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Sample records for multi-visit endodontic treatment

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

    Jabeen, S; Khurshiduzzaman, M

    2014-04-01

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

  3. Implant treatment planning: endodontic considerations.

    PubMed

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

    2014-12-01

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

  4. 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

  5. Treatment of endodontic urgent care cases.

    PubMed

    Antrim, D D; Bakland, L K; Parker, M W

    1986-07-01

    This article describes treatment for urgent care cases involving the dental pulp and periradicular tissues: acute pain of pulpal or periradicular origin, acute pain from endodontic procedures, and management of traumatically injured teeth.

  6. Periostitis ossificans managed with endodontic treatment.

    PubMed

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

    2015-01-01

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

  7. Nonsurgical re-treatment of endodontic failures.

    PubMed

    Weine, F S

    1995-03-01

    Endodontic treatment has a very high percentage of success. When failures did occur, many were re-treated with surgery, although nonsurgical re-treatment often was an option. Recently, improvements in instruments for use in endodontic surgery have increased the ability to perform such re-treatments. Even so, this author believes that nonsurgical re-treatment is preferable to surgical intervention whenever possible because of the greater comfort to the patient and the increased indication of failure for amalgam reverse fillings. Advice for recall appointments and evaluations and the correct procedures for re-treating common failures without surgery are presented. These include failures caused by short or incomplete canal fillings, overextended canal fillings, untreated major canals, and chronically draining teeth.

  8. Assessment of treatment failure in endodontic therapy.

    PubMed

    Bergenholtz, G

    2016-10-01

    There is a paucity of guidelines for the dental profession to assess failure of endodontic therapy. While a successful treatment can be well defined by the absence of apical periodontitis and clinical symptoms after a period of observation, failed treatment has escaped a distinct standing over the years. This article highlights aspects of significance and concludes that research ought to better explore the general health properties of persistent apical periodontitis on root-filled teeth and finally confirm the extent there is an association between apical periodontitis and adverse systemic health effects. Clearing this condition will determine whether clinicians should take a serious or relaxed attitude to persistent apical periodontitis subsequent to endodontic treatment. PMID:27519460

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

    PubMed

    Love, Robert M

    2012-04-01

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

  10. Mandibular nerve paresthesia caused by endodontic treatment.

    PubMed

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

    2003-01-01

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

  11. Treatment selection for anterior endodontically involved teeth.

    PubMed

    Rifkin, Robert; McLaren, Ed

    2004-09-01

    Innovations in material science and clinical techniques have expanded the number of treatment options available for nonvital anterior teeth. These options include the use of composite to fill the access opening with no additional treatment, crown placement, orthodontic extrusion, crown lengthening with or without orthodontic extrusion, dowel restorations with crown placement, and fixed bridge or implant therapy when extraction is necessary. Clinicians need to understand the benefits and limitations of each option in order to provide their patients with optimum function and aesthetics. Using case presentations, this article describes predictable approaches for the diagnosis, treatment planning, and restoration or replacement of endodontically treated teeth in the anterior region.

  12. [Single file endodontic treatment: a new era?].

    PubMed

    Shay, B; Moshonov, J

    2013-04-01

    Root canal shaping is one of the key stages of endodontic treatment, when performed properly, it is a predictive factor for the outcome of the treatment. It is critical for an adequate disinfection, which is more effective at the completion of a proper shaping procedure. The introduction of NiTi instruments into endodontic greatly improved the root canal shaping and decreased the time required for a full mechanical preparation. Over the last 2 decades, numerous attempts have been made to further improve the procedure with a wide range of rotary NiTi endodontic file systems. All these systems require several subsequent files. Recently, three different concepts of single-file systems have been introduced: 1. The single file reciprocating working motion: it consists of a reciprocating counterclockwise and a clockwise motion. This reciprocal motion reduces torsional loads thus, allows safer instrumentation with less working time. 2. Single-file instrumentation using full 360 degrees rotational movement to be used in a full clockwise rotation. Some of these files also have an Anti Breakage Control (ABC) which protects from catastrophic procedural malfunction by unwinding of these file before breakage. 3. The Self-Adjusting File (SAF) which is a thin-walled, pointed cylinder, hollow nickel-titanium endodontic file that is elastically compressible into a root canal that has been previously negotiated using a #20 hand file and can widened inside it, facilitating removal of debris and dentin from the canal wall. The file conforms to the canal shape and permits irrigant flow through the file. The SAF works in a combined vibrating and partial rotational motions, and circumferentially simultaneously enlarging and irrigating the canal. The objectives of these new approaches is to reduce the working time and cost and improve safety of the shaping procedure, and suggest to have a lower procedural errors incidents. Few studies, conducted in the recent years, using these new

  13. [Single file endodontic treatment: a new era?].

    PubMed

    Shay, B; Moshonov, J

    2013-04-01

    Root canal shaping is one of the key stages of endodontic treatment, when performed properly, it is a predictive factor for the outcome of the treatment. It is critical for an adequate disinfection, which is more effective at the completion of a proper shaping procedure. The introduction of NiTi instruments into endodontic greatly improved the root canal shaping and decreased the time required for a full mechanical preparation. Over the last 2 decades, numerous attempts have been made to further improve the procedure with a wide range of rotary NiTi endodontic file systems. All these systems require several subsequent files. Recently, three different concepts of single-file systems have been introduced: 1. The single file reciprocating working motion: it consists of a reciprocating counterclockwise and a clockwise motion. This reciprocal motion reduces torsional loads thus, allows safer instrumentation with less working time. 2. Single-file instrumentation using full 360 degrees rotational movement to be used in a full clockwise rotation. Some of these files also have an Anti Breakage Control (ABC) which protects from catastrophic procedural malfunction by unwinding of these file before breakage. 3. The Self-Adjusting File (SAF) which is a thin-walled, pointed cylinder, hollow nickel-titanium endodontic file that is elastically compressible into a root canal that has been previously negotiated using a #20 hand file and can widened inside it, facilitating removal of debris and dentin from the canal wall. The file conforms to the canal shape and permits irrigant flow through the file. The SAF works in a combined vibrating and partial rotational motions, and circumferentially simultaneously enlarging and irrigating the canal. The objectives of these new approaches is to reduce the working time and cost and improve safety of the shaping procedure, and suggest to have a lower procedural errors incidents. Few studies, conducted in the recent years, using these new

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

    PubMed

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

    2015-01-01

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

  15. A review of the regenerative endodontic treatment procedure.

    PubMed

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

    2015-08-01

    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.

  16. 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

  17. Radiographic study of the problems and failures of endodontic treatment

    PubMed Central

    Akbar, Iftikhar

    2015-01-01

    Objectives The aim of the present study was to determine radiographically the different reasons and problems of endodontic treatment failure. Methods The periapical radiographs of 100 patients with one hundred teeth (130 root canals) were examined to identify the problems and failures of endodontic treatment. The various reasons of failure that is under filling, poor filling, over filling and presence of procedural errors were recorded for each root filled canal. Chi square test was used to determine statistical significance between different parameters. Results Under fillings were found in 46.9% of the root canals. The percentage of poor fillings and over fillings were 28.5% and 13% respectively. Separated instruments and strip perforations were present in 4% and 3% of the teeth, while the presence of furcal perforation and coronal leakage was observed in one case each (1%).Endodontic problems and failures were most commonly observed in molars compare to anterior and premolar teeth. Mesiobuccal, mesiolingual and distobuccal root canals were the most frequently canals with endodontic problems and failures. The relationship between mesiobuccal, mesiolingual and distal canals in mandibular molars and mesiobuccal, distobuccal and palatal canals in maxillary molars in terms of endodontic failures were statistically significant by chi square analysis (P≤0.05). Conclusion The most common cause of endodontic treatment failure was under filling followed by poor filling and over filling and first molar was the most frequently involved tooth with endodontic problems and failures. PMID:26309429

  18. 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

  19. Endodontic treatment of a taurodontic premolar with five canals.

    PubMed

    Demiryürek, Ebru Özsezer; Gönülol, Nihan; Bulucu, Bilinç

    2013-08-01

    Taurodontism is a morpho-anatomical abnormality in the shape of a tooth. An enlarged pulp chamber, apical displacement of the pulpal floor and no constriction at the level of the cemento-enamel junction are the characteristic features. Special care is required in all aspects of endodontic treatment of a taurodontal tooth, including identifying the orifice, canal exploration, cleaning, shaping and obturation of the root canal. This case report describes the successful endodontic treatment of a taurodontic mandibular second premolar with five root canals. PMID:23890265

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

    PubMed

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

    2016-05-01

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

  1. Progression of periapical cystic lesion after incomplete endodontic treatment

    PubMed Central

    Yang, Dong-Kyu; Jeon, Kug-Jin

    2016-01-01

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

  2. Retrospective evaluation of surgical endodontic treatment: traditional versus modern technique.

    PubMed

    Tsesis, Igor; Rosen, Eyal; Schwartz-Arad, Devorah; Fuss, Zvi

    2006-05-01

    The aim of this retrospective study was to compare the outcome of surgical endodontic treatment preformed using the traditional versus modern techniques. There were 110 patients who were treated by surgical endodontic treatment between 2000 and 2002 and evaluated from their dental charts. The surgical endodontic treatment was preformed using a traditional or modern technique. The traditional technique included root-end resection with a 45 degrees bevel angle, and retrograde preparation using a carbide round bur. The modern technique included root-end resection with minimal or no bevel, and retrograde preparation using ultrasonic retro-tips with the aid of a dental operating microscope. The retrograde filling material for both techniques was intermediate restorative material. There were 71 patients with 88 treated teeth that were compatible with the inclusion criteria. Complete healing rate for the teeth treated with the modern technique (91.1%) was significantly higher than that for teeth treated using the traditional technique (44.2%) (p < 0.0001). In the traditional technique a significant (p = 0.032) negative influence of the tooth type was found. Modern surgical endodontic treatment using operative microscope and ultrasonic tips significantly improves the outcome of the therapy compared to the traditional technique.

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

    Wong, Amy Wy; Zhang, Chengfei; Chu, Chun-Hung

    2014-01-01

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

  5. Endodontic treatment of a large periradicular lesion: a case report.

    PubMed

    Asgary, Saeed; Ehsani, Sara

    2008-01-01

    This case report describes the endodontic treatment of a large cyst-like periradicular lesion a 29-year-old female with a large chronic periapical abscess in the region of right maxillary sinus presented into private practice, accompanied with non-vital first upper molar and poorly root treated second upper molar. Conservative root canal treatment was carried out for both of the involved teeth in a single appointment. Post operative examination after two weeks revealed complete resolution of the sinus tract. The clinical and radiographic examination after 9 months revealed complete periapical healing. The appropriate diagnosis of periradicular lesion and the treatment of the infected root canal system allowed complete healing of these large lesions without endodontic surgery. PMID:24082906

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

    PubMed

    Schipper, M; Peters, L B

    2015-12-01

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

  7. [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.

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

    PubMed

    Zabalegui, B

    1990-01-01

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

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

    PubMed

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

    2015-12-01

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

  10. 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

  11. 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

  12. Laser scanning dental probe for endodontic root canal treatment

    NASA Astrophysics Data System (ADS)

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

    2011-03-01

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

  13. 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

  14. Regenerative endodontic treatment for necrotic immature permanent teeth.

    PubMed

    Chueh, Ling-Huey; Ho, Yi-Ching; Kuo, Tien-Chun; Lai, Wing-Hong; Chen, Yea-Huey Melody; Chiang, Chun-Pin

    2009-02-01

    This retrospective study included 23 necrotic immature permanent teeth treated for either short-term (treatment period <3 months) or long-term (treatment period >3 months) using conservative endodontic procedures with 2.5% NaOCl irrigations without instrumentation but with Ca(OH)(2) paste medication. For seven teeth treated short-term, the gutta-percha points were filled onto an artificial barrier of mineral trioxide aggregate (MTA). For 16 teeth treated long-term, the gutta-percha points, amalgam, or MTA were filled onto the Ca(OH)(2)-induced hard tissue barrier in the root canal. We found that all apical lesions showed complete regression in 3 to 21 (mean, 8) months after initial treatment. All necrotic immature permanent teeth achieved a nearly normal root development 10 to 29 (mean, 16) months after initial treatment. We conclude that immature permanent teeth with pulp necrosis and apical pathosis can still achieve continued root development after proper short-term or long-term regenerative endodontic treatment procedures. PMID:19166764

  15. Endodontic treatment of infected primary teeth, using Maisto's paste.

    PubMed

    Mass, E; Zilberman, U L

    1989-01-01

    A method of endodontic treatment, using a modification of Maisto's paste, is suggested for preservation of infected primary teeth. Adding more zinc-oxide reagent and other anti-bacterial materials to the original Walkhoff's paste (Kri 1), for pulp canal medication and final filling, seems to improve the pharmacological effect of the paste by reducing the resorption rate. The literature is reviewed and a case with a follow-up time of three and a half years is described, in which the tooth remained stable. PMID:2656788

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

    PubMed

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

    2016-07-28

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

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

    PubMed Central

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

    2016-01-01

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

  18. Endodontic treatment in the primary dentition.

    PubMed

    Koshy, Sajeev; Love, Robert M

    2004-08-01

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

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

    PubMed

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

    1989-01-01

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

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

    PubMed

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

    1989-01-01

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

  1. 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

  2. 3D root canal modeling for advanced endodontic treatment

    NASA Astrophysics Data System (ADS)

    Hong, Shane Y.; Dong, Janet

    2002-06-01

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

  3. Treatment Options: Biological Basis of Regenerative Endodontic Procedures

    PubMed Central

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

    2013-01-01

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

  4. 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.

  5. 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.

  6. Synergistic Antimicrobial Action of Chlorhexidine and Ozone in Endodontic Treatment

    PubMed Central

    Pina-Vaz, Cidália; Rocha, Rita; Carvalho, Manuel Fontes; Gonçalves, Acácio

    2014-01-01

    Objectives. The aim of this study was to determine whether irrigation with sodium hypochlorite, chlorhexidine, and ozone gas, alone or in combination, were effective against Enterococcus faecalis and Candida albicans; these are microorganisms frequently isolated from teeth with periapical lesions resistant to endodontic treatment. Material and Methods. 220 single root teeth, recently extracted, were inoculated with Candida albicans and Enterococcus faecalis. The formulations tested were sodium hypochlorite at 1, 3, and 5% chlorhexidine at 0.2% and 2% and ozone gas applied for different periods of time. The combination of sodium hypochlorite at 5% and chlorhexidine at 2%, with gaseous ozone, were also assessed. For the most active treatments the mechanism of action was assessed through flow cytometry. Results. Sodium hypochlorite, chlorhexidine, and gaseous ozone alone were ineffective in completely eliminating the microorganisms. The association of chlorhexidine at 2% followed by ozone gas for 24 seconds promoted the complete elimination of Candida albicans and Enterococcus faecalis. Flow cytometry shows that ozone and chlorhexidine act differently, which could explain its synergic activity. Conclusions. This new disinfection protocol, combining irrigation with chlorhexidine at 2% and ozone gas for 24 seconds, may be advantageous when treating infected root canals. PMID:24982899

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

    PubMed Central

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

    2005-01-01

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

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

    PubMed

    Hou, B X

    2016-08-01

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

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

    PubMed

    Hou, B X

    2016-08-01

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

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

    PubMed

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

    2016-01-01

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

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

    PubMed

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

    2016-01-01

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

  12. Delayed Replantation after Endodontic and Fluoride Treatment: A 5-Year Follow-up

    PubMed Central

    Thomas, Abi Mathew; Akkara, Francis; Fernandes, Kristlee Sabrin

    2011-01-01

    Aim To evaluate if endodontic and fluoride treatment of the root before delayed replantation would render the tooth a favorable prognosis. Methods A 10-year-old boy reported 10 hours after he had avulsed his maxillary right permanent central incisor. The pulp and PDL cells were considered to be nonviable. Endodontic treatment for the tooth was performed extraorally and obturated with gutta-percha. Prior to replantation, the root was treated with 1.23% APSF for 15 minutes. Result An intraoral radiograph taken 6 months after replantation revealed narrowing of the PDL space around the replanted tooth due to apposition from the surrounding alveolar bone. A radiograph taken 5 years after replantation revealed no evidence of external root resorption. There was no abnormal mobility either. Conclusion Extraoral endodontic treatment and root treatment with 1.23% APSF prior to delayed replantation might prevent the occurrence of external root resorption.

  13. 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

  14. 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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2007-01-01

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

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

    PubMed

    de Lange, J

    2016-02-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2012-04-01

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

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

    PubMed

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

    2012-04-01

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

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

    PubMed Central

    Khoshkhounejad, Mehrfam; Shokouhinejad, Noushin

    2015-01-01

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

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

    PubMed

    Khoshkhounejad, Mehrfam; Shokouhinejad, Noushin; Pirmoazen, Salma

    2015-06-01

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

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

    PubMed

    Khoshkhounejad, Mehrfam; Shokouhinejad, Noushin; Pirmoazen, Salma

    2015-06-01

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

  3. Penetrability of AH plus and MTA fillapex after endodontic treatment and retreatment: a confocal laser scanning microscopy study.

    PubMed

    Kok, Daniela; Rosa, Ricardo Abreu da; Barreto, Mirela Sangoi; Busanello, Fernanda Hoffmann; Santini, Manuela Favarin; Pereira, Jefferson Ricardo; Só, Marcus Vinícius Reis

    2014-06-01

    The aim of the study was to assess the penetrability of two endodontic sealers (AH Plus and MTA Fillapex) into dentinal tubules, submitted to endodontic treatment and subsequently to endodontic retreatment. Thirty ex vivo incisors were prepared using ProTaper rotary system up to F3 instrument and divided in three groups according to the endodontic sealer used for root canal filling: AH Plus (AHP), MTA Fillapex (MTAF), and control group (CG) without using EDTA previously to the root canal filling. Rhodamine B dye (red) was incorporated to the sealers in order to provide the fluorescence which will enable confocal laser scanning microscopy (CLSM) assessment. All specimens were filled with gutta-percha cones using the lateral compaction technique. The specimens were submitted to endodontic retreatment using ProTaper Retreatment system, re-prepared up to F5 instruments and filled with gutta-percha cones and the same sealer used during endodontic retreatment. Fluorescein dye (green) was incorporated to the sealer in order to distinguish from the first filling. The roots were sectioned 2 mm from the apex and assessed by CLSM. No difference was found between the two experimental groups (P > 0.05). On the other hand, in the control group the sealers were not capable to penetrate into dentinal tubules after endodontic treatment (P > 0.05). In retreatment cases, none of the sealers were able to penetrate into dentin tubules. It can be concluded that sealer penetrability is high during endodontic treatment. However, MTA Fillapex and AH Plus do not penetrate into dentinal tubules after endodontic retreatment.

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2016-01-01

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

  6. Single versus multiple visits for endodontic treatment of permanent teeth: a Cochrane systematic review.

    PubMed

    Figini, Lara; Lodi, Giovanni; Gorni, Fabio; Gagliani, Massimo

    2008-09-01

    The Cochrane Collaboration promotes evidence-based healthcare decision making globally through systematic reviews of the effects of healthcare intervention. The purpose of this systematic review was to investigate whether the effectiveness and frequency of short-term and long-term complications are different when endodontic procedure is completed in one or multiple visits. Randomized and quasi-randomized controlled trials enrolling patients undergoing endodontic treatment were identified by searching biomedical databases and hand-searching relevant journals. The following outcomes were considered: tooth extraction as a result of endodontic problems and radiologic failure after 1 year, postoperative discomfort, swelling, analgesic use, or sinus track. Twelve studies were included in the review. No detectable difference was found in the effectiveness of root canal treatment in terms of radiologic success between single and multiple visits. Neither single-visit root canal treatment nor multiple-visit root canal treatment can prevent 100% of short-term and long-term complications. Patients undergoing a single visit might experience a slightly higher frequency of swelling and refer significantly more analgesic use. PMID:18718362

  7. Validity of self-reported history of endodontic treatment in the Baltimore Longitudinal Study of Aging

    PubMed Central

    Gomes, Maximiliano Schünke; Hugo, Fernando Neves; Hilgert, Juliana Balbinot; Padilha, Dalva Maria Pereira; Simonsick, Eleanor Marie; Ferrucci, Luigi; Reynolds, Mark Allan

    2012-01-01

    Introduction Self-reported history of endodontic treatment (SRHET) has been used as a simplified method to estimate history of endodontic disease and treatment. This study aimed to quantify the validity of SRHET, as reported in the Baltimore Longitudinal Study of Aging (BLSA), as a method to: 1- identify individuals who experienced endodontic treatment (ET); and 2- identify individuals who present with apical periodontitis (AP). Methods SRHET was collected through the BLSA questionnaire in 247 participants. Data on ET and AP were determined from panoramic radiographs. The total number of ET, AP and missing teeth were recorded for each individual. Validity of SRHET was determined based on ET and AP, separately. Accuracy, efficiency, sensitivity, specificity, positive and negative predictive values (+PV, −PV) and positive and negative likelihood ratios (+LR, −LR) were calculated according to standard methods. Results After exclusions, 229 participants were available for ET analysis and 129 for AP analysis. The SRHET validity values were: sensitivity (ET=0.915; AP=0.782), specificity (ET=0.891; AP=0.689), +PV (ET=0.824; AP=0.353), −PV (ET=0.949; AP=0.936), +LR (ET=8.394; AP=2.514) and −LR (ET=0.095; AP=0.316). Conclusions SRHET was found to be a highly accurate method to predict ET but a weak predictor of the presence of AP among participants in the BLSA. PMID:22515884

  8. Surgical treatment of cementoblastoma associated with apicoectomy and endodontic therapy: Case report

    PubMed Central

    Costa, Bernardo Cesar; de Oliveira, Guilherme José Pimentel Lopes; Chaves, Maria das Graças Afonso Miranda; da Costa, Renan Roberto; Gabrielli, Mário Francisco Real; Guerreiro-Tanomaru, Juliane Maria; Tanomaru-Filho, Mário

    2016-01-01

    This case report describes the surgical removal of cementoblastoma associated with apicoectomy and endodontic therapy. The patient, an 18-year-old man, presented pain in the region of the mandibular body on the right side. On clinical exam, bone expansion was observed in the region at the bottom of the vestibular sulcus, pain on palpation, slight extrusion of tooth 46 with presence of pulp vitality. Radiographic exams demonstrated the presence of a radiopaque area and discrete radiolucent halo associated with the root of tooth 46, suggesting the diagnosis of cementoblastoma. Endodontic treatment of tooth 46 was performed and exeresis of the lesion by apicoectomy. Twelve months after the first surgery, recurrence of the lesion was observed, and a new apicoectomy was necessary, this time up to the middle third of the root. Clinical radiographic control 12 mo after the second surgical intervention demonstrated absence of signs and symptoms, radiographic repair, with tooth 46 shown to be fully functional.

  9. Surgical treatment of cementoblastoma associated with apicoectomy and endodontic therapy: Case report.

    PubMed

    Costa, Bernardo Cesar; de Oliveira, Guilherme José Pimentel Lopes; Chaves, Maria das Graças Afonso Miranda; da Costa, Renan Roberto; Gabrielli, Mário Francisco Real; Guerreiro-Tanomaru, Juliane Maria; Tanomaru-Filho, Mário

    2016-09-16

    This case report describes the surgical removal of cementoblastoma associated with apicoectomy and endodontic therapy. The patient, an 18-year-old man, presented pain in the region of the mandibular body on the right side. On clinical exam, bone expansion was observed in the region at the bottom of the vestibular sulcus, pain on palpation, slight extrusion of tooth 46 with presence of pulp vitality. Radiographic exams demonstrated the presence of a radiopaque area and discrete radiolucent halo associated with the root of tooth 46, suggesting the diagnosis of cementoblastoma. Endodontic treatment of tooth 46 was performed and exeresis of the lesion by apicoectomy. Twelve months after the first surgery, recurrence of the lesion was observed, and a new apicoectomy was necessary, this time up to the middle third of the root. Clinical radiographic control 12 mo after the second surgical intervention demonstrated absence of signs and symptoms, radiographic repair, with tooth 46 shown to be fully functional. PMID:27672646

  10. Surgical treatment of cementoblastoma associated with apicoectomy and endodontic therapy: Case report

    PubMed Central

    Costa, Bernardo Cesar; de Oliveira, Guilherme José Pimentel Lopes; Chaves, Maria das Graças Afonso Miranda; da Costa, Renan Roberto; Gabrielli, Mário Francisco Real; Guerreiro-Tanomaru, Juliane Maria; Tanomaru-Filho, Mário

    2016-01-01

    This case report describes the surgical removal of cementoblastoma associated with apicoectomy and endodontic therapy. The patient, an 18-year-old man, presented pain in the region of the mandibular body on the right side. On clinical exam, bone expansion was observed in the region at the bottom of the vestibular sulcus, pain on palpation, slight extrusion of tooth 46 with presence of pulp vitality. Radiographic exams demonstrated the presence of a radiopaque area and discrete radiolucent halo associated with the root of tooth 46, suggesting the diagnosis of cementoblastoma. Endodontic treatment of tooth 46 was performed and exeresis of the lesion by apicoectomy. Twelve months after the first surgery, recurrence of the lesion was observed, and a new apicoectomy was necessary, this time up to the middle third of the root. Clinical radiographic control 12 mo after the second surgical intervention demonstrated absence of signs and symptoms, radiographic repair, with tooth 46 shown to be fully functional. PMID:27672646

  11. 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

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

    PubMed Central

    Lim, Jae-Hyung; Lee, Ji-Hyun

    2014-01-01

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

  13. Effects of alpha-tocopherol on fracture resistance after endodontic treatment, bleaching and restoration.

    PubMed

    Jordão-Basso, Keren Cristina Fagundes; Kuga, Milton Carlos; Dantas, Andrea Abi Rached; Tonetto, Mateus Rodrigues; Lima, Suellen Nogueira Linhares; Bandéca, Matheus Coêlho

    2016-05-20

    This study evaluated the effects of 10% alphatocopherol on the fracture resistance of endodontically treated teeth subjected to tooth bleaching with hydrogen peroxide and immediately restored with composite resin. Fifty bovine incisors were selected, including 10 sound teeth that constituted the control group (G1 (C)). The remaining 40 teeth, which were endodontically treated, were divided into four groups (n = 10): G2 (CR), consisting of teeth immediately restored with composite resin; G3 (HP + CR), consisting of teeth subjected to tooth bleaching with 38% hydrogen peroxide and immediately restored with composite resin; G4 (HP + SA + CR), which received treatment similar to that used for G3, but with 10% sodium ascorbate gel applied after the bleaching protocol; and G5 (HP + AT + CR), which was similar to G4 but included 10% alphatocopherol gel as an antioxidant. After 24 h, composite restorations were performed, and teeth were subjected to a fracture resistance test at a speed of 0.5 mm/min in an electromechanical testing machine. The axial force was applied with an angle of incidence of 135° relative to the long axis of the root. Data were subjected to ANOVA and Tukey tests (p = 0.05). G1 exhibited the highest fracture resistance (p < 0.05). No significant differences among the other experimental groups were observed. The 10% sodium ascorbate and 10% alphatocopherol gels did not improve the fracture resistance of endodontically treated teeth subjected to bleaching with 38% hydrogen peroxide. PMID:27223140

  14. Regenerative Endodontic Treatment versus Apical Plug in Immature Teeth: Three-Year Follow-Up.

    PubMed

    Asgary, Saeed; Fazlyab, Mahta; Nosrat, Ali

    2016-01-01

    This report compares and evaluates the treatment outcomes of regenerative endodontic treatment and apical plug as two accepted treatment protocols in a pair of necrotic immature maxillary central incisors of a 12-year old female. The patient was referred complaining of a dull pain and swelling in her upper lip area. She had a history of trauma to the anterior maxilla two years earlier. Both teeth were clinically diagnosed with pulp necrosis and periapical radiographs revealed that separate periapical radiolucent lesions surrounded the immature apices of both teeth. The left and right incisors were treated with apical plug and regenerative endodontic treatment, respectively, using calcium-enriched mixture (CEM) cement. The patient was followed-up for three years. During this period, both teeth were clinically asymptomatic and showed complete radiographic healing of the periapical lesions. The right central incisor showed root development. No tooth discoloration was evident. Apexification by apical plug placement and pulp regeneration are both reliable treatments for immature non-vital teeth. In order to choose the right treatment the advantages of either technique should be weighed against its drawbacks. CEM cement can be successfully applied for both purposes. This biomaterial causes less discoloration of the tooth. PMID:27617375

  15. 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)

  16. En face optical coherence tomography investigation of apical microleakage after laser-assisted endodontic treatment.

    PubMed

    Todea, Carmen; Balabuc, Cosmin; Sinescu, Cosmin; Filip, Laura; Kerezsi, Cristina; Calniceanu, Mircea; Negrutiu, Meda; Bradu, Adrian; Hughes, Michael; Podoleanu, Adrian Gh

    2010-09-01

    The aim of our study was to evaluate the potential of en face optical coherence tomography (OCT) for the detection of apical microleakage after 980 nm and 1,064 nm laser-assisted endodontic treatment. Ninety, human, single-rooted teeth with one straight root canal and closed apices were used. All roots were prepared biomechanically to the working length at an apical size 30 and 0.06 taper. The teeth were divided into three equal groups of 30 samples each, according to the treatment to be applied to the root canal. Group I received 980 nm diode laser (3 W, 0.01 s on time, 0.01 s off time, 5 s per procedure, four procedures); group II received neodymium:yttrium-aluminum-garnet (Nd:YAG) laser (1.5 W, 15 Hz, 5 s per procedure, four procedures). In group III the root canals were approached conventionally only. In all groups the root canal filling was performed with AH Plus endodontic sealer and gutta-percha points. An en face OCT prototype was used for the investigation of apical microleakage. According to one-way analysis of variance (ANOVA) and en face OCT, the number of defects in the laser groups was significantly lower (P < 0.005) than in the control group. No statistical differences were noted between the laser groups (P = 0.049). En face OCT imaging proved that laser-assisted endodontic treatment improved the prognosis of root canal filling and led to a reduction in apical microleakage.

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

    PubMed Central

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

    2016-01-01

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

  18. Hemisection: A Treatment Option for an Endodontically treated Molar with Vertical Root Fracture.

    PubMed

    Anitha, S; Rao, Deepika S C

    2015-02-01

    Vertical root fractures (VRF) in endodontically treated teeth have long been reported and pose diagnostic difficulties. A hemisection/root resection procedures removes the fractured fragments completely, and retains a portion of the compromized tooth offers a predictable treatment option. The key to this rests in ideal case selection involving balancing all indications and contraindications. The success of the treatment depends on careful case selection based on a firm set of guidelines. This article presents a case with VRF in an endodontic treated molar. This article describes the case of a 65-year-old man with a VRF on the mesial root and a healthy periodontium supporting the distal root making it ideal for retention as well as restoration and support of the final prosthesis. Also, the patient was motivated to try and save as much of the tooth as possible. Postoperatively no untoward complication was reported making it an alternative treatment option in patients with VRF in a molar, willing to retain the remaining tooth portion. With all other factors balanced, it allows for retaining the remaining intact portion of the tooth structure. PMID:25906809

  19. Combined Endodontic Therapy and Intentional Replantation for the Treatment of Palatogingival Groove.

    PubMed

    Garrido, Iván; Abella, Francesc; Ordinola-Zapata, Ronald; Duran-Sindreu, Fernando; Roig, Miguel

    2016-02-01

    A palatogingival groove is an anatomic malformation that predisposes the involved tooth to a severe periodontal defect. When the condition is complicated by pulpal necrosis, affected teeth often present a dilemma in terms of diagnosis and treatment planning. In this report, we describe the case of a patient with a maxillary lateral incisor with a deep palatogingival groove extending to the root apex and severe periodontal destruction (local pocketing). Suggested treatment modalities included curettage of the affected tissues, elimination of the groove by grinding and/or sealing with a variety of filling materials, and surgical procedures. In this case, a combined treatment approach, involving both endodontic therapy and intentional replantation after restoration with a self-etching flowable composite, resulted in periodontal healing and significant healing of the periradicular radiolucency at 12 months. In short, intentional replantation offers a predictable procedure and should be considered a viable treatment modality for the management of palatogingival grooves, especially for single-rooted teeth.

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

    PubMed

    Meireles, Daniely Amorin; Bastos, Mariana Mena Barreto; Marques, André Augusto Franco; Garcia, Lucas da Fonseca Roberti; Sponchiado, Emílio Carlos

    2013-08-01

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

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

    PubMed Central

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

    2013-01-01

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

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

    PubMed

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

    2014-01-01

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

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

    NASA Astrophysics Data System (ADS)

    Moshari, Amirabbas; Vatanpour, Mehdi; Zakershahrak, Mehrsa

    2016-03-01

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

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

    PubMed Central

    2016-01-01

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

  5. From files to SAF: 3D endodontic treatment is possible at last.

    PubMed

    Metzger, Zvi

    2011-01-01

    3D cleaning, shaping and obturation of root canals has always been the desired goal of endodontic treatment which in many cases is difficult to attain. The introduction of NiTi rotary files made a major change in endodontic practice, making treatment easier, safer and faster. Nevertheless, after 16 years of intensive development, most of these instruments still share several drawbacks, the major one being the inability to three-dimensionally clean and shape oval root canals. The Self-Adjusting File (SAF) System was designed to overcome many of the current drawbacks of rotary file systems. It is based on a hollow, highly compressible file that adapts itself three-dimensionally to the shape of a given root canal, including its cross section. The file is operated with vibratory in-and-out motion, with continuous irrigation delivered by a peristaltic pump through the hollow file. A uniform layer of dentin is removed from the whole circumference of the root canal, thus achieving the main goals of root canal treatment while preserving the remaining root dentin. The 3D scrubbing effect of the file, combined with the always fresh irrigant, result in unprecedentedly clean canals which facilitate in turn better obturation. More effective disinfection of flat-oval root canals is another goal which is simultaneously attained. The safety of the root-canal treatment is also greatly enhanced by the high mechanical stability of the SAF and by using a new concept of no-pressure irrigation. The SAF System gets the operator much closer to the long-desired goal of 3D root-canal treatment.

  6. Nonsurgical endodontic treatments in molar teeth with large periapical lesions in children: 2-year follow-up.

    PubMed

    Kusgoz, Adem; Yildirim, Sibel; Gokalp, Alparslan

    2007-07-01

    Profound caries lesions may lead to invasion of microorganisms to the dental pulp, and periapical areas can promote the development of dentoalveolar abscess and periapical bone loss. Treatment options to manage large periapical lesions range from nonsurgical root canal treatment and/or apical surgical procedure to extraction. Young molar teeth with pulp necrosis and large periapical lesions in children are frequently treated with root canal treatment because the therapy is more difficult in multirooted teeth. In these case reports, nonsurgical endodontic treatments performed on 6 molar teeth with large periapical lesions, by repeated intracanal dressing with calcium hydroxide, are presented. Radiographs displayed significant bony healing at the end of the second year. In conclusion, large periapical lesions can respond favorably to nonsurgical treatment, and complex and difficult endodontic treatments in children might not be required.

