Reciprocating vs Rotary Instrumentation in Pediatric Endodontics: Cone Beam Computed Tomographic Analysis of Deciduous Root Canals using Two Single-file Systems.

PubMed

Prabhakar, Attiguppe R; Yavagal, Chandrashekar; Dixit, Kratika; Naik, Saraswathi V

2016-01-01

Primary root canals are considered to be most challenging due to their complex anatomy. "Wave one" and "one shape" are single-file systems with reciprocating and rotary motion respectively. The aim of this study was to evaluate and compare dentin thickness, centering ability, canal transportation, and instrumentation time of wave one and one shape files in primary root canals using a cone beam computed tomographic (CBCT) analysis. This is an experimental, in vitro study comparing the two groups. A total of 24 extracted human primary teeth with minimum 7 mm root length were included in the study. Cone beam computed tomographic images were taken before and after the instrumentation for each group. Dentin thickness, centering ability, canal transportation, and instrumentation times were evaluated for each group. A significant difference was found in instrumentation time and canal transportation measures between the two groups. Wave one showed less canal transportation as compared with one shape, and the mean instrumentation time of wave one was significantly less than one shape. Reciprocating single-file systems was found to be faster with much less procedural errors and can hence be recommended for shaping the root canals of primary teeth. How to cite this article: Prabhakar AR, Yavagal C, Dixit K, Naik SV. Reciprocating vs Rotary Instrumentation in Pediatric Endodontics: Cone Beam Computed Tomographic Analysis of Deciduous Root Canals using Two Single-File Systems. Int J Clin Pediatr Dent 2016;9(1):45-49.

Root canal morphology and variations in mandibular second molar teeth of an Indian population: an in vivo cone-beam computed tomography analysis.

PubMed

Pawar, Ajinkya Mansing; Pawar, Mansing; Kfir, Anda; Singh, Shishir; Salve, Prashant; Thakur, Bhagyashree; Neelakantan, Prasanna

2017-12-01

This study aims to investigate the root canal morphology of permanent mandibular second molars of an Indian population in vivo using cone-beam computed tomography (CBCT) images. CBCT images (n = 983; males = 489, females = 494) of untreated, completely developed permanent mandibular second molar teeth were examined. CBCT scans were acquired as part of diagnosis and treatment planning for treatments unrelated to the present study. The number of roots and root canals were recorded. Canal configuration was classified based on Vertucci's and Fan's classifications. The most common configuration was two-root (79.35%) and three-root canals (53.50%). The incidence of three-rooted molars was 7.53%, whereas 13.12% of the studied teeth studied have fused roots with C-shaped canals. The predominant canal morphology in the mesial roots was Vertucci's type IV (45.17%), followed by type II (32.55%), type I (7.23%), type V (1.02%), and type III (0.91%). The distal root in contrast showed type I (61.14%) as the predominant canal configuration, followed by type II (18.21%) and type IV (7.53%). The incidence of three-rooted molars was higher in males (n = 55; 5.59%) than in females (n = 19; 1.94%) (p < 0.01). The canals in the extra roots exhibited type I (100%) root canal morphology. In teeth with C-shaped root canal (13.12%), the variations in the coronal, middle, and apical third ranged from C1 to C4. Root canal systems of the mesial roots of mandibular second molars of the study population demonstrated a high degree of variability. While three roots were rare, there was a sexual predisposition. Fused roots with C-shaped canals were rare and demonstrated significant variations from the coronal to apical third. Root canal morphology can demonstrate variations based on race and sex of patients. Clinicians must always consider the possible variations to ensure successful endodontic treatment.

Evaluation of instrumentation systems in reducing E. faecalis from root canals: TF adaptive and ProTaper next versus single file systems.

PubMed

Karataş, Ertuğrul; Gültekin, Esra; Arslan, Hakan; Kirici, Damla Özsu; Alsancak, Meltem; Topçu, Meltem Çolak

2015-03-01

To compare the effect of the TF Adaptive, ProTaper Next, OneShape, WaveOne, Reciproc, (SAF) on the reduction of E. faecalis in experimentally infected root canals. 70 human mandibular incisor teeth with straight roots and single root canals were selected for this experiment and the root canals of the selected teeth were infected with E. faecalis. After contamination, all the root canals were randomly divided into 7 groups: control, ProTaper Next, TF Adaptive, SAF, WaveOne, Reciproc, and OneShape. After the irrigation procedures, samples were taken from root canals with paper points and incubated in blood agar plates. The colonies grown on the blood agar were counted and interpreted as colony forming units per milliliter. Analysis of results showed that all instrumentation systems were more effective in reducing the number of bacteria than the control (P<.001). The ProTaper Next, TF Adaptive, WaveOne, Reciproc, and OneShape systems were significantly more effective than the SAF system in reducing E. faecalis within the root canals (P<.001). All instrumentation systems used in this study provided a significant reduction in bacterial populations.

Quantitative evaluation of root canal surface roughness after filing with adaptive reciprocating and continuous rotary instruments.

PubMed

Sakhaei Manesh, Vahid; Giacomin, Paul; Stoll, Richard

2017-06-01

Obtaining clean and smooth root canal walls is the ideal clinical outcome of the cleaning and shaping stage in root canal treatment. This study compares the surface roughness of root canal surfaces instrumented with a NiTi filing system with either adaptive reciprocating (AR) or continuous rotation (CR). Root canal cleaning and shaping was carried out on the mesial canals of 24 extracted first molars roots with either AR or CR. Roots were split in half and the surface roughness of their canals was evaluated in 12 three dimensional roughness reconstructions using a scanning electron microscope. Rz (nm) values were calculated in three areas of each reconstruction and analyzed (α = 0.05). Mann-Whitney tests showed that surface roughness was significantly higher overall in the AR group (Rz = 967 ± 250 nm) compared with the CR group (Rz = 739 ± 239 nm; p = 0.044). The roughness values generally increased from apical towards the coronal third in both groups. A less aggressive finishing file or a continuous rotary system to end the cleaning and shaping stage may be beneficial to reduce roughness of the root canal surface. © 2017 Wiley Periodicals, Inc.

Comparison between rotary and manual instrumentation in primary teeth.

PubMed

Crespo, S; Cortes, O; Garcia, C; Perez, L

2008-01-01

The aim of this study was to compare the efficiency in both, preparation time and root canal shape, when using the Nickel Titanium (Ni-Ti) rotary and K-Files hand instrumentation on root canal preparation of single rooted primary teeth. Sixty single rooted primary teeth were selected and divided into two equal groups: Group (I) 30 teeth instrumented with manual K-files and group (II) 30 teeth instrumented with Ni-Ti rotary files (ProFile 0.04). Instrumentation times were calculated and root canal impressions were taken with light bodied silicone in order to evaluate the shape. The data was analyzed with SPSS program using the t-test and the Chi-square test to compare their means. The preparation time with group (I) K-files was significantly higher than in group (II) rotary files (ProFile 0.04), with a p= .005. The ProFile system showed a significantly more favorable canal taper when compared to the K-files system (P= .002). The use of rotary files in primary teeth has several advantages when compared with manual K files: the efficiency in both, preparation time and root canal shape. 1. A decreased working time, that helps maintain patient cooperation by diminishing the potential for tiredness. 2. The shape of the root canal is more conical, favoring a higher quality of the root canal filling, and increasing clinical success.

Micro-computed Tomographic Analysis of Mandibular Second Molars with C-shaped Root Canals.

PubMed

Amoroso-Silva, Pablo Andrés; Ordinola-Zapata, Ronald; Duarte, Marco Antonio Hungaro; Gutmann, James L; del Carpio-Perochena, Aldo; Bramante, Clovis Monteiro; de Moraes, Ivaldo Gomes

2015-06-01

The goal of the present study was to evaluate the morphometric aspects of the internal anatomy of the root canal system of mandibular second molars with C-shaped canals. Fifty-two extracted second mandibular molars with C-shaped canals, fused roots, and radicular grooves were selected from a Brazilian population. The samples were scanned with a micro-computed tomographic scanner at a voxel size of 19.6 μm. The root canal cross sections were recorded as C1, C2, C3, and C4 root canal configurations according to the modified Melton classification. Morphometric parameters, including the major and minor diameters of the root canals, the aspect ratio, the roundness, and the tridimensional configuration (merging, symmetric, and asymmetric), were evaluated. The 3-dimensional reconstruction images of the teeth indicated an even distribution within the sample. The analysis of the prevalence of the different cross-sectional configurations of the C-shaped molars revealed that these were predominantly of the C4 and C3 configurations (1 mm from the apex) and the C1 and C2 configurations in the cervical third. According to the morphometric parameters, the C1 and the distal aspect of the C2 configurations exhibited the lowest roundness values and higher values for the area, major diameter, and aspect ratio in the apical third. Mandibular molars with C-shaped root canals exhibited similar distributions of symmetric, asymmetric, and merging type canals. The C1 configuration and the distal aspect of the C2 configuration exhibited the highest area values, low roundness values, and large apical diameters. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Comparison of the root canal debridement ability of two single file systems with a conventional multiple rotary system in long oval-shaped root canals: In vitro study.

PubMed

Khoshbin, Elham; Shokri, Abbas; Donyavi, Zakieh; Shahriari, Shahriar; Salehimehr, Golsa; Farhadian, Maryam; Kavandi, Zeinab

2017-08-01

This study sought to compare the root canal debridement ability of Neolix, Reciproc and ProTaper rotary systems in long oval-shaped root canals. Eighty five extracted single-rooted human teeth with long oval-shaped single root canals were selected and divided into three experimental groups(n=25) and one control group (n= 10). Root canals were filled with Vitapex radiopaque contrast medium and prepared with Neolix, Reciproc or ProTaper systems. The control group only received irrigation. Digital radiographs were obtained at baseline and postoperatively and subjected to digital subtraction. The percentage of reduction in contrast medium was quantified at 0-5 mm and 5-10 mm distances from the apex. The data were analyzed using one-way ANOVA and t-test. The mean percentage of the contrast medium removed was not significantly different in the 0-5mm segment among the three groups ( P =0.6). In the 5-10mm segment a significant difference was found in this regard among the ProTaper and Reciproc groups ( P =0.02) and the highest mean percentage of contrast medium was removed by ProTaper. But, difference between ProTaper and Neolix as well as Neolix and Reciproc was not significant. In Neolix ( P =0.024) and Reciproc ( P =0.002) systems, the mean percentage of the contrast medium removed from the 0-5mm segment was significantly greater than that in 5-10mm segment; however, this difference was not significant in ProTaper group ( P =0.069). Neolix single-file system may be a suitable alternative to ProTaper multiple-file system in debridement of long oval shaped canals. Key words: Root Canal Preparation, Debridement, Root Canal Therapy.

Reciprocating vs Rotary Instrumentation in Pediatric Endodontics: Cone Beam Computed Tomographic Analysis of Deciduous Root Canals using Two Single-file Systems

PubMed Central

Prabhakar, Attiguppe R; Yavagal, Chandrashekar; Naik, Saraswathi V

2016-01-01

ABSTRACT Background: Primary root canals are considered to be most challenging due to their complex anatomy. "Wave one" and "one shape" are single-file systems with reciprocating and rotary motion respectively. The aim of this study was to evaluate and compare dentin thickness, centering ability, canal transportation, and instrumentation time of wave one and one shape files in primary root canals using a cone beam computed tomographic (CBCT) analysis. Study design: This is an experimental, in vitro study comparing the two groups. Materials and methods: A total of 24 extracted human primary teeth with minimum 7 mm root length were included in the study. Cone beam computed tomographic images were taken before and after the instrumentation for each group. Dentin thickness, centering ability, canal transportation, and instrumentation times were evaluated for each group. Results: A significant difference was found in instrumentation time and canal transportation measures between the two groups. Wave one showed less canal transportation as compared with one shape, and the mean instrumentation time of wave one was significantly less than one shape. Conclusion: Reciprocating single-file systems was found to be faster with much less procedural errors and can hence be recommended for shaping the root canals of primary teeth. How to cite this article: Prabhakar AR, Yavagal C, Dixit K, Naik SV. Reciprocating vs Rotary Instrumentation in Pediatric Endodontics: Cone Beam Computed Tomographic Analysis of Deciduous Root Canals using Two Single-File Systems. Int J Clin Pediatr Dent 2016;9(1):45-49. PMID:27274155

Effect of canal preparation with TRUShape and Vortex rotary instruments on three-dimensional geometry of oval root canals.

PubMed

Arias, Ana; Paqué, Frank; Shyn, Stephanie; Murphy, Sarah; Peters, Ove A

2018-04-01

The purpose of this study was to assess the geometry of non-round root canals after preparation with TRUShape (a novel instrument with s-shaped longitudinal design) in comparison to conventional rotary instrumentation using micro-computed tomography. Twenty distal root canals of mandibular molars were randomly distributed in two groups to be shaped with either TRUShape or Vortex rotaries. Percentages of unprepared surface and volume of dentin removal for the entire canal and for the apical 4 mm were calculated. Canal transportation and the structure model index (SMI) were assessed. Data were compared with Student t-tests. Shaping with both techniques resulted in similar prepared surface and volume of dentin removed, as well as the extent of canal transportation. The SMI shape factor was significantly lower for TRUShape preparations (P = 0.04) suggesting less rounding during rotary preparation. Although both instruments were suitable for the preparation of oval canals, TRUShape appeared to better conform to the original ribbon-shaped anatomy. © 2017 Australian Society of Endodontology Inc.

Root canal morphology of primary molars: a micro-computed tomography study.

PubMed

Fumes, A C; Sousa-Neto, M D; Leoni, G B; Versiani, M A; da Silva, L A B; da Silva, R A B; Consolaro, A

2014-10-01

This was to investigate the root canal morphology of primary molar teeth using micro-computed tomography. Primary maxillary (n = 20) and mandibular (n = 20) molars were scanned at a resolution of 16.7 μm and analysed regarding the number, location, volume, area, structured model index (SMI), area, roundness, diameters, and length of canals, as well as the thickness of dentine in the apical third. Data were statistically compared by using paired-sample t test, independent sample t test, and one-way analysis of variance with significance level set as 5%. Overall, no statistical differences were found between the canals with respect to length, SMI, dentine thickness, area, roundness, and diameter (p > 0.05). A double canal system was observed in the mesial and mesio-buccal roots of the mandibular and maxillary molars, respectively. The thickness in the internal aspect of the roots was lower than in the external aspect. Cross-sectional evaluation of the roots in the apical third showed flat-shaped canals in the mandibular molars and ribbon- and oval-shaped canals in the maxillary molars. External and internal anatomy of the primary first molars closely resemble the primary second molars. The reported data may help clinicians to obtain a thorough understanding of the morphological variations of root canals in primary molars to overcome problems related to shaping and cleaning procedures, allowing appropriate management strategies for root canal treatment.

Nickel-Titanium Single-file System in Endodontics.

PubMed

Dagna, Alberto

2015-10-01

This work describes clinical cases treated with a innovative single-use and single-file nickel-titanium (NiTi) system used in continuous rotation. Nickel-titanium files are commonly used for root canal treatment but they tend to break because of bending stresses and torsional stresses. Today new instruments used only for one treatment have been introduced. They help the clinician to make the root canal shaping easier and safer because they do not require sterilization and after use have to be discarded. A new sterile instrument is used for each treatment in order to reduce the possibility of fracture inside the canal. The new One Shape NiTi single-file instrument belongs to this group. One Shape is used for complete shaping of root canal after an adequate preflaring. Its protocol is simple and some clinical cases are presented. It is helpful for easy cases and reliable for difficult canals. After 2 years of clinical practice, One Shape seems to be helpful for the treatment of most of the root canals, with low risk of separation. After each treatment, the instrument is discarded and not sterilized in autoclave or re-used. This single-use file simplifies the endodontic therapy, because only one instrument is required for canal shaping of many cases. The respect of clinical protocol guarantees predictable good results.

Shaping Ability of Single-file Systems with Different Movements: A Micro-computed Tomographic Study.

PubMed

Santa-Rosa, Joedy; de Sousa-Neto, Manoel Damião; Versiani, Marco Aurelio; Nevares, Giselle; Xavier, Felipe; Romeiro, Kaline; Cassimiro, Marcely; Leoni, Graziela Bianchi; de Menezes, Rebeca Ferraz; Albuquerque, Diana

2016-01-01

This study aimed to perform a rigorous sample standardization and also evaluate the preparation of mesiobuccal (MB) root canals of maxillary molars with severe curvatures using two single-file engine-driven systems (WaveOne with reciprocating motion and OneShape with rotary movement), using micro-computed tomography (micro-CT). Ten MB roots with single canals were included, uniformly distributed into two groups (n=5). The samples were prepared with a WaveOne or OneShape files. The shaping ability and amount of canal transportation were assessed by a comparison of the pre- and post-instrumentation micro-CT scans. The Kolmogorov-Smirnov and t-tests were used for statistical analysis. The level of significance was set at 0.05. Instrumentation of canals increased their surface area and volume. Canal transportation occurred in coronal, middle and apical thirds and no statistical difference was observed between the two systems (P>0.05). In apical third, significant differences were found between groups in canal roundness (in 3 mm level) and perimeter (in 3 and 4 mm levels) (P<0.05). The WaveOne and One Shape single-file systems were able to shape curved root canals, producing minor changes in the canal curvature.

Root and Root Canal Morphology of Human Third Molar Teeth.

PubMed

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

2015-04-01

Successful root canal treatment depends on having comprehensive information regarding the root(s)/canal(s) anatomy. Dentists may have some complication in treatment of third molars because the difficulty in their access, their aberrant occlusal anatomy and different patterns of eruption. The aim of this review was to review and address the number of roots and root canals in third molars, prevalence of confluent canals in third molars, C-shaped canals, dilaceration and fusion in third molars, autotransplantation of third molars and endodontic treatment strategies for third molars.

Computed Tomographic Morphometry of the Internal Anatomy of Mandibular Second Primary Molars.

PubMed

Kurthukoti, Ameet J; Sharma, Pranjal; Swamy, Dinesh Francis; Shashidara, R; Swamy, Elaine Barretto

2015-01-01

Need for the study: The most important procedure for a successful endodontic treatment is the cleaning and shaping of the canal system. Understanding the internal anatomy of teeth provides valuable information to the clinician that would help him achieve higher clinical success during endodontic therapy. To evaluate by computed tomography-the internal anatomy of mandibular second primary molars with respect to the number of canals, cross-sectional shape of canals, cross-sectional area of canals and the root dentin thickness. A total of 31 mandibular second primary molars were subjected to computed-tomographic evaluation in the transverse plane, after mounting them in a prefabricated template. The images, thus, obtained were analyzed using De-winter Bio-wizard® software. All the samples demonstrated two canals in the mesial root, while majority of the samples (65.48%) demonstrated two canals in the distal root. The cross-sectional images of the mesial canals demonstrated a round shape, while the distal canals demonstrated an irregular shape. The root dentin thickness was highly reduced on the distal aspect of mesial and mesial aspect of distal canals. The mandibular second primary molars demonstrated wide variation and complexities in their internal anatomy. A thorough understanding of the complexity of the root canal system is essential for understanding the principles and problems of shaping and cleaning, determining the apical limits and dimensions of canal preparations, and for performing successful endodontic procedures. How to cite this article: Kurthukoti AJ, Sharma P, Swamy DF, Shashidara R, Swamy EB. Computed Tomographic Morphometry of the Internal Anatomy of Mandibular Second Primary Molars. Int J Clin Pediatr Dent 2015;8(3):202-207.

Computed Tomographic Morphometry of the Internal Anatomy of Mandibular Second Primary Molars

PubMed Central

Sharma, Pranjal; Swamy, Dinesh Francis; Shashidara, R; Swamy, Elaine Barretto

2015-01-01

ABSTRACT Need for the study: The most important procedure for a successful endodontic treatment is the cleaning and shaping of the canal system. Understanding the internal anatomy of teeth provides valuable information to the clinician that would help him achieve higher clinical success during endodontic therapy. Aims: To evaluate by computed tomography—the internal anatomy of mandibular second primary molars with respect to the number of canals, cross-sectional shape of canals, cross-sectional area of canals and the root dentin thickness. Materials and methods: A total of 31 mandibular second primary molars were subjected to computed-tomographic evaluation in the transverse plane, after mounting them in a prefabricated template. The images, thus, obtained were analyzed using De-winter Bio-wizard® software. Results: All the samples demonstrated two canals in the mesial root, while majority of the samples (65.48%) demonstrated two canals in the distal root. The cross-sectional images of the mesial canals demonstrated a round shape, while the distal canals demonstrated an irregular shape. The root dentin thickness was highly reduced on the distal aspect of mesial and mesial aspect of distal canals. Conclusion: The mandibular second primary molars demonstrated wide variation and complexities in their internal anatomy. A thorough understanding of the complexity of the root canal system is essential for understanding the principles and problems of shaping and cleaning, determining the apical limits and dimensions of canal preparations, and for performing successful endodontic procedures. How to cite this article: Kurthukoti AJ, Sharma P, Swamy DF, Shashidara R, Swamy EB. Computed Tomographic Morphometry of the Internal Anatomy of Mandibular Second Primary Molars. Int J Clin Pediatr Dent 2015;8(3):202-207. PMID:26628855

Comparison of canal transportation and centering ability of rotary protaper, one shape system and wave one system using cone beam computed tomography: An in vitro study

PubMed Central

Tambe, Varsha Harshal; Nagmode, Pradnya Sunil; Abraham, Sathish; Patait, Mahendra; Lahoti, Pratik Vinod; Jaju, Neha

2014-01-01

Aim: The aim of the present study was to compare the canal transportation and centering ability of Rotary ProTaper, One Shape and Wave One systems using cone beam computed tomography (CBCT) in curved root canals to find better instrumentation technique for maintaining root canal geometry. Materials and Methods: Total 30 freshly extracted premolars having curved root canals with at least 10 degrees of curvature were divided into three groups of 10 teeth each. All teeth were scanned by CBCT to determine the root canal shape before instrumentation. In Group 1, the canals were prepared with Rotary ProTaper files, in Group 2 the canals were prepared with One Shape files and in Group 3 canals were prepared with Wave One files. After preparation, post-instrumentation scan was performed. Pre-instrumentation and post-instrumentation images were obtained at three levels, 3 mm apical, 3 mm coronal and 8 mm apical above the apical foramen were compared using CBCT software. Amount of transportation and centering ability were assessed. The three groups were statistically compared with analysis of variance and Tukey honestly significant. Results: All instruments maintained the original canal curvature with significant differences between the different files. Data suggested that Wave One files presented the best outcomes for both the variables evaluated. Wave One files caused lesser transportation and remained better centered in the canal than One Shape and Rotary ProTaper files. Conclusion: The canal preparation with Wave One files showed lesser transportation and better centering ability than One Shape and ProTaper. PMID:25506145

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.

Micro-Computed Tomography Analysis of the Root Canal Morphology of Palatal Roots of Maxillary First Molars.

PubMed

Marceliano-Alves, Marília; Alves, Flávio Rodrigues Ferreira; Mendes, Daniel de Melo; Provenzano, José Claudio

2016-02-01

A thorough knowledge of root canal anatomy is critical for successful root canal treatments. This study evaluated the internal anatomy of the palatal roots of maxillary first molars with micro-computed tomography (microCT). The palatal roots of extracted maxillary first molars (n = 169) were scanned with microCT to determine several anatomic parameters, including main canal classification, lateral canal occurrence and location, degree of curvature, main foramen position, apical constriction presence, diameters 1 and 2 mm from the apex and 1 mm from the foramen, minor dentin thickness in those regions, canal volume, surface area, and convexity. All canals were classified as Vertucci type I. The cross sections were oval in 61% of the canals. Lateral canals were found in 25% of the samples. The main foramen did not coincide with the root apex in 95% of the cases. Only 8% of the canals were classified as straight. Apical constriction was identified in 38% of the roots. The minor and major canal diameters and minor dentin thickness were decreased near the apex. The minor dentin thickness 1 mm from the foramen was 0.82 mm. The palatal canals exhibited a volume of 6.91 mm(3) and surface area of 55.31 mm(2) and were rod-shaped. The root canals of the palatal roots were classified as type I. However, some factors need to be considered during the treatment of these roots, including the frequent ocurrence of moderate/severe curvatures, oval-shaped cross-sections, and lateral canals, noncoincidence of the apical foramen with the root apex, and absence of apical constriction in most cases. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

[Shaping ability of multi-taper nickel-titanium files in simulated resin curved root canal].

PubMed

Luo, Hong-Xia; Huang, Ding-Ming; Jia, Liu-He; Luo, Shi-Gao; Gao, Xiao-Jie; Tan, Hong; Zhou, Xue-Dong

2006-08-01

To compare the shaping ability of ISO standard stainless steel K files and multi-taper ProTaper nickel-titanium files in simulated resin curved root canals. METHODS Thirty simulated resin root canals were randomly divided into three groups and prepared by stainless steel K files, hand ProTaper, rotary ProTaper, respectively. The amount of material removed from inner and outer wall and canal width after canal preparation was measured, while the canal curvature before and after canal preparation and canals aberrations were recorded. The stainless steel K files removed more material than hand ProTaper and rotary ProTaper at the outer side of apex and inner side of curvature (P < 0.05). The mean degree of straightening in stainless steel K files group was significantly bigger than in ProTaper group (P < 0.05). The canals prepared by ProTaper had no evident aberration. The shaping ability of ProTaper is better than stainless steel K files.

Influence of NiTi alloy on the root canal shaping capabilities of the ProTaper Universal and ProTaper Gold rotary instrument systems.

PubMed

Duque, Jussaro Alves; Vivan, Rodrigo Ricci; Cavenago, Bruno Cavalini; Amoroso-Silva, Pablo Andrés; Bernardes, Ricardo Affonso; Vasconcelos, Bruno Carvalho de; Duarte, Marco Antonio Hungaro

2017-01-01

This study aimed to evaluate the influence of the NiTi wire in Conventional NiTi (ProTaper Universal PTU) and Controlled Memory NiTi (ProTaper Gold PTG) instrument systems on the quality of root canal preparation. Twelve mandibular molars with separate mesial canals were scanned using a high-definition microcomputed tomography system. The PTU and PTG instruments were used to shape twelve mesial canals each. The canals were scanned after preparation with F2 and F3 instruments of the PTU and PTG systems. The analyzed parameters included the remaining dentin thickness at the apical and cervical levels, root canal volume and untouched canal walls. Data was analyzed for statistical significance by the Friedman and Dunn's tests. For the comparison of data between groups, the Mann-Whitney test was used. In the pre-operative analysis, there were no statistically significant differences between the groups in terms of the area and volume of root canals (P>.05). There was also no statistically significant difference between the systems with respect to root canal volume after use of the F2 and F3 instruments. There was no statistical difference in the dentin thickness at the first apical level between, before and after instrumentation for both systems. At the 3 cervical levels, the PTG maintained centralization of the preparation on the transition between the F2 and F3 instruments, which did not occur with the PTU. Conclusion The Conventional NiTi (PTU) and Controlled Memory NiTi (PTG) instruments displayed comparable capabilities for shaping the straight mesial root canals of mandibular molars, although the PTG was better than the PTU at maintaining the centralization of the shape in the cervical portion.

[Continuous observation of canal aberrations in S-shaped simulated root canal prepared by hand-used ProTaper files].

PubMed

Xia, Ling-yun; Leng, Wei-dong; Mao, Min; Yang, Guo-biao; Xiang, Yong-gang; Chen, Xin-mei

2009-08-01

To observe the formation of canal aberrations in S-shaped root canals prepared by every file of hand-used ProTaper. Fifteen S-shaped simulated resin root canals were selected. Each root canal was prepared by every file of hand-used ProTaper following the manufacturer instruction. The images of canals prepared by S1, S2, F1, F2 and F3 were taken and stored, which were divided into group S1, S2, F1, F2 and F3. One image of canal unprepared was superposed with the images of the same root canal in these five groups respectively to observe the types and number of canal aberrations, which included unprepared area, danger zone, ledge, elbow, zip and perforation. SPSS12.0 software pakage was used for Fisher's exact probabilities in 2x2 table. Unprepared area decreased following preparation by every file of ProTaper, but it still existed when the canal preparation was finished. The incidence of danger zone, elbow and zip in group F1 was 15/15, 11/15, 4/15, respectively, which was significantly higher than that in group S2(2/15,0,0) (P<0.001). Ledge appeared after prepared by F2, and increased sharply in group F3. None perforation was found in all groups. The incidence of canal aberrations begins to increase after prepared by finishing files of ProTaper.The presence of unprepared area suggests that it is essential to rinse canal abundantly during complicated canal preparation and canal antisepsis after preparation.

The self-adjusting file (SAF) system: An evidence-based update.

PubMed

Metzger, Zvi

2014-09-01

Current rotary file systems are effective tools. Nevertheless, they have two main shortcomings: They are unable to effectively clean and shape oval canals and depend too much on the irrigant to do the cleaning, which is an unrealistic illusionThey may jeopardize the long-term survival of the tooth via unnecessary, excessive removal of sound dentin and creation of micro-cracks in the remaining root dentin. The new Self-adjusting File (SAF) technology uses a hollow, compressible NiTi file, with no central metal core, through which a continuous flow of irrigant is provided throughout the procedure. The SAF technology allows for effective cleaning of all root canals including oval canals, thus allowing for the effective disinfection and obturation of all canal morphologies. This technology uses a new concept of cleaning and shaping in which a uniform layer of dentin is removed from around the entire perimeter of the root canal, thus avoiding unnecessary excessive removal of sound dentin. Furthermore, the mode of action used by this file system does not apply the machining of all root canals to a circular bore, as do all other rotary file systems, and does not cause micro-cracks in the remaining root dentin. The new SAF technology allows for a new concept in cleaning and shaping root canals: Minimally Invasive 3D Endodontics.

An Approach for a Mathematical Description of Human Root Canals by Means of Elementary Parameters.

PubMed

Dannemann, Martin; Kucher, Michael; Kirsch, Jasmin; Binkowski, Alexander; Modler, Niels; Hannig, Christian; Weber, Marie-Theres

2017-04-01

Root canal geometry is an important factor for instrumentation and preparation of the canals. Curvature, length, shape, and ramifications need to be evaluated in advance to enhance the success of the treatment. Therefore, the present study aimed to design and realize a method for analyzing the geometric characteristics of human root canals. Two extracted human lower molars were radiographed in the occlusal direction using micro-computed tomographic imaging. The 3-dimensional geometry of the root canals, calculated by a self-implemented image evaluation algorithm, was described by 3 different mathematical models: the elliptical model, the 1-circle model, and the 3-circle model. The different applied mathematical models obtained similar geometric properties depending on the parametric model used. Considering more complex root canals, the differences of the results increase because of the different adaptability and the better approximation of the geometry. With the presented approach, it is possible to estimate and compare the geometry of natural root canals. Therefore, the deviation of the canal can be assessed, which is important for the choice of taper of root canal instruments. Root canals with a nearly elliptical cross section are reasonably approximated by the elliptical model, whereas the 3-circle model obtains a good agreement for curved shapes. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Mechanized instrumentation of root canals oscillating systems.

PubMed

Leonardo, Renato de Toledo; Puente, Carlos Garcia; Jaime, Alejandro; Jent, Carol

2013-01-01

Cleaning and shaping are important steps in the root canal treatment. Despite the technological advances in endodontics, K and Hedstroen files are still widely used. In an attempt to be more effective in preparing the root canals, faster and more cutting efficient kinematic, alloys and design alternatives utilizing mechanically oscillating or rotary files are proposed. Even with all these technological innovating alternatives, the preparation of root canals remains a challenge.

Canal Transportation, Unprepared Areas, and Dentin Removal after Preparation with BT-RaCe and ProTaper Next Systems.

PubMed

Brasil, Sabrina C; Marceliano-Alves, Marília F; Marques, Márcia L; Grillo, João P; Lacerda, Mariane F L S; Alves, Flávio R F; Siqueira, José F; Provenzano, José C

2017-10-01

This study compared the shaping ability of ProTaper Next (Dentsply Sirona, Tulsa, OK) and BT-RaCe (FKG Dentaire, La Chaux-de-Fonds, Switzerland) instrument systems in the mesial canals of mandibular molars using micro-computed tomographic (micro-CT) imaging. A total of 17 type IV mesial roots of extracted first mandibular molars were scanned using micro-CT imaging before and after root canal preparation with the 2 instrument systems. Both systems were used in the same root but alternating the mesial canals from root to root. The following parameters were analyzed: root canal volume, surface area, unprepared surface areas, transportation, canal/root width ratio, and preparation time. There were no statistically significant differences between the 2 systems for all evaluated parameters (P > .05). The unprepared surface areas for the full canal length and the apical 5-mm segment were 33% and 14% for BT-RaCe and 31% and 14% for ProTaper Next, respectively. After preparation, all root canals had a diameter that was not larger than 35% of the root diameter at the coronal and middle segments. The 2 systems showed no differences in any of the evaluated shaping parameters. None of the tested systems put the roots at risk of fracture because of excessive dentin removal. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Ex Vivo Comparison of Mtwo and RaCe Rotary File Systems in Root Canal Deviation: One File Only versus the Conventional Method.

PubMed

Aminsobhani, Mohsen; Razmi, Hasan; Nozari, Solmaz

2015-07-01

Cleaning and shaping of the root canal system is an important step in endodontic therapy. New instruments incorporate new preparation techniques that can improve the efficacy of cleaning and shaping. The aim of this study was to compare the efficacy of Mtwo and RaCe rotary file systems in straightening the canal curvature using only one file or the conventional method. Sixty mesial roots of extracted human mandibular molars were prepared by RaCe and Mtwo nickel-titanium (NiTi) rotary files using the conventional and only one rotary file methods. The working length was 18 mm and the curvatures of the root canals were between 15-45°. By superimposing x-ray images before and after the instrumentation, deviation of the canals was assessed using Adobe Photoshop CS3 software. Preparation time was recorded. Data were analyzed using three-way ANOVA and Tukey's post hoc test. There were no significant differences between RaCe and Mtwo or between the two root canal preparation methods in root canal deviation in buccolingual and mesiodistal radiographs (P>0.05). Changes of root canal curvature in >35° subgroups were significantly more than in other subgroups with smaller canal curvatures. Preparation time was shorter in one file only technique. According to the results, the two rotary systems and the two root canal preparation methods had equal efficacy in straightening the canals; but the preparation time was shorter in one file only group.

Root and Canal Morphology of Mandibular Molars in a Selected Iranian Population Using Cone-Beam Computed Tomography

PubMed Central

Madani, Zahra Sadat; Mehraban, Nika; Moudi, Ehsan; Bijani, Ali

2017-01-01

Introduction: The aim of this study was to evaluate the root canal morphology of mandibular first and second molars using cone-beam computed tomography (CBCT) in northern Iranian population and also to indicate the thinnest area around root canals. Methods and Materials: We evaluated CBCT images of 154 first molars and 147 second molars. By evaluating three axial, sagittal and coronal planes of each tooth we determined the number of root canals, prevalence of C-shaped Melton types, and prevalence of Vertucci configuration and inter orifice distance. Also the minimum wall thickness of root canals was determined by measuring buccal, lingual, distal and mesial wall thicknesses of each canal in levels with 2 mm intervals from apex to orifice. Results: Amongst 154 first mandibular molars, 149 (96.7%) had two roots, 3 (1.9%) had three roots and 2 (1.2%) had C-shaped root configuration. Of 147 second mandibular molars, 120 (81.6%) had two roots, 1 (0.6%) had three roots and 26 (17.6%) had C-shaped roots. There was no significant difference in the prevalence of Vertucci’s type between two genders. The most common configuration in mesial roots of first and second molars were type IV (57%-42.9%) and type II (31.5%-28%). Mesial and distal walls had the most frequency as the thinnest wall in all levels of root canals with mostly less than 1 mm thickness. In second molars the DB-DL inter orifice distance and in first molars the MB-ML distance were the minimum. MB-D in first molars had the maximum distance while ML-DL, MB-DB and ML-D had the same and maximum distance in second molars. Conclusion: Vertucci’s type IV and type I were the most prevalent configurations in mesial and distal roots of first and second mandibular molars and the thickness of thinnest area around the canals should be considered during endodontic treatments. PMID:28512476

[Comparison of effectiveness and safety between Twisted File technique and ProTaper Universal rotary full sequence based on micro-computed tomography].

PubMed

Chen, Xiao-bo; Chen, Chen; Liang, Yu-hong

2016-02-18

To evaluate the efficacy and security of two type of rotary nickel titanium system (Twisted File and ProTaper Universal) for root canal preparation based on micro-computed tomography(micro-CT). Twenty extracted molars (including 62 canals) were divided into two experimental groups and were respectively instrumented using Twisted File rotary nickel titanium system (TF) and ProTaper Universal rotary nickel titanium system (PU) to #25/0.08 following recommended protocol. Time for root canal instrumentation (accumulation of time for every single file) was recorded. The 0-3 mm root surface from apex was observed under an optical stereomicroscope at 25 × magnification. The presence of crack line was noted. The root canals were scanned with micro-CT before and after root canal preparation. Three-dimensional shape images of canals were reconstructed, calculated and evaluated. The amount of canal central transportation of the two groups was calculated and compared. The shorter preparation time [(0.53 ± 0.14) min] was observed in TF group, while the preparation time of PU group was (2.06 ± 0.39) min (P<0.05). In mid-root level, TF group shaping resulted in less canal center transportation than PU group [(0.070 ± 0.056) mm vs. (0.097 ± 0.084) mm, P<0.05]. No instrument separation was observed in both the groups. Cracks were not found in both the groups either based in micro-CT images or observation under an optical stereomicroscope at 25 × magnification. Compared with ProTaper Universal, Twisted File took less time in root canal preparation and exhibited better shaping ability, and less canal transportation.

Shaping ability of nickel-titanium rotary instruments in curved root canals.

PubMed

Talati, Ali; Moradi, Saeed; Forghani, Maryam; Monajemzadeh, Ali

2013-01-01

Disinfection and subsequent obturation of the root canal space require adequate mechanical enlargement of the canals. The purpose of this in vitro study was to compare the shaping ability of Mtwo, RaCe and Medin rotary instruments during the preparation of curved root canals. Sixty mesiobuccal root canals of mandibular molars with severe curvatures between 25-35(°) and radius of 4-9 mm were randomly divided into three groups of 20 canals each. Using pre- and post-instrumentation radiographs, straightening of the canal and the apical transportation were determined with AutoCAD software. The data were analyzed using Chi square, analysis of variance, and post-hoc tests and the significance level was set at P<0.05. Mtwo instruments maintained the canal curvature significantly better than Race and Medin instruments (P<0.05). There was significant difference between the rotary instruments for iatrogenic transportation of the major foramen (P>0.05). Under the conditions of this in vitro study, Mtwo instruments seemed superior to the two other rotary instruments.

Endodontic management of maxillary first molar with seven root canals diagnosed using Cone Beam Computed Tomography scanning

PubMed Central

Raghavendra, Srinidhi Surya; Hindlekar, Ajit Narayan; Desai, Niranjan Nanasaheb; Vyavahare, Nishant Kishor; Napte, Bandu Devrao

2014-01-01

The main objective of root canal treatment is thorough cleaning and shaping of the entire pulp space and its complete filling with an inert filling material. A major cause of post-treatment disease is the inability to locate, debride or adequately fill all canals of the root canal system. The form, configuration, and number of root canals in the maxillary first molars have been discussed for more than half a century. Maxillary first molars commonly present with three roots and three canals, with a second mesiobuccal canal (MB2) also present. With the advent of improved magnification there are reports of multiple root canals in the maxillary first molars. Nonsurgical endodontic therapy of a left maxillary first molar with three roots and seven root canals was successfully performed under a dental operating microscope. The diagnosis of multiple root canals was confirmed with the help of Cone Beam Computed Tomography (CBCT) images. PMID:25565745

Effect of finishing instrumentation using NiTi hand files on volume, surface area and uninstrumented surfaces in C-shaped root canal systems.

PubMed

Amoroso-Silva, P; Alcalde, M P; Hungaro Duarte, M A; De-Deus, G; Ordinola-Zapata, R; Freire, L G; Cavenago, B C; De Moraes, I G

2017-06-01

To assess the effect of 90°-oscillatory instrumentation with hand files on several morphological parameters (volume, surface area and uninstrumented surface) in C-shaped root canals after instrumentation using a single-file reciprocation system (Reciproc; VDW, Munich, Germany) and a Self-Adjusting File System (SAF; ReDent Nova, Ra'anana, Israel). Twenty mandibular second molars with C-shaped canals and C1 canal configurations were divided into two groups (n = 10) and instrumented with Reciproc and SAF instruments. A size 30 NiTi hand K-file attached to a 90°-oscillatory motion handpiece was used as final instrumentation in both groups. The specimens were scanned using micro-computed tomography after all procedures. Volume, surface area increase and uninstrumented root canal surface were analysed using CTAn software (Bruker-microCT, Kontich, Belgium). Also, the uninstrumented root canal surface was calculated for each canal third. All values were compared between groups using the Mann-Whitney test and within groups using the Wilcoxon's signed-rank test. Instrumentation with Reciproc significantly increased canal volume compared with instrumentation with SAF. Additionally, the canal volumes were significantly increased after 90°-oscillatory instrumentation (between and within group comparison; (P < 0.05)). Regarding the increase in surface area after all instrumentation protocols, statistical analysis only revealed significant differences in the within groups comparison (P < 0.05). Reciproc and SAF instrumentation yielded an uninstrumented root canal surface of 28% and 34%, respectively, which was not significantly different (P > 0.05). Final oscillatory instrumentation significantly reduced the uninstrumented root canal surface from 28% to 9% (Reciproc) and from 34% to 15% (SAF; P < 0.05). The apical and middle thirds exhibited larger uninstrumented root canal surfaces after the first instrumentation that was significantly reduced after oscillatory instrumentation (P < 0.05). The Reciproc and SAF system were associated with similar morphological parameters after instrumentation of mandibular second molars with C-shaped canals except for a higher canal volume increase in the Reciproc group compared to the SAF. Furthermore, the final use of 90°-oscillatory instrumentation using NiTi hand files significantly decreased the uninstrumented canal walls that remained after Reciproc and SAF instrumentation. © 2016 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Comparative evaluation of root canal preparations of maxillary first molars with self-adjusting file, reciproc single file, and revo-s rotary file: A micro-computed tomography study.

PubMed

Ahmetoglu, Fuat; Keles, Ali; Simsek, Neslihan; Ocak, M Sinan; Yologlu, Saim

2015-01-01

This study was aimed to use micro-computed tomography (μ-CT) to evaluate the canal shaping properties of three nickel-titanium instruments, Self-Adjusting File (SAF), Reciproc, and Revo-S rotary file, in maxillary first molars. Thirty maxillary molars were scanned preoperatively by using micro-computed tomography (μ-CT) scans at 13,68 μm resolution. The teeth were randomly assigned to three groups (n = 10). The root canals were shaped with SAF, Reciproc, and Revo-S, respectively. The shaped root canals were rescanned. Changes in canal volumes and surface areas were compared with preoperative values. The data were analyzed using Kruskal-Wallis and Conover's post hoc tests, with p < .05 denoting a statistically significant difference. Preoperatively canal volumes and surface area were statistically similar among the three groups (p > .05). There were statistically significant differences in all measures comparing preoperative and postoperative canal models (p = 0.0001). These differences occurred after instrumentation among the three experimental groups showed no statistically significant difference for volume (p > .05). Surface area showed the similar activity in buccal canals in each of the three techniques whereas no statistically significant difference was detected among surface area, the SAF, and the Revo-S in the palatal (P) canal. Each of three shaping system showed the similar volume activity in all canals, but SAF and Revo-S provided more effectively root planning in comparison with Reciproc in P canal. © Wiley Periodicals, Inc.

The self-adjusting file (SAF) system: An evidence-based update

PubMed Central

Metzger, Zvi

2014-01-01

Current rotary file systems are effective tools. Nevertheless, they have two main shortcomings: They are unable to effectively clean and shape oval canals and depend too much on the irrigant to do the cleaning, which is an unrealistic illusionThey may jeopardize the long-term survival of the tooth via unnecessary, excessive removal of sound dentin and creation of micro-cracks in the remaining root dentin. The new Self-adjusting File (SAF) technology uses a hollow, compressible NiTi file, with no central metal core, through which a continuous flow of irrigant is provided throughout the procedure. The SAF technology allows for effective cleaning of all root canals including oval canals, thus allowing for the effective disinfection and obturation of all canal morphologies. This technology uses a new concept of cleaning and shaping in which a uniform layer of dentin is removed from around the entire perimeter of the root canal, thus avoiding unnecessary excessive removal of sound dentin. Furthermore, the mode of action used by this file system does not apply the machining of all root canals to a circular bore, as do all other rotary file systems, and does not cause micro-cracks in the remaining root dentin. The new SAF technology allows for a new concept in cleaning and shaping root canals: Minimally Invasive 3D Endodontics. PMID:25298639

Influence of NiTi alloy on the root canal shaping capabilities of the ProTaper Universal and ProTaper Gold rotary instrument systems

PubMed Central

DUQUE, Jussaro Alves; VIVAN, Rodrigo Ricci; CAVENAGO, Bruno Cavalini; AMOROSO-SILVA, Pablo Andrés; BERNARDES, Ricardo Affonso; de VASCONCELOS, Bruno Carvalho; DUARTE, Marco Antonio Hungaro

2017-01-01

Abstract Objective This study aimed to evaluate the influence of the NiTi wire in Conventional NiTi (ProTaper Universal PTU) and Controlled Memory NiTi (ProTaper Gold PTG) instrument systems on the quality of root canal preparation. Material and Methods Twelve mandibular molars with separate mesial canals were scanned using a high-definition microcomputed tomography system. The PTU and PTG instruments were used to shape twelve mesial canals each. The canals were scanned after preparation with F2 and F3 instruments of the PTU and PTG systems. The analyzed parameters included the remaining dentin thickness at the apical and cervical levels, root canal volume and untouched canal walls. Data was analyzed for statistical significance by the Friedman and Dunn’s tests. For the comparison of data between groups, the Mann-Whitney test was used. Results In the pre-operative analysis, there were no statistically significant differences between the groups in terms of the area and volume of root canals (P>.05). There was also no statistically significant difference between the systems with respect to root canal volume after use of the F2 and F3 instruments. There was no statistical difference in the dentin thickness at the first apical level between, before and after instrumentation for both systems. At the 3 cervical levels, the PTG maintained centralization of the preparation on the transition between the F2 and F3 instruments, which did not occur with the PTU. Conclusion The Conventional NiTi (PTU) and Controlled Memory NiTi (PTG) instruments displayed comparable capabilities for shaping the straight mesial root canals of mandibular molars, although the PTG was better than the PTU at maintaining the centralization of the shape in the cervical portion. PMID:28198973

Technical quality of a matching-taper single-cone filling technique following rotary instrumentation compared with lateral compaction after manual preparation: a retrospective study.

PubMed

Krug, R; Krastl, G; Jahreis, M

2017-03-01

The objectives of the study were to evaluate the radiographic technical quality of root canal treatment before and after the implementation of a nickel-titanium rotary (NiTiR) preparation followed by a matching-taper single-cone (mSC) obturation and to detect the procedural errors associated with this technique. A random sample of 535 patients received root canal treatment at the Department of Conservative Dentistry and Periodontology at the University of Würzburg: 254 teeth were treated in 2002-2003 by using stainless steel instruments (SSI) for preparation and a lateral compaction (LC) technique (classic group (CG)). Two hundred eighty-one teeth were root filled in 2012-2013 employing NiTiR instruments for the root canal shaping and a mSC technique (advanced group (AG)). The quality assessments were based on the radiographic criteria of the European Society of Endodontology. The presence of voids was recorded separately for the apical, central and cervical thirds of the root canals. Procedural errors, such as ledges, apical transportations, perforations and fractured instruments, were detected. The root canal fillings in the CG and AG were compared using chi-squared and Fisher's exact tests. Multivariable logistic regression was performed to investigate the association between the independent variables (patient age, tooth type and type of treatment) and the dependent variables (density and length). Adequate length was achieved significantly more often in the AG compared to the CG for molars (p = 0.017), mandibular teeth (p = 0.013) and primary root canal treatments (p = 0.024). No significant difference was detected between the AG and CG regarding adequate length in general (p = 0.051) or adequate overall quality of root canal filling (p = 0.1). In the AG, a significant decrease in procedural errors was evident (p = 0.019) and decreases in the densities of the root canal fillings in the cervical (p = 0.01) and central (p = 0.01) thirds of the root canals were also observed. Moreover, root canals in elderly patients exhibited fewer voids (p = 0.009). Rotary root canal preparation followed by a matching-taper single-cone filling technique provides a reliable shaping of the root canal, with fewer procedural errors and a more acceptable filling quality in terms of length and homogeneity in the apical third. Less favourable results were achieved in the central and cervical parts of the root canals. The matching-taper single-cone technique seems to effectively obturate well-tapered root canals after adequate rotary instrumentation. Irregularly shaped canals require additional lateral or warm vertical condensation to avoid voids.

Hand-operated and rotary ProTaper instruments: a comparison of working time and number of rotations in simulated root canals.

PubMed

Pasqualini, Damiano; Scotti, Nicola; Tamagnone, Lorenzo; Ellena, Federica; Berutti, Elio

2008-03-01

The aim of this study was to compare the effective shaping time and number of rotations required by an endodontist working with hand and rotary ProTaper instruments to completely shape simulated root canals. Eighty Endo Training Blocks (curved canal shape) were used. Manual preflaring was performed with K-Flexofiles #08-10-12-15-17 and #20 Nitiflex at a working length of 18 mm. Specimens were then randomly assigned to 2 different groups (n = 40); group 1 was shaped by using hand ProTaper and group 2 with ProTaper rotary. The number of rotations made in the canal and the effective time required to achieve complete canal shaping were recorded for each instrument. Differences between groups were analyzed with the nonparametric Mann-Whitney U test (P < .05). Hand ProTaper required significantly fewer rotations (P < .001) than rotary ProTaper, whereas the effective working time to fully shape the simulated canal was significantly higher (P < .001) with hand ProTaper.

Ex Vivo Comparison of Mtwo and RaCe Rotary File Systems in Root Canal Deviation: One File Only versus the Conventional Method

PubMed Central

Aminsobhani, Mohsen; Nozari, Solmaz

2015-01-01

Objectives: Cleaning and shaping of the root canal system is an important step in endodontic therapy. New instruments incorporate new preparation techniques that can improve the efficacy of cleaning and shaping. The aim of this study was to compare the efficacy of Mtwo and RaCe rotary file systems in straightening the canal curvature using only one file or the conventional method. Materials and Methods: Sixty mesial roots of extracted human mandibular molars were prepared by RaCe and Mtwo nickel-titanium (NiTi) rotary files using the conventional and only one rotary file methods. The working length was 18 mm and the curvatures of the root canals were between 15–45°. By superimposing x-ray images before and after the instrumentation, deviation of the canals was assessed using Adobe Photoshop CS3 software. Preparation time was recorded. Data were analyzed using three-way ANOVA and Tukey’s post hoc test. Results: There were no significant differences between RaCe and Mtwo or between the two root canal preparation methods in root canal deviation in buccolingual and mesiodistal radiographs (P>0.05). Changes of root canal curvature in >35° subgroups were significantly more than in other subgroups with smaller canal curvatures. Preparation time was shorter in one file only technique. Conclusion: According to the results, the two rotary systems and the two root canal preparation methods had equal efficacy in straightening the canals; but the preparation time was shorter in one file only group. PMID:26877736

Comparative evaluation of dentinal crack formation after root canal preparation using ProTaper Next, OneShape, and Hyflex EDM

PubMed Central

Das, Sanjib; Pradhan, Prasanti Kumari; Lata, S.; Sinha, Sachidananda Prasad

2018-01-01

Introduction: The purpose of this study was to compare the incidence of dentinal crack formation after root canal preparation using ProTaper Next, OneShape, and Hyflex electrodischarge machining (HEDM). Materials and Methods: A total of 75 extracted mandibular premolars were selected. The root canals were instrumented using ProTaper Next, OneShape, and HEDM rotary files. All roots were horizontally sectioned at 3, 6, and 9 mm from apex with slow-speed saw under water cooling. The sections were observed under a stereomicroscope at ×25 to determine the absence or presence of crack. Data were analyzed using post hoc test and one-way ANOVA. Results: ProTaper Next and HEDM produced significantly less cracks than OneShape. Conclusion: Within the limitation of this in vitro study, it can be concluded that nickel–titanium instruments may cause cracks on the root surface. ProTaper Next and HEDM tend to produce less number of cracks as compared to OneShape. PMID:29674816

The effect of cervical preflaring using different rotary nickel-titanium systems on the accuracy of apical file size determination.

PubMed

Tennert, Christian; Herbert, Josef; Altenburger, Markus Jörg; Wrbas, Karl-Thomas

2010-10-01

An exact determination of the apical root canal diameter is crucial for correct cleaning and shaping of a root canal. The aim of this study was to investigate the discrepancies of the initial apical root canal diameter and the diameter that is measured by the initial apical file (IAF) after cervical flaring using current rotary nickel-titanium systems. Mesiobuccal canals of 40 extracted mandibular molars were randomly assigned to four groups. In the first group, root canals were not flared. Root canals of the other groups were preflared using FlexMaster (VDW, Munich, Germany), ProTaper (Dentsply, Konstanz, Germany), or RaCe (FKG Dentaire, Genf, Switzerland) instruments. The tooth length was determined by inserting an ISO 06 K-file to the apical foramen. The working length (WL) was set 1 mm short of the apical foramen. File sizes were increased after binding sensation was felt at the WL. Transversal sections of the WL regions were examined under stereomicroscope, and the diameter of the root canal and the IAF at WL were assessed. Canals preflared with RaCe instruments had the lowest discrepancy between the apical root canal diameter and the IAF diameter (15.7 ± 9.7 μm) followed by ProTaper (22.2 ± 11.0 μm) and FlexMaster (35.0 ± 17.2 μm). Preflaring of root canals prevents underestimation of the actual apical root canal diameter. The type of instruments used for preflaring show differences on the accuracy of IAF determination. Preflaring with larger tapered instruments leads to a more accurate apical sizing, and this information is crucial concerning the appropriate final diameter for complete apical shaping. Copyright © 2010 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Retrospective study of root canal configurations of maxillary third molars in Central India population using cone beam computed tomography Part- I.

PubMed

Rawtiya, Manjusha; Somasundaram, Pavithra; Wadhwani, Shefali; Munuga, Swapna; Agarwal, Manish; Sethi, Priyank

2016-01-01

The aim of this study was to investigate the root and canal morphology of maxillary third molars in Central India population using cone-beam computed tomography (CBCT) analysis. CBCT images of 116 maxillary third molars were observed, and data regarding the number of roots, the number of canals, and Vertucci's Classification in each root was statistically evaluated. Majority of Maxillary third molars had three roots (55.2%) and three canals (37.9%). Most MB root (43.8%), DB root (87.5%), and palatal root (100%) of maxillary third molars had Vertucci Type I. Mesiobuccal root of three-rooted maxillary third molars had Vertucci Type I (43.8%) and Type IV (40.6%) configuration. Overall prevalence of C-shaped canals in maxillary third molars was 3.4%. There was a high prevalence of three-rooted maxillary molars with three canals.

Potential relationship between design of nickel-titanium rotary instruments and vertical root fracture.

PubMed

Kim, Hyeon-Cheol; Lee, Min-Ho; Yum, Jiwan; Versluis, Antheunis; Lee, Chan-Joo; Kim, Byung-Min

2010-07-01

Nickel-titanium (NiTi) rotary files can produce cleanly tapered canal shapes with low tendency of transporting the canal lumen. Because NiTi instruments are generally perceived to have high fracture risk during use, new designs have been marketed to lower fracture risks. However, these design variations may also alter the forces on a root during instrumentation and increase dentinal defects that predispose a root to fracture. This study compared the stress conditions during rotary instrumentation in a curved root for three NiTi file designs. Stresses were calculated using finite element (FE) analysis. FE models of ProFile (Dentsply Maillefer, Ballaigues, Switzerland; U-shaped cross-section and constant 6% tapered shaft), ProTaper Universal (Dentsply; convex triangular cross-section with notch and progressive taper shaft), and LightSpeed LSX (Lightspeed Technology, Inc, San Antonio, TX; noncutting round shaft) were rotated within a curved root canal. The stress and strain conditions resulting from the simulated shaping action were evaluated in the apical root dentin. ProTaper Universal induced the highest von Mises stress concentration in the root dentin and had the highest tensile and compressive principal strain components at the external root surface. The calculated stress values from ProTaper Universal, which had the biggest taper shaft, approached the strength properties of dentin. LightSpeed generated the lowest stresses. The stiffer file designs generated higher stress concentrations in the apical root dentin during shaping of the curved canal, which raises the risk of dentinal defects that may lead to apical root cracking. Thus, stress levels during shaping and fracture susceptibility after shaping vary with instrument design. Copyright 2010 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

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

PubMed

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

2014-04-01

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

[Comparison of the shaping ability of three Ni-Ti rotary instruments in the preparation of simulated curved root canals].

PubMed

Qiu, Ning; Wang, Chu-yu; Liu, Yu-fei; Yu, Xiao-qing; Xue, Ming

2016-04-01

To compare the shaping ability of three rotary Ni-Ti instruments in simulated root canals. A total of 30 simulated resin blocks were divided randomly into 3 groups: ProTaper Universal, ProTaper Next and TF Adaptive. Each group consisted of 10 root canals. The preparation time and changes in canal curvature were measured. Pre- and post-instrumentation photograghs were taken by precise camera and superimposed through Photoshop. The material removed from the inner and outer canal walls at 9 points beginning at 0 mm from the foramen were measured with Image Pro Plus. Centering ability was determined accordingly. The data was analyzed with SPSS13.0 software package. During root canal preparation, no instruments fractured. ProTaper Next was much faster than ProTaper Universal(P<0.05). At the apical curvature, transportation was the least with TF Adaptive, followed by Protaper Next (P<0.05). There were no significant differences in 3 groups with respect to coronal curvature transportation (P>0.05). Under the conditions of this study, ProTaper Next was the most efficient instrument. TF Adaptive and Protaper Next showed better shaping ability. In general, all the instruments respected original canal curvature well and were safe to be used.

The effect of a manual instrumentation technique on five types of premolar root canal geometry assessed by microcomputed tomography and three-dimensional reconstruction

PubMed Central

2011-01-01

Background Together with diagnosis and treatment planning, a good knowledge of the root canal system and its frequent variations is a necessity for successful root canal therapy. The selection of instrumentation techniques for variants in internal anatomy of teeth has significant effects on the shaping ability and cleaning effectiveness. The aim of this study was to reveal the differences made by including variations in the internal anatomy of premolars into the study protocol for investigation of a single instrumentation technique (hand ProTaper instruments) assessed by microcomputed tomography and three-dimensional reconstruction. Methods Five single-root premolars, whose root canal systems were classified into one of five types, were scanned with micro-CT before and after preparation with a hand ProTaper instrument. Instrumentation characteristics were measured quantitatively in 3-D using a customized application framework based on MeVisLab. Numeric values were obtained for canal surface area, volume, volume changes, percentage of untouched surface, dentin wall thickness, and the thickness of dentin removed. Preparation errors were also evaluated using a color-coded reconstruction. Results Canal volumes and surface areas were increased after instrumentation. Prepared canals of all five types were straightened, with transportation toward the inner aspects of S-shaped or multiple curves. However, a ledge was formed at the apical third curve of the type II canal system and a wide range in the percentage of unchanged canal surfaces (27.4-83.0%) was recorded. The dentin walls were more than 0.3 mm thick except in a 1 mm zone from the apical surface and the hazardous area of the type II canal system after preparation with an F3 instrument. Conclusions The 3-D color-coded images showed different morphological changes in the five types of root canal systems shaped with the same hand instrumentation technique. Premolars are among the most complex teeth for root canal treatment and instrumentation techniques for the root canal systems of premolars should be selected individually depending on the 3-D canal configuration of each tooth. Further study is needed to demonstrate the differences made by including variations in the internal anatomy of teeth into the study protocol of clinical RCT for identifying the best preparation technique. PMID:21676233

[Evaluation of preparation of curved root canals using hand-used ProTaper].

PubMed

Nie, Min; Zhao, Xin-Chen; Peng, Bin; Fan, Ming-Wen; Bian, Zhuan

2009-05-01

To evaluate the shaping ability of hand-used ProTaper on curved canals using Endodontic Cube. Fifty-four curved root canals in vitro were selected and divided into three groups according to the curved degree (alpha), group A: 0 degrees < or = alpha < 25 degrees , group B: 25 degrees < or = alpha < 40 degrees , group C: 40 degrees < or = alpha < 55 degrees . Endodontic Cube was assembled, and each sample was sectioned perpendicular to the axis of the tooth into four sections with Isomer-Buhler in low speed. Then the root canals were prepared with hand-used ProTaper. Before and after shaping, photograph of all the sections were taken under a stereomicroscope. Statistical analyses were performed. The dentin cutting quantity of the whole canal prepared with ProTaper in group B and C was larger than that of group A. The deviation distance of the whole canal prepared by ProTaper in group C was significantly larger than that in group A, and the deviation distance in middle portion larger than that in group B. The maintaining ability in the middle portion of group C by ProTaper was worse than that of group A and B. The curvature of root canal may increase the cutting quantity of the -dentin and reduce the ability of remaining original canal shape prepared by ProTaper.

Evaluation of Root Canal Preparation Using Rotary System and Hand Instruments Assessed by Micro-Computed Tomography

PubMed Central

Stavileci, Miranda; Hoxha, Veton; Görduysus, Ömer; Tatar, Ilkan; Laperre, Kjell; Hostens, Jeroen; Küçükkaya, Selen; Muhaxheri, Edmond

2015-01-01

Background Complete mechanical preparation of the root canal system is rarely achieved. Therefore, the purpose of this study was to evaluate and compare the root canal shaping efficacy of ProTaper rotary files and standard stainless steel K-files using micro-computed tomography. Material/Methods Sixty extracted upper second premolars were selected and divided into 2 groups of 30 teeth each. Before preparation, all samples were scanned by micro-computed tomography. Thirty teeth were prepared with the ProTaper system and the other 30 with stainless steel files. After preparation, the untouched surface and root canal straightening were evaluated with micro-computed tomography. The percentage of untouched root canal surface was calculated in the coronal, middle, and apical parts of the canal. We also calculated straightening of the canal after root canal preparation. Results from the 2 groups were statistically compared using the Minitab statistical package. Results ProTaper rotary files left less untouched root canal surface compared with manual preparation in coronal, middle, and apical sector (p<0.001). Similarly, there was a statistically significant difference in root canal straightening after preparation between the techniques (p<0.001). Conclusions Neither manual nor rotary techniques completely prepared the root canal, and both techniques caused slight straightening of the root canal. PMID:26092929

Evaluation of Root Canal Preparation Using Rotary System and Hand Instruments Assessed by Micro-Computed Tomography.

PubMed

Stavileci, Miranda; Hoxha, Veton; Görduysus, Ömer; Tatar, Ilkan; Laperre, Kjell; Hostens, Jeroen; Küçükkaya, Selen; Muhaxheri, Edmond

2015-06-20

Complete mechanical preparation of the root canal system is rarely achieved. Therefore, the purpose of this study was to evaluate and compare the root canal shaping efficacy of ProTaper rotary files and standard stainless steel K-files using micro-computed tomography. Sixty extracted upper second premolars were selected and divided into 2 groups of 30 teeth each. Before preparation, all samples were scanned by micro-computed tomography. Thirty teeth were prepared with the ProTaper system and the other 30 with stainless steel files. After preparation, the untouched surface and root canal straightening were evaluated with micro-computed tomography. The percentage of untouched root canal surface was calculated in the coronal, middle, and apical parts of the canal. We also calculated straightening of the canal after root canal preparation. Results from the 2 groups were statistically compared using the Minitab statistical package. ProTaper rotary files left less untouched root canal surface compared with manual preparation in coronal, middle, and apical sector (p<0.001). Similarly, there was a statistically significant difference in root canal straightening after preparation between the techniques (p<0.001). Neither manual nor rotary techniques completely prepared the root canal, and both techniques caused slight straightening of the root canal.

Influence of operator's experience on root canal shaping ability with a rotary nickel-titanium single-file reciprocating motion system.

