[Use of Cone Beam Computed Tomography in endodontics: rational case selection criteria].

PubMed

Rosen, E; Tsesis, I

2016-01-01

To present rational case selection criteria for the use of CBCT (Cone Beam Computed Tomography) in endodontics. This article reviews the literature concerning the benefits of CBCT in endodontics, alongside its radiation risks, and present case selection criteria for referral of endodontic patients to CBCT. Up to date, the expected ultimate benefit of CBCT to the endodontic patient is yet uncertain, and the current literature is mainly restricted to its technical efficacy. In addition, the potential radiation risks of CBCT scan are stochastic in nature and uncertain, and are worrying especially in pediatric patients. Both the efficacy of CBCT in supporting the endodontic practitioner decision making and in affecting treatment outcomes, and its long term potential radiation risks are yet uncertain. Therefore, a cautious rational decision making is essential when a CBCT scan is considered in endodontics. Risk-benefit considerations are presented.

Non-surgical management of paraesthesia and pain associated with endodontic sealer extrusion into the mandibular canal.

PubMed

Froes, Fabiana Gama Benevides; Miranda, Aguida Maria Menezes Aguiar; Abad, Ernani da Costa; Riche, Fernanda Nehme; Pires, Fábio Ramôa

2009-12-01

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.

A review of the regenerative endodontic treatment procedure

PubMed Central

Lee, Bin-Na; Moon, Jong-Wook; Chang, Hoon-Sang; Hwang, In-Nam; Oh, Won-Mann

2015-01-01

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

[Colonization of Porphyromonas endodontalis in primary and secondary endodontic infections].

PubMed

Hong, Li; Hai, Ji; Yan-Yan, He; Shenghui, Yang; Benxiang, Hou

2015-02-01

This study aims to assess and compare the prevalence of Porphyromonas endodontalis (P. endodontalis) in root canals associated with primary and secondary endodontic infections by using 16s rDNA PCR and real-time fluorescence quantitative polymerase chain reaction (RTFQ-PCR). A total of 120 adult patients with one radiographically documented periapical lesion were included. Sixty teeth presented with primary endodontic infections and 60 with secondary endodontic infections requiring retreatment. P. endodontalis was identified by using 16s rDNA PCR techniques. The positive DNA expression of P. endodontalis in two types of infected root canals were quantitatively compared by using SYBR GREEN I RTFQ-PCR. The prevalence of P. endodontalis in the root canals with primary endodontic infections was significantly higher than that in root canals with secondary endodontic infections (P = 0.001). However, RTFQ-PCR results showed no significant difference in DNA expression quantities between the primary and secondary endodontic infections root canals (P = 0.303). P. endodontalis is more highly associated with root canals having primary endodontic infections, although P. endodontalis colonize in both root canals with primary and secondary chronic apical periodontitis.

A survey of attitude and opinions of endodontic residents towards regenerative endodontics

PubMed Central

Utneja, Shivani; Nawal, Ruchika Roongta; Ansari, Mohammed Irfan; Talwar, Sangeeta; Verma, Mahesh

2013-01-01

Aim: The objective of this survey was to study the level of awareness, current state of knowledge and opinions towards regenerative endodontic treatments amongst the endodontic residents of India. Settings and Design: Questionnaire based survey was designed. Materials and Methods: After approval from the organizing committee of 26th Federation of Operative Dentistry of India and 19th Indian Endodontic Society National conference 2011, 200 copies of the questionnaire were circulated amongst the endodontic residents in conservative dentistry and endodontics at various colleges across the country about regenerative endodontic procedures. The survey included profile of the respondents and consisted of 23 questions about their knowledge, attitude and opinions regarding use of these procedures as part of future dental treatment. Results: The survey showed that half the participants (50.6%) had received continued education in stem cells and/or regenerative dental treatments. The majority of participants were of the opinion (86.6%) that regenerative therapy should be incorporated into dentistry, and most of them (88%) were willing to acquire training in learning this new treatment strategy. The results indicated that half of the participants (52.6%) were already using some type of regenerative therapy in their clinical practice; however, with a majority of these limited to use of membranes, scaffolds or bioactive materials. Conclusions: These results reflect that endodontic residents are optimistic about the use of regenerative endodontic procedures; however, a need for more research and training was felt. PMID:23956532

The trend of quality of publications in endodontic surgery: a 10-year systematic survey of the literature.

PubMed

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

2015-03-01

The aims of the present systematic literature analysis were to evaluate, over a 10-year period, the trend of the proportion of RCT, SR, MA published on endodontic surgery, and to investigate if the impact factor (IF) of the main endodontic Journals correlates with the proportion of RCT, SR, MA they publish. An electronic search of the RCT, SR and MA published on the topic "endodontic surgery" from 2001 to 2010 was performed on Medline and Cochrane CENTRAL database using specific search terms combined with Boolean operators. Endodontic Journals impact factor was retrieved by the Thomson Scientific database. The proportion of each study type over the total number of articles on endodontic surgery published per year was estimated. The correlation between the number of high-evidence level studies published on the main endodontic Journals and the IF of such Journals per year was estimated. From a total of 900 articles published in 2001-2010 on endodontic surgery, there were 114 studies of high evidence level. A significant increase of the proportion of either RCT, SR and MA over the years was found. A modest to unclear correlation was found between the Journal IF and the number of high-evidence articles published. There is a positive trend over the years among researchers in performing studies of good quality in endodontic surgery. The impact factor of endodontic Journals is not consistently influenced by publication of high-evidence level articles. Copyright © 2015 Elsevier Inc. All rights reserved.

Regenerative endodontics: a comprehensive review.

PubMed

Kim, S G; Malek, M; Sigurdsson, A; Lin, L M; Kahler, B

2018-05-19

The European Society of Endodontology and the American Association for Endodontists have released position statements and clinical considerations for regenerative endodontics. There is increasing literature on this field since the initial reports of Iwaya et al. (Dental Traumatology, 17, 2001, 185) and Banchs & Trope (Journal of Endodontics, 30, 2004, 196). Endogenous stem cells from an induced periapical bleeding and scaffolds using blood clot, platelet rich plasma or platelet-rich fibrin have been utilized in regenerative endodontics. This approach has been described as a 'paradigm shift' and considered the first treatment option for immature teeth with pulp necrosis. There are three treatment outcomes of regenerative endodontics; (i) resolution of clinical signs and symptoms; (ii) further root maturation; and (iii) return of neurogenesis. It is known that results are variable for these objectives, and true regeneration of the pulp/dentine complex is not achieved. Repair derived primarily from the periodontal and osseous tissues has been shown histologically. It is hoped that with the concept of tissue engineering, namely stem cells, scaffolds and signalling molecules, that true pulp regeneration is an achievable goal. This review discusses current knowledge as well as future directions for regenerative endodontics. Patient-centred outcomes such as tooth discolouration and possibly more appointments with the potential for adverse effects needs to be discussed with patients and parents. Based on the classification of Cvek (Endodontics and Dental Traumatology, 8, 1992, 45), it is proposed that regenerative endodontics should be considered for teeth with incomplete root formation although teeth with near or complete root formation may be more suited for conventional endodontic therapy or MTA barrier techniques. However, much is still not known about clinical and biological aspects of regenerative endodontics. © 2018 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Three-dimensional imaging modalities in endodontics

PubMed Central

Mao, Teresa

2014-01-01

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

Endodontic decisions based on clinical appearance.

PubMed

Lobprise, H B; Bloom, B C

2001-08-01

Too often, endodontically compromised teeth are ignored because they are not accurately identified, nor their significance realized. By systematically evaluating each potentially affected tooth, a practitioner can correctly diagnose endodontic cases and plan therapy accordingly. Endodontic pathology, with non-vital pulps and subsequent abscessation, can affect not only the tooth but also the rest of the patient. Physical examination, both external and oral, can be combined with tactile and transillumination assessment. Radiographic appraisal is essential in determining periapical health, both to determine the vitality of the tooth and to ascertain if endodontic therapy is appropriate, of if extraction is the best choice. This report aims to provide the reader with a clearer understanding of diagnosing endodontic cases to facilitate selection of the appropriate treatment.

Worldwide pattern of antibiotic prescription in endodontic infections.

PubMed

Segura-Egea, Juan José; Martín-González, Jenifer; Jiménez-Sánchez, María Del Carmen; Crespo-Gallardo, Isabel; Saúco-Márquez, Juan José; Velasco-Ortega, Eugenio

2017-08-01

Odontogenic infections, and especially endodontic infections, are polymicrobial, involving a combination of Gram-positive and Gram-negative facultative anaerobes and strictly anaerobic bacteria. Therefore, antibiotics can be used as an adjunct to endodontic treatment. However, most chronic and even acute endodontic infections can be successfully managed by disinfection of the root-canal system, which eliminates the source of infection, followed by abscess drainage or tooth extraction, without the need for antibiotics. The literature provides evidence of inadequate prescribing practices by dentists. The aim of this concise review was to analyse the worldwide pattern of antibiotic prescription in endodontic infections. Comprehensive searches were conducted in MEDLINE/PubMed, Wiley Online Database, Web of Science and Scopus. The databases were searched up to 13 March 2016 for studies in which dentists used systemic antibiotics to treat endodontic lesions and which reported data on the type of antibiotic prescribed and on the diagnosis of the endodontic disease treated. The electronic and hand searches identified 69 titles, of which 25 were included in the final analysis. Amoxicillin was reported as the drug of choice for endodontic infections in most countries, and clindamycin and erythromycin were the choice for patients allergic to penicillin. Dentists worldwide prescribe antibiotics for non-indicated conditions, such as pulpitis. Antibiotics are overprescribed for the management of endodontic infections. It is necessary to improve antibiotic-prescribing habits in the treatment of endodontic infections, as well as to introduce educational initiatives to encourage the coherent and proper use of antibiotics in such conditions. © 2017 FDI World Dental Federation.

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

PubMed

Zabalegui, B; Gil, J; Zabalegui, I

1989-01-01

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

Effect of prophylactic amoxicillin on endodontic flare-up in asymptomatic, necrotic teeth.

PubMed

Pickenpaugh, L; Reader, A; Beck, M; Meyers, W J; Peterson, L J

2001-01-01

The purpose of this prospective, randomized, double-blind, placebo-controlled study was to determine the effect of prophylactic amoxicillin on the occurrence of endodontic flare-up in asymptomatic, necrotic teeth. Seventy patients participated and had a clinical diagnosis of an asymptomatic, necrotic tooth with associated periapical radiolucency. One hour before endodontic treatment, patients randomly received either 3 g of amoxicillin or 3 g of a placebo control in a double-blind manner. After endodontic treatment, each patient received: ibuprofen; acetaminophen with codeine (30 mg); and a 5 1/2-day diary to record pain, swelling, percussion pain, and number and type of pain medication taken. The results demonstrated 10% of the 70 patients had a flare-up characterized by moderate-to-severe postoperative pain or swelling that began approximately 30 h after endodontic treatment and persisted for an average of 74 h. Of the seven patients who had flare-ups, 4 were in the amoxicillin group and 3 were not. Prophylactic amoxicillin did not significantly (p = 0.80) influence the endodontic flare-up. We concluded that a prophylactic dose of amoxicillin before endodontic treatment of asymptomatic, necrotic teeth had no effect on the endodontic flare-up.

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

PubMed Central

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

2014-01-01

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

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

PubMed

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

2014-11-01

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

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

PubMed Central

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

2013-01-01

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

Why intravenous moderate sedation should be taught in graduate endodontic programs.

PubMed

Montagnese, Thomas Anthony

2012-03-01

The purpose of this opinion article is to present reasons why intravenous moderate sedation should be taught in graduate endodontic programs. Access to oral health care is an area of much interest and concern, but some patients are unable to get endodontic care because they have special needs. Special needs can refer to patients who fear dentistry itself and other aspects of dental treatment. A variety of phobias and medical, developmental, and physical conditions can make it difficult for some patients to tolerate the endodontic care they need and want. Moderate sedation can help many of these patients. Endodontists in general are not trained to provide intravenous moderate sedation. By incorporating intravenous moderate sedation into endodontic practice, many of these patients can be treated. The first step in achieving this goal is to add intravenous moderate sedation training to graduate endodontic programs. The long-term effect will be to make specialty endodontic care available to more people.

Endodontic therapy for a fused mandibular molar.

PubMed

Rotstein, I; Moshonov, J; Cohenca, N

1997-06-01

Variations in tooth morphology present a clinical challenge when endodontic treatment is required. A case of conservative endodontic therapy for a fused mandibular second and third molar is presented.

Pain and anxiety control: an online study guide.

PubMed

2008-05-01

The Editorial Board of the Journal of Endodontics has developed a literature-based study guide of topical areas related to endodontics. This study guide is intended to give the reader a focused review of the essential endodontic literature and does not cite all possible articles related to each topic. Although citing all articles would be comprehensive, it would defeat the idea of a study guide. This section will cover pain theories and dentin hypersensitivity, referred pain, oral pain not of dental origin, barodontalgia, local anesthetics, long-acting local anesthetics, intrapulpal anesthesia, intraligamentary anesthesia, intraosseous anesthesia, inferior alveolar nerve block anesthesia, Gow-Gates anesthesia technique, Vazirani-Akinosi anesthesia technique, second-division block anesthesia technique, endodontic postoperative pain, effect of occlusal adjustment on endodontic pain, paresthesia associated with periradicular pathosis, analgesics, sedation, and endodontic flare-ups.

[Effect of Radix scutellariae on the growth and form of Porphyromanus endodontics in vitro].

PubMed

Tan, Hong; Tang, Yaling; Zhou, Xuedong; Xiao, Xiaorong; Li, Jiyao

2003-07-01

To provide scientific evidence for underpinning the use of Radix Scutellariae in the treatment of pulp and periapical diseases. Using minute amount serial dilution test, this study assessed the minimal inhibitory concentration of Radix Scutellariae extreact against Porphyromanus Endodontics. The forms of Porphyromanus endodontics treated with Radix Scutellariae extract at different concentrations were observed by use of SEM. The MIC of Radix Scutellariae extract was determined to be 1 mg/ml. Radix Scutellariae changed the forms of Porphyromanus endodontics, making them become bigger, longer and crumbled. Radix Scutellariae could inhibit the growth of Porphyromanus Endodontics.

Endodontics and litigation: an American perspective.

PubMed

Cohen, S C

1989-03-01

Dentists can reduce the risk of legal entanglements following endodontic treatment. Dentists should not fail to meet the standard of care required at one or more of the several stages in endodontic treatment: at diagnosis, in record keeping, by accidentally treating the wrong tooth, by not using rubber dam, by breaking endodontic instruments in the root canal, by using inappropriate endodontic implants, by creating root perforations, by failing to give adequate instructions for home care and by not providing emergency care. Recognition of problems likely to rise to litigation and the methods to be used in their avoidance are emphasized.

Advances in endodontics: Potential applications in clinical practice

PubMed Central

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

2016-01-01

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

A Naval Postgraduate Dental School Analysis of Initial Endodontic Treatment

DTIC Science & Technology

2013-06-01

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

One-visit endodontics.

PubMed

Ashkenaz, P J

1984-10-01

I would like to conclude with some personal observations and comments on the use of single-visit endodontics in private practice based on my 12 years of experience utilizing this procedure. I cannot stress in strong enough terms that one-visit endodontics should not be undertaken by the novice. As an evolutionary philosophy of treatment, its use grows out of a full understanding of fundamental endodontic principles by the experienced practitioner. It is only after considering all of the indications and contraindications in each case on an individual basis, that a decision should be made as to whether or not it can be completed in a single visit. However, it is also important for the practitioner to have a clinical sense of what can be accomplished once the rubber dam has been placed and work commenced on the tooth. I submit to you that this very important clinical sense can be gained only after many years of clinical experience. Therefore, the endodontic competence of the practicing dentist becomes the overriding factor in determining the outcome of any one particular case. This is not to say that only a specialized few can and should perform this procedure. However, it does mean that a high degree of clinical skill is necessary to perform it in a successful manner. The performance of better endodontics in multiple visits will ensure success in single visits. Therefore, it is incumbent upon the individual practitioner to objectively evaluate his or her endodontic skills. The clinician should critically evaluate every aspect of his or her endodontic practice by determining the incidences of biomechanical errors such as ledging, perforations, overinstrumentation, broken instruments, interappointment flare-ups, and failures. For only after evaluating these areas will the clinician have an indication as to his or her level of endodontic skill and whether or not future study and practice need be done in one or more specific aspects of endodontic practice. Once a high level of competence is attained, one-visit endodontics can be successfully performed if well-skilled clinicians choose their cases carefully and adhere to basic endodontic principles.(ABSTRACT TRUNCATED AT 400 WORDS)

Assessment of the Incidence of Posttreatment Endodontic Flare-ups in Patients undergoing Single-sitting Root Canal Therapies: A Clinical Study.

PubMed

Priyank, Harsh; Devi, T M Chaitra; Goel, Pallavi; Sahu, Nivedita; Nihalani, Shweta; Shandilya, Ashutosh

2016-10-01

Endodontic therapy is one of the commonly used procedures for treating the teeth affected by various pathologies. One of the major problems for endodontists despite the advancements in the root canal procedures is the posttreatment endodontic flare-ups. Much debate exists regarding the completion of endodontic therapy in a single sitting or multiple sittings. Hence, we assessed the incidence of endodontic flare-ups in patients undergoing single-sitting root canal therapies. The present study included 200 patients who underwent single-sitting endodontic therapy. Clinical details and conditions of each and every tooth of every patient were recorded before and after the completion of endodontic therapy. Irrigation during the root canal procedures was done by 2.5% NaOCl solution in most of the cases while others were irrigated with various combinations of ethylenediaminetetraacetic acid (EDTA) and cycloheximide (CHX) solutions. Follow-up records and readings of the patents were noted and were subjected to statistical analysis. Four groups were formed which divided the patients equally on the basis of their age. Out of 50 patients in the age group of 21 to 30 years, only 4 showed posttreatment endodontic flare-ups, while no endodontic flare-up was recorded in patients with age group of 31 to 50 years. Only two male and four females showed flare-ups postoperatively. A nonsignificant correlation was obtained when flare-up cases were compared on the basis of type of irrigation solution used during canal preparation. Single-sitting endodontic therapy appears to be a successful procedure with good prognosis and minimal posttreatment flare-up results, even in patients with periapical pathologies. Single-sitting root canal procedures can be successfully carried in patients with vital or nonvital pulp tissues and also in patients with periapical lesions.

Implant failure and history of failed endodontic treatment: A retrospective case-control study.

PubMed

Chatzopoulos, Georgios S; Wolff, Larry F

2017-11-01

Residual bacterial biofilm and/or bacteria in planktonic form may be survived in the bone following an extraction of an infected tooth that was endodontically treated unsuccessfully Failed endodontic treatment may be associated with failure of implants to osseointegrate in the same sites. Therefore, the aim of this retrospective case-control study is to examine the risk of implant failure in previous failed endodontic sites. This retrospective case-control study is based on 94 dental records of implants placed at the University of Minnesota School of Dentistry. Dental records of patients who received an implant in sites with previously failed endodontic therapy in the dental school were identified from the electronic database, while control subjects were obtained from the same pool of patients with the requirement to have received an implant in a site that was not endodontically treated. The mean age of the population was 62.89±14.17 years with 57.4% of the sample being females and 42.6% of them being males. In regards to the socio-economic status and dental insurance, 84.0% of this population was classified as low socio-economic status and 68.1% had dental insurance. Tobacco use was self-reported by 9.6% and hypercholesterolemia was the most prevalent systemic medical condition. Dental implant failure was identified in two of the included records (2.1%), both of which were placed in sites with a history of failed endodontic treatment. Within the limitations of this retrospective case-control study, further investigation with a larger population group into implant failure of sites that previously had unsuccessful endodontic treatment would be warranted. Implant failure may be associated with a history of failed endodontic treatment. Key words: Implantology, endodontics, osseointegration, treatment outcome, case-control study.

A review of instrumentation kinematics of engine-driven nickel-titanium instruments.

PubMed

Çapar, I D; Arslan, H

2016-02-01

Over the years, NiTi alloys have become indispensable materials in endodontic treatment. With technological advancements in metallurgy, manufacturers have attempted to produce instruments with enhanced features. In parallel with these developments, endodontic motors have undergone improvements in terms of torque control and kinematics that are adjustable in different directions. This review presents an overview of the advancements in instrumentation kinematics and the effect of instrumentation kinematics on root canal shaping procedures and instrument performance. The literature search for this narrative review was conducted in Google Scholar, Scopus, PubMed and Web of Science using the keywords 'kinematics and endodontics' and 'reciprocation and endodontics'. In addition, historical literature was searched using the keyword 'nickel-titanium and endodontics'. Overall, 143 articles were included up to 2015. © 2015 International Endodontic Journal. Published by John Wiley & Sons Ltd.

The importance of cone-beam computed tomography in the management of endodontic problems: a review of the literature.

PubMed

Venskutonis, Tadas; Plotino, Gianluca; Juodzbalys, Gintaras; Mickevičienė, Lina

2014-12-01

To obtain essential information in clinical endodontics, cone-beam computed tomographic (CBCT) imaging can be used in all phases of treatment including diagnosis, treatment planning, during the treatment phase, and through post-treatment assessment and follow-up. The purpose of this article was to review the use of CBCT imaging in the diagnosis, treatment planning, and assessing the outcome of endodontic complications. Literature was selected through a search of PubMed electronic databases for the following keywords: tooth root injuries, tooth root radiography, tooth root perforation, tomography, cone-beam computed tomography, endodontic complications, tooth root internal/external resorption, root fractures, and broken instruments. The research was restricted to articles published in English. One hundred twelve articles met the inclusion criteria and were included in this review. Currently, intraoral radiography is the imaging technique of choice for the management of endodontic disease, but CBCT imaging appears to have a superior validity and reliability in the management of endodontic diagnosis and complications. Endodontic cases should be judged individually, and CBCT imaging should be considered in situations in which information from conventional imaging systems may not yield an adequate amount of information to allow the appropriate management of endodontic problems. CBCT imaging has the potential to become the first choice for endodontic treatment planning and outcome assessment, especially when new scanners with lower radiation doses will be available. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Is endodontic treatment performed under general anaesthesia technically acceptable?

PubMed

Alsaleh, Iyad; Cousson, Pierre-Yves; Nicolas, Emmanuel; Hennequin, Martine

2012-12-01

Undertaking endodontic treatment under general anaesthesia (GA) is often described as difficult and hazardous, but no study reports on safe and efficacious conditions for endodontic treatment under GA. This study aims to evaluate whether compromises made for the endodontic treatment of permanent teeth under GA are acceptable. It describes the quality of endodontic treatment undertaken in two series of consecutive patients treated either under GA or local anaesthesia (LA). Post-operative data sheets and periapical radiographs were collected for 255 permanent teeth treated under GA during a 4-year period (GA group, 125 patients with special needs) and for 246 permanent teeth treated under local anaesthesia over 7 months (LA group, 180 healthy patients). The radiographic criteria for quality of endodontic treatment (RCQET) were considered satisfactory when (1) the root filling was within 2 mm of the apex; (2) the filling displayed no voids or defects; and (3) all the visible canals had been obturated. The type of tooth, pulpal status and periapical status were considered independent variables for RCQET. The proportion of satisfactory RCQET reached 63% in both groups and differed by type of tooth, being significantly lower for molars than for other teeth. From a technical point of view, compromises made for the endodontic treatment of permanent teeth under GA are acceptable. Further studies should be conducted to evaluate the long-term success of endodontic treatment performed under GA. This study supports the feasibility of endodontic treatment for patients treated under GA.

An overview of the endodontic curriculum in Fiji from 2009 to 2013.

PubMed

Devi, Arpana A; Abbott, Paul V

2015-12-01

This paper seeks to provide the reader with an overview of the endodontic curriculum in Fiji from 2009 to 2013. It also intends to inform readers of the changes in endodontic teaching, the learning methods utilised, curriculum development, the transition from block teaching to partial block teaching combined with longitudinal teaching, and the future plans for the endodontic module. © 2015 Australian Society of Endodontology.

The Effect of 8.25% Sodium Hypochlorite on Dental Pulp Dissolution and Dentin Flexural Strength and Modulus

DTIC Science & Technology

2015-06-18

sodium hypochlorite (NaOCl) became a main irrigant in endodontics (6) and is currently the preferred endodontic ... sodium hypochlorite used during endodontic irrigation (8). Since there may be many different concentrations of sodium hypochlorite available, the dentist...A, Brandt M. Toxicity of concentrated sodium hypochlorite used as an endodontic irrigant. Int Endod J 2004;37:272–80. 18. Hulsmann M, Hahn

Effect of Alcohol on the Spreading Ability of Sodium Hypochlorite Endodontic Irrigant

DTIC Science & Technology

1982-09-01

Research Progress Sodium Hypochlorite Endodontic Irrigant Report (Interim) 6. PERFORMING ORG. REPORT NUMBER 7. AU THOR(s) 8. CONTRACT OR GRANT NUMBER(s...neceewary and Identify by block nam.ber) Alcohol Sodium hypochlorite Endodontics Root canal 20, ABSTRACT (Continue on reveree side If neceeseay and...depressant significantly increased the ability of the sodium hypochlorite endodontic irrigant to penetrate in vitro. A freshly mixed solution containing 30

Regenerative endodontics: barriers and strategies for clinical translation.

PubMed

Mao, Jeremy J; Kim, Sahng G; Zhou, Jian; Ye, Ling; Cho, Shoko; Suzuki, Takahiro; Fu, Susan Y; Yang, Rujing; Zhou, Xuedong

2012-07-01

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. Copyright © 2012 Elsevier Inc. All rights reserved.

Unusual anatomy of a maxillary first molar with two palatal roots: a case report.

PubMed

Tomazinho, Flávia S F; Baratto-Filho, Flares; Zaitter, Suellen; Leonardi, Denise P; Gonzaga, Carla C

2010-03-01

The success of endodontic therapy is based on good endodontic access, correct cleaning and shaping, and adequate root canal obturation. However, endodontic treatment is also dependent on a sound knowledge of the internal anatomy of human teeth, especially when anatomical variations are present. Certain anatomical changes may be present to varying degrees, and it is important to report these to improve the understanding and expertise of endodontic specialists. With this aim in mind, this study reports an example of a maxillary first molar showing unusual anatomy (four roots and six root canals) and describes the endodontic treatment that was employed.

Endodontic management of mandibular first molars with mid mesial canal: A case series.

PubMed

Nagmode, Pradnya Sunil; Patel, Ankit Vasant; Satpute, Archana Bhaskar; Gupta, Pooja L

2017-01-01

The purpose of this study is to demonstrate the importance of knowledge of the internal anatomy of root canals for the success of endodontic treatment. Lack of knowledge of anatomic variations and their characteristics in different teeth has been pointed out as one of the main cause of endodontic therapy failure. Dental operating microscope plays a key role in the identification of canal and success of endodontic treatment. This case series describes the endodontic treatment of mandibular first molars with extra root canals, evaluate the occurrence of this extra canal, and discuss the importance of their identification and treatment.

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

PubMed

Fahmy, Mina D; Luepke, Paul G; Ibrahim, Mohamed S; Guentsch, Arndt

2016-01-01

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

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

PubMed Central

2016-01-01

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

Failure of endodontic treatment: The usual suspects.

PubMed

Tabassum, Sadia; Khan, Farhan Raza

2016-01-01

Inappropriate mechanical debridement, persistence of bacteria in the canals and apex, poor obturation quality, over and under extension of the root canal filling, and coronal leakage are some of the commonly attributable causes of failure. Despite the high success rate of endodontic treatment, failures do occur in a large number of cases and most of the times can be attributed to the already stated causes. With an ever increasing number of endodontic treatments being done each day, it has become imperative to avoid or minimize the most fundamental of reasons leading to endodontic failure. This paper reviews the most common causes of endodontic failure along with radiographic examples.

Failure of endodontic treatment: The usual suspects

PubMed Central

Tabassum, Sadia; Khan, Farhan Raza

2016-01-01

Inappropriate mechanical debridement, persistence of bacteria in the canals and apex, poor obturation quality, over and under extension of the root canal filling, and coronal leakage are some of the commonly attributable causes of failure. Despite the high success rate of endodontic treatment, failures do occur in a large number of cases and most of the times can be attributed to the already stated causes. With an ever increasing number of endodontic treatments being done each day, it has become imperative to avoid or minimize the most fundamental of reasons leading to endodontic failure. This paper reviews the most common causes of endodontic failure along with radiographic examples. PMID:27011754

Endodontic treatment of a mandibular second premolar with three root canals.

PubMed

Aguiar, Carlos; Mendes, Daniela; Câmara, Andréa; Figueiredo, Jose

2010-03-01

The purpose of this case report is to describe a nonsurgical endodontic treatment of a mandibular left second premolar with two separate roots and three distinct root canals. In endodontics, the possible existence of extra canals must be considered before endodontic treatment is instituted. A wide morphological variation of the root canal system is known to exist. A 36-year-old male patient was referred for endodontic treatment on the left mandibular second premolar. Radiographic examination of the involved tooth revealed an unusual, complex root canal anatomy. There was an irregular root morphology consisting of two distinct roots and three canals. This case report describes the successful nonsurgical endodontic treatment of a mandibular left second premolar with two separate roots and three distinct root canals filled using size 35 Thermafil gutta-percha carriers and AH Plus sealer. On the one-year follow-up radiograph, the tooth was asymptomatic, confirming adequate healing with no complications. Even in a tooth with an extremely complex root canal morphology, conventional endodontic treatment without surgical intervention can result in adequate healing without any complications.

Endo-periodontal lesion--endodontic approach.

PubMed

Jivoinovici, R; Suciu, I; Dimitriu, B; Perlea, P; Bartok, R; Malita, M; Ionescu, C

2014-01-01

Endo-perio lesions might be interdependent because of the vascular and anatomic connections between the pulp and the periodontium. The aim of this study is to emphasise that primary endodontic lesion heals after a proper instrumentation, disinfection and sealing of the endodontic space. The primary endodontic lesion with a secondary periodontal involvement first requires an endodontic therapy and, in the second stage, a periodontal therapy. The prognosis is good, with an adequate root canal treatment; it depends on the severity of the periodontal disease, appropriate healing time and the response to the treatment. A correct diagnosis is sometimes difficult; an accurate identification of the etiologic factors is important for an adequate treatment. Primary perio-endo lesion may heal after a proper disinfection and sealing of the endodontic system, the one-year follow-up radiograph showing bonny repair. Invasive periodontal procedures should be avoided at that moment. The microorganisms and by-products from the infected root canal may cross accessory and furcal canals and determine sinus tract and loss of attachment. In both clinical cases presented in this article, successful healing was obtained after a proper disinfection and sealing of the endodontic system.

Prevalence of technical errors and periapical lesions in a sample of endodontically treated teeth: a CBCT analysis.

PubMed

Nascimento, Eduarda Helena Leandro; Gaêta-Araujo, Hugo; Andrade, Maria Fernanda Silva; Freitas, Deborah Queiroz

2018-01-21

The aims of this study are to identify the most frequent technical errors in endodontically treated teeth and to determine which root canals were most often associated with those errors, as well as to relate endodontic technical errors and the presence of coronal restorations with periapical status by means of cone-beam computed tomography images. Six hundred eighteen endodontically treated teeth (1146 root canals) were evaluated for the quality of their endodontic treatment and for the presence of coronal restorations and periapical lesions. Each root canal was classified according to dental groups, and the endodontic technical errors were recorded. Chi-square's test and descriptive analyses were performed. Six hundred eighty root canals (59.3%) had periapical lesions. Maxillary molars and anterior teeth showed higher prevalence of periapical lesions (p < 0.05). Endodontic treatment quality and coronal restoration were associated with periapical status (p < 0.05). Underfilling was the most frequent technical error in all root canals, except for the second mesiobuccal root canal of maxillary molars and the distobuccal root canal of mandibular molars, which were non-filled in 78.4 and 30% of the cases, respectively. There is a high prevalence of apical radiolucencies, which increased in the presence of poor coronal restorations, endodontic technical errors, and when both conditions were concomitant. Underfilling was the most frequent technical error, followed by non-homogeneous and non-filled canals. Evaluation of endodontic treatment quality that considers every single root canal aims on warning dental practitioners of the prevalence of technical errors that could be avoided with careful treatment planning and execution.

Dentists with enhanced skills (Special Interest) in Endodontics: gatekeepers views in London.

PubMed

Ghotane, Swapnil G; Al-Haboubi, Mustafa; Kendall, Nick; Robertson, Claire; Gallagher, Jennifer E

2015-09-21

Dentists with a special interest hold enhanced skills enabling them to treat cases of intermediate complexity. The aim of this study was to explore primary dental care practitioners' views of dentists with a special interest (DwSIs) in Endodontics in London, with reference to an educational and service initiative established by (the former) London Deanery in conjunction with the NHS. A cross-sectional postal survey of primary care dentists working across different models of care within London was conducted, with a target to achieve views of at least 5 % of London's dentists. The questionnaire instrument was informed by qualitative research and the dental literature and piloted prior to distribution; data were analysed using SPSS v19 and STATA v12.0. Six per cent of London's primary care dentists (n = 243) responded to the survey; 53 % were male. Just over one third (37 %; n = 90) were aware of the DwSI service being provided. Most practitioners reported that having access to a DwSI in Endodontics would support the care of their patients (89 %; n = 215), would carry out more endodontic treatment in the NHS primary dental care if adequately reimbursed (93 %; n = 220), and had more time (76 %; n = 180). Female respondents appeared to be less confident in doing endodontic treatment (p = 0.001). More recently qualified respondents reported greater need for training/support for performing more endodontic treatment in the NHS primary dental care (p = 0.001), were more dissatisfied with access to endodontic service in the NHS primary dental care (p = 0.007) and more interested to train as a DwSI in endodontics (p = 0.001) compared with respondents having a greater number of years of clinical experience since qualification. The findings lend support to the concept of developing dentists with enhanced skills as well as ensuring additional funding, time and support to facilitate more routine endodontics through the NHS primary care to meet patient needs. More recently qualified dentists working in London were more concerned regarding endodontic service access, expressed need for training/support for undertaking more endodontic treatment in the NHS primary dental care and a desire to train as a DwSI in endodontics.

Endodontic flare-ups: a prospective study.

PubMed

Alves, Vanessa de Oliveira

2010-11-01

The objective of this prospective clinical study was to evaluate the incidence of flare-ups (pain and/or swelling requiring endodontic interappointment and emergency treatment) and identify the risk factors associated with their occurrence in patients who received endodontic treatment from June 2006 to June 2007 at the endodontics clinic of the São Paulo Dental Association (APCD), Jardim Paulista branch, São Paulo, Brazil. The incidence of flare-ups was 1.71% out of 408 teeth that had received endodontic therapy. Statistical analysis using the chi-squared test (P < .05) indicated a direct correlation between the flare-up rate and the presence of a periradicular radiolucency. Copyright © 2010 Mosby, Inc. All rights reserved.

Bioactive Materials in Endodontics: An Evolving Component of Clinical Dentistry.

PubMed

Mohapatra, Satyajit; Patro, Swadheena; Mishra, Sumita

2016-06-01

Achieving biocompatibility in a material requires an interdisciplinary approach that involves a sound knowledge of materials science, bioengineering, and biotechnology. The host microbial-material response is also critical. Endodontic treatment is a delicate procedure that must be planned and executed properly. Despite major advances in endodontic therapy in recent decades, clinicians are confronted with a complex root canal anatomy and a wide selection of endodontic filling materials that, in turn, may not be well tolerated by the periapical tissues and may evoke an immune reaction. This article discusses published reports of various bioactive materials that are used in endodontic therapy, including calcium hydroxide, mineral trioxide aggregate, a bioactive dentin substrate, calcium phosphate ceramics, and calcium phosphate cements.

Polymerase chain reaction detection of Propionibacterium propionicus and Actinomyces radicidentis in primary and persistent endodontic infections.

PubMed

Siqueira, José F; Rôças, Isabela N

2003-08-01

Propionibacterium propionicus and the recently described species Actinomyces radicidentis have been isolated from infections of endodontic origin; nevertheless, the possibility exists that their actual prevalence may have been underestimated by culture. The purpose of our study was to assess the occurrence of these 2 species in different types of endodontic infections by using the sensitive 16S rDNA-based nested polymerase chain reaction approach. To detect these 2 species, nested polymerase chain reaction was performed directly in samples taken from primary endodontic infections associated with asymptomatic periradicular lesions, acute apical periodontitis, or acute periradicular abscesses and in samples from patients in whom endodontic therapy had failed. DNA was extracted from the samples and initially amplified by using universal 16S rDNA primers. In the second round of amplification, the first polymerase chain reaction products were used to detect a specific 16S rDNA fragment of either P propionicus or A radicidentis. P propionicus was detected in 6/21 (29%) root canal samples from teeth with chronic periradicular lesions, in 5/10 (50%) cases diagnosed as acute apical periodontitis, and in 7/19 (37%) pus samples aspirated from acute periradicular abscesses. Overall, this species was found in 18/50 (36%) samples taken from primary endodontic infections. Of the root canal samples obtained from root-filled teeth with chronic periradicular lesions, P propionicus was detected in 7/12 (58%) cases. A radicidentis was detected in 1/21 (5%) root canal samples from teeth with chronic periradicular lesions and in 1/10 (10%) cases of acute apical periodontitis. No pus sample yielded this species. In general, A radicidentis was detected in 2/50 (4%) samples taken from primary endodontic infections and in 1/12 (8%) root canal samples taken from patients in whom endodontic treatment had failed. P propionicus was found in a relatively large number of patients with primary and persistent endodontic infections. This strengthens the assumption that this bacterial species is an endodontic pathogen associated with different forms of periradicular diseases. In contrast, A radicidentis was only occasionally detected in the patients examined. The role played by this species in endodontic infections remains to be clarified.

Lasers in endodontics: an overview

NASA Astrophysics Data System (ADS)

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

2002-06-01

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

Introduction of implants into postdoctoral endodontic residency programs.

PubMed

Aminoshariae, Anita; Montagnese, Thomas A; Solanki, Poonam D; Mickel, Andre K

2011-09-01

The purpose of this study was to survey the directors of postdoctoral endodontic programs in the United States to ascertain their attitudes and approaches regarding incorporation of implants into the endodontic curriculum. We hypothesized that program directors would agree that implant training should be incorporated into the endodontic curriculum. We also hypothesized that they would all prefer apical surgeries and retreatment over implants when plausible. A twenty-item online survey was emailed to all fifty-two postdoctoral endodontic program directors in the United States. A 100 percent response was received. The results showed that 78.6 percent agreed that implant training should be incorporated, 85.7 percent preferred the didactic approach, and 42.9 percent preferred clinical implant training. One hundred percent preferred apical surgeries and retreatment over implants when plausible, and 53.8 percent did not prefer implants over endodontic treatment for teeth with a questionable prognosis. This survey indicates that implant training has been incorporated into postdoctoral endodontic programs and that the Commission on Dental Accreditation standards are being met. The trend may be to become more hands-on in the future if program directors believe there is a need to provide training in actual placement of implants.

Endo-periodontal lesion – endodontic approach

PubMed Central

Jivoinovici, R; Suciu, I; Dimitriu, B; Perlea, P; Bartok, R; Malita, M; Ionescu, C

2014-01-01

Endo-perio lesions might be interdependent because of the vascular and anatomic connections between the pulp and the periodontium. The aim of this study is to emphasise that primary endodontic lesion heals after a proper instrumentation, disinfection and sealing of the endodontic space. The primary endodontic lesion with a secondary periodontal involvement first requires an endodontic therapy and, in the second stage, a periodontal therapy. The prognosis is good, with an adequate root canal treatment; it depends on the severity of the periodontal disease, appropriate healing time and the response to the treatment. A correct diagnosis is sometimes difficult; an accurate identification of the etiologic factors is important for an adequate treatment. Primary perio-endo lesion may heal after a proper disinfection and sealing of the endodontic system, the one-year follow-up radiograph showing bonny repair. Invasive periodontal procedures should be avoided at that moment. The microorganisms and by-products from the infected root canal may cross accessory and furcal canals and determine sinus tract and loss of attachment. In both clinical cases presented in this article, successful healing was obtained after a proper disinfection and sealing of the endodontic system. PMID:25713618

Teacher Training in Graduate Endodontic Programs.

ERIC Educational Resources Information Center

Burrell, William; Lee, Mickey M.

1981-01-01

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

Cone beam computed tomography in Endodontics - a review.

PubMed

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

2015-01-01

Cone beam computed tomography (CBCT) produces undistorted three-dimensional information of the maxillofacial skeleton, including the teeth and their surrounding tissues with a lower effective radiation dose than computed tomography. The aim of this paper is to: (i) review the current literature on the applications and limitations of CBCT; (ii) make recommendations for the use of CBCT in Endodontics; (iii) highlight areas of further research of CBCT in Endodontics. © 2014 International Endodontic Journal. Published by John Wiley & Sons Ltd.

The Effect of Autoclaving on Torsional Moment of Two Nickel-Titanium Endodontic Files

DTIC Science & Technology

2012-01-01

titanium endodontic files 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6 . AUTHOR(S) J. B. King, H. W. Roberts, B. E...effect of a new finishing process on the torsional resistance of twisted nickel- titanium rotary instruments. Minerva Stomatologica 59, 401– 6 . GT Series X...rotary nickel- titanium endodontic files. Journal of Endodontics 23, 731– 4 . Spanali-Voreadi A, Kerezoudis N, Zinelis S (2006) Failure mechanism of

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

PubMed

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

2015-08-01

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

Comparison of the effect of endodontic-periodontal combined lesion on the outcome of endodontic microsurgery with that of isolated endodontic lesion: survival analysis using propensity score analysis.

PubMed

Song, Minju; Kang, Minji; Kang, Dae Ryong; Jung, Hoi In; Kim, Euiseong

2018-05-01

The purpose of this retrospective clinical study was to evaluate the effect of lesion types related to endodontic microsurgery on the clinical outcome. Patients who underwent endodontic microsurgery between March 2001 and March 2014 with a postoperative follow-up period of at least 1 year were included in the study. Survival analyses were conducted to compare the clinical outcomes between isolated endodontic lesion group (endo group) and endodontic-periodontal combined lesion group (endo-perio group) and to evaluate other clinical variables. To reduce the effect of selection bias in this study, the estimated propensity scores were used to match the cases of the endo group with those of the endo-perio group. Among the 414 eligible cases, the 83 cases in the endo-perio group were matched to 166 out of the 331 cases in the endo group based on propensity score matching (PSM). The cumulated success rates of the endo and endo-perio groups were 87.3 and 72.3%, respectively. The median success period of the endo-perio group was 12 years (95% CI: 5.507, 18.498). Lesion type was found to be significant according to both Log-rank test (P = 0.002) and Cox proportional hazard regression analysis (P = 0.001). Among the other clinical variables, sex (female or male), age, and tooth type (anterior, premolar, or molar) were determined to be significant in Cox regression analysis (P < 0.05). Endodontic-periodontal combined lesions had a negative effect on the clinical outcome based on an analysis that utilized PSM, a useful statistical matching method for observational studies. Lesion type is a significant predictor of the outcome of endodontic microsurgery.

Endodontic treatment of a maxillary second molar with developmental anomaly: a case report.

PubMed

Asgary, Saeed

2007-01-01

Fusion is a rare occurrence in molar teeth. The purpose of this rare case presentation is to describe the nonsurgical endodontic treatment of maxillary molar. A 28-year-old patient was referred for endodontic treatment of her chronic apical abscess of right maxillary second molar. In the clinical examination, a sinus tract adjacent to involved tooth and a small crown of supernumerary tooth fused to the buccal surface of the molar at gingival margin was observed. Endodontic treatment was decided for the involved molar for functional reason. Recall examination, a year after completion of endodontic and restorative treatments, showed the tooth was clinically asymptomatic and there was no radiographic lucency around the apical region.

Flare-up rate in molars with periapical radiolucency in one-visit vs two-visit endodontic treatment.

PubMed

Akbar, Iftikhar; Iqbal, Azhar; Al-Omiri, Mahmoud K

2013-05-01

The objective of this study was to compare postobturation flare-ups following single and two-visit endodontic treatment of molar teeth with periapical radiolucency. A total of 100 patients with asymptomatic molar teeth with periapical radiolucency were selected. They were randomly allocated into two groups. Fifty patients received complete endodontic treatment in one-visit. Fifty patients received treatment by debridement and instrumentation at the first visit followed by obturation at the second visit. 10% of patients had flare-ups in the single visit group and 8% of patients had flare-ups in the two-visit group. Number of visits did not affect the success of endodontic treatment (p>0.05). Age, gender and tooth type had no effects on the occurrence of flare-ups regardless the number of visits (p>0.05). One-visit endodontic treatment was as successful as two-visit endodontic treatment as evaluated by rate of flareups in asymptomatic molar teeth with periapical radiolucency.

Discoloration Potential of Endodontic Sealers: A Brief Review

PubMed Central

Tour Savadkouhi, Sohrab; Fazlyab, Mahta

2016-01-01

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

3D Computer aided treatment planning in endodontics.

PubMed

van der Meer, Wicher J; Vissink, Arjan; Ng, Yuan Ling; Gulabivala, Kishor

2016-02-01

Obliteration of the root canal system due to accelerated dentinogenesis and dystrophic calcification can challenge the achievement of root canal treatment goals. This paper describes the application of 3D digital mapping technology for predictable navigation of obliterated canal systems during root canal treatment to avoid iatrogenic damage of the root. Digital endodontic treatment planning for anterior teeth with severely obliterated root canal systems was accomplished with the aid of computer software, based on cone beam computer tomography (CBCT) scans and intra-oral scans of the dentition. On the basis of these scans, endodontic guides were created for the planned treatment through digital designing and rapid prototyping fabrication. The custom-made guides allowed for an uncomplicated and predictable canal location and management. The method of digital designing and rapid prototyping of endodontic guides allows for reliable and predictable location of root canals of teeth with calcifically metamorphosed root canal systems. The endodontic directional guide facilitates difficult endodontic treatments at little additional cost. Copyright © 2016. Published by Elsevier Ltd.

[Theory and practice of minimally invasive endodontics].

PubMed

Jiang, H W

2016-08-01

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

Diagnostic ability of computed tomography using DentaScan software in endodontics: case reports.

PubMed

Siotia, Jaya; Gupta, Sunil K; Acharya, Shashi R; Saraswathi, Vidya

2011-01-01

Radiographic examination is essential in diagnosis and treatment planning in endodontics. Conventional radiographs depict structures in two dimensions only. The ability to assess the area of interest in three dimensions is advantageous. Computed tomography is an imaging technique which produces three-dimensional images of an object by taking a series of two-dimensional sectional X-ray images. DentaScan is a computed tomography software program that allows the mandible and maxilla to be imaged in three planes: axial, panoramic, and cross-sectional. As computed tomography is used in endodontics, DentaScan can play a wider role in endodontic diagnosis. It provides valuable information in the assessment of the morphology of the root canal, diagnosis of root fractures, internal and external resorptions, pre-operative assessment of anatomic structures etc. The aim of this article is to explore the clinical usefulness of computed tomography and DentaScan in endodontic diagnosis, through a series of four cases of different endodontic problems.

Prevalence of apical periodontitis and quality of root canal fillings in population of Zagreb, Croatia: a cross-sectional study

PubMed Central

Matijević, Jurica; Čižmeković Dadić, Tina; Prpić Mehičić, Goranka; Anić, Ivica; Šlaj, Mladen; Jukić Krmek, Silvana

2011-01-01

Aim To determine the prevalence of apical periodontitis and assess the quality of endodontic fillings in the population of the city of Zagreb, Croatia. Methods A total of 1462 orthopantomograms from new patients at 6 different dental practices was analyzed during 2006 and 2007. The presence of periapical lesions was determined by using the periapical index score (PAI). The quality of endodontic fillings was assessed according to the filling length and homogeinicity. Data were analyzed using t test and ANOVA with Scheffe post-hoc test. Results There were 75.9% of participants with endodontically treated teeth and 8.5% of all teeth were endodontically treated. Only 34.2% of endodontically treated roots had adequate root canal filling length, while 36.2% of root canal fillings had homogenous appearance. From the total number of teeth with intracanal post, 17.5% had no visible root canal filling. Using PAI 3 as a threshold value for apical periodontitis, periapical lesions were detected in 8.5% of teeth. Adequate quality of root canal fillings was associated with a lower prevalence of periapical lesions. Conclusion We found a large proportion of endodontically treated teeth with apical periodontitis and a correlation between the quality of endodontic filling and the prevalence of periapical lesions. This all suggests that it is necessary to improve the quality of endodontic treatment in order to reduce the incidence and prevalence of apical periodontitis. PMID:22180266

Sterilization of rotary NiTi instruments within endodontic sponges.

PubMed

Chan, H W A; Tan, K H; Dashper, S G; Reynolds, E C; Parashos, P

2015-08-17

To determine whether the following can be sterilized by autoclaving - endodontic sponges, rotary nickel-titanium (NiTi) instruments within endodontic sponges, and rotary NiTi instruments with rubber stoppers. Sixty-four samples of eight different endodontic sponges (n = 512) were placed into brain heart infusion broth (BHI) for 72 h. An aliquot of this was then spread onto horse blood agar and cultured aerobically and anaerobically to test sterility at purchase. Bacterial suspensions of Enterococcus faecalis, Porphyromonas gingivalis and Geobacillus stearothermophilus in BHI were used to contaminate sterile sponges and rotary NiTi instruments (with and without rubber stoppers) inserted into sponges. The various samples were autoclaved and then cultured aerobically and anaerobically. Success of sterilization was measured qualitatively as no growth. The experiment was repeated with clinically used rotary NiTi instruments (n = 512). All experiments were conducted in quadruplicate. No sponges on purchase had microbial growth when anaerobically cultured but some did when aerobically cultured. All autoclaved sponges and instruments (within or without sponges, and with or without rubber stoppers) were associated with no microbial growth. All nonautoclaved positive control samples showed microbial growth. Autoclaving was effective in the sterilization of sponges and endodontic instruments. Endodontic sponges should be autoclaved before clinical use. For clinical efficiency and cost-effectiveness, rotary NiTi instruments can be sterilized in endodontic sponges without removal of rubber stoppers. © 2015 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Orthograde endodontic retreatment of teeth with individual cast posts: report of two cases.

PubMed

Ramić, Bojana; Stojanac, Igor; Premović, Milica; Drobac, Milan; Petrović, Ljubomir

2012-01-01

The failure of primary endodontic treatment is manifested by various clinical symptoms following endodontic therapy or, more frequently, by the development of chronic inflammatory process in the apex region without any subjective symptoms. In case of unfavorable outcome of the primary endodontic treatment, orthograde endodontic retreatment is the method of choice for a prolonged therapy. Two female patients, 47 and 44 years old, were presented at the Dental Clinic of Vojvodina for endodontic retreatment of teeth 22, 23 and 13, within the repeated prosthetic restoration. Intraradicular individual cast posts were removed using ultrasonic instruments. Remains of gutta-percha were removed by engine driven rotary re-treatment files, root canals were shaped and cleaned using the crown-down technique, and obturated with gutta-percha and epoxy-resin-based sealer using the lateral compaction technique. When there are metal posts or broken instruments in the root canal, the use of ultrasonic instruments is considered a safe method characterized by negligible tooth substance loss and minimal root damage causing fractures and perforations, and the entire procedure is effective and predictable. Non-surgical orthograde endodontic retreatment, when properly performed in accessible and penetrable root canals, achieves a high cure rate, good and lasting results and eliminates the need for radical procedures, such as apical surgery or tooth extraction. When nonsurgical endodontic retreatment is done, treated teeth must be restored by full coronal coverage as soon as possible, to prevent coronal leakage or fracture.

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

ERIC Educational Resources Information Center

Sandoval, Victor A.; And Others

1987-01-01

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

Curricular Guidelines for Endodontics.

ERIC Educational Resources Information Center

Journal of Dental Education, 1981

1981-01-01

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

21 CFR 872.3890 - Endodontic stabilizing splint.

Code of Federal Regulations, 2014 CFR

2014-04-01

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

21 CFR 872.3830 - Endodontic paper point.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Endodontic paper point. 872.3830 Section 872.3830 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3830 Endodontic paper point. (a) Identification...

21 CFR 872.3840 - Endodontic silver point.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Endodontic silver point. 872.3840 Section 872.3840 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3840 Endodontic silver point. (a) Identification...

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

ERIC Educational Resources Information Center

Mendel, Robert W.; Scheetz, James P.

1981-01-01

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

Imaging Techniques in Endodontics: An Overview

PubMed Central

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

2012-01-01

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

The 'E' factor -- evolving endodontics.

PubMed

Hunter, M J

2013-03-01

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.

The periodontal – endodontic continuum: A review

PubMed Central

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

2008-01-01

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

Restoration of Endodontically Treated Molars Using All Ceramic Endocrowns

PubMed Central

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

2013-01-01

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

Endodontic Management of a Mandibular First Molar with Radix Entomolaris and Conservative Post-endodontic Restoration with CAD/CAM Onlay: A Novel Clinical Technique

PubMed Central

De Ataide, Ida De Noronha; Fernandes, Marina; Lambor, Rajan; Alreja, Dalip

2016-01-01

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

Regenerative endodontics: A way forward.

PubMed

Diogenes, Anibal; Ruparel, Nikita B; Shiloah, Yoav; Hargreaves, Kenneth M

2016-05-01

Immature teeth are susceptible to infections due to trauma, anatomic anomalies, and caries. Traditional endodontic therapies for immature teeth, such as apexification procedures, promote resolution of the disease and prevent future infections. However, these procedures fail to promote continued root development, leaving teeth susceptible to fractures. Regenerative endodontic procedures (REPs) have evolved in the past decade, being incorporated into endodontic practice and becoming a viable treatment alternative for immature teeth. The authors have summarized the status of regenerative endodontics on the basis of the available published studies and provide insight into the different levels of clinical outcomes expected from these procedures. Substantial advances in regenerative endodontics are allowing a better understanding of a multitude of factors that govern stem cell-mediated regeneration and repair of the damaged pulp-dentin complex. REPs promote healing of apical periodontitis, continued radiographic root development, and, in certain cases, vitality responses. Despite the clinical success of these procedures, they appear to promote a guided endodontic repair process rather than a true regeneration of physiological-like tissue. Immature teeth with pulpal necrosis with otherwise poor prognosis can be treated with REPs. These procedures do not preclude the possibility of apexification procedures if attempts are unsuccessful. Therefore, REPs may be considered first treatment options for immature teeth with pulpal necrosis. Copyright © 2016 American Dental Association. Published by Elsevier Inc. All rights reserved.

Are clinical decisions in endodontics influenced by the patient's fee-paying status?

PubMed

Walker, I; Gilbert, D; Asimakopoulou, K

2015-12-01

We explored whether the fee status of a UK patient influences clinical decision-making in endodontics. In a randomised-controlled vignette study describing either an 'NHS-funded', 'Privately-funded' or undisclosed fee-status patient, we examined the importance vocational trainer dentists placed on a series of factors normally considered when deciding whether to offer patients endodontic treatment as opposed to extracting the tooth. N = 119 experienced (M years post qualification = 20.01) dentists participated. Having read a vignette describing a hypothetical patient who could potentially be treated either endodontically or through an extraction, dentists rated a series of factors they would normally consider (for example, poor oral hygiene, the rest of their mouth is unfilled and caries-free), before recommending either endodontic treatment or an extraction. The patient's funding status had no influence on these dentists' clinical decision-making when considering endodontic treatment as an option (p >0.05) with the exception of a single item relating to infrequent attendance where the NHS patient was more likely than the 'undisclosed-fee' patient, to be offered extractions (F (2, 116) 3.43, p <0.04). We have found no strong evidence to suggest that the fee-status of a patient influences clinical decision-making in endodontic treatment by experienced dentists.

The design of an fast Fourier filter for enhancing diagnostically relevant structures - endodontic files.

PubMed

Bruellmann, Dan; Sander, Steven; Schmidtmann, Irene

2016-05-01

The endodontic working length is commonly determined by electronic apex locators and intraoral periapical radiographs. No algorithms for the automatic detection of endodontic files in dental radiographs have been described in the recent literature. Teeth from the mandibles of pig cadavers were accessed, and digital radiographs of these specimens were obtained using an optical bench. The specimens were then recorded in identical positions and settings after the insertion of endodontic files of known sizes (ISO sizes 10-15). The frequency bands generated by the endodontic files were determined using fast Fourier transforms (FFTs) to convert the resulting images into frequency spectra. The detected frequencies were used to design a pre-segmentation filter, which was programmed using Delphi XE RAD Studio software (Embarcadero Technologies, San Francisco, USA) and tested on 20 radiographs. For performance evaluation purposes, the gauged lengths (measured with a caliper) of visible endodontic files were measured in the native and filtered images. The software was able to segment the endodontic files in both the samples and similar dental radiographs. We observed median length differences of 0.52 mm (SD: 2.76 mm) and 0.46 mm (SD: 2.33 mm) in the native and post-segmentation images, respectively. Pearson's correlation test revealed a significant correlation of 0.915 between the true length and the measured length in the native images; the corresponding correlation for the filtered images was 0.97 (p=0.0001). The algorithm can be used to automatically detect and measure the lengths of endodontic files in digital dental radiographs. Copyright © 2016 Elsevier Ltd. All rights reserved.