  7. Nonsurgical endodontic treatment of a maxillary lateral incisor with dens invaginatus type II: A case report

    PubMed Central

    Shadmehr, Elham; Kiaani, Sima; Mahdavian, Parinaz

    2015-01-01

    Dens invaginatus is a rare developmental anomaly of teeth with complex root canal system morphology. The present case describes a peg shape maxillary lateral incisor with dens invaginatus (Oehlers type II), necrotic pulp, and an associated large periradicular lesion. Nonsurgical endodontic treatment was performed with the aim of removing the blind sac with diamond bur under the use of operating surgical microscope. The root canal system was obturated with thermoplastic technique. Final restoration was done using composite. The 20-months clinical and radiological follow up revealed an asymptomatic tooth with healing of the periapical pathology; however, for complete healed periradicular lesion more follow up is needed. This case illustrated that a dens invaginatus malformed teeth with a large periradicular lesion can be managed successfully with nonsurgical root canal therapy (NSRCT). PMID:25878686

  8. Digital video image processing from dental operating microscope in endodontic treatment.

    PubMed

    Suehara, Masataka; Nakagawa, Kan-Ichi; Aida, Natsuko; Ushikubo, Toshihiro; Morinaga, Kazuki

    2012-01-01

    Recently, optical microscopes have been used in endodontic treatment, as they offer advantages in terms of magnification, illumination, and documentation. Documentation is particularly important in presenting images to patients, and can take the form of both still images and motion video. Although high-quality still images can be obtained using a 35-mm film or CCD camera, the quality of still images produced by a video camera is significantly lower. The purpose of this study was to determine the potential of RegiStax in obtaining high-quality still images from a continuous video stream from an optical microscope. Video was captured continuously and sections with the highest luminosity chosen for frame alignment and stacking using the RegiStax program. The resulting stacked images were subjected to wavelet transformation. The results indicate that high-quality images with a large depth of field could be obtained using this method.

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

    NASA Astrophysics Data System (ADS)

    Gregg, Robert H., II

    1992-06-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2011-03-01

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

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

    PubMed

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

    2016-02-01

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

  12. 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

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

    PubMed

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

    2016-06-01

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

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

    PubMed Central

    Panse, Amey Manohar; Gawali, Pritesh Namdeo

    2015-01-01

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

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

    PubMed

    Martins, Jorge N R

    2014-06-01

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

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

    PubMed Central

    2014-01-01

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

  17. Influence of calcium hydroxide on the post-treatment pain in Endodontics: A systematic review

    PubMed Central

    Anjaneyulu, K.; Nivedhitha, Malli Sureshbabu

    2014-01-01

    Introduction: Pain of endodontic origin has been a major concern to the patients and the clinicians for many years. Post-operative pain is associated with inflammation in the periradicular tissues caused by irritants egressing from root canal during treatment. It has been suggested that calcium hydroxide intra-canal medicament has pain-preventive properties because of its anti-microbial or tissue altering effects. Some dispute this and reasoned that calcium hydroxide may initiate or increase pain by inducing or increasing inflammation. Objective: To evaluate the effectiveness of calcium hydroxide in reducing the post-treatment pain when used as an intra-canal medicament Materials and Methods: The following databases were searched: PubMed CENTRAL (until July 2013), MEDLINE, and Cochrane Database of Systematic Reviews. Bibliographies of clinical studies and reviews identified in the electronic search were analyzed for studies published outside the electronically searched journals. The primary outcome measure was to evaluate the post-treatment pain reduction when calcium hydroxide is used as an intra-canal medicament in patients undergoing root canal therapy. Results: The reviews found some clinical evidence that calcium hydroxide is not very effective in reducing post-treatment pain when it is used alone, but its effectiveness can be increased when used in combination with other medicaments like chlorhexidine and camphorated monochlorophenol (CMCP). Conclusion: Even though calcium hydroxide is one of the most widely used intra-canal medicament due to its anti-microbial properties, there is no clear evidence of its effect on the post-treatment pain after the chemo-mechanical root canal preparation. PMID:24944439

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

    PubMed

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

    2013-01-01

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

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

    PubMed

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

    2013-01-01

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

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

    PubMed

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

    2013-05-01

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

  1. Endodontic Epidemiology

    PubMed Central

    Shahravan, Arash; Haghdoost, Ali Akbar

    2014-01-01

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

  2. Long-term survival rate of teeth receiving multidisciplinary endodontic, periodontal and prosthodontic treatments.

    PubMed

    Moghaddam, A S; Radafshar, G; Taramsari, M; Darabi, F

    2014-03-01

    Deciding whether to replace or preserve a compromised tooth, even with emerging trends in implant dentistry, is still a common dilemma for practitioners. This study sought to determine the 3- to more than 10-year survival rate of teeth that had undergone endodontic, periodontal and prosthodontic treatments. A total of 245 teeth in 87 patients were clinically and radiographically evaluated. All the teeth had received crown lengthening surgery by a single periodontist. Root canal therapy and prosthodontic procedures were rendered either by specialists or by experienced general dentists. Numbers of lost teeth were recorded and the criteria for hopeless teeth were defined. Survival rate was determined using the Kaplan-Meier estimator. Clinical indices including pocket depth (PD), bleeding index (BI), C/R ratio, position of the restoration margin relative to the gingival margin (RM-GM) and the presence of intra-canal post were compared between different survival groups (<3, 3-5, 5-10 and >10 years) using one-way analysis of variance (anova). Potential predictors of failure were determined using the Cox regression model. The mean ± s.d. of 3-, 5-, 10- and 13-year survival rates was 98 ± 1%, 96 ± 1·6%, 83·1 ± 4·5% and 51·9 ± 14·5%, respectively. The mean PD (P < 0·013), as well as C/R ratio in the mesial (P = 0·003) and distal (P = 0·007) surfaces, was significantly higher in the >10-year-survived teeth. Bleeding index and RM-GM showed no significant differences between the groups. C/R ratio and RM-GM position appeared to be the major determinants of tooth loss. The long-term survival rate of multidisciplinary-treated teeth was 83-98% in this specific sample.

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

    PubMed

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

    2013-01-01

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

  4. Treatment of combined endodontic-periodontic lesions by intentional replantation and application of hydroxyapatites.

    PubMed

    Yu, Liying; Xu, Beiyun; Wu, Bin

    2003-02-01

    A case of combined endodontic-periodontic lesions on a mandibular first molar was treated by intentional replantation and application of hydroxyapatites. Four months after the surgery, a porcelain-mental full crown restoration was completed. The 15-month follow-up examination showed that the tooth was clinically and radiographically healthy and functioned well.

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2010-12-01

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

  7. The Attitudes of Dentists Towards the Prescription of Antibiotics During Endodontic Treatment in North of Saudi Arabia

    PubMed Central

    2015-01-01

    Objective The use of antimicrobial agents has been increased, leading to bacterial resistance. Therefore the health professionals should have a sound knowledge about the prescription of antibiotics to overcome the increasing bacterial resistance. The main objective of this study was to evaluate the attitudes of dentists towards the prescription of antibiotics during endodontic treatment in north of Saudi Arabia. Materials and Methods This was a survey based descriptive cross-sectional study. This study has been done among the dentists of northern region of Saudi Arabia. A questionnaire was designed, regarding pattern of prescription of antibiotics by the dentists in the north of Saudi Arabia and the use of antibiotics in the treatment of different endodontic conditions during endodontic treatment. This questionnaire was distributed among 200 dentists in the north of Saudi Arabia. This study will encourage the dentists of the northern region of Saudi Arabia to be up to date about the current and prospective guidelines for the prescription of antibiotics and follow these guidelines for the antibiotic prescription. Results The collected information was analysed by using a computer software SPSS version 18. Majority of the dentists were male accounting for 86%. The age range for 68% of the respondents was 25-35 years. Most of the dentists were having just a basic dental qualification i.e. 65.60%. Out of the total responding dentists, 50% were working in the ministry of health. 77% of the respondents prescribed the antibiotics for necrotic pulp with acute apical periodontitis; swelling present; mod/ severe preoperative symptoms. Out of the total responding dentists, 45.2% prescribed amoxicillin and clavulanic acid combination as the drug of choice. Conclusion It is concluded from the present study that the dentists should know the scientific basis for the prescription of antibiotics during endodontic therapy. They should follow and should not neglect the current

  8. 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.

  9. Endodontic Treatment of Maxillary Premolar with Three Root Canals Using Optical Microscope and NiTi Rotatory Files System.

    PubMed

    Relvas, João Bosco Formiga; de Carvalho, Fredsom Marcio Acris; Marques, André Augusto Franco; Sponchiado, Emílio Carlos; Garcia, Lucas da Fonseca Roberti

    2013-01-01

    The aim of the study was to report a clinical case of endodontic treatment of a maxillary first premolar with three root canals using an optical microscope and rotary instrumentation technique. The main complaint of the patient, a 16-year-old girl, was pain in tooth 14. After clinical and radiographic examination, irreversible pulpitis was diagnosed. An alteration in the middle third of the pulp chamber radiographically observed suggested the presence of three root canals. Pulp chamber access and initial catheterization using size number 10 K-files were performed. The optical microscope and radiographic examination were used to confirm the presence of three root canals. PathFiles #13, #16, and #19 were used to perform catheterization and ProTaper files S1 and S2 for cervical preparation. Apical preparation was performed using F1 file in the buccal canals and F2 in the palatal canal up to the working length. The root canals were filled with Endofill sealer by thermal compaction technique using McSpadden #50. The case has been receiving follow-up for 12 months and no painful symptomatology or periapical lesions have been found. The use of technological tools was able to assist the endodontic treatment of teeth with complex internal anatomy, such as three-canal premolars.

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

    PubMed Central

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

    2015-01-01

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

  11. The influence of three different instrumentation techniques on the incidence of postoperative pain after endodontic treatment

    PubMed Central

    Gambarini, Gianluca; Testarelli, Luca; De Luca, Massimo; Milana, Valerio; Plotino, Gianluca; Grande, Nicola Maria; Rubini, Alessio Giansiracusa; Al Sudani, Dina; Sannino, Gianpaolo

    2013-01-01

    Summary Aims. Apical extrusion of infected debris to the periradicular tissues is one of the principal causes of postoperative pain and discomfort. Recent researches have shown that reciprocating instrumentation techniques seem to significantly increase the amount of debris extruded beyond the apex and, consequently, the risk of postoperative pain. The goal of the present study was to evaluate and compare postoperative pain using three different nickel-titanium instrumentation techniques: a rotary crown-down technique using TF instruments (SybronEndo, Orange, Ca), a reciprocating single-file technique using WaveOne instruments (Maillefer DEntsply, Baillagues, CH), and a novel instrumentation technique (TF Adaptive, SybronEndo, Orange, Ca), using a unique, proprietary movement, combining reciprocation and continuous rotation. Methods. Ninety patients requiring endodontic treatment on permanent premolar and molar teeth with non vital pulps preoperatively were included in the study. The patients were assigned into three groups of 30 patients each, trying to make the groups very similar, concerning the number of root canals, presence of initial pain and periapical lesions. The teeth in group 1 (n = 30) were instrumented with a crown-down technique using TF instruments, whilst those in group 2 (n = 30) were instrumented with a single-file technique using Waveone 08 25. The third group (n = 30) used the 3-file Tf Adaprtive sequence. All techniques were performed following manufacturers’ instructions and all canals were shaped, cleaned and obturated in a single-visit by the same operator. The assessment of postoperative pain was carried out at 3 days by using a visual analogue scale. VAS pain scores were compared using one-way ANOVA post hoc Tukey test. A value of p < 0.05 was required for statistical significance. Results. Results for VAS pain scores showed a statistically significant difference was found between the WaveOne (p=0,021) technique and the other two

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

    PubMed

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

    2016-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  14. Biomimetic microenvironments for regenerative endodontics.

    PubMed

    Kaushik, Sagar N; Kim, Bogeun; Walma, Alexander M Cruz; Choi, Sung Chul; Wu, Hui; Mao, Jeremy J; Jun, Ho-Wook; Cheon, Kyounga

    2016-01-01

    Regenerative endodontics has been proposed to replace damaged and underdeveloped tooth structures with normal pulp-dentin tissue by providing a natural extracellular matrix (ECM) mimicking environment; stem cells, signaling molecules, and scaffolds. In addition, clinical success of the regenerative endodontic treatments can be evidenced by absence of signs and symptoms; no bony pathology, a disinfected pulp, and the maturation of root dentin in length and thickness. In spite of the various approaches of regenerative endodontics, there are several major challenges that remain to be improved: a) the endodontic root canal is a strong harbor of the endodontic bacterial biofilm and the fundamental etiologic factors of recurrent endodontic diseases, (b) tooth discolorations are caused by antibiotics and filling materials, (c) cervical root fractures are caused by endodontic medicaments, (d) pulp tissue is not vascularized nor innervated, and (e) the dentin matrix is not developed with adequate root thickness and length. Generally, current clinical protocols and recent studies have shown a limited success of the pulp-dentin tissue regeneration. Throughout the various approaches, the construction of biomimetic microenvironments of pulp-dentin tissue is a key concept of the tissue engineering based regenerative endodontics. The biomimetic microenvironments are composed of a synthetic nano-scaled polymeric fiber structure that mimics native pulp ECM and functions as a scaffold of the pulp-dentin tissue complex. They will provide a framework of the pulp ECM, can deliver selective bioactive molecules, and may recruit pluripotent stem cells from the vicinity of the pulp apex. The polymeric nanofibers are produced by methods of self-assembly, electrospinning, and phase separation. In order to be applied to biomedical use, the polymeric nanofibers require biocompatibility, stability, and biodegradability. Therefore, this review focuses on the development and application of the

  15. Biomimetic microenvironments for regenerative endodontics.

    PubMed

    Kaushik, Sagar N; Kim, Bogeun; Walma, Alexander M Cruz; Choi, Sung Chul; Wu, Hui; Mao, Jeremy J; Jun, Ho-Wook; Cheon, Kyounga

    2016-01-01

    Regenerative endodontics has been proposed to replace damaged and underdeveloped tooth structures with normal pulp-dentin tissue by providing a natural extracellular matrix (ECM) mimicking environment; stem cells, signaling molecules, and scaffolds. In addition, clinical success of the regenerative endodontic treatments can be evidenced by absence of signs and symptoms; no bony pathology, a disinfected pulp, and the maturation of root dentin in length and thickness. In spite of the various approaches of regenerative endodontics, there are several major challenges that remain to be improved: a) the endodontic root canal is a strong harbor of the endodontic bacterial biofilm and the fundamental etiologic factors of recurrent endodontic diseases, (b) tooth discolorations are caused by antibiotics and filling materials, (c) cervical root fractures are caused by endodontic medicaments, (d) pulp tissue is not vascularized nor innervated, and (e) the dentin matrix is not developed with adequate root thickness and length. Generally, current clinical protocols and recent studies have shown a limited success of the pulp-dentin tissue regeneration. Throughout the various approaches, the construction of biomimetic microenvironments of pulp-dentin tissue is a key concept of the tissue engineering based regenerative endodontics. The biomimetic microenvironments are composed of a synthetic nano-scaled polymeric fiber structure that mimics native pulp ECM and functions as a scaffold of the pulp-dentin tissue complex. They will provide a framework of the pulp ECM, can deliver selective bioactive molecules, and may recruit pluripotent stem cells from the vicinity of the pulp apex. The polymeric nanofibers are produced by methods of self-assembly, electrospinning, and phase separation. In order to be applied to biomedical use, the polymeric nanofibers require biocompatibility, stability, and biodegradability. Therefore, this review focuses on the development and application of the

  16. Endodontic treatment of a maxillary lateral incisor presenting dens invaginatus and transposition to the region of the canine--case report.

    PubMed

    Pécora, J D; Saquy, P C; de Souza, J E; Sousa Neto, M D

    1991-01-01

    Endodontic treatment was performed in a maxillary lateral incisor presenting two different types of anomalies: dens invaginatus and transposition to the region of the canine. The two transposed teeth were subsequently restored with light-cured composite, bringing dental esthetics to normal in a single session.

  17. [An endodontic ultrasonic system for apical endodontic surgery].

    PubMed

    de Lange, I; Putters, T; Baas, E M; van Ingen, J M

    2009-09-01

    Apical endodontic surgery is applied frequently following a failed conventional endodontic treatment. The apical preparation can be carried out conventionally using a round bur or using an endodontic ultrasonic system. The purpose of this study was to compare the outcome of the 2 treatment options by a randomized prospective clinical study. Patients (n=399) were at random allocated to treatment using a conventional round bur or using an ultrasonic system (P-max Newtron) according to a for the rest similar treatment protocol. One year post treatment, the treatment outcomes were determined by 2 oral and maxillofacial surgeons, blinded for the treatment option. Adequate follow-up data were obtained from 290 patients. The overall success rate was 71% in the patients treated conventionally and 81% in the patients treated using the ultrasonic system. In molar teeth, the difference in success rate was statistically significant. PMID:19791493

  18. 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.

  19. [Evaluation of endodontic treatment with modified Walkhoff technique in teeth with necrotic pulp and/or periapical lesions].

    PubMed

    Villa Vigil, M A; Alvarez Arenal, A; Rodriguez Gonzalez, M A; Garcia, T L; Soarez Feito, R; Aguado Blazquez, F

    1990-01-01

    A treatment has been carried out in a total of 112 dental cases with necrotic pulp and/or periapical lesions using yodoformic paste. The technique employed was that of a conventional endodontic therapy of the root and ductal filling, using yodoformic paste and gutta-percha. The clinical and radiological follow up checks, three, six and twelve months after treatment, show improvement in the periapical lesions, with bone regrowth and complete disappearance of the radio-lucity within a variable time span, depending on the gravity of the damage, but never greater than twelve months. The immediate post-operative well being and absence of complications in the majority of cases also be highlighted.

  20. 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

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

    PubMed

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

    2016-01-01

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

  2. Endodontic treatment and esthetic management of a primary double tooth with direct composite using silicone buildup guide

    PubMed Central

    Kulkarni, Vinaya Kumar; Ragavendra, T. Raju; Deshmukh, Jeevanand; Vanka, Amit; Duddu, Mahesh Kumar; Patil, Anand Kumar G.

    2012-01-01

    Gemination and fusion are morphological dental anomalies, characterized by the formation of a clinically wide tooth. Gemination occurs when one tooth bud tries to divide, while fusion occurs if two buds unite. The terms double teeth, double formation, conjoined teeth, geminifusion, vicinifusion and dental twinning are often used to describe fusion and gemination. Double teeth are associated with clinical problems such as poor esthetics, spacing problems and caries susceptibility. Management of such cases requires a comprehensive knowledge of the clinical entity as well as the problems associated with it. This report presents a case of primary double tooth in a 6-year-old boy involving maxillary left central incisor. The anomalous tooth was carious and pulpally involved. This was treated conservatively by endodontic treatment and esthetic rehabilitation was done with direct composite restoration using a silicone buildup guide. The treated tooth was followed up until exfoliation. PMID:22629077

  3. Flare-ups after endodontic treatment: a meta-analysis of literature.

    PubMed

    Tsesis, Igor; Faivishevsky, Vadim; Fuss, Zvi; Zukerman, Ofer

    2008-10-01

    The purpose of this study was to determine the frequency of flare-ups and to evaluate factors that affect it by using meta-analysis of results of previous studies. MEDLINE database was searched by using Entrez PubMed search engine and Medical Subject Headings (MeSH) search with EviDents Search Engine to identify the studies dealing with endodontic flare-up phenomenon. The search covered all articles published in dental journals in English from 1966-May 2007, and the relevancy of 119 selected articles was evaluated by reading their titles and abstracts, from which 54 were rejected as irrelevant and 65 were subjected to a suitability test. Six studies that met all the above mentioned criteria were included in the study. Average percentage of incidence of flare-ups for 982 patients was 8.4 (standard deviation +/-57). There were insufficient data to investigate the effect of the influencing factors. PMID:18793915

  4. Survey of attitudes, materials and methods employed in endodontic treatment by general dental practitioners in North Jordan

    PubMed Central

    Al-Omari, Wael M

    2004-01-01

    Background General dental practitioners provide the majority of endodontic treatment in Jordan. The aim of this study was to gather information on the methods, materials and attitudes employed in root canal treatment by dentists in North Jordan, in order to evaluate and improve the quality of current practice. Methods A questionnaire was posted to all registered general dental practitioners working in private practice in Irbid Governate in North Jordan (n = 181). The questionnaire included information on methods, materials and techniques used in endodontic treatment. Results Reply rate was 72% (n = 131). The results demonstrated that only five dentists used rubber dam occasionally and not routinely. The majority used cotton rolls for isolation solely or in combination with a high volume saliva ejector (n = 116). The most widely used irrigants were sodium hypochlorite and hydrogen peroxide, which were used by 32.9% (n = 43) and 33.6% (n = 44) of the respondents, respectively. Forty eight percent of the respondents (n = 61) used the cold lateral condensation technique for canal obturation, 31.3% (n = 41) used single cone, 9.9% (n = 13) used vertical condensation and 12.2% (n = 16) used paste or cement only for the obturation. The majority used zinc oxide eugenol as a sealer (72.5%). All, but one, respondents used hand instruments for canal preparation and the technique of choice was step back (52.7%). More than 50% (n = 70) of the dentists took one radiograph for determining the working length, whilst 22.9% (n = 30) did not take any radiograph at all. Most practitioners performed treatment in three visits for teeth with two or more root canals, and in two visits for teeth with a single root canal. Conclusions This study indicates that dentists practicing in North Jordan do not comply with international quality standards and do not use recently introduced techniques. Many clinicians never take a radiograph for determining the working length and never used rubber dam

  5. Antibacterial Efficacy of Calcium Hydroxide and Chlorhexidine Mixture for Treatment of Teeth with Primary Endodontic Lesions: A Randomized Clinical Trial

    PubMed Central

    Donyavi, Zakiyeh; Ghahari, Parastoo; Esmaeilzadeh, Mohammad; Kharazifard, Mohammadjavad; Yousefi-Mashouf, Rasoul

    2016-01-01

    Introduction: This study compared the root canal microbial count of necrotic teeth after irrigation with 6% sodium hypochlorite (NaOCl) (single session treatment) and two-session root canal treatment with two-week application of calcium hydroxide (CH) mixed with 0.2% chlorhexidine (CHX) as intracanal medicament. Methods and Materials: In this randomized clinical trial, single-rooted necrotic teeth were divided into two groups. Root canal was irrigated with 2 mL of 6% NaOCl in one group, and a mixture of 0.2% CHX and CH powder as an intracanal medicament for two weeks, in the other group. Root canal samples were obtained before and after the intervention and number of colony forming units (CFUs) was counted in each phase. Results: The reduction of Enterococcus faecalis CFU was not significantly different between the two groups (P=0.233) but the CFU of aerobic and anaerobic bacteria was significantly lower in CH+CHX group (P<0.001). Conclusion: Two-week application of CH+CHX caused significant reduced the aerobic, anaerobic and E. faecalis colony counts. Thus, it may be beneficial to carry out primary root canal treatment of necrotic teeth with endodontic lesions in two sessions with intracanal medicaments to achieve predictable results. PMID:27790252

  6. 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

  7. Biofilm in endodontics: A review.

    PubMed

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

    2015-01-01

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

  8. Biofilm in endodontics: A review.

    PubMed

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

    2015-01-01

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

  9. 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

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

    PubMed Central

    Bertrand, Thikamphaa

    2016-01-01

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

  11. 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

  12. Regenerative Endodontic Treatment of an Infected Immature Dens Invaginatus with the Aid of Cone-Beam Computed Tomography

    PubMed Central

    Kaya-Büyükbayram, Işıl; Özalp, Şerife; Aydemir, Seda

    2014-01-01

    Dens invaginatus is a developmental anomaly that results in an enamel-lined cavity intruding into the crown or root before the mineralization phase. This report presents regenerative endodontic treatment of a necrotic immature tooth with Oehler's type III dens invaginatus of a nine-year-old female patient. A diagnosis of dens invaginatus (Oehler's type III) and a large periapical lesion was established with the aid of cone-beam computed tomography (CBCT). In the presented case contrary to the classic revascularization protocol, mechanical instrumentation was performed which apparently did not interfere with the regeneration process. After mechanical instrumentation of the invaginated canal by manual K-files, the invaginated canal space was disinfected by triple antibiotic paste followed by blood clot induction from the periapical tissues and the placement of mineral trioxide aggregate. At one-year follow-up, the tooth remained clinically asymptomatic. Radiographic examination revealed complete healing of the periapical lesion. At the 20-month follow-up, the radiographic examination also showed that the open apex was closed and the walls of the root canal were thickened. PMID:25530890

  13. Endodontic considerations in restoration of partial overdenture abutments.

    PubMed

    Safavi, K E; Grasso, J E

    1990-10-01

    Overdenture abutment teeth often require endodontic treatment. Various factors, such as status of the pulp, periodontal state of the tooth, and the sequence of overdenture treatment, influence endodontic management of the patient. After completion of endodontic treatment, the coronal part of the root filling is removed, leaving an adequate amount of the root filling in the apical part of the root canal undisturbed. The abutment tooth is then permanently restored with a filling material, or is prepared for a cast restoration.

  14. [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.

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

    PubMed

    Zabalegui, B; Gil, J; Zabalegui, I

    1989-01-01

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

  16. Endodontic retreatment in case of failure. Case report.

    PubMed

    Mărgărit, Ruxandra; Andrei, Oana Celia

    2011-01-01

    In medical practice, clinicians come across an increased number of endodontic treatments, which, like other dental treatments, can fail. The increase in the number of endodontic treatment resulted in an increased number of failures, their management raising complex and serious endodontic problems. The endodontic retreatment of a failure is required by the increased desire to preserve the tooth on the dental arch, thus preventing the need for dental extraction that may have adverse consequences in terms of functional and psychological effect on patients. This article presents two clinical cases that required endodontic retreatment in order to avoid the complications that could ultimately require tooth extraction. The teeth in question (a mandibular first molar and an upper central incisor) having a special importance, and a physiognomic role, the endodontic retreatment consisted in covering them in porcelain fused to the metal crowns. PMID:22046813

  17. Ultrasonics in endodontics: a review of the literature.

    PubMed

    Plotino, Gianluca; Pameijer, Cornelis H; Grande, Nicola Maria; Somma, Francesco

    2007-02-01

    During the past few decades endodontic treatment has benefited from the development of new techniques and equipment, which have improved outcome and predictability. Important attributes such as the operating microscope and ultrasonics (US) have found indispensable applications in a number of dental procedures in periodontology, to a much lesser extent in restorative dentistry, while being very prominently used in endodontics. US in endodontics has enhanced the quality of treatment and represents an important adjunct in the treatment of difficult cases. Since its introduction, US has become increasingly more useful in applications such as gaining access to canal openings, cleaning and shaping, obturation of root canals, removal of intracanal materials and obstructions, and endodontic surgery. This comprehensive review of the literature aims at presenting the numerous uses of US in clinical endodontics and emphasizes the broad applications in a modern-day endodontic practice.

  18. Surgical endodontic management of infected lateral canals of maxillary incisors

    PubMed Central

    2015-01-01

    This case report presents surgical endodontic management outcomes of maxillary incisors that were infected via the lateral canals. Two cases are presented in which endodontically-treated maxillary central incisors had sustained lateral canal infections. A surgical endodontic treatment was performed on both teeth. Flap elevation revealed vertical bone destruction along the root surface and infected lateral canals, and microscopy revealed that the lateral canals were the origin of the lesions. After the infected lateral canals were surgically managed, both teeth were asymptomatic and labial fistulas were resolved. There were no clinical or radiographic signs of surgical endodontic management failure at follow-up visits. This case report highlights the clinical significance and surgical endodontic management of infected lateral canal of maxillary incisor. It is important to be aware of root canal anatomy variability in maxillary incisors. Maxillary central incisors infected via the lateral canal can be successfully managed by surgical endodontic treatment. PMID:25671217

  19. Surgical endodontic management of infected lateral canals of maxillary incisors.

    PubMed

    Jang, Ji-Hyun; Lee, Jung-Min; Yi, Jin-Kyu; Choi, Sung-Baik; Park, Sang-Hyuk

    2015-02-01

    This case report presents surgical endodontic management outcomes of maxillary incisors that were infected via the lateral canals. Two cases are presented in which endodontically-treated maxillary central incisors had sustained lateral canal infections. A surgical endodontic treatment was performed on both teeth. Flap elevation revealed vertical bone destruction along the root surface and infected lateral canals, and microscopy revealed that the lateral canals were the origin of the lesions. After the infected lateral canals were surgically managed, both teeth were asymptomatic and labial fistulas were resolved. There were no clinical or radiographic signs of surgical endodontic management failure at follow-up visits. This case report highlights the clinical significance and surgical endodontic management of infected lateral canal of maxillary incisor. It is important to be aware of root canal anatomy variability in maxillary incisors. Maxillary central incisors infected via the lateral canal can be successfully managed by surgical endodontic treatment.

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2015-07-10

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

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

    PubMed

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

    2013-04-01

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

  3. 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.

  4. Advances in endodontics: Potential applications in clinical practice

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2016-01-01

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

  6. 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. PMID:25719896

  7. [Sinus aspergillosis after an endodontic treatment. Presentation of a clinical case].

    PubMed

    Milián Masanet, A; Bagán Sebastián, J V; Riera Grimalt, J; Lloria de Miguel, E; Jiménez Soriano, Y

    1998-01-01

    Aspergillosis is an opportunistic deep mycosis that occurs in immunocompromised patients, often in the paranasal sinuses. However, it sometimes occurs in healthy subjects, producing symptoms similar to those of a chronic sinusitis that is unresponsive to conventional treatment. A possible entry point for Aspergillus is the oroantral communication originated by perforation of the dental root cavity during root canal of a molar with penetration of material. We report the clinical case of a patient with symptoms of chronic sinusitis who was diagnosed as sinus aspergillosis after radiological and histological study. The origin may have been a third upper molar in which a root canal was performed. PMID:9717333

  8. Treatment outcome in endodontics: the Toronto study--phases 3 and 4: orthograde retreatment.

    PubMed

    de Chevigny, Cristian; Dao, Thuan T; Basrani, Bettina R; Marquis, Vincent; Farzaneh, Mahsa; Abitbol, Sarah; Friedman, Shimon

    2008-02-01

    Outcome 4-6 years after retreatment was assessed for Phases 3 and 4 of the Toronto Study. Of 477 teeth retreated, 333 were lost to follow-up, 18 were extracted, and 126 (41% recall, excluding 124 discontinuers) were examined for outcome of healed (periapical index score, < or = 2; no signs or symptoms) or diseased. When pooled with Phases 1 and 2, 187 of 229 teeth (82%) were healed. Logistic regression identified significant (P < or = .05) preoperative outcome predictors: root filling quality (odds ratio [OR], 4.18; confidence interval [CI], 1.72-10.12; healed: inadequate, 88%; adequate, 66%), perforation (OR, 4.01; CI, 1.28-12.62; healed: absent, 87%; present, 56%), and radiolucency (OR, 3.33; CI, 1.19-9.36; healed: absent, 93%; present, 80%). In teeth with radiolucency, outcome predictors were number of treatment sessions (OR, 12.08; CI, 1.84-infinity; healed: one, 100%; > or = 2, 77%) and previous root filling quality (OR, 7.68; CI, 2.36-26.89; healed: inadequate, 86%; adequate, 50%). Outcome was better in teeth with inadequate previous root filling, without perforation and radiolucency. Suggested significance of number of treatment sessions in teeth with radiolucency requires validation from randomized controlled trials.

  9. Surgical Retreatment of an Invaginated Maxillary Central Incisor Following Overfilled Endodontic Treatment: A Case Report

    PubMed Central

    Ozbas, Hakan; Subay, Rustem Kemal; Ordulu, Melike

    2010-01-01

    This case report presents the periapical surgical retreatment of an Oehlers Class III invaginated maxillary central incisor with extruded root canal filling into the periapical lesion. After local anesthesia, a full-thickness mucoperiosteal flap was reflected, and the granulomatous tissue and extruded gutta-percha points were curetted carefully. A deep and wide root-end cavity was prepared and filled with mineral trioxide aggregate (MTA). At 6 months and 2 years after the treatment, the tooth exhibited no clinical symptoms, and the radiograph performed during the 2-year follow-up showed a complete periapical healing around the root end. The present report indicates that MTA retrofilling can be used successfully in the surgical retreatment of dens invaginatus type III cases in which the invagination exits apically. PMID:20613922

  10. Microleakage in Endodontics

    PubMed Central

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

    2014-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  12. Dentinogenesis imperfecta: endodontic implications. Case report.

    PubMed

    Pettiette, M T; Wright, J T; Trope, M

    1998-12-01

    Dentinogenesis imperfecta is a hereditary disorder resulting in defective dentin in both the primary and secondary dentitions. The complications of dentinogenesis imperfecta are difficult to manage and provide a challenge to the dentist. This case report concerns treating an African American patient with dentinogenesis imperfecta who appeared for treatment with endodontic pathosis. It illustrates the need for appropriate and timely restorative treatment to prevent pulpal pathosis. Also demonstrated is the difficulty of endodontically treating dentinogenesis imperfecta teeth because of pulpal obliteration and abnormal dentin mineralization. Early and correct diagnosis of dentinogenesis imperfecta is imperative to enable appropriate preventive interventions and optimal dental treatment. Although pulpal pathosis is rarely reported with dentinogenesis imperfecta, endodontic treatment is occasionally necessary and has a guarded prognosis if initiated after pulp canal obliteration has occurred.

  13. Accidental Ingestion of Endodontic File: A Case Report

    PubMed Central

    Saraf, Hrushikesh P.; Nikhade, Pradnya P.; Chandak, Manoj G.

    2012-01-01

    Ingestion of the endodontic instrument during root canal treatment is rare but can result in serious complications. The present paper reports a case in which endodontic file was accidentally swallowed by the patient undergoing root canal therapy, which entered digestive tract and passed uneventfully. PMID:22577586

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

    PubMed

    Jiang, H W

    2016-08-01

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

  15. 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.

  16. 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

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

    NASA Astrophysics Data System (ADS)

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

    2016-04-01

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

  18. Current overview on challenges in regenerative endodontics

    PubMed Central

    Bansal, Ramta; Jain, Aditya; Mittal, Sunandan

    2015-01-01

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

  19. [Endodontics in horses. An experimental study].

    PubMed

    Garcia, F; Sanromán, F; Llorens, M P

    1990-04-01

    A total of 44 experimental endodontic treatments were performed in incisors of eight horses of different ages. Four different endodontic pastes were used: Cloropercha, AH26 De Trey, Eugenol-Endometasone, and Universal N2. Gutta-percha points were also included in the last two treatments. Access to the pulp cavity of incisors was gained through their vestibular and occlusal faces. Holes drilled in vestibular faces were sealed with composite and those drilled in occlusal faces were sealed with Amalgama. Animals were observed during eighteen months at least after endodontics. Radiographic controls were done just after surgery and before slaughtering. Treated incisors and alveoli were studied histopathologically. During the experiment all animals were in good condition. They ate apparently without trouble, and neither clinical nor radiological signs were present.

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

    PubMed

    van der Sluis, L W M

    2015-10-01

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

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

    PubMed

    van der Sluis, L W M

    2015-10-01

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

  2. 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.