PubMed

Muñoz, Estefanía; Forner, Leopoldo; Llena, Carmen

2014-04-01

The aim of this study was to evaluate the influence of the operator's experience on the shaping of double-curvature simulated root canals with a nickel-titanium single-file reciprocating motion system. Sixty double-curvature root canals simulated in methacrylate blocks were prepared by 10 students without any experience in endodontics and by 10 professionals who had studied endodontics at the postgraduate level. The Reciproc-VDW system's R25 file was used in the root canal preparation. The blocks were photographed before and after the instrumentation, and the time of instrumentation was also evaluated. Changes in root canal dimensions were analyzed in 6 positions. Significant differences (P < .05) were found in the apical transport of the first root canal curvature, with a larger percentage of increase of the root canal occurring in the novice group than in the expert one, as well as in the canal deviation at the beginning of the curvatures, whereas no significant results were obtained in the growth rate of the canal area. There was difference in the time of instrumentation, with 3.76 minutes observed in the novice group, as opposed to 2.05 minutes in the expert group. The use of the single-file reciprocating motion system Reciproc is not seen to be influenced by the operator's experience regarding the increase of the canal area. Previous training and the need to acquire experience are important in the use of this system, in spite of its apparent simplicity. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Influence of Operator's Experience on the Shaping Ability of Protaper Universal and Waveone Systems: A Comparative Study on Simulated Root Canals.

PubMed

Troiano, Giuseppe; Dioguardi, Mario; Cocco, Armando; Giannatempo, Giovanni; Laino, Luigi; Ciavarella, Domenico; Berutti, Elio; Lo Muzio, Lorenzo

2016-01-01

To assess the influence of operator experience on: shaping and centering ability, mean preparation time and presence of canal aberrations of ProTaper Universal and WaveOne systems on simulated root canals. Sixty S-shaped canals in resin blocks were assigned to four groups (n=15 for each group). Group1 (Experienced operator, ProTaper), Group2 (Experienced operator, WaveOne), Group3 (Inexperienced operator, ProTaper), Group4 (Inexperienced operator, WaveOne). Photographic method was used to record pre- and post-instrumentations images. After superimposition, it has been evaluated presence of canal aberrations and differences in shaping and centering ability between groups. WaveOne system produced a lower amount of canal aberrations both in the hand of expert than inexpert operators. However, a WaveOne instrument breakage occurred in the hands of an inexperienced operator. No differences have been found in the evaluation of shaping ability with both systematics. Operator's experience doesn't influence the shaping ability of ProTaper and WaveOne systems. Experience factor could influence the centering ability in the use of both the systematics. However, WaveOne Primary reduce the mean preparation time and the presence of canal aberrations.

[Scanning electron microscopy investigation of canal cleaning after canal preparation with nickel titanium files].

PubMed

Brkanić, Tatjana; Ivana, Stojsin; Vukoje, Karolina; Zivković, Slavoljub

2010-01-01

Root canal preparation is the most important phase of endodontic procedure and it consists of adequate canal space cleaning and shaping. In recent years, rotary instruments and techniques have gained importance because of the great efficacy, speed and safety of the preparation procedure. The aim of this research was to investigate the influence of different NiTi files on the canal wall cleaning quality, residual dentine debris and smear layer. The research was conducted on extracted human teeth in vitro conditions. Teeth were divided in 7 main groups depending on the kind of instruments used for root canal preparation: ProTaper, GT, ProFile, K-3, FlexMaster, hand ProTaper and hand GT. Root canal preparation was accomplished by crown-down technique. Prepared samples were assessed on scanning electron microscopy JEOL, JSM-6460 LV. The evaluation of dentine debris was done with 500x magnification, and the evaluation of smear layer with 1,000 times magnification. Quantitive assessment of dentine debris and smear layer was done according to the criteria of Hulsmann. The least amount of debris and smear layer has been found in canals shaped with ProFile instruments, and the largest amount in canals shaped with FlexMaster instruments. Canal cleaning efficacy of hand GTand ProTaperfiles has been similar to cleaning efficacy of rotary NiTi files. Statistic analysis has shown a significant difference in amount of dentine debris and smear layer on the canal walls between sample groups. shaped with different instruments. Completely clean canals have not been found in any tested group of instruments. The largest amount of debris and smear layer has been found in the apical third of all canals. The design and the type of endodontic instruments influence the efficacy of the canal cleaning.

Retrospective study of root canal configurations of maxillary third molars in Central India population using cone beam computed tomography Part- I

PubMed Central

Rawtiya, Manjusha; Somasundaram, Pavithra; Wadhwani, Shefali; Munuga, Swapna; Agarwal, Manish; Sethi, Priyank

2016-01-01

Objective: The aim of this study was to investigate the root and canal morphology of maxillary third molars in Central India population using cone-beam computed tomography (CBCT) analysis. Materials and Methods: CBCT images of 116 maxillary third molars were observed, and data regarding the number of roots, the number of canals, and Vertucci's Classification in each root was statistically evaluated. Results: Majority of Maxillary third molars had three roots (55.2%) and three canals (37.9%). Most MB root (43.8%), DB root (87.5%), and palatal root (100%) of maxillary third molars had Vertucci Type I. Mesiobuccal root of three-rooted maxillary third molars had Vertucci Type I (43.8%) and Type IV (40.6%) configuration. Overall prevalence of C-shaped canals in maxillary third molars was 3.4%. Conclusion: There was a high prevalence of three-rooted maxillary molars with three canals. PMID:27011747

Root Canal Treatment of Mandibular Second Premolar with Three Separate Roots and Canals Using Spiral Computed Tomographic

PubMed Central

Hariharavel, V. P.; Kumar, A. Ashok; Ganesh, C.; Aravindhan, R.

2014-01-01

Anatomic and internal morphology of a root canal system is more complex and differs for each individual tooth of which mandibular premolars have earned the reputation for having aberrant anatomy. The occurrence of three canals with three separate foramina in mandibular second premolars is very rare. A wider knowledge on both clinical and radiological anatomy especially spiral computed tomographic is absolutely essential for the success of endodontic treatment. These teeth may require skillful and special root canal special shaping and obturating techniques. This paper reports an unusual case of a mandibular second premolar with atypical canal pattern that was successfully treated endodontically. PMID:25101187

Micro-computed tomography evaluation of the removal of calcium hydroxide medicament from C-shaped root canals of mandibular second molars.

PubMed

Ma, J Z; Shen, Y; Al-Ashaw, A J; Khaleel, H Y; Yang, Y; Wang, Z J; Peng, B; Haapasalo, M

2015-04-01

To use micro-computed tomography (μ-CT) to evaluate the amount of calcium hydroxide [Ca(OH)2 ] remaining in the C-shaped root canals of mandibular second molars after attempting to remove it with passive ultrasonic and sonic irrigation. Thirty mandibular second molars, 15 in C1 and 15 in C2 configurations as first identified by μ-CT, were divided into three groups (five C1 and five C2 in each group) for the three irrigation methods. All teeth were prepared to ProTaper Universal F2 and filled with Ca(OH)2 paste. The Ca(OH)2 was removed with F2 files and irrigation without agitation or with agitation using either EndoActivator or ultrasonics. μ-CT was used to measure the initial amount of Ca(OH)2 present. After removal of Ca(OH)2, μ-CT imaging was used to assess the percentage of volume of residual Ca(OH)2 in the canal. Data were analysed using one-way anova test. There was no significant difference in the mean volume of the root canal systems after instrumentation amongst the three groups. The three irrigation techniques left 2-17% of Ca(OH)2 in the root canals after removal. The mean volume of the remaining Ca(OH)2 was higher in the group without agitation than in the groups with sonic or ultrasonic agitation (P < 0.05). In the apical third, 68% of the canal space remained occupied by Ca(OH)2 when no agitation was used, whereas 28% and 31% remained filled by Ca(OH)2 in the EndoActivator and ultrasonic groups, respectively. There was no significant difference in the amount of residual Ca(OH)2 between the EndoActivator and ultrasonic groups. The proportion of remaining Ca(OH)2 in the apical canals was higher than in the middle and coronal canals in all groups (P < 0.05). A considerable proportion of the apical canal space remained filled with Ca(OH)2 in the C-shaped root canals after instrumentation and conventional needle irrigation. Although combining rotary instrumentation and irrigation with sonic or ultrasonic agitation reduced the amount of residual Ca(OH)2 in the C-shaped root canals, the large amount of calcium hydroxide in the critical apical area remains a concern. Alternative strategies should be considered in medication of the apical canal in C-shaped teeth. © 2014 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Shaping ability of ProFile.04 Taper Series 29 rotary nickel-titanium instruments in simulated root canals. Part 1.

PubMed

Thompson, S A; Dummer, P M

1997-01-01

The aim of this study was to determine the shaping ability of ProFile.04 Taper Series 29 nickel-titanium instruments in simulated canals. A total of 40 simulated root canals made up of four different shapes in terms of angle and position of curvature were prepared by ProFile instruments using a step-down approach. Part 1 of this two-part report describes the efficacy of the instruments in terms of preparation time, instrument failure, canal blockages, loss of canal length and three-dimensional canal form. The time necessary for canal preparation was not influenced significantly by canal shape. No instrument fractures occurred but a total of 52 instruments deformed. Size 6 instruments deformed the most followed by sizes 5, 3 and 4. Canal shape did not influence significantly instrument deformation. None of the canals became blocked with debris and loss of working distance was on average 0.5 mm or less. Intracanal impressions of canal form demonstrated that most canals had definite apical stops, smooth canal walls and good flow and taper. Under the conditions of this study, ProFile.04 Taper Series 29 rotary nickel-titanium instruments prepared simulated canals rapidly and created good three-dimensional form. A substantial number of instruments deformed but it was not possible to determine whether this phenomenon occurred because of the nature of the experimental model or through an inherent design weakness in the instruments.

Mandibular first and second molars with three mesial canals: a case series

PubMed Central

Aminsobhani, Mohsen; Bolhari, Behnam; Shokouhinejad, Noushin; Ghorbanzadeh, Abdollah; Ghabraei, Sholeh; Rahmani, Mohamad Bagher

2010-01-01

Adequate cleaning, shaping and filling of the root canal system are mandatory for successful root canal treatment. Thorough knowledge of root canal morphology and unusual anatomy of the tooth is critical for the practitioner. The occurrence and location of the third mesial canal (Middle Mesial Canal) in mandibular first and second molars in relation to other two mesial canals that were treated in private practice were studied. In 27 clinical cases, the presence of a middle mesial canal was demonstrated. The third canal was located in the middle of the distance between the mesiobuccal and mesiolingual canals. This canal configuration was found in six second lower molars and twenty one first molars. Middle mesial canal in all of our cases joined to mesiobuccal or mesiolingual canals. None of the teeth consisted of three independent canals with three apical foramina. In conclusion, every attempt should be made to find and treat all root canals of a tooth. PMID:24778681

Micro-computed tomography evaluation of the preparation of mesiobuccal root canals in maxillary first molars with Hyflex CM, Twisted Files, and K3 instruments.

PubMed

Zhao, Dan; Shen, Ya; Peng, Bin; Haapasalo, Markus

2013-03-01

The aim of this study was to describe the canal shaping properties of Hyflex CM, Twisted Files (TF), and K3 rotary nickel-titanium files by using micro-computed tomography in maxillary first molars. A total of 36 mesiobuccal root canals of maxillary first molars were prepared with Hyflex CM, TF, or K3 system. Micro-computed tomography was used to scan the specimens before and after instrumentation. The volume of untreated canal, volume of dentin removed after preparation, amount of uninstrumented area, and the transportation for the coronal, middle, and apical thirds of canals were measured. Instrumentation of canals increased their volume and surface area. TF group showed the greatest amount of volumetric dentin removal (P < .05), whereas no significant difference was found in Hyflex CM and K3 groups. There were no significant differences among instrument types concerning uninstrumented area. The TF system produced significantly less transportation than the K3 system in the apical third of canals. No significant difference was found between TF and Hyflex CM instruments relating to apical transportation. In vitro, Hyflex and TF instruments shaped curved root canals in maxillary first molar without significant shaping errors. Crown Copyright © 2013. Published by Elsevier Inc. All rights reserved.

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

[Root canal treatment of mandibular second premolar tooth with taurodontism].

PubMed

Vujasković, Mirjana; Karadzić, Branislav; Miletić, Vesna

2008-01-01

Taurodontism is a morphoanatomical change in the shape of a tooth. An enlarged body of a tooth with smaller than usual roots is a characteristic feature. Internal tooth anatomy correlates with this appearance, which means that a taurodontal tooth has a large pulp chamber and apically positioned furcations. This dental anomaly may be associated with different syndromes and congenital discoders. The case report presents the patient of a rare case of taurodontism in the mandibular second premolar with chronic periodontitis. Endodontic treatment was performed after dental history and clinical examination. Special care is required in all segments of endodontic treatment of a taurodontal tooth from the identification orifice, canal exploration, determining working length, cleaning and shaping and obturation of the root canal. Precurved K-file was used for canal exploration and location of the furcation. One mesial and one distal canal with the buccal position were identified in the apical third of the root canal. The working lengths of two canals were determined by radiographic interpretation with two K-files in each canal and verified with the apex locator. During canal instrumentation, the third canal was located in the disto-lingual position. The working length of the third canal was established using the apex locator. Thorough knowledge of tooth anatomy and its variations can lead to lower percentage of endodontic failure. Each clinical case involving these teeth should be investigated carefully, clinically and radiographically to detect additional root canals. High quality radiographs from different angles and proper instrumentarium improve the quality of endodontic procedure.

3-Rooted Maxillary First Premolars: An Ex Vivo Study of External and Internal Morphologies.

PubMed

Beltes, Panagiotis; Kalaitzoglou, Maria-Elpida; Kantilieraki, Eleni; Beltes, Charalampos; Angelopoulos, Christos

2017-08-01

This study aimed to analyze the external and internal morphologies of 3-rooted maxillary first premolars using cone-beam computed tomographic (CBCT) imaging. Fifty-six three-rooted maxillary first premolars were imaged by CBCT imaging and classified into 4 groups on the basis of external root morphology. Internal morphologic features, including the shapes of the buccal and palatal orifices and distances of bifurcation of the buccal-palatal and mesiobuccal-distobuccal root canals from the cementoenamel junction (CEJ), were measured. The teeth were classified into 4 groups on the basis of external morphology: group A, separation of the buccal and palatal roots with bifurcation of the former into the mesiobuccal and distobuccal roots (n = 22); group B, fusion of 2 buccal roots with the palatal root being separate (n = 19); group C, complete or partial fusion of the distobuccal and palatal roots (n = 9); and group D, fusion of all 3 roots (n = 6). The buccal orifice was mainly triangular/heart shaped. The distance of bifurcation of the buccal-palatal root canals from the CEJ in group A differed significantly from those in groups B and C (P < .05). There were significant differences in the distance of bifurcation of the mesiobuccal-distobuccal root canals from the CEJ among groups A, B, and C (P < .05). Four teeth exhibited C-shaped root canal systems of different configurations. The external and internal morphologies of 3-rooted maxillary first premolars vary considerably. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

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.

Root canal shaping with manual stainless steel files and rotary Ni-Ti files performed by students.

PubMed

Sonntag, D; Guntermann, A; Kim, S K; Stachniss, V

2003-04-01

To investigate root canal shaping with manual stainless steel files and rotary Ni-Ti files by students. Two hundred and ten simulated root canals with the same geometrical shape and size in acrylic resin blocks were prepared by 21 undergraduate dental students with manual stainless steel files using a stepback technique or with rotary Ni-Ti files in crown-down technique. Preparation length, canal shape, incidence of fracture and preparation time were investigated. Zips and elbows occurred significantly (P < 0.001) less frequently with rotary than with manual preparation. The correct preparation length was achieved significantly (P < 0.05) more often with rotary Ni-Ti files than with manual stainless steel files. Fractures occurred significantly (P < 0.05) less frequently with hand instrumentation. The mean time required for manual preparation was significantly (P < 0.001) longer than that required for rotary preparation. Prior experience with a hand preparation technique was not reflected in an improved quality of the subsequent engine-driven preparation. Inexperienced operators achieved better canal preparations with rotary Ni-Ti instruments than with manual stainless steel files. However, rotary preparation was associated with significantly more fractures.

Three rooted, four canalled mandibular first molar (Radix Entomolaris).

PubMed

Parolia, Abhishek; Kundabala, M; Thomas, M S; Mohan, M; Joshi, N

2009-01-01

A mandibular first molar with two distal roots is an interesting example of anatomic variation. This paper describes case reports of mandibular first molar with three roots (one mesial and two distal) and four canals (two in mesial and one in each distobuccal and distolingual root). The canals were shaped with protaper rotary files and irrigated with 5.25% sodium hyochlorite, 0.2 %w/v of chlorhexidine gluconate and normal saline as the fi nal irrigant. The canals were then obturated with gutta- percha and AH plus sealer. These case reports show an anatomic variation of internal morphology of the tooth and points out the importance of searching for additional canals.

Use of cone-beam computed tomography to evaluate root and canal morphology of mandibular first and second molars in Turkish individuals

PubMed Central

Sekerci, Ahmet E.; Dinçer, Asiye N.; Cayabatmaz, Muhammed; Zorba, Yahya O.

2013-01-01

Objective: The aim of this study was to investigate the root and canal morphology of mandibular first and second molars in a Turkish population by using cone beam computed tomography (CBCT). Study design: CBCT images of mandibular first (n = 823) and second molar (n = 925) teeth from 605 Turkish patients were analyzed. The root canal configurations were classified according to the method of Vertucci. Results: The majority of mandibular molars (95.8% of first molars, 85.4% of second molars) had two separate roots; however, three roots were identified in 2.06% of first molars and 3.45% of second molars. C-shaped canals occurred 0.85% of first molars and 4.1% of second molars. Three canals were found in 79.9% of first molars and 72.8% of second molars. Most distal roots had a simple type I configuration, whereas mesial roots had more complex canal systems, with more than one canal. The most common root morphology of first and second molars is the two rooted morphology with three canals. Both the mesial and distal roots showed wide variations in canal anatomy with type IV and type I canal configuration predominating in the mesial and distal roots, respectively. Conclusion: Vertucci type I and IV canal configurations were the most prevalent in the distal and mesial roots, respectively, of both the mandibular first and second permanent molar teeth. Key words:Cone-beam CT, Turkish, mandibular molars, root and canal morphology. PMID:23524421

Micro-computed Tomographic Analysis of Apical Microcracks before and after Root Canal Preparation by Hand, Rotary, and Reciprocating Instruments at Different Working Lengths.

PubMed

de Oliveira, Bruna Paloma; Câmara, Andréa Cruz; Duarte, Daniel Amancio; Heck, Richard John; Antonino, Antonio Celso Dantas; Aguiar, Carlos Menezes

2017-07-01

This study aimed to compare apical microcrack formation after root canal shaping by hand, rotary, and reciprocating files at different working lengths using micro-computed tomographic analysis. Sixty mandibular incisors were randomly divided into 6 experimental groups (n = 10) according to the systems and working lengths used for the root canal preparation: ProTaper Universal for Hand Use (Dentsply Maillefer, Ballaigues, Switzerland), HyFlex CM (Coltene-Whaledent, Allstetten, Switzerland), and Reciproc (VDW, Munich, Germany) files working at the apical foramen (AF) and 1 mm short of the AF (AF - 1 mm). The teeth were imaged with micro-computed tomographic scanning at an isotropic resolution of 14 μm before and after root canal preparation, and the cross-sectional images generated were assessed to detect microcracks in the apical portion of the roots. Overall, 17 (28.3%) specimens presented microcracks before instrumentation. Apical microcracks were present in 1 (ProTaper Universal for Hand Use), 3 (Hyflex CM), and 2 (Reciproc) specimens when the instrumentation terminated at the AF. When instrumentation was terminated at AF - 1 mm, apical microcracks were detected in 3 (ProTaper Universal for Hand Use) and 4 (Hyflex CM and Reciproc) specimens. All these microcracks detected after root canal preparation were already present before instrumentation, and no new apical microcrack was visualized. For all groups, the number of slices presenting microcracks after root canal preparation was the same as before canal preparation. Root canal shaping with ProTaper Universal for Hand Use, HyFlex CM, and Reciproc systems, regardless of the working length, did not produce apical microcracks. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Analysis of the gutta-percha filled area in C-shaped mandibular molars obturated with a modified MicroSeal technique.

PubMed

Ordinola-Zapata, R; Bramante, C M; de Moraes, I G; Bernardineli, N; Garcia, R B; Gutmann, J L

2009-03-01

To analyse the gutta-percha filled area of C-shaped molar teeth root filled with the modified MicroSeal technique with reference to the radiographic features and the C-shaped canal configuration. Twenty-three mandibular second molar teeth with C-shaped roots were classified according to their radiographic features as: type I--merging, type II--symmetrical and type III--asymmetrical. The canals were root filled using a modified technique of the MicroSeal system. Horizontal sections at intervals of 600 mum were made 1 mm from the apex to the subpulpal floor level. The percentage of gutta-percha area from the apical, middle and coronal levels of the radiographic types was analysed using the Kruskal-Wallis test. Complementary analysis of the C-shaped canal configurations (C1, C2 and C3) determined from cross-sections from the apical third was performed in a similar way. No significant differences were found between the radiographic types in terms of the percentage of gutta-percha area at any level (P > 0.05): apical third, type I: 77.04%, II: 70.48% and III: 77.13%, middle third, type I: 95.72%, II: 93.17%, III: 91.13% and coronal level, type I: 98.30%, II: 98.25%, III: 97.14%. Overall, the percentage of the filling material was lower in the apical third (P < 0.05). No significant differences were found between the C-shaped canal configurations apically; C1: 72.64%, C2: 79.62%, C3: 73.51% (P > 0.05). The percentage of area filled with gutta-percha was similar in the three radiographic types and canal configuration categories of C-shaped molars. These results show the difficulty of achieving predictable filling of the root canal system when this anatomical variation exists. In general, the apical third was less completely filled.

Endodontic shaping performance using nickel-titanium hand and motor ProTaper systems by novice dental students.

PubMed

Tu, Ming-Gene; Chen, San-Yue; Huang, Heng-Li; Tsai, Chi-Cheng

2008-05-01

Preparing a continuous tapering conical shape and maintaining the original shape of a canal are obligatory in root canal preparation. The purpose of this study was to compare the shaping performance in simulated curved canal resin blocks of the same novice dental students using hand-prepared and engine-driven nickel-titanium (NiTi) rotary ProTaper instruments in an endodontic laboratory class. Twenty-three fourth-year dental students attending China Medical University Dental School prepared 46 simulated curved canals in resin blocks with two types of NiTi rotary systems: hand and motor ProTaper files. Composite images were prepared for estimation. Material removed, canal width and canal deviation were measured at five levels in the apical 4 mm of the simulated curved canals using AutoCAD 2004 software. Data were analyzed using Wilcoxon's rank-sum test. The hand ProTaper group cut significantly wider than the motor rotary ProTaper group in the outer wall, except for the apical 0 mm point. The total canal width was cut significantly larger in the hand group than in the motor group. There was no significant difference between the two groups in centering canal shape, except at the 3 mm level. These findings show that the novice students prepared the simulated curved canal that deviated more outwardly from apical 1 mm to 4 mm using the hand ProTaper. The ability to maintain the original curvature was better in the motor rotary ProTaper group than in the hand ProTaper group. Undergraduate students, if following the preparation sequence carefully, could successfully perform canal shaping by motor ProTaper files and achieve better root canal geometry than by using hand ProTaper files within the same teaching and practicing sessions.

Micro-computed tomographic analysis of the root canal morphology of the distal root of mandibular first molar.

PubMed

Filpo-Perez, Carolina; Bramante, Clovis Monteiro; Villas-Boas, Marcelo Haas; Húngaro Duarte, Marco Antonio; Versiani, Marco Aurélio; Ordinola-Zapata, Ronald

2015-02-01

The aim of this study was to evaluate the morphologic aspects of the root canal anatomy of the distal root of a mandibular first molar using micro-computed tomographic analysis. One-hundred distal roots of mandibular first molars were scanned using a micro-computed tomographic device at an isotropic resolution of 19.6 μm. The percentage frequency distribution of the morphologic configuration of the root canal was performed according to the Vertucci classification system. Two-dimensional parameters (area, perimeter, roundness, aspect ratio, and major and minor diameters) and the cross-sectional shape of the root canal were analyzed in the apical third at every 1-mm interval from the main apical foramen in roots presenting Vertucci types I and II configurations (n = 79). Data were statistically compared using the Kruskal-Wallis and Dunn tests with a significance level set at 5%. Seventy-six percent of the distal roots had a single root canal. Two, three, and four canals were found in 13%, 8%, and 3% of the sample, respectively. In 13 specimens, the configuration of the root canal did not fit into Vertucci's classification. Overall, 2-dimensional parameter values significantly increased at the 3-mm level (P < .05). The prevalence of oval canals was higher at the 1-mm level and decreased at the 5-mm level in which long oval and flattened canals were more prevalent. The distal roots of the mandibular first molars showed a high prevalence of single root canals. The prevalence of long oval and flattened canals increased in the coronal direction. In 13% of the samples, canal configurations that were not included in Vertucci's configuration system were found. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Shaping ability of NT Engine and McXim rotary nickel-titanium instruments in simulated root canals. Part 2.

PubMed

Thompson, S A; Dummer, P M

1997-07-01

The aim of this laboratory-based study was to determine the shaping ability of NT Engine and McXim nickel-titanium rotary instruments in simulated root canals. A total of 40 canals with four different shapes in terms of angle and position of curve were prepared with NT Engine and McXim instruments, using the technique recommended by the manufacturer. Part 2 of this report describes the efficacy of the instruments in terms of prevalence of canal aberrations, the amount and direction of canal transportation and overall postoperative shape. Pre- and postoperative images of the canals were taken using a video camera attached to a computer with image analysis software. The pre- and postoperative views were superimposed to highlight the amount and position of material removed during preparation. No zips, elbows, perforations or danger zones were created during preparation. Forty-two per cent of canals had ledges on the outer aspect of the curve, the majority of which (16 out of 17) occurred in canals with short acute curves. There were significant differences (P < 0.001) between canal shapes in terms of the incidence of ledges. There were highly significant differences (P < 0.001) between the canal shapes in total canal width at specific points along the canal length and in the amount or resin removed from the inner and outer aspects of the curve. The direction of canal transportation at the end-point of preparation was most frequently towards the outer aspect of the curve, especially in canals with 40 degrees curves. At the beginning of the curve, transportation in the majority of canals was towards the inner aspect of the curve. Mean absolute transportation was less than 0.03 mm throughout the curve and towards the end-point, with significant differences between canal shapes occurring at the apex (P < 0.05) and at the beginning of the curve (P < 0.001). Under the conditions of this study, NT Engine and McXim rotary nickel-titanium instruments created no aberrations other than ledges and produced only minimal transportation. The overall shape of canals was good.

Evaluation of Root Canal Cleaning and Shaping Efficacy of Three Engine-driven Instruments: SafeSider, ProTaper Universal and Lightspeed LSX.

PubMed

Wigler, Ronald; Koren, Tal; Tsesis, Igor

2015-11-01

To compare the cleaning effectiveness and shaping ability of SafeSider, ProTaper Universal and Lightspeed rotary instruments during the preparation of curved root canals in extracted human teeth. A total of 63 roots with curved root canals were divided into three groups. Canals were prepared using SafeSider, ProTaper Universal or Lightspeed LSX. Using pre- and post-instrumentation radiographs, straightening of the canal curvatures and loss of working length were determined with a computer image analysis program. The amounts of debris at the apical 5 mm were quantified on the basis of a numerical evaluation scale. The data were analyzed statistically using the two-way analysis of variance (ANOVA). There was significantly more transportation among the Lightspeed LSX group compared to the SafeSider and ProTaper Universal groups only at the 4 mm level (p < 0.05). The ProTaper Universal instruments performed significantly faster than other groups. No significant differences were observed between the three engine-driven instruments with regards to debris removal. SafeSider, ProTaper Universal and Lightspeed LSX rotary instruments maintained the original canal curvature well at the apical 3 mm and were safe to use. No difference was found in cleaning efficacy and none rendered the apical part of the canal free of debris. SafeSider, ProTaper Universal and Lightspeed LSX rotary instruments are safe to use in curved root canals.

Shaping Ability of Reciproc, UnicOne, and Protaper Universal in Simulated Root Canals

PubMed Central

Matos Maia Filho, Etevaldo; de Castro Rizzi, Cláudia; Bandeca Coelho, Matheus; Freitas Santos, Sara; Mayanne Oliveira Costa, Luzia; Nunes Carvalho, Ceci; Rodolfo de Jesus Tavarez, Rudys; Alves Soares, Janir

2015-01-01

The study aimed to compare the shaping effects, preservation of the original curvature, and transportation of the apical foramen of Reciproc (VDW, Munich, Germany), UnicOne (Medin, Nové Město na Moravě, Czech Republic), and Protaper Universal (Dentsply Maillefer, Ballaigues, Switzerland) in simulated root canals. Thirty resin blocks with simulated curved root canals were distributed into three groups (n = 10), and prepared using Reciproc (RCp), UnicOne (UnO) and the Protaper Universal (PTu). Standardized photographs were taken before and after the instrumentation, after which they were superimposed. Measurements were taken of the quantity of resin removed from the inner and outer walls of the curvature at 6 levels, the curvature angles before and after instrumentation, and the transportation of the apical foramen. RCp obtained the highest values for amount of resin removed from the inner wall while UnO demonstrated similar shaping on both the inner and outer walls. PTu produced the greatest transportation of foramen when compared to the reciprocating instruments. There was no significant difference between the groups in terms of the change in angle (P > 0.05). All the instruments were capable of maintaining the original curvature of the root canal; however, the UnO, which used reciprocating movement, produced more conservative shapes with lower foramen transportation. PMID:25950022

Preparation of the apical part of the root canal by the Lightspeed and step-back techniques.

PubMed

Portenier, I; Lutz, F; Barbakow, F

1998-03-01

This study measured in vitro the displacement of natural canal centres in 18 human teeth before and after shaping by the step-back or Lightspeed techniques. Experimental roots (n = 9 per group), embedded in clear plastic, were cross-sectioned using a 0.1-mm-thick band saw at distances 1.25 mm, 3.25 mm and 5.25 mm from the apices. A stereo microscope was used to take 35 mm slides of the cut surfaces of the sectioned roots and canals. The slides of the uninstrumented canals were scanned into a computer and saved. Each sectioned root was then reassembled and the canals shaped by the step-back or Lightspeed technique. File size 40 and instrument size 50 were selected as the master apical file and master apical rotary for the step-back and Lightspeed groups, respectively. The 18 prepared canals were photographed, and the 35 mm slides scanned and computer stored as previously. This allowed the positions of the pre- and postinstrumented roots to be electronically superimposed for subsequent analyses. Displacements of the root canal centres before and after preparation were assessed in relation to the cross-sectional diameter of the files or instruments used. In addition, increases in cross-sectional area of the root canals after preparation were evaluated in relation to the cross-sectional area of the files or instruments used. Engine-driven nickel-titanium Lightspeed instruments caused significantly less (P < 0.001) displacement of the canal centres, so roots in the Lightspeed group remained better centred than those in the step-back group. The mean cross-sectional area after preparation in the Lightspeed group was significantly less (P < 0.001) than that recorded in the step-back group. Clinically, this implies less apical transportation and less dentine destruction with the Lightspeed technique than with the step-back technique.

Mandibular second molar exhibiting a unique "Y-" and "J-" "shaped" root canal anatomy diagnosed using cone-beam computed tomographic scanning: A case report.

PubMed

Parashar, Saumya-Rajesh; Kowsky, R Dinesh; Natanasabapathy, Velmurugan

2017-01-01

This article aims to report a unique case with aberrant root canal anatomy exhibiting "Y-" and "J"-shaped canal pattern in a mandibular second molar. Anatomic complexities may pose challenges for endodontic treatment. Before performing endodontic treatment, the clinician should be aware of the internal anatomy of the tooth being treated and should recognize anatomic aberrations if present. Presence of unusual anatomy may call for modifications in treatment planning. This report describes in detail about a mandibular second molar tooth associated with two paramolar tubercles having a peculiar "Y-" and "J-"shaped canal anatomy detected with the aid of cone beam computed tomography, which has never been reported in the dental literature. The proposed treatment protocol for the endodontic management of the same has also been discussed.

Shaping ability of NT Engine and McXim rotary nickel-titanium instruments in simulated root canals. Part 1.

PubMed

Thompson, S A; Dummer, P M

1997-07-01

The aim of this study was to determine the shaping ability of NT Engine and McXim nickel-titanium rotary instruments in simulated root canals. In all, 40 canals consisting of four different shapes in terms of angle and position of curvature were prepared by a combination of NT Engine and McXim instruments using the technique recommended by the manufacturer. Part 1 of this two-part report describes the efficacy of the instruments in terms of preparation time, instrument failure, canal blockages, loss of canal length and three-dimensional canal form. Overall, the mean preparation time for all canals was 6.01 min, with canal shape having a significant effect (P < 0.01) on the speed of preparation. One instrument fractured and only four instruments deformed, with most of the failures occurring in canals with curves which began 12 mm from the orifice, that is, in short acute curves. None of the canals became blocked with debris. Following preparation, 20 canals retained their original working length but 19 lost length and one gained in length; there were significant differences (P < 0.05) between the canal shapes in terms of mean loss of distance and in the category of distance change. Apical stops as determined from intracanal impressions were present in 37 of the canals; 16 were judged to be of good quality and 21 of poor quality. The canals were found to be smooth in the apical half of the canal in 33 specimens and in the coronal half of 39 specimens. All canals had good taper characteristics and 35 had good flow characteristics. Under the conditions of this study, NT Engine and McXim instruments prepared canals rapidly, with few deformations, no canal blockages and with minimal change in working length. The three-dimensional form of the canals demonstrated good flow and taper characteristics.

Non-surgical root canal treatment of Dens invaginatus: reports of three cases.

PubMed

Cengiz, Sevi Burcak; Korasli, Deniz; Ziraman, Fatmagul; Orhan, Kaan

2006-02-01

Dens invaginatus is a rare developmental malformation of teeth showing a deep infolding of enamel and dentine which may extend deep into the root. To date, conventional root canal therapy, endodontic surgery and extraction have been reported as treatment modalities, when the pulpo-dentinal complex of such teeth is affected. In the present report, non-surgical endodontic treatment of three maxillary lateral incisors with invaginatus (DI) is discussed. The Tri Auto ZX rotary system was used for shaping the root canals of two affected teeth and the Profile system was used in the third. Teeth with periradicular lesions received calcium hydroxide as an interim therapy. Two teeth were obturated with gutta percha points and AH Plus sealer using cold lateral compaction. In the third case, obturation was accomplished using a coated carrier system (Thermafil) due to the specific shape of the root canal system. Twelve months postoperatively all teeth were asymptomatic with resolution of the periapical radiolucency on two affected teeth, as confirmed radiographically. Healing was achieved without any need for further surgical intervention.

Variable permanent mandibular first molar: Review of literature

PubMed Central

Ballullaya, Srinidhi V; Vemuri, Sayesh; Kumar, Pabbati Ravi

2013-01-01

Introduction: The success of root canal therapy depends on the locations of all the canals, thourough debridement and proper sealing. At times the clinicians are challenged with variations in morphology of root canal. This review article attempts to list out all the variations of permanent mandibular first molar published so for in the literature. Materials and Methods: An exhaustive search was undertaken using PUBMED database to identify published literature from 1900 to 2010 relating to the root canal morphology of permanent first molar by using key words. The selected artcles were obtained and reviewed. Results: Total ninty seven articles were selected out of which 50 were original article and forty seven were case reports. The incidence of third canal in mesial root was 0.95% to 15%. The incidence of three rooted mandibular first molar was 3% to 33%. Only ninety cases reported with c-shape canal configuration. Incidence of Taurodintism without congenital disorder was very rare. Conclusion: The root canal treatment requires proper knowlegde of variations in root canal morphology in order to recognise, disinfect and seal all portal of exit. This can be accomplished with proper diagnosis using newer modes, modification in access preparation, use of operating microscope, enhanced methods of disinfecting and sealing of all canals. PMID:23716959

Comparison of air-driven vs electric torque control motors on canal centering ability by ProTaper NiTi rotary instruments.

PubMed

Zarei, Mina; Javidi, Maryam; Erfanian, Mahdi; Lomee, Mahdi; Afkhami, Farzaneh

2013-01-01

Cleaning and shaping is one of the most important phases in root canal therapy. Various rotary NiTi systems minimize accidents and facilitate the shaping process. Todays NiTi files are used with air-driven and electric handpieces. This study compared the canal centering after instrumentation using the ProTaper system using Endo IT, electric torque-control motor, and NSK air-driven handpiece. This ex vivo randomized controlled trial study involved 26 mesial mandibular root canals with 10 to 35° curvature. The roots were randomly divided into 2 groups of 13 canals each. The roots were mounted in an endodontic cube with acrylic resin, sectioned horizontally at 2, 6 and 10 mm from the apex and then reassembled. The canals were instrumented according to the manufacturer's instructions using ProTaper rotary files and electric torque-control motors (group 1) or air-driven handpieces (group 2). Photographs of the cross-sections included shots before and after instrumentation, and image analysis was performed using Photoshop software. The centering ability and canal transportation was also evaluated. Repeated measurement and independent t-test provided statistical analysis of canal transportation. The comparison of the rate of transportation toward internal or external walls between the two groups was not statistically significant (p = 0.62). Comparison of the rate of transportation of sections within one group was not significant (p = 0.28). Use of rotary NiTi file with either electric torquecontrol motor or air-driven handpiece had no effect on canal centering. NiTi rotary instruments can be used with air-driven motors without any considerable changes in root canal anatomy, however it needs the clinician to be expert.

Evaluation of bond strength of various epoxy resin based sealers in oval shaped root canals.

PubMed

Cakici, Fatih; Cakici, Elif Bahar; Ceyhanli, Kadir Tolga; Celik, Ersan; Kucukekenci, Funda Fundaoglu; Gunseren, Arif Onur

2016-09-30

The aim of this study was to evaluate the bond strength of AH plus, Acroseal, and Adseal to the root canal dentin. A total of 36 single-rooted, mandibular premolar teeth were used. Root canal shaping procedures were performed with ProTaper rotary instruments (Dentsply Maillefer) up to size F4. The prepared samples were then randomly assembled into 3 groups (n = 12). For each group, an ultrasonic tip (size 15, 0.02 taper) which was also coated with an epoxy resin based sealer and placed 2 mm shorter than the working length. The sealer was then activated for 10 s. A push-out test was used to measure the bond strength between the root canal dentine and the sealer. Kruskal-Wallis test to evaluate the push-out bond strength of epoxy based sealer (P = 0.05). The failure mode data were statistically analyzed using Pearson's chi square test (P = 0.05). Kruskal-Wallis test indicated that there were no statistically significant difference among the push out bond strength values of 3 mm (p = 0.123) and 6 mm (P = 0.057) for groups, there was statistically significant difference push out bond strength value of 9 mm (P = 0.032). Pearson's chi square test showed statistically significant differences for the failure types among the groups. Various epoxy resin based sealers activated ultrasonically showed similar bond strength in oval shaped root canals. Apical sections for all groups have higher push out bond strength values than middle and coronal sections.

The incidence of root microcracks caused by 3 different single-file systems versus the ProTaper system.

PubMed

Liu, Rui; Hou, Ben Xiang; Wesselink, Paul R; Wu, Min-Kai; Shemesh, Hagay

2013-08-01

The aim of this study was to compare the incidence of root cracks observed at the apical root surface and/or in the canal wall after canal instrumentation with 3 single-file systems and the ProTaper system (Dentsply Maillefer, Ballaigues, Switzerland). One hundred mandibular incisors were selected. Twenty control teeth were coronally flared with Gates-Glidden drills (Dentsply Maillefer). No further preparation was made. The other 80 teeth were mounted in resin blocks with simulated periodontal ligaments, and the apex was exposed. They were divided into 4 experimental groups (n = 20); the root canals were first coronally flared with Gates-Glidden drills and then instrumented to the full working length with the ProTaper, OneShape (Micro-Mega, Besancon, France), Reciproc (VDW, Munich, Germany), or the Self-Adjusting File (ReDent-Nova, Ra'anana, Israel). The apical root surface and horizontal sections 2, 4, and 6 mm from the apex were observed under a microscope. The presence of cracks was noted. The chi-square test was performed to compare the appearance of cracked roots between the experimental groups. No cracks were found in the control teeth and teeth instrumented with the Self-Adjusting File. Cracks were found in 10 of 20 (50%), 7 of 20 (35%), and 1 of 20 (5%) teeth after canal instrumentation with the ProTaper, OneShape, and Reciproc files, respectively. The difference between the experimental groups was statistically significant (P < .001). Nickel-titanium instruments may cause cracks on the apical root surface or in the canal wall; the Self-Adjusting File and Reciproc files caused less cracks than the ProTaper and OneShape files. Copyright © 2013 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Visualization of irrigant flow and cavitation induced by Er:YAG laser within a root canal model.

PubMed

Matsumoto, Himeka; Yoshimine, Yoshito; Akamine, Akifumi

2011-06-01

Laser-activated irrigation (LAI) has recently been introduced as an innovative method for root canal irrigation. However, there is limited information about the cleaning mechanism of an Er:YAG laser. In this study, we visualized the action of laser-induced bubbles and fluid flow in vitro to better understand the physical mechanisms underlying LAI. An Er:YAG laser was equipped with a novel cone-shaped tip with a lateral emission rate of approximately 80%. Laser light was emitted at a pulse energy of 30, 50, or 70 mJ (output energy: 11, 18, or 26 mJ) and a repetition rate of 1 or 20 pulses per second, without air or water spray. Fluid flow dynamics in a root canal model were observed by using glass-bead tracers under a high-speed camera. Moreover, laser-induced bubble patterns were visualized in both free water and the root canal model. Tracers revealed high-speed motion of the fluid. A full cycle of expansion and implosion of vapor and secondary cavitation bubbles were clearly observed. In free water, the vapor bubble expanded for 220 microseconds, and its shape resembled that of an apple. In the root canal model, the vapor bubble expanded in a vertical direction along the canal wall, and bubble expansion continued for ≥700 microseconds. Furthermore, cavitation bubbles were created much more frequently in the canal model than in free water. These results suggest that the cleaning mechanism of an Er:YAG laser within the root canal might depend on rapid fluid motion caused by expansion and implosion of laser-induced bubbles. Copyright © 2011 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Torsional Performance of ProTaper Gold Rotary Instruments during Shaping of Small Root Canals after 2 Different Glide Path Preparations.

PubMed

Arias, Ana; de Vasconcelos, Rafaela Andrade; Hernández, Alexis; Peters, Ove A

2017-03-01

The purpose of this study was to assess the ex vivo torsional performance of a novel rotary system in small root canals after 2 different glide path preparations. Each independent canal of 8 mesial roots of mandibular molars was randomly assigned to achieve a reproducible glide path with a new set of either PathFile #1 (Dentsply Maillefer, Ballaigues, Switzerland) and #2 or ProGlider (Dentsply Maillefer) after negotiation with a 10 K-file. After glide path preparation, root canals in both groups were shaped with the same sequence of ProTaper Gold (Dentsply Tulsa Dental Specialties, Tulsa, OK) following the directions for use recommended by the manufacturer. A total of 16 new sets of each instrument of the ProTaper Gold (PTG) system were used. The tests were run in a standardized fashion in a torque-testing platform. Peak torque (Ncm) and force (N) were registered during the shaping procedure and compared with Student t tests after normal distribution of data was confirmed. No significant differences were found for any of the instruments in peak torque or force after the 2 different glide path preparations (P > .05). Data presented in this study also serve as a basis for the recommended torque for the use of PTG instruments. Under the conditions of this study, differences in the torsional performance of PTG rotary instruments after 2 different glide path preparations could not be shown. The different geometry of glide path rotary systems seemed to have no effect on peak torque and force induced by PTG rotary instruments when shaping small root canals in extracted teeth. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Wear of the Primary WaveOne single file when shaping vestibular root canals of first maxillary molar

PubMed Central

Borie, Eduardo; Betancourt, Pablo; Aracena, Angella; Guzmán, Mario

2017-01-01

Background It is very important for a clinician to know the increased wear of mechanized files when establishing endodontic therapy. The aim of this study was to check the wear of the Primary WaveOne file upon shaping two, four and six maxillary molar vestibular canals. Material and Methods The deterioration of 40 files, divided into four groups, was evaluated microscopically: group 1, control (unused); group 2, two canals; group 3, four canals; and group 4, six canals. After instrumentation, the files were embedded in resin and sectioned at their apical third into three equal parts. To analyze the wear of edges in the different sections, AutoCAD software was used and analysis of variance (ANOVA) was then performed to compare the mean rake angles. Results The files with two and four uses showed slight wear, whereas those with six applications showed significant wear (p<0.05). Conclusions Primary WaveOne files can be used in up to four root canals without their edges losing effectiveness. Key words:Files wear, reciprocating motion, shaping capacity, WaveOne. PMID:28298976

Wear of the Primary WaveOne single file when shaping vestibular root canals of first maxillary molar.

PubMed

Aracena, Daniel; Borie, Eduardo; Betancourt, Pablo; Aracena, Angella; Guzmán, Mario

2017-03-01

It is very important for a clinician to know the increased wear of mechanized files when establishing endodontic therapy. The aim of this study was to check the wear of the Primary WaveOne file upon shaping two, four and six maxillary molar vestibular canals. The deterioration of 40 files, divided into four groups, was evaluated microscopically: group 1, control (unused); group 2, two canals; group 3, four canals; and group 4, six canals. After instrumentation, the files were embedded in resin and sectioned at their apical third into three equal parts. To analyze the wear of edges in the different sections, AutoCAD software was used and analysis of variance (ANOVA) was then performed to compare the mean rake angles. The files with two and four uses showed slight wear, whereas those with six applications showed significant wear ( p <0.05). Primary WaveOne files can be used in up to four root canals without their edges losing effectiveness. Key words: Files wear, reciprocating motion, shaping capacity, WaveOne.

External and internal macromorphology in 3D-reconstructed maxillary molars using computerized X-ray microtomography.

PubMed

Bjørndal, L; Carlsen, O; Thuesen, G; Darvann, T; Kreiborg, S

1999-01-01

The aim of this study was to perform a qualitative analysis of the relationship between the external and internal macromorphology of the root complex and to use fractal dimension analysis to determine the correlation between the shape of the outer surface of the root and the shape of the root canal. On the basis of X-ray computed transaxial microtomography, a qualitative and quantitative analysis of the external and internal macromorphology of the root complex in permanent maxillary molars was performed using well-defined macromorphological variables and fractal dimension analysis. Five maxillary molars were placed between a microfocus X-ray tube with a focal spot size of 0.07 mm, a Thomson-SCF image intensifier, and a CCD camera compromising a detector for the tomograph. Between 100 and 240 tomographic 2D slices were made of each tooth. Assembling slices for 3D volume was carried out with subsequent median noise filtering. Segmentation into enamel, dentine and pulp space was achieved through thresholding followed by morphological filtering. Surface representations were then constructed. A useful visualization of the tooth was created by making the dental hard tissues transparent and the pulp chamber and root-canal system opaque. On this basis it became possible to assess the relationship between the external and internal macromorphology of the crown and root complex. There was strong agreement between the number, position and cross-section of the root canals and the number, position and degree of manifestation of the root complex macrostructures. Data from a fractal dimension analysis also showed a high correlation between the shape of the root canals and the corresponding roots. It is suggested that these types of 3D volumes constitute a platform for preclinical training in fundamental endodontic procedures.

Microtomography-based comparison of reciprocating single-file F2 ProTaper technique versus rotary full sequence.

PubMed

Paqué, Frank; Zehnder, Matthias; De-Deus, Gustavo

2011-10-01

A preparation technique with only 1 single instrument was proposed on the basis of the reciprocating movement of the F2 ProTaper instrument. The present study was designed to quantitatively assess canal preparation outcomes achieved by this technique. Twenty-five extracted human mandibular first molars with 2 separate mesial root canals were selected. Canals were randomly assigned to 1 of the 2 experimental groups: group 1, rotary conventional preparation by using ProTaper, and group 2, reciprocate instrumentation with 1 single ProTaper F2 instrument. Specimens were scanned initially and after root canal preparation with an isotropic resolution of 20 μm by using a micro-computed tomography system. The following parameters were assessed: changes in dentin volume, percentage of shaped canal walls, and degree of canal transportation. In addition, the time required to reach working length with the F2 instrument was recorded. Preoperatively, there were no differences regarding root canal curvature and volume between experimental groups. Overall, instrumentation led to enlarged canal shapes with no evidence of preparation errors. There were no statistical differences between the 2 preparation techniques in the anatomical parameters assessed (P > .01), except for a significantly higher canal transportation caused by the reciprocating file in the coronal canal third. On the other hand, preparation was faster by using the single-file technique (P < .01). Shaping outcomes with the single-file F2 ProTaper technique and conventional ProTaper full-sequence rotary approach were similar. However, the single-file F2 ProTaper technique was markedly faster in reaching working length. Copyright © 2011 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Debris Evaluation after Root Canal Shaping with Rotating and Reciprocating Single-File Systems

PubMed Central

Dagna, Alberto; Gastaldo, Giulia; Beltrami, Riccardo; Poggio, Claudio

2016-01-01

This study evaluated the root canal dentine surface by scanning electron microscope (SEM) after shaping with two reciprocating single-file NiTi systems and two rotating single-file NiTi systems, in order to verify the presence/absence of the smear layer and the presence/absence of open tubules along the walls of each sample; Forty-eight single-rooted teeth were divided into four groups and shaped with OneShape (OS), F6 SkyTaper (F6), WaveOne (WO) and Reciproc and irrigated using 5.25% NaOCl and 17% EDTA. Root canal walls were analyzed by SEM at a standard magnification of 2500×. The presence/absence of the smear layer and the presence/absence of open tubules at the coronal, middle, and apical third of each canal were estimated using a five-step scale for scores. Numeric data were analyzed using Kruskal-Wallis and Mann-Whitney U statistical tests and significance was predetermined at P < 0.05; The Kruskal-Wallis ANOVA for debris score showed significant differences among the NiTi systems (P < 0.05). The Mann-Whitney test confirmed that reciprocating systems presented significantly higher score values than rotating files. The same results were assessed considering the smear layer scores. ANOVA confirmed that the apical third of the canal maintained a higher quantity of debris and smear layer after preparation of all the samples; Single-use NiTi systems used in continuous rotation appeared to be more effective than reciprocating instruments in leaving clean walls. The reciprocating systems produced more debris and smear layer than rotating instruments. PMID:27763503

Canal Transportation and Centering Ability of ProTaper and SafeSider in Preparation of Curved Root Canals: A CBCT Evaluation

PubMed Central

Delgoshayi, Negar; Abbasi, Mansoure; Bakhtiar, Hengameh; Sakhdari, Shirin; Ghannad, Setareh; Ellini, Mohammad Reza

2018-01-01

Introduction: Maintaining the original central canal path is an important parameter in efficient root canal preparation. Instruments causing minimal changes in original canal path are preferred for this purpose. This study sought to compare canal transportation and centering ability of ProTaper and SafeSider instruments in curved mesiobuccal root canals of mandibular first molars using cone beam computed tomography (CBCT). Methods and Materials : In this experimental study, 30 mesiobuccal root canals of extracted human mandibular first molars with 20° to 40° curvature were randomly divided into two groups (n=15). After mounting in putty, preoperative CBCT scans were obtained of teeth. Root canals in group A were shaped using S1, S2, F1 and F2 of ProTaper system. Root canals in group B were instrumented to size 25 using SafeSider system according to the manufacturers’ instructions. Postoperative CBCT scans were then obtained. The distance between the external root surface and internal canal wall was measured at the mesial and distal at 1, 3 and 7 mm from the apex. The values measured on primary and secondary CBCT scans were compared to assess possible changes in original central canal path and canal transportation. Data were compared using the t-test and repeated measure ANOVA. Results: ProTaper and SafeSider were significantly different in terms of canal transportation and centering ability, and ProTaper was significantly superior to SafeSider in this respect (P<0.001). Conclusion: ProTaper (in contrast to SafeSider) is well capable of maintaining the original central canal path with the least amount of transportation. PMID:29707022

Root-canal shaping with manual and rotary Ni-Ti files performed by students.

PubMed

Sonntag, D; Delschen, S; Stachniss, V

2003-11-01

To investigate root-canal shaping with manual and rotary Ni-Ti files performed by students. Thirty undergraduate dental students prepared 150 simulated curved root canals in resin blocks with manual Ni-Ti files with a stepback technique and 450 simulated curved canals with rotary Ni-Ti files with a crowndown technique. Incidence of fracture, preparation length, canal shape and preparation time were investigated. Questionnaires were then issued to the students for them to note their experience of the two preparation methods. Zips and elbows occurred significantly (P < 0.001) less frequently with rotary than with manual preparation. The correct preparation length was achieved significantly (P < 0.05) more often with rotary files than with manual files. Instrument fractures were recorded in only 1.3% of cases with both rotary and manual preparation. The mean time required for manual preparation was significantly (P < 0.001) longer than that required for rotary preparation. Prior experience with a hand preparation technique was not reflected in an improved quality of the subsequent rotary preparation. Approximately 83% of the students claimed to have a greater sense of security in rotary than in manual preparation. Overall 50% felt that manual and engine-driven preparation should be given equal status in undergraduate dental education. Inexperienced operators achieved better canal preparations with rotary instruments than with manual files. No difference in fracture rate was recorded between the two systems.

Debris remaining in the apical third of root canals after chemomechanical preparation by using sodium hypochlorite and glyde: an in vivo study.

PubMed

Cruz, Alvaro; Vera, Jorge; Gascón, Gerardo; Palafox-Sánchez, Claudia A; Amezcua, Octavio; Mercado, Gabriela

2014-09-01

During chemomechanical instrumentation, several liquid or paste substances are used to ease the action of the files and to eliminate debris and the smear layer. The aim of this study was to evaluate whether the use of a paste containing EDTA during cleaning and shaping of the root canal helps to eliminate debris. Twenty root canals in dog teeth were instrumented by a crown-down technique by using nickel-titanium rotary files. In 10 root canals (group A), sodium hypochlorite was used during instrumentation, followed by a final irrigation with 17% liquid EDTA. In another 10 canals (group B), sodium hypochlorite was again used as the irrigating solution, but Glyde File Prep paste was used with every instrument, and a final irrigation with EDTA was also carried out. Two additional teeth were used as positive and 2 as negative controls. The jaws were prepared for histologic evaluation. In group A where Glyde was not used during cleaning and shaping, little or no debris was found in the apical third of the instrumented root canals; however; in group B in which Glyde File Prep paste was used during chemomechanical instrumentation, moderate to high accumulation of debris was observed in the apical third. The use of Glyde File Prep paste during rotary mechanical instrumentation favors the accumulation of debris in the apical third of the root canals. Irrigation with NaOCl and a final flush with EDTA by means of a small-gauge needle with simultaneous aspiration led to less accumulation of debris than in the Glyde File Prep group (P < .05). Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Root canal volume change and transportation by Vortex Blue, ProTaper Next, and ProTaper Universal in curved root canals

PubMed Central

2018-01-01

Objectives The aim of this study was to compare root canal volume change and canal transportation by Vortex Blue (VB; Dentsply Tulsa Dental Specialties), ProTaper Next (PTN; Dentsply Maillefer), and ProTaper Universal (PTU; Dentsply Maillefer) nickel-titanium rotary files in curved root canals. Materials and Methods Thirty canals with 20°–45° of curvature from extracted human molars were used. Root canal instrumentation was performed with VB, PTN, and PTU files up to #30.06, X3, and F3, respectively. Changes in root canal volume before and after the instrumentation, and the amount and direction of canal transportation at 1, 3, and 5 mm from the root apex were measured by using micro-computed tomography. Data of canal volume change were statistically analyzed using one-way analysis of variance and Tukey test, while data of amount and direction of transportation were analyzed using Kruskal-Wallis and Mann-Whitney U test. Results There were no significant differences among 3 groups in terms of canal volume change (p > 0.05). For the amount of transportation, PTN showed significantly less transportation than PTU at 3 mm level (p = 0.005). VB files showed no significant difference in canal transportation at all 3 levels with either PTN or PTU files. Also, VB files showed unique inward transportation tendency in the apical area. Conclusions Other than PTN produced less amount of transportation than PTU at 3 mm level, all 3 file systems showed similar level of canal volume change and transportation, and VB file system could prepare the curved canals without significant shaping errors. PMID:29487834

Centering Ability of ProTaper Next and WaveOne Classic in J-Shape Simulated Root Canals

PubMed Central

Dioguardi, Mario; Cocco, Armando; Giuliani, Michele; Fabiani, Cristiano; D'Alessandro, Alfonso; Ciavarella, Domenico

2016-01-01

Introduction. The aim of this study was to evaluate and compare the shaping and centering ability of ProTaper Next (PTN; Dentsply Maillefer, Ballaigues, Switzerland) and WaveOne Classic systems (Dentsply Maillefer) in simulated root canals. Methods. Forty J-shaped canals in resin blocks were assigned to two groups (n = 20 for each group). Photographic method was used to record pre- and postinstrumentation images. After superimposition, centering and shaping ability were recorded at 9 different levels from the apex using the software Autocad 2013 (Autodesk Inc., San Rafael, USA). Results. Shaping procedures with ProTaper Next resulted in a lower amount of resin removed at each reference point level. In addition, the pattern of centering ability improved after the use of ProTaper Next in 8 of 9 measurement points. Conclusions. Within the limitations of this study, shaping procedures with ProTaper Next instruments demonstrated a lower amount of resin removed and a better centering ability than WaveOne Classic system. PMID:28054031

Centering Ability of ProTaper Next and WaveOne Classic in J-Shape Simulated Root Canals.

PubMed

Troiano, Giuseppe; Dioguardi, Mario; Cocco, Armando; Giuliani, Michele; Fabiani, Cristiano; D'Alessandro, Alfonso; Ciavarella, Domenico; Lo Muzio, Lorenzo

Introduction . The aim of this study was to evaluate and compare the shaping and centering ability of ProTaper Next (PTN; Dentsply Maillefer, Ballaigues, Switzerland) and WaveOne Classic systems (Dentsply Maillefer) in simulated root canals. Methods . Forty J-shaped canals in resin blocks were assigned to two groups ( n = 20 for each group). Photographic method was used to record pre- and postinstrumentation images. After superimposition, centering and shaping ability were recorded at 9 different levels from the apex using the software Autocad 2013 (Autodesk Inc., San Rafael, USA). Results . Shaping procedures with ProTaper Next resulted in a lower amount of resin removed at each reference point level. In addition, the pattern of centering ability improved after the use of ProTaper Next in 8 of 9 measurement points. Conclusions . Within the limitations of this study, shaping procedures with ProTaper Next instruments demonstrated a lower amount of resin removed and a better centering ability than WaveOne Classic system.

Engine-driven preparation of curved root canals: measuring cyclic fatigue and other physical parameters.

PubMed

Peters, Ove A; Kappeler, Stefan; Bucher, Willi; Barbakow, Fred

2002-04-01

An increasing number of engine-driven rotary systems are marketed to shape root canals. Although these systems may improve the quality of canal preparations, the risk for instrument fracture is also increased. Unfortunately, the stresses generated in rotary instruments when shaping curved root canals have not been adequately studied. Consequently, the aim of an ongoing project was to develop a measurement platform that could more accurately detail physical parameters generated in a simulated clinical situation. Such a platform was constructed by fitting a torque-measuring device between the rotating endodontic instrument and the motor driving it. Apically directed force and instrument insertion depth were also recorded. Additional devices were constructed to assess cyclic fatigue and static fracture loads. The current pilot study evaluated GT rotary instruments during the shaping of curved canals in plastic blocks as well as "ISO 3630-1 torque to fracture" and number of rotations required for fatigue fracture. Results indicated that torques in excess of 40 Nmm were generated by rotary GT-Files, a significantly higher figure than static fracture loads (less than 13 Nmm for the size 20. 12 GT-File). Furthermore, the number of rotations needed to shape simulated canals with a 5 mm radius of curvature in plastic blocks was 10 times lower than the number of rotations needed to fracture instruments in a "cyclic fatigue test". Apical forces were always greater than 1 N, and in some specimens, scores of 8 N or more were recorded. Further studies are required using extracted natural teeth, with their wide anatomical variation, in order to reduce the incidence of fracture of rotary instruments. In this way, the clinical potential of engine-driven rotary instruments to safely prepare curved canals can be fully appreciated.

Quality aspects of ex vivo root canal treatments done by undergraduate dental students using four different endodontic treatment systems.

PubMed

Jungnickel, Luise; Kruse, Casper; Vaeth, Michael; Kirkevang, Lise-Lotte

2018-04-01

To evaluate factors associated with treatment quality of ex vivo root canal treatments performed by undergraduate dental students using different endodontic treatment systems. Four students performed root canal treatment on 80 extracted human teeth using four endodontic treatment systems in designated treatment order following a Latin square design. Lateral seal and length of root canal fillings was radiographically assessed; for lateral seal, a graded visual scale was used. Treatment time was measured separately for access preparation, biomechanical root canal preparation, obturation and for the total procedure. Mishaps were registered. An ANOVA mirroring the Latin square design was performed. Use of machine-driven nickel-titanium systems resulted in overall better quality scores for lateral seal than use of the manual stainless-steel system. Among systems with machine-driven files, scores did not significantly differ. Use of machine-driven instruments resulted in shorter treatment time than manual instrumentation. Machine-driven systems with few files achieved shorter treatment times. With increasing number of treatments, root canal-filling quality increased, treatment time decreased; a learning curve was plotted. No root canal shaping file separated. The use of endodontic treatment systems with machine-driven files led to higher quality lateral seal compared to the manual system. The three contemporary machine-driven systems delivered comparable results regarding quality of root canal fillings; they were safe to use and provided a more efficient workflow than the manual technique. Increasing experience had a positive impact on the quality of root canal fillings while treatment time decreased.

CRITICAL ANALYSIS OF ARTIFICIAL TEETH FOR ENDODONTIC TEACHING

PubMed Central

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

2008-01-01

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

Shaping ability and safety of five different rotary nickel-titanium instruments compared with stainless steel hand instrumentation in simulated curved root canals.

PubMed

Schirrmeister, Jörg F; Strohl, Christian; Altenburger, Markus J; Wrbas, Karl-Thomas; Hellwig, Elmar

2006-06-01

To compare the shaping ability and safety of engine-driven FlexMaster, GT Rotary, ProFile, ProTaper, and RaCe rotary instrumentation and Hedström hand instrumentation in simulated root canals. One hundred fifty simulated colored root canals with a curvature of 20 degrees and a radius of 10 mm were randomly distributed among 6 groups of 25 specimens each. After preparation to apical size 30 the area of remaining color on the canal wall indicating unprepared areas was measured in mm2 using image analyzer software. Specimens treated with RaCe left least areas of remaining color compared to all other groups (P < .001), followed by ProTaper. Preparation with ProFile left behind the highest amount of unprepared areas. The ProFile group revealed significantly more remaining color than ProTaper, GT Rotary, and FlexMaster (P < .05). Four FlexMaster files separated. RaCe rotary files were safe and more effective compared to the other instruments.

Critical analysis of artificial teeth for endodontic teaching.

PubMed

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

2008-01-01

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

In vitro evaluation of efficacy of different rotary instrument systems for gutta percha removal during root canal retreatment

PubMed Central

Joseph, Mercy; Malhotra, Amit; Rao, Murali; Sharma, Abhimanyu; Talwar, Sangeeta

2016-01-01

Background Complete removal of old filling material during root canal retreatment is fundamental for predictable cleaning and shaping of canal anatomy. Most of the retreatment methods tested in earlier studies have shown inability to achieve complete removal of root canal filling. Therefore the aim of this investigation was to assess the efficacy of three different rotary nickel titanium retreatment systems and Hedstrom files in removing filling material from root canals. Material and Methods Sixty extracted mandibular premolars were decoronated to leave 15 mm root. Specimen were hand instrumented and obturated using gutta percha and AH plus root canal sealer. After storage period of two weeks, roots were retreated with three (Protaper retreatment files, Mtwo retreatment files, NRT GPR) rotary retreatment instrument systems and Hedstroem files. Subsequently, samples were sectioned longitudinally and examined under stereomicroscope. Digital images were recorded and evaluated using Digital Image Analysing Software. The retreatment time was recorded for each tooth using a stopwatch. The area of canal and the residual filling material was recorded in mm2 and the percentage of remaining filling material on canal walls was calculated. Data was analysed using ANOVA test. Results Significantly less amount of residual filling material was present in protaper and Mtwo instrumented teeth (p < 0.05) compared to NRT GPR and Hedstrom files group. Protaper instruments also required lesser time during removal of filling material followed by Mtwo instruments, NRT GPR files and Hedstrom files. Conclusions None of the instruments were able to remove the filling material completely from root canal. Protaper universal retreatment system and Mtwo retreatment files were more efficient and faster compared to NRT GPR fles and Hedstrom files. Key words:Gutta-percha removal, nickel titanium, root canal retreatment, rotary instruments. PMID:27703601

Analysis of the internal anatomy of maxillary first molars by using different methods.

