to enhance endodontic skills and their views on the implications for the NHS.Design Qualitative study using anonymised free text questionnaires.Setting Primary care general dental services within the National Health Service (NHS) in London, United Kingdom.Subjects and methods Eight primary care dentists who completed this training were asked about factors affecting participant experience of the course, perceived impact on themselves, their organisation, their patients and barriers/facilitators to providing endodontic treatment in NHS primary care. Data were transferred verbatim to a spreadsheet and thematically analysed.Intervention 24-month part-time educational and service initiative to provide endodontics within the NHS, using a combination of training in simulation lab and treatment of patients in primary care.Results Positive impacts were identified at individual (gains in knowledge, skills, confidence, personal development), patient (more teeth saved, quality of care improved) and system levels (access, value for money). Suggested developments for future courses included more case discussions, teaching of practical skills earlier in the course and refinement of the triaging processes. Barriers to using the acquired skills in providing endodontic treatment in primary care within the NHS were perceived to be resources (remuneration, time, skills) and accountability. Facilitators included appropriately remunerated contracts, necessary equipment and time.Conclusion This novel pilot training programme in endodontics combining general practice experience with education/training, hands-on experience and a portfolio was perceived by participants as beneficial for extending skills and service innovation in primary dental care. The findings provide insight into primary dental care practitioners' experience with education/training and have implications for future educational initiatives in
Haimed, Tariq Abu
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
Al-Omari, Wael M
Background General dental practitioners provide the majority of endodontic treatment in Jordan. The aim of this study was to gather information on the methods, materials and attitudes employed in root canal treatment by dentists in North Jordan, in order to evaluate and improve the quality of current practice. Methods A questionnaire was posted to all registered general dental practitioners working in private practice in Irbid Governate in North Jordan (n = 181). The questionnaire included information on methods, materials and techniques used in endodontic treatment. Results Reply rate was 72% (n = 131). The results demonstrated that only five dentists used rubber dam occasionally and not routinely. The majority used cotton rolls for isolation solely or in combination with a high volume saliva ejector (n = 116). The most widely used irrigants were sodium hypochlorite and hydrogen peroxide, which were used by 32.9% (n = 43) and 33.6% (n = 44) of the respondents, respectively. Forty eight percent of the respondents (n = 61) used the cold lateral condensation technique for canal obturation, 31.3% (n = 41) used single cone, 9.9% (n = 13) used vertical condensation and 12.2% (n = 16) used paste or cement only for the obturation. The majority used zinc oxide eugenol as a sealer (72.5%). All, but one, respondents used hand instruments for canal preparation and the technique of choice was step back (52.7%). More than 50% (n = 70) of the dentists took one radiograph for determining the working length, whilst 22.9% (n = 30) did not take any radiograph at all. Most practitioners performed treatment in three visits for teeth with two or more root canals, and in two visits for teeth with a single root canal. Conclusions This study indicates that dentists practicing in North Jordan do not comply with international quality standards and do not use recently introduced techniques. Many clinicians never take a radiograph for determining the working length and never used rubber dam
Photo shows a subway station in Toronto, Ontario, which is entirely glass-enclosed. The all-glass structure was made possible by a unique glazing concept developed by PPG Industries, Pittsburgh, Pennsylvania, one of the largest U.S. manufacturers of flat glass. In the TVS glazing system, transparent glass "fins" replace conventional vertical support members used to provide support for wind load resistance. For stiffening, silicone sealant bonds the fins to adjacent glass panels. At its glass research center near Pittsburgh, PPG Industries uses the NASTRAN computer program to analyze the stability of enclosures made entirely of glass. The company also uses NASTRAN to simulate stresses on large containers of molten glass and to analyze stress effects of solar heating on flat glass.
Rawlings, R D
Bioactive materials are designed to induce a specific biological activity; in most cases the desired biological activity is one that will give strong bonding to bone. A range of materials has been assessed as being capable of bonding to bone, but this paper is solely concerned with bioactive glasses and glass-ceramics. Firstly, the structure and processing of glasses and glass-ceramics are described, as a basic knowledge is essential for the understanding of the development and properties of the bioactive materials. The effect of composition and structure on the bioactivity is then discussed, and it will be shown that bioactivity is associated with the formation of an apatite layer on the surface of the implant. A survey of mechanical performance demonstrates that the structure and mechanical properties of glass-ceramics depend upon whether the processing involves casting or sintering and that the strength and toughness of glass-ceramics are superior to those of glasses. Attempts to further improve the mechanical performance by the use of non-monolithic components, i.e. bioactive coatings on metal substrates and glass and glass-ceramic matrix composites, are also reviewed and are shown to have varying degrees of success. Finally, some miscellaneous applications, namely bioactive bone cements and bone fillers, are briefly covered.
Goldstein, H. E.; Leiser, D. B.; Katvala, V. W. (Inventor)
The invention relates to reaction cured glass and glass coatings prepared by reacting a compound selected from the group consisting of silicon tetraboride, silicon hexaboride, other boron silicides, boron and mixtures with a reactive glass frit composed of a porous high silica borosilicate glass and boron oxide. The glassy composites of the present invention are useful as coatings on low density fibrous porous silica insulations used as heat shields and for articles such as reaction vessels that are subjected to high temperatures with rapid heating and cooling and that require resistance to temperature and repeated thermal shock at temperatures up to about 1482C (2700PF).
Molgaard, Joshua J; Auxier, John D; Giminaro, Andrew V; Oldham, Colton J; Gill, Jonathan; Hall, Howard L
Realistic surrogate nuclear debris is needed within the nuclear forensics community to test and validate post-detonation analysis techniques. Here we outline a novel process for producing bulk surface debris using a high temperature furnace. The material developed in this study is physically and chemically similar to trinitite (the melt glass produced by the first nuclear test). This synthetic nuclear melt glass is assumed to be similar to the vitrified material produced near the epicenter (ground zero) of any surface nuclear detonation in a desert environment. The process outlined here can be applied to produce other types of nuclear melt glass including that likely to be formed in an urban environment. This can be accomplished by simply modifying the precursor matrix to which this production process is applied. The melt glass produced in this study has been analyzed and compared to trinitite, revealing a comparable crystalline morphology, physical structure, void fraction, and chemical composition.
Hoseini, Atefeh; Abbaszadegan, Abbas
Maxillary lateral incisors are widely known to be single rooted with one root canal. Although rare cases with root canal variations are being reported in many populations, the reports regarding Iranian population is extremely limited. In this report, we are presenting the endodontic treatment of a double rooted maxillary lateral incisor. These rare root-canal variations should be considered in pretreatment evaluations by clinicians who perform endodontic treatments. PMID:25469361
Shin, Hyeongsoon; Ko, Hyunjung
Objectives Endodontically treated teeth with insufficient tooth structure are often restored with esthetic restorations. This study evaluated the cytotoxicity and biological effects of yttria partially stabilized zirconia (Y-TZP) blocks in combination with several dental cements. Materials and Methods Pairs of zirconia cylinders with medium alone or cemented with three types of dental cement including RelyX U200 (3M ESPE), FujiCEM 2 (GC), and Panavia F 2.0 (Kuraray) were incubated in medium for 14 days. The cytotoxicity of each supernatant was determined using 3-(4,5-dimethylthiazole-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assays on L929 fibroblasts and MC3T3-E1 osteoblasts. The levels of interleukin-6 (IL-6) mRNA were evaluated by reverse transcription polymerase chain reaction (RT-PCR), and IL-6 protein was evaluated by enzyme-linked immunosorbent assays (ELISA). The data were analyzed using one-way ANOVA and Tukey post-hoc tests. A p < 0.05 was considered statistically significant. Results The MTT assays showed that MC3T3-E1 osteoblasts were more susceptible to dental cements than L929 fibroblasts. The resin based dental cements increased IL-6 expression in L929 cells, but reduced IL-6 expression in MC3T3-E1 cells. Conclusions Zirconia alone or blocks cemented with dental cement showed acceptable biocompatibilities. The results showed resin-modified glass-ionomer based cement less produced inflammatory cytokines than other self-adhesive resin-based cements. Furthermore, osteoblasts were more susceptible than fibroblasts to the biological effects of dental cement. PMID:27508157
Karthikeyan, Shanmugaavel; Subramanian, EMG; Gurunathan, Deepa
Abstract Introduction Aesthetic restoration of severely mutilated primary anterior teeth still remains as a special challenge to paediatric dentist. Due to increased parent’s concern for aesthetic rehabilitation for their children, paediatric dentist are in a state to improve technique sensitive restorative procedure to improve aesthetic rehabilitation in children. Aim The purpose of the study was to evaluate the effect of different root surface treatment on the shear bond strength of glass fibre reinforced post in primary anterior teeth using Universal Testing Machine (UTM). Materials and Methods Twenty single rooted primary anterior teeth were selected. Coronal portions of the teeth were sectioned transversally 2 mm above the Cemento-Enamel Junction (CEJ) and specimens were treated endodontically and obturated using metapex. Then the specimens were randomly divided into four groups. Group 1: Control group; Group 2: Chemical surface treatment of the root with 2% chlorhexidine; Group 3: Mechanical surface treatment with mushroom-shaped undercut; Group 4: Combination of mechanical and chemical surface treatments. Samples were tested for shear bond strength. ANOVA and Post-hoc Tukey test were used for statistical analysis using SPSS version 20.0. Results Combination of mechanical and chemical surface treatments exhibited higher mean shear bond strength (8.41 MPa), followed by mechanical surface treatment (4.68 MPa), chemical surface treatment (3.92 MPa) and control group (2.76 MPa). Conclusion Mechanical and chemical surface treatments together led to a improved shear bond strength and increased the retention of the post to the root surface. PMID:28274043
Patel, Parimal J.; Messier, Donald R.; Rich, R. E.
Research at the Army Materials Technology Laboratory (AMTL) and elsewhere has shown that many glass properties including elastic modulus, hardness, and corrosion resistance are improved markedly by the substitution of nitrogen for oxygen in the glass structure. Oxynitride glasses, therefore, offer exciting opportunities for making high modulus, high strength fibers. Processes for making oxynitride glasses and fibers of glass compositions similar to commercial oxide glasses, but with considerable enhanced properties, are discussed. We have made glasses with elastic moduli as high as 140 GPa and fibers with moduli of 120 GPa and tensile strengths up to 2900 MPa. AMTL holds a U.S. patent on oxynitride glass fibers, and this presentation discusses a unique process for drawing small diameter oxynitride glass fibers at high drawing rates. Fibers are drawn through a nozzle from molten glass in a molybdenum crucible at 1550 C. The crucible is situated in a furnace chamber in flowing nitrogen, and the fiber is wound in air outside of the chamber, making the process straightforward and commercially feasible. Strengths were considerably improved by improving glass quality to minimize internal defects. Though the fiber strengths were comparable with oxide fibers, work is currently in progress to further improve the elastic modulus and strength of fibers. The high elastic modulus of oxynitride glasses indicate their potential for making fibers with tensile strengths surpassing any oxide glass fibers, and we hope to realize that potential in the near future.
Zeigler, Ryan A.; Korotev, Randy L.; Jolliff, Bradley L.; Haskin, Larry A.; Floss, Christine
, alkali-rich, and moderately titaniferous; they are unlike any previously recognized lunar lithology or glass group. Their likely provenance is within the Procellarum KREEP Terrane, but they are not found within the Apollo 16 ancient regolith breccias and therefore were likely deposited at the Apollo 16 site post-Imbrium. The basaltic-andesite glasses are the most ferroan variety of KREEP yet discovered.
Klein, J. A.; Murray, C. D.; Stein, J. A.
Tool accurately splits glass tubing so cuts are aligned 180 deg apart and reassembled tube forms low pressure, gastight enclosure. Device should interest industries using cylindrical closed glass containers.