Low carb endodontics.

PubMed

Bahcall, James K

2005-01-01

The field of endodontics has seen great technological advances and changes in thought processes over the last decade. Unfortunately, with these advances and changes has come an overload of information (too many carbs!). This article will help to reduce your intake of carbohydrate information and provide you with what you need to know about conventional endodontic treatment.

Endodontic treatment of an unusual connation of permanent mandibular molars: a case report.

PubMed

Liu, Shengbo; Fan, Bing; Peng, Bin; Fan, Mingwen; Bian, Zhuan

2006-10-01

A 27-year-old patient with an anomalous mandibular molar was referred for endodontic therapy. Clinical and radiographic examination revealed the connation of a second mandibular molar with a third molar. Challenging endodontic therapy was performed in the unusual connated molars. A 2-year recall showed good treatment result.

One-appointment endodontic therapy: biological considerations.

PubMed

Lin, Louis M; Lin, Jarshen; Rosenberg, Paul A

2007-11-01

The authors conducted a literature review to present the best available biological evidence concerning one-appointment endodontic therapy for asymptomatic teeth with apical periodontitis. Because of recent advances in technology, such as rotary engines and nickel-titanium instruments, some practitioners are performing one-appointment endodontic therapy for asymptomatic teeth with apical periodontitis. The authors reviewed the literature, which revealed only a small number of randomized, controlled clinical trials that have been conducted on one-appointment versus multiple-appointment endodontic therapy. As the apical canal preparation is enlarged, a greater percentage of bacteria is eradicated from infected root canals. In addition, sufficiently large apical root canal enlargement facilitates the delivery of antimicrobial irrigant to the apical portion of the canal. However, an association between positive or negative preobturation root canal culture results and the outcome of endodontic treatment has not been well-established. The best available evidence, based on a systematic literature review, indicates that one-appointment endodontic therapy may be feasible in selected cases of apical periodontitis in asymptomatic teeth. However, additional randomized, controlled clinical trials are required.

Antimicrobial photodynamic therapy combined with conventional endodontic treatment to eliminate root canal biofilm infection.

PubMed

Garcez, Aguinaldo S; Ribeiro, Martha S; Tegos, George P; Núñez, Silvia C; Jorge, Antonio O C; Hamblin, Michael R

2007-01-01

To compare the effectiveness of antimicrobial photodynamic therapy (PDT), standard endodontic treatment and the combined treatment to eliminate bacterial biofilms present in infected root canals. Ten single-rooted freshly extracted human teeth were inoculated with stable bioluminescent Gram-negative bacteria, Proteus mirabilis and Pseudomonas aeruginosa to form 3-day biofilms in prepared root canals. Bioluminescence imaging was used to serially quantify bacterial burdens. PDT employed a conjugate between polyethylenimine and chlorin(e6) as the photosensitizer (PS) and 660-nm diode laser light delivered into the root canal via a 200-micro fiber, and this was compared and combined with standard endodontic treatment using mechanical debridement and antiseptic irrigation. Endodontic therapy alone reduced bacterial bioluminescence by 90% while PDT alone reduced bioluminescence by 95%. The combination reduced bioluminescence by >98%, and importantly the bacterial regrowth observed 24 hours after treatment was much less for the combination (P<0.0005) than for either single treatment. Bioluminescence imaging is an efficient way to monitor endodontic therapy. Antimicrobial PDT may have a role to play in optimized endodontic therapy. (c) 2006 Wiley-Liss, Inc.

Regenerative endodontics--Creating new horizons.

PubMed

Dhillon, Harnoor; Kaushik, Mamta; Sharma, Roshni

2016-05-01

Trauma to the dental pulp, physical or microbiologic, can lead to inflammation of the pulp followed by necrosis. The current treatment modality for such cases is non-surgical root canal treatment. The damaged tissue is extirpated and the root canal system prepared. It is then obturated with an inert material such a gutta percha. In spite of advances in techniques and materials, 10%-15% of the cases may end in failure of treatment. Regenerative endodontics combines principles of endodontics, cell biology, and tissue engineering to provide an ideal treatment for inflamed and necrotic pulp. It utilizes mesenchymal stem cells, growth factors, and organ tissue culture to provide treatment. Potential treatment modalities include induction of blood clot for pulp revascularization, scaffold aided regeneration, and pulp implantation. Although in its infancy, successful treatment of damaged pulp tissue has been performed using principles of regenerative endodontics. This field is dynamic and exciting with the ability to shape the future of endodontics. This article highlights the fundamental concepts, protocol for treatment, and possible avenues for research in regenerative endodontics. © 2015 Wiley Periodicals, Inc.

Association between Systemic Diseases and Endodontic Outcome: A Systematic Review.

PubMed

Aminoshariae, Anita; Kulild, James C; Mickel, Andre; Fouad, Ashraf F

2017-04-01

To date, the relationships between systemic diseases and endodontic treatment outcomes remain poorly studied. Thus, the purpose of this systematic review was to evaluate the relationship between host-modifying factors and their association with endodontic outcomes. Two reviewers independently conducted a comprehensive literature search. The MEDLINE, Embase, Cochrane, and PubMed databases were searched. In addition, the bibliographies and gray literature of all relevant articles and textbooks were manually searched. There was no disagreement between the 2 reviewers. Sixteen articles met the inclusion criteria with moderate to high risk of bias. There was no article with low risk of bias. Available scientific evidence remains inconclusive as to whether diabetes and/or cardiovascular disease(s) may be associated with endodontic outcomes. Human immunodeficiency virus and oral bisphosphonate did not appear to be associated with endodontic outcomes. Although additional well-designed longitudinal clinical studies are needed, the results of this systematic review suggest that some systemic diseases may be correlated with endodontic outcomes. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Bisphosphonates and their clinical implications in endodontic therapy.

PubMed

Moinzadeh, A-T; Shemesh, H; Neirynck, N A M; Aubert, C; Wesselink, P R

2013-05-01

This review gives an overview of the factors that may play a role in the development of osteonecrosis of the jaw in patients treated with bisphosphonates (BPs) and undergoing nonsurgical endodontic treatment as well as some recommendations for its prevention. BPs are a widely prescribed group of drugs for diverse bone diseases. The occasional but devastating adverse effect of these drugs has been described as bisphosphonate-related osteonecrosis of the jaw (BRONJ). As this condition is debilitating and difficult to treat, all efforts should be made to prevent its occurence in patients at risk. The main triggering event is considered to be dental extraction. Even though nonsurgical endodontic treatment appears to be a relatively safe procedure, care remains essential. After an overview of this class of drugs, the clinical presentation, epidemiology and pathogenesis of BRONJ, as well as the possible risk factors associated with its development after nonsurgical endodontic treatment will be described. Finally, several strategies will be proposed for the prevention of BRONJ during nonsurgical endodontic treatment. © 2012 International Endodontic Journal. Published by Blackwell Publishing Ltd.

Discuss the impact technological advances in equipment and materials have made on the delivery and outcome of endodontic treatment.

PubMed

Lababidi, Emad Aldin

2013-12-01

Recent advances in endodontic equipment and materials have considerably changed the manner in which endodontic treatment is delivered. Specific technological advances, including nickel-titanium instruments, ultrasonic instruments and the dental operating microscope have been associated with increased efficiency and efficacy of treatment and simplification of delivery. The effects of most of these changes have been tested via in vitro studies and case reports. Ongoing studies should constantly investigate what effects technological advances might have on the outcome of endodontic treatment. © 2013 Australian Society of Endodontology.

Clinical applications of cone beam computed tomography in endodontics: A comprehensive review.

PubMed

Cohenca, Nestor; Shemesh, Hagay

2015-09-01

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.

Methodological Quality Assessment of Meta-analyses in Endodontics.

PubMed

Kattan, Sereen; Lee, Su-Min; Kohli, Meetu R; Setzer, Frank C; Karabucak, Bekir

2018-01-01

The objectives of this review were to assess the methodological quality of published meta-analyses related to endodontics using the assessment of multiple systematic reviews (AMSTAR) tool and to provide a follow-up to previously published reviews. Three electronic databases were searched for eligible studies according to the inclusion and exclusion criteria: Embase via Ovid, The Cochrane Library, and Scopus. The electronic search was amended by a hand search of 6 dental journals (International Endodontic Journal; Journal of Endodontics; Australian Endodontic Journal; Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology; Endodontics and Dental Traumatology; and Journal of Dental Research). The searches were conducted to include articles published after July 2009, and the deadline for inclusion of the meta-analyses was November 30, 2016. The AMSTAR assessment tool was used to evaluate the methodological quality of all included studies. A total of 36 reports of meta-analyses were included. The overall quality of the meta-analyses reports was found to be medium, with an estimated mean overall AMSTAR score of 7.25 (95% confidence interval, 6.59-7.90). The most poorly assessed areas were providing an a priori design, the assessment of the status of publication, and publication bias. In recent publications in the field of endodontics, the overall quality of the reported meta-analyses is medium according to AMSTAR. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Risk factors for failure of glass fiber-reinforced composite post restorations: a prospective observational clinical study.

PubMed

Naumann, Michael; Blankenstein, Felix; Kiessling, Saskia; Dietrich, Thomas

2005-12-01

Glass fiber-reinforced endodontic posts are considered to have favorable mechanical properties for the reconstruction of endodontically treated teeth. The aim of the present investigation was to evaluate the survival of two tapered and one parallel-sided glass fiber-reinforced endodontic post systems in teeth with different stages of hard tissue loss and to identify risk factors for restoration failure. One-hundred and forty-nine glass fiber-reinforced endodontic posts in 122 patients were followed-up for 5-56 months [mean +/- standard deviation (SD): 39 +/- 11 months]. Glass fiber-reinforced endodontic posts were adhesively luted and the core was built with a composite resin. Cox proportional hazards models were used to evaluate the association of clinical variables and failure rate. Higher failure rates were found for restorations of anterior teeth compared with posterior teeth [Hazard-Ratios (HR): 3.1; 95% confidence interval (CI): 1.3-7.4], for restorations in teeth with no proximal contacts compared with at least one proximal contact (HR: 3.0; 95% CI: 1.0-9.0), and for teeth restored with single crowns compared with fixed bridges (HR: 4.3; 95% CI: 1.1-16.2). Tooth type, type of final restoration and the presence of adjacent teeth were found to be significant predictors of failure rates in endodontically treated teeth restored with glass fiber-reinforced endodontic posts.

The Effect of Smear Layer Removal on Endodontic Outcomes

DTIC Science & Technology

2016-06-01

THE EFFECT OF SMEAR LAYER REMOVAL ON ENDODONTIC OUTCOMES by Spencer Weiss Bjarnason, D.M.D. Lieutenant, Dental Corps United...States Navy A thesis submitted to the Faculty of the Endodontic Graduate Program Naval Postgraduate Dental School Uniformed...June 2016 3 Naval Postgraduate Dental School Uniformed Services University of the Health Sciences Bethesda, Maiyland CERTIFICATE OF

Subcutaneous emphysema during root canal therapy: endodontic accident by sodium hypoclorite.

PubMed

Tenore, Gianluca; Palaia, Gaspare; Ciolfi, Chiara; Mohsen, Mohamed; Battisti, Andrea; Romeo, Umberto

2017-01-01

Cervicofacial subcutaneous emphysema is defined as the abnormal introduction of air in the subcutaneous tissues of the head and neck. It is mainly caused by trauma, head and neck surgery, general anesthesia, and coughing or habitual performance of Valsalva manoeuvre. The occurrence of subcutaneous emphysema after dental treatment is rare, and diffusion of gas into the mediastinum is much rarer, especially when the procedure is a nonsurgical treatment. Presented here is a case of subcutaneous emphysema that occurred after sodium hypochlorite irrigation during endodontic treatment, and the description of its etiologies and prevention during nonsurgical endodontic treatment. Endodontic success can be essentially achieved via good debridement of a root canal, and an ideal endodontic irrigant is effective in removing the smear layer, opening the dentinal tubules, and producing a clean surface for closer obturation. A 60-years-old woman had an abnormal swelling and pain during an endodontic treatment accompanied by her dentist to the emergency room and was referred to our observation for complaining of severe pain, ecchymosis and severe swelling on the left side of her face. The aforementioned symptoms appeared after sodium hypochlorite irrigation and aggressive use of air spray for drying the root canal during the endodontic treatment of the upper left lateral incisor. An extrusion during an inappropriate endodontic treatment may occasionally be reported and can cause tissue damage. NaOCl is one of the best and most commonly used irrigating solutions because of its efficacy, but it can also negatively affect the periapical tissues. Determining the correct working length, even when performing an intraoperative periapical radiograph and confirming the root canal integrity, could help avoid these kinds of accidents.

Photodynamic therapy in endodontics: a literature review.

PubMed

Trindade, Alessandra Cesar; De Figueiredo, José Antônio Poli; Steier, Liviu; Weber, João Batista Blessmann

2015-03-01

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.

Antimicrobial Activity of Calcium Hydroxide in Endodontics: A Review

PubMed Central

Shalavi, S; Yazdizadeh, M

2012-01-01

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

A sequential approach in treatment of perio-endo lesion

PubMed Central

Narang, Sumit; Narang, Anu; Gupta, Ruby

2011-01-01

The success of a combined periodontal and endodontic lesion depends on the elimination of both of these disease processes. In the case of a combined endo-perio lesion, the endodontic therapy results in healing of the endodontic component of involvement while the prognosis of tooth would finally depend on the healing of the periodontal structures. This case report evaluates the efficacy of bioactive glass in the management of furcation defect associated with an endo-perio lesion in a right mandibular first molar. A 22-year-old male patient with an endo-perio lesion in the right mandibular first molar was initially treated with endodontic therapy. Following the endodontic treatment, the furcation defect was treated using bioactive glass in a putty form. At the end of 9 months, there was a gain in the clinical attachment level and reduction in probing depth. Radiographic evidence showed that there was a significant bony fill. PMID:21976845

A sequential approach in treatment of perio-endo lesion.

PubMed

Narang, Sumit; Narang, Anu; Gupta, Ruby

2011-04-01

The success of a combined periodontal and endodontic lesion depends on the elimination of both of these disease processes. In the case of a combined endo-perio lesion, the endodontic therapy results in healing of the endodontic component of involvement while the prognosis of tooth would finally depend on the healing of the periodontal structures. This case report evaluates the efficacy of bioactive glass in the management of furcation defect associated with an endo-perio lesion in a right mandibular first molar. A 22-year-old male patient with an endo-perio lesion in the right mandibular first molar was initially treated with endodontic therapy. Following the endodontic treatment, the furcation defect was treated using bioactive glass in a putty form. At the end of 9 months, there was a gain in the clinical attachment level and reduction in probing depth. Radiographic evidence showed that there was a significant bony fill.

Meant to make a difference, the clinical experience of minimally invasive endodontics with the self-adjusting file system in India.

PubMed

Pawar, Ajinkya M; Pawar, Mansing G; Kokate, Sharad R

2014-01-01

The vital steps in any endodontic treatment are thorough mechanical shaping and chemical cleaning followed by obtaining a fluid tight impervious seal by an inert obturating material. For the past two decades, introduction and use of rotary nickel-titanium (Ni-Ti) files have changed our concepts of endodontic treatment from conventional to contemporary. They have reported good success rates, but still have many drawbacks. The Self-Adjusting File (SAF) introduces a new era in endodontics by performing the vital steps of shaping and cleaning simultaneously. The SAF is a hollow file in design that adapts itself three-dimensionally to the root canal and is a single file system, made up of Ni-Ti lattice. The case series presented in the paper report the clinical experience, while treating primary endodontic cases with the SAF system in India.

Inferior alveolar nerve paresthesia after overfilling of endodontic sealer into the mandibular canal.

PubMed

González-Martín, Maribel; Torres-Lagares, Daniel; Gutiérrez-Pérez, José Luis; Segura-Egea, Juan José

2010-08-01

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. Copyright 2010 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Lesions of endodontic origin and risk of coronary heart disease.

PubMed

Caplan, D J; Chasen, J B; Krall, E A; Cai, J; Kang, S; Garcia, R I; Offenbacher, S; Beck, J D

2006-11-01

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.

The effect of the duration of intravenous zolendronate medication on the success of non-surgical endodontic therapy: a retrospective study.

PubMed

Dereci, Ömür; Orhan, Ekim Onur; Irmak, Özgür; Ay, Sinan

2016-02-01

Aim of this study is to compare the clinical and radiographic success of non-surgical endodontic therapy in patients receiving intravenous zolendronate less than 1 year and more than 1 year. The clinical and radiographic follow-up data of 24 patients who were receiving IV zolendronate with 37 teeth were retrieved from the archives to evaluate clinical and radiographic healing at the end of 12 months after non-surgical endodontic therapy. The clinical and radiographic scores of teeth treated with non-surgical endodontic therapy were analyzed. The amount of non-healed and incomplete healed teeth in patients receiving zolendronate more than 1 year were more than the amount of teeth of non-healed and incomplete healed in patients receiving bisphosphonates less than 1 year (p <0.05). There was a strong relationship between the duration of the bisphosphonate medication and endodontic success.

Pulse oximetry: a potential aid in endodontic diagnosis?

PubMed

Caplan, Dan

2010-06-01

Pulse oximetry: review of a potential aid in endodontic diagnosis. Jafarzadeh H, Rosenberg PA. J Endod 2009;35(3):329-33. Dan Caplan, DDS, PhD. This article provided a description of pulse oximetry, its use in patient care settings, and its potential for use in endodontic diagnosis. Information not available. Comprehensive literature review. Level 3: Other evidence. Not applicable.

[Formulation of guidelines for microscopic endodontics suitable for the situation of China].

PubMed

Ling, J Q

2016-08-01

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.

Vertical Root Fracture Detection Using Limited-FOV Cone-Beam Computed Tomography

DTIC Science & Technology

2012-06-01

A thesis submitted to the Faculty of the Endodontics Graduate Program Naval Postgraduate Dental School Uniformed Services...Dental Program Navy Medicine Professional Development Center Terry D. Webb, DDS, MS CAPT, DC, USN Chairman, Endodontics Dept. Glen M. Imamura, S...Computed Tomography Geoffrey McMurray, DDS, MS ABSTRACT Introduction: Vertical root fractures (VRF) often occur in endodontically treated teeth

Interaction between endodontics and periodontics.

PubMed

Rotstein, Ilan

2017-06-01

Endodontic-periodontal lesions present challenges to the clinician regarding diagnosis, treatment planning and prognosis. Etiologic factors, such as bacteria and viruses, as well as contributing factors, such as trauma, root resorptions, perforations, cracks and dental malformations, play an important role in the development and progression of such lesions. Treatment and prognosis of endodontic-periodontal lesions vary, depending on the etiology, pathogenesis and correct diagnosis of each specific condition. This chapter will appraise the interrelationship between endodontic and periodontal lesions and provide biological and clinical evidence for diagnosis, prognosis and decision-making in the treatment of these conditions. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Spontaneous resolution of a periapical lesion during orthodontic treatment: a case report.

PubMed

Bainbridge, Mark; Cousley, Richard R J

2013-03-01

Teeth with periapical lesions can undergo successful orthodontic treatment, but conventional protocols indicate that such teeth should be endodontically stabilized prior to such treatment. A case report is presented where such endodontic stabilization was not possible, yet a chronic periapical lesion resolved as orthodontic treatment progressed. This paper will discuss the possible causes of the initial lesion, and reasons why it resolved without endodontic treatment. This report illustrates the possible combined roles of trauma, occlusion and periodontal disease in the development of a perio-endo lesion, and how orthodontic treatment potentially relieved some of the exacerbating factors, thus enabling resolution of the infection without endodontic treatment.

Root canal debridement: an online study guide.

PubMed

2008-05-01

The Editorial Board of the Journal of Endodontics has developed a literature-based study guide of topical areas related to endodontics. This study guide is intended to give the reader a focused review of the essential endodontic literature and does not cite all possible articles related to each topic. Although citing all articles would be comprehensive, it would defeat the idea of a study guide. This section will present root canal debridement including subdivisions on canal access, canal debridement, orifice enlargement and preflaring, crown-down technique, balanced force, nickel titanium and other shape memory alloys, rotary engine-driven techniques, endodontic instruments, irrigation, electronic apex locators, sonics/ultrasonics, smear layer, and intracanal medicaments.

Endodontic treatment of a mandibular first molar with three mesial canals and broken instrument removal.

PubMed

Faramarzi, Farhad; Fakhri, Hamidreza; Fakri, Hamidreza; Javaheri, Homan H

2010-04-01

To succeed in any dental procedure, the clinician's awareness of the patient's dental anatomy and its variations is crucial. In endodontic therapy, obtaining full information about the root canals' variations can affect the outcome substantially. This case report presents the endodontic treatment of a mandibular first molar exhibiting three mesial root canals with 4 mm of a separated K-file in the coronal third of the mesiolingual canal on an 18-year-old female patient. This case demonstrates the importance of locating additional canals in any roots undergoing endodontic treatment and how the clinician's awareness of aberrant internal anatomy may change the treatment results.

Antimicrobial Photodynamic Therapy Combined With Conventional Endodontic Treatment to Eliminate Root Canal Biofilm Infection

PubMed Central

Garcez, Aguinaldo S.; Ribeiro, Martha S.; Tegos, George P.; Núñez, Silvia C.; Jorge, Antonio O.C.; Hamblin, Michael R.

2011-01-01

Background and Objective To compare the effectiveness of antimicrobial photodynamic therapy (PDT), standard endodontic treatment and the combined treatment to eliminate bacterial biofilms present in infected root canals. Study Design/Materials and Methods Ten single-rooted freshly extracted human teeth were inoculated with stable bioluminescent Gram-negative bacteria, Proteus mirabilis and Pseudomonas aeruginosa to form 3-day biofilms in prepared root canals. Bioluminescence imaging was used to serially quantify bacterial burdens. PDT employed a conjugate between polyethylenimine and chlorin(e6) as the photosensitizer (PS) and 660-nm diode laser light delivered into the root canal via a 200-µ fiber, and this was compared and combined with standard endodontic treatment using mechanical debridement and antiseptic irrigation. Results Endodontic therapy alone reduced bacterial bioluminescence by 90% while PDT alone reduced bioluminescence by 95%. The combination reduced bioluminescence by >98%, and importantly the bacterial regrowth observed 24 hours after treatment was much less for the combination (P<0.0005) than for either single treatment. Conclusions Bioluminescence imaging is an efficient way to monitor endodontic therapy. Antimicrobial PDT may have a role to play in optimized endodontic therapy. PMID:17066481

Nuclear Magnetic Resonance Imaging in Endodontics: A Review.

PubMed

Di Nardo, Dario; Gambarini, Gianluca; Capuani, Silvia; Testarelli, Luca

2018-04-01

This review analyzes the increasing role of magnetic resonance imaging (MRI) in dentistry and its relevance in endodontics. Limits and new strategies to develop MRI protocols for endodontic purposes are reported and discussed. Eligible studies were identified by searching the PubMed databases. Only original articles on dental structures, anatomy, and endodontics investigated by in vitro and in vivo MRI were included in this review. Original articles on MRI in dentistry not concerning anatomy and endodontics were excluded. All the consulted studies showed well-defined images of pathological conditions such as caries and microcracks. The enhanced contrast of pulp provided a high-quality reproduction of the tooth shape and root canal in vitro and in vivo. Assessment of periapical lesions is possible even without the use of contrast medium. MRI is a nonionizing technique characterized by high tissue contrast and high image resolution of soft tissues; it could be considered a valid and safe diagnostic investigation in endodontics because of its potential to identify pulp tissues, define root canal shape, and locate periapical lesions. Copyright © 2018 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Root dentine and endodontic instrumentation: cutting edge microscopic imaging

PubMed Central

2016-01-01

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

Root dentine and endodontic instrumentation: cutting edge microscopic imaging.

PubMed

Atmeh, Amre R; Watson, Timothy F

2016-06-06

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.

Endodontic-related inferior alveolar nerve injuries: A review and a therapeutic flow chart.

PubMed

Castro, R; Guivarc'h, M; Foletti, J M; Catherine, J H; Chossegros, C; Guyot, L

2018-05-03

Inferior alveolar nerve (IAN) lesions related to endodontic treatments can be explained by the anatomical proximity between the apices of the mandibular posterior teeth and the mandibular canal. The aim of this article is to review the management of inferior alveolar nerve lesions due to endodontic treatments and to establish a therapeutic flow chart. A review of publications reporting IAN damage related to endodontic treatment over the past 20 years has been conducted, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist; it combines an electronic search of the Pubmed ® and Google Scholar ® databasis. Forty-two full-text articles corresponding to 115 clinical cases have been selected. Two personal clinical cases were additionally reported. IAN lesions due to endodontic treatments require urgent management. Early surgical removal of the excess of endodontic material, in contact with the nerve allows the best recovery prognosis (72h). Beyond this delay, irreversible nervous lesions prevail and a medical symptomatic treatment, most of the time with pregabalin, must be/can be carried out. A delayed surgical procedure shows some good benefits for patients. However, the healing prognosis remains poorly predictable. Copyright © 2018. Published by Elsevier Masson SAS.

Successful Nonsurgical Management of Periapical Lesions of Endodontic Origin: A Conservative Orthograde Approach

PubMed Central

Karunakaran, J. V.; Abraham, Chris Susan; Karthik, A. Kaneesh; Jayaprakash, N.

2017-01-01

Periapical lesions of endodontic origin are common pathological conditions affecting periradicular tissues. Microbial infection of pulpal tissues is primarily responsible for initiation and progression of apical periodontitis. The primary objective of endodontic therapy should be to restore involved teeth to a state of normalcy nonsurgically. Different nonsurgical management techniques, namely, conservative root canal therapy, decompression technique, method using calcium hydroxide, aspiration-irrigation technique, lesion sterilization and tissue repair therapy, active nonsurgical decompression technique, and the apexum procedure have been advocated. New techniques which use drug-loaded injectable scaffolds, simvastatin, and epigallocatechin-3-gallate have been tried. Surgical option should be considered when intra- or extra-radicular infections are persistent. Incidence of nonendodontic periapical lesions has also been reported. An accurate diagnosis of the periapical lesion whether it is of endodontic or nonendodontic origin has to be made. Surgical methods have many disadvantages, and hence should be considered as an option only in the case of failure of nonsurgical techniques. Assessment of healing of periapical lesions has to be done periodically which necessitates a long-term follow-up. Even large periapical lesions and retreatment cases where the lesion is of endodontic origin have been successfully managed nonsurgically with orthograde endodontic therapy. PMID:29284973

A Naval Postgraduate Dental School Analysis Of Initial Endodontic Treatment

DTIC Science & Technology

2016-06-30

A NAVAL POSTGRADUATE DENTAL SCHOOL ANALYSIS OF INITIAL ENDODONTIC TREATMENT by Alexander Kareem Desta, D.D.S. Lieutenant Commander, Dental Corps...United States Navy A thesis submitted to the Faculty of the Endodontic Graduate Program Naval Postgraduate Dental School Uniformed Services...Postgraduate Dental School Unifo1med Services University of the Health Sciences Bethesda, Maryland CERTIFICATE OF APPROVAL MASTER’S THESIS This is

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

PubMed

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

2014-11-01

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

Restorative outcomes for endodontically treated teeth in the Practitioners Engaged in Applied Research and Learning network.

PubMed

Spielman, Howard; Schaffer, Scott B; Cohen, Mitchell G; Wu, Hongyu; Vena, Donald A; Collie, Damon; Curro, Frederick A; Thompson, Van P; Craig, Ronald G

2012-07-01

The authors aimed to determine the outcome of and factors associated with success and failure of restorations in endodontically treated teeth in patients in practices participating in the Practitioners Engaged in Applied Research and Learning (PEARL) Network. Practitioner-investigators (P-Is) invited the enrollment of all patients seeking care at participating practices who had undergone primary endodontic therapy and restoration in a permanent tooth three to five years earlier. P-Is classified endodontically reated teeth as restorative failures if the restoration was replaced, the restoration needed replacement or the tooth was cracked or fractured. P-Is from 64 practices enrolled in the study 1,298 eligible patients who had endodontically treated teeth that had been restored. The mean (standard deviation) time to follow-up was 3.9 (0.6) years. Of the 1,298 enrolled teeth, P-Is classified 181 (13.9 percent; 95 percent confidence interval [CI], 12.1-15.8 percent) as restorative failures: 44 (3.4 percent) due to cracks or fractures, 57 (4.4 percent) due to replacement of the original restoration for reasons other than fracture and 80 (6.2 percent) due to need for a new restoration. When analyzing the results by means of multivariate logistic regression, the authors found a greater risk of restorative failure to be associated with canines or incisors and premolars (P = .04), intracoronal restorations (P < .01), lack of preoperative proximal contacts (P < .01), presence of periodontal connective-tissue attachment loss (P < .01), younger age (P = .01), Hispanic/Latino ethnicity (P = .04) and endodontic therapy not having been performed by a specialist (P = .04). These results suggest that molars (as opposed to other types of teeth), full-coverage restorations, preoperative proximal contacts, good periodontal health, non-Hispanic/Latino ethnicity, endodontic therapy performed by a specialist and older patient age are associated with restorative success for endodontically treated teeth in general practice. These results contribute to the clinical evidence base to help guide practitioners when planning the restoration of endodontically treated teeth.

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

PubMed

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

1997-01-01

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

Endodontic, surgical and periodontal treatment of dens invaginatus. Case report.

PubMed

Castellarin, M; Demitri, V; Politi, M

2001-01-01

The aim of this paper is to propose a single stage global treatment of endodontic, periapical and periodontal lesions in a lateral maxillary incisor with dens invaginatus. A 24 year-old woman presenting a lateral maxillary incisor with dens invaginatus in association with periapica1 and periodontal lesions underwent simultaneous surgical, endodontic and periodontal regenerative procedures. At 2, 6, 12, 18 months follow-up the radiographic healing appeared to be improved and the periapical lesion healed completely 1 year after surgical intervention. Surgery in association with endodontic and periodontal procedures represents the treatment of choice to maximize long term prognosis in cases of dens invaginatus with chronic periapical and periodontal lesions.

[Bio-Oss collagen bone grafting in the treatment of endodontic-periodontic lesion].

PubMed

Sun, Jiang; Liu, Qiong

2009-09-01

To study the effect of Bio-Oss collagen for bone grafting in the treatment of endodontic-periodontic lesion. Thirty patients (37 teeth) with endodontic-periodontic lesions received root canal therapy and periodontal treatment. Four weeks after the treatment, Bio-Oss collagen was grafted in these teeth. Clinical examinations were performed 1, 3, 6, 9, and 12 months after the surgery. The mobility of these teeth improved 1 month after the surgery. At 3, 6, 9, and 12 months after the surgery, the pocket depth reduced obviously good attachment and further improvement of the tooth mobility. Bio-Oss collagen for bone grafting can achieve good therapeutic effect for endodontic-periodontic lesions.

Treatment of combined endodontic-periodontic lesions using guided tissue regeneration: clinical case and histology.

PubMed

Ghezzi, Carlo; Virzì, Mauro; Schupbach, Peter; Broccaioli, Alessandro; Simion, Massimo

2012-08-01

The aim of this case report is to histologically evaluate periapical healing after combined endodontic-periodontic treatment. A maxillary left central incisor was treated with conventional endodontic therapy, followed by periodontal surgery. The facial bony defect was filled with a mixture of autologous bone and Bio-Oss. A resorbable membrane was used. Histology showed the presence of new cementum, ligament, and bone around the apex of the treated tooth. This finding was clinically associated with minimal residual probing depth and maximum attachment gain. This histologic report demonstrates the possibility of true regeneration in a case of severe periodontal attachment loss resulting from an endodontic-periodontic lesion.

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

PubMed Central

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

2014-01-01

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

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

PubMed Central

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

2014-01-01

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

Endodontic retreatment vs dental implants of teeth with an uncertain endodontic prognosis: 1-year results from a randomised controlled trial.

PubMed

Esposito, Marco; Tallarico, Marco; Trullenque-Eriksson, Anna; Gianserra, Rodolfo

To ascertain whether in the presence of a previously endodontically treated tooth with a periapical pathology and/or symptoms and an uncertain prognosis, it is better to endodontically retreat it or to replace the tooth with a single implant-supported crown. Forty patients requiring the treatment of a previously endodontically treated tooth, with a periapical pathology and/or symptoms of endodontic origin and an uncertain prognosis, as judged by the recruiting investigators, were randomly allocated to endodontic retreatment (endo group; 20 patients) or tooth extraction and replacement with an implant-supported crown (implant group; 20 patients) according to a parallel group design at two different centres. Patients were followed to 1 year after completion of the treatment. Outcome measures were: failure of the procedure, complications, marginal bone level changes at both teeth and implants, endodontic radiographic success (teeth only), number of patients' visits and days to complete the treatment, patients' chair time, costs, aesthetics assessed using the pink esthetic score (PES) for the soft tissues and the white esthetic score (WES) for the tooth/crown recorded by independent assessors. No patient dropped out and no complications occurred during the entire follow-up; however, one endodontically retreated tooth (5%) and one implant (5%) fractured, the difference for treatment failures being not statistically significant (difference in proportions = 0; 95% CI -0.14 to 0.14; P Fisher's exact test) = 1.000). The mean marginal bone levels at endo retreatment/implant insertion were 2.34 ± 0.88 mm for the endo and 0.23 ± 0.35 mm for the implant group, which was statistically significantly different (mean difference = 2.11 mm; 95% CI: 1.68 to 2.55; P (t-test) < 0.001). One year after completion of the treatment, teeth lost on average 0.32 ± 0.53 mm and implants 0.48 ± 0.72, the difference not being statistically significant (mean difference = -0.16 mm; 95% CI: -0.58 to 0.27; P (t-test) = 0.457). One year after completion of the endodontic retreatment, of the 13 teeth that originally had a periapical radiolucency, one was lost, six showed complete healing; four a radiographic improvement; and two showed no changes/worsening. Two of the teeth originally without a lesion developed a lesion. There were no statistically significant differences for the number of patients' visits (endo = 5.2 ± 1.8; implant = 5.5 ± 1.1; mean difference = -0.03 95% CI: -1.24 to 0.64; P (t-test) = 0.522). It took significantly more days to complete the implant rehabilitation (endo = 48.9 ± 19.5; implant = 158.5 ± 67.2; mean difference = -109.60; 95% CI: -141.26 to -77.94; P (t-test) < 0.001), but less patients' chair time (endo = 405.5 ± 230.3 min; implant = 260.0 ± 154.6 min; mean difference = 45.50; 95% CI: 19.35 to 271.65; P (t-test) = 0.025). Implant treatment was significantly more expensive (endo = 1195 ± 503.7 €; implant = 1907.5 ± 232.4 €; mean difference = -712.50; 95% CI: -963.59 to -461.41; P (t-test) < 0.001). One year after treatment completion, the mean PES was 10.92 ± 1.93 and 7.07 ± 2.87 and the mean WES was 7.67 ± 1.83 and 7.60 ± 2.32 in the endo group and implant group, respectively. Soft tissues aesthetics (PES) was significantly better at endodontically retreated teeth (mean difference 3.85; 95% CI 1.94 to 5.76; P (t-test) < 0.001) whereas no significant differences were observed for tooth aesthetics (WES) (mean difference 0.07; 95% CI -1.62 to 1.76; P (t-test) = 0.936) between treatments. The preliminary results suggest that both endodontic retreatment and replacement of previously endodontically treated teeth with persisting pathology and a dubious endodontic prognosis provided similar short-term success rates. Aesthetics of the soft tissues and time needed to complete treatment were in favour of endodontic retreatment, whereas implant rehabilitation required half of the chair time than endodontic retreatment, but was significantly more expensive. Although much larger patient populations and longer follow-ups are needed to fully answer this question, in this scenario the less invasive endodontic retreatment could be the first therapeutic option to be considered.

Thermal Properties of Contemporary and Conventional Gutta Percha Materials Used in Root Canal Treatment

DTIC Science & Technology

2015-01-15

α crystalline form to an amorphous gutta-percha.6,18 It should be noted that these temperatures for commercial endodontic gutta-percha will be...slightly different, as these temperature values are for pure gutta-percha. With the increased number endodontic gutta-percha materials being marketed...clinical technique. Furthermore, some literature has suggested that not all commercially available endodontic gutta-percha materials exist in the same

A Retrospective Analysis of Initial Posterior Root Canal Therapy on United States Air Force Personnel

DTIC Science & Technology

2016-06-01

and John Yaccino, DDS Abstract Introduction: The Air Force Dental Service (AFDS) has established evidence-based treatment standards for endodontics...and cuspal coverage restorations (4-6). With this research, the Air Force Dental Service (AFDS) established evidence-based treatment standards for...endodontics to ensure Airmen receive high-quality, safe dental care (7). These standards are taught at the two Air Force (AF) Postgraduate Endodontic

A Review of Antibacterial Agents in Endodontic Treatment

PubMed Central

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

2014-01-01

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

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

PubMed Central

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

2014-01-01

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

Current overview on challenges in regenerative endodontics

PubMed Central

Bansal, Ramta; Jain, Aditya; Mittal, Sunandan

2015-01-01

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

Regenerative endodontics: a true paradigm shift or a bandwagon about to be derailed?

PubMed

Nazzal, H; Duggal, M S

2017-02-01

Regenerative endodontic techniques (RETs) have been hailed as a paradigm shift for the management of traumatised non-vital immature permanent anterior teeth. In this article the aim was to critically appraise the literature with regards to the outcome of regenerative endodontics on root development. Critical review of the literature where regenerative endodontic techniques have been used in the management of immature non-vital teeth with continuation of root development as the main outcome reported. Most studies published were in the form of case reports and series with very few randomised controlled trials with a high risk of bias. Continuation of root development following the use of RET has been shown to be unpredictable at best with lower success in those teeth losing vitality as a result of dental trauma. Despite the high success of regenerative endodontics in terms of periodontal healing including resolution of clinical and radiographic signs and symptoms of infection, continuation of root development remains an unpredictable outcome. The use of a blood clot as a scaffold in regenerative endodontics should be reviewed carefully as that might offer an environment for repair rather than regeneration. In addition, preservation of structures, such as Hertwig's epithelial root sheath, may have an important bearing on the success of this approach and should be further investigated.

Regenerative Endodontics: Barriers and Strategies for Clinical Translation

PubMed Central

Kim, Sahng G.; Zhou, Jian; Ye, Ling; Cho, Shoko; Suzuki, Takahiro; Fu, Susan Y.; Yang, Rujing; Zhou, Xuedong; Mao, Jeremy J.

2014-01-01

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

Endodontic Treatment of an Autogenous Transplanted Tooth Using an Er,Cr:YSGG Laser and Radial Firing Tips: Case Report.

PubMed

Martins, Miguel Rodrigues; Lima, Rita C; Pina-Vaz, Irene; Carvalho, Manuel Fontes; Gutknecht, Norbert

2016-10-01

Although several surgical techniques have been reported, no study has yet reported alternative strategies for endodontic treatment of autogenous transplanted teeth. Therefore, the aim of this clinical report is to present the long-term endodontic outcome of a nonvital autogenously transplanted third molar treated with an Er,Cr:YSGG laser and radial firing tips (RFTs). Autogenous tooth transplantation can be considered an alternative to restore edentulous areas and, in donor's teeth with complete root formation, root canal treatment should be performed up to 14 days following transplantation. In the present case report, the patient returned only after 6 months, with clinical and radiological signs of apical periodontitis (AP) associated with the transplanted tooth. Instead of traditional endodontic chemical irrigants or medications, the protocol for smear-layer removal and root canal disinfection was based on intracanal irradiation with an Er,Cr:YSGG laser and RFTs. After 3-years' follow-up, the complete reestablishment of the periodontal ligament and the arrest of the resorptive process could be noticed. This protocol has shown to be effective for the endodontic treatment of a transplanted multi-rooted tooth with AP. Further randomized clinical trials should be conducted to clearly demonstrate the effectiveness of this laser-assisted endodontic protocol.

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

PubMed

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

2012-01-01

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

Assessment of the Effect of Orthodontic Treatment on the Periodontal Health of Endodontically Restored Tooth.

PubMed

Jalaluddin, Md; Goyal, Vinod; Naqvi, Zuber A; Gupta, Bhaskar; Asnani, Mohil M; Sonigra, Hitesh M

2017-07-01

Intorduction: Patients usually undergo orthodontic treatment for achieving ideal interocclusal relationship between the dental tissue and bony tissue along with improving the speech, mastication, and facial esthetic appearance. Literature quotes paucity in the studies evaluating the effect of orthodontic treatment on the periodontal health of endodontically treated teeth. Hence, we planned the present study to assess the effect of orthodontic treatment on the periodontal health of endodonti-cally restored tooth. The present study included assessment of 80 patients who underwent orthodontic treatment. All the patients were divided broadly into two study groups: groups I and II. Group I included patients with the absence of endodontically treated teeth, while group II included patients which maxillary central incisors were resorted endodontically. Examination of the periodontal health of the patients was done using the community periodontal index of treatment need (CPITN) around the selected teeth. All the values were recorded during the preorthodontic time, postorthodontic time, and after the first 6 months of starting of the orthodontic treatment. All the results were recorded separately and analyzed. In the groups I and II, 28 and 25 patients respectively, had score of 1, while 10 patients in group I and 12 patients in group II had score of 2. Nonsignificant results were obtained while comparing the CPITN score in between the two study groups when measured at the pre-, intra-, and postortho time. In patients undergoing orthodontic treatment, having endodontically resorted teeth, no difference exists in relation to the periodontal health. Orthodontic treatment can be safely carried in patients with endodontically restored teeth.

Osmolarity and root canal antiseptics.

PubMed

Rossi-Fedele, G; Guastalli, A R

2014-04-01

Antiseptics used in endodontics for disinfection purposes include root canal dressings and irrigants. Osmotic shock is known to cause the alteration of microbial cell viability and might have a role in the mechanism of action of root canal antiseptics. The aim of this review was to determine the role of osmolarity on the performance of antiseptics in root canal treatment. A literature search using the Medline electronic database was conducted up to 30 May 2013 using the following search terms and combinations: 'osmolarity AND root canal or endodontic or antiseptic or irrigation or irrigant or medication or dressing or biofilm; osmolality AND root canal or endodontic or antiseptic or irrigation or irrigant or medication or dressing or biofilm; osmotic AND root canal or endodontic or antiseptic or irrigation or irrigant or medication or dressing or biofilm; osmosis AND root canal or endodontic or antiseptic or irrigation or irrigant or medication or dressing or biofilm; sodium chloride AND root canal or endodontic or antiseptic or irrigation or irrigant or medication or dressing or biofilm'. Publications were included if the effects of osmolarity on the clinical performance of antiseptics in root canal treatment were stated, if preparations with different osmolarities values were compared and if they were published in English. A hand search of articles published online, 'in press' and 'early view', and in the reference list of the included papers was carried out following the same criteria. A total of 3274 publications were identified using the database, and three were included in the review. The evidence available in endodontics suggests a possible role for hyperosmotic root canal medicaments as disinfectants, and that there is no influence of osmolarity on the tissue dissolution capacity of sodium hypochlorite. There are insufficient data to obtain a sound conclusion regarding the role of hypo-osmosis in root canal disinfection, or osmosis in any further desirable ability. © 2013 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Use of Cone Beam Computed Tomography in Endodontics

PubMed Central

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

2009-01-01

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

Endodontic management of contralateral mandibular first molars with six root canals

PubMed Central

Bhargav, Kambhampati; Sirisha, Kantheti; Jyothi, Mandava; Boddeda, Mohan Rao

2017-01-01

The knowledge of variations in root canal morphology is essential for a successful endodontic outcome. Contralateral mandibular molar with six root canals is a rare entity. Root canal treatment of mandibular molars with aberrant canal configuration can be diagnostically and technically challenging. While dealing with variant mandibular molars, mishaps may happen. This case report describes variations in contralateral mandibular molars and also an endodontic mishap while managing them. PMID:29259369

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

PubMed

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

2016-01-01

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

Hemisection for treatment of an advanced endodontic-periodontal lesion: a case report.

PubMed

Haueisen, H; Heidemann, D

2002-06-01

To emphasize the importance of primary endodontic treatment when dealing with endo-perio lesions and to demonstrate the considerable healing potential of the endodontic aspect. After several years of unsuccessful symptomatic periodontal treatment, an advanced endo-perio lesion on a right-mandibular first molar was successfully treated by root-canal treatment and hemisection after the re-evaluation of the lesion. This successful treatment appeared to have a positive effect on the patient's general well-being. The origin of a combined endo-perio lesion is indicated by its clinical and radiographic appearance. The periodontal situation is often misinterpreted. The prognosis for the endodontic element of treatment is excellent. Local pathologic processes in the oral cavity may affect a patient's general health.

Traumatic bone cyst suggestive of a chronic periapical abscess: a case report.

PubMed

Kahler, Bill

2011-08-01

Traumatic bone cysts can mimic the signs and symptoms of an endodontic lesion. This case reports on a 19-year-old male patient who was referred for endodontic assessment of a symptomatic tooth with a gingival swelling and a draining sinus at the furcation of a mandibular second molar. Radiographically, a periradicular radiolucency is evident. A prior history of trauma as well as removal of the wisdom teeth was determined. After careful diagnosis unnecessary endodontic intervention was avoided. Surgical exploration, curettage and the generation of a blood clot resulted in healing at the 6 month review appointment. The tooth remained responsive to pulp sensibility testing at that time. © 2010 The Author. Australian Endodontic Journal © 2010 Australian Society of Endodontology.

Regeneration and Repair in Endodontics-A Special Issue of the Regenerative Endodontics-A New Era in Clinical Endodontics.

PubMed

Saoud, Tarek Mohamed A; Ricucci, Domenico; Lin, Louis M; Gaengler, Peter

2016-02-27

Caries is the most common cause of pulp-periapical disease. When the pulp tissue involved in caries becomes irreversibly inflamed and progresses to necrosis, the treatment option is root canal therapy because the infected or non-infected necrotic pulp tissue in the root canal system is not accessible to the host's innate and adaptive immune defense mechanisms and antimicrobial agents. Therefore, the infected or non-infected necrotic pulp tissue must be removed from the canal space by pulpectomy. As our knowledge in pulp biology advances, the concept of treatment of pulpal and periapical disease also changes. Endodontists have been looking for biologically based treatment procedures, which could promote regeneration or repair of the dentin-pulp complex destroyed by infection or trauma for several decades. After a long, extensive search in in vitro laboratory and in vivo preclinical animal experiments, the dental stem cells capable of regenerating the dentin-pulp complex were discovered. Consequently, the biological concept of 'regenerative endodontics' emerged and has highlighted the paradigm shift in the treatment of immature permanent teeth with necrotic pulps in clinical endodontics. Regenerative endodontics is defined as biologically based procedures designed to physiologically replace damaged tooth structures, including dentin and root structures, as well as the pulp-dentin complex. According to the American Association of Endodontists' Clinical Considerations for a Regenerative Procedure, the primary goal of the regenerative procedure is the elimination of clinical symptoms and the resolution of apical periodontitis. Thickening of canal walls and continued root maturation is the secondary goal. Therefore, the primary goal of regenerative endodontics and traditional non-surgical root canal therapy is the same. The difference between non-surgical root canal therapy and regenerative endodontic therapy is that the disinfected root canals in the former therapy are filled with biocompatible foreign materials and the root canals in the latter therapy are filled with the host's own vital tissue. The purpose of this article is to review the potential of using regenerative endodontic therapy for human immature and mature permanent teeth with necrotic pulps and/or apical periodontitis, teeth with persistent apical periodontitis after root canal therapy, traumatized teeth with external inflammatory root resorption, and avulsed teeth in terms of elimination of clinical symptoms and resolution of apical periodontitis.

Whitening of endodontically untreated calcified anterior teeth.

PubMed

Pedorella, C A; Meyer, R D; Woollard, G W

2000-01-01

Definitive treatment for whitening endodontically untreated anterior teeth with dystrophic calcification is provided by removing the coronal sclerotic dentin and utilizing internal and external bleaching as necessary.

Periapical and endodontic status scale based on periapical bone lesions and endodontic treatment quality evaluation using cone-beam computed tomography.

PubMed

Venskutonis, Tadas; Plotino, Gianluca; Tocci, Luigi; Gambarini, Gianluca; Maminskas, Julius; Juodzbalys, Gintaras

2015-02-01

The purpose of this study was to present a new periapical and endodontic status scale (PESS) that is based on the complex periapical index (COPI), which was designed for the identification and classification of periapical bone lesions in cases of apical periodontitis, and the endodontically treated tooth index, which was designed for endodontic treatment quality evaluation by means of cone-beam computed tomographic (CBCT) analysis. Periapical and endodontic status parameters were selected from the already known indexes and scientific literature for radiologic evaluation. Radiographic images (CBCT imaging, digital orthopantomography [DOR], and digital periapical radiography) from 55 patients were analyzed. All parameters were evaluated on CBCT, DOR, and digital periapical radiographic images by 2 external observers. The statistical analysis was performed with software SPSS version 19.0 (SPSS Inc, Chicago, IL). Chi-square tests were used to compare frequencies of qualitative variables. The level of significance was set at P ≤ .05. Overall intraobserver and interobserver agreements were very good and good, respectively. CBCT analysis found more lesions and lesions of bigger dimension (P < .001). CBCT imaging was also superior in locating lesions in the apical part on the side compared with DOR and in the diagnosis of cortical bone destruction compared with both methods (P < .001). Through CBCT analysis, more root canals and more canals associated with lesions were found. The most informative and reproducible periapical and endodontic status parameters were selected, and a new PESS was proposed. The classification proposed in the present study seems to be reproducible and objective and adds helpful information with respect to the existing indexes. Future studies need to be conducted to validate PESS. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

"Ferrule Comes First. Post Is Second!" Fake News and Alternative Facts? A Systematic Review.

PubMed

Naumann, Michael; Schmitter, Marc; Frankenberger, Roland; Krastl, Gabriel

2018-02-01

Both the role of an endodontic post and the ferrule effect have been discussed for decades. The clinical impact of endodontic posts compared with post-free restoration with or without ferrule support was not systematically reviewed so far. It was assumed that the effect of an endodontic post compared with a post-free restoration can be evaluated only when at the same time a ferrule or no-ferrule situation was clinically compared. The specific PICO question was as follows: Patient: adults with sufficient endodontic treatment needing a core or post; Intervention: post-endodontic treatment using posts with or without ferrule; Comparison: post-endodontic treatment without posts with or without ferrule; Outcomes: failure rates of post/core complexes with or without ferrule support. A Medline search was performed via PubMed in June 2017 using relevant electronic databases. Additionally, hand search was performed. Only prospective clinical studies in humans comparing the success/survival of teeth restored with or without posts over a minimum time of observation of 5 years were included. In total, 7 randomized controlled trials and 1 prospective clinical trial met inclusion criteria. Cochrane rating showed high risk of bias in 5 studies. Two of 3 studies support the ferrule-effect concept. Seven of 8 show no post effect. Clinical evidence regarding the influence of tooth location on its survival is scarce. Ferrule effect and maintaining cavity walls are the predominant factors with regard to tooth and restoration survival of endodontically treated teeth. Most studies do not confirm a positive effect of post placement. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Biofilm in endodontics: A review

PubMed Central

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

2015-01-01

Endodontic disease is a biofilm-mediated infection, and primary aim in the management of endodontic disease is the elimination of bacterial biofilm from the root canal system. The most common endodontic infection is caused by the surface-associated growth of microorganisms. It is important to apply the biofilm concept to endodontic microbiology to understand the pathogenic potential of the root canal microbiota as well as to form the basis for new approaches for disinfection. It is foremost to understand how the biofilm formed by root canal bacteria resists endodontic treatment measures. Bacterial etiology has been confirmed for common oral diseases such as caries and periodontal and endodontic infections. Bacteria causing these diseases are organized in biofilm structures, which are complex microbial communities composed of a great variety of bacteria with different ecological requirements and pathogenic potential. The biofilm community not only gives bacteria effective protection against the host's defense system but also makes them more resistant to a variety of disinfecting agents used as oral hygiene products or in the treatment of infections. Successful treatment of these diseases depends on biofilm removal as well as effective killing of biofilm bacteria. So, the fundamental to maintain oral health and prevent dental caries, gingivitis, and periodontitis is to control the oral biofilms. From these aspects, the formation of biofilms carries particular clinical significance because not only host defense mechanisms but also therapeutic efforts including chemical and mechanical antimicrobial treatment measures have the most difficult task of dealing with organisms that are gathered in a biofilm. The aim of this article was to review the mechanisms of biofilms’ formation, their roles in pulpal and periapical pathosis, the different types of biofilms, the factors influencing biofilm formation, the mechanisms of their antimicrobial resistance, techniques to identify biofilms. PMID:25767760

The antimicrobial effectiveness of photodynamic therapy used as an addition to the conventional endodontic re-treatment: a clinical study.

PubMed

Jurič, Ivona Bago; Plečko, Vanda; Pandurić, Dragana Gabrić; Anić, Ivica

2014-12-01

The purpose of the study was to evaluate the efficacy of antimicrobial photodynamic therapy (aPDT) used as an adjunct to the endodontic re-treatment in the eradication of microorganisms from previously filled root canals. The study sample consisted of 21 randomly selected patients with root filled and infected root canal system with chronic apical periodontitis on incisors or canines, who have had previously endodontic treatment. Microbiological samples from the root canals were collected after accessing the canal, following the endodontic re-treatment and after the aPDT procedure. During instrumentation, the root canals were irrigated with 2.5% sodium hypochlorite (NaOCl), and the final irrigation protocol included 17% ethylenediaminetetraacetic acid followed by NaOCl. Root canals were filled with a phenothiazinium chloride and irradiated with a diode laser (λ=660 nm, 100 mW) for 1 min. Microbiological samples from the root canals were cultivated on selective plates, and the identification was done by micromorphology, macromorphology and different API strips as well as bacterial counts (colony forming units). Fourteen bacteria species were isolated from the root canals initially, with a mean value of 4.57 species per canal. Although endodontic re-treatment alone produced a significant reduction in the number of bacteria species (p<0.001), the combination of endodontic treatment and aPDT was statistically more effective (p<0.001). No bacteria were cultivated from the main root canals of 11 teeth. The results indicated that the aPDT used as an adjunct to the conventional endodontic therapy achieved a significant further reduction of intracanal microbial load. Copyright © 2014 Elsevier B.V. All rights reserved.

Impact of cone beam computed tomography (CBCT) on diagnostic thinking in endodontics of posterior teeth: A before- after study.

PubMed

Al-Salehi, S K; Horner, K

2016-10-01

The aim of this study was to evaluate the impact of limited volume CBCT upon diagnosis as part of endodontic management of posterior teeth. The null hypothesis that CBCT does not make any difference in endodontic diagnosis was tested. A single-centre "before-after" study was conducted in a secondary healthcare establishment. Eligible patients were all adults aged 18 years or over who were referred to a specialist endodontic unit. Further inclusion criteria were that the cases were either re-treatment or de novo root canal treatment where the anatomy was judged to be complex. Exclusion criteria included vulnerable groups and de novo endodontic treatment with uncomplicated root canal anatomy. As well as a full history and clinical examination, a high quality colour photographic intraoral image, two paralleling technique periapical radiographs and limited volume CBCT examination were carried out for each patient. All components, except the CBCT dataset, were combined into a Powerpoint presentation and assessed by 4 observers. A questionnaire was designed for the observers as part of the study. CBCT information only changed the radiological findings and the final diagnosis in a minority of cases. There was no clear evidence that CBCT increases the confidence of observers or that CBCT was helpful in making a diagnosis. Routine use of CBCT cannot not be justified on the basis of a change in diagnosis and carefully selected use is appropriate. CBCT is being increasingly used in the field of endodontics. The benefits gained from the use of CBCT must be carefully balanced against the increased radiation dosage. Determination of selection criteria for the use of CBCT in endodontics is, therefore, essential. Copyright © 2016 Elsevier Ltd. All rights reserved.

An "XL" endodontics intervention for dental students required to repeat the course: changing frustration to improved grades and attitudes.

PubMed

Alcota, Marcela; Fuenzalida, Alejandra; Barrientos, Claudia; Garrido, Mauricio; Ruiz de Gauna, Pilar; González, Fermín E

2015-04-01

Given the psychological and financial costs involved with failing a clinical course, especially in developing countries, an alternative educational method was tested with students who had to repeat the year-long endodontic course at the University of Chile Faculty of Dentistry. The objectives of the intervention were to deepen theoretical knowledge and practical experiences, as well as to reinforce personal confidence in an endodontic clinical setting for students who failed the regular endodontic course. The aim of this study was to evaluate the success of this new model of educational intervention. In the study, 28 students who had failed the endodontic course repeated it with an alternative teaching method. The students attended patients immediately following practical competence exams, and they had access to simulated models that used rotary instruments and access cavities and had emergency care practice. Feedback sessions were held after each clinical session. Final grades were compared with those of other students who repeated the course without the intervention from 2007 to 2009. A survey was administered to understand the causes of initial failure and their opinions of the intervention. Students who participated in the alternative course did significantly better than their counterparts from previous years who did not receive the intervention (5.7±0.3 vs. 5.4±0.2; p<0.05). Their overall perception of the intervention was positive, and the main cause for previous course failure was personal insecurity and slow clinical care performance (54.2% of the students). The intervention course not only improved grades but also generated interest in endodontics, a contrasting perspective to the frustration students usually express after repeating the course. The results of this study support the introduction of similar interventions in endodontics and perhaps other courses.