PubMed

Baratto Filho, Flares; Zaitter, Suellen; Haragushiku, Gisele Aihara; de Campos, Edson Alves; Abuabara, Allan; Correr, Gisele Maria

2009-03-01

The success of endodontic treatment depends on the identification of all root canals so that they can be cleaned, shaped, and obturated. This study investigated internal morphology of maxillary first molars by 3 different methods: ex vivo, clinical, and cone beam computed tomography (CBCT) analysis. In all these different methods, the number of additional root canals and their locations, the number of foramina, and the frequency of canals that could or could not be negotiated were recorded. In the ex vivo study, 140 extracted maxillary first molars were evaluated. After canals were accessed and detected by using an operating microscope, the teeth with significant anatomic variances were cleared. In the clinical analysis, the records of 291 patients who had undergone endodontic treatment in a dental school during a 2-year period were used. In the CBCT analysis, 54 maxillary first molars were evaluated. The ex vivo assessment results showed a fourth canal frequency in 67.14% of the teeth, besides a tooth with 7 root canals (0.72%). Additional root canals were located in the mesiobuccal root in 92.85% of the teeth (17.35% could not be negotiated), and when they were present, 65.30% exhibited 1 foramen. Clinical assessment showed that 53.26%, 0.35%, and 0.35% of the teeth exhibited 4, 5, and 6 root canals, respectively. Additional root canals were located in this assessment in mesiobuccal root in 95.63% (27.50% could not be negotiated), and when they were present, 59.38% exhibited 1 foramen. CBCT results showed 2, 4, and 5 root canals in 1.85%, 37.05%, and 1.85% of the teeth, respectively. When present, additional canals showed 1 foramen in 90.90% of the teeth studied. This study demonstrated that operating microscope and CBCT have been important for locating and identifying root canals, and CBCT can be used as a good method for initial identification of maxillary first molar internal morphology.

[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.

Endodontic Management of the Three-Rooted Mandibular First Permanent Molar: a Case Report.

PubMed

Štamfelj, Iztok

2014-09-01

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.

Prevalence of C-shaped canals in mandibular second and third molars in a central India population: A cone beam computed tomography analysis.

PubMed

Wadhwani, Shefali; Singh, Mahesh Pratap; Agarwal, Manish; Somasundaram, Pavithra; Rawtiya, Manjusha; Wadhwani, P K

2017-01-01

To evaluate the prevalence of C-shaped root canals in mandibular molars using cone beam computed tomography (CBCT) in a subpopulation of Central India. CBCT scans of patients from diagnostic imaging center were selected in accordance with the criteria given by Fan et al . (2004) for C-shaped canals. A total of 238 CBCT scans fulfilled the inclusion criteria and thereby divided into two groups: Group 1: Images showing C-shaped canal configuration in mandibular second molars. Group 2: Images showing C-shaped canal configuration in mandibular third molars. The frequency and distribution of canals and their configuration along with the position of lingual/buccal grooves in the images were evaluated, and the data was analyzed. CBCT evaluation showed that 9.7% of second molars and 8% of third molars had C-shaped canals. A prominent buccal groove was seen in these teeth. The data showed a significant difference ( P = 0.038) for the presence of such anatomy on the right side for mandibular third molars. The study showed a significant prevalence of C-shaped canal configuration in the subpopulation studied.

Prevalence of C-shaped canals in mandibular second and third molars in a central India population: A cone beam computed tomography analysis

PubMed Central

Wadhwani, Shefali; Singh, Mahesh Pratap; Agarwal, Manish; Somasundaram, Pavithra; Rawtiya, Manjusha; Wadhwani, P. K.

2017-01-01

Introduction: To evaluate the prevalence of C-shaped root canals in mandibular molars using cone beam computed tomography (CBCT) in a subpopulation of Central India. Materials and Methods: CBCT scans of patients from diagnostic imaging center were selected in accordance with the criteria given by Fan et al. (2004) for C-shaped canals. A total of 238 CBCT scans fulfilled the inclusion criteria and thereby divided into two groups: Group 1: Images showing C-shaped canal configuration in mandibular second molars. Group 2: Images showing C-shaped canal configuration in mandibular third molars. The frequency and distribution of canals and their configuration along with the position of lingual/buccal grooves in the images were evaluated, and the data was analyzed. Results: CBCT evaluation showed that 9.7% of second molars and 8% of third molars had C-shaped canals. A prominent buccal groove was seen in these teeth. The data showed a significant difference (P = 0.038) for the presence of such anatomy on the right side for mandibular third molars. Conclusion: The study showed a significant prevalence of C-shaped canal configuration in the subpopulation studied. PMID:29386785

Sterilization of root canal spaces using an Nd:YAG laser, in vitro

NASA Astrophysics Data System (ADS)

Goodis, Harold E.; White, Joel M.; Yee, Barbara; Marshall, Sally J.; Marshall, Grayson W.

1995-05-01

A smear layer is created during the cleaning and shaping of root canal systems. The Nd:YAG laser has been shown to be effective in removing that smear layer and any tissue remnants from prepared root canal systems suggesting that it may aid in root canal sterilization without detrimental thermal effects to adjacent tissues. The root canal system of 72 single-rooted teeth was conventionally prepared and sterilized using gamma radiation. The teeth were divided into three groups of 24 each, 8 of which were inoculated only with sterile broth and remained as negative controls. Sixteen teeth of each group were inoculated with one of three organisms of 106 to 1010 CFU/(mu) l: B subtilis (BS), E. coli (EC) and S. marcescens (SM) (10 (mu) l). Eight in each group were not treated further and served as positive controls. Sixteen test teeth were treated with the laser three times using each exposure parameter: 1 W, 10 Hz pulses per second (pps); 2 W, 20 Hz; and 3 W, 30 Hz inserted to the radiographic apex. Laser exposures were completed while withdrawing the fiber from the root canal system. At completion of laser exposure, all teeth were cultured, using sterile paper points and plated on brain heat infusion agar. Three cultures were taken for each tooth, the plates incubated for 72 hours, and read for the presence of growth of colony-forming units. The laser was able to reduce the number of organisms placed in root canal systems, and suggests that the laser may be used in root canal therapy for bacterial reduction and cleaning of the root canal space.

Effect of root canal treatment procedures with a novel rotary nickel titanium instrument (TRUShape) on stress in mandibular molars: a comparative finite element analysis.

PubMed

Bonessio, Noemi; Arias, Ana; Lomiento, Guiseppe; Peters, Ove A

2017-01-01

The aim of this study was to investigate and compare, via finite element analysis (FEA), the effects of endodontic access and canal preparation on stress distribution under functional loading of a mandibular molar treated with novel (TRUShape) and conventional (Vortex) rotary root canal preparation instruments. Identical plastic mandibular molars with natural anatomy had all 4 canals shaped with either TRUShape or a conventional rotary, Vortex (#20 and #30, both by Dentsply Tulsa Dental). Finite element analysis was used to evaluate stress distribution in untreated and treated models. Micro-computed tomography (MCT) of the extracted teeth shaped in vitro was used to inform the FEA model regarding the geometry of root canals and external surfaces. Modeling the intact periodontal support and cancellous/cortical bone was based on anatomical data. Profiles of average and maximum von Mises stresses in dentin of the four treated conditions under functional loading were compared to the untreated model. This comparison was performed for each tooth model with and without root canal obturation and composite restoration. On average, the dentin sections with the most changes after preparation were located in the access cavity, with average stress increase up to +5.7, +8.5, +8.9, and +10.2 % for the TRUShape #20, Vortex #20, TRUShape #30 and Vortex #30, respectively, relative to the untreated model. Within the root canal system, the average stress differences were smaller than <5 % with lower values for TRUShape preparation. A reduction of the average stress in the access cavity was observed as an effect of the composite restoration, while about the same von Mises stress' profiles were found into the root canal. In this finite element analysis, preparation of the access cavity resulted in increased von Mises stresses under functional occlusal load. The limited (up to 0.7 %) retained radicular dentin in the TRUShape versus the Vortex cavity proved effective in reducing masticatory stresses. The bonded restoration modeled in this study only partially counterbalance the combined effects of access cavity and root canal preparation.

In vivo antimicrobial efficacy of 6% Morinda citrifolia, Azadirachta indica, and 3% sodium hypochlorite as root canal irrigants.

PubMed

Podar, Rajesh; Kulkarni, Gaurav P; Dadu, Shifali S; Singh, Shraddha; Singh, Shishir H

2015-01-01

To evaluate and compare the antimicrobial efficacy of 6% Morinda citrifolia, Azadirachta indica, and 3% sodium hypochlorite (NaOCl) as root canal irrigants. Thirty nonvital maxillary anteriors were randomly assigned to one of the three groups corresponding to the irrigant to be tested; 6% Morinda citrifolia juice (MCJ) (n = 10), A. indica (n = 10) and 3% NaOCl (n = 10). After the root canal access opening a root canal culture sample was taken with two paper points and cultured under aerobic and anaerobic conditions. Cleaning and shaping were completed with irrigation by 10 mL of respective irrigants and 5 mL of final rinse. The patients were recalled after 3 days and canals were rinsed again with 5 mL of the test irrigants. This was followed by obtaining a posttreatment root canal culture sample and culturing and analyzed by counting the colony forming units (CFUs). Six percentage MCJ, A. indica, and 3% NaOCl showed a significant reduction (P < 0.05) in the mean CFU counts for aerobic and anaerobic bacteria between baseline and 3 days. There was no difference in the antimicrobial efficacy of 6% M. citrifolia, A. indica, and 3% NaOCl as root canal irrigants.

Root canal preparation of mandibular molars with 3 nickel-titanium rotary instruments: a micro-computed tomographic study.

PubMed

Zhao, Dan; Shen, Ya; Peng, Bin; Haapasalo, Markus

2014-11-01

The aim of this study was to describe the canal shaping properties of ProTaper Next (PTN; Dentsply Maillefer, Ballaigues, Switzerland), ProTaper Universal (PTU; Dentsply Tulsa Dental Specialties, Johnson City, TN), and WaveOne (Dentsply Maillefer) nickel-titanium instruments in mandibular first molars by using micro-computed tomographic (micro-CT) scanning. A total of 36 maxillary first molars with 2 separate mesial canals and 1 distal canal were selected and scanned preoperatively and postoperatively by using micro-CT scanning with a voxel size of 30 μm. Canals were prepared with PTU, PTN, and WaveOne systems under hypochlorite irrigation. The volume of the untreated canal; the volume of dentin removed after preparation; the amount of the uninstrumented area; and the transportation to the coronal, middle, and apical thirds of canals were measured. The preparation time and instrument failure were also recorded. Instrumentation of canals increased their volume and surface area. The distal canals had a significantly higher proportion of unprepared surfaces than mesial canals (P < .05). The PTN system produced less transportation than the WaveOne and PTU systems in the apical third of the mesial canals (P < .05). There was no significant difference on apical transportation in distal canals among the 3 instrument systems. Instrumentation with WaveOne was significantly faster than with the other 2 instruments (P < .05). The PTN, PTU, and WaveOne instruments shaped root canals in mandibular first molars in vitro without significant shaping errors. The curved canals prepared using PTN had less apical transportation than the canals prepared using WaveOne and PTU. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Comparative study of 6 rotary nickel-titanium systems and hand instrumentation for root canal preparation in severely curved root canals of extracted teeth.

PubMed

Celik, Davut; Taşdemir, Tamer; Er, Kürşat

2013-02-01

Some improvements have been developed with new generations of nickel-titanium (NiTi) rotary instruments that led to their successful and extensive application in clinical practice. The purpose of this in vitro study was to compare the root canal preparations performed by using GT Series X and Twisted File systems produced by innovative manufacturing process with Revo-S, RaCe, Mtwo, and ProTaper Universal systems manufactured directly from conventional nitinol and with stainless steel K-Flexofile instruments. The mesiobuccal root canals of 140 maxillary first permanent molars that had between 30°-40° curvature angle and 4- to 9-mm curvature radius of the root canal were used. After root canal preparations made by using GT Series X, Twisted File, Revo-S, RaCe, Mtwo, and ProTaper Universal NiTi rotary systems and stainless steel K-Flexofile instruments, transportation occurred in the root canal, and alteration of working length (WL) was assessed by using a modified double-digital radiographic technique. The data were compared by the post hoc Tukey honestly significant difference test. NiTi rotary systems caused less canal transportation and alteration of WL than K-Flexofile instruments (P < .05). There was no significant difference between NiTi rotary system groups at any levels (P > .05) except 2.5 mm from the WL. At this level ProTaper Universal system caused significant canal transportation (P < .05). GT Series X and Twisted File rotary systems produced with innovative process were concluded to shape the curved canals to result in minimal canal transportation, similar to Revo-S, RaCe, Mtwo, and ProTaper Universal rotary systems manufactured by traditional methods. Copyright © 2013 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

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

PubMed

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

2017-01-01

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

Cone-beam computed tomography analysis of curved root canals after mechanical preparation with three nickel-titanium rotary instruments

PubMed Central

Elsherief, Samia M.; Zayet, Mohamed K.; Hamouda, Ibrahim M.

2013-01-01

Cone beam computed tomography is a 3-dimensional high resolution imaging method. The purpose of this study was to compare the effects of 3 different NiTi rotary instruments used to prepare curved root canals on the final shape of the curved canals and total amount of root canal transportation by using cone-beam computed tomography. A total of 81 mesial root canals from 42 extracted human mandibular molars, with a curvature ranging from 15 to 45 degrees, were selected. Canals were randomly divided into 3 groups of 27 each. After preparation with Protaper, Revo-S and Hero Shaper, the amount of transportation and centering ability that occurred were assessed by using cone beam computed tomography. Utilizing pre- and post-instrumentation radiographs, straightening of the canal curvatures was determined with a computer image analysis program. Canals were metrically assessed for changes (surface area, changes in curvature and transportation) during canal preparation by using software SimPlant; instrument failures were also recorded. Mean total widths and outer and inner width measurements were determined on each central canal path and differences were statistically analyzed. The results showed that all instruments maintained the original canal curvature well with no significant differences between the different files (P = 0.226). During preparation there was failure of only one file (the protaper group). In conclusion, under the conditions of this study, all instruments maintained the original canal curvature well and were safe to use. Areas of uninstrumented root canal wall were left in all regions using the various systems. PMID:23885273

Cone-beam Computed Tomography Evaluation of Root Canal Preparation using Various Rotary Instruments: An in vitro Study.

PubMed

Ramanathan, Suhashini; Solete, Pradeep

2015-11-01

To evaluate the remaining dentin thickness of teeth after cleaning and shaping the root canal using three rotary instrumentation technique using cone-beam computed tomography (CBCT). This in vitro study is being done with 30 premolar samples with 20' curvature. The study is divided into three groups a CBCT was taken to measure the shortest distance from the root canal outline to the closest adjacent root surface was measured at each level from the cementoenamel junction (CEJ) (1,3, 5 and 7 mm) before and after root canal instrumentation. The purpose of this study was to compare the effects of different instruments used to prepare curved root canals on the remaining cervical dentin thickness and total amount of dentin removed from root canals during instrumentation by using multi-slice CBCT. The remaining dentin thickness is very much necessary for the success rate of root canal treatment. However, this study helps to prove that a conservative preparation with a sound remaining dentin thickness is much more advisable. It was observed that there was a significant difference at 1 and 3 mm (p < 0.05) and at 5 and 7 mm there was no significant difference ( p > 0.05). Mtwo has removed less amount dentin when compared to ProTaper Universal and ProTaper Next system at 1 and 3 mm. Under the conditions of the study, we concluded that ProTaper Universal and ProTaper Next should be used judiciously, as it causes higher thinning of root dentin of the root when compared with Mtwo.

Comparative evaluation of the shaping ability of two different nickel-titanium rotary files in curved root canals of extracted human molar teeth.

PubMed

Ferrara, Giulia; Taschieri, Silvio; Corbella, Stefano; Ceci, Caterina; Del Fabbro, Massimo; Machtou, Pierre

2017-02-01

The aim of the present study was to compare the shaping ability of two different nickel-titanium rotary files in the curved root canals of extracted human molar teeth. Thirty root canals of 17 extracted human molars teeth were randomly assigned to two experimental groups (n = 15): ProTaper Next and ProTaper Universal (PTU), on the basis of the rotary files system used. The final size of all apical foramina was 0.25 mm in diameter. Standardized digital radiographs were taken before and after instrumentation in both clinical and proximal views, with a size 10 K-file inserted into the canal for the determination of the angle of curvature and apical transportation. Preparation time and fractured or deformed instruments were also recorded. The unpaired Student's t-test was used to compare results. There was no significant difference between the two instruments with respect to canal straightening and apical transportation before and after instrumentation (P > 0.05). The use of both instruments resulted in a significant reduction in the angle of curvature after instrumentation (P < 0.05). Instrumentation time was significantly greater for PTU (P < 0.05). The ProTaper Universal and ProTaper Next systems performed similarly with regard to the straightening of curved root canals and apical transportation. ProTaper Next was significantly faster than ProTaper Universal. © 2015 Wiley Publishing Asia Pty Ltd.

Dispersion of near-infrared laser energy through radicular dentine when using plain or conical tips.

PubMed

Teo, Christine Yi Jia; George, Roy; Walsh, Laurence J

2018-02-01

The aim of this study was to investigate the influence of tip design on patterns of laser energy dispersion through the dentine of tooth roots when using near-infrared diode lasers. Diode laser emissions of 810 or 940 nm were used in combination with optical fiber tips with either conventional plain ends or conical ends, to irradiate tooth roots of oval or round cross-sectional shapes. The lasers were operated in continuous wave mode at 0.5 W for 5 s with the distal end of the fiber tip placed in the apical or coronal third of the root canal at preset positions. Laser light exiting through the roots and apical foramen was imaged, and the extent of lateral spread calculated. There was a significant difference in infrared light exiting the root canal apex between plain and conical fiber tips for both laser wavelengths, with more forward transmission of laser energy through the apex for plain tips. For both laser wavelengths, there were no significant differences in emission patterns when the variable of canal shape was used and all other variables were kept the same (plain vs conical tip, tip position). To ensure optimal treatment effect and to prevent the risks of inadvertent laser effects on the adjacent periapical tissues, it is important to have a good understanding of laser transmission characteristics of the root canal and root dentine. Importantly, it is also essential to understand transmission characteristics of plain and conical fibers tips.

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

PubMed

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

2008-12-01

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

How accurate replicates the Thermafil System the morphology of the apical endodontic space? An ex vivo study.

PubMed

Stratul, S I; Didilescu, Andreea; Grigorie, Mihaela; Ianes, Emilia; Rusu, D; Nica, Luminiţa

2011-01-01

To evaluate the morphology of the root canal in its apical third and the capacity of the Thermafil System to reproduce the entire morphology of the cleaned and shaped root canal. Thirty-two roots of periodontally compromised teeth were prepared using the ProTaper System to an apical size 30 and filled with the Thermafil obturation technique and sealer. The roots were surgically amputated and prepared for metallographic evaluation by incremental reductions of 0.5 mm each, starting with the apical foramen. Photomicrographs of each section were taken at a magnification of 500x and 100x. The images were analyzed and processed. The position of the apical foramen with respect to the anatomical apex was identified and marked. Additional morphological details as lateral canals and recesses were also recorded. The cross-sectioned area of the canal and gutta-percha, the total perimeter, the shaped perimeter and the filled perimeter were recorded for each sample and the results were expressed as percentages. Multiple images of successive sections were used to create a 3D reconstruction of the apical anatomy of the tooth. The ANOVA test was performed to assess mean differences between evaluations of perimeters/areas at different levels. The anatomical apical foramen was found at the tip of the root in 50% of the evaluated samples. In the remaining samples, the foramen was located between 0.5 and 2.5 mm from the centre of the apex. Lateral canals, which opened in accessory foramens, were recorded in 25% of the evaluated samples. Statistical significant differences (p<0.05) were found between different levels of preparation and obturation. The complex morphology of the apical third of the root canal is satisfactory microstructurally replicated by the Thermafil System. Moreover, polarized light microscopy and the 3D reconstruction offered a discriminative vision of morphological details as lateral canals, recesses, the gutta-percha and debris.

Radiological evaluation of the morphological changes of root canals shaped with ProTaper for hand use and the ProTaper and RaCe rotary instruments.

PubMed

Aguiar, Carlos M; Câmara, Andréa C

2008-12-01

This study evaluated, by means of the radiography examination, the occurrence of deviations in the apical third of root canals shaped with hand and rotary instruments. Sixty mandibular human molars were divided into three groups. The root canals in group 1 were instrumented with ProTaper (Dentsply/Maillefer, Ballaigues, Switzerland) for hand use, group 2 with ProTaper and group 3 with RaCe. The images obtained by double superimposition of the pre- and postoperative radiographs were evaluated by two endodontists with the aid of a magnifier-viewer and a fivefold magnifier. Statistical analysis was performed using the Fisher-Freeman-Halton. The instrumentation using the ProTaper for hand use showed 25% of the canals with a deviation in the apical third, as did the ProTaper, while the corresponding figure for the RaCe (FKG Dentaire, La-Chaux-de-Fonds, Switzerland) was 20%, but these results were not statistically significant. There was no correlation between the occurrence of deviations in the apical third and the systems used.

Efficiency of the Self Adjusting File, WaveOne, Reciproc, ProTaper and hand files in root canal debridement.

PubMed

Topcu, K Meltem; Karatas, Ertugrul; Ozsu, Damla; Ersoy, Ibrahim

2014-07-01

The aim of this study was to compare the canal debridement capabilities of three single file systems, ProTaper, and K-files in oval-shaped canals. Seventy-five extracted human mandibular central incisors with oval-shaped root canals were selected. A radiopaque contrast medium (Metapex; Meta Biomed Co. Ltd., Chungcheongbuk-do, Korea) was introduced into the canal systems and the self-adjusting file (SAF), WaveOne, Reciproc, ProTaper, and K-files were used for the instrumentation of the canals. The percentage of removed contrast medium was calculated using pre- and post-operative radiographs. An overall comparison between the groups revealed that the hand file (HF) and SAF groups presented the lowest percentage of removed contrast medium, whereas the WaveOne group showed the highest percentage (P < 0.001). The ProTaper group removed more contrast medium than the SAF and HF groups (P < 0.05). None of the instruments was able to remove the contrast medium completely. WaveOne performed significantly better than other groups.

Efficiency of the Self Adjusting File, WaveOne, Reciproc, ProTaper and hand files in root canal debridement

PubMed Central

Topcu, K. Meltem; Karatas, Ertugrul; Ozsu, Damla; Ersoy, Ibrahim

2014-01-01

Objectives: The aim of this study was to compare the canal debridement capabilities of three single file systems, ProTaper, and K-files in oval-shaped canals. Materials and Methods: Seventy-five extracted human mandibular central incisors with oval-shaped root canals were selected. A radiopaque contrast medium (Metapex; Meta Biomed Co. Ltd., Chungcheongbuk-do, Korea) was introduced into the canal systems and the self-adjusting file (SAF), WaveOne, Reciproc, ProTaper, and K-files were used for the instrumentation of the canals. The percentage of removed contrast medium was calculated using pre- and post-operative radiographs. Results: An overall comparison between the groups revealed that the hand file (HF) and SAF groups presented the lowest percentage of removed contrast medium, whereas the WaveOne group showed the highest percentage (P < 0.001). The ProTaper group removed more contrast medium than the SAF and HF groups (P < 0.05). Conclusions: None of the instruments was able to remove the contrast medium completely. WaveOne performed significantly better than other groups. PMID:25202211

Geometric analysis of root canals prepared by four rotary NiTi shaping systems.

PubMed

Hashem, Ahmed Abdel Rahman; Ghoneim, Angie Galal; Lutfy, Reem Ahmed; Foda, Manar Yehia; Omar, Gihan Abdel Fatah

2012-07-01

A great number of nickel-titanium (NiTi) rotary systems with noncutting tips, different cross-sections, superior resistance to torsional fracture, varying tapers, and manufacturing method have been introduced to the market. The purpose of this study was to evaluate and compare the effect of 4 rotary NiTi preparation systems, Revo-S (RS; Micro-Mega, Besancon Cedex, France), Twisted file (TF; SybronEndo, Amersfoort, The Netherlands), ProFile GT Series X (GTX; Dentsply, Tulsa Dental Specialties, Tulsa, OK), and ProTaper (PT; Dentsply Maillefer, Ballaigues, Switzerland), on volumetric changes and transportation of curved root canals. Forty mesiobuccal canals of mandibular molars with an angle of curvature ranging from 25° to 40° were divided according to the instrument used in canal preparation into 4 groups of 10 samples each: group RS, group TF, group GTX, and group PT. Canals were scanned using an i-CAT CBCT scanner (Imaging Science International, Hatfield, PA) before and after preparation to evaluate the volumetric changes. Root canal transportation and centering ratio were evaluated at 1.3, 2.6, 5.2, and 7.8 mm from the apex. The significance level was set at P ≤ .05. The PT system removed a significantly higher amount of dentin than the other systems (P = .025). At the 1.3-mm level, there was no significant difference in canal transportation and centering ratio among the groups. However, at the other levels, TF maintained the original canal curvature recording significantly the least degree of canal transportation as well as the highest mean centering ratio. The TF system showed superior shaping ability in curved canals. Revo-S and GTX were better than ProTaper regarding both canal transportation and centering ability. Copyright © 2012 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

[Pain, flare-ups and failures in root canal therapy].

PubMed

Moorer, W R

1989-10-01

In this overview the incidences and causes of pain, flare-ups and failures that occur after root canal therapy are discussed. Infection is considered the most important single, underlying determinant of the many factors that may cause pain and failures. Therefore, strict adherence to recognized therapeutic principles of shaping, disinfection and filling, in addition to proper aftercare, is of importance to diminish postoperative sequelae.

Comparative study of root-canal shaping with stainless steel and rotary NiTi files performed by preclinical dental students.

PubMed

Alrahabi, Mothanna

2015-01-01

We evaluated the use of NiTi rotary and stainless steel endodontic instruments for canal shaping by undergraduate students. We also assessed the quality of root canal preparation as well as the occurrence of iatrogenic events during instrumentation. In total, 30 third-year dental students attending Taibah University Dental College prepared 180 simulated canals in resin blocks with NiTi rotary instruments and stainless steel hand files. Superimposed images were prepared to measure the removal of material at different levels from apical termination using the GSA image analysis software. Preparation time, procedural accidents, and canal shape after preparation were analyzed using χ 2 and t-tests. The statistical significance level was set at P < 0.05. There were significant differences in preparation time between NiTi instruments and stainless steel files; the former was associated with shorter preparation time, less ledge formation (1.1% vs. 14.4%), and greater instrument fracture (5.56% vs. 1.1%). These results indicate that NiTi rotary instruments result in better canal geometry and cause less canal transportation. Manual instrumentation using stainless steel files is safer than rotary instrumentation for inexperienced students. Intensive preclinical training is a prerequisite for using NiTi rotary instruments. These results prompted us to reconsider theoretical and practical coursework when teaching endodontics.

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

PubMed

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

2017-04-01

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

Root canal debridement: an online study guide.

PubMed

2008-05-01

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

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

PubMed

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

2011-03-01

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

Worldwide Prevalence of Mandibular Second Molar C-Shaped Morphologies Evaluated by Cone-Beam Computed Tomography.

PubMed

von Zuben, Murilo; Martins, Jorge N R; Berti, Luiza; Cassim, Imran; Flynn, Daniel; Gonzalez, Jose Antonio; Gu, Yongchun; Kottoor, Jojo; Monroe, Adam; Rosas Aguilar, Rubén; Marques, Miguel Seruca; Ginjeira, António

2017-09-01

The aim of this study was to evaluate and compare the C-shaped mandibular second molar prevalence in different regions around the world with the aid of cone-beam computed tomography technology. Nine field observers from 9 different geographic regions were calibrated. A total of 400 samples were collected in each region. The prevalence of C-shaped anatomy was calculated. The number of roots and the configuration of the C-shaped canals at 3 different axial levels were also evaluated. The z-test was used to analyze the difference between the means of each independent group. Intrarater reliability was also tested. A total of 3600 teeth from 2735 patients were included in this research; 499 teeth presented C-shaped root canal configuration, representing a global prevalence of 13.9%. China had a prevalence of 44.0%, which was significantly higher than any other region. The C-shape prevalence in women was 16.5%, which was significantly higher than the 10.4% prevalence found in men. No difference between sides (37 or 47) was evident in the global sample. Cone-beam computed tomography is a valuable tool to evaluate the C-shaped root canal configuration in vivo. In the present study, China presented the highest prevalence of C-shaped mandibular second molars when compared with other regions. Women exhibited a higher prevalence than men. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

A study on FlexMaster : a Ni-Ti rotary engine driven system for root canal preparation.

PubMed

Alam, M S; Bashar, A K; Begumr, J A; Kinoshita, J I

2006-07-01

In the present study, the effectiveness of recently introduced rotary Nickel Titanium FlexMaster engine driven system was evaluated for cleaning and shaping of root canals in extracted human teeth and compared with that done by the Nickel Titanium Flexofile hand instruments. A total of 40 root canals from 36 extracted mandibular and maxillary teeth with curvature ranging between 20 and 30 degree were divided into two groups, consisting 20 canals in each. FlexMaster instrumentation was done in 20 canals, using crown-down technique and manual filing with Flexofile was done in other 20 canals, using conventional and step-back techniques. 5.25% sodium hypochlorite (NaOCl) solution and 17% ethelene di-amine tetra-acetic acid (EDTA) were used alternatively for irrigation after canal preparation by each instrument size. Time needed for canal preparation of individual canal was recorded. A procedural error such as instrument breakage was also noted. After preparation, all the roots were cut longitudinally by using diamond burs in turbine handpiece and examined under scanning electron microscope. Apical region was quantified for debris and smear layer based on a 5-score numerical evaluation scale. The data established for scoring the debris and smear layer and preparation time of individual canal were analyzed statistically using the Mann-Whitney U test. Completely cleaned root canals were not found with any of the two instruments and none of the instruments maintained the original canal uniformity and regular dentine surface. Because significantly less debris was found in the apical region using the manual filing technique (p< 0.05). Thus the flexmaster system was found to produce less cleaner root canal walls than manual technique. Only one FlexMaster finishing file sized 30 was separated in the apical region during preparation of 30 degree curved canal. The time taken by FlexMaster was significantly better (p< 0.01) than that of hand instruments.

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

PubMed

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

2016-01-01

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

Root canal morphology of Chalcolithic and early bronze age human populations of El Mirador Cave (Sierra de Atapuerca, Spain).

PubMed

Ceperuelo, Dolors; Lozano, Marina; Duran-Sindreu, Fernando; Mercadé, Montse

2014-12-01

This study provides a morphological characterization of the inner anatomy of the root canals of permanent first and second molars in Chalcolithic and early Bronze Age human fossils using cone-beam computed tomography. The general evolutionary trend in present-day human dentition is related to morphological simplification. As little is known about when this trend appeared in Homo sapiens populations, the aim of this work is to test the presence of modern radicular morphology 4,400 years ago. Fifty-four permanent first and second maxillary and mandibular molars of 17 individuals were included in the study. All maxillary first and second molars showed three separate roots. Almost all the lower molars analyzed (100% of first molars and 75% of second molars) had two separate roots. More differences in the canal system configuration were documented in the maxillary mesiobuccal roots than in the palatal or distobuccal roots. The most variable tooth in root and canal configuration is the maxillary second molar. It should be pointed out that 12.5% of the teeth analyzed showed a C-shaped root configuration. © 2014 Wiley Periodicals, Inc.

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.

A micro-computed tomographic evaluation of dentinal microcrack alterations during root canal preparation using single-file Ni-Ti systems.

PubMed

Li, Mei-Lin; Liao, Wei-Li; Cai, Hua-Xiong

2018-01-01

The aim of the present study was to evaluate the length of dentinal microcracks observed prior to and following root canal preparation with different single-file nickel-titanium (Ni-Ti) systems using micro-computed tomography (micro-CT) analysis. A total of 80 mesial roots of mandibular first molars presenting with type II Vertucci canal configurations were scanned at an isotropic resolution of 7.4 µm. The samples were randomly assigned into four groups (n=20 per group) according to the system used for root canal preparation, including the WaveOne (WO), OneShape (OS), Reciproc (RE) and control groups. A second micro-CT scan was conducted after the root canals were prepared with size 25 instruments. Pre- and postoperative cross-section images of the roots (n=237,760) were then screened to identify the lengths of the microcracks. The results indicated that the microcrack lengths were notably increased following root canal preparation (P<0.05). The alterations in microcrack length in the OS group were more significant compared with those in the WO, RE and control groups (P<0.05). In conclusion, the formation and development of dentinal microcracks may be associated with the movement caused by preparation rather than the taper of the files. Among the single-file Ni-Ti systems, WO and RE were not observed to cause notable microcracks, while the OS system resulted in evident microcracks.

In vitro Comparison of Apical Debris Extrusion Using Rotary and Reciprocating Systems in Severely Curved Root Canals

PubMed Central

Delvarani, Abbas; Mohammadzadeh Akhlaghi, Nahid; Aminirad, Raana; Tour Savadkouhi, Sohrab; Vahdati, Seyed Aliakbar

2017-01-01

Introduction: The aim of this in vitro study was to compare the amount of apically extruded debris after root canal preparation using rotary and reciprocating systems in severely curved root canals. Methods and Materials: Thirty six extracted human mandibular first molars with 25-35° curvature in their mesiobuccal (MB) canal (according to Schneider’s method) were cleaned and shaped with ProTaper and WaveOne systems. The extruded debris was collected and their net weight was calculated. To compare the efficiency of the two systems, the operation time was also measured. The data were analyzed with t-test. Results: The amount of extruded debris in WaveOne group was significantly greater in comparison with ProTaper group (26%). The operating time for ProTaper was however, significantly longer than WaveOne. Conclusion: Both root preparation systems caused some degree of debris extrusion through the apical foramen. However, this amount was greater in WaveOne instruments. PMID:28179921

Sodium Hypochlorite Irrigation and Its Effect on Bond Strength to Dentin

PubMed Central

Abuhaimed, Tariq S.

2017-01-01

Effective shaping and cleaning of root canals are essential for the success of endodontic treatment. Due to the complex anatomy of root canal spaces, the use of various instrumentation techniques alone is not effective in producing bacteria-free root canal spaces. Irrigation, disinfectants, rinses, and intervisit medications are used in conjunction with the mechanical instrumentation to ensure the success of endodontic treatment. Sodium hypochlorite (NaOCl), a halogenated compound, is routinely used to irrigate the root canal during endodontic treatments. NaOCl has been known for its antibacterial action, proteolytic and dissolution capacity, and debridement properties. NaOCl, however, can alter the composition of dentin and hence its interaction with the adhesive resins used to bond the restorative materials to treated dentin. This review therefore covers in depth the action of NaOCl on dentin-adhesive resin bond strength including both enhancement and reduction, then mechanisms proposed for such action, and finally how the adverse action of NaOCl on dentin can be reversed. PMID:28904947

Sodium Hypochlorite Irrigation and Its Effect on Bond Strength to Dentin.

PubMed

Abuhaimed, Tariq S; Abou Neel, Ensanya A

2017-01-01

Effective shaping and cleaning of root canals are essential for the success of endodontic treatment. Due to the complex anatomy of root canal spaces, the use of various instrumentation techniques alone is not effective in producing bacteria-free root canal spaces. Irrigation, disinfectants, rinses, and intervisit medications are used in conjunction with the mechanical instrumentation to ensure the success of endodontic treatment. Sodium hypochlorite (NaOCl), a halogenated compound, is routinely used to irrigate the root canal during endodontic treatments. NaOCl has been known for its antibacterial action, proteolytic and dissolution capacity, and debridement properties. NaOCl, however, can alter the composition of dentin and hence its interaction with the adhesive resins used to bond the restorative materials to treated dentin. This review therefore covers in depth the action of NaOCl on dentin-adhesive resin bond strength including both enhancement and reduction, then mechanisms proposed for such action, and finally how the adverse action of NaOCl on dentin can be reversed.

Sealing properties of one-step root-filling fibre post-obturators vs. two-step delayed fibre post-placement.

PubMed

Monticelli, Francesca; Osorio, Raquel; Toledano, Manuel; Ferrari, Marco; Pashley, David H; Tay, Franklin R

2010-07-01

The sealing properties of a one-step obturation post-placement technique consisting of Resilon-capped fibre post-obturators were compared with a two-step technique based on initial Resilon root filling following by 24h-delayed fibre post-placement. Thirty root segments were shaped to size 40, 0.04 taper and filled with: (1) InnoEndo obturators; (2) Resilon/24h-delayed FibreKor post-cementation. Obturator, root filling and post-cementation procedures were performed using InnoEndo bonding agent/dual-cured root canal sealer. Fluid flow rate through the filled roots was evaluated at 10psi using a computerised fluid filtration model before root resection and after 3 and 9mm apical resections. Fluid flow data were analysed using two-way repeated measures ANOVA and Tukey test to examine the effects of root-filling post-placement techniques and root resection lengths on fluid leakage from the filled canals (alpha=0.05). A significantly greater amount of fluid leakage was observed with the one-step technique when compared with two-step technique. No difference in fluid leakage was observed among intact canals and canals resected at different lengths for both materials. The seal of root canals achieved with the one-step obturator is less effective than separate Resilon root fillings followed by a 24-h delay prior to the fibre post-placement. Incomplete setting of the sealer and restricted relief of polymerisation shrinkage stresses may be responsible for the inferior seal of the one-step root-filling/post-restoration technique. Copyright 2010 Elsevier Ltd. All rights reserved.

Geometric analysis of maxillary first premolar prepared by two nickel-titanium rotary instruments.

PubMed

Al-Sudani, Dina; Almalki, Majed; Al-Shahrani, Saad; Ahlquist, Michael

2014-03-01

The present study was conducted with the aim of evaluating and comparing the shaping ability of two Nickel-titanium rotary instruments, with two disparate design features, on root canal geometry of extracted human maxillary first premolars using microcomputed tomography. Twenty four bifurcated maxillary first premolars were divided into two groups and embedded in a rubber-based impression material. Both groups were submitted to micro-computed tomography before and after canal preparation (buccal and palatal) with either ProFile Vortex or Revo-S rotary instruments. Images were reconstructed and cross-sections corresponding to a distance 1, 2, 3, 4, 5, 6, and 7 mm from the anatomical apex were selected for canal transportation analysis. Volume changes were also measured. The degree and direction of canal transportation were non-significant for both instruments. Statistically significant differences were observed only between levels in the buccal canal in both groups. There was no significant difference between the two rotary systems in regards to the volume of dentin removed. Our findings showed that ProFile Vortex and Revo-S instruments respected the original root canal anatomy and behaved similarly. ProFile Vortex rotary systems produced with innovative process were concluded to shape the upper maxillary premolar by leading minimal canal transportation, similar to Revo-S, rotary systems produced from traditional process.

Correlative bacteriologic and micro-computed tomographic analysis of mandibular molar mesial canals prepared by self-adjusting file, reciproc, and twisted file systems.

PubMed

Siqueira, José F; Alves, Flávio R F; Versiani, Marco A; Rôças, Isabela N; Almeida, Bernardo M; Neves, Mônica A S; Sousa-Neto, Manoel D

2013-08-01

This ex vivo study evaluated the disinfecting and shaping ability of 3 protocols used in the preparation of mesial root canals of mandibular molars by means of correlative bacteriologic and micro-computed tomographic (μμCT) analysis. The mesial canals of extracted mandibular molars were contaminated with Enterococcus faecalis for 30 days and assigned to 3 groups based on their anatomic configuration as determined by μCT analysis according to the preparation technique (Self-Adjusting File [ReDent-Nova, Ra'anana, Israel], Reciproc [VDW, Munich, Germany], and Twisted File [SybronEndo, Orange, CA]). In all groups, 2.5% NaOCl was the irrigant. Canal samples were taken before (S1) and after instrumentation (S2), and bacterial quantification was performed using culture. Next, mesial roots were subjected to additional μCT analysis in order to evaluate shaping of the canals. All instrumentation protocols promoted a highly significant intracanal bacterial reduction (P < .001). Intergroup quantitative and qualitative comparisons disclosed no significant differences between groups (P > .05). As for shaping, no statistical difference was observed between the techniques regarding the mean percentage of volume increase, the surface area increase, the unprepared surface area, and the relative unprepared surface area (P > .05). Correlative analysis showed no statistically significant relationship between bacterial reduction and the mean percentage increase of the analyzed parameters (P > .05). The 3 instrumentation systems have similar disinfecting and shaping performance in the preparation of mesial canals of mandibular molars. Copyright © 2013 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

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

PubMed

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

2010-03-01

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

CBCT Assessment of Root Dentine Removal by Gates-Glidden Drills and Two Engine-Driven Root Preparation Systems.

PubMed

Harandi, Azade; Mohammadpour Maleki, Fatemeh; Moudi, Ehsan; Ehsani, Maryam; Khafri, Soraya

2017-01-01

The aim of this study was to compare the dentine removing efficacy of Gates-Glidden drills with hand files, ProTaper and OneShape single-instrument system using cone-beam computed tomography (CBCT). A total of 39 extracted bifurcated maxillary first premolars were divided into 3 groups ( n =13) and were prepared using either Gates-Glidden drills and hand instruments, ProTaper and OneShape systems. Pre- and post-instrumentation CBCT images were obtained. The dentin thickness of canals was measured at furcation, and 1 and 2 mm from the furcation area in buccal, palatal, mesial and distal walls. Data were analyzed using one-way ANOVA test. Tukey's post hoc tests were used for two-by-two comparisons. Gates-Glidden drills with hand files removed significantly more ( P <0.001) dentine than the engine-driven systems in all canal walls (buccal, palatal, mesial and distal). There were no significant differences between OneShape and ProTaper rotary systems ( P >0.05). The total cervical dentine removal during canal instrumentation was significantly less with engine-driven file systems compared to Gates-Glidden drills. There were no significant differences between residual dentine thicknesses left between the various canal walls.

Analysis of mandibular second molars with fused roots and shallow radicular grooves by using micro-computed tomography.

PubMed

Amoroso-Silva, Pablo; De Moraes, Ivaldo Gomes; Marceliano-Alves, Marilia; Bramante, Clovis Monteiro; Zapata, Ronald Ordinola; Hungaro Duarte, Marco Antonio

2018-01-01

This study aimed to describe the morphological and morphometric aspects of fused mandibular second molars with radicular shallow grooves using micro-computed tomography (CT). Eighty-eight mandibular second molars with fused roots were scanned in a micro-CT scanner at a voxel size of 19.6 μm. After reconstruction, only molars without C-shaped roots and presenting shallow radicular grooves were selected. 30 molars were chosen for further analysis. Canal cross-sections were classified according to Fan's modified classification (C1, C2, C3, and C4) and morphometric parameters at the apical region, examination of accessory foramina and tridimensional configuration were evaluated. Three-dimensional reconstructions indicated a higher prevalence of merging type ( n = 22). According to Fan's modified classification, the C4 configuration was predominant in the 3 apical mm. Roundness median values revealed a more round-shaped canals at 3 mm (0.72) than at 2 (0.63) and 1 (0.61) mm from the apex. High values of major and minor diameters were observed in the canals of these evaluated sections. In addition, few accessory apical foramina were observed at 1 and 2 mm from the apex. The average distance between last accessory foramina and the anatomic apex was 1.17 mm. A less complex internal anatomy is found when a mandibular second molar presents fused roots with shallow radicular grooves. The merging type canal was frequently observed. Moreover, the C4 configuration was predominant at a point 3 mm from the apex and presented rounded canals, large apical diameters, and few accessory foramina. The cervical and middle thirds presented C3 and C1 canal configurations most frequently. A minor morphological complexity is found when fused mandibular second molars present shallow radicular grooves.

Comparative Analysis of Canal Centering Ability of Different Single File Systems Using Cone Beam Computed Tomography- An In-Vitro Study.

PubMed

Agarwal, Rolly S; Agarwal, Jatin; Jain, Pradeep; Chandra, Anil

2015-05-01

The ability of an endodontic instrument to remain centered in the root canal system is one of the most important characteristic influencing the clinical performance of a particular file system. Thus, it is important to assess the canal centering ability of newly introduced single file systems before they can be considered a viable replacement of full-sequence rotary file systems. The aim of the study was to compare the canal transportation, centering ability, and time taken for preparation of curved root canals after instrumentation with single file systems One Shape and Wave One, using cone-beam computed tomography (CBCT). Sixty mesiobuccal canals of mandibular molars with an angle of curvature ranging from 20(o) to 35(o) were divided into three groups of 20 samples each: ProTaper PT (group I) - full-sequence rotary control group, OneShape OS (group II)- single file continuous rotation, WaveOne WO - single file reciprocal motion (group III). Pre instrumentation and post instrumentation three-dimensional CBCT images were obtained from root cross-sections at 3mm, 6mm and 9mm from the apex. Scanned images were then accessed to determine canal transportation and centering ability. The data collected were evaluated using one-way analysis of variance (ANOVA) with Tukey's honestly significant difference test. It was observed that there were no differences in the magnitude of transportation between the rotary instruments (p >0.05) at both 3mm as well as 6mm from the apex. At 9 mm from the apex, Group I PT showed significantly higher mean canal transportation and lower centering ability (0.19±0.08 and 0.39±0.16), as compared to Group II OS (0.12±0.07 and 0.54±0.24) and Group III WO (0.13±0.06 and 0.55±0.18) while the differences between OS and WO were not statistically significant. It was concluded that there was minor difference between the tested groups. Single file systems demonstrated average canal transportation and centering ability comparable to full sequence Protaper system in curved root canals.

Micro-CT evaluation of several glide path techniques and ProTaper Next shaping outcomes in maxillary first molar curved canals.

PubMed

Alovisi, M; Cemenasco, A; Mancini, L; Paolino, D; Scotti, N; Bianchi, C C; Pasqualini, D

2017-04-01

To evaluate the ability of ProGlider instruments, PathFiles and K-files to maintain canal anatomy during glide path preparation using X-ray computed micro-tomography (micro-CT). Forty-five extracted maxillary first permanent molars were selected. Mesio-buccal canals were randomly assigned (n = 15) to manual K-file, PathFile or ProGlider groups for glide path preparation. Irrigation was achieved with 5% NaOCl and 10% EDTA. After glide path preparation, each canal was shaped with ProTaper Next X1 and X2 to working length. Specimens were scanned (isotropic voxel size 9.1 μm) for matching volumes and surface areas and post-treatment analyses. Canal volume, surface area, centroid shift, canal geometry variation through ratio of diameter ratios and ratio of cross-sectional areas were assessed in the apical and coronal levels and at the point of maximum canal curvature. One-way factorial anovas were used to evaluate the significance of instrument in the various canal regions. Post-glide path analysis revealed that instrument factor was significant at the apical level for both the ratio of diameter ratios and the ratio of cross-sectional areas (P < 0.001), with an improved maintenance of root canal geometry by ProGlider and PathFile. At the coronal level and point of maximum canal curvature, ProGlider demonstrated a tendency to pre-flare the root canal compared with K-file and PathFile. PathFile and ProGlider demonstrated a significantly lower centroid shift compared with K-file at the apical level (P = 0.023). Post-shaping analysis demonstrated a more centred preparation of ProGlider, compared with PathFile and K-files, with no significant differences for other parameters. Use of ProGlider instruments led to less canal transportation than PathFiles and K-files. © 2016 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Micro-CT evaluation of apical delta morphologies in human teeth.

PubMed

Gao, Xianhua; Tay, Franklin R; Gutmann, James L; Fan, Wei; Xu, Ting; Fan, Bing

2016-11-07

The apical delta is an intricate system within the root canal and incompletely debridement may affect the long-term prognosis of root canal therapy. The aim of the present study is to investigate the morphologic features of apical deltas in human teeth with micro-computed tomography (micro-CT) using a centreline-fitting algorithm. One hundred and thirty-six apical deltas were detected in 1400 teeth. Molars had more apical deltas (15.8%) than anterior teeth (6.3%). In maxillary molars, the mesiobuccal root had a significantly higher prevalence of apical delta than the palatal root or the distobuccal root. The median vertical distance of the apical delta was 1.87 mm with 13% more than 3 mm. The median diameter and length of the apical delta branches were 132.3 and 934.5 μm. Apical delta branches were not straight with cross-sectional shapes being non-circular. These morphological features of apical delta may complicate debridement of the infected root canal system.

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

PubMed

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

2015-01-01

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

Antimicrobial Activity of Photodynamic Therapy Against Enterococcus faecalis Before and After Reciprocating Instrumentation in Permanent Molars.

PubMed

Pinheiro, Sérgio Luiz; Azenha, Giuliana Rodrigues; Democh, Yasmin Marialva; Nunes, Daniela Camila; Provasi, Silvia; Fontanetti, Giovana Masiero; Duarte, Danilo Antônio; Fontana, Carlos Eduardo; da Silveira Bueno, Carlos Eduardo

2016-12-01

The present study sought to evaluate the antimicrobial activity against Enterococcus faecalis of photodynamic therapy applied before and after reciprocating instrumentation of permanent molars. Apical extrusion of debris can cause flare-ups due to introduction of bacteria into the periapical tissues. Eighteen mesial roots from permanent mandibular molars were selected. The crowns were removed to obtain a standard root length of 15 mm. The included mesial roots had an angulation of 10°-40° and canals with independent foramina. The orifice of each mesiolingual canal was sealed with light-curing resin, and the working length was established visually, 1 mm short of the apical foramen. The roots were rendered impermeable and sterilized, and the mesiobuccal canals were contaminated with a standard strain of E. faecalis for 21 days. Specimens were randomly divided into three groups (n = 6): G1, photodynamic therapy performed before instrumentation and irrigation with 0.9% NaCl (saline) solution; G2, photodynamic therapy performed after instrumentation and irrigation with 0.9% NaCl; and G3 (control), instrumentation and irrigation with 2.5% NaOCl (sodium hypochlorite) solution. Canals were shaped with a WaveOne primary file (25.08) and irrigated with 0.9% NaCl. E. faecalis samples were collected before and after each procedure, and the results were analyzed using descriptive statistics and the Kruskal-Wallis and Wilcoxon tests. Significant reductions in E. faecalis were observed when photodynamic therapy was performed before and after instrumentation of the root canal system (p < 0.05). Reciprocating instrumentation significantly reduced E. faecalis colonies in experimentally contaminated root canal systems (p < 0.05). Photodynamic therapy was effective in removing E. faecalis from the root canal system, whether performed before or after reciprocating instrumentation.

CBVT analysis of canal configuration of the mesio-buccal root of maxillary first permanent molar teeth: An in vitro study.

PubMed

Shenoi, R Pratima; Ghule, Hrishikesh M

2012-07-01

For successful endodontic treatment, it's imperative to locate and obturate all root canals. As concluded by Ingle, the major cause for failure of root canal therapy is in ability to recognize all theexisting canals and subsequent failure in their obturation. To analyze the canal configuration of the mesio-buccal root of maxillary first permanent molar teeth. A total of 30 recently extracted human permanent maxillary first molars were collected and stored in a container with 5% Sodium Chloride solution for four days. Teeth with open apices, external resorption, improperly formed roots and teeth with previous restorations were excluded. Using the dental modeling wax, teeth were arranged in a 'U' shaped arch with roots embedded inside the wax and occlusal surface remaining free. 10 teeth were arranged in each arch and three such sample plates were prepared. Flat surface of the base encasing enabled the plate to be mounted on flat plastic bite plate. With bite plate roughly centered in the focal trough area Axial, Coronal and Sagittal section Cone-Beam Computed Tomography (CBCT) images were taken with Kodak 9000 Extra-oral Imaging System. Images displayed on a monitor were inspected by two endodontists using Kodak Dental Imaging Software 3D Module V2.2. When the data was observed, it was found that 24 teeth out of total 30 teeth examined showed some variation (i.e. possible additional canal) along the length of the mesio-buccal root canal. Out of these 24 teeth, 13 showed presence of additional canal at coronal third, 7 showed presence of additional canal at middle third and four showed presence of additional canal in apical third level. Percentage analysis was done as there was no group comparison to be done. Cone-Beam Volumetric Tomography (CBVT) evaluation positively identified the variations in mesio-buccal canal in 80% of samples. Out of these, 54.16% were in coronal 3(rd), 29.16% in middle 3(rd) and 16.66% were in apical 3(rd). Within the limitations of this study, it can be concluded that- (1) more than half of maxillary first molars have four canals and (2) most of the additional canals were located in the MBR and CBVT is a good diagnostic tool to help diagnose these additional canals. Further investigations using larger sample sizes would be helpful.

Evaluating Transportation by Comparing Several uses of Rotary Endodontic Files.

PubMed

Elemam, Ranya F; Capelas, J A; Vaz, Mário A P; Viriato, Nuno; Pereira, M L; Azevedo, A; West, John

2015-12-01

To evaluate the frequent use of ProTaper Next (PTN; Dentsply Maillefer, Ballaigues, Switzerland) systems on shaping ability of root canal utilizing Solidworks (2014, Dassault Systemes) software. Thirty-six root canals in clear resin blocks (Dentsply-Maillefer) were allocated into six experimental groups (n = 36). Six new sets of PTN instruments (Dentsply Maillefer, Ballaigues, Switzerland) were used six times to shape the resin blocks. A #15 K-file was inserted to the working length (WL), followed by ProGlider (PG) to create a glide path. Sequential use of PTN instrumentation in a crown-down technique was used to reach size (30/07) apically. Macroscopic photos of the blocks were taken before and after instrumentation, layered by Paint Shop Pro 9 from JascSoftware, and then canal transportation was measured using Solidwork 2014. The data were analyzed by SPSS software version 22. Multivariate statistical analysis general linear model (GLM) was also applied. Bonferroni correction test was used in multiple comparisons and the statistical significance was set to 0.05. There was no difference in canal transportation resulted from utilizing PTN files after six multiple uses; in addition, the PTN files showed ability to maintain the original canal anatomy, especially in the apical level, where lowest total mean value of canal center displacement was seen (3 mm level) (0.019 ± 0.017). ProTaper Next files can be used to prepare single and multiple canals in a single furcated tooth. ProTaper Next nickel-titanium (NiTi) file system is a safe instrument that respects the canal shape, allows practitioners to treat difficult cases with good results, and low risk of separation.

[µCT analysis of mandibular molars before and after instrumentation by Reciproc files].

PubMed

Ametrano, Gianluca; Riccitiello, Francesco; Amato, Massimo; Formisano, Anna; Muto, Massimo; Grassi, Roberta; Valletta, Alessandra; Simeone, Michele

2013-01-01

Cleaning and shaping are important section for the root canal treatment. A number of different methodologies have been developed to overcome these problems, including the introduction of rotary instruments nickel-titanium (NiTi). In endodontics NiTi have been shown to significantly reduce procedural errors compared to manual techniques of instrumentation. The efficiency of files is related to many factor. Although previous investigations that have used µCT analysis were hampered by insufficient resolution or projection incorrect. The new generation of μCT performance best offer, as micron resolution and accurate measurement software for evaluating the accurate anatomy of the root canal. The aim the paper was to evaluate the efficiency of Reciproc files in root canal treatment, evaluated before and after instrumentation by using μ-CT analysis.

A micro-computed tomographic study of band-shaped root canal isthmuses, having their floor in the apical third of mesial roots of mandibular first molars.

PubMed

Keleş, A; Keskin, C

2018-02-01

To conduct a quantitative and qualitative analysis of the band-shaped isthmus area, the floor of which was in the apical third in the mesial roots of mandibular first molars using micro-computed tomography (micro-CT). Micro-CT images of 269 mesial roots of mandibular first molars were evaluated, and 40 specimens with a band-shaped isthmus, with a floor in the apical third, were selected. The major diameter, minor diameter, roundness, area and perimeter values for the most coronal and apical slices where the isthmus was visible were measured. The distances between these slices were measured as the isthmus length, and the total volume, structure model index and surface area of the isthmus were measured. The distances between the isthmus floor and two apical foramina and the number of root canal orifices were calculated. The dimensions of the isthmus roof and the floor were compared, and the data were analysed using descriptive statistics and Student's t-tests with a significance threshold set at 5%. A total of 15% of the specimens had band-shaped isthmuses with a floor in the apical third. The isthmus roof exhibited significantly greater major and minor diameter values compared to the isthmus floor (P < 0.05). No significant difference was detected between the isthmus roof and the floor with regard to roundness (P > 0.05). Three- and two-dimensional analyses of the mesial roots of mandibular molars revealed that band-shaped isthmuses had complex shapes. © 2017 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Radicular anatomy of permanent mandibular second molars in an Iranian population: A preliminary study

PubMed Central

Akhlaghi, Nahid M.; Abbas, Fatemeh Mashadi; Mohammadi, Mostafa; Shamloo, Mohammad Reza Karami; Radmehr, Orkideh; Kaviani, Ramin; Rakhshan, Vahid

2016-01-01

Background: Root morphology is of utmost importance to endodontic sciences. Since there are a few studies on the morphology of mandibular second molars' roots, and some anatomical variables are not evaluated before, the aim of this study was to investigate thoroughly radicular anatomy of this tooth. Materials and Methods: This ex vivo study was performed on 150 intact mandibular second molars. After access cavity preparation and ensuring canal patency, Indian ink was injected into root canals from the orifices. The teeth became transparent using methyl salicylate storage. Then, they were inspected by an endodontist under a ×10 stereomicroscope regarding numerous root morphological variables. Data were analyzed using chi-square test and analysis of variance (α = 0.05). Results: About 86.7% of teeth had two roots and 13.3% were single-rooted (P = 0.0001), of which, 50% were C-shaped (6.7% of all teeth, P = 0.0001). 86.7% of mesial roots were double canalled, whereas 75.3% of distal roots were single canalled (P = 0.0001). 71.45% and 95.3% of the mesial and distal roots had one apical foramen, respectively (P = 0.0001). Apical foramens were mostly central followed by lingual in most cases. Distances between apical foramen and apical constriction ranged between 0.27 and 0.40 mm (P = 0.0545). Distances between apical foramen and root apices ranged between 0.30 and 0.47 mm (P = 0.0001). Vertucci classifications of mesial canals were Type II in 62.6% and Type IV in 37.4%. 86.2% of single-canal distal roots were Type I. 66.7% of double-canal distal roots were Type II and 33.3% were Type IV (P = 0.0001). The mean root lengths from cervical to apex of mesial, distal, and single roots were 14.02 ± 0.85 (95% confidence interval [CI] = 13.87–14.17), 13.35 ± 0.91 (95% CI = 13.19–13.50), and 14.25 ± 0.72 mm (95% CI = 13.91–14.58), respectively. The extents of canal curvatures varied between 20° and 31° buccolingually (P = 0.0000), and between 19° and 27° mesiodistally (P = 0.0000). Conclusion: There was a considerable rate of eccentric apical foramen in mandibular second molars. PMID:27605995

Combined effects of photodynamic therapy and irrigants in disinfection of root canals.

PubMed

Susila, Anand V; Sugumar, R; Chandana, C S; Subbarao, C V

2016-06-01

In this study, the combined effects of photodynamic therapy and irrigants in eradicating common endodontic pathogens are evaluated. Roots of 80 extracted single rooted teeth are divided into 2 groups (1) mechanical flushing; (2) antibacterial irrigation. After cleaning and shaping, they are inoculated with either (A) Streptococcus mutans or (B) Enterococcus faecalis and incubated. They are again subdivided and either only irrigated or irrigated and lased. Dentin shavings are taken from root canal walls and cultured. Statistical analysis using One-Way ANOVA and Post-hoc tests are done. The combination eradicated both bacteria. Antibacterial irrigants controlled S. mutans better than PDT (p = 0.041). The combination of PDT and antibacterial irrigation proposed in this study can be used in all primary cases for thorough and reliable disinfection of root canals but may be highly effective in resistant cases like endodontic failures, as E. faecalis is prevalent in such cases. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Efficacy of irrigation systems on penetration of sodium hypochlorite to working length and to simulated uninstrumented areas in oval shaped root canals.

PubMed

de Gregorio, C; Paranjpe, A; Garcia, A; Navarrete, N; Estevez, R; Esplugues, E O; Cohenca, N

2012-05-01

To assess the ability of sodium hypochlorite (NaOCl) to penetrate simulated lateral canals and to reach working length (WL) when using the self-adjusting file (SAF). Seventy single-rooted teeth with oval-shaped canals were used. Upon access, presence of a single canal was confirmed by direct visualization under a dental-operating microscope. Canal length and patency were obtained using a size 10 K-file and root length standardized to 18 mm. Pre-enlargement was restricted to the coronal one-third. The apical size of each canal was gauged at WL and samples larger than size 30 were excluded. Canals were instrumented for 5 min using the SAF system while delivering a total of 20 mL of 5.25% NaOCl and 5 mL of 17% EDTA. Then, the apical diameters were standardized to size 35 using hand files. Four hundred and twenty simulated lateral canals were then created during the clearing process and roots coated with wax to create a closed system. All samples were then cleared and randomly assigned to four experimental groups: 1 (n = 15) positive pressure; 2 (n = 15) SAF without pecking motion; 3 (n = 15) SAF with pecking motion; 4 (n = 15) apical negative pressure (ANP) irrigation and (n = 10) control groups. Samples were scored on the basis of the ability of the contrast solution to reach WL and permeate into the simulated lateral canals to at least 50% of the total length. The Kruskal-Wallis test was used to analyse irrigant penetration and the Tukey test to determine statistical differences between groups (P < 0.05). All samples irrigated with ANP were associated with irrigant penetration to WL (Table 1). The differences between group 4 (ANP) and all other groups were significant in penetration to WL (P < 0.05). The pecking motion allowed for further penetration of the irrigant when using the SAF system but failed to irrigate at WL. None of the experimental groups demonstrated predictable irrigation of simulated lateral canals. In this laboratory model, ANP was the only delivery system capable of irrigating consistently to full WL. None of the systems tested produced complete irrigation in artificial lateral canals. © 2012 International Endodontic Journal.

The effect of larger apical preparations in the danger zone of lower molars prepared using the Mtwo and Reciproc systems.

PubMed

Sant'Anna Júnior, Arnaldo; Cavenago, Bruno Cavalini; Ordinola-Zapata, Ronald; De-Deus, Gustavo; Bramante, Clovis Monteiro; Duarte, Marco Antonio Hungaro

2014-11-01

The aim of this study was to evaluate the effects of large apical preparations in the danger zones of the mesial root canals of mandibular molars instrumented with the Mtwo and Reciproc systems (VDW, Munich, Germany) until reaching apical diameters of 0.25 and 0.40 mm. Twelve mandibular molars, the mesial roots of which presented distinct foramens and similar anatomies, were selected using micro-computed tomographic scanning. Mtwo and Reciproc instruments were used to shape the mesiobuccal or mesiolingual canals. The mesial canals were scanned before and after the use of 0.25- and 0.40-mm Mtwo and Reciproc instruments. The analyzed parameters included the root canal volume and remaining dentin thickness at 5 different levels. The obtained data were subjected to paired analysis of variance and Tukey or Friedman and Dunn tests for intragroup analysis and the Mann-Whitney U test for comparison between the mesial and distal walls. There were no significant differences between the mesial and distal dentin thickness for the points analyzed with both instrumentation techniques (P > .05). The volumetric analysis revealed a significant difference (P < .05) among the initial volume and after the use of the 0.25- and 0.40-mm instruments for both systems. The use of the 0.40-mm instrument increased the root canal volume in comparison to the 0.25-mm instrument (P < .05). Both systems performed similarly for the preparation of curved root canals with separate apical foramens. The increase of the root canal preparation with the 0.40-mm instrument significantly increased the root canal volume at the apical third without significantly reducing the dentin thickness in the danger zone for both instrument systems. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Cyclic fatigue of nickel-titanium rotary instruments in a double (S-shaped) simulated curvature.