  3. 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

  4. Natural Therapeutic Options in Endodontics - A Review.

    PubMed

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

    2016-01-01

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

  5. Surgical laser use in implantology and endodontics.

    PubMed

    Parker, S

    2007-04-14

    The use of surgical lasers has been advocated to aid in the placement and second stage recovery of dental implants, together with soft tissue contouring. In addition, laser use has been suggested as an aid in decontamination of the implant surface in cases of peri-implantitis. In endodontics, the association of laser energy with dentine hypersensitivity, bacteriocidal action and pulp-capping, has led to a growing number of reports as to its beneficial use, together with claims of morphological changes in the canal wall, to enhance endodontic treatment success.

  6. Preclinical endodontic teaching

    PubMed Central

    Narayanaraopeta, Udaya; AlShwaimi, Emad

    2015-01-01

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

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

    PubMed Central

    Anderson, Craig

    2015-01-01

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

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

    PubMed

    Martins, Jorge N R; Anderson, Craig

    2015-04-01

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

  9. [The application of laser in endodontics].

    PubMed

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

    2016-08-01

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

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

    PubMed Central

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

    2016-01-01

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

  11. Role of provisional restorations in endodontic therapy

    PubMed Central

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

    2013-01-01

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

  12. The Landscape of Predoctoral Endodontic Education in the United States and Canada: Results of a Survey.

    PubMed

    Woodmansey, Karl; Beck, Lynn G; Rodriguez, Tobias E

    2015-08-01

    Few recent surveys have examined the contemporary landscape of predoctoral endodontic education in the United States and Canada, but anecdotal reports suggest that current dental students have difficulty obtaining adequate clinical endodontic experiences. The aims of this study were to quantify the clinical endodontic experiences of current U.S. and Canadian dental students, to explore the issues surrounding their clinical endodontic competence, and to ask more broadly if current graduating dentists are competent to perform endodontic procedures. In August 2014, a hyperlink to a web-based survey with 27 questions was emailed to the 67 predoctoral endodontic directors of U.S. and Canadian dental schools using a list provided by the American Association of Endodontists. Out of these 67 possible participants, 40 responded, for a response rate of 60%. The findings were varied. The average 2014 graduate completed 5.9 (± 2.4) root canal treatments on live patients, and 69% of the respondents voiced concern regarding a shortage of patient experiences. A majority (59%) of the respondents reported thinking that the supply of endodontic patients has decreased and that students have an inadequate supply of endodontic patients. This study found that a clear majority of predoctoral endodontics directors perceived a shortage of patient experiences for their students although, in reality, the number of completed clinical cases appeared to be unchanged since 1975. In addition, 36% of the respondents reported feeling that their 2014 graduates were not competent to perform molar endodontic treatment in their practices. PMID:26246530

  13. The Landscape of Predoctoral Endodontic Education in the United States and Canada: Results of a Survey.

    PubMed

    Woodmansey, Karl; Beck, Lynn G; Rodriguez, Tobias E

    2015-08-01

    Few recent surveys have examined the contemporary landscape of predoctoral endodontic education in the United States and Canada, but anecdotal reports suggest that current dental students have difficulty obtaining adequate clinical endodontic experiences. The aims of this study were to quantify the clinical endodontic experiences of current U.S. and Canadian dental students, to explore the issues surrounding their clinical endodontic competence, and to ask more broadly if current graduating dentists are competent to perform endodontic procedures. In August 2014, a hyperlink to a web-based survey with 27 questions was emailed to the 67 predoctoral endodontic directors of U.S. and Canadian dental schools using a list provided by the American Association of Endodontists. Out of these 67 possible participants, 40 responded, for a response rate of 60%. The findings were varied. The average 2014 graduate completed 5.9 (± 2.4) root canal treatments on live patients, and 69% of the respondents voiced concern regarding a shortage of patient experiences. A majority (59%) of the respondents reported thinking that the supply of endodontic patients has decreased and that students have an inadequate supply of endodontic patients. This study found that a clear majority of predoctoral endodontics directors perceived a shortage of patient experiences for their students although, in reality, the number of completed clinical cases appeared to be unchanged since 1975. In addition, 36% of the respondents reported feeling that their 2014 graduates were not competent to perform molar endodontic treatment in their practices.

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

    PubMed Central

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

    2010-01-01

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

  15. [Decision-making of restorations for endodontically treated teeth].

    PubMed

    Zhi, Chen; Binwen, Chen

    2015-04-01

    Coronal restoration of endodontically treated teeth may be viewed as one of the main parameters that influence the outcome of endodontic treatment. The purposes of restoring endodontically-treated teeth include preventing recontamination of the root canal system and periapical area, replacing the compromised dental hard tissue, restoring the coronal morphology and function, providing necessary strength for the restoration/tooth complex for functional stress, and avoiding crown and/or root fracture. This article reviewed recent researches on the restoration of endodontically treated teeth, provided evidence for clinical practice on topics as when to restore them, basic principles to be considered during treatment planning, and specific restoration options for both anterior and posterior teeth under different functional occulsal load conditions. Several issues should be taken into account during the decision making process, such as remaining tooth tissue, functional masticatory forces, comprehensive oral rehabilitation, and esthetic requirements.

  16. The endodontic workforce.

    PubMed

    Johns, Beverly A; Brown, L Jackson; Nash, Kent D; Warren, Matthew

    2006-09-01

    The amount of endodontic care provided in the US requires an understanding of the supply and demand for such care. The supply side includes the number and location of endodontists, type of provider, and productivity. The demand side consists of the changing demographics of the age groups that endodontists predominantly treat along with changes in their dental health. To address these issues, we have compiled and analyzed data from American Dental Association (ADA) with other sources such as US government census data and the National Health and Nutrition Examination Surveys (NHANES). From 1982 to 2002, the supply of endodontists increased at a rate greater than that observed with general practitioners or the other specialty areas. The growth of endodontists in relation to general practitioners is important. The latter are co-providers of endodontic care as well as a primary source for referral of patients to endodontists. Demographic and disease changes are likely to impact the need and demand for endodontic services. Endodontists' patients are generally between the ages of 25 and 64 yrs. Currently, the majority of endodontists' patients are members of the large baby boom generation who in 2000 ranged in age from their late 30s to their late 50s. During the next 20 yrs the Baby Boom generation will be replaced by the numerically smaller Generation-X cohort. This generation has experienced substantially less total caries than baby-boomers and they most likely will have fewer endodontic sequela as they age. A moderating factor that could partially offset the predicted decline in numbers of patients is the increased number of teeth that Generation-Xers are likely to retain. A flexible endodontic workforce strategy must assess the impending demographic and disease trends in relation to future growth rates of both endodontists and general practitioners.

  17. 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

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

    PubMed

    Ling, J Q

    2016-04-01

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

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

    PubMed Central

    Setzer, F.C.; Kim, S.

    2014-01-01

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

  20. Guided Tissue Regeneration Using a Barrier Membrane in Endodontic Surgery.

    PubMed

    Corbella, Stefano; Taschieri, Silvio; Elkabbany, Ahmed; Del Fabbro, Massimo; von Arx, Thomas

    2016-01-01

    Endodontic surgery aims at the resolution of a periapical inflammatory process by surgical access followed by enucleation of the lesion and root-end filling to curb any potentially noxious agent within the physical confines of the affected root. Guided bone regeneration could be associated to endodontic surgery aiming to enhance periradicular tissue regeneration. The objective of this paper was to review the scientific literature about guided bone regeneration in endodontic surgery, evaluating the effects on periapical lesion healing process. The included articles are classified considering the anatomical characteristics of the lesion. Fourteen articles were included in the review after abstract and title selection. Eight articles were on studies on lesions affecting only the periapical region (three about through-and-through lesions) while six were about the treatment of apico-marginal lesions. On the basis of the currently available literature, there is a low scientific evidence of a benefit related. to the use of guided bone regeneration procedure in endodontic surgery.

  1. Chlorhexidine in endodontics.

    PubMed

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

    2013-01-01

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

  2. Chloroform in the endodontic operatory

    SciTech Connect

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

    1992-06-01

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

  3. Accidental Contamination with Oil during Endodontic Surgery

    PubMed Central

    Plascencia, Hugo; Díaz, Mariana; Cholico, Patricia; del Real, Monserrat; Márquez-de Alba, Salvador

    2016-01-01

    The modern surgical endodontic treatment is a safe and predictable procedure with high success rate. However, several factors can retard or impede the proper healing process. Use of a high speed handpiece during hard tissues management (osteotomy and apical resection) can potentially be one of these factors. Formation of metallic debris from the surgical diamond burs, production of necrotic local tissue due to overheating and the direct liberation of air from conventional handpiece into the working area are potential irritants able to delay the tissue healing. The aim of the present article is to report the histopathological findings of the trans-operational accidental contamination with oil in the surgical area during an endodontic surgery. PMID:27790269

  4. 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.

  5. Dental Identification Through Endodontic Radiographic Records: a Case Report

    PubMed Central

    Franco, Ademir; Picoli, Fernando Fortes; Nunes, Fernando Gomes; Estrela, Carlos

    2014-01-01

    Objective of work The present study aims to report a case of successful human identification based on the comparison of ante-mortem and post-mortem records of endodontic treatment. Based on these, the legal value of storing and updating clinical records is highlighted throughout the text. Case report An unknown body was recovered from a traffic accident site. Forensic examination was conducted in order to establish the identity of the victim. Based on the absence of ante-mortem fingerprint registration in the national database, the search for AM data was performed using periapical radiographic records from private dental clinics. A positive dental identification was achieved analyzing evidence of endodontic treatment. Conclusion Dental radiographs play a valuable role as legal tools supporting the criminal demands on the daily forensic practice. Specifically in endodontics, periapical radiographs are essential for a proper treatment. In forensics, these radiographs represent a solid source of ante-mortem data for human identifications.

  6. Maxillary fungus ball: zinc-oxide endodontic materials as a risk factor.

    PubMed

    Nicolai, P; Mensi, M; Marsili, F; Piccioni, M; Salgarello, S; Gilberti, E; Apostoli, P

    2015-04-01

    The objective of this study was to demonstrate the correlation between endodontic treatment on maxillary teeth and fungus ball with inductively coupled plasma mass spectrometry measurement of zinc and other metals (barium, lead and copper) in fungus ball samples. Samples of normal maxillary mucosa were used as comparison. Metal concentration was also measured in several endodontic materials. A significant difference was found between the concentration of zinc and copper in fungus ball compared to normal mucosa. Metal distribution was more similar in fungus ball and in the endodontic materials tested than normal mucosa. The similar metal concentration in the endodontic materials and fungus ball suggests that endodontic materials play a role in the pathogenesis of fungus ball. Endodontic materials accidentally pushed into the maxillary sinus during endodontic treatments may play a crucial role. Dentists should be as careful as possible when treating maxillary teeth to avoid perforating the maxillary sinus floor; the use of zinc-free endodontic materials, as zinc is a metal that plays a pivotal role in fungus growth, should be encouraged.

  7. CBCT: a revolutionary diagnostic aid for endodontic dilemmas.

    PubMed

    Gurtu, A; Aggarwal, A; Mohan, S; Singhal, A; Bansal, R; Agnihotri, K

    2014-09-01

    Successful management of endodontic problems is reliant on diagnostic imaging techniques to provide critical information about the teeth under investigation, and their surrounding anatomy. Until recently, most of this core information was obtained from conventional radiographs. The introduction of cone-beam computed tomography (CBCT) specifically dedicated to imaging the maxillofacial region heralds a true paradigm shift from a two dimensional (2D) to a three dimensional (3D) approach to data acquisition and image reconstruction. CBCT systems provide small field of view images at low dose with sufficient spatial resolution for applications in endodontic diagnosis, treatment guidance, and post treatment evaluation. CBCT has been the subject of unparalleled levels of independent research in dental imaging in the area of endodontics. It gives the edge of 3D imaging at lower radiation level in comparison to conventional CT and has helped to treat endodontic cases with external resoption, root canal variations and apical periodontitis providing the size, site and extent accurately. This paper reviews the fundamentals of CBCT and presents the applications of this imaging system in contemporary endodontic practice. PMID:25308570

  8. Stress, relaxation, and saliva: a pilot study involving endodontic patients.

    PubMed

    Morse, D R; Schacterle, G R; Furst, M L; Bose, K

    1981-09-01

    Thirty-four endodontic patients completed dental anxiety questionnaires and had saliva samples taken prior to and at the conclusion of their initial endodontic treatment. Pain and anxiety were managed with local anesthesia, nitrous oxide--oxygen psychosedation, hypnosis, and meditation, either alone or in combination. For most patients, by the conclusion of the treatment, anxiety had decreased, salivary volume had increased, and salivary protein was reduced. Meditation and hypnosis, either alone or in combination with local anesthesia, were most effective in anxiety reduction as measured by questionnaire and/or salivary changes.

  9. Tooth discoloration induced by endodontic materials: a literature review.

    PubMed

    Krastl, Gabriel; Allgayer, Nikola; Lenherr, Patrik; Filippi, Andreas; Taneja, Pankaj; Weiger, Roland

    2013-02-01

    It is common knowledge that materials used in endodontics may cause discoloration and thus impair the aesthetic outcome of the treated tooth. The purpose of this review is to summarise the existing knowledge on the discoloration potential of materials used for endodontic procedures. A comprehensive literature search covering the period from 1966 to 2011 was conducted on Pubmed and the Cochrane Library using different keyword combinations including 'tooth', 'colour', 'discoloration', 'staining', 'endodontic''root canal''sealer', 'dressing', 'medicament', 'obturation', 'filling', 'treatment', 'portland cement', 'MTA' and 'antibiotic paste'. Any relevant work published in the English language in peer-reviewed journals and presenting pertinent information related to the purpose of this overview was considered for inclusion. In addition, bibliographies of all relevant papers and previous review articles were hand searched and the reference lists from endodontic textbooks were also reviewed. Articles were excluded if an English abstract was unavailable, if only single clinical reports or conference reports were included, or if the topic was unrelated to the subject. Ten in-vitro studies, one randomized controlled trial and one multicenter randomized controlled trial met the inclusion criteria. There were not any recently used endodontic materials that would not induce at least measurable colour changes. For a wide range of materials currently available on the market there is only scarce or no evidence available on their staining ability. Endodontic therapy should not focus solely on biological and functional aspects, but take aesthetic considerations into account as well. To reduce the risk of material-induced tooth discoloration all materials should be applied carefully in areas of aesthetic concern. The need for further research in this field and for the development of non-staining endodontic materials is evident. PMID:22513082

  10. CBCT Use in Endodontic Diagnosis.

    PubMed

    Beach, David A

    2016-02-01

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

  11. CBCT Use in Endodontic Diagnosis.

    PubMed

    Beach, David A

    2016-02-01

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

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

    PubMed

    Atmeh, Amre R; Watson, Timothy F

    2016-06-01

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

  13. Rapid Kill—Novel Endodontic Sealer and Enterococcus faecalis

    PubMed Central

    Zaltsman, Nathan; Houri-Haddad, Yael; Abramovitz, Itzhak; Davidi, Michael Perez; Weiss, Ervin I.

    2013-01-01

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

  14. 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

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

    PubMed

    Atmeh, Amre R; Watson, Timothy F

    2016-06-01

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

  16. Cardiovascular effect of epinephrine in endodontic microsurgery: a review.

    PubMed

    Jang, Youngjune; Kim, Euiseong

    2013-11-01

    Epinephrine is one of the most widely-used vasoconstrictors in dental treatment including endodontic microsurgery. However, the systemic safety of epinephrine has been in debate for many years because of its potential risk to cause cardiovascular complications. The purpose of this review was to assess the cardiovascular effect of epinephrine use in endodontic microsurgery. Endodontic microsurgery directly applies epinephrine into the bone cavity, and the amount is reported to be much larger than other dental surgeries. Moreover, when considering that systemic potency of intraosseous application is reported to be comparable to intravenous application, the systemic influence of epinephrine could be increased in endodontic microsurgery. Besides, pre-existing cardiovascular complications or drug interactions can enhance its systemic influence, resulting in increased susceptibility to cardiovascular complications. Although clinical studies have not reported significant complications for patients without severe systemic complications, many epinephrine-induced emergency cases are warning the cardiovascular risk related with pre-existing systemic disease or drug interactions. Epinephrine is a dose-sensitive drug, and its hypersensitivity reaction can be fatal to patients when it is related to cardiovascular complications. Therefore, clinicians should recognize the risk, and the usage of pre-operative patient evaluation, dose control and patient monitoring are required to ensure patient's safety during endodontic microsurgery.

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

    NASA Astrophysics Data System (ADS)

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

    2008-03-01

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

  18. Resolution of endodontic issues linked to complex anatomy.

    PubMed

    Migliau, Guido; Pepla, Erlind; Besharat, Laith Kostantinos; Gallottini, Livio

    2014-01-01

    Anatomical abnormalities of the root canal system are frequently seen in specialist endodontic practice, and represent a challenge to be faced with skill and thoroughness, beginning with an accurate diagnostic phase and devising the most appropriate treatment plan. Fortunately, much progress has been made in endodontic research thanks to technological advances and the evolution of higher performance instruments, which now consent even very complex cases to be resolved with relative ease. Below are described the salient features of recent progress in endodontics, along with a description of several clinical cases in which the operator has encountered numerous difficulties due to peculiar tooth morphology, overcome successfully thanks to the application of modern tools and consolidated clinical experience in the field.

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

    PubMed

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

    1978-04-01

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

  20. Endodontic configuration of the lower incisors in a Romanian population: a radiological study.

    PubMed

    Perlea, Paula; Nistor, Cristina Coralia; Toma, C; Dimitriu, B

    2013-01-01

    The significant rate of failure of endodontic treatment to lower incisors was attributed to poor knowledge of their endodontic morphology. As emphasized by Tinelli ME et al. (2011), the morphology of the endodontic system is strongly related to ethnicity, making possible the existence of important anatomical variations at different population groups. The present study analyzes, using radiological means, the endodontic anatomy of lower incisors extracted from a Romanian population. Five hundred seventy-five lower central and lateral incisors were radiographed and Weine's classification was used to evaluate their endodontic morphology. After processing the data, it was concluded that 81% of the studied teeth have one canal and the remaining 19% have two canals. In terms of endodontic configuration, 81% of 575 studied teeth are Weine Type I, 17% Type II, 1% Type III and 1% Type IV. Results obtained in this study are within existing international endodontic literature. Type II and IV configurations have a high degree of treatment difficulty. This requires thorough clinical and radiological examination of several incidents, possibly cone beam computed tomography (CBCT) and individualized therapeutic means to ensure treatment success. This study is the first of this magnitude in the Romanian specialty literature.

  1. 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…

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

    PubMed

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

    2016-05-20

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

  3. 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.

  4. Optical coherence tomography for endodontic imaging

    NASA Astrophysics Data System (ADS)

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

    2008-02-01

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

  5. 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. PMID:20647109

  6. 21 CFR 872.3830 - Endodontic paper point.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3830 Endodontic paper point. (a) Identification. An endodontic paper point is a device made of paper intended for use during endodontic therapy to...

  7. 21 CFR 872.3840 - Endodontic silver point.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3840 Endodontic silver point. (a) Identification. An endodontic silver point is a device made of silver intended for use during endodontic therapy...

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

    PubMed

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

    1995-06-01

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

  9. 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

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

    PubMed

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

    2015-03-01

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

  11. [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.

  12. Clinical and pharmacological management of endodontic flare-up.

    PubMed

    Jayakodi, Harikaran; Kailasam, Sivakumar; Kumaravadivel, Karthick; Thangavelu, Boopathi; Mathew, Sabeena

    2012-08-01

    Knowledge of the causes of and mechanisms behind interappointment pain in endodontics is of utmost importance for the clinician to properly prevent or manage this undesirable condition. The causative factors of interappointment pain encompass mechanical, chemical, and microbial injuries to the pulp or periradicular tissues, which are induced or exacerbated during root canal treatment. This review article underlines the various treatment modalities for relief of pain and swelling in such situations, including premedication, drainage establishment, relief of occlusion, and intracanal and systemic medication.

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

    PubMed

    Fabra Campos, H; Millet Part, J

    1989-01-01

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

  14. Pathogenesis of apical periodontitis and the causes of endodontic failures.

    PubMed

    Nair, P N R

    2004-01-01

    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. PMID:15574679

  15. 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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

    Szánto, Erika; Gera, István

    2011-12-01

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

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

    PubMed

    Szánto, Erika; Gera, István

    2011-12-01

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

  19. Comparative characteristics of endodontic drills.

    PubMed

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

    2015-01-01

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

  20. 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

  1. Overview on the current antibiotic containing agents used in endodontics.

    PubMed

    Bansal, Ramta; Jain, Aditya

    2014-08-01

    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

  2. Regenerative Endodontics: A Road Less Travelled

    PubMed Central

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

    2014-01-01

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

  3. 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)

  4. 21 CFR 872.3840 - Endodontic silver point.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

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

  5. 21 CFR 872.3840 - Endodontic silver point.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

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

  6. 21 CFR 872.3840 - Endodontic silver point.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

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

  7. 21 CFR 872.3840 - Endodontic silver point.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

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

  8. 21 CFR 872.3830 - Endodontic paper point.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

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

  9. 21 CFR 872.3830 - Endodontic paper point.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

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

  10. 21 CFR 872.3830 - Endodontic paper point.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

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

  11. Laser applications in endodontics: an update review.

    PubMed

    Mohammadi, Zahed

    2009-02-01

    The search for new devices and technologies for endodontic procedures always has been challenging. Since the development of the ruby laser by Maiman in 1960 and the application of the laser for endodontics by Weichman in 1971, a variety of potential applications for lasers in endodontics have been proposed. With the development of thinner, more flexible and durable laser fibres, laser applications in endodontics have increased. Since laser devices are still relatively costly, access to them is limited. The purpose of this paper is to summarise laser applications in endodontics, including their use in pulp diagnosis, dentinal hypersensitivity, pulp capping and pulpotomy, sterilisation of root canals, root canal shaping and obturation and apicectomy. The effects of lasers on root canal walls and periodontal tissues are also reviewed. PMID:19323310

  12. A practical guide to endodontic access cavity preparation in molar teeth.

    PubMed

    Patel, S; Rhodes, J

    2007-08-11

    The main objective of access cavity preparation is to identify the root canal entrances for subsequent preparation and obturation of the root canal system. Access cavity preparation can be one of the most challenging and frustrating aspects of endodontic treatment, but it is the key to successful treatment. Inadequate access cavity preparation may result in difficulty locating or negotiating the root canals. This may result in inadequate cleaning, shaping and filling of the root canal system. It may also contribute to instrument separation and aberrations of canal shape. These factors may ultimately lead to failure of treatment. Good access cavity design and preparation is therefore imperative for quality endodontic treatment, prevention of iatrogenic problems, and prevention of endodontic failure.

  13. 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

  14. 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

  15. 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.

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

    PubMed

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

    2015-01-01

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

  17. 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.

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

    PubMed

    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

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

    PubMed Central

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

    2009-01-01

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

  20. 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

  1. Dimensional changes of endodontic sealers.

    PubMed

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

    1993-12-01

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

  2. Biomimetic endodontics: the final evolution?

    PubMed

    Clark, David J

    2007-07-01

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

  3. 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

  4. Treponema diversity in root canals with endodontic failure

    PubMed Central

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

    2013-01-01

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

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

    PubMed

    Paul, Bonny; Dube, Kavita

    2015-01-01

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

  6. Irrigation in endodontics.

    PubMed

    Haapasalo, M; Shen, Y; Wang, Z; Gao, Y

    2014-03-01

    Irrigation is a key part of successful root canal treatment. It has several important functions, which may vary according to the irrigant used: it reduces friction between the instrument and dentine, improves the cutting effectiveness of the files, dissolves tissue, cools the file and tooth, and furthermore, it has a washing effect and an antimicrobial/antibiofilm effect. Irrigation is also the only way to impact those areas of the root canal wall not touched by mechanical instrumentation. Sodium hypochlorite is the main irrigating solution used to dissolve organic matter and kill microbes effectively. High concentration sodium hypochlorite (NaOCl) has a better effect than 1 and 2% solutions. Ethylenediaminetetraacetic acid (EDTA) is needed as a final rinse to remove the smear layer. Sterile water or saline may be used between these two main irrigants, however, they must not be the only solutions used. The apical root canal imposes a special challenge to irrigation as the balance between safety and effectiveness is particularly important in this area. Different means of delivery are used for root canal irrigation, from traditional syringe-needle delivery to various machine-driven systems, including automatic pumps and sonic or ultrasonic energy.

  7. Endodontic Retreatment of a Mandibular Second Molar with four Separate Roots: A Case Report

    PubMed Central

    Idris, Mohamed; Sakkir, Nasil; KJ, Nandakishore; Kini, Annapurna

    2014-01-01

    Aberrations in the root canal anatomy are a commonly occurring phenomenon. Although the mandibular second molar is commonly a bi-rooted tooth with an uncomplicated endodontic anatomy, variations have to be considered every time endodontic therapy is performed. This case report describes the non-surgical endodontic retreatment performed on a mandibular second molar with four seperate roots and canals. ProTaper Universal rotary nickel-titanium instruments (Dentsply Maillefer, Ballaigues, Switzerland) for treatment and retreatment were used to remove the old gutta percha and to clean and shape all root canals, followed by the complete obturation of root canal system. Post-operative CBCT scan was taken to confirm the quality of the performed treatment. PMID:24783160

  8. Root Canal Stripping: Malpractice or Common Procedural Accident-An Ethical Dilemma in Endodontics.

    PubMed

    Ciobanu, Ionela Elisabeta; Rusu, Darian; Stratul, Stefan-Ioan; Didilescu, Andreea Cristina; Cristache, Corina Marilena

    2016-01-01

    Root canal stripping is defined as an oblong, vertical perforation that appears especially in the middle section of curved root canals during endodontic treatments with nickel-titanium (Ni-Ti) instruments. Its occurrence may drastically affect the outcome of the treatment, transforming a common otherwise efficient endodontic procedure into a complication such as tooth extraction. In order to discuss the ethical and legal consequences, two cases of dental strip perforations are herewith presented. Due to the existence of risk factors for dental strip perforation, experience of the clinician and the use of magnification and modern imagistic methods (CBCT) may avoid or reduce the frequency of this type of accidents. Under correct working circumstances, dental stripping should not be regarded as a malpractice but as a procedural accident. However, the patient must always be informed, before and during the endodontic procedure, about the event and the possible complications that may occur. PMID:27672458

  9. Root Canal Stripping: Malpractice or Common Procedural Accident—An Ethical Dilemma in Endodontics

    PubMed Central

    Ciobanu, Ionela Elisabeta; Rusu, Darian; Didilescu, Andreea Cristina

    2016-01-01

    Root canal stripping is defined as an oblong, vertical perforation that appears especially in the middle section of curved root canals during endodontic treatments with nickel-titanium (Ni-Ti) instruments. Its occurrence may drastically affect the outcome of the treatment, transforming a common otherwise efficient endodontic procedure into a complication such as tooth extraction. In order to discuss the ethical and legal consequences, two cases of dental strip perforations are herewith presented. Due to the existence of risk factors for dental strip perforation, experience of the clinician and the use of magnification and modern imagistic methods (CBCT) may avoid or reduce the frequency of this type of accidents. Under correct working circumstances, dental stripping should not be regarded as a malpractice but as a procedural accident. However, the patient must always be informed, before and during the endodontic procedure, about the event and the possible complications that may occur. PMID:27672458

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

    PubMed

    Asgary, Saeed; Fazlyab, Mahta

    2014-05-01

    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.

  11. Root Canal Stripping: Malpractice or Common Procedural Accident—An Ethical Dilemma in Endodontics

    PubMed Central

    Ciobanu, Ionela Elisabeta; Rusu, Darian; Didilescu, Andreea Cristina

    2016-01-01

    Root canal stripping is defined as an oblong, vertical perforation that appears especially in the middle section of curved root canals during endodontic treatments with nickel-titanium (Ni-Ti) instruments. Its occurrence may drastically affect the outcome of the treatment, transforming a common otherwise efficient endodontic procedure into a complication such as tooth extraction. In order to discuss the ethical and legal consequences, two cases of dental strip perforations are herewith presented. Due to the existence of risk factors for dental strip perforation, experience of the clinician and the use of magnification and modern imagistic methods (CBCT) may avoid or reduce the frequency of this type of accidents. Under correct working circumstances, dental stripping should not be regarded as a malpractice but as a procedural accident. However, the patient must always be informed, before and during the endodontic procedure, about the event and the possible complications that may occur.

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

    PubMed

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

    1989-01-01

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

  13. Endodontic Surgery of a Deviated Premolar Root in the Surgical Orthodontic Management of an Impacted Maxillary Canine.

    PubMed

    Pedullà, Eugenio; Valentino, Jessica; Rapisarda, Silvia

    2015-10-01

    Maxillary canine impactions are of multifactorial etiology. The incidence of maxillary canine impaction ranges from 1% to 4%. One of the reasons for canine impaction might be a deviated premolar root. This report describes surgical-orthodontic extrusion of an upper canine that occurred only after the endodontic surgery treatment of the adjacent deviated premolar root. Orthograde endodontic treatment followed by endodontic surgery with retrograde filling of the deviated premolar root was performed to obtain a surgical-orthodontic extrusion of the upper canine. A female patient, aged 15 years, with a class I molar relationship was referred to continue the orthodontic therapy. Although a correct surgical-orthodontic extrusion with adequate anchorage was carried out, the maxillary left canine had not erupted. Radiographic examination showed a deviated palatal root of the adjacent maxillary first premolar in the canine eruption path. Root canal filling followed by endodontic surgery of the first premolar deviated root has led to rapid progression of the canine and its placement in the arch in just 3 months. A multidisciplinary management involving endodontic treatment, endodontic surgery, and surgical-orthodontic extrusion could be considered a successful approach in the maxillary impacted canine cases in which adjacent premolar root is deviated. Long-term radiographic follow-up (6 years) indicated stable periodontal health of the canine and premolar without the presence of root resorption.

  14. Clinical and pharmacological management of endodontic flare-up

    PubMed Central

    Jayakodi, Harikaran; Kailasam, Sivakumar; Kumaravadivel, Karthick; Thangavelu, Boopathi; Mathew, Sabeena

    2012-01-01

    Knowledge of the causes of and mechanisms behind interappointment pain in endodontics is of utmost importance for the clinician to properly prevent or manage this undesirable condition. The causative factors of interappointment pain encompass mechanical, chemical, and microbial injuries to the pulp or periradicular tissues, which are induced or exacerbated during root canal treatment. This review article underlines the various treatment modalities for relief of pain and swelling in such situations, including premedication, drainage establishment, relief of occlusion, and intracanal and systemic medication. PMID:23066274

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

    Bahcall, James K

    2014-09-01

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

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

    PubMed

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

    2016-01-01

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

  18. Contemporary endodontic management of four rooted maxillary second molar using waveOne

    PubMed Central

    Pawar, Ajinkya M; Kokate, Sharad R

    2014-01-01

    Knowledge of root canal morphology and variations is an essential factor to successful endodontic treatment. Presence of extra roots, canals, lateral canals, deltas etc., is commonly encountered. Maxillary second molar with two palatal roots or root canals is a rare dental anatomy. The purpose of this case report is to describe the successful endodontic management of a maxillary second molar with four root canals using a single reciprocating file system. The morphology is a typical characterized by two palatal roots with widely separated two orifices and canals. The tooth presented an individual mesiobuccal, distobuccal and two separate palatal roots. PMID:24808714

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

    PubMed

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

    2016-04-01

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

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

    PubMed

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

    2016-04-01

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

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

    PubMed Central

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

    2016-01-01

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

  2. 21 CFR 872.6730 - Endodontic dry heat sterilizer.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Endodontic dry heat sterilizer. 872.6730 Section... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Miscellaneous Devices § 872.6730 Endodontic dry heat sterilizer. (a) Identification. An endodontic dry heat sterilizer is a device intended to sterilize...

  3. 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... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3890 Endodontic stabilizing splint. (a) Identification. An endodontic stabilizing splint is a device made of a material, such as titanium, intended to...

  4. 21 CFR 872.6730 - Endodontic dry heat sterilizer.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Endodontic dry heat sterilizer. 872.6730 Section... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Miscellaneous Devices § 872.6730 Endodontic dry heat sterilizer. (a) Identification. An endodontic dry heat sterilizer is a device intended to sterilize...

  5. 21 CFR 872.3890 - Endodontic stabilizing splint.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Endodontic stabilizing splint. 872.3890 Section... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3890 Endodontic stabilizing splint. (a) Identification. An endodontic stabilizing splint is a device made of a material, such as titanium, intended to...

  6. 21 CFR 872.3890 - Endodontic stabilizing splint.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Endodontic stabilizing splint. 872.3890 Section... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3890 Endodontic stabilizing splint. (a) Identification. An endodontic stabilizing splint is a device made of a material, such as titanium, intended to...

  7. 21 CFR 872.6730 - Endodontic dry heat sterilizer.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Endodontic dry heat sterilizer. 872.6730 Section... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Miscellaneous Devices § 872.6730 Endodontic dry heat sterilizer. (a) Identification. An endodontic dry heat sterilizer is a device intended to sterilize...

  8. 21 CFR 872.6730 - Endodontic dry heat sterilizer.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Endodontic dry heat sterilizer. 872.6730 Section... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Miscellaneous Devices § 872.6730 Endodontic dry heat sterilizer. (a) Identification. An endodontic dry heat sterilizer is a device intended to sterilize...

  9. 21 CFR 872.6730 - Endodontic dry heat sterilizer.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Endodontic dry heat sterilizer. 872.6730 Section... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Miscellaneous Devices § 872.6730 Endodontic dry heat sterilizer. (a) Identification. An endodontic dry heat sterilizer is a device intended to sterilize...

  10. Manual versus mechanical endodontic glidepath.

    PubMed

    West, John

    2011-01-01

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

  11. Manual versus mechanical endodontic glidepath.

    PubMed

    West, John

    2011-01-01

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

  12. On implementation of an endodontic program.

    PubMed

    Koch, Margaretha

    2013-01-01

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

  13. Antimicrobial activity of cationic peptides in endodontic procedures

    PubMed Central

    Winfred, Sofi Beaula; Meiyazagan, Gowri; Panda, Jiban J.; Nagendrababu, Venkateshbabu; Deivanayagam, Kandaswamy; Chauhan, Virander S.; Venkatraman, Ganesh

    2014-01-01

    Objectives: The present study aimed to investigate the antimicrobial and biofilm inhibition activity of synthetic antimicrobial peptides (AMPs) against microbes such as Enterococcus faecalis, Staphylococcus aureus, and Candida albicans which are involved in endodontic infections. Materials and Methods: Agar diffusion test was done to determine the activity of peptides. The morphological changes in E. faecalis and reduction in biofilm formation after treatment with peptides were observed using scanning electron microscope. The efficacy of peptides using an ex vivo dentinal model was determined by polymerase chain reaction and confocal laser scanning microscopy. Platelet aggregation was done to determine the biocompatibility of peptides. Results: Among 11 peptides, two of the amphipathic cationic peptides were found to be highly active against E. faecalis, S. aureus, C. albicans. Efficacy results using dentinal tubule model showed significant reduction in microbial load at 400 μm depth. The peptides were also biocompatible. Conclusion: These results suggest that synthetic AMPs have the potential to be developed as antibacterial agents against microorganisms involved in dental infections and thus could prevent the spread and persistence of endodontic infections improving treatment outcomes and teeth preservation. PMID:24966779

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

    NASA Astrophysics Data System (ADS)

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

    1999-05-01

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

  15. 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.