Influence of Endodontic Treatment and Retreatment on the Fatigue Failure Load, Numbers of Cycles for Failure, and Survival Rates of Human Canine Teeth.

PubMed

Missau, Taiane; De Carlo Bello, Mariana; Michelon, Carina; Mastella Lang, Pauline; Kalil Pereira, Gabriel; Baldissara, Paolo; Valandro, Luiz Felipe; Souza Bier, Carlos Alexandre; Pivetta Rippe, Marília

2017-12-01

This study evaluated the effects of endodontic treatment and retreatment on the fatigue failure load, numbers of cycles for failure, and survival rates of canine teeth. Sixty extracted canine teeth, each with a single root canal, were selected and randomly divided into 4 groups (n = 15): untreated, teeth without endodontic intervention; prepared, teeth subjected only to rotary instrumentation; filled, teeth receiving complete endodontic treatment; and retreated, teeth retreated endodontically. After the different endodontic interventions, the specimens were subjected to fatigue testing by the stepwise method: 200 N (× 5000 load pulses), 300 N, 400 N, 500 N, 600 N, 800 N, and 900 N at a maximum of 30,000 load pulses each or the occurrence of fracture. Data from load to failure and numbers of cycles for fracture were recorded and subjected to Kaplan-Meier and Log Rank tests (P < .05), in addition to Weibull analysis. The fractures of the specimens were classified as repairable or catastrophic. The retreated, filled, and untreated groups presented statistically significantly higher fatigue failure loads and numbers of cycles for failure than did the prepared group. Weibull analysis showed no statistically significant difference among the treatments for characteristic load to failure and characteristic number of cycles for failure, although, for number of cycles, a higher Weibull modulus was observed in filled and retreated conditions. The predominant mode of failure was catastrophic. Teeth subjected to complete endodontic treatment and retreatment behaved similarly in terms of fatigue failure load and number of cycles to failure when compared with untreated teeth. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Effect of combined digital imaging parameters on endodontic file measurements.

PubMed

de Oliveira, Matheus Lima; Pinto, Geraldo Camilo de Souza; Ambrosano, Glaucia Maria Bovi; Tosoni, Guilherme Monteiro

2012-10-01

This study assessed the effect of the combination of a dedicated endodontic filter, spatial resolution, and contrast resolution on the determination of endodontic file lengths. Forty extracted single-rooted teeth were x-rayed with K-files (ISO size 10 and 15) in the root canals. Images were acquired using the VistaScan system (Dürr Dental, Beitigheim-Bissingen, Germany) under different combining parameters of spatial resolution (10 and 25 line pairs per millimeter [lp/mm]) and contrast resolution (8- and 16-bit depths). Subsequently, a dedicated endodontic filter was applied on the 16-bit images, creating 2 additional parameters. Six observers measured the length of the endodontic files in the root canals using the software that accompanies the system. The mean values of the actual file lengths and the measurements of the radiographic images were submitted to 1-way analysis of variance and the Tukey test at a level of significance of 5%. The intraobserver reproducibility was assessed by the intraclass correlation coefficient. All combined image parameters showed excellent intraobserver agreement with intraclass correlation coefficient means higher than 0.98. The imaging parameter of 25 lp/mm and 16 bit associated with the use of the endodontic filter did not differ significantly from the actual file lengths when both file sizes were analyzed together or separately (P > .05). When the size 15 file was evaluated separately, only 8-bit images differed significantly from the actual file lengths (P ≤ .05). The combination of an endodontic filter with high spatial resolution and high contrast resolution is recommended for the determination of file lengths when using storage phosphor plates. Copyright © 2012 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Influences of 432 Hz Music on the Perception of Anxiety during Endodontic Treatment: A Randomized Controlled Clinical Trial.

PubMed

Di Nasso, Luca; Nizzardo, Andrea; Pace, Riccardo; Pierleoni, Felicita; Pagavino, Gabriella; Giuliani, Valentina

2016-09-01

Patients undergoing endodontic therapy often have severe perioperative and intraoperative anxiety, which may lead to increased perceptions of pain and vital sign instability throughout treatment. The purpose of this study was to test the influences of music, as a nonpharmacologic adjuvant, in terms of significant changes for systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) before, during, and after endodontic treatment in a population with different levels of anxiety assessed with the Corah Dental Anxiety Scale. A total of 100 patients were recruited in the present study; before starting the endodontic treatment, the interviewer administered the Corah Dental Anxiety Scale to the participants to assess the baseline level of anxiety. Patients were randomly divided into 2 groups: the first one listened to the music and the second one did not. Before, during, and after the endodontic procedures, the vital signs (diastolic and systolic blood pressure and heart rate) were recorded. Results were collected and statistically analyzed. Direct contrasts between patients listening or not listening to music showed that all the measured vital signs decreased considering the overall period (during and after the canal therapy) in the group of patients listening to music (P < .05). This study shows the effects of music therapy on vital values and on subjective perception of anxiety during endodontic therapy. Music and medicine always work together; the soothing effects of sounds and musical frequencies make this union an extraordinary tool of synergistic care. Music therapy is a valid nonpharmacologic adjuvant to anxiety perception in endodontic therapies. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Evaluation of Related Factors in the Failure of Endodontically Treated Teeth: A Cross-sectional Study.

PubMed

Olcay, Keziban; Ataoglu, Hanife; Belli, Sema

2018-01-01

The aim of this study was to review the factors related to the failure and extraction of unsuccessful endodontically treated teeth. A total of 1000 teeth treated with nonsurgical root canal therapy were analyzed, and the following information was recorded for each patient: reasons for failure and extraction, type of tooth, presence and type of coronal restoration, smoking status, age, gender, and level of education. One main reason was recorded for each failed tooth. The associations between reasons for failure, patient, and tooth were tested by using χ 2 analysis. Of the 1000 endodontically failed teeth analyzed in this study, 28.1% (n = 281) were extracted, 66% (n = 660) were re-treated, and 5.9% (n = 59) were treated with apical surgery. Among the reasons for failure, restorative and endodontic reasons were seen most frequently (43.9%, n = 439), whereas orthodontic reasons were seldom seen (0.1%, n = 1). The most common reason for extraction was for prosthetic reasons (40.8%), and perforation/stripping was the least common (2.9%). The mandibular first molars were the most frequently extracted teeth (27.4%, n = 77). The most common reason for the extraction of endodontically treated teeth was for prosthetic reasons. Among the reasons for failure, restorative and endodontic reasons were the most frequently seen, and orthodontic reasons were the most seldom. The teeth that failed most frequently were mandibular first molars, and the teeth that failed least frequently were maxillary third molars. The most common reason for the extraction of failed endodontically treated teeth was for prosthetic reasons. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Regenerative Endodontic Treatment of an Immature Necrotic Molar with Arrested Root Development by Using Recombinant Human Platelet-derived Growth Factor: A Case Report.

PubMed

Zhujiang, Annie; Kim, Sahng G

2016-01-01

Regenerative endodontic treatment has provided a treatment option that aims to allow root maturation. The present report describes the regenerative endodontic treatment of a necrotic, immature molar by using recombinant human platelet-derived growth factor (rhPDGF-BB) and shows the continued root maturation in the tooth with arrested root development. A regenerative endodontic procedure that used a growth factor was performed for a necrotic molar with arrested root formation in a 20-year-old patient. Thorough disinfection by using mechanical instrumentation and copious irrigation of antimicrobial agents as well as intracanal medication with calcium hydroxide was performed throughout the first 2 appointments. At the third appointment, the root canals were irrigated with an antimicrobial solution and 17% EDTA, and bleeding was evoked by passing sterile paper points beyond the apex in each canal. Small pieces of a collagen membrane saturated with rhPDGF-BB solution from GEM 21S were packed into each canal. Mineral trioxide aggregate was placed, and Cavit and composite resin were used to restore the tooth. Complete root maturation and resolution of a periapical radiolucency were observed at the 15-month follow-up. The present report presents a regenerative endodontic procedure that uses rhPDGF-BB for a necrotic molar with arrested root development. The finding of continued root development in the present case suggests that regenerative endodontic treatment may be able to resume the root maturation process in teeth with arrested root formation. Further clinical studies are required to investigate the efficacy of rhPDGF-BB in regenerative endodontic treatment. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Endodontic Treatment of an Anomalous Anterior Tooth with the Aid of a 3-dimensional Printed Physical Tooth Model.

PubMed

Byun, Chanhee; Kim, Changhwan; Cho, Seungryong; Baek, Seung Hoon; Kim, Gyutae; Kim, Sahng G; Kim, Sun-Young

2015-06-01

Endodontic treatment of tooth formation anomalies is a challenge to clinicians and as such requires a complete understanding of the aberrant root canal anatomy followed by careful root canal disinfection and obturation. Here, we report the use of a 3-dimensional (3D) printed physical tooth model including internal root canal structures for the endodontic treatment of a challenging tooth anomaly. A 12-year-old boy was referred for endodontic treatment of tooth #8. The tooth showed class II mobility with swelling and a sinus tract in the buccal mucosa and periapical radiolucency. The tooth presented a very narrow structure between the crown and root by distal concavity and a severely dilacerated root. Moreover, a perforation site with bleeding and another ditching site were identified around the cervical area in the access cavity. A translucent physical tooth model carrying the information on internal root canal structures was built through a 3-step process: data acquisition by cone-beam computed tomographic scanning, virtual modeling by image processing, and manufacturing by 3D printing. A custom-made guide jig was then fabricated to achieve a safe and precise working path to the root canal. Endodontic procedures including access cavity preparation were performed using the physical tooth model and the guide jig. At the 7-month follow-up, the endodontically treated tooth showed complete periapical healing with no clinical signs and symptoms. This case report describes a novel method of endodontic treatment of an anomalous maxillary central incisor with the aid of a physical tooth model and a custom-made guide jig via 3D printing technique. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Applications of piezoelectric surgery in endodontic surgery: a literature review.

PubMed

Abella, Francesc; de Ribot, Joan; Doria, Guillermo; Duran-Sindreu, Fernando; Roig, Miguel

2014-03-01

Piezosurgery (piezoelectric bone surgery) devices were developed to cut bone atraumatically using ultrasonic vibrations and to provide an alternative to the mechanical and electrical instruments used in conventional oral surgery. Indications for piezosurgery are increasing in oral and maxillofacial surgery, as in other disciplines, such as endodontic surgery. Key features of piezosurgery instruments include their ability to selectively cut bone without damaging adjacent soft tissue, to provide a clear operative field, and to cut without generating heat. Although piezosurgery instruments can be used at most stages of endodontic surgery (osteotomy, root-end resection, and root-end preparation), no published data are available on the effect of piezosurgery on the outcomes of endodontic surgery. To our knowledge, no study has evaluated the effect of piezosurgery on root-end resection, and only 1 has investigated root-end morphology after retrograde cavity preparation using piezosurgery. We conducted a search of the PubMed and Cochrane databases using appropriate terms and keywords related to the use and applications of piezoelectric surgery in endodontic surgery. A hand search also was conducted of issues published in the preceding 2 years of several journals. Two independent reviewers obtained and analyzed the full texts of the selected articles. A total of 121 articles published between January 2000 and December 2013 were identified. This review summarizes the operating principles of piezoelectric devices and outlines the applications of piezosurgery in endodontic surgery using clinical examples. Piezosurgery is a promising technical modality with applications in several aspects of endodontic surgery, but further studies are necessary to determine the influence of piezosurgery on root-end resection and root-end preparation. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Fracture Strength of Endodontically Treated Teeth with Different Access Cavity Designs.

PubMed

Plotino, Gianluca; Grande, Nicola Maria; Isufi, Almira; Ioppolo, Pietro; Pedullà, Eugenio; Bedini, Rossella; Gambarini, Gianluca; Testarelli, Luca

2017-06-01

The purpose of this study was to compare in vitro the fracture strength of root-filled and restored teeth with traditional endodontic cavity (TEC), conservative endodontic cavity (CEC), or ultraconservative "ninja" endodontic cavity (NEC) access. Extracted human intact maxillary and mandibular premolars and molars were selected and assigned to control (intact teeth), TEC, CEC, or NEC groups (n = 10/group/type). Teeth in the TEC group were prepared following the principles of traditional endodontic cavities. Minimal CECs and NECs were plotted on cone-beam computed tomographic images. Then, teeth were endodontically treated and restored. The 160 specimens were then loaded to fracture in a mechanical material testing machine (LR30 K; Lloyd Instruments Ltd, Fareham, UK). The maximum load at fracture and fracture pattern (restorable or unrestorable) were recorded. Fracture loads were compared statistically, and the data were examined with analysis of variance and the Student-Newman-Keuls test for multiple comparisons. The mean load at fracture for TEC was significantly lower than the one for the CEC, NEC, and control groups for all types of teeth (P < .05), whereas no difference was observed among CEC, NEC, and intact teeth (P > .05). Unrestorable fractures were significantly more frequent in the TEC, CEC, and NEC groups than in the control group in each tooth type (P < .05). Teeth with TEC access showed lower fracture strength than the ones prepared with CEC or NEC. Ultraconservative "ninja" endodontic cavity access did not increase the fracture strength of teeth compared with the ones prepared with CEC. Intact teeth showed more restorable fractures than all the prepared ones. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

In Vitro Study Comparing the Marginal Leakage of Different Powder/Liquid Ratios of ZOE.

DTIC Science & Technology

1985-01-01

a Tarno FP hand instrument and the cavity was filled flush with the margin of the simulated endodontic access preparation cut in the amalgam... endodontic access preparations placed in tooth structure, as well as in amalgam anj composite resin. 0 Class V cavity preparations with a 90" cavosurface...opportunity to continue his education. Special thanks are expressed to Dr. Carl Newton, Chair- man of the Department of Endodontics and Director of

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

PubMed

Ling, J Q

2016-04-09

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.

Effect of Ibuprofen on masking endodontic diagnosis.

PubMed

Read, Jason K; McClanahan, Scott B; Khan, Asma A; Lunos, Scott; Bowles, Walter R

2014-08-01

An accurate diagnosis is of upmost importance before initiating endodontic treatment; yet, there are occasions when the practitioner cannot reproduce the patient's chief complaint because the patient has become asymptomatic. Ibuprofen taken beforehand may "mask" or eliminate the patient's symptoms. In fact, 64%-83% of patients with dental pain take analgesics before seeing a dentist. The purpose of this study was to examine the possible "masking" effect of ibuprofen on endodontic diagnostic tests. Forty-two patients with endodontic pain underwent testing (cold, percussion, palpation, and bite force measurement) and then received either placebo or 800 mg ibuprofen. Both patients and operators were blinded to the medication received. One hour later, diagnostic testing was repeated and compared with pretreatment testing. Ibuprofen affected testing values for vital teeth by masking palpation 40%, percussion 25%, and cold 25% on affected teeth with symptomatic irreversible pulpitis and symptomatic apical periodontitis. There was no observed masking effect in the placebo group on palpation, percussion, or cold values. When nonvital teeth were included, the masking effect of ibuprofen was decreased. However, little masking occurred with the bite force measurement differences. Analgesics taken before the dental appointment can affect endodontic diagnostic testing results. Bite force measurements can assist in identifying the offending tooth in cases in which analgesics "mask" the endodontic diagnosis. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Saving Single-rooted Teeth with Combined Endodontic-periodontal Lesions.

PubMed

Pico-Blanco, Alexandre; Castelo-Baz, Pablo; Caneiro-Queija, Leticia; Liñares-González, Antonio; Martin-Lancharro, Pablo; Blanco-Carrión, Juan

2016-12-01

Teeth affected by combined endodontic-periodontal lesions are usually considered by all prognosis classifications as hopeless teeth. The development of new biomaterials combined with modern endodontic and periodontal regeneration techniques may improve dental prognosis and maintain the affected teeth. Moreover, 1 of the replacement options for those teeth, dental implants, has shown an increasing number of biological and technical complications. Five patients were included in this case series study. Full periodontal and radiographic examination revealed generalized chronic periodontitis. Moreover, endodontic-periodontal lesions affecting single-rooted teeth were detected in those patients with tissue destruction beyond the apex. After splinting those teeth, conventional endodontic and nonsurgical periodontal treatment was performed. Three months later, periodontal regeneration was applied at those teeth in order to reconstruct supporting tissues and to improve dental prognosis. After a follow-up period ranging from 14 months to 17 years, it was observed that all teeth remain asymptomatic and in normal function. No signs of apical pathosis were observed, and the periodontium was stable. All patients were included in a strict maintenance program to check the periodontal and apical status. This case series shows that it is possible to change the prognosis of teeth affected by combined endodontic-periodontal lesions, even if the periodontal support is destroyed beyond the apex. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

In-vitro comparison of instrumentation time and cleaning capacity between endodontic handpiece and manual preparation techniques in primary molar teeth.

PubMed

Seraj, B; Ramezani, G; Ghadimi, S; Mosharrafian, S H; Motahhary, P; Safari, M

2013-01-01

The aim of this study was to evaluate and compare the cleaning ability and instrumentation time of manual method and use of endodontic handpiece for preparation of primary molar teeth. Forty primary teeth canals were used in this experimental study. Access cavities were prepared and India ink was injected into the canals. The samples were divided into three groups according to the preparation technique. In the first group the root canals were manually instrumented by k_files. Endodontic handpiece (TEP-ER10, NSK, Japan) were used for canal preparation in the second group and the samples in the third group (control) were not instrumented. After preparing the canal, the teeth were cleared with methyl salicylate and the removal of India ink was measured in the cervical, middle and apical thirds. The instrumentation time was transcribed by chronometer. Statistical analysis was performed using Mann-Whitney and t-test. There was no significant difference in cleaning capacity between the two techniques, but results of the first and second group differ from those of the control group. In fact, time taken for preparation was significantly shorter with endodontic handpiece system. Seen the shorter working time of endodontic handpiece and the similar cleaning ability of the two techniques, the application of the endodontic handpiece is recommended for preparation of deciduous root canals during pulpectomy.

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

PubMed Central

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

2015-01-01

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

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

PubMed Central

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

2015-01-01

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

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

PubMed

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

2015-01-01

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

PCR methodology as a valuable tool for identification of endodontic pathogens.

PubMed

Siqueira, José F; Rôças, Isabela N

2003-07-01

This paper reviews the principles of polymerase chain reaction (PCR) methodology, its application in identification of endodontic pathogens and the perspectives regarding the knowledge to be reached with the use of this highly sensitive, specific and accurate methodology as a microbial identification test. Studies published in the medical, dental and biological literature. Evaluation of published epidemiological studies examining the endodontic microbiota through PCR methodology. PCR technology has enabled the detection of bacterial species that are difficult or even impossible to culture as well as cultivable bacterial strains showing a phenotypically divergent or convergent behaviour. Moreover, PCR is more rapid, much more sensitive, and more accurate when compared with culture. Its use in endodontics to investigate the microbiota associated with infected root canals has expanded the knowledge on the bacteria involved in the pathogenesis of periradicular diseases. For instance, Tannerella forsythensis (formerly Bacteroides forsythus), Treponema denticola, other Treponema species, Dialister pneumosintes, and Prevotella tannerae were detected in infected root canals for the first time and in high prevalence when using PCR analysis. The diversity of endodontic microbiota has been demonstrated by studies using PCR amplification, cloning and sequencing of the PCR products. Moreover, other fastidious bacterial species, such as Porphyromonas endodontalis, Porphyromonas gingivalis and some Eubacterium spp., have been reported in endodontic infections at a higher prevalence than those reported by culture procedures.

Application of Chitosan and Propolis in Endodontic Treatment: A Review.

PubMed

Skoskiewicz-Malinowska, Katarzyna; Kaczmarek, Urszula; Malicka, Barbara; Walczak, Katarzyna; Zietek, Marek

2017-01-01

Chitosan and propolis are natural substances that can be commonly found in the environment. Chitosan is one of the several cationic polysaccharides found in nature. It is a natural biopolymer transformed from chitin which is a product of crustacean shells. Propolis is produced by honeybees through mixing the secretions of their hypopharyngeal glands with the digested product of resins collected from plants. Due to their excellent chemical and biological properties, chitosan and propolis arouse keen interest in dental science, including endodontics. There are various possibilities for applying propolis and chitosan based medicaments in endodontic treatment of root canals, and what is particularly emphasized is their potential effectiveness against resistant microorganisms such as E. faecalis and C. albicans, as well as biocompatible to the periapical tissues in comparison with the most commonly used agents. They aim at microflora which is difficult to eliminate, and their medicinal properties, including anti-inflammatory, antifungal and antiseptic properties, make them suitable for use in endodontic treatment. Due to the potential side effects of commonly used synthetic drugs and other safety related reasons, natural alternatives for endodontic usage are continuously explored and tested. The paper presents the possibilities of applying propolis and chitosan in endodontic treatment on the basis of chosen articles published in recent years. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

The Sensitivity of Endodontic Enterococcus spp. Strains to Geranium Essential Oil.

PubMed

Łysakowska, Monika E; Sienkiewicz, Monika; Banaszek, Katarzyna; Sokołowski, Jerzy

2015-12-21

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.

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

PubMed

Kashefinejad, Mohamad; Harandi, Azade; Eram, Saeed; Bijani, Ali

2016-01-01

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. 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). Patients treated with rotary instruments experienced significantly less post-endodontic pain than those treated with hand instruments (P<0.001). The use of Mtwo (NiTi) rotary instruments in root canal preparation contributed to lower incidence of postoperative pain than hand K-files.

Detection of Porphyromonas gingivalis, Porphyromonas endodontalis, Prevotella intermedia, and Prevotella nigrescens in chronic endodontic infection.

PubMed

Tomazinho, Luiz Fernando; Avila-Campos, Mario J

2007-02-01

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.

[Quantitive study of interleukin 1beta in periapical exudates of chronic periapical periodontitis in the course of root canal therapy].

PubMed

Yan, Pei-fang; Liang, Jing-ping; Chen, Wei-min; Gu, Shen-sheng

2007-06-01

To evaluate the relationship between IL-1beta and clinical findings of chronic apical periodontitis and to explore the function of IL-1beta during the endodontic interappointment flare-ups. Periapical exudates samples were obtained from 19 teeth suffering from endodontic flare-ups after root canal preparation and 20 teeth without any symptoms and signs at the second visit after root canal preparation. The levels of IL-1beta were determined by ELISA and the data was analyzed by SAS6.12 software package. Significantly higher levels of IL-1beta were found in periapical exudates from teeth suffering from endodontic flare-ups than that before canal preparation(P<0.001). The mean IL-1beta levels significantly decreased following the endodontic therapy if there were no symptom at the second visit (P<0.001). The level of IL-1beta in the exudates of root canals were related with the exist of infection which might take an active part in the occurrence of endodontic interappointment flare-up.

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

PubMed Central

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

2011-01-01

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

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

PubMed

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

2016-01-01

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

Endodontic Management of Maxillary First Molar With Two Palatal Canals Aided With Cone Beam Computed Tomography: A Case Report.

PubMed

Pamboo, Jaya; Hans, Manoj Kumar; Chander, Subhas; Sharma, Kapil

2017-04-01

The success of endodontic therapy is based on having sufficient endodontic access, correct cleaning and shaping, and adequate root canal obturation. However, endodontic treatment is also dependent on having a sound knowledge of the internal anatomy of human teeth, especially when anatomic variations are present. Reporting these alterations is important for improving the understanding and expertise of endodontists. The aim of this case report is to describe a unique case of maxillary first molar with 2 palatal canals within a single root, as confirmed by cone-beam computed tomography (CBCT) scans. This article also reviews recent case reports of extra palatal root canals in the maxillary first molars and the role of CBCT analysis in successfully diagnosing them.

Middle mesial canal of the permanent mandibular first molars: an anatomical challenge directly related to the outcome of endodontic treatment.

PubMed

Perlea, Paula; Nistor, Cristina Coralia; Imre, Marina; Gheorghiu, Irina Maria; Iliescu, Alexandru Andrei

2017-01-01

To effectively clean and shape the mandibular permanent first molars it is mandatory to understand in detail their complex internal anatomy. The middle mesial canal is an additional canal located between the usual mesiobuccal and mesiolingual canals in the mesial root of mandibular first molars. The incidence of the middle mesial canal, its relationship with main canals of the mesial root and the possibility for it to be negotiated is an important practical issue in endodontics. To identify the presence of this canal is mandatory. Accordingly, a modified endodontic access, the use of the operating microscope and periapical radiographs in two different horizontal projections are indicated to enhance the long-term favorable outcome of the endodontic treatment.

Clinically Enhancing Local Anesthesia Techniques for Endodontic Treatment.

PubMed

Bahcall, James; Xie, Qian

2017-02-01

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.

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

PubMed Central

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

2015-01-01

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

Update of guidelines for surgical endodontics - the position after ten years.

PubMed

Evans, G E; Bishop, K; Renton, T

2012-05-25

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.

Comparison of the Relative Risk of Molar Root Perforations Using Various Endodontic Instrumentation Techniques.

DTIC Science & Technology

1983-03-01

sodium hypochlorite using a standard endodontic irrigating syringe (Monoject Endodontic Syringe, Sherwood Medical Co., St. Louis, MO), and the...the sample. The Joel R. Kessler 8 teeth were placed in a 5.25% sodium hypochlorite solution for 30 minutes in order to remove soft tissue on the root...molars. J Endodon 1975;1:211-14. 7. Senia ES, Marshall FJ, Rosen S. The solvent action of sodium hypochlorite on pulp tissue of extracted teeth. Oral

Evaluation of Debridement Techniques for Endodontic Instruments

DTIC Science & Technology

1976-08-20

were used to instrument canals on extracted teeth. The instrumentation was per- formed first in wet canals irrigated with 2.5% sodium hypochlorite ...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

Evaluation of a New Thermoplastic Gutta Percha Obturation Technique Using 45Ca.

DTIC Science & Technology

1980-10-27

Codes A,’lzi 1 and/or D 1 Spoe 0, ’ -mi ll .. ., , N .... i I .. hl i Ii n . .. . .. INTRODUCTION In the development of endodontic therapy, many types...of filling material have been used for obturation.1-3 Various techniques of obturation have also been employed. In present day endodontic therapy, the...primary objectives of endodontic therapy.3 ,6𔄁 Various radioisotopes have been utilized to evaluate the adequacy of the apical seal. 8-13 One

Abstracts of Research Project Reports by Naval Dental Clinic First- and Second-Year Residents - June 1983.

DTIC Science & Technology

1983-12-01

The teeth were boiled in water and soaked in a 5.25-percent solution of sodium hypochlorite to clean the root surfaces of any soft tissue and debris...UOSBATR- BOWED DENTAL INVESTMNT 6 Z.T. Nelar CONTENTS (cmt’d) Abstract pase NO. 13. CLINICAL AND HISTOLOGIC EVALUATION OF EXTRUDED ENDODONTICALLY THUR M...AN IN VITRO EVALUATION OF PERFLUOROCTYLBRONIDE AS AN ENDODONTIC - IRRIGATING SOLUTION IN ENDODONTIC TREATMENT J. D. Allemang Perfluoroctylbromide (POD

Comparison of Gutta Percha Filling Techniques. Part 1. Compaction (Mechanical), Vertical (Warm), and Lateral Condensation Techniques.

DTIC Science & Technology

1980-06-01

endodontically and filed to a size #60 file. The tooth was soaked in a 5% sodium hypochlorite solution for 2 days,12 washed in tap water and then placed...IS. KEY WORDS (Continue on reverse side If necessary and identify by block number) Endodontics ; gutta percha; obturation; lateral condensation...Condensation Techniques M. Wong, DDS Resident, Endodontics Dept. of Dentistry - PO Box 59 Madigan Army Medical Center Tacoma, Washington 98431 D.D. Peters, BA

Role of occlusion in endodontic management: report of two cases.

PubMed

Yu, Christine Y

2004-12-01

The two clinical cases reported demonstrate that traumatic occlusion can play a role in the initiation and progression of pulp and periradicular inflammation. The symptom of persistent pain did not subside after the commencement of endodontic treatment. Traumatic occlusion was identified in both cases to be the main cause and hence occlusal adjustment was performed. This resulted in the gradual resolution of the symptoms. The findings suggest that occlusal trauma is often overlooked in the diagnosis and management of endodontic diseases.

Endodontic and Clinical Considerations in the Management of Variable Anatomy in Mandibular Premolars: A Literature Review

PubMed Central

Hammo, Mohammad

2014-01-01

Mandibular premolars are known to have numerous anatomic variations of their roots and root canals, which are a challenge to treat endodontically. The paper reviews literature to detail the various clinically relevant anatomic considerations with detailed techniques and methods to successfully manage these anomalies. An emphasis and detailed description of every step of treatment including preoperative diagnosis, intraoperative identification and management, and surgical endodontic considerations for the successful management of these complex cases have been included. PMID:24895584

Endodontic treatment of a fused tooth. Report of a case.

PubMed

Gallottini, L; Barbato Bellatini, R C; Migliau, G

2007-01-01

Dental fusion, a rare developmental anomaly present in 0.2% of the general population, consists of the union of two teeth originating from two different tooth germs. The irregular coronal morphology and the complex endodontic anatomy, characterized by the partial or total union of the pulp chambers, together with the peculiarity of the root canal systems, make diagnosis, therapy and rehabilitation difficult. The authors describe the endodontic treatment of a permanent lower second molar fused with a third molar and having four root canals.

Mandibular molar with five root canals.

PubMed

Barletta, Fernando Branco; Dotto, Sidney Ricardo; Reis, Magda de Sousa; Ferreira, Ronise; Travassos, Rosana Maria Coelho

2008-12-01

The purpose of this study was to demonstrate the importance of knowledge of the internal anatomy of root canals for the success of endodontic treatment. Lack of knowledge of anatomic variations and their characteristics in different teeth has been pointed out as one of the main causes of endodontic therapy failure. In this report, the authors describe the endodontic treatment of a mandibular first molar with five root canals, evaluate the rate of occurrence of this number of canals, and discuss the importance of their identification and treatment.

Efficacy of orally administered prednisolone versus partial endodontic treatment on pain reduction in emergency care of acute irreversible pulpitis of mandibular molars: study protocol for a randomized controlled trial.

PubMed

Kérourédan, Olivia; Jallon, Léonard; Perez, Paul; Germain, Christine; Péli, Jean-François; Oriez, Dominique; Fricain, Jean-Christophe; Arrivé, Elise; Devillard, Raphaël

2017-03-28

Irreversible pulpitis is a highly painful inflammatory condition of the dental pulp which represents a common dental emergency. Recommended care is partial endodontic treatment. The dental literature reports major difficulties in achieving adequate analgesia to perform this emergency treatment, especially in the case of mandibular molars. In current practice, short-course, orally administered corticotherapy is used for the management of oral pain of inflammatory origin. The efficacy of intraosseous local steroid injections for irreversible pulpitis in mandibular molars has already been demonstrated but resulted in local comorbidities. Oral administration of short-course prednisolone is simple and safe but its efficacy to manage pain caused by irreversible pulpitis has not yet been demonstrated. This trial aims to evaluate the noninferiority of short-course, orally administered corticotherapy versus partial endodontic treatment for the emergency care of irreversible pulpitis in mandibular molars. This study is a noninferiority, open-label, randomized controlled clinical trial conducted at the Bordeaux University Hospital. One hundred and twenty subjects will be randomized in two 1:1 parallel arms: the intervention arm will receive one oral dose of prednisolone (1 mg/kg) during the emergency visit, followed by one morning dose each day for 3 days and the reference arm will receive partial endodontic treatment. Both groups will receive planned complete endodontic treatment 72 h after enrollment. The primary outcome is the proportion of patients with pain intensity below 5 on a Numeric Scale 24 h after the emergency visit. Secondary outcomes include comfort during care, the number of injected anesthetic cartridges when performing complete endodontic treatment, the number of antalgic drugs and the number of patients coming back for consultation after 72 h. This randomized trial will assess the ability of short-term corticotherapy to reduce pain in irreversible pulpitis as a simple and rapid alternative to partial endodontic treatment and to enable planning of endodontic treatment in optimal analgesic conditions. ClinicalTrials.gov, identifier: NCT02629042 . Registered on 7 December 2015. (Version n°1.1 28 July 2015).

Predictive models of pain following root canal treatment: a prospective clinical study.

PubMed

Arias, A; de la Macorra, J C; Hidalgo, J J; Azabal, M

2013-08-01

To determine the probability of the incidence, intensity, duration and triggering of post-endodontic pain, considering factors related to the patient (age, gender, medical evaluation) and to the affected tooth (group, location, number of canals, pulp vitality, preoperative pain, periapical radiolucencies, previous emergency access, presence of occlusal contacts with antagonist). A total of 500 one-visit root canal treatments (RCTs) were performed on patients referred to an endodontist. Shaping of root canals was performed manually with Gates-Glidden drills and K-Flexofiles, and apical patency was maintained with a size 10 file. A 5% NaOCl solution was used for irrigation, and canals were filled with lateral compaction and AH-Plus sealer. Independent factors were recorded during the treatment, and characteristics of post-endodontic pain (incidence, intensity, type and duration) were later surveyed through questionnaires. Of the 500 questionnaires, 374 were properly returned and split in two groups for two different statistical purposes: 316 cases were used to adjust the logistic regression models to predict each characteristic of post-endodontic pain using predictive factors, and the remaining 58 cases were used to test the validity of each model. The predictive models showed that the incidence of post-endodontic pain was significantly lower when the treated tooth was not a molar (P = 0.003), demonstrated periapical radiolucencies (P = 0.003), had no history of previous pain (P = 0.006) or emergency endodontic treatment (P = 0.045) and had no occlusal contact (P < 0.0001). The probability of experiencing moderate or severe pain was higher with increasing age (P = 0.09) and in mandibular teeth (P = 0.045). The probability of pain lasting more than 2 days was increased with age (P = 0.1) and decreased in males (P = 0.007) and when a radiolucent lesion was present on radiographs (P = 0.1). Predictive formulae for the incidence, the intensity and the duration of post-endodontic pain were generated and validated taking account of the interrelation of multiple concomitant clinical factors. A predictive model for triggering post-endodontic pain could not be established. © 2013 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Evolving Trends in Endodontic Research: An Assessment of Published Articles in 2 Leading Endodontic Journals.

PubMed

Tzanetakis, Giorgos N; Stefopoulos, Spyridon; Loizides, Alexios L; Kakavetsos, Vasileios D; Kontakiotis, Evangelos G

2015-12-01

The aim of this study was to evaluate and analyze the evolving trends in endodontic research in 2 leading endodontic journals (ie, Journal of Endodontics and International Endodontic Journal) in articles published from January 2009 to December 2013. The differences in content between this period and a 10-year earlier period from January 1999 to December 2003 were also evaluated. Each journal's content was accessed through the web edition. For each article, the following parameters were recorded: number of authors, article type, number of affiliations, field of study, source of article, and geographic origin. The recorded data were analyzed using both descriptive and analytic statistics. During 2009-2013 (second period), the mean number of authors per article increased significantly compared with 1999-2003 (first period). The main volume of the literature in both periods and journals was original research articles. The number of published reviews increased significantly from the first to the second study period in contrast to case reports/clinical articles, which presented a significant decrease. "Endodontic materials" was the most prevalent thematic category in both study periods. The number of published articles related to "biology" and "chemical preparation and disinfection" increased significantly from the first to the second study period. On the contrary, the number of articles regarding "obturation and microleakage" presented a considerable decrease at the same time. The United States was the leading country in the number of publications in the first period followed by Brazil. In the second period, this rank was reversed with Brazil becoming the leading country followed by the United States. In the last 15 years, the progress of the specialty of endodontology was apparent as shown through the trends and shifts in research orientation in published articles in the 2 leading endodontic journals. The results of the present reviewing process encourage both journals to publish well-designed research projects with a high degree of difficulty, thus contributing to a more evidence-based approach of endodontology. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

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

PubMed

Kamberi, Blerim; Hoxha, Veton; Stavileci, Miranda; Dragusha, Edmond; Kuçi, Astrit; Kqiku, Lumnije

2011-11-29

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

3D imaging, 3D printing and 3D virtual planning in endodontics.

PubMed

Shah, Pratik; Chong, B S

2018-03-01

The adoption and adaptation of recent advances in digital technology, such as three-dimensional (3D) printed objects and haptic simulators, in dentistry have influenced teaching and/or management of cases involving implant, craniofacial, maxillofacial, orthognathic and periodontal treatments. 3D printed models and guides may help operators plan and tackle complicated non-surgical and surgical endodontic treatment and may aid skill acquisition. Haptic simulators may assist in the development of competency in endodontic procedures through the acquisition of psycho-motor skills. This review explores and discusses the potential applications of 3D printed models and guides, and haptic simulators in the teaching and management of endodontic procedures. An understanding of the pertinent technology related to the production of 3D printed objects and the operation of haptic simulators are also presented.

Endodontics and the ageing patient.

PubMed

Johnstone, M; Parashos, P

2015-03-01

Patients are living longer and the rate of edentulism is decreasing. Endodontic treatment is an essential part of maintaining the health and well-being of the elderly. Retention of natural teeth improves the quality of life and the overall health and longevity of ageing patients. Also, teeth that might be otherwise extracted may be strategically valuable to retain a prosthesis, and elderly patients are more likely to have medical complications that may prevent dental extractions from being safely performed. The technical goals of endodontic treatment in the elderly are the same as those for younger patients. However, the pulpo-dentinal complex undergoes calcific changes over time, which may pose challenges for the clinician. The purposes of this review are to discuss age changes in the pulp and the challenges posed by diagnosing, treatment planning and treating the elderly endodontic patient. © 2015 Australian Dental Association.

Sodium hypochlorite accident with evaluation by cone beam computed tomography.

PubMed

Behrents, K T; Speer, M L; Noujeim, M

2012-05-01

To show the radiographic manifestation of sodium hypochlorite after accidental injection past the apical foramen and into the soft tissues. A female patient was seen for an emergency visit after suffering a sodium hypochlorite accident at her general dentist's office. The patient was seen within 1 h of the accident and was in pain associated with facial swelling. Radiographs, including a Cone Beam Computed Tomography (CBCT), and photographs were taken. Endodontic emergency treatment was initiated. The patient was reassured and given pain medication and antibiotics. Follow-up visits were scheduled over 6 days when the swelling had resolved. • Importance of multiple radiographic images during preoperative endodontic evaluation when undertaking endodontic retreatment. • Knowledge of apical anatomy as related to surrounding structures. • Effect of sodium hypochlorite when injected in the soft tissues. © 2012 International Endodontic Journal.

Endodontic management of supernumerary tooth fused with maxillary first molar by using cone-beam computed tomography.

PubMed

Song, Chang-Kyu; Chang, Hoon-Sang; Min, Kyung-San

2010-11-01

Fusion is a rare occurrence, and its definitive diagnosis is of prime importance for successful root canal treatment. This case report discusses the endodontic management of a supernumerary tooth fused with a right maxillary first molar by using cone-beam computed tomography (CBCT). Nonsurgical endodontic retreatment was performed on the supernumerary tooth. A communication between the maxillary first molar and the supernumerary tooth was repaired by using flowable resin. After 1 year of follow-up, there were no clinical symptoms, and the maxillary first molar remained vital. Recall radiographs and CBCT showed satisfactory healing of the periapical pathosis. Proper diagnosis and treatment planning for endodontic management of fused teeth by using CBCT can ensure predictable and successful results. Copyright © 2010 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

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

PubMed Central

Asgary, Saeed

2014-01-01

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

Proposal of a “Checklist” for endodontic treatment

PubMed Central

Díaz-Flores–García, Víctor; Perea-Pérez, Bernardo; Santiago-Sáez, Andrés; Cisneros-Cabello, Rafael

2014-01-01

Objectives: On the basis of the “Surgical Checklist” proposed by the WHO, we propose a new Checklist model adapted to the procedures of endodontic treatment. Study Design: The proposed document contains 21 items which are broken down into two groups: those which must be verified before beginning the treatment, and those which must be verified after completing it, but before the patient leaves the dentist’s office. Results: The Checklist is an easy-to-use tool that requires little time but provides, order, logic and systematization by taking into account certain basic concepts to increase patient safety. Discussion: We believe that the result is a Checklist that is easy to complete and which ensure the fulfillment of the key points on patient safety in the field of endodontics. Key words:Checklist, endodontics, patient safety, adverse event. PMID:24790707

Local anesthetics: special considerations in endodontics.

PubMed

Jeske, Arthur H

2003-03-01

Local anesthetics are essential for successful endodontic treatment, and their pharmacologic characteristics have special implications for the treatment of painful, chronically-inflamed or necrotic teeth. Their dosages must be limited to prevent toxicity, which may be enhanced by the coadministration of sedative agents or drugs which affect hepatic drug metabolism. Endodontic patients with established central and peripheral sensitization represent special challenges for pain control, since morphogenetic changes resulting from neurogenic inflammation can render pain fibers more resistant to local anesthesia. The use of vasconstrictors with conventional and alternative injection techniques, e.g., intraosseous injections, are necessary to prolong the duration of action of local anesthesia but can place patients with cardiovascular disease at some risk. An appreciation of all of these aspects of local anesthesia in endodontics will better prepare the operator for predictably safe and effective patient care.

Biocorrosion of Endodontic Files through the Action of Two Species of Sulfate-reducing Bacteria: Desulfovibrio desulfuricans and Desulfovibrio fairfieldensis.

PubMed

Heggendorn, Fabiano Luiz; Gonçalves, Lucio Souza; Dias, Eliane Pedra; de Oliveira Freitas Lione, Viviane; Lutterbach, Márcia Teresa Soares

2015-08-01

This study assessed the biocorrosive capacity of two bacteria: Desulfovibrio desulfuricans and Desulfovibrio fairfieldensis on endodontic files, as a preliminary step in the development of a biopharmaceutical, to facilitate the removal of endodontic file fragments from root canals. In the first stage, the corrosive potential of the artificial saliva medium (ASM), modified Postgate E medium (MPEM), 2.5 % sodium hypochlorite (NaOCl) solution and white medium (WM), without the inoculation of bacteria was assessed by immersion assays. In the second stage, test samples were inoculated with the two species of sulphur-reducing bacteria (SRB) on ASM and modified artificial saliva medium (MASM). In the third stage, test samples were inoculated with the same species on MPEM, ASM and MASM. All test samples were viewed under an infinite focus Alicona microscope. No test sample became corroded when immersed only in media, without bacteria. With the exception of one test sample between those inoculated with bacteria in ASM and MASM, there was no evidence of corrosion. Fifty percent of the test samples demonstrated a greater intensity of biocorrosion when compared with the initial assays. Desulfovibrio desulfuricans and D. fairfieldensis are capable of promoting biocorrosion of the steel constituent of endodontic files. This study describes the initial development of a biopharmaceutical to facilitate the removal of endodontic file fragments from root canals, which can be successfully implicated in endodontic therapy in order to avoiding parendodontic surgery or even tooth loss in such events.

A study of visual and blood contamination on reprocessed endodontic files from general dental practice.

PubMed

Letters, S; Smith, A J; McHugh, S; Bagg, J

2005-10-22

This study examined methods used for reprocessing endodontic instruments in general dental practice and determined the degree of residual visual contamination and blood contamination on 250 reprocessed files collected from 25 general dental practices. A questionnaire was administered to 25 general dental practitioners to obtain information on the re-processing of used endodontic files. Ten files which had been used and reprocessed were also collected from each practice. These were examined visually under a dissecting light microscope for residual contamination and then tested for blood deposits using the Kastle-Meyer test. Nineteen of the 25 practices used stainless steel hand files. No practitioners used endodontic files as single use devices. Ninety-two per cent of the practitioners discarded and replaced files when they were bent or damaged. Several decontamination methods were reported. The two combinations employed most frequently were manual cleaning and autoclaving or manual cleaning, followed by ultrasonic cleaning and autoclaving. Of the 250 files, 75% showed some degree of visual contamination and seven percent tested positive for residual blood. Blood contaminated files were significantly more heavily contaminated when examined visually. Large variations were found in residual contamination of files collected from practices using the same methods of decontamination. While all practitioners re-used endodontic files, the variations in decontamination methods reported indicate a lack of clarity on best practice. This study demonstrates that endodontic files are not reliably decontaminated by methods currently employed in dental practice.

Healing of Horizontal Intra-alveolar Root Fractures after Endodontic Treatment with Mineral Trioxide Aggregate.

PubMed

Kim, Dohyun; Yue, Wonyoung; Yoon, Tai-Cheol; Park, Sung-Ho; Kim, Euiseong

2016-02-01

The purpose of this retrospective study was to evaluate the healing type and assess the outcome of horizontal intra-alveolar root fractures after endodontic treatment with mineral trioxide aggregate (MTA) as filling material. The clinical database of the Department of Conservative Dentistry at Yonsei University Dental Hospital, Seoul, Korea, was searched for patients with histories of intra-alveolar root fractures and endodontic treatments with MTA between October 2005 and September 2014. Radiographic healing at the fracture line was evaluated independently by 2 examiners and was classified into 4 types according to Andreasen and Hjørting-Hansen. Of the 22 root-fractured teeth that received endodontic treatment with MTA, 19 cases participated in the follow-up after a period of at least 3 months. Seventeen of the 19 teeth (89.5%) exhibited healing of the root fractures. For each healing type, 7 teeth (36.8%) showed healing with calcified tissue, 8 teeth (42.1%) showed interposition of connective tissue, 2 teeth (10.5%) showed interposition of connective tissue and bone, and 2 teeth (10.5%) showed interposition of granulation tissue without healing. Within the limitations of this study, intra-alveolar root fractures showed satisfactory healing outcomes after endodontic treatment with MTA. MTA could be considered to be suitable filling material for the endodontic treatment of horizontal intra-alveolar root fractures. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Undergraduate endodontic education: what are the challenges?

PubMed

Qualtrough, A J E

2014-03-01

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

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

PubMed Central

Kashefinejad, Mohamad; Harandi, Azade; Bijani, Ali

2016-01-01

Objectives: Pain is an unpleasant outcome of endodontic treatment that can be unbearable to patients. Instrumentation techniques may affect the frequency and intensity of post-endodontic pain. This study aimed to compare single visit post endodontic pain using Mtwo (NiTi) rotary and hand K-file instruments. Materials and Methods: In this randomized controlled trial, 60 teeth with symptomatic irreversible pulpitis in 53 patients were selected and randomly assigned into two groups of 30 teeth. In group A, the root canals were prepared with Mtwo (NiTi) rotary instruments. In group B, the root canals were prepared with hand K-file instruments. Pain assessment was implemented using visual analog scale (VAS) at four, eight, 12 and 24 hours after treatment. The acquired data were analyzed using chi-square, Mann-Whitney U and Student’s t-test (P<0.05). Results: Patients treated with rotary instruments experienced significantly less post-endodontic pain than those treated with hand instruments (P<0.001). Conclusions: The use of Mtwo (NiTi) rotary instruments in root canal preparation contributed to lower incidence of postoperative pain than hand K-files. PMID:27536323

[Evaluation of postoperative pain comparing manual and ultrasonic endodontic instrumentation in patients with cleft lip and palate].

PubMed

Brosco, H B; Pimentel, P A; Lacerda, A G; Nishiyama, C K; de Moraes, I G

1989-01-01

Our purpose was to compare incidence of post-surgical pain associated to the endodontic therapy where the instrumentation on the root canal was performed by the method of Marshall & Pappin and the method of Marshall & Pappin complemented by the ultrasonic. Seventy patients with only one tooth needing endodontic treatment were treated by one of the methods and, posteriorly, evaluated. The endodontic treatment was performed at one time and from the seventy teeth, thirty have been instrumented by the manual method complemented by the ultrasonic and forty by the manual instrumentation. The patients were clinically controlled after the endodontic treatment was finished during periods of 24, 48 and 72 hours to evaluate their post-surgical condition. The results suggest that were no statistically significant differences (p less than 0.05) in the incidence of pain between the employed methods or according to the pulpar semiologic condition in any of the observed periods. However, we have realized that there was a tendency for a smaller percentage of a postoperative pain in those cases of necropulpectamy treated by the endosonic ultrasonic synergistic system. In those cases of biopulpectomy this has been not observed.

Definition and endodontic treatment of dilacerated canals: a survey of Diplomates of the American Board of Endodontics.

PubMed

Dastmalchi, Nafiseh; Kazemi, Zeinab; Hashemi, Siroos; Peters, Ove A; Jafarzadeh, Hamid

2011-01-01

To gather data from Diplomates of the American Board of Endodontics regarding treatment of dilacerated canals. A questionnaire addressing definition, endodontic treatment procedures and prognosis was constructed and distributed via e-mail to 708 Diplomates of the American Board of Endodontics. Data from 150 respondents, a 21% response rate, were collected by using a Web-based interface. For statistical analysis, Chi-square tests were used. More than 25% of respondents believed that a dilacerated root should have a curvature > 40°. One-visit treatment is the best therapeutic approach and transportation is the most likely complication in preparation of these canals. A crown-down technique, watch-winding motion and a master apical file # 25 are the best choices for preparation of these canals. Any warm obturation technique is preferred over lateral compaction by most respondents. A crown-down technique for root canal preparation and a thermoplastic obturation technique are recommended for canals whose curvature is more than 40°. The prognosis of the treatment of these canals is judged not lower than normal canals. Crown-down technique and thermoplastic obturation are recommended for dilacerated canals.

Morphologic variations of maxillary molars palatal root and the importance of its knowledge for endodontic practice: a case series.

PubMed

Scarparo, Roberta Kochenborger; Pereira, Leticia; Moro, Diana; Grundling, Grasiela; Gomes, Maximiliano; Grecca, Fabiana Soares

2011-03-01

The present report describes and discusses root canal variations in the internal morphology of maxillary molars. Dental internal anatomy is directly related to all the technical stages of the endodontic treatment. Even though, in some situations a typical anatomical characteristics can be faced, and the professional should be able to identify them. This clinical report describes five cases with different pulpar and periapical diagnostics where the endodontic treatment was performed, in which during the treatment the unusual occurrence of two or three canals in the palatal root 'or even two distinct palatal roots' of first and second maxillary molars, were described and important details for achieving treatment success were discussed. The knowledge of tooth internal anatomy must be considered during clinical and radiographic examinations. This should be valued not only to find atypical canals but also to enable calcified canals cleaning and shaping, once they are frequently omitted during endodontic therapy. Anatomic variations can occur in any tooth, and palatal roots of maxillary first and second molars are no exception. The complexity of the root canal system and the importance of identifying its internal anatomy for planning endodontic treatment increase the chances of success.

Possibilities and limits of imaging endodontic structures with CBCT.

PubMed

Weber, Marie-Theres; Stratz, Nadja; Fleiner, Jonathan; Schulze, Dirk; Hannig, Christian

2015-01-01

An adequate portrayal of the root canal anatomy by diagnostic imaging is a prerequisite for a successful diagnosis and therapy in endodontics. The introduction of dental cone beam computed tomography (CBCT) has considerably expanded the scope of imaging diagnostics. The aim of the following study was to evaluate the imaging of endodontic structures with CBCT. One hundred and twenty teeth were examined with a CBCT device (ProMax 3D). Subsequently, the findings of the three-dimensional images were evaluated and compared to those of dental radiographs and tangential section preparations of the examined teeth. Results with high prevalence, such as existing roots and root canals, as well as results with low prevalence, e.g., extremely fine anatomical structures of the endodontic tissue, could be visualized precisely by dental CBCT; side canals, ramifications, communications, pulp stones, and obliterations could also be detected. Additionally, the length of curved root canals could be determined accurately. Likewise, root fractures were visualized reliably with CBCT. However, carious lesions could not be diagnosed adequately, and the evaluation of fillings and prosthetic restorations was complicated due to scattered X-ray artifacts. CBCT datasets qualify to visualize and diagnose small anatomical structures of the endodontic tissue.

21 CFR 872.3890 - Endodontic stabilizing splint.

Code of Federal Regulations, 2011 CFR

2011-04-01

...) Identification. An endodontic stabilizing splint is a device made of a material, such as titanium, intended to be inserted through the root canal into the upper or lower jaw bone to stabilize a tooth. (b) Classification...

Endodontic management of a mandibular third molar fused with a fourth molar.

PubMed

Turell, I L; Zmener, O

1999-05-01

Developmental anomalies in permanent molars frequently require surgical intervention. A case of a mandibular third molar fused with a fourth molar which was successfully treated with conservative endodontic therapy is reported.

Endodontic Microbiology and Pathobiology: Current State of Knowledge.

PubMed

Fouad, Ashraf F

2017-01-01

Newer research tools and basic science knowledge base have allowed the exploration of endodontic diseases in the pulp and periapical tissues in novel ways. The use of next generation sequencing, bioinformatics analyses, genome-wide association studies, to name just a few of these innovations, has allowed the identification of hundreds of microorganisms and of host response factors. This review addresses recent advances in endodontic microbiology and the host response and discusses the potential for future innovations in this area. Copyright © 2016 Elsevier Inc. All rights reserved.

Argon laser application to endodontics

NASA Astrophysics Data System (ADS)

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

1993-07-01

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

The Effect of Immediate versus Delayed Dowel Space Preparation on Endodontically Filled Teeth.

DTIC Science & Technology

1981-01-01

solution of 1% sodium hypochlorite (Chlorox Corp., Oakland, CA) to remove any tissue tags attached to the root surface. The crowns of all the teeth were...stored. Two weeks later, twenty more weo~ similarly filled. Using hot endodontic pluggers, dowel spaces were prepare d 4h-th~t eithe 3mm or 71T11 of...Preparation on Endodontically Filled Teeth Acce sion r NTIS .... D TTC TAB Distrilu Av r i 0ou- Dist 1 A! The Effect of Immediate Versus Delayed Dowel

A Histologic Comparison of the Canal Wall Planning Ability of Two New Endodontic Files,

DTIC Science & Technology

1983-01-01

preparation of root canals. Oral Surg 1968; 25: 108-116. 14. Senia ES, Marshall FJ, Rosen S. The solvent action of sodium hypochlorite on pulp tissue of...PERiOO COGERED A Histologic Comparison Of The Canal Wall Planning Ability Of Two New Endodontic Files THESIS/rI1 N 6 PERFORMi-4G 01 G. REPORT NuMBI...TITLE: A Histologic Comparison Of The Canal Wall Planning Ability Of Two New Endodontic Files AUTHOR: Robert L Hill and Carlos E. del Rio RESEARCH

A Sequential Approach in Treatment of Endo-Perio Lesion A Case Report

PubMed Central

Aspalli, Nagaveni; Munavalli, Anil; Ajgaonkar, Nishant; Babannavar, Roopa

2014-01-01

Endo-perio lesions primarily occur by way of the intimate anatomic and vascular connections between the pulp and the periodontium. Endodontic-periodontal combined lesion is a clinical dilemma because making a differential diagnosis and deciding a prognosis are difficult. An untreated primary endodontic lesion may become secondarily involved with periodontal breakdown, which clinically present unusual signs and symptoms. This may delay the diagnosis and hence the correct treatment. This case report describes diagnosis and treatment protocol for an endo-perio lesion of primary endodontic with secondary periodontal involvement. PMID:25302276

A sequential approach in treatment of endo-perio lesion a case report.

PubMed

Kambale, Sharanappa; Aspalli, Nagaveni; Munavalli, Anil; Ajgaonkar, Nishant; Babannavar, Roopa

2014-08-01

Endo-perio lesions primarily occur by way of the intimate anatomic and vascular connections between the pulp and the periodontium. Endodontic-periodontal combined lesion is a clinical dilemma because making a differential diagnosis and deciding a prognosis are difficult. An untreated primary endodontic lesion may become secondarily involved with periodontal breakdown, which clinically present unusual signs and symptoms. This may delay the diagnosis and hence the correct treatment. This case report describes diagnosis and treatment protocol for an endo-perio lesion of primary endodontic with secondary periodontal involvement.

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

PubMed Central

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

2014-01-01

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

The prognosis of root canal therapy: a 10-year retrospective cohort study on 411 patients with 1175 endodontically treated teeth.