PubMed

Al-Sudani, Dina; Grande, Nicola M; Plotino, Gianluca; Pompa, Giorgio; Di Carlo, Stefano; Testarelli, Luca; Gambarini, Gianluca

2012-07-01

The goal of the present study was to test the fatigue resistance of nickel-titanium rotary files in a double curvature (S-shaped) artificial root canal and to compare those results with single curvature artificial root canals. Two nickel-titanium endodontic instruments consisting of identical instrument sizes (constant .06 taper and 0.25 tip diameter) were tested, ProFile instruments and Vortex instruments. Both instruments were tested for fatigue inside an artificial canal with a double curvature and inside a curved artificial canal with a single curvature. Ten instruments for each group were tested to fracture in continuous rotary motion at 300 rpm. Number of cycles to failure (NCF) was calculated to the nearest whole number, and the length of the fractured fragment was measured in millimeters. Data were statistically analyzed with a level of significance set at 95% confidence level. The NCF value was always statistically lower in the double curved artificial canal when compared with the single curve (P < .05) in both the apical and coronal curvatures. Statistically significant differences (P < .05) were noted between instruments of the same size of different brand only in the single curve; ProFile registered a mean of 633.5 ± 75.1 NCF, whereas Vortex registered a mean of 548 ± 48.9 NCF. Regardless of the differences between the instruments used in the present study, the results suggest that the more complex is the root canal, the more adverse are the effects on the cyclic fatigue resistance of the instruments. Copyright © 2012 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Comparison of preparation of curved root canals with Hyflex CM and Revo-S rotary nickel-titanium instruments.

PubMed

Bürklein, S; Börjes, L; Schäfer, E

2014-05-01

To compare the shaping ability of three different nickel-titanium rotary instruments during the preparation of curved root canals in extracted teeth. A total of 60 root canals with curvatures ranging between 25° and 35° were divided into three groups of 20 canals. Based on radiographs taken prior to instrumentation, the groups were balanced with respect to the angle and the radius of canal curvature. Canals were prepared to a final apical size of 35 using Mtwo, Hyflex CM, and Revo-S. Using pre- and post-instrumentation radiographs, straightening of the canal curvatures was determined with a computer image analysis program. Preparation time, changes of working length and instrument failures were also recorded. These data were analysed statistically using anova and Student-Newman-Keuls test. During preparation, no file fractured. Mtwo and Hyflex CM maintained the original canal curvature significantly better than Revo-S (P < 0.05). Instrumentation with Mtwo and Hyflex CM was significantly faster than with Revo-S and resulted in less loss of working length (P < 0.05), whilst no significant differences were obtained between Mtwo and Hyflex CM (P > 0.05). Under the conditions of this study, Mtwo and Hyflex CM respected the original canal curvature well and were safe to use. The use of Revo-S instruments required more time to prepare the curved canals and resulted in more pronounced canal straightening compared with Mtwo and Hyflex CM. © 2013 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Shaping ability of single-file reciprocating and heat-treated multifile rotary systems: a micro-CT study.

PubMed

Marceliano-Alves, M F V; Sousa-Neto, M D; Fidel, S R; Steier, L; Robinson, J P; Pécora, J D; Versiani, M A

2015-12-01

To investigate changes in three-dimensional geometry, in various cross-sectional morphological parameters and in the centring ability of root canals prepared with different preparation systems using microcomputed tomographic imaging technology. Sixty-four mesial canals of mandibular molars were matched based on similar morphological dimensions using micro-CT evaluation and assigned to four experimental groups (n = 16), according to the canal preparation technique: Reciproc, WaveOne, Twisted File and HyFlex CM systems. Changes in several 2D (area, perimeter, form factor, roundness, minor and major diameter) and 3D [volume, surface area, structure model index (SMI)] morphological parameters, as well as canal transportation, were compared with preoperative values using Kruskal-Wallis and anovapost hoc Tukey's tests with the significance level set at 5%. Preparation significantly increased all tested parameters in the experimental groups. No significant differences were observed between groups regarding changes in volume, surface area, SMI, form factor and roundness of the root canal after preparation (P > 0.05). In the apical third, the Reciproc group had significantly greater changes in canal area, perimeter, major and minor diameters than the other groups (P < 0.05). Overall, the Twisted File and HyFlex CM systems were associated with significantly less transportation than the reciprocating instruments, Reciproc and WaveOne (P < 0.05). Shaping procedures led to the enlargement of the root canal space with no evidence of significant preparation errors. Changes in 3D parameters were not different between groups whilst, in the apical third, Reciproc was associated with significantly greater changes in several 2D parameters compared to the other groups. Twisted File and HyFlex CM systems were able to maintain the original canal anatomy with less canal transportation than Reciproc and WaveOne; however, these differences are unlikely to be of clinical significance. © 2014 International Endodontic Journal. Published by John Wiley & Sons Ltd.

CBCT Assessment of Root Dentine Removal by Gates-Glidden Drills and Two Engine-Driven Root Preparation Systems

PubMed Central

Harandi, Azade; Mohammadpour Maleki, Fatemeh; Moudi, Ehsan; Ehsani, Maryam; Khafri, Soraya

2017-01-01

Introduction: The aim of this study was to compare the dentine removing efficacy of Gates-Glidden drills with hand files, ProTaper and OneShape single-instrument system using cone-beam computed tomography (CBCT). Methods and Materials: A total of 39 extracted bifurcated maxillary first premolars were divided into 3 groups (n=13) and were prepared using either Gates-Glidden drills and hand instruments, ProTaper and OneShape systems. Pre- and post-instrumentation CBCT images were obtained. The dentin thickness of canals was measured at furcation, and 1 and 2 mm from the furcation area in buccal, palatal, mesial and distal walls. Data were analyzed using one-way ANOVA test. Tukey’s post hoc tests were used for two-by-two comparisons. Results: Gates-Glidden drills with hand files removed significantly more (P<0.001) dentine than the engine-driven systems in all canal walls (buccal, palatal, mesial and distal). There were no significant differences between OneShape and ProTaper rotary systems (P>0.05). Conclusion: The total cervical dentine removal during canal instrumentation was significantly less with engine-driven file systems compared to Gates-Glidden drills. There were no significant differences between residual dentine thicknesses left between the various canal walls. PMID:28179920

Instrument separation analysis of multi-used ProTaper Universal rotary system during root canal therapy.

PubMed

Wu, Jintao; Lei, Gang; Yan, Ming; Yu, Yan; Yu, Jinhua; Zhang, Guangdong

2011-06-01

The purpose of this study was to identify the influential factors responsible for clinical instrument separation of reused ProTaper Universal rotary instruments (Dentsply Maillefer, Ballaigues, Switzerland). Six thousand one hundred fifty-four root canals in 2,654 teeth were prepared using ProTaper Universal files in endodontic clinics. Separation incidence was determined based on the number of treated teeth or canals. Data were collected including the size of fractured instrument, the length and location of a broken segment within the root canal, and the curvature of canal. The chi-square test and independent samples t test were used to determine the statistical significance. The overall instrument separation incidences were 2.6% according to the number of teeth and 1.1% according to the canal number, respectively. Separation incidences according to the number of teeth or canals were significantly higher (P < .05) in molars than those in premolars or anterior teeth. Because of its largest diameter, F3 file presented the highest separation incidence according to the number of teeth (1.0%) or canals (0.4%); 47.5% instrument separation of mandibular molars and 61.5% instrument separation of maxillary molars happened in the mesiobuccal canals. Moreover, 91.4% fragments were located in the apical third of root canals, and 54.2% instrument separation occurred in severely curved canals. There was a significant difference (P < .05) in the mean fracture length between shaping (2.42 ± 0.73 mm) and finishing files (3.32 ± 0.73 mm). Separation incidence according to the canal number is more reliable than that according to the number of teeth because of the variable canal number in different teeth. The tooth type, rotary file size, canal location, and anatomy were correlated with the instrument separation of reused ProTaper Universal files. Copyright © 2011 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

A comparison of the shaping ability of three nickel-titanium rotary instruments: a micro-computed tomography study via a contrast radiopaque technique in vitro.

PubMed

Wei, Zhao; Cui, Zhi; Yan, Ping; Jiang, Han

2017-01-09

Micro-CT (μCT) studies that combine simulated canals with meglucamine diatrizoate to evaluate the shaping ability of nickel-titanium (NiTi) rotary instruments are lacking in the literature. The purpose of this study was to evaluate the shaping ability of three new different nickel-titanium rotary instruments in simulated root canals using μCT. Thirty simulated root canals with a curvature of 60° were randomly allocated into the following 3 groups (n = 10): Group 1, ProTaper Universal (PTU) rotary system; Group 2, Reciproc single-file system; and Group 3, K3XF rotary system. Pre- and post-instrumented images of simulated canals were scanned with μCT via a radiopaque contrast technique to build a 3-dimensional (3D) model. Canal transportation, volumetric change and centring ability were evaluated in each group. Instrument failure and preparation time were also recorded. The Kruskal-Wallis test was used for statistical analysis and the significance level was set at p = 0.05. Reciproc produced greater volume change in the apical part of the canals compared with PTU and K3XF (p < 0.05). K3XF exhibited less transportation and better centring ability at the 2- and 3-mm levels from the apical foramen compared with PTU and Reciproc (p < 0.05). There were no significant differences in the centring ratio and transportation between PTU and Reciproc. Preparation time was significantly shorter in the Reciproc group (p < 0.05). Under the conditions of our study, all of the canals were 3D reconstructed successfully via the radiopaque contrast technique. Reciproc showed enhanced apical volume changes and K3XF exhibited better centring ability when compared with other groups.

Analysis of C-shaped canal systems in mandibular second molars using surgical operating microscope and cone beam computed tomography: A clinical approach.

PubMed

Chhabra, Sanjay; Yadav, Seema; Talwar, Sangeeta

2014-05-01

The study was aimed to acquire better understanding of C-shaped canal systems in mandibular second molar teeth through a clinical approach using sophisticated techniques such as surgical operating microscope and cone beam computed tomography (CBCT). A total of 42 extracted mandibular second molar teeth with fused roots and longitudinal grooves were collected randomly from native Indian population. Pulp chamber floors of all specimens were examined under surgical operating microscope and classified into four types (Min's method). Subsequently, samples were subjected to CBCT scan after insertion of K-files size #10 or 15 into each canal orifice and evaluated using the cross-sectional and 3-dimensional images in consultation with dental radiologist so as to obtain more accurate results. Minimum distance between the external root surface on the groove and initial file placed in the canal was also measured at different levels and statistically analyzed. Out of 42 teeth, maximum number of samples (15) belonged to Type-II category. A total of 100 files were inserted in 86 orifices of various types of specimens. Evaluation of the CBCT scan images of the teeth revealed that a total of 21 canals were missing completely or partially at different levels. The mean values for the minimum thickness were highest at coronal followed by middle and apical third levels in all the categories. Lowest values were obtained for teeth with Type-III category at all three levels. The present study revealed anatomical variations of C-shaped canal system in mandibular second molars. The prognosis of such complex canal anatomies can be improved by simultaneous employment of modern techniques such as surgical operating microscope and CBCT.

Canal transportation and centering ability of protaper and self-adjusting file system in long oval canals: An ex-vivo cone-beam computed tomography analysis.

PubMed

Shah, Dipali Yogesh; Wadekar, Swati Ishwara; Dadpe, Ashwini Manish; Jadhav, Ganesh Ranganath; Choudhary, Lalit Jayant; Kalra, Dheeraj Deepak

2017-01-01

The purpose of this study was to compare and evaluate the shaping ability of ProTaper (PT) and Self-Adjusting File (SAF) system using cone-beam computed tomography (CBCT) to assess their performance in oval-shaped root canals. Sixty-two mandibular premolars with single oval canals were divided into two experimental groups ( n = 31) according to the systems used: Group I - PT and Group II - SAF. Canals were evaluated before and after instrumentation using CBCT to assess centering ratio and canal transportation at three levels. Data were statistically analyzed using one-way analysis of variance, post hoc Tukey's test, and t -test. The SAF showed better centering ability and lesser canal transportation than the PT only in the buccolingual plane at 6 and 9 mm levels. The shaping ability of the PT was best in the apical third in both the planes. The SAF had statistically significant better centering and lesser canal transportation in the buccolingual as compared to the mesiodistal plane at the middle and coronal levels. The SAF produced significantly less transportation and remained centered than the PT at the middle and coronal levels in the buccolingual plane of oval canals. In the mesiodistal plane, the performance of both the systems was parallel.

Efficacy of 3D conforming nickel titanium rotary instruments in eliminating canal wall bacteria from oval-shaped root canals.

PubMed

Bortoluzzi, Eduardo A; Carlon, Daniel; Meghil, Mohamed M; El-Awady, Ahmed R; Niu, Lina; Bergeron, Brian E; Susin, Lisiane; Cutler, Christopher W; Pashley, David H; Tay, Franklin R

2015-05-01

To evaluate the effectiveness of TRUShape® 3D Conforming Files, compared with Twisted Files, in reducing bacteria load from root canal walls, in the presence or absence of irrigant agitation. Extracted human premolars with single oval-shaped canals were infected with Enterococcus faecalis. Teeth in Group I (N=10; NaOCl and QMix® 2in1 as respective initial and final irrigants) were subdivided into 4 subgroups: (A) TRUShape® instrumentation without irrigant activation; (B) TRUShape® instrumentation with sonic irrigant agitation; (C) Twisted Files without irrigant agitation; (D) Twisted Files with sonic irrigant agitation. To remove confounding factor (antimicrobial irrigants), teeth in Group II (N=10) were irrigated with sterile saline, using the same subgroup designations. Specimens before and after chemomechanical débridement were cultured for quantification of colony-forming units (CFUs). Data from each group were analyzed separately using two-factor ANOVA and Holm-Sidak multiple comparison (α=0.05). Canal wall bacteria were qualitatively examined using scanning electron microscopy (SEM) and light microscopy of Taylor-modified Brown and Brenn-stained demineralised sections. CFUs from subgroups in Group I were not significantly different (P=0.935). For Group II, both file type (P<0.001) and irrigant agitation (P<0.001) significantly affected log-reduction in CFU concentrations. The interaction of these two factors was not significant (P=0.601). Although SEM showed reduced canal wall bacteria, bacteria were present within dentinal tubules after rotary instrumentation, as revealed by light microscopy of longitudinal root sections. TRUShape® files removed significantly more canal wall bacteria than Twisted Files when used without an antibacterial irrigant; the latter is required to decontaminate dentinal tubules. Root canal disinfection should not be focused only on a mechanistic approach. Rather, the rational choice of a rotary instrumentation system should be combined with the use of well-tested antimicrobial irrigants and delivery/agitation techniques to establish a clinically realistic chemomechanical débridement protocol. Published by Elsevier Ltd.

Effect of Instrument Design and Access Outlines on the Removal of Root Canal Obturation Materials in Oval-shaped Canals.

PubMed

Niemi, Tuomas K; Marchesan, Melissa A; Lloyd, Adam; Seltzer, Robert J

2016-10-01

The aim of this study was to compare the effectiveness of TRUShape (TS) instruments with ProFile Vortex Blue (VB) instruments for the removal of obturation materials during retreatment of single-canal mandibular premolars performed through 2 access outlines. Initial root canal treatment was completed through a contracted endodontic cavity (CEC) design. Canals were instrumented to an F2 ProTaper instrument, obturated with warm lateral condensation of gutta-percha with AH Plus sealer, and allowed to set for 30 days at 37°C and 100% humidity. For retreatment, specimens were divided into 2 groups (n = 24) on the basis of access outline, CEC or traditional endodontic cavity (TEC). Retreatment was initiated by using ProTaper Retreatment instruments (D1-D3). Specimens were then stratified, further divided (n = 12), and reinstrumented up to TS 40 .06v or 40 .06 VB. Irrigation was performed by using 8.25% NaOCl and QMix 2in1. Retreatment time was recorded. Teeth were sectioned and photographed, and the percentage of remaining obturation materials was measured. Data were analyzed with Kruskal-Wallis analysis of variance for two-factor tests (α < 0.05). The interaction between access design and instrument type showed that the combination of CEC-VB presented significantly higher amounts of remaining obturation materials on the canal surface when compared with TEC-VB, CEC-TS, and TEC-TS (P ≤ .05). None of these other combinations were different from each other (P > .05). Significantly more time was required for retreatment with CEC-TS (27.68 ± 1.4 minutes) than the other groups (P < .05). Neither retreatment protocol was able to completely eliminate all obturation materials from the root canal surface of mandibular premolars. However, in the presence of a CEC access design, using TS instruments removed more obturating material in single-rooted, oval-shaped canals. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Comparison of Shaping Ability of 10 Rotary and Reciprocating Systems: an In Vitro Study with AutoCad.

PubMed

Rubio, Jorge; Zarzosa, José Ignacio; Pallarés, Antonio

2017-09-01

The aim of this study was to compare the cutting are, root canal anatomy preservation and non-instrumented areas of F360®, F6-SkyTaper®, Hyflex-EDM®, iRACE®, Neoniti®, O.Shape®, P.Next®, Reciproc®, Revo-S® and Wave-One-Gold® size 25 files. 300 teeth with a single straight root and a circular or elliptical root canal were divided into 10 groups (1-F360®, 2- F6-SkyTaper®, 3-Hyflex-EDM®, 4-iRACE®, 5-Neoniti®, 6-O.Shape®, 7-P.Next®, 8-Reciproc®, 9-Revo-S® and 10-Wave-One-Gold®) cut into 3 cross sections using an ultrafine cutting disc. They were photographed under a stereo microscope and preinstrumentation analyses were made before rebuilding the teeth with# 10 K- File and epoxy glue. A glide path was created with #10 and #15 K files and each group was instrumented using rotary or reciprocating systems. Cutting areas, root canal anatomy preservation and non-instrumented areas were analyzed using the AutoCAD 2015 Levene's test, the Welch´s test, and the Games-Howell´s test. The Pearson's chi-squared test was used for statistical analysis. Levene's test showed no equality of variances (P<0.05), therefore Welch´s and Games-Howell's tests were applied to cutting areas, showing significant differences in all thirds and overall (P<0.05). No differences in root canal anatomy preservation were observed (P>0.05). In non-instrumented areas, significant differences were found (P<0.05) in middle third being better in Reciproc®, Neoniti® and WaveOneGold®, and in apical thirds being higher P.Next®, Reciproc®, HyflexEDM®, Neoniti® and WaveOneGold®. In cutting area, P.Next® and Reciproc® were superior in coronal third, Neoniti® and Hyflex EDM® medially and apically and Neoniti® and Reciproc® overall. Regarding the root canal anatomy preservation, all systems were similar. For non-instrumented areas, all systems achieved similar results coronally, but Reciproc®, Neoniti® and Wave One Gold® were superior in middle third and P.Next®, Reciproc®, Hyflex EDM®, Neoniti® and Wave One Gold® were superior in apically.

Comparison of Shaping Ability of 10 Rotary and Reciprocating Systems: an In Vitro Study with AutoCad

PubMed Central

Zarzosa, José Ignacio; Pallarés, Antonio

2017-01-01

Objective The aim of this study was to compare the cutting are, root canal anatomy preservation and non-instrumented areas of F360®, F6-SkyTaper®, Hyflex-EDM®, iRACE®, Neoniti®, O.Shape®, P.Next®, Reciproc®, Revo-S® and Wave-One-Gold® size 25 files. Materials and Methods 300 teeth with a single straight root and a circular or elliptical root canal were divided into 10 groups (1-F360®, 2- F6-SkyTaper®, 3-Hyflex-EDM®, 4-iRACE®, 5-Neoniti®, 6-O.Shape®, 7-P.Next®, 8-Reciproc®, 9-Revo-S® and 10-Wave-One-Gold®) cut into 3 cross sections using an ultrafine cutting disc. They were photographed under a stereo microscope and preinstrumentation analyses were made before rebuilding the teeth with# 10 K- File and epoxy glue. A glide path was created with #10 and #15 K files and each group was instrumented using rotary or reciprocating systems. Cutting areas, root canal anatomy preservation and non-instrumented areas were analyzed using the AutoCAD 2015 Levene's test, the Welch´s test, and the Games-Howell´s test. The Pearson’s chi-squared test was used for statistical analysis. Results Levene's test showed no equality of variances (P<0.05), therefore Welch´s and Games-Howell's tests were applied to cutting areas, showing significant differences in all thirds and overall (P<0.05). No differences in root canal anatomy preservation were observed (P>0.05). In non-instrumented areas, significant differences were found (P<0.05) in middle third being better in Reciproc®, Neoniti® and WaveOneGold®, and in apical thirds being higher P.Next®, Reciproc®, HyflexEDM®, Neoniti® and WaveOneGold®. Conclusions In cutting area, P.Next® and Reciproc® were superior in coronal third, Neoniti® and Hyflex EDM® medially and apically and Neoniti® and Reciproc® overall. Regarding the root canal anatomy preservation, all systems were similar. For non-instrumented areas, all systems achieved similar results coronally, but Reciproc®, Neoniti® and Wave One Gold® were superior in middle third and P.Next®, Reciproc®, Hyflex EDM®, Neoniti® and Wave One Gold® were superior in apically. PMID:29225361

Shaping ability of reciprocating single-file systems in severely curved canals: WaveOne and Reciproc versus WaveOne Gold and Reciproc blue.

PubMed

Bürklein, Sebastian; Flüch, Stefanie; Schäfer, Edgar

2018-05-18

The aim was to compare the canal straightening of M-wire [Reciproc (VDW, Munich, Germany) and WaveOne (Dentsply Maillefer, Ballaigues, Switzerland)] and gold- and blue-wire heat-treated [Reciproc blue (VDW) and WaveOne Gold (Dentsply Maillefer)] instruments in severely curved root canals. A total of 80 root canals in extracted human teeth with angles of curvatures ranging between 25° and 35° and radii ranging between 3.1 and 8.5 mm were divided into four groups (n = 20). Based on radiographs taken prior to instrumentation, the groups were balanced with respect to the angle and the radius of canal curvature (P = 1.0 and P = 1.0, respectively). All canals were prepared to an apical size 25 according to the manufacturers' instructions. Pre- and post-instrumentation radiographs were superimposed and canal straightening was analysed using a computer imaging programme. Preparation time and instrument failure were also recorded. Data were analysed statistically using ANOVA and Student-Newman-Keuls test. During preparation no instrument fractured. All instruments maintained the original canal curvature well with no significant differences between the instruments (P = 0.278). Regarding preparation time, no significant differences between the four instruments were obtained (P > 0.05). Under the conditions of this study, all instruments respected the original canal curvature well. Instruments were safe to use. The use of the gold- and blue-wire heat-treated instruments was not associated with an improved shaping ability.

Root canal preparation with a novel nickel-titanium instrument evaluated with micro-computed tomography: canal surface preparation over time.

PubMed

Peters, Ove A; Boessler, Claudia; Paqué, Frank

2010-06-01

The aim of this part of an ongoing study was to describe the dentin removal ability of a novel nickel-titanium instrument, the self-adjusting file (SAF), by using micro-computed tomography. Twenty maxillary incisors were scanned preoperatively at 20-microm resolution and postoperatively after up to 6 minutes of preparation with an SAF with 1.5-mm or 2-mm diameter. SAFs were operated with continuous irrigation in a handpiece that provided an oscillating, in-and-out movement. Changes in canal volume compared with preoperative values as well as unprepared canal surface area were determined. Data were normally distributed and compared by analysis of variance and regression analyses. Preoperatively canal volumes were statistically similar in both groups (9.86 +/- 3.97 mm3 and 9.80 +/- 2.67 mm3). Volumes increased during preparation to 13.58 +/- 3.85 mm3 (after 6 minutes with SAF 1.5 mm) and 16.43 +/- 3.64 mm3 (after 5 minutes with SAF 2.0 mm), and overall canal shapes were adequate. Unprepared canal surface area decreased from 63.0% +/- 15.1% (2 minutes with SAF 1.5 mm) to 8.6% +/- 4.1% (5 minutes with SAF 2.0 mm). Preparation of straight root canals in maxillary anterior teeth left little canal surface uninstrumented after shaping with the SAF. The timeframe of clinical application will depend on the amount of desired dentin removal and done with an SAF selected on the basis of apical gauging. Copyright 2010 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Comparative Analysis of Canal Centering Ability of Different Single File Systems Using Cone Beam Computed Tomography- An In-Vitro Study

PubMed Central

Agarwal, Jatin; Jain, Pradeep; Chandra, Anil

2015-01-01

Background The ability of an endodontic instrument to remain centered in the root canal system is one of the most important characteristic influencing the clinical performance of a particular file system. Thus, it is important to assess the canal centering ability of newly introduced single file systems before they can be considered a viable replacement of full-sequence rotary file systems. Aim The aim of the study was to compare the canal transportation, centering ability, and time taken for preparation of curved root canals after instrumentation with single file systems One Shape and Wave One, using cone-beam computed tomography (CBCT). Materials and Methods Sixty mesiobuccal canals of mandibular molars with an angle of curvature ranging from 20o to 35o were divided into three groups of 20 samples each: ProTaper PT (group I) – full-sequence rotary control group, OneShape OS (group II)- single file continuous rotation, WaveOne WO – single file reciprocal motion (group III). Pre instrumentation and post instrumentation three-dimensional CBCT images were obtained from root cross-sections at 3mm, 6mm and 9mm from the apex. Scanned images were then accessed to determine canal transportation and centering ability. The data collected were evaluated using one-way analysis of variance (ANOVA) with Tukey’s honestly significant difference test. Results It was observed that there were no differences in the magnitude of transportation between the rotary instruments (p >0.05) at both 3mm as well as 6mm from the apex. At 9 mm from the apex, Group I PT showed significantly higher mean canal transportation and lower centering ability (0.19±0.08 and 0.39±0.16), as compared to Group II OS (0.12±0.07 and 0.54±0.24) and Group III WO (0.13±0.06 and 0.55±0.18) while the differences between OS and WO were not statistically significant Conclusion It was concluded that there was minor difference between the tested groups. Single file systems demonstrated average canal transportation and centering ability comparable to full sequence Protaper system in curved root canals. PMID:26155551

Cleaning efficacy of reciprocal and rotary systems in the removal of root canal filling material

PubMed Central

Koçak, Mustafa Murat; Koçak, Sibel; Türker, Sevinç Aktemur; Sağlam, Baran Can

2016-01-01

Aim: The aim of this study was to compare the efficacy of hand file, nickel titanium rotary instrument, and two reciprocating instruments for removing gutta-percha and sealer from the root canals. Materials and Methods: Eighty-eight mandibular premolar teeth were used. The root canals were shaped and filled with gutta-percha and a resin-based sealer. The specimens were divided into four groups according to the technique by which the root filling material was removed: Group 1 — Wave One; Group 2 — Reciproc; Group 3 — ProTaper; and Group 4 — Gates-Glidden burs and stainless steel hand file. Then teeth were split longitudinally and photographed. The images were transferred to a computer. The ratio of remaining filling material to the root canal periphery was calculated with the aid of ImageJ software. Statistical analysis was performed using Kruskal–Wallis and Mann–Whitney tests. Results: A significant difference was found among all groups (P < 0.001). The WaveOne group demonstrated significantly less remaining filling material. The greatest amount of filling material was found in specimens where gutta-percha was removed with Gates-Glidden burs and stainless steel hand file. Conclusion: The reciprocating files were found to be significantly more effective in removing the filling material from the canal walls compared to the rotational file and hand file. PMID:27099429

Lasers in Apicoectomy: A Brief Review.

PubMed

Mohammadi, Zahed; Jafarzadeh, Hamid; Shalavi, Sousan; Kinoshita, Jun-Ichiro; Giardino, Luciano

2017-02-01

Since the invention of laser, various applications for lasers in endodontics have been proposed, such as disinfection of the root canal system, canal shaping, pulp diagnosis, and apico-ectomy. One of the major applications of laser in endodontics is apicoectomy. The aim of this article is to review the benefits and drawbacks of laser applications in apicoectomy, including effect on apical seal, effect on dentin permeability, effect on postsurgery pain, effect on crack formation, effect on root-end morphology, effect on treatment outcome, and connective tissue response to laser-treated dentin.

Critical instrumentation area: influence of root canal anatomy on the endodontic preparation.

PubMed

de Oliveira, Maria Antonieta Veloso Carvalho; Venâncio, Jessyca Figueira; Pereira, Analice Giovani; Raposo, Luís Henrique Araújo; Biffi, João Carlos Gabrielli

2014-01-01

The aim of this study was to evaluate the root canal anatomy of mandibular incisors before and after endodontic instrumentation, identifying regions inaccessible to the action of files (Critical instrumentation Area - CA) in a three-dimensional perspective. Thirty human mandibular central incisors were selected, assigned to two groups (n=15) and instrumented using ProTaper Universal rotary files. In the RX group, longitudinal digital radiographic images were obtained in the buccolingual (BL) and mesiodistal (MD) views. In the CT group, cross-sectional micro-computed tomography (µCT) images were obtained at 3, 9 and 15 mm from the apex. The canal area of the specimens was evaluated before and after instrumentation using digital images from each group. Data were analyzed using t-test, one-way ANOVA with subdivided parcels and Tukey's test (α=0.05). The canal area found in the MD radiographs was larger than in the BL radiographs, which was also confirmed in the transversal images (p<0.01). The CA was only detected in the MD radiographs and µCT scans. On the root canal configuration, a continuous reduction in the canal conicity was observed in BL radiographs, while in MD view there was a constriction at the cervical third and subsequent increase at the middle third (p<0.01). The conical shape of the root canal was observed only in the BL view. The canal enlargement in BL radiographs was not indicative of homogeneous instrumentation, since unprepared areas (CA) were also verified on the buccal and lingual walls in different images.

Root Canal Morphology and Configuration of 118 Mandibular First Molars by Means of Micro-Computed Tomography: An Ex Vivo Study.

PubMed

Wolf, Thomas Gerhard; Paqué, Frank; Zeller, Maximilian; Willershausen, Brita; Briseño-Marroquín, Benjamín

2016-04-01

The aim of this study was to investigate the root canal system morphology of the mandibular first molar by means of micro-computed tomography. The root canal configuration, foramina, and accessory canals frequency of 118 mandibular first molars were investigated by means of micro-computed tomography and 3-dimensional software imaging. A 4-digit system describes the root canal configuration from the coronal to apical thirds and the main foramina number. The most frequent root canal configurations in mesial root were 2-2-2/2 (31.4%), 2-2-1/1 (15.3%), and 2-2-2/3 (11.9%); another 24 different root canal configurations were observed in this root. A 1-1-1/1 (58.5%), 1-1-1/2 (10.2%), and 16 other root canal configurations were observed in the distal root. The mesiobuccal root canal showed 1-4 foramina in 24.6%, and the mesiolingual showed 1-3 foramina in 28.0%. One connecting canal between the mesial root canals was observed in 30.5% and 2 in 3.4%. The distolingual root canal showed 1-4 foramina in 23.7%, whereas a foramen in the distobuccal root canal was rarely detected (3.4%). The mesiobuccal, mesiolingual, and distolingual root canals showed at least 1 accessory canal (14.3, 10.2, and 4.2%, respectively), but the distobuccal had none. The root canal configuration of mandibular first molars varies strongly. According to our expectations, both the mesial and distal roots showed a high number of morphologic diversifications. The root canal system of the mesial root showed more root canal configuration variations, connecting and accessory canals than the distal root. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Comparative in vivo analysis of the sealing ability of three endodontic sealers in post-prepared root canals.

PubMed

Kopper, P M P; Figueiredo, J A P; Della Bona, A; Vanni, J R; Bier, C A; Bopp, S

2003-12-01

To compare the sealing ability of the endodontic sealers AH Plus, Sealer 26 and Endofill in premolar teeth of dogs exposed to the oral cavity after post-preparation. Forty teeth with two canals each underwent root canal cleaning and shaping. Before filling, the canals were randomly distributed into three groups according to the sealer to be used: Group 1 - AH Plus; Group 2 - Sealer 26; and Group 3 - Endofill (Dentsply, Indústria e Comércio Ltda.). Immediately after filling, the gutta percha and sealer were partially removed from the canals, leaving material only in the apical third of the root. The teeth were temporarily sealed with glass ionomer sealer for 72 h to ensure setting. The coronal seal was then removed and the canals were exposed to the oral cavity for 45 days. The animals were euthanased and their mandibles and maxillae were removed. After abundant irrigation with distilled water, the canals were dried and filled with India ink. The teeth were sealed again for 96 h before extraction. The roots of the extracted premolars were separated and stored in labelled test tubes. The roots were cleared and the extent of dye penetration was measured with a 20x stereoscopic magnifying lens. Statistical analysis revealed that there were significant differences between the sealers studied (P < 0.001). Means for the extent of dye penetration for AH Plus, Endofill and Sealer 26 were, respectively, 0.13, 2.27 and 3.08 mm. After 45 days exposure to the oral cavity, none of the sealers was capable of preventing leakage and coronal dye penetration. There were significant differences between the sealers studied, in terms of mean dye penetration.

Effectiveness of various irrigation activation protocols and the self-adjusting file system on smear layer and debris removal.

PubMed

Çapar, İsmail Davut; Aydinbelge, Hale Ari

2014-01-01

The purpose of the present study is to evaluate smear layer generation and residual debris after using self-adjusting file (SAF) or rotary instrumentation and to compare the debris and smear layer removal efficacy of the SAF cleaning/shaping irrigation system against final agitation techniques. One hundred and eight maxillary lateral incisor teeth were randomly divided into nine experimental groups (n = 12), and root canals were prepared using ProTaper Universal rotary files, with the exception of the SAF instrumentation group. During instrumentation, root canals were irrigated with a total of 16 mL of 5% NaOCl. For final irrigation, rotary-instrumented groups were irrigated with 10 mL of 17% EDTA and 10 mL of 5% NaOCl using different irrigation agitation regimens (syringe irrigation with needles, NaviTip FX, manual dynamic irrigation, CanalBrush, EndoActivator, EndoVac, passive ultrasonic irrigation (PUI), and SAF irrigation). In the SAF instrumentation group, root canals were instrumented for 4 min at a rate of 4 mL/min with 5% NaOCl and received a final flush with same as syringe irrigation with needles. The surface of the root dentin was observed using a scanning electron microscope. The SAF instrumentation group generated less smear layer and yielded cleaner canals compared to rotary instrumentation. The EndoActivator, EndoVac, PUI, and SAF irrigation groups increased the efficacy of irrigating solutions on the smear layer and debris removal. The SAF instrumentation yielded cleaner canal walls when compared to rotary instrumentation. None of the techniques completely removed the smear layer from the root canal walls. © 2014 Wiley Periodicals, Inc.

Determination of Root Canal Cleanliness by Different Irrigation Methods and Morphometric Analysis of Apical Third.

PubMed

Seixas, Fábio Heredia; Estrela, Carlos; Bueno, Mike Reis; Sousa-Neto, Manoel Damião; Pécora, Jesus Djalma

2015-06-01

The aim of this study was to determine the root canal area before and after the instrumentation 1 mm short of the apical foramen by clinical and cone beam computed tomography (CBCT) methods, and to evaluate the cleanliness of the apical region in mesiodistal flattened teeth by using optical microscopy. Forty-two human single-canal mandibular incisors were instrumented using the Free Tip Preparation technique up to three, four or five instruments from the initial. Cone beam computed tomography scans were acquired of the samples before and after root canal preparation (RCP). Irrigation was performed by conventional or hydrodynamic means, using 2.5% sodium hypochlorite. The samples were prepared for observation under an optical microscope. Images were digitally obtained, analyzed and the results were submitted to statistical analysis (two-way ANOVA complemented by Bonferroni's post-test). There was no significant difference between the studied anatomical areas with both CBCT and clinical methods. There were no differences between irrigation methods. It was verified differences between instrumentation techniques. Instrumentation with four instruments from the initial instrument determined a significant increase in the contact area when compared to preparation with three instruments, but RCP with 5 instruments did not result in a better cleanliness. The analysis with CBCT was not capable to determine the precise shape of surgical apical area comparing to the clinical method. Both the conventional and hydrodynamic irrigation techniques were not able to promote root canals debris-free. The instruments action in root canal walls was proportional to the number of instruments used from the initial apical instrument.

Comparative Analysis of Crack Propagation in Roots with Hand and Rotary Instrumentation of the Root Canal -An Ex-vivo Study.

PubMed

Kumari, Manju Raj; Krishnaswamy, Manjunath Mysore

2016-07-01

Success of any endodontic treatment depends on strict adherence to 'endodontic triad'. Preparation of root canal system is recognized as being one of the most important stages in root canal treatment. At times, we inevitably end up damaging root dentin which becomes a Gateway for infections like perforation, zipping, dentinal cracks and minute intricate fractures or even vertical root fractures, thereby resulting in failure of treatment. Several factors may be responsible for the formation of dentinal cracks like high concentration of sodium hypochlorite, compaction methods and various canal shaping methods. To compare and evaluate the effects of root canal preparation techniques and instrumentation length on the development of apical root cracks. Seventy extracted premolars with straight roots were mounted on resin blocks with simulated periodontal ligaments, exposing 1-2 mm of the apex followed by sectioning of 1mm of root tip for better visualization under stereomicroscope. The teeth were divided into seven groups of 10 teeth each - a control group and six experimental groups. Subgroup A & B were instrumented with: Stainless Steel hand files (SS) up to Root Canal Length (RCL) & (RCL -1 mm) respectively; sub group C & D were instrumented using ProTaper Universal (PTU) up to RCL and (RCL -1mm) respectively; subgroup E & F were instrumented using ProTaper Next (PTN) up to RCL & (RCL -1 mm) respectively. Stereomicroscopic images of the instrumentation sequence were compared for each tooth. The data was analyzed statistically using descriptive analysis by 'Phi' and 'Cramers' test to find out statistical significance between the groups. The level of significance was set at p< 0.05 using SPSS software. Stainless steel hand file group showed most cracks followed by ProTaper Universal & ProTaper Next though statistically not significant. Samples instrumented up to 1mm short of working length (RCL-1mm) showed lesser number of cracks. All groups showed cracks formation, the stainless steel group being the highest. Working 1mm short of apex reduces the incidence of crack formation.

Canal transportation and centering ability of protaper and self-adjusting file system in long oval canals: An ex-vivo cone-beam computed tomography analysis

PubMed Central

Shah, Dipali Yogesh; Wadekar, Swati Ishwara; Dadpe, Ashwini Manish; Jadhav, Ganesh Ranganath; Choudhary, Lalit Jayant; Kalra, Dheeraj Deepak

2017-01-01

Context and Aims: The purpose of this study was to compare and evaluate the shaping ability of ProTaper (PT) and Self-Adjusting File (SAF) system using cone-beam computed tomography (CBCT) to assess their performance in oval-shaped root canals. Materials and Methods: Sixty-two mandibular premolars with single oval canals were divided into two experimental groups (n = 31) according to the systems used: Group I – PT and Group II – SAF. Canals were evaluated before and after instrumentation using CBCT to assess centering ratio and canal transportation at three levels. Data were statistically analyzed using one-way analysis of variance, post hoc Tukey's test, and t-test. Results: The SAF showed better centering ability and lesser canal transportation than the PT only in the buccolingual plane at 6 and 9 mm levels. The shaping ability of the PT was best in the apical third in both the planes. The SAF had statistically significant better centering and lesser canal transportation in the buccolingual as compared to the mesiodistal plane at the middle and coronal levels. Conclusions: The SAF produced significantly less transportation and remained centered than the PT at the middle and coronal levels in the buccolingual plane of oval canals. In the mesiodistal plane, the performance of both the systems was parallel. PMID:28855757

Influence of lasing parameters on the cleaning efficacy of laser-activated irrigation with pulsed erbium lasers.

PubMed

Meire, Maarten A; Havelaerts, Sophie; De Moor, Roeland J

2016-05-01

Laser-activated irrigation (LAI) using erbium lasers is an irrigant agitation technique with great potential for improved cleaning of the root canal system, as shown in many in vitro studies. However, lasing parameters for LAI vary considerably and their influence remains unclear. Therefore, this study sought to investigate the influence of pulse energy, pulse frequency, pulse length, irradiation time and fibre tip shape, position and diameter on the cleaning efficacy of LAI. Transparent resin blocks containing standardized root canals (apical diameter of 0.4 mm, 6% taper, 15 mm long, with a coronal reservoir) were used as the test model. A standardized groove in the apical part of each canal wall was packed with stained dentin debris. The canals were filled with irrigant, which was activated by an erbium: yttrium aluminium garnet (Er:YAG) laser (2940 nm, AT Fidelis, Fotona, Ljubljana, Slovenia). In each experiment, one laser parameter was varied, while the others remained constant. In this way, the influence of pulse energy (10-40 mJ), pulse length (50-1000 μs), frequency (5-30 Hz), irradiation time (5-40 s) and fibre tip shape (flat or conical), position (pulp chamber, canal entrance, next to groove) and diameter (300-600 μm) was determined by treating 20 canals per parameter. The amount of debris remaining in the groove after each LAI procedure was scored and compared among the different treatments. The parameters significantly (P < 0.05, Kruskal-Wallis) affecting debris removal from the groove were fibre tip position, pulse length, pulse energy, irradiation time and frequency. Fibre tip shape and diameter had no significant influence on the cleaning efficacy.

[The effect of instrumentation on original apical foramen shape using steel vs niti rotatory: computerized analysis].

PubMed

Gallina, G; Cumbo, E; Gallo, P; Pizzo, G; D'Angelo, M

2002-01-01

A fundamental requirement to obtain a correct endodontic preparation depends on the respect, during cleaning and shaping, of the original morphology of the apical foramen, (AF), so that the filling material will form a complete seal. In our previous studies, in order to verify if this presumption was respected using rotary NiTi instruments with cutting tip, we instrumented extracted teeth characterised by a different degree of root curvatures. Using a standardized system to replace the sample, the original shape of the apical foramen of each tooth was recorded using a computerised technique and then compared to the shape after instrumentation. The data showed differences on AF shapes depending on the degree of root canal curvatures. In fact, the teeth with straight canals showed the least alterations on the original AF shape; on the contrary, the teeth with curved canals showed apical foramen enlargement or transportation. Therefore, in the current study we aimed to compare the in vitro effects of stainless steel, (Flexofile, Dentsply Maillefer, Baillaigues, Switzerland), vs NiTi safe cutting tip (Quantec SC, (Tycom Dental, Irvine CA, U:S.A.), vs NiTi non cutting tip, (Quantec LX, Tycom Dental, Irvine CA, U:S.A.), instrumentation on original apical foramen shape. We used NiTi instruments according to standard technique suggested by Tycom, and hand steel files, to instrument the apical third, according to the Crown-Down technique. Working length was fixed at -0.5 from AF. Our results suggested that in the presence of accentuated canal curves rotary Niti, with cutting tip, cause significantly more enlargement of the AF area. At the same time, we also observed that NiTi rotary files, with both cutting and non-cutting tip, cause eccentric enlargement of AF in curved canals. Therefore, NiTi engine-driven instruments should be used carefully in the presence of accentuated canal curves to avoid enlargement or transportation of AF, probably because rotary NiTi files may slip out of operative control, leaving a mark on the foramen shape. In the presence of severe curves, we suggest modifying the operative sequences by alternating rotary NiTi with hand NiTi or stainless steel instruments, especially in the preparation of apical third.

Shaping ability of the conventional nickel-titanium and reciprocating nickel-titanium file systems: a comparative study using micro-computed tomography.

PubMed

Hwang, Young-Hye; Bae, Kwang-Shik; Baek, Seung-Ho; Kum, Kee-Yeon; Lee, WooCheol; Shon, Won-Jun; Chang, Seok Woo

2014-08-01

This study used micro-computed tomographic imaging to compare the shaping ability of Mtwo (VDW, Munich, Germany), a conventional nickel-titanium file system, and Reciproc (VDW), a reciprocating file system morphologically similar to Mtwo. Root canal shaping was performed on the mesiobuccal and distobuccal canals of extracted maxillary molars. In the RR group (n = 15), Reciproc was used in a reciprocating motion (150° counterclockwise/30° clockwise, 300 rpm); in the MR group, Mtwo was used in a reciprocating motion (150° clockwise/30° counterclockwise, 300 rpm); and in the MC group, Mtwo was used in a continuous rotating motion (300 rpm). Micro-computed tomographic images taken before and after canal shaping were used to analyze canal volume change and the degree of transportation at the cervical, middle, and apical levels. The time required for canal shaping was recorded. Afterward, each file was analyzed using scanning electron microscopy. No statistically significant differences were found among the 3 groups in the time for canal shaping or canal volume change (P > .05). Transportation values of the RR and MR groups were not significantly different at any level. However, the transportation value of the MC group was significantly higher than both the RR and MR groups at the cervical and apical levels (P < .05). In the scanning electron microscopic analysis, file deformation was observed for 1 file in group RR (1/15), 3 files in group MR (3/15), and 5 files in group MC (5/15). In terms of shaping ability, Mtwo used in a reciprocating motion was not significantly different from the Reciproc system. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Bioactive Glass Scaffolds for Dental Pulp and Dentin Tissue Engineering

NASA Astrophysics Data System (ADS)

Shawli, Hassan Talat

Current and historical endodontic "root canal" treatments employ inert obturating materials inserted into the teeth's pulp chambers and root canals, often saving teeth but without adequate function. Furthermore, the occurrence of pulpal necrosis in the immature permanent tooth is considered to be a challenging situation, clinically, in treatment because the thin and often short roots increase the risk of fracture. The ideal treatment would be to promote continued root development. This work demonstrated that endodontically-shaped and durable scaffolds of slowly resorbable fibrous (HT) glass and faster-resorbing small-particle Bioglass can be sintered at 900 degrees C for such placement, and that cell growth of osteoblasts in these scaffolds shows good early results. Retained bioactivity in the sintered specimen was revealed by Multiple Attenuated Internal Reflection Infrared Spectroscopy.

A Comparative Study of Shaping Ability of four Rotary Systems.

PubMed

Rubio, Jorge; Zarzosa, José Ignacio; Pallarés, Antonio

2015-12-01

This study compared the cutting area, instrumentation time, root canal anatomy preservation and non-instrumented areas obtained by F360(®), Mtwo(®), RaCe(®) and Hyflex(®) files with ISO size 35. 120 teeth with a single straight root and root canal were divided into 4 groups. Working length was calculated by using X-rays. The teeth were sectioned with a handpiece and a diamond disc, and the sections were observed with Nikon SMZ-2T stereoscopic microscope and an Intralux 4000-1 light source. The groups were adjusted with a preoperative analysis with AutoCAD. The teeth were reconstructed by a #10 K-File and epoxy glue. Each group was instrumented with one of the four file systems. The instrumentation time was calculated with a 1/100 second chronometer. The area of the thirds and root canal anatomy preservation were analyzed with AutoCAD 2013 and the non-instrumented areas with AutoCAD 2013 and SMZ-2T stereoscopic microscope. The statistical analysis was made with Levene's Test, ANOVA, Bonferroni Test and Pearson´s Chi-square. Equal variances were shown by Levene's Test (P > 0.05). ANOVA (P > 0.05) showed the absence of significant differences. There were significant differences in the instrumentation time (P < 0.05). For root canal anatomy preservation and non-instrumented areas, there were no significant differences between all systems (P > 0.05). The 4 different rotary systems produced similar cutting area, root canal anatomy preservation and non-instrumented areas. Regarding instrumentation time, F360(®) was the fastest system statistically.

A Comparative Study of Shaping Ability of four Rotary Systems

PubMed Central

Zarzosa, José Ignacio; Pallarés, Antonio

2015-01-01

Purpose This study compared the cutting area, instrumentation time, root canal anatomy preservation and non-instrumented areas obtained by F360®, Mtwo®, RaCe® and Hyflex® files with ISO size 35. Material and Methods 120 teeth with a single straight root and root canal were divided into 4 groups. Working length was calculated by using X-rays. The teeth were sectioned with a handpiece and a diamond disc, and the sections were observed with Nikon SMZ-2T stereoscopic microscope and an Intralux 4000-1 light source. The groups were adjusted with a preoperative analysis with AutoCAD. The teeth were reconstructed by a #10 K-File and epoxy glue. Each group was instrumented with one of the four file systems. The instrumentation time was calculated with a 1/100 second chronometer. The area of the thirds and root canal anatomy preservation were analyzed with AutoCAD 2013 and the non-instrumented areas with AutoCAD 2013 and SMZ-2T stereoscopic microscope. The statistical analysis was made with Levene’s Test, ANOVA, Bonferroni Test and Pearson´s Chi-square. Results Equal variances were shown by Levene’s Test (P > 0.05). ANOVA (P > 0.05) showed the absence of significant differences. There were significant differences in the instrumentation time (P < 0.05). For root canal anatomy preservation and non-instrumented areas, there were no significant differences between all systems (P > 0.05). Conclusions The 4 different rotary systems produced similar cutting area, root canal anatomy preservation and non-instrumented areas. Regarding instrumentation time, F360® was the fastest system statistically. PMID:27688412

Comparison of retreatment ability of full-sequence reciprocating instrumentation and 360° rotary instrumentation.

PubMed

Capar, Ismail Davut; Gok, Tuba; Orhan, Ezgi

2015-12-01

The purpose of the present study was to investigate the amount of root canal filling material after root canal filling removal with 360° rotary instrumentation or reciprocating motion with the same file sequence. Root canals of the 36 mandibular premolars were shaped with ProTaper Universal instruments up to size F2 and filled with corresponding single gutta-percha cone and sealer. The teeth were assigned to two retreatment groups (n = 18): group 1 360° rotational motion and group 2 reciprocating motion of ATR Tecnika motors (1310° clockwise and 578° counterclockwise). Retreatment procedure was performed with ProTaper Universal retreatment files with a sequence of D1-3 and ProTaper Universal F3 instruments. Total time required to remove filling material were recorded. Remaining filling material was examined under stereomicroscope at ×8 magnification. The data were analysed statistically using the Mann-Whitney U test, and testing was performed at 95 % confidence level (p < 0.05). There were no significant differences between the groups (p > 0.05) in terms of remaining filling material. The total time required for retreatment was shorter in 360° rotational motion group compared to reciprocating motion group (p < 0.05). Both continuous rotation and reciprocating motion showed similar effectiveness in terms of root canal filling material removal. Using ProTaper Universal retreatment instruments with reciprocating motion of ATR motor and conventional rotary motion have similar efficacy in root canal filling removal.

Microscopic assessment of the sealing ability of three endodontic filling techniques

PubMed Central

Cueva-Goig, Roger; Llena-Puy, Mª Carmen

2016-01-01

Background Several techniques have been proposed for root canal filling. New rotary files, with non-standardized taper, are appearing, so, points adapted to the taper of the last instrument used to prepare the canal can help in the obturation process. The aim of this study is to assess the sealing ability of different root canal filling techniques. Material and Methods Root canals from 30 teeth were shaped with Mtwo and divided in three groups; A, standard lateral condensation with size 35 and 20 gutta-percha points; B, standard lateral condensation and injected gutta-percha; C, single gutta-percha point (standardized 35 Mtwo), continuous wave technique and injected gutta-percha. Root surfaces were covered with nail varnish, except for the apical 2 mm, and submerged in a NO3Ag2 solution; apical stain penetration was measured in mm. Data were compared using the Kruskal-Wallis test with a 90% confidence interval. Results A and B groups showed stain leakage in the 90% of the cases, whereas it was of 80% for group C. Stain leakage intervals were 1-5 mm for groups A and B and 1-3 mm for group C. There were no statistically significant differences between the three studied groups (p>.05). Conclusions All the analyzed root canal filling techniques showed some apical stain leakage, without significant differences among them. Key words:Gutta-percha filling, microleakage, single cone, injected gutta-percha, warm gutta-percha. PMID:26855702

Ex vivo study on root canal instrumentation of two rotary nickel-titanium systems in comparison to stainless steel hand instruments.

PubMed

Vaudt, J; Bitter, K; Neumann, K; Kielbassa, A M

2009-01-01

To investigate instrumentation time, working safety and the shaping ability of two rotary nickel-titanium (NiTi) systems (Alpha System and ProTaper Universal) in comparison to stainless steel hand instruments. A total of 45 mesial root canals of extracted human mandibular molars were selected. On the basis of the degree of curvature the matched teeth were allocated randomly into three groups of 15 teeth each. In group 1 root canals were prepared to size 30 using a standardized manual preparation technique; in group 2 and 3 rotary NiTi instruments were used following the manufacturers' instructions. Instrumentation time and procedural errors were recorded. With the aid of pre- and postoperative radiographs, apical straightening of the canal curvature was determined. Photographs of the coronal, middle and apical cross-sections of the pre- and postoperative canals were taken, and superimposed using a standard software. Based on these composite images the portion of uninstrumented canal walls was evaluated. Active instrumentation time of the Alpha System was significantly reduced compared with ProTaper Universal and hand instrumentation (P < 0.05; anova). No instrument fractures occurred in any of the groups. The Alpha System revealed significantly less apical straightening compared with the other instruments (P < 0.05; Mann-Whitney U test). In the apical cross-sections Alpha System resulted in significantly less uninstrumented canal walls compared with stainless steel files (P < 0.05; chi-squared test). Despite the demonstrated differences between the systems, an apical straightening effect could not be prevented; areas of uninstrumented root canal wall were left in all regions using the various systems.

External and internal anatomy of third molars.

PubMed

Guerisoli, D M; de Souza, R A; de Sousa Neto, M D; Silva, R G; Pécora, J D

1998-01-01

The external and internal anatomy of 269 third molars (155 maxillary and 114 mandibular) were studied. The teeth were measured, classified according to their root number and shape and the internal anatomy was observed by the use of diaphanization. A great anatomical variability was found, with the presence of up to 5 roots in maxillary third molars and 3 roots in mandibular third molars. The number of root canals followed the same pattern.

Comparison of the shaping ability of GT® Series X, Twisted Files and AlphaKite rotary nickel-titanium systems in simulated canals

PubMed Central

2013-01-01

Background Efforts to improve the performance of rotary NiTi instruments by enhancing the properties of NiTi alloy, or their manufacturing processes rather than changes in instrument geometries have been reported. The aim of this study was to compare in-vitro the shaping ability of three different rotary nickel-titanium instruments produced by different manufacturing methods. Methods Thirty simulated root canals with a curvature of 35˚ in resin blocks were prepared with three different rotary NiTi systems: AK- AlphaKite (Gebr. Brasseler, Germany), GTX- GT® Series X (Dentsply, Germany) and TF- Twisted Files (SybronEndo, USA). The canals were prepared according to the manufacturers’ instructions. Pre- and post-instrumentation images were recorded and assessment of canal curvature modifications was carried out with an image analysis program (GSA, Germany). The preparation time and incidence of procedural errors were recorded. Instruments were evaluated under a microscope with 15 × magnifications (Carl Zeiss OPMI Pro Ergo, Germany) for signs of deformation. The Data were statistically analyzed using SPSS (Wilcoxon and Mann–Whitney U-tests, at a confidence interval of 95%). Results Less canal transportation was produced by TF apically, although the difference among the groups was not statistically significant. GTX removed the greatest amount of resin from the middle and coronal parts of the canal and the difference among the groups was statistically significant (p < 0.05). The shortest preparation time was registered with TF (444 s) and the longest with GTX (714 s), the difference among the groups was statistically significant (p < 0.05). During the preparation of the canals no instrument fractured. Eleven instruments of TF and one of AK were deformed. Conclusion Under the conditions of this study, all rotary NiTi instruments maintained the working length and prepared a well-shaped root canal. The least canal transportation was produced by AK. GTX displayed the greatest cutting efficiency. TF prepared the canals faster than the other two systems. PMID:24341354

Shaping ability of two M-wire and two traditional nickel-titanium instrumentation systems in S-shaped resin canals.

PubMed

Ceyhanli, K T; Kamaci, A; Taner, M; Erdilek, N; Celik, D

2015-01-01

The aim of this study was to evaluate the shaping effects of two M-wire and two traditional nickel-titanium (NiTi) rotary systems in simulated S-shaped resin canals. Forty simulated S-shaped canals in resin blocks were instrumented with two traditional (ProTaper, Sendoline S5) and two M-wire (WaveOne, GT series X) NiTi systems according to the manufacturers' instructions. Ten resin blocks were used for each system. Pre- and post-instrumentation images were captured using a stereomicroscope and superimposed with an image program. Canal transportation, material removal, and aberrations were evaluated and recorded as numeric parameters. Data were analyzed using one-way ANOVA and post-hoc Tukey tests with a 95% confidence interval. There were significant differences between systems in terms of transportation and material removal (P<0.05). Coronal danger zone was the most common aberration. Within the limits of this ex vivo study, it was found that the manufacturing methods (M-wire or traditional NiTi) and kinematics (rotary or reciprocating motion) did not affect the shaping abilities of the systems. The extended file designs of highly tapered NiTi systems (ProTaper, WaveOne) resulted in greater deviations from the original root canal trace and more material removal when compared to less tapered systems (Sendoline S5, GT series X).

MicroCT and optical coherence tomography imagistic assessment of the dental roots adhesive

NASA Astrophysics Data System (ADS)

Sinescu, Cosmin; Negrutiu, Meda Lavinia; Nica, Luminita; Manescu, Adrian; Duma, Virgil-Florin; Podoleanu, Adrian G.

2015-03-01

Several obturation methods are available today to study the 3D filling of the root canal. There are also several methods capable to evaluate the ability to seal apically the root canals. However, the common methods of investigation are invasive; they also lead to the destruction of the samples. If the sectioning differs slightly from the desired area, the investigation is non-conclusive regarding the micro-leakages. Also, although the use of Cone-Beam Micro Computer Tomography (CBCT) appears to be most promising for endodontic purposes, its effective radiation doses are higher than with conventional intra-oral and panoramic imaging. In contrast, enface (ef) Optical Coherence Tomography (OCT) proves to be efficient for the investigation of material defects of dental restorations, dental materials, and micro-leakage at the interfaces, where the penetration depth depends on the material. Therefore, ef OCT has been proposed in our studies as a potential tool for in vivo endodontic imaging. Twenty five recently extracted human maxillary molars were selected for the study for caries or periodontal reasons. The pulp chambers were completely opened, the dental pulp was removed, and the root canals were shaped. Silver nanoparticles were used in half of the samples in order to increase the scattering of the adhesive material in comparison with the dental roots walls. The sample teeth were then probed using Time Domain (TD) OCT working at 1300 nm. A synchrotron radiation X-Ray microCT experiment was also performed. The imagistic results pointed out the efficiency of the silver nanoparticle layer used in order to increase the scattering of the root canal adhesive scattering for the OCT non-invasive investigation. MicroCT allowed for obtaining qualitative data related to the depth penetration of the root canal adhesive into the dentin walls.

Micro-computed tomographic comparison of nickel-titanium rotary versus traditional instruments in C-shaped root canal system.

PubMed

Yin, Xingzhe; Cheung, Gary Shun-Pan; Zhang, Chengfei; Masuda, Yoshiko Murakami; Kimura, Yuichi; Matsumoto, Koukichi

2010-04-01

The purpose of this study was to assess the efficacy of instrumentation of C-shaped canals with ProTaper rotary system and traditional instruments by using micro-computed tomography (micro-CT). Twenty-four mandibular molars with C-shaped canals were selected in pairs and sorted equally into 2 groups, which were assigned for instrumentation by ProTaper rotary system (ProTaper group) or by K-files and Gates-Glidden burs (Hand Instrument group). Three-dimensional images were constructed by micro-CT. The volume of dentin removed, uninstrumented canal area, time taken for instrumentation, and iatrogenic error of instrumentation were investigated. Hand Instrument group showed greater amount of volumetric dentin removal and left less uninstrumented canal area than ProTaper group (P < .01). The time needed for instrumentation was shorter for ProTaper group than for Hand Instrument group (P < .05). No instrument breakage occurred in both groups, but more conspicuous procedural errors were detected in Hand Instrument group than for ProTaper group. It was concluded that ProTaper rotary system maintained the canal curvature with speediness and few procedural errors, whereas traditional instrumentation can clean more canal surface. Copyright (c) 2010 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

SEM observations of resected root canal ends following apicoectomy.

PubMed

Furusawa, Masahiro; Asai, Yasuhiro

2002-02-01

The purpose of this study was to examine the apical foramen of root apices extracted during apicotomies. A total of 25 teeth extracted from 25 patients admitted to the Department of Conservative Dentistry at Tokyo Dental College's Chiba Hospital were used for the study. All patients were between 22 to 56 years of age at the time of the study, and each of the 25 cases was determined clinically on radiographs to be chronic apical suppurative periodontitis. Microsurgery was performed on all cases, and the extracted root apices were then observed using SEM. The results demonstrated a wide opening, greater than 350 microns as measured along the major axis, of the apical foramen in 80% of the cases. Various characteristics indicative of resorption were observed around the apical foramen. These features included those believed to have been caused by overinstrumentation during root canal treatment as well as irregularly shaped areas presumed to be apical lesions that had enlarged and eroded. We observed a high frequency of manifestations of cementum resorption surrounding the root apices of teeth with apical lesions. Furthermore, we concluded that in the majority of cases in the present study, due to the fact that the apical foramen exceeded normal opening dimensions as a result of overinstrumentation during root canal treatment or resorption around the root apex, prolongation of the lesions had occurred in response to direct contact of microbial infectious matter and tissues surrounding the root apex over a large area. The above finding suggested that, in cases in which the apical foramen is destroyed through overinstrumentation larger than #35 or in which the apical foramen opens up to dimensions greater than 350 microns due to pathologic resorption, surgical intervention may be indicated. On the other hand, in 64% of the cases, an accessory canal was observed in the root apical lesion. Based on this observation, the presence of an accessory canal in the root apex may contribute to some degree to the prolongation of the lesion.

Prevalence of inter-appointment endodontic flare-ups and host-related factors.

PubMed

Azim, Adham A; Azim, Katharina A; Abbott, Paul V

2017-04-01

The aims of this study were to report the prevalence of inter-appointment flare-ups following adequate root canal disinfection and to investigate the host factors contributing to its occurrence. One thousand five hundred patient records were reviewed and the prevalence of flare-up was recorded. Patients' root canal space status (vital, non-vital or retreatment), medical condition and demographics (age, gender, tooth type and position) were recorded from their dental records. Statistical analyses were performed to determine the impact of the recorded factors on flare-up occurrence. Nine hundred fifty-one patient records met the inclusion criteria. The prevalence of flare-up was 2.3 %. There was a correlation between the canal space status and patient's age with flare-up development (P < 0.05). There was no association between flare-up occurrence and tooth type, location, gender or medical condition (P > 0.5). The root canal space status was the primary factor affecting flare-up occurrence. Patients >50 years had the highest risk in developing flare-ups. This article provides evidence that patients suffering from inflamed pulp will not develop flare-up if adequate cleaning and shaping of the root canal space was performed. It also shows that patients above the age of 50 are a high-risk group that is prone to flare-up development.

Thermal measurement of root surface temperatures during application of intracanal laser energy in vitro

NASA Astrophysics Data System (ADS)

Goodis, Harold E.; White, Joel M.; Neev, Joseph

1993-07-01

The use of laser energy to clean, shape, and sterilize a root canal system space involves the generation of heat due to the thermal effect of the laser on the organic tissue contents and dentin walls of that space. If heat generation is above physiologic levels, irreparable damage may occur to the periodontal ligament and surrounding bone. This study measured temperature rise on the outer root surfaces of extracted teeth during intracanal laser exposure. Thirty single rooted, recently extracted teeth free of caries and restorations were accessed pulps extirpated and divided into three groups. Each root canal system was treated with a 1.06 micrometers pulsed Nd:YAG laser with quartz contact probes. Temperatures were recorded for all surfaces (mesial distal, buccal, lingual, apical) with infrared thermography utilizing a detector response time of 1 (mu) sec, sensitivity range (infrared) of 8 to 12 micrometers and a scan rate of 30 frames/sec.

Computed Tomographic Evaluation of K3 Rotary and Stainless Steel K File Instrumentation in Primary Teeth

PubMed Central

Kavitha, Swaminathan; Thomas, Eapen; Anadhan, Vasanthakumari; Vijayakumar, Rajendran

2016-01-01

Introduction The intention of root canal preparation is to reduce infected content and create a root canal shape allowing for a well condensed root filling. Therefore, it is not necessary to remove excessive dentine for successful root canal preparation and concern must be taken not to over instrument as perforations can occur in the thin dentinal walls of primary molars. Aim This study was done to evaluate the time preparation, the risk of lateral perforation and dentine removal of the stainless steel K file and K3 rotary instrumentation in primary teeth. Materials and Methods Seventy-five primary molars were selected and divided into three groups. Using spiral computed tomography the teeth were scanned before instrumentation. Teeth were prepared using a stainless steel K file for manual technique. All the canals were prepared up to file size 35. In K3 rotary files (.02 taper) instrumentation was done up to 35 size file. In K3 rotary files (.04 taper) the instrumentation was done up to 25 size file and simultaneously the instrumentation time was recorded. The instrumented teeth were once again scanned and the images were compared with the images of the uninstrumented canals. Statistical Analysis Data was statistically analysed using Kruskal Wallis One-way ANOVA, Mann-Whitney U-Test and Pearson’s Chi-square Test. Results K3 rotary files (.02 taper) removed a significantly less amount of dentine, required less instrumentation time than a stainless steel K file. Conclusion K3 files (.02 taper) generated less dentine removal than the stainless steel K file and K3 files (.04 taper). K3 rotary files (.02 taper) were more effective for root canal instrumentation in primary teeth. PMID:26894166

Morphometric analysis of root canal cleaning after rotary instrumentation with or without laser irradiation

NASA Astrophysics Data System (ADS)

Marchesan, Melissa A.; Geurisoli, Danilo M. Z.; Brugnera, Aldo, Jr.; Barbin, Eduardo L.; Pecora, Jesus D.