  16. Benchmarking the endodontic literature on MEDLINE.

    PubMed

    Kim, M Y; Lin, J; White, R; Niederman, R

    2001-07-01

    The purpose of this study was to identify and quantify the endodontic literature available for clinical decision making. A search strategy based on Medical Subject Headings for endodontics was developed to examine MEDLINE. The identified articles were limited to human subjects and English. Sensitive and specific methodological search filters identified four categories of information: etiology, diagnosis, therapy, and prognosis. The results were then subdivided by year to identify trends. Between 1990 and 1998 MEDLINE identified 3,152 articles published in English on endodontics in humans. The number of articles per year (mean +/- SD) for sensitive and specific searches was etiology (28+/-10, 1+/-2), diagnosis (38+/-11, 1+/-1), therapy (59+/-15, 3+/-3), and prognosis (40+/-13, 10+/-5), respectively. The number of articles in each category increased by 1 to 3% each year. There were 150 articles/yr in endodontics in at least 120 journals cited on MEDLINE on which to base clinical decisions. PMID:11503999

  17. The Level of Anxiety and Pain Perception of Endodontic Patients

    PubMed Central

    Perković, Ivana; Romić, Martina Knežević; Perić, Marina

    2014-01-01

    Objectives to compare the level of anxiety reported by patients and assessed by dentists. Also, the expected and actual pain during the treatment perceived by the patient and dentist were assessed. Methods sixty six endodontic patients filled in two questionnaires, prior to and after the treatment, so did their therapists. The first set of questions for patients was regarding demographics, the frequency of dental visits, the level of anxiety and expectations about the level of pain. Before the treatment, dentists estimated the level of patients' anxiety and the expected intensity of pain. After the treatment, the patients evaluated the level of experienced pain and dentists' empathy during the treatment, while dentists reassessed the intensity of patients' pain.The data were statistically analysed by t-test for paired samples and by Spearmans's Rho correlation coefficient at level of significance set at 0.05. Results Patients' expectation of pain intensity was higher than the actual pain during the treatment (t-test=3.540, p=0.001). There was no difference in the level of pain which dentists expected and their perception of pain during the procedure. There was a statistically significant correlation between the patients' level of anxiety and recognition of it by dentists (Spearman Rho=0.460, p<0.001). A higher level of anxiety increased the expected intensity of pain (Spearman Rho=0.401, p=0.001). Actual intensity of pain was not significantly associated with dental anxiety (Spearman Rho=0.080, p=0.524). Conclusion Since the level of dental anxiety was associated with the increased intensity of expected pain, a vicious cycle of pain and anxiety may be terminated by giving positive information to the patient before and during endodontic procedures.

  18. A method to minimize complications in endodontic access cavity preparation.

    PubMed

    Zelikow, Robert; Cozzarelli-Moldauer, Gina; Keiner, Steven; Hardigan, Patrick C

    2008-06-01

    This article presents a method of avoiding some operative errors in endodontic-access cavity preparation. Utilizing the radiograph, a line representing the coronal extension of the image of the coronal two-thirds of the root canal(s) is drawn on the facial surface of the crown (Fig. 1). This line determines the proper angulation of the bur to facilitate entry into the pulp chamber in proper mesio-distal orientation, thereby reducing the likelihood of mesial and distal gouging and perforating. Marking the tooth to be treated prior to rubber-dam placement help in preventing treatment of an incorrect tooth. Two studies utilizing Nova Southeastern University College of Dental Medicine (NSUCDM) second-year dental students (D-2), one utilizing University of Florida, College of Dentistry (UFCD) second year dental students (D2) and one utilizing NSUCDM Advanced Education in General Dentistry (AEGD) faculty and students were undertaken to evaluate the method. Evaluation was by endodontic teachers. Results indicate use of the line-drawing method may facilitate more ideal access cavities than those prepared without the method. Welch's t-test, chi-square test and estimating equations were employed. One study showed significant difference between control and test groups (p less than 045). All studies indicated a difference. Further testing of the method is indicated. This valuable tool should be considered for use in teaching and practice.

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

    PubMed

    Monea, Monica; Moldovan, Cosmin

    2016-05-01

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

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

    PubMed

    2009-08-01

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

  1. 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

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

    PubMed

    Tanikonda, Rambabu

    2016-01-01

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

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

    PubMed Central

    Tanikonda, Rambabu

    2016-01-01

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

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

    Hauman, C H J; Love, R M

    2003-03-01

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

  7. 21 CFR 872.3830 - Endodontic paper point.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

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

  8. 21 CFR 872.3890 - Endodontic stabilizing splint.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Endodontic stabilizing splint. 872.3890 Section 872.3890 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3890 Endodontic stabilizing splint....

  9. 21 CFR 872.3890 - Endodontic stabilizing splint.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2009-08-01

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

  11. Application of lasers in endodontics

    NASA Astrophysics Data System (ADS)

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

    1997-12-01

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

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

    PubMed

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

    2016-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  14. Histologic Outcomes of Uninfected Human Immature Teeth Treated with Regenerative Endodontics: 2 Case Reports.

    PubMed

    Nosrat, Ali; Kolahdouzan, Alireza; Hosseini, Farzaneh; Mehrizi, Ehsan A; Verma, Prashant; Torabinejad, Mahmoud

    2015-10-01

    A growing body of evidence exists showing the possibility of growing vital tissues in the root canal spaces of teeth with necrotic pulps and open apices. However, there is very limited histologic information regarding characteristics of tissues formed in the root canal space of human teeth after regenerative endodontics. The aim of this study was to examine clinically and histologically the outcomes of human immature teeth treated with regenerative endodontics. Two healthy birooted human maxillary first premolar teeth scheduled for extraction were included. Preoperative radiographs confirmed that these teeth had immature apices. Vitality tests showed the presence of vital pulps in these teeth. After receiving consent forms, the teeth were isolated with a rubber dam, and the pulps were completely removed. After the formation of blood clots in the canals, the teeth were covered with mineral trioxide aggregate. Four months later, the teeth were clinically and radiographically evaluated, extracted, and examined histologically. Both patients remained asymptomatic after treatment. Radiographic examination of the teeth showed signs of root development after treatment. Histologic examination of tissues growing into the root canal space of these teeth shows the presence of connective tissue, bone and cementum formation, and thickening of roots. Based on our findings, it appears that when canals of teeth with open apices are treated with regenerative endodontics, tissues of the periodontium grow into the root canals of these teeth.

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

    PubMed

    Mohammadi, Z; Dummer, P M H

    2011-08-01

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

  16. 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

  17. The Adoption of New Endodontic Technology by Indian Dental Practitioners: A Questionnaire Survey

    PubMed Central

    Gupta, Ruchi; Rai, Rochna

    2013-01-01

    Aim: To ascertain the adoption of new endodontic technology in general dental practice in India in 2011. Methodology: A postal questionnaire survey comprising 26 questions was sent to 700 general dental practitioners. The questions covered professional activity, root canal preparation and instrumentation, choice of irrigants and intracanal medicaments, choice of obturation techniques and other aspects of endodontics. The data were analyzed using descriptive statistics and the Chi-square (χ2) test at 0.05 level of significance. Results: The overall response rate was 88%. The results showed that rubber dams were used by 27% of dental practitioners in India. The most widely used irrigant was sodium hypochlorite, which was used by 33% of the respondents. Thirty nine percent of the practitioners were still incorporating only hand files during the cleaning and shaping phase of treatment. The technique of choice was both step back and crown down (35%). Calcium hydroxide was found to be the most frequently used (62%) intracanal medicament. Lateral condensation with guttapercha (61%) was the most common method used for obturation. Majority used zinc oxide eugenol as a sealer (55%). The post obturation restoration was done mostly by composite material (46%). Most of the respondents placed crowns after root canal treatment. Digital radiography was reported as being used by 17% of the respondents. There was no difference between males and females with respect to the incorporation of new technologies in dentistry. They had been incorporated significantly more by respondents who held postgraduate qualifications and had professional activities of <5 years. Conclusion: The results indicated that new endodontic technology and materials are slowly being incorporated in clinical practice of endodontics in India. This survey shows the importance of continuing dental education for practitioners to update their knowledge. PMID:24392420

  18. An innovative approach in microscopic endodontics.

    PubMed

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

    2014-05-01

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

  19. 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

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

    PubMed Central

    Kumar, Varun

    2016-01-01

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

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

    PubMed

    Juneja, Ruchi; Kumar, Varun

    2016-02-01

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

  2. The Level of Evidence in Two Leading Endodontic Journals

    PubMed Central

    Shafiei, Leila; Shahravan, Arash

    2013-01-01

    Introduction The successful practice of dentistry, including endodontics, relies on a wide spectrum of dental research. The quantity and quality of research evidence in endodontics have seldom been evaluated. The aim of this study was to evaluate the level of evidence in current leading endodontic journals. Materials and Methods All the articles published in 2000, 2006 and 2010 in two major endodontic journals (Journal of Endodontics and International Endodontic Journal) were evaluated. These articles were classified according to the level of evidence (LOE) using Oxford Scale from 0 to 5 and type of the study. Results Of the articles assessed, 3.2% were clinical trials, 47.8% were experimental, 5.6% were animal studies and 43.4% were of other types. Subdivisions according to LOE were 4.3% as level 1, 0.9 % level 2, 7.3% level 3, 0.4% level 4 and 3.5% level 5. Overall, 83.6% of the articles were classified as “non-evidence-based”. There was a marginally significant increase in the percentage of articles with high level of evidence in recent years. Conclusion There is a substantial shortage of articles with high level of evidence in clinical endodontics. However, there was a gradual increase in the number of high LOE articles published in both journals. PMID:23411681

  3. 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

  4. 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.

  5. Severe tissue necrosis following intra-arterial injection of endodontic calcium hydroxide: a case series.

    PubMed

    Sharma, Sanjay; Hackett, Robert; Webb, Roger; Macpherson, David; Wilson, Alan

    2008-05-01

    We present 2 cases of intra-arterial injection of endodontic calcium hydroxide via the root canal system of molar teeth. Nonsetting calcium hydroxide paste was used as a temporary dressing during endodontic treatment and in both cases delivered via an injectable syringe technique. Retrograde flow of the calcium hydroxide occurred along the artery until its origin where orthograde flow continued to the capillary bed. Case 1 demonstrates calcium hydroxide injected into the distal root canal of a lower second molar resulting in its distribution to the external carotid bed and case 2 demonstrates calcium hydroxide injected into the palatal root of an upper second molar with flow into the infraorbital artery. In both cases this resulted in severe clinical signs and symptoms ending in tissue necrosis. Long-term sequelae included scarring, deformity, and chronic pain. This case series illustrates the high toxicity of calcium hydroxide when displaced into vessels and soft tissues. Caution should be exercised when using injectable systems for endodontic calcium hydroxide. PMID:18442746

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

    PubMed Central

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

    2016-01-01

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

  7. On the local applications of antibiotics and antibiotic-based agents in endodontics and dental traumatology.

    PubMed

    Mohammadi, Z; Abbott, P V

    2009-07-01

    Antibiotics are a valuable adjunctive to the armamentarium available to health professionals for the management of bacterial infections. During endodontic treatment and when managing trauma to the teeth, antibiotics may be applied systemically (orally and/or parenterally) or locally (i.e. intra-dentally via irrigants and medicaments). Due to the potential risk of adverse effects following systemic application, and the ineffectiveness of systemic antibiotics in necrotic pulpless teeth and the periradicular tissues, the local application of antibiotics may be a more effective mode for delivery in endodontics. The aim of this article was to review the history, rationale and applications of antibiotic-containing irrigants and medicaments in endodontics and dental traumatology. The search was performed from 1981 to 2008 and was limited to English-language papers. The keywords searched on Medline were 'Antibiotics AND endodontics', 'Antibiotics AND root canal irrigation', 'Antibiotics AND intra-canal medicament', 'Antibiotics AND Dental trauma' and 'Antibiotics AND root resorption'. The reference section of each article was manually searched to find other suitable sources of information. It seems that local routes of antibiotic administration are a more effective mode than systemic applications. Various antibiotics have been tested in numerous studies and each has some advantages. Tetracyclines are a group of bacteriostatic antibiotics with antibacterial substantivity for up to 12 weeks. They are typically used in conjunction with corticosteroids and these combinations have anti-inflammatory, anti-bacterial and anti-resorptive properties, all of which help to reduce the periapical inflammatory reaction including clastic-cell mediated resorption. Tetracyclines have also been used as part of irrigating solutions but the substantivity is only for 4 weeks. Clindamycin and a combination of three antibiotics (metronidazole, ciprofloxacin and minocycline) have also been

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

    PubMed

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

    2016-01-01

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

  9. 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.

  10. The properties and applications of chlorhexidine in endodontics.

    PubMed

    Mohammadi, Z; Abbott, P V

    2009-04-01

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

  11. 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.

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

    PubMed

    Monea, Monica; Moldovan, Cosmin

    2016-05-01

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

  13. Healing of a fibrous dysplastic lesion in a permanent molar after endodontic therapy.

    PubMed

    Slutzky-Goldberg, Iris; Heling, Ilana

    2007-03-01

    Fibrous dysplasia presents in two forms: monostotic and polyostotic. Both forms are more widespread among children and juveniles and may result in facial asymmetry. Neoplastic bone lesions, localized over the root apices and mimicking periapical pathosis, have been observed. Irregular pulp morphology not previously reported is described in the following case report. A 14-year-old boy diagnosed with fibrous dysplasia was referred for endodontic treatment as the result of a necrotic pulp in an upper molar. A periapical lesion was diagnosed when the tooth was intact. After complex root canal treatment the periapical lesion healed. PMID:17320723

  14. Absorbed radiation by various tissues during simulated endodontic radiography

    SciTech Connect

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

    1989-06-01

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

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

    PubMed

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

    2016-01-01

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

  16. Translational opportunities in stem cell-based endodontic therapy: where are we and what are we missing?

    PubMed

    Peters, Ove A

    2014-04-01

    Pulp regeneration is a biologic process occurring under specific circumstances. An endodontic treatment modality to accomplish pulp regeneration has emerged based on the response of undifferentiated cells that are often referred to as stem cells. The treatment itself is currently empirical based on clinicians' thoughts and observations. The demonstration of a variety of dental stem cells initiated basic research detailing the properties and behavior of these cells. Attempts are made to bridge gaps in knowledge regarding treatment strategies by translating basic stem cell research into practice. However, neither the patient population likely to benefit from pulp regeneration nor most clinical parameters are well described. Classic topics in endodontics (eg, indication/clinical diagnosis, disinfection/irrigation, and root canal preparation/pretreatment) have to be revisited under the premises of pulp regeneration. Furthermore, new topics like the development of new diagnostic tools or new clinical success criteria will emerge, and the translational research itself will generate new insight into pulp regeneration mechanisms.

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

    PubMed

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

    2009-01-01

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

  18. 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

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

    PubMed

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

    2014-12-01

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

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2016-05-01

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

  2. Clinical decision-making after endodontic instrument fracture.

    PubMed

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

    2013-04-01

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

  3. Endoscopic removal of an endodontic file accidentally swallowed: clinical and legal approaches.

    PubMed

    Silva, Rhonan F; Martins, Emerson C; Prado, Felippe B; Júnior, Jacy R C; Júnior, Eduardo D

    2011-08-01

    The use of a rubber dam is an essential procedure when treating root canals, and not using it may compromise the success of the treatment, as well as the patient's health. This report presents a case in which a K-file was accidentally swallowed during an endodontic procedure, performed without the use of a rubber dam. Given the absence of immediate clinical complications, the subject underwent a chest radiograph. The file was located at the oesophagogastric junction and was later removed by endoscopy. In addition to the clinical repercussions, this example also illustrates the ethical-legal aspects of this type of accident.

  4. Endodontic Management of Maxillary First Molar with Type I Canal Configuration– A Rare Case Report

    PubMed Central

    Desai, Niranjan; Raghavendra, Srinidhi Surya; Mittal, Priya; Patil, Gururaj

    2015-01-01

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

  5. Crown and post-free adhesive restorations for endodontically treated posterior teeth: from direct composite to endocrowns.

    PubMed

    Rocca, Giovanni Tommaso; Krejci, Ivo

    2013-01-01

    Coronal rehabilitation of endodontically treated posterior teeth is still a controversial issue. Although the classical crown supported by radicular metal posts remains widely spread in dentistry, its invasiveness has been largely criticized. New materials and therapeutic options based entirely on adhesion are nowadays available. They allow performing a more conservative, faster and less expensive dental treatment. All clinical cases presented in this paper are solved by using these modern techniques, from direct composite restorations to indirect endocrowns.

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

    PubMed Central

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

    2013-01-01

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

  7. 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

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

    PubMed Central

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

    2015-01-01

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

  9. Endodontic management of immature teeth with spontaneous apical closure and periapical lesions: case series and review of the literature.

    PubMed

    Çalışkan, Mehmet Kemal; Kaval, Mehmet Emin

    2015-08-01

    Spontaneous apical closure in non-vital immature teeth has been rarely encountered and outcome of non-surgical endodontic treatment of related teeth associated with periapical lesions has not yet been adequately elucidated. The aim of this article was to report endodontic management of spontaneous apical closure of infected untreated immature teeth with periapical lesions and to review previously proposed mechanisms for the development of spontaneous hard tissue barrier. Three patients were referred at different time intervals to the endodontic clinic for treatment of their maxillary anterior incisors with acute or chronic apical periodontitis. Dental histories indicated that related teeth had been subjected to trauma approximately 12-18 years previously. Radiographically, the involved teeth exhibited incomplete root formation with spontaneous apical closure and were associated with an apical radiolucency. After biomechanical preparation, calcium hydroxide paste was applied and was changed once or twice within 3 months. All canals were then filled with gutta-percha and AH Plus and the follow-up period was 16-50 months; both clinical and radiographic examinations revealed adequate function, the absence of clinical symptoms and significant healing of the periapical radiolucency.

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

    PubMed

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

    2015-01-01

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

  11. MicroRNAs: New Insights Into the Pathogenesis of Endodontic Periapical Disease

    PubMed Central

    Chan, Linda T.; Zhong, Sheng; Naqvi, Afsar Raza; Self-Fordham, Jezrom; Nares, Salvador; Bair, Eric; Khan, Asma

    2013-01-01

    Introduction Apical periodontitis is an inflammatory disease of the periradicular tissues caused by the host’s immune response to infection of the root canal system. microRNAs (miRNAs) have been shown to play an important role in the regulation of inflammation and the immune response; however, their role in the pathogenesis of endodontic periapical disease has not been explored. The purpose of this study was to examine the differential expression of miRNAs in diseased periapical tissues as compared to healthy controls. Methods We first compared miRNA profiles in diseased periapical tissues collected from patients undergoing endodontic surgery to that of healthy pulps using microarray analyses. The target genes of the differentially expressed miRNAs were identified using miRWalk and PUBMED. Selected miRNAs linked to inflammation and the immune response were then confirmed in a separate cohort of diseased and healthy tissues using quantitative RT-PCR. Healthy pulps and periodontal ligaments were used as controls. Data was normalized to the level of SNORD 44 which served as an endogenous control. Results Of the 381 miRNAs identified using microarray, 24 miRNAs were down-regulated in diseased periapical tissues compared to controls (n=13) (P<0.003). The down-regulation of 7 miRNAs was confirmed from 9 selected miRNAs using qRT-PCR (n=19) (P<0.05). Target genes of these miRNAs include key mediators in the immune and inflammatory response such as of IL-6, MMP-9 and TGF-β. Conclusions These findings offer new insight into the pathogenesis of endodontic disease and have the potential to impact the development of new methods for prevention, diagnosis, and treatment of apical periodontitis. PMID:24238436

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

    PubMed Central

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

    2016-01-01

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

  13. Presence of Candida Albicans in Root Canal System of Teeth Requiring Endodontic Retreatment with and without Periapical Lesions

    PubMed Central

    Ashraf, Hengameh; Samiee, Mohammad; Eslami, Gita; Ghodse Hosseini, Mohammad Reza

    2007-01-01

    INTRODUCTION: An important consideration in endodontic treatment is the elimination of microorganisms, including fungi, from the complex three- dimensional root canal system. Candida Albicans (CA) has a major role in endodontic treatment failure as the most important fungus isolated from the root canal system. The present study was carried out to evaluate the presence of CA in the teeth requiring endodontic retreatment, with or without periapical lesions. MATERIALS AND METHODS: This study was carried out on 60 root canals from human molars requiring endodontic retreatment. The root canals were randomly divided into two equal groups of 30 canals with versus without periapical lesions. Samples were collected from the root canals and cultured on MacConkey and blood agar culture media. The samples suspected of having CA were streaked on Sabouraud’s Dextrose Agar (SDA) and evaluated under a light microscope. Data was analyzed and compared using Chi- square and Kappa tests. RESULTS: CA was found in 11 patients (36.7%) with periapical lesions. In the patients without periapical lesions only 4 samples demonstrated CA in the root canal systems (13.3%). The difference between the two groups as to the presence of CA was statistically significant (p<0.037). In addition, evaluation of salivary samples revealed 15 cases (50%) of CA presence in the patients with periapical lesions and 16 cases (53.3%) of CA in the patients without periapical lesions, demonstrating no statistically significant difference between the two groups. CONCLUSION: Considering the fact that the presence of CA in the root canal systems of teeth with periapical lesions was more noticeable and statistically significant compared to the teeth without periapical lesions, the elimination of this microorganism from the root canal system, using appropriate intracanal solutions and medications is of utmost importance. PMID:24348654

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

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

    2015-01-01

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

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

    PubMed Central

    Yousuf, Waqas; Khan, Moiz; Mehdi, Hasan

    2015-01-01

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

  17. Removal of Separated Endodontic K-File with the Aid of Hypodermic Needle and Cyanoacrylate

    PubMed Central

    Frota, Luciana Maria Arcanjo; Aguiar, Bernardo Almeida; Aragão, Maria Gerusa Brito

    2016-01-01

    A wide range of accidents might happen during the treatment of the root canal system, where the instrument separation is one of the most unpleasant occurrences. Several techniques have been developed to facilitate the removal of the fragments; however, they generally require specific devices that not always are available to the clinician. The aim of this case report is to present a simple alternative technique to remove from the root canals manual instruments fractured during the treatment. The case has its outline based on a 31-year-old patient who sought the clinic to have her maxillary first left premolar rehabilitated. The clinic and radiographic examinations revealed the need of endodontic retreatment and the presence of a fragment of a K-file instrument localized at the apical third of the palatine canal. The retreatment was initiated by the removal of the obturation materials followed by several unsuccessful attempts to take out the fractured instrument. Hence, it was chosen to perform the fragment removal using a hypodermic needle and cyanoacrylate adhesive. The fragment easily came out, which reinforces the technique adopted as a safe, simple, and low cost mean to solve the problem of fractured instruments using only items already present in the endodontic arsenal. PMID:27781128

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

    PubMed

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

    2013-01-01

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

  19. 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

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

    PubMed

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

    2015-02-01

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

  1. The effect of some fluids on surface oxidation and amount of released iron of stainless steel endodontic files.

    PubMed

    Saghiri, Mohammad Ali; García-Godoy, Franklin; Lotfi, Mehrdad; Mehrvazfar, Peyman; Aminsobhani, Mohsen; Rezaie, Samad; Asgar, Kamal

    2012-01-01

    Endodontic files come in contact with blood, infected pulp tissue, and irrigating solutions during root canal therapy. Some instruments such as stereomicroscopy and scanning electron microscopy are used to observe corrosion of endodontic files which are complicated and dependent on preparation methods. Having knowledge of the corrosion and ion release of endodontic files can help in drawing firm deductions as to which files would perform better in the clinical scenario. Therefore, we have used energy dispersive X-ray analysis and an atomic absorption spectrophotometer to track oxygen on the surface and iron in the exposed media to observe the oxidative rate of the media. In this study, corrosion by blood was higher than other biological fluids, but less than with sodium hypochlorite (NaOCl). Observations of energy dispersive X-ray analysis and atomic absorption spectrophotometer results demonstrated that after exposure the amount of oxygen on the surface and surrounding areas increased. Therefore, the files should be rinsed as soon as possible during and after use to hinder the oxidation rate, but blood may produce a different behavior and it might be considered as a decreased risk of broken stainless steel files remaining in the root canal after treatment.

  2. [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.

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

    PubMed Central

    2011-01-01

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

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

    PubMed

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

    1991-01-01

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

  5. 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…

  6. Influence of root canal instrumentation and obturation techniques on intra-operative pain during endodontic therapy

    PubMed Central

    Martín-González, Jenifer; Echevarría-Pérez, Marta; Sánchez-Domínguez, Benito; Tarilonte-Delgado, Maria L.; Castellanos-Cosano, Lizett; López-Frías, Francisco J.

    2012-01-01

    Objective: To analyse the influence of root canal instrumentation and obturation techniques on intra-operative pain experienced by patients during endodontic therapy. Method and Materials: A descriptive cross-sectional study was carried out in Ponferrada and Sevilla, Spain, including 80 patients (46 men and 34 women), with ages ranged from 10 to 74 years, randomly recruited. Patient gender and age, affected tooth, pulpal diagnosis, periapical status, previous NSAID or antibiotic (AB) treatment, and root canal instrumentation and obturation techniques were recorded. After root canal treatment (RCT), patients completed a 10-cm visual analogue scale (VAS) that ranked the level of pain. Results were analysed statistically using the Chi-square and ANOVA tests and logistic regression analysis. Results: The mean pain level during root canal treatment was 2.9 ± 3.0 (median = 2) in a VAS between 0 and 10. Forty percent of patients experienced no pain. Gender, age, arch, previous NSAIDs or AB treatment and anaesthetic type did not influence significantly the pain level (p > 0.05). Pain during root canal treatment was significantly greater in molar teeth (OR = 10.1; 95% C.I. = 1.6 - 63.5; p = 0.013). Root canal instrumentation and obturation techniques did not affect significantly patient’s pain during root canal treatment (p > 0.05). Conclusion: Patients feel more pain when RCT is carried out on molar teeth. The root canal instrumentation and obturation techniques do not affect significantly the patients’ pain during RCT. Key words:Anaesthesia, endodontic pain, pulpitis, root canal instrumentation, root canal obturation, rotary files. PMID:22549694

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

    PubMed

    Kvist, T

    2001-01-01

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

  8. Use of photoactivated disinfection and platelet-rich fibrin in regenerative Endodontics

    PubMed Central

    Johns, Dexton Antony; Shivashankar, Vasundara Yayathi; Krishnamma, Shoba; Johns, Manu

    2014-01-01

    Aim: Photoactivated disinfection has been used as an adjunct to conventional endodontic treatment. Its use in regenerative endodontics is not reported in literature. The aim of this case report was to describe a new proposal for pulp revascularization with disinfection of pulp canal space using a unique combination of a photosensitizer solution and low-power laser light. Materials and Methods: A 9-year-old boy came with the chief complaint of discolored upper central incisors (#8, #9). A diagnosis of pulp necrosis was made on the basis of clinical and radiographic findings. The canal was irrigated with 5.25% sodium hypochlorite solution and dried with paper points. Photodynamic therapy was used to disinfect the root canal and platelet-rich fibrin was used to revitalize the pulp. Three millimeters of gray mineral trioxide aggregate was placed directly over the platelet-rich plasma clot. Three days later, the tooth was double-sealed with permanent filling materials. Results: Clinical examination revealed no sensitivity to percussion or palpation tests. Radiograph revealed continued thickening of the dentinal walls, root lengthening, regression of the peri-apical lesion and apical closure. Both the roots showed complete apical closure at the 10-month follow-up. However, the teeth were not responsive to electric pulp test. Conclusion: This report of pulp revascularization shows that disinfection with photodynamic therapy combined with platelet-rich fibrin leads to satisfactory root development in necrotic immature teeth. PMID:25298655

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

    PubMed

    Zarow, Maciej; Devoto, Walter; Saracinelli, Monalds

    2009-01-01

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

  10. Magnifying loupes versus surgical microscope in endodontic surgery: a four-year retrospective study.

    PubMed

    Taschieri, Silvio; Weinstein, Tommaso; Tsesis, Igor; Bortolin, Monica; Del Fabbro, Massimo

    2013-08-01

    The purpose of this retrospective study was to evaluate the 4-year outcome of endodontic microsurgery using two different magnification devices. One-hundred and two teeth in 65 patients were included according to specific selection criteria. Endodontic surgery was performed under surgical microscope as magnification device in 63 teeth in 36 patients, while 39 teeth in 29 patients were treated under magnifying loupes. Thirteen patients did not attend the 4-year follow up. The overall success rate on a patient basis was 91.7% at the 1-year and 90.5% at the 4-year follow up for the group using loupes, while for the group using microscope it was 91.4% at the 1-year and 93.3% at the 4-year follow up. The relative risk was 2.07 (95% confidence interval: 0.31, 13.95) in favour of the group in which microscope was used. No statistically significant difference was found in the treatment outcomes relating to the type of magnification device. PMID:23890264

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

    PubMed

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

    2013-01-01

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

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

    PubMed

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

    2016-01-01

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

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

    PubMed

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

    2015-01-01

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

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

    PubMed

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

    2015-01-01

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

  15. Intentional replantation of a mandibular canine with multiple iatrogenic endodontic complications.

    PubMed

    Sübay, R K; Sübay, M O; Balkaya, C M

    2014-09-01

    Teeth being exposed to multiple iatrogenic complications during root canal treatment are usually extracted and replaced with a dental implant. This case report presents the treatment of a mandibular canine that had multiple endodontic complications using an intentional replantation technique. The case was showing swelling and pain, unusual canal anatomy, periapical lesion, broken instruments, and root perforation in association with overfilling. After extraction of the root, the resected root end and perforation were sealed using mineral trioxide aggregate. The root was replanted extrusively, fixed and restored with a crown. Appearances of slowly progressing replacement resorption were detected radio graphically at 6-, 12- and 24-month recalls. The tooth was functioning successfully without showing clinical symptoms at 6-, 12-and 24-month recalls.

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

    PubMed Central

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

    2016-01-01

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

  17. Analysis of endodontic therapy in patients irradiated for head and neck cancer

    SciTech Connect

    Seto, B.G.; Beumer, J. 3d.; Kagawa, T.; Klokkevold, P.; Wolinsky, L.

    1985-11-01

    The outcome of endodontic therapy in 16 patients irradiated for head and neck cancer was studied. Thirty-five postradiation endodontically treated teeth (54 roots) were included in the study. The follow-up period ranged from 6 months to 54 months. At the time of last follow-up, 46 of 54 roots were being maintained. No osteoradionecroses were seen in association with teeth that had been endodontically treated. From this review, it is clear that endodontic therapy is a viable method of treating diseased teeth in patients irradiated for oral neoplasms.

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

    PubMed Central

    Alshiddi, Ibraheem F.; Aljinbaz, Amjad

    2015-01-01

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

  19. A Natural Meliorate: Revolutionary Tissue Engineering in Endodontics

    PubMed Central

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

    2013-01-01

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

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

    PubMed Central

    Makkar, Sameer; Gupta, Pranav

    2015-01-01

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

  1. 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

  2. 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

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

    PubMed

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

    2016-01-01

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

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

    PubMed

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

    2016-01-01

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

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

    PubMed

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

    2016-01-01

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

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

    PubMed

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

    2016-01-01

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

  7. 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

  8. Identification of selected respiratory pathogens in endodontic infections

    PubMed Central

    Nandakumar, R.; Whiting, J.; Fouad, A. F.

    2008-01-01

    Objective To determine whether endodontic infections could harbor common etiologic agents of respiratory infections such as Streptococcus pneumoniae and Chlamydia pneumoniae. Methods Specimens were aseptically obtained from 40 patients with endodontic infections. For the detection of C. pneumoniae, a single step 16S rRNA based PCR and a nested PCR targeting aromatic amino acid hydroxylase were used. For the identification of S. pneumoniae, primers targeting 16S rRNA gene and autolysin (lytA) were used. Results Of 21 patient samples tested with the 16S rRNA-based PCR for S. pneumoniae, positive amplification was observed in all except three specimens. However, sequencing and phylogenetic analysis revealed that the product belonged to other bacterial phylotypes. The lytA-based PCR for S. pneumoniae and both PCR assays for C. pneumoniae failed to detect these organisms in all the specimens tested. Conclusions S. pneumoniae and C. pneumoniae were not present in endodontic infections. PCR primers with less stringent specificity will inaccurately identify respiratory pathogens. PMID:18585629

  9. Intraradicular Splinting with Endodontic Instrument of Horizontal Root Fracture

    PubMed Central

    Çiçek, Ersan; Yılmaz, Neslihan; Koçak, Mustafa Murat

    2015-01-01

    Introduction. Root fractures, defined as fractures involving dentine, cementum, and pulpal and supportive tissues, constitute only 0.5–7% of all dental injuries. Horizontal root fractures are commonly observed in the maxillary anterior region and 75% of these fractures occur in the maxillary central incisors. Methods. A 14-year-old female patient was referred to our clinic three days after a traffic accident. In radiographic examination, the right maxillary central incisor was fractured horizontally in apical thirds. Initially, following local infiltrative anesthetics, the coronal fragment was repositioned and this was radiographically confirmed. Then the stabilization splint was applied and remained for three months. After three weeks, according to the results of the vitality tests, the right and left central incisors were nonvital. For the right central incisor, both the coronal and apical fragments were involved in the endodontic preparation. Results. For the right central tooth, both the coronal and apical root fragments were endodontically treated and obturated at a single visit with white mineral trioxide aggregate whilst the fragments were stabilized internally by insertion of a size 40 Hedstrom stainless-steel endodontic file into the canal. Conclusion. Four-year follow-up examination revealed satisfactory clinical and radiographic findings with hard tissue repair of the fracture line. PMID:25648395

  10. Structural behaviour of endodontically treated teeth under thermomechanical loading.

    PubMed

    Genovese, K; Lamberti, L; Pappalettere, C

    2006-11-01

    Choosing the optimal combination of post construction and restorative materials to minimize thermomechanical stresses in endodontically post-restored teeth is a very challenging task. In fact, while thermal properties of metallic alloys used for endodontic posts are rather similar to those of natural dental tissues, composite restorative materials used for constructing post and postcore usually possess better mechanical properties than metallic alloys. This may make it very difficult to evaluate directly thermomechanical stresses in the restored tooth. Therefore, this paper presents a detailed analysis of the structural behaviour of several post-endodontic restorations submitted to different combinations of thermomechanical load. The aim of the study is to compare the relative merits of different restoration concepts. Three-dimensional finite element method (FE) analysis is carried out for an upper incisor restored with composite as well as metallic post systems. Furthermore, customized and standard post constructions are compared. Two loading cases are considered: (a) exposure to cold irritants in absence of mastication; (b) mastication of cold or hot foods. Effects of thermal field inhomogeneity and occlusal force magnitude are also included in the analysis. Because of the transient nature of thermal loads, relative performance of different restorations is investigated as the thermal perturbation spreads through the restored tooth. Results indicate that composite post systems are globally more efficient than restorations including a metallic alloy post when thermal cycles and mastication act together. However, relative performance of different restoration concepts in the absence of mastication may depend strongly on the time of exposure to thermal irritants.