PubMed

Fonzar, Federica; Fonzar, Alberto; Buttolo, Piercarlo; Worthington, Helen V; Esposito, Marco

2009-01-01

To evaluate the 10-year prognosis of consecutively endodontically treated or retreated teeth and to investigate some of the prognostic factors which could predict the long-term outcome of endodontic therapy. This retrospective cohort study included any patient who had endodontically treated or retreated teeth from 1986 to 1998 by a single operator in a private practice. Outcome measures were clinical and radiographic success assessed by the operator, radiographic success assessed by an independent outcome assessor and complications evaluated 10 years after treatment. Descriptive statistics, life table, Kaplan-Meier and Cox regression analyses for success were fitted. A total of 411 patients with 1175 endodontically treated teeth were identified. Ten years after treatment 102 patients (24.8%) with 223 (19.0%) teeth were lost at the follow-up. The number of teeth that were originally treated and retreated were 704 and 471, respectively. Thirty-two teeth (2.7%) had one complication, which was successfully treated. A total of 988 (84.1%) teeth were considered a complete success, 46 (3.9%) a partial success, 52 (4.4%) a partial failure and 68 (5.8%) had to be extracted according to the treating clinician. For 21 teeth (1.8%) there was no follow-up information. The radiographic healing of 1086 teeth was evaluated by an independent assessor: 980 (90.2%) showed complete healing, 52 (4.8%) improvement, and 54 (5.0%) no change or worsening. The life-table analysis showed 93% of teeth surviving at 10 years after endodontic treatment. There were no differences for survival rates between teeth treated for the first time and those that were retreated (Kaplan-Meier). Teeth retreated because of symptoms or for a periapical/lateral radiolucency were more likely to fail. Approximately 7% of endodontically treated teeth were extracted 10 years after treatment. Symptoms and radiolucency of teeth needing retreatment may be important predictors for failure.

Antimicrobial Activity of Endodontic Medicaments and Vehicles using Agar Well Diffusion Method on Facultative and Obligate Anaerobes

PubMed Central

Bhat, Kishore G; Sogi, Suma

2016-01-01

Aims The aim of this study was to determine the relative antimicrobial effectiveness of these endodontic medicaments and various vehicles using an agar well diffusion assay. Materials and methods Double Antibiotic Paste(DAP), modified DAP, 2% Chlorhexidine gluconate and their combination with four vehicles namely Polyethylene glycol 400 (PEG), Propylene glycol (PG), combinations of PG with PEG and lastly Glycerine were tested using agar well diffusion assay. The minimum bactericidal concentration was noted against four standard strains of organisms ie Streptococcus mutans ATCC( American Type Culture Collection) 25175, Staphylococcus aureus ATCC 12598, Enterococcus faecalis ATCC 35550 and Eschericia coli ATCC 25922. Successful endodontic therapy depends upon thorough disinfection of root canals. In some refractory cases, routine endodontic therapy is not sufficient, so intracanal medicaments are used for proper disinfection of canals. Issues of resistance, limited spectrum of activity and lack of antifungal properties, the hunt for the ideal intracanal medicament continues. In this regard, the vehicles used to form the pastes play a supportive role by forming the appropriate consistency for placement and may dramatically influence their chemical characteristics like their solubility and diffusion. Thus, inorder to use safer and equally effective intracanal medicaments, Chlorhexidine gluconate is being unveiled in this study. Results The difference between the four vehicles when combined with the same endodontic medicament studied above is nonsignificant (NS) except against Porphyromonas gingivalis. Propylene glycol is significantly effective than Glycerine when used with DAP ie C+M medicament combination. (p = 0.029) Conclusion 2% chlorhexidine gluconate and modified DAP can definitely replace DAP and triple antibiotic paste as end-odontic medicaments with chlorhexidine having an added advantage of bactericidal action, substantivity, biocompatibility, low toxicity, and lesser chances of developing resistance. How to cite this article Nalawade TM, Bhat KG, Sogi S. Antimicrobial Activity of Endodontic Medicaments and Vehicles using Agar Well Diffusion Method on Facultative and Obligate Anaerobes. Int J Clin Pediatr Dent 2016;9(4):335-341. PMID:28127166

Dentin-like versus Rigid Endodontic Post: 11-year Randomized Controlled Pilot Trial on No-wall to 2-wall Defects.

PubMed

Naumann, Michael; Sterzenbach, Guido; Dietrich, Thomas; Bitter, Kerstin; Frankenberger, Roland; von Stein-Lausnitz, Manja

2017-11-01

This is the first long-term randomized controlled trial to evaluate dentin-like glass fiber posts (GFPs) compared with rather rigid titanium posts (TPs) for post-endodontic restoration of severely damaged endodontically treated teeth with 2 or fewer remaining cavity walls. Ninety-one subjects in need of post-endodontic restorations were randomly assigned to receive either a tapered GFP (n = 45) or TP (n = 46). Posts were adhesively luted by using self-adhesive resin cement, followed by composite core build-up and preparation of 2-mm ferrule design. Primary end point was loss of restoration for any reason. Kaplan-Meier curves were constructed, and log-rank test was calculated (P < .05). After a follow-up of 132 months, 17 GFP and 20 TP restorations survived, and 19 failed (12 GFP, 7 TP). Failure modes for GFP were root fracture (n = 4), core fracture (n = 1), secondary caries (n = 1), endodontic failure (n = 2), extraction because of tooth mobility grade III associated with insufficient design of removable partial denture (n = 1), tooth fracture (n = 1), and changes in treatment plan (n = 2); failure modes for TP were endodontic failure (n = 5), root fracture (n = 1), and 1 extraction for other reasons. Cumulative survival probability was 58.7% for GFP and 74.2% for TP. When using self-adhesively luted prefabricated posts, resin composite core build-up, and 2-mm ferrule to reconstruct severely damaged endodontically treated teeth, tooth survival is not influenced by post rigidity. Survival decreased rapidly after 8 years of observation in both groups. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

An in vitro Evaluation of Fracture Resistance of endodontically treated Teeth with Different Restorative Materials.

PubMed

Sangwan, Babita; Rishi, Rahul; Seal, Mukut; Jain, Kanav; Dutt, Pranjali; Talukdar, Pratim

2016-07-01

The aim of the present study is to compare and assess the fracture resistance of root canal treated teeth with different restorative materials. The present in vitro study was carried out on seventy-five freshly extracted, noncarious, single-canal human lower-first premolars with similar anatomic characteristics. Teeth were randomly assigned to five groups with 15 teeth being present in each group. Group I is control group (no alteration done), group II is restored with silver amalgam after endodontic therapy, group III is restored with posterior composite after end-odontic therapy, group IV is restored with posterior glass ionomer cement (GIC) after endodontic therapy, and group V is restored with miracle mix after endodontic therapy. Universal testing machine was used to assess the fracture strength. Analysis of variance (ANOVA) test followed by Tukey's post hoc test were used to determine the significant difference between each group. A p-value of < 0.05 was considered as statistically significant. The mean fracture resistance of control group showed highest fracture resistance with a mean Newton of 1083.33 ± 136.78. Among the restorative material, the highest fracture resistance was shown by teeth restored by composite (845.46 ± 47.36), followed by silver amalgam (845.46 ± 47.36). There was statistically significant difference among all the restorative materials compared with the control group (p < 0.05). However, among the teeth restored with silver amalgam and miracle mix, there was no statistical significance (p > 0.05). The present study concludes that composites are found to be having more fracture resistance followed by silver amalgam on endodontically treated premolar teeth. Restoring nonvital teeth represents a major challenge for clinicians as they are extensively damaged due to caries and endodontic access preparations. With various restorative materials in the market, it becomes difficult for the clinician to choose the better restorative material for postendodontic restoration.

Endodontic 'solutions' part 1: a literature review on the use of endodontic lubricants, irrigants and medicaments.

PubMed

Good, Melissa; El, Karim Ikhlas A; Hussey, David L

2012-05-01

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.

Fracture resistance and primary failure mode of endodontically treated teeth restored with a carbon fiber-reinforced resin post system in vitro.

PubMed

Raygot, C G; Chai, J; Jameson, D L

2001-01-01

This study was undertaken to characterize the fracture resistance and mode of fracture of endodontically treated incisors restored with cast post-and-core, prefabricated stainless steel post, or carbon fiber-reinforced composite post systems. Ten endodontically treated teeth restored with each technique were subjected to a compressive load delivered at a 130-degree angle to the long axis until the first sign of failure was noted. The fracture load and the mode of fracture were recorded. The failure loads registered in the three groups were not significantly different. Between 70%, and 80% of teeth from any of the three groups displayed fractures that were located above the simulated bone level. The use of carbon fiber-reinforced composite posts did not change the fracture resistance or the failure mode of endodontically treated central incisors compared to the use of metallic posts.

Pulsed Nd-YAG laser in endodontics

NASA Astrophysics Data System (ADS)

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

1994-12-01

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

Endodontic treatment associated with photodynamic therapy: Case report.

PubMed

Firmino, Ramon Targino; Brandt, Lorenna Mendes Temóteo; Ribeiro, Gustavo Leite; Dos Santos, Katia Simone Alves; Catão, Maria Helena Chaves de Vasconccelos; Gomes, Daliana Queiroga de Castro

2016-09-01

The complete elimination of bacteria inside the root canal is a difficult task, and inconsistent removal of the innermost layer of contaminated dentin leaves bacteria behind. PDT is an adjunct to conventional endodontic treatment due to its potential to reduce bacteria and its biocompatibility. Report a case of endodontic treatment associated with Photodynamic Therapy (PDT). A patient with chronic dentoalveolar abscess with radiolucent lesion next to the apexes of teeth 11 and 21 was submitted to conventional endodontic treatment associated with PDT. The canals were filled after two PDT sessions with an interval of 15days between applications. After six months, total regression of apical periodontitis and no fistula or associated symptoms were observed. The treatment proposed is a viable option for the clinician as it is easy to perform, has relatively low-cost and allows the improvement of symptoms in a short period of time. Copyright © 2016 Elsevier B.V. All rights reserved.

A case series associated with different kinds of endo-perio lesions.

PubMed

Aksel, Hacer; Serper, Ahmet

2014-02-01

Pulpal and periodontal problems are responsible for more than half of the tooth mortality. There are some articles published in the literature about this issue. Many of them are quite old. There has been also lack of knowledge about the effect of endodontic treatment on the periodontal tissue healing and suitable treatment interval between endodontic and periodontal treatments. In this case report, different kinds of endo-perio lesion were treated with sequential endodontic and periodontal treatment. The follow-up radiographs showed complete healing of the hard and soft tissue lesions. The tooth with endo-perio lesions should be evaluated thoroughly in terms of any cracks and fracture, especially furcation areas for a long term prognosis. In this case report, it was showed that 3 months treatment intervals between endodontic treatment and periodontal surgery has no harmful effect on periodontal tissue healing. Key words:Endo-perio lesion, furcation, mandibular molar, bone graft, crack line, treatment interval.

Searching for Helicobacter pylori and Chlamydia pneumoniae in primary endodontic infections.

PubMed

Rôças, Isabela N; Siqueira, José F

2012-04-01

The purpose of this study was to search samples from primary endodontic infections for the presence of two common human bacterial pathogens - Helicobacter pylori and Chlamydia pneumoniae. Genomic DNA isolated from samples taken from 25 root canals of teeth with asymptomatic (chronic) apical periodontitis and 25 aspirates from acute apical abscess was initially amplified by the multiple displacement amplification approach and then used as template in species-specific polymerase chain reaction (PCR) for detection of H. pylori and C. pneumoniae. All clinical samples were positive for the presence of bacterial DNA. However, no clinical sample was positive for either H. pylori or C. pneumoniae. Neither H. pylori nor C. pneumoniae were found in samples from primary endodontic infections. These findings suggest that these species are not candidate endodontic pathogens and that the necrotic root canal does not serve as a reservoir for these human pathogens in healthy patients.

Stimulation of proinflammatory cytokines by volatile sulfur compounds in endodontically treated teeth.

PubMed

Lechner, Johann; von Baehr, Volker

2015-01-01

Persistent microorganisms in endodontically treated teeth produce volatile sulfur compounds (VSC) such as methyl mercaptan, hydrogen sulfide, and thioether. In this retrospective study, we evaluated the ex vivo immune response of peripheral blood mononuclear cells to sulfur compounds in 354 patients with systemic diseases. These systemic findings are correlated with semiquantitative values of a VSC indicator applied directly on endodontically treated teeth. Data elucidate the role of VSC in patients with immunologic diseases and the role of a semiquantitative chairside test, like the VSC indicator presented here, in correlation to IFNg and IL-10 sensitization in peripheral blood mononuclear cells. The association between ex vivo-stimulated cytokines and endodontically derived sulfur components is supported by the fact that the number of interferon gamma- and/or interleukin-10-positive sensitized patients declined significantly 3-8 months after extraction of the corresponding teeth.

Stimulation of proinflammatory cytokines by volatile sulfur compounds in endodontically treated teeth

PubMed Central

Lechner, Johann; von Baehr, Volker

2015-01-01

Persistent microorganisms in endodontically treated teeth produce volatile sulfur compounds (VSC) such as methyl mercaptan, hydrogen sulfide, and thioether. In this retrospective study, we evaluated the ex vivo immune response of peripheral blood mononuclear cells to sulfur compounds in 354 patients with systemic diseases. These systemic findings are correlated with semiquantitative values of a VSC indicator applied directly on endodontically treated teeth. Data elucidate the role of VSC in patients with immunologic diseases and the role of a semiquantitative chairside test, like the VSC indicator presented here, in correlation to IFNg and IL-10 sensitization in peripheral blood mononuclear cells. The association between ex vivo-stimulated cytokines and endodontically derived sulfur components is supported by the fact that the number of interferon gamma- and/or interleukin-10-positive sensitized patients declined significantly 3–8 months after extraction of the corresponding teeth. PMID:25792853

Technological advances in endodontics: treatment of a mandibular molar with internal root resorption using a reciprocating single-file system.

PubMed

de Souza, Samir Noronha; Marques, André Augusto Franco; Sponchiado-Júnior, EmÍlio Carlos; Roberti Garcia, Lucas da Fonseca; da Frota, Matheus Franco; de Carvalho, Fredson Márcio Acris

2017-01-01

The field of endodontics has become increasingly successful due to technological advances that allow clinicians to solve clinical cases that would have been problematic a few years ago. Despite such advances, endodontic treatment of teeth with internal root resorption remains challenging. This article presents a clinical case in which a reciprocating single-file system was used for endodontic treatment of a mandibular molar with internal root resorption. Radiographic examination revealed the presence of internal root resorption in the distobuccal root canal of the mandibular right first molar. A reciprocating single-file system was used for root canal instrumentation and final preparation, and filling was obtained through a thermal compaction technique. No painful symptoms or periapical lesions were observed in 12 months of follow-up. The results indicate that a reciprocating single-file system is an adequate alternative for root canal instrumentation, particularly in teeth with internal root resorption.

Recommendations for using regenerative endodontic procedures in permanent immature traumatized teeth.

PubMed

Garcia-Godoy, Franklin; Murray, Peter E

2012-02-01

The regeneration of immature permanent teeth following trauma could be beneficial to reduce the risk of fracture and loss of millions of teeth each year. Regenerative endodontic procedures include revascularization, partial pulpotomy, and apexogenesis. Several case reports give these procedures a good prognosis as an alternative to apexification. Care is needed to deliver regenerative endodontic procedures that maintain or restore the vitality of teeth, but which also disinfect and remove necrotic tissues. Regeneration can be accomplished through the activity of the cells from the pulp, periodontium, vascular, and immune system. Most therapies use the host's own pulp or vascular cells for regeneration, but other types of dental stem cell therapies are under development. There are no standardized treatment protocols for endodontic regeneration. The purpose of this article is to review the recent literature and suggest guidelines for using regenerative endodontic procedures for the treatment of permanent immature traumatized teeth. Recommendations for the selection of regenerative and conventional procedures based on the type of tooth injury, fracture type, presence of necrosis or infection, periodontal status, presence of periapical lesions, stage of tooth development, vitality status, patient age, and patient health status will be reviewed. Because of the lack of long-term evidence to support the use of regenerative endodontic procedures in traumatized teeth with open apices, revascularization regeneration procedures should only be attempted if the tooth is not suitable for root canal obturation, and after apexogenesis, apexification, or partial pulpotomy treatments have already been attempted and have a poor prognosis. © 2011 John Wiley & Sons A/S.

Prevalence of treponema species detected in endodontic infections: systematic review and meta-regression analysis.

PubMed

Leite, Fábio R M; Nascimento, Gustavo G; Demarco, Flávio F; Gomes, Brenda P F A; Pucci, Cesar R; Martinho, Frederico C

2015-05-01

This systematic review and meta-regression analysis aimed to calculate a combined prevalence estimate and evaluate the prevalence of different Treponema species in primary and secondary endodontic infections, including symptomatic and asymptomatic cases. The MEDLINE/PubMed, Embase, Scielo, Web of Knowledge, and Scopus databases were searched without starting date restriction up to and including March 2014. Only reports in English were included. The selected literature was reviewed by 2 authors and classified as suitable or not to be included in this review. Lists were compared, and, in case of disagreements, decisions were made after a discussion based on inclusion and exclusion criteria. A pooled prevalence of Treponema species in endodontic infections was estimated. Additionally, a meta-regression analysis was performed. Among the 265 articles identified in the initial search, only 51 were included in the final analysis. The studies were classified into 2 different groups according to the type of endodontic infection and whether it was an exclusively primary/secondary study (n = 36) or a primary/secondary comparison (n = 15). The pooled prevalence of Treponema species was 41.5% (95% confidence interval, 35.9-47.0). In the multivariate model of meta-regression analysis, primary endodontic infections (P < .001), acute apical abscess, symptomatic apical periodontitis (P < .001), and concomitant presence of 2 or more species (P = .028) explained the heterogeneity regarding the prevalence rates of Treponema species. Our findings suggest that Treponema species are important pathogens involved in endodontic infections, particularly in cases of primary and acute infections. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Analysis of the cause of failure in nonsurgical endodontic treatment by microscopic inspection during endodontic microsurgery.

PubMed

Song, Minju; Kim, Hyeon-Cheol; Lee, Woocheol; Kim, Euiseong

2011-11-01

This study examined the clinical causes of failure and the limitation of a previous endodontic treatment by an inspection of the root apex and resected root surface at 26× magnification during endodontic microsurgery. The data were collected from patients in the Department of Conservative Dentistry at the Dental College, Yonsei University in Seoul, Korea between March 2001 and January 2011. All root-filled cases with symptomatic or asymptomatic apical periodontitis were enrolled in this study. All surgical procedures were performed by using an operating microscope. The surface of the apical root to be resected or the resected root surface after methylene blue staining was examined during the surgical procedure and recorded carefully with 26× magnification to determine the state of the previous endodontic treatment by using an operating microscope. Among the 557 cases with periapical surgery, 493 teeth were included in this study. With the exclusion of unknown cases, the most common possible cause of failure was perceived leakage around the canal filling material (30.4%), followed by a missing canal (19.7%), underfilling (14.2%), anatomical complexity (8.7%), overfilling (3.0%), iatrogenic problems (2.8%), apical calculus (1.8%), and cracks (1.2%). The frequency of possible failure causes differed according to the tooth position (P < .001). An appreciation of the root canal anatomy by using an operating microscope in nonsurgical endodontic treatment can make the prognosis more predictable and favorable. Copyright © 2011 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Post-endodontic treatment of incisors and premolars among dental practitioners in Saarland: an interactive Web-based survey.

PubMed

Mitov, Gergo; Dörr, Michael; Nothdurft, Frank P; Draenert, Florian; Pospiech, Peter R

2015-06-01

The aim of the present study was to evaluate the trend of dental practitioners in the federal state of Saarland in Germany in regard to restoring endodontically treated teeth using a Web-based survey. An interactive Web-based survey instrument was developed, including seven clinical scenarios, presented by photographs of natural incisor and premolar with different types of cavities. Following a decision tree adapted to the clinical treatment, questions on different aspects of the post-endodontic treatment were asked. All 615 members of the Saarland Dental Association (SDA) were asked to participate in the survey. A total of 33 % completed the survey. The majority of the participants believed in the reinforcement effect of the ferrule design, as well as the post placement. The vast majority of the responding practitioners (92 %) adapted their treatment strategies to a high extent to the destruction degree of the endodontically treated tooth. Fiber-reinforced composite (FRC) posts are the most popular prefabricated post type, regardless of the cavity size and tooth localization. Significant differences between the dentists according to the degree of experience were detected only for the use of glass-ionomer cements as core buildup material. The predominant post-endodontic treatment strategies of German dental practitioners are only partly in agreement with the current literature. There is a clear trend toward the increasing use of metal-free post and core materials. Although the participants showed a general adoption of modern materials and techniques, different patterns of post-endodontic treatment were revealed that were not consistent with approaches supported by the literature.

Regenerative Endodontic Treatment with Orthodontic Treatment in a Tooth with Dens Evaginatus: A Case Report with a 4-year Follow-up.

PubMed

Natera, Marianella; Mukherjee, Padma M

2018-06-01

Dens evaginatus is a developmental tooth anomaly in which an extra cusp or tubercle protrudes on the occlusal surface of the tooth along with some pulpal tissue. Because of the fragile nature of the protrusion, these teeth are often at risk of pulpal exposure. When this occurs in an immature tooth, regenerative endodontic treatment may be a good treatment approach to promote root formation. There is limited literature that documents the occurrence of orthodontic treatment in teeth that have undergone regenerative endodontic therapy using triple antibiotic paste. Here we present a case of an immature premolar tooth with dens evaginatus that was diagnosed with pulp necrosis and chronic apical abscess. The tooth was treated with regenerative endodontic treatment; after which, the patient received orthodontic treatment with fixed appliances for 2 years. The tooth responded favorably to the regenerative endodontic treatment and orthodontic tooth movement. Clinically and radiographically, all the follow-up examinations revealed an asymptomatic tooth with evidence of periapical healing with stunted root development. The tooth remained asymptomatic even after 4 years. The regenerative endodontic procedure (REP) was successful in treating an immature permanent premolar with pulp necrosis and apical periodontitis with dens evaginatus. In this case, the tooth treated with an REP responded to orthodontic treatment similar to the nonendodontically treated teeth. Further studies are recommended to clarify the precise effects of orthodontic treatment on teeth treated with an REP. Copyright © 2018 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

New bacterial composition in primary and persistent/secondary endodontic infections with respect to clinical and radiographic findings.

PubMed

Tennert, Christian; Fuhrmann, Maximilian; Wittmer, Annette; Karygianni, Lamprini; Altenburger, Markus J; Pelz, Klaus; Hellwig, Elmar; Al-Ahmad, Ali

2014-05-01

The aim of the present study was to analyze the microbiota of primary and secondary/persistent endodontic infections of patients undergoing endodontic treatment with respect to clinical and radiographic findings. Samples from the root canals of 21 German patients were taken using 3 sequential sterile paper points. In the case of a root canal filling, gutta-percha was removed with sterile files, and samples were taken using sterile paper points. The samples were plated, and microorganisms were then isolated and identified morphologically by biochemical analysis and sequencing the 16S rRNA genes of isolated microorganisms. In 12 of 21 root canals, 33 different species could be isolated. Six (50%) of the cases with isolated microorganisms were primary, and 6 (50%) cases were endodontic infections associated with root-filled teeth. Twelve of the isolated species were facultative anaerobic and 21 obligate anaerobic. Monomicrobial infections were found for Enterococcus faecalis and Actinomyces viscosus. E. faecalis was most frequently isolated in secondary endodontic infections (33%). Moraxella osloensis was isolated from a secondary endodontic infection that had an insufficient root canal filling accompanied by a mild sensation of pain. A new bacterial composition compromising Atopobium rimae, Anaerococcus prevotii, Pseudoramibacter alactolyticus, Dialister invisus, and Fusobacterium nucleatum was recovered from teeth with chronic apical abscesses. New bacterial combinations were found and correlated to clinical and radiographic findings, particularly to chronic apical abscesses. M. osloensis was detected in root canals for the second time and only in German patients. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

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

NASA Astrophysics Data System (ADS)

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

2011-03-01

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

Periapical healing outcome following single visit endodontic treatment in patients with type 2 diabetes mellitus

PubMed Central

Nayak, Moksha; Babshet, Medha

2016-01-01

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

Flare-ups in endodontics: II. Therapeutic measures. 1985.

PubMed

Seltzer, Samuel; Naidorf, Irving J

2004-07-01

Various treatment regimens for the relief of pain during endodontic therapy, including relief of occlusion, pre-medication, establishment of drainage, and intracanal and systemic medications are presented. In addition, the rationale for the use of placebos is discussed.

A review of endodontic medicaments.

PubMed

Doran, M G; Radtke, P K

1998-01-01

Endodontic intracanal medicaments are often used when root canal therapy cannot be completed in a single visit. Properties of the more commonly used medicaments are outlined, their effectiveness is examined, and recommendations for use are made, based on evidence in the literature reviewed here.

A clarification on endodontic flare-ups.

PubMed

Morse, D R; Esposito, J V

1990-09-01

In an article on endodontic flare-ups by Robert J. Matusow, our research and publications are discussed. Since we found what we consider to be distortions and misinterpretations of our work, it was decided to clarify the apparent discrepancies found in Matusow's article.

European Society of Endodontology position statement: the use of CBCT in endodontics.

PubMed

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

2014-06-01

This Position Statement represents a consensus of an expert committee convened by the European Society of Endodontology (ESE) on the use of Cone Beam Computed Tomography (CBCT). The statement is based on the current scientific evidence, and provides the clinician with evidence-based criteria on when to use CBCT in Endodontics. Given the dynamic and changing nature of research, development of new devices and clinical practice relating to CBCT, this Position Statement will be updated within 3 years, or before that time should new evidence become available. © 2014 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Regenerative endodontics and tissue engineering: what the future holds?

PubMed

Goodis, Harold E; Kinaia, Bassam Michael; Kinaia, Atheel M; Chogle, Sami M A

2012-07-01

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. Copyright © 2012 Elsevier Inc. All rights reserved.

Natural Therapeutic Options in Endodontics - A Review

PubMed Central

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

2016-01-01

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

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

PubMed Central

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

2014-01-01

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

Musical Auditory Stimulation Influences Heart Rate Autonomic Responses to Endodontic Treatment

PubMed Central

Martiniano, Eli Carlos; Monteiro, Larissa Raylane Lucas; Valenti, Vitor E.; Sorpreso, Isabel Cristina Esposito; de Abreu, Luiz Carlos

2017-01-01

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

Post endodontic pain following single-visit root canal preparation with rotary vs reciprocating instruments: a meta-analysis of randomized clinical trials.

PubMed

Hou, Xiao-Mei; Su, Zheng; Hou, Ben-Xiang

2017-05-25

In endodontic therapy, continuous rotary instrumentation reduced debris compared to reciprocal instrumentation, which might affect the incidence of post-endodontic pain (PP). The aim of our study was to assess whether PP incidence and levels were influenced by the choice of rotary or reciprocal instruments. In this meta-analysis the Pubmed and EM databases were searched for prospective clinical randomized trials published before April 20, 2016, using combinations of the keywords: root canal preparation/instrumentation/treatment/therapy; post-operative/endodontic pain; reciprocal and rotary instruments. Three studies were included, involving a total of 1,317 patients, 659 treated with reciprocating instruments and 658 treated with rotary instruments. PP was reported in 139 patients in the reciprocating group and 172 in the rotary group. The PP incidence odds ratio was 1.27 with 95% confidence interval (CI) (0.25, 6.52) favoring rotary instruments. The mild, moderate and severe PP levels odds ratios were 0.31 (0.11, 0.84), 2.24 (0.66, 7.59) and 11.71 (0.63, 218.15), respectively. No evidence of publication bias was found. Rotary instrument choice in endodontic therapy is associated with a lower incidence of PP than reciprocating instruments, while reciprocating instruments are associated with less mild PP incidence.

Incidence and factors associated with flare-ups in a post graduate programme in the indian population.

PubMed

Pamboo, Jaya; Hans, Manoj-Kumar; Kumaraswamy, Bangalore-Niranjan; Chander, Subhash; Bhaskaran, Sajeev

2014-12-01

The study had twin objectives: to assess the incidence of flare-ups (a severe problem requiring an unscheduled visit and treatment) among patients who received endodontic treatment in the Department of Conservative Dentistry and Endodontics in Vyas Dental college and hospital, Jodhpur during a period of one year, and also to examine the correlation with pre-operative and operative variables. Data was collected from 1023 teeth from 916 patients who had received endodontic treatment over a 12- month period. Information was obtained for each patient treated, including pulp and peri-radicular diagnosis for the tooth, presence of pre-operatory pain, type of medication being used, type of instrumentation technique used and number of appointments needed to complete the root canal treatment. The results showed an incidence of 2.35% for flare-ups from 1023 endodontically treated teeth. Statistical analysis was done using the chi-square test. Flare-ups were found to be affected significantly by gender of patient, presence of radiolucent lesions, patients taking pre-operative analgesic or anti-inflammatory drugs and on type of instrumentation technique. In contrast, there was no correlation between flare-ups and age, different arch/tooth groups and single or multiple visit endodontics. Key words:Anti-inflammatory, flare-ups, instrumentation, prospective.

Infectious flare-ups and serious sequelae following endodontic treatment: a prospective randomized trial on efficacy of antibiotic prophylaxis in cases of asymptomatic pulpal-periapical lesions.

PubMed

Morse, D R; Furst, M L; Belott, R M; Lefkowitz, R D; Spritzer, I B; Sideman, B H

1987-07-01

Without peritreatment antibiotics, infectious flare-ups (about 15% incidence) and serious sequelae follow endodontic treatment of asymptomatic teeth with necrotic pulps and associated periapical lesions. Antibiotics administered after endodontic treatment (4-day regimen) reduce the flare-up incidence to about 2%, but hypersensitivity responses, sensitization, resistant microbes, and drug-taking compliance are potential problems. To ascertain whether a specific prophylactic antibiotic (high-dose, 1-day regimen) would preferentially maintain this low flare-up incidence while overcoming antibiotic-related problems, 315 patients with quiescent pulpal necrosis and an associated periapical lesion were randomly given either penicillin V or erythromycin (base or stearate). Evaluations of flare-up after endodontic treatment were done at 1 day, 1 week, and 2 months. A 2.2% flare-up incidence was found, with no statistically significant differences for penicillin (0.0%), base (2.9%), and stearate (3.8%). No hypersensitivity responses occurred. Gastrointestinal side effects were found primarily with the erythromycins (12.4%). A comparative analysis of the data from our first study (no peritreatment antibiotics) and the pooled data from our last two investigations (including the current trial) showed that peritreatment antibiotic coverage significantly reduced flare-ups and serious sequelae after endodontic treatment (p less than 0.001).

Incidence and factors associated with flare-ups in a post graduate programme in the indian population

PubMed Central

Pamboo, Jaya; Kumaraswamy, Bangalore-Niranjan; Chander, Subhash; Bhaskaran, Sajeev

2014-01-01

Objectives: The study had twin objectives: to assess the incidence of flare-ups (a severe problem requiring an unscheduled visit and treatment) among patients who received endodontic treatment in the Department of Conservative Dentistry and Endodontics in Vyas Dental college and hospital, Jodhpur during a period of one year, and also to examine the correlation with pre-operative and operative variables. Material and Methods: Data was collected from 1023 teeth from 916 patients who had received endodontic treatment over a 12- month period. Information was obtained for each patient treated, including pulp and peri-radicular diagnosis for the tooth, presence of pre-operatory pain, type of medication being used, type of instrumentation technique used and number of appointments needed to complete the root canal treatment. Results: The results showed an incidence of 2.35% for flare-ups from 1023 endodontically treated teeth. Statistical analysis was done using the chi-square test. Conclusions: Flare-ups were found to be affected significantly by gender of patient, presence of radiolucent lesions, patients taking pre-operative analgesic or anti-inflammatory drugs and on type of instrumentation technique. In contrast, there was no correlation between flare-ups and age, different arch/tooth groups and single or multiple visit endodontics. Key words:Anti-inflammatory, flare-ups, instrumentation, prospective. PMID:25674318

A survey of dental residents' expectations for regenerative endodontics.

PubMed

Manguno, Christine; Murray, Peter E; Howard, Cameron; Madras, Jonathan; Mangan, Stephen; Namerow, Kenneth N

2012-02-01

The objective was to survey a group of dental residents regarding their expectations for using regenerative endodontic procedures as part of future dental treatments. After institutional review board approval, the opinions of 32 dentists who were having postgraduate residency training to become specialists in a dental school were surveyed. The survey had 40 questions about professional status, ethical beliefs, judgment, and clinical practice. It was found that 83.9% of dentists had no continuing education or training in stem cells or regenerative endodontic procedures. Results showed that 96.8% of dentists are willing to receive training to be able to provide regenerative endodontic procedures for their patients. Of the total group, 49.1% of dentists already use membranes, scaffolds, or bioactive materials to provide dental treatment. It was determined that 47.3% of dentists agree that the costs of regenerative procedures should be comparable with current treatments. It was also found that 55.1% of dentists were unsure whether regenerative procedures would be successful. Dentists are supportive of using regenerative endodontic procedures in their dental practice, and they are willing to undergo extra training and to buy new technology to provide new procedures. Nevertheless, dentists also need more evidence for the effectiveness and safety of regenerative treatments before they will be recommended for most patients. Copyright © 2012. Published by Elsevier Inc.

Endodontic retreatment of dens invaginatus presenting with gutta-percha overfilling at the attached gingiva and chronic apical periodontitis: unusual clinical report.

PubMed

Robazza, Carlos Roberto Colombo; Alves e Motta, Julio Cesar; de Carli, Marina Lara; de Oliveira Pedreira, Fernanda Rafaelly; Hanemann, Joao Adolfo Costa

2013-05-01

This work describes the retreatment of an unusual case of dens invaginatus with gutta-percha overfilling at the gingival mucosa and chronic apical periodontitis in a 34-year-old woman. Initial periapical radiograph showed the presence of type II dens invaginatus with poor quality obturation, root perforation and chronic apical periodontitis of tooth 22. Dens invaginatus is a tooth malformation caused by infolding of the dental papilla during tooth development. This anomaly has been associated with increased prevalence of pulpal and periapical diseases. Conventional endodontic retreatment was performed using rotary files and calcium hydroxide paste as intracanal dressing. After 7 days, root canal was filled with guttapercha points and Sealapex® sealer. Obturation was radiographically followed and, after 3 years, absence of fistula and periapical radiolucency was observed, thus conventional endodontic therapy proved to be successful. Conventional endodontic retreatment of type II dens invaginatus has been successful for a 3-year period, showing a better treatment alternative. Conservative endodontic retreatment of dens invaginatus should be considered to promote periapical healing with complete reconstitution of bone and periodontal ligament regeneration without signs of recurrence over a period of 3 years. Moreover, it preserves the entire tooth.

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

PubMed Central

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

2013-01-01

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

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

NASA Astrophysics Data System (ADS)

Moshari, Amirabbas; Vatanpour, Mehdi; Zakershahrak, Mehrsa

2016-03-01

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

Indexing of Iranian Publications in Well-known Endodontic Textbooks: A Scientometric Analysis.

PubMed

Kakooei, Sina; Mostafavi, Mahshid; Parirokh, Masoud; Asgary, Saeed

2016-01-01

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. 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. 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. Number and percentage of Iranian publications in the field of endodontics in all three textbooks have remarkably increased since 2000.

Cone Beam Computed Tomography Evaluation of the Diagnosis, Treatment Planning, and Long-Term Followup of Large Periapical Lesions Treated by Endodontic Surgery: Two Case Reports

PubMed Central

Shekhar, Vijay; Shashikala, K.

2013-01-01

The aim of this case report is to present two cases where cone beam computed tomography (CBCT) was used for the diagnosis, treatment planning, and followup of large periapical lesions in relation to maxillary anterior teeth treated by endodontic surgery. Periapical disease may be detected sooner using CBCT, and their true size, extent, nature, and position can be assessed. It allows clinician to select the most relevant views of the area of interest resulting in improved detection of periapical lesions. CBCT scan may provide a better, more accurate, and faster method to differentially diagnose a solid (granuloma) from a fluid-filled lesion or cavity (cyst). In the present case report, endodontic treatment was performed for both the cases followed by endodontic surgery. Biopsy was done to establish the confirmatory histopathological diagnosis of the periapical lesions. Long-term assessment of the periapical healing following surgery was done in all the three dimensions using CBCT and was found to be more accurate than IOPA radiography. It was concluded that CBCT was a useful modality in making the diagnosis and treatment plan and assessing the outcome of endodontic surgery for large periapical lesions. PMID:23762646

Differential diagnosis of endodontic-related inferior alveolar nerve paraesthesia with cone beam computed tomography: a case report.

PubMed

Gambarini, G; Plotino, G; Grande, N M; Testarelli, L; Prencipe, M; Messineo, D; Fratini, L; D'Ambrosio, F

2011-02-01

To discuss the use of cone-beam computed tomography (CBCT) in the differential diagnosis of a case of labiomandibular paraesthesia caused by extrusion of endodontic sealer into the mandibular canal. A 59-year-old woman suffering from a paraesthesia on the left posterior mandible and numbness on the left side of the lower lip was referred to an endodontic specialist 1 month after multiple root canal treatments. A panoramic radiograph revealed the presence of extruded root filling material beyond the apex of the mesial root of the mandibular left second molar and also beyond the apex of the first premolar. A cone beam computed tomography examination was undertaken, which confirmed the presence of radiopaque root canal filling material in the periapical area of the second molar, and revealed that the material was inside the mandibular canal. No extruded filling material was found inside the mental foramen beyond the apex of the first premolar tooth. Small field of view CBCT (where possible) can be considered an effective radiographic diagnostic device when endodontic-related inferior alveolar nerve or mental foramen paraesthesia are suspected. CBCT is able to provide detailed three-dimensional images of the tooth, the root canal system and the surrounding tissue. © 2010 International Endodontic Journal.

Temperature increases on the external root surface during endodontic treatment using single file systems.

PubMed

Özkocak, I; Taşkan, M M; Gökt Rk, H; Aytac, F; Karaarslan, E Şirin

2015-01-01

The aim of this study is to evaluate increases in temperature on the external root surface during endodontic treatment with different rotary systems. Fifty human mandibular incisors with a single root canal were selected. All root canals were instrumented using a size 20 Hedstrom file, and the canals were irrigated with 5% sodium hypochlorite solution. The samples were randomly divided into the following three groups of 15 teeth: Group 1: The OneShape Endodontic File no.: 25; Group 2: The Reciproc Endodontic File no.: 25; Group 3: The WaveOne Endodontic File no.: 25. During the preparation, the temperature changes were measured in the middle third of the roots using a noncontact infrared thermometer. The temperature data were transferred from the thermometer to the computer and were observed graphically. Statistical analysis was performed using the Kruskal-Wallis analysis of variance at a significance level of 0.05. The increases in temperature caused by the OneShape file system were lower than those of the other files (P < 0.05). The WaveOne file showed the highest temperature increases. However, there were no significant differences between the Reciproc and WaveOne files. The single file rotary systems used in this study may be recommended for clinical use.

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

PubMed

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

2015-08-01

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

Illumina MiSeq Sequencing for Preliminary Analysis of Microbiome Causing Primary Endodontic Infections in Egypt

PubMed Central

Azab, Marwa Mohamed; Fayyad, Dalia Mukhtar

2018-01-01

The use of high throughput next generation technologies has allowed more comprehensive analysis than traditional Sanger sequencing. The specific aim of this study was to investigate the microbial diversity of primary endodontic infections using Illumina MiSeq sequencing platform in Egyptian patients. Samples were collected from 19 patients in Suez Canal University Hospital (Endodontic Department) using sterile # 15K file and paper points. DNA was extracted using Mo Bio power soil DNA isolation extraction kit followed by PCR amplification and agarose gel electrophoresis. The microbiome was characterized on the basis of the V3 and V4 hypervariable region of the 16S rRNA gene by using paired-end sequencing on Illumina MiSeq device. MOTHUR software was used in sequence filtration and analysis of sequenced data. A total of 1858 operational taxonomic units at 97% similarity were assigned to 26 phyla, 245 families, and 705 genera. Four main phyla Firmicutes, Bacteroidetes, Proteobacteria, and Synergistetes were predominant in all samples. At genus level, Prevotella, Bacillus, Porphyromonas, Streptococcus, and Bacteroides were the most abundant. Illumina MiSeq platform sequencing can be used to investigate oral microbiome composition of endodontic infections. Elucidating the ecology of endodontic infections is a necessary step in developing effective intracanal antimicrobials. PMID:29849646

Endotoxin content in endodontically involved teeth. 1975.

PubMed

Schein, Benjamin; Schilder, Herbert

2006-04-01

Fluid was aspirated from the root canals of 40 endodontically involved teeth. This fluid was assayed for endotoxin with the limulus lysate test. Pulpless teeth contained greater concentrations of endotoxin than those with vital pulps. Symptomatic teeth also contained more endotoxin than asymptomatic teeth.

Endodontic medicine: connections between apical periodontitis and systemic diseases.

PubMed

Segura-Egea, J J; Martín-González, J; Castellanos-Cosano, L

2015-10-01

The prevalence of apical periodontitis (AP) in Europe has been reported to affect 61% of individuals and 14% of teeth, and increase with age. Likewise, the prevalence of root canal treatment (RCT) in Europe is estimated to be around 30-50% of individuals and 2-9% of teeth with radiographic evidence of chronic persistent AP in 30-65% of root filled teeth (RFT). AP is not only a local phenomenon and for some time the medical and dental scientific community have analysed the possible connection between apical periodontits and systemic health. Endodontic medicine has developed, with increasing numbers of reports describing the association between periapical inflammation and systemic diseases. The results of studies carried out both in animal models and humans are not conclusive, but suggest an association between endodontic variables, that is AP and RCT, and diabetes mellitus (DM), tobacco smoking, coronary heart disease and other systemic diseases. Several studies have reported a higher prevalence of periapical lesions, delayed periapical repair, greater size of osteolityc lesions, greater likelihood of asymptomatic infections and poorer prognosis for RFT in diabetic patients. On the other hand, recent studies have found that a poorer periapical status correlates with higher HbA1c levels and poor glycaemic control in type 2 diabetic patients. However, there is no scientific evidence supporting a causal effect of periapical inflammation on diabetes metabolic control. The possible association between smoking habits and endodontic infection has also been investigated, with controversial results. The aim of this paper was to review the literature on the association between endodontic variables and systemic health (especially DM and smoking habits). © 2015 International Endodontic Journal. Published by John Wiley & Sons Ltd.

An experimental study for rapid detection and quantification of endodontic microbiota following photo-activated disinfection via new multiplex real-time PCR assay.

PubMed

Pourhajibagher, Maryam; Raoofian, Reza; Ghorbanzadeh, Roghayeh; Bahador, Abbas

2018-03-01

The infected root canal system harbors one of the highest accumulations of polymicrobial infections. Since the eradication of endopathogenic microbiota is a major goal in endodontic infection therapy, photo-activated disinfection (PAD) can be used as an alternative therapeutic method in endodontic treatment. Compared to cultivation-based approaches, molecular techniques are more reliable for identifying microbial agents associated with endodontic infections. The purpose of this study was to evaluate the ability of designed multiplex real-time PCR protocol for the rapid detection and quantification of six common microorganisms involved in endodontic infection before and after the PAD. Samples were taken from the root canals of 50 patients with primary and secondary/persistent endodontic infections using sterile paper points. PAD with toluidine blue O (TBO) plus diode laser was performed on root canals. Resampling was then performed, and the samples were transferred to transport medium. Then, six target microorganisms were detected using multiplex real-time PCR before and after the PAD. Veillonella parvula was found using multiplex real-time PCR to have the highest frequency among samples collected before the PAD (29.4%), followed by Porphyromonas gingivalis (23.1%), Aggregatibacter actinomycetemcomitans (13.6%), Actinomyces naeslundii (13.0%), Enterococcus faecalis (11.5%), and Lactobacillus rhamnosus (9.4%). After TBO-mediated PAD, P. gingivalis strains, the most resistance microorganisms, were recovered in 41.7% of the samples using molecular approach (P > 0.05). As the results shown, multiplex real-time PCR as an accurate detection approach with high-throughput and TBO-mediated PAD as an efficient antimicrobial strategy due to the significant reduction of the endopathogenic count can be used for detection and treatment of microbiota involved in infected root canals, respectively. Copyright © 2018 Elsevier B.V. All rights reserved.

Direct restoration of endodontically treated maxillary central incisors: post or no post at all?

PubMed

von Stein-Lausnitz, Manja; Bruhnke, M; Rosentritt, M; Sterzenbach, G; Bitter, K; Frankenberger, R; Naumann, M

2018-04-30

The aim of this ex-vivo study was to evaluate the impact of cavity size and glass-fiber post (GFP) placement on the load capability of endodontically treated maxillary incisors directly restored with resin composite. Ninety-six extracted human maxillary central incisors were endodontically treated and distributed to four groups (n = 24): access cavity (A), access cavity and uni-proximal class III cavity (U), access cavity and bi-proximal class III cavity (B), and decoronated tooth (D). Specimens were restored with resin composite, and 12 specimen of each group received an adhesively placed glass-fiber post (P). Prior to linear loading, specimens were exposed to thermo-mechanical loading (TCML). Statistical analysis was performed using log-rank test after TCML, Kruskall-Wallis and Mann-Whitney U test to compare load capabilities (F max) . Significantly more failures occurred in group D for specimens without GFP during TCML (p = 0.001). F max (mean (SD) in N was (A) 513 (124), (AP) 554 (201), (U) 438 (171), (UP) 537 (232) (B) 483 (219), (BP) 536 (281), D 143 (181), and DP 500 (331), and differed significantly among groups (p = 0.003). Pair-wise comparison revealed lower F max values for group D compared to all other groups (p < 0.034) except group DP. Endodontically treated maxillary central incisors with cavity sizes up to bi-proximal class III may be successfully directly restored with resin composite. Post placement shows no additional effect except for decoronated endodontically treated incisors. Endodontically treated incisors with access cavities to class III cavities can be successfully restored with resin composite. Post placement for decoronated ETT is recommended.

Endodontic retreatment: clinical comparison of reciprocating systems versus rotary system in disinfecting root canals.

PubMed

Martinho, Frederico C; Freitas, Lilian F; Nascimento, Gustavo G; Fernandes, Aleteia M; Leite, Fabio R M; Gomes, Ana P M; Camões, Izabel C G

2015-07-01

This clinical study was conducted to compare the effectiveness of single-file reciprocating systems and rotary systems in removing endotoxins and cultivable bacteria in endodontic retreatment. Thirty endodontically treated teeth with post-treatment apical periodontitis were selected. The specimens were divided into three groups according to the system used: WaveOne (n = 10), Reciproc instrument (n = 10), and ProTaper Universal Retreatment system (n = 10). Samples were collected before and after chemomechanical preparation. The irrigation was performed by using 2.5% sodium hypochlorite. A chromogenic limulus amebocyte lysate assay test was used to quantify endotoxins. Culture techniques were used to determine bacterial colony-forming unit counts. At baseline, endotoxins and cultivable bacteria were recovered from 100% of the root canal samples in a median value of 5.84 EU/mL and 4.98 × 10(3) CFU/mL, respectively. After CMP, no differences were found in the median percentage values of endotoxin reduction achieved with reciprocating systems-WaveOne [94.11%] and Reciproc [93.29%] and with rotary systems-ProTaper [94.98%] (P > 0.05). Both single-file reciprocating systems [WaveOne (98.27%) and Reciproc (99.54%)] and rotary system [ProTaper (98.73%)] were effective in reducing bacterial load (P > 0.05). Moreover, no differences were found among the systems tested. The Reciproc and WaveOne reciprocating systems were as effective as the ProTaper system for removal of endotoxins and bacteria in endodontic retreatment. All systems tested were effective to remove cultivable bacteria and endotoxin in endodontic retreatment. As no differences among systems were observed, it is possible to suggest that clinicians should choose the preferred technique to perform endodontic.

Endodontic flare-ups: comparison of incidence between single and multiple visits procedures in patients attending a Nigerian teaching hospital.

PubMed

Oginni, Ao; Udoye, C I

2004-12-01

The present study was performed to compare the incidence of endodontic flare ups in single with multiple visits treatment procedures, to establish the relationship between pre-operative and post obturation pain in patients attending for endodontic therapy in a Nigerian teaching Hospital. Patients were randomly assigned to either single visit or multiple visits group. Data collected at root canal treatment appointment and recall visits (1st, 7th and 30th day post obturation) include pulp vitality status, the presence or absence of pre-operative pain, presence and degree of post obturation pain. Presence of endodontic flare-ups (defined as either patient's report of pain not controlled with over the counter medication and or increasing swelling). The compiled data were analyzed using chi-square where applicable. P level < 0.05 was taken as significant. Ten endodontic flare-ups (8.1 %) were recorded in the multiple visits group compared to 19 (18,3%) flare-ups for the single visit group, P = 0.02. For both single and multiple visits procedures, there were statistically significant correlations between pre operative and post obturation pain (P = 0.002 and P = 0.0004 respectively). Teeth with vital pulps reported the lowest frequency of post obturation pain (48.8%), while those with non vital pulps were found to have the highest frequency oh post obturation pain (50,3%), P = 0.9. Although the present study reported higher incidences for post obturation pain and flare-ups following the single visit procedures, single visit endodontic therapy has been shown to be a safe and effective alternative to multiple visits treatment.

What Is the Outcome of an Incision and Drainage Procedure in Endodontic Patients? A Prospective, Randomized, Single-blind Study.

PubMed

Beus, Hannah; Fowler, Sara; Drum, Melissa; Reader, Al; Nusstein, John; Beck, Mike; Jatana, Courtney

2018-02-01

There are no prospective endodontic studies to determine the outcome of an incision and drainage (I&D) procedure for swelling in healthy, endodontic patients. The purpose of this prospective, randomized, single-blind study was to compare the postoperative course of I&D with drain placement versus a mock I&D procedure with mock drain placement after endodontic debridement in swollen emergency patients with symptomatic teeth and a pulpal diagnosis of necrosis. Eighty-one adult emergency patients presenting with clinical swelling received either penicillin or, if allergic, clindamycin and complete endodontic debridement, and then were randomly divided into 2 treatment groups: I&D with drain placement or a mock I&D procedure with mock drain placement. At the end of the appointment, all patients received a combination of ibuprofen/acetaminophen and, if needed, an opioid-containing escape medication. Patients recorded their pain and medication use for 4 days postoperatively. Success was defined as no or mild postoperative pain and no use of an opioid-containing escape medication. Success was evaluated using repeated measure mixed model logistic regression. Both groups had a decrease in postoperative pain and medication use over the 4 days. The mock I&D group had significantly higher success than the I&D group (odds ratio = 2.00; 95% confidence interval, 1.16-3.41). The success rate was 45% with the mock I&D and 33% with the I&D. After endodontic debridement, patients who received a mock I&D procedure with mock drain placement had more success than patients who received I&D with drain placement. Both groups clinically improved over 4 days. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

The experience of dentists who gained enhanced skills in endodontics within a novel pilot training programme.

PubMed

Eliyas, S; Briggs, P; Gallagher, J E

2017-02-24

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 support of systems innovation within the NHS.

Critical Assessment of Search Strategies in Systematic Reviews in Endodontics.

PubMed

Yaylali, Ibrahim Ethem; Alaçam, Tayfun

2016-06-01

The aim of this study was to perform an overview of literature search strategies in systematic reviews (SRs) published in 2 endodontic journals, Journal of Endodontics and International Endodontic Journal. A search was done by using the MEDLINE (PubMed interface) database to retrieve the articles published between January 1, 2000 and December 31, 2015. The last search was on January 10, 2016. All the SRs published in the 2 journals were retrieved and screened. Eligible SRs were assessed by using 11 questions about search strategies in the SRs that were adapted from 2 guidelines (ie, AMSTAR checklist and the Cochrane Handbook). A total of 83 SRs were retrieved by electronic search. Of these, 55 were from the Journal of Endodontics, and 28 were from the International Endodontic Journal. After screening, 2 SRs were excluded, and 81 SRs were included in the study. Some issues, such as search of grey literature and contact with study authors, were not fully reported (30% and 25%, respectively). On the other hand, some issues, such as the use of index terms and key words and search in at least 2 databases, were reported in most of the SRs (97% and 95%, respectively). The overall quality of the search strategy in both journals was 61%. No significant difference was found between the 2 journals in terms of evaluation criteria (P > .05). There exist areas for improving the quality of reporting of search strategies in SRs; for example, grey literature should be searched for unpublished studies, no language limitation should be applied to databases, and authors should make an attempt to contact the authors of included studies to obtain further relevant information. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Endodontic treatment-related antibiotic prescribing patterns of South African oral health professionals.

PubMed

Lalloo, R; Solanki, G; Ramphoma, K; Myburgh, N G

2017-11-01

To assess the antibiotic prescribing patterns of South African dentists for patients undergoing endodontic treatment. This study used data from 2013 health insurance claims submitted by South African oral health professionals to determine the antibiotic prescribing patterns related to endodontic treatment. A logistic regression model was used to test the fully adjusted statistical significance of the association between the exploratory variables (gender, age group, event type, abscess treatment, chronic health) and the dependent variable (antibiotic prescription). Odds ratios with 95% confidence intervals (CI) are reported, and a 95% CI excluding 1 was considered statistically significant. Almost 10% of endodontic treatments were prescribed an antibiotic. There were no significant differences in prescribing patterns by gender, age and chronic health status. Prescriptions were more common at the preparatory stage (9.4%) of root canal treatment compared to the therapy (4.7%) and canal filling (2%) stages. Patients who received apical surgery (OR = 2.28; 95% CI 1.38-3.76) and treatment of an abscess (OR = 2.57; 95% 1.82-3.63) had a significantly increased odds of being prescribed an antibiotic. Almost three-quarters of prescriptions were for narrow spectrum antibiotics. The frequency of antibiotic prescribing by South African dental practitioners for patients undergoing endodontic treatment is relatively low and predominantly involved narrow spectrum antibiotics. It, however, remains important that antibiotics are only prescribed when clinically essential, such as when there are obvious systemic effects. These include fever above 37 degrees, malaise, lymphadenopathy, trismus, increase swelling, cellulitis, osteomyelitis and persistent infection. The wider dissemination and adherence to clear evidence-based prescribing guidelines for antibiotics in this clinical area are important. © 2016 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Undergraduate education in endodontology at two European dental schools. A comparison between the Faculty of Odontology, Malmö University, Malmö, Sweden and Faculty of Odontology, Paris 5 University (René Descartes), France.

PubMed

Petersson, Kerstin; Olsson, Helena; Söderström, Christina; Fouilloux, Isabelle; Jegat, Nadège; Lévy, Gérard

2002-11-01

The aim of this study was to compare the courses in endodontics and to assess the treatment quality in the student clinics in two dental schools, in Malmö, Sweden and Paris, France. A further aim was to improve the curriculum development in Paris 5 and Malmö by testing student exchange programmes. The comparison was based on the guidelines for undergraduate education set up by the European Society of Endodontology (ESE) [Int. Endod. J. 25 (1992) 169] and on the criteria formulated by Qualtrough and Dummer [Int. Endod. J. 30 (1997) 234]. The latter criteria covered the following aspects: educational methods, the timing of endodontic teaching, pre-clinical practical exercises, student assessment, recommended literature, clinical/practical procedures, the education of the staff and number of students per teacher. The quality guidelines for endodontic treatment set up by the ESE [Int. Endod. J. 27 (1994) 115] were used for the assessment of the quality of the treatment. The following aspects were covered: history, diagnosis and treatment planning, records, infection control, root-canal treatment, assessment of endodontic treatment. The undergraduate education in endodontics was fundamentally similar in Paris 5 and Malmö. The main differences observed were related to: Educational methods: In Malmö, problem-based learning and in Paris 5, traditional. Assessment of student performance. In Malmö, self-assessment and in Paris 5, credits for clinical/practical procedures. Clinical/practical procedures relating to infection control. Aseptic treatment regimens were more meticulously performed in Malmö than in Paris 5. Assessment (follow-up) of all endodontic treatments was a routine only in Malmö.

Role of Prophylactic Antibiotics in the Management of Postoperative Endodontic Pain.

PubMed

Alsomadi, Leena; Al Habahbeh, Riyad

2015-12-01

To investigate the efficacy of using antibiotics in post endodontic treatment as a method to alleviate post-treatment pain. After completion of endodontic treatment 129 patients were randomly divided into two groups: Group A (65 patients) received Ibuprofen 400 mg one tablet before procedure and one tablet every 8 hours for the first day, then one tablet once indicated by pain. Group B (64 patients) received the same regimen as group A in addition to amoxicillin, clavulanic acid tablets (one tablet before the procedure, and then one tablet twice daily for a total of 3 days). Intensity of pain at 8 hours interval using visual analog scale (VAS) and total number of Ibuprofen tablets used was recorded by patients. Peak postoperative pain occurred at 16 hours post-treatment in both groups, there was a significant difference in the pain scale between the two groups in favor for group B over group A (3.8 vs 2.1 respectively). Pain scale was significantly lower in group B at 24, 32, 40, and 48 hours post-treatment with a p-value of < 0.05. The pain scale at 56, 64 and 72 hours were also less in group B, although could not show up as statistical difference. Patients in group A used statistically significant more Ibuprofen than patients in group B (486 vs 402). Antibiotic prescription to manage post endodontic treatment pain results in less pain with less consumption of Ibuprofens. Pain management in endodontics is a real challenge, nonsteroidal anti-inflammatory drugs (NSAIDS) are used effectively in many patients to alleviate post endodontic pain. Nonsteroidal anti-inflammatory drugs may have adverse reactions or may be contraindicated. Short-term use of antibiotics to alleviate pain can be of clinical benefits in these patients.