2002-06-01

The present study examined root canal cleaning, using the optic microscope, after rotary instrumentation with ProFile.04 with or without laser application with different output energies. Cleaning and shaping can be accomplished manually, with ultra-sonic and sub-sonic devices, with rotary instruments and recently, increasing development in laser radiation has shown promising results for disinfection and smear layer removal. In this study, 30 palatal maxillary molar roots were examined using an optic microscope after rotary instrumentation with ProFile .04 with or without Er:YAG laser application (KaVo KeyLaser II, Germany) with different output energies (2940 nm, 15 Hz, 300 pulses, 500 milli-sec duration, 42 J, 140 mJ showed on the display- input, 61 mJ at fiberoptic tip-output and 140 mJ showed on the display-input and 51 mJ at fiberoptic tip-output). Statistical analysis showed no statistical differences between the tested treatments (ANOVA, p>0.05). ANOVA also showed a statistically significant difference (p<0.01) between the root canal thirds, indicating that the middle third had less debris than the apical third. We conclude that: 1) none of the tested treatments led to totally cleaned root canals; 2) all treatments removed debris similarly, 3) the middle third had less debris than the apical third; 4) variation in output energy did not increase cleaning.

Shaping ability of reciproc and TF adaptive systems in severely curved canals of rapid microCT-based prototyping molar replicas.

PubMed

Ordinola-Zapata, Ronald; Bramante, Clovis Monteiro; Duarte, Marco Antonio Húngaro; Cavenago, Bruno Cavalini; Jaramillo, David; Versiani, Marco Aurélio

2014-01-01

To evaluate the shaping ability of Reciproc and Twisted-File Adaptive systems in rapid prototyping replicas. Two mandibular molars showing S-shaped and 62-degree curvatures in the mesial root were scanned by using a microcomputed tomography (μCT) system. The data were exported in the stereolitograhic format and 20 samples of each molar were printed at 16 µm resolution. The mesial canals of 10 replicas of each specimen were prepared with each system. Transportation was measured by overlapping radiographs taken before and after preparation and resin thickness after instrumentation was measured by μCT. Both systems maintained the original shape of the apical third in both anatomies (P>0.05). Overall, considering the resin thickness in the 62-degree replicas, no statistical difference was found between the systems (P>0.05). In the S-shaped curvature replica, Reciproc significantly decreased the thickness of the resin walls in comparison with TF Adaptive. The evaluated systems were able to maintain the original shape at the apical third of severely curved mesial canals of molar replicas.

Micro-CT analyses of apical enlargement and molar root canal complexity.

PubMed

Markvart, M; Darvann, T A; Larsen, P; Dalstra, M; Kreiborg, S; Bjørndal, L

2012-03-01

To compare the effectiveness of two rotary hybrid instrumentation techniques with focus on apical enlargement in molar teeth and to quantify and visualize spatial details of instrumentation efficacy in root canals of different complexity. Maxillary and mandibular molar teeth were scanned using X-ray microcomputed tomography. Root canals were prepared using either a GT/Profile protocol or a RaCe/NiTi protocol. Variables used for evaluation were the following: distance between root canal surfaces before and after preparation (distance after preparation, DAP), percentage of root canal area remaining unprepared and increase in canal volume after preparation. Root canals were classified according to size and complexity, and consequences of unprepared portions of narrow root canals and intraradicular connections/isthmuses were included in the analyses. One- and two-way anova were used in the statistical analyses. No difference was found between the two techniques: DAP(apical-third) (P = 0.590), area unprepared(apical-third) (P = 0.126) and volume increase(apical-third) (P = 0.821). Unprepared root canal area became larger in relation to root canal size and complexity, irrespective of the technique used. Percentage of root canal area remaining unprepared was significantly lower in small root canals and complex systems compared to large root canals. The isthmus area per se contributed with a mean of 17.6%, and with a mean of 25.7%, when a narrow root canal remained unprepared. The addition of isthmuses did not significantly alter the ratio of instrumented to unprepared areas at total root canal level. Distal and palatal root canals had the highest level of unprepared area irrespective of the two instrumentation techniques examined. © 2011 International Endodontic Journal.

Significance of moist root canal dentin with the use of methacrylate-based endodontic sealers: an in vitro coronal dye leakage study.

PubMed

Zmener, Osvaldo; Pameijer, Cornelis H; Serrano, Susana Alvarez; Vidueira, Mercedes; Macchi, Ricardo L

2008-01-01

This in vitro study compared the effect of different levels of moisture of root canals, from none to wet, on the coronal seal after filling with resin-coated gutta-percha cones/EndoRez [RGPC/ER (groups 1-4)], Resilon/Epiphany [RE/EP (groups 5-8)], and gutta-percha/Grossman's cement [GP/G (groups 9-12)]. The length of 76 single-rooted extracted human teeth was standardized to approximately 17 mm. After instrumentation with size 10 K-Files, #2 and #3 Gates Glidden burs, and preparation to the working length with K-Type files, the smear layer was removed with 17% ethylenediaminetetraacetic acid followed by flooding with distilled water. On the basis of similarities of canal shape determined by x-rays, roots were assigned to the groups (n = 5 per group) and treated according to one of the following protocols. (I) ETOH: excess distilled water was removed with paper points followed by dehydration with 95% ethanol; (II) PAPER POINTS: the canals were blot-dried with paper points with the last one appearing dry; (III) MOIST: the canals were dried with low vacuum by using a luer adapter for 5 seconds followed by 1 paper point for 1 second; and (IV) WET: the canals remained totally flooded. The roots were then filled with one of the obturation systems outlined above. The teeth were coated with 2 layers of nail varnish and 1 layer of sticky wax, except for the coronal access. In addition, positive and negative controls were added. After immersion in 2% methylene blue dye for 7 days, the samples were embedded in clear orthodontic resin and cross-sectioned at 0.5-mm intervals along the length of the roots. Dye penetration was evaluated by an independent investigator with a stereomicroscope at 40x magnification. The results indicated that dye leakage was affected by the degree of moisture. All materials evaluated showed some evidence of dye penetration, however, root canals filled with resin-coated gutta-percha/EndoRez and Resilon/Epiphany demonstrated significantly less leakage (P < .05) when moist conditions II and III were present.

Apical root canal transportation of different pathfinding systems and their effects on shaping ability of ProTaper Next

PubMed Central

Türker, Sevinç-Aktemur

2015-01-01

Background This study aimed to compare glide path preparation of different pathfinding systems and their effects on the apical transportation of ProTaper Next (Dentsply Maillefer, Ballaigues, Switzerland) in mesial root canals of extracted human mandibular molars, using digital subtraction radiography. Material and Methods The mesial canals of 40 mandibular first molars (with curvature angles between 25° and 35°) were selected for this study. The specimens were divided randomly into 4 groups with 10 canals each. Glide paths were created in group 1 with #10, #15 and #20 K-type (Dentsply Maillefer, Ballaigues, Switzerland) stainless steel manual files; in group 2 with Path-File (Dentsply Maillefer) #1, #2, and #3 and in group 3 with #16 ProGlider (Dentsply Maillefer) rotary instruments; in group 4 no glide paths were created. All canals were instrumented up to ProTaper Next X2 to the working length. A double digital radiograph technique was used, pre and post-instrumentation, to assess whether apical transportation and/or aberration in root canal morphology occurred. Instrument failures were also recorded. The data were analyzed statistically using ANOVA and Tukey tests (p<0.05). Results No significant differences were found among groups regarding apical transportation (p>0.05). Two ProTaper Next instruments failed in-group 4. Conclusions Within the parameters of this study, there was no difference between the performance of path-finding files and ProTaper Next system maintained root canal curvature well and was safe to use either with path-finding files or alone. Key words:Glide path, PathFile, ProGlider, ProTaper Next, transportation. PMID:26330936

A Comparison of Apical Transportation in Severely Curved Canals Induced by Reciproc and BioRaCe Systems.

PubMed

Nabavizadeh, Mohammadreza; Abbaszadegan, Abbas; Khojastepour, Leila; Amirhosseini, Mohsen; Kiani, Ebrahim

2014-01-01

Preserving the apical root structure during cleaning and shaping of the canal has always been a challenge in endodontics particularly when the root canals are curved. The purpose of this in vitro study was to compare the apical transportation induced by the Reciproc and BioRaCe rotary systems in preparing the mesiobuccal root canal of the human maxillary molars. The mesiobuccal canals of sixty extracted maxillary molars with curvature angle of 25˚-35˚ were selected and randomly assigned into two groups. Each canal was prepared by either Reciproc or BioRaCe rotary systems. A double-digital radiographic technique and AutoCAD software were used to compare the apical transportation at 0.5, 1, 2, 3, 4 and 5 mm distances from the working length (WL). The distance between the master apical rotary file and the initial K-file in the superimposed radiographs determined the amount of apical transportation. An independent t-test was used to compare the groups. The statistical significant level was set at 0.05. Apical transportation of the Reciproc group was significantly greater than the BioRaCe group in all distances (P<0.001). The maximum apical transportation occurred in the Reciproc group at 0.5 mm from the WL (0.048±0.0028 mm) and the minimum occurred for BioRaCe at 5 mm from the WL (0.010±0.0005 mm). The Reciproc system produced significantly more apical transportation than the BioRaCe, but this fact does not seem to negatively alter the clinical success or quality of root canal treatment.

A Comparison of Apical Transportation in Severely Curved Canals Induced by Reciproc and BioRaCe Systems

PubMed Central

Nabavizadeh, Mohammadreza; Abbaszadegan, Abbas; Khojastepour, Leila; Amirhosseini, Mohsen; Kiani, Ebrahim

2014-01-01

Introduction: Preserving the apical root structure during cleaning and shaping of the canal has always been a challenge in endodontics particularly when the root canals are curved. The purpose of this in vitro study was to compare the apical transportation induced by the Reciproc and BioRaCe rotary systems in preparing the mesiobuccal root canal of the human maxillary molars. Materials and Methods: The mesiobuccal canals of sixty extracted maxillary molars with curvature angle of 25˚-35˚ were selected and randomly assigned into two groups. Each canal was prepared by either Reciproc or BioRaCe rotary systems. A double-digital radiographic technique and AutoCAD software were used to compare the apical transportation at 0.5, 1, 2, 3, 4 and 5 mm distances from the working length (WL). The distance between the master apical rotary file and the initial K-file in the superimposed radiographs determined the amount of apical transportation. An independent t-test was used to compare the groups. The statistical significant level was set at 0.05. Results: Apical transportation of the Reciproc group was significantly greater than the BioRaCe group in all distances (P<0.001). The maximum apical transportation occurred in the Reciproc group at 0.5 mm from the WL (0.048±0.0028 mm) and the minimum occurred for BioRaCe at 5 mm from the WL (0.010±0.0005 mm). Conclusions: The Reciproc system produced significantly more apical transportation than the BioRaCe, but this fact does not seem to negatively alter the clinical success or quality of root canal treatment. PMID:24688580

Apical extrusion of debris: a literature review of an inherent occurrence during root canal treatment.

PubMed

Tanalp, J; Güngör, T

2014-03-01

Extrusion of intracanal debris as well as irrigants is a common occurrence during root canal treatment, and no instrument or technique has thoroughly solved this problem. Because flare-ups may arise with any irritation directed towards periapical tissues, a shaping or irrigation technique should minimize the risk of apical extrusion, even though it may not be prevented. There has been a rapid evolution of root canal instruments and irrigation systems through the last decade, and many have been assessed for their debris extrusion potential. The purpose of this review was to identify publications regarding the evaluation of debris, bacteria and irrigant extrusion during root canal treatment. A PubMed, Ovid and MEDLINE search was conducted using the keywords "apical extrusion", "debris extrusion" and "endodontic treatment". The literature search extended over a period of more than 30 years up to 2012. Content of the review was limited to apical extrusion of debris and irrigants, extrusion of liquid by irrigation methods and bacterial extrusion. Issues relevant to apical extrusion were obtained by further search in the reference sections of the retrieved articles. The review provides an update on the current status of apical extrusion. © 2013 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Human tooth and root canal morphology reconstruction using magnetic resonance imaging.

PubMed

Drăgan, Oana Carmen; Fărcăşanu, Alexandru Ştefan; Câmpian, Radu Septimiu; Turcu, Romulus Valeriu Flaviu

2016-01-01

Visualization of the internal and external root canal morphology is very important for a successful endodontic treatment; however, it seems to be difficult considering the small size of the tooth and the complexity of the root canal system. Film-based or digital conventional radiographic techniques as well as cone beam computed tomography provide limited information on the dental pulp anatomy or have harmful effects. A new non-invasive diagnosis tool is magnetic resonance imaging, due to its ability of imaging both hard and soft tissues. The aim of this study was to demonstrate magnetic resonance imaging to be a useful tool for imaging the anatomic conditions of the external and internal root canal morphology for endodontic purposes. The endodontic system of one freshly extracted wisdom tooth, chosen for its well-known anatomical variations, was mechanically shaped using a hybrid technique. After its preparation, the tooth was immersed into a recipient with saline solution and magnetic resonance imaged immediately. A Bruker Biospec magnetic resonance imaging scanner operated at 7.04 Tesla and based on Avance III radio frequency technology was used. InVesalius software was employed for the 3D reconstruction of the tooth scanned volume. The current ex-vivo experiment shows the accurate 3D volume rendered reconstruction of the internal and external morphology of a human extracted and endodontically treated tooth using a dataset of images acquired by magnetic resonance imaging. The external lingual and vestibular views of the tooth as well as the occlusal view of the pulp chamber, the access cavity, the distal canal opening on the pulp chamber floor, the coronal third of the root canals, the degree of root separation and the apical fusion of the two mesial roots, details of the apical region, root canal curvatures, furcal region and interradicular root grooves could be clearly bordered. Magnetic resonance imaging offers 3D image datasets with more information than the conventional radiographic techniques. Due to its ability of imaging both hard and soft dental tissues, magnetic resonance imaging can be successfully used as a 3D diagnostic imaging technique in dentistry. When choosing the imaging method, dental clinicians should weight the benefit-risk ratio, taking into account the costs associated to magnetic resonance imaging and the harmful effects of ionizing radiations when cone beam computed tomography or conventional x-ray are used.

Evaluation of surface preparation and maintenance of canal curvature following instrumentation with hand 'K' file and three different Ni-Ti rotary systems: A radiographic and SEM study.

PubMed

Bhatti, Namrata; Sroa, Renu; Sikri, Vimal K

2010-04-01

To determine the shaping ability and cleaning efficiency of hand K-flexofiles, ProTaper, LightSpeed and Mtwo instruments during the preparation of curved root canals in extracted human teeth. A total of 120 root canals of mandibular and maxillary molars with curvature more than 20° were divided into four groups of 30 each. In group A, canals were prepared using hand K-flexofiles following the crown down technique. In group B LightSpeed, in group C ProTaper, and in group D Mtwo rotary instruments were used to prepare the root canals. Using pre- and post-instrumentation radiographs, straightening of the canal curvature was determined with Corel Draw 9.0 software tools. The amount of debris and smear layer were quantified at three different areas (coronal, middle, and apical thirds) of root canal using SEM. The collected data were analyzed statistically using Student's paired 't' test. The mean change in curvature for hand K-files was 7.71°, for ProTaper files 6.03°, for Mtwo 5.43°, and for LightSpeed instruments were found to be 4.57°. The percentage change in the curvature for all the four groups was statistically highly significant (P< 0.01). LightSpeed instruments maintained the original canal curvature significantly (P< 0.01) better than the other instruments. For leftover debris, the minimum percentage was found to be associated with ProTaper (65.48%) followed by Mtwo (66.22%), LightSpeed (71.67%) and the maximum with hand K-files (74.16%). However, the difference in mean leftover debris between ProTaper and Mtwo was not significant. ProTaper and Mtwo resulted in good cleaning, and LightSpeed maintained the original canal curvature better than the ProTaper, Mtwo, or Hand K-files.

The self-adjusting file (SAF). Part 1: respecting the root canal anatomy--a new concept of endodontic files and its implementation.

PubMed

Metzger, Zvi; Teperovich, Ehud; Zary, Raviv; Cohen, Raphaela; Hof, Rafael

2010-04-01

To introduce a new concept, the self-adjusting file (SAF), and discuss its unique features compared with current rotary nickel-titanium file systems. The SAF file is hollow and designed as a thin cylindrical nickel-titanium lattice that adapts to the cross-section of the root canal. A single file is used throughout the procedure. It is inserted into a path initially prepared by a # 20 K-file and operated with a transline- (in-and-out) vibration. The resulting circumferential pressure allows the file's abrasive surface to gradually remove a thin uniform hard-tissue layer from the entire root canal surface, resulting in a canal with a similar cross-section but of larger dimensions. This holds also for canals with an oval or flat cross-section, which will be enlarged to a flat or oval cross-section of larger dimensions. The straightening of curved canals is also reduced because of the high pliability of the file and the absence of a rigid metal core. Thus, the original shape of the root canal is respected both longitudinally and in cross-section. The hollow SAF file is operated with a constant flow of irrigant that enters the full length of the canal and that is activated by the vibration and is replaced continuously throughout the procedure. This results in effective cleaning even at the cul de sac apical part of the canal. The SAF has high mechanical endurance; file separation does not occur; and mechanical failure, if it occurs, is limited to small tears in the latticework. The SAF represents a new step forward in endodontic file development that may overcome many of the shortcomings of current rotary nickel-titanium file systems. Copyright (c) 2010 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Endodontic treatment of mandibular molars with atypical root canal anatomy: reports of 4 cases.

PubMed

Chauhan, Raju; Singh, Shweta

2015-01-01

The variations in root canal anatomy of multirooted teeth represent a continuous challenge to endodontic diagnosis and treatment. Although the most common configuration of mandibular molars is one containing 2 roots and 3 root canals, there are many different combinations. Very rarely, an additional third (supernumerary) root is seen. When it is located distolingually to the main distal root, this third root is called radix entomolaris (RE), and when it is located mesiobuccally to the mesial root, it is called radix paramolaris (RP). Variations of root canal systems need not always be in the form of extra roots or extra canals. Single roots with single canals can also occur. A general dentist should be aware of these unusual root canal morphologies in mandibular molars for the success of endodontic treatment. These case reports describe the root canal treatment of a case of RE in the mandibular first molar, 2 rare cases of RP (1 each in the mandibular first and second molars), and a mandibular second molar with a single root and root canal.

A comparison of mesial molar root canal preparations using two engine-driven instruments and the balanced-force technique.

PubMed

Imura, N; Kato, A S; Novo, N F; Hata, G; Uemura, M; Toda, T

2001-10-01

The purpose of this study was to compare the effects of two engine-driven, nickel-titanium instrument systems with hand files in the final shape of slight and moderately curved canals. A total of 72 mesial roots of extracted human mandibular molars were divided into three groups: ProFile .04 taper, Pow-R rotary systems, and Flex-R hand-filing technique. The roots were mounted and cross-sectioned at two different horizontal levels using a modified Bramante technique. Pre- and postinstrumented cross-sectional roots were imaged, recorded, and computer analyzed. Results showed that, at the middle third, in almost all groups, there was a tendency of cutting more toward the mesial side with only one exception: Pow-R cut more to the distal side (danger zone) (p < 0.02). At the apical third, Flex-R (p < 0.03) and ProFile (0.001) transported to the mesial side (danger zone) when the curvature increased. When the three techniques were compared analyzing each side and considering the two groups of curvature, at the middle third in the moderately curved-canal group, Flex-R cut statistically more than Pow-R toward the lingual side. The other comparisons showed no statistically significant difference. When the techniques were compared in relation with the degree of curvature, in the apical third, ProFile .04 cut statistically more toward the mesial side in the moderately curved canal group than in the slightly curved canal group. The other comparisons showed no statistically significant difference. Canal preparation time was shorter with hand instrumentation (p < .05) in a few instances.

Irrigation of human prepared root canal – ex vivo based computational fluid dynamics analysis

PubMed Central

Šnjarić, Damir; Čarija, Zoran; Braut, Alen; Halaji, Adelaida; Kovačević, Maja; Kuiš, Davor

2012-01-01

Aim To analyze the influence of the needle type, insertion depth, and irrigant flow rate on irrigant flow pattern, flow velocity, and apical pressure by ex-vivo based endodontic irrigation computational fluid dynamics (CFD) analysis. Methods Human upper canine root canal was prepared using rotary files. Contrast fluid was introduced in the root canal and scanned by computed tomography (CT) providing a three-dimensional object that was exported to the computer-assisted design (CAD) software. Two probe points were established in the apical portion of the root canal model for flow velocity and pressure measurement. Three different CAD models of 27G irrigation needles (closed-end side-vented, notched open-end, and bevel open-end) were created and placed at 25, 50, 75, and 95% of the working length (WL). Flow rates of 0.05, 0.1, 0.2, 0.3, and 0.4 mL/s were simulated. A total of 60 irrigation simulations were performed by CFD fluid flow solver. Results Closed-end side-vented needle required insertion depth closer to WL, regarding efficient irrigant replacement, compared to open-end irrigation needle types, which besides increased velocity produced increased irrigant apical pressure. For all irrigation needle types and needle insertion depths, the increase of flow rate was followed by an increased irrigant apical pressure. Conclusions The human root canal shape obtained by CT is applicable in the CFD analysis of endodontic irrigation. All the analyzed values –irrigant flow pattern, velocity, and pressure – were influenced by irrigation needle type, as well as needle insertion depth and irrigant flow rate. PMID:23100209

Irrigation of human prepared root canal--ex vivo based computational fluid dynamics analysis.

PubMed

Snjaric, Damir; Carija, Zoran; Braut, Alen; Halaji, Adelaida; Kovacevic, Maja; Kuis, Davor

2012-10-01

To analyze the influence of the needle type, insertion depth, and irrigant flow rate on irrigant flow pattern, flow velocity, and apical pressure by ex-vivo based endodontic irrigation computational fluid dynamics (CFD) analysis. Human upper canine root canal was prepared using rotary files. Contrast fluid was introduced in the root canal and scanned by computed tomography (CT) providing a three-dimensional object that was exported to the computer-assisted design (CAD) software. Two probe points were established in the apical portion of the root canal model for flow velocity and pressure measurement. Three different CAD models of 27G irrigation needles (closed-end side-vented, notched open-end, and bevel open-end) were created and placed at 25, 50, 75, and 95% of the working length (WL). Flow rates of 0.05, 0.1, 0.2, 0.3, and 0.4 mL/s were simulated. A total of 60 irrigation simulations were performed by CFD fluid flow solver. Closed-end side-vented needle required insertion depth closer to WL, regarding efficient irrigant replacement, compared to open-end irrigation needle types, which besides increased velocity produced increased irrigant apical pressure. For all irrigation needle types and needle insertion depths, the increase of flow rate was followed by an increased irrigant apical pressure. The human root canal shape obtained by CT is applicable in the CFD analysis of endodontic irrigation. All the analyzed values -irrigant flow pattern, velocity, and pressure - were influenced by irrigation needle type, as well as needle insertion depth and irrigant flow rate.

Vertical Load Induced with Twisted File Adaptive System during Canal Shaping.

PubMed

Jamleh, Ahmed; Alfouzan, Khalid

2016-12-01

To evaluate the vertical load induced with the Twisted File Adaptive (TFA; SybronEndo, Orange, CA) system during canal shaping of extracted teeth by comparing it with the Twisted File (TF, SybronEndo), ProTaper Next (PTN; Dentsply Maillefer, Ballaigues, Switzerland), and ProTaper Universal (PTU, Dentsply Maillefer) systems. Fifty-two root canals were shaped using the TFA, TF, PTN, or PTU systems (n = 13 for each system). They were shaped gently according to the manufacturers' instructions. During canal shaping, vertical loads were recorded and shown in 2 directions, apically and coronally directed loads. The vertical peak loads of 3 instrumentation stages were used for comparison. The effects of rotary systems on the mean positive and negative peak loads were analyzed statistically using the Kruskal-Wallis and Mann-Whitney tests at a confidence level of 95%. The overall pattern of the instantaneous loads appeared to increase with the use of successive instruments within the system. During canal shaping in all groups, the apically and coronally directed peak loads ranged from 0.84-7.55 N and 2.16-2.79 N, respectively. There were significant differences in both peak loads among the tested systems at each instrumentation stage. TFA had the lowest apically directed peak loads. In terms of coronally directed peak loads, the TFA and TF had a significantly lower amount of loads developed with their instruments than PTN and PTU. The choice of instrument system had an influence on the loads developed during canal shaping. TFA instruments were associated favorably with the lowest values of peak loads followed by TF, PTN, and PTU. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Root anatomy and canal configuration of the permanent mandibular first molar: a systematic review.

PubMed

de Pablo, Oliver Valencia; Estevez, Roberto; Péix Sánchez, Manuel; Heilborn, Carlos; Cohenca, Nestor

2010-12-01

The main goal of endodontic therapy is to prevent or heal apical periodontitis. However, root canal anatomy might present a clinical challenge directly related to the treatment outcome. The purpose of this study was to review published literature related to root anatomy and root canal configuration of the permanent mandibular first molar. An exhaustive search was undertaken to identify published literature related to the root anatomy and root canal morphology of the permanent mandibular first molar by using key words. The search of the MEDLINE database included all publications from 1966-May 2010. Selected articles were then obtained and reviewed. Data evaluated and summarized in the data sheet included methodology, population, number of teeth per study (power), number of root canals, type of root canal configuration, and identification of number of apical foramina. Forty-one studies were identified including a total of 18,781 teeth. The incidence of a third root was 13% and was strongly correlated with the ethnicity of the studied population. Three canals were present in 61.3%, 4 canals in 35.7%, and 5 canals in approximately 1%. Root canal configuration of the mesial root revealed 2 canals in 94.4% and 3 canals in 2.3%. The most common canal system configuration was Vertucci type IV (52.3%), followed by type II (35%). Root canal configuration of the distal root revealed type I configuration in 62.7%, followed by types II (14.5%) and IV (12.4%). The presence of isthmus communications averaged 54.8% on the mesial and 20.2% on the distal root. The number of roots on the mandibular first molar is directly related to ethnicity. Root canal morphology and configuration might present the clinician with a complex anatomy requiring more diagnostic approaches, access modifications, and clinical skills to successfully localize, negotiate, disinfect, and seal the root canal system. Crown Copyright © 2010. Published by Elsevier Inc. All rights reserved.

Micro-Computed Tomography Evaluation of ProTaper Next and BioRace Shaping Outcomes in Maxillary First Molar Curved Canals.

PubMed

Pasqualini, Damiano; Alovisi, Mario; Cemenasco, Andrea; Mancini, Lucia; Paolino, Davide Salvatore; Bianchi, Caterina Chiara; Roggia, Andrea; Scotti, Nicola; Berutti, Elio

2015-10-01

The aim of this micro-computed tomography study was to describe the shaping properties of ProGlider/ProTaper Next (PG/PTN) and ScoutRace/BioRace (SR/BR) nickel-titanium rotary systems. Thirty maxillary first permanent molars were selected. Mesiobuccal canals were randomly assigned (n = 15) to PG/PTN or SR/BR groups. Irrigation was performed with 5% NaOCl and 10% EDTA. Specimens were scanned (voxel size, 9.1 μm) for matching volumes and surface areas and post-treatment analyses. Root canal centering ability, canal geometry enlargement, and thickness of dentinal wall at inner curvature were assessed at apical level and point of maximum curvature. Results were analyzed with 4 one-way analyses of variance. Canal centering ability was superior in PG/PTN (P = .006 at apical level, P = .025 at point of maximum curvature). PG/PTN demonstrated a more conservative increase of canal areas (P = .027 at apical level, P = .038 at point of maximum curvature). Centrifugal increase in canal diameters did not significantly differ between groups (P = .65 at apical level, P = .61 at point of maximum curvature). Inner dentinal wall thickness was less reduced with PG/PTN compared with SR/BR, with no statistical differences (P = .23 at point of maximum curvature, P = .89 at apical level). PG/PTN shaping taper ranged between 6% and 7%. Neither system produced significant shaping errors in curved canals. PG/PTN system showed better preservation of canal anatomy. PTN offset section did not influence final preparation taper. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

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

PubMed

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

2010-01-01

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

Single-rooted maxillary first molar with a single canal: endodontic retreatment.

PubMed

de la Torre, Francisco; Cisneros-Cabello, Rafael; Aranguren, José Luis; Estévez, Roberto; Velasco-Ortega, Eugenio; Segura-Egea, Juan José

2008-12-01

This case report presents an unusual root canal system in a maxillary first molar tooth: a single canal in a single root. The endodontic access cavity displayed only 1 canal orifice. This case demonstrated that: 1) clinicians must have adequate knowledge about root canal morphology and its variations; 2) the location and morphology of root canals should be identified radiologically before the root canal treatment; and 3) careful examination of radiographs and the internal anatomy of teeth is essential.

Presence of Metallic Microfragments on Dentinal Walls and Instrument Defects following Root Canal Preparation.

PubMed

Solda, Caroline; Langaro, Marina C; Machado, Alessandra N; Vanni, José R; de A Decurcio, Daniel; Silva, Julio A; Estrela, Carlos; Barletta, Fernando B

2017-04-01

To determine the presence of metallic microfragments and their elemental composition in the dentinal walls of root canals following preparation using different endodontic instruments and to assess the active cutting edges of instruments with regard to structural defects. A total of 108 molar teeth were selected and prepared using different endodontic instruments. Teeth were randomly divided into nine groups of 12 teeth each, according to the instruments employed: Manual systems -K-FlexoFile, K-File, and Hedstroem; rotary systems - ProTaper Next, Mtwo, BioRaCe; and reciprocating systems - Reciproc, Unicone, and WaveOne. Both root canals and instruments were assessed using scanning electron microscopy, and the elemental composition of metallic microfragments was determined using energy-dispersive X-ray spectroscopy. Metallic microfragments were found in the groups prepared with both manual and reciprocating instruments, with no statistically significant differences between groups, thirds, or presence of metallic microfragments (p ≥ 0.05). Moreover, all groups presented structural defects in both new and used instruments; however, rotary instruments (ProTaper Next, Mtwo 702, BioRaCe) were the ones with the lowest number of defects, at statistically significant differences in comparison with other instruments (p < 0.05). The presence of metallic microfragments on dentinal walls following root canal preparation was associated with manual and reciprocating instrumentation. Furthermore, rotary instruments were the ones with the lowest number of defects. Considering the outcomes measured in this study, rotary instruments performed better than the other two groups, as they were associated with the lowest number of metallic microfragments and structural defects. During root canal preparation, operative procedures may induce changes to the root canal shape, as well as the release of metallic fragments resulting from the action of instruments on dentinal walls. Therefore, it is important to determine, among the different techniques used for this purpose, which ones are least susceptible to this occurrence.

[Root canal treatment of mandibular first premolar with 4 root canals: a case report].

PubMed

Liu, Xin-yang; Zhan, Fu-Liang

2015-10-01

The mandibular first premolar can be considered one of the most challenging teeth to treat, due to the complexity of its root canal morphology and increased incidence of multiple canals. A case of endodontic treatment of a mandibular first premolar exhibiting a total of 4 distinct root canals and 4 apical foramina was described. Anatomic variation of root canal morphology should be considered in endodontic treatment to ensure a favorable healing outcome, and its identification could be enhanced by careful examination using a dental operating microscope. Obturation of root canals using a warm vertical compaction technique with a highly-radiopaque root canal sealer, such as AH Plus, after careful ultrasonic activated irrigation might allow the flow of sealer into the narrowed but unprepared part of the canal, thereby facilitating optimum chemo-mechanical debridement of the root canal system.

Comparison of Antibacterial Effects of 810 and 980- nanometer Diode Lasers on Enterococcus Faecalis in the Root Canal System -An in vitro study.

PubMed

Asnaashari, Mohamad; Ebad, Leila Tahmasebi; Shojaeian, Shiva

2016-10-01

Background and aim: Use of laser technology in endodontics has greatly increased in the recent years due to the introduction of new wavelengths and methods and optimal antimicrobial and smear layer removal properties of lasers. This in vitro study aimed to compare the antibacterial effects of diode lasers of 810 nm and 980 nm wavelength on Enterococcus faecalis (E. faecalis) biofilm in the root canal system. Materials and methods: Fifty single-canal human anterior teeth were cleaned, shaped, sterilized and randomly divided into four groups namely two experimental, one positive and one negative control group. The experimental and positive control groups were inoculated with E. faecalis and incubated for two weeks. The experimental group one (n=20) received 810 nm diode laser irradiation (1.5W) while the experimental group two (n=20) was subjected to 980 nm diode laser irradiation (1.5W). The E. faecalis colony forming units (CFUs) were counted in each root canal before and after laser irradiation. Results: Laser irradiation significantly decreased the bacterial colony count in both experimental groups. The reduction in microbial count was significantly greater in 810 nm laser group compared to 980 nm laser group. Conclusion: Irradiation of both 810 and 980 nm lasers significantly decreased the E. faecalis count in the root canal system; 810 nm laser was more effective in decreasing the intracanal microbial load.

Comparison of Antibacterial Effects of 810 and 980- nanometer Diode Lasers on Enterococcus Faecalis in the Root Canal System —An in vitro study

PubMed Central

Asnaashari, Mohamad; Ebad, Leila Tahmasebi

2016-01-01

Background and aim: Use of laser technology in endodontics has greatly increased in the recent years due to the introduction of new wavelengths and methods and optimal antimicrobial and smear layer removal properties of lasers. This in vitro study aimed to compare the antibacterial effects of diode lasers of 810 nm and 980 nm wavelength on Enterococcus faecalis (E. faecalis) biofilm in the root canal system. Materials and methods: Fifty single-canal human anterior teeth were cleaned, shaped, sterilized and randomly divided into four groups namely two experimental, one positive and one negative control group. The experimental and positive control groups were inoculated with E. faecalis and incubated for two weeks. The experimental group one (n=20) received 810 nm diode laser irradiation (1.5W) while the experimental group two (n=20) was subjected to 980 nm diode laser irradiation (1.5W). The E. faecalis colony forming units (CFUs) were counted in each root canal before and after laser irradiation. Results: Laser irradiation significantly decreased the bacterial colony count in both experimental groups. The reduction in microbial count was significantly greater in 810 nm laser group compared to 980 nm laser group. Conclusion: Irradiation of both 810 and 980 nm lasers significantly decreased the E. faecalis count in the root canal system; 810 nm laser was more effective in decreasing the intracanal microbial load. PMID:27853346

Endodontic management of mesiobuccal-2 canal in four-rooted and five-canalled mandibular third molar.

PubMed

Garg, Amit Kumar; Bhardwaj, Anuj; Mantri, Vijay R; Agrawal, Neha

2014-05-01

A case of unusual Root morphology is presented to demonstrate anatomic variations in mandibular third molar. The most common configuration of mandibular third molar is two Roots and three canals; however they may have many different combinations. Endodontic treatment was performed in mandibular third molar having aberrant anatomy. Four Root canal orifices were located with the aid of dental operating microscope (DOM) and three separate Roots were diagnosed with radiographs. Spiral computed tomography (SCT) showed the presence of an extra canal and extra Root, indicating a rare anatomic configuration. Looking for additional canals and Roots are important part of successful endodontics, as the knowledge of their existence enable clinicians to treat a case successfully that otherwise might end in failure. The use of DOM and SCT in this case greatly contributed toward making a confirmatory diagnosis and successful endodontic treatment of four-rooted and five-canalled mandibular third molar. Variation in Root canal anatomy is very common. Knowledge of these variations is very essential for successful Root canal outcome, inability to do so can lead to missed canals and failures. Hence, thorough knowledge of Root canal anatomy and advances in diagnostic aids are essential.

The fluid mechanics of root canal irrigation.

PubMed

Gulabivala, K; Ng, Y-L; Gilbertson, M; Eames, I

2010-12-01

Root canal treatment is a common dental operation aimed at removing the contents of the geometrically complex canal chambers within teeth; its purpose is to remove diseased or infected tissue. The complex chamber is first enlarged and shaped by instruments to a size sufficient to deliver antibacterial fluids. These irrigants help to dissolve dying tissue, disinfect the canal walls and space and flush out debris. The effectiveness of the procedure is limited by access to the canal terminus. Endodontic research is focused on finding the instruments and clinical procedures that might improve success rates by more effectively reaching the apical anatomy. The individual factors affecting treatment outcome have not been unequivocally deciphered, partly because of the difficulty in isolating them and in making the link between simplified, general experimental models and the complex biological objects that are teeth. Explicitly considering the physical processes within the root canal can contribute to the resolution of these problems. The central problem is one of fluid motion in a confined geometry, which makes the dispersion and mixing of irrigant more difficult because of the absence of turbulence over much of the canal volume. The effects of treatments can be understood through the use of scale models, mathematical modelling and numerical computations. A particular concern in treatment is that caustic irrigant may penetrate beyond the root canal, causing chemical damage to the jawbone. In fact, a stagnation plane exists beyond the needle tip, which the irrigant cannot penetrate. The goal is therefore to shift the stagnation plane apically to be coincident with the canal terminus without extending beyond it. Needle design may solve some of the problems but the best design for irrigant penetration conflicts with that for optimal removal of the bacterial biofilm from the canal wall. Both irrigant penetration and biofilm removal may be improved through canal fluid agitation using a closely fitting instrument or by sonic or ultrasonic activation. This review highlights a way forward by understanding the physical processes involved through physical models, mathematical modelling and numerical computations.

Root Canal Anatomy and Morphology of Mandibular First Molars in a Selected Iranian Population: An In Vitro Study

PubMed Central

Mohammadzadeh Akhlaghi, Nahid; Khalilak, Zohreh; Vatanpour, Mehdi; Mohammadi, Saman; Pirmoradi, Sakineh; Fazlyab, Mahta; Safavi, Kamran

2017-01-01

Introduction: The aim of this study was to evaluate root canal anatomy of mandibular first molars (MFM) in a selected Iranian Population using clearing technique. Methods and Materials: A total of 150 extracted MFMs were cleared. The root canal morphology (including the root numbers and root length) and the anatomy of the root canal system (including is the number and type of canals based on Vertucci’s classification, canal curvature according to Schneider's method and the presence of isthmus) was evaluated using the buccolingual and mesiodistal parallel x-rays and stereomicroscope. The data were analyzed using the chi-square test. Results: Two and three roots were present in 96.7% and 33% of the teeth, respectively (P=0.0001). All the teeth (100%) had two canals in the mesial root, while 61.3% of the samples had one distal root canal (P=0.006). The root canal configuration in the mesial canal included type IV (55.3%) and type II (41.3%) (P=0.0001). In doubled-canalled distal roots, 68.8% and 24.3% were type II and type IV, respectively (P=0.0001). Isthmii were observed in 44.6% of mesial and 27.3% of distal roots (P=0.0001). Conclusion: The notable prevalence of type IV configuration in both roots of mandibular first molars, presence of isthmus and root curvature, necessitates the careful negotiation and cleaning of all accessible canal spaces. PMID:28179932

A cone-beam computed tomography study of maxillary first permanent molar root and canal morphology in a Chinese population.

PubMed

Zheng, Qing-hua; Wang, Yao; Zhou, Xue-dong; Wang, Qian; Zheng, Guang-ning; Huang, Ding-ming

2010-09-01

This study evaluated root and canal morphology of permanent maxillary first molars in a Chinese population using cone-beam computed tomography scanning. The sample included 775 cone-beam computed tomography images of maxillary first molars; 627 of the subjects had unilateral qualifying molars and 74 had bilateral qualifying molars. The following observations were made: (1) frequency of root and canal numbers, (2) frequency of additional canals in the mesiobuccal root by sex, age, and tooth position, and (3) unilateral and bilateral occurrence of additional canals in the mesiobuccal root. Fused roots were present in 2.71% of unilateral qualifying molars. Multiple canals were present in the following frequencies: two canals in 0.31%, three canals in 47.21%, four canals in 50.40%, five canals in 1.75%, and six canals in 0.31% of teeth. Additional canals were detected in 52.24% of mesiobuccal roots, 1.12% of distobuccal roots, and 1.76% of palatal roots. Patients aged 20 to 30 years showed a higher prevalence of additional mesiobuccal root canals. This prevalence did not differ with sex and tooth position. Most (71.11%) of the additional mesiobuccal root canals in subjects with bilateral qualifying molars were symmetric. Cone-beam computed tomography scanning is an effective method for studying external and internal dental morphology. The root and canal configurations of maxillary first molars in this Chinese population were consistent with previously reported data. More attention should be given to the detection of additional canals in patients between 20 and 30 years of age. These data may facilitate successful endodontic treatment. Copyright 2010 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Measurement of the percentage of root filling in oval-shaped canals obturated with Thermafil Obturators and Beefill 2in1: In vitro study

PubMed Central

Collado-Castellanos, Nicolás; Alegre-Domingo, Teresa; Dolz-Solsona, María; Faus-Matoses, Vicente

2015-01-01

Background The aim of the study was to measure the percentage of root canal fillings in long oval canals obturated with thermoplasticized gutta-percha techniques, Beefill 2in1® and Thermafil Obturators®. Material and Methods Fifty four mandibular incisors were selected after bucco-lingual and mesio-distal radiographs showed at 5 mm from apex an internal long:short diameter ≥2. Teeth were instrumented with Protaper Universal and divided in two groups of 27. Group 1 was obturated with Thermafil Obturators® and group 2 with Beefill 2in1®. Two horizontal sections were cut at 5 and 7 mm from the apex and photographed in a stereo-microscope. The total area of the canal and filled canal in cross-sections were measured with AutoCad and the percentages of gutta-percha-sealer and voids in the canal were obtained. Results Both systems achieved high percentage of filled canal, Thermafil 96.8% and Beefill 2in1 98.9%. The percentages of voids in both groups were very low. No significant differences were found between the two groups . The percentage obtained at 5 and 7 mm from the apex in both groups showed no significant difference. Conclusions The percentages of filled canal (gutta-percha-sealer) were high and these two thermoplasticized techniques are suitable for long oval canals obturation. Key words:Long oval canal, oval canal, thermoplasticized obturation. PMID:26155350

Measurement of the percentage of root filling in oval-shaped canals obturated with Thermafil Obturators and Beefill 2in1: In vitro study.

PubMed

Faus-Llácer, Vicente; Collado-Castellanos, Nicolás; Alegre-Domingo, Teresa; Dolz-Solsona, María; Faus-Matoses, Vicente

2015-04-01

The aim of the study was to measure the percentage of root canal fillings in long oval canals obturated with thermoplasticized gutta-percha techniques, Beefill 2in1® and Thermafil Obturators®. Fifty four mandibular incisors were selected after bucco-lingual and mesio-distal radiographs showed at 5 mm from apex an internal long:short diameter ≥2. Teeth were instrumented with Protaper Universal and divided in two groups of 27. Group 1 was obturated with Thermafil Obturators® and group 2 with Beefill 2in1®. Two horizontal sections were cut at 5 and 7 mm from the apex and photographed in a stereo-microscope. The total area of the canal and filled canal in cross-sections were measured with AutoCad and the percentages of gutta-percha-sealer and voids in the canal were obtained. Both systems achieved high percentage of filled canal, Thermafil 96.8% and Beefill 2in1 98.9%. The percentages of voids in both groups were very low. No significant differences were found between the two groups . The percentage obtained at 5 and 7 mm from the apex in both groups showed no significant difference. The percentages of filled canal (gutta-percha-sealer) were high and these two thermoplasticized techniques are suitable for long oval canals obturation. Key words:Long oval canal, oval canal, thermoplasticized obturation.

Morphology of mandibular first molars analyzed by cone-beam computed tomography in a Korean population: variations in the number of roots and canals.

PubMed

Kim, Sin-Young; Kim, Bom Sahn; Woo, Jein; Kim, Yemi

2013-12-01

The aim of this study was to determine the root and canal morphology of the mandibular first molars in a Korean population of Mongolian origin by retrospective analysis of a large number of cone-beam computed tomography (CBCT) images. A total of 976 subjects with bilateral mandibular first molars were examined by using in vivo CBCT methods. The number and configuration of roots, the number of root canals, and the canal configuration based on Vertucci's classification were determined. Overall, 25.82% of examined molars had 3 roots, 73.51% had 2 roots, and 0.67% had 1 root. The incidence of fourth canal was 50.36%. A right-sided predominance was noted for extra distal roots (P < .001), whereas a left-sided predominance was observed for extra distal canals (P < .001). No significant sex-related differences were shown for their prevalence. The bilateral prevalence rate was 69.13% for extra distal roots and 78.08% for extra distolingual (DL) canals. In the mesial roots, type IV canal was the most frequent (76.86% for 2-rooted molars and 72.96% for 3-rooted molars). In the distal roots, type l was the most common (66.62% for 2-rooted molars and 99.40%-100% for 3-rooted molars). The incidence of 2 canals in distobuccal roots, first reported in this study, was 0.15%. Among mandibular first molars, there is a high prevalence of a separate DL root and/or a separate DL canal, and such molars commonly have 4 canals in the Korean population. CBCT is a useful tool for determining root and canal morphology. Copyright © 2013 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Endodontic management of radix paramolaris with six canals: a clinical case report.

PubMed

Acharya, N; Singh, A; Samant, P S; Gautam, V

2013-01-01

Endodontic therapy of mandibular molars is a challenging task due to its varied root canal morphology. A mandibular first molar with additional buccal root (Radix paramolaris) and additional distolingual root (Radix Entomolaris) is an example of its varied anatomy. A successful management of atypical root canal configurations is an important aspect in determining the success rate of root canal therapy. The detail knowledge of the root morphology and canal anatomy allows the clinician for accurate location of the extra roots and canals and accordingly the refinement of the access cavity for the stress free entry of complex anatomy. Hence, for a successful root canal therapy, clinician must be aware of the external and internal anatomic variations .The aim of this clinical case report is to present and describe the unusual presence of two separate mesial roots and six root canals in mandibular first molar, detected during routine endodontic therapy.

Endodontic management of maxillary first molar with atypical canal morphology: Report of three cases

PubMed Central

Sherwani, Osama Adeel Khan; Kapoor, Bhumika; Sharma, Rajat; Mishra, Surendra Kumar

2016-01-01

Maxillary first molar with three roots and 3–4 canals is a common occurrence. However, extreme variations in their canal morphology have been reported ranging from one single canal and one root to as many as eight root canals. This article presents three cases of successful endodontic management of maxillary first molars with atypical canal morphologies, thus highlighting the fact that variations do occur and an endodontist should always be aware of aberrancies in root canal system apart from the knowledge of normal root canal anatomy. PMID:27994427

[Engine-driven preparation of curved root canals: a platform to assess physical parameters].

PubMed

Peters, O A; Kappeler, S; Bucher, W; Barbakow, F

2001-01-01

The number of engine-driven rotary instruments available on the market is steadily increasing. These instruments enable clinicians to prepare better shaped root canals, however, rotary instruments have a higher risk for fracture than hand instruments. Unfortunately, the stresses placed on engine-driven rotary instruments in curved canals are insufficiently studied. The aim of this study was to develop a device which could measure more accurately the physical parameters influencing rotary instruments in curved canals. For this purpose, a specially designed machine was constructed to measure the torque which develops between the rotary instrument and the motor. Apical forces and penetration depths could also be directly measured in real time. A variety of other measurements was also possible because of other special set-ups integrated into the device. In the current study torque was assessed for GT-Files, size 35 with a .12 and sizes 20 with a .12 to .06 taper. In additions to preparations in simulated canals in plastic blocks, the "ISO 3630-1 specification for fracture moment" and "number of cycles till fatigue fracture" was measured. The findings indicated that when instruments were used for preparations, torques up to 40 Nmm were present. This exceeded the static fracture load, which was less than than 13 Nmm for the size 20 with .12 taper. In contrast, the number of rotations were more than 10 times lower when shaping canals in plastic blocks with a 5 mm radius of curvature than the number of rotations to fracture in the "cyclic fatigue test". This suggests that a GT-instrument could be used in ten canals. The apical force was always greater than 1 N and occasionally, 8 N or more was recorded. Further studies on natural teeth with varying canal geometries are required using the specially developed torsional machine to reduce the incidence of instrument fracture. In this way an efficient clinical potential can be confirmed for engine-driven rotary instruments in canal preparation.

Endodontic management of a mandibular first molar with six root canal systems.

PubMed

Jain, Dilip; Reddy, Smitha; Venigalla, Bhuvan Shome; Kamishetty, Shekhar

2015-01-01

Internal anatomy of pulp is complex. The first mandibular molars typically have two roots, one mesial with two root canals and another distal root, which contains one or two canals. A 20-year-old female patient reported with intermittent pain and incomplete root canal treatment in left lower back region since 1-week. Refined access cavity revealed initially two canals in mesial and two canals in the distal root. With operating microscope and cone beam computerized tomography, two additional canals (L-mesio-buccal and B-mesio-lingual) were identified in mesial root. One-year follow-up showed patient was asymptomatic and complete healing of periapical radiolucency.

Maxillary molars with morphologic variations of the palatal root canals: a report of four cases.

PubMed

Holderrieth, Silke; Gernhardt, Christian Ralf

2009-07-01

The purpose of this article was to show the importance of the knowledge of the anatomy of root canals. Unusual root and root canal morphologies associated with both buccal roots of upper molars have been recorded in several studies in the literature. However, scientific information focusing on variations of the palatal root is rare. In this report, four cases are presented involving the root canal treatment of maxillary first and second molars with unusual morphologic configurations of the palatal root canals. During root canal treatment, type IV and V configurations as defined by Vertucci of the palatal canals of two first and two second maxillary molars were identified. After mechanical instrumentation, the canals were obturated. Radiologic and clinical re-evaluation showed no signs of inflammation. This report describes and discusses the possibility of different root and canal variations of the maxillary molars from a clinical point of view. Anatomic variations can occur in any tooth, and palatal roots of maxillary first and second molars are no exception. Therefore, careful examination of radiographs and internal anatomy of teeth is essential.

Prevalence and morphometric analysis of three-rooted mandibular first molars in a Brazilian subpopulation

PubMed Central

Rodrigues, Clarissa Teles; de Oliveira-Santos, Christiano; Bernardineli, Norberti; Duarte, Marco Antonio Hungaro; Bramante, Clovis Monteiro; Minotti-Bonfante, Paloma Gagliardi; Ordinola-Zapata, Ronald

2016-01-01

ABSTRACT The knowledge of the internal anatomy of three-rooted mandibular molars may help clinicians to diagnose and plan the root canal treatment in order to provide adequate therapy when this variation is present. Objectives: To determine the prevalence of three-rooted mandibular molars in a Brazilian population using cone beam computed tomography (CBCT) and to analyze the anatomy of mandibular first molars with three roots through micro-CT. Material and Methods: CBCT images of 116 patients were reviewed to determine the prevalence of three-rooted first mandibular molars in a Brazilian subpopulation. Furthermore, with the use of micro-CT, 55 extracted three-rooted mandibular first molars were scanned and reconstructed to assess root length, distance between canal orifices, apical diameter, Vertucci's classification, presence of apical delta, number of foramina and furcations, lateral and accessory canals. The distance between the orifice on the pulp chamber floor and the beginning of the curvature and the angle of canal curvature were analyzed in the distolingual root. Data were compared using the Kruskal-Wallis test (α=0.05). Results: The prevalence of three-rooted mandibular first molars was of 2.58%. Mesial roots showed complex distribution of the root canal system in comparison to the distal roots. The median of major diameters of mesiobuccal, mesiolingual and single mesial canals were: 0.34, 0.41 and 0.60 mm, respectively. The higher values of major diameters were found in the distobuccal canals (0.56 mm) and the lower diameters in the distolingual canals (0.29 mm). The lowest orifice distance was found between the mesial canals (MB-ML) and the highest distance between the distal root canals (DB-DL). Almost all distal roots had one root canal and one apical foramen with few accessory canals. Conclusions: Distolingual root generally has short length, severe curvature and a single root canal with low apical diameter. PMID:27812625

Evaluation of Root Canal Configuration of Mandibular First Molars in a Palestinian Population by Using Cone-Beam Computed Tomography: An Ex Vivo Study

PubMed Central

Mukhaimer, Raed Hakam

2014-01-01

Aim. The purpose of this study was to investigate the number of canals and variations in root canal configuration in the mandibular permanent first molar teeth of a Palestinian population using cone-beam computed tomography (CBCT). Methods. A sample of 320 extracted double-rooted mandibular permanent first molars from Palestinian population was collected for this study and scanned with CBCT scanner. The following observations were made: number of root canals per root and canal configuration in each root based on Vertucci's classification. Results. Of the 320 mandibular first molars analyzed, 174 (54.4%) had three canals, 132 teeth (41.3%) had four canals, and only four teeth had two canals. The most common canal configuration in the mesial roots was Vertucci type IV (53.8%) followed by type II (38.8%). In the distal roots, the most prevalent canal configuration was Vertucci type I (57.5%) followed by type II ( 22.5%) and type III (10.6%). Conclusion. Our results showed that the number of canals and canal configuration in Palestinian population were consistent with previously reported data. The present study also indicates that CBCT is helpful as a diagnostic tool for the investigation of root canal morphology. PMID:27379321

Cleaning effectiveness and shaping ability of rotary ProTaper compared with rotary GT and manual K-Flexofile.

PubMed

Liu, Sheng-Bo; Fan, Bin; Cheung, Gary S P; Peng, Bing; Fan, Ming-Wen; Gutmann, James L; Song, Ya-Ling; Fu, Qiang; Bian, Zhuan

2006-12-01

To compare the cleaning efficacy and shaping ability of engine-driven ProTaper and GT files, and manual preparation using K-Flexofile instruments in curved root canals of extracted human teeth. 45 canals of maxillary and mandibular molars with curvatures between 25 degrees and 40 degrees were divided into three groups. The groups were balanced with regard to the angle and the radius of canal curvature. Canals in each group were prepared to an apical size of 25 with either the rotary ProTaper or GT system, or manually with K-Flexofile using the modified double-flared technique. Irrigation was done with 2 mL 2.5% NaOCl after each instrument and, as the final rinse, 10 mL 2.5% NaOCl then 10 mL 17% EDTA and finally 5 mL distilled water. The double-exposure radiographic technique was used to examine for the presence of apical transportation. The time required to complete the preparation, as well as any change in working length after preparation were recorded. The roots were then grooved and split longitudinally. The amounts of debris and smear layer were evaluated at the apical, middle and coronal regions under the scanning electron microscope. Data were analyzed either parametrically with the F-test or non-parametrically using the Kruskal-Wallis test, where appropriate. Two GT files but none of the K-Flexofile and ProTaper instruments separated. For debris removal, the ProTaper group achieved a better result than GT (P < 0.05) but not the K-Flexofile group at all three regions (apical, middle and coronal). K-Flexofiles produced significantly less smear layer than ProTaper and GT files only in the middle third of the canal (P < 0.01). Both NiTi rotary instruments maintained the original canal shape better than the K-Flexofiles (P < 0.05) and required significantly less time to complete the preparation.

Smear layer and debris removal using manual Ni-Ti files compared with rotary Protaper Ni- Ti files - An In-Vitro SEM study.

PubMed

Reddy, J M V Raghavendra; Latha, Prasanna; Gowda, Basavana; Manvikar, Varadendra; Vijayalaxmi, D Benal; Ponangi, Kalyana Chakravarthi

2014-02-01

Predictable successful endodontic therapy depends on correct diagnosis, effective cleaning, shaping and disinfection of the root canals and adequate obturation. Irrigation serves as a flush to remove debris, tissue solvent and lubricant from the canal irregularities; however these irregularities can restrict the complete debridement of root canal by mechanical instrumentation.Various types of hand and rotary instruments are used for the preparation of the root canal system to obtain debris free canals. The purpose of this study was to evaluate the amount of smear layer and debris removal on canal walls following the using of manual Nickel-Titanium (NiTi) files compared with rotary ProTaperNiTi files using a Scanning Electron Microscope in two individual groups. A comparative study consisting of 50 subjects randomized into two groups - 25 subjects in Group A (manual) and 25 subjects in Group B (rotary) was undertaken to investigate and compare the effects of smear layer and debris between manual and rotary NiTi instruments. Chi square test was used to find the significance of smear layer and debris removal in the coronal, middle and apical between Group A and Group B. Both systems of Rotary ProTaperNiTi and manual NiTi files used in the present study, did not create completely clean root canals. Manual NiTi files produced significantly less smear layer and debris compared to Rotary ProTaperNiTi instruments. Rotary instruments were less time consuming when compared to manual instruments. Instrument separation was not found to be significant with both the groups. Both systems of Rotary ProTaperNiTi and manual NiTi files used did not produce completely clean root canals. Manual NiTi files produced significantly less smear layer and debris compared to Rotary protaper instruments. How to cite the article: Reddy JM, Latha P, Gowda B, Manvikar V, Vijayalaxmi DB, Ponangi KC. Smear layer and debris removal using manual Ni-Ti files compared with rotary Protaper Ni-Ti files - An In-Vitro SEM study. J Int Oral Health 2014;6(1):89-94.

Smear layer and debris removal using manual Ni-Ti files compared with rotary Protaper Ni- Ti files - An In-Vitro SEM study

PubMed Central

Reddy, J M V Raghavendra; Latha, Prasanna; Gowda, Basavana; Manvikar, Varadendra; Vijayalaxmi, D Benal; Ponangi, Kalyana Chakravarthi

2014-01-01

Background: Predictable successful endodontic therapy depends on correct diagnosis, effective cleaning, shaping and disinfection of the root canals and adequate obturation. Irrigation serves as a flush to remove debris, tissue solvent and lubricant from the canal irregularities; however these irregularities can restrict the complete debridement of root canal by mechanical instrumentation.Various types of hand and rotary instruments are used for the preparation of the root canal system to obtain debris free canals. The purpose of this study was to evaluate the amount of smear layer and debris removal on canal walls following the using of manual Nickel-Titanium (NiTi) files compared with rotary ProTaperNiTi files using a Scanning Electron Microscope in two individual groups. Materials & Methods: A comparative study consisting of 50 subjects randomized into two groups – 25 subjects in Group A (manual) and 25 subjects in Group B (rotary) was undertaken to investigate and compare the effects of smear layer and debris between manual and rotary NiTi instruments. Chi square test was used to find the significance of smear layer and debris removal in the coronal, middle and apical between Group A and Group B. Results: Both systems of Rotary ProTaperNiTi and manual NiTi files used in the present study, did not create completely clean root canals. Manual NiTi files produced significantly less smear layer and debris compared to Rotary ProTaperNiTi instruments. Rotary instruments were less time consuming when compared to manual instruments. Instrument separation was not found to be significant with both the groups. Conclusions: Both systems of Rotary ProTaperNiTi and manual NiTi files used did not produce completely clean root canals. Manual NiTi files produced significantly less smear layer and debris compared to Rotary protaper instruments. How to cite the article: Reddy JM, Latha P, Gowda B, Manvikar V, Vijayalaxmi DB, Ponangi KC. Smear layer and debris removal using manual Ni-Ti files compared with rotary Protaper Ni-Ti files - An In-Vitro SEM study. J Int Oral Health 2014;6(1):89-94. PMID:24653610

Comparison of positive-pressure, passive ultrasonic, and laser-activated irrigations on smear-layer removal from the root canal surface.

PubMed

Sahar-Helft, Sharonit; Sarp, Ayşe Sena Kabaş; Stabholtz, Adam; Gutkin, Vitaly; Redenski, Idan; Steinberg, Doron

2015-03-01

The purpose of this study was to compare the efficacy of three irrigation techniques for smear-layer removal with 17% EDTA. Cleaning and shaping the root canal system during endodontic treatment produces a smear layer and hard tissue debris. Three irrigation techniques were tested for solution infiltration of this layer: positive-pressure irrigation, passive ultrasonic irrigation, and laser-activated irrigation. Sixty extracted teeth were divided into six equal groups; 17% EDTA was used for 60 sec irrigation of five of the groups. The groups were as follows: Group 1, treated only with ProTaper™ F3 Ni-Ti files; Group 2, positive-pressure irrigation, with a syringe; Group 3, passive ultrasonic irrigation, inserted 1 mm short of the working length; Group 4, passive ultrasonic irrigation, inserted in the upper coronal third of the root; Group 5, Er:YAG laser-activated irrigation, inserted 1 mm short of the working length; and Group 6, Er:YAG laser-activated irrigation, inserted in the upper coronal third of the root. Scanning electron microscopy showed that the smear layer is removed most efficiently using laser-activated irrigation at low energy with 17% EDTA, inserted either at the working length or only in the coronal upper third of the root. Amounts of Ca, P, and O were not significantly different on all treated dentin surfaces. Smear-layer removal was most effective when the root canals were irrigated using Er:YAG laser at low energy with 17% EDTA solution. Interestingly, removal of the smear layer along the entire canal was similar when the laser was inserted in the upper coronal third and at 1 mm short of the working length of the root canal. This effect was not observed with the ultrasonic and positive-pressure techniques.

A mandibular third molar with three mesial roots: a case report.

PubMed

Plotino, Gianluca

2008-02-01

Although its most common configuration is 2 roots and 3 root canals, mandibular molars might have many different combinations. A case of unusual root canal morphology is presented to demonstrate anatomic variations in mandibular molars. Endodontic therapy was performed in a mandibular third molar with 3 separate mesial roots. The appearance of the pulp chamber floor revealed 4 separate canal orifices. Radiographically the 4 root canals ended in their own distinct foramen. Many reports deal with 3 orifices or 3 independent canals in the mesial root, but none described 3 mesial canals in 3 separate mesial roots, indicating a rare anatomic configuration. This report points out the importance of looking for additional canals and unusual canal morphology, because knowledge of their existence might occasionally enable clinicians to treat a case successfully that otherwise might have ended in failure.

Effect of Instrumentation Techniques and Preparation Taper on Apical Extrusion of Bacteria.

PubMed

Aksel, Hacer; Küçükkaya Eren, Selen; Çakar, Aslı; Serper, Ahmet; Özkuyumcu, Cumhur; Azim, Adham A

2017-06-01

The aim of this in vitro study was to evaluate the effects of different root canal instrumentation techniques and preparation tapers on the amount of apically extruded bacteria. The root canals of 98 extracted human mandibular incisors were contaminated with Enterococcus faecalis suspension. After incubation at 37°C for 24 hours, the root canals were instrumented with K3 rotary files in a crown-down (CD) or full-length linear instrumentation technique (FL) by using 3 different root canal tapers (0.02, 0.04, and 0.06). During instrumentation, apically extruded bacteria were collected into vials containing saline solution. The microbiological samples were taken from the vials and incubated in brain-heart agar medium for 24 hours, and the numbers of colony-forming units (CFUs) were determined. The obtained results were analyzed with t test and one-way analysis of variance for the comparisons between the instrumentation techniques (CD and FL) and the preparation tapers (0.02, 0.04, and 0.06), respectively. Tukey honestly significant difference test was used for pairwise comparisons. The preparation taper had no effect on the number of CFUs when a FL instrumentation technique was used (P > .05). There was a statistically significant difference in the CFUs between FL and CD techniques when the preparation taper was 0.02 (P < .05). There was no statistically significant difference between the 0.04 and 0.06 preparation tapers in any of the instrumentation techniques (P > .05). Using a 0.02 taper in a CD manner results in the least amount of bacterial extrusion. The instrumentation technique did not seem to affect the amount of bacterial extrusion when 0.04 and 0.06 taper instruments were used for cleaning and shaping the root canal space. Published by Elsevier Inc.

Microtensile bond strength of etch-and-rinse and self-etching adhesives to intrapulpal dentin after endodontic irrigation and setting of root canal sealer.