  11. Effective exposure level and diagnostic performance in endodontic radiography

    SciTech Connect

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

    1983-05-01

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

  12. Nonsurgical Endodontic Retreatment of Advanced Inflammatory External Root Resorption Using Mineral Trioxide Aggregate Obturation

    PubMed Central

    Utneja, Shivani; Garg, Gaurav; Arora, Shipra; Talwar, Sangeeta

    2012-01-01

    Inflammatory external root resorption is one of the major complications after traumatic dental injury. In this case report, we describe treatment of a maxillary central incisor affected by severe, perforating external root resorption. An 18-year-old patient presented with a previously traumatized, root-filled maxillary central incisor associated with pain and sinus tract. Radiographic examination revealed periradicular lesion involving pathologic resorption of the apical region of the root and lateral root surface both mesially and distally. After removal of the root canal filling, the tooth was disinfected with intracanal triple antibiotic paste for 2 weeks. The antibiotic dressing was then removed, and the entire root canal was filled with mineral trioxide aggregate. The endodontic access cavity was restored with composite resin. After 18 months, significant osseous healing of the periradicular region and lateral periodontium had occurred with arrest of external root resorption, and no clinical symptoms were apparent. PMID:23304567

  13. Restoration of Endodontically Treated Teeth Review and Treatment Recommendations

    PubMed Central

    Slutzky-Goldberg, Iris; Slutzky, Hagay; Gorfil, Colin; Smidt, Ami

    2009-01-01

    Coronal restorations and posts can positively influence the long-term prognosis of teeth following root canal therapy. Final sealing the canal by placing an appropriate post and core will minimize leakage of oral fluids and bacteria into the periradicular area and is recommended as soon as possible after completion of root canal filling. Glass ionomer or MTA placed over the residual root canal filling after post space preparation may be effective to prevent bacterial leakage. A ferrule of 1-2 mm of tooth tissue coronal to the finish line of the crown significantly improves the fracture resistance of the tooth and is more important than the type of the material the core and post are made of. PMID:20309408

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

    PubMed

    Canalda Sahli, C

    1990-01-01

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

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

    PubMed

    Canalda Sahli, C

    1990-01-01

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

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

    NASA Astrophysics Data System (ADS)

    Yassen, Ghaeth H.

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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2015-01-01

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

  19. 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.…

  20. 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)

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

    PubMed Central

    MESTIERI, Leticia Boldrin; GOMES-CORNÉLIO, Ana Lívia; RODRIGUES, Elisandra Márcia; SALLES, Loise Pedrosa; BOSSO-MARTELO, Roberta; GUERREIRO-TANOMARU, Juliane Maria; TANOMARU, Mário

    2015-01-01

    Mineral Trioxide Aggregate (MTA) is a calcium silicate-based material. New sealers have been developed based on calcium silicate as MTA Fillapex and MTA Plus. Objective The aim of this study was to evaluate biocompatibility and bioactivity of these two calcium silicate-based sealers in culture of human dental pulp cells (hDPCs). Material and Methods The cells were isolated from third molars extracted from a 16-year-old patient. Pulp tissue was sectioned into fragments with approximately 1 mm3 and kept in supplemented medium to obtain hDPCs adherent cultures. Cell characterization assays were performed to prove the osteogenic potential. The evaluated materials were: MTA Plus (MTAP); MTA Fillapex (MTAF) and FillCanal (FC). Biocompatibility was evaluated with MTT and Neutral Red (NR) assays, after hDPCs exposure for 24 h to different dilutions of each sealer extract (1:2, 1:3 and 1:4). Unexposed cells were the positive control (CT). Bioactivity was assessed by alkaline phosphatase (ALP) enzymatic assay in cells exposed for one and three days to sealer extracts (1:4 dilution). All data were analyzed by ANOVA and Tukey post-test (p≤0.05%). Results MTT and NR results showed suitable cell viability rates for MTAP at all dilutions (90-135%). Cells exposed to MTAF and FC (1:2 and 1:4 dilutions) showed significant low viability rate when compared to CT in MTT. The NR results demonstrated cell viability for all materials tested. In MTAP group, the cells ALP activity was similar to CT in one and three days of exposure to the material. MTAF and FC groups demonstrated a decrease in ALP activity when compared to CT at both periods of cell exposure. Conclusions The hDPCs were suitable for the evaluation of new endodontic materials in vitro. MTAP may be considered a promising material for endodontic treatments. PMID:26537716

  2. 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

  3. Endodontic periapical lesion-induced mental nerve paresthesia.

    PubMed

    Shadmehr, Elham; Shekarchizade, Neda

    2015-01-01

    Paresthesia is a burning or prickling sensation or partial numbness, resulting from neural injury. The symptoms can vary from mild neurosensory dysfunction to total loss of sensation in the innervated area. Only a few cases have described apical periodontitis to be the etiological factor of impaired sensation in the area innervated by the inferior alveolar and mental nerves. The aim of the present paper is to report a case of periapical lesion-induced paresthesia in the innervation area of the mental nerve, which was successfully treated with endodontic retreatment. PMID:25878687

  4. [Physico-chemical properties of 4 endodontic sealing cements].

    PubMed

    Halimi, P; Camps, J; Roche, M; Proust, J P

    1990-12-01

    Four endodontic sealers were compared with two series of tests, in thin layer and in 10 mm long and 5 mm diameter rods. Under these conditions, the Pulp Canal Sealer showed the best ability to present a thin layer and the same flow than the Cortisomol. Its setting time was 15 minutes. Forty-eight hours later, the Sealite showed a very good tightness compared to the other sealers. At 30 days, the Pulp Canal Sealer and the OZn-Eugénol were the tightest ones. Less water was absorbed with the Cortisomal and the Sealite. Is there, for these sealers, any correlation between water-absorbtion and tightness? PMID:2077577

  5. Endodontic periapical lesion-induced mental nerve paresthesia

    PubMed Central

    Shadmehr, Elham; Shekarchizade, Neda

    2015-01-01

    Paresthesia is a burning or prickling sensation or partial numbness, resulting from neural injury. The symptoms can vary from mild neurosensory dysfunction to total loss of sensation in the innervated area. Only a few cases have described apical periodontitis to be the etiological factor of impaired sensation in the area innervated by the inferior alveolar and mental nerves. The aim of the present paper is to report a case of periapical lesion-induced paresthesia in the innervation area of the mental nerve, which was successfully treated with endodontic retreatment. PMID:25878687

  6. Endodontic and periodontal management of a severely affected maxillary lateral incisor having combined mucosal fenestration and palatogingival groove

    PubMed Central

    Sharma, Sarang; Srivastava, Dhirendra; Sood, Vishal; Yadav, Priya

    2015-01-01

    Mucosal fenestrations, wherein the tooth root apices are clinically discernible in the oral cavity subsequent to loss of overlying alveolar bone and mucosa, are rare pathologic entities. Palato gingival grooves- anatomic aberrations are also infrequent occurrences that notoriously predispose to periodontal pathologies of varying extent. Both conditions independently are known to popularly affect maxillary lateral incisors. Coexistent fenestration defect and palato gingival groove in the same tooth is extremely rare and undoubtedly is a perfect combination to precipitate severe endodontic-periodontal consequences. In this report, a 34-year-old patient presented to the dental department with complaint of esthetics in relation to exposed root of right maxillary lateral incisor. On closer inspection, a palato gingival groove in addition to fenestration defect was evident on the root surface along with a periodontal pocket of >5 mm. An interdisciplinary treatment was instituted which included endodontic treatment followed by root end resection, osseous bone graft placement and guided tissue regeneration procedures for repair of mucosal fenestration defect. Debridement of the palatal pocket, with saucerization of the groove and restoration with glass ionomer cement were simultaneously employed to correct the palatal defect. PMID:26229283

  7. Treatment of a Maxillary First Molar with Two Palatal Roots

    PubMed Central

    Asghari, Vahideh; Rahimi, Saeed; Ghasemi, Negin; Talebzadeh, Bita; Norlouoni, Ahmad

    2015-01-01

    Thorough knowledge of the morphology and internal anatomy of the root canal system is essential, because it determines the successful outcome of endodontic treatment. The main goal of endodontic treatment is to prevent apical periodontitis and/or to promote the healing of periapical lesion. Presence of two canals or roots on the palatal side of the first maxillary molar has rarely been reported. This case report presents a maxillary first molar with two separate palatal roots. PMID:26523146

  8. Proteomic analysis of endodontic infections by liquid chromatography–tandem mass spectrometry

    PubMed Central

    Nandakumar, R.; Madayiputhiya, N.; Fouad, A.F.

    2009-01-01

    Introduction Endodontic infections are very prevalent and have a polymicrobial etiology characterized by complex interrelationships between endodontic microorganisms and the host defenses. Proteomic analysis of endodontic infections can provide global insights into the invasion, pathogenicity mechanisms, and multifactorial interactions existing between root canal bacteria and the host in the initiation and progression of apical periodontitis. The purpose of this study was to apply proteomic techniques such as liquid chromatography–tandem mass spectrometry (LC–MS/MS) for the identification of proteins of bacterial origin present in endodontic infections. Methods Endodontic specimens were aseptically obtained from seven patients with root canal infections. Protein mixtures were subjected to tryptic in-solution digestion and analysed by reverse-phase nano-LC–MS/MS followed by a database search. Results Proteins, mainly of cell wall or membrane origin, from endodontic bacteria especially Enterococcus faecalis, Enterococcus faecium, Porphyromonas gingivalis, Fusobacterium nucleatum, and Treponema denticola were identified from all the samples tested. Identified proteins included adhesins, autolysins, proteases, virulence factors, and antibiotic-resistance proteins. Conclusions LC–MS/MS offers a sensitive analytical platform to study the disease processes in the root canal environment. The array of proteins expressed in endodontic infections reflects the complex microbial presence and highlights the bacterial species involved in the inflammatory process. PMID:19572900

  9. Influence of Ultrasonic Irrigation and Chloroform on Cleanliness of Dentinal Tubules During Endodontic Retreatment-An Invitro SEM Study

    PubMed Central

    Singhal, Anurag; Gurtu, Anuraag; Vinayak, Vineet

    2015-01-01

    Background Ultrasonic irrigation has been proved for its remarkable cleaning efficiency in the field of endodontics. But its role in endodontic re-treatment has been understated. There is not much data available to understand the effect of ultrasonic irrigation for the evaluation of cleanliness of dentinal tubules when it is used with or without chloroform, a gutta percha solvent during endodontic retreatment. Aim To compare the influence of ultrasonic irrigation with syringe irrigation on cleanliness of dentinal tubules after gutta perch removal for endodontic retreatment with or without the use of chloroform a gutta percha solvent using scanning electron microscope (SEM). Materials and Methods Freshly extracted 45 human mandibular premolar teeth for periodontal and orthodontic reasons were taken and were occlusally adjusted to a working length of 19 mm. The root canals of all teeth were prepared chemo mechanically to a master apical file size 40 and were divided in various groups. In Group 1 (n = 5; control group), the canals remained unfilled. In Groups 2 and 3 (n = 20 each), the canals were filled using lateral compaction with gutta-percha and AH plus sealer, removal of root fillings was undertaken after 2 weeks using Gates Glidden drills and H files without chloroform in Group 2 and with chloroform in group 3. The specimen of Group 2 and 3 were further divided into two subgroups I and II (n=10). In subgroup I, irrigation was done using side vented needles and sodium hypochlorite. In subgroup II irrigation was done using passive ultrasonic irrigation with sodium hypochlorite. Thereafter, the roots were split and the sections were observed under SEM. The number of occluded dentinal tubules /total number of dentinal tubules were calculated for the coronal, middle and apical third of each root half. Statistical analysis was performed using one-way ANOVA followed by Tukey’s test using standardized technique. Result Results indicated that the cleanest dentinal

  10. Hypohidrotic Ectodermal Dysplasia: Prosthetic and Endodontic Management

    PubMed Central

    Jain, Sandhya; Kumar, Alok; Rahangdale, Tripty

    2010-01-01

    Individuals affected by ectodermal dysplasia syndromes have abnormalities of the glands, tooth buds, hair follicles, and nail development. Oral finding in ectodermal dysplasia patient are significant and can include multiple abnormalities of the dentition such as anodontia, hy-podontia or malformed and widely spaced peg like teeth, loss of occlusal vertical dimension, protuberant lips and lack of normal alveolar ridge development. This clinical report describes a combined surgical, pedodontic, and prosthodontic approach for the treatment of a patient with hypohidrotic ectodermal dysplasia.

  11. The effect of temperature on rheological properties of endodontic sealers

    PubMed Central

    Rai, Roshni U.; Singbal, Kiran P.; Parekh, Vaishali

    2016-01-01

    Aim: The purpose of this study was to investigate temperature-dependent rheological properties of three endodontic sealers MTA Fillapex (Angelus, Brazil), AH Plus (Dentsply, Germany), and EndoREZ (Ultradent, USA). Materials and Methods: Five samples of each group of endodontic sealers (n = 30) were freshly mixed and placed on the plate of a rheometer (MCR 301, AntonPaar, Physica) and examined at 25°C and 37°C temperature, respectively. Rheological properties of the sealers were calculated according to the loss modulus (G″), storage modulus (G′), loss factor (Tan δ), and complex viscosity (η*) using dynamic oscillatory shear tests. Results: Statistical analysis (Wilcoxon signed-rank test) demonstrated that MTA Fillapex exhibited higher loss modulus (G″ > G′) and a crossover region. AH Plus and EndoREZ had a higher storage modulus (G′ > G″) at both temperatures. Loss factor (Tan δ) of MTA Fillapex was the highest compared to AH Plus, followed by EndoREZ. With a temperature change from 25°C to 37°C, MTA Fillapex exhibited a decrease while AH Plus exhibited an increase and, EndoREZ exhibited the least change, in complex viscosity (η*). Conclusions: EndoREZ exhibited better rheological properties compared to the other two test sealers. PMID:27099414

  12. Fracture resistance of endodontically treated premolars with direct composite restorations

    PubMed Central

    Moezizadeh, Maryam; Mokhtari, Nastaran

    2011-01-01

    Purpose: To determine the fatigue resistance and failure mode of endodontically treated premolars using direct composite resin restorations. Materials and Methods: Eighty-four human premolars were divided into seven groups of 12, prepared as follows: Intact teeth used in Group 1 as control, the second group covers the endodontically treated teeth, restored with direct onlays using Z250 composite resin, the next two groups (i.e. 3,4) were similar to the second group, but subjected to 1 and 2 million fatigue load cycles, respectively. Groups 5, 6, 7 were similar to groups 2, 3, 4, however, in these groups Tetric Ceram was used as the restorative material. All specimens were loaded using a Universal Testing Machine until fracture occurred. One-way Anova andTukey's HSD tests were used to analyze the data of onlay groups. Results: All specimens withstood the masticating simulation. The mean fracture strength for Goups 1 to 7 was: 1276.92, 1373.47, 1269/70, 486/35, 484/12, 1130/49, 1113/79 Newton, respectively. No statistically significant differences were found between the groups in fracture strength and failure mode. Conclusions: No statistically significant differences in fracture strength were found between sound teeth and composite onlays that were subjected to 1 and 2 million fatigue load cycles. PMID:22025833

  13. A virtual system for cavity preparation in endodontics.

    PubMed

    Marras, Ioannis; Nikolaidis, Nikolaos; Mikrogeorgis, Georgios; Lyroudia, Kleoniki; Pitas, Ioannis

    2008-04-01

    This article presents a novel virtual teeth drilling system designed to aid dentists, dental students, and researchers in getting acquainted with teeth anatomy, the handling of drilling instruments, and the challenges associated with drilling procedures during endodontic therapy. The system is designed to be used for educational and research purposes in dental schools. The application features a 3D face and oral cavity model constructed using anatomical data that can be adapted to the characteristics of a specific patient using either facial photographs or 3D data. Animation of the models is also feasible. Virtual drilling using a Phantom Desktop (Sensable Technologies Inc., Woburn, MA) force feedback haptic device is performed within the oral cavity on 3D volumetric and surface models of teeth, obtained from serial cross sections of natural teeth. Final results and intermediate steps of the drilling procedure can be saved on a file for future use. The application has the potential to be a very promising educational and research tool that allows the user to practice virtual teeth drilling for endodontic cavity preparation or other related procedures on high-detail teeth models placed within an adaptable and animated 3D face and oral cavity model. PMID:18381855

  14. A virtual system for cavity preparation in endodontics.

    PubMed

    Marras, Ioannis; Nikolaidis, Nikolaos; Mikrogeorgis, Georgios; Lyroudia, Kleoniki; Pitas, Ioannis

    2008-04-01

    This article presents a novel virtual teeth drilling system designed to aid dentists, dental students, and researchers in getting acquainted with teeth anatomy, the handling of drilling instruments, and the challenges associated with drilling procedures during endodontic therapy. The system is designed to be used for educational and research purposes in dental schools. The application features a 3D face and oral cavity model constructed using anatomical data that can be adapted to the characteristics of a specific patient using either facial photographs or 3D data. Animation of the models is also feasible. Virtual drilling using a Phantom Desktop (Sensable Technologies Inc., Woburn, MA) force feedback haptic device is performed within the oral cavity on 3D volumetric and surface models of teeth, obtained from serial cross sections of natural teeth. Final results and intermediate steps of the drilling procedure can be saved on a file for future use. The application has the potential to be a very promising educational and research tool that allows the user to practice virtual teeth drilling for endodontic cavity preparation or other related procedures on high-detail teeth models placed within an adaptable and animated 3D face and oral cavity model.

  15. Utilization of blended learning to teach preclinical endodontics.

    PubMed

    Maresca, Cristina; Barrero, Carlos; Duggan, Dereck; Platin, Enrique; Rivera, Eric; Hannum, Wallace; Petrola, Frank

    2014-08-01

    Blended learning (BL) is the integration of classroom learning with an online environment. The purpose of this study was to determine whether dental students who experienced BL in a preclinical endodontic course demonstrated better manual skills, conceptual knowledge, and learning experience compared to those experiencing traditional learning. All eighty-one students (100 percent) in a preclinical endodontics course agreed to participate and were assigned to either the traditional or BL group. A root canal procedure was used to determine the level of manual skills gained by each group. Pre- and post-intervention quizzes were given to all students to evaluate conceptual knowledge gained, and the students' perspectives on the methods were evaluated with a survey. The BL group scored better than the traditional group on the manual skills exercise at a statistically significant level (p=0.0067). There were no differences in the post-intervention quiz scores between the two groups, and the students' opinions were positive regarding BL. With BL, the students were able to learn and demonstrate dental skills at a high level.

  16. Chemical constituent and antimicrobial effect of essential oil from Myrtus communis leaves on microorganisms involved in persistent endodontic infection compared to two common endodontic irrigants: An in vitro study

    PubMed Central

    Nabavizadeh, Mohammadreza; Abbaszadegan, Abbas; Gholami, Ahmad; Sheikhiani, Reza; Shokouhi, Mehdi; Shams, Mahdi Sedigh; Ghasemi, Younes

    2014-01-01

    Introduction: Persistent infections of human root canals play a fundamental role in the failure of endodontic treatment. The purpose of this study is to determine the chemical composition of Myrtus communis (M. communis) essential oil and to assess its antimicrobial activity against Enterococcus faecalis, Staphylococcus aureus and Candida albicans compared to that of sodium hypochlorite (NaOCl) and chlorhexidine (CHX). Materials and Methods: Gas chromatography-mass spectrometry (GC-MS) was used to determine the chemical composition of essential oil from M. communis leaves. A micro-dilution susceptibility assay and disk diffusion methods were utilized to evaluate the antimicrobial activity [minimum inhibitory concentration (MIC) and minimum lethal dose concentration] of the tested solutions against selected microorganisms. Results: GC-MS analyses revealed that M. communis contained 1, 8-Cineole (28.62%), α-Pinene (17.8%), Linalool (17.55%), and Geranylacetate (6.3%) as the major compounds and Geraniol (1.6%), α-Humulene (1.5%), eugenol (1.3%), isobutyl-isobutyrate (0.8%), and methyl chavicol (0.5%) as minor components. Chlorhexidine had the lowest MIC value among all medicaments tested. M. communis oil had less MIC values than NaOCl against both bacteria, but it had more MIC value against C. albicans. Conclusion: M. communis essential oil with the minimum inhibitory concentration in the range of 0.032-32 μg/mL was an effective antimicrobial agent against persistent endodontic microorganisms. PMID:25298646

  17. RNA interference-mediated silencing of Atp6i prevents both periapical bone erosion and inflammation in the mouse model of endodontic disease.

    PubMed

    Ma, Junqing; Chen, Wei; Zhang, Lijie; Tucker, Byron; Zhu, Guochun; Sasaki, Hajime; Hao, Liang; Wang, Lin; Ci, Hongliang; Jiang, Hongbing; Stashenko, Philip; Li, Yi-Ping

    2013-04-01

    Dental caries is one of the most prevalent infectious diseases in the United States, affecting approximately 80% of children and the majority of adults. Dental caries may lead to endodontic disease, where the bacterial infection progresses to the root canal system of the tooth, leading to periapical inflammation, bone erosion, severe pain, and tooth loss. Periapical inflammation may also exacerbate inflammation in other parts of the body. Although conventional clinical therapies for this disease are successful in approximately 80% of cases, there is still an urgent need for increased efficacy of treatment. In this study, we applied a novel gene-therapeutic approach using recombinant adeno-associated virus (AAV)-mediated Atp6i RNA interference (RNAi) knockdown of Atp6i/TIRC7 gene expression to simultaneously target periapical bone resorption and periapical inflammation. We found that Atp6i inhibition impaired osteoclast function in vitro and in vivo and decreased the number of T cells in the periapical lesion. Notably, AAV-mediated Atp6i/TIRC7 knockdown gene therapy reduced bacterial infection-stimulated bone resorption by 80% in the mouse model of endodontic disease. Importantly, Atp6i(+/-) mice with haploinsufficiency of Atp6i exhibited protection similar to that in mice with bacterial infection-stimulated bone erosion and periapical inflammation, which confirms the potential therapeutic effect of AAV-small hairpin RNA (shRNA)-Atp6i/TIRC7. Our results demonstrate that AAV-mediated Atp6i/TIRC7 knockdown in periapical tissues can inhibit endodontic disease development, bone resorption, and inflammation, indicating for the first time that this potential gene therapy may significantly improve the health of those who suffer from endodontic disease.

  18. Intentional replantation of endodontically treated teeth.

    PubMed

    Bender, I B; Rossman, L E

    1993-11-01

    This article reports 31 cases of intentional replantation with an overall success rate of 80.6% with six recorded failures. Survival times varied from 1 day to 22 years. A second mandibular molar that failed after 3 weeks was replanted successfully a second time with no signs of failure after a 46-month follow-up period. Two cases of intentional replantation of deciduous molars are also reported. We suggest that intentional replantation reduces adverse outcomes and should be considered as another treatment modality and not as a procedure of last resort. This procedure is recommended as the treatment of choice in the following instances: for lower second molars, for single-rooted teeth, and lower first molars when there is difficulty in accessibility to perform apical surgery; when the mental foramen is superimposed over the apex of the premolars; when the molar apex is in proximity to the mandibular canal; when patients object to periradicular surgery; when failures occur after apical surgery, or when surgery would create a periodontal pocket as a result of extensive bone removal. Periradicular surgery with a retroseal is more advantageous for first molars when roots are more curved, widespread, and are more prone to fracture compared with second molars whose roots are more tapered and close together.

  19. Endodontic management of open apex using MTA and platelet – rich fibrin membrane barrier: A newer matrix concept

    PubMed Central

    Chaudhry, Sarika; Talwar, Sangeeta; Verma, Mahesh

    2013-01-01

    Objectives: Endodontic management of open apex using MTA and platelet – rich fibrin membrane as an apical matrix barrier. Study design: An immature tooth with pulpal necrosis and periapical pathology imposes a great difficulty to the endodontist. Endodontic treatment options for such teeth consist of conventional apexification procedure with and without apical barriers. This article demonstrates the use of an apical matrix barrier in form of a platelet rich fibrin membrane for stabilization of MTA in root end apexification procedure. PRF is an autologous fibrin matrix containing a large quantity of platelet and leukocyte cytokines, which enhance healing by release of growth factors. These case reports present apexification and successful healing with combined use of MTA and PRF membrane as an apical barrier Results: PRF membrane can serve as an efficient apical matrix for condensation of MTA. Combination of PRF membrane and MTA is an effective method for management of difficult cases of open apex. PRF is a strong fibrin membrane enriched with platelet and growth factors that accelerate periapical healing. Key words:Apexification, apical barrier, platelet rich fibrin (PRF), mineral trioxide (MTA). PMID:24455097

  20. Aetiology, incidence and morphology of the C-shaped root canal system and its impact on clinical endodontics

    PubMed Central

    Kato, A; Ziegler, A; Higuchi, N; Nakata, K; Nakamura, H; Ohno, N

    2014-01-01

    The C-shaped root canal constitutes an unusual root morphology that can be found primarily in mandibular second permanent molars. Due to the complexity of their structure, C-shaped root canal systems may complicate endodontic interventions. A thorough understanding of root canal morphology is therefore imperative for proper diagnosis and successful treatment. This review aims to summarize current knowledge regarding C-shaped roots and root canals, from basic morphology to advanced endodontic procedures. To this end, a systematic search was conducted using the MEDLINE, BIOSIS, Cochrane Library, EMBASE, Google Scholar, Web of Science, PLoS and BioMed Central databases, and many rarely cited articles were included. Furthermore, four interactive 3D models of extracted teeth are introduced that will allow for a better understanding of the complex C-shaped root canal morphology. In addition, the present publication includes an embedded best-practice video showing an exemplary root canal procedure on a tooth with a pronounced C-shaped root canal. The survey of this unusual structure concludes with a number of suggestions concerning future research efforts. PMID:24483229

  1. Comparison of fracture resistance and failure pattern of endodontically treated premolars with different esthetic onlay systems: An in vitro study

    PubMed Central

    Mynampati, Praffulla; Babu, Mandava Ramesh; Saraswathi, Devabhaktuni Disha; Kumar, Janga Ravi; Gudugunta, Leneena; Gaddam, Divya

    2015-01-01

    Aim: To compare the fracture resistance and modes of failures of three different aesthetic MOD onlays on endodontically treated premolars. Materials and Methods: Forty sound maxillary premolars were selected of which 10 untreated teeth were taken as control (Group I). The other thirty premolars were subjected to standardized MOD onlay preparations and root canal treatments and divided into 3 equal groups. Onlays were prepared in Group II- Indirect composite, Group III- Lithium Disilicate ceramic and Group IV- Full Zirconia. All onlays were cemented using Multilink Automix. All the 40 samples were subjected to fracture resistance testing on Universal testing machine. Also fractured specimens were observed under stereo-microscope for modes of failure. Results: Group IV presented the highest fracture resistance. Groups II and III presented no significant difference in fracture resistance from each other (P > 0.05). Group II and Group III showed significantly lower fracture resistance values than Group I. Coming to modes of failure, only Group IV had showed no cracks in any of the restorations. Conclusion: Full Zirconia MOD onlays increased the fracture resistance of endodontically treated premolars to a significantly higher level than the sound teeth. PMID:25829694

  2. Effect of novel restoration techniques on the fracture resistance of teeth treated endodontically: An in vitro study.

    PubMed

    Kemaloglu, Hande; Emin Kaval, Mehmet; Turkun, Murat; Micoogullari Kurt, Seniha

    2015-01-01

    The aim was to evaluate the effects of fiber-reinforced composite restorations and a bulk-fill resin composite on the fracture strength of mandibular premolars treated endodontically. Standard mesio-occluso-distal (MOD) cavities were prepared in 48 mandibular premolars. Following root canal treatment, teeth were assigned to four groups: Group 1, nano-hybrid resin composite; Group 2, polyethylene woven fiber plus nano-hybrid resin composite; Group 3, short fiber-reinforced resin composite plus nano-hybrid resin composite; and Group 4, bulk-fill resin composite plus nano-hybrid resin composite. Then, the teeth were subjected to the fracture toughness test. The data were analyzed statistically using one-way ANOVA, followed by Tukey's post-hoc test. The fiber-reinforced groups had better results than the nano-hybrid and bulk-fill composites (p<0.05), while the bulk-fill and nano-hybrid composite restorations gave similar results (p>0.05). Fiber-reinforcement improved the fracture strength of teeth with large MOD cavities treated endodontically. Bulk-fill composites can be used reliably as well as nano-hybrid composites.

  3. [Resistance to fracture of direct restorations with cuspal coverage in endodontically treated upper bicuspids].

    PubMed

    Takahashi, C U; De Cara, A A; Contin, I

    2001-01-01

    Endodontically treated teeth are considered more susceptible to fracture because of the loss of tooth structure. The aim of this study was to evaluate the increase of resistance to fracture of upper bicuspids that underwent endodontic access and were restored with composite resin, with cuspal coverage. Forty extracted human maxillary premolars were divided in 4 groups: I--intact teeth; II--teeth with endodontic access and MOD preparation, restored with composite resin, without cuspal coverage; III--teeth with endodontic access, MOD preparation and occlusal reduction, restored with composite resin, with cuspal coverage; IV--teeth with endodontic access and MOD preparation, without any restoration. The test specimens were submitted to compression test up to their fracture. The test of Turkey and the ANOVA analysis were used to compare and test the results. The teeth from group III (with cuspal coverage) presented with significantly greater resistance to fracture, when compared with those from groups II (restored without cuspal coverage) and IV (not restored). The composite restoration with cuspal coverage can be considered an alternative for endodontically treated premolars.

  4. Immediate endodontic access cavity sealing: fundamentals of a new restorative technique.

    PubMed

    De Rose, Luca; Krejci, I; Bortolotto, T

    2015-09-01

    Endodontic access cavity sealing is conventionally performed after endodontic irrigation, referred to as delayed endodontic sealing (DES). Evidence shows that endodontic irrigation with NaOCl decreases dentinal bond quality and could cause coronal leakage. Access cavity sealing before endodontic irrigation is a new restorative approach, referred to as immediate endodontic sealing (IES). The primary aim of this in vitro study was to investigate whether IES improved internal adaptation. The secondary aim was to investigate the influence of the viscosity of the composite used to seal the dentine, on the internal adaptation in both IES and DES groups. Third molars (n= 40) with fully developed apices were used. The teeth were prepared into standard Class II MO cavities, and divided in 4 groups according to the approach, and composite viscosity was used for sealing. Group 1: IES + low viscosity composite; group 2: IES + high viscosity composite; group 3: DES + low viscosity composite; and group 4: DES + high viscosity composite. Samples were then sectioned axially for observation using scanning electron microscopy. Outcome was evaluated by determining the internal adaptation of the samples, which was judged based on the percentage of a continuous margin at the tooth-composite interface. The results were analyzed using a two-way analysis of variance and Mann-Whitney test. IES groups exhibited significantly greater internal adaptation (p = 0.000) as compared with DES groups. Composite viscosity did not significantly affect internal adaptation in either IES or DES groups (p > 0.005).

  5. The causes, prevention, and clinical management of broken endodontic rotary files.

    PubMed

    Bahcall, James K; Carp, Stewart; Miner, Marcus; Skidmore, Lance

    2005-11-01

    Complications can occur during many dental procedures. The prepared clinician responds by either correcting the problem during treatment, or, ideally, preventing the problem from occurring in the first place. In endodontic treatment separated rotary Ni-Ti files are a common procedural problem. Through understanding that the main causes of file breakage are cyclic fatigue and torsional stress, a dentist can best prevent this occurrence by using hand files before rotary files, creating a straight-line (glide path) access into a canal, and preflaring the coronal portion before using rotary files in the apical third of the canal. In addition, using an up and down motion with the electric slow-speed handpiece (not allowing the file to bind within the canal) will significantly reduce the incidence of file breakage. If a file does break, successful removal primarily depends on the location of the file in the canal rather than the specific technique employed for removal. A case does not necessarily fail if the separated file cannot be removed. The prognosis when file separation occurs can still be favorable, especially if care was taken to reduce the critical concentration of canal debris with hand instrumentation and chemical irrigation prior to rotary file insertion. In addition, the introduction of a new CS file design will help the dentist increase the chance of removing the file in the event of breakage.

  6. Intentional replantation of periodontally involved and endodontically mistreated tooth.

    PubMed

    Lu, D P

    1986-05-01

    This article presents a case in which a tooth was intentionally replanted after it was endodontically mistreated; there was also a severe periodontal involvement. The unusually long period of time that the tooth survived might be attributed to a different approach to the replantation technique, such as occlusion adjustment prior to replantation, preoperative reduction of oral cavity bacteria and of the harmful aerosols commonly found in the dental operatory, placement of a noneugenol periodontal packing under the acrylic splint to prevent residual liquid monomer from seeping into the periodontal space, use of the patient's own blood and no other material to moisten the root while it was out of the socket, a short extraoral period, loose splinting, complete isolation of the operative site in the oral cavity, and completion of periodontal therapy before intentional replantation.