Endodontic cellulitis 'flare-up'. Case report.

PubMed

Matusow, R J

1995-02-01

Endodontic cellulitis involves facial swelling which can vary from mild to severe and can occur as a primary case or a flare-up following initial treatment of asymptomatic teeth with periapical lesions. The microbial spectrum in primary cases involves a significant mixture of anaerobic and facultative aerobic microbes, chiefly streptococci. In a previous study, cultures from flare-up cases, utilizing the same anaerobic techniques as in primary cases, revealed an absence of obligate anaerobes and an 80 per cent incidence of facultative aerobic streptococci. These cases also revealed a significant time lapse from onset of symptoms to the cellulitis phase. No sex or age factors were noted in the primary or flare-up cases. The purpose of this case report is to restate a traditional theory, namely, the alteration of the oxidation/reduction potential (Eh), as a major factor for endodontic cellulitis flare-ups; to confirm the pathogenic potential of oral facultative streptococci; and that asymptomatic endodontic lesions tend to exist with mixed aerobic/anaerobic microbial flora.

A bibliometric analysis of two PubMed-indexed high-impact factor endodontic journals: A comparison of India with other countries

PubMed Central

Mishra, Lora; Pattnaik, Prajna; Kumar, Manoj; Aggarwal, Sonia; Misra, Satya Ranjan

2016-01-01

Aim: The present study was conducted with an aim to determine the number and trends of published articles in the International Endodontic Journal (IEJ) and Journal of Endodontics (JOE) from 2009 to 2014. Settings and Designs: A retrospective observational study was conducted for IEJ and JOE. Subjects and Methods: All issues of IEJ and JOE were electronically and hand searched for the following parameters: Amount of papers, publication year, affiliated organizations, and countries. Statistical Analysis Used: The data were organized and analyzed using software SPSS version 21.0; descriptive statistics was used. Results: A total of 872 articles were analyzed in the IEJ and JOE with 1606 papers. Brazil had the largest number of articles (170) mainly in IEJ, and the USA (350) in JOE. Indians published more of their research in JOE than IEJ. Conclusions: Original articles in endodontic publication from different universities in India have considerably increased, showing that research is becoming more important. PMID:27795645

[Application of case-based learning in clinical internship teaching of conservative dentistry and endodontics].

PubMed

Liu, Sheng-bo; Peng, Bin; Song, Ya-ling; Xu, Qing-an

2013-12-01

To investigate the education effect of case-based learning (CBL) pattern on clinical internship of conservative dentistry and endodontics. Forty-one undergraduates were randomly assigned into CBL group and traditional teaching group. After clinical internship in the department of conservative dentistry and endodontics for 11 weeks, each student in the 2 groups underwent comprehensive examinations including medical record writing, case analysis, academic knowledge, professional skills and the ability of winning the trust of the patients. The scores were compared between the 2 groups using SPSS 13.0 software package. There was no significant difference between the 2 groups with regard to the scores of academic knowledge and profession skills (P>0.05). However, the results of medical record writing, case analysis and the ability of winning the trust of the patients showed significant difference between the 2 groups(P<0.05). Proper application of CBL in clinical internship of conservative dentistry and endodontics contributes to improve students' ability of clinical thinking, synthetical analysis and adaptability to different patients.

CRITICAL ANALYSIS OF ARTIFICIAL TEETH FOR ENDODONTIC TEACHING

PubMed Central

Nassri, Maria Renata Giazzi; Carlik, Jaime; da Silva, Camila Roberta Nepomuceno; Okagawa, Renata Elisa; Lin, Suzy

2008-01-01

The purpose of this study was to evaluate the use of artificial teeth for endodontic teaching. A questionnaire was prepared and submitted to 18 professors of Endodontics from different Brazilian universities to evaluate the following features of five cloudy resin artificial teeth: internal and external anatomy; coronal chambers regarding their size, shape and canal path; root canal regarding their size, shape and position; fulfillment of the pulp chamber and root canals by considering the texture, quantity, color, and ease of handling; resin hardness and visualization of the radiographic image. The results presented favorable opinions, in terms of internal and external anatomy, coronal pulp chambers and root canal and handling and radiographic imaging. The contents of the pulp space and hardness of the teeth were considered satisfactory. The average grade assigned to the artificial tooth quality was 8.4, in a 0-10 scale. In conclusion, the artificial teeth have potential to replace the natural teeth in endodontic teaching; however, improvements are still necessary to reach a better quality model. PMID:19089288

Effect of Aquatine Endodontic Cleanser on smear layer removal in the root canals of ex vivo human teeth.

PubMed

Garcia, Faustino; Murray, Peter E; Garcia-Godoy, Franklin; Namerow, Kenneth N

2010-01-01

The purpose of this study was to measure and compare the root canal cleanliness and smear layer removal effectiveness of Aquatine Endodontic Cleanser (Aquatine EC) when used as an endodontic irrigating solution in comparison with 6% sodium hypochlorite (NaOCl). Forty-five human teeth were randomly allocated to five treatment groups; the pulp chamber was accessed, cleaned, and shaped by using ProTaper and ProFile rotary instrumentation to an ISO size #40. The teeth were then processed for scanning electron microscopy, and the root canal cleanliness and removal of smear layer were examined. The most effective removal of smear layer occurred with Aquatine EC and NaOCl, both with a rinse of EDTA. Aquatine EC appears to be the first hypochlorous acid approved by the FDA to be a possible alternative to the use of NaOCl as an intracanal irrigant. Further research is needed to identify safer and more effective alternatives to the use of NaOCl irrigation in endodontics.

A New Classification of Endodontic-Periodontal Lesions

PubMed Central

Al-Fouzan, Khalid S.

2014-01-01

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

A case series associated with different kinds of endo-perio lesions

PubMed Central

Serper, Ahmet

2014-01-01

Pulpal and periodontal problems are responsible for more than half of the tooth mortality. There are some articles published in the literature about this issue. Many of them are quite old. There has been also lack of knowledge about the effect of endodontic treatment on the periodontal tissue healing and suitable treatment interval between endodontic and periodontal treatments. In this case report, different kinds of endo-perio lesion were treated with sequential endodontic and periodontal treatment. The follow-up radiographs showed complete healing of the hard and soft tissue lesions. The tooth with endo-perio lesions should be evaluated thoroughly in terms of any cracks and fracture, especially furcation areas for a long term prognosis. In this case report, it was showed that 3 months treatment intervals between endodontic treatment and periodontal surgery has no harmful effect on periodontal tissue healing. Key words:Endo-perio lesion, furcation, mandibular molar, bone graft, crack line, treatment interval. PMID:24596642

A new classification of endodontic-periodontal lesions.

PubMed

Al-Fouzan, Khalid S

2014-01-01

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.

Frequency, microbial interactions, and antimicrobial susceptibility of Fusobacterium nucleatum and Fusobacterium necrophorum isolated from primary endodontic infections.

PubMed

Jacinto, Rogério C; Montagner, Francisco; Signoretti, Fernanda G C; Almeida, Geovania C; Gomes, Brenda P F A

2008-12-01

This study assessed the prevalence and microbial interactions of Fusobacterium nucleatum and Fusobacterium necrophorum in primary endodontic infections from a Brazilian population and their antimicrobial susceptibility to some antibiotics by the E-test. One hundred ten samples from infected teeth with periapical pathologies were analyzed by culture methods. Five hundred eighty individual strains were isolated; 81.4% were strict anaerobes. F. nucleatum was found in 38 root canals and was associated with Porphyromonas gingivalis, Prevotella spp., and Eubacterium spp. F. necrophorum was found in 20 root canals and was associated with Peptostreptococcus prevotii. The simultaneous presence of F. nucleatum and F. necrophorum was not related to endodontic symptoms (p > 0.05). They were 100% susceptible to amoxicillin, amoxicillin/clavulanate, and cephaclor. Fusobacterium spp. is frequently isolated from primary-infected root canals of teeth with periapical pathologies. Amoxicillin is a useful antibiotic against F. nucleatum and F. necrophorum in endodontic infections and has been prescribed as the first choice in Brazil.

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

PubMed

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

2008-12-01

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

Influence of calcium hydroxide debris on the quality of endodontic apical seal.

PubMed

Contardo, L; De Luca, M; Bevilacqua, L; Breschi, L; Di Lenarda, R

2007-10-01

The aim of the study was to study investigate the influence of calcium hydroxide used as intermediate medication on the quality of apical seal of a silicon based and an experimental resin based endodontic sealer. Eighty endodontic canals were prepared and divided in four groups. Calcium hydroxide was applied in groups 2 and 4. After 7 days, medication was removed and canals were filled with gutta-percha and RoekoSeal Automix (groups 1 and 2) or Scotchbond MP+C&B cement B (groups 3 and 4). Specimens were placed into India ink, cleared and analyzed under a stereomicroscope to investigate apical leakage. Specimens that received calcium hydroxide medication showed leakage means higher than the corresponding untreated ones (i.e. group 1< group 2 and group 3< group 4; P<0.001). Calcium hydroxide interferes with the sealing ability of silicon based sealer, since it frequently remains entrapped within the endodontic space even after careful removal procedures.

Endodontic-related facial paresthesia: systematic review.

PubMed

Alves, Flávio R; Coutinho, Mariana S; Gonçalves, Lucio S

2014-01-01

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.

Autotransplantation of endodontically treated third molars.

PubMed

Sobhi, Muhammad Bakhsh; Rana, Muzammil Jamil Ahmed; Manzoor, Manzoor Ahmed; Ibrahim, Mohammad; Tasleem-ul-Hudda

2003-07-01

To determine the success rate in autotransplantation of endodontically treated third molars. A descriptive study. This study was carried out at Armed Forces Institute of Dentistry (AFID), Rawalpindi (Pakistan) from January 2002 to December 2002. A total of 50 patients meeting the inclusion criteria were selected who had their first or second molars in unrestorable condition with intact third molars. The donor teeth were extracted after the preparation of recipient site. After endodontically treated in vitro the donor teeth were carried to the recipient site and immobilized. Postoperative variables were recorded and analyzed on SPSS version 10. The overall success rate after six months of the transplantation of third molars was 88% with complete root formation after endodontic treatment. All the patients(12%) who had complaints were more than 35 years of age. Third molars are good substitute for the unrestorable first or second molars and would be as effective as endosseous implants. The procedure is likely to have complications in the advanced age group.

Endodontic management of mandibular third molar with three mesial roots using spiral computed tomography scan as a diagnostic aid: a case report.

PubMed

Tomar, Deepak; Dhingra, Anil; Tomer, Anil; Sharma, Shalini; Sharma, Vivek; Miglani, Anjali

2013-05-01

Aberrant root canal anatomy is diagnostically and clinically challenging for clinicians. The most common root canal configuration of human molars is 2 roots and 3 canals, but various combinations may still exist. Third molars are known to have the most unusual anatomy among human teeth. Restorative, prosthetic, and orthodontic considerations often require endodontic treatment of third molars in order for them to be retained as functional components of the dental arch. The present case report demonstrates unusual root canal morphology of the mandibular third molar. Roentgenographic examination, which included spiral CT scan, revealed 3 separate mesial roots in tooth #48 with 3 independent canals and 3 canal orifices, indicating an endodontic rarity. The present case report puts impetus on exploration of additional canals using advanced diagnostic aids, such as spiral computed tomography, which can have a huge impact on the successful outcome of endodontic therapy. Copyright © 2013 Elsevier Inc. All rights reserved.

Critical analysis of artificial teeth for endodontic teaching.

PubMed

Nassri, Maria Renata Giazzi; Carlik, Jaime; da Silva, Camila Roberta Nepomuceno; Okagawa, Renata Elisa; Lin, Suzy

2008-01-01

The purpose of this study was to evaluate the use of artificial teeth for endodontic teaching. A questionnaire was prepared and submitted to 18 professors of Endodontics from different Brazilian universities to evaluate the following features of five cloudy resin artificial teeth: internal and external anatomy; coronal chambers regarding their size, shape and canal path; root canal regarding their size, shape and position; fulfillment of the pulp chamber and root canals by considering the texture, quantity, color, and ease of handling; resin hardness and visualization of the radiographic image. The results presented favorable opinions, in terms of internal and external anatomy, coronal pulp chambers and root canal and handling and radiographic imaging. The contents of the pulp space and hardness of the teeth were considered satisfactory. The average grade assigned to the artificial tooth quality was 8.4, in a 0-10 scale. In conclusion, the artificial teeth have potential to replace the natural teeth in endodontic teaching; however, improvements are still necessary to reach a better quality model.

Radiologic assessment of quality of root canal fillings and periapical status in an Austrian subpopulation – An observational study

PubMed Central

Frank, Wilhelm; Madaus, Theresa

2017-01-01

Background/Objective Progress in endodontic techniques and methodological advances have altered root canal therapy over the last decades. These techniques and methods need periodical documentation. This observational study determined the current prevalence of endodontic treatments, and investigated the relationship of various factors with the periapical status in a Lower Austrian subpopulation. Methodology One thousand orthopantomograms of first-time university adult patients radiographed at an outpatient clinic were evaluated. For each tooth, the presence of periradicular pathosis and/or endodontic treatment was recorded, as was the quality of (post-)endodontic treatment (homogeneity and length of root canal fillings; preparation failures; posts/screws; apicoectomies; coronal restorations). Two evaluators, blinded to each other, scored all teeth. In cases of disagreement, they joined for a consensus score. Results In all, 22,586 teeth were counted. Of these, 2,907 teeth (12.9%) had periapical pathosis, while 2,504 teeth had undergone root canal treatment. Of the endodontically treated teeth, 52% showed no radiographic signs of apical periodontitis, while 44.9% had overt apical lesions, and 3,1% revealed widened periodontal ligament space. The majority of the root canal fillings was inhomogeneous (70.4%); 75.4% were rated too short, and 3.8% too long. The presence of apical pathosis was significantly correlated (odds ratio (OR) 2.556 [confidence interval (CI) 2.076–3.146]; P<0.0001) with poor root canal fillings (length and homogeneity). Posts or screws positively affected periapical status (OR 1.853 [CI 1.219–2.819]; P = 0.004), but endodontically treated posterior teeth were infrequently restored (posts, 7.5%; screws, 2.7%). Best results were found for teeth with both appropriate endodontic treatment and adequate coronal restoration. Conclusion A high prevalence of periradicular radiolucencies was observed with root canal filled teeth, along with high numbers of unmet treatment needs. Periapical health was associated with adequate root canal obturation and high-grade postendodontic restorations, and quality regarding these latter aspects is considered mandatory to promote periapical health. PMID:28464019

Apical Periodontitis and Endodontic Treatment in Patients with Type II Diabetes Mellitus: Comparative Cross-sectional Survey.

PubMed

Smadi, Leena

2017-05-01

The aims of this study were to investigate the prevalence of apical periodontitis (AP) in diabetes mellitus (DM) patients compared with nondiabetic patients and to examine the effect of glycemic control on the prevalence of AP. Radiographs of a group of DM patients were compared with those of a matched nondiabetic group to identify AP. The diabetic group was subdivided according to the level of glycemic control into two subgroups: A well-controlled DM and a poorly controlled DM. The periapical index score was used to assess the periapical status. All groups were compared in regard to the presence of AP lesions, the number of end-odontically treated teeth (ET), and the percentage of failure of endodontically treated teeth (AP/ET ratio). Statistical Package for the Social Sciences (SPSS version 20.0, Chicago, Illinois, USA) was used for all the analyses; p ≤ 0.05 was considered as statistically significant. The prevalence of AP was higher in diabetic group than in the nondiabetic group (13.5 vs 11.9% respectively). Diabetic group had more teeth with endodontic treatment ET compared with nondiabetic group (4.18 vs 1.82% respectively); this difference was statistically significant (p = 0.001) along with higher AP/ET ratio (27.7 vs 19.3 respectively). The poorly controlled DM group had a higher prevalence of AP lesions compared with the well-controlled DM group (18.29 vs 9.21 respectively). This difference was statistically significant (p = 0.001); they also had a higher percentage of ET (5.55 vs 3.13% respectively) and AP/ ET ratio (32.0 vs 21.8% respectively). This survey demonstrates a higher prevalence of AP in DM patients compared with nondiabetic group, with an increased prevalence of persistent chronic AP. Compared with a well-controlled diabetic group, a poor glycemic control may be associated with a higher prevalence of AP and increased rate of endodontic failures. Counseling diabetic patients, particularly those with poor glycemic control, about the risk of failure of endodontic treatment can be part of planning management, which could include refereeing diabetic patients who need endodontic treatment for consultant care.

Bilateral presence of two root canals in maxillary central incisors: A rare case study.

PubMed

Kavitha, M; Gokul, Kannan; Ramaprabha, B; Lakshmi, Amudha

2014-04-01

Success in root canal treatment is achieved after thorough cleaning and shaping followed by complete obturation of the canal system. Therefore, endodontic therapy requires specific and complete knowledge of the internal and external dental anatomy, and its variations in presentation. The internal anatomy of the maxillary central incisor is well-known and usually presents one root canal system. This case report describes an endodontic treatment of traumatized both maxillary central incisors with two canal systems. Knowledge of dental anatomy is fundamental for proper endodontic practice. When root canal treatment is performed, the clinician should be aware that both external and internal anatomy may be abnormal.

Maxillary First Molars with 2 Distobuccal Canals: A Case Series.

PubMed

Fogel, Howard M; Cunha, Rodrigo Sanches

2017-11-01

An appreciation of the anatomic complexity of the root canal system is essential at every step of endodontic treatment. Endodontic treatment of teeth with unusual root canal anatomy presents a unique challenge. Eight patients underwent nonsurgical root canal treatment of 3-rooted maxillary first molars in a specialty endodontic private practice. Four cases of Weine type II and 4 cases of Weine type III canal configurations in the distobuccal root of maxillary first molars were presented.This article highlighted an uncommon anatomic variation of 2 canals in the distobuccal root of the maxillary first molar. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

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

PubMed

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

2014-01-01

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

Endodontic therapy of a mandibular third molar with 5 canals: a case report.

PubMed

Silberman, Adrian; Heilborn, Carlos; Cohenca, Nestor

2009-06-01

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.

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

PubMed

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

1991-01-01

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

[Analysis of different endodontic sealers and strategies of root canal irrigation on the bond strength of fiber posts].

PubMed

Zhu, Shujin; Liu, Cuiling; Zheng, Zheng; Yang, Liyuan; Gao, Xu

2015-06-01

To evaluate the influence of eugenol-containing and resin-containing endodontic sealers on the bond strength of fiber posts using different strategies of root canal irrigation. Forty-eight mandibular premolars were endodontically treated. The specimens were randomly assigned into two groups according to different endodontic sealers. Group A used Endofil (eugenol-containing endodontic sealer), and group B used AH-plus (resin-containing endodontic sealer). After post space preparation, each group was randomly assigned into three subgroups according to the strategies of root canal irrigation (eight premolars in each subgroup). Group Al and B1: 0.9%NaCl irrigation; Group A2 and B2: 17% ethylene diamine tetraacetic acid (EDTA)+5.25%NaClO+0.9%NaCl irrigation; Group A3 and B3: ultrasonic agitation associated with 1 7%EDTA+5.25%NaClO+0.9%NaCl. One week after the cementation of fiber posts using RelyX™ Unicem, a push-out test was performed to measure the bond strength of the posts. The microstructure of the root canal surface was examined under scanning electron microscope (SEM). The bond strengths of the six groups were as follows: Al (7.96±2.23) MPa, A2 (9.95±2.89) MPa, A3 (18.88±3.69) MPa, B1 (11.41±3.71) MPa, B2 (14.00±4.04) MPa, and B3 (19.14±3.27) MPa. Statistical analysis revealed a significant interaction between the different endodontic sealers and the strategies of root canal irrigation (P<0.05). Lower bond strength was found in group Al but not in group BI (P<0.05), and the same result was revealed when comparing group A2 and B2. No significant difference was observed between group A3 and B3 (P>0.05). SEM showed that the root canal in group A3 and B3 achieved the cleanest surface with nearly all dentine tubules opened. The eugenol-containing endodontic sealer can impair the bond strength of fiber posts compared with the resin-containing sealer when the root canal is irrigated by 0.9% NaCl or 17%EDTA+5.25%NaClO+0.9%NaC. No difference was observed between the two sealers when using 17%EDTA+5.25% NaCIO+0.9%NaCl combined with ultrasonic irrigation.

Effects of R-Phase on Mechanical Responses of a Nickel-Titanium Endodontic Instrument: Structural Characterization and Finite Element Analysis

PubMed Central

Santos, Leandro de Arruda; Resende, Pedro Damas; Bahia, Maria Guiomar de Azevedo; Buono, Vicente Tadeu Lopes

2016-01-01

The effects of the presence of the R-phase in a near-equiatomic NiTi alloy on the mechanical responses of an endodontic instrument were studied by using finite element analysis. The input data for the constitutive model in the simulation were obtained by tensile testing of three NiTi wires: superelastic austenite NiTi, austenite + R-phase NiTi, and fully R-phased NiTi. The wires were also characterized by X-ray diffraction and differential scanning calorimetry. A commercially available endodontic instrument was scanned using microcomputed tomography, and the resulting images were used to build the geometrical model. The numerical analyses were performed in ABAQUS using load and boundary conditions based on the ISO 3630-1 specification for the bending and torsion of endodontic instruments. The modeled instrument containing only R-phase demanded the lowest moment to be bent, followed by the one with mixed austenite + R-phase. The superelastic instrument, containing essentially austenite, required the highest bending moment. During bending, the fully R-phased instrument reached the lowest stress values; however, it also experienced the highest angular deflection when subjected to torsion. In summary, this simulation showed that NiTi endodontic instruments containing only R-phase in their microstructure would show higher flexibility without compromising their performance under torsion. PMID:27314059

Root Canal Irrigation: Chemical Agents and Plant Extracts Against Enterococcus faecalis

PubMed Central

Borzini, Letizia; Condò, Roberta; De Dominicis, Paolo; Casaglia, Adriano; Cerroni, Loredana

2016-01-01

Background: There are various microorganisms related to intra and extra-radicular infections and many of these are involved in persistent infections. Bacterial elimination from the root canal is achieved by means of the mechanical action of instruments and irrigation as well as the antibacterial effects of the irrigating solutions. Enterococcus faecalis can frequently be isolated from root canals in cases of failed root canal treatments. Antimicrobial agents have often been developed and optimized for their activity against endodontic bacteria. An ideal root canal irrigant should be biocompatible, because of its close contact with the periodontal tissues during endodontic treatment. Sodium hypoclorite (NaOCl) is one of the most widely recommended and used endodontic irrigants but it is highly toxic to periapical tissues. Objectives: To analyze the literature on the chemotherapeutic agent and plant extracts studied as root canal irrigants. In particularly, the study is focused on their effect on Enterococcus faecalis. Method: Literature search was performed electronically in PubMed (PubMed Central, MEDLINE) for articles published in English from 1982 to April 2015. The searched keywords were “endodontic irrigants” and “Enterococcus faecalis” and “essential oil” and “plant extracts”. Results: Many of the studied chemotherapeutic agents and plant extracts have shown promising results in vitro. Conclusion: Some of the considered phytotherapic substances, could be a potential alternative to NaOCl for the biomechanical treatment of the endodontic space. PMID:28217184

The effect of cone beam CT (CBCT) on therapeutic decision-making in endodontics.

PubMed

Mota de Almeida, F J; Knutsson, K; Flygare, L

2014-01-01

The aim was to assess to what extent cone beam CT (CBCT) used in accordance with current European Commission guidelines in a normal clinical setting has an impact on therapeutic decisions in a population referred for endodontic problems. The study includes data of consecutively examined patients collected from October 2011 to December 2012. From 2 different endodontic specialist clinics, 57 patients were referred for a CBCT examination using criteria in accordance with current European guidelines. The CBCT examinations were performed using similar equipment and standardized among clinics. After a thorough clinical examination, but before CBCT, the examiner made a preliminary therapy plan which was recorded. After the CBCT examination, the same examiner made a new therapy plan. Therapy plans both before and after the CBCT examination were plotted for 53 patients and 81 teeth. As four patients had incomplete protocols, they were not included in the final analysis. 4% of the patients referred to endodontic clinics during the study period were examined with CBCT. The most frequent reason for referral to CBCT examination was to differentiate pathology from normal anatomy, this was the case in 24 patients (45% of the cases). The primary outcome was therapy plan changes that could be attributed to CBCT examination. There were changes in 28 patients (53%). CBCT has a significant impact on therapeutic decision efficacy in endodontics when used in concordance with the current European Commission guidelines.

The properties of chlorhexidine and undesired effects of its use in endodontics.

PubMed

Bernardi, Anarela; Teixeira, Cleonice Silveira

2015-01-01

The purpose of this article was to review the literature on the properties of chlorhexidine (CHX) and the adverse effects that may occur from its use in endodontics. In addition, adverse effects that may result from its use, such as dark staining of teeth, chemical interaction with sodium hypochlorite and formed flocculate, biologic hazards, and interactions with the filling material were evaluated. Relevant publications on the use CHX in endodontics were thoroughly reviewed from the literature published between the years 2007 and 2014. The authors conducted an electronic search using the English language databases Medline and PubMed. According to the reviewed studies, it was concluded that CHX has proven antimicrobial activity, excellent substantivity, low surface tension, and low cytotoxicity and genotoxicity that depend on the dose and exposed area. There is scientific evidence showing the possibility of tooth staining and formation of brown precipitate when its use is associated with sodium hypochlorite. On the other hand, it is not well established that its use interferes with the quality of endodontic fillings. With respect to the biologic risks, the degradation of CHX may generate para-chloroaniline and free radicals, which are harmful to the vital tissues. There is no established consensus on the potential risk of CHX. The final considerations of this review will encourage researchers to seek scientific evidence demonstrating the safety of the use and applicability of CHX in endodontic therapy.

A Survey of Endodontic Practices among Dentists in Burkina Faso.

PubMed

Kaboré, Wendpoulomdé Ad; Chevalier, Valérie; Gnagne-Koffi, Yolande; Ouédraogo, Carole Dw; Ndiaye, Diouma; Faye, Babacar

2017-08-01

Dental surgeons must be aware of the most appropriate endodontic treatments and how to properly conduct them. The aim of this study was to evaluate the knowledge of dental surgeons in Burkina Faso in terms of endodontic treatment procedures. This descriptive, cross-sectional study was performed during the regular annual conference of the National Board of Dental Surgeons of Burkina Faso, held on February 27 and 28, 2015 in Ouagadougou, through a questionnaire. A total of 33 practitioners took part (52.4% of the dental surgeons of Burkina Faso) in the study. The majority of them (90.9%) used sodium hypochlorite as their preferred irrigation solution. Nearly half of the dental surgeons (48.5%) did not know how to use a permeabilization file, and most did not make use of nickel-titanium (NiTi) mechanized instruments (78.8%) or rubber dams (93.9%). Approximately two-thirds of participants did not perform file-in-place radiography (66.7%) or control radiography of the canal obturation (63.6%). The adjusted single-cone technique was the most commonly used (87.9%). This study highlights that the majority of dental surgeons in Burkina Faso are not using the currently recommended endodontic procedures to perform obturations. Dental surgeons in Burkina Faso must commit to regularly upgrading their knowledge and techniques. Key words: Burkina faso, Cross-sectional study, Dental surgeons, Endodontic treatments, Protocol adherence.

Review of osteoimmunology and the host response in endodontic and periodontal lesions

PubMed Central

Graves, Dana T.; Oates, Thomas; Garlet, Gustavo P.

2011-01-01

Both lesions of endodontic origin and periodontal diseases involve the host response to bacteria and the formation of osteolytic lesions. Important for both is the upregulation of inflammatory cytokines that initiate and sustain the inflammatory response. Also important are chemokines that induce recruitment of leukocyte subsets and bone-resorptive factors that are largely produced by recruited inflammatory cells. However, there are differences also. Lesions of endodontic origin pose a particular challenge since that bacteria persist in a protected reservoir that is not readily accessible to the immune defenses. Thus, experiments in which the host response is inhibited in endodontic lesions tend to aggravate the formation of osteolytic lesions. In contrast, bacteria that invade the periodontium appear to be less problematic so that blocking arms of the host response tend to reduce the disease process. Interestingly, both lesions of endodontic origin and periodontitis exhibit inflammation that appears to inhibit bone formation. In periodontitis, the spatial location of the inflammation is likely to be important so that a host response that is restricted to a subepithelial space is associated with gingivitis, while a host response closer to bone is linked to bone resorption and periodontitis. However, the persistence of inflammation is also thought to be important in periodontitis since inflammation present during coupled bone formation may limit the capacity to repair the resorbed bone. PMID:21547019

Occurrence of two newly named oral treponemes - Treponema parvum and Treponema putidum - in primary endodontic infections.

PubMed

Rôças, I N; Siqueira, J F

2005-12-01

Recent evidence from molecular genetic studies has revealed that oral Treponema species are involved in infections of endodontic origin. This study assessed the occurrence of two newly named oral treponemes - Treponema parvum and Treponema putidum - in primary endodontic infections using a culture-independent identification technique. Genomic DNA was isolated directly from clinical samples, and a 16S rRNA gene-based nested polymerase chain reaction (PCR) assay was used to determine the presence of T. parvum and T. putidum. Species-specific primer pairs were developed by aligning closely related 16S rRNA gene sequences. The specificity for each primer pair was validated by running PCR against a panel of oral bacteria and by sequence analysis of PCR products from positive clinical samples. T. parvum was detected in 52% of the root canals associated with chronic apical periodontitis, in 20% of the cases diagnosed as acute apical periodontitis, and in no abscessed case. In general, T. parvum was detected in 26% of the samples from primary endodontic infections. T. putidum was found in only one case of acute apical periodontitis (2% of the total number of cases investigated). The devised nested PCR protocol was able to identify both T. parvum and T. putidum directly in clinical samples and demonstrated that these two treponemes can take part in endodontic infections.

Is endodontic treatment necessary during coronectomy procedure?

PubMed

Sencimen, Metin; Ortakoglu, Kerim; Aydin, Cumhur; Aydintug, Yavuz S; Ozyigit, Aykut; Ozen, Tuncer; Gunaydin, Yilmaz

2010-10-01

Close proximity of the inferior alveolar nerve (IAN) to the third molar roots can result in nerve injuries during extraction of third molars. Consequently, it is necessary to determine the relationship of the nerve and roots to avoid damage to the IAN. Computed tomography scans are widely used to determine the correct relationship between the IAN and lower third molars. The study consisted of 10 patients with 16 lower third molars in close relationship with the IAN who were divided into a study group and a control group. The patients in the study group were treated via coronectomies performed with endodontic treatments. The patients in the control group underwent coronectomies without endodontic treatment. The patients were followed up for at least 1 year. We had to extract 7 of the roots because of the infection in 8 patients belonging to the study group, which were treated endodontically. Moreover, there were 3 cases of IAN damage because of the extraction in the study group. However, in the control group, no infection was determined and IAN damage was absent. Coronectomy appears to be a reliable technique to protect the IAN from damage. This procedure has a low incidence of complications. Endodontic treatment does not affect the success of this method according to our results. Copyright © 2010 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Success rates of a mixture of ciprofloxacin, metronidazole, and minocycline antibiotics used in the non-instrumentation endodontic treatment of mandibular primary molars with carious pulpal involvement.

PubMed

Trairatvorakul, Chutima; Detsomboonrat, Palinee

2012-05-01

To evaluate the clinical and radiographic success rates of three mixed antibiotics in the non-instrumentation endodontic treatment of primary mandibular molars at 24-27 months postoperatively. Eighty cariously involved lower primary molars from 58 children (ages 3-8 years) received a 3Mix medicament by non-instrumentation endodontic treatment and were then sealed with glass-ionomer cement and composite resin before permanent restoration with stainless steel crowns. The patients received a clinical and radiographic assessment every 6 months over a 2-year follow-up period with an intra-examiner reliability of 0.83-1.00 (κ value). In 60 cases at 24- to 27-month follow-up, the success rates as determined by clinical and radiographic evaluation were 75% and 36.7%, respectively; however, the overall success rate of 3Mix non-instrumentation endodontic treatment was 36.7% with 15.8% of cases demonstrating a pulpal response of internal resorption. Non-instrumentation endodontic treatment using 3Mix-MP showed good clinical success but had a low success rate based on radiographic evaluation at 2-year follow-up. Hence, 3Mix antibiotic treatment cannot replace a conventional root canal treatment agent as a long-term therapy. © 2011 The Authors. International Journal of Paediatric Dentistry © 2011 BSPD, IAPD and Blackwell Publishing Ltd.

Irrigation in endodontic treatment.

PubMed

Basrani, Bettina

2011-01-01

The primary endodontic treatment goal is to optimize root canal disinfection and to prevent reinfection. Successful root canal therapy relies on the combination of proper instrumentation, irrigation, and obturation of the root canal system. In this review of the literature, various irrigants and the interactions between irrigants are discussed and new delivery systems are introduced.

Student Endodontic Performance with and without Numerical Requirements.

ERIC Educational Resources Information Center

Lee, Charles Q.; And Others

1994-01-01

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

An energy-dispersive X-ray analysis and SEM study of debris remaining on endodontic instruments after ultrasonic cleaning and autoclave sterilization.

PubMed

Parirokh, Masoud; Asgary, Saeed; Eghbal, Mohammad Jafar

2005-08-01

This study was carried out to investigate metallic and non-metallic debris remaining on endodontic files after ultrasonic cleaning and autoclave processing. Forty-eight unused rotary and hand endodontic files, including eight different brands, were tested. Instruments were cleaned with ultrasound, autoclaved and before and after each step were observed by scanning electron microscopy (SEM). Adherent debris was analysed by energy-dispersive X-ray analysis (EDXA). All of the instruments before ultrasound cleaning were contaminated with metallic and non-metallic debris. Although most non-metallic debris was removed by ultrasonic cleaning, most of the metallic debris remained even after the final step of sterilization.

Diagnosis demystified: CT as diagnostic tool in endodontics

PubMed Central

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

2013-01-01

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

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

PubMed

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

2016-01-01

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

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

PubMed

Zabalegui, B

1990-01-01

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

An Insight Into Neurophysiology of Pulpal Pain: Facts and Hypotheses

PubMed Central

Gupta, Abhishek; N., Meena

2013-01-01

Pain and pain control are important to the dental profession because the general perception of the public is that dental treatment and pain go hand in hand. Successful dental treatment requires that the source of pain be detected. If the origin of pain is not found, inappropriate dental care and, ultimately, extraction may result. Pain experienced before, during, or after endodontic therapy is a serious concern to both patients and endodontists, and the variability of discomfort presents a challenge in terms of diagnostic methods, endodontic therapy, and endodontic knowledge. This review will help clinicians understand the basic neurophysiology of pulpal pain and other painful conditions of the dental pulp that are not well understood. PMID:24156000

Nasopalatine duct cyst mimicking an endodontic periapical lesion: a case report.

PubMed

Bains, Rhythm; Verma, Promila; Chandra, Anil; Tikku, A P; Singh, Nimisha

2016-01-01

Lesions of nonendodontic origin, such as nasopalatine or globulomaxillary cysts, may mimic periapical radiolucencies associated with pulpal pathosis, and incorrect diagnosis may lead to unnecessary endodontic treatment. Horizontal root fractures most commonly affect the maxillary central and lateral incisors. Prognosis depends largely on the level of fracture; fractures in the apical third have the best prognosis, and those in the cervical third have the worst. This case report discusses surgical and restorative management of a patient who had a nasopalatine cyst that had been misdiagnosed and treated as an endodontic lesion of the maxillary right central incisor as well as a midroot horizontal fracture of the adjacent lateral incisor.

An insight into neurophysiology of pulpal pain: facts and hypotheses.

PubMed

Jain, Niharika; Gupta, Abhishek; N, Meena

2013-10-01

Pain and pain control are important to the dental profession because the general perception of the public is that dental treatment and pain go hand in hand. Successful dental treatment requires that the source of pain be detected. If the origin of pain is not found, inappropriate dental care and, ultimately, extraction may result. Pain experienced before, during, or after endodontic therapy is a serious concern to both patients and endodontists, and the variability of discomfort presents a challenge in terms of diagnostic methods, endodontic therapy, and endodontic knowledge. This review will help clinicians understand the basic neurophysiology of pulpal pain and other painful conditions of the dental pulp that are not well understood.

Midtreatment flare-ups.

PubMed

Harrington, G W; Natkin, E

1992-04-01

It should be apparent that the prompt and effective treatment of midtreatment flare-ups of all types is an essential and integral part of the overall endodontic treatment procedure. The expeditious management of these flare-ups will do much to enhance a positive attitude among patients toward endodontic treatment and to ensure the well-being and comfort of these patients.

Effectiveness of an Endodontic Diagnosis Computer Simulation Program.

ERIC Educational Resources Information Center

Fouad, Ashraf F.; Burleson, Joseph A.

1997-01-01

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

Endodontic treatment of mandibular canine with two roots and two canals.

PubMed

Moogi, Prashant P; Hegde, Reshma S; Prashanth, B R; Kumar, G Vinay; Biradar, Nandini

2012-11-01

In majority of cases, mandibular canines have one root and one root canal, although 15% may have two canals. Literature report shows incidence of two-rooted canine as low as 1.7%. This article reports a clinical case of endodontic treatment of mandibular canine with two roots and two canals.

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

PubMed Central

2016-01-01

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

Diabetes mellitus, periapical inflammation and endodontic treatment outcome

PubMed Central

Castellanos-Cosano, Lizett; Machuca, Guillermo; López-López, Jose; Martín-González, Jenifer; Velasco-Ortega, Eugenio; Sánchez-Domínguez, Benito; López-Frías, Francisco J.

2012-01-01

The possible connection between chronic oral inflammatory processes, such as apical periodontitis and periodontal disease (PD), and systemic health is one of the most interesting aspects faced by the medical and dental scientific community. Chronic apical periodontitis shares important characteristics with PD: 1) both are chronic infections of the oral cavity, 2) the Gram-negative anaerobic microbiota found in both diseases is comparable, and 3) in both infectious processes increased local levels of inflammatory mediators may have an impact on systemic levels. One of the systemic disorders linked to PD is diabetes mellitus (DM); is therefore plausible to assume that chronic apical periodontitis and endodontic treatment are also associated with DM. The status of knowledge regarding the relationship between DM and endodontics is reviewed. Upon review, we conclude that there are data in the literature that associate DM with a higher prevalence of periapical lesions, greater size of the osteolityc lesions, greater likelihood of asymptomatic infections and worse prognosis for root filled teeth. The results of some studies suggest that periapical disease may contribute to diabetic metabolic dyscontrol. Key words: Apical periodontitis, diabetes mellitus, endodontics, root canal treatment. PMID:22143698

Diversity of spirochetes in endodontic infections.

PubMed

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

2009-05-01

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

Fabricating fiber-reinforced composite posts.

PubMed

Manhart, Jürgen

2011-03-01

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.

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

PubMed Central

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

2015-01-01

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

Effect of aquatine endodontic cleanser on smear layer removal in the root canals of ex vivo human teeth

PubMed Central

GARCIA, Faustino; MURRAY, Peter E.; GARCIA-GODOY, Franklin; NAMEROW, Kenneth N.

2010-01-01

Objectives The purpose of this study was to measure and compare the root canal cleanliness and smear layer removal effectiveness of Aquatine Endodontic Cleanser (Aquatine EC) when used as an endodontic irrigating solution in comparison with 6% sodium hypochlorite (NaOCl). Material and Methods Forty-five human teeth were randomly allocated to five treatment groups; the pulp chamber was accessed, cleaned, and shaped by using ProTaper and ProFile rotary instrumentation to an ISO size #40. The teeth were then processed for scanning electron microscopy, and the root canal cleanliness and removal of smear layer were examined. Results The most effective removal of smear layer occurred with Aquatine EC and NaOCl, both with a rinse of EDTA. Conclusions Aquatine EC appears to be the first hypochlorous acid approved by the FDA to be a possible alternative to the use of NaOCl as an intracanal irrigant. Further research is needed to identify safer and more effective alternatives to the use of NaOCl irrigation in endodontics. PMID:20835577

Endo-Perio Dilemma: A Brief Review

PubMed Central

Singh, Preetinder

2011-01-01

The actual relationship between periodontal and pulpal disease was first described by Simring and Goldberg in 1964. Since then, the term “perio-endo” lesion has been used to describe lesions due to inflammatory products found in varying degrees in both the periodontium and the pulpal tissues. The pulp and periodontium have embryonic, anatomic and functional inter-relationships. The simultaneous existence of pulpal problems and inflammatory periodontal disease can complicate diagnosis and treatment planning. A perio-endo lesion can have a varied pathogenesis which ranges from quite simple to relatively complex one. Knowledge of these disease processes is essential in coming to the correct diagnosis. This is achievable by careful history taking, examination and the use of special tests. The prognosis and treatment of each endodontic-periodontal disease type varies. Primary periodontal disease with secondary endodontic involvement and true combined endodontic-periodontal diseases require both endodontic and periodontal therapies. The prognosis of these cases depends on the severity of periodontal disease and the response to periodontal treatment. This enables the operator to construct a suitable treatment plan where unnecessary, prolonged or even detrimental treatment is avoided. PMID:22132014

Endodontic-periodontic bifurcation lesions: a novel treatment option.

PubMed

Lin, Shaul; Tillinger, Gabriel; Zuckerman, Offer

2008-05-01

The purpose of this preliminary clinical report is to suggest a novel treatment modality for periodontal bifurcation lesions of endodontic origin. The study consisted of 11 consecutive patients who presented with periodontal bifurcation lesions of endodontic origin (endo-perio lesions). All patients were followed-up for at least 12 months. Treatment included calcium hydroxide with iodine-potassium iodide placed in the root canals for 90 days followed by canal sealing with gutta-percha and cement during a second stage. Dentin bonding was used to seal the furcation floor to prevent the ingress of bacteria and their by-products to the furcation root area through the accessory canals. A radiographic examination showed complete healing of the periradicular lesion in all patients. Probing periodontal pocket depths decreased to 2 to 4 mm (mean 3.5 mm), and resolution of the furcation involvement was observed in post-operative clinical evaluations. The suggested treatment of endo-perio lesions may result in complete healing. Further studies are warranted. This treatment method improves both the disinfection of the bifurcation area and the healing process in endodontically treated teeth considered to be hopeless.

Endo-perio dilemma: a brief review.

PubMed

Singh, Preetinder

2011-01-01

The actual relationship between periodontal and pulpal disease was first described by Simring and Goldberg in 1964. Since then, the term "perio-endo" lesion has been used to describe lesions due to inflammatory products found in varying degrees in both the periodontium and the pulpal tissues. The pulp and periodontium have embryonic, anatomic and functional inter-relationships. The simultaneous existence of pulpal problems and inflammatory periodontal disease can complicate diagnosis and treatment planning. A perio-endo lesion can have a varied pathogenesis which ranges from quite simple to relatively complex one. Knowledge of these disease processes is essential in coming to the correct diagnosis. This is achievable by careful history taking, examination and the use of special tests. The prognosis and treatment of each endodontic-periodontal disease type varies. Primary periodontal disease with secondary endodontic involvement and true combined endodontic-periodontal diseases require both endodontic and periodontal therapies. The prognosis of these cases depends on the severity of periodontal disease and the response to periodontal treatment. This enables the operator to construct a suitable treatment plan where unnecessary, prolonged or even detrimental treatment is avoided.

Advantages and disadvantages of new torque-controlled endodontic motors and low-torque NiTi rotary instrumentation.

PubMed

Gambarini, G

2001-12-01

The main problem with the NiTi rotary instrumentation technique is instrument failure. During shaping procedures, rotary instruments might lock and/or screw into canals and, consequently, be subjected to high levels of stress. This may frequently lead to instrument separation or deformation. If a high-torque motor is used, the applied forces are usually very high and the instrument-fracture limit is often exceeded, thus increasing the risk of intracanal failure. A possible solution of this problem is to use a low-torque endodontic motor, which operates below the maximum permissible torque limit of each and every rotary instrument. During clinical instrumentation of root canals, if a torque-controlled motor is loaded right up to the instrument-specific torque, the motor stops momentarily and/or starts rotating counter-clockwise (auto-reverse function) to disengage the locked instrument. These safety mechanisms were developed to reduce the risk of instrument fracture. The author fully discusses the rationale for selecting lower torque values in everyday endodontic practice, and provides clinicians with useful information on the advantages and disadvantages of new endodontic motors with torque control.

Endodontic treatment of developmental anomalies in posterior teeth: treatment of geminated/fused teeth--report of two cases.

PubMed

Tsesis, I; Steinbock, N; Rosenberg, E; Kaufman, A Y

2003-05-01

Gemination or fusion is a rare occurrence in the mandibular posterior teeth. Endodontic treatment of these teeth needs special care and attention to the bizarre anatomy. The aim of this article is to describe the problems encountered and the strategy in treating such cases. Two cases of complex endodontic treatment of fused/geminated teeth are presented. The first is an 11-year-old girl with an anomalous 'double' first mandibular molar and premolar diagnosed as having necrotic pulp with chronic apical abscess of endodontic origin; the second is a 16-year-old boy with 'double' second and supernumerary mandibular molars, who was diagnosed with irreversible pulpitis. Both cases were treated successfully in multiple appointments. The common features and treatment modalities are discussed. Failure to diagnose fused/geminated teeth leads to misdiagnosis and a treatment plan that could cause permanent damage and tooth loss. Generally, there is communication between root canal systems of fused/geminated teeth which should be treated as one entity. Use of magnification is an important aid during treatment.

Associations of endodontic symptoms and signs with particular combinations of specific bacteria.

PubMed

Gomes, B P; Lilley, J D; Drucker, D B

1996-03-01

Significant associations have been reported between (a) specific bacterial species isolated from root canals and (b) between individual bacterial species and endodontic symptoms and signs. The prime objective of this study was to determine whether particular combinations of specific bacteria are associated with individual endodontic symptoms and signs. Seventy root canals were investigated microbiologically taking care to maintain the viability of obligate anaerobes, which accounted for 64% of the total species isolated, including Peptostreptococcus micros, Prevotella melaninogenica, Prevotella oralis, Eubacterium aerofaciens, Eubacterium lentum, Fusobacterium nucleatum, Prevotella buccae and Prevotella intermedia. Significant associations were found between individual clinical features and the following pairs of species: (a) pain (37 cases) and Peptostreptococcus spp./Prevotella spp., Peptostreptococcus spp./Prevotella melaninogenica, Pstr. micros/Prev. melaninogenica (all P < 0.01); (b) swelling (23 cases) and Pstr. micros/Prevotella spp. (P < 0.01); (c) 'Wet' canal (57 cases) and Prevotella spp./Eubacterium spp. (P < 0.01), Peptostreptococcus spp./Eubacterium spp. (P < 0.05). Thus data from this investigation suggests that statistically significant associations exist between individual endodontic symptoms and signs and particular combinations of specific bacteria.

Experimental and numerical analysis of penetration/removal response of endodontic instrument made of single crystal Cu-based SMA: comparison with NiTi SMA instruments

NASA Astrophysics Data System (ADS)

Vincent, M.; Xolin, P.; Gevrey, A.-M.; Thiebaud, F.; Engels-Deutsch, M.; Ben Zineb, T.

2017-04-01

This paper presents an experimental and numerical study showing that single crystal shape memory alloy (SMA) Cu-based endodontic instruments can lead to equivalent mechanical performances compared to NiTi-based instruments besides their interesting biological properties. Following a previous finite element analysis (FEA) of single crystal CuAlBe endodontic instruments (Vincent et al 2015 J. Mater. Eng. Perform. 24 4128-39), prototypes with the determined geometrical parameters were machined and experimentally characterized in continuous rotation during a penetration/removal (P/R) protocol in artificial canals. The obtained mechanical responses were compared to responses of NiTi endodontic files in the same conditions. In addition, FEA was conducted and compared with the experimental results to validate the adopted modeling and to evaluate the local quantities inside the instrument as the stress state and the distribution of volume fraction of martensite. The obtained results highlight that single crystal CuAlBe SMA prototypes show equivalent mechanical responses to its NiTi homologous prototypes in the same P/R experimental conditions.

Endodontic management of C-shaped root canal system of mandibular first molar by using a modified technique of self-adjusting file system.

PubMed

Helvacioglu-Yigit, Dilek

2015-01-01

C-shaped canal system is a seldom-found root canal anatomy which displays a challenge in all stages of endodontic treatment. According to the literature, this type of canal morphology is not a common finding in the mandibular first molar teeth. This case report presents endodontic management of a mandibular first molar with a C-shaped canal system. Root canal system was cleaned and shaped by nickel-titanium (NiTi) rotary instruments combined with self-adjusting file (SAF). Obturation was performed using warm, vertical condensation combined with the injection of warm gutta-percha. Follow-up examination 12 months later showed that the tooth was asymptomatic. The radiological findings presented no signs of periapical pathology. The clinician must be aware of the occurence and complexity of C-shaped canals in mandibular first molar teeth to perform a successful root canal treatment. The supplementary use of SAF after application of rotary instruments in C-shaped root canals might be a promising approach in endodontic treatment of this type of canal morphology.

Postprocedural problems in an overdenture population: a longitudinal study.

PubMed

Ettinger, Ronald L; Qian, Fang

2004-05-01

This study reports on endodontic and other post-procedural problems experienced by overdenture patients from 1973 to 1996. There were 395 subjects enrolled in the study; 273 fulfilled the recall criteria. At recall, all subjects were examined by a single examiner, and appropriate maintenance care was performed. The 273 subjects had 666 abutments and 626 endodontically treated teeth; of these, 51 subjects had postprocedural problems in 81 teeth. Thus, 87.1% of the endodontically treated teeth had no postprocedural problems, and 12.9% had postprocedural problems. Of the subpopulation with postprocedural problems, the most common problem was endodontically treated teeth developing periradicular lesions (37.0%) because of recurrent caries causing loss of the restoration sealing the root canal. Twenty of the 30 teeth were successfully retreated. The next most common problem was vertical root fractures (30.9%), followed by vital teeth developing periradicular lesions (19.8%). Most of the failures could have been prevented by better oral hygiene. Vertical root fractures were statistically associated with abutments in the maxilla and opposed by natural teeth; protection of these abutments with thimble crowns could prevent fractures.

Root resection under the surgical field employed for extraction of impacted tooth and management of external resorption.

PubMed

Pai, Ar Vivekananda; Khosla, Manak

2012-07-01

This case report illustrates determination of prognosis and immediate resection carried out, before completing the endodontic therapy, during the surgery employed for managing a nonperiodontal problem. This case showed external pressure resorption in the distobuccal root of maxillary second molar caused by the impingement of impacted third molar. Extraction of third molar was decided when healing was not seen, despite initiating endodontic therapy in second molar. Following elevation of flap and extraction of third molar, the poor prognosis due to severe bone loss around the resorbed root was evident. But due to strategic value of second molar, it was found beneficial to employ resection. Therefore, immediate resection was carried out in the same surgical field before the completion of endodontic therapy. This prevented the need for another surgical entry with its associated trauma to carry out resection separately later. Resection followed by the completion of endodontic therapy and full crown assisted in salvaging the remaining functional portion of the tooth and prevented the occurrence of distal extension with its potential drawbacks.

Movement kinematics and cyclic fatigue of NiTi rotary instruments: a systematic review.

PubMed

Ferreira, F; Adeodato, C; Barbosa, I; Aboud, L; Scelza, P; Zaccaro Scelza, M

2017-02-01

The aim of this review was to provide a detailed analysis of the literature concerning the correlation between different movement kinematics and the cyclic fatigue resistance of NiTi rotary endodontic instruments. From June 2014 to August 2015, four independent reviewers comprehensively and systematically searched the Medline (PubMed), EMBASE, Web of Science, Scopus and Google Scholar databases for works published since January 2005, using the following search terms: endodontics; nickel-titanium rotary files; continuous rotation; reciprocating motion; cyclic fatigue. In addition to the electronic searches, manual searches were performed to include articles listed in the reference sections of high-impact published articles that were not indexed in the databases. Laboratory studies in English language were considered for this review. The electronic and manual searches resulted in identification of 75 articles. Based on the inclusion criteria, 32 articles were selected for analysis of full-text copies. Specific analysis was then made of 20 articles that described the effects of reciprocating and continuous movements on cyclic fatigue of the instruments. A wide range of testing conditions and methodologies have been used to compare the cyclic fatigue resistance of rotary endodontic instruments. Most studies report that reciprocating motion improves the fatigue resistance of endodontic instruments, compared to continuous rotation, independent of other variables such as the speed of rotation, the angle or radius of curvature of simulated canals, geometry and taper, or the surface characteristics of the NiTi instruments. © 2016 International Endodontic Journal. Published by John Wiley & Sons Ltd.

The effect of cone beam CT (CBCT) on therapeutic decision-making in endodontics

PubMed Central

Knutsson, K; Flygare, L

2014-01-01

Objectives: The aim was to assess to what extent cone beam CT (CBCT) used in accordance with current European Commission guidelines in a normal clinical setting has an impact on therapeutic decisions in a population referred for endodontic problems. Methods: The study includes data of consecutively examined patients collected from October 2011 to December 2012. From 2 different endodontic specialist clinics, 57 patients were referred for a CBCT examination using criteria in accordance with current European guidelines. The CBCT examinations were performed using similar equipment and standardized among clinics. After a thorough clinical examination, but before CBCT, the examiner made a preliminary therapy plan which was recorded. After the CBCT examination, the same examiner made a new therapy plan. Therapy plans both before and after the CBCT examination were plotted for 53 patients and 81 teeth. As four patients had incomplete protocols, they were not included in the final analysis. Results: 4% of the patients referred to endodontic clinics during the study period were examined with CBCT. The most frequent reason for referral to CBCT examination was to differentiate pathology from normal anatomy, this was the case in 24 patients (45% of the cases). The primary outcome was therapy plan changes that could be attributed to CBCT examination. There were changes in 28 patients (53%). Conclusions: CBCT has a significant impact on therapeutic decision efficacy in endodontics when used in concordance with the current European Commission guidelines. PMID:24766060

Aspergillus in endodontic infection near the maxillary sinus.

PubMed

Gomes, Cinthya Cristina; Pinto, Larissa Christina Costa; Victor, Fernanda Loretti; Silva, Erlange Andrade Borges da; Ribeiro, Apoena de Aguiar; Sarquis, Maria Inês de Moura; Camões, Isabel Coelho Gomes

2015-01-01

Diseases of the maxillary sinus have been associated with dental roots near the maxillary sinus that have undergone endodontic treatment. To investigate the presence of filamentous fungi in patients with dental roots near the maxillary sinus who had apical periodontitis treated endodontically, and to alert practitioners that this could be a possible avenue of contamination of the sinus in patients who develop maxillary sinus infection. Cross-sectional study in 60 palatal roots of the first maxillary molars near the maxillary sinus, that underwent endodontic treatment for apical periodontitis. After removal of the filling material, dentin shavings were collected and placed in test tubes containing Sabouraud dextrose agar and chloramphenicol. The phenotype was determined by macroscopic and microscopic examination of the colonies. For polymerase chain reaction, the primers ITS-5 and ITS-4 were used. The sequences obtained were compared with those deposited at GenBank using the Basic Local Alignment Search Tool program. Filamentous fungi were isolated from 6 of 60 canals (10%): Aspergillus niger (6.7%), Aspergillus versicolor (1.6%), and Aspergillus fumigatus (1.6%). Root canals near the maxillary sinus with endodontic treatment and apical periodontitis may exhibit positive cultures for filamentous fungi. Interested professionals should be alert, because these microorganisms have pathogenic characteristics that can cause disease of odontogenic origin in the maxillary sinus. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

The use of optical fiber in endodontic photodynamic therapy. Is it really relevant?

PubMed

Garcez, Aguinaldo S; Fregnani, Eduardo R; Rodriguez, Helena M; Nunez, Silvia C; Sabino, Caetano P; Suzuki, Hideo; Ribeiro, Martha S

2013-01-01

This study analyzed the necessity of use of an optical fiber/diffusor when performing antimicrobial photodynamic therapy (PDT) associated with endodontic therapy. Fifty freshly extracted human single-rooted teeth were used. Conventional endodontic treatment was performed using a sequence of ProTaper (Dentsply Maillefer Instruments), the teeth were sterilized, and the canals were contaminated with Enterococcus faecalis 3 days' biofilm. The samples were divided into five groups: group 1--ten roots irradiated with a laser tip (area of 0.04 cm(2)), group 2--ten roots irradiated with a smaller laser tip (area of 0.028 cm(2)), and group 3--ten teeth with the crown, irradiate with the laser tip with 0.04 cm(2) of area. The forth group (G4) followed the same methodology as group 3, but the irradiation was performed with smaller tip (area of 0.028 cm(2)) and G5 ten teeth with crown were irradiated using a 200-mm-diameter fiber/diffusor coupled to diode laser. Microbiological samples were taken after accessing the canal, after endodontic therapy, and after PDT. Groups 1 and 2 showed a reduction of two logs (99%), groups 3 and 4 of one log (85% and 97%, respectively), and group 5 of four logs (99.99%). Results suggest that the use of PDT added to endodontic treatment in roots canals infected with E. faecalis with the optical fiber/diffusor is better than when the laser light is used directed at the access of cavity.