PubMed

Wattanawongpitak, Nipaporn; Nakajima, Masatoshi; Ikeda, Masaomi; Foxton, Richard M; Tagami, Junji

2009-02-01

To evaluate the effect of endodontic irrigation regimens and calcium hydroxide root canal sealer (Sealapex) on the microtensile bond strengths (muTBS) of dual-curing resin composite (Clearfil DC Core Automix) to the intrapulpal dentin. Forty standardized coronal-half root canal dentin specimens obtained from human premolars were divided into 4 groups: group A, no treatment (control); group B, Sealapex; group C, NaOCl/Sealapex; group D, EDTA/NaOCl/Sealapex. After 7 days of storage in 100% relative humidity, Sealapex was removed. Dentin surfaces were bonded with adhesives, either etch-and-rinse (Single Bond) or self-etching (Clearfil SE Bond), and built up with resin composite. The bonded specimens were trimmed into an hourglass shape with a 1-mm2 cross-sectional area for microtensile testing (n = 20). The muTBS to intrapulpal dentin was analyzed using two-way ANOVA and Dunnett's TC test. Two teeth of each group were prepared for micromorphological analysis of dentin surface. The root canal sealer with or without endodontic irrigation significantly affected the bond strengths of resin composite to intrapulpal dentin compared with the control group (p < 0.05). There were no significant differences in muTBS of each experimental group between etch-and-rinse and self-etching adhesives (p > 0.05). The dentin surface was covered with a mud-like material after sealer application for 7 days. The root canal sealer reduced the muTBS of dual-curing resin composite with etch-and-rinse and self-etching adhesive systems to intrapulpal dentin. Treatment with EDTA followed by NaOCI prior to obturation caused an additional reduction in muTBS of both adhesive systems to intrapulpal dentin.

INTERNAL ROOT MORPHOLOGY IN MANDIBULAR FIRST PERMANENT MOLARS IN A KENYAN POPULATION.

PubMed

Muriithi, N J; Maina, S W; Okoth, J; Gathece, L W

2012-05-01

To determine the internal root morphology and gender variations in mandibular first permanent molars in a Kenyan population. In vitro descriptive cross sectional study. School of Dental Sciences, University of Nairobi The mesial root of mandibular first molars had two canals in 96.3% of the teeth in both males and females and-type IV canal configuration was most prevalent in the mesial root. The distal root of the mandibular first molar had one canal in 57.7% of the teeth in males and females. There were significant gender variations in the number of canals and canal configurations in the distal root. Two canals were more prevalent in females (53.6%) compared to males (30.4%) and a single canal was more frequent in males (69.6%) compared to females (46.4%) (P=0.001). Canal types 1, 11 and IV were the most frequent in the mandibular distal root. The gender variation in the frequency of canal types I, II and IV in the distal root was statistically significant (P=0.001). Most of the mandibular first molars have three canals (56%). Two canals in the distal root are more frequent among females (53.6%) compared to males (30.4%).

Root canal irrigants

PubMed Central

Kandaswamy, Deivanayagam; Venkateshbabu, Nagendrababu

2010-01-01

Successful root canal therapy relies on the combination of proper instrumentation, irrigation, and obturation of the root canal. Of these three essential steps of root canal therapy, irrigation of the root canal is the most important determinant in the healing of the periapical tissues. The primary endodontic treatment goal must thus be to optimize root canal disinfection and to prevent reinfection. In this review of the literature, various irrigants and the interactions between irrigants are discussed. We performed a Medline search for English-language papers published untill July 2010. The keywords used were ‘root canal irrigants’ and ‘endodontic irrigants.’ The reference lists of each article were manually checked for additional articles of relevance. PMID:21217955

Analysis of mechanical preparations in extracted teeth using ProTaper rotary instruments: value of the safety quotient.

PubMed

Blum, J Y; Machtou, P; Ruddle, C; Micallef, J P

2003-09-01

The purpose of this study was to apply the Endographe to analyze the vertical forces and torque developed during mechanical preparations in extracted teeth. The data collected in this study may be used to calculate the safety quotient (SQ) as proposed by J.T. McSpadden. The SQ formula is defined as the torque required to break a file at D3 divided by the mean working torque required to cut dentin. The Endographe is a unique force-analyzer device equipped to measure, record, and generate graphs of the vertical forces and torque exerted during root canal preparation. All preparations were performed by endodontists in roots with narrow, more restrictive canals, larger, more open canals, or in roots sectioned in two halves. All canals, including the sectioned canals, were prepared with ProTaper files in accordance with the manufacturer's guidelines for use. For narrow canals, the mean values of the generated vertical forces (g) and torque (g.cm) varied from 80 (+/- 20) g (SX) to 232 (+/- 60) g (F2) and from 80 (+/- 24) g x cm (F1) to 150 (+/- 45) g x cm (S2), respectively. For large canals, the mean values of the generated vertical forces (g) and torque (g x cm) varied from 80 (+/- 20) g (SX) to 340 (+/- 20) g (F1) and from 31 (+/- 9) g x cm (S2) to 96 (+/- 35) g x cm (SX), respectively. The SQ varied from 0.93 to 7.95 for narrow canals and from 1.58 to 14.50 for large canals. The SQ is intended to provide values that can be analyzed to predict whether a rotary file will have a tendency to break or will work safely during clinical use. However, if the formula is going to provide useful information, it must index the "rotation to failure torque" with the "mean working torque" at a specific location along the cutting blades of a file. Additionally, this mathematical formula does not account for factors such as the concentration of forces, the way the instruments are used, or the wear of the instruments. A precise protocol for canal preparation should emphasize using small flexible stainless steel hand files to create or verify that within any portion of a root canal there is sufficient space for rotary instruments to follow. When there is a confirmed smooth, reproducible glide path, then a "secured" space exists to safely guide the more flexible terminal extent of a rotary NiTi file. Endogrammes provide an innovative approach to the analysis of mechanical preparations and suggest that the ProTaper shaping files are best used with lateral forces to decrease the coronal screwing effect. The ProTaper finishing files should be used with slow penetration and be introduced only into canals that have a confirmed smooth and reproducible glide path. When any part of the overall length of a canal has been secured, then the number of instruments, the time spent utilizing each instrument, and the overall time progressing through a sequence of instruments to shape this region of the canal is reduced.

Assessment of apical transportation caused by nickel-titanium rotary systems with full rotation and reciprocating movements using extracted teeth and resin blocks with simulated root canals: A comparative study.

PubMed

Alrahabi, M; Zafar, M S

2018-06-01

: We compared apical transportation in the WaveOne and ProTaper Next systems, which are rotary nickel-titanium systems with reciprocating and continuous rotation movements, respectively, using manual measurements obtained from resin blocks with simulated root canals and double digital radiographs of extracted teeth. : We used 30 resin blocks with simulated root canals and 30 extracted teeth for this study. The same endodontist performed root canal shaping using the WaveOne or ProTaper Next system. We assessed apical transportation by measuring the amounts (in mm) of material lost 1 mm from the apical foramen in the resin blocks and by using double digital radiography for the extracted teeth. Significant differences between groups were assessed using t-tests. P < 0.05 was considered statistically significant. : The amount of apical transportation differed significantly between the two systems when resin blocks were used for assessment (P < 0.05), but there were no significant differences when extracted teeth were used (P < 0.05). In the current study, there was no significant difference in apical transportation between natural teeth prepared using WaveOne and those prepared using ProTaper Next. However, significant differences were observed between the two systems with resin blocks. These findings indicate that the use of resin blocks is not an accurate method for apical transportation evaluation.

Shaping ability of Reciproc and TF Adaptive systems in severely curved canals of rapid microCT-based prototyping molar replicas

PubMed Central

ORDINOLA-ZAPATA, Ronald; BRAMANTE, Clovis Monteiro; DUARTE, Marco Antonio Húngaro; CAVENAGO, Bruno Cavalini; JARAMILLO, David; VERSIANI, Marco Aurélio

2014-01-01

Objective: To evaluate the shaping ability of Reciproc and Twisted-File Adaptive systems in rapid prototyping replicas. Material and Methods: Two mandibular molars showing S-shaped and 62-degree curvatures in the mesial root were scanned by using a microcomputed tomography (μCT) system. The data were exported in the stereolitograhic format and 20 samples of each molar were printed at 16 µm resolution. The mesial canals of 10 replicas of each specimen were prepared with each system. Transportation was measured by overlapping radiographs taken before and after preparation and resin thickness after instrumentation was measured by μCT. Results: Both systems maintained the original shape of the apical third in both anatomies (P>0.05). Overall, considering the resin thickness in the 62-degree replicas, no statistical difference was found between the systems (P>0.05). In the S-shaped curvature replica, Reciproc significantly decreased the thickness of the resin walls in comparison with TF Adaptive. Conclusions: The evaluated systems were able to maintain the original shape at the apical third of severely curved mesial canals of molar replicas. PMID:24918662

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.

A new anatomically based nomenclature for the roots and root canals-part 1: maxillary molars.

PubMed

Kottoor, Jojo; Albuquerque, Denzil Valerian; Velmurugan, Natanasabapathy

2012-01-01

Numerous terminologies have been employed in the dental literature to describe the roots and root canal systems of maxillary molars. This multiplicity in naming of roots and canals makes the reader susceptible to misinterpretation and confusion. No consensus thus far has been arrived at for defining the names of roots and root canals in maxillary molars, including their various morphological aberrations. The anatomical relation of roots and their root canals were identified and were subsequently named based on definite sets of criteria. A new method for identification and naming of roots and root canal anatomy in maxillary molars, based on their root and canal relationship, was formulated and is presented in this paper. The nomenclature makes certain essential modifications to the traditional approach to accommodate naming of the various aberrations presented in the maxillary molars. A simple, yet extensive, nomenclature system has been proposed that appropriately names the internal and external morphology of maxillary molars.

The effect of four different irrigation systems in the removal of a root canal sealer.

PubMed

Grischke, J; Müller-Heine, A; Hülsmann, M

2014-09-01

The aim of this study was to compare the efficiency of sonic, ultrasonic, and hydrodynamic devices in the removal of a root canal sealer from the surface and from simulated irregularities of root canals. Fifty-three root canals with two standardized grooves in the apical and coronal parts of longitudinally split roots were covered with AH Plus root canal sealer. Compared were the effects of (control) syringe irrigation, (1) CanalBrush, (2) passive ultrasonic irrigation, (3) EndoActivator, and (4) RinsEndo on the removal of the sealer. The specimens were divided into four groups (N = 12) and one control group (N = 5) via randomization. The amount of remaining sealer in the root canal irregularities was evaluated under a microscope using a 4-grade scoring system, whereas the remaining sealer on the root canal surface was evaluated with a 7-grade scoring system. Passive ultrasonic irrigation is more effective than the other tested irrigation systems or syringe irrigation in removing sealer from root canal walls (p < 0.01). None of the techniques had a significant effect on cleaning the lateral grooves. Within the limitations of this study protocol ultrasonic irrigation shows a superior effect on sealer removal from the root canal surface during endodontic retreatment. Cleaning of lateral grooves seems not to be possible with one of the techniques investigated. Incomplete removal of root canal sealer during re-treatment may cause treatment failure. Passive Ultrasonic irrigation seems to be the most effective system to remove sealer from a root canal.

Deviations of Mesial Root Canals of Mandibular First Molar Teeth at the Apical Third: A Micro-computed Tomographic Study.

PubMed

Keles, Ali; Keskin, Cangül

2018-06-01

The present study aimed to quantitatively analyze apical foramen deviations of mesial root canals of mandibular first molar teeth by means of micro-computed tomographic (micro-CT) imaging. Micro-CT images of the mesial roots of 109 mandibular first molar teeth with independent mesiobuccal (MB) and mesiolingual (ML) root canals were analyzed. The deviations of the apical foramina of the MB, ML, and middle mesial root canals from the anatomic apex were measured. The vertical distance between the apical foramina of each mesial root canal in relation to each other was also calculated. The distances from the apical foramina of the MB, ML, and middle mesial root canals to the anatomic apex of the mesial root were up to 2.51 mm, 3.21 mm, and 5.67 mm, respectively. There was no significant difference between the deviations of MB and ML root canals from each other (P > .05). The middle mesial root canal showed the greatest deviation compared with the MB and ML canals (P < .05). The apical foramina of mesial root canals of mandibular first molar teeth showed greater variations from each other and anatomic apices than previously reported. Clinically, the use of electronic apex locators for the detection of minor apical foramen of each mesial root canal is of the utmost important. Copyright © 2018 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

In vitro particle image velocity measurements in a model root canal: flow around a polymer rotary finishing file.

PubMed

Koch, Jon D; Smith, Nicholas A; Garces, Daniel; Gao, Luyang; Olsen, F Kris

2014-03-01

Root canal irrigation is vital to thorough debridement and disinfection, but the mechanisms that contribute to its effectiveness are complex and uncertain. Traditionally, studies in this area have relied on before-and-after static comparisons to assess effectiveness, but new in situ tools are being developed to provide real-time assessments of irrigation. The aim in this work was to measure a cross section of the velocity field in the fluid flow around a polymer rotary finishing file in a model root canal. Fluorescent microparticles were seeded into an optically accessible acrylic root canal model. A polymer rotary finishing file was activated in a static position. After laser excitation, fluorescence from the microparticles was imaged onto a frame-transfer camera. Two consecutive images were cross-correlated to provide a measurement of a projected, 2-dimensional velocity field. The method reveals that fluid velocities can be much higher than the velocity of the file because of the shape of the file. Furthermore, these high velocities are in the axial direction of the canal rather than only in the direct of motion of the file. Particle image velocimetry indicates that fluid velocities induced by the rotating file can be much larger than the speed of the file. Particle image velocimetry can provide qualitative insight and quantitative measurements that may be useful for validating computational fluid dynamic models and connecting clinical observations to physical explanations in dental research. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Influence of multiple clinical use on fatigue resistance of ProTaper rotary nickel-titanium instruments.

PubMed

Vieira, E P; França, E C; Martins, R C; Buono, V T L; Bahia, M G A

2008-02-01

To examine the influence of clinical use on the occurrence of deformation and fracture and on the fatigue resistance of ProTaper rotary instruments. Root canal treatments were performed on patients using the ProTaper rotary system. Ten sets of instruments were used by an experienced endodontist, each set in five molars. Another 10 sets of instruments were used by the same operator, each set in eight molars. In addition, 10 sets of instruments were used, each set in five molars, by undergraduate students with no clinical experience with the system. After clinical use, S1, S2, F1 and F2 instruments were analysed for damage by optical and scanning electron microscopy. The used sets, along with a control group of 12 sets of new instruments, were then tested in a bench device for fatigue resistance. The use of the ProTaper rotary instruments by an experienced endodontist allowed for the cleaning and shaping of the root canal system of up to eight molars without fracture. During the students work, six instruments fractured. Fatigue resistance decreased upon clinical use for all instruments analysed. Fatigue resistance of used instruments was reduced, but no significant change was observed amongst the instruments used for shaping the canals of five and eight molars. Operator experience affected the occurrence of fracture and plastic deformation during shaping.

Effect of canal length and curvature on working length alteration with WaveOne reciprocating files.

PubMed

Berutti, Elio; Chiandussi, Giorgio; Paolino, Davide Salvatore; Scotti, Nicola; Cantatore, Giuseppe; Castellucci, Arnaldo; Pasqualini, Damiano

2011-12-01

This study evaluated the working length (WL) modification after instrumentation with WaveOne Primary (Dentsply Maillefer, Ballaigues, Switzerland) reciprocating files and the incidence of overinstrumentation in relation to the initial WL. Thirty-two root canals of permanent teeth were used. The angles of curvature of the canals were calculated on digital radiographs. The initial WL with K-files was transferred to the matched WaveOne Primary reciprocating files. After glide paths were established with PathFile (Dentsply Maillefer, Ballaigues, Switzerland), canals were shaped with WaveOne Primary referring to the initial WL. The difference between the postinstrumentation canal length and the initial canal length was analyzed by using a fiberoptic inspection microscope. Data were analyzed with a balanced 2-way factorial analysis of variance (P < .05). Referring to the initial WL, 24 of 32 WaveOne Primary files projected beyond the experimental apical foramen (minimum-maximum, 0.14-0.76 mm). A significant decrease in the canal length after instrumentation (95% confidence interval ranging from -0.34 mm to -0.26 mm) was detected. The canal curvature significantly influenced the WL variation (F(1) = 30.65, P < .001). The interaction between the initial canal length and the canal curvature was statistically significant (F(2) = 4.38, P = .014). Checking the WL before preparation of the apical third of the root canal is recommended when using the new WaveOne NiTi single-file system. Copyright © 2011 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Evaluation of the root and canal morphology of mandibular permanent molars in a south-eastern Turkish population using cone-beam computed tomography

PubMed Central

Nur, Bilge Gulsum; Ok, Evren; Altunsoy, Mustafa; Aglarci, Osman Sami; Colak, Mehmet; Gungor, Enes

2014-01-01

Objective: The aim of this retrospective study was to determine the root and canal morphology of the mandibular first and second permanent molars in a Turkish population using cone-beam computed tomography (CBCT). Materials and Methods: CBCT images of mandibular first (n = 966) and second molar (n = 1165) teeth from 850 Turkish patients were evaluated. The root canal configurations were classified according to the method of Vertucci. The data were analyzed by Pearson's Chi-square test. Results: The majority of mandibular molars were two rooted with three canals; however, three roots were identified in 0.05% of the first molars and 0.01% of the second molars, and 100% of the additional root canals were of type I configuration. Mesial roots had more complex canal systems with more than one canal, whereas most distal roots had a type I configuration. Conclusions: Within the limitations of this study, it can be concluded that CBCT scanning provides supplemental information about the root canal configurations of mandibular molars in a Turkish population. This study may help clinicians in the root canal treatment of mandibular molars. PMID:24966763

Antibacterial Nanoparticles in Endodontics: A Review.

PubMed

Shrestha, Annie; Kishen, Anil

2016-10-01

A major challenge in root canal treatment is the inability of the current cleaning and shaping procedures to eliminate bacterial biofilms surviving within the anatomic complexities and uninstrumented portions of the root canal system. Nanoparticles with their enhanced and unique physicochemical properties, such as ultrasmall sizes, large surface area/mass ratio, and increased chemical reactivity, have led research toward new prospects of treating and preventing dental infections. This article presents a comprehensive review on the scientific knowledge that is available on the application of antibacterial nanoparticles in endodontics. The application of nanoparticles in the form of solutions for irrigation, medication, and as an additive within sealers/restorative materials has been evaluated to primarily improve the antibiofilm efficacy in root canal and restorative treatments. In addition, antibiotic or photosensitizer functionalized nanoparticles have been proposed recently to provide more potent antibacterial efficacy. The increasing interest in this field warrants sound research based on scientific and clinical collaborations to emphasize the near future potential of nanoparticles in clinical endodontics. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

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

PubMed Central

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

2010-01-01

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

Smear Layer Evaluation on Root Canal Preparation with Manual and Rotary Techniques using EDTA as an Irrigant: A Scanning Electron Microscopy Study

PubMed Central

Manjunatha, M; Annapurna, Kini; Sudhakar, V; Sunil Kumar, VC; Hiremath, Vinay Kumar; Shah, Ankur

2013-01-01

Introduction: The aim of any root canal treatment is to achieve a canal free of micro organisms, residual pulp remnants, debris and smear layer for the long term success of the procedure. Manual and automated instrumentation techniques along with proper irrigation regime is used to arrive at the aforementioned goal. Many authors focused on the preparation capabilities of various manual and rotary instruments but very few investigators stressed on the actual cleaning abilities of these instruments. Aims and objectives: This study was undertaken to evaluate the cleaning efficiency of manual K flex files and rotary Pro File systems in the root canals using a scanning electron microscope. Material and Methods:Thirty single rooted mandibular first premolars were divided into two groups and randomized (the manual group-M and the ProFile group-P) with respect to the preparation technique. The Manual group was hand instrumented with stainless steel K- Flexofiles by means of a conventional filing technique. The Pro File group was instrumented according to the manufacturer's instructions using a rotary handpiece. All canals were shaped and cleaned under frequent irrigation with EDTA. Final irrigation was carried out with 3 mL of normal saline solution to neutralize the action of the irrigant. The roots were split, one half of each tooth was selected for further SEM technique analysis and examined under the scanning electron microscope. The canal walls were quantitatively evaluated for the amount of debris and smear layer. The apical, middle and coronal regions of the canal surface, were graded (1-5) for debris and smear layer. A statistical analysis was performed using a Mann-Whitney Rank Sum test. ProFile performed least effective cleaning. Manual K-Flexofiles led to a grooved pattern. Results and Conclusion: A statistically significant difference was observed (p<0.05) between the two instrumentation techniques concerning the amount of debris and smear layer at the apical level. The manually filed canals had less debris and smear layer than those using a rotary technique. It was concluded from this study that none of the instrumentation techniques employed, produced the canal walls which were free of surface debris and smear layer. The manual instrumentation technique was better in cleaning the canals compared to the ProFile rotary Ni-Ti instruments despite the step-back technique used for manual instrumentation. How to cite this article: Manjunatha M, Kini A, Sudhakar V, Sunil K V C, Hiremath V K, Shah A. Smear Layer Evaluation on Root Canal Preparation with Manual and Rotary Techniques using EDTA as an Irrigant: A Scanning Electron Microscopy Study. J Int Oral Health 2013; 5(1):66-78. PMID:24155580

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

PubMed

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

2012-11-01

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

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

PubMed

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

2010-03-01

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

Decreased levels of matrix metalloproteinase-2 in root-canal exudates during root canal treatment.

PubMed

Pattamapun, Kassara; Handagoon, Sira; Sastraruji, Thanapat; Gutmann, James L; Pavasant, Prasit; Krisanaprakornkit, Suttichai

2017-10-01

To determine the matrix metalloproteinase-2 (MMP-2) levels in root-canal exudates from teeth undergoing root-canal treatment. The root-canal exudates from six teeth with normal pulp and periradicular tissues that required intentional root canal treatment for prosthodontic reasons and from twelve teeth with pulp necrosis and asymptomatic apical periodontitis (AAP) were sampled with paper points for bacterial culture and aspirated for the detection of proMMP-2 and active MMP-2 by gelatin zymography and the quantification of MMP-2 levels by ELISA. By gelatin zymography, both proMMP-2 and active MMP-2 were detected in the first collection of root-canal exudates from teeth with pulp necrosis and AAP, but not from teeth with normal pulp, and their levels gradually decreased and disappeared at the last collection. Consistently, ELISA demonstrated a significant decrease in MMP-2 levels in the root-canal exudates of teeth with pulp necrosis and AAP following root canal procedures (p<0.05). Furthermore, the MMP-2 levels were significantly lower in the negative bacterial culture than those in the positive bacterial culture (p<0.001). The levels of MMP-2 in root-canal exudates from teeth with pulp necrosis and AAP were gradually reduced during root canal procedures. Future studies are required to determine if MMP-2 levels may be used as a biomolecule for the healing of apical lesions, similar to the clinical application of MMP-8 as a biomarker. Copyright © 2017 Elsevier Ltd. All rights reserved.

Evaluation of the Root and Canal Morphology of Maxillary Permanent Molars and the Incidence of the Second Mesiobuccal Root Canal in Greek Population Using Cone-beam Computed Tomography

PubMed Central

Nikoloudaki, Georgia E.; Kontogiannis, Taxiarchis G.; Kerezoudis, Nikolaos P.

2015-01-01

Objectives: Cone-Beam Computed Tomography is an alternative imaging technique which has been recently introduced in the field of Oral & Maxillofacial Radiology. It has rapidly gained great popularity among clinicians due to its ability to detect lesions and defects of the orofacial region and provide three-dimensional information about them. In the field of Endodontics, CBCT can be a useful tool to reveal tooth morphology irregularities, additional root canals and vertical root fractures. The objective of this study is to evaluate the root and root canal morphology of the maxillary permanent molars in Greek population using Cone-Beam Computed Tomography. Materials and Methods : 273 cone-beam computed tomography (CBCT) images were examined. The number of roots and root canals of the first and second maxillary molars were evaluated. Root canal configuration was classified according to Weine’s classification by two independent examiners and statistical analysis was performed. Results : A total of 812 molars (410 first and 402 second ones) were evaluated. The vast majority of both first and second molars had three roots (89.26% and 85.07%, respectively). Most first molars had four canals, while most second molars had three. In the mesiobuccal roots, one foramen was recorded in 80.91% of all teeth. Other rare morphologic variations were also found, such as fusion of a maxillary second molar with a supernumerary tooth. Conclusion : Within the limitations of this study, it can be concluded that more attention should be given to the detection of additional canals during root canal treatment in maxillary permanent molars. Towards this effort, CBCT can provide the clinician with supplemental information about the different root canal configurations for successful Root Canal Treatment. PMID:26464594

A study of root canal morphology of human primary incisors and molars using cone beam computerized tomography: an in vitro study.

PubMed

Gaurav, Vivek; Srivastava, Nikhil; Rana, Vivek; Adlakha, Vivek Kumar

2013-01-01

Variations in morphology of root canals in primary teeth usually leads to complications during and after endodontic therapy. To improve the success in endodontics, a thorough knowledge of the root canal morphology is essential. The aim of this study was to assess the variation in number and morphology of the root canals of primary incisors and molars and to study the applicability of cone beam computerized tomography (CBCT) in assessing the same. A total of 60 primary molars and incisors with full root length were collected and various parameters such as the number of roots, number of canals, diameter of root canal at cementoenamel junction and middle-third, length and angulations of roots of primary molars and incisors were studied using CBCT. The observations were put to descriptive statistics to find out the frequency, mean, standard deviation and range for all four subgroups. Further, unpaired t-test was used to compare these parameters between subgroups and analysis of variance test was implemented to evaluate the parameters within the subgroups. The CBCT showed the presence of bifurcation of root canal at middle third in 13% of mandibular incisors while 20% of mandibular molars had two canals in distal root. The diameter of distobuccal root canal of maxillary molars and mesiolingual canal of mandibular molars was found to be minimum. CBCT is a relatively new and effective technology, which provides an auxiliary imaging modality to supplement conventional radiography for assessing the variation in root canal morphology of primary teeth.

Report of a Rare Case: A Maxillary First Molar with Seven Canals Confirmed with Cone-Beam Computed Tomography

PubMed Central

Kumar, Rahul

2014-01-01

Introduction: Coronal anatomic variations in permanent maxillary molars are unusual; conversely variations involving the number of root canals or number of roots are more common. Methods and Materials: This case report presents a successful nonsurgical endodontic therapy of left maxillary first molar with three roots and seven root canals. This unusual morphology was diagnosed using a dental operating microscope (DOM) and confirmed with the help of cone-beam computed tomography (CBCT) images. Results: CBCT axial images showed that both of the palatal and distobuccal roots had Vertucci type II canal pattern, whereas the mesiobuccal root canal showed a Sert and Bayirli’s type XV configuration. Conclusion: The use of a DOM and CBCT imaging in endodontically challenging cases can facilitate a better understanding of the complex root canal anatomy, which ultimately enables the clinician to explore the root canal system, and therefore treat it far more efficiently. PMID:24688587

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

PubMed

Fogel, Howard M; Cunha, Rodrigo Sanches

2017-11-01

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

Survey of Anatomy and Root Canal Morphology of Maxillary First Molars Regarding Age and Gender in an Iranian Population Using Cone-Beam Computed Tomography

PubMed Central

Naseri, Mandana; Safi, Yaser; Akbarzadeh Baghban, Alireza; Khayat, Akbar; Eftekhar, Leila

2016-01-01

Introduction: The purpose of this study was to investigate the root and canal morphology of maxillary first molars with regards to patients’ age and gender with cone-beam computed tomography (CBCT). Methods and Materials: A total of 149 CBCT scans from 92 (67.1%) female and 57 (31.3%) male patients with mean age of 40.5 years were evaluated. Tooth length, presence of root fusion, number of the roots and canals, canal types based on Vertucci’s classification, deviation of root and apical foramen in coronal and sagittal planes and the correlation of all items with gender and age were recorded. The Mann Whitney U, Kruskal Wallis and Fisher’s exact tests were used to analyze these items. Results: The rate of root fusion was 1.3%. Multiple canals were present in the following frequencies: four canals 78.5%, five canals 11.4% and three canals 10.1%. Additional canal was detected in 86.6% of mesiobuccal roots in which Vertucci’s type VI configuration was the most prevalent followed by type II and I. Type I was the most common one in distobuccal and palatal roots. There was no statistically significant difference in the canal configurations in relation to gender and age as well as the incidence root or canal numbers (P>0.05). The mean tooth length was 19.3 and 20.3 mm in female and male patients, respectively which was statistically significant (P<0.05). Evaluation of root deviation showed that most commonly, a general pattern of straight-distal in the mesiobuccal and straight-straight for distobuccal and palatal roots occurred. In mesiobuccal roots, straight and distal deviations were more dominant in male and female, respectively (P<0.05). The prevalence of apical foramen deviation in mesiobuccal and palatal roots statistically differed with gender. Conclusion: The root and canal configuration of Iranian population showed different features from those of other populations. PMID:27790259

Influence of a glide path on apical extrusion of debris during canal preparation using single-file systems in curved canals.

PubMed

Topçuoğlu, H S; Düzgün, S; Akpek, F; Topçuoğlu, G; Aktı, A

2016-06-01

To evaluate the effect of a glide path on the amount of apically extruded debris during canal preparation using single-file systems in curved canals. Ninety extracted mandibular molar teeth were randomly assigned to six groups (n = 15 for each group) for canal instrumentation. Endodontic access cavities were prepared in each tooth. In three of the six groups, a glide path was not created whereas a glide path was created using PathFile instruments on the mesial canals of all teeth in the remaining three groups. The mesial canals of the teeth were then instrumented with the following single-file instrument systems: WaveOne, Reciproc and OneShape. Debris extruded apically during instrumentation was collected into pre-weighed Eppendorf tubes. The tubes were then stored in an incubator at 70 °C for 5 days. The weight of the dry extruded debris was established by subtracting the pre-instrumentation and post-instrumentation weight of the Eppendorf tubes for each group. The data obtained were analysed using one-way analysis of variance (anova) and Tukey's post hoc tests. The OneShape file was associated with less debris extrusion than the Reciproc and WaveOne files when canal instrumentation was performed without a glide path (P < 0.05). However, no significant difference was found between the Reciproc and WaveOne files (P > 0.05). There was no significant difference amongst the OneShape, Reciproc and WaveOne files when a glide path was created before canal preparation in curved root canals (P > 0.05). All systems extruded significantly less debris in groups with a glide path than in groups without a glide path (P < 0.05). All instruments were associated with apical extrusion of debris. Creating a glide path prior to canal instrumentation reduced the amount of apically extruded debris in curved canals. © 2015 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Association of manual or engine-driven glide path preparation with canal centring and apical transportation: a systematic review.

PubMed

Hartmann, R C; Peters, O A; de Figueiredo, J A P; Rossi-Fedele, G

2018-04-28

The role and effect of glide path preparation in root canal treatment remain controversial. This systematic review aims to compare apical transportation and canal centring of different glide path preparation techniques, with or without subsequent engine-driven root canal preparation. A database search in PubMed, PubMed Central, Embase, Scopus, EBSCO Dentistry & Oral Sciences Source and Virtual Health Library was conducted, using appropriate key words to identify the effect of glide path preparation (or its absence) on apical transportation and canal centring. An assessment for the risk of bias in included studies was carried out. Amongst 2146 studies, 18 satisfied the inclusion criteria. Nine studies assessed glide path preparation per se, comparing apical transportation and canal centring of rotary systems and/or manual files; eleven further investigations examined the efficacy of the glide path prior to final canal preparation with different engine-driven systems. Risk of bias and other study design features with potential influence on study outcomes and clinical implications were assessed. Based on the available evidence, and within the limitation of the studies included, preparation of a glide path using rotary sequences performs similarly (in most of the component studies) or significantly better than manual preparation when assessing apical transportation or canal centring. When compared to the absence of a glide path, canal shaping following glide path preparation was of similar, or significantly better quality, in regard to apical transportation or canal centring. © 2018 International Endodontic Journal. Published by John Wiley & Sons Ltd.

The efficiency of different irrigation solutions and techniques for the removal of triple antibiotic paste from simulated immature root canals.

PubMed

Ustun, Y; Düzgün, S; Aslan, T; Aktı, A

2018-03-01

The purpose of this study was to evaluate the efficiencies of different irrigation protocols in the removal of triple antibiotic paste (TAP) from root canals. A total of 127 extracted human maxillary incisor teeth were prepared. Then, root-end resection of 3 mm was accomplished to simulate immature apex model. The root canals were filled with TAP, after 21 days, randomly divided into nine groups according to irrigation systems and solutions (n = 13). Conventional irrigation (CI) groups - Group 1: Root canal irrigation was performed with CI by Peracetic acid (PAA) solution, Group 2: Root canal irrigation was performed with CI by etidronic acid 1-hydroxyethylidene-1, 1-bisphosphonate (HEBP) + sodium hypochlorite (NaOCl) solution, Group 3: Root canal irrigation was performed with CI by ethylenediaminetetraacetic acid (EDTA)/NaOCl solutions. Vibringe system groups - Group 4: Root canal irrigation was performed with Vibringe system by PAA solution, Group 5: Root canal irrigation was performed with Vibringe system by HEBP + NaOCl solution, Group 6: Root canal irrigation was performed with Vibringe system by EDTA/NaOCl solution. EndoVac system groups - Group 7: Root canal irrigation was performed with EndoVac system by PAA solution, Group 8: Root canal irrigation was performed with EndoVac system by HEBP + NaOCl solution, Group 9: Root canal irrigation was performed with EndoVac system by EDTA/NaOCl solution. Control Group: (n = 0). Samples were sectioned vertically, and the amount of remaining medicament was scored for each root half and data were statistically analyzed. Among the irrigation systems, CI groups showed the highest scores at both apical and coronal parts (P < 0.05). In comparisons among the solutions, at the apical part, PAA groups showed the highest scores (P < 0.05). At the coronal part, EDTA + NaOCl groups showed the lowest score values (P < 0.05). The use of irrigation systems improved the removal of TAP from the simulated immature root canals. Also, as an irrigation solution EDTA gives more promising results than PAA and HEBP solutions.

Two-rooted maxillary first molars with two canals: a case series.

PubMed

Shakouie, Sahar; Mokhtari, Hadi; Ghasemi, Negin; Gholizadeh, Seddigheh

2013-01-01

Thorough understanding of the anatomic and internal morphology of a root canal system is absolutely essential for the success of endodontic treatment. Since permanent maxillary first molars have shown variation in internal anatomy, morphology, this tooth has been reviewed extensively. Presence of two canals in a two-rooted maxillary first molar has rarely been reported in studies describing tooth and root canal anatomies. In this report, three cases are presented, which involve the root canal treatment of maxillary first molars with fusion of the two buccal roots.

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

21 CFR 872.3810 - Root canal post.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Root canal post. 872.3810 Section 872.3810 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3810 Root canal post. (a) Identification. A root canal...

Comparison of the remaining dentin thickness in the root after hand and four rotary instrumentation techniques: an in vitro study.

PubMed

Rao, M S Rama; Shameem, Abdul; Nair, Rashmi; Ghanta, Sureshbabu; Thankachan, Rekha P; Issac, Johnson K

2013-07-01

The aim of the present study was to compare the remaining dental thickness (RDT) in the mesiobuccal root of mandibular first molars at 3 and 7 mm from the anatomic apex after instrumentation with ProTaper, light speed LSX, K3 and M2 and to compare with that of K-files. In this study, 60 extracted, untreated human mandibular first molars with fully formed apices, with curvature less than 35° and no root resorption were used. Prepared specimens were cut horizontally at 3 and 7 mm short of anatomic apex. The least dentin thickness from canal to external root surface was observed under 3× magnification and recorded using Clemax measuring tool and the sections were reassembled. Group I-instrumentation with ProTaper, group II-instrumentation with K3, group III-instrumentation with Light Speed LSX, group IV-instrumentation with M2 and group V- instrumentation with K-files and RDT was measured. Results showed that group V removed lesser amount of dentin compared to all other groups while all the three instrumentation techniques removed almost equal amount of dentin apically. Cleaning and shaping of the root canal space involves the elimination of pathogenic contents as well as attaining a uniform specific shape. However, the RDT following the use of various intraradicular procedures is an important factor to be considered as an iatrogenic cause that may result in root fracture. To avoid this, newer rotary instruments are being introduced.

In vitro investigation of the cleaning efficacy, shaping ability, preparation time and file deformation of continuous rotary, reciprocating rotary and manual instrumentations in primary molars.

PubMed

Ramazani, Nahid; Mohammadi, Abbas; Amirabadi, Foroogh; Ramazani, Mohsen; Ehsani, Farzane

2016-01-01

Background. Efficient canal preparation is the key to successful root canal treatment. This study aimed to assess the cleaning and shaping ability, preparation time and file deformation of rotary, reciprocating and manual instrumentation in canal preparation of primary molars. Methods. The mesiobuccal canals of 64 extracted primary mandibular second molars were injected with India ink. The samples were randomly divided into one control and three experimental groups. Experimental groups were instrumented with K-file, Mtwo in continuous rotation and Reciproc in reciprocating motion, respectively. The control group received no treatment. The files were discarded after four applications. Shaping ability was evaluated using CBCT. After clearing, ink removal was scored. Preparation time and file fracture or deformation was also recorded. Data were analyzed with SPSS 19 using chi-squared, Fisher's exact test, Kruskal-Wallis and post hoc tests at a significance level of 0.05. Results. Considering cleanliness, at coronal third Reciproc was better than K-file (P < 0.001), but not more effective than Mtwo (P = 0.080). Furthermore, Mtwo leaved the canal cleaner than K-file (P = 0.001). In the middle third, only Reciproc exhibited better cleaning efficacy than K-file (P = 0.005). In the apical third, no difference was detected between the groups (P = 0.794). Regarding shaping ability, no differences were found between Reciproc and Mtwo (P = 1.00). Meanwhile, both displayed better shaping efficacy than K-file (P < 0.05). Between each two groups, there were differences in preparation time (P < 0.05), with Reciproc being the fastest. No file failure occurred. Conclusion. Fast and sufficient cleaning and shaping could be achieved with Mtwo and especially with Reciproc.

Endodontic management of middle mesial canal of the mandibular molar

PubMed Central

Sundaresh, K J; Srinivasan, Raghu; Mallikarjuna, Rachappa; Rajalbandi, Sandeep

2013-01-01

Thorough knowledge of root canal morphology and unusual anatomy of the tooth is critical for successful endodontic treatment. Although the most common configuration is two roots and three root canals, mandibular molars might have many different combinations. In the literature, it is less described about three mesial canals and two distal canals in mandibular second molars, indicating a rare anatomical configuration. A case of unusual root canal morphology is presented to demonstrate anatomical variations in mandibular molars. Endodontic therapy was performed in a mandibular second molar with five separate canals, three mesial and two distal. This report points out the importance of looking for additional canals and unusual canal morphology, because knowledge of their existence might occasionally enable clinicians to treat a case successfully that otherwise might have ended in failure. In conclusion, every attempt should be made to find and treat all root canals of a tooth. PMID:23349182

Determining the apical terminus of root-end resected teeth using three modern apex locators: a comparative ex vivo study.

PubMed

ElAyouti, A; Kimionis, I; Chu, A-L; Löst, C

2005-11-01

To assess ex vivo the accuracy of various electronic apex locators in locating the apical terminus of root-end resected teeth. Ninety extracted human posterior teeth (182 root canals) were prepared to a minimum size of 40 and filled with gutta-percha and sealer. After resection of the apical 3 mm of the root, the root canal filling was removed using HERO rotary instruments. The size of the root canal at the apical terminus after removal of the filling ranged from size 50 to 90. The root canal length to the apical terminus was determined using 3 apex locators (Root ZX, Raypex4 and Apex Pointer). A new mounting model that utilized a micrometer was used to perform the measurements and to visually determine the actual position of the apical terminus. The frequency of locating the apical terminus and the corresponding 95% confidence interval (CI) were calculated. Additionally, the coefficient of repeatability of each apex locator and the limits of inter-operator agreement were determined. All apex locators showed an acceptable repeatability (0.02-0.03 mm coefficient of repeatability) and narrow limits of inter-operator agreement (+0.07 and -0.07 mm). The accuracy of determining the apical terminus within 1 mm in the root canal was as follows: Root ZX 90% (164/182 root-canals) [95%CI: 86-94%], Raypex4 74% (135/182 root-canals) [95%CI: 68-80%], and Apex Pointer 71% (129/182 root canals) [95%CI: 65-77%]. No over-instrumentation resulted when the Root ZX device was used. In contrast, using the Raypex4 or the Apex Pointer device resulted in over-instrumentation in 8 of 182 root canals (4%). Under the conditions of this study all three apex locators were able to detect the apical terminus of root-end resected teeth with an acceptable range. The Root ZX device was the most accurate without over-instrumentation of the root canals.

Effect of photodynamic therapy (PDT) on Enterococcus faecalis biofilm in experimental primary and secondary endodontic infections.

PubMed

Tennert, Christian; Feldmann, Katharina; Haamann, Edwina; Al-Ahmad, Ali; Follo, Marie; Wrbas, Karl-Thomas; Hellwig, Elmar; Altenburger, Markus J

2014-11-04

To determine the antibacterial effect of photodynamic Therapy on Enterococcus faecalis (E. faecalis) biofilms in experimentally infected human root canals in primary infections and endodontic retreatments. One hundred and sixty single-rooted extracted teeth with one root canal were prepared using ProTaper instruments. Seventy specimens were left without root canal filling and autoclaved. The root canals of another 70 specimens were filled with Thermafil and AH Plus and the root canal fillings were removed after 24 hours using ProTaper D files and plasma sterilized. The specimens were infected with a clinical isolate of E. faecalis for 72 hours. Samples were taken using sterile paper points to determine the presence of E. faecalis in the root canals. The specimens were randomly divided into groups according to their treatment with 20 teeth each and a control. In the PDT group the teeth were treated using PDT, consisting of the photosensitizer toluidine blue and the PDT light source at 635 nm. In the NaOCl (sodium hypochlorite) group the root canals were rinsed with 10 mL of 3% NaOCl. In the NaOCl-PDT group the root canals were rinsed with 10 mL of 3% of sodium hypochlorite and then treated with PDT. Samples were taken after treatments using sterile paper points. Additionally, remaining root canal filling material was recovered from the root canal walls. Survival fractions of the samples were calculated by counting colony-forming units. A one-way analysis of variance (ANOVA) was applied to the data to assess the effect of different treatment techniques. Antimicrobial treatment of root canals caused a significant reduction of bacterial load in all groups. NaOCl irrigation eliminated E. faecalis most effectively. PDT alone was less effective compared to NaOCl irrigation and the combination of NaOCl irrigation and PDT. CFU levels recovered from the filling material after NaOCl irrigation of the root canals were 10fold higher compared to PDT and the combination of NaOCl irrigation and PDT. Photodynamic therapy killed E. faecalis in experimental primary endodontic infections and retreated human root canals. PDT is an effective supplement in root canal disinfection, especially in endodontic retreatments.

3D Computer aided treatment planning in endodontics.

PubMed

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

2016-02-01

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

Dilemmas pertaining to three canals in the mesiobuccal root of a maxillary second molar: a case report.

PubMed

Arora, Ankit; Acharya, Shashi Rashmi; Saraswathi, Muliya Vidya; Sharma, Padmaja; Ather, Amber

2013-08-01

The mesiobuccal root of the maxillary molars is well known to pose a hindrance during endodontic therapy. Presented here is a case of a maxillary left second molar where three canals were located in its mesiobuccal root with the use of visual and diagnostic aids. Difficulties encountered during the process of unveiling the tooth's internal anatomy were discussed. The dilemmas encountered pertained to the root canal configuration, the nomenclature of the extra canals, and the justification for the presence of a third canal. The root canal configuration of 3-2-1 was confirmed for the mesiobuccal root using information gained from clinical, radiographic, and multi-detector computed tomography (MDCT) scan findings. This case demonstrates the need for efforts to locate extra canals in the mesiobuccal root of the maxillary molars as their internal anatomy remains a mystery.

Root anatomy and canal configuration of the permanent mandibular first molar: clinical implications and recommendations.

PubMed

de Pablo, Oliver Valencia; Estevez, Roberto; Heilborn, Carlos; Cohenca, Nestor

2012-01-01

Root canal anatomy may present clinicians with a complex clinical challenge that requires diagnostic approaches, access modification, and clinical skills to successfully localize, negotiate, disinfect, and seal the root canal system. This article discusses the clinical implications of endodontic therapy on permanent mandibular first molars. The number of roots on the mandibular first molar is directly related to ethnicity. Canal morphology has a significant effect on treatment protocol: Mesial roots present two canals on a regular basis, adopting 2-2 and 2-1 as the most common configurations. A third canal is present in 2.6% of the population. The most common configuration in the distal root is type I (62.7%), followed by type II (14.5%) and type IV (12.4%). Diagnosis and treatment of complex root canal systems often require specialized training that may be beyond the scope of the average general practitioner. Access modifications are required to find extra roots and/or canals. The instrumentation of the third root requires a different access and small, flexible instruments, given the curvature that is usually present buccally in the apical third. The incidence of isthmuses is 55% in the mesial root and 20% in the distal root. This anatomical configuration should be taken into consideration during endodontic treatment as well as during periapical surgery.

An original micro-CT study and meta-analysis of the internal and external anatomy of maxillary molars - implications for endodontic treatment.

PubMed

Tomaszewska, Iwona M; Jarzębska, Anna; Skinningsrud, Bendik; Pękala, Przemysław A; Wroński, Sebastian; Iwanaga, Joe

2018-05-07

The aim of this work was to conduct a radiological micro-CT study and meta-analysis to determine the morphological features of the root canal anatomy of the maxillary molars. The radiological study included micro-CT scans of 110 maxillary first molars and 98 maxillary second molars. To identify articles eligible for inclusion in our meta-analysis, PubMed, Embase, and Web of Science were search comprehensively. The following data were extracted: study type (cadaveric, intraoperative or imaging), Vertucci types of canal configuration, presence/number of canals, roots, apical foramina, apical deltas, and inter-canal communications. The mesiobuccal root was the most variable with respect to canal configuration, type I being the most common configuration followed by type II and type IV. Type I was the most common canal configuration in the distobuccal and palatal root. Regarding the number of canals in the maxillary first and second molars, one canal was most prevalent in all roots of the three molars, except for the mesiobuccal root of maxillary first molar, in which two canals were most prevalent. The most prevalent number of roots in all maxillary molars was three. Knowledge of endodontic anatomy determines the parameters of root canal treatment and significantly affects the probability of success. It is therefore especially important to know the morphology of the root canal system in order to perform endodontic treatment correctly. This article is protected by copyright. All rights reserved. © 2018 Wiley Periodicals, Inc.

Effectiveness of Rotary Endodontic Instruments on Smear Layer Removal in Root Canals of Primary Teeth: A Scanning Electron Microscopy Study.

PubMed

Subramaniam, Priya; Girish Babu, K L; Tabrez, T A

2016-01-01

The present SEM study was undertaken to evaluate the effect of root canal instrumentation using both manual and rotary files in the root canals of primary anterior teeth. Thirty freshly extracted primary maxillary incisors were divided into 3 groups of 10 teeth each. In Group I, root canals were instrumented with rotary NiTi files; in Group II, the root canals were instrumented using manual NiTi K files and; in Group III, manual instrumentation was done with stainless steel K files. Longitudinal sections were prepared and processed for observation under SEM at the coronal, middle and apical thirds. Scoring of smear layer was done according to Hulsmann and the data obtained was subjected to statistical analysis. Rotary files cleaned the coronal and middle thirds of root canals more effectively. Statistically there was no significant difference between the groups. Lowest score of 2.6 in the apical third of root canals was seen with hand NiTi files. Rotary instrumentation was as effective as manual instrumentation in removal of smear layer in the root canals of primary anterior teeth.

Comparison of cyclic fatigue resistance of three different rotary nickel-titanium instruments designed for retreatment.

PubMed

Inan, Ugur; Aydin, Cumhur

2012-01-01

A number of rotary nickel-titanium (NiTi) systems have been developed to provide better, faster, and easier cleaning and shaping of the root canal system, and recently, rotary NiTi systems designed for root canal retreatment have been introduced. Because the main problem with the rotary NiTi files is fracture, the aim of this study was to compare the cyclic fatigue resistance of 3 different rotary NiTi systems designed for root canal retreatment. Total of 60 instruments of 3 different rotary NiTi systems designed for root canal retreatment were used in this study. Twenty R-Endo R3, 20 ProTaper D3, and 20 Mtwo R (Retreatment) 25.05 instruments were tested. Cyclic fatigue testing of instruments was performed by using a device that allowed the instruments to rotate freely inside an artificial canal. Each instrument was rotated until fracture occurred, and the number of cycles to fracture for each instrument was calculated. Representative samples were also evaluated under a scanning electron microscope to confirm the fracture was flexural. Data were analyzed by using 1-way analysis of variance test. R-Endo R3 instruments showed better cyclic fatigue resistance than ProTaper D3 and Mtwo R 25.05 instruments, and the difference was statistically significant (P < .05). There was no significant difference between ProTaper D3 and Mtwo R 25.05 groups. The R-Endo R3 instruments were more resistant to fatigue failure than ProTaper D3 and Mtwo R 25.05. Copyright © 2012 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Influence of oval and circular post placement using different resin cements on push-out bond strength and void volume analysed by micro-CT.

PubMed

Uzun, I; Keleş, A; Arslan, H; Güler, B; Keskin, C; Gündüz, K

2016-12-01

To evaluate the percentage volume of voids within cement layers, to determine the push-out bond strength of circular and oval fibre posts luted with different commercial resin cements in oval cross-sectional root canals, and to correlate push-out bond strength values and volume of voids of circular and oval fibre posts. Seventy-two mandibular premolars with oval-shaped root canals were selected. The specimens were divided into two main groups according to the post type (oval and circular). Groups were further divided into three subgroups (n = 24) according to resin cement type: Maxcem Elite, Rely-X Unicem and Duo-Link. The volumes of voids within the cements were analysed by micro-computed tomography (micro-CT). The bond strength was then measured using a push-out test with an Instron universal testing machine. The failure modes were evaluated. Statistical analyses were performed using a three-way anova, Tukey's post hoc, Pearson's correlation and chi-square test (P = 0.05). The push-out bond strength values were significantly affected by root canal region, post type and cement type (P < 0.001). Root canal region, post type and cement type also significantly affected void volume (P < 0.001). There was a significant interaction between post type and cement type (P < 0.001). The most frequent failure type was adhesive failure in all the groups. There was no significant correlation between the push-out bond strength and void volume (P > 0.05). Void volume did not affect push-out bond strength of oval and circular posts luted in oval canals. © 2015 International Endodontic Journal. Published by John Wiley & Sons Ltd.

[Comparative study of root canal morphology of mandibular first premolar by micro-CT and radio visio graphy].

PubMed

Li, Xiangjie; Liu, Na; Liu, Rui; Dong, Zhengmou; Liu, Luchuan; Deng, Manjing

2012-02-01

To compare the consistency of root canal configuration types of mandibular first premolar by using micro-CT and radio visio graphy (RVG). One hundred extracted mandibular first premolars with complete dental root and apex which received no endodontic treatment were randomly selected. Each tooth was radiographed with RVG through a buccolingual and mesiodistal direction, and then scanned with micro-CT and reconstructed. The classifications of the root canal types according to Vertucci's type with the two methods were compared. The canal patterns were classified as type I (67%), type III (3%), type V (18%), type VII (2%), additional type (10%) with micro-CT and canal patterns as type I (71%), type III (2%), type V (23%), type VII (1%), additional type (3%) with RVG. 63% of teeth showed one canal in both micro-CT and RVG. Only 25% of teeth were diagnosed as complex canal by the same canal type in both micro-CT and RVG. The Kappa value between micro-CT and RVG was 0.541 which suggested that the two kinds of methods had intermediate consistency. 82.8% of the premolars with root groove had two or more than two canals. Although RVG can basically reflect the root canal system type of the mandibular first premolars in vitro, it offers poor accuracy images to complex root canals. Micro-CT three-dimensional images could clearly and precisely display the root canal system morphology of the mandibular first pre-molars in vitro.

Osmolarity and root canal antiseptics.

PubMed

Rossi-Fedele, G; Guastalli, A R

2014-04-01

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

Management of a maxillary first molar having atypical anatomy of two roots diagnosed using cone beam computed tomography.

PubMed

Sharma, Sarang; Mittal, Meenu; Passi, Deepak; Grover, Shibani

2015-01-01

Most often, a clinician working on maxillary first molar when anticipates an aberration thinks of an extra canal but rarely does he preempt fewer canals. Maxillary first molar is a tooth, which has been extensively reviewed with respect to its external and internal morphology. Abundant literature related to its anatomy is available, but reports on incidence of two roots and two root canals in maxillary first molar are very limited. Here, a case of maxillary first molar is presented that had two roots: one palatal root with Type I canal configuration and one bulbous fused buccal root with Type V canal configuration; a unique root and canal configuration not seen in any of the earlier reported cases. Diagnosis of root canal aberrancy and subsequently, accurate management of the tooth was greatly facilitated by cone beam computed tomography (CBCT) scan. The relevance of CBCT in improving treatment prognosis is greatly emphasized in this report.

Root canal morphology of South Asian Indian maxillary molar teeth

PubMed Central

Singh, Shishir; Pawar, Mansing

2015-01-01

Objective: The objective was to study the root canal morphology of South Asian Indian Maxillary molars using a tooth clearing technique. Materials and Methods: Hundred teeth each comprising of first, second, and third molars collected from different dental schools and clinics in India were subjected to standard dye penetration, decalcification and clearing procedure before being studied. Results: The first molar mesiobuccal roots exhibited 69% Type I, 24% Type II, 4% Type IV, 2% Type V, and 1% exhibited a Vertuccis Type VIII canal anatomy. In the group with three separate roots the second molar mesiobuccal roots in exhibited 80.6% Type I, 15.3% Type II, 2.7% Type IV, and 1.4% Type V canal anatomy while the third molars mesiobuccal roots exhibited 57.4% Type I, 32% Type II, 2.1% Type III, 8.5% Type IV, 1% had a Type V canal anatomy in the similar group. Conclusion: A varied root canal anatomy was seen in the mesiobuccal root canal of the maxillary molars. PMID:25713497

Micro computed tomography evaluation of the Self-adjusting file and ProTaper Universal system on curved mandibular molars.

PubMed

Serefoglu, Burcu; Piskin, Beyser

2017-09-26

The aim of this investigation was to compare the cleaning and shaping efficiency of Self-adjusting file and Protaper, and to assess the correlation between root canal curvature and working time in mandibular molars using micro-computed tomography. Twenty extracted mandibular molars instrumented with Protaper and Self-adjusting file and the total working time was measured in mesial canals. The changes in canal volume, surface area and structure model index, transportation, uninstrumented area and the correlation between working-time and the curvature were analyzed. Although no statistically significant difference was observed between two systems in distal canals (p>0.05), a significantly higher amount of removed dentin volume and lower uninstrumented area were provided by Protaper in mesial canals (p<0.0001). A correlation between working-time and the canal-curvature was also observed in mesial canals for both groups (SAFr 2 =0.792, p<0.0004, PTUr 2 =0.9098, p<0.0001).

An in vitro study of mesiobuccal root thickness of maxillary first molars.

PubMed

Mohammadzadeh Akhlaghi, Nahid; Ravandoust, Yasaman; Najafi, Mohammad; Dadresanfar, Bahareh

2012-01-01

Understanding the internal anatomy of root canal system can significantly influence outcomes of root canal treatment. The aim of this in vitro study was to measure the thickness of mesiobuccal root at different levels in maxillary first molars. In this cross-sectional study, forty extracted human maxillary first molars were radiographed; accordingly, the mesial and distal root thicknesses of mesiobuccal (MB) roots were measured at four parallel horizontal levels. The samples were sectioned at the measured levels and then sections were scanned and saved in the computer. Buccal (B), Palatal (P), Mesial (M) and Distal (D) aspects of root thicknesses in single-canalled roots were measured. In two-canalled mesiobuccal roots, Distobuccal (DB) and Distopalatal (DP) aspects were evaluated alongside other measurements. Average radicular thickness in each aspect and each level was compared using ANOVA and t-test. A total of 25 had two canals and 15 had one canal in MB root. In single-canalled roots M and D aspects were the thinnest whereas in two-canalled samples, the thicknesses of DP and DB aspects were significantly less than others (P<0.001). The B and P had the greatest thicknesses in all the samples. The results showed that special attention should be paid to "danger zone" areas of mesiobuccal maxillary first molar roots in order to avoid technical mishaps.

Endodontic management of contralateral mandibular first molars with six root canals

PubMed Central

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

2017-01-01

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

Comparative evaluation of apically extruded debris during root canal instrumentation using two Ni-Ti single file rotary systems: An in vitro study

PubMed Central

Singbal, Kiran; Jain, Disha; Raja, Kranthi; Hoe, Tan Ming

2017-01-01

Background: Apical extrusion of debris during instrumentation is detrimental to the patient. Aim: The aim of this study was to evaluate the apical extrusion of debris during root canal instrumentation using two single file rotary Ni-Ti systems. Materials and Methods: Thirty freshly extracted mandibular premolars with straight roots were sterilized and divided into two groups instrumented using: One Shape rotary Ni-Ti system with Endoflare orifice shaper (Group 1) and Neo-Niti rotary Ni-Ti system with C1 orifice shaper (Group 2). Preweighed Eppendorf tubes fitted for each tooth before instrumentation. During instrumentation, 1 mL of distilled water with a 30-gauge needle was used to irrigate after every instrument. Tips of the tooth were irrigated with 2 ml distilled water after removal from Eppendorf tubes. The total volume of irrigant in each group was the same 8 ml. All tubes were incubated at 68°C for 15 days and subsequently weighed. The difference between pre- and post-debris weights was calculated, and statistical analysis was performed using independent t-test and level of significance was set at 0.05. Results: The difference between pre- and post-weights was significantly greater for the One Shape system. Conclusions: The Neolix Niti single file was associated with less extrusion compared to One Shape single file system. PMID:28855748

Comparative evaluation of apically extruded debris during root canal instrumentation using two Ni-Ti single file rotary systems: An in vitro study.

PubMed

Singbal, Kiran; Jain, Disha; Raja, Kranthi; Hoe, Tan Ming

2017-01-01

Apical extrusion of debris during instrumentation is detrimental to the patient. The aim of this study was to evaluate the apical extrusion of debris during root canal instrumentation using two single file rotary Ni-Ti systems. Thirty freshly extracted mandibular premolars with straight roots were sterilized and divided into two groups instrumented using: One Shape rotary Ni-Ti system with Endoflare orifice shaper (Group 1) and Neo-Niti rotary Ni-Ti system with C1 orifice shaper (Group 2). Preweighed Eppendorf tubes fitted for each tooth before instrumentation. During instrumentation, 1 mL of distilled water with a 30-gauge needle was used to irrigate after every instrument. Tips of the tooth were irrigated with 2 ml distilled water after removal from Eppendorf tubes. The total volume of irrigant in each group was the same 8 ml. All tubes were incubated at 68°C for 15 days and subsequently weighed. The difference between pre- and post-debris weights was calculated, and statistical analysis was performed using independent t -test and level of significance was set at 0.05. The difference between pre- and post-weights was significantly greater for the One Shape system. The Neolix Niti single file was associated with less extrusion compared to One Shape single file system.

Endoscopic root canal treatment.

PubMed

Moshonov, Joshua; Michaeli, Eli; Nahlieli, Oded

2009-10-01

To describe an innovative endoscopic technique for root canal treatment. Root canal treatment was performed on 12 patients (15 teeth), using a newly developed endoscope (Sialotechnology), which combines an endoscope, irrigation, and a surgical microinstrument channel. Endoscopic root canal treatment of all 15 teeth was successful with complete resolution of all symptoms (6-month follow-up). The novel endoscope used in this study accurately identified all microstructures and simplified root canal treatment. The endoscope may be considered for use not only for preoperative observation and diagnosis but also for active endodontic treatment.

Prevalence of Enterococcus faecalis in saliva and filled root canals of teeth associated with apical periodontitis

PubMed Central

Wang, Qian-Qian; Zhang, Cheng-Fei; Chu, Chun-Hung; Zhu, Xiao-Fei

2012-01-01

To investigate the prevalence of Enterococcus faecalis in saliva and filled root canals of patients requiring endodontic retreatment for apical periodontitis. Patients with apical periodontitis who were referred for endodontic retreatment were examined. The type and quality of the restoration, symptoms, quality of obturation were recorded. During retreatment, an oral rinse sample and root canal sample were cultured using brain-heart infusion agar and bile esculinazide agar to select for E. faecalis. The 16S rRNA technique was used to identify E. faecalis. A total of 32 women and 22 men (mean age: 38 years; s.d.: 11 years) and 58 teeth were studied. The prevalence of E. faecalis was 19% in the saliva and 38% in the root canals. The odds that root canals harbored E. faecalis were increased if the saliva habored this bacterium (odds ratio=9.7; 95% confidence interval=1.8–51.6; P<0.05). Teeth with unsatisfactory root obturation had more cultivable bacterial species in root canals than teeth with satisfactory root obturation (P<0.05). E. faecalis is more common in root canals of teeth with apical periodontitis than in saliva. The prevalence of E. faecalis in root canals is associated with the presence of E. faecalis in saliva. PMID:22422085

Mandibular first premolar with four canals.

PubMed

Du, Yi; Lee, Angeline H C; Zhang, Chengfei

2013-02-01

A case of endodontic treatment of a mandibular first premolar exhibiting a total of four distinct root canals and four apical foramina is described. This occurrence in mandibular first premolar has rarely been reported in the endodontic literature. Endodontic treatment that considers the anatomic variation of root canal morphology is important to ensure a favorable healing outcome, and its identification could be enhanced by careful examination using a dental operating microscope. Obturation of root canals using a warm vertical compaction technique with a highly-radiopaque root canal sealer, such as AH Plus, after careful ultrasonic activated irrigation with ethylenediaminetetraacetic acid might allow the flow of sealer into the narrowed but unprepared part of the canal. This offers valuable adjuncts for the successful negotiation of calcified main canals, thereby facilitating optimum chemo-mechanical debridement of the root canal system. © 2013 Blackwell Publishing Asia Pty Ltd.

Ex vivo accuracy of an apex locator using digital signal processing in primary teeth.

PubMed

Leonardo, Mário Roberto; da Silva, Lea Assed Bezerra; Nelson-Filho, Paulo; da Silva, Raquel Assed Bezerra; Lucisano, Marília Pacífico

2009-01-01

The purpose of this study was to evaluate ex vivo the accuracy an electronic apex locator during root canal length determination in primary molars. One calibrated examiner determined the root canal length in 15 primary molars (total=34 root canals) with different stages of root resorption. Root canal length was measured both visually with the placement of a K-file 1 mm short of the apical foramen or the apical resorption bevel, and electronically using an electronic apex locator (Digital Signal Processing). Data were analyzed statistically using the intraclass correlation (ICC) test. Comparing the actual and electronic root canal length measurements in the primary teeth showed a high correlation (ICC=0.95). The Digital Signal Processing apex locator is useful and accurate for apex foramen location during root canal length measurement in primary molars.

Comparative Evaluation of Stress Distribution in Experimentally Designed Nickel-titanium Rotary Files with Varying Cross Sections: A Finite Element Analysis.

PubMed

Basheer Ahamed, Shadir Bughari; Vanajassun, Purushothaman Pranav; Rajkumar, Kothandaraman; Mahalaxmi, Sekar

2018-04-01

Single cross-sectional nickel-titanium (NiTi) rotary instruments during continuous rotations are subjected to constant and variable stresses depending on the canal anatomy. This study was intended to create 2 new experimental, theoretic single-file designs with combinations of triple U (TU), triangle (TR), and convex triangle (CT) cross sections and to compare their bending stresses in simulated root canals with a single cross-sectional instrument using finite element analysis. A 3-dimensional model of the simulated root canal with 45° curvature and NiTi files with 5 cross-sectional designs were created using Pro/ENGINEER Wildfire 4.0 software (PTC Inc, Needham, MA) and ANSYS software (version 17; ANSYS, Inc, Canonsburg, PA) for finite element analysis. The NiTi files of 3 groups had single cross-sectional shapes of CT, TR, and TU designs, and 2 experimental groups had a CT, TR, and TU (CTU) design and a TU, TR, and CT (UTC) design. The file was rotated in simulated root canals to analyze the bending stress, and the von Mises stress value for every file was recorded in MPa. Statistical analysis was performed using the Kruskal-Wallis test and the Bonferroni-adjusted Mann-Whitney test for multiple pair-wise comparison with a P value <.05 (95 %). The maximum bending stress of the rotary file was observed in the apical third of the CT design, whereas comparatively less stress was recorded in the CTU design. The TU and TR designs showed a similar stress pattern at the curvature, whereas the UTC design showed greater stress in the apical and middle thirds of the file in curved canals. All the file designs showed a statistically significant difference. The CTU designed instruments showed the least bending stress on a 45° angulated simulated root canal when compared with all the other tested designs. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

An in vitro morphological investigation of the endodontic spaces of third molars.