  7. A MODEL SYSTEM TO STUDY ANTIMICROBIAL STRATEGIES IN ENDODONTIC BIOFILMS

    PubMed Central

    Estrela, Carlos; Sydney, Gilson Blitzkow; Figueiredo, José Antonio Poli; Estrela, Cyntia Rodrigues de Araújo

    2009-01-01

    The purpose of this work was to develop a model system to study antimicrobial strategies in endodontic biofilms. Enterococcus faecalis suspension was colonized in 10 human root canals. Five milliliters of Brain Heart Infusion (BHI) were mixed with 5 mL of the bacterial inoculums (E. faecalis) and inoculated with sufficient volume to fill the root canal during 60 days. This procedure was repeated every 72 h, always using 24-h pure culture prepared and adjusted to No. 1 MacFarland turbidity standard. Biofilm formation was analyzed by scanning electron microscopy (SEM). E. faecalis consistently adhered to collagen structure, colonized dentin surface, progressed towards the dentinal tubules and formed a biofilm. The proposed biofilm model seems to be viable for studies on antimicrobial strategies, and allows for a satisfactory colonization time of selected bacterial species with virulence and adherence properties. PMID:19274391

  8. Root canal treatment of a maxillary first premolar with three roots

    PubMed Central

    Mathew, Josey; Devadathan, Aravindan; Syriac, Gibi; Shamini, Sai

    2015-01-01

    Successful root canal treatment needs a thorough knowledge of both internal and external anatomy of a tooth. Variations in root canal anatomy constitute an impressive challenge to the successful completion of endodontic treatment. Undetected extra roots and canals are a major reason for failed root canal treatment. Three separate roots in a maxillary first premolar have a very low incidence of 0.5–6%. Three rooted premolars are anatomically similar to molars and are sometimes called “small molars or radiculous molars.” This article explains the diagnosis and endodontic management of a three rooted maxillary premolar with separate canals in each root highlighting that statistics may indicate a low incidence of abnormal variations in root canal morphology of a tooth, but aberrant anatomy is a possibility in any tooth. Hence, modern diagnostics like cone beam computed tomography, and endodontic operating microscope may have to be used more for predictable endodontic treatment. PMID:26538958

  9. Prevalence of Sinus Tract in the Patients Visiting Department of Endodontics, Kermanshah School of Dentistry

    PubMed Central

    Miri, Shima Sadat; Atashbar, Omid; Atashbar, Fardin

    2015-01-01

    Introduction: Sinus tract is one of the manifestations of chronic dental infections, which is a path for the drainage of the infection and pus. The present study was aimed to investigate the prevalence of sinus tract with dental origin analyze the correlation between sinus tract and related factors. Methods: This study was conducted on 1527 patients, visiting Kermanshah school of dentistry, in 2014.The related teeth were examined in terms of vitality test and exact location of sinus tract. Moreover, the causes of this lesion and the needs for root canal treatment were assessed in these teeth. Having obtained the data from the patients, analyzed by Mann-Whitney, Chi-square tests. Results: The frequency of sinus tract was 9.89% patients. There was a significant correlation between the prevalence of sinus tract and factors such as age, general health status, location of sinus tract and history of root canal treatment. The prevalence of sinus tract in maxilla was higher than the mandible (p=0.087). The prevalence of sinus tract in the posterior teeth (69.54%) was significantly higher than that of anterior teeth (30.46%) (p=0.000). From 724 teeth with periapical inflammation and radiolucency, 9.89% teeth had odontogenic sinus tract, and 23.42% teeth with history of root canal treatment had sinus tract. Conclusions: The most common cause of sinus tract incidence was previous root canal treatment. Therefore, clinicians need to pay a more attention to examining the posterior teeth referred for endodontic treatment. PMID:26153170

  10. Diagnosis and Endodontic Management of Fused Mandibular Second Molar and Paramolar with Concrescent Supernumerary Tooth Using Cone-beam CT and 3-D Printing Technology: A Case Report.

    PubMed

    Kato, Hiroshi; Kamio, Takashi

    2015-01-01

    Supernumerary teeth in the molar area are classified as paramolars or distomolars based on location. They occur frequently in the maxilla, but only rarely in the mandible. These teeth are frequently fused with adjacent teeth. When this occurs, the pulp cavities may also be connected. This makes diagnosis and planning of endodontic treatment extremely difficult. Here we report a case of a mandibular second molar fused with a paramolar, necessitating dental pulp treatment. Intraoral and panoramic radiographs were obtained for an evaluation and diagnosis. Although the images revealed a supernumerary tooth-like structure between the posterior area of the mandibular second molar and mandibular third molar, it was difficult to confirm the morphology of the tooth root apical area. Subsequent cone-beam computed tomography (CBCT) revealed that the supernumerary tooth-like structure was concrescent with the root apical area of the mandibular second molar. Based on these findings, the diagnosis was a fused mandibular second molar and paramolar with a concrescent supernumerary tooth. A 3-dimensional (3-D) printer was used to produce models based on the CBCT data to aid in treatment planning and explanation of the proposed procedures to the patient. These models allowed the complicated morphology involved to be clearly viewed, which facilitated a more precise diagnosis and better treatment planning than would otherwise have been possible. These technologies were useful in obtaining informed consent from the patient, promoting 3-D morphological understanding, and facilitating simulation of endodontic treatment. PMID:26370578

  11. A preliminary report on histological outcome of pulpotomy with endodontic biomaterials vs calcium hydroxide

    PubMed Central

    Peimani, Ali; Asgary, Saeed

    2013-01-01

    Objectives The purpose of the study was to evaluate human dental pulp response to pulpotomy with calcium hydroxide (CH), mineral trioxide aggregate (MTA), and calcium enriched mixture (CEM) cement. Materials and Methods A total of nine erupted third molars were randomly assigned to each pulpotomy group. The same clinician performed full pulpotomies and coronal restorations. The patients were followed clinically for six months; the teeth were then extracted and prepared for histological assessments. The samples were blindly assessed by an independent observer for pulp vitality, pulp inflammation, and calcified bridge formation. Results All patients were free of clinical signs/symptoms of pulpal/periradicular diseases during the follow up period. In CH group, one tooth had necrotic radicular pulp; other two teeth in this group had vital uninflamed pulps with complete dentinal bridge formation. In CEM cement and MTA groups all teeth had vital uninflamed radicular pulps. A complete dentinal bridge was formed beneath CEM cement and MTA in all roots. Odontoblast-like cells were present beneath CEM cement and MTA in all samples. Conclusions This study revealed that CEM cement and MTA were reliable endodontic biomaterials in full pulpotomy treatment. In contrast, the human dental pulp response to CH might be unpredictable. PMID:24303358

  12. Fibre reinforcement in a structurally compromised endodontically treated molar: a case report

    PubMed Central

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

    2016-01-01

    The reconstruction of structurally compromised posterior teeth is a rather challenging procedure. The tendency of endodontically treated teeth (ETT) to fracture is considerably higher than vital teeth. Although posts and core build-ups followed by conventional crowns have been generally employed for the purpose of reconstruction, this procedure entails sacrificing a considerable amount of residual sound enamel and dentin. This has drawn the attention of researchers to fibre reinforcement. Fibre-reinforced composite (FRC), designed to replace dentin, enables the biomimetic restoration of teeth. Besides improving the strength of the restoration, the incorporation of glass fibres into composite resins leads to favorable fracture patterns because the fibre layer acts as a stress breaker and stops crack propagation. The following case report presents a technique for reinforcing a badly broken-down ETT with biomimetic materials and FRC. The proper utilization of FRC in structurally compromised teeth can be considered to be an economical and practical measure that may obviate the use of extensive prosthetic treatment. PMID:27200283

  13. Comparison of the Degree of Conversion of Resin Based Endodontic Sealers Using the DSC Technique

    PubMed Central

    Cotti, Elisabetta; Scungio, Paola; Dettori, Claudia; Ennas, Guido

    2011-01-01

    Objectives: The aim of this study was to determine the degree of conversion (DC) of three resin based endodontic sealers using the DSC technique. Methods: The sealers tested were: EndoREZ (ER) (Ultradent, South Jordan, UT); EndoREZ with Accelerator (ER+A) (Ultradent, South Jordan, UT); RealSeal (RS) (SybronEndo, Orange, CA). Two LED units were used to activate the sealers: UltraLume LED 5 (Ultradent, South Jordan, UT, USA); Mini LED Satelec (Satelec Acteon Group, Mérignac Cedex, France). Samples of 4.0 mg were analyzed with a DSC 7 calorimeter (Perkin Elmer Inc., Wellesley, MA, US). Each specimen was irradiated by each lamp four times for 20 seconds at an interval of 2 mins, while the DSC 7 recorded the heat flow developed during the treatment. The degree of conversion and the kinetic curves were calculated from the values of heat developed during each polymerization. The data were statistically analysed with a Kruskal-Wallis one-way ANOVA multiple range and Student-Newman-Keuls (SNK) tests at a P value of .05. Results: Statistically significant differences were found in the degree of conversion among the sealers: ER+A showed the highest values with both lamps. Conclusions: The higher polymerization rate in resin sealers is obtained with the addition of a catalyst. PMID:21494378

  14. A small molecule, odanacatib, inhibits inflammation and bone loss caused by endodontic disease.

    PubMed

    Hao, Liang; Chen, Wei; McConnell, Matthew; Zhu, Zheng; Li, Sheng; Reddy, Michael; Eleazer, Paul D; Wang, Min; Li, Yi-Ping

    2015-04-01

    Periapical disease, an inflammatory disease mainly caused by dental caries, is one of the most prevalent infectious diseases of humans, affecting both children and adults. The infection travels through the root, leading to inflammation, bone destruction, and severe pain for the patient. Therefore, the development of a new class of anti-periapical disease therapies is necessary and critical for treatment and prevention. A small molecule, odanacatib (ODN), which is a cathepsin K (Ctsk) inhibitor, was investigated to determine its ability to treat this disease in a mouse model of periapical disease. While Ctsk was originally found in osteoclasts as an osteoclast-specific lysosomal protease, we were surprised to find that ODN can suppress the bacterium-induced immune response as well as bone destruction in the lesion area. X rays and microcomputed tomography (micro-CT) showed that ODN treatment had significant bone protection effects at different time points. Immunohistochemical and immunofluorescent staining show that ODN treatment dramatically decreased F4/80+ macrophages and CD3+ T cells in the lesion areas 42 days after infection. Consistent with these findings, quantitative real-time PCR (qRT-PCR) and enzyme-linked immunosorbent assay (ELISA) analysis showed low levels of proinflammatory mRNAs (for tumor necrosis factor alpha, interleukin 6, and interleukin 23α) and corresponding cytokine expression in the ODN-treated disease group. The levels of mRNA for Toll-like receptors 4, 5, and 9 also largely decreased in the ODN-treated disease group. Our results demonstrated that ODN can inhibit endodontic disease development, bone erosion, and immune response. These results indicate that application of this small molecule offers a new opportunity to design effective therapies that could prevent periapical inflammation and revolutionize current treatment options.

  15. Survey of Endodontic Practice amongst Iranian Dentists Participating Restorative Dentistry Congress in Shiraz, November 2007

    PubMed Central

    Ravanshad, Shohreh; Sahraei, Saied; Khayat, Akbar

    2008-01-01

    INTRODUCTION: General dental practitioners provide the majority of treatment in Iran. The aim of this study was to gather information on the methods, materials and attitudes employed in root canal treatment by dentists participated in 7th Congress of Iranian Academy of Restorative Dentistry in Shiraz /2007 in order to evaluate the quality of current practice. MATERIALS AND METHODS: A questionnaire for this cross-sectional study was designed with the purpose of evaluating the routine endodontic treatment performed by Iranian dentists. The questionnaire made up of 24 questions with multiple-choice answers. Covering subjects are demographic and professional activity, root-canal preparation and instrumentation, choice of irrigants and disinfectants, and choice of obturation techniques. RESULTS: A total of 247 questionnaires (49.4%) were returned. Ninety-one percent of the respondents were general dental practitioners. The results indicate that there are discrepancies between daily practice and academic teaching, especially regarding the use of rubber dam (only 0.9 % report using it as a standard procedure). Most of practitioners used manual instruments manipulated with a filing technique and few used rotary for canal preparation. The majority of the respondents prepared root canals 0.5-1 mm short of the radiographic apex. The first-choice root-canal irrigant was normal saline (55%), followed by sodium hypochlorite. Approximately, 68% used intracanal medications. The most popular obturation technique was cold lateral condensation (90%) with zinc-oxide eugenol as sealer. Most practitioners performed treatment in two visits for teeth with two or more canals. Eighty-four percent of the dentists used radiograph for determining the working length, and only 2.7% used Apex-locator. CONCLUSION: The survey mentions the importance of continuing dental education for practitioners to update their knowledge. PMID:24265636

  16. The effect of amount of lost tooth structure and restorative technique on fracture resistance of endodontically treated premolars

    PubMed Central

    Bassir, Mahshid Mohammadi; Labibzadeh, Akram; Mollaverdi, Fatemeh

    2013-01-01

    Aim: Endodontic treatment generally reduces the fracture resistance of teeth. The purpose of this study was to evaluate the fracture resistance and the mode of fracture of endodontically treated human premolars with different amounts of remaining tooth structure. Materials and Methods: Seventy non-carious human premolars were randomly assigned into 7 groups. Group 1 (ST) did not receive any preparation. The teeth in groups 2-7 received root canal treatment and different preparations. Group 2 (MO-NF): Mesio-occlusal preparation without filling; Group 3 (MOD-NF): Mesio-occluso-distal preparation without filling; Group 4 (MO-F): Mesio-occlusal preparation with direct composite restoration (Z250); Group 5 (MOD-F): Mesio-occluso-distal preparation with direct composite restoration (Z250); Group 6 (CC-D): Mesio-occluso-distal preparation with cusp reduction and direct composite restoration (Z250); Group 7 (CC-InD): Mesio-occluso-distal preparation with cusp reduction and indirect composite restoration (Gradia GC). The fracture resistance (N) was assessed under compressive load in a universal testing machine (Zwick) perpendicular to the occlusal surface at a cross-head speed of 1 mm/min, and the mode of fracture was assessed under stereomicroscope. Statistical analysis: Data was analyzed by Kruskal – Wallis and Mann – Whitney tests and the mode of fracture was analyzed by Chi-square test (P < 0.05). Results: Statistical analysis showed that MO and MOD cavity preparations significantly reduced the fracture resistance of sound teeth. Direct composite restorations can improve the fracture resistance, and Groups 7 and 6 presented the highest fracture resistance values. Conclusions: Teeth with adhesive restorations showed significantly higher fracture resistance values as compared with the non-restored ones. PMID:24082569

  17. A comparison of fracture resistance of endodontically treated teeth restored with bonded partial restorations and full-coverage porcelain-fused-to-metal crowns.

    PubMed

    Gupta, Abhishek; Musani, Smita; Dugal, Ramandeep; Jain, Nikhil; Railkar, Bhargavi; Mootha, Ajay

    2014-01-01

    The aim of this study was to evaluate the use of bonded partial restorations compared with full-coverage porcelain-fused-to-metal (PFM) crowns as a viable treatment option for endodontically treated posterior teeth. Forty-five recently extracted maxillary first premolars were collected, endodontically treated, and mounted in acrylic blocks. The specimens were randomly divided into three groups and prepared to receive their respective restorations. The teeth in group 1 received full-coverage porcelain-fused-to-metal crowns. The teeth in group 2 received bonded partial restorations made from pressed ceramics (lithium disilicate) involving a functional cusp (palatal). Finally, group 3 received bonded partial restorations made from pressed ceramics involving the buccal cusp and keeping a functional cusp (palatal) intact. All group 1 restorations were cemented using glass ionomer cement. Restorations in groups 2 and 3 were bonded using a dual-cured resin cement. All specimens were subjected to an aging process and tested for shear bond strength using a universal loading machine. The mean force applied in Newtons to cause failure for group I was 674.90 ± 94.16 N, for group 2, 463.46 ± 61.11 N, and for group 3, 849.33 ± 68.92 N. P values obtained using one-way analysis of variance showed a highly significant difference between groups 2 and 3 (P = .001), groups 1 and 2 (P = .001), and groups 1 and 3 (P = .001). The fracture modes observed in all groups involved restorations and tooth fracture. This in vitro study suggests that endodontically treated posterior teeth with intact functional cusps can be restored with bonded partial porcelain restorations. However, if the loss of tooth structure involves the functional cusp, full-coverage PFM crowns are the treatment of choice.

  18. 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.

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

    PubMed

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

    2015-01-01

    Enterococci are able to survive endodontic procedures and contribute to the failure of endodontic therapy. Thus, it is essential to identify novel ways of eradicating them from infected root canals. One such approach may be the use of antimicrobials such as plant essential oils. Enterococcal strains were isolated from endodontically treated teeth by standard microbiological methods. Susceptibility to antibiotics was evaluated by the disc-diffusion method. The minimal inhibitory concentration (MIC) of geranium essential oil was investigated by microdilution in 96-well microplates in Mueller Hinton Broth II. Biofilm eradication concentrations were checked in dentin tests. Geranium essential oil inhibited enterococcal strains at concentrations ranging from 1.8-4.5 mg/mL. No correlation was shown between resistance to antibiotics and the MICs of the test antimicrobials. The MICs of the test oil were lower than those found to show cytotoxic effects on the HMEC-1 cell line. Geranium essential oil eradicated enterococcal biofilm at concentrations of 150 mg/mL. Geranium essential oil inhibits the growth of endodontic enterococcal species at lower concentrations than those required to reach IC50 against the HMEC-1 cell line, and is effective against bacteria protected in biofilm at higher concentrations. In addition, bacteria do not develop resistance to essential oils. Hence, geranium essential oil represents a possible alternative to other antimicrobials during endodontic procedures. PMID:26703546

  20. Evolution of the role of phototherapy during endodontic decontamination

    PubMed Central

    Muhammad, Omid Heidar; Rocca, Jean-Paul; Fornaini, Carlo

    2015-01-01

    A microbe free root canal space before obturation leads to higher success rate and conventional chemo-mechanical debridement might not achieve this goal completely. First trials of laser in dentistry started from surgical intervention on caries and bones of oral cavity and extended to prepare cavities and even shaping root canals. Afterward lasers were implicated soon into direct debridement of root canal space. Anyhow failure of laser to remove debris totally from root canal space is demonstrated recently, additionally it might lead to damages to surrounding tissues or inorganic material of root canal if be used without precaution. Nowadays the theory of light assisted protocols became another start point for laser in endodontics. Laser has been introduced as an adjuvant to conventional debridement of root canals. We used Medline search engine to collect scientific publications to edit this review article in purpose of revealing the evolution of laser position from an ultimate cleaning methodology to an adjuvant to conventional root canal disinfection protocols. PMID:26877593

  1. Evolution of the role of phototherapy during endodontic decontamination.

    PubMed

    Muhammad, Omid Heidar; Rocca, Jean-Paul; Fornaini, Carlo; Medioni, Etienne

    2015-12-30

    A microbe free root canal space before obturation leads to higher success rate and conventional chemo-mechanical debridement might not achieve this goal completely. First trials of laser in dentistry started from surgical intervention on caries and bones of oral cavity and extended to prepare cavities and even shaping root canals. Afterward lasers were implicated soon into direct debridement of root canal space. Anyhow failure of laser to remove debris totally from root canal space is demonstrated recently, additionally it might lead to damages to surrounding tissues or inorganic material of root canal if be used without precaution. Nowadays the theory of light assisted protocols became another start point for laser in endodontics. Laser has been introduced as an adjuvant to conventional debridement of root canals. We used Medline search engine to collect scientific publications to edit this review article in purpose of revealing the evolution of laser position from an ultimate cleaning methodology to an adjuvant to conventional root canal disinfection protocols. PMID:26877593

  2. Evolution of the role of phototherapy during endodontic decontamination.

    PubMed

    Muhammad, Omid Heidar; Rocca, Jean-Paul; Fornaini, Carlo; Medioni, Etienne

    2015-12-30

    A microbe free root canal space before obturation leads to higher success rate and conventional chemo-mechanical debridement might not achieve this goal completely. First trials of laser in dentistry started from surgical intervention on caries and bones of oral cavity and extended to prepare cavities and even shaping root canals. Afterward lasers were implicated soon into direct debridement of root canal space. Anyhow failure of laser to remove debris totally from root canal space is demonstrated recently, additionally it might lead to damages to surrounding tissues or inorganic material of root canal if be used without precaution. Nowadays the theory of light assisted protocols became another start point for laser in endodontics. Laser has been introduced as an adjuvant to conventional debridement of root canals. We used Medline search engine to collect scientific publications to edit this review article in purpose of revealing the evolution of laser position from an ultimate cleaning methodology to an adjuvant to conventional root canal disinfection protocols.

  3. Biocompatibility of two experimental scaffolds for regenerative endodontics

    PubMed Central

    Setzer, Frank C.; Trope, Martin; Karabucak, Bekir

    2016-01-01

    Objectives The biocompatibility of two experimental scaffolds for potential use in revascularization or pulp regeneration was evaluated. Materials and Methods One resilient lyophilized collagen scaffold (COLL), releasing metronidazole and clindamycin, was compared to an experimental injectable poly(lactic-co-glycolic) acid scaffold (PLGA), releasing clindamycin. Human dental pulp stem cells (hDPSCs) were seeded at densities of 1.0 × 104, 2.5 × 104, and 5.0 × 104. The cells were investigated by light microscopy (cell morphology), MTT assay (cell proliferation) and a cytokine (IL-8) ELISA test (biocompatibility). Results Under microscope, the morphology of cells coincubated for 7 days with the scaffolds appeared healthy with COLL. Cells in contact with PLGA showed signs of degeneration and apoptosis. MTT assay showed that at 5.0 × 104 hDPSCs, COLL demonstrated significantly higher cell proliferation rates than cells in media only (control, p < 0.01) or cells co-incubated with PLGA (p < 0.01). In ELISA test, no significant differences were observed between cells with media only and COLL at 1, 3, and 6 days. Cells incubated with PLGA expressed significantly higher IL-8 than the control at all time points (p < 0.01) and compared to COLL after 1 and 3 days (p < 0.01). Conclusions The COLL showed superior biocompatibility and thus may be suitable for endodontic regeneration purposes. PMID:27200277

  4. Sound levels in conservative dentistry and endodontics clinic

    PubMed Central

    Dutta, Arindam; Mala, Kundabala; Acharya, Shashi Rashmi

    2013-01-01

    Aim: To evaluate the sound levels generated in dental clinics of conservative dentistry and endodontics. Material and Methods: A decibel-meter with digital readout was used to measure sound levels at different time intervals at the chairside and at the center of the clinic. Minimum and maximum readings during a 3 min interval were recorded. Results: In the post-graduate (PG) clinic, there was significant difference in noise levels between the chairside (66-81 dB[A]) and the center of the clinic (66-67 dB[A]) at certain times. In the under graduate (UG) clinic, noise levels with suction and either high/slow speed handpieces (67-80 dB[A]) were significantly higher than the center of clinic. Suction alone in the UG clinic (63-75 dB[A]) was significantly quieter than in the PG clinic (69-79 dB[A]). Conclusions: (1) Mean sound levels in the working clinics ranged from 63.0 dB[A] to 81.5 dB[A]. These are within the recommended range for dental equipment. (2) With suction and either low/high speed handpiece combination, the PG clinic was significantly noisier than the UG clinic at several time periods. PMID:23716962

  5. 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

  6. Management of Class-II Furcation Complicated with Endodontic involvement using Two Different Regenerative Materials

    PubMed Central

    Inamdar, Mohammed Nasir K; Khan, Sheeba; Ali, Syed Akbar; Ahmad, Ezaz

    2015-01-01

    This paper presents a case series of furcation involved teeth complicated with endodontic involvement which were treated with periodontal, endodontic and restorative procedures using different bone regenerative materials like; (a) Calcium phosphosilicate bone substitute having bioactive glass 69% mixed with glycerin 19% and poly-ethylene 12% dispensed in a putty form; (b) hydroxyapatite 70% and β-tricalcium phosphate 30% dispensed in granular form. All the cases were randomly selected having Grade II furcation defect with primary or secondary endodontic involvement. All cases were under observation for a period of 9 months. Measurements at 9 months post-surgery demonstrated that dental putty as bone graft substitute which was in combination of bioactive glass mixed with glycerine and polyethylene glycol showed better result as compared granular bone graft which was in combination of hydroxyapatite and β-tricalcium phosphate. PMID:26668489

  7. A review of the effects of formaldehyde release from endodontic materials.

    PubMed

    Athanassiadis, B; George, G A; Abbott, P V; Wash, L J

    2015-09-01

    Formaldehyde is present in most living cells and the environment. In dentistry, patients may be exposed to formaldehyde through the use of several endodontic materials (e.g. AH 26) and during formocresol pulpotomies. This review outlines how the human body reacts to formaldehyde exposure, how recent data has relooked at the issue of carcinogenicity and leukaemia associated with formaldehyde, and whether it is possible to quantify the amount of formaldehyde produced by endodontic cements. The review analyses the way formaldehyde is produced from epoxy resins and addresses the question of whether the amount of formaldehyde from endodontic cements is large enough to override the body's ability to deal with its own endogenous levels of formaldehyde and should the amount of formaldehyde produced be a concern.

  8. Evaluation of the Fractured Surface of Five Endodontic Rotary Instruments: A Metallurgical Study

    PubMed Central

    Aminsobhani, Mohsen; Khalatbari, Mohamad Saleh; Meraji, Naghmeh; Ghorbanzadeh, Abdollah; Sadri, Ehsan

    2016-01-01

    Introduction: The aim of this study was to compare several metallurgic properties of Neoniti instrument with four other commonly used endodontic rotary files. Methods and Materials: Neoniti A1 (25/0.08), RaCe (25/0.06), Mtwo (25/0.06), Twisted file (25/0.06) and ProTaper Next X2 (25/0.06) were examined by differential scanning calorimetry (DSC) before and after heat treatment at 500°C. X-ray diffraction (XRD) was also performed on the specimens. Furthermore, scanning electron microscopy (SEM) and x-ray energy-dispersive spectrometric (EDS) analyses were carried out on randomly selected fractured files. Results: In SEM tests, dimpled ruptures, characteristic of ductile fracture, were seen in all evaluated cross sections of all files. The SEM results of all evaluated files were alike. EDS results revealed higher proportions of Nickel (Ni) rich intermetallic compounds in Neoniti; whereas, in all the other files the proportion of Titanium (Ti) rich precipitates was higher. DSC results indicated that the temperature present in the oral environment, the austenite phase existed in all files. Mtwo and RaCe files did not show austenite transformation in the temperature range evaluated in this study. Only Neoniti revealed rhombohedal phase (R-phase) transformation. After heat treatment. No significant difference was seen in the transformation temperatures of all evaluated files. XRD evaluations revealed that Neoniti contained both Ni-rich and Ti-rich precipitates. The amount of the martensite phase was higher in ProTaper Next. Conclusion: The metallurgic properties of Neoniti files were different from other evaluated rotary files. This file contained higher proportions of Ni-rich precipitates. PMID:27790257

  9. A case of accidental aspiration of an endodontic instrument by a child treated under conscious sedation.

    PubMed

    Mahesh, R; Prasad, Vishnu; Menon, Padma A

    2013-04-01

    Dental management of children with attention-deficit hyperactivity disorder (ADHD) often requires the need for pharmacological behavior management techniques such as the use of sedation. The purpose of this article is to describe a clinical case involving accidental aspiration of an Endodontic instrument during root canal therapy under sedation. To our knowledge, this is the first case report of aspiration of an Endodontic instrument and should serve to heighten the awareness with regard to aspiration during dental procedures under sedation. It also emphasizes the need for proper isolation techniques in patients treated under sedation, thereby preventing such complications.

  10. A case of accidental aspiration of an endodontic instrument by a child treated under conscious sedation.

    PubMed

    Mahesh, R; Prasad, Vishnu; Menon, Padma A

    2013-04-01

    Dental management of children with attention-deficit hyperactivity disorder (ADHD) often requires the need for pharmacological behavior management techniques such as the use of sedation. The purpose of this article is to describe a clinical case involving accidental aspiration of an Endodontic instrument during root canal therapy under sedation. To our knowledge, this is the first case report of aspiration of an Endodontic instrument and should serve to heighten the awareness with regard to aspiration during dental procedures under sedation. It also emphasizes the need for proper isolation techniques in patients treated under sedation, thereby preventing such complications. PMID:24883031

  11. Endodontic retreatment of an autotransplanted lower first premolar: a case report.

    PubMed

    Koshy, Sajeev; Love, Robert Matthew

    2003-08-01

    A 24-year-old female with no contributory medical history had been treated by orthodontic alignment and transplantation of the lower left first premolar to the upper left first premolar site to correct for congenitally missing upper premolars. Subsequently, the transplanted premolar was treated by conventional endodontics and apical surgery for persistent periapical periodontitis over a span of 12 years. A combination of conventional endodontic retreatment and periapical surgery resulted in periapical healing. This case outlines the need for careful preoperative case assessment. PMID:12848718

  12. Amputation of an Extra-root with an Endodontic Lesion in an Invaginated Vital Maxillary Lateral Incisor: A Rare Case with Seven-year Follow-up.

    PubMed

    Çalışkan, Mehmet Kemal; Asgary, Saeed; Tekin, Uğur; Güneri, Pelin

    2016-01-01

    The developmental abnormality of tooth resulting from the infolding of enamel/dentin into the root is called dens invaginatus. Management of such cases is usually challenging due to the morphological complexity of root canal system. This report presents a rare treatment protocol of a clinical case of Oehler's type III dens invaginatus combined with an endodontic lesion in a vital maxillary lateral incisor. Access to the endodontic lesion located between the central and lateral incisors was achieved by reflection of a full mucoperiosteal flap. Granulomatous tissue as well as aberrant root was removed and the surface of the root and adjacent coronal region were reshaped. Three years later, the patient was orthodontically treated. Seven years after completion of surgical/orthodontic management, the tooth remained asymptomatic and functional with normal periodontium/vital pulp. Radiographically, the healing of the lesion was observed. Actually, vitality of the invaginated tooth and communication between the invagination and the root canal were the most important factors in determining such minimally invasive treatment protocol. Depending on the anatomy of the root canal system, surgical amputation of an invaginated root can be performed to achieve a successful outcome in Oehler's type III dens invaginatus cases, even though it is associated with apical periodontitis. PMID:27141224

  13. Fracture resistance exhibited by endodontically treated and retreated teeth shaped by ProTaper NEXT versus WaveOne: An in vitro study

    PubMed Central

    Khalap, Neha Deepak; Hegde, Vibha; Kokate, Sharad

    2015-01-01

    Aim: To compare the fracture resistance exhibited by teeth after primary endodontic treatment and retreatment. Materials and Methods: One hundred freshly extracted human teeth were selected. 20 samples served as control (untreated). Eighty experimental samples were divided into two groups (n = 40) for instrumentation using rotary Protaper NEXT (PTN) or reciprocating WaveOne (WO) files and obturated using warm lateral compaction. Half of the samples (n = 20) from each group were subjected to a load. The remaining half were subjected to retreatment using Protaper universal retreatment files (RFs) followed by a file larger than the master apical file used in groups 1 and 2 and reobturated. Group A: Control, Group B: PTN + obturation, Group C: WO + obturation, Group D: RF + PTN + obturation and Group E: RF + WO + obturation. The retreatment specimens were also subjected to load and the readings acquired were statistically analyzed. Result: When compared between the groups, control group exhibited the highest fracture resistance (P < 0.01). When multiple tests were performed, Group E exhibited significantly less fracture resistance (P < 0.01). Conclusion: Endodontic treatment and retreatment both results in lowering the fracture resistance of a tooth. PMID:26752838

  14. Amputation of an Extra-root with an Endodontic Lesion in an Invaginated Vital Maxillary Lateral Incisor: A Rare Case with Seven-year Follow-up

    PubMed Central

    Çalışkan, Mehmet Kemal; Asgary, Saeed; Tekin, Uğur; Güneri, Pelin

    2016-01-01

    The developmental abnormality of tooth resulting from the infolding of enamel/dentin into the root is called dens invaginatus. Management of such cases is usually challenging due to the morphological complexity of root canal system. This report presents a rare treatment protocol of a clinical case of Oehler’s type III dens invaginatus combined with an endodontic lesion in a vital maxillary lateral incisor. Access to the endodontic lesion located between the central and lateral incisors was achieved by reflection of a full mucoperiosteal flap. Granulomatous tissue as well as aberrant root was removed and the surface of the root and adjacent coronal region were reshaped. Three years later, the patient was orthodontically treated. Seven years after completion of surgical/orthodontic management, the tooth remained asymptomatic and functional with normal periodontium/vital pulp. Radiographically, the healing of the lesion was observed. Actually, vitality of the invaginated tooth and communication between the invagination and the root canal were the most important factors in determining such minimally invasive treatment protocol. Depending on the anatomy of the root canal system, surgical amputation of an invaginated root can be performed to achieve a successful outcome in Oehler’s type III dens invaginatus cases, even though it is associated with apical periodontitis. PMID:27141224

  15. Intentional replantation - a 'last resort' treatment or a conventional treatment procedure? nine case reports.

    PubMed

    Peer, Michael

    2004-02-01

    Intentional replantation is an accepted endodontic treatment procedure in which a tooth is extracted and treated outside the oral cavity and then inserted into its socket to correct an obvious radiographic or clinical endodontic failure. This article reviews nine cases of intentional replantation (IR) that show the feasibility of the procedure in a variety of indications. Only one case of replantation showed evidence of pathosis that reflected root resorption or ankylosis. This report suggests that IR is a reliable and predictable procedure and should be more often considered as a treatment modality in our efforts to maintain the natural dentition.

  16. Comparison of three imaging techniques for assessing endodontic working length.

    PubMed

    Griffiths, B M; Brown, J E; Hyatt, A T; Linney, A D

    1992-11-01

    The accuracy of endodontic working length estimation was investigated using three imaging techniques: radiography (Rd), Xeroradiography (Xr) and Radiovisiography (RVG positive and negative prints). An in-vitro model of extracted single straight roots, mounted in wooden blocks with wax, was employed in the study. Optimum exposures were established for each of the imaging techniques. The magnification of the images was measured and the resolution of the RVG images was also investigated. Comparable Rd (D-speed film), Xr,RVG positive and RVG negative images were made of five roots with size 10 files in situ. Images of 10 standard files were made, ranging from 2.0 mm through the root apex to 2.5 mm short of the apex, resulting in 200 images. Six observers each assessed the working distance on 100 images, measuring the distance from the apical foramen to the file tip. After allowing for the magnification of the images, these results were compared with the 'true' file tip to apical foramen (measured with the aid of a reflex microscope). The inaccuracy of working distance estimations was considered to be of clinical significance (> 0.5 mm) in 6% of measurements made from Rd and Xr, 19.2% of measurements from RVG negative and 32.3% from RVG positive images. In addition, 14% of RVG images were too poorly defined to be assessed. The first-generation RVG system was used in this study. It was therefore concluded that the most accurate estimates of working distance were made from Xr and Rd images, and that RVG images, particularly the RVG positive images, were the least accurate and most difficult to read.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1306859

  17. Tissue-engineering-based Strategies for Regenerative Endodontics

    PubMed Central

    Albuquerque, M.T.P.; Valera, M.C.; Nakashima, M.; Nör, J.E.; Bottino, M.C.