Endodontic complications in teeth with vital pulps restored with composite resins: a systematic review.

PubMed

Dawson, V S; Amjad, S; Fransson, H

2015-07-01

Composite resin is used extensively for restoration of teeth with vital pulps. Although cell culture studies have disclosed harmful effects on pulpal cells, any untoward clinical effects, manifest as adverse pulpal responses, have yet to be determined. This study comprises a systematic review, designed to address the question of whether the risk of endodontic complications is greater with composite resin restorations than with other restorative materials, such as amalgam. The study methodology involved (i) formulation of the research question, (ii) construction and conduct of an extensive literature search with (iii) interpretation and assessment of the retrieved literature. A search of the medical database PubMed was complemented with a search of the Controlled Trials Register (CENTRAL). The initial search yielded 1043 publications, the abstracts of which were read independently by the authors. After additional searches, 10 studies were included in the review. In all the included studies, the level of evidence was assessed as low. No conclusions could therefore be drawn. The included studies reported few, if any, endodontic complications. Little or no differences emerged between teeth restored with composite resins and those restored with amalgam. To determine whether composite resin restorations of teeth with vital pulps are associated with an increased risk for development of endodontic complications such as apical periodontitis, further evidence is needed, from well-constructed studies with a large number of participants. © 2014 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Clustering behavior in microbial communities from acute endodontic infections.

PubMed

Montagner, Francisco; Jacinto, Rogério C; Signoretti, Fernanda G C; Sanches, Paula F; Gomes, Brenda P F A

2012-02-01

Acute endodontic infections harbor heterogeneous microbial communities in both the root canal (RC) system and apical tissues. Data comparing the microbial structure and diversity in endodontic infections in related ecosystems, such as RC with necrotic pulp and acute apical abscess (AAA), are scarce in the literature. The aim of this study was to examine the presence of selected endodontic pathogens in paired samples from necrotic RC and AAA using polymerase chain reaction (PCR) followed by the construction of cluster profiles. Paired samples of RC and AAA exudates were collected from 20 subjects and analyzed by PCR for the presence of selected strict and facultative anaerobic strains. The frequency of species was compared between the RC and the AAA samples. A stringent neighboring clustering algorithm was applied to investigate the existence of similar high-order groups of samples. A dendrogram was constructed to show the arrangement of the sample groups produced by the hierarchical clustering. All samples harbored bacterial DNA. Porphyromonas endodontalis, Prevotella nigrescens, Filifactor alocis, and Tannerela forsythia were frequently detected in both RC and AAA samples. The selected anaerobic species were distributed in diverse small bacteria consortia. The samples of RC and AAA that presented at least one of the targeted microorganisms were grouped in small clusters. Anaerobic species were frequently detected in acute endodontic infections and heterogeneous microbial communities with low clustering behavior were observed in paired samples of RC and AAA. Copyright © 2012. Published by Elsevier Inc.

Root resorption of endodontically treated teeth following orthodontic treatment: a meta-analysis.

PubMed

Ioannidou-Marathiotou, Ioulia; Zafeiriadis, Anastasios A; Papadopoulos, Moschos A

2013-09-01

The aim of this meta-analysis was to investigate the effect of orthodontic treatment on root resorption of endodontically treated teeth compared to vital teeth. A literature search was conducted in 18 electronic databases. Review articles and relevant articles were searched for cross-references. Two independent reviewers screened all articles according to predefined inclusion and exclusion criteria and extracted the corresponding data. The pooled estimate of mean difference of root resorption weighted by the fixed-effect model and the corresponding 95 % confidence intervals (CIs) were used to construct a forest plot by implementing the "RevMan 5.1" software. Quality and heterogeneity assessments as well as publication bias evaluation and sensitivity analyses were performed. Inter-reviewer agreement for data selection, data extraction and quality analysis was evaluated by Cohen's kappa. Six out of 1,942 original papers met the inclusion criteria. Four out of six studies were included in the quantitative analysis. Root resorption was less in endodontically treated teeth than in vital teeth (MD = -0.48 mm; 95 % CI = -0.81 to -0.14 mm). The funnel plot indicated no evidence of publication bias, while no data heterogeneity was present (I(2) = 0 %). However, the overall quality of the included studies was considered as "low." Following orthodontic treatment, endodontically treated teeth exhibit relatively less root resorption than teeth with vital pulps. Clinicians should consider orthodontic movement of endodontically treated teeth as a relatively safe clinical procedure.

Long-term prognosis of endodontically treated teeth: a retrospective analysis of preoperative factors in molars.

PubMed

Setzer, Frank C; Boyer, Keith R; Jeppson, Joshua R; Karabucak, Bekir; Kim, Syngcuk

2011-01-01

Long-term predictability of restored endodontically treated teeth is important for the decision of tooth retention versus extraction and implant placement. The purpose of this study was to validate the hypothesis that preoperative factors can predict the long-term prognosis of molars requiring endodontic and restorative treatment for future prognostic investigations. A clinical database was searched for molar endodontic treatments with crown placement and a minimum of 4-year follow-up. Charts of 42 patients with 50 individual treatments were randomly selected. Information concerning crown lengthening; periodontal diagnosis; attachment loss; furcation involvement; mobility; and internal, external, or periradicular resorption was recorded. Radiographs from treatment initiation and follow-up were digitalized. The presence of apical periodontitis was evaluated. Available ferrule was calculated from bitewing radiographs using CAD software (AutoCAD; Autodesk, Cupertino, CA). The resulting data, age, sex, and times of restoration and follow-up were analyzed for correlation with the presence of apical radiolucency at follow-up and the following four possible outcome scenarios: "no event," "nonsurgical retreatment," "surgical retreatment," or "extraction" using Spearman rank order correlation analysis. Patients' ages ranged from 19 to 87 years, 22 were male and 20 female, and 48 teeth (96.0%) were retained at follow-up. Of those, 44 (88.0%) were without intervention ("no event"), and four (8.0%) underwent surgical or nonsurgical retreatment. Two teeth (4.0%) had been extracted. Significant positive correlations existed between "untoward events" (any form of retreatment or extraction) and "prognostic value according to periodontal status" (p = 0.047) and "attachment loss" (p = 0.042). The only preoperative factors significant for the prognosis of restored endodontically treated molars were related to periodontal prognostic value and attachment loss. It can be concluded that it may be difficult to predict the prognosis of molars in need for endodontic treatment and restoration from prognostic factors not related to periodontal disease. Copyright © 2011 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Outcomes of endodontic therapy in general practice

PubMed Central

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

2014-01-01

Background The authors undertook a study involving members of a dental practice-based research network to determine the outcome and factors associated with success and failure of endodontic therapy. Methods Members in participating practices (practitioner-investigators [P-Is]) invited the enrollment of all patients seeking treatment in the practice who had undergone primary endodontic therapy and restoration in a permanent tooth three to five years previously. If a patient had more than one tooth so treated, the P-I selected as the index tooth the tooth treated earliest during the three- to five-year period. The authors excluded from the study any teeth that served as abutments for removable partial dentures or overdentures, third molars and teeth undergoing active orthodontic endodontic therapy. The primary outcome was retention of the index tooth. Secondary outcomes, in addition to extraction, that defined failure included clinical or radiographic evidence (or both) of periapical pathosis, endodontic retreatment or pain on percussion. Results P-Is in 64 network practices enrolled 1,312 patients with a mean (standard deviation) time to follow-up of 3.9 (0.6) years. During that period, 3.3 percent of the index teeth were extracted, 2.2 percent underwent retreatment, 3.6 percent had pain on percussion and 10.6 percent had periapical radiolucencies for a combined failure rate of 19.1 percent. The presence of preoperative periapical radiolucency with a diagnosis of either irreversible pulpitis or necrotic pulp was associated with failure after multivariate analysis, as were multiple canals, male sex and Hispanic/Latino ethnicity. Conclusions These results suggest that failure rates for endodontic therapy are higher than previously reported in general practices, according to results of studies based on dental insurance claims data. Clinical Implications The results of this study can help guide the practitioner in deciding the most appropriate course of therapy for teeth with irreversible pulpitis, necrotic pulp or periapical periodontitis. PMID:22547719

Outcomes of endodontic therapy in general practice: a study by the Practitioners Engaged in Applied Research and Learning Network.

PubMed

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

2012-05-01

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. 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. 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. 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. The results of this study can help guide the practitioner in deciding the most appropriate course of therapy for teeth with irreversible pulpitis, necrotic pulp or periapical periodontitis.

Influence of Cone-Beam Computed Tomography filters on diagnosis of simulated endodontic complications.

PubMed

Verner, F S; D'Addazio, P S; Campos, C N; Devito, K L; Almeida, S M; Junqueira, R B

2017-11-01

To evaluate the influence of cone-beam computed tomography (CBCT) filters on diagnosis of simulated endodontic complications. Sixteen human teeth, in three mandibles, were submitted to the following simulated endodontic complications: (G1) fractured file, (G2) perforations in the canal walls, (G3) deviated cast post, and (G4) external root resorption. The mandibles were submitted to CBCT examination (I-Cat ® Next Generation). Five oral radiologists evaluated the images independently with and without XoranCat ® software filters. Accuracy, sensitivity and specificity were determined. ROC curves were calculated for each group with the filters, and the areas under the curves were compared using anova (one-way) test. McNemar test was applied for pair-wise agreement between all images versus the gold standard and original images versus images with filters (P < 0.05). G1 was the most difficult endodontic complication to diagnosis, followed by G2, G4 and G3. There were no differences between areas under the ROC curves for the filters in all groups; however, Sharpen Super Mild filter had the best results for G1 (0.47), Angio Sharpen Low 3 × 3 for G2 (0.93), Angio Sharpen Low 3 × 3, S9, Shadow and Sharpen for G3 (1.00) and Sharpen 3 × 3 for G4 (1.00). The McNemar test revealed significant differences between all filters with the gold standard (P = 0.00 for all filters) and the originals images (P = 0.00 for all filters) only in G1 group. There were no differences in the other groups. The filters did not improve the diagnosis of the simulated endodontic complications evaluated. Their diagnosis remains a major challenge in clinical practice. © 2016 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Periodontal and endodontic infectious/inflammatory profile in primary periodontal lesions with secondary endodontic involvement after a calcium hydroxide-based intracanal medication.

PubMed

Duque, Thais M; Prado, Maira; Herrera, Daniel R; Gomes, Brenda P F A

2018-03-23

The aim of the present study was to investigate the effects of a calcium hydroxide-based intracanal medication (ICM) on periodontal and endodontic infectious/inflammatory contents and on periodontal clinical parameters in teeth with primary periodontal lesion and secondary endodontic involvement. Ten patients with abnormal pulp test results and deep probing depth derived from primary periodontal disease with secondary endodontic involvement were included. Samples were collected from root canals (RC) and periodontal pockets (PP) in order to investigate the microbiological status, levels of endotoxin (LPS), cytokines, and matrix metalloproteinases (MMP), before and after ICM. PCR was used for microbiological assessment. The kinetic-chromogenic LAL assay was used for LPS quantification. Quantikine ELISA kits were used for measurement of IL-1 α, IL-1 β, TNF-α, PGE 2 , MMP-2, MMP-3, MMP-8, MMP-9, and MMP-13 levels. The statistical analyses were made using the Friedman and Wilcoxon tests (p < 0.05). T test was used to compare data on periodontal characteristics. ICM did not reduce the number of microorganisms in PP and RC, except for Fusobacterium nucleatum in RC. There was a significant reduction in LPS, MMPs, IL-1 β, and TNF-α levels in PP after ICM. In RC, LPS, MMP13, PGE 2 , and IL-1β levels remained unaltered (p > 0.05); however, the levels of the other MMPs and cytokines were reduced (p < 0.05). After 1 year of the root canal treatment, tooth mobility was significantly reduced (p ≤ 0.05). The use of a calcium hydroxide-based ICM showed positive effects for periodontal treatment prognosis, as it reduced LPS, cytokine, and MMP levels in periodontal pockets. Patients presenting deep probing depth and undergoing periodontal treatment for at least 6 months, with no positive response to periodontal therapy, might benefit with the endodontic treatment.

[Nonsurgical retreatment in a case of a radiolucent apical lesion].

PubMed

Vicente Gómez, A; Rodríguez Ponce, A

1989-01-01

We present a case of failure that was helpful solved without surgical endodontic treatment. We don't achieve clinical success besides endodontic treatment was twice remade. Finally we decided to put a temporary filling with calcium hydroxide and wait until apical radiolucency disappear and complete our treatment with gutta-percha, sealer and lateral condensation.

Endodontic management of maxillary third molar with MB2 (Vertucci type IV) canal configuration diagnosed with Cone Beam Computed Tomography - a case report.

PubMed

Jain, Pradeep; Patni, Pallav; Yogesh, Pant; Anup, Vyas

2017-01-01

The endodontic treatment of maxillary third molar often poses a challenge even to an experienced endodontist because of their most posterior location in the dental arch, aberrant occlusal anatomy, abnormal root canal configuration and eruption patterns. Owing to these anatomical limitations, their extraction remains the treatment of choice for many clinicians. As we know, retaining every functional component of the dental arch is of prime importance in contemporary dental practice. This clinical case report aims to discuss the endodontic treatment of maxillary third molar with MB2 root canal separated throughout the length and exit at two separate apical foramina (Vertucci type IV) diagnosed with Cone Beam Computed Tomography (CBCT)..

Porphyromonas (Bacteroides) endodontalis: its role in endodontal infections.

PubMed

van Winkelhoff, A J; van Steenbergen, T J; de Graaff, J

1992-09-01

Porphyromonas endodontalis (formerly Bacteroides endodontalis) is a black-pigmented anaerobic Gram-negative rod which is associated with endodontal infections. It has been isolated from infected dental root canals and submucous abscesses of endodontal origin. The presence of P. endodontalis in infected dental root canals has been correlated with symptoms of an acute infection. It is occasionally found on oral mucous membranes and periodontal pockets. P. endodontalis has shown relatively low virulence in experimental monoinfections. In anaerobic mixed infections it can play an essential role. Differences in virulence between strains have been related to capsular material. On the basis of different types of capsules, three serotypes have been described. P. endodontalis is sensitive to a wide range of antibiotics, including the penicillins, the tetracyclines, and metronidazole.

Overview on the Current Antibiotic Containing Agents Used in Endodontics

PubMed Central

Bansal, Ramta; Jain, Aditya

2014-01-01

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

The relationship between self-reported history of endodontic therapy and coronary heart disease in the Atherosclerosis Risk in Communities Study

PubMed Central

Caplan, Daniel J.; Pankow, James S.; Cai, Jianwen; Offenbacher, Steven; Beck, James D.

2009-01-01

Background Results from numerous studies have suggested links between periodontal disease and coronary heart disease (CHD), but endodontic disease has not been studied extensively in this regard. Methods The authors evaluated the relationship between self-reported history of endodontic therapy (ET) and prevalent CHD in the Atherosclerosis Risk in Communities (ARIC) Study, aprospective epidemiologic study sponsored by the National Heart, Lung, and Blood Institute. The authors used multivariable logistic regres-sionto analyze data obtained from oral health questionnaires, medical evaluations and clinical dental examinations. Results Of 6,651 participants analyzed, 50.4 percent reported never having had ET; 21.5 percent reported having had ET one time; and 28.0 percent reported having had ET two or more times. Final multivariable regression models indicated that among participants with 25 or more teeth, those reporting having had ET two or more times had 1.62 (95 percent confidence interval [CI], 1.04–2.53) times the odds of prevalent CHD compared with those reporting never having had ET. Among participants with 24 or fewer teeth, no significant differences in CHD prevalence were observed among groups regardless of their history of ET. Conclusions Among participants with 25 or more teeth, those with a greater self-reported history of ET were more likely to have CHD than were those reporting no history of ET. Clinical Implications More accurate epidemiologic quantification of endodontic infection and inflammation is required before definitive conclusions can be made about potential relationships between endodontic disease and CHD. PMID:19654253

Effect of premedication to provide analgesia as a supplement to inferior alveolar nerve block in patients with irreversible pulpitis.

PubMed

Lapidus, Daniel; Goldberg, Jack; Hobbs, Edward H; Ram, Saravanan; Clark, Glenn T; Enciso, Reyes

2016-06-01

The authors' objective was to determine whether scientific evidence supports the use of oral premedication to increase the efficacy of inferior alveolar nerve block (IANB) and to decrease endodontic treatment pain in patients with diagnosed irreversible pulpitis. The authors included randomized controlled trials that involved enteral premedication and 2% lidocaine IANB for adults with irreversible pulpitis compared with placebo. In particular, the authors reviewed studies comparing nonsteroidal anti-inflammatory drugs (NSAIDs), benzodiazepines, acetaminophen, and corticosteroids with placebo. The authors searched the following electronic databases: the Cochrane Library, MEDLINE, and Web of Science. The authors analyzed 9 randomized controlled clinical trials. Patients who took the NSAIDs under study, including ibuprofen, ketorolac, diclofenac, indomethacin, and lornoxicam, 1 hour before endodontic treatment showed statistically significant improvement in the outcome of having "little or no pain" during endodontic treatment compared with patients who took a placebo 1 hour before endodontic treatment (risk ratio [RR], 1.989; 95% confidence interval [CI], 1.495-2.646; P < .001). Benzodiazepines were not as well represented in the literature, but the 2 included studies did not show a significant improvement in patients' having "little or no pain" during endodontic treatment over placebo (RR, 0.989; 95% CI, 0.677-1.444; P = .954). There is moderate evidence to support the use of oral NSAIDs-in particular, ibuprofen (600 milligrams)-1 hour before the administration of IANB local anesthetic (1.8-3.6 milliliters of 2% lidocaine) to provide additional analgesia to the patient. Copyright © 2016 American Dental Association. Published by Elsevier Inc. All rights reserved.

The flexural properties of endodontic post materials.

PubMed

Stewardson, Dominic A; Shortall, Adrian C; Marquis, Peter M; Lumley, Philip J

2010-08-01

To measure the flexural strengths and moduli of endodontic post materials and to assess the effect on the calculated flexural properties of varying the diameter/length (D/L) ratio of three-point bend test samples. Three-point bend testing of samples of 2mm diameter metal and fiber-reinforced composite (FRC) rods was carried out and the mechanical properties calculated at support widths of 16 mm, 32 mm and 64 mm. Weibull analysis was performed on the strength data. The flexural strengths of all the FRC post materials exceeded the yield strengths of the gold and stainless steel samples; the flexural strengths of two FRC materials were comparable with the yield strength of titanium. Stainless steel recorded the highest flexural modulus while the titanium and the two carbon fiber materials exhibited similar values just exceeding that of gold. The remaining glass fiber materials were of lower modulus within the range of 41-57 GPa. Weibull modulus values for the FRC materials ranged from 16.77 to 30.09. Decreasing the L/D ratio produced a marked decrease in flexural modulus for all materials. The flexural strengths of FRC endodontic post materials as new generally exceed the yield strengths of metals from which endodontic posts are made. The high Weibull modulus values suggest good clinical reliability of FRC posts. The flexural modulus values of the tested posts were from 2-6 times (FRC) to 4-10 times (metal) that of dentin. Valid measurement of flexural properties of endodontic post materials requires that test samples have appropriate L/D ratios. Copyright 2010 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Pathogenesis of apical periodontitis and the causes of endodontic failures.

PubMed

Nair, P N R

2004-11-01

Apical periodontitis is a sequel to endodontic infection and manifests itself as the host defense response to microbial challenge emanating from the root canal system. It is viewed as a dynamic encounter between microbial factors and host defenses at the interface between infected radicular pulp and periodontal ligament that results in local inflammation, resorption of hard tissues, destruction of other periapical tissues, and eventual formation of various histopathological categories of apical periodontitis, commonly referred to as periapical lesions. The treatment of apical periodontitis, as a disease of root canal infection, consists of eradicating microbes or substantially reducing the microbial load from the root canal and preventing re-infection by orthograde root filling. The treatment has a remarkably high degree of success. Nevertheless, endodontic treatment can fail. Most failures occur when treatment procedures, mostly of a technical nature, have not reached a satisfactory standard for the control and elimination of infection. Even when the highest standards and the most careful procedures are followed, failures still occur. This is because there are root canal regions that cannot be cleaned and obturated with existing equipments, materials, and techniques, and thus, infection can persist. In very rare cases, there are also factors located within the inflamed periapical tissue that can interfere with post-treatment healing of the lesion. The data on the biological causes of endodontic failures are recent and scattered in various journals. This communication is meant to provide a comprehensive overview of the etio-pathogenesis of apical periodontitis and the causes of failed endodontic treatments that can be visualized in radiographs as asymptomatic post-treatment periapical radiolucencies.

Oral microbiota species in acute apical endodontic abscesses.

PubMed

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

2016-01-01

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. 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). 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). 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 identified in endodontic abscesses between the demographic region in Portland, Oregon and other regions.

Biomechanical interactions of endodontically treated tooth implant-supported prosthesis under fatigue test with acoustic emission monitoring.

PubMed

Huang, Shao-Fu; Chen, Wan-Rung; Lin, Chun-Li

2016-02-24

This study investigated the biomechanical interactions in endodontically treated tooth implant-supported prosthesis (TISP) with implant system variations under dynamic cyclic loads monitored using the acoustic emission (AE) technique. Macrostructure implants using a taper integrated screw-in (TIS; 2-piece implant) and a retaining-screw (RS; 3-piece implant) connected to an abutment were used for this investigation and their corresponding mechanical resistances in conformity with the ISO 14801 standard were evaluated. The endodontically treated TISP samples were constructed containing TIS and RS implants splinted to the second premolar with fatigue tests performed by applying occlusal force onto the premolar simulating the bending moment effect. The numbers of accumulated AE signals in the fatigue tests and failure modes for the sample were recorded to evaluate the mechanical resistance. The maximum load in the static test for RS (3-piece) implant (797N) was significantly higher than that for the TIS (2-piece) implant (559N). Large deformations were found at abutment screws in both RS and TIS implants. Although the numbers of accumulated AE signals for the TIS implant (72511) were higher than those for the RS implant (437), statistical non-significant differences were found between TIS and RS implants. No obvious damage was noted in endodontically treated TISP samples using RS implants but two of the corresponding TIS implants fractured in the abutment screws. Splints with RS (3-piece) implant prosthesis produce better mechanical responses than the TIS (2-piece) implant when connected to an endodontically treated tooth restored with a post core and crown.

The Diagnostic Efficacy of Cone-beam Computed Tomography in Endodontics: A Systematic Review and Analysis by a Hierarchical Model of Efficacy.

PubMed

Rosen, Eyal; Taschieri, Silvio; Del Fabbro, Massimo; Beitlitum, Ilan; Tsesis, Igor

2015-07-01

The aim of this study was to evaluate the diagnostic efficacy of cone-beam computed tomographic (CBCT) imaging in endodontics based on a systematic search and analysis of the literature using an efficacy model. A systematic search of the literature was performed to identify studies evaluating the use of CBCT imaging in endodontics. The identified studies were subjected to strict inclusion criteria followed by an analysis using a hierarchical model of efficacy (model) designed for appraisal of the literature on the levels of efficacy of a diagnostic imaging modality. Initially, 485 possible relevant articles were identified. After title and abstract screening and a full-text evaluation, 58 articles (12%) that met the inclusion criteria were analyzed and allocated to levels of efficacy. Most eligible articles (n = 52, 90%) evaluated technical characteristics or the accuracy of CBCT imaging, which was defined in this model as low levels of efficacy. Only 6 articles (10%) proclaimed to evaluate the efficacy of CBCT imaging to support the practitioner's decision making; treatment planning; and, ultimately, the treatment outcome, which was defined as higher levels of efficacy. The expected ultimate benefit of CBCT imaging to the endodontic patient as evaluated by its level of diagnostic efficacy is unclear and is mainly limited to its technical and diagnostic accuracy efficacies. Even for these low levels of efficacy, current knowledge is limited. Therefore, a cautious and rational approach is advised when considering CBCT imaging for endodontic purposes. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Do gingival soft tissues benefit from the application of a papilla preservation flap technique in endodontic surgery?

PubMed

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

2014-10-01

A healthy gingival condition after endodontic surgery may depend on adequate soft tissue management. The aim of this study was to compare 2 incision techniques, papilla base incision (PBI) and intrasulcular flap (IS), which are currently used in endodontic surgery. In the present nonrandomized controlled clinical trial, patients requiring endodontic surgery on a single tooth were enrolled. PBI was used in 1 group and IS was used in the other group. The primary outcomes were changes in periodontal probing depth, gingival recession, and height of the interproximal mesial and distal papillae. Outcome variables were assessed preoperatively and 6 months after surgery. Between-group differences were evaluated through appropriate statistical analysis, with significance set at a P value equal to .05. Each group was composed of 12 patients and the 2 groups were comparable at baseline. Two weeks after surgery, papilla height decreased significantly in the IS group (2.05 and 1.80 mm at the mesial and distal aspects, respectively), whereas no significant decrease in papilla height was observed in the PBI group (0.10 and 0.20 mm). No statistically significant difference between groups was observed after 6 months. No significant difference between groups was found for gingival recession or probing depth at any follow-up time. Better soft tissue preservation in the early postoperative period was achieved using the PBI approach compared with the IS approach. The PBI can be recommended for endodontic surgical procedures involving esthetic regions. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Praxis teaching in the ambit of learning assessment of endodontics in a Chilean university.

PubMed

Sánchez-Sanhueza, Gabriela; Cisterna Cabrera, Francisco

2015-01-01

The practice of assessing must ensure that the outcome of the process be a reflection of the learning achieved by students. The aim of this study was to describe the essential attributes of the praxis teacher in the area of Endodontics Learning Evaluation, in the School of Dentistry at the Universidad de Concepción, Chile. This study is designed to diagnose the reliability and objectivity of assessing the learning process, as a framework for innovation, and with a focus on evaluating endodontics skills. This hermeneutic study has a qualitative methodology. It was based on in-depth semi-structured interviews applied to 14 students and 5 teachers, and two focus groups consisting of eight students each. When the study was conducted, the research findings indicated that the evaluation process was not objective and lacked established criteria, and especially a guide to determining the skills. The theoretical evaluation was only summative. The formative role was not formally established. The subjects answered mostly psychometric instruments by multiple choice and with short or extended answers. It was concluded that teacher practice held meaning only if it was backed by academic expertise in the area of endodontics, according to no clear criteria or validated instruments. On the other hand, the groundwork was in place for using an epistemological style in endodontics. This provided a basis for the actual improvements, and allowed the tools developed to be dialectically interconnected with teacher experience. A quantitative analysis was not considered, but could be supplemented later to enhance the data analysis in a future study.

Influence of Cone-beam Computed Tomography on Endodontic Retreatment Strategies among General Dental Practitioners and Endodontists.

PubMed

Rodríguez, Gustavo; Patel, Shanon; Durán-Sindreu, Fernando; Roig, Miguel; Abella, Francesc

2017-09-01

Treatment options for endodontic failure include nonsurgical or surgical endodontic retreatment, intentional replantation, and extraction with or without replacement of the tooth. The aim of the present study was to determine the impact of cone-beam computed tomographic (CBCT) imaging on clinical decision making among general dental practitioners and endodontists after failed root canal treatment. A second objective was to assess the self-reported level of difficulty in making a treatment choice before and after viewing a preoperative CBCT scan. Eight patients with endodontically treated teeth diagnosed as symptomatic apical periodontitis, acute apical abscess, or chronic apical abscess were selected. In the first session, the examiners were given the details of each case, including any relevant radiographs, and were asked to choose 1 of the proposed treatment alternatives and assess the difficulty of making a decision. One month later, the examiners reviewed randomly the same 8 cases with the additional information from the CBCT data. The examiners altered their treatment plan after viewing the CBCT scan in 49.8% of the cases. A significant difference in the treatment plan between the 2 imaging modalities was recorded for endodontists and general practitioners (P < .05). After CBCT evaluation, neither group altered their self-reported level of difficulty when choosing a treatment plan (P = .0524). The extraction option rose significantly to 20% after viewing the CBCT scan (P < .05). CBCT imaging directly influences endodontic retreatment strategies among general dental practitioners and endodontists. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Anatomical analysis of the resected roots of mandibular first molars after failed non-surgical retreatment

PubMed Central

2018-01-01

Objectives Understanding the reason for an unsuccessful non-surgical endodontic treatment outcome, as well as the complex anatomy of the root canal system, is very important. This study examined the cross-sectional root canal structure of mandibular first molars confirmed to have failed non-surgical root canal treatment using digital images obtained during intentional replantation surgery, as well as the causative factors of the failed conventional endodontic treatments. Materials and Methods This study evaluated 115 mandibular first molars. Digital photographic images of the resected surface were taken at the apical 3 mm level and examined. The discolored dentin area around the root canal was investigated by measuring the total surface area, the treated areas as determined by the endodontic filling material, and the discolored dentin area. Results Forty 2-rooted teeth showed discolored root dentin in both the mesial and distal roots. Compared to the original filled area, significant expansion of root dentin discoloration was observed. Moreover, the mesial roots were significantly more discolored than the distal roots. Of the 115 molars, 92 had 2 roots. Among the mesial roots of the 2-rooted teeth, 95.7% of the roots had 2 canals and 79.4% had partial/complete isthmuses and/or accessory canals. Conclusions Dentin discoloration that was not visible on periapical radiographs and cone-beam computed tomography was frequently found in mandibular first molars that failed endodontic treatment. The complex anatomy of the mesial roots of the mandibular first molars is another reason for the failure of conventional endodontic treatment. PMID:29765897

Evaluation of efficacy of combinations of five endodontic sealers with five antibiotics against Enterococcus Faecalis – An in-vitro study

PubMed Central

Sharma, Deepak; Grover, Rohit; Pinnameneni, Prasanth Sai; Dey, Subhra; Raju, P Ramakrishnam

2014-01-01

Background: To evaluate and compare in vitro the antibacterial efficacy of five antibiotics when added individually to five endodontic sealers against Enterococcus faecalis (EF). Materials & Methods: This controlled trial with systematic allocation method was carried out to detect the combined antibacterial activity of five endodontic sealers (Kerr sealer EWT, Endomethasone, AH26, AH Plus, Roekoseal) with five antibiotics regularly used (Amoxicillin, metronidazole, azithromyacin, gatifloxacin, doxycycline) on EF. For each sealerantibiotic combinations, thirty BHI agar plates (15 aerobic and 15 anaerobic) were inoculated with EF, containing five sterile paper discs- three of various sealer- antibiotic combinations, one of sealer alone (positive control) & plain disc as negative control were incubated at 370C for 48 hrs and the zone of inhibition was measured. Data analysis was done by ANOVA and Tukey’s post- hoc test using SPSS( version 17). Results: The findings of this study revealed that sealer-antibiotic combination containing amoxicillin had the significant difference (p<0.001) in the mean zone of inhibition compared to other combinations. Metronidazole showed the minimum zone of inhibition among used antibiotics. The sealers in the decreasing order according to their effectiveness on EF were Kerr sealer endomethasone, AH26, Rockseal, AH plus. Conclusion: Addition of antibiotics to endodontic sealers enhances their antibacterial activity against Enterococcus faecalis. How to cite the article: Sharma D, Grover R, Pinnameneni PS, Dey S, Raju PR. Evaluation of efficacy of combinations of five endodontic sealers with five antibiotics against Enterococcus Faecalis – An in-vitro study. J Int Oral Health 2014;6(2):90-5. PMID:24876708

Guided Endodontic Access in Maxillary Molars Using Cone-beam Computed Tomography and Computer-aided Design/Computer-aided Manufacturing System: A Case Report.

PubMed

Lara-Mendes, Sônia T de O; Barbosa, Camila de Freitas M; Santa-Rosa, Caroline C; Machado, Vinícius C

2018-05-01

The aim of this study was to describe a guided endodontic technique that facilitates access to root canals of molars presenting with pulp calcifications. A 61-year-old woman presented to our service with pain in the upper left molar region. The second and third left molars showed signs of apical periodontitis confirmed by the cone-beam computed tomographic (CBCT) scans brought to us by the patient at the initial appointment. Conventional endodontic treatment was discontinued given the difficulty in locating the root canals. Intraoral scanning and the CBCT scans were used to plan the access to the calcified canals by means of implant planning software. Guides were fabricated through rapid prototyping and allowed for the correct orientation of a cylindrical drill used to provide access through the calcifications. Second to that, the root canals were prepared with reciprocating endodontic instruments and rested for 2 weeks with intracanal medication. Subsequently, canals were packed with gutta-percha cones using the hydraulic compression technique. Permanent restorations of the access cavities were performed. By comparing the tomographic images, the authors observed a drastic reduction of the periapical lesions as well as the absence of pain symptoms after 3 months. This condition was maintained at the 1-year follow-up. The guided endodontic technique in maxillary molars was shown to be a fast, safe, and predictable therapy and can be regarded as an excellent option for the location of calcified root canals, avoiding failures in complex cases. Copyright © 2018 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Combinations of bacterial species associated with symptomatic endodontic infections in a Chinese population.

PubMed

Qi, Z; Cao, H; Jiang, H; Zhao, J; Tang, Z

2016-01-01

To use microarrays to detect 11 selected bacteria in infected root canals, revealing bacterial combinations that are associated with clinical symptoms and signs of primary endodontic infections in a Chinese population. DNA was extracted from 90 samples collected from the root canals of teeth with primary endodontic infections in a Chinese population, and the 16S rRNA gene was amplified by polymerase chain reaction (PCR). The PCR products were hybridized to microarrays containing specific oligonucleotide probes targeting 11 species, and the arrays were screened with a confocal laser scanner. Pearson's chi-squared test and cluster analysis were performed to investigate the associations between the bacterial combinations and clinical symptoms and signs using SAS 8.02. Seventy-seven samples (86%) yielded at least one of the 11 target species. Parvimonas micra (56%), Porphyromonas endodontalis (51%), Tannerella forsythia (48%), Prevotella intermedia (44%) and Porphyromonas gingivalis (37%) were the most prevalent taxa and were often concomitant. The following positive associations were found between the bacterial combinations and clinical features: P. endodontalis and T. forsythia with abscess; P. gingivalis and P. micra with sinus tract; P. gingivalis and P. endodontalis or P. micra and P. endodontalis with abscess and sinus tract; and the combination of P. endodontalis, P. micra, T. forsythia and P. gingivalis with sinus tract (P < 0.05). Various combinations of P. micra, P. endodontalis, T. forsythia and P. gingivalis may contribute to abscesses or sinus tracts of endodontic origin with bacterial synergism in a Chinese population. © 2015 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Fracture resistance of endodontically treated teeth restored with short fiber composite used as a core material-An in vitro study.

PubMed

Garlapati, Tejesh Gupta; Krithikadatta, Jogikalmat; Natanasabapathy, Velmurugan

2017-10-01

This in-vitro study tested the fracture resistance of endodontically treated molars with Mesial-Occluso-Distal (MOD) cavities restored with fibre reinforced composite material everX posterior in comparision with hybrid composite and ribbond fiber composite. Fifty intact freshly extracted human mandibular first molars were collected and were randomly divided into five groups (n=10). Group 1: positive control (PC) intact teeth without any endodontic preparation. In groups 2 through 6 after endodontic procedure standard MOD cavities were prepared and restored with their respective core materials as follows: group 2, negative control (NC) left unrestored or temporary flling was applied. Group 3, Hybrid composite (HC) as a core material (Te-Econom Plus Ivoclar Vivadent Asia) group 4, Ribbond (Ribbond; Seattle, WA, USA)+conventional composite resin (RCR) group 5, everX posterior (everX Posterior GC EUROPE)+conventional composite resin (EXP) after thermocycling fracture resistance for the samples were tested using universal testing machine. The results were analysed using ANOVA and Tukey's HSD post hoc tests. Mean fracture resistance (in Newton, N) was group 1: 1568.4±221.71N, group 2: 891.0±50.107N, group 3: 1418.3±168.71N, group 4:1716.7±199.51N and group 5: 1994.8±254.195N. Among the materials tested, endodontically treated teeth restored with everX posterior fiber reinforced composite showed superior fracture resistance. Copyright © 2017 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

Interpretation of Endodontic File Length Adjustments Using Radiovisiography

DTIC Science & Technology

1993-01-01

periapical tissues would cause apical granulomas, and sometimes epithelial proliferation leading to cyst formation. They believed that better results...RVG) images. Comparisons were made between RVG images and conventional periapical radiographs. Maxillary and mandibular human cadaver sections with a...Biologic aspects of endodontics IV. Periapical tissue reactions to root-filled teeth whose canals had been instrumented short of their apices. Oral

A Naval Postgraduate Dental School Analysis Of Initial Endodontic Treatment

DTIC Science & Technology

2015-07-01

available for consideration as a study pmiicipant. Exclusion Criteria: Patients whose record did not include a final treatment radiograph or whose...of symptoms, tooth type (single versus multi-root), and existing medical conditions (smoker, coronary heart disease , diabetes). lntraoperative...A NAVAL POSTGRADUATE DENT AL SCHOOL ANALYSIS OF INITIAL ENDODONTIC TREATMENT by Allen Daniel Rasmussen, D.M.D. Lieutenant Commander, Dental Corps

Component Release and Mechanical Properties of Endodontic Sealers following Incorporation of Antimicrobial Agents.

PubMed

Gjorgievska, Elizabeta S; Nicholson, John W; Coleman, Nichola J; Booth, Samantha; Dimkov, Aleksandar; Hurt, Andrew

2017-01-01

Root canal sealers with antimicrobial activity are highly beneficial; therefore, their antimicrobial properties could be improved by incorporation of antimicrobial agents. In the present study, the release of the quaternary ammonium compounds from endodontic sealers admixed with either benzalkonium chloride (BC) or cetylpyridinium chloride (CPC) at loadings of 2% wt was monitored. The effect of these additives on the compressive strengths and their release from the sealers was determined after 1 and 4 weeks. All of the materials studied were found to be capable of releasing antimicrobial additive in useful quantities. The release of CPC occurred to a statistically significant greater extent than BC for all materials. The addition of both BC and CPC generally decreased the compressive strength of all the endodontic sealers, with the exception of CPC in AH Plus, where the compressive strength was significantly increased. This suggests that, for these endodontic sealers, the antimicrobial additives alter the setting chemistry. AH Plus is an epoxy-based material cured with an amine, and in this case the increase in compressive strength with CPC is attributed to an enhanced cure reaction with this system. In all other cases, the additive inhibited the cure reaction to a greater or lesser extent.

Comparison of an adaptive local thresholding method on CBCT and µCT endodontic images

NASA Astrophysics Data System (ADS)

Michetti, Jérôme; Basarab, Adrian; Diemer, Franck; Kouame, Denis

2018-01-01

Root canal segmentation on cone beam computed tomography (CBCT) images is difficult because of the noise level, resolution limitations, beam hardening and dental morphological variations. An image processing framework, based on an adaptive local threshold method, was evaluated on CBCT images acquired on extracted teeth. A comparison with high quality segmented endodontic images on micro computed tomography (µCT) images acquired from the same teeth was carried out using a dedicated registration process. Each segmented tooth was evaluated according to volume and root canal sections through the area and the Feret’s diameter. The proposed method is shown to overcome the limitations of CBCT and to provide an automated and adaptive complete endodontic segmentation. Despite a slight underestimation (-4, 08%), the local threshold segmentation method based on edge-detection was shown to be fast and accurate. Strong correlations between CBCT and µCT segmentations were found both for the root canal area and diameter (respectively 0.98 and 0.88). Our findings suggest that combining CBCT imaging with this image processing framework may benefit experimental endodontology, teaching and could represent a first development step towards the clinical use of endodontic CBCT segmentation during pulp cavity treatment.

In vitro and ex vivo microbial leakage assessment in endodontics: A literature review.

PubMed

Savadkouhi, Sohrab Tour; Bakhtiar, Hengameh; Ardestani, Safoura Emami

2016-01-01

The aim of this study was to perform a literature review of published in-vitro and ex-vivo studies, which evaluated microbial leakage in endodontics in the past 10 years. A comprehensive electronic literature search was carried out in PubMed database for English articles published from 2005 to 2016 using the keywords "endodontics," " in vitro ," " ex vivo ," "microbial leakage," "microbial penetration," "saliva," " Enterococcus faecalis ," " E. faecalis ," "endodontic sealers," "temporary filling material," "apical plug," "mineral trioxide aggregate," and "MTA." The keywords were combined using Boolean operators AND/OR. Based on our search strategy, 33 relevant articles were included in the study. There are three main methods for assessment of bacterial microleakage, namely, (A) the dual-chamber leakage model, (B) detection of bacteria using a scanning electron microscope (SEM), and (C) polymerase chain reaction. All bacterial leakage models have some limitations and may yield different results compared to other microleakage evaluation techniques (i.e., dye penetration, fluid filtration, or electrochemical tests). The results of SEM correlated with those of microbial leakage test in most studies. Microbial leakage test using saliva better simulates the clinical setting for assessment of the leakage of single or mixed bacterial species.

Antimicrobial activity of four root canal sealers against endodontic pathogens.

PubMed

Lai, C C; Huang, F M; Yang, H W; Chan, Y; Huang, M S; Chou, M Y; Chang, Y C

2001-12-01

The antibacterial effects of various types of widely used endodontic sealers have not been compared systematically on facultative or obligate anaerobic endodontic pathogens. The aim of this study was to evaluate the antimicrobial properties of four commonly used endodontic sealers: two epoxy-resin-based sealers (AH26, AH plus), one zinc-oxide eugenol-based sealer (N2), and one calcium hydroxide-based sealer (Sealapex). The testing microbes were four facultative anaerobic species (Streptococcus mutans, Streptococcus sanguis, Escherichia coli, and Staphylococcus aureus) and four obligate anaerobic species (Porphyromonas gingivalis, Porphyromonas endodontalis, Fusobacterium nucleatum, and Prevotella intermedia). The freshly mixed sealers were placed into the prepared wells of agar plates inoculated with the test microorganisms. After varying periods of incubation (2 days for facultative anaerobic species and 7 days for obligate anaerobic species), the zones of growth inhibition were observed and measured. All the sealers were distinctly different from each other in their antimicrobial activity. The sealers showed different inhibitory effects depending on the types and bacterial strains. N2 containing formaldehyde and eugenol proved to be the most effective against the microorganisms. The extreme antimicrobial potency of this root canal sealer must be weighted against its pronounced tissue toxic effect.

Evidence-based recommendations for antibiotic usage to treat endodontic infections and pain: A systematic review of randomized controlled trials.

PubMed

Aminoshariae, Anita; Kulild, James C

2016-03-01

The purpose of this investigation was to identify evidence-based scientific methodologies to aid dental clinicians in establishing the indications for prescribing antibiotics for endodontic infection or pain. The authors prepared and registered a protocol on PROSPERO. They conducted electronic searches in MEDLINE, Scopus, Cochrane Library, and ClinicalTrials.gov. In addition, the authors hand searched the bibliographies of all relevant articles, the gray literature, and textbooks for randomized controlled clinical studies. The authors independently selected the relevant articles. The overall quality of the studies was fair with a low risk of bias, but 2 studies had a moderate risk of bias. The best available clinical evidence signals no indications for prescribing antibiotics preoperatively or postoperatively to prevent endodontic infection or pain unless the spread of infection is systemic, the patient is febrile, or both. Generally, an accurate diagnosis coupled with effective endodontic treatment will decrease microbial flora enough for healing to occur. To help decrease the number of drug-resistant microbes, oral health care providers should not prescribe antibiotics when they are not indicated. Copyright © 2016 American Dental Association. Published by Elsevier Inc. All rights reserved.

Clinical evaluation of fiber-reinforced epoxy resin posts and cast post and cores.

PubMed

Ferrari, M; Vichi, A; García-Godoy, F

2000-05-01

This retrospective study evaluated treatment outcome of cast post and core and Composipost systems after 4 yrs of clinical service. 200 patients were included in the study. They were divided in two groups of 100 endodontically treated teeth restored with a post. Group 1: Composipost systems were luted into root canal following the manufacturer's instructions. Group 2: Cast post and cores were cemented into root canal preparations with a traditional technique. The patients were recalled after 6 months, 1, 2 and 4 yrs and clinical and radiographic examinations were completed. Endodontic and prosthodontic results were recorded. Group 1: 95% of the teeth restored with Composiposts showed clinical success; 3% of these samples were excluded for noncompliance and 2% showed endodontic failure. Group 2: Clinical success was found with 84% of teeth restored with cast post and core. 2% of these samples were excluded for noncompliance, 9% showed root fracture, 2% dislodgment of crown and 3% endodontic failure. Statistical evaluation showed significant differences between Groups 1 and 2 (P < 0.001). The results of this retrospective study indicated that the Composipost system was superior to the conventional cast post and core system after 4 yrs of clinical service.

From stem to roots: Tissue engineering in endodontics

PubMed Central

Kala, M.; Banthia, Priyank; Banthia, Ruchi

2012-01-01

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

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

PubMed Central

Mozo, Sandra; Llena, Carmen

2012-01-01

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

Establishment and maintenance of asepsis in endodontics - a review of the literature.

PubMed

Malmberg, Leona; Björkner, Annika Elisabeth; Bergenholtz, Gunnar

2016-08-01

Successful endodontic treatment depends on effective measures to eliminate and prevent infection of root canals. Initially treatment should start with isolation and disinfection of the operating field. This review makes an inventory of the available knowledge regarding its establishment and maintenance. A literature search was conducted in the PubMed database in order to identify clinical trials examining disinfection or unintentional contamination of the endodontic operative field. A list of 115 articles was obtained and screened. Five relevant articles were identified. These articles were read in full text. The reference lists from these articles were checked manually for additional studies and three studies were obtained. A total of eight articles met the inclusion criteria. There was a great variety in terms of aim, method, and material of the included studies. None could prove a totally reliable aseptic operative field and not one chemical, or combination of chemicals, were found in more than one study. No study documented complete asepsis following initial disinfection, and no study could document predictable maintenance of an established bacteria-free surface. Critical appraisal and standardization of the disinfection and aseptic procedures in endodontics are needed.

An in vitro Comparative Evaluation of Efficacy of Disinfecting Ability of Garlic Oil, Neem Oil, Clove Oil, and Tulsi Oil with autoclaving on Endodontic K Files tested against Enterococcus faecalis.

PubMed

Hugar, Shivayogi; M Patel, Punit; Nagmoti, Jyoti; Uppin, Chaitanya; Mistry, Laresh; Dhariwal, Neha

2017-01-01

To comparatively evaluate the efficacy of disinfecting ability of garlic oil, neem oil, clove oil, and tulsi oil with autoclaving on endodontic K files tested against Enterococcus faecalis. Fifty endodontic K files were exposed to the test micro-organism and checked for its disinfecting ability using three different methods. Garlic oil, clove oil, tulsi oil and autoclave showed considerable effectiveness against E. faecalis except neem oil. Garlic oil, clove oil and tulsi oil are an effective disinfectant and can be used as an alternative to autoclaving against the test micro-organism. Herbs and herbal extracts are a natural and harmless way of controlling infection. These products are readily available and comparable to gold standard, thus can have its applications in rural India. Hugar S, Patel PM, Nagmoti J, Uppin C, Mistry L, Dhariwal N. An in vitro Comparative Evaluation of Efficacy of Disinfecting Ability of Garlic Oil, Neem Oil, Clove Oil, and Tulsi Oil with autoclaving on Endodontic K Files tested against Enterococcus faecalis. Int J Clin Pediatr Dent 2017;10(3):283-288.

Rubber dam application in endodontic practice: an update on critical educational and ethical dilemmas.

PubMed

Ahmed, H M A; Cohen, S; Lévy, G; Steier, L; Bukiet, F

2014-12-01

Proper isolation is an essential prerequisite for successful endodontic treatment. This article aims to provide an update on the prevalence of rubber dam (RD) use, and the role of education along with attitudes of general dental practitioners (GDPs) and patients towards the application of RD in endodontics. Critical ethical issues are also highlighted. Using certain keywords, an electronic search was conducted spanning the period from January 1983 to April 2013 to identify the available related investigations, and the pooled data were then analysed. The results show that although RD is the Standard of Care in endodontic practice, there is a clear discrepancy in what GDPs are taught in dental school and what they practice after graduation. There is little scientific evidence to support the application of RD; however, patient safety and clinical practice guidelines indicate that it is unnecessary and unethical to consider a cohort study to prove what is already universally agreed upon. A few clinical situations may require special management which should be highlighted in the current guidelines. This would pave the way for clear and straightforward universal guidelines. © 2014 Australian Dental Association.

Endodontic management of mesiobuccal-2 canal in four-rooted and five-canalled mandibular third molar.

PubMed

Garg, Amit Kumar; Bhardwaj, Anuj; Mantri, Vijay R; Agrawal, Neha

2014-05-01

A case of unusual Root morphology is presented to demonstrate anatomic variations in mandibular third molar. The most common configuration of mandibular third molar is two Roots and three canals; however they may have many different combinations. Endodontic treatment was performed in mandibular third molar having aberrant anatomy. Four Root canal orifices were located with the aid of dental operating microscope (DOM) and three separate Roots were diagnosed with radiographs. Spiral computed tomography (SCT) showed the presence of an extra canal and extra Root, indicating a rare anatomic configuration. Looking for additional canals and Roots are important part of successful endodontics, as the knowledge of their existence enable clinicians to treat a case successfully that otherwise might end in failure. The use of DOM and SCT in this case greatly contributed toward making a confirmatory diagnosis and successful endodontic treatment of four-rooted and five-canalled mandibular third molar. Variation in Root canal anatomy is very common. Knowledge of these variations is very essential for successful Root canal outcome, inability to do so can lead to missed canals and failures. Hence, thorough knowledge of Root canal anatomy and advances in diagnostic aids are essential.

Rotary endodontics in primary teeth – A review

PubMed Central

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

2015-01-01

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

Rotary endodontics in primary teeth - A review.

PubMed

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

2016-01-01

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

Platelet-rich fibrin: a boon in regenerative endodontics.

PubMed

Rebentish, Priyanka D; Umashetty, Girish; Kaur, Harpreet; Doizode, Trupthi; Kaslekar, Mithun; Chowdhury, Shouvik

2016-12-01

Research into regenerative dentistry has contributed momentum to the field of molecular biology. Periapical surgery aims at removing periapical pathology to achieve complete wound healing and regeneration of bone and periodontal tissue. Regenerative endodontic procedures are widely being added to the current armamentarium of pulp therapy procedures. The regenerative potential of platelets has been deliberated. Platelet-rich fibrin (PRF) is a wonderful tissue-engineering product and has recently gained much popularity due its promising results in wound healing bone induction. The features of this product are an attribute of platelets which, after cellular interactions, release growth factors and have shown application in diverse disciplines of dentistry. This paper is intended to shed light onto the various prospects of PRF and to provide clinical insight into regenerative endodontic therapy.

Regenerative endodontics.

PubMed

Simon, S; Smith, A J

2014-03-01

Significant advances in our understanding of the biological processes involved in tooth development and repair at the cellular and molecular levels have underpinned the newly emerging area of regenerative endodontics. Development of treatment protocols based on exploiting the natural wound healing properties of the dental pulp and applying tissue engineering principles has allowed reporting of case series showing preservation of tissue vitality and apexogenesis. To review current case series reporting regenerative endodontics. Current treatment approaches tend to stimulate more reparative than regenerative responses in respect of the new tissue generated, which often does not closely resemble the physiological structure of dentine-pulp. However, despite these biological limitations, such techniques appear to offer significant promise for improved treatment outcomes. Improved biological outcomes will likely emerge from the many experimental studies being reported and will further contribute to improvements in clinical treatment protocols.

Chlorhexidine gluconate, its properties and applications in endodontics

PubMed Central

Mohammadi, Zahed

2008-01-01

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

Four canals in the mesial root of a mandibular first molar. A case report under the operating microscope.

PubMed

Kontakiotis, Evangelos G; Tzanetakis, Giorgos N

2007-08-01

In this era of microscope-assisted endodontics, finding variations in root canal system anatomy is not uncommon. Operating microscopes combined with careful clinical examination and radiographic interpretation can aid the clinician to successfully treat cases with such internal anatomy. The understanding of this view enables the possible location of additional canals in any tooth requiring endodontic treatment. The present clinical article demonstrates a rare anatomical complexity in the mesial root of a mandibular first molar. Four independent root canal orifices were found in this root by clinical detection with the aid of a dental operating microscope. This case shows that additional canals can be located in any root undergoing endodontic treatment and clinicians should always be aware of aberrant internal anatomy.

Internal and external resorption in a lower molar with an associated endodontic-periodontic lesion: a case report.

PubMed

Komabayashi, Takashi; Zhu, Qiang

2012-08-01

This article describes a unique case in which both internal and external inflammatory resorption and endodontic-periodontic lesions were present at the same time in the patient's left mandibular first molar. Based on clinical and radiographic findings, it was determined that the nature of this case was a pulpal infection-induced inflammatory resorption and furcation lesion. After root canal therapy, the furcation lesion and external inflammatory resorption were completely resolved. This case indicates that the correct diagnosis of the stimulating factor for tooth resorption and determination of the primary origin of endodontic-periodontic lesions are critical for clinical management and success. Published 2011. This article is a U.S. Government work and is in the public domain in the USA.

The Biocompatibility and Bioactivity of Biodentine in Contact with Cementoblast Cells

DTIC Science & Technology

2016-07-18

REPLY TO ATTENTION OF DEPARTMENT OF THE ARMY UNITED STATES ARMY DENTAL ACTIVITY ADVANCED EDUCATION PROGRAM IN ENDODONTICS 228... Activity , Department of Endodontics, Fort Gordon, GA 30905. E-mail address:kimberly.w.lindsey.mil@mail.mil The Biocompatibility and Bioactivity of...biocompatibility towards surrounding tissues (3,4,5). Additionally , it possesses good antimicrobial activity (6), in part related to the significant release of

Twenty Years of Endodontic Success and Failure at West Virginia University.

DTIC Science & Technology

1982-01-01

Analysis of Success and Failure - Apical Termination of Filling Material ........... 21 7 Analysis of Success and Failure - Posttreatment Restoration...system with healthy periapical and periodontal tissues. The dentist must reduce or eliminate toxic or irritating substances from within the root canals to...adequate for evaluating endodontic success and that success should be based on the radiographic presence of a periodontal membrane space of approximately

Pro-oxidant status and matrix metalloproteinases in apical lesions and gingival crevicular fluid as potential biomarkers for asymptomatic apical periodontitis and endodontic treatment response

PubMed Central

2012-01-01

Background Oxidative stress and matrix metalloproteinases -9 and -2 are involved in periodontal breakdown, whereas gingival crevicular fluid has been reported to reflect apical status. The aim of this study was to characterize oxidant balance and activity levels of MMP -2 and -9 in apical lesions and healthy periodontal ligament; and second, to determine whether potential changes in oxidant balance were reflected in gingival crevicular fluid from asymptomatic apical periodontitis (AAP)-affected teeth at baseline and after endodontic treatment. Methods Patients with clinical diagnosis of AAP and healthy volunteers having indication of tooth extraction were recruited. Apical lesions and healthy periodontal ligaments, respectively, were homogenized or processed to obtain histological tissue sections. Matrix metalloproteinase -9 and -2 levels and/or activity were analyzed by Immunowestern blot, zymography and consecutive densitometric analysis, and their tissue localization was confirmed by immunohistochemistry. A second group of patients with AAP and indication of endodontic treatment was recruited. Gingival crevicular fluid was extracted from AAP-affected teeth at baseline, after endodontic treatment and healthy contralateral teeth. Total oxidant and antioxidant status were determined in homogenized tissue and GCF samples. Statistical analysis was performed using STATA v10 software with unpaired t test, Mann-Whitney test and Spearman's correlation. Results Activity of MMP-2 and MMP-9 along with oxidant status were higher in apical lesions (p < 0.05). Total oxidant status correlated positively with matrix metalloproteinase-2 and lesion size (p < 0.05). Gingival crevicular fluid showed significantly lower levels of total antioxidant status in diseased teeth at baseline compared to controls and endodontically-treated groups. Conclusions Apical lesions display an oxidant imbalance along with increased activity of matrix metalloproteinase-2 and -9 and might contribute to AAP progression. Oxidant imbalance can also be reflected in GCF from AAP-affected teeth and was restored to normal levels after conservative endodontic treatment. These mediators might be useful as potential biomarkers for chair-side complementary diagnostic of apical status in GCF. PMID:22436166

Influence of Endodontic Treatment on Systemic Oxidative Stress

PubMed Central

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

2014-01-01

Introduction: An increased production of oxidizing species related to reactive oral diseases, such as chronic apical periodontitis, could have systemic implications such as an increase in cardiovascular morbidity. Based on this consideration, we conducted a prospective study to assess whether subjects affected by chronic periodontitis presented with higher values of oxidative stress than reference values before endodontic treatment, and whether endodontic treatment can reduce the oxidative imbalance and bring it back to normal in these subjects. Materials and methods: The authors recruited 2 groups of patients from private studies and dental clinics: these patients were recruited randomly. The oxidative balance in both patients with chronic apical periodontitis (CAP) and healthy control patients was determined by measuring the oxidant status, using an identification of the reactive oxygen metabolites (d-ROMs) test, while the antioxidant status in these patients was determined using a biological antioxidant potential (BAP) test. Both these tests were carried on plasma samples taken from enrolled patients. Values were measured both before the endodontic treatment of the patients with chronic apical periodontitis, and 30 and 90 days after treatment, and compared to those obtained from healthy control patients. Results: It was found that, on recruitment, the patients with chronic apical periodontitis exhibited significantly higher levels of oxidative stress than control patients, as determined by the d-ROMs and BAP tests. Furthermore, the d-ROMs test values were shown to decrease and the BAP test values to increase over time in patients with chronic apical periodontitis following endodontic therapy. As the levels of oxidative stress in these patients tended to reduce and return to normal by 90 days following treatment. Conclusions: This study has demonstrated a positive association between chronic apical periodontitis and oxidative stress. Subjects affected by chronic apical periodontitis are exposed to a condition of oxidative stress, which is extremely dangerous to general health. Moreover, one can infer from these findings that through proper endodontic therapy, a good oxidative balance can be restored, thereby avoiding the risk of contracting the abovementioned diseases. PMID:24396280

Pro-oxidant status and matrix metalloproteinases in apical lesions and gingival crevicular fluid as potential biomarkers for asymptomatic apical periodontitis and endodontic treatment response.