PubMed

Cosić, Jozo; Galić, Nada; Vodanović, Marin; Njemirovskij, Vera; Segović, Sanja; Pavelić, Bozidar; Anić, Ivica

2013-06-01

Aim of this paper was to investigate the particular anatomic features of the endodontic space of third molars in the general population of Croatia. A total of 106 fully developed third molars (56 maxillar and 50 mandibular) has been analyzed. The respective number of roots and of root canals, the structure of the roots, and the curvature and absolute length of the root-canals were analyzed. In most cases, upper third molars had three roots (83.9%), while most of the lower molars were single rooted (56.0%). Upper third molars had mostly three root canals (75.1%), lower third molars two (90.0%). In both jaws, most third molars had curved canals (60.7% in the upper and 84.0% in the lower jaw). 12.5% of upper third molars had lateral and accessory canals, whereas only 4.0% of the lower third molars were found to have them. The Student t-test showed statistically significant differences (p < 0.05) in the length of the root-canals, mesiobuccal and distobuccal canals being significantly shorter than palatinal canals. The same test showed that in the lower third molars the mesial root canals were significantly longer that the distal ones, although slightly. The results obtained are in compliance with similar results by other authors; however, they tend to show some specific population-related features.

Comparative study of ProTaper gold, reciproc, and ProTaper universal for root canal preparation in severely curved root canals

PubMed Central

Arslan, Hakan; Yildiz, Ezgi Doganay; Gunduz, Hicran Ates; Sumbullu, Meltem; Bayrakdar, Ibrahim Sevki; Karatas, Ertugrul; Sumbullu, Muhammed Akif

2017-01-01

Aim: The aim of this study is to evaluate the root canal transportation, centering ability, and instrumentation times with the ProTaper Gold (Dentsply Tulsa Dental, Tulsa, OK, USA), Reciproc (VDW, Munich, Germany), and ProTaper Universal (Dentsply Maillefer, Ballaigues, Switzerland) using cone-beam computed tomography (CBCT). Materials and Methods: Thirty mesial root canals of mandibular first molars with curvature angles of 35°–70° and radii of 2–6 mm were included in the study. Root canal instrumentation was performed up to F2 or R25. The instrumentation times were recorded. CBCT scanning was performed both pre- and post-instrumentation. Root canal transportation and the centering ratio were calculated for groups, and the data were analyzed using a one-way ANOVA and least significant difference post hoc tests for the instrumentation time, root canal transportation, and centering ratio at the 95% confidence level (P = 0.05). Results: At 3, 5, and 7 mm levels, there was no significant difference in the root canal transportation and centering ratio among the groups (P > 0.05). There were significant differences between the Reciproc and ProTaper Universal groups in the instrumentation times (P < 0.05). Conclusion: Root canal transportation and the centering ratio with the ProTaper Gold were similar to those obtained with the ProTaper Universal and Reciproc. PMID:29259355

Effect of Peracetic Acid as A Final Rinse on Push Out Bond Strength of Root Canal Sealers to Root Dentin.

PubMed

Gaddala, Naresh; Veeramachineni, Chandrasekhar; Tummala, Muralidhar

2015-05-01

Smear layer which was formed during the instrumentation of root canals hinders the penetration of root canal sealers to root dentin and affect the bond strength of root canal sealers to root dentin. Final irrigant such as demineralizing agents are used to remove the inorganic portion of the smear layer. In the present study, peracetic acid used as a final rinse, to effect the bond strength of root canal sealers to root dentin. The purpose of the present study was to evaluate the efficacy of peracetic acid as a final irrigant on bond strength of root canal sealers to root dentin. Sixty six freshly extracted human single rooted mandibular premolars were used for this study. After decoronation the samples were instrumented with Protaper upto F3 and irrigated with 5.25% NaOcl. The teeth were then divided into three groups based on final irrigant used: Group-1(control group) Canals were irrigated with distilled water. Group-2: Canals were irrigated with peracetic acid. Group-3: Canals were irrigated with smear clear. Each group was further divided into three subgroups (n=30) based on the sealer used to obturate the canals. Subgroup-1: kerr, Subgroup-2: Apexit plus, Subgroup-3: AH PLUS. Each sealer was mixed and coated to master cone and placed in the canal. The bonding between sealer and dentin surface was evaluated using push out bond strength by universal testing machine. The mean bond strength values of each group were statistically evaluated using Two-way ANOVA followed by Tukey post-hoc test. Significant difference was found among the bond strength of the sealers. But, there is no statistically significant difference between the groups irrigated with peracetic acid and smear clear compared to control group. AH Plus showed highest bond strength irrespective of the final irrigant used. Peracetic acid when employed as final irrigant improved the bond strength of root canal sealers compared to control group but not statistically significant than smear clear.

Effect of Peracetic Acid as A Final Rinse on Push Out Bond Strength of Root Canal Sealers to Root Dentin

PubMed Central

Gaddala, Naresh; Veeramachineni, Chandrasekhar

2015-01-01

Background Smear layer which was formed during the instrumentation of root canals hinders the penetration of root canal sealers to root dentin and affect the bond strength of root canal sealers to root dentin. Final irrigant such as demineralizing agents are used to remove the inorganic portion of the smear layer. In the present study, peracetic acid used as a final rinse, to effect the bond strength of root canal sealers to root dentin. Aim The purpose of the present study was to evaluate the efficacy of peracetic acid as a final irrigant on bond strength of root canal sealers to root dentin. Materials and Methods Sixty six freshly extracted human single rooted mandibular premolars were used for this study. After decoronation the samples were instrumented with Protaper upto F3 and irrigated with 5.25% NaOcl. The teeth were then divided into three groups based on final irrigant used: Group-1(control group) Canals were irrigated with distilled water. Group-2: Canals were irrigated with peracetic acid. Group-3: Canals were irrigated with smear clear. Each group was further divided into three subgroups (n=30) based on the sealer used to obturate the canals. Subgroup-1: kerr, Subgroup-2: Apexit plus, Subgroup-3: AH PLUS. Each sealer was mixed and coated to master cone and placed in the canal. The bonding between sealer and dentin surface was evaluated using push out bond strength by universal testing machine. The mean bond strength values of each group were statistically evaluated using Two-way ANOVA followed by Tukey post-hoc test. Results Significant difference was found among the bond strength of the sealers. But, there is no statistically significant difference between the groups irrigated with peracetic acid and smear clear compared to control group. AH Plus showed highest bond strength irrespective of the final irrigant used. Conclusion Peracetic acid when employed as final irrigant improved the bond strength of root canal sealers compared to control group but not statistically significant than smear clear. PMID:26155568

Canal transportation after root canal instrumentation: a comparative study with computed tomography.

PubMed

Hartmann, Mateus Silveira Martins; Barletta, Fernando Branco; Camargo Fontanella, Vânia Regina; Vanni, José Roberto

2007-08-01

This in vitro study used computed tomography (CT) to compare the occurrence of canal transportation in the apical third of mesiobuccal canals in maxillary molars instrumented with 3 techniques. Sixty teeth were assigned to 3 groups (n = 20), and the root canals were instrumented as follows: Group 1, hand instrumentation with K-files; Group 2, K-files coupled to an oscillatory system powered by an electric engine; Group 3, ProTaper NiTi rotary system powered by an electric engine. To compare the canal transportation produced by the different techniques, preinstrumentation and postinstrumentation 3-dimensional CT images were obtained from root cross-sections of the region located 3 mm short of the apical foramen of each root canal. The CT scans were exported to Adobe Photoshop software, and the initial and final images were superimposed to detect the root canal wall differences between them. Canal transportation was measured by the distance between the prepared canal center and the anatomic canal center. The manual technique produced lesser canal transportation (0.10 mm) than the oscillatory and rotary techniques (0.37 and 0.22 mm, respectively); this difference was statistically significant (P=.021). All studied techniques produced canal transportation.

The Use of Lasers in Disinfection and Cleanliness of Root Canals: a Review

PubMed Central

Anić, Ivica

2014-01-01

The outcome of root canal treatment is based on efficient disinfection of the root canal system and prevention of reinfection. Current chemomechanical cleaning methods do not always achieve these goals, and insufficient root canal disinfection is the main reason for endodontic failure. Due to high energy content and specific characteristics of laser light, laser treatment has been proposed for cleaning and disinfecting the root canal system. This paper reviews the literature covering the effect of Er:YAG, Er,Cr:YSGG, Nd:YAG and diode laser on the root canal wall in the removal of smear layer and against intracanal bacteria. Recently, the use of laser energy to induce cavitation and acoustic streaming of intracanal irrigants has been investigated. Based on recent literature, it can be concluded that lasers have bactericidal effects. However, they still cannot replace sodium hypochlorite and should be considered as an adjunct to the current chemical root canal disinfection protocols. Certain lasers can help in removing the smear layer and debris and can modify the morphology of the root canal wall. Unfortunately, there have not been enough randomized clinical studies evaluating endodontic treatment outcome following the use of laser. PMID:27688346

Interrelationships in the Variability of Root Canal Anatomy among the Permanent Teeth: A Full-Mouth Approach by Cone-Beam CT

PubMed Central

Peters, Ove A.; Maury, Elisabeth; Telmon, Norbert; Georgelin-Gurgel, Marie; Maret, Delphine

2016-01-01

Objectives In endodontic practice, clinicians should be aware of possible root canal anatomic variations. The aim of this study was to assess using CBCT acquisitions regarding whether one root canal anatomy of a tooth is associated with a specific anatomy of another tooth. Methods A total of 106 CBCT acquisitions were obtained using a CBCT scanner with 200μm voxel size. Numbers of roots and canals of the entire dentition were described. Bivariate analyses and logistic regressions were conducted to explore root canal anatomy on one tooth according to age, gender, jaw, side and the others teeth. Multiple correspondence analysis (MCA) was performed to correlate the different numbers of canals profiles. Results A total of 2424 teeth were analyzed. Independently from the other variables, the presence of an additional root canal on a mandibular incisor increases the risk of having an additional root canal on a mandibular premolar (OR [95%] 3.7 [1.0;13.2]). The mandibular molar variability increases in women compared to men (OR [95%] 0.4 [0.1; 0.9]). MCA showed correspondence between 2-canals maxillary incisor and canines and 5-canals maxillary molars, and some correlation between additional canal on maxillary and mandibular premolars. Conclusions Although CBCT examinations are conducted in the first intention of making a diagnosis or prognostic evaluation, medium FOV acquisitions could be used as an initial database thus furnishing preliminary evaluations and information. In endodontic practice, clinicians should be aware of possible root canal anatomic variations. The visualization of all canals is considered essential in endodontic therapy. The use of multi-correspondence analysis for statistics in endodontic research is a new approach as a prognostic tool. PMID:27764246

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.

An In Vitro Study of the Number of Distal Roots and Canals in mandibular First Molars in Iranian Population.

PubMed

Razmi, Hasan; Shokouhinejad, Noushin; Hooshyar, Mohsen

2008-01-01

The purpose of this study was to evaluate the number of distal roots and canals in mandibular first molars and their internal anatomy radiographically within Iranian population. A total of 310 distal roots of mandibular first molars were incorporated in this study and evaluated in terms of number of roots and number and types of canals. Root canal systems were studied in vitro by means of radiography and based on Vertucci's classifications. It was shown that 4.5% of the teeth in this study had two distal roots, of which, 100% indicated type I for both distobuccal and distolingual roots. Among all the teeth, 43.2% had two canals, 24.2% two apical foramina, and 38.7% two orifices in their distal roots. According to Vertucci's classification 54.9% of the teeth were type I, 19% type II, 1.9% type III, 14.2% type IV, 4.2% type V, 1% type VI, 0.3% type VII and 0% type VIII. In as many as 43.2% of all teeth assessed in this study, bicanaled distal roots were observed, dentists are always recommended to search for the second canal in distal roots of mandibular first molars. In case the second canal in the distal root is missed, failure of endodontic treatment will be anticipated. A rectangular type access cavity design allows better visualization and negotiation of the probable second canals within the distal roots of mandibular first molars.

Clinical and Radiographic Evaluation of Procedural Errors during Preparation of Curved Root Canals with Hand and Rotary Instruments: A Randomized Clinical Study.

PubMed

Khanna, Rajesh; Handa, Aashish; Virk, Rupam Kaur; Ghai, Deepika; Handa, Rajni Sharma; Goel, Asim

2017-01-01

The process of cleaning and shaping the canal is not an easy goal to obtain, as canal curvature played a significant role during the instrumentation of the curved canals. The present in vivo study was conducted to evaluate procedural errors during the preparation of curved root canals using hand Nitiflex and rotary K3XF instruments. Procedural errors such as ledge formation, instrument separation, and perforation (apical, furcal, strip) were determined in sixty patients, divided into two groups. In Group I, thirty teeth in thirty patients were prepared using hand Nitiflex system, and in Group II, thirty teeth in thirty patients were prepared using K3XF rotary system. The evaluation was done clinically as well as radiographically. The results recorded from both groups were compiled and put to statistical analysis. Chi-square test was used to compare the procedural errors (instrument separation, ledge formation, and perforation). In the present study, both hand Nitiflex and rotary K3XF showed ledge formation and instrument separation. Although ledge formation and instrument separation by rotary K3XF file system was less as compared to hand Nitiflex. No perforation was seen in both the instrument groups. Canal curvature played a significant role during the instrumentation of the curved canals. Procedural errors such as ledge formation and instrument separation by rotary K3XF file system were less as compared to hand Nitiflex.

Clinical and Radiographic Evaluation of Procedural Errors during Preparation of Curved Root Canals with Hand and Rotary Instruments: A Randomized Clinical Study

PubMed Central

Khanna, Rajesh; Handa, Aashish; Virk, Rupam Kaur; Ghai, Deepika; Handa, Rajni Sharma; Goel, Asim

2017-01-01

Background: The process of cleaning and shaping the canal is not an easy goal to obtain, as canal curvature played a significant role during the instrumentation of the curved canals. Aim: The present in vivo study was conducted to evaluate procedural errors during the preparation of curved root canals using hand Nitiflex and rotary K3XF instruments. Materials and Methods: Procedural errors such as ledge formation, instrument separation, and perforation (apical, furcal, strip) were determined in sixty patients, divided into two groups. In Group I, thirty teeth in thirty patients were prepared using hand Nitiflex system, and in Group II, thirty teeth in thirty patients were prepared using K3XF rotary system. The evaluation was done clinically as well as radiographically. The results recorded from both groups were compiled and put to statistical analysis. Statistical Analysis: Chi-square test was used to compare the procedural errors (instrument separation, ledge formation, and perforation). Results: In the present study, both hand Nitiflex and rotary K3XF showed ledge formation and instrument separation. Although ledge formation and instrument separation by rotary K3XF file system was less as compared to hand Nitiflex. No perforation was seen in both the instrument groups. Conclusion: Canal curvature played a significant role during the instrumentation of the curved canals. Procedural errors such as ledge formation and instrument separation by rotary K3XF file system were less as compared to hand Nitiflex. PMID:29042727

[Influence of different ultrasonic irrigation solutions after root canal preparation with ProTaper by machine on micro-hardness of root canal dentin].

PubMed

Guo, Jiang-li; Zhang, Yan; Zhen, Lei

2015-08-01

To develope the influence of different ultrasonic irrigations after root canal preparation with nickel titanium ProTaper on micro-hardness of root canal dentin. Sixty of maxillary anterior teeth with single-canal were collected and randomly divided into 6 groups. Group A was control group, group B was prepared to F3 with nickel titanium ProTaper by machine, group C was ultrasonic irrigated with 3% hydrogen peroxide solution for 1 minute after preparation, group D was ultrasonic irrigated with koutai mouthwash for 1 minute after preparation, group E was ultrasonic irrigated with 17% EDTA solution for 1 minute after preparation, group F was ultrasonic irrigated with distilled water for 1 minute after preparation. The roots were then sectioned horizontally into 3 parts, split longitudinally into halves and examined under a micro Vickers hardness test machine. The data was analyzed by one-way ANOVA and t test with SPSS 17.0 software package. The micro-hardness of group A was (52.66 ± 1.64) HV,(52.08 ± 1.53) HV and (51.47 ± 2.53) HV. There was no significant difference in all parts of the root canal in group A (P>0.05). The micro-hardness of the apical third of root canal was lower than that of the cervical and middle of root canal in the other groups (P<0.05). In the cervical and middle third of the root canals, the micro-hardness of group E was (44.65 ± 1.33) HV and(42.55 ± 1.12) HV, and there were statistical significances between group E and the other groups (P<0.05). In the apical third of root canal,the micro-hardness of group E was (37.82 ± 1.60) HV, and group C was (44.14±1.73) HV, both of the comparative differences with other groups were statistically significant (P<0.05). There was no significant difference among group B, group D and group F (P>0.05). Root canal preparation to F3 with nickel titanium ProTaper by machine can make the micro-hardness of the apical third of root canal decrease. Ultrasonic irrigation with 17% EDTA solution for 1 minute can make the micro-hardness of the root canal decrease ultrasonic irrigation with. Ultrasonic irrigation with 3% hydrogen peroxide can make the micro-hardness of the apical third of root canal decrease. Ultrasonic irrigation with Koutai mouthwash and distilled water for 1 minute have no influence on the micro-hardness of root canal.

Canal Configuration of Mesiobuccal Roots in Permanent Maxillary First Molars in Iranian Population: A Systematic Review.

PubMed

Naseri, Mandana; Kharazifard, Mohammad Javad; Hosseinpour, Sepanta

2016-11-01

It is essential for clinicians to have adequate knowledge about root canal configurations; although its morphology varies largely in different ethnicities and even in different individuals with the same ethnic background. The current study aims to review the root canal configurations of mesiobuccal roots of maxillary first molars in an Iranian population based on different epidemiological studies. A comprehensive search was conducted to retrieve articles related to root canal configuration and prevalence of each type of root canal based on Vertucci's classification for the mesiobuccal root of maxillary first molars. An electronic search was conducted in Medline, Scopus and Google Scholar from January 1984 to September 2015. The articles were evaluated and methods, population, number of teeth and percentage of each root canal type evaluated in each study were summarized in the data table. Websites such as http://www.magiran.com/ , http://health.barakatkns.com/journal-internal-list and www.sid.ir were used to search all related studies published in Persian. Totally, out of nine studies conducted on the Iranian populations in nine provinces of Iran and 798 teeth, the Vertucci's type I was the most common type (35.70%), followed by type II (30.37%), type IV (16.66%), type III (7.93%) and type V (2.61%). From this review article, it is concluded that the root canal morphology of mesiobuccal roots of maxillary first molars in the Iranian population predominantly has more than one canal. Therefore, careful evaluation of radiographs and anatomy of the pulp chamber is essential in order to achieve a successful root canal therapy.

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.

A comparative evaluation of the increase in root canal surface area and canal transportation in curved root canals by three rotary systems: A cone-beam computed tomographic study

PubMed Central

Prasanthi, Nalam NVD; Rambabu, Tanikonda; Sajjan, Girija S; Varma, K Madhu; Satish, R Kalyan; Padmaja, M

2016-01-01

Aim: The aim of this study was to measure the increase in root canal surface area and canal transportation after biomechanical preparation at 1, 3, and 5 mm short of the apex with three different rotary systems in both continuous rotary and reciprocating rotary motions. Materials and Methods: Sixty freshly extracted human mandibular molars with mesial root canal curvatures between 20° and 30° were included in the study. Teeth were randomly distributed into three groups (n = 20). Biomechanical preparations were done in all the mesial canals. In Group 1, instrumentation was done with ProTaper universal rotary files, Group 2, with K3XF rotary files, and Group 3, with LSX rotary files. Each group was further subdivided into subgroups A and B (n = 10) where instrumentation was done by continuous rotary and reciprocating rotary techniques, respectively. Increase in root canal surface area and canal transportation was measured using the preoperative and postoperative cone-beam computed tomography scans. Statistical Analysis: The data were analyzed by one-way ANOVA followed by Tukey pairwise multiple comparison tests. Results: Increase in root canal surface area was significantly more (P < 0.05) in ProTaper and K3XF groups when compared to LSX group. Canal transportation was significantly more (P < 0.05) in ProTaper group when compared to K3XF and LSX groups. There was no significant difference (P > 0.05) in increase of root canal surface area and canal transportation between continuous rotary and reciprocating rotary techniques for ProTaper Universal, K3XF and LSX groups. Conclusion: LSX rotary system showed minimal increase of root canal surface area and minimal canal transportation when compared to ProTaper and K3XF rotary systems. PMID:27656062

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

[Non-destructive, preclinical evaluation of root canal anatomy of human teeth with flat-panel detector volume CT (FD-VCT)].

PubMed

Heidrich, G; Hassepass, F; Dullin, C; Attin, T; Grabbe, E; Hannig, C

2005-12-01

Successful endodontic diagnostics and therapy call for adequate depiction of the root canal anatomy with multimodal diagnostic imaging. The aim of the present study is to evaluate visualization of the endodont with flat-panel detector volume CT (FD-VCT). 13 human teeth were examined with the prototype of a FD-VCT. After data acquisition and generation of volume data sets in volume rendering technology (VRT), the findings obtained were compared to conventional X-rays and cross-section preparations of the teeth. The anatomical structures of the endodont such as root canals, side canals and communications between different root canals as well as denticles could be detected precisely with FD-VCT. The length of curved root canals was also determined accurately. The spatial resolution of the system is around 140 microm. Only around 73 % of the main root canals detected with FD-VCT and 87 % of the roots could be visualized with conventional dental X-rays. None of the side canals, shown with FD-VCT, was detectable on conventional X-rays. In all cases the enamel and dentin of the teeth could be well delineated. No differences in image quality could be discerned between stored and freshly extracted teeth, or between primary and adult teeth. FD-VCT is an innovative diagnostic modality in preclinical and experimental use for non-destructive three-dimensional analysis of teeth. Thanks to the high isotropic spatial resolution compared with conventional X-rays, even the minutest structures, such as side canals, can be detected and evaluated. Potential applications in endodontics include diagnostics and evaluation of all steps of root canal treatment, ranging from trepanation through determination of the length of the root canal to obturation.

Guided Endodontics: a novel treatment approach for teeth with pulp canal calcification and apical pathology.

PubMed

Krastl, Gabriel; Zehnder, Marc S; Connert, Thomas; Weiger, Roland; Kühl, Sebastian

2016-06-01

To present a new treatment approach for teeth with pulp canal calcification (PCC) which require root canal treatment. A 15-year-old male patient presented with pain of his upper right central incisor. The tooth showed signs of apical periodontitis. Due to PCC, location of the root canal was judged to be difficult and associated with a high risk of perforation. A cone beam computed tomography (CBCT) and an intra-oral surface scan were performed and matched using software for virtual implant planning. After planning the position of the drill for root canal location, a virtual template was designed, and the data were exported as an STL file and sent to a 3D printer for template fabrication. The template was positioned on the anterior maxillary teeth. A specific drill was used to penetrate through the obliterated part of the root canal and obtain minimally invasive access to the apical part. The root canal was accessible at 9 mm distance from the apex. Further root canal preparation was carried out using an endodontic rotary instrumentation system. After an interappointment dressing for 4 weeks, the root canal was filled with vertically condensed gutta-percha using an epoxy sealer. The access cavity was restored with a composite material. After 15 months, the patient was clinically asymptomatic with no pain on percussion. The radiograph showed no apical pathology. The presented guided endodontic approach seems to be a safe, clinically feasible method to locate root canals and prevent root perforation in teeth with PCC. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Present and future in the use of micro-CT scanner 3D analysis for the study of dental and root canal morphology.

PubMed

Grande, Nicola M; Plotino, Gianluca; Gambarini, Gianluca; Testarelli, Luca; D'Ambrosio, Ferdinando; Pecci, Raffaella; Bedini, Rossella

2012-01-01

The goal of the present article is to illustrate and analyze the applications and the potential of microcomputed tomography (micro-CT) in the analysis of tooth anatomy and root canal morphology. The authors performed a micro-CT analysis of the following different teeth: maxillary first molars with a second canal in the mesiobuccal (MB) root, mandibular first molars with complex anatomy in the mesial root, premolars with single and double roots and with complicated apical anatomy. The hardware device used in this study was a desktop X-ray microfocus CT scanner (SkyScan 1072, SkyScan bvba, Aartselaar, Belgium). A specific software ResolveRT Amira (Visage Imaging) was used for the 3D analysis and imaging. The authors obtained three-dimensional images from 15 teeth. It was possible to precisely visualize and analyze external and internal anatomy of teeth, showing the finest details. Among the 5 upper molars analyzed, in three cases, the MB canals joined into one canal, while in the other two molars the two mesial canals were separate. Among the lower molars two of the five samples exhibited a single canal in the mesial root, which had a broad, flat appearance in a mesiodistal dimension. In the five premolar teeth, the canals were independent; however, the apical delta and ramifications of the root canals were quite complex. Micro-CT offers a simple and reproducible technique for 3D noninvasive assessment of the anatomy of root canal systems.

Composite resin reinforcement of flared canals using light-transmitting plastic posts.

PubMed

Lui, J L

1994-05-01

Composite resins have been advocated as a reinforcing build-up material for badly damaged endodontically treated teeth with flared canals. However, the control of an autocuring composite resin is difficult because it polymerizes rapidly within the root canal. While the light-curing composite resins are more user friendly, their polymerization can be a problem deep in the root canal. Light-transmitting plastic posts allow the transmission of light into the root canal and enable intraradicular composite resin reconstitution and reinforcement of weakened roots. At the same time, the light-transmitting plastic post forms an optimal post canal in the rehabilitated root and can accurately fit a matching retentive final post. These light-transmitting posts are a useful addition to the dental armamentarium.

Apical and root canal space sealing abilities of resin and glass ionomer-based root canal obturation systems.

PubMed

Royer, Kinga; Liu, Xue Jun; Zhu, Qiang; Malmstrom, Hans; Ren, Yan-Fang

2013-01-01

To investigate the apical sealing ability of glass ionomer and resin-based root canal obturation systems in comparison to a conventional vertical compaction of warm guttapercha. Forty-five extracted human teeth were randomly assigned into 3 groups of 15 each: a resin-based (EndoRez), a glass ionomer-based (Activ GP), and a conventional gutta-percha plus pulp sealer obturation system (GP/EWT). Apical and root canal space sealing abilities were assessed on five cross-sections 1.0 mm apart starting from the apex. Cross-section images were analysed using a focus-variation 3D scanning microscope and unsealed space was calculated as the percentage of total root canal space occupied by voids and debris. EndoRez had significantly higher rate of apical leakage and deeper dye penetration as compared to GP/EWT and Activ GP. EndoRez group had also more voids and debris (22.5%) in the root canal spaces as compared to GP/EWT (10.5%) and Activ GP (10.8%). Apical leakages occurred not only along the root canal walls, but also along the gutta-percha cones with EndoRez as a result of significant polymerisation shrinkage of the resin sealer. Resin-based EndoRez did not form an adequate apical seal of filled root canals. Glass ionomer-based Activ GP was comparable to a vertical compaction of warm guttapercha plus EWT sealer in sealing root canal spaces.

Three-rooted premolar analyzed by high-resolution and cone beam CT.

PubMed

Marca, Caroline; Dummer, Paul M H; Bryant, Susan; Vier-Pelisser, Fabiana Vieira; Só, Marcus Vinicius Reis; Fontanella, Vania; Dutra, Vinicius D'avila; de Figueiredo, José Antonio Poli

2013-07-01

The aim of this study was to analyze the variations in canal and root cross-sectional area in three-rooted maxillary premolars between high-resolution computed tomography (μCT) and cone beam computed tomography (CBCT). Sixteen extracted maxillary premolars with three distinct roots and fully formed apices were scanned using μCT and CBCT. Photoshop CS software was used to measure root and canal cross-sectional areas at the most cervical and the most apical points of each root third in images obtained using the two tomographic computed (CT) techniques, and at 30 root sections equidistant from both root ends using μCT images. Canal and root areas were compared between each method using the Student t test for paired samples and 95 % confidence intervals. Images using μCT were sharper than those obtained using CBCT. There were statistically significant differences in mean area measurements of roots and canals between the μCT and CBCT techniques (P < 0.05). Root and canal areas had similar variations in cross-sectional μCT images and became proportionally smaller in a cervical to apical direction as the cementodentinal junction was approached, from where the area then increased apically. Although variation was similar in the roots and canals under study, CBCT produced poorer image details than μCT. Although CBCT is a strong diagnosis tool, it still needs improvement to provide accuracy in details of the root canal system, especially in cases with anatomical variations, such as the three-rooted maxillary premolars.

Extrusion of Debris from Primary Molar Root Canals following Instrumentation with Traditional and New File Systems.

PubMed

Thakur, Bhagyashree; Pawar, Ajinkya M; Kfir, Anda; Neelakantan, Prasanna

2017-11-01

To assess the amount of debris extruded apically during instrumentation of distal canals of extracted primary molars by three instrument systems [ProTaper Universal (PTU), ProTaper NEXT (PTN), and self-adjusting file (SAF)] compared with conventional stainless steel hand K-files (HF, control). Primary mandibular molars (n = 120) with a single distal canal were selected and randomly divided into four groups (n = 30) for root canal instrumentation using group I, HF (to size 0.30/0.02 taper), group II, PTU (to size F3), group III, PTN (to size X3), and group IV, SAF. Debris extruded during instrumentation was collected in preweighed Eppendorf tubes, stored in an incubator at 70°C for 5 days and then weighed. Statistical analysis was performed by one-way analysis of variance (ANOVA), followed by Turkey's post hoc test (p = 0.05). All the groups resulted in extrusion of debris. There was statistically significant difference (p < 0.001) in the debris extrusion between the three groups: HF (0.00133 ± 0.00012), PTU (0.00109 ± 0.00005), PTN (0.00052 ± 0.00008), and SAF (0.00026 ± 0.00004). Instrumentation with SAF resulted in the least debris extrusion when used for shaping root canals of primary molar teeth. Debris extrusion in primary teeth poses an adverse effect on the stem cells and may also alter the permanent dental germ. Debris extrusion is rarely reported for primary teeth and it is important for the clinician to know which endodontic instrumentation leads to less extrusion of debris.

Effect of coronal flaring on apical extrusion of debris during root canal instrumentation using single-file systems.

PubMed

Topçuoğlu, H S; Üstün, Y; Akpek, F; Aktı, A; Topçuoğlu, G

2016-09-01

To evaluate the effect of coronal flaring on the amount of debris extruded apically during root canal preparation using the Reciproc, WaveOne (WO) and OneShape (OS) single-file systems. Ninety extracted single-rooted mandibular incisor teeth were randomly assigned to six groups (n = 15 for each group) for canal instrumentation. Endodontic access cavities were prepared in each tooth. In three of the six groups, coronal flaring was not performed; coronal flaring was performed with Gates-Glidden drills on all teeth in the remaining three groups. The canals were then instrumented with one or other of the following single-file instrument systems: Reciproc, WO and OS. Debris extruded apically during instrumentation was collected into pre-weighed Eppendorf tubes. The tubes were then stored in an incubator at 70 °C for 5 days. The weight of the dry extruded debris was established by subtracting the pre-instrumentation and post-instrumentation weight of the Eppendorf tubes for each group. Data were analysed using one-way analysis of variance (anova) and Tukey's post hoc tests (P = 0.05). Reciproc and WO files without coronal flaring produced significantly more debris compared with the other groups (P < 0.05). There was no significant difference in apical extrusion of debris amongst the other groups (P > 0.05). All single-file systems caused apical extrusion of debris. Performing coronal flaring prior to canal preparation reduced the amount of apically extruded debris when using Reciproc or WO systems. © 2015 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Undergraduate students introduction to manual and rotary root canal instrumentation.

PubMed

Leonardi, Denise Piotto; Haragushiku, Gisele Aihara; Tomazinho, Flavia Sens Fagundes; Furuse, Adilson Yoshio; Volpato, Lusiane; Baratto-Filho, Flares

2012-01-01

The aim of this study was to evaluate the performance of undergraduates in their first contact with manual and rotary root canal instrumentation. Forty-two students who had never worked on a root canal before instrumented 42 extracted lower-incisors. Participants were assigned to one of two groups: Rotary instrumentation or manual instrumentation. Pre- and post-operative computed tomography scans were obtained with a 3-dimensional dental imaging system. Starting and finishing times of preparation were recorded. The cross-sectional area of the root canal was analyzed with 2-mm-below-the-apex initial and final transverse images recorded through a digital imaging system and analyzed with software to measure the initial and final area of the root canal in mm(2). Data from the cross-sectional area of the root canal and time spent were subjected to the Mann-Whitney's U-test (p<0.05). The rotary instrumentation group showed smaller time for preparation (p=0.0204). No differences between rotary and manual instrumentation regarding the cross-sectional area of the root canal were observed (p=0.25). No accidents occurred. Undergraduate students showed good performance in their first contact with the manual and rotary instrumentation with regard to time spent and cross-sectional area of the root canal, with no operative accidents.

Cone-beam computed tomography as advanced diagnostic aid in endodontic treatment of molars with multiple canals: Two case reports

PubMed Central

Kamble, Amit Pralhad; Pawar, Rohini Rangarao; Mattigatti, Sudha; Mangala, T. M.; Makandar, Saleem

2017-01-01

The purpose of these case reports is to emphasize the importance of knowledge regarding the root canal morphology and current diagnostic aids one should have as both of these important factors going to affect the prognosis of the endodontic treatment. These two case reports describe the maxillary and mandibular first molars with multiple canals. After clinical and radiographic diagnosis, additional help of cone-beam computed tomography (CBCT) of mandibular molar has been taken to evaluate the morphology and canal pattern; while maxillary molar was evaluated using CBCT scan to evaluate the canal configuration and obturation. In CBCT evaluation, the mandibular molar was diagnosed with six separated canals with three mesial and three distal canals and with radix paramolaris and radix entomolaris. The maxillary molar had five canals with three mesiobuccal (MB) canals. Both molars were instrumented with conventional hand and rotary file systems and obturated by conventional lateral compaction method. The axial images from CBCT show Vertucci Type VIII canal pattern in both roots of first mandibular molars and in MB root of maxillary first molar Sert and Bayirli Type XVIII canal configuration and no accessory canal in distobuccal and palatal root. With the recent innovations in diagnostic and operating aids, we can come across many variations in the root canal morphology of both mandibular and maxillary teeth, especially multi-rooted one (i.e., molars), and the knowledge of which leads to successful endodontic treatment with an excellent prognosis. PMID:29259367

Endodontic management of an unusual maxillary first molar with a single buccal root.

PubMed

Nayak, Gurudutt; Dahiya, Surya; Singh, Inderpreet; Mohammad, Faiz Hasan

2014-05-01

The aim of this clinical article is to describe the unusual anatomy that was detected in a maxillary first molar during routine endodontic treatment. Variation in Root and Root canal morphology especially in multirooted teeth presents a constant challenge for a clinician in their detection and management. The literature is replete with cases that have extra canal or Root but cases with fused Root and fewer numbers of canals are sparse. This case report describes the endodontic management of one such unusual case of maxillary first molar presenting with a single fused buccal and a palatal Root. The confirmatory diagnosis of this morphologic aberration was done with the help of spiral computerized tomography, which revealed that the contralateral tooth also had a similar morphology. Dental practitioners should always be aware of the fact that abnormalities need not be in form of extra Roots or Root canals; anomalies can also be in form of fewer number of Roots or Root canals. A thorough knowledge of the complexities and variations of the Root canal system would help in avoiding some of the common iatrogenic access opening errors like perforations and excessive tooth removal caused during the search for the missing or extracanal.

Resistance to fracture of roots filled with different sealers.

PubMed

Sağsen, Burak; Ustün, Yakup; Pala, Kanşad; Demırbuğa, Sezer

2012-01-01

The aim of this study was to compare the fracture resistance of roots filled with gutta percha (GP) and different root canal sealers.Fifty-five human maxillary central incisors were selected and randomly divided into three experimental groups (Groups 1-3) and two control groups (Groups 4 and 5). They were Group 1-15 root canals filled with an epoxy resin-based sealer (AH Plus) and GP, Group 2 -15 root canals filled with a calcium silicate-based sealer (iRoot SP) and GP, Group 3: 15 root canals filled with another calcium silicate-based sealer (MTA Fillapex) and GP, Group 4: five roots were instrumented but not filled, and Group 5: five roots were neither instrumented nor filled. Compressive loading was carried out using a universal testing machine until fracture occurred. Force applied at time of fracture was recorded as fracture strength of specimen in Newtons. There were no significant differences in fracture strength among the three experimental groups (p>0.05), whose results were significantly superior to that of Group 4 (p<0.05). In conclusion, all the root canal sealers used in the present study increased the fracture resistance of instrumented root canals.

Canal Configuration of Mesiobuccal Roots in Permanent Maxillary First Molars in Iranian Population: A Systematic Review

PubMed Central

Naseri, Mandana; Kharazifard, Mohammad Javad

2016-01-01

Objectives: It is essential for clinicians to have adequate knowledge about root canal configurations; although its morphology varies largely in different ethnicities and even in different individuals with the same ethnic background. The current study aims to review the root canal configurations of mesiobuccal roots of maxillary first molars in an Iranian population based on different epidemiological studies. Materials and Methods: A comprehensive search was conducted to retrieve articles related to root canal configuration and prevalence of each type of root canal based on Vertucci’s classification for the mesiobuccal root of maxillary first molars. An electronic search was conducted in Medline, Scopus and Google Scholar from January 1984 to September 2015. The articles were evaluated and methods, population, number of teeth and percentage of each root canal type evaluated in each study were summarized in the data table. Websites such as http://www.magiran.com/ , http://health.barakatkns.com/journal-internal-list and www.sid.ir were used to search all related studies published in Persian. Results: Totally, out of nine studies conducted on the Iranian populations in nine provinces of Iran and 798 teeth, the Vertucci’s type I was the most common type (35.70%), followed by type II (30.37%), type IV (16.66%), type III (7.93%) and type V (2.61%). Conclusions: From this review article, it is concluded that the root canal morphology of mesiobuccal roots of maxillary first molars in the Iranian population predominantly has more than one canal. Therefore, careful evaluation of radiographs and anatomy of the pulp chamber is essential in order to achieve a successful root canal therapy. PMID:28243306

Identification of Apical and Cervical Curvature Radius of Human Molars.

PubMed

Estrela, Carlos; Bueno, Mike R; Barletta, Fernando B; Guedes, Orlando A; Porto, Olavo C; Estrela, Cyntia R A; Pécora, Jesus Djalma

2015-01-01

To determine the frequency of apical and cervical curvatures in human molars using the radius method and cone-beam computed tomography (CBCT) images. Four hundred images of mandibular and maxillary first and second molars were selected from a database of CBCT exams. The radius of curvature of curved root canals was measured using a circumcenter based on three mathematical points. Radii were classified according to the following scores: 0 - straight line; 1 - large radius (r > 8 mm, mild curvature); 2 - intermediate radius (r > 4 and r < 8 mm, moderate curvature); and 3 - small radius (r ≤ 4 mm, severe curvature). The frequency of curved root canals was analyzed according to root canal, root thirds, and coronal and sagittal planes, and assessed using the chi-square test (significance at α = 0.05). Of the 1,200 evaluated root canals, 92.75% presented curved root canals in the apical third and 73.25% in the cervical third on coronal plane images; sagittal plane analysis yielded 89.75% of curved canals in the apical third and 77% in the cervical third. Root canals with a large radius were significantly more frequent when compared with the other categories, regardless of root third or plane. Most root canals of maxillary and mandibular first and second molars showed some degree of curvature in the apical and cervical thirds, regardless of the analyzed plane (coronal or sagittal).

Unusual Root Canal Irrigation Solutions.

PubMed

Mohammadi, Zahed; Jafarzadeh, Hamid; Shalavi, Sousan; Kinoshita, Jun-Ichiro

2017-05-01

Microorganisms and their by-products play a critical role in pulp and periradicular pathosis. Therefore, one of the main purposes of root canal treatment is disinfection of the entire system of the canal. This aim may be obtained using mechanical preparation, chemical irrigation, and temporary medication of the canal. For this purpose, various irrigation solutions have been advocated. Common root canal irrigants, such as sodium hypochlorite, chlorhexidine, and a mixture of tetracycline, acid, and detergent have been extensively reviewed. The aim of this review was to address the less common newer root canal irrigation solutions, such as citric acid, maleic acid, electrochemically activated water, green tea, ozonated water, and SmearClear.

[A mandibular second molar with three mesial roots: report of one case].

PubMed

Zhang, Ping

2010-02-01

A case of unusual root canal morphology was presented to demonstrate anatomic variations in mandibular second molars. This case report presented the endodontic therapy of a mandibular second molar with three canals in the mesial root. A mesial middle canal was found between the mesiobuccal and mesiolingual canals. This report indicated the importance of looking for additional canals and unusual canal morphology, because knowledge of their existence might occasionally enable clinicians to treat a case successfully that otherwise to fail.

[Association between Bacteroides forsythus in the infected root canals and clinical symptoms of chronic apical periodontitis].

PubMed

Huang, Ding-ming; Fu, Chun-hua; Zhou, Xue-dong

2005-01-01

To investigate the distribution of Bacteroides forsythus in root canals with chronic apical periodontitis and to determine its associations with clinical symptoms. Thirty-eight tooth root canals from 31 subjects were studied with a 16S rDNA-directed polymerase chain reaction (PCR). These teeth were classified into symptomatic and asymptomatic groups according to the clinical symptoms and signs, including spontaneous pain, percussion pain, sinus tract and swelling, respectively. Ten of the 38 root canal samples were positive for B. forsythus. The prevalence of B. forsythus was 26.3% for 38 root canals, 45.5% for spontaneous pain group, 39.1% for percussion pain group, 29.4% for sinus tract group, 42.9% for swelling group, respectively. Significant positive associations were observed between B. forsythus in infected root canals and the spontaneous pain, percussion pain, and swelling of apical periodontitis, respectively (OR=infinity, 9, 12; P<0.05). There was no significant association between B. forsythus and sinus tract of apical periodontitis (OR=1.33). B. forsythus colonized in the infected root canals. It is the putative pathogen of apical periodontitis.

Nonsurgical root canal therapy of large cyst-like inflammatory periapical lesions and inflammatory apical cysts.

PubMed

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

2009-05-01

It is a general belief that large cyst-like periapical lesions and apical true cysts caused by root canal infection are less likely to heal after nonsurgical root canal therapy. Nevertheless, there is no direct evidence to support this assumption. A large cyst-like periapical lesion or an apical true cyst is formed within an area of apical periodontitis and cannot form by itself. Therefore, both large cyst-like periapical lesions and apical true cysts are of inflammatory and not of neoplastic origin. Apical periodontitis lesions, regardless of whether they are granulomas, abscesses, or cysts, fail to heal after nonsurgical root canal therapy for the same reason, intraradicular and/or extraradicular infection. If the microbial etiology of large cyst-like periapical lesions and inflammatory apical true cysts in the root canal is removed by nonsurgical root canal therapy, the lesions might regress by the mechanism of apoptosis in a manner similar to the resolution of inflammatory apical pocket cysts. To achieve satisfactory periapical wound healing, surgical removal of an apical true cyst must include elimination of root canal infection.

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

PubMed

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

2015-02-01

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

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

PubMed

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

2013-05-01

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

Hand and nickel-titanium root canal instrumentation performed by dental students: a micro-computed tomographic study.

PubMed

Peru, M; Peru, C; Mannocci, F; Sherriff, M; Buchanan, L S; Pitt Ford, T R

2006-02-01

The aim of this study was to evaluate root canals instrumented by dental students using the modified double-flared technique, nickel-titanium (NiTi) rotary System GT files and NiTi rotary ProTaper files by micro-computed tomography (MCT). A total of 36 root canals from 18 mesial roots of mandibular molar teeth were prepared; 12 canals were prepared with the modified double-flared technique, using K-flexofiles and Gates-Glidden burs; 12 canals were prepared using System GT and 12 using ProTaper rotary files. Each root was scanned using MCT preoperatively and postoperatively. At the coronal and mid-root sections, System GT and ProTaper files produced significantly less enlarged canal cross-sectional area, volume and perimeter than the modified double-flared technique (P < 0.05). In the mid-root sections there was significantly less thinning of the root structure towards the furcation with System GT and ProTaper (P < 0.05). The rotary techniques were both three times faster than the modified double-flared technique (P < 0.05). Qualitative evaluation of the preparations showed that both ProTaper and System GT were able to prepare root canals with little or no procedural error compared with the modified double-flared technique. Under the conditions of this study, inexperienced dental students were able to prepare curved root canals with rotary files with greater preservation of tooth structure, low risk of procedural errors and much quicker than with hand instruments.

Three-year outcomes of root canal treatment: Mining an insurance database.

PubMed

Raedel, Michael; Hartmann, Andrea; Bohm, Steffen; Walter, Michael H

2015-04-01

There is doubt whether success rates of root canal treatments reported from clinical trials are achievable outside of standardized study populations. The aim of this study was to analyse the outcome of a large number of root canal treatments conducted in general practice. The data was collected from the digital database of a major German national health insurance company. All teeth with complete treatment data were included. Only patients who had been insurance members for the whole 3-year period from 2010 to 2012 were eligible. Kaplan-Meier survival analyses were conducted based on completed root canal treatments. Target events were re-interventions as (1) retreatment of the root canal treatment, (2) apical root resection (apicoectomy) and (3) extraction. The influences of vitality status and root numbers on survival were tested with the log-rank test. A total of 556,067 root canal treatments were included. The cumulative overall survival rate for all target events combined was 84.3% for 3 years. The survival rate for nonvital teeth (82.6%) was significantly lower than for vital teeth (85.6%; p<0.001). The survival rate for single rooted teeth (83.4%) was significantly lower than for multi-rooted teeth (85.5%; p<0.001). The most frequent target event was extraction followed by apical root resection and retreatment. Based on these 3-year outcomes, root canal treatment is considered a reliable treatment in practice routine under the conditions of the German national health insurance system. Root canal treatment can be considered as a reliable treatment option suitable to salvage most of the affected teeth. This statement applies to treatments that in the vast majority of cases were delivered by general practitioners under the terms and conditions of a nationwide health insurance system. Copyright © 2015 Elsevier Ltd. All rights reserved.

Additional disinfection with a modified salt solution in a root canal model.

PubMed

van der Waal, Suzette V; Oonk, Charlotte A M; Nieman, Selma H; Wesselink, Paul R; de Soet, Johannes J; Crielaard, Wim

2015-10-01

The aim of this study is to investigate the disinfecting properties of a modified salt solution (MSS) and calcium hydroxide (Ca(OH)2) in a non-direct-contact ex-vivo model. Seventy-four single-canal roots infected with Enterococcus faecalis were treated with 1% sodium hypochlorite (NaOCl) irrigation or with NaOCl irrigation with subsequent dressing with MSS or Ca(OH)2. After removal of the dressings, the roots were filled with bacterial growth medium and incubated for seven days to enable the surviving bacteria to repopulate the root canal lumen. Growth was determined by sampling the root canals with paper points before treatment (S1), after treatment (S2) and incubation after treatment (S3). The colony forming units were counted at S1 and S2. At S3, growth was determined as no/yes regrowth. The Kruskal-Wallis, McNemar and χ(2) test were used for statistical analyses. At S2, in the NaOCl group, growth was found in 5 of 19 root canals. After the removal of MSS or Ca(OH)2 bacteria were retrieved from one root canal in both groups. At S3, repopulation of the root canals had occurred in 14 of 19 roots after sole NaOCl irrigation, 6 of 20 roots after MSS-dressing and in 14 of 20 roots after Ca(OH)2-dressing. MSS was more effective in preventing regrowth than Ca(OH)2 (P=0.009). The modified salt solution prevented regrowth in roots which indicates that it can eliminate persistent bacteria. Dressing the root canals with Ca(OH)2 did not provide additional disinfection after NaOCl irrigation. Copyright © 2015 Elsevier Ltd. All rights reserved.

Endodontic treatment of a maxillary central incisor with two roots.

PubMed

Maghsoudlou, Amir; Jafarzadeh, Hamid; Forghani, Maryam

2013-03-01

This clinical report presents a rare case of maxillary central incisor with two separate roots. Unusual morphology of the roots and root canals may exist in any tooth. Recognition of the dental anatomy and its variations is necessary for successful endodontic therapy. It is well known that maxillary incisors are usually single-rooted teeth. The root canals were instrumented with conventional hand files and Gates Glidden and obturated by using the lateral technique. Recall radiograph after 1 year shows the healing process of the preoperative apical periodontitis. Clinicians should be aware of unexpected root canal morphology when performing root canal therapy. The present case demonstrated the importance of accurate preoperative radiograph and adequate access preparation.

[Analysis of interappointment flare-ups after root canal preparation with Mtwo NiTi rotary system].

PubMed

Han, Jun-li; He, Hong; Zhu, Ya-qin

2011-08-01

To study the interappointment flare-ups after root canal preparation with Mtwo NiTi rotary system and explore the influence factors. Ninty-seven pulp cases caused by caries or invisible cracks which consisted of 37 males and 60 females,16 to 62 years old were selected and divided into 2 groups randomly. One group was treated with Mtwo NiTi rotary system while the other was treated with K file, the interappointment flare-ups after root canal preparation was compared between the 2 groups. The data were subjected to Mann-Whitney U test and X(2) test with SPSS13.0 software package. Less flare-ups occurred in the group of root canal preparation with NiTi rotary system, the difference was statistically significant (P=0.027). Root canal preparation with Mtwo NiTi rotary system could decrease the flare-ups after root canal therapy.

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

PubMed

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

2014-12-01

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

[Evaluation of root canal isthmus debridement efficacy of Er:YAG laser in combination with sodium hypochlorite].

PubMed

Zhou, Meng-Qi; Wang, Hao-Ming; Xiao, Jia-Qi; Hong, Jin

2016-10-01

To histologically evaluate the efficacy of sodium hypochlorite (NaClO) in combination with Er:YAG (erbium-doped yttrium aluminium garnet) laser in dissolving necrotic tissue and cleaning root canals as well as canal isthmuses. After scanned by cone-beam CT (CBCT), 50 well-prepared premolars with root canal isthmuses were selected and randomly assigned into 5 groups. They were subsequently subjected to different regimens as followed: group A-irrigated with 1% NaClO for 1 minute, group B- irradiated by Er:YAG laser at 0.5 W combined with 1% NaClO irrigation for 1 minute, group C- irradiated by Er:YAG laser at 1.0 W combined with 1% NaClO irrigation for 1 minute, group D- irradiated by Er:YAG laser at 2.0 W combined with 1% NaClO irrigation for 1 minute,group E- negative control. After histological preparation and staining, the cross-sections were evaluated for percentage of tissue removal from root canals and isthmuses. The cleanliness values were calculated using SPSS 13.0 software package. The mean percentage of root canals in group A, B, C and D was 95.24%, 96.53%、97.63% and 98.22%, respectively, and the mean percentage of isthmuses was 16.50%, 51.48%, 52.56% and 53.83%, respectively. The mean percentage of root canal and isthmus cleanliness values were significantly higher in group B, C and D (P<0.05) than that in group A. There was no significant differences of root canal and isthmus cleanliness among group B, C and D. Er:YAG laser combined with 1% NaClO irrigation may be used effectively in root canal and root canal isthmus cleanliness as a new method.

Microbial profile of root canals of primary teeth with pulp necrosis and periradicular lesion.

PubMed

Triches, Thaisa Cezária; de Figueiredo, Luciene Cristina; Feres, Magda; de Freitas, Sérgio Fernando Torres; Zimmermann, Gláucia Santos; Cordeiro, Mabel Mariela Rodríguez

2014-01-01

The purpose of this study was to assess the microbial content of root canals of human primary teeth with pulp necrosis and periradicular lesion. Microbial samples were collected from 24 canals of children treated at a pediatric dentistry clinic. Microbiological identification was performed using checker-board DNA-DNA hybridization for 40 different bacteria. Data were analyzed per canal based on the mean count and frequency of each bacterial species. Detectable levels of bacterial species were observed for 35 probes (88%). The most frequent bacteria were Fusobacterium nucleatum sp. nucleatum, Fusobacterium periodonticum, Prevotella melaninogenica, Prevotella nigrescens, and Prevotella intermedia. Facultative species were identified in 20 root canals (83%), anaerobic species were identified in 24 root canals (100%), and aerobic species in 18 root canals (75%). Black-pigmented bacilli were found in 23 samples (96%). The number of different bacterial species detected per canal ranged from five to 33. Endodontic infection in primary teeth with pulp necrosis and periradicular lesion is multimicrobial, including aerobic, facultative, and anaerobic micro-organisms.

Aberration in the palatal root of the maxillary first molar

PubMed Central

Rajalbandi, Sandeep; Shingte, Sandhya Narayan; Sundaresh, K J; Mallikarjuna, Rachappa

2013-01-01

Thorough knowledge of root canal morphology is essential for the endodontic therapy. Variations in the root and root canal morphology, especially in multirooted teeth, are a constant challenge for diagnosis and management. The dentist needs to be familiar with the various root canal configurations and their variations for successful endodontic therapy. There are rare variations in canal number and configuration in maxillary molars, which could affect treatment outcome. Two lingual root structures are occasionally found on human permanent maxillary molars. One of these is the normal lingual root, which is always present, the other is a supernumerary structure which can be located either mesiolingually (radix mesiolingualis) or distolingually (radix distolingualis). The purpose of this paper is to review the literature and to demonstrate a case report which describes the successful non-surgical endodontic management of an unusual maxillary first molar with four separate roots and four canals. PMID:23632609

[In vitro comparison of root canal preparation with step-back technique and GT rotary file--a nickel-titanium engine driven rotary instrument system].

PubMed

Krajczár, Károly; Tóth, Vilmos; Nyárády, Zoltán; Szabó, Gyula

2005-06-01

The aim of the authors' study was to compare the remaining root canal wall thickness and the preparation time of root canals, prepared either with step-back technique, or with GT Rotary File, an engine driven nickel-titanium rotary instrument system. Twenty extracted molars were decoronated. Teeth were divided in two groups. In Group 1 root canals were prepared with step-back technique. In Group 2 GT Rotary File System was utilized. Preoperative vestibulo-oral X-ray pictures were taken from all teeth with radiovisiograph (RVG). The final preparations at the mesiobuccal canals (MB) were performed with size #30 and palatinal/distal canals with size #40 instruments. Postoperative RVG pictures were taken ensuring the preoperative positioning. The working time was measured in seconds during each preparation. The authors also assessed the remaining root canal wall thickness at 3, 6 and 9 mm from the radiological apex, comparing the width of the canal walls of the vestibulo-oral projections on pre- and postoperative RVG pictures both mesially and buccally. The ratios of the residual and preoperative root canal wall thickness were calculated and compared. The largest difference was found at the MB canals of the coronal and middle third level of the root, measured on the distal canal wall. The ratio of the remaining dentin wall thickness at the coronal and the middle level in the case of step-back preparation was 0.605 and 0.754, and 0.824 and 0.895 in the cases of GT files respectively. The preparation time needed for GT Rotary File System was altogether 68.7% (MB) and 52.5% (D/P canals) of corresponding step-back preparation times. The use of GT Rotary File with comparison of standard step-back method resulted in a shortened preparation time and excessive damage of the coronal part of the root canal could be avoided.

[Bond strengths of absorbable polylactic acid root canal post with three different adhesives].

PubMed

Pan, Hui; Cheng, Can; Hu, Jia; Liu, He; Sun, Zhi-hui

2015-12-18

To find absorbable adhesives with suitable bonding properties for the absorbable polylactic acid root canal post. To test and compare the bond strengths of absorbable polylactic acid root canal post with three different adhesives. The absorbable polylactic acid root canal posts were used to restore the extracted teeth, using 3 different adhesives: cyanoacrylates, fibrin sealant and glass ionomer cement. The teeth were prepared into slices for micro-push-out test. The bond strength was statistically analyzed using ANOVA. The specimens were examined using microscope and the failure mode was divided into four categories: cohesive failure between absorbable polylactic acid root canal posts and adhesives, cohesive failure between dentin and adhesives, failure within the adhesives and failure within the absorbable polylactic acid root canal posts. The bond strength of cyanoacrylates [(16.83 ± 6.97) MPa] and glass ionomer cement [(12.10 ± 5.09) MPa] were significantly higher than fibrin sealant [(1.17 ± 0.50) MPa], P<0.001. There was no significant difference between cyanoacrylates and glass ionomer cement (P=0.156). In the group of cyanoacrylates, the cohesive failure between the absorbable polylactic acid root canal posts and the adhesives was 25.0%, the cohesive failure between the dentin and the adhesives was 16.7%, the failure within the adhesives was 33.3%, and the failure within the absorbable polylactic acid root canal posts was 25.0%. In the group of fibrin sealant, the cohesive failure between the absorbable polylactic acid root canal posts and the adhesives was 66.7%, the cohesive failure between the dentin and the adhesives was 22.2%, the failure within the adhesives was 11.1%. In the group of glass ionomer cement, the cohesive failure between the absorbable polylactic acid root canal posts and the adhesives was 87.5%, the failure within the adhesives was 12.5%. The major failure mode in fibrin sealant and glass ionomer cement was the cohesive failure between the absorbable polylactic acid root canal posts and the adhesives. No major failure modes were found in the group of cyanoacrylates. The bond strength of fibrin sealant is low, which cannot meet the requirement of clinical use. The bond strengths of cyanoacrylates and glass ionomer cement are suitable for clinical use. The cyanoacrylates are a kind of absorbable adhesive which has suitable bonding properties for the absorbable polylactic acid root canal post.

The Tennessee study: factors affecting treatment outcome and healing time following nonsurgical root canal treatment.

PubMed

Azim, A A; Griggs, J A; Huang, G T-J

2016-01-01

To determine factors that may influence treatment outcome and healing time following root canal treatment. Root filled and restored teeth by pre-doctoral students were included in this study. Teeth/roots were followed-up regularly, and treatment outcome was evaluated at every follow-up appointment (healed, healing, uncertain or unsatisfactory). Host (age, immune condition, pulp/periapical diagnosis, tooth/root type, location and anatomy) and treatment factors (master apical file size, apical extension, voids and density of root filling) were recorded from patient dental records. Univariate, bivariate and multivariate analyses were performed to determine the impact of the factors on treatment outcomes and healing times. A total of 422 roots from 291 teeth met the inclusion criteria with a mean follow-up period of 2 years. The preoperative pulp condition, procedural errors during treatment, apical extension and density of root fillings significantly affected the treatment outcome. The average time required for a periapical lesion to heal was 11.78 months. The healing time increased in patients with compromised healing, patients older than 40 years, roots with Weine type II root canal systems, root canal systems prepared to a master apical file size <35, and roots with overextended fillings (P < 0.1). Multiple host and treatment factors affected the healing time and outcome of root canal treatment. Follow-up protocols should consider these factors before concluding the treatment outcome: patient's age, immune condition, as well as roots with overextended fillings, root canal systems with smaller apical preparations (size <35) or roots with complex canal systems. Intervention may be recommended if the treatment quality was inadequate or if patients became symptomatic. © 2015 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Endodontic Management of a Maxillary Lateral Incisor with 4 Root Canals and a Dens Invaginatus Tract.

PubMed

Nosrat, Ali; Schneider, S Craig

2015-07-01

Dens invaginatus (DI) is associated with complex internal anatomy. This article represents a maxillary lateral incisor with 5 root canals including DI. The treatment was planned and performed using cone-beam computed tomographic (CBCT) imaging. After clinical and radiographic evaluations, tooth #7 was diagnosed with DI and pulp necrosis with symptomatic apical periodontitis. Periapical radiographs of the tooth showed 2 roots and complex internal anatomy. CBCT evaluation revealed tooth #7 had 5 separate canals (4 root canals and 1 DI canal extending through the root to the periodontal ligament), communication between DI and the root canal system, and severe and multiple curvatures of the palatal canals. Root canal treatment was completed in 2 visits. Modified access openings were required to safely treat the dilacerated palatal canals. At the 6-month re-evaluation, the patient reported he had remained asymptomatic and his tooth had remained functional since the treatment was completed. Clinical examination showed tooth #7 had no sensitivity to percussion or palpation, probe depths within normal limits (≤3 mm), and no mobility. Radiographic assessment of the tooth showed significant osseous healing of the preoperative lesion. Three-dimensional imaging is a valuable tool for endodontic management of teeth with complex internal anatomy. Three-dimensional imaging is recommended for evaluating and treatment planning cases with DI. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Natural medicaments in dentistry

PubMed Central

Sinha, Dakshita J.; Sinha, Ashish A.

2014-01-01

The major objective in root canal treatment is to disinfect the entire root canal system. Cleaning, shaping, and use of antimicrobial medicaments are effective in reducing the bacterial load to some extent, but some bacteria do remain behind and multiply, causing reinfection. Taking into consideration the ineffectiveness, potential side-effects and safety concerns of synthetic drugs, the herbal alternatives for endodontic usage might prove to be advantageous. Over the past decade, interest in drugs derived from medicinal plants has markedly increased. Phytomedicine has been used in dentistry as anti-inflammatory, antibiotic, analgesic, sedative and also as endodontic irrigant. Herbal preparations can be derived from the root, leaves, seeds, stem, and flowers. The PubMed database search revealed that the reference list for natural medicaments featured 1480 articles and in dentistry 173 articles. A forward search was undertaken on the selected articles and author names. This review focuses on various natural drugs and products as well as their therapeutic applications when used as phytomedicine in dentistry. PMID:25558153

One- versus two-visit endodontic treatment of teeth with apical periodontitis: a histobacteriologic study.

PubMed

Vera, Jorge; Siqueira, José F; Ricucci, Domenico; Loghin, Simona; Fernández, Nancy; Flores, Belina; Cruz, Alvaro G

2012-08-01

This study analyzed the in vivo microbiological status of the root canal systems of mesial roots of mandibular molars with primary apical periodontitis after 1- or 2-visit endodontic treatment. Mesial root canals were instrumented by using either a combination of K3 and LightSpeed instruments (mesiobuccal canals) or the ProTaper system (mesiolingual canals), with 5% NaOCl irrigation. Patency files were used. Smear layer was removed, and a final rinse with 5 mL of 2% chlorhexidine was performed. In the 2-visit group (7 roots, 14 canals), canals were medicated with calcium hydroxide for 1 week and then obturated by using the continuous wave of compaction technique. In the 1-visit group (6 roots, 12 canals), canals were immediately obturated after chemomechanical procedures. Teeth were extracted 1 week after root canal instrumentation and processed for histobacteriologic analysis. In the 1-visit group, no case was completely free of bacteria; residual bacteria occurred in the main root canal (5 of 6 cases), isthmus (5 of 6), apical ramifications (4 of 6), and dentinal tubules (5 of 6). In the 2-visit group, 2 cases were rendered bacteria-free; residual bacteria were found in the main canal only in 2 cases (none of them with persistent dentinal tubule infection), in the isthmus (4 of 7 cases), and in ramifications (2 of 7). The 2 instrumentation techniques performed similarly. When filling material was observed in ramifications, it was usually intermixed with necrotic tissue, debris, and bacteria. The 2-visit protocol by using an interappointment medication with calcium hydroxide resulted in improved microbiological status of the root canal system when compared with the 1-visit protocol. Residual bacteria were more frequent and abundant in ramifications, isthmuses, and dentinal tubules when root canals were treated without an interappointment medication. Apical ramifications and isthmuses were never completely filled. The use of an antibacterial interappointment agent is necessary to maximize bacterial reduction before filling. Copyright © 2012 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Surface modification of tooth root canal after application of an X-ray opaque waveguide

NASA Astrophysics Data System (ADS)

Dostálová, T.; Jelínková, H.; Šulc, J.; Němec, M.; Koranda, P.; Bartoňová, M.; Radina, P.; Miyagi, M.; Shi, Y.-W.; Matsuura, Y.

The interest in endodontic use of dental laser systems has been increasing. With the development of thin and flexible delivery systems for various wavelengths, laser applications in endodontics may become even more desirable. The aim of this study is to check the X-ray opacity of a hollow waveguide and to observe the results after laser root canal treatment. The root canal systems of 10 molars were treated endodontically by laser. For the laser radiation source, an Er:YAG laser system generating a wavelength of 2940 nm and an Alexandrite laser system generating a wavelength of 375 nm were used. The hollow waveguide used was checked under X-ray . A root canal surface treated by laser radiation was analyzed by a scanning electron microscope (SEM). The special hollow glass waveguide used was visible in the root canal system under X-ray imaging. Surface modification of the root canal after laser treatment was not found. After conventional treatment the root canal was enlarged. The surface was covered with a smear layer. After application of both laser systems, the smear layer was removed. The resulting canal surface was found to be clean and smooth. Under SEM observation open dentinal tubules were visible. No cracks were present, nor were surface modifications observed.