    2014-01-01

    Stemming from in vitro and in vivo pre-clinical and human models, tissue-engineering-based strategies continue to demonstrate great potential for the regeneration of the pulp-dentin complex, particularly in necrotic, immature permanent teeth. Nanofibrous scaffolds, which closely resemble the native extracellular matrix, have been successfully synthesized by various techniques, including but not limited to electrospinning. A common goal in scaffold synthesis has been the notion of promoting cell guidance through the careful design and use of a collection of biochemical and physical cues capable of governing and stimulating specific events at the cellular and tissue levels. The latest advances in processing technologies allow for the fabrication of scaffolds where selected bioactive molecules can be delivered locally, thus increasing the possibilities for clinical success. Though electrospun scaffolds have not yet been tested in vivo in either human or animal pulpless models in immature permanent teeth, recent studies have highlighted their regenerative potential both from an in vitro and in vivo (i.e., subcutaneous model) standpoint. Possible applications for these bioactive scaffolds continue to evolve, with significant prospects related to the regeneration of both dentin and pulp tissue and, more recently, to root canal disinfection. Nonetheless, no single implantable scaffold can consistently guide the coordinated growth and development of the multiple tissue types involved in the functional regeneration of the pulp-dentin complex. The purpose of this review is to provide a comprehensive perspective on the latest discoveries related to the use of scaffolds and/or stem cells in regenerative endodontics. The authors focused this review on bioactive nanofibrous scaffolds, injectable scaffolds and stem cells, and pre-clinical findings using stem-cell-based strategies. These topics are discussed in detail in an attempt to provide future direction and to shed light on

  18. Control of microorganisms in vitro by endodontic irrigants.

    PubMed

    Estrela, Cyntia R A; Estrela, Carlos; Reis, Cleômenes; Bammann, Lili Luschke; Pécora, Jesus Djalma

    2003-01-01

    The aim of this study was to determine the minimum inhibitory concentration (MIC) and antimicrobial effectiveness by the direct exposure test of 4 endodontic irrigants [1% sodium hypochlorite (NaOCl), 2% chlorhexidine (CHX), 1% calcium hydroxide (Ca(OH)2; prepared with 1 g of Ca(OH)2 and 100 mL of sterile distilled water), a solution of Ca(OH)2 + detergent (HCT20)] for S. aureus, E. faecalis, P. aeruginosa, B. subtilis, C. albicans and a mixed culture. Microbial growth was analyzed by two methods: turbidity of the culture medium that was confirmed by Gram stain and subculture in a specific nutrient broth. In the dilution test, NaOCl solution showed MIC equal to 0.1% for S. aureus, E. faecalis, P. aeruginosa and C. albicans and equal to 1% for B. subtilis and the mixed culture. CHX (2%) presented MIC equal to 0.000002% for S. aureus, 0.02% for E. faecalis, B. subtilis, C. albicans and the mixed culture and 0.002% for P. aeruginosa. Ca(OH)2 solution (1%) showed MIC greater than 1% for all the microorganisms except P. aeruginosa for which it was equal to 1%. Calcium hydroxide solution + detergent showed MIC equal to 4.5 mL for S. aureus, P. aeruginosa, B. subtilis, C. albicans and the mixed culture and greater than 4.5 mL for E. faecalis. In the direct exposure test, NaOCl had better antimicrobial effectiveness for all microorganisms at all times. CHX (2%) was effective for S. aureus, E. faecalis and C. albicans at all times, and ineffective for P. aeruginosa, B. subtilis and the mixed culture. The other solutions showed the worst results. PMID:15057395

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

    PubMed Central

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

    2016-01-01

    Introduction: Quoting an article in well-known textbooks is held as a credit for that paper. The numbers of Iranian publications mentioned in endodontic textbooks have increased during recent years. The aim of this investigation was to evaluate the number of Iranian articles quoted in eminent endodontic textbooks. Methods and Materials: Three known textbooks (Ingle’s Endodontics, Seltzer and Bender’s Dental Pulp and Cohen’s Pathways of the Pulp) were chosen and all the editions of the textbooks since 2000 were investigated for quoted Iranian publications. Only Iranian authors with affiliations from a domestic university were chosen. All references at the end of each chapter were read by hand searching, and results were noted. The trend and percentage of Iranian publications in different editions of the textbooks were also calculated. The number of citations of these publications in Google Scholar and Scopus databases were also obtained. Results: The number of Iranian publications in all well-known textbooks have notably increased since 2000. The number and percentage of Iranian publications in the latest edition of Cohen’s Pathways of the Pulp was higher compared to other textbooks as well as the previous edition of the same text. Conclusion: Number and percentage of Iranian publications in the field of endodontics in all three textbooks have remarkably increased since 2000. PMID:27471523

  20. Radix entomolaris: 2 case reports and clinical guidelines for endodontic management.

    PubMed

    Latha, S Jothi; Velmurugan, N; Kavitha, M; Kumar, A R Pradeep

    2014-01-01

    Variations in dental anatomy and root canal systems are often reported in the dental literature. Among them, Radix entomolaris (RE) is the presence of an additional lingual root in mandibular molars. Though RE appears relatively infrequently, knowledge of the condition will aid in its management. This article presents 2 case reports of RE and clinical guidelines for endodontic management.

  1. Impact of different file systems on the amount of apically extruded debris during endodontic retreatment

    PubMed Central

    Uzunoglu, Emel; Turker, Sevinc Aktemur

    2016-01-01

    Objective: The goal of present study was to determine the effect of different nickel–titanium file systems on the amount of apically extruded debris during endodontic retreatment: D-RaCe retreatment systems, EdgeFile XR retreatment rotary files, and Reciproc R40. Materials and Methods: Thirty-six single-rooted prepared mandibular premolar teeth were filled with Gutta-percha and AH Plus sealer. The teeth were then randomly assigned into three groups (n = 12) for retreatment. The endodontic retreatment was performed as follows: D-RaCe, EdgeFile XR, Reciproc 40. Debris extruded apically during the retreatment was collected into preweighed Eppendorf tubes. An incubator was used to store tubes at 70° C for 5 days. The initial weight was subtracted from final weight of the Eppendorf tubes to calculate the weight of the dry extruded debris for each group. The data obtained were evaluated using Welch analysis of variance and Games-Howell post-hoc tests (P < 0.05). Results: All files resulted in apical extrusion of debris. Reciproc caused significantly less debris extrusion compared to D-RaCe and EdgeFile XR (P < 0.05). Conclusions: The findings revealed that during endodontic retreatment, number, and taper of files might have an influence on the amount of apically extruded debris during endodontic retreatment. PMID:27095898

  2. Endodontic management of a hypertaurodontic tooth associated with 48, XXYY syndrome: A review and case report

    PubMed Central

    Krishnamoorthy, Sridevi; Gopikrishna, Velayutham

    2015-01-01

    Taurodontism is a developmental anomaly of a tooth characterized by large pulp chamber and short roots. Patients with multiple taurodontic teeth are associated with the probability of a systemic syndrome or chromosomal anomaly. This is the first reported incidence of the endodontic management of a hyper taurodontic mandibular second molar in a patient diagnosed with 48, XXYY syndrome. PMID:26069418

  3. Morphological and chemical changes in dentin after using endodontic agents: Fourier transform Raman spectroscopy, energy-dispersive x-ray fluorescence spectrometry, and scanning electron microscopy study

    NASA Astrophysics Data System (ADS)

    Pascon, Fernanda Miori; Kantovitz, Kamila Rosamilia; Soares, Luís Eduardo Silva; Santo, Ana Maria do Espírito; Martin, Airton Abraha~o.; Puppin-Rontani, Regina Maria

    2012-07-01

    We examine the morphological and chemical changes in the pulp chamber dentin after using endodontic agents by scanning electron microscopy (SEM), Fourier transform Raman spectroscopy (FT-Raman), and micro energy-dispersive x-ray fluorescence spectrometry (μEDXRF). Thirty teeth were sectioned exposing the pulp chamber and divided by six groups (n=5): NT-no treatment; CHX-2% chlorhexidine; CHXE-2% chlorhexidine+17% EDTA E-17% EDTA; SH5-5.25% NaOCl; SH5E-5.25% NaOCl+17% EDTA. The inorganic and organic content was analyzed by FT-Raman. μEDXRF examined calcium (Ca) and phosphorus (P) content as well as Ca/P ratio. Impressions of specimens were evaluated by SEM. Data were submitted to Kruskal-Wallis and Dunn tests (p<0.05). Differences were observed among groups for the 960 cm-1 peak. Ca and P content differences were significant (SH5>NT=SH5E>CHX>E>CHXE). CHXE and E presented the highest Ca/P ratio values compared to the other groups (p<0.05). The SEM images in the EDTA-treated groups had the highest number of open tubules. Erosion in the tubules was observed in CHX and SH5E groups. Endodontic agents change the inorganic and organic content of pulp chamber dentin. NaOCl used alone, or in association with EDTA, was the most effective agent considering chemical and morphological approaches.

  4. Evaluation of the endodontic apical seal after post insertion by synchrotron radiation microtomography

    NASA Astrophysics Data System (ADS)

    Contardo, L.; De Luca, M.; Biasotto, M.; Longo, R.; Olivo, A.; Pani, S.; Di Lenarda, R.

    2005-08-01

    The commonly used methods for evaluating the endodontic apical seal, such as longitudinal and transversal section and diaphanization, show some operative difficulties and intrinsic limitation. This study suggests and describes a new method of analysis using a synchrotron radiation microtomography to analyse the root apex after post insertion, creating a three-dimensional image and analysing sections of the specimen every 5 μm. The study was performed at SYRMEP beam line at the Electra Synchrotron in Trieste using monochromatic X-rays of 32 KeV. Eleven monoradicular teeth were prepared using NiTi GT Rotary files instruments to an apical size 20 with conicity .06 and divided in four groups: in G1 ( n=4) and G2 ( n=2), the specimens were endodontically filled with guttapercha and a zinc-oxide sealer, in G3 ( n=3) and G4 ( n=2) guttapercha and a silicon-based sealer were used. An endodontic post was inserted in specimens of groups 1 and 3 following the manufacturer's instructions. Specimens were analysed using monochromatic X-rays of 32 KeV. A CCD detector with pixel dimension pf 5×5 μm 2 was used for the acquisition process. Seven hundred and twenty projections were performed over 180° range using a high-resolution rotator. The projections were reconstructed using standard algorithms for tomographic reconstruction. The apical infiltration was evaluated by verifying if black spots were detectable on the images. The specimens of groups 3 and 4 showed a better apical seal than the ones of groups 1 and 2. Post insertion, when a ZOE-based sealer is used, increases the apical gap even if it does not seem to be clinically relevant and sufficient to be a cause of endodontic failure. The new method for analysis appeared to be effective to detect small defects in endodontic obturation, analysing guttapercha-sealer and sealer-dentin interfaces.

  5. A histologic comparison of Hydron and zinc oxide-eugenol as endodontic filling materials in the primary teeth of dogs.

    PubMed

    Woods, R L; Kildea, P M; Gabriel, S A; Freilich, L S

    1984-07-01

    Currently available endodontic filling materials for primary teeth demonstrate several inadequacies. Therefore, this study histologically evaluates Hydron (2-hydroxyethylmethacrylate) and zinc oxide and eugenol (ZOE) as primary tooth endodontic filling materials in dogs to compare the materials' biocompatibility and to determine whether they undergo resorption in a physiologic manner. Primary molars of six mongrel dogs, 2 to 3 months old, received one-step endodontic therapy. By random selection, two thirds of the molars were filled with either Hydron or ZOE and the remainder were used as unoperated controls. Block sections taken during physiologic root resorption were used to obtain serial hematoxylin and eosin sections of periapical regions. Hydron was phagocytosed by mononuclear macrophages in a physiologic manner and at a rate comparable to that of root tissues. In contrast, ZOE demonstrated delayed resorption and transitory inflammation. Neither material showed cytotoxicity. Hydron may therefore be a suitable endodontic material for human primary teeth.

  6. A Case Report of Tooth Wear Associated with a Patient's Inappropriate Efforts to Reduce Oral Malodor Caused by Endodontic Lesion.

    PubMed

    Yoneda, Masahiro; Uchida, Hatsumi; Suzuki, Nao; Mine, Mariko; Iwamoto, Tomoyuki; Masuo, Yosuke; Naito, Toru; Hatano, Yuko; Hirofuji, Takao

    2009-01-01

    Here, we report a case of severe tooth wear associated with a patient's inappropriate efforts to reduce oral malodor. A 72-year-old male patient visited our breath clinic complaining of strong breath odor. Former dentists had performed periodontal treatments including scaling and root planing, but his oral malodor did not decrease. His own subsequent breath odor-reducing efforts included daily use of lemons and vinegar to reduce or mask the odor, eating and chewing hard foods to clean his teeth, and extensive tooth brushing with a hard-bristled toothbrush. Oral malodor was detected in our breath clinic by several tests, including an organoleptic test, portable sulphide monitor, and gas chromatography. Although patient's oral hygiene and periodontal condition were not poor on presentation, his teeth showed heavy wear and hypersensitiving with an unfitted restoration on tooth 16. Radiographic examination of the tooth did not reveal endodontic lesion, but when the metal crown was removed, severe pus discharge and strong malodor were observed. When this was treated, his breath odor was improved. After dental treatment and oral hygiene instruction, no further tooth wear was observed; he was not concerned about breath odor thereafter. PMID:20339568

  7. Fracture Resistance of Endodontically-treated Maxillary Premolars Restored with Composite Resin along with Glass Fiber Insertion in Different Positions

    PubMed Central

    Jafari Navimipour, Elmira; Ebrahimi Chaharom, Mohammad Esmaeel; Alizadeh Oskoee, Parnian; Mohammadi, Narmin; Bahari, Mahmoud; Firouzmandi, Maryam

    2012-01-01

    Background and aims The aim was to evaluate the effect of three methods of fiber insertion on fracture resistance of root-filled maxillary premolars in vitro. Materials and methods Sixty extracted human maxillary premolars received endodontic treatment followed by preparation of mesioocclusodistal (MOD) cavities, with gingival cavosurface margin 1.5 mm coronal to the cementoenamel junction (CEJ). Subsequently, the samples were randomly divided into four groups: no-fiber group; occlusal fiber group (fiber was placed in the occlusal third); circumferential fiber group (fiber was placed circumferentially in the cervical third); and dual-fiber group (occlusal and circumferential fibers). Subsequent to restoring with composite resin and thermocycling, a compressive force was applied until fracture. Data was analyzed using one-way ANOVA and Tukey test at significance levels of P < 0.05 and P < 0.02, respectively. Results Fiber placement significantly increased fracture resistance. Fracture resistance in the dual-fiber group was significantly higher than that in the circumferential fiber group (P < 0.007); however, there were no significant differences between the dual-fiber and occlusal fiber groups (P = 0.706). The highest favorable fracture rate was observed in the circumferential fiber group (60%). Conclusion Composite resin restoration along with glass fiber in the occlusal and gingival thirds can be an acceptable treatment option for restoring root-filled upper premolars. PMID:23277858

  8. Effect of Dexamethasone Intraligamentary Injection on Post-Endodontic Pain in Patients with Symptomatic Irreversible Pulpitis: A Randomized Controlled Clinical Trial

    PubMed Central

    Mehrvarzfar, Payman; Esnashari, Ehsan; Salmanzadeh, Reyhaneh; Fazlyab, Mahta; Fazlyab, Mahyar

    2016-01-01

    Introduction: The aim of this randomized-controlled clinical trial was to assess the effect of intraligamentary (PDL) injection of dexamethasone on onset and severity of post-treatment pain in patients with symptomatic irreversible pulpitis. Methods and Materials: A total number of 60 volunteers were included according to the inclusion criteria and were assigned to three groups (n=20). After administration of local anesthesia and before treatment, group 1 (control) PDL injection was done with syringe containing empty cartridge, while in groups 2 and 3 the PDL injection was done with 0.2 mL of 2% lidocaine or dexamethasone (8 mg/2 mL), respectively. Immediately after endodontic treatment patients were requested to mark their level of pain on a visual analogue scale (VAS) during the next 48 h (on 6, 12, 24 and 48-h intervals). They were also asked to mention whether analgesics were taken and its dosage. Considering the 0-170 markings on the VAS ruler, the level of pain was scored as follows: score 0 (mild pain; 0-56), score 1 (moderate pain; 57-113) and score 3 (severe pain; 114-170). The data were analyzed using the Kruskal-Wallis and the Chi-square tests and the level of significance was set at 0.05. Results: After 6 and 12 h, group 1 and group 3 had the highest and lowest pain values, respectively (P<0.01 and P<0.001 for 6 and 12 h, respectively). However, after 24 and 48 h the difference in the pain was not significant between groups 1 and 2 (P<0.6) but group 3 had lower pain levels (P<0.01 and P<0.8 for 24 and 48 h, respectively). Conclusion: Pretreatment PDL injection of dexamethasone can significantly reduce the post-treatment endodontic pain in patients with symptomatic irreversible pulpitis. PMID:27790253

  9. What can cause the pulps of immature, permanent teeth with open apices to become necrotic and what treatment options are available for these teeth.

    PubMed

    Flanagan, Thomas Andrew

    2014-12-01

    Pulp necrosis of immature permanent teeth represents a significant challenge for clinical management as root development ceases and open apices remain. The aetiology of pulp necrosis in immature permanent teeth can include caries, trauma or the presence of the dental anomalies, dens invaginatus and dens evaginatus. Endodontic treatment is complicated by the resultant thin dentinal root walls and the lack of apical closure. The long-term prognosis is compromised by increased risk of cervical root fracture and reduced crown to root ratio. Currently there is a paradigm shift in the management of such cases from traditional apexification procedures towards regenerative endodontic procedures. Regenerative endodontics can promote continued root development and apical closure, which does not occur with calcium hydroxide or mineral trioxide aggregate apexification. As supporting evidence grows and clear treatment guidelines are developed for regenerative endodontics, it is likely to become the gold standard for management of such teeth.

  10. The ratio in choosing access flap for surgical endodontics: a review

    PubMed Central

    GRANDI, C.; PACIFICI, L.

    2009-01-01

    SUMMARY In Surgical Endodontics we face complex situations that require the knowlflap and application of both principles of endodontics (cleansing shaping and filling) in the root management, and the principles of surgery (asepsis, non harmfulness and hemostasis) in the phase of access to the root. Among the factors of surgical relevance that for which have been proposed with the largest number of alternatives is the design of access flap. That clearly indicates that not only one flap design can be ideal in all clinical situations. In this article all proposed access flap designs are evaluated in the light of their degree of compliance with ideal requirements in different circumstances. A clear pattern in the decision-making criteria for the selection of access flaps is proposed. PMID:23285356

  11. Use of a new retrograde filling material (Biodentine) for endodontic surgery: two case reports.

    PubMed

    Caron, Grégory; Azérad, Jean; Faure, Marie-Odile; Machtou, Pierre; Boucher, Yves

    2014-12-01

    Mineral trioxide aggregate (MTA) is considered at the present time as the gold standard for root-end filling in endodontic surgery. However, this biocompatible material presents several drawbacks such as a long setting time and handling difficulties. The aim of this article is to present a new commercialized calcium silicate-based material named Biodentine with physical improved properties compared to MTA in a clinical application. Two endodontic microsurgeries were performed by using specific armamentarium (microsurgical instrumentation, ultrasonic tips) under high-power magnification with an operatory microscope. Biodentine was used as a root-end filling in order to seal the root canal system. The two cases were considered completely healed at 1 year and were followed for one more year. The 2-year follow-up consolidated the previous observation with absence of clinical symptoms and radiographic evidence of regeneration of the periapical tissues.

  12. 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.

  13. Survival time of endodontically treated teeth: a 7-year retrospective clinical study

    NASA Astrophysics Data System (ADS)

    Baldea, Bogdan; Canjau, Silvana; Popescu, Dragos; Tudor, Anca; Todea, Carmen

    2014-01-01

    The aim of this retrospective clinical study was to examine the survival time of endodontically treated teeth (ETT) and the factors that may influence the failure risk, over a period of up to 7 years. The files of 67 patients that received metal free post and core restorations using a standardized technique were analyzed. The survival probability was assessed using Kaplan-Meyer analysis and Log Rank (Matel-Cox). Cox regression was used to assess the risk of failure and to identify possible covariates. The average survival time of the ETT was 6.6 Years. The cumulative failure rate was 5.82% for all type of the restored endodontically treated teeth. The main failure type was encountered in the cervical area of the teeth, and due to the extensive hard tissue loss, the teeth were extracted.

  14. 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.

  15. Inflammatory suppression by endodontic sealers after aging 12 weeks In vitro.

    PubMed

    Brackett, Martha Goël; Marshall, Aksana; Lockwood, Petra E; Lewis, Jill B; Messer, Regina L W; Bouillaguet, Serge; Wataha, John C

    2009-11-01

    Dental endodontic sealers are in intimate contact with tissues around the root apex (periapical area) for extended periods. New endodontic sealers have been developed in the past decade, but the biological responses to many new products are not well documented. In this study, we assessed in vitro monocytic cytotoxic and inflammatory responses to several contemporary endodontic sealers. AH-Plus (AH), Pulp Canal Sealer (PC), Epiphany (EPH), Endo-Rez (ER), and an experimental Endo-Rez (ERx) were initially placed in buffered-saline for 12 weeks to simulate in vivo use. After "aging," specimens were placed in direct contact with THP1 monocytes for 72 h and their cytotoxicity (mitochondrial response; MTT) or ability to trigger or suppress cytokine secretion (ELISA; TNFalpha, IL1beta, IL=6; +/- lipopolysaccharide (LPS) exposure) were measured relative to Teflon (Tf) negative controls. Cellular responses among conditions were compared with ANOVA and Tukey post-hoc analysis (alpha = 0.05). Two of the five sealers, EPH and PC, still suppressed cell mitochondrial activity by 70% or more after 12 weeks of conditioning in saline. No sealer alone activated monocytic TNFalpha, IL1beta, or IL6 secretion (p > 0.05 vs. +LPS controls). When THP1 were activated by LPS after exposure to the sealers, differential suppression of TNFalpha, IL1beta, and IL6 secretion was observed for two of the five sealers tested. (EPH and PC) This data suggest that common endodontic sealers do not activate monocytic TNFalpha, IL1beta, and IL6 secretion in vitro by themselves, but degradation products of the sealers may suppress activation of monocytes.

  16. XRD Study of NiTi Endodontic Files Using Synchrotron Radiation

    NASA Astrophysics Data System (ADS)

    Braz Fernandes, Francisco Manuel; Oliveira, J. P.; Machado, A.; Schell, Norbert

    2014-07-01

    Two types of endodontic files (ProFile and Mtwo) were studied in order to analyze the effect of geometry on the stress-induced martensitic (SIM) transformation during bending. The use of a fine beam spot of synchrotron radiation allowed a detailed structural characterization with a fine spatial resolution. Experimental evidence of the effect of the cross-section geometry on the stress localization giving rise to different degrees of SIM transformation is presented for the first time in the published literature.

  17. A rationale for the use of Erbium.YAG lasers in endodontic therapy

    NASA Astrophysics Data System (ADS)

    Convissar, Robert A.

    2004-09-01

    Since the introduction of lasers to dentistry, dentists have been intrigued with the idea of placing laser energy into an infected root canal with the goal of removing the bacteria and infected tissue, and sterilizing the root canal system. This paper will discuss the bacterial origin of endodontic infections, and describe the use of the Er.YAG laser to remove bacteria, prepare the canal walls, and aid in the creation of a superior seal of the root canal system.

  18. 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

  19. Fracture strength of endodontically treated premolars: An In-vitro evaluation

    PubMed Central

    Pradeep, PR; Kumar, VC Sunil; Bantwal, Sunil Rao; Gulati, Gurinderjeet Singh

    2013-01-01

    Background: The aim of this study is to measure the invitro fracture strength of endodontically treated maxillary premolars restored with silver amalgam, composite resins and bonded amalgam. Materials & Methods: Sixty mature maxillary premolars free of caries, restoration or fracture extracted for orthodontic purpose or periodontal reasons were selected. The teeth were randomly divided into six groups of 10 teeth each. Group I: Intact teeth, Group II: Access opening only, Group III: Standard MOD cavity preparation + superimposed endodontic access (Unrestored). In Group IV, Group V & Group VI preparation was done as in Group III and they were restored with amalgam, bonded amalgam and composite resins respectively. All the teeth were thermo cycled and were mounted on custom made rings and the fracture strength was calculated with an Instron testing machine and the results were analysed statistically. Results: Group I showed the highest fracture resistance followed by Group II . The difference in the values between the two groups were not significant. Group III showed the lowest fracture resistance the decrease in fracture strength was highly statistically significant when compared to all other groups investigated in the present study. Fracture strength of teeth restored with Group IV, Group V, Group VI did not differ significantly from each other. Conclusion: Fracture strength of intact natural teeth was superior to all the teeth tested in the study. Fracture strength of endodontically treated teeth restored with conventional amalgam, bonded amalgam and composite resin did not differ significantly from each other. Bonding of restorations to tooth structure has failed to bring about any improvement in the strength of the teeth tested. How to cite this article: Pradeep PR, Kumar VC, Bantwal SR, Gulati GS. Fracture strength of endodontically treated premolars: An In-vitro evaluation. J Int Oral Health 2013; 5(6):9-17 . PMID:24453439

  20. 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.

  1. Use of ultrasound, color Doppler imaging and radiography to monitor periapical healing after endodontic surgery.

    PubMed

    Tikku, Aseem P; Kumar, Sunil; Loomba, Kapil; Chandra, Anil; Verma, Promila; Aggarwal, Renu

    2010-09-01

    This study evaluated the effectiveness of ultrasound, color Doppler imaging and conventional radiography in monitoring the post-surgical healing of periapical lesions of endodontic origin. Fifteen patients who underwent periapical surgery for endodontic pathology were randomly selected. In all patients, periapical lesions were evaluated preoperatively using ultrasound, color Doppler imaging and conventional radiography, to analyze characteristics such as size, shape and dimensions. On radiographic evaluation, dimensions were measured in the superoinferior and mesiodistal direction using image-analysis software. Ultrasound evaluation was used to measure the changes in shape and dimensions on the anteroposterior, superoinferior, and mesiodistal planes. Color Doppler imaging was used to detect the blood-flow velocity. Postoperative healing was monitored in all patients at 1 week and 6 months by using ultrasound and color Doppler imaging, together with conventional radiography. The findings were then analyzed to evaluate the effectiveness of the 3 imaging techniques. At 6 months, ultrasound and color Doppler imaging were significantly better than conventional radiography in detecting changes in the healing of hard tissue at the surgical site (P < 0.004). This study demonstrates that ultrasound and color Doppler imaging have the potential to supplement conventional radiography in monitoring the post-surgical healing of periapical lesions of endodontic origin.

  2. 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

  3. An in vivo assessment of the influence of needle gauges on endodontic irrigation flow rate

    PubMed Central

    Gopikrishna, Velayutham; Sibi, Swamy; Archana, Durvasulu; Pradeep Kumar, Angabakkam Rajasekaran; Narayanan, Lakshmi

    2016-01-01

    Aim: The aim of this clinical study was to assess the influence of irrigation needle gauge on endodontic irrigation flow rates. Settings and Design: In vivo assessment. Materials and Methods: Five specialist endodontists performed intracanal irrigation procedures on 50 mesiobuccal canal of mandibular first molars using three different irrigation needle gauges. Data of time taken for irrigation was recorded by an irrigation testing system and analyzed using independent sample “T” test and one-way analysis of variance (ANOVA) test. The level of significance was set at P < 0.05. Statistical Analysis Used: The following tests were used for the statistical analysis: Independent sample “T” test, one-way ANOVA test, and post hoc multiple comparison was carried out using Tukey's honest significant difference (HSD) test using Statistical Package for the Social Sciences (SPSS) version 16 for Windows. Results: The average flow rate of 26 gauge was 0.27 mLs−1, of 27 gauge was 0.19 mLs−1, and of 30 gauge was 0.09 mls−1. There was statistical significance among the gauges (P < 0.001). 26 gauge had highest flow rate when compared with other groups followed by 27 gauge and 30 gauge respectively. The operator variability for flow rate of three endodontic irrigation needle gauges (26 gauge, 27 gauge, and 30 gauge) was found to be not significant. Conclusions: Needle gauge has significant influence on endodontic irrigation flow rate. PMID:27099430

  4. Radiological Evaluation of Penetration of the Irrigant according to Three Endodontic Irrigation Techniques

    PubMed Central

    Benkiran, Imane; El Ouazzani, Amal

    2016-01-01

    Introduction. This experimental study is to compare radiographs based on the penetration depth of the irrigant following three final irrigation techniques. Material and Method. A sample of sixty teeth with single roots were prepared with stainless steel K files followed by mechanized Ni-Ti files iRace® under irrigation with 2.5% sodium hypochlorite. Radiopaque solution was utilized to measure the penetration depth of the irrigant. Three irrigation techniques were performed during this study: (i) passive irrigation, (ii) manually activated irrigation, and (iii) passive irrigation with an endodontic needle CANAL CLEAN®. Radiographs were performed to measure the length of irrigant penetration in each technique. Results. In comparison, passive irrigation with a conventional syringe showed infiltration of the irrigant by an average of 0.682 ± 0.105, whereas the manually activated irrigation technique indicated an average of 0.876 ± 0.066 infiltration. Irrigation with an endodontic syringe showed an average infiltration of 0.910 ± 0.043. The results revealed highly significant difference between the three irrigation techniques (α = 5%). Conclusion. Adding manual activation to the irrigant improved the result by 20%. This study indicates that passive irrigation with an endodontic needle has proved to be the most effective irrigation technique of the canal system. PMID:27433162

  5. In vivo fractures of endodontically treated posterior teeth restored with amalgam.

    PubMed

    Hansen, E K; Asmussen, E; Christiansen, N C

    1990-04-01

    The cumulative survival rate (retention of both cusps) and the fracture pattern of 1639 endodontically treated posterior teeth were assessed in a retrospective study. All teeth had an MO/DO or an MOD cavity restored with amalgam without cuspal overlays. The 20-year survival rate of teeth with an MO/DO cavity was markedly higher than that of teeth with an MOD cavity. The lowest survival rate was found for the upper premolars with an MOD cavity: 28% of these teeth fractured within 3 years after endodontic therapy, 57% were lost after 10 years, and 73% after 20 years. Generally, the cusp most prone to fracture was the lingual one, and lingual fractures caused significantly more damage to the periodontal tissues than did facial or total crown fractures. The severity of periodontal damage increased with posterior location of the tooth. By far the most serious failures, irrespective of the cavity type, were found for the upper second molar, as 10 of 29 fractures led to extraction. It is concluded that amalgam, especially in MOD cavities, is an unacceptable material for restoration of endodontically treated posterior teeth if used without cuspal overlays. PMID:2132209

  6. Investigation of Bacterial Contents From Persistent Endodontic Infection and Evaluation of Their Inflammatory Potential.

    PubMed

    Cardoso, Flávia Goulart da Rosa; Chung, Adriana; Martinho, Frederico Canato; Camargo, Carlos Henrique Ribeiro; Carvalho, Claudio Antônio Talge; Gomes, Brenda Paula Figueiredo de Almeida; Valera, Marcia Carneiro

    2016-01-01

    This clinical study investigated and quantified cultivable bacteria and their levels of endotoxins in persistent endodontic infection, determining their antigenicity against macrophages and fibroblast cells by IL-1β and TNF-α secretion and evaluating their relationship with clinical and radiographic features. Samples from the root canals were obtained after root filling removal. Culture techniques were used to determine the bacterial count and the endotoxins were determined by LAL-assay. PCR analysis (16S rDNA) was used for bacterial detection. Raw 264.5 macrophages and V79 fibroblast were stimulated with endodontic contents. ELISA assay measured the amounts of IL-1ß/TNF-?#61537; secretion. Bacteria and endotoxin medians were 1.24x105 CFU/mL and 9.62 EU/mL, respectively. Porphyromonas endodontalis was the most frequently detected species. Higher levels of endotoxins were found in teeth with pain on palpation (23.56 EU/mL) rather than in its absence (8.21 EU/mL). Larger areas of bone destruction were related to higher levels of endotoxins and IL-1β and TNF-α secretion. The study findings revealed the presence of Gram-negative bacteria species in persistent endodontic infection, with their endotoxins related to both severity of bone destruction and development of symptomatology. Moreover, larger areas of bone destruction were related to higher levels of IL-1β and TNF-α secreted by macrophages and fibroblast cells. PMID:27652703

  7. The organization and running of postgraduate endodontic 'hands-on' courses.

    PubMed

    Saunders, E M

    1991-07-01

    Considerable preparation, planning and detailed organization are necessary if endodontic 'hands-on' courses are to be stimulating and worthwhile for participant and teacher alike. Projection facilities, lighting, seating and working surface requirements must be checked immediately on arrival at the venue. The format, although flexible enough to allow for the wide range of knowledge and practical ability found within any one group, must adhere to and stress the current fundamentals in endodontic teaching. Not only can information and skill in diagnosis, root canal preparation and obturation be taught in a 'hands-on' format, but rubber dam isolation techniques can also be practised very successfully. Tutors must be prepared to demonstrate personally their clinical ability and experience of principles and techniques taught during the course. Post-course feedback can be an extremely useful means of ensuring that 'hands-on' courses are relevant, with the appropriate practical emphasis required by the general dental practitioner, as well as the necessary stress on endodontic principles.

  8. Culture-based identification of pigmented Porphyromonas and Prevotella species in primary endodontic infections.

    PubMed

    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

  9. Fracture resistance of endodontically treated maxillary central incisors with varying ferrule heights and configurations: In vitro study

    PubMed Central

    Singh, Smita; Thareja, Prerna

    2014-01-01

    Objective: The objective of this study is to determine the best ferrule configuration of endodontically treated teeth. Materials and Methods: A total of 40 freshly extracted maxillary central incisors were collected. Teeth were allocated into following four groups of each having 10 teeth. Group 1 teeth restored with crowns (CRN), Group 2 endodontically treated teeth restored with crowns (RCT and CRN), Group 3 endodontically treated teeth restored with cast dowel cores and crowns incorporating uniform 2 mm ferrule (2 FRL), Group 4 endodontically treated teeth restored with cast dowel cores and crowns incorporating uniform 1 mm ferrule (1 FRL). Crown preparation was performed with varying ferrule heights, crowns were cemented with resin modified glass ionomer cement and were kept in 100% humidity for 3 days, all specimens were loaded to failure in a universal testing machine at 0.5 mm/min. Results were obtained in the form of kilo Newton and Newton. Result: The statistical analysis applied was an analysis of variance to detect the presence of group differences. Pair wise comparisons between the groups were analyzed with the Tukey Kramer significant difference test for multiple comparisons. Conclusion: Ferrule had a significant role in the fracture resistance of custom cast post core restored teeth. Endodontically treated maxillary central incisors with a uniform 2 mm ferrule were more fracture resistant than those with a uniform 1 mm ferrule. PMID:24778504

  10. Cone Beam Computed Tomography Assisted Endodontic Management of a Rare Case of Mandibular First Premolar with Three Roots

    PubMed Central

    Balakasireddy, K; Kumar, K Pavan; John, Gijo; Gagan, C

    2015-01-01

    Understanding the morphological anatomy of the root and root canal systems of the teeth increases the success rate of endodontic therapy. Advanced diagnostic imaging techniques like cone beam computed tomography (CBCT) are an essential aid in understanding the anatomy of teeth especially in mandibular premolars. Most commonly mandibular first and second premolars have a single root and a single canal. However, multiple root and canals have also been reported. The present case report discusses endodontic management of a three rooted mandibular first premolar using CBCT. PMID:26124611

  11. Single Step Endodontic Management of Immature Apices using MTA

    PubMed Central

    Mishra, SK; Kumar, Ashok; Garg, Amit Kumar; Jindal, MK; Juneja, Harish

    2011-01-01

    Aim To examine the clinical and radiographic appearance of teeth with immature apices that were treated by single step procedure using mineral trioxide aggregate (MTA). Summary Creation of a physiological hard tissue barrier with calcium hydroxide in a nonvital tooth although quite predictable has certain limitations, such as the very long duration of the treatment spread over multiple visits and increased risk of root fracture. Plugging the root canal end with MTA has been advocated as an alternative treatment modality for open apices. The technique has been proven to be successful in many recently reported cases. The cases reported here present the successful treatment of two traumatized maxillary central incisors with open apices and periapical lesions using MTA. In this case report, MTA has been used to create a hard tissue barrier after disinfection of the root canal.