PubMed

Dezerega, Andrea; Madrid, Sonia; Mundi, Verónica; Valenzuela, María A; Garrido, Mauricio; Paredes, Rodolfo; García-Sesnich, Jocelyn; Ortega, Ana V; Gamonal, Jorge; Hernández, Marcela

2012-03-21

Oxidative stress and matrix metalloproteinases -9 and -2 are involved in periodontal breakdown, whereas gingival crevicular fluid has been reported to reflect apical status. The aim of this study was to characterize oxidant balance and activity levels of MMP -2 and -9 in apical lesions and healthy periodontal ligament; and second, to determine whether potential changes in oxidant balance were reflected in gingival crevicular fluid from asymptomatic apical periodontitis (AAP)-affected teeth at baseline and after endodontic treatment. Patients with clinical diagnosis of AAP and healthy volunteers having indication of tooth extraction were recruited. Apical lesions and healthy periodontal ligaments, respectively, were homogenized or processed to obtain histological tissue sections. Matrix metalloproteinase -9 and -2 levels and/or activity were analyzed by Immunowestern blot, zymography and consecutive densitometric analysis, and their tissue localization was confirmed by immunohistochemistry. A second group of patients with AAP and indication of endodontic treatment was recruited. Gingival crevicular fluid was extracted from AAP-affected teeth at baseline, after endodontic treatment and healthy contralateral teeth. Total oxidant and antioxidant status were determined in homogenized tissue and GCF samples. Statistical analysis was performed using STATA v10 software with unpaired t test, Mann-Whitney test and Spearman's correlation. Activity of MMP-2 and MMP-9 along with oxidant status were higher in apical lesions (p < 0.05). Total oxidant status correlated positively with matrix metalloproteinase-2 and lesion size (p < 0.05). Gingival crevicular fluid showed significantly lower levels of total antioxidant status in diseased teeth at baseline compared to controls and endodontically-treated groups. Apical lesions display an oxidant imbalance along with increased activity of matrix metalloproteinase-2 and -9 and might contribute to AAP progression. Oxidant imbalance can also be reflected in GCF from AAP-affected teeth and was restored to normal levels after conservative endodontic treatment. These mediators might be useful as potential biomarkers for chair-side complementary diagnostic of apical status in GCF.

Endodontic applications of a short pulsed FR Nd:YAG dental laser: photovaporization of extruded pulpal tissue following traumatic fractures of two maxillary central incisors--a clinical trial repor

NASA Astrophysics Data System (ADS)

Gregg, Robert H., II

1992-06-01

Historically, many techniques have been attempted in the search for a satisfactory and consistent treatment of inflamed, painful, hyperemic pulpal tissue. Present techniques attempting to achieve profound local anesthesia in such tissue, have not been satisfactory. Local anesthesia techniques acceptable to the patient with painful hyperemic pulpal tissue, has eluded previous technology. The subsequent treatment of hyperemic tissue without sufficient anesthesia primarily involves undesirable invasive mechanical/surgical procedures. Described in this clinical trial is a technique using free running (FR) pulsed, Nd:YAG laser energy to ablate soft tooth pulpal tissue--a technique employed after conventional endodontic methods failed. A free running pulsed, FR Nd:YAG dental laser was successfully used at 20 pulses per second and 1.25 watts to photovaporize endodontic pulpal tissue (pulpectomy) to allow a conventional endodontic file to extirpate the remaining soft tissue remnants and access the root apex. Also described in this paper is the 'hot-tip' effect of contact fiber laser surgery. This clinical trial achieved the immediate, short term objective of endodontic soft tissue removal via photovaporization, without pain reported by the patient. The pulsed FR Nd:YAG dental laser used as described in this clinical report appears to be a very safe and very effective technique; offers a treatment alternative to traditional therapy that suggests high patient acceptance; and is significantly less stressful for the doctor and staff than traditional treatment options. Long-term, controlled scientific and clinical studies are necessary to establish the safety and efficacy of both the helium-neon energy for visualization and the low-watt pulsed FR Nd:YAG energy for photovaporization of soft endodontic pulpal tissue within the root canal. Research is especially needed to understand the effects of a low-watt, pulsed FR, Nd:YAG laser on the activity of osteoclasts and odontoclasts and identify risks for developing external and/or internal resorption after intracanal application of pulsed FR Nd:YAG laser energy.

Properties of calcium silicate-monobasic calcium phosphate materials for endodontics containing tantalum pentoxide and zirconium oxide.

PubMed

Zamparini, Fausto; Siboni, Francesco; Prati, Carlo; Taddei, Paola; Gandolfi, Maria Giovanna

2018-05-08

The aim of the study was to evaluate chemical-physical properties and apatite-forming ability of three premixed calcium silicate materials containing monobasic calcium phosphate (CaH 4 P 2 O 8 ) bioceramic, tantalum pentoxide and zirconium oxide, recently marketed for endodontics (TotalFill BC-Sealer, BC-RRM-Paste, BC-RRM-Putty). Microchemical and micromorphological analyses, radiopacity, initial and final setting times, calcium release and alkalising activity were tested. The nucleation of calcium phosphates (CaPs) and/or apatite after 28 days ageing was evaluated by ESEM-EDX and micro-Raman spectroscopy. BC-Sealer and BC-RRM-Paste showed similar initial (23 h), prolonged final (52 h) setting times and good radiopacity (> 7 mm Al); BC-RRM-Putty showed fast initial (2 h) and final setting times (27 h) and excellent radiopacity (> 9 mm Al). All materials induced a marked alkalisation (pH 11-12) up to 28 days and showed the release of calcium ions throughout the entire test period (cumulative calcium release 641-806 ppm). After 28 days ageing, a well-distributed mineral layer was present on all samples surface; EDX demonstrated relevant calcium and phosphorous peaks. B-type carbonated apatite and calcite deposits were identified by micro-Raman spectroscopy on all the 28-day-aged samples; the deposit thickness was higher on BC-RRM-Paste and BC-RRM-Putty, in agreement with calcium release data. These materials met the required chemical and physical standards and released biologically relevant ions. The CaSi-CaH 4 P 2 O 8 system present in the materials provided Ca and OH ions release with marked abilities to nucleate a layer of B-type carbonated apatite favoured/accelerated by the bioceramic presence. The ability to nucleate apatite may lead many clinical advantages: In orthograde endodontics, it may improve the sealing ability by the deposition of CaPs at the material-root dentine interface, and in endodontic surgery, it could promote bone and periodontal tissue regeneration. As premixed materials, their application in endodontics may result easier in several complex endodontic situations (apicoectomy, root perforation, presence of wide/wet apices).

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

PubMed

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

2014-12-01

Endodontic infections have a polymicrobial nature, but anaerobic bacteria prevail among the infectious microbes. Considering that it is easy to eliminate planktonic bacteria, biofilm-forming bacteria still challenge clinicians during the fight against endodontic diseases. The chemical constituents of the oleoresin of Pinus elliottii, a plant belonging to the family Pinaceae, stand out in the search for biologically active compounds based on natural products with potential application in the treatment of endodontic infections. Indeed, plant oleoresins are an abundant natural source of diterpenes that display significant and well-defined biological activities as well as potential antimicrobial action. In this context, this study aimed to (1) evaluate the in vitro antibacterial activity of the oleoresin, fractions, and subfractions of P. elliottii as well as the action of dehydroabietic acid against 11 anaerobic bacteria that cause endodontic infection in both their planktonic and biofilm forms and (2) assess the in vitro antibiofilm activity of dehydroabietic acid against the same group of bacteria. The broth microdilution technique helped to determine the minimum inhibitory concentration (MIC) of the oleoresin and fractions. This same technique aided determination of the MIC values of nine subfractions of Fraction 1, the most active fraction. The MIC, minimum bactericidal concentration, and antibiofilm activity of dehydroabietic acid against the tested anaerobic bacteria were also examined. The oleoresin and fractions, especially fraction PE1, afforded promising MIC values, which ranged from 0.4 to 50 μg/mL. Concerning the nine evaluated subfractions, PE1.3 and PE1.4 furnished the most noteworthy MIC values, between 6.2 and 100 μg/mL. Dehydroabietic acid displayed antibacterial activity, with MIC values lying from 6.2 to 50 μg/mL, as well as bactericidal effect for all the investigated bacteria, except for Prevotella nigrescens. Assessment of the antibiofilm activity revealed significant results--MICB50 lay between 7.8 and 62.5 μg/mL, and dehydroabietic acid prevented all the evaluated bacteria from forming a biofilm. Hence, the chemical constituents of P. elliottii are promising biomolecules to develop novel therapeutic strategies to fight against endodontic infections. Copyright © 2014 Elsevier Ltd. All rights reserved.

Effect of educational intervention on adoption of new endodontic technology by general dental practitioners: a questionnaire survey.

PubMed

Koch, M; Eriksson, H G; Axelsson, S; Tegelberg, A

2009-04-01

To survey the clinical endodontic protocols of general dental practitioners (GDPs) in public dental clinics and to assess the effect of an educational intervention on the adoption of a nickel-titanium (Ni-Ti) rotary system. General dental practitioners in a Swedish Intervention County (IC), underwent an educational programme in endodontics. A follow-up questionnaire was posted to 98 GDPs in the IC and to 97 GDPs in a Control County (CC), where no specific training had been provided. The questionnaire concerned demographics, clinical endodontic protocols and instrumentation techniques. The response rate to the questionnaire was 87%. More than 90% of all GDPs reported they always or generally used rubber dam, determined working length, used the canal irrigant 0.5% buffered NaOCl and calcium hydroxide as an interappointment dressing. Two of three GDPs reported, they generally or always informed the patient of the prognosis. Every second GDP reported routines for postoperative recall and follow-up. The Ni-Ti rotary technique was reported to be completely adopted by 77% of the GDPs in the IC, significantly higher than in the CC (6%), P < 0.001. In the IC 79% of the GDPs reported they completed instrumentation in one treatment session, compared with only 32% in the CC, P < 0.001. The 'single-cone' mode of canal filling was reported to be significantly more frequent amongst GDPs in the IC, P < 0.001. General dental practitioners in both counties reported using contemporary clinical endodontic protocols. GDPs who had undergone an educational programme in Ni-Ti rotary instrumentation reported they had successfully integrated the technique into daily clinical practice.

Persistent extraradicular infection in root-filled asymptomatic human tooth: scanning electron microscopic analysis and microbial investigation after apical microsurgery.

PubMed

Signoretti, Fernanda G C; Endo, Marcos S; Gomes, Brenda P F A; Montagner, Francisco; Tosello, Fernanda B; Jacinto, Rogério C

2011-12-01

Procedural accidents have a negative effect on healing and might contribute to the persistence of infections in inaccessible apical areas, requiring surgical intervention. This report describes a case of persistent apical periodontitis of a lower left first molar associated with the sinus tract and a periapical lesion that required nonsurgical endodontic retreatment and apical surgery for resolution. The tooth had received endodontic treatment 3 years ago and had to be retreated using the crown-down technique with chemical auxiliary substance (2% chlorhexidine gel), foramen patency, and enlargement and was filled in a single appointment. The occlusal access cavity was immediately restored with composite resin. After 1 month, it could be observed that the sinus tract persisted and, radiographically, the lesion remained unaltered. Therefore, endodontic microsurgery was indicated. Apical microsurgery was performed under magnification with the use of a dental operating microscope including apicectomy, root end with ultrasound, and sealing with mineral trioxide aggregate. A microbiological sample was collected from the apical lesion. The resected distal root apex was observed by scanning electron microscopy. The following species were detected: Actinomyces naeslundii and Actinomyces meyeri, Propionibacterium propionicum, Clostridium botullinum, Parvimonas micra, and Bacteroides ureolyticus; scanning electron microscopic analysis revealed bacterial biofilm surrounding the apical foramen and external radicular surface. Gutta-percha overfilling at the apex because of a zip caused during initial endodontic treatment could be observed. A 6-month follow-up showed apparent radiographic periapical healing, which progressed after 24 months. Gram-positive anaerobic bacteria and extraradicular biofilm seem to participate in the maintenance of persistent periapical pathology, and endodontic retreatment followed by periapical microsurgery proved to be a successful alternative in the resolution of persistent extraradicular infections. Copyright © 2011 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Detection of Porphyromonas endodontalis, Porphyromonas gingivalis and Prevotella intermedia in primary endodontic infections in a Chinese population.

PubMed

Cao, H; Qi, Z; Jiang, H; Zhao, J; Liu, Z; Tang, Z

2012-08-01

To assess the prevalence of three black-pigmented bacterial species (Porphyromonas endodontalis, Porphyromonas gingivalis and Prevotella intermedia) using microarray technology in root canals of teeth associated with primary endodontic infections in a Chinese population. Microbial samples were taken from root canals of 80 teeth with pulp necrosis and primary endodontic infections in a Chinese population. DNA extracted from the samples was amplified by PCR with universal bacterial primers based on 16S rRNA gene sequences, and the products hybridized with the microarrays in which the specific oligonucleotide probes were added. The results of hybridization were screened by a confocal laser scanner. Pearson chi-square test and the two-sided Fisher exact test were used to analyse whether a significant association existed between the species and symptoms as well as in co-existence of two target organisms by a statistical software package (SAS 8.02). The 16S rRNA gene microarray detected at least one of the three test species in 76% of the study teeth. P. endodontalis, P. gingivalis and P. intermedia were found in 50%, 33% and 45%, respectively. A significant association was found in the presence of the pair P. endodontalis / P. gingivalis (P < 0.005). Both P. endodontalis (P <0.05) and P. gingivalis (P <0.005) had a statistically significant association with the presence of a sinus tract. The simultaneous presence of P. endodontalis and P. gingivalis was also associated with the presence of a sinus tract (P<0.005) and abscess formation (P<0.05). The three black-pigmented bacteria were prevalent in teeth with pulp necrosis and primary endodontic infections in a Chinese population. P. gingivalis and P. endodontalis were associated with the presence of sinus tract and abscess formation. © 2012 International Endodontic Journal.

Oral microbiota species in acute apical endodontic abscesses

PubMed Central

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

2016-01-01

Background and objectives Acute apical abscesses are serious endodontic diseases resulting from pulpal infection with opportunistic oral microorganisms. The objective of this study was to identify and compare the oral microbiota in patients (N=18) exhibiting acute apical abscesses, originating from the demographic region in Portland, Oregon. The study hypothesis is that abscesses obtained from this demographic region may contain unique microorganisms not identified in specimens from other regions. Design Endodontic abscesses were sampled from patients at the Oregon Health & Science University (OHSU) School of Dentistry. DNA from abscess specimens was subjected to polymerase chain reaction amplification using 16S rRNA gene-specific primers and Cy3-dCTP labeling. Labeled DNA was then applied to microbial microarrays (280 species) generated by the Human Oral Microbial Identification Microarray Laboratory (Forsyth Institute, Cambridge, MA). Results The most prevalent microorganisms, found across multiple abscess specimens, include Fusobacterium nucleatum, Parvimonas micra, Megasphaera species clone CS025, Prevotella multisaccharivorax, Atopobium rimae, and Porphyromonas endodontalis. The most abundant microorganisms, found in highest numbers within individual abscesses, include F. nucleatum, P. micra, Streptococcus Cluster III, Solobacterium moorei, Streptococcus constellatus, and Porphyromonas endodontalis. Strong bacterial associations were identified between Prevotella multisaccharivorax, Acidaminococcaceae species clone DM071, Megasphaera species clone CS025, Actinomyces species clone EP053, and Streptococcus cristatus (all with Spearman coefficients >0.9). Conclusions Cultivable and uncultivable bacterial species have been identified in endodontic abscesses obtained from the Portland, Oregon demographic region, and taxa identifications correlated well with other published studies, with the exception of Treponema and Streptococcus cristae, which were not commonly identified in endodontic abscesses between the demographic region in Portland, Oregon and other regions. PMID:26983837

Evaluation of dental students’ perception and self-confidence levels regarding endodontic treatment

PubMed Central

Tanalp, Jale; Güven, Esra Pamukçu; Oktay, Inci

2013-01-01

Objectives: The aim of this study was to obtain information about senior dental students’ perceptions and self-confidence levels regarding endodontic practice. Materials and Methods: Anonymous survey forms were handed out to senior students at Yeditepe University, Faculty of Dentistry. The students were asked to score their level of confidence using a 5-point scale and comment about future practices. Results: The response rate of the survey was 88%. 11.9% expressed endodontics as the first branch in terms of difficulty. The majority (90.5%) indicated they would perform root canal treatments within their expertise limit in the future but refer difficult cases to an endodontist. Bleaching of endodontically treated teeth, managing flare-ups, placement of a rubber dam were procedures in which students reported the lowest confidence (2.55 ± 1.17, 3.24 ± 0.96, 3.24 ± 1.19, respectively). On the other hand, students felt the lowest confidence in the treatment of maxillary molars followed by mandibular molars (3.43 ± 1.02 and 3.93 ± 0.97, respectively). Students also reported the lowest confidence in root resorptions, endo-perio lesions, traumas, retreatments and apexifications (2.93 ± 1.16, 3.07 ± 0.89, 3.24 ± 0.85, 3.33 ± 1.7 and 3.36 ± 1.1, respectively). Conclusions: The results showing students’ lower confidence in more challenging aspects of dentistry may be related with the attitude of dental schools to refer these cases to post graduate students and instilling information about these cases on a theoretical basis only. Though there seems to be a tendency for students to refer challenging cases to a specialist in future, authorities should give priority to enhance the way information and experience is conveyed regarding various aspects of endodontic treatment. PMID:24883030

Evaluation of dental students' perception and self-confidence levels regarding endodontic treatment.

PubMed

Tanalp, Jale; Güven, Esra Pamukçu; Oktay, Inci

2013-04-01

The aim of this study was to obtain information about senior dental students' perceptions and self-confidence levels regarding endodontic practice. Anonymous survey forms were handed out to senior students at Yeditepe University, Faculty of Dentistry. The students were asked to score their level of confidence using a 5-point scale and comment about future practices. The response rate of the survey was 88%. 11.9% expressed endodontics as the first branch in terms of difficulty. The majority (90.5%) indicated they would perform root canal treatments within their expertise limit in the future but refer difficult cases to an endodontist. Bleaching of endodontically treated teeth, managing flare-ups, placement of a rubber dam were procedures in which students reported the lowest confidence (2.55 ± 1.17, 3.24 ± 0.96, 3.24 ± 1.19, respectively). On the other hand, students felt the lowest confidence in the treatment of maxillary molars followed by mandibular molars (3.43 ± 1.02 and 3.93 ± 0.97, respectively). Students also reported the lowest confidence in root resorptions, endo-perio lesions, traumas, retreatments and apexifications (2.93 ± 1.16, 3.07 ± 0.89, 3.24 ± 0.85, 3.33 ± 1.7 and 3.36 ± 1.1, respectively). The results showing students' lower confidence in more challenging aspects of dentistry may be related with the attitude of dental schools to refer these cases to post graduate students and instilling information about these cases on a theoretical basis only. Though there seems to be a tendency for students to refer challenging cases to a specialist in future, authorities should give priority to enhance the way information and experience is conveyed regarding various aspects of endodontic treatment.

Microbiologic endodontic status of young traumatized tooth.

PubMed

Baumotte, Karla; Bombana, Antonio C; Cai, Silvana

2011-12-01

Traumatic dental injuries could expose the dentin and, even the pulp, to the oral environment, making possible their contamination. The presence of microorganisms causes pulpal disease and further a tecidual clutter in the periradicular region. The therapy of periradicular pathosis is the consequence of a correct diagnoses which depends on the knowledge of the nature and complexity of endodontic infections. As there is no information on the microbiology of primary endodontic infection in young teeth, the aim of the current study was to investigate the microbiologic status of root canals from permanent young teeth with primary endodontic infection. Twelve patients with the need for endodontic treatment participated in the study. The selected teeth were uniradicular and had an incomplete root formation. They had untreated necrotic pulp. After the access preparation, nineteen microbiologic samples were obtained from the root canals with sterile paper points. Afterwards, the paper points were pooled in a sterile tube containing 2 ml of prereduced transport fluid. The samples were diluted and spread onto plates with selective medium for Enterococcus spp. and for yeast species and onto plates with non-selective medium. A quantitative analysis was performed. The mean number of cultivable bacterial cells in the root canals was 5.7 × 10(6). In four samples (21.05%) black pigmented species were recovered and the mean number of cells was 6.5 × 10(5). One specimen (5.25%) showed the growth of Enterococcus species and the mean number of cells in this case was of 1.5 × 10(4) . The results showed a root canal microbiota with similar design as seen in completely formed teeth. © 2011 John Wiley & Sons A/S.

A quality assessment of randomized controlled trial reports in endodontics.

PubMed

Lucena, C; Souza, E M; Voinea, G C; Pulgar, R; Valderrama, M J; De-Deus, G

2017-03-01

To assess the quality of the randomized clinical trial (RCT) reports published in Endodontics between 1997 and 2012. Retrieval of RCTs in Endodontics was based on a search of the Thomson Reuters Web of Science (WoS) database (March 2013). Quality evaluation was performed using a checklist based on the Jadad criteria, CONSORT (Consolidated Standards of Reporting Trials) statement and SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials). Descriptive statistics were used for frequency distribution of data. Student's t-test and Welch test were used to identify the influence of certain trial characteristics upon report quality (α = 0.05). A total of 89 RCTs were evaluated, and several methodological flaws were found: only 45% had random sequence generation at low risk of bias, 75% did not provide information on allocation concealment, and 19% were nonblinded designs. Regarding statistics, only 55% of the RCTs performed adequate sample size estimations, only 16% presented confidence intervals, and 25% did not provide the exact P-value. Also, 2% of the articles used no statistical tests, and in 87% of the RCTs, the information provided was insufficient to determine whether the statistical methodology applied was appropriate or not. Significantly higher scores were observed for multicentre trials (P = 0.023), RCTs signed by more than 5 authors (P = 0.03), articles belonging to journals ranked above the JCR median (P = 0.03), and articles complying with the CONSORT guidelines (P = 0.000). The quality of RCT reports in key areas for internal validity of the study was poor. Several measures, such as compliance with the CONSORT guidelines, are important in order to raise the quality of RCTs in Endodontics. © 2016 International Endodontic Journal. Published by John Wiley & Sons Ltd.

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

NASA Astrophysics Data System (ADS)

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

2015-10-01

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

A prospective clinical study of regenerative endodontic treatment of traumatized immature teeth with necrotic pulps using bi-antibiotic paste.

PubMed

Nazzal, H; Kenny, K; Altimimi, A; Kang, J; Duggal, M S

2018-04-01

To evaluate the treatment outcomes of a revitalization endodontic technique (RET) for the management of traumatized immature teeth with necrotic pulps in children. Fifteen healthy children (age range = 7-10 years) with traumatized immature maxillary incisors with necrotic pulps treated with bi-antibiotic revitalization endodontic technique were prospectively assessed over approximately two years (mean = 22 months). One operator undertook all treatments, clinical reviews and standardized radiographic exposures with radiographic analysis being carried out by two calibrated experienced clinicians. Crown colour change was assessed using an objective published methodology. Wilcoxon signed-rank test was used to compare root lengths, root dentinal widths and apical foramen widths over time. Interoperator measurement reliability was consistently strong for all measurements. There was no significant difference in root lengths or root dentinal wall widths following RET. A significant difference in apical foramen widths was observed after 2 years (P = 0.013) with resolution of clinical signs of infection in all cases. Despite omitting minocycline and using Portland cement (nonbismuth containing cement), a noticeable crown colour change (yellower, redder and lighter), as measured by an objective colour measurement system with ΔE = 7.39, was recorded. Most patients, however, were satisfied with the aesthetic outcome. Traumatized immature teeth with necrotic pulps treated with revitalization endodontic technique did not demonstrate continuation of root development or dentine formation when assessed by periapical radiographs. However, apical closure and periodontal healing were observed. A measurable change in crown colour (yellower, redder and lighter), with mostly no aesthetic concern to the patients/parents, was also observed. © 2017 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Cytokine analysis in lesions refractory to endodontic treatment.

PubMed

Henriques, Luiz Carlos Feitosa; de Brito, Luciana Carla Neves; Tavares, Warley Luciano Fonseca; Vieira, Leda Quércia; Ribeiro Sobrinho, Antônio Paulino

2011-12-01

Failure in endodontic treatment is often caused by the persistence of microorganisms in the root canal after therapy. When treatment fails, an immune response develops that is characterized by an extensive network of immunologic mechanisms that lead to the production of cytokines and chemokines. The objective of this study was to determine the relative messenger RNA (mRNA) expression of IFN-γ, TNF-α, IL-1β, IL-17A, IL-10, and MCP-1 in periapical dental lesions refractory to treatment. Clinical samples were taken from teeth presenting periapical lesions refractory to endodontic treatment (the experimental group) or from healthy teeth with pulp vitality (the control group). Three paper points passing through the root apex (2 mm) were used to collect the samples. The total RNA was extracted from each sample, complementary DNA was synthesized, and quantitative polymerase chain reaction analysis was performed. The Mann-Whitney U test was used to determine the statistical significance of our findings (P < .05). Significant differences in the levels of IFN-γ, TNF-α, IL-17A, and MCP-1 mRNA expression were observed in cases refractory to endodontic treatment as compared with the control group. The expression of IL-1β mRNA was not significantly different between the groups. The expression of IL-10 mRNA was insignificant in both the experimental and control groups. A significantly increased expression of TNF-α, IFN-γ, IL-17A, and MCP-1 mRNA was observed in the periapical immune response in cases of endodontic failure. These results suggest that a proinflammatory cytokine profile predominates in these types of dental lesions. Copyright © 2011 American Association of Endodontists. All rights reserved.

The reinforcement effect of polyethylene fibre and composite impregnated glass fibre on fracture resistance of endodontically treated teeth: An in vitro study

PubMed Central

Luthria, Archana; Srirekha, A; Hegde, Jayshree; Karale, Rupali; Tyagi, Sanjana; Bhaskaran, Sajeev

2012-01-01

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

Effect of Root Filling on Stress Distribution in Premolars with Endodontic-Periodontal Lesion: A Finite Elemental Analysis Study.

PubMed

Belli, Sema; Eraslan, Oğuz; Eskitascioglu, Gürcan

2016-01-01

Endodontic-periodontal (EP) lesions require both endodontic and periodontal therapies. Impermeable sealing of the root canal system after cleaning and shaping is essential for a successful endodontic treatment. However, complete healing of the hard and soft tissue lesions takes time, and diseased bone, periodontal ligament, and tooth fibrous joints are reported to have an increased failure risk for a given load. Considering that EP lesions may affect the biomechanics of teeth, this finite elemental analysis study aimed to test the effect of root fillings on stress distribution in premolars with EP lesions. Three finite elemental analysis models representing 3 different types of EP lesions (primary endodontic disease [PED], PED with secondary periodontic involvement, and true combined) were created. The root canals were assumed as nonfilled or filled with gutta-percha, gutta-percha/apical mineral trioxide aggregate (MTA) plug, and MTA-based sealer. Materials used were assumed to be homogenous and isotropic. A 300-N load was applied from the buccal cusp of the crown with a 135° angle. The Cosmoworks structural-analysis program (SolidWorks Corp, Waltham, MA) was used for analysis. Results were presented considering von Mises criteria. Stresses at the root apex increased with an increase in lesion dimensions. Root filling did not affect stress distribution in the PED model. An MTA plug or MTA-based sealer created more stress areas within the root compared with the others in the models representing PED with periodontic involvement and true combined lesions. Stresses at the apical end of the root increase with increases in lesion dimensions. MTA-based sealers or an MTA plug creates more stresses when there is periodontic involvement or a true combined lesion. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

The effect of surface tension reduction on the clinical performance of sodium hypochlorite in endodontics.

PubMed

Rossi-Fedele, G; Prichard, J W; Steier, L; de Figueiredo, J A P

2013-06-01

Sodium hypochlorite (NaOCl) is recommended as an endodontic irrigant in view of its broad antimicrobial and tissue dissolution capacities. To enhance its penetration into inaccessible areas of root canals and to improve its overall effect, the addition of surface-active agents has been suggested. The aim of this investigation was to review the effect of the reduction of the surface tension on the performance of NaOCl in endodontics. A search was performed in the Medline electronic database (articles published up to 28 July 2012, in English) with the search terms and combinations as follows: 'sodium hypochlorite AND surface tension or interfacial force or interfacial tension or surface-active agent or amphiphilic agent or surface active agent or surfactant or tenside or detergent'. The purpose of this search was to identify publications that compared NaOCl alone and NaOCl modified with the addition of a surface-active agent in endodontics. A hand search of articles published online ('in-press' and 'early view'), and appearing in the reference list of the articles included, was further performed, using the same search criteria as the electronic search. The search identified 302 publications, of which 11 fulfilled the inclusion/exclusion criteria of the review. The evidence available suggests that surface-active agents improve the penetration of NaOCl in the main canal and have no effect on its pulp tissue dissolution ability. There are, however, insufficient data to enable a sound conclusion to be drawn regarding the effect of modifying NaOCl's surface tension on lubrication, antimicrobial and smear layer or debris removal abilities. © 2012 International Endodontic Journal.

Electromagnetic interference of endodontic equipments with cardiovascular implantable electronic device.

PubMed

Dadalti, Manoela Teixeira de Sant'Anna; da Cunha, Antônio José Ledo Alves; de Araújo, Marcos César Pimenta; de Moraes, Luis Gustavo Belo; Risso, Patrícia de Andrade

2016-03-01

Assess the electromagnetic interference (EMI) of endodontic equipment with cardiovascular implantable electronic devices (CIEDs) and related factors. The laser device, electronic apex locators (EAL), optical microscope, endodontic rotary motors, gutta-percha heat carrier (GH), gutta-percha gun and ultrasonic device were tested next to CIEDs (Medtronic and Biotronik) with varied sensitivity settings and distances. CIEDs were immersed in a saline solution to simulate the electrical resistence of the human body. The endodontic equipment was tested in both horizontal and vertical positions in relation to the components of the CIED. The tests were performed on a dental chair in order to assess the cumulative effect of electromagnetic fields. It was found no EMI with the Biotronik pacemaker. EALs caused EMI with Medtronic PM at a 2 cm distance, with the NSK(®) EAL also affecting the Medtronic defibrillator. GH caused EMI at 2 cm and 5 cm from the Medtronic defibrillator. EMI occurred when devices were horizontally positioned to the CIED. In the majority of the cases, EMI occurred when the pacemaker was set to maximum sensitivity. There was cumulative effect of electromagnetic fields between GH and dental chair. EALs and GH caused EMI which ranged according to type and sensitivity setting of the CIEDs and the distance. However, no endodontic equipment caused permanent damage to the CIED. The use of GH caused a cumulative effect of electromagnetic fields. It suggests that during the treatment of patients with CIEDs, only the necessary equipments should be kept turned on. Patients with CIEDs may be subject to EMI from electronic equipment used in dental offices, as they remain turned on throughout the treatment. This is the first article assessing the cumulative effect of electromagnetic fields. Copyright © 2016. Published by Elsevier Ltd.

Effect of Post Placement on the Restoration of Endodontically Treated Teeth: A Systematic Review.

PubMed

Zhu, Zufeng; Dong, Xiao-Yu; He, Shuai; Pan, Xiangqing; Tang, Lifang

2015-01-01

The aim of this study was to assess the effect of root canal post placement on the restoration of endodontically treated teeth. PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, and two Chinese databases (China National Knowledge Internet and the Wan-fang database) were searched to identify randomized or quasi-randomized clinical trials related to post-and-core systems for the restoration of endodontically treated teeth. Studies published prior to August 2013, performed on humans, and written in English or Chinese were considered for inclusion. Two of the authors independently extracted data and assessed the quality of the selected studies. Three studies involving 317 participants were included in the review. Meta-analysis revealed that the risk of overall failure was greater with nonpost (104/271) than with post (78/377) restorations, irrespective of the number of remaining coronal walls (risk ratio [RR] = 0.41; 95% confidence interval [CI], 0.23 to 0.74). The risk of catastrophic failure was greater with nonpost (24/227) than with post (4/329) restorations, irrespective of the remaining coronal walls in restored teeth (RR = 0.11; 95% CI, 0.04 to 0.31). When three or four coronal walls remained, no catastrophic failure occurred in either the post group or the nonpost group. The difference in noncatastrophic failure between the two groups had no statistical significance no matter how many coronal walls remained (P > .05). Post placement appears to have a significant influence on reducing the catastrophic failure rate of endodontically treated teeth. When three or four coronal walls remain, post placement seems to have no influence on the restoration of endodontically treated teeth.

A questionnaire study to derive information on the working environment, clinical training, use of ancillary staff and optimization of patient radiation dose within UK dental practice.

PubMed

Orafi, I; Rushton, V E

2012-08-01

To evaluate the working environment of GDPs and Endodontists and the methods used to optimize patient radiation dose. A total of 857 GDPs and 170 specialist Endodontists were contacted. The responders, 603 of the former and 132 of the latter, completed a questionnaire covering practitioner demographics, pattern of practice, the use of radiographic techniques and the optimization of dose. Chi-squared tests were used to compare groups at the P=0.05 level of significance. For nonparametric data, the Mann-Whitney U-test was employed. A response rate of 73% was achieved. Overall, 79.5% of endodontic specialists used film holders compared with 65.9% of GDPs (P=0.001). One hundred and thirty (98.5%) endodontists and 581 (96.3%) GDPs reported that they were well prepared or adequately prepared in radiographically assessing the presence of apical pathosis. The study found significant differences (P<0.001) between the use of digital radiography by specialist endodontists 93 (70.5%) compared with general dental practitioners 167 (27.7%). Significant differences (P=0.004) were also observed in the use of rectangular collimation between endodontic specialists 55 (42%) and GDPs 223 (37%). With regard to the use of film holders in diagnostic radiography, 105 (79.5%) of endodontic specialists employed these devices compared with 396 (65.7%) GDPs; this finding was significant (P=0.005). For working length estimation, significant differences (P=0.001) were noted in the use of a film holder between endodontic specialists 105 (79.5%) and GDPs 386 (64%). Both Endodontists and GDPs demonstrated compliance with guidelines relating to radiation protection being more significant amongst those clinicians working within specialist clinical practice. © 2012 International Endodontic Journal.

Impact of the use of plasma rich in growth factors (PRGF) on the quality of life of patients treated with endodontic surgery when a perforation of sinus membrane occurred. A comparative study.

PubMed

Taschieri, S; Corbella, S; Tsesis, I; Del Fabbro, M

2014-03-01

The aim of this retrospective investigation was to evaluate the postoperative quality of life after endodontic surgery in maxillary molars when a sinus membrane perforation occurred and platelet concentrates were used. Included patients were treated by microsurgical endodontic treatment in molar and premolar maxillary regions between 2007 and 2010. Patients who fulfilled the inclusion criteria were screened. Data from the quality of life questionnaire were analyzed. The use of plasma rich in growth factors (PRGF) (test group) was compared with a control group when a Schneiderian membrane perforation occurred during endodontic surgery performed with a modern technique in maxillary molars and premolars. A total of 20 patients (12 in the control group and eight in the test group) fulfilled the inclusion criteria. No differences were evaluated at baseline for clinical parameters. Significantly improved patients' quality of life was observed in the test group considering symptoms as swelling, bad breath or taste, and pain. Functional activities were less impaired in the test group and swelling was significantly higher in the control group. In the test group, pain was significantly lower than the control group during the first 6 days after surgery and also, the consumption of painkillers was lower for patients belonging to the test group even if it was not statistically significant. In general, a small sinus membrane perforation (less than 6 mm) during endodontic surgery did not cause severe complications. The use of platelet concentrates could be effective in reducing the impact on patients' quality of life, decreasing pain and surgery side effects as well as swelling.

Isolation of Propionibacterium acnes among the microbiota of primary endodontic infections with and without intraoral communication.

PubMed

Niazi, Sadia Ambreen; Al Kharusi, Hana Suleiman; Patel, Shanon; Bruce, Kenneth; Beighton, David; Foschi, Federico; Mannocci, Francesco

2016-11-01

The presence of opportunistic pathogens such as Propionibacterium acnes (P. acnes) may contribute to the endodontic pathology. The presence of P. acnes may be influenced by different endodontic conditions. The aims of the study were firstly, to identify P. acnes within the whole cultivable microbiota of primary endodontic infections, to investigate which P. acnes phylotypes predominate in such infections and secondly to determine if the presence of an "open" communication (e.g. a sinus) can be associated with the isolation of P. acnes from the root canal. The predominant cultivable microbiota of 15 primary endodontic lesions (7 without communication with the oral environment and 8 with an open communication) were identified using partial 16S ribosomal RNA (rRNA) gene sequence analysis. The identification of the organism was determined by interrogating the Human Oral Microbiome Database. The P. acnes isolates were typed on the basis of the recA gene sequence comparison. A neighbor-joining tree was constructed using MEGA 4.1 with the inclusion of known recA sequences. There was no difference in the number of species identified from lesions without communication (5.86 ± 3.7) and those with communication (5.37 ± 3.6) (P > 0.05). PCR-based 16S rRNA gene sequencing revealed P. acnes as the most prevalent isolate recovered from lesions with communication. recA gene sequencing revealed two phylogenetic lineages present in lesion with communication, with mainly type I (further split into type IA and type IB) and type II. The presence of P. acnes as opportunistic pathogens has been confirmed and may sustain the traits observed in specific clinical presentations. Clinical management of open lesions may require further disinfection to eliminate opportunistic bacteria.

Fracture resistance of endodontically treated molars restored with horizontal fiberglass posts or indirect techniques.

PubMed

Bromberg, Carolina Ritter; Alves, Caroline Beatriz; Stona, Deborah; Spohr, Ana Maria; Rodrigues-Junior, Sinval Adalberto; Melara, Rafael; Burnett, Luiz Henrique

2016-12-01

Because of the many possibilities for endodontically restoring the posterior teeth and the high prevalence of restoration failures, this topic continues to be of major concern. A composite resin (CR) restoration reinforced by a horizontal fiberglass post may improve the fracture resistance of endodontically treated teeth. The authors investigated this possibility by comparing the fracture resistance of molars restored with direct techniques with that of molars restored with indirect techniques. The authors divided 50 extracted sound third molars into 5 groups: sound teeth, onlay (ON), inlay (IN), direct CR, and transfixed fiberglass post (TFP) plus direct CR. The authors performed standardized mesio-occlusodistal cavity preparations and endodontic treatments. The authors cemented indirect restorations of Lava Ultimate (3M ESPE) adhesively in the ON and IN groups. The authors restored CR group teeth directly with Filtek Z230 XT (3M ESPE). In the TFP group, the authors transfixed 2 fiberglass posts horizontally and restored the teeth directly with CR. Thereafter, the authors submitted the teeth to cyclic fatigue loading with 500,000 cycles at 200 newtons. The authors tested fracture resistance in newtons in a universal testing machine. The authors analyzed data with 1-way analysis of variance and a Tukey test (P < .05). Sound teeth had the highest fracture resistance. ON had the highest recovery of resistance, followed by TFP. CR had the lowest recovery, which was similar to that of IN. Endodontically treated molars restored with TFP plus CR had fracture resistance similar to those restored with ON, which was higher than that for IN or CR only. Horizontal TFPs placed inside a composite restoration had the same performance as did ON restorations. Copyright © 2016 American Dental Association. Published by Elsevier Inc. All rights reserved.

Bacteroides endodontalis and other black-pigmented Bacteroides species in odontogenic abscesses.

PubMed Central

van Winkelhoff, A J; Carlee, A W; de Graaff, J

1985-01-01

Twenty-eight odontogenic abscesses were examined for the presence of black-pigmented Bacteroides spp. Of the 28 samples, 26 were found to contain one or more species of black-pigmented Bacteroides. Abscesses were divided into three categories according to the tissue of origin: endodontal, periodontal, and pericoronal. Four abscesses which developed after extraction were also examined. It was found that Bacteroides endodontalis, a newly described species of asaccharolytic black-pigmented Bacteroides, was isolated almost exclusively from periapical abscesses of endodontal origin. B. intermedius proved to be the most frequently isolated species in all of the samples. B. gingivalis was present in all of the periodontal abscesses studied, as well as in two endodontal abscesses. B. melaninogenicus was recovered once from a pericoronal abscess. Precautions for the isolation of B. endodontalis are discussed. PMID:4030089

Factors associated with endodontic flare-ups: a prospective study.

PubMed

Imura, N; Zuolo, M L

1995-09-01

The purpose of this prospective study was to assess the incidence of flare-ups (a severe problem requiring an unscheduled visit and treatment) among patients who received endodontic treatment by the two authors in their respective practices during a period of one year, and also to examine the correlation with pre-operative and operative variables. The results showed an incidence of 1.58% for flare-ups from 1012 endodontically treated teeth. Statistical analysis using the chi-square test (P<0.05) indicated that flare-ups were found to be positively correlated with multiple appointments, retreatment cases, periradicular pain prior to treatment, presence of radiolucent lesions, and patients taking analgesic or anti-inflammatory drugs. In contrast, there was no correlation between flare-up, and age, sex, different arch/tooth groups and the status of the pulp.

Summary of: Regenerative endodontics.

PubMed

Clark, Stephen J

2014-03-01

Significant advances in our understanding of the biological processes involved in tooth development and repair at the cellular and molecular levels have underpinned the newly emerging area of regenerative endodontics. Development of treatment protocols based on exploiting the natural wound healing properties of the dental pulp and applying tissue engineering principles has allowed reporting of case series showing preservation of tissue vitality and apexogenesis. To review current case series reporting regenerative endodontics. Current treatment approaches tend to stimulate more reparative than regenerative responses in respect of the new tissue generated, which often does not closely resemble the physiological structure of dentine-pulp. However, despite these biological limitations, such techniques appear to offer significant promise for improved treatment outcomes. Improved biological outcomes will likely emerge from the many experimental studies being reported and will further contribute to improvements in clinical treatment protocols.

Mandibular first premolar with four canals.

PubMed

Du, Yi; Lee, Angeline H C; Zhang, Chengfei

2013-02-01

A case of endodontic treatment of a mandibular first premolar exhibiting a total of four distinct root canals and four apical foramina is described. This occurrence in mandibular first premolar has rarely been reported in the endodontic literature. Endodontic treatment that considers the anatomic variation of root canal morphology is important to ensure a favorable healing outcome, and its identification could be enhanced by careful examination using a dental operating microscope. Obturation of root canals using a warm vertical compaction technique with a highly-radiopaque root canal sealer, such as AH Plus, after careful ultrasonic activated irrigation with ethylenediaminetetraacetic acid might allow the flow of sealer into the narrowed but unprepared part of the canal. This offers valuable adjuncts for the successful negotiation of calcified main canals, thereby facilitating optimum chemo-mechanical debridement of the root canal system. © 2013 Blackwell Publishing Asia Pty Ltd.

Er:YAG laser for endodontics: efficiency and safety

NASA Astrophysics Data System (ADS)

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

1997-12-01

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

Mixed periapical lesion: an atypical radicular cyst with extensive calcifications.

PubMed

Ramos-Perez, Flávia Maria de Moraes; Pontual, Andréa dos Anjos; França, Talita Ribeiro Tenório de; Pontual, Maria Luiza dos Anjos; Beltrão, Ricardo Villar; Perez, Danyel Elias da Cruz

2014-01-01

The radicular cyst is an inflammatory odontogenic cyst of endodontic origin. Radiographically, the lesion appears as a periapical radiolucent image. This report describes a very rare case of a mixed periapical radiographic image diagnosed as a radicular cyst. A 37-year-old female patient presented a mixed, well-circumscribed image located in the periapical region of the left maxillary central incisor, which presented unsatisfactory endodontic treatment. Microscopic examination revealed a cavity lined by non-keratinized squamous epithelium and extensive calcifications in the cystic lumen and lining epithelium. Diagnosis of radicular cyst with extensive calcifications was established. Endodontic retreatment was performed and no radiographic signs of recurrence were observed 18 months after treatment. Although very rare, a radicular cyst should be considered in the differential diagnosis of a mixed periapical image associated to teeth with pulp necrosis.

Treatment of paraesthesia following root canal treatment by intentional tooth replantation: a review of the literature and a case report.

PubMed

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

2014-01-01

Some endodontic procedures may cause damage to the inferior alveolar nerve, leading to paraesthesia. When such complication is due to extrusion of obturation material beyond the apex, it can be managed by intentional replantation (IR). IR consists of the removal of a tooth and its re-insertion into the socket after performing a proper root end manipulation. It is a relatively conservative procedure aimed at preserving the tooth and, with correct case selection, can provide a predictable outcome. The aim of the present paper is to report a case of paraesthesia following endodontic treatment of second mandibular molar successfully treated by intentional replantation. In our opinion this treatment modality may be considered when the extrusion of root canal filling material causes irritation to the periapical tissues and endodontic retreatment is unfeasible.

Characterization of the dental pulp using optical coherence tomography

NASA Astrophysics Data System (ADS)

Kauffman, C. M. F.; Carvalho, M. T.; Araujo, R. E.; Freitas, A. Z.; Zezell, D. M.; Gomes, A. S. L.

2006-02-01

The inner structure of teeth, i.e. the root canal anatomy, is very complex. However a good knowledge of endodontic architecture is the first step towards successful endodontic treatment. Optical coherence tomography (OCT) is a powerful technique to generate images of hard and soft tissue. Its images show dependency on the optical properties of the tissue under analysis. Changes in the scattering and absorption of tissues can be observed through the OCT images. In this work, we used optical coherence tomography to perform in vitro studies of the inner structure of the first molar of albino rats (Rattus norvegicus). Focusing on the pulp chamber and in the root canal, we compare the images generated with the OCT technique to the histology. We are analyzing the feasibility of OCT to help on the diagnostic of endodontic diseases.

Mandibular second molar exhibiting a unique "Y-" and "J-" "shaped" root canal anatomy diagnosed using cone-beam computed tomographic scanning: A case report.

PubMed

Parashar, Saumya-Rajesh; Kowsky, R Dinesh; Natanasabapathy, Velmurugan

2017-01-01

This article aims to report a unique case with aberrant root canal anatomy exhibiting "Y-" and "J"-shaped canal pattern in a mandibular second molar. Anatomic complexities may pose challenges for endodontic treatment. Before performing endodontic treatment, the clinician should be aware of the internal anatomy of the tooth being treated and should recognize anatomic aberrations if present. Presence of unusual anatomy may call for modifications in treatment planning. This report describes in detail about a mandibular second molar tooth associated with two paramolar tubercles having a peculiar "Y-" and "J-"shaped canal anatomy detected with the aid of cone beam computed tomography, which has never been reported in the dental literature. The proposed treatment protocol for the endodontic management of the same has also been discussed.

Antimicrobial activity of Arctium lappa constituents against microorganisms commonly found in endodontic infections.

PubMed

Pereira, Juliana Vianna; Bergamo, Débora Cristina Baldoqui; Pereira, José Odair; França, Suzelei de Castro; Pietro, Rosemeire Cristina Linhares Rodrigues; Silva-Sousa, Yara T Corrêa

2005-01-01

This study evaluated in vitro the antimicrobial activity of rough extracts from leaves of Arctium lappa and their phases. The following microorganisms, commonly found in the oral cavity, specifically in endodontic infections, were used: Enterococcus faecalis, Staphylococcus aureus, Pseudomonas aeruginosa, Bacillus subtilis and Candida albicans. The agar-diffusion method allowed detection of the hexanic phase as an inhibitor of microbial growth. Bioautographic assays identified antimicrobial substances in the extract. The results showed the existence, in the rough hexanic phase and in its fractions, of constituents that have retention factors (Rf) in three distinct zones, thereby suggesting the presence of active constituents with chemical structures of different polarities that exhibited specificity against the target microorganisms. It may be concluded that the Arctium lappa constituents exhibited a great microbial inhibition potential against the tested endodontic pathogens.

In Vitro Cold Transference of Bases and Restorations.

DTIC Science & Technology

1980-07-01

Donald D. Peters, COL, DC and Robert A. Augsburger, MAJ, DC Dr. Peters, an Army colonel, is Assistant Director, Endodontic Residency Training Program...United States Army Institute of Dental Research, Washington, DC 20012 Dr. Augsburger is Chief, Department of Endodontics , William Beaumont Army...by eight different operative grinding techniques. JAOA 58(5):49-59, 1959. 4. Zach, L. and Cohen, G. Biology of high speed rotary operative dental

Comparison of Curved Root Canals Prepared with Various Chelating Agents

DTIC Science & Technology

2012-06-01

J Endod 2000;26:210-6. 19. Rajasingham R, Ng Y.-L, Knowles JC, Gulabivala K. The effect of sodium hypochlorite and ethylenediaminetetraacetic...A thesis submitted to the Faculty of the Endodontics Graduate Program Naval Postgraduate Dental School Uniformed Services...Professional Development Center ~ Terry D. Webb, DDS, MS CAPT, DC, USN Chairman, Endodontics Dept. Glen M. Imamura, s: MS CAPT, DC, USN Ch"JiiL=h n

The Effect of Smear Layer Removal on Endodontic Outcomes

DTIC Science & Technology

2012-06-01

Sundqvist G. The antibacterial effect of sodium hypochlorite and EDTA in 60 cases of endodontic therapy. Int Endod J 1985;18:35-40. 11. Conner DA, Caplan...outcomes. KEY WORDS: Smear layer, smear layer removal, smear layer creation, EDTA, Sodium hypochlorite , Periapical index INTRODUCTION: The...identified the most efficient process for removal of the smear layer. Normal saline and sodium hypochlorite (NaOCl) have been shown not to remove

A novel method for soft tissue retraction during periapical surgery using 3D technology: a case report.

PubMed

Patel, S; Aldowaisan, A; Dawood, A

2017-08-01

This case report describes a new approach to isolation and soft tissue retraction during endodontic surgery using cone-beam computed tomography (CBCT), computer-aided design (CAD) and three-dimensional (3D) printing. A 53-year-old patient presented for endodontic treatment of her maxillary left central incisor. It was decided to treat this tooth with a microsurgical approach. The data from the diagnostic CBCT scan were also used to make a physical model of the operative site, and CAD software was used to design a soft tissue retractor to be used during the patient's surgery. A custom retractor was then fabricated using a 3D printer. The custom-made retractor enhanced visualization and soft tissue handling during the patient's surgery. The patient was asymptomatic at a 1-year review. No abnormalities were detected during her clinical examination, and radiographic examination revealed complete healing of the surgical site. The significance of proper soft tissue retraction in periapical microsurgery is underemphasized. Geometric data from CBCT scans may be harvested for a variety of uses, adding value to the examination. 3D printing is a promising technology that may potentially have many uses in endodontic surgery. © 2016 International Endodontic Journal. Published by John Wiley & Sons Ltd.

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

PubMed Central

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

2014-01-01

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

New nanostructural biomaterials based on active silicate systems and hydroxyapatite: characterization and genotoxicity in human peripheral blood lymphocytes.

PubMed

Opačić-Galić, V; Petrović, V; Zivković, S; Jokanović, V; Nikolić, B; Knežević-Vukčević, J; Mitić-Ćulafić, D

2013-06-01

To characterize and investigate the genotoxic effect of a new endodontic cement based on dicalcium- and tricalcium-silicate (CS) with hydroxyapatite (HA) on human lymphocytes. Hydrothermal treatment was applied for synthesis of CS and HA. The final mixture HA-CS, with potential to be used in endodontic practice, is composed of CS (34%) and HA (66%). Human lymphocytes were incubated with HA, HA-CS and CS for 1 h, at 37 °C and 5% CO2. Cell viability was determined using the trypan blue exclusion assay. To evaluate the level of DNA damage comet assay (single cell gel electrophoresis) was performed. For the statistical analysis anova and Duncan's Post Hoc Test were used. The SEM analysis indicated that CS consisted mostly of agglomerates of several micrometers in size, built up from smaller particles, with dimensions between 117 and 477 nm. This is promising because dimensions of agglomerates are not comparable with channels inside the cell membranes, whereas their nano-elements provide evident activity, important for faster setting of these mixtures compared to MTA. Values of DNA damage obtained in the comet assay indicated low genotoxic risk of the new endodontic materials. The significantly improved setting characteristics and low genotoxic risk of the new material support further research. © 2012 International Endodontic Journal.

Dental Stem Cell Migration on Pulp Ceiling Cavities Filled with MTA, Dentin Chips, or Bio-Oss

PubMed Central

Lymperi, Stefania; Taraslia, Vasiliki; Tsatsoulis, Ioannis N.; Samara, Athina; Agrafioti, Anastasia; Anastasiadou, Ema; Kontakiotis, Evangelos

2015-01-01

MTA, Bio-Oss, and dentin chips have been successfully used in endodontics. The aim of this study was to assess the adhesion and migration of dental stem cells on human pulp ceiling cavities filled with these endodontic materials in an experimental model, which mimics the clinical conditions of regenerative endodontics. Cavities were formed, by a homemade mold, on untouched third molars, filled with endodontic materials, and observed with electron microscopy. Cells were seeded on cavities' surface and their morphology and number were analysed. The phenomenon of tropism was assessed in a migration assay. All three materials demonstrated appropriate microstructures for cell attachment. Cells grew on all reagents, but they showed a differential morphology. Moreover, variations were observed when comparing cells numbers on cavity's filling versus the surrounding dentine disc. The highest number of cells was recorded on dentin chips whereas the opposite was true for Bio-Oss. This was confirmed in the migration assay where a statistically significant lower number of cells migrated towards Bio-Oss as compared to MTA and dentin chips. This study highlights that MTA and dentin chips have a greater potential compared to Bio-Oss regarding the attraction of dental stem cells and are good candidates for bioengineered pulp regeneration. PMID:26146613

The Microbial Challenge to Pulp Regeneration

PubMed Central

Fouad, A.F.

2011-01-01

Pulp regeneration is considered in cases where the dental pulp has been destroyed because of microbial irritation. Diverse oral and food-borne micro-organisms are able to invade the pulp space, form biofilm on canal walls, and infiltrate dentinal tubules. Prior to pulp regeneration procedures, the pulp space and dentinal walls need to be sufficiently disinfected to allow for and promote regeneration. The necessary level of disinfection is likely higher than that accepted for traditional endodontic therapy, because in traditional techniques the mere lowering of bacterial loads and prevention of bacterial access to periapical tissues is conducive to healing. Moreover, several of the non-specific antimicrobials used in traditional endodontic therapy may cause significant changes in remaining dentin that interfere with its inherent potential to mediate regeneration. Non-specific antimicrobials also suppress all microbial taxa, which may allow residual virulent micro-organisms to preferentially repopulate the pulp space. Therefore, it is important for endodontic pathogens to be studied by molecular methods that allow for a broad depth of coverage. It is then essential to determine the most effective protocols to disinfect the pulp space, with minimal disruption of remaining dentin. These protocols include the topical use of effective antibiotics, including newer agents that have demonstrated efficacy against endodontic pathogens. PMID:21677080

Comparative evaluation of endodontic pressure syringe, insulin syringe, jiffy tube, and local anesthetic syringe in obturation of primary teeth: An in vitro study.

PubMed

Hiremath, Mallayya C; Srivastava, Pooja

2016-01-01

The purpose of this in vitro study was to compare four methods of root canal obturation in primary teeth using conventional radiography. A total of 96 root canals of primary molars were prepared and obturated with zinc oxide eugenol. Obturation methods compared were endodontic pressure syringe, insulin syringe, jiffy tube, and local anesthetic syringe. The root canal obturations were evaluated by conventional radiography for the length of obturation and presence of voids. The obtained data were analyzed using Chi-square test. The results showed significant differences between the four groups for the length of obturation (P < 0.05). The endodontic pressure syringe showed the best results (98.5% optimal fillings) and jiffy tube showed the poor results (37.5% optimal fillings) for the length of obturation. The insulin syringe (79.2% optimal fillings) and local anesthetic syringe (66.7% optimal fillings) showed acceptable results for the length of root canal obturation. However, minor voids were present in all the four techniques used. Endodontic pressure syringe produced the best results in terms of length of obturation and controlling paste extrusion from the apical foramen. However, insulin syringe and local anesthetic syringe can be used as effective alternative methods.

An in vitro Comparative Evaluation of Efficacy of Disinfecting Ability of Garlic Oil, Neem Oil, Clove Oil, and Tulsi Oil with autoclaving on Endodontic K Files tested against Enterococcus faecalis

PubMed Central

Hugar, Shivayogi; Nagmoti, Jyoti; Uppin, Chaitanya; Mistry, Laresh; Dhariwal, Neha

2017-01-01

Aim To comparatively evaluate the efficacy of disinfecting ability of garlic oil, neem oil, clove oil, and tulsi oil with autoclaving on endodontic K files tested against Enterococcus faecalis. Materials and methods Fifty endodontic K files were exposed to the test micro-organism and checked for its disinfecting ability using three different methods. Result Garlic oil, clove oil, tulsi oil and autoclave showed considerable effectiveness against E. faecalis except neem oil. Conclusion Garlic oil, clove oil and tulsi oil are an effective disinfectant and can be used as an alternative to autoclaving against the test micro-organism. Clinical Significance Herbs and herbal extracts are a natural and harmless way of controlling infection. These products are readily available and comparable to gold standard, thus can have its applications in rural India. How to cite this article Hugar S, Patel PM, Nagmoti J, Uppin C, Mistry L, Dhariwal N. An in vitro Comparative Evaluation of Efficacy of Disinfecting Ability of Garlic Oil, Neem Oil, Clove Oil, and Tulsi Oil with autoclaving on Endodontic K Files tested against Enterococcus faecalis. Int J Clin Pediatr Dent 2017;10(3):283-288. PMID:29104390

A method for retrieving endodontic or atypical nonendodontic separated instruments from the root canal: a report of two cases.

PubMed

Monteiro, Jardel Camilo do Carmo; Kuga, Milton Carlos; Dantas, Andrea Abi Rached; Jordão-Basso, Keren Cristina Fagundes; Keine, Katia Cristina; Ruchaya, Prashant Jay; Faria, Gisele; Leonardo, Renato de Toledo

2014-11-01

This clinical report presents a new method for retrieving separated instruments from the root canal with minimally invasive procedures. The presence of separated instrument in root canal may interfere in the endodontic treatment prognosis. There are several recommended methods to retrieve separated instruments, but some are difficult in clinically practice. This study describes two cases of separated instrument removal from the root canal using a stainless-steel prepared needle associated with a K-file. Case 1 presented a fractured gutta-percha condenser within the mandibular second premolar, it was separated during incorrect intracanal medication calcium hydroxide placement. Case 2 had a fractured sewing needle within the upper central incisor that the patient used to remove food debris from the root canal. After cervical preparation, the fractured instruments were fitted inside a prepared needle and then an endodontic instrument (#25 K-file) was adapted with clockwise turning motion between the needle inner wall and the fragment. The endodontic or atypical nonendodontic separated instrument may be easily pull on of the root canal using a single and low cost device. The methods for retrieving separated instruments from root canal are difficult and destructive procedures. The present case describes a simple method to solve this problem.

Microorganisms in periradicular tissues: Do they exist? A perennial controversy

PubMed Central

Dudeja, Pooja Gupta; Dudeja, Krishan Kumar; Srivastava, Dhirendra; Grover, Shibani

2015-01-01

There is no greater association between the basic science and the practice of endodontics than that of microbiology. One of the strongest factors contributing to the controversies often encountered in the endodontic field is the lack of understanding that the disease processes of the pulp and periradicular tissues generally have a microbiological etiology. The vast majority of diseases of dental pulp and periradicular tissues are associated with microorganisms. After the microbial invasion of these tissues, the host responds with both nonspecific inflammatory responses and with specific immunologic responses to encounter such infections. The aim of this study is to fill the gaps in our knowledge regarding the role of microorganisms in endodontics and to discuss in depth whether their presence in periradicular lesions is a myth or a reality. An electronic search was carried out on PubMed database (custom range of almost 50 years) and Google using specific keywords and phrases. Inclusion and exclusion criteria were specified and around 50 articles were found suitable for inclusion. Full text of all the articles was retrieved and studied. Appropriate data were extracted and pooled and finally synthesized. It is important to understand the close relationship between the presence of microorganisms and endodontic disease process to develop an effective rationale for treatment. PMID:26980965

Clinical effectiveness of combining platelet rich fibrin with alloplastic bone substitute for the management of combined endodontic periodontal lesion

PubMed Central

2014-01-01

The term "endo-perio" lesion has been proposed to describe the destructive lesion resulting from inflammatory products found in varying degrees in both the periodontium and the pulpal tissues. In most of the cases, clinical symptoms disappear following successful endodontic therapy. However failure after conventional root canal treatment calls for surgical intervention. A 35 year old male patient with endo-perio lesion in right maxillary lateral incisor was treated with platelet rich fibrin (PRF) and alloplastic bone substitute after conventional endodontic therapy. At the end of 6 months there was gain in clinical attachment, increased radiographic bone fill and reduction in probing depth which was maintained till 18 month follow-up. Present case report aims to evaluate the efficacy of PRF and alloplastic bone substitute in the management of intrabony defect associated with endo-perio lesion in maxillary lateral incisor because the healing potential of PRF and bone graft has not been widely studied in endodontics. The use of PRF allows the clinician to optimize tissue remodelling, wound healing and angiogenesis by the local delivery of growth factors and proteins. The novel technique described here enables the clinician to be benefited from the full regenerative capacity of this autologous biologic material. PMID:24516830

Sudden improvement of insulin sensitivity related to an endodontic treatment.

PubMed

Schulze, A; Schönauer, M; Busse, M

2007-12-01

Inflammation contributes to the pathogenesis of diabetes. A reciprocal relationship exists between diabetes and chronic periodontitis. This report describes the effects of an acute focal dental inflammation and subsequent endodontic treatment on the required insulin dosage of a 70-year-old man who had moderately controlled diabetes. Following an exacerbation of a combined endodontic-periodontic (endo-perio) lesion of tooth #3, the patient noticed a sudden increase in his insulin demand. After 3 weeks, the required dosage was approximately 100% greater. In association with hyperglycemic incidents, he reported a prickling sensation in this tooth. The radiograph showed circular bone loss around the tooth. Just 1 day after the root-canal preparation, the insulin need decreased to approximately 50% of that required prior to treatment. Subsequently, an incision and systemic antibiotics were necessary because of the formation of a periodontal abscess. The insulin demand remained low despite this complication. Forty days after endodontic treatment, the insulin dosage was at a level comparable to that taken 4 weeks before the root-canal preparation. This clinical case revealed a highly relevant correlation between insulin resistance and a local dental inflammation. To avoid an increase in insulin resistance, it seems important to attend to radically non-vital teeth as well as any other dental inflammation in diabetic patients.

Clinical effectiveness of combining platelet rich fibrin with alloplastic bone substitute for the management of combined endodontic periodontal lesion.

PubMed

Goyal, Lata

2014-02-01

The term "endo-perio" lesion has been proposed to describe the destructive lesion resulting from inflammatory products found in varying degrees in both the periodontium and the pulpal tissues. In most of the cases, clinical symptoms disappear following successful endodontic therapy. However failure after conventional root canal treatment calls for surgical intervention. A 35 year old male patient with endo-perio lesion in right maxillary lateral incisor was treated with platelet rich fibrin (PRF) and alloplastic bone substitute after conventional endodontic therapy. At the end of 6 months there was gain in clinical attachment, increased radiographic bone fill and reduction in probing depth which was maintained till 18 month follow-up. Present case report aims to evaluate the efficacy of PRF and alloplastic bone substitute in the management of intrabony defect associated with endo-perio lesion in maxillary lateral incisor because the healing potential of PRF and bone graft has not been widely studied in endodontics. The use of PRF allows the clinician to optimize tissue remodelling, wound healing and angiogenesis by the local delivery of growth factors and proteins. The novel technique described here enables the clinician to be benefited from the full regenerative capacity of this autologous biologic material.

Premixed calcium silicate cement for endodontic applications

PubMed Central

Persson, Cecilia; Engqvist, Håkan

2011-01-01

Calcium silicate-based materials (also called MTA) are increasingly being used in endodontic applications. However, the handling properties of MTA are not optimal when it comes to injectability and cohesion. Premixing the cements using glycerol avoids these issues. However, there is a lack of data on the effect of common cement variables on important properties of premixed cements for endodontic applications. In this study, the effects of liquid-to-powder ratio, amount of radiopacifier and amount of calcium sulfate (added to control the setting time) were screened using a statistical model. In the second part of the study, the liquid-to-powder ratio was optimized for cements containing three different amounts of radiopacifier. Finally, the effect of using glycerol rather than water was evaluated in terms of radiopacity. The setting time was found to increase with the amount of radiopacifier when the liquid-to-powder ratio was fixed. This was likely due to the higher density of the radiopacifier in comparison to the calcium silicate, which gave a higher liquid-to-powder ratio in terms of volume. Using glycerol rather than water to mix the cements led to a decrease in radiopacity of the cement. In conclusion, we were able to produce premixed calcium silicate cements with acceptable properties for use in endodontic applications. PMID:23507729

Premixed calcium silicate cement for endodontic applications: injectability, setting time and radiopacity.

PubMed

Persson, Cecilia; Engqvist, Håkan

2011-01-01

Calcium silicate-based materials (also called MTA) are increasingly being used in endodontic applications. However, the handling properties of MTA are not optimal when it comes to injectability and cohesion. Premixing the cements using glycerol avoids these issues. However, there is a lack of data on the effect of common cement variables on important properties of premixed cements for endodontic applications. In this study, the effects of liquid-to-powder ratio, amount of radiopacifier and amount of calcium sulfate (added to control the setting time) were screened using a statistical model. In the second part of the study, the liquid-to-powder ratio was optimized for cements containing three different amounts of radiopacifier. Finally, the effect of using glycerol rather than water was evaluated in terms of radiopacity. The setting time was found to increase with the amount of radiopacifier when the liquid-to-powder ratio was fixed. This was likely due to the higher density of the radiopacifier in comparison to the calcium silicate, which gave a higher liquid-to-powder ratio in terms of volume. Using glycerol rather than water to mix the cements led to a decrease in radiopacity of the cement. In conclusion, we were able to produce premixed calcium silicate cements with acceptable properties for use in endodontic applications.

Catonella morbi and Granulicatella adiacens: new species in endodontic infections.

PubMed

Siqueira, José F; Rôças, Isabela N

2006-08-01

This study intended to examine samples from primary endodontic infections for the presence of Catonella morbi and Granulicatella adiacens, 2 species that have been recently suggested to be involved with infections in other oral sites. Genomic DNA was isolated directly from samples taken from teeth with different forms of apical periodontitis, and a devised culture-independent 16S rRNA gene-based heminested PCR assay was used to determine the prevalence of these 2 target species. Species-specific primers were developed by aligning closely related 16S rRNA gene sequences. Species-specificity for each primer pair was confirmed by running PCR against a panel of oral bacteria and by sequencing of DNA from representative positive samples. C morbi and G adiacens were detected in 33% and 19%, respectively, of the root canals associated with chronic apical periodontitis; 30% and 10%, respectively, of the cases diagnosed as acute apical periodontitis, and 16% and 11%, respectively, of the pus samples taken from acute apical abscesses. Overall, C morbi occurred in 26% and G adiacens in 14% of the samples taken from primary endodontic infections. Our findings demonstrate that C morbi and G adiacens can take part in the microbiota associated with primary endodontic infections, and their specific role in the disease process warrants further elucidation.

Herpesviruses in Abscesses and Cellulitis of Endodontic Origin

PubMed Central

Chen, Vicky; Chen, Yanwen; Li, Hong; Kent, Karla; Baumgartner, J. Craig; Machida, Curtis A.

2009-01-01

Acute apical abscesses and cellulitis are severe endodontic diseases caused by opportunistic bacteria with possible co-infection with latent herpesviruses. The objectives of this study are to identify herpesviruses, including human cytomegalovirus (HCMV), Epstein-Barr virus (EBV), herpes simplex virus-1 (HSV-1) and Varicella zoster virus (VZV), in patients (n=31) presenting with acute apical abscesses and cellulitis of endodontic origin. Primary and nested polymerase chain reaction (PCR) was conducted using virus-specific primers and DNA isolated from cell-free abscess fluid. From patients exhibiting concurrent spontaneous pain (n=28), nine abscesses contained HCMV, two abscesses contained EBV, one abscess contained HSV-1, and no abscesses contained VZV. Control PCR using genomic or recombinant templates demonstrated detection limits to a single genomic copy of HCMV, 100 genomic copies for EBV, and 1-10 copies for HSV-1, with no cross-amplification between herpesviral DNA targets. Nested PCR was required for detection of herpesviral DNA in the abscess specimens, indicating that these viruses were present in low copy number. Filtration of abscess specimens and virus transfer experiments using human fibroblastic MRC-5 cells confirmed the presence of HCMV particles in several abscess specimens. We conclude that herpesviruses are present, but not required for development of acute apical abscesses and cellulitis of endodontic origin. PMID:19166769

Culture-based identification of pigmented Porphyromonas and Prevotella species in primary endodontic infections

PubMed Central

Rajaram, Anuradha; Kotrashetti, Vijayalakshmi S.; Somannavar, Pradeep D.; Ingalagi, Preeti; Bhat, Kishore

2016-01-01

Background. The most common species isolated from primary endodontic infections are black-pigmented bacteria. These species are implicated in apical abscess formation due to their proteolytic activity and are fastidious in nature. Therefore, the present study was carried out to evaluate the presence and identification of various pigmented Porphyromonas and Prevotella species in the infected root canal through culture-based techniques. Methods. Thirty-one patients with primary endodontic infections were selected. Using sterile paper points, samples were collected from the root canals after access opening and prior to obturation, which were cultured using blood and kanamycin blood agar. Subsequently, biochemical test was used to identify the species and the results were analyzed using percentage comparison analysis, McNemar and chi-squared tests, Wilcoxon match pair test and paired t-test. Results. Out of 31 samples 26 were positive for black-pigmented organisms; the predominantly isolated species were Prevotella followed by Porphyromonas. In Porphyromonas only P. gingivalis was isolated. One of the interesting features was isolation of P. gingivalis through culture, which is otherwise very difficult to isolate through culture. Conclusion. The presence of Prevotella and Porphyromonas species suggests that a significant role is played by these organisms in the pathogenesis of endodontic infections. PMID:27651878

Component Release and Mechanical Properties of Endodontic Sealers following Incorporation of Antimicrobial Agents

PubMed Central

Nicholson, John W.; Coleman, Nichola J.; Booth, Samantha; Dimkov, Aleksandar

2017-01-01

Root canal sealers with antimicrobial activity are highly beneficial; therefore, their antimicrobial properties could be improved by incorporation of antimicrobial agents. In the present study, the release of the quaternary ammonium compounds from endodontic sealers admixed with either benzalkonium chloride (BC) or cetylpyridinium chloride (CPC) at loadings of 2% wt was monitored. The effect of these additives on the compressive strengths and their release from the sealers was determined after 1 and 4 weeks. All of the materials studied were found to be capable of releasing antimicrobial additive in useful quantities. The release of CPC occurred to a statistically significant greater extent than BC for all materials. The addition of both BC and CPC generally decreased the compressive strength of all the endodontic sealers, with the exception of CPC in AH Plus, where the compressive strength was significantly increased. This suggests that, for these endodontic sealers, the antimicrobial additives alter the setting chemistry. AH Plus is an epoxy-based material cured with an amine, and in this case the increase in compressive strength with CPC is attributed to an enhanced cure reaction with this system. In all other cases, the additive inhibited the cure reaction to a greater or lesser extent. PMID:28620615

Post-processing open-source software for the CBCT monitoring of periapical lesions healing following endodontic treatment: technical report of two cases.

PubMed

Villoria, Eduardo M; Lenzi, Antônio R; Soares, Rodrigo V; Souki, Bernardo Q; Sigurdsson, Asgeir; Marques, Alexandre P; Fidel, Sandra R

2017-01-01

To describe the use of open-source software for the post-processing of CBCT imaging for the assessment of periapical lesions development after endodontic treatment. CBCT scans were retrieved from endodontic records of two patients. Three-dimensional virtual models, voxel counting, volumetric measurement (mm 3 ) and mean intensity of the periapical lesion were performed with ITK-SNAP v. 3.0 software. Three-dimensional models of the lesions were aligned and overlapped through the MeshLab software, which performed an automatic recording of the anatomical structures, based on the best fit. Qualitative and quantitative analyses of the changes in lesions size after treatment were performed with the 3DMeshMetric software. The ITK-SNAP v. 3.0 showed the smaller value corresponding to the voxel count and the volume of the lesion segmented in yellow, indicating reduction in volume of the lesion after the treatment. A higher value of the mean intensity of the segmented image in yellow was also observed, which suggested new bone formation. Colour mapping and "point value" tool allowed the visualization of the reduction of periapical lesions in several regions. Researchers and clinicians in the monitoring of endodontic periapical lesions have the opportunity to use open-source software.

Antibacterial and antifungal activity of endodontic intracanal medications

PubMed Central

TONEA, ANDRADA; BADEA, MANDRA; OANA, LIVIU; SAVA, SORINA; VODNAR, DAN

2017-01-01

Background and aims The sterilization of the entire root canal system represents the main goal of every endodontist, given the fact that the control of the microbial flora is the key point of every root canal treatment. The diversity of microorganisms found inside the root canal and also the resistance of some bacterial species to intracanal medications led to a continuous development of new endodontic products. The present study focuses on the comparison of the antibacterial and antifungal properties of different endodontic products, two commercially available, one experimental plant based extract, and two control substances. Methods The disc diffusion assay was used to determine the antibacterial and antifungal properties of chlorhexidine, calcium hydroxide, a mix extract between Arctium lappa root powder and Aloe barbadensis Miller gel, Amoxicillin with clavulanic acid and Fluconazole (as control substances). Two of the most common microorganisms found in endodontic infections were chosen: Enterococcus faecalis (ATCC 29212) and Candida albicans ATCC(10231). Results All tested substances showed inhibition zones around the discs, for Enterococcus faecalis and Candida albicans, including the experimental mix extract of Arctium lappa root powder with Aloe vera gel. Conclusion The experimental mix extract of Arctium lappa root powder and Aloe vera gel is able to inhibit very resistant microorganisms, like Enterococcus faecalis and Candida albicans. PMID:28781531

Outcome of Endodontic Surgery: A Meta-analysis of the Literature-Part 3: Comparison of Endodontic Microsurgical Techniques with 2 Different Root-end Filling Materials.

PubMed

Kohli, Meetu R; Berenji, Homayon; Setzer, Frank C; Lee, Su-Min; Karabucak, Bekir

2018-06-01

The aim of the present study was to investigate the influence of root-end preparation and filling material on endodontic surgery outcome. A systematic review and meta-analysis was conducted to determine the outcome of resin-based endodontic surgery (RES, the use of high-magnification preparation of a shallow and concave root-end cavity and bonded resin-based root-end filling material) versus endodontic microsurgery (EMS, the use of high-magnification ultrasonic root-end preparation and root-end filling with SuperEBA [Keystone Industries, Gibbstown, NJ], IRM [Dentsply Sirona, York, PA], mineral trioxide aggregate [MTA], or other calcium silicate cements). An exhaustive literature search was conducted to identify prognostic studies on the outcome of root-end surgery. Human studies conducted from 1966 to the end of December 2016 in 5 different languages (ie, English, French, German, Italian, and Spanish) were searched in 4 electronic databases (ie, Medline, Embase, PubMed, and Cochrane Library). Relevant review articles on the subject were scrutinized for cross-references. In addition, 5 dental and medical journals (Journal of Endodontics; International Endodontic Journal; Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics; Journal of Oral and Maxillofacial Surgery; and International Journal of Oral and Maxillofacial Surgery) were hand checked dating back to 1975. All abstracts were screened by 3 independent reviewers (H.B., M.K., and F.S.). Strict inclusion-exclusion criteria were defined to identify relevant articles. Raw data were extracted from the full-text review of these selected articles independently by each of the 3 reviewers. In case of disagreement, an agreement was reached by discussion, and qualifying articles were assigned to group RES. For EMS, the same search strategy was performed for the time frame October 2009 to December 2016, whereas up to October 2009 the data were obtained from a previous systematic review with identical criteria and search strategy. Weighted pooled success rates and a relative risk assessment between RES and EMS were calculated. To make a comparison between groups, a random effects model was used. Sixty-eight articles were eligible for full-text review. Of these, per strict inclusion exclusion criteria, 14 studies qualified, 3 for RES (n = 862) and 11 for EMS (n = 915). Weighted pooled success rates for RES were 82.20% (95% confidence interval [CI], 0.7965-0.8476) and 94.42% for EMS (95% CI, 0.9295-0.9590). This difference was statistically significant (P < .0005). The probability for success for EMS proved to be significantly greater than the probability for success for RES, providing best available evidence on the influence of cavity preparation with ultrasonic tips and/or SuperEBA (Keystone Industries, Gibbstown, NJ), IRM (Dentsply Sirona, York, PA), MTA, or silicate cements as root-end filling material instead of a shallow cavity preparation and placement of a resin-based material. Additional large-scale randomized clinical trials are needed to assess other predictors of outcome. Copyright © 2018 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Effect of Endodontic Access on the Failure Load of Lithium Disilicate and Resin Nano-ceramic CADCAM Crowns

DTIC Science & Technology

2017-06-09

3 August 2016 Douglas D. Lancaster, COL, DC Army Post Graduate Dental School Effect of Endodontic Access on the Failure Load of Lithium...University of the Health Sciences, Bethesda, MD; Schofield Barracks Dental Clinic, Schofield Barracks, HI; Tripler Army Medical Center, Honolulu...underlying die was reached. (Neo Diamond, Microcopy Dental ). The access outline was then completed with a medium (100-110µm) grit round-ended

Endodontic implications of the variability of the root canal systems of posterior teeth.

PubMed

Biggs, J T; Benenati, F W

1995-01-01

Variations in the morphology of roots and root canal systems create challenges which the dental practitioner must be able to recognize. Endodontic therapy is predictable and successful only to the extent that the root canal system can be debrided, disinfected and sealed against future contamination. In order to accomplish these goals it is necessary to become familiar with the variability of the system we seek to treat.

Microscope-aided endodontic treatment of maxillary first premolars with three roots: a case series.

PubMed

Karumaran, C S; Gunaseelan, R; Krithikadatta, J

2011-01-01

Maxillary premolars have a highly variable root canal morphology. However, the presence of three roots is a rare occurrence. This clinical article describes the unusual anatomy detected in maxillary premolars during routine endodontic treatment using microscope. The diagnosis and clinical management of maxillary first premolars with three roots and canals using radiographic interpretation, access cavity modification and visual enhancement with operative microscopes is discussed in the article.

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

PubMed

Fabra Campos, H; Millet Part, J

1989-01-01

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

Outcomes of regenerative endodontic procedures.

PubMed

Law, Alan S

2012-07-01

The use of regenerative endodontic techniques holds great promise for the treatment of immature teeth with necrotic pulp tissue. Several published case reports and case series have demonstrated radiographic evidence of apical bone healing, increases in root length, and root wall thickness. Although histologic changes have been demonstrated in animal models, histology in human teeth is lacking. A summary of these outcomes is discussed in this article. Copyright © 2012 Elsevier Inc. All rights reserved.

Combined endodontic-periodontic treatment of a palatal groove: a case report.

PubMed

Schwartz, Scott A; Koch, Michael A; Deas, David E; Powell, Charles A

2006-06-01

The palatal groove is a developmental anomaly that predisposes the tooth involved to a severe periodontal defect. When further complicated by pulp necrosis, these grooves often present a diagnostic and treatment planning challenge that requires an interdisciplinary treatment approach. This case report describes the successful collaborative management of a maxillary lateral incisor with an extensive palatal groove using a combination of nonsurgical endodontic therapy, odontoplasty, and periodontal regenerative techniques.

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

PubMed

Martins, Jorge N R

2014-06-01

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

Photodynamic therapy for endodontic disinfection.

PubMed

Soukos, Nikolaos S; Chen, Peter Shih-Yao; Morris, Jason T; Ruggiero, Karriann; Abernethy, Abraham D; Som, Sovanda; Foschi, Federico; Doucette, Stephanie; Bammann, Lili Luschke; Fontana, Carla Raquel; Doukas, Apostolos G; Stashenko, Philip P

2006-10-01

The aims of this study were to investigate the effects of photodynamic therapy (PDT) on endodontic pathogens in planktonic phase as well as on Enterococcus faecalis biofilms in experimentally infected root canals of extracted teeth. Strains of microorganisms were sensitized with methylene blue (25 microg/ml) for 5 minutes followed by exposure to red light of 665 nm with an energy fluence of 30 J/cm2. Methylene blue fully eliminated all bacterial species with the exception of E. faecalis (53% killing). The same concentration of methylene blue in combination with red light (222 J/cm2) was able to eliminate 97% of E. faecalis biofilm bacteria in root canals using an optical fiber with multiple cylindrical diffusers that uniformly distributed light at 360 degrees. We conclude that PDT may be developed as an adjunctive procedure to kill residual bacteria in the root canal system after standard endodontic treatment.

Flare-ups in endodontics and their relationship to various medicaments.

PubMed

Ehrmann, Ernest H; Messer, Harold H; Clark, Robert M

2007-12-01

The purpose of this research is to investigate the frequency of endodontic flare-ups using a visual analogue scale. Definitions of flare-ups vary widely as does their reported frequency. A flare-up was defined as an increase of 20 or more points on the visual analogue scale for a given tooth, within the periods of 4 h and 24 h after the initial treatment appointment. The data from a previous study were used to determine the incidence of flare-ups after using three modalities (Ledermix, calcium hydroxide and no medication) to manage patients presenting for relief of pain of endodontic origin. A statistical analysis showed that there were no significant differences in flare-up rates at both the 4-h and 24-h periods between the three modalities. Further research is required using the above definition of a flare-up and standardising treatment protocols.

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

PubMed

Jensen, Arna-Lee; Abbott, Paul V

2007-10-01

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

The failures of root canal preparation with hand ProTaper.

PubMed

Bătăiosu, Marilena; Diaconu, Oana; Moraru, Iren; Dăguci, C; Tuculină, Mihaela; Dăguci, Luminiţa; Gheorghiţă, Lelia

2012-07-01

The failures of root canal preparation are due to some anatomical deviation (canal in "C" or "S") and some technique errors. The technique errors are usually present in canal root cleansing and shaping stage and are the result of endodontic treatment objectives deviation. Our study was made on technique errors while preparing the canal roots with hand ProTaper. Our study was made "in vitro" on 84 extracted teeth (molars, premolars, incisors and canines). The canal root of these teeth were cleansed and shaped with hand ProTaper by crown-down technique and canal irrigation with NaOCl(2,5%). The dental preparation control was made by X-ray. During canal root preparation some failures were observed like: canal root overinstrumentation, zipping and stripping phenomenon, discarded and/or fractured instruments. Hand ProTaper represents a revolutionary progress of endodontic treatment, but a deviation from accepted rules of canal root instrumentation can lead to failures of endodontic treatment.

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

PubMed

Ben Rejeb, H; Douki, N

2015-09-01

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

A Review Over Benefits and Drawbacks of Combining Sodium Hypochlorite with Other Endodontic Materials.

PubMed

Mohammadi, Zahed; Shalavi, Sousan; Moeintaghavi, Amir; Jafarzadeh, Hamid

2017-01-01

As the root canal system considered to be complex and unpredictable, using root canal irrigants and medicaments are essential in order to enhance the disinfection of the canal. Sodium hypochlorite is the most common irrigant in endodontics. Despite its excellent antimicrobial activity and tissue solubility, sodium hypochlorite lacks some important properties such as substantivity and smear layer removing ability. The aim of this review was to address benefits and drawbacks of combining sodium hypochlorite with other root canal irrigants and medicaments. According to the reviewed articles, NaOCl is the most common irrigation solution in endodontics. However, it has some drawbacks such as inability to remove smear layer. One of the drawbacks of NaOCl is its inability to remove the smear layer and lack of substantivity. The adjunctive use of other materials has been suggested to improve NaOCl efficacy. Nevertheless, further studies are required in this field.

Evaluation of antimicrobial activity of extracts of Tibouchina candolleana (melastomataceae), isolated compounds and semi-synthetic derivatives against endodontic bacteria.

PubMed

Dos Santos, Fernanda M; de Souza, Maria Gorete; Crotti, Antônio E Miller; Martins, Carlos H G; Ambrósio, Sérgio R; Veneziani, Rodrigo C S; E Silva, Márcio L Andrade; Cunha, Wilson R

2012-04-01

This work describes the phytochemical study of the extracts from aerial parts of Tibouchina candolleana as well as the evaluation of the antimicrobial activity of extracts, isolated compounds, and semi-synthetic derivatives of ursolic acid against endodontic bacteria. HRGC analysis of the n-hexane extract of T. candolleana allowed identification of β-amyrin, α-amyrin, and β-sitosterol as major constituents. The triterpenes ursolic acid and oleanolic acid were isolated from the methylene chloride extract and identified. In addition, the flavonoids luteolin and genistein were isolated from the ethanol extract and identified. The antimicrobial activity was investigated via determination of the minimum inhibitory concentration (MIC) using the broth microdilution method. Amongst the isolated compounds, ursolic acid was the most effective against the selected endodontic bacteria. As for the semi-synthetic ursolic acid derivatives, only the methyl ester derivative potentiated the activity against Bacteroides fragilis.

Evaluation of antimicrobial activity of extracts of Tibouchina candolleana (melastomataceae), isolated compounds and semi-synthetic derivatives against endodontic bacteria

PubMed Central

dos Santos, Fernanda M.; de Souza, Maria Gorete; Crotti, Antônio E. Miller; Martins, Carlos H. G.; Ambrósio, Sérgio R.; Veneziani, Rodrigo C. S.; e Silva, Márcio L. Andrade; Cunha, Wilson R.

2012-01-01

This work describes the phytochemical study of the extracts from aerial parts of Tibouchina candolleana as well as the evaluation of the antimicrobial activity of extracts, isolated compounds, and semi-synthetic derivatives of ursolic acid against endodontic bacteria. HRGC analysis of the n-hexane extract of T. candolleana allowed identification of β-amyrin, α-amyrin, and β-sitosterol as major constituents. The triterpenes ursolic acid and oleanolic acid were isolated from the methylene chloride extract and identified. In addition, the flavonoids luteolin and genistein were isolated from the ethanol extract and identified. The antimicrobial activity was investigated via determination of the minimum inhibitory concentration (MIC) using the broth microdilution method. Amongst the isolated compounds, ursolic acid was the most effective against the selected endodontic bacteria. As for the semi-synthetic ursolic acid derivatives, only the methyl ester derivative potentiated the activity against Bacteroides fragilis. PMID:24031892

Regenerative endodontics: a state of the art.

PubMed

Bansal, Rashmi; Bansal, Rajesh

2011-01-01

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.

A clinical report demonstrating the significance of distinguishing a nasopalatine duct cyst from a radicular cyst

PubMed Central

Aparna, Manikkath; Chakravarthy, Arumugam; Acharya, Shashi Rashmi; Radhakrishnan, Raghu

2014-01-01

Endodontic diagnosis is challenging and depends on the organisation of information from the patient history, clinical examination and analysis of the pulp, radiographic and histopathological assessment. A 35-year-old man was endodontically treated for radiolucency in relation to the roots of maxillary central incisors as it was a provisionally diagnosed case of radicular cyst. Since the palatal swelling persisted, the lesion was re-evaluated using relevant diagnostic aids and a diagnosis of nasopalatine duct cyst (NPDC) was made, which was missed during the initial assessment. An erroneous interpretation of cystic radiolucency in relation to maxillary central incisors can often lead to inappropriate treatment planning. This case highlights the relevant aspects in the diagnosis of NPDC when it is mistaken for a radicular cyst and emphasises the need for thorough clinical examination and relevant investigations for periapical radiolucencies of questionable origin before initiating endodontic therapy. PMID:24642171

Comparison of hand-instrumented, heated gutta-percha and engine-driven, cold gutta-percha endodontic techniques.

PubMed

Stein, Keith E; Manfra Marretta, Sandra; Siegel, Arthur; Vitoux, Jeanne

2004-09-01

An in vitro study compared two gutta-percha obturation techniques of the mandibular first molar in dogs. The mandibular first molars were instrumented and obturated using either K-files and the SuccessFil vertical compaction technique or rotary instruments and the Simplifill/guttapercha master cone technique. Instrumentation and obturation times were recorded for each tooth. Radiographs were used for evaluation of overall appearance of the final fill. A modified apical dye leakage technique was used to evaluate the ability of each method to provide an adequate barrier to apical leakage. The endodontic technique utilizing rotary instruments and Simplifill/gutta-percha master cone required less time and provided a better radiographic appearance to the endodontic fill. In addition, there was no apical dye leakage associated with this technique compared with a 44% leakage incidence in teeth treated with K-file instrumentation and SuccessFil.

Aberration in the palatal root of the maxillary first molar

PubMed Central

Rajalbandi, Sandeep; Shingte, Sandhya Narayan; Sundaresh, K J; Mallikarjuna, Rachappa

2013-01-01

Thorough knowledge of root canal morphology is essential for the endodontic therapy. Variations in the root and root canal morphology, especially in multirooted teeth, are a constant challenge for diagnosis and management. The dentist needs to be familiar with the various root canal configurations and their variations for successful endodontic therapy. There are rare variations in canal number and configuration in maxillary molars, which could affect treatment outcome. Two lingual root structures are occasionally found on human permanent maxillary molars. One of these is the normal lingual root, which is always present, the other is a supernumerary structure which can be located either mesiolingually (radix mesiolingualis) or distolingually (radix distolingualis). The purpose of this paper is to review the literature and to demonstrate a case report which describes the successful non-surgical endodontic management of an unusual maxillary first molar with four separate roots and four canals. PMID:23632609

Endodontic management of middle mesial canal of the mandibular molar

PubMed Central

Sundaresh, K J; Srinivasan, Raghu; Mallikarjuna, Rachappa; Rajalbandi, Sandeep

2013-01-01

Thorough knowledge of root canal morphology and unusual anatomy of the tooth is critical for successful endodontic treatment. Although the most common configuration is two roots and three root canals, mandibular molars might have many different combinations. In the literature, it is less described about three mesial canals and two distal canals in mandibular second molars, indicating a rare anatomical configuration. A case of unusual root canal morphology is presented to demonstrate anatomical variations in mandibular molars. Endodontic therapy was performed in a mandibular second molar with five separate canals, three mesial and two distal. This report points out the importance of looking for additional canals and unusual canal morphology, because knowledge of their existence might occasionally enable clinicians to treat a case successfully that otherwise might have ended in failure. In conclusion, every attempt should be made to find and treat all root canals of a tooth. PMID:23349182

Endodontic management of radix paramolaris with six canals: a clinical case report.

PubMed

Acharya, N; Singh, A; Samant, P S; Gautam, V

2013-01-01

Endodontic therapy of mandibular molars is a challenging task due to its varied root canal morphology. A mandibular first molar with additional buccal root (Radix paramolaris) and additional distolingual root (Radix Entomolaris) is an example of its varied anatomy. A successful management of atypical root canal configurations is an important aspect in determining the success rate of root canal therapy. The detail knowledge of the root morphology and canal anatomy allows the clinician for accurate location of the extra roots and canals and accordingly the refinement of the access cavity for the stress free entry of complex anatomy. Hence, for a successful root canal therapy, clinician must be aware of the external and internal anatomic variations .The aim of this clinical case report is to present and describe the unusual presence of two separate mesial roots and six root canals in mandibular first molar, detected during routine endodontic therapy.

An application framework of three-dimensional reconstruction and measurement for endodontic research.

PubMed

Gao, Yuan; Peters, Ove A; Wu, Hongkun; Zhou, Xuedong

2009-02-01

The purpose of this study was to customize an application framework by using the MeVisLab image processing and visualization platform for three-dimensional reconstruction and assessment of tooth and root canal morphology. One maxillary first molar was scanned before and after preparation with ProTaper by using micro-computed tomography. With a customized application framework based on MeVisLab, internal and external anatomy was reconstructed. Furthermore, the dimensions of root canal and radicular dentin were quantified, and effects of canal preparation were assessed. Finally, a virtual preparation with risk analysis was performed to simulate the removal of a broken instrument. This application framework provided an economical platform and met current requirements of endodontic research. The broad-based use of high-quality free software and the resulting exchange of experience might help to improve the quality of endodontic research with micro-computed tomography.

Antibiotic prescribing for endodontic therapies: a comparative survey between general dental practitioners and final year Bachelor of Dental Surgery students in Cardiff, UK.

PubMed

Al Masan, A A; Dummer, P M H; Farnell, D J J; Vianna, M E

2018-07-01

To evaluate the views of final year dental surgery students (BDS; G1) at Cardiff University and general dental practitioners (GDPs; G2) within the geographic area of Cardiff, Wales, on antibiotic prescribing for endodontic conditions, and investigate the potential differences between the two groups. A cross-sectional online questionnaire-based survey of 12 qualitative and quantitative questions was distributed to 76 final year BDS Cardiff University students and 55 dental practices within Cardiff, UK. Six questions recorded general information, and the remaining questions included a series of hypothetical clinical scenarios, where the participants were asked to state whether they would or would not prescribe antibiotics. The data were analysed using spss version 23 to produce descriptive statistics, contingency tables and to run chi-square (χ²) tests, Fisher's exact tests and relative risk calculations. The response rate was 60% (n = 79). All G1 participants were aware of the consequences of antibiotic overuse. Approximately 60% of responders were aware of guidelines for antibiotic use in endodontic therapies, and 83% would only use antibiotics for a limited selection of patients (e.g. patients with systemic complications). G1 responses to clinical scenarios indicated overall that they were comparable to the ideal answers except for acute apical abscess (64% believed that antibiotics were indicated). The majority of G2 were aware of the consequences of antibiotic overuse. Only 28% of G2 were aware of guidelines for antibiotic use in endodontic therapies. Overall responses revealed that antibiotics would be prescribed for: systemic complications (78%), acute apical abscess (72%) and symptomatic apical periodontitis (28%). The clinical scenarios revealed G1 were more likely to prescribe antibiotics compared to G2 for cases of necrotic pulp with symptomatic apical periodontitis without systemic complications (incorrect answer) and less likely to other clinical scenarios such as necrotic pulp and asymptomatic apical periodontitis for patients with a history of rheumatic fever (ideal answers), symptomatic irreversible/reversible pulpitis, failure to achieve anaesthesia, chronic apical abscess for patients with diabetes. The recognition of antibiotic prescription for cases with signs of spreading infection was more evident in G2. Final year undergraduate students were aware of the antibiotic resistance crisis, although a third was not aware of guidelines for use of antibiotics in endodontic conditions; their responses to clinical scenario were generally compatible with the guidelines. General dentists were less aware of the implications of overuse of antibiotics and the existence of guidelines, and their responses were occasionally incompatible with antibiotic guidelines for endodontic therapies. © 2018 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Regeneration and Repair in Endodontics—A Special Issue of the Regenerative Endodontics—A New Era in Clinical Endodontics

PubMed Central

Saoud, Tarek Mohamed A.; Ricucci, Domenico; Lin, Louis M.; Gaengler, Peter

2016-01-01

Caries is the most common cause of pulp-periapical disease. When the pulp tissue involved in caries becomes irreversibly inflamed and progresses to necrosis, the treatment option is root canal therapy because the infected or non-infected necrotic pulp tissue in the root canal system is not accessible to the host's innate and adaptive immune defense mechanisms and antimicrobial agents. Therefore, the infected or non-infected necrotic pulp tissue must be removed from the canal space by pulpectomy. As our knowledge in pulp biology advances, the concept of treatment of pulpal and periapical disease also changes. Endodontists have been looking for biologically based treatment procedures, which could promote regeneration or repair of the dentin-pulp complex destroyed by infection or trauma for several decades. After a long, extensive search in in vitro laboratory and in vivo preclinical animal experiments, the dental stem cells capable of regenerating the dentin-pulp complex were discovered. Consequently, the biological concept of ‘regenerative endodontics’ emerged and has highlighted the paradigm shift in the treatment of immature permanent teeth with necrotic pulps in clinical endodontics. Regenerative endodontics is defined as biologically based procedures designed to physiologically replace damaged tooth structures, including dentin and root structures, as well as the pulp-dentin complex. According to the American Association of Endodontists’ Clinical Considerations for a Regenerative Procedure, the primary goal of the regenerative procedure is the elimination of clinical symptoms and the resolution of apical periodontitis. Thickening of canal walls and continued root maturation is the secondary goal. Therefore, the primary goal of regenerative endodontics and traditional non-surgical root canal therapy is the same. The difference between non-surgical root canal therapy and regenerative endodontic therapy is that the disinfected root canals in the former therapy are filled with biocompatible foreign materials and the root canals in the latter therapy are filled with the host's own vital tissue. The purpose of this article is to review the potential of using regenerative endodontic therapy for human immature and mature permanent teeth with necrotic pulps and/or apical periodontitis, teeth with persistent apical periodontitis after root canal therapy, traumatized teeth with external inflammatory root resorption, and avulsed teeth in terms of elimination of clinical symptoms and resolution of apical periodontitis. PMID:29563445

[The application of laser in endodontics].

PubMed

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

2016-08-01

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

Comparison of the Effectiveness of Four Different Types of Needles in Irrigating Endodontically Treated Teeth.

DTIC Science & Technology

1980-02-08

3. Shih, M.; Marshall, F. J.; and Rosen, S. The bactericidal efficiency of sodium hypochlorite as an endodontic irrigant. Oral Surg 29(4): 613-619...and Rosen9 investi- gated the cleansing effect of sodium hypochlorite and normal saline on the apical one third using a standard irrigating method. They...found that sodium hypochlorite was no better than normal saline solutiun in irrigating this segment. Salzgeber and Brilliant10 investigated the

A Technique for Staining Extracted Teeth: A Research and Teaching Aid for Bleaching.

DTIC Science & Technology

1980-10-01

teeth, the pulps extirpated, and the root canals instrumented with #10 to #20 files. The teeth were then placed in 5.25% sodium hypochlorite solution for...patient and the dentist.4 Hence, the bleaching of these discolored non-vital teeth becomes an extremely important phase of endodontic therapy. 1-6...dentists at the Edward C. Penick Endodontic Study Club stated they never bleached a tooth as an undergraduate. Six chairmen of dental school

Endodontic diagnostic terminology update.

PubMed

McClannahan, Scott B; Baisden, Michael K; Bowles, Walter R

2011-01-01

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.

A Review of the Properties and Applications of Ozone in Endodontics: An Update

PubMed Central

Mohammadi, Zahed; Shalavi, Sousan; Soltani, Mohammad Karim; Asgary, Saeed

2013-01-01

Ozone is a triatomic molecule consisting of three oxygen atoms. It is applied to oral tissues in the forms of ozonated water, ozonated olive oil and oxygen/ozone gas. This paper presents a brief review on the chemistry of ozone as well as its medical and dental applications focusing on its use in endodontics. Ozone’s antimicrobial activity, its effect on dentin bonding, toxicity and contra-indications are also reviewed. PMID:23717326

Evidenced-based review of clinical studies on periodontics.

PubMed

2009-08-01

Periodontal diseases have several implications for the practice of endodontics. First, advanced periodontitis often has direct implications for the long-term prognosis of the case and requires careful evaluation and coordinated treatment of both the periodontic and endodontic diseases. Second, the potential for functional interactions between odontogenic pathoses and marginal periodontitis requires careful collection of clinical observations and monitoring the outcome of various treatments. In this section, we provide an analysis of recent clinical studies in this area.

Influence of ferrule preparation with or without glass fiber post on fracture resistance of endodontically treated teeth

PubMed Central

de LIMA, Alexandra Furtado; SPAZZIN, Aloísio Oro; GALAFASSI, Daniel; CORRER-SOBRINHO, Lourenço; CARLINI-JÚNIOR, Bruno

2010-01-01

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

A cost-effective simulation curriculum for preclinical endodontics.

PubMed

Pileggi, Roberta; Glickman, Gerald N

2004-02-01

A challenge in contemporary dental education is to achieve a smooth transition from preclinical teaching environments to patient-care clinics in a cost-effective manner. The preclinical endodontic courses at The University of Texas, Dental Branch at Houston provide a unique learning environment that enables the student to perform endodontic treatment on extracted teeth in a typodont, and be involved in diagnosis and treatment-planning discussions. The specially designed stone typodont used has built-in radiographic capability, and is mounted at each chair in the clinic. During each preclinical session, students are assigned clinical cubicles and proper aseptic protocol is followed. Students are required to wear gloves, masks and eyewear, and place a rubber dam during treatment. Written self-assessment evaluations based upon prescribed criteria are utilised; feedback is given by faculty composed of both full-time endodontists and graduate students who periodically rotate and are calibrated on a regular basis. In the lecture phase, clinical case scenarios are presented to reinforce concepts of diagnosis and emergency care and to help integrate endodontics with other disciplines; a Socratic-like teaching style is established by the faculty facilitator to create an environment for developing critical-thinking and problem-solving skills. The overall feedback from graduating students has been very positive. Advantages of this format are an easier transition to patient management, a more keen interest in specialsation and a perceived increase in levels of confidence.

Regenerative Endodontic Therapy in a Single Visit Using Platelet-rich Plasma and Biodentine in Necrotic and Asymptomatic Immature Molar Teeth: A Report of 3 Cases.

PubMed

Topçuoğlu, Gamze; Topçuoğlu, Hüseyin Sinan

2016-09-01

This report describes 3 successful single-visit regenerative endodontic therapy cases using platelet-rich plasma (PRP) and Biodentine (Septodont, Saint Maurdes Fossés, France) for 3 immature mandibular molar teeth, all with necrotic pulp, in 2 children aged 8 years and 1 aged 9 years. Three teeth were separately diagnosed as having a necrotic pulp. After preparation of the access cavity under rubber dam isolation, the necrotic pulp was removed, and each canal was irrigated with 2.5% sodium hypochlorite, sterile saline, and 17% EDTA solutions. Freshly prepared PRP was injected into each canal up to the cementoenamel junction, and Biodentine was placed directly over the PRP clot. Each access cavity was then restored with composite resin. Follow-up clinical examinations revealed negative responses to cold and electric pulp tests. None of the treated teeth were sensitive to percussion or palpation. Radiographic examination showed continued thickening of root canal walls and apical closure of the root apex of each tooth. Single-visit regenerative endodontic therapy can be considered in necrotic and asymptomatic immature permanent teeth. PRP and Biodentine may serve as scaffold and barrier materials in regenerative endodontic procedures. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Guided endodontics: accuracy of a novel method for guided access cavity preparation and root canal location.

PubMed

Zehnder, M S; Connert, T; Weiger, R; Krastl, G; Kühl, S

2016-10-01

To present a novel method utilizing 3D printed templates to gain guided access to root canals and to evaluate its accuracy in vitro. Sixty extracted human teeth were placed into six maxillary jaw models. Preoperative CBCT scans were matched with intra-oral scans using the coDiagnostix(™) software. Access cavities, sleeves and templates for guidance were virtually planned. Templates were produced by a 3D printer. After access cavity preparation by two operators, a postoperative CBCT scan was superimposed on the virtual planning. Accuracy was measured by calculating the deviation of planned and prepared cavities in three dimensions and angle. Ninety-five per cent confidence intervals were calculated for both operators. All root canals were accessible after cavity preparation with 'Guided Endodontics'. Deviations of planned and prepared access cavities were low with means ranging from 0.16 to 0.21 mm for different aspects at the base of the bur and 0.17-0.47 mm at the tip of the bur. Mean of angle deviation was 1.81°. Overlapping 95% confidence intervals revealed no significant difference between operators. 'Guided Endodontics' allowed an accurate access cavity preparation up to the apical third of the root utilizing printed templates for guidance. All root canals were accessible after preparation. © 2015 International Endodontic Journal. Published by John Wiley & Sons Ltd.

An animal model to study regenerative endodontics.

PubMed

Torabinejad, Mahmoud; Corr, Robert; Buhrley, Matthew; Wright, Kenneth; Shabahang, Shahrokh

2011-02-01

A growing body of evidence is demonstrating the possibility for regeneration of tissues within the pulp space and continued root development in teeth with necrotic pulps and open apices. There are areas of research related to regenerative endodontics that need to be investigated in an animal model. The purpose of this study was to investigate ferret cuspid teeth as a model to investigate factors involved in regenerative endodontics. Six young male ferrets between the ages of 36-133 days were used in this investigation. Each animal was anesthetized and perfused with 10% buffered formalin. Block sections including the mandibular and maxillary cuspid teeth and their surrounding periapical tissues were obtained, radiographed, decalcified, sectioned, and stained with hematoxylin-eosin to determine various stages of apical closure in these teeth. The permanent mandibular and maxillary cuspid teeth with open apices erupted approximately 50 days after birth. Initial signs of closure of the apical foramen in these teeth were observed between 90-110 days. Complete apical closure was observed in the cuspid teeth when the animals were 133 days old. Based on the experiment, ferret cuspid teeth can be used to investigate various factors involved in regenerative endodontics that cannot be tested in human subjects. The most appropriate time to conduct the experiments would be when the ferrets are between the ages of 50 and 90 days. Copyright © 2011. Published by Elsevier Inc.

Radiographic endodontic working length estimation: comparison of three digital image receptors.

PubMed

Athar, Anas; Angelopoulos, Christos; Katz, Jerald O; Williams, Karen B; Spencer, Paulette

2008-10-01

This in vitro study was conducted to evaluate the accuracy of the Schick wireless image receptor compared with 2 other types of digital image receptors for measuring the radiographic landmarks pertinent to endodontic treatment. Fourteen human cadaver mandibles with retained molars were selected. A fine endodontic file (#10) was introduced into the canal at random distances from the apex and at the apex of the tooth; images were made with 3 different #2-size image receptors: DenOptix storage phosphor plates, Gendex CCD sensor (wired), and Schick CDR sensor (wireless). Six raters viewed the images for identification of the radiographic apex of the tooth and the tip of a fine (#10) endodontic file. Inter-rater reliability was also assessed. Repeated-measures analysis of variance revealed a significant main effect for the type of image receptor. Raters' error in identifying structures of interest was significantly higher for Denoptix storage phosphor plates, whereas the least error was noted with the Schick CDR sensor. A significant interaction effect was observed for rater and type of image receptor used, but this effect contributed only 6% (P < .01; eta(2) = 0.06) toward the outcome of the results. Schick CDR wireless sensor may be preferable to other solid-state sensors, because there is no cable connecting the sensor to the computer. Further testing of this sensor for other diagnostic tasks is recommended, as well as evaluation of patient acceptance.

Bacterial examination of endodontic infections by clonal analysis in concert with denaturing high-performance liquid chromatography.

PubMed

Jacinto, R C; Gomes, B P F A; Desai, M; Rajendram, D; Shah, H N

2007-12-01

The aim of this study was to examine the diversity of bacterial species in the infected root canals of teeth associated with endodontic abscesses by cloning and sequencing techniques in concert with denaturing high-performance liquid chromatography. Samples collected from five infected root canals were subjected to polymerase chain reaction (PCR) with universal 16S ribosomal DNA primers. Products of these PCRs were cloned and sequenced. Denaturing high-performance liquid chromatography (DHPLC) was used as a screening method to reduce the number of clones necessary for DNA sequencing. All samples were positive for the presence of bacteria and a range of 7-13 different bacteria were found per root canal sample. In total, 48 different oral clones were detected among the five root canal samples. Olsenella profusa was the only species present in all samples. Porphyromonas gingivalis, Dialister pneumosintes, Dialister invisus, Lachnospiraceae oral clone, Staphylococcus aureus, Pseudoramibacter alactolyticus, Peptostreptococcus micros and Enterococcus faecalis were found in two of the five samples. The majority of the taxa were present in only one sample, for example Tannerella forsythia, Shuttleworthia satelles and Filifactor alocis. Some facultative anaerobes that are frequently isolated from endodontic infections such as E. faecalis, Streptococcus anginosus and Lactobacillus spp. were also found in this study. Clonal analysis of the microflora associated with endodontic infections revealed a wide diversity of oral species.

Immediate implants placed into infected sockets: a case report with 3-year follow-up.

PubMed

Naves, Marina de Melo; Horbylon, Bruna Zacharias; Gomes, Camila de Freitas; Menezes, Helder Henrique Machado de; Bataglion, César; Magalhães, Denildo de

2009-01-01

The esthetics and functional integrity of the periodontal tissue may be compromised by dental loss. Immediate implants became a viable option to maintain the periodontal architecture because of their anatomic compatibility with the dental socket and the possibility of eliminating local contamination. This article describes the procedure of immediate implant placement in the anterior maxilla replacing teeth with chronic periapical lesions, which were condemned due to endodontic lesions persisting after failed endodontic treatment and endodontic surgery, and discusses the relationship between the procedure and periapical lesions. Surgical removal of hopeless teeth 11, 12 and 21 was performed conservatively in such a way to preserve the anatomy and gingival esthetics. A second surgical access was gained at the apical level, allowing the debridement of the surgical chamber for elimination of the periapical lesion, visual orientation for setting of the implants and filling of the surgical chamber with xenogenous bovine bone graft. After this procedure, the bone chamber was covered with an absorbent membrane and the healing screws were positioned on the implants. Later, a provisional partial removable denture was installed and the implants were inserted after 6 months. After 3 years of rehabilitation, the implants present satisfactory functional and esthetic conditions, suggesting that immediate implant placement combined with guided bone regeneration may be indicated for replacing teeth lost due to chronic periapical lesions with endodontic failure history in the anterior maxilla.

Comparative analysis of torsional and bending behavior through finite-element models of 5 Ni-Ti endodontic instruments.

PubMed

Arbab-Chirani, Reza; Chevalier, Valérie; Arbab-Chirani, Shabnam; Calloch, Sylvain

2011-01-01

The objectives of this study were to compare numerically the bending and torsional mechanical behavior of 5 endodontic rotary Ni-Ti instruments with equivalent size and various designs for tapers, pitch, and cutting blades.First, the geometries of Hero (20/0.06), HeroShaper (20/0.06), ProFile (20/0.06), Mtwo (20/0.06), and ProTaper F1 were generated by finite element code. Then, the 2 most representative clinical loadings, i.e., bending and torsion, were studied with an ad hoc model for the superelasticity of Ni-Ti. Bending was generated by tip deflection and torsion by a constant twist-angle of the tip. Mechanical behavior of these 5 endodontic rotary Ni-Ti instruments could be evaluated and compared. Protaper F1 presented the greatest level of bending stress and torque. Hero and HeroShaper were more rigid than ProFile and Mtwo. This numerical comparison evaluated the effects of the geometrical parameters on the instrumental mechanical behavior. The 5 endodontic instruments, investigated in the present study, do not have the same bending and torsional mechanical behavior. Each clinician must be aware of these behavior differences so as to use the adequate file according to the clinical situation and to the manufacturer's recommendations. Copyright © 2011 Mosby, Inc. All rights reserved.

Comparison of the incidence of postoperative pain after using a continuous rotary system, a reciprocating system, and a Self-Adjusting File system in single-visit endodontics: A prospective randomized clinical trial.

PubMed

Saha, Suparna Ganguly; Gupta, Rudra Kumar; Bhardwaj, Anuj; Misuriya, Abhinav; Saha, Mainak Kanti; Nirwan, Amit Singh

2018-01-01

The aim of this study is to compare the incidence of postoperative pain using the ProTaper Next (PTN), WaveOne Gold (WOG), and Self-Adjusting File (SAF) systems. Two hundred and fourteen patients with irreversible pulpitis were selected for single-visit endodontics. The teeth were blindly assigned to three groups based on the instrumentation system used: Group A (PTN), Group B (WOG), and Group C (SAF). Participants were asked to note the incidence of the pre- and postoperative pain on a visual analog scale at different time intervals. Paired t -test and one-way ANOVA were used along with post hoc Tukey's test. The greatest mean pain in Group A (PTN) and Group B (WOG) was found to be maximum in the first 24 h with a significant reduction in pain at the subsequent observation time points of 48 h, 72 h, and 7 days. Group C (SAF) showed minimum pain followed by Group B followed by Group A which showed comparatively higher pain scores even at the end of 7 days. In single-visit endodontics, SAF system may prove to be a better system compared with PTN and WOG as it produces minimal postoperative pain, thus improving the overall acceptance of endodontic treatment.