A comparative scanning electron microscopic investigation of the smear layer after the use of sodium hypochlorite gel and solution forms as root canal irrigants.

PubMed

Zand, Vahid; Lotfi, Mehrdad; Rahimi, Saeed; Mokhtari, Hadi; Kazemi, Ali; Sakhamanesh, Vahideh

2010-07-01

The effect of sodium hypochlorite (NaOCl) gel along with EDTA on the removal of the smear layer has not been studied; therefore, the aim of the present study was to compare the efficacy of gel and solution forms of NaOCl in removal of the smear layer from root canal walls. A total of 40 single-rooted teeth with minimum curvature (<5 degrees) were selected and divided into two experimental groups, each containing 15 teeth and one positive control group containing 10 teeth. The canals of all the teeth were prepared with rotary RaCe instruments up to #35. In the NaOCl solution group, the root canals were flushed with 2.5% NaOCl solution during instrumentation and in NaOCl gel group, the instruments were coated with gel form of NaOCl and used inside the root canals; then saline was used for root canal irrigation. Finally, 1 mL of 17% EDTA was used to rinse inside the root canals and remained in the root canals for 2 minutes in the both experimental groups; in the saline group, only saline was used for irrigation. The amount of the smear layer was quantified according to the Torabinejad method using a scanning electron microscope. Data were analyzed by the Kruskal-Wallis and Mann-Whitney tests. All the statistical analyses were set with a significance level of alpha = 0.05. There were no significant differences between NaOCl gel and solution forms in the coronal, middle, and apical thirds of root canals. There were significant differences between NaOCl solution and saline groups in the three parts of root canal walls and between NaOCl gel and saline in the coronal, middle, and apical thirds. The use of NaOCl gel can be as effective as NaOCl solution along with EDTA in smear layer removal in the three parts of root canal walls. Copyright 2010 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Proinflammatory Activity of Primarily Infected Endodontic Content against Macrophages after Different Phases of the Root Canal Therapy.

PubMed

Marinho, Ariane C S; Martinho, Frederico C; Leite, Fábio R M; Nascimento, Gustavo G; Gomes, Brenda P F A

2015-06-01

This study investigated the presence of target bacterial species and the levels of endotoxins in teeth with apical periodontitis. Levels of inflammatory mediators (interleukin [IL]-1β and tumor necrosis factor [TNF]-α) were determined after macrophage stimulation with endodontic content after different phases of endodontic therapy using different irrigants. Thirty primarily infected root canals were randomly assigned into 3 groups according to the irrigant used for root canal preparation (n = 10 per group): GI: 2.5% sodium hypochlorite, GII: 2% chlorhexidine gel, and GIII (control group): saline solution. Root canal samples were taken by using paper points before (s1) and after root canal instrumentation (s2), subsequently to 17% EDTA (s3), after 30 days of intracanal medication (Ca[OH]2 + saline solution) (s4), and before root canal obturation (s5). Polymerase chain reaction (16S recombinant DNA) and limulus amebocyte lysate assay were used for bacterial and endotoxin detection, respectively. Macrophages were stimulated with the root canal contents for IL-1β/TNF-α measurement using enzyme-linked immunosorbent assay. Porphyromonas gingivalis (17/30), Porphyromonas endodontalis (15/30), and Prevotella nigrescens (11/30) were the most prevalent bacterial species. At s1, endotoxins were detected in 100% of the root canals (median = 32.43 EU/mL). In parallel, substantial amounts of IL-1β and TNF-α were produced by endodontic content-stimulated macrophages. At s2, a significant reduction in endotoxin levels was observed in all groups, with GI presenting the greatest reduction (P < .05). After a root canal rinse with EDTA (s3), intracanal medication (s4), and before root canal obturation (s5), endotoxin levels reduced without differences between groups (P < .05). IL-1β and TNF-α release decreased proportionally to the levels of residual endotoxin (P < .05). Regardless of the use of sodium hypochlorite or CHX, the greatest endotoxin reduction occurs after chemomechanical preparation. Increasing steps of root canal therapy associated with intracanal medication enhances endotoxin reduction, leading to a progressively lower activation of proinflammatory cells such as macrophages. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Four canals in the mesial root of a mandibular first molar. A case report under the operating microscope.

PubMed

Kontakiotis, Evangelos G; Tzanetakis, Giorgos N

2007-08-01

In this era of microscope-assisted endodontics, finding variations in root canal system anatomy is not uncommon. Operating microscopes combined with careful clinical examination and radiographic interpretation can aid the clinician to successfully treat cases with such internal anatomy. The understanding of this view enables the possible location of additional canals in any tooth requiring endodontic treatment. The present clinical article demonstrates a rare anatomical complexity in the mesial root of a mandibular first molar. Four independent root canal orifices were found in this root by clinical detection with the aid of a dental operating microscope. This case shows that additional canals can be located in any root undergoing endodontic treatment and clinicians should always be aware of aberrant internal anatomy.

Comparison of Apical Extrusion of Debris by Using Single-File, Full-Sequence Rotary and Reciprocating Systems

PubMed Central

Ehsani, Maryam; Harandi, Azadeh; Tavanafar, Saeid; Raoof, Maryam; Galledar, Saeedeh

2016-01-01

Objectives: During root canal preparation, apical extrusion of debris can cause inflammation, flare-ups, and delayed healing. Therefore, instrumentation techniques that cause the least extrusion of debris are desirable. This study aimed to compare apical extrusion of debris by five single-file, full-sequence rotary and reciprocating systems. Materials and Methods: One hundred twenty human mandibular premolars with similar root lengths, apical diameters, and canal curvatures were selected and randomly assigned to six groups (n=20): Reciproc R25 (25, 0.08), WaveOne Primary (25, 0.08), OneShape (25, 0.06), F360 (25, 0.04), Neoniti A1 (25, 0.08), and ProTaper Universal. Instrumentation of the root canals was performed in accordance with the manufacturers’ instructions. Each tooth's debris was collected in a pre-weighed vial. After drying the debris in an incubator, the mass was measured three times consecutively; the mean was then calculated. The preparation time by each system was also measured. For data analysis, one-way ANOVA and Games-Howell post hoc test were used. Results: The mean masses (±standard deviation) of the apical debris were as follows: 2.071±1.38mg (ProTaper Universal), 1.702±1.306mg (Neoniti A1), 1.295±0.839mg (OneShape), 1.109±0.676mg (WaveOne), 0.976±0.478mg (Reciproc) and 0.797±0.531mg (F360). Compared to ProTaper Universal, F360 generated significantly less debris (P=0.02). The ProTaper system required the longest preparation time (mean=88.6 seconds); the Reciproc (P=0.008), OneShape (P=0.006), and F360 (P=0.001) required significantly less time (P<0.05). Conclusions: All instruments caused extrusion of debris through the apex. The F360 produced significantly less debris than did the ProTaper Universal. PMID:28243300

Comparison of Apical Extrusion of Debris by Using Single-File, Full-Sequence Rotary and Reciprocating Systems.

PubMed

Ehsani, Maryam; Farhang, Robab; Harandi, Azadeh; Tavanafar, Saeid; Raoof, Maryam; Galledar, Saeedeh

2016-11-01

During root canal preparation, apical extrusion of debris can cause inflammation, flare-ups, and delayed healing. Therefore, instrumentation techniques that cause the least extrusion of debris are desirable. This study aimed to compare apical extrusion of debris by five single-file, full-sequence rotary and reciprocating systems. One hundred twenty human mandibular premolars with similar root lengths, apical diameters, and canal curvatures were selected and randomly assigned to six groups (n=20): Reciproc R25 (25, 0.08), WaveOne Primary (25, 0.08), OneShape (25, 0.06), F360 (25, 0.04), Neoniti A1 (25, 0.08), and ProTaper Universal. Instrumentation of the root canals was performed in accordance with the manufacturers' instructions. Each tooth's debris was collected in a pre-weighed vial. After drying the debris in an incubator, the mass was measured three times consecutively; the mean was then calculated. The preparation time by each system was also measured. For data analysis, one-way ANOVA and Games-Howell post hoc test were used. The mean masses (±standard deviation) of the apical debris were as follows: 2.071±1.38mg (ProTaper Universal), 1.702±1.306mg (Neoniti A1), 1.295±0.839mg (OneShape), 1.109±0.676mg (WaveOne), 0.976±0.478mg (Reciproc) and 0.797±0.531mg (F360). Compared to ProTaper Universal, F360 generated significantly less debris (P=0.02). The ProTaper system required the longest preparation time (mean=88.6 seconds); the Reciproc (P=0.008), OneShape (P=0.006), and F360 (P=0.001) required significantly less time (P<0.05). All instruments caused extrusion of debris through the apex. The F360 produced significantly less debris than did the ProTaper Universal.

[Research on cleaning rate of the C-shaped canal treated by manual or rotary endodontic file combined with ultrasonic rinsing].

PubMed

Wang, Jing; Gao, Yan; Wang, Qing-shan; Zhang, Yan; Rong, Li; Wang, Jiu

2014-08-01

To evaluate the cleaning effect of the C-shaped canal treated by manual K file and ProTaper rotary endodontic file combined with ultrasonic cleaning, and find a better cleaning program for the C-shaped root canal. Fifty mandibular second molars were randomly divided into 5 groups: K file group, K file+ultrasonic rinsing group, ProTaper group, ProTaper+ultrasonic rinsing group and the control group. After initial shaping and cleaning, the mandibular second molars were soaked in formalin and stained. Under microscopy, the cleaning rate of necrotic tissue and cutting area were observed and analyzed. The data was processed with SPSS 17.0 software package. The cleaning rates of the treated groups were significantly higher than that of the control group (P<0.05); In each treatment group, the cleaning rate of the apex was significantly lower than that of the crown and central part (P<0.05); The cutting score of ProTaper+ultrasonic cleaning group was lower than that of the other treatment groups; The cutting score of the K file+ultrasonic rinsing group was significantly lower than that of the K file group (P<0.05); The cutting score and cleaning rate were negatively correlated (r=-0.712, P=0.000 ), the linear regression was the cleaning rate =98.325-4.325 × wall cutting score (R=0.454, P<0.05). In the process of shaping and cleaning of C-shaped canal, it is recommended that the ProTaper nickel-titanium rotary endodontic file should be chosen to clean the top of the taproot pipe and combined with ultrasonic rinsing to achieve better results.

Histological changes induced by CO2 laser microprobe specially designed for root canal sterilization: in vivo study.

PubMed

Kesler, G; Koren, R; Kesler, A; Hay, N; Gal, R

1998-10-01

Until now, no suitable delivery fiber has existed for CO2 laser endodontic radiation in the apical region, where it is most difficult to eliminate the pulp tissue using conventional methods. To overcome this problem, we have designed a microprobe that reaches closer to the apex, distributing the energy density to a smaller area of the root canal and thus favorably increasing the thermal effects. A CO2 laser microprobe coupled onto a special hand piece was attached to the delivery fiber of a Sharplan 15-F CO2 laser. The study was conducted on 30 vital maxillary or mandibulary, central, lateral, or premolar teeth destined for extraction due to periodontal problems. Twenty were experimentally treated with pulsed CO2 laser delivered by this newly developed fiber after conventional root canal preparation. Temperature measured at three points on the root surface during laser treatment did not exceed 38 degrees C. Ten teeth represented the control group, in which only root canal preparation was performed in the conventional method. Histological examination of the laser-treated teeth showed coagulation necrosis and vacuolization of the remaining pulp tissue in the root canal periphery. Primary and secondary dentin appeared normal in all cases treated with 15-F CO2 laser. Gram stain and bacteriologic examination revealed complete sterilization. These results demonstrate the unique capabilities of this special microprobe in sterilization of the root canal, with no thermal damage to the surrounding tissue. The combination of classical root canal preparation with CO2 laser irradiation using this special microprobe before closing the canal can drastically change the quality of root canal fillings.

Er:YAG laser: antimicrobial effects in the root canals of dogs' teeth with pulp necrosis and chronic periapical lesions.

PubMed

Leonardo, Mário R; Guillén-Carías, M G; Pécora, J D; Ito, I Y; Silva, L A B

2005-06-01

Our goal in this study was to evaluate the antimicrobial effect of Er:YAG laser applied after biomechanical preparation of the root canals of dog's teeth with apical periodontitis. Various in vitro studies have reported effective bacterial reduction in infected root canals using Er:YAG laser. However, there is no in vivo research to support these results. Forty root canals of dogs' premolar teeth with pulp necrosis and chronic periapical lesions were used. An initial microbiological sample was taken, and after biomechanical preparation was carried out, a second microbiological sample was taken. The teeth were divided into two groups: Group I-biomechanical preparation was taken of root canals without Er:YAG laser application; Group II-biomechanical preparation was taken of root canals with Er:YAG laser application using 140-mJ input, 63-mJ output/15 Hz. After coronal sealing, the root canals were left empty for 7 days at which time a third microbiological sample was taken. The collected material was removed from the root canal with a #40 K file and placed in transport media. It was serially diluted and seeded on culture dishes selective for anaerobes, aerobes, and total streptococci. Colony-forming units per milliliter (CFU/mL) were counted. Groups I and II showed an increase of CFU/mL for all microorganisms 7 days after treatment, being statistically significant for anaerobes in Group I and for anaerobes and total streptococci in Group II. When comparing CFU/mL of Groups I and II, there was a statistically significant increase after 7 d for total streptococci in Group II. Er:YAG laser applied after biomechanical preparation did not reduce microorganisms in the root canal system.

The effect of photodynamic therapy in root canal disinfection: a systematic review.

PubMed

Chrepa, Vanessa; Kotsakis, Georgios A; Pagonis, Tom C; Hargreaves, Kenneth M

2014-07-01

Effective root canal disinfection is a fundamental component of successful root canal treatment. Photodynamic therapy (PDT) has been proposed as a new adjunctive method for additional disinfection of the root canal system with the possibility of improved treatment outcomes. The aim of this systematic review was to investigate the effect of PDT on bacterial load reduction during root canal disinfection. Two reviewers independently conducted a comprehensive literature search using a combination of medical subject heading terms and key words to identify studies relevant to the Population Intervention Control Outcome question. The selection of articles for inclusion was performed in 2 phases based on predetermined eligibility criteria according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Inter-reviewer agreement for each phase was recorded. The effect of PDT on bacterial load reduction during root canal disinfection was evaluated as the primary outcome variable during data extraction. The literature search provided 57 titles and abstracts. Three articles met the inclusion criteria and were selected for this systematic review. The reasons for study exclusion in each phase were recorded. Because of the heterogeneity in clinical indications and PDT protocols among the included studies, a meta-analysis could not be performed. All included studies showed a positive effect of PDT in the reduction of microbial load in root canal treatment ranging from 91.3%-100%. Limited clinical information is currently available on the use of PDT in root canal disinfection. If supported by future clinical research, PDT may have efficacy for additional root canal disinfection, especially in the presence of multi-drug-resistant bacteria. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Efficacy of laser-driven irrigation versus ultrasonic in removing an airlock from the apical third of a narrow root canal.

PubMed

Peeters, Harry Huiz; Gutknecht, Norbert

2014-08-01

The purpose of the study was to test the hypothesis that air entrapment occurs in the apical third of a root canal during irrigation. A second objective was to test the null hypothesis that there is no difference between laser-driven irrigation (an erbium, chromium:yttrium-scandium-gallium-garnet laser) and passive ultrasonic irrigation in removing an airlock from the apical third. One hundred twenty extracted human teeth with single narrow root canals were randomised into two experimental groups (n = 40) and two control groups (n = 20). The specimens were shaped using hand instruments up to a size 30/0.02 file. The teeth were irrigated with a mixture of saline, radiopaque contrast and ink in solution. In the passive ultrasonic irrigation group, the irrigant was activated with an ultrasonic device for 60 s. In the laser group, the irrigant was activated with a laser for 60 s. It was concluded that if the insertion of irrigation needle is shorter than the working length, air entrapment may develop in the apical third, but the use of laser-driven irrigation is completely effective in removing it. © 2013 The Authors. Australian Endodontic Journal © 2013 Australian Society of Endodontology.

An Investigation of Current Endodontic Practice in Turkey

PubMed Central

Kaptan, R. F.; Haznedaroglu, F.; Kayahan, M. B.; Basturk, F. B.

2012-01-01

Objectives. The aim of this study was to gather information about the quality and quantity of root canal treatments carried out by general dental practitioners in Turkey. Methods. Questionnaires were given to 1400 dentists who attended the 16th National Congress organized by the Turkish Dental Association. The participants were asked to answer 34 multiple-choice questions. The questions were subdivided into 3 main topics; general information; general approach to endodontic treatment; and cleaning, shaping, and obturation of root canals. The statistical analysis was carried out by an χ 2-test to compare the means at a significance level of P < 0.05. Results. The response rate for this study was 43%. There was a wide variation in the number of root canal treatments completed per month. Nearly 92% of practitioners stated that they never used rubber dam. The most commonly used working length determination technique was radiographic evaluation (P < 0.05). Sodium hypochlorite was the irrigant of choice with varying concentrations and AH Plus was the sealer of choice (P < 0.05). Resin composite was the most frequently used material for final restorations. Conclusions. Endodontic procedures in general practice in Turkey have differences from widely acknowledged quality guidelines. Despite the introduction of new instruments and techniques, most of the general practitioners chose conventional methods. PMID:23251103

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

PubMed

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

2018-01-21

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

An optimized video system for augmented reality in endodontics: a feasibility study.

PubMed

Bruellmann, D D; Tjaden, H; Schwanecke, U; Barth, P

2013-03-01

We propose an augmented reality system for the reliable detection of root canals in video sequences based on a k-nearest neighbor color classification and introduce a simple geometric criterion for teeth. The new software was implemented using C++, Qt, and the image processing library OpenCV. Teeth are detected in video images to restrict the segmentation of the root canal orifices by using a k-nearest neighbor algorithm. The location of the root canal orifices were determined using Euclidean distance-based image segmentation. A set of 126 human teeth with known and verified locations of the root canal orifices was used for evaluation. The software detects root canals orifices for automatic classification of the teeth in video images and stores location and size of the found structures. Overall 287 of 305 root canals were correctly detected. The overall sensitivity was about 94 %. Classification accuracy for molars ranged from 65.0 to 81.2 % and from 85.7 to 96.7 % for premolars. The realized software shows that observations made in anatomical studies can be exploited to automate real-time detection of root canal orifices and tooth classification with a software system. Automatic storage of location, size, and orientation of the found structures with this software can be used for future anatomical studies. Thus, statistical tables with canal locations will be derived, which can improve anatomical knowledge of the teeth to alleviate root canal detection in the future. For this purpose the software is freely available at: http://www.dental-imaging.zahnmedizin.uni-mainz.de/.

Prevalence of Three-Rooted Mandibular First Molars among Indians Using SCT

PubMed Central

Garg, Amit Kumar; Tewari, Rajendra Kumar; Agrawal, Neha

2013-01-01

Undetected extra roots or root canals are a major reason for failure of endodontic treatment. Failure to recognize an extra distolingual (DL) root in mandibular first molar may lead to incomplete debridement of the root canal system and eventually treatment failure. Therefore, it is crucial that atypical anatomy is identified before and during dental treatment. Spiral computed tomography (SCT) images can show 3D images, and therefore much detail can be used when traditional methods prevent adequate endodontic treatment. The overall incidence of DL roots on the mandibular first molars was 6.40% for all patients and 5.00% for all teeth, respectively. The occurrence of DL roots on the right side and on the left side showed a statistically significant difference. The bilateral incidence of symmetrical distribution of DL roots was 56.25%. The DL root canal orifice was separated from DB canal orifice by 2.79 ± 0.34 mm, from the MB canal orifice by 4.23 ± 0.81 mm, and from the ML canal orifice by 3.29 ± 0.52 mm. The high prevalence of the DL root in permanent mandibular first molars among the Indian population by using SCT and estimations of the interorifice distance of such teeth might be useful for successful endodontic treatments. PMID:23840212

Morphology of Mesiobuccal Root Canals of Maxillary First Molars: a comparison of CBCT scanning and Cross-sectioning.

PubMed

Lyra, Carina Maria; Delai, Débora; Pereira, Keila Cristina Rausch; Pereira, Guy Martins; Pasternak Júnior, Bráulio; Oliveira, César Augusto Pereira

2015-10-01

The aim of this study was to evaluate the mesiobuccal root of maxillary first molars, according to the root canal configuration, prevalence and location of isthmuses at 3 and 6 mm from the apex, comparing cone-beam computed tomography (CBCT) analysis and cross sectioning of roots by thirds. Images of the mesiobuccal root of 100 maxillary first molars were acquired by CBCT and then roots were cross-sectioned into two parts, starting at 3 mm from the apex. Data were recorded and analyzed according to Weine's classification for root canal configuration, and Hsu and Kim's classification for isthmuses. In the analysis of CBCT images, 8 root canals were classified as type I, 57 as type II, 35 as type III. In the cross-sectioning technique, 19 root canals were classified as type I, 60 as type II, 20 as type III and 1 as type IV. The classification of isthmuses was predominantly type I in both CBCT and cross-sectioning evaluations for sections at 3 mm from the apex, while for sections at 6 mm from the apex, the classification of isthmuses was predominantly types V and II in CBCT and cross-sectioning evaluations, respectively. The cross-sectioning technique showed better results in detection of the internal morphology of root canals than CBCT scanning.

Comparative evaluation of canal isthmus debridement efficacy of modified EndoVac technique with different irrigation systems.

PubMed

Thomas, Anchu Rachel; Velmurugan, Natanasabapathy; Smita, Surendran; Jothilatha, Sundaramurthy

2014-10-01

The purpose of this study was to evaluate the canal isthmus debridement efficacy of a new modified EndoVac (Discus Dental, Culver City, CA) irrigation protocol in comparison with EndoVac, passive ultrasonic irrigation (PUI), and conventional needle irrigation in mesial roots of mandibular molars. The mesial roots of 64 extracted mandibular molars mounted in resin using Kuttler's endodontic cube, sectioned at 2 and 4 mm from the working length, were randomly divided into 4 groups (n = 16): group 1: Max-I-Probe (Dentsply Tulsa Dental, York, PA), group 2: EndoVac (EVI), group 3: modified EndoVac, and group 4: PUI. The specimens were reassembled and instrumented. A standard irrigation protocol was used during cleaning and shaping and final irrigation with the 4 irrigation/agitation techniques. Images of the isthmus region were taken before and after cleaning and shaping and after final irrigation. The percentage reduction of debris in the isthmus region was calculated by using the software program Image J (v1.43; National Institutes of Health, Bethesda, MD). Intergroup analysis was performed using the Kruskal Wallis and Mann-Whitney U tests. Intragroup analysis was performed using Friedman and Wilcoxon signed rank tests. The level of significance was set at P < .05. Intragroup analysis revealed a statistically significant difference in the percentage reduction of debris after cleaning and shaping and after final irrigation protocol in all the groups (P < .001). The final irrigation protocol produced significantly cleaner canal isthmuses in all the groups (P < .001). On intergroup analysis, the modified EVI group performed significantly better than the other groups. The EVI and PUI groups performed better than the Max-I-Probe group. There was no statistical significance between the EVI and PUI groups. Canal isthmuses were significantly cleaner with the modified EndoVac irrigation technique when compared with the cleanliness seen with the other irrigation systems. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Dentin moisture conditions affect the adhesion of root canal sealers.

PubMed

Nagas, Emre; Uyanik, M Ozgur; Eymirli, Ayhan; Cehreli, Zafer C; Vallittu, Pekka K; Lassila, Lippo V J; Durmaz, Veli

2012-02-01

The purpose of this study was to evaluate the effects of intraradicular moisture conditions on the push-out bond strength of root canal sealers. Eighty root canals were prepared using rotary instruments and, thereafter, were assigned to 4 groups with respect to the moisture condition tested: (1) ethanol (dry): excess distilled water was removed with paper points followed by dehydration with 95% ethanol, (2) paper points: the canals were blot dried with paper points with the last one appearing dry, (3) moist: the canals were dried with low vacuum by using a Luer adapter for 5 seconds followed by 1 paper point for 1 second, and (4) wet: the canals remained totally flooded. The roots were further divided into 4 subgroups according to the sealer used: (1) AH Plus (Dentsply-Tulsa Dental, Tulsa, OK), (2) iRoot SP (Innovative BioCeramix Inc, Vancouver, Canada), (3) MTA Fillapex (Angelus Indústria de Produtos Odontológicos S/A, Londrina, Brasil), and (4) Epiphany (Pentron Clinical Technologies, Wallingford, CT). Five 1-mm-thick slices were obtained from each root sample (n = 25 slices/group). Bond strengths of the test materials to root canal dentin were measured using a push-out test setup at a cross-head speed of 1 mm/min. The data were analyzed statistically by two-way analysis of variance and Tukey tests at P = .05. Irrespective of the moisture conditions, iRoot SP displayed the highest bond strength to root dentin. Statistical ranking of bond strength values was as follows: iRoot SP > AH Plus > Epiphany ≥ MTA Fillapex. The sealers displayed their highest and lowest bond strengths under moist (3) and wet (4) conditions, respectively. The degree of residual moisture significantly affects the adhesion of root canal sealers to radicular dentin. For the tested sealers, it may be advantageous to leave canals slightly moist before filling. Copyright © 2012 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Microbiological assessment of root canals following use of rotary and manual instruments in primary molars.

PubMed

Subramaniam, Priya; Tabrez, T A; Babu, K L Girish

2013-01-01

To assess the microflora of root canals in primary molars following use of rotary NiTi files and conventional hand NiTi and stainless steel files. This randomized clinical trial consisted of a total of 60 first and second primary molars requiring root canal treatment, who were selected from children aged 5-9 years. Based on type of root canal instrumentation, the teeth were randomly assigned to three groups of twenty teeth each; Group A: Rotary NiTi files, Group B: Hand NiTi files and Group C: Hand stainless steel files. Following administration of local anesthesia, isolation with rubber dam was carried out. For the purpose of instrumentation and sampling, the palatal canal of maxillary molars and the distal canal of mandibular molars were selected. Prior to sampling, the orifices of other canals in these teeth were sealed, so as to prevent any contamination. Instrumentation was carried out in each group using respective instruments along with intermittent saline irrigation. Root canal samples were obtained both before and after instrumentation, using sterile absorbent paper points and transferred to a sterile vial with transport fluid. Serial dilutions were prepared and cultured on suitable agar media. Both aerobic and anaerobic microbial counts were made. Data obtained was subjected to statistical analysis using Wilcoxon signed rank test and one-way Analysis of variance. In all three groups, there was a significant reduction in both aerobic and anaerobic mean microbial count following root canal instrumentation. (p < 0.001). Rotary NiTi files were as efficient as conventional hand instruments in significantly reducing the root canal microflora.

Effects of metal- and fiber-reinforced composite root canal posts on flexural properties.

PubMed

Kim, Su-Hyeon; Oh, Tack-Oon; Kim, Ju-Young; Park, Chun-Woong; Baek, Seung-Ho; Park, Eun-Seok

2016-01-01

The aim of this study was to observe the effects of different test conditions on the flexural properties of root canal post. Metal- and fiber-reinforced composite root canal posts of various diameters were measured to determine flexural properties using a threepoint bending test at different conditions. In this study, the span length/post diameter ratio of root canal posts varied from 3.0 to 10.0. Multiple regression models for maximum load as a dependent variable were statistically significant. The models for flexural properties as dependent variables were statistically significant, but linear regression models could not be fitted to data sets. At a low span length/post diameter ratio, the flexural properties were distorted by occurrence of shear stress in short samples. It was impossible to obtain high span length/post diameter ratio with root canal posts. The addition of parameters or coefficients is necessary to appropriately represent the flexural properties of root canal posts.

[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.

Semiconductor laser irradiation improves root canal sealing during routine root canal therapy

PubMed Central

Hu, Xingxue; Wang, Dashan; Cui, Ting; Yao, Ruyong

2017-01-01

Objective To evaluate the effect of semiconductor laser irradiation on root canal sealing after routine root canal therapy (RCT). Methods Sixty freshly extracted single-rooted human teeth were randomly divided into six groups (n = 10). The anatomic crowns were sectioned at the cementoenamel junction and the remaining roots were prepared endodontically with conventional RCT methods. Groups A and B were irradiated with semiconductor laser at 1W for 20 seconds; Groups C and D were ultrasonically rinsed for 60 seconds as positive control groups; Groups E and F without treatment of root canal prior to RCT as negative control groups. Root canal sealing of Groups A, C and E were evaluated by measurements of apical microleakage. The teeth from Groups B, D and F were sectioned, and the micro-structures were examined with scanning electron microscopy (SEM). One way ANOVA and LSD-t test were used for statistical analysis (α = .05). Results The apical sealing of both the laser irradiated group and the ultrasonic irrigated group were significantly different from the control group (p<0.5). There was no significant difference between the laser irradiated group and the ultrasonic irrigated group (p>0.5). SEM observation showed that most of the dentinal tubules in the laser irradiation group melted, narrowed or closed, while most of the dentinal tubules in the ultrasonic irrigation group were filled with tooth paste. Conclusion The application of semiconductor laser prior to root canal obturation increases the apical sealing of the roots treated. PMID:28957407

The ability of Reciproc instruments to reach full working length without glide path preparation: a clinical retrospective study.

PubMed

Bartols, Andreas; Robra, Bernt-Peter; Walther, Winfried

2017-01-01

Reciproc instruments are the only contemporary root canal instruments where glide path preparation is no longer strictly demanded by the manufacturer. As the complete preparation of root canals is associated with success in endodontic treatment we wanted to assess the ability and find predictors for Reciproc instruments to reach full working length (RFWL) in root canals of maxillary molars in primary root canal treatment (1°RCTx) and retreatment (2°RCTx) cases. This retrospective study evaluated 255 endodontic treatment cases of maxillary molars. 180 were 1°RCTx and 75 2°RCTx. All root canals were prepared with Reciproc instruments. The groups were compared and in a binary logistic regression model predictors for RFWL were evaluated. A total of 926 root canals were treated with Reciproc without glide path preparation. This was possible in 885 canals (95.6%). In 1°RCTx cases 625 of 649 (96.3%) canals were RFWL and in 2°RCTx cases 260 of 277 (93.9%). In second and third mesiobuccal canals (MB2/3) 90 out of 101 (89.1%) were RFWL with Reciproc in 1°RCTx and in the 2°RCTx treatment group 49 out of 51 cases (96.1%). In mesio-buccal (MB1) canals "2°RCTx" was identified as negative predictor for RFWL (OR 0.24 (CI [0.08-0.77])). In MB2/3 canals full working length was reached less often (OR 0.04 (CI [0.01-0.31])) if the tooth was constricted and more often if MB2/3 and MB1 canals were convergent (OR 4.60 (CI [1.07-19.61])). Using Reciproc instruments, the vast majority of root canals in primary treatment and retreatment cases can be prepared without glide path preparation.

Effects of NiTi rotary and reciprocating instruments on debris and smear layer scores: an SEM evaluation.

PubMed

Poggio, Claudio; Dagna, Alberto; Chiesa, Marco; Scribante, Andrea; Beltrami, Riccardo; Colombo, Marco

2014-12-30

The purpose of the present study was to investigate the cleaning efficacy of 2 different nickel-titanium (NiTi) rotary systems: a new single system Reciproc compared with the rotary full sequence Mtwo. The amount of debris and the morphology of smear layer were the parameters for the evaluation of the cleanliness of root canals. The null hypothesis of the study was that there would be no significant difference in debris scores and smear layer scores between the 2 systems. 
 Forty single-rooted freshly extracted teeth were selected and divided into 2 groups. For each group, all root canals were shaped with 2 different NiTi instruments (Mtwo and Reciproc) and irrigated with 5.25% NaOCl and 17% ethylenediaminetetraacetic acid (EDTA) solutions by 3 trained operators. Specimens were fractured longitudinally and prepared for scanning electron microscopy (SEM) analysis at a standard magnification of ×5,000. The presence/absence of smear layer and the presence/absence of debris at the coronal, middle and apical third of each canal were evaluated using two 5-step scales for scores. Numeric data were analyzed using the Kruskal-Wallis and Mann-Whitney U statistical tests, and significance was set at a P value <0.05. 
 This study revealed significant differences among the various groups. The Mtwo group presented significantly lower smear layer scores than the Reciproc group (P<0.01) in the middle and apical third of the canal. 
 Conventional continuous rotary NiTi instruments associated with 5.25% NaOCl and 17% EDTA solutions seem to be better for obtaining clean dentinal canal walls. Reciprocating instruments leave a higher quantity of smear layer which covers dentinal walls and dentinal tubules.

ANTIMICROBIAL ACTIVITY OF SODIUM HYPOCHLORITE ASSOCIATED WITH INTRACANAL MEDICATION FOR Candida albicans AND Enterococcus faecalis INOCULATED IN ROOT CANALS

PubMed Central

Valera, Marcia Carneiro; da Silva, Katy Costa Godinho; Maekawa, Lilian Eiko; Carvalho, Cláudio Antonio Talge; Koga-Ito, Cristiane Yumi; Camargo, Carlos Henrique Ribeiro; Silva e Lima, Raphael

2009-01-01

Objective: The purpose of this study was to evaluate the action of sodium hypochlorite (NaOCl) associated with an intracanal medication against Candida albicans and Enterococcus faecalis inoculated in root canals. Material and Methods: Thirty-six human single-rooted teeth with single root canals were used. The canals were contaminated with C. albicans and E. faecalis for 21 days and were then instrumented with 1% NaOCl. The roots were divided into 3 groups (n=12) according to the intracanal medication applied: calcium hydroxide paste, 2% chlorhexidine (CHX) gel, and 2% CHX gel associated with calcium hydroxide. The following collections were made from the root canals: a) initial sample (IS): 21 days after contamination (control), b) S1: after instrumentation, c) S2: 14 days after intracanal medication placement; S3: 7 days after intracanal medication removal. The results were analyzed statistically by the Kruskal-Wallis test at 5% significance level. Results and Conclusions: Both 1% NaOCl irrigation and the intracanal medications were effective in eliminating E. faecalis and C. albicans inoculated in root canals. PMID:20027425

Antimicrobial activity of sodium hypochlorite associated with intracanal medication for Candida albicans and Enterococcus faecalis inoculated in root canals.

PubMed

Valera, Marcia Carneiro; Silva, Katy Costa Godinho da; Maekawa, Lilian Eiko; Carvalho, Cláudio Antonio Talge; Koga-Ito, Cristiane Yumi; Camargo, Carlos Henrique Ribeiro; Lima, Raphael Silva e

2009-01-01

The purpose of this study was to evaluate the action of sodium hypochlorite (NaOCl) associated with an intracanal medication against Candida albicans and Enterococcus faecalis inoculated in root canals. Thirty-six human single-rooted teeth with single root canals were used. The canals were contaminated with C. albicans and E. faecalis for 21 days and were then instrumented with 1% NaOCl. The roots were divided into 3 groups (n=12) according to the intracanal medication applied: calcium hydroxide paste, 2% chlorhexidine (CHX) gel, and 2% CHX gel associated with calcium hydroxide. The following collections were made from the root canals: a) initial sample (IS): 21 days after contamination (control), b) S1: after instrumentation, c) S2: 14 days after intracanal medication placement; S3: 7 days after intracanal medication removal. The results were analyzed statistically by the Kruskal-Wallis test at 5% significance level. Both 1% NaOCl irrigation and the intracanal medications were effective in eliminating E. faecalis and C. albicans inoculated in root canals.

A comparison of three rotary systems and hand instrumentation technique for the elimination of Enterococcus faecalis from the root canal.

PubMed

Gorduysus, Melahat; Nagas, Emre; Torun, Ozgur Yildirim; Gorduysus, Omer

2011-12-01

The aim of this study was to compare the in vitro reduction of a bacterial population in a root canal by mechanical instrumentation using three rotary systems and hand instrumentation technique. The root canals contaminated with a suspension of Enterococcus faecalis were instrumented using ProTaper, K3, HeroShaper and K-file hand instrumentation technique. Later the root canals were sampled. After serial dilutions, samples were incubated in culture media for 24 h. Bacterial colonies were counted and the results were given as number of colony-forming units per millilitre. The results showed that all the canal instrumentation systems reduced the number of bacterial cells in the root canals. Statistically, ProTaper instruments were more effective in reducing the number of bacteria than the other rotary files or hand instruments. © 2010 The Authors. Australian Endodontic Journal © 2010 Australian Society of Endodontology.

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.

Technical Quality of Root Canal Treatment Performed by Undergraduate Clinical Students of Isfahan Dental School.

PubMed

Saatchi, Masoud; Mohammadi, Golshan; Vali Sichani, Armita; Moshkforoush, Saba

2018-01-01

The aim of the present study was to evaluate the radiographic quality of RCTs performed by undergraduate clinical students of Dental School of Isfahan University of Medical Sciences. In this cross sectional study, records and periapical radiographs of 1200 root filled teeth were randomly selected from the records of patients who had received RCTs in Dental School of Isfahan University of Medical Sciences from 2013 to 2015. After excluding 416 records, the final sample consisted of 784 root-treated teeth (1674 root canals). Two variables including the length and the density of the root fillings were examined. Moreover, the presence of ledge, foramen perforation, root perforation and fractured instruments were also evaluated as procedural errors. Descriptive statistics were used for expressing the frequencies of criteria and chi square test was used for comparing tooth types, tooth locations and academic level of students ( P <0.05). The frequency of root canals with acceptable filling was 54.1%. Overfilling was found in 11% of root canals, underfilling in 8.3% and inadequate density in 34.6%. No significant difference was found between the frequency of acceptable root fillings in the maxilla and mandible ( P =0.072). More acceptable fillings were found in the root canals of premolars (61.3%) than molars (51.3%) ( P =0.001). The frequency of procedural errors was 18.6%. Ledge was found in 12.5% of root canals, foramen perforation in 2%, root perforation in 2.4% and fractured instrument in 2%. Procedural errors were more frequent in the root canals of molars (22.5%) than the anterior teeth (12.3%) ( P =0.003) and the premolars (9.5%) ( P <0.001). Technical quality of RCTs performed by clinical students was not satisfactory and incidence of procedural errors was considerable.

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

PubMed Central

2018-01-01

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

Clinical features and endodontic treatment of two-rooted mandibular canines: report of four cases.

PubMed

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

2014-01-01

Predictable endodontic treatment depends on the dentist's knowledge about root canal morphology and its possible anatomic variations. The majority of mandibular canines have one root and root canal, but 15% may have two canals and a smaller number may have two distinct roots. The following clinical reports describe endodontic treatment of mandibular canines with two roots and two root canals. OUTLINE OF CASES Four clinical case reports are presented to exemplify anatomical variation in the human mandibular canine. Detailed analysis of the preoperative radiographs and careful examination of the pulp chamber floor detected the presence of two root canal orifices in all canines. Working length was determined with an electronic apex locator and biomechanical preparation was carried out by using engine driven BioRaCe Ni-Ti rotary instruments in a crown-down manner, followed by copious irrigation with 1% sodium hypochlorite. Definitive obturation was performed using cold lateral condensation with gutta-percha cones and Top Seal paste. The treatment outcome was evaluated using postoperative radiographs. Endodontists should be aware of anatomical variations of the treated teeth, and should never presume that canal systems are simple.

A Review on Root Anatomy and Canal Configuration of the Maxillary Second Molars

PubMed Central

Ghasemi, Negin; Rahimi, Saeed; Shahi, Shahriar; Samiei, Mohammad; Frough Reyhani, Mohammad; Ranjkesh, Bahram

2017-01-01

Introduction: The complexity of the root canal system presents a challenge for the practitioner. This systematic review evaluated the papers published in the field of root canal anatomy and configuration of the root canal system in permanent maxillary second molars. Methods and Materials: All articles related to the root morphology and root canal anatomy of the permanent maxillary second molars were collected by suitable keywords from PubMed database. The exhaustive search included all publications from 1981 to December 2015. The articles relevant to the study were evaluated and data was extracted. The author/year of publication, country, number of the evaluated teeth, type of study (method of the evaluation), number of roots and the canals, type of canals and the morphology of the apical foramen was noted. Results: The highest studied populations were in Brazil and United States. A total of 116 related papers were found, which had investigated 11945 teeth in total. Across all the studied populations, the three-rooted anatomy was most common, while the four-rooted anatomy had the lowest prevalence. The presence of the second mesiobuccal canal ranged from 11.53 % to 93.7%, where type II (2-1) configuration was the predominant type in Brazil and USA and types II and III (1-2-1) in Chinese populations. In 8.8-44% of cases, fusion was observed. The main reported cases were related to palatal root. The major method of anatomical investigation in case reports was periapical radiography, and the chief method in morphological studies was CBCT. Conclusion: The clinicians should be aware of normal morphology and anatomic variations to reduce the treatment failure. PMID:28179915

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

Microorganism penetration in dentinal tubules of instrumented and retreated root canal walls. In vitro SEM study.

PubMed

Al-Nazhan, Saad; Al-Sulaiman, Alaa; Al-Rasheed, Fellwa; Alnajjar, Fatimah; Al-Abdulwahab, Bander; Al-Badah, Abdulhakeem

2014-11-01

This in vitro study aimed to investigate the ability of Candida albicans (C. albicans) and Enterococcus faecalis (E. faecalis) to penetrate dentinal tubules of instrumented and retreated root canal surface of split human teeth. Sixty intact extracted human single-rooted teeth were divided into 4 groups, negative control, positive control without canal instrumentation, instrumented, and retreated. Root canals in the instrumented group were enlarged with endodontic instruments, while root canals in the retreated group were enlarged, filled, and then removed the canal filling materials. The teeth were split longitudinally after canal preparation in 3 groups except the negative control group. The teeth were inoculated with both microorganisms separately and in combination. Teeth specimens were examined by scanning electron microscopy (SEM), and the depth of penetration into the dentinal tubules was assessed using the SMILE view software (JEOL Ltd). Penetration of C. albicans and E. faecalis into the dentinal tubules was observed in all 3 groups, although penetration was partially restricted by dentin debris of tubules in the instrumented group and remnants of canal filling materials in the retreated group. In all 3 groups, E. faecalis penetrated deeper into the dentinal tubules by way of cell division than C. albicans which built colonies and penetrated by means of hyphae. Microorganisms can easily penetrate dentinal tubules of root canals with different appearance based on the microorganism size and status of dentinal tubules.

Use of calcium-containing endodontic sealers as apical barrier in fluid-contaminated wide-open apices.

PubMed

Prati, Carlo; Siboni, Francesco; Polimeni, Antonella; Bossu, Maurizio; Gandolfi, Maria Giovanna

2014-12-30

The sealing of wide-open apex roots is still a challenge and requires the use of apical barrier techniques. The aim was to evaluate ex vivo the sealing and the apical morphology of 3 commercial calcium oxide (CaO)-containing sealers - namely, 2 zinc oxide-based (CRCS and Sealapex) and a calcium silicate MTA-based (TechBiosealer Endo) - placed in wet root canals with artificial wide-open apices.
 Thirty human single-rooted teeth were shaped with Protaper and an artificial open apex (diameter size 110) was created. Each root was inserted in a custom-designed support containing simulated body fluid (Hank's balanced salt solution, HBSS) at the bottom simulating the presence of periapical fluid in the canal. Each sealer (TechBiosealer Endo, CRCS, Sealapex) was compacted to the apical 5 mm and the filled roots stored in HBSS at 37°C. The sealing was evaluated as microinfiltrated fluid since 24 hours up to 6 months using a high-precision digital fluid flow meter. The sealers were also studied for setting time in HBSS, calcium releasing (statistical analysis by 2-way ANOVA followed by Student-Newman-Keuls test, P<0.05) and surface morpho-chemistry by ESEM-EDX and OM analysis.
 All sealers showed a stable seal. TechBiosealer Endo maintained a better seal than the other materials (P<0.05) and ESEM-EDX and OM analyses showed the presence of apatite deposits.
 The clinical use of hydraulic hydrophilic MTA-based sealers can be recommended to stop/reduce the fluid flow rate through the apex. The artificial apical barrier in wet wide apices is a suitable technique able to seal wet root canals.

Characteristic findings on panoramic radiography and cone-beam CT to predict paresthesia after extraction of impacted third molar.

PubMed

Harada, Nana; Beloor Vasudeva, Subash; Matsuda, Yukiko; Seki, Kenji; Kapila, Rishabh; Ishikawa, Noboru; Okano, Tomohiro; Sano, Tsukasa

2015-01-01

The purpose of this study was to compare findings on the relationship between impacted molar roots and the mandibular canal in panoramic and three-dimensional cone-beam CT (CBCT) images to identify those that indicated risk of postoperative paresthesia. The relationship between impacted molars and the mandibular canal was first classified using panoramic images. Only patients in whom the molar roots were either in contact with or superimposed on the canal were evaluated using CBCT. Of 466 patients examined using both panoramic and CBCT images, 280 underwent surgical extraction of an impacted molar, and 15 of these (5%) reported postoperative paresthesia. The spatial relationship between the impacted third molar root and the mandibular canal was determined by examining para-sagittal sections (lingual, buccal, inter-radicular, inferior, and combinations) obtained from the canal to the molar root and establishing the proximity of the canal to the molar root (in contact with or without loss of the cortical border and separate). The results revealed that darkening of the roots with interruption of the mandibular canal on panoramic radiographs and the inter-radicular position of the canal in CBCT images were characteristic findings indicative of risk of postoperative paresthesia. These results suggest that careful surgical intervention is required in patients with the above characteristics.

Evaluation of canal transportation after preparation with Reciproc single-file systems with or without glide path files.

PubMed

Aydin, Ugur; Karataslioglu, Emrah

2017-01-01

Canal transportation is a common sequel caused by rotary instruments. The purpose of the present study is to evaluate the degree of transportation after the use of Reciproc single-file instruments with or without glide path files. Thirty resin blocks with L-shaped canals were divided into three groups ( n = 10). Group 1 - canals were prepared with Reciproc-25 file. Group 2 - glide path file-G1 was used before Reciproc. Group 3 - glide path files-G1 and G2 were used before Reciproc. Pre- and post-instrumentation images were superimposed under microscope, and resin removed from the inner and outer surfaces of the root canal was calculated throughout 10 points. Statistical analysis was performed with Kruskal-Wallis test and post hoc Dunn test. For coronal and middle one-thirds, there was no significant difference among groups ( P > 0.05). For apical section, transportation of Group 1 was significantly higher than other groups ( P < 0.05). Using glide path files before Reciproc single-file system reduced the degree of apical canal transportation.

Exploiting the potential of free software to evaluate root canal biomechanical preparation outcomes through micro-CT images.

PubMed

Neves, A A; Silva, E J; Roter, J M; Belladona, F G; Alves, H D; Lopes, R T; Paciornik, S; De-Deus, G A

2015-11-01

To propose an automated image processing routine based on free software to quantify root canal preparation outcomes in pairs of sound and instrumented roots after micro-CT scanning procedures. Seven mesial roots of human mandibular molars with different canal configuration systems were studied: (i) Vertucci's type 1, (ii) Vertucci's type 2, (iii) two individual canals, (iv) Vertucci's type 6, canals (v) with and (vi) without debris, and (vii) canal with visible pulp calcification. All teeth were instrumented with the BioRaCe system and scanned in a Skyscan 1173 micro-CT before and after canal preparation. After reconstruction, the instrumented stack of images (IS) was registered against the preoperative sound stack of images (SS). Image processing included contrast equalization and noise filtering. Sound canal volumes were obtained by a minimum threshold. For the IS, a fixed conservative threshold was chosen as the best compromise between instrumented canal and dentine whilst avoiding debris, resulting in instrumented canal plus empty spaces. Arithmetic and logical operations between sound and instrumented stacks were used to identify debris. Noninstrumented dentine was calculated using a minimum threshold in the IS and subtracting from the SS and total debris. Removed dentine volume was obtained by subtracting SS from IS. Quantitative data on total debris present in the root canal space after instrumentation, noninstrumented areas and removed dentine volume were obtained for each test case, as well as three-dimensional volume renderings. After standardization of acquisition, reconstruction and image processing micro-CT images, a quantitative approach for calculation of root canal biomechanical outcomes was achieved using free software. © 2014 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Irrigation in endodontic treatment.

PubMed

Basrani, Bettina

2011-01-01

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

[Upper lateral incisor with 2 canals].

PubMed

Fabra Campos, H

1991-01-01

Clinical case summary of the patient with an upper lateral incisor with two root canals. The suspicion that there might be an anatomic anomaly in the root that includes a complex root canal system was made when an advanced radicular groove was detected in the lingual surface or an excessively enlarged cingulum.

21 CFR 872.3820 - Root canal filling resin.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Root canal filling resin. 872.3820 Section 872.3820 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3820 Root canal filling resin. (a) Identification...

Role of the confinement of a root canal on jet impingement during endodontic irrigation

NASA Astrophysics Data System (ADS)

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

2012-12-01

During a root canal treatment the root canal is irrigated with an antimicrobial fluid, commonly performed with a needle and a syringe. Irrigation of a root canal with two different types of needles can be modeled as an impinging axisymmetric or non-axisymmetric jet. These jets are investigated experimentally with high-speed Particle Imaging Velocimetry, inside and outside the confinement (concave surface) of a root canal, and compared to theoretical predictions for these jets. The efficacy of irrigation fluid refreshment with respect to the typical reaction time of the antimicrobial fluid with a biofilm is characterized with a non-dimensional Damköhler number. The pressure that these jets induce on a wall or at the apex of the root canal is also measured. The axisymmetric jet is found to be stable and its velocity agrees with the theoretical prediction for this type of jet, however, a confinement causes instabilities to the jet. The confinement of the root canal has a pronounced influence on the flow, for both the axisymmetric and non-axisymmetric jet, by reducing the velocities by one order of magnitude and increasing the pressure at the apex. The non-axisymmetric jet inside the confinement shows a cascade of eddies with decreasing velocities, which at the apex does not provide adequate irrigation fluid refreshment.

A method for retrieving endodontic or atypical nonendodontic separated instruments from the root canal: a report of two cases.

PubMed

Monteiro, Jardel Camilo do Carmo; Kuga, Milton Carlos; Dantas, Andrea Abi Rached; Jordão-Basso, Keren Cristina Fagundes; Keine, Katia Cristina; Ruchaya, Prashant Jay; Faria, Gisele; Leonardo, Renato de Toledo

2014-11-01

This clinical report presents a new method for retrieving separated instruments from the root canal with minimally invasive procedures. The presence of separated instrument in root canal may interfere in the endodontic treatment prognosis. There are several recommended methods to retrieve separated instruments, but some are difficult in clinically practice. This study describes two cases of separated instrument removal from the root canal using a stainless-steel prepared needle associated with a K-file. Case 1 presented a fractured gutta-percha condenser within the mandibular second premolar, it was separated during incorrect intracanal medication calcium hydroxide placement. Case 2 had a fractured sewing needle within the upper central incisor that the patient used to remove food debris from the root canal. After cervical preparation, the fractured instruments were fitted inside a prepared needle and then an endodontic instrument (#25 K-file) was adapted with clockwise turning motion between the needle inner wall and the fragment. The endodontic or atypical nonendodontic separated instrument may be easily pull on of the root canal using a single and low cost device. The methods for retrieving separated instruments from root canal are difficult and destructive procedures. The present case describes a simple method to solve this problem.

Effect of Reciprocating Systems and Working Lengths on Apical Microcrack Development: a micro-CT Study.

PubMed

Oliveira, Bruna Paloma de; Câmara, Andréa Cruz; Duarte, Daniel Amancio; Heck, Richard John; Antonino, Antonio Celso Dantas; Aguiar, Carlos Menezes

2017-01-01

The objective of this study was to evaluate the effect of root canal preparation with single-file reciprocating systems at different working lengths on the development of apical microcracks using micro-computed tomographic (micro-CT) imaging. Forty extracted human mandibular incisors were randomly assigned to 4 groups (n=10) according to the systems and working length used to prepare the root canals: Group A - WaveOne Gold at apical foramen (AF), Group B - WaveOne Gold 1 mm short of the AF (AF-1 mm), Group C - Unicone (AF) and Group D - Unicone (AF-1 mm). Micro-CT scanning was performed before and after root canal preparation at an isotropic resolution of 14 µm. Then, three examiners assessed the cross-sectional images generated to detect microcracks in the apical portion of the roots. Apical microcracks were visualized in 3, 1, 1, and 3 specimens in groups A, B, C, and D, respectively. All these microcracks observed after root canal preparation already existed prior to instrumentation, and no new apical microcrack was detected. For all groups, the number of slices presenting microcracks after root canal preparation was the same as before canal preparation. Root canal preparation with WaveOne Gold and Unicone, regardless of the working length, was not associated with apical microcrack formation.

Preparation Prerequisites for Effective Irrigation of Apical Root Canal: A Critical Review.

PubMed

Tziafas, Dimitrios; Alraeesi, Dana; Al Hormoodi, Reem; Ataya, Maamoun; Fezai, Hessa; Aga, Nausheen

2017-10-01

It is well recognized that disinfection of the complex root canal system at the apical root canal remains the most critical therapeutic measure to treat apical periodontitis. Observational and experimental data in relation to the anatomy of the apical root canal in different tooth types and the cross sectional diameters of the apical part of the most commonly used hand and rotary files are critically reviewed. The present data analysis confirm that the challenging issue of antibacterial efficacy of modern preparation protocols in non-surgical endodontics requires more attention to apical root canal irrigation as a balance between safety and effectiveness. Ex vivo investigations clearly indicate that a specific design of the chemo-mechanical preparation is needed at the onset of RCT, more particularly in infected teeth. Design should be based on specific anatomical parameters, and must determine the appropriate size and taper of preparation as pre-requirements for effective and safe apical irrigation. The optimal irrigation protocols might be designed on the basis of technical specifications of the preparations procedures, such as the penetration depth, the type of the needle, the required time for continuous irrigant flow, the concentration of NaOCl, and the activation parameters. Key words: Endodontics, root canal treatment, instrumentation, irrigation, apical root canal.

In vitro comparative study of manual and mechanical rotary instrumentation of root canals using computed tomography.

PubMed

Limongi, Orlando; de Albuquerque, Diana Santana; Baratto Filho, Flares; Vanni, José Roberto; de Oliveira, Elias P Motcy; Barletta, Fernando Branco

2007-01-01

This in vitro study compared, using computed tomography (CT), the amount of dentin removed from root canal walls by manual and mechanical rotary instrumentation techniques. Forty mandibular incisors with dental crown and a single canal were selected. The teeth were randomly assigned to two groups, according to the technique used for root canal preparation: Group I - manual instrumentation with stainless steel files; Group II - mechanical instrumentation with RaCe rotary nickel-titanium instruments. In each tooth, root dentin thickness of the buccal, lingual, mesial and distal surfaces in the apical, middle and cervical thirds of the canal was measured (in mm) using a multislice CT scanner (Siemens Emotion, Duo). Data were stored in the SPSS v. 11.5 and SigmaPlot 2001 v. 7.101 softwares. After crown opening, working length was determined, root canals were instrumented and new CT scans were taken for assessment of root dentin thickness. Pre- and post-instrumentation data were compared and analyzed statistically by ANOVA and Tukey's post-hoc test for significant differences (p=0.05). Based on the findings of this study, it may be concluded that regarding dentin removal from root canal walls during instrumentation, neither of the techniques can be considered more effective than the other.

Cone-beam Computed Tomographic Study of Root Anatomy and Canal Configuration of Molars in a Spanish Population.

PubMed

Pérez-Heredia, Mercedes; Ferrer-Luque, Carmen María; Bravo, Manuel; Castelo-Baz, Pablo; Ruíz-Piñón, Manuel; Baca, Pilar

2017-09-01

The aim of this study was to identify morphologic peculiarities of roots and analyze the root canal configuration in maxillary and mandibular first and second molars by means using cone-beam computed tomographic (CBCT) imaging in a Spanish population. A total of 284 maxillary molars and 242 mandibular molars from 112 patients were examined in vivo by CBCT imaging; only untreated molars with healthy and fully matured apices were included in this study. Details regarding the number of roots, number of canals, and root canal configuration were recorded. Maxillary first and second molars had 3 roots in 97.2% and 79%, respectively. In mandibular molars, the frequency of 2 roots was 94% in first molars and 83% in second molars. The canal configuration of the palatal root was 100% Vertucci type I (1-1) in first and second molars. The distobuccal root showed a Vertucci type I configuration in 97% of first and 100% of maxillary second molars. The mesiobuccal root for first molars showed a Vertucci type II configuration (2-1) in 56.5% cases and Vertucci type IV (2-2) in 23.2%. For maxillary second molars, the Vertucci type I configuration reached 52.7%. In mandibular molars, the mesial root showed higher variability. Most frequent was the presence of 2 canals, Vertucci type II for first and second molars. In the distal root, the most common configuration was Vertucci type I in both molars. The greater percentage of fused roots was observed in maxillary molars. Vertucci type II configuration was more frequent than type IV in the mesial root of mandibular molars and the mesiobuccal root of maxillary molars. A third canal in the mesial root of first mandibular molars (6.7%) was higher than expected. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Root form and canal morphology of maxillary first premolars of a Yemeni population.

PubMed

Senan, Elham M; Alhadainy, Hatem A; Genaid, Thuraia M; Madfa, Ahmed A

2018-05-31

The purpose of this study was to investigate variations in the root canal systems of permanent maxillary first premolars in a Yemeni population using a clearing technique. Two hundred fifty permanent maxillary first premolar teeth extracted from Yemeni individuals were collected. A small hole in the center of the occlusal surface of each tooth was prepared and pulp tissue was removed by immersion in 5.25% sodium hypochlorite. Teeth were stored in 5-10% nitric acid solution for 5-6 days. Next, teeth were rinsed, dried, and dehydrated using ascending concentrations of ethanol (70, 95, and 100%) successively for 12 h each. Waterproof black ink was injected into the dried dehydrated teeth. Stained teeth were then rendered clear by immersion in methyl salicylate solution (98%) until evaluation. Root canal morphology of each tooth was then examined. 54.8% of teeth were single-rooted, while 44.4% were double-rooted and only 0.8% had three separated roots. The most common canal system configuration was Vertucci type IV (55.6%). Eight specimens of the single-rooted premolars (3.2%) had new canal configurations that have not been recognized in previous published studies. Accessory canals and inter-canal communications were detected in a total of 52.8 and 34.4% of the specimens, respectively. The apical foramen was located centrally to the apex in 84.9% and apical deltas were found in 13.2% of the studied sample. Yemeni permanent maxillary first premolars are mainly single-rooted and predominantly present Vertucci type IV canal morphology. The finding of additional canal configurations in this study is low but should be kept in mind when performing endodontic therapy for these teeth.

The self-adjusting file (SAF). Part 3: removal of debris and smear layer-A scanning electron microscope study.

PubMed

Metzger, Zvi; Teperovich, Ehud; Cohen, Raphaela; Zary, Raviv; Paqué, Frank; Hülsmann, Michael

2010-04-01

The aim of this study was to evaluate the cleaning ability of the Self-Adjusting File (SAF) system in terms of removal of debris and smear layer. Root canal preparations were performed in 20 root canals using an SAF operated with a continuous irrigation device. The glide path was initially established using a size 20 K-file followed by the SAF file that was operated in the root canal via a vibrating motion for a total of 4 minutes. Sodium hypochlorite (3%) and EDTA (17%) were used as continuous irrigants and were alternated every minute during this initial 4-minute period. This was followed by a 30-second rinse using EDTA applied through a nonactivated SAF and a final flush with sodium hypochlorite. The roots were split longitudinally and subjected to scanning electron microscopy (SEM). The presence of debris and a smear layer in the coronal, middle, and apical thirds of the canal were evaluated through the analysis of the SEM images using five-score evaluation systems based on reference photographs. The SAF operation with continuous irrigation, using alternating irrigants, resulted in root canal walls that were free of debris in all thirds of the canal in all (100%) of the samples. In addition, smear layer-free surfaces were observed in 100% and 80% of the coronal and middle thirds of the canal, respectively. In the apical third of the canal, smear layer-free surfaces were found in 65% of the root canals. The operation of the SAF system with continuous irrigation coupled with alternating sodium hypochlorite and EDTA treatment resulted in a clean and mostly smear layer-free dentinal surface in all parts of the root canal. Copyright (c) 2010 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

A comparison of the antibacterial activity of the two methods of photodynamic therapy (using diode laser 810 nm and LED lamp 630 nm) against Enterococcus faecalis in extracted human anterior teeth.

PubMed

Asnaashari, Mohammad; Mojahedi, Seyed Masoud; Asadi, Zahra; Azari-Marhabi, Saranaz; Maleki, Alireza

2016-03-01

Failure of endodontic treatment is usually due to an inadequate disinfection of the root canal system. Enterococcus faecalis has been widely used as a valuable microbiological marker for in-vitro studies because of its ability to colonize in a biofilm like style in root canals, invading dentinal tubules and resistance to some endodontic treatments. The aim of this study was to investigate the antibacterial effects of two methods of photodynamic therapy using a light emitting diode lamp (LED lamp, 630 nm) and a diode laser (810 nm) on E. faecalis biofilms in anterior extracted human teeth. Fifty six single-rooted extracted teeth were used in this study. After routine root canal cleansing, shaping and sterilization, the teeth were incubated with E. faecalis for a period of two weeks. Teeth were then divided into two experimental groups (nu=23) and two control groups (nu=5). Teeth in one experimental group were exposed to a diode laser (810 nm), and in the other group samples were exposed to a LED lamp (630 nm). Intracanal bacterial sampling was done, and bacterial survival rate was then evaluated for each group. The Colony Forming Unit (CFU) in LED group (log10 CFUs=4.88±0.82) was significantly lower than the laser group (log CFUs=5.49±0.71) (p value=0.021). CFUs in positive control group (Log10 CFUs=10.96±0.44) were significantly higher than the treatment group (p˂0.001). No bacterial colony was found in negative control group. The results of this research show that photodynamic therapy could be an effective supplement in root canal disinfection. PDT using LED lamp was more effective than diode laser 810 nm in reducing CFUs of E. faecalis in human teeth. Copyright © 2015 Elsevier B.V. All rights reserved.

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

PubMed

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

2012-01-01

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

Novel navigation technique for the endodontic treatment of a molar with pulp canal calcification and apical pathology.

PubMed

Shi, Xilin; Zhao, Shiyong; Wang, Weidong; Jiang, Qianzhou; Yang, Xuechao

2018-04-01

Apical periodontitis, the inflammation of periapical tissue, commonly requires root canal treatment to achieve apical healing. However, if it is accompanied by pulp canal calcification, the treatment becomes complicated, and locating the root canal can be challenging. This case report describes a novel approach for treating a molar with pulp canal calcification and apical pathology. Due to the risk of perforation during treatment, a digitally printed template was used to assist in accurately locating the root canal. After six months, the patient was asymptomatic and the periradicular radiolucency was gradually reducing in size. © 2017 Australian Society of Endodontology Inc.

Anatomic symmetry of root and root canal morphology of posterior teeth in Indian subpopulation using cone beam computed tomography: A retrospective study

PubMed Central

Felsypremila, Gnanasekaran; Vinothkumar, Thilla Sekar; Kandaswamy, Deivanayagam

2015-01-01

Objective: To investigate the anatomic symmetry of maxillary and mandibular posteriors in Indian subpopulation using cone beam computed tomography (CBCT). Materials and Methods: CBCT images of 246 patients that had at least one noncarious, posterior tooth free of restorations in each quadrant were enrolled for retrospective analysis. A total of 3015 teeth (811 maxillary premolars, 845 mandibular premolars, 738 maxillary molars, and 621 mandibular molars) were analyzed for number of roots and root canals, canal morphology and anatomic symmetry, and concurrent types between the maxilla and mandible. Results: There was no difference in the percentage of symmetry for maxillary first (81.5%) and second (81.5%) premolars. Mandibular second premolars (98.3%) exhibited greater symmetry than mandibular first premolars (96.1%). First molars (77.5% and 82.1%) showed greater symmetry than second molars (70.8% and 78.6%), in both maxillary and mandibular arches, respectively. The most common anatomy observed were: maxillary first premolars – 2 roots with 2 canals, maxillary second premolars – 1 root with 2 canals, mandibular first and second premolars – 1 root with 1 canal, maxillary first and second molars – 3 roots with 4 canals, and mandibular first and second molars – 2 roots with 3 canals. When compared with any other teeth, maximum asymmetry was observed in maxillary second molar (29.2%). Conclusion: The percentage of symmetry observed in the present study varied from 70% to 98% with least percentage of symmetry in maxillary second molars. These data should alert the clinicians while treating homonymous teeth of the same patient. PMID:26929687

Evaluation of apical transportation and centring ability of five thermally treated NiTi rotary systems.