  12. Single Step Endodontic Management of Immature Apices using MTA

    PubMed Central

    Mishra, SK; Kumar, Ashok; Garg, Amit Kumar; Jindal, MK; Juneja, Harish

    2011-01-01

    Aim To examine the clinical and radiographic appearance of teeth with immature apices that were treated by single step procedure using mineral trioxide aggregate (MTA). Summary Creation of a physiological hard tissue barrier with calcium hydroxide in a nonvital tooth although quite predictable has certain limitations, such as the very long duration of the treatment spread over multiple visits and increased risk of root fracture. Plugging the root canal end with MTA has been advocated as an alternative treatment modality for open apices. The technique has been proven to be successful in many recently reported cases. The cases reported here present the successful treatment of two traumatized maxillary central incisors with open apices and periapical lesions using MTA. In this case report, MTA has been used to create a hard tissue barrier after disinfection of the root canal. PMID:27678239

  13. A new device to test cutting efficiency of mechanical endodontic instruments

    PubMed Central

    Rubini, Alessio Giansiracusa; Plotino, Gianluca; Al-Sudani, Dina; Grande, Nicola M.; Putorti, Ermanno; Sonnino, GianPaolo; Cotti, Elisabetta; Testarelli, Luca; Gambarini, Gianluca

    2014-01-01

    Background The purpose of the present study was to introduce a new device specifically designed to evaluate the cutting efficiency of mechanically driven endodontic instruments. Material/Methods Twenty new Reciproc R25 (VDW, Munich, Germany) files were used to be investigated in the new device developed to test the cutting ability of endodontic instruments. The device consists of a main frame to which a mobile plastic support for the hand-piece is connected and a stainless-steel block containing a Plexiglas block against which the cutting efficiency of the instruments was tested. The length of the block cut in 1 minute was measured in a computerized program with a precision of 0.1mm. The instruments were activated by using a torque-controlled motor (Silver Reciproc; VDW, Munich, Germany) in a reciprocating movement by the “Reciproc ALL” program (Group 1) and in counter-clockwise rotation at 300 rpm (Group 2). Mean and standard deviations of each group were calculated and data were statistically analyzed with a one-way ANOVA test (P<0.05). Results Reciproc in reciprocation (Group 1) mean cut in the Plexiglas block was 8.6 mm (SD=0.6 mm), while Reciproc in rotation mean cut was 8.9 mm (SD=0.7 mm). There was no statistically significant difference between the 2 groups investigated (P>0.05). Conclusions The cutting testing device evaluated in the present study was reliable and easy to use and may be effectively used to test cutting efficiency of both rotary and reciprocating mechanical endodontic instruments. PMID:24603777

  14. Fracture resistance of endodontically treated teeth restored with a bulkfill flowable material and a resin composite

    PubMed Central

    Isufi, Almira; Plotino, Gianluca; Grande, Nicola Maria; Ioppolo, Pietro; Testarelli, Luca; Bedini, Rossella; Al-Sudani, Dina; Gambarini, Gianluca

    2016-01-01

    Summary Aim To determine and compare the fracture resistance of endodontically treated teeth restored with a bulk fill flowable material (SDR) and a traditional resin composite. Methods Thirty maxillary and 30 mandibular first molars were selected based on similar dimensions. After cleaning, shaping and filling of the root canals and adhesive procedures, specimens were assigned to 3 subgroups for each tooth type (n=10): Group A: control group, including intact teeth; Group B: access cavities were restored with a traditional resin composite (EsthetX; Dentsply-Italy, Rome, Italy); Group C: access cavities were restored with a bulk fill flowable composite (SDR; Dentsply-Italy), except 1.5 mm layer of the occlusal surface that was restored with the same resin composite as Group B. The specimens were subjected to compressive force in a material static-testing machine until fracture occurred, the maximum fracture load of the specimens was measured (N) and the type of fracture was recorded as favorable or unfavorable. Data were statistically analyzed with one-way analysis of variance (ANOVA) and Bonferroni tests (P<0.05). Results No statistically significant differences were found among groups (P<0.05). Fracture resistance of endodontically treated teeth restored with a traditional resin composite and with a bulk fill flowable composite (SDR) was similar in both maxillary and mandibular molars and showed no significant decrease in fracture resistance compared to intact specimens. Conclusions No significant difference was observed in the mechanical fracture resistance of endodontically treated molars restored with traditional resin composite restorations compared to bulk fill flowable composite restorations. PMID:27486505

  15. Efficacy of Different Techniques for Removing Debris from Endodontic Files Prior to Sterilization

    PubMed Central

    Nosouhian, Saeid; Bajoghli, Farshad; Sabouhi, Mahmoud; Barati, Masoud; Davoudi, Amin; Sharifipour, Maryam

    2015-01-01

    Background: Dental instruments, like endodontic files, are hardly disinfected. The aim of this study was to evaluate the efficacy of mechanical, chemical, and ultrasonic (in combinations or separately) techniques for removing debris from files, prior to sterilization. Materials and Methods: Totally, 90 new endodontic files with size of 15, 25, and 40 (30 files of each one) were sterilized and one files of each one kept as negative control (NC) group. The rest of files (29 files of each size) were divided into five groups after endodontic therapies and prior to autoclaving: (Positive control [PC]: Without interventions, A: Cleaned with scouring sponge soaked in chlorhexidine 0.2%, B: Stored in Micro 10 enzyme, C: Subjected to Micro 10 enzyme in both conventional and ultrasonic way for 15 min, D: Decontaminated by Micro 10 enzyme with ultrasonic). Finally, the samples were observed under a metallographic microscope, and the data were analyzed by Tuckey, paired t-test, two-way ANOVA tests using SPSS software version 15 at a significant level of 0.05. Results: Significant differences were observed in heads of the files among groups C and PC (P = 0.02), and high amount of debris were seen in the shafts of groups A and D (P < 0.001). The amount of remaining debris were significant in the shafts of sizes 15 (P < 0.001) and 25 (P = 0.01). Conclusion: Using Micro 10 in both ultrasonic and conventional methods were acceptable for removing debris from the files. Furthermore, higher amounts of debris were found in the shafts and heads of files with lower sizes (15 and 25). PMID:26464538

  16. 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.

  17. Sample Size Calculation of Clinical Trials Published in Two Leading Endodontic Journals

    PubMed Central

    Shahravan, Arash; Haghdoost, Ali-Akbar; Rad, Maryam; Hashemipoor, Maryamalsadat; Sharifi, Maryam

    2014-01-01

    Introduction: The purpose of this article was to evaluate the quality of sample size calculation reports in published clinical trials in Journal of Endodontics and International Endodontic Journal in years 2000-1 and 2009-10. Materials and Methods: Articles fulfilling the inclusion criteria were collected. The criteria were: publication year, research design, types of control group, reporting sample size calculation, the number of participants in each group, study outcome, amount of type I (α) and II (β) errors, method used for estimating prevalence or standard deviation, percentage of meeting the expected sample size and considering clinically importance level in sample size calculation. Data were extracted from all included articles. Descriptive analyses were conducted. Inferential statistical analyses were done using independent T-test and Chi-square test with the significance level set at 0.05. Results: There was a statistically significant increase in years between 2009 and 10 compared to 2000-1 in terms of reporting sample size calculation (P=0.002), reporting clinically importance level (P=0.003) and in samples size of clinical trials (P=0.01). But there was not any significant difference between two journals in terms of reporting sample size calculation, type of control group, frequency of various study designs and frequency of positive and negative clinical trials in different time periods (P>0.05). Conclusion: Sample size calculation in endodontic clinical trials improved significantly in 2009-10 when compared to 2000-1; however further improvements would be desirable. PMID:24396377

  18. Enhancement of NiTi superelastic endodontic instruments by TiO2 coating.

    PubMed

    Aun, Diego Pinheiro; Peixoto, Isabella Faria da Cunha; Houmard, Manuel; Buono, Vicente Tadeu Lopes

    2016-11-01

    Rotary nickel-titanium (NiTi) endodontic instruments were coated with a nanometric flexible TiO2 layer through dip-coating sol-gel. Control groups and coated samples of superelastic NiTi instruments model RaCe 25/0.06 (0.25mm tip-diameter, 6% conicity) were comparatively investigated with respect to the cutting efficiency, fatigue life, and corrosion resistance. Results showed an improvement in cutting efficiency for the coated samples and a high resistance to corrosion in NaClO. The coated instruments showed a better performance in fatigue life after corrosion.

  19. Enhancement of NiTi superelastic endodontic instruments by TiO2 coating.

    PubMed

    Aun, Diego Pinheiro; Peixoto, Isabella Faria da Cunha; Houmard, Manuel; Buono, Vicente Tadeu Lopes

    2016-11-01

    Rotary nickel-titanium (NiTi) endodontic instruments were coated with a nanometric flexible TiO2 layer through dip-coating sol-gel. Control groups and coated samples of superelastic NiTi instruments model RaCe 25/0.06 (0.25mm tip-diameter, 6% conicity) were comparatively investigated with respect to the cutting efficiency, fatigue life, and corrosion resistance. Results showed an improvement in cutting efficiency for the coated samples and a high resistance to corrosion in NaClO. The coated instruments showed a better performance in fatigue life after corrosion. PMID:27524067

  20. Intentional replantation of endodontically treated teeth: an update.

    PubMed

    Wolcott, James; Rossman, Louis E

    2003-01-01

    The IR technique is a clinically successful procedure, so long as the following conditions, as outlined by Niemczyk, are met: 1) Avoid any crushing or scraping contact with the root surface or socket; 2) Root surface must be continually hydrated with tissue culture media (e.g., HBSS); 3) Tooth should be splinted, if indicated; and 4) Soft diet and hygiene instructions must be implemented and reinforced. The IR technique should not be considered a procedure of last resort. Rather, it should be used in situations where conventional apical surgery is difficult or places the patient at risk. The IR technique expands potential treatment alternatives and allows the patient to successfully retain his or her own tooth following treatment.

  1. Endodontic Considerations in Three-canalled Premolars: A Practical Update

    PubMed Central

    Mohammadi, Zahed; Shalavi, Sousan; Giardino, Luciano; Asgary, Saeed

    2016-01-01

    The most difficult clinical considertions in orthograde root canal treatment are generally related to the anatomy of the teeth. Three-canalled maxillary and mandibular premolars (mini-molars) have been reported in several studies. The purpose of this paper was to review various aspects of three-canalled premolars including incidence, clinical and radiographic diagnosis, racial predisposition, access cavity preparation, instrumentation and obturation. PMID:27141223

  2. Effect of Endodontic Irrigating Solutions on the Micro Push-out Bond Strength of a Fibre Glass Dowel

    PubMed Central

    Crispim da Silveira, Olimpia; Bras da Silva, Rodivan; Dametto, Fabio Roberto; Machado, Claudia Tavares; Souza dos Santos, Alex Jose

    2014-01-01

    Purpose To evaluate the effect of different endodontic irrigating solutions on the micro push-out bond strength of a fiber glass dowel. Material and Methods Seventy 16-mm long root segments of bovine incisors were prepared and randomly assigned to 7 groups (n=10) according to the type of irrigating solution used prior to the cementation of the intra-radicular fiber glass dowels: G1: 5.25% NaOCl + 17% EDTA; G2: 5.25% NaOCl; G3: 17% EDTA; G4: 2% chlorhexidine gel; G5: 70% alcohol; G6: 11.5% polyacrylic acid; and G7: saline (control). After treatment of intracanal dentin, the glass fibre dowels were cemented with self-adhesive resin cement (RelyX Unicem). Six slices with the thickness of 1.00 ± 0.05 mm were obtained from each tooth at the coronal, middle and apical root thirds (2 slices per third) using a low-speed saw. Micro push-out tests were performed at a crosshead speed of 0.5mm/min and the data (MPa) were analyzed statistically by ANOVA and Tukey’s and Dunnett’s tests. Results There were statistically significant differences (p<0.0001) among the irrigating solutions, but no significant difference (p=0.0591) was found among the root thirds. G5 presented the highest bond strength mean of all groups (p<0.0001). The use of 70% alcohol increased the adhesion values by 53% compared to the group control. Conclusion The use of 70% alcohol increased the bond strength of the fiber glass dowel to the dentin walls. However, the push-out bond strength between the dowel and the root dentin was not affected by the root third (coronal, middle and apical). PMID:27688347

  3. Fracture Strength of Endodontically Treated Teeth Restored with Casting Post and Core and Glass-Fiber with Composite Core

    PubMed Central

    Saatian, Sedigheh

    2006-01-01

    INTRODUCTION: Prefabricated metal and ceramic posts can be used with different kinds of core materials as an alternative to the conventional casting post and cores. It is unclear how these post and core systems can withstand different kind of forces in the mouth. The purpose of this study was to compare the fracture strength of endodontically treated, crowned maxillary incisors restored with casting post and cores and glass- fiber post with composite core and to evaluate their mode of fractures. MATERIALS AND METHODS: Thirty caries free, human maxillary central incisors with incisoapical length of 23 ± 1 mm were divided into two groups. After root canal treatment procedures and decronation of teeth 2mm above cementoenamel junction, Grope 1 was restored with glass- fiber posts and composite cores and group 2 received casting post and cores. Teeth were prepared with a circumferential shoulder including a 1-2 mm ferrule and 0.5 mm bevel; all posts were cemented with an adhesive resin and teeth were restored with complete coverage crowns. Loads were applied at an angle of 135 degrees using a universal testing machine. Compression force was applied until the specimens fractured. RESULTS: The median fracture strengths of groups 1 and 2 were 459 and 686 respectively (p<0.5). In group I, all fractures occurred in incisal third of roots. In groups II, 40% of fractures were in apical third and middle of roots. CONCLUSION: Within the limitation of this study, the results suggested that glass fiber with composite cores can be used as an alternative to cast posts and cores in anterior teeth when creating 2mm ferrule effect was possible in normal occlusion. Clinical trial is required to verify these in vitro results. PMID:24470803

  4. Evaluation of Cytotoxic Effects of Various Endodontic Irrigation Solutions on the Survival of Stem Cell of Human Apical Papilla

    PubMed Central

    Farhad Mollashahi, Narges; Saberi, Eshaghali; Karkehabadi, Hamed

    2016-01-01

    Introduction: Root canal disinfection is an important step in regenerative endodontic treatments. An ideal irrigating solution must have high antimicrobial activity and minimum cytotoxicity. This study sought to assess the effect of some irrigating solutions on stem cells from the human apical papilla (SCAP) after different periods of exposure. Methods and Materials: Stem cells were isolated from immature, impacted mandibular third molars, transferred to 24-well plates, randomly divided into 6 experimental groups and exposed to BioPure MTAD Cleanser, QMix, 17% EDTA, 2% chlorhexidine (CHX), 5.25% sodium hypochlorite (NaOCl), sterile saline and untreated control group. Cytotoxicity of these solutions was assessed after 1, 5 and 15 min of exposure using the methyl thiazol tetrazolium (MTT) assay. Data were statistically analyzed using repeated measures ANOVA. Level of significance was set at 0.05. Results: The mean percentage of viable cells in all experimental groups was significantly different from the control and sterile saline groups at all the time points (P<0.0001). The mean percentage of viable cells significantly decreased over time in NaOCl, QMix, EDTA and MTAD groups, but no significant reduction was noted in CHX group. At all the time points the highest and the lowest cytotoxicity were seen in MTAD and normal saline groups, respectively. Cytotoxicity of the understudy materials from the highest to the lowest was as follows: MTAD>EDTA>QMax=NaOCl>CHX> sterile saline. Conclusion: Chlorhexidine had the lowest cytotoxicity compared to EDTA, MTAD, QMix and NaOCl and its cytotoxicity did not change over time compared to other solutions. PMID:27790258

  5. Effect of Endodontic Irrigating Solutions on the Micro Push-out Bond Strength of a Fibre Glass Dowel

    PubMed Central

    Crispim da Silveira, Olimpia; Bras da Silva, Rodivan; Dametto, Fabio Roberto; Machado, Claudia Tavares; Souza dos Santos, Alex Jose

    2014-01-01

    Purpose To evaluate the effect of different endodontic irrigating solutions on the micro push-out bond strength of a fiber glass dowel. Material and Methods Seventy 16-mm long root segments of bovine incisors were prepared and randomly assigned to 7 groups (n=10) according to the type of irrigating solution used prior to the cementation of the intra-radicular fiber glass dowels: G1: 5.25% NaOCl + 17% EDTA; G2: 5.25% NaOCl; G3: 17% EDTA; G4: 2% chlorhexidine gel; G5: 70% alcohol; G6: 11.5% polyacrylic acid; and G7: saline (control). After treatment of intracanal dentin, the glass fibre dowels were cemented with self-adhesive resin cement (RelyX Unicem). Six slices with the thickness of 1.00 ± 0.05 mm were obtained from each tooth at the coronal, middle and apical root thirds (2 slices per third) using a low-speed saw. Micro push-out tests were performed at a crosshead speed of 0.5mm/min and the data (MPa) were analyzed statistically by ANOVA and Tukey’s and Dunnett’s tests. Results There were statistically significant differences (p<0.0001) among the irrigating solutions, but no significant difference (p=0.0591) was found among the root thirds. G5 presented the highest bond strength mean of all groups (p<0.0001). The use of 70% alcohol increased the adhesion values by 53% compared to the group control. Conclusion The use of 70% alcohol increased the bond strength of the fiber glass dowel to the dentin walls. However, the push-out bond strength between the dowel and the root dentin was not affected by the root third (coronal, middle and apical).

  6. Endodontic Management of the Three-Rooted Mandibular First Permanent Molar: a Case Report

    PubMed Central

    2014-01-01

    The distal root of the mandibular first permanent molar (MFPM) contains one or two canals. More rarely, the second/third distal canal is found in a separate root in a distolingual (DL) position – a radix entomolaris (RE). In Caucasians, this occurs in less than 4% of cases, but it is equally important to be aware of this possibility. Careful examination of the preoperative periapical radiographs (orthoradial and mesially angled) and inspection of the pulp chamber floor during endodontic management may indicate that this radicular variant is present. RE’s lingual inclination and buccolingual curvature must be taken into account during cleaning and shaping of the canal within this root to avoid procedural errors, such as straightening and ledging of the root canal, perforation or instrument fracture. The aim of the present paper was to discuss a case report of a young patient, referred to an endodontic office after a ledge was created by inappropriate instrumentation of a buccolingually curved RE canal.

  7. Prevalence of selected bacterial named species and uncultivated phylotypes in endodontic abscesses from two geographic locations.

    PubMed

    Rôças, Isabela N; Baumgartner, J Craig; Xia, Tian; Siqueira, José F

    2006-12-01

    Evidence is mounting that the prevalence of some putative endodontic pathogens can significantly vary according to the geographic location in which samples were taken. This study aimed to provide additional knowledge on this subject by comparing the frequencies of 10 selected candidate endodontic pathogens in samples of acute apical abscesses obtained from two distinct geographic locations; Portland, OR, and Rio de Janeiro, Brazil. DNA was extracted from aspirates and used as template in nested PCR assays using 16S rRNA gene taxon-specific oligonucleotide primers. Of the target species/phylotypes, Treponema denticola (73% of the cases), Porphyromonas endodontalis (70%), and Tannerella forsythia (57%) were the most prevalent taxa found in Brazilian samples. Dialister invisus (70% of the cases), P. endodontalis (63%) and Dialister pneumosintes (55%) were the most frequent taxa in the Portland, OR samples. Data analysis revealed that T. denticola and T. forsythia were significantly more detected in Brazilian samples than in the Portland, OR samples. Although D. invisus, Filifactor alocis, and Synergistes oral clone W090 were detected in many more samples from the Portland, OR patients, differences were not found to be statistically significant. These findings confirmed that some bacterial taxa can markedly differ in the frequencies they occur in samples from different locations. It remains to be clarified whether this observation translates into relevant therapeutic implications.

  8. In vitro antimicrobial activity of endodontic sealers, MTA-based cements and Portland cement.

    PubMed

    Tanomaru-Filho, Mário; Tanomaru, Juliane M G; Barros, Danilo B; Watanabe, Evandro; Ito, Izabel Y

    2007-03-01

    The aim of this study was to evaluate the antimicrobial activity of different root-end filling materials - Sealer 26, Sealapex with zinc oxide, zinc oxide and eugenol, white and gray Portland cement, white and gray MTA-Angelus, and gray Pro Root MTA - against six different microorganism strains. The agar diffusion method was used. A base layer was made using Müller-Hinton agar (MH) and wells were formed by removing the agar. The materials were placed in the wells immediately after manipulation. The microorganisms used were: Micrococcus luteus (ATCC9341), Staphylococcus aureus (ATCC6538), Escherichia coli (ATCC10538), Pseudomonas aeruginosa (ATCC27853), Candida albicans (ATCC 10231), and Enterococcus faecalis (ATCC 10541). The plates were kept at room temperature for 2 h for prediffusion and then incubated at 37 degrees C for 24 h. Triphenyltetrazolium chloride 0.05% gel was added for optimization, and the zones of inhibition were measured. Data were subjected to the Kruskal-Wallis and Dunn tests at a 5% significance level. The results showed that all materials had antimicrobial activity against all the tested strains. Analysis of the efficacy of the materials against the microbial strains showed that Sealapex with zinc oxide, zinc oxide and eugenol and Sealer 26 created larger inhibition halos than the MTA-based and Portland cements (P < 0.05). On the basis of the methodology used, it may be concluded that all endodontic sealers, MTA-based and Portland cements evaluated in this study possess antimicrobial activity, particularly the endodontic sealers.

  9. Successful clinical and organisational change in endodontic practice: a qualitative study.

    PubMed

    Koch, M; Englander, M; Tegelberg, Å; Wolf, E

    2014-08-01

    The aim of this study was to explicate and describe the qualitative meaning of successful clinical and organizational change in endodontic practice, following a comprehensive implementation program, including the integration of the nickel-titanium-rotary-technique. After an educational intervention in the Public Dental Service in a Swedish county, thematic in-depth interviews were conducted, with special reference to the participants' experience of the successful change. Interviews with four participants, were purposively selected on the basis of occupation (dentist, dental assistant, receptionist, clinical manager), for a phenomenological human scientific analysis. Four constituents were identified as necessary for the invariant, general structure of the phenomenon: 1) disclosed motivation, 2) allowance for individual learning processes, 3) continuous professional collaboration, and 4) a facilitating educator. The perceived requirements for achieving successful clinical and organizational change in endodontic practice were clinical relevance, an atmosphere which facilitated discussion and allowance for individual learning patterns. The qualities required in the educator were acknowledged competence with respect to scientific knowledge and clinical expertise, as well as familiarity with conditions at the dental clinics. The results indicate a complex interelationship among various aspects of the successful change process.

  10. Antibiofilm and antibacterial activities of farnesol and xylitol as potential endodontic irrigants.

    PubMed

    Alves, Flávio R F; Neves, Mônica A S; Silva, Marlei G; Rôças, Isabela N; Siqueira, José F

    2013-01-01

    This study investigated the antibiofilm and antibacterial effects of farnesol and xylitol in a series of experiments in order to evaluate their potential use as root canal irrigants. The following substances were tested: 0.2% farnesol; 5% and 20% xylitol; 0.2% farnesol plus 20% xylitol; and saline (control). For comparison with an established endodontic irrigant, 2.5% NaOCl was included in each test. Three experiments were conducted: the crystal violet assay, to evaluate the effects on the biofilm biomass; the dentin disinfection test, to evaluate the effects on bacterial viability in biofilms; and the root canal disinfection test, to simulate the use in the root canal environment. Farnesol was the most effective substance in reducing the biofilm biomass, followed by 20% xylitol. All substances affected bacterial viability in biofilms; farnesol showed the best results followed by the farnesol/xylitol combination. Irrigation with all substances significantly reduced the bacterial load (p<0.001), but only the farnesol/xylitol combination was significantly more effective than saline (p=0.02). NaOCl was more effective than any other substance tested in the three experiments (p<0.001). The findings demonstrated that farnesol affected both the biofilm biomass and the viability of cells in the biofilm, while 20% xylitol affected only the biofilm biomass. Although not more effective than NaOCl, the combination of these two antibiofilm substances has potential to be used in endodontics in certain situations. PMID:23969910

  11. The effect of a multimedia interactive tutorial on learning endodontic problem-solving.

    PubMed

    Plasschaert, A J; Cailleteau, J G; Verdonschot, E H

    1997-05-01

    New technology may create additional opportunities for learning in dental education. One of these new features is a multimedia approach, courseware combining sound, text, stills and video with interactive learning. A multimedia program was developed to train dental students and dental practitioners in decision making and problem solving in endodontics. This study compared the effects of the multimedia program with a more traditional approach consisting of written information, without interaction. 28, 4th-year dental students at the University of Kentucky in Lexington, KY, USA were randomly assigned to the multimedia or the text-based groups. They were given a written pre-test using 2 cases of dental pain and were instructed to study independently using either the multimedia program (group A) or the written information (group B). No restrictions were imposed on the amount of time to be invested, and the total study time was recorded for each student. 3 weeks after the pre-test, the students completed the post-test. A total of 18 students completed both the pre-test and the post-test and their scores were included in the final data. Statistical analysis of the average scores using paired t-tests revealed no significant difference between the performance of the students in either group, indicating that the multimedia approach to learning endodontic problem solving may successfully replace traditional learning strategies. PMID:9567903

  12. Antibiofilm and antibacterial activities of farnesol and xylitol as potential endodontic irrigants.

    PubMed

    Alves, Flávio R F; Neves, Mônica A S; Silva, Marlei G; Rôças, Isabela N; Siqueira, José F

    2013-01-01

    This study investigated the antibiofilm and antibacterial effects of farnesol and xylitol in a series of experiments in order to evaluate their potential use as root canal irrigants. The following substances were tested: 0.2% farnesol; 5% and 20% xylitol; 0.2% farnesol plus 20% xylitol; and saline (control). For comparison with an established endodontic irrigant, 2.5% NaOCl was included in each test. Three experiments were conducted: the crystal violet assay, to evaluate the effects on the biofilm biomass; the dentin disinfection test, to evaluate the effects on bacterial viability in biofilms; and the root canal disinfection test, to simulate the use in the root canal environment. Farnesol was the most effective substance in reducing the biofilm biomass, followed by 20% xylitol. All substances affected bacterial viability in biofilms; farnesol showed the best results followed by the farnesol/xylitol combination. Irrigation with all substances significantly reduced the bacterial load (p<0.001), but only the farnesol/xylitol combination was significantly more effective than saline (p=0.02). NaOCl was more effective than any other substance tested in the three experiments (p<0.001). The findings demonstrated that farnesol affected both the biofilm biomass and the viability of cells in the biofilm, while 20% xylitol affected only the biofilm biomass. Although not more effective than NaOCl, the combination of these two antibiofilm substances has potential to be used in endodontics in certain situations.

  13. Vibrational investigation of calcium-silicate cements for endodontics in simulated body fluids

    NASA Astrophysics Data System (ADS)

    Taddei, Paola; Modena, Enrico; Tinti, Anna; Siboni, Francesco; Prati, Carlo; Gandolfi, Maria Giovanna

    2011-05-01

    Calcium-silicate MTA (Mineral Trioxide Aggregate) cements have been recently developed for oral and endodontic surgery. This study was aimed at investigating commercial (White ProRoot MTA, White and Grey MTA-Angelus) and experimental (wTC-Bi) accelerated calcium-silicate cements with regards to composition, hydration products and bioactivity upon incubation for 1-28 days at 37 °C, in Dulbecco's Phosphate Buffered Saline (DPBS). Deposits on the surface of the cements and the composition changes during incubation were investigated by micro-Raman and ATR/FT-IR spectroscopy, and pH measurements. Vibrational techniques disclosed significant differences in composition among the unhydrated cements, which significantly affected the bioactivity as well as pH, and hydration products of the cements. After one day in DPBS, all the cements were covered by a more or less homogeneous layer of B-type carbonated apatite. The experimental cement maintained a high bioactivity, only slightly lower than the other cements and appears a valid alternative to commercial cements, in view of its adequate setting time properties. The bioactivity represents an essential property to favour bone healing and makes the calcium-silicate cements the gold standard materials for root-apical endodontic surgery.

  14. Radiopacity measurements of three endodontic sealers using digital x-rays

    NASA Astrophysics Data System (ADS)

    Chisnoiu, R.; Moldovan, M.; Pǎstrav, O.; Delean, A.; Prodan, D.; Boboia, S.; Prejmerean, V.; Chisnoiu, A.

    2015-12-01

    The aim of this experimental study was to assess the radiopacity of three endodontic sealers: a self-curing epoxy resin - AH Plus, a dual cure urethane dimethacrylate resin - RealSeal and a new dual cure endodontic hydroxyapatite based filling material developed in collaboration with "Raluca Ripan" Institute for Research in Chemistry from Cluj-Napoca. Material and methods: Five specimens, 10 mm diameter and 1 mm thickness, were digital x-rayed simultaneously with an aluminum step-wedge, varying from 1 to 12 mm thickness, according to ISO 6876:2012 standards. The radiopacity was determined by digital processing of the images, using specially designed software. Four different areas were selected for each specimen, according to quadrants of the sealer disks. Statistical analysis using ANOVA test was performed. Results: AH Plus sealer showed the highest radiopacity, the differences being statistically significant comparing to the others two tested sealers (p<0.05). Real Seal presented intermediate radiopacity values and the new experimental sealer radiopacity showed the lowest values (p>0.05). Conclusions: All tested materials were above the minimum radiopacity level recommended by the ISO 6876:2012. Acknowledgements: This work was funded by: the Romanian Ministry of Education and Research, National Project PN-II-PT-PCCA-2011-3.2-1275, no: 165/2012.

  15. Undergraduate endodontic teaching in New Zealand: students' experience, perceptions and self-confidence levels.

    PubMed

    Murray, Colleen M; Chandler, Nicholas P

    2014-12-01

    The aim was to investigate undergraduate students' experiences, perceptions of future practice and self-rated confidence levels across endodontic tasks. After ethical approval, a survey involved all fourth and fifth year students. Quantitative data were analysed in SPSS version 20.0. Qualitative data were analysed using a general inductive approach. The participation rate was 84% (n = 136 of 162). The mean number of canals completed was 2.6 by fourth years and 10.4 by fifth years. Maxillary premolars were the most common first tooth treated. Pulpal factors and root morphology were the most common reasons for experiencing difficulty. Self-rated confidence levels were lower for the more junior students and complex procedures. Students felt that an increased use of extracted natural teeth would be beneficial in their pre-clinical practice. A high level of interest was shown in future specialisation in endodontics. Students may benefit from further didactic teaching or pre-clinical instruction in selected topics.

  16. The effect of chloroform, orange oil and eucalyptol on root canal transportation in endodontic retreatment.

    PubMed

    Karataş, Ertuğrul; Kol, Elif; Bayrakdar, İbrahim Şevki; Arslan, Hakan

    2016-04-01

    The purpose of the present study was to assess the effect of solvents on root canal transportation in endodontic retreatment. Sixty extracted human permanent mandibular first molars with curved root canals were selected. All of the root canals were prepared using Twisted File Adaptive instruments (SybronEndo, Orange, CA, USA) and filled with gutta-percha and AH Plus sealer (Dentsply DeTrey, Konstanz, Germany) using the cold lateral compaction technique. The teeth were assigned to four retreatment groups as follows (n = 15): eucalyptol, chloroform, orange oil and control. The canals were scanned using cone-beam computed tomography scanning before and after instrumentation. The chloroform group showed a significantly higher mean transportation value than the orange oil and control groups at the 3 and 5 mm levels (P = 0.011 and P = 0.003, respectively). There was no significant difference among the orange oil, eucalyptol and control groups in terms of canal transportation (P > 0.61). The chloroform led to more canal transportation than the eucalyptol and orange oil during endodontic retreatment. PMID:26420757

  17. The management of endodontically treated teeth using a Computer-Aided Design and Computer-Assisted Manufacturing/Computer-Aided Design and Computer-Integrated Manufacturing system.

    PubMed

    Foerster, J G; von Gonten, A S; Robert, G H

    1999-01-01

    This article introduces a new approach for restoring endodontically treated posterior teeth. Significantly reduced natural tooth structure often remains not only because of previous restorative measures but also because of endodontic procedures. Cast restorations for these teeth are almost universally recommended. The exception to this is the rare instance in which only conservative endodontic access openings exist in teeth presenting with no former existing restorations. Typically, multiple clinical appointments are required to complete the final cast restoration. This article presents Computer-Aided Design and Computer-Assisted Manufacturing/Computer-Aided Design and Computer-Integrated Manufacturing applications for restorative dentistry that provide the necessary care in an expeditious manner.

  18. Is stopping of anticoagulant therapy really required in a minor dental surgery? - How about in an endodontic microsurgery?

    PubMed Central

    Cho, Yong-Wook

    2013-01-01

    Nowadays, oral anticoagulants are commonly prescribed to numerous patients for preventing cardiovascular accident such as thromboembolism. An important side effect of anticoagulant is anti-hemostasis. In a major surgery, the oral anticoagulant therapy (OAT) regimen must be changed before the surgery for proper post-operative bleeding control. However, in a minor dental surgery and endodontic surgery, the necessity for changing or discontinuing the OAT is open to debate. In this study, risks of the consequences were weighed and analyzed. In patients who stop the OAT, the occurrence of thromboembolic complication is rare but the result is fatal. In patients who continuing the OAT, post-operative bleeding can be controlled well with the local hemostatic measures. In the endodontic surgery, there are almost no studies about this issue. The intra-operative bleeding control is particularly important in the endodontic surgery because of its delicate and sensitive procedures such as inspection of resected root surface using dental microscope and retrograde filling. Further studies are necessary about this issue in the viewpoint of endodontic surgery. PMID:24010076

  19. Clinical Management of Two Root Resorption Cases in Endodontic Practice.

    PubMed

    Mincik, Jozef; Urban, Daniel; Timkova, Silvia

    2016-01-01

    Root resorption is a pathological process involving loss of hard dental tissues. It may occur as a consequence of dental trauma, orthodontic treatment, and bleaching, and occasionally it accompanies periodontal disease. Although the mechanism of resorption process is examined in detail, its etiology is not fully understood. Wide open apical foramen is more difficult to manage and the root canal may often overfill. In this report we present two cases of root resorption and describe means for its clinical management. We conclude that useful measure of a success or failure in managing root resorption is the persistence of the resorption process. It is a clear sign of an active ongoing inflammatory process and shows the clinical need for retreatment. PMID:27648314

  20. Application of Low level Lasers in Dentistry (Endodontic)

    PubMed Central

    Asnaashari, Mohammad; Safavi, Nassimeh

    2013-01-01

    Low level lasers, cold or soft lasers: These lasers do not produce thermal effects on tissues and induce photoreactions in cells through light stimulation which is called photobiostimulation. Power of these lasers is usually under 250mW. The main point differentiating low level lasers and high power ones is the activation of photochemical reactions without heat formation. The most important factor to achieve this light characteristic in lasers is not their power, but their power density for each surfa ceunit (i.e cm2). Density lower than 670mW/cm2, can induce the stimulatory effects of low level lasers without thermal effects. Low level lasers (therapeutic) used today as treatment adjunctive devices in medicine and dentistry. Numerous studies have been performed on the applications of low level lasers in patient pain reduction. Mechanisms of pain reduction with therapeutic lasers and their application are expressed, and the studies realized in this field are presented. PMID:25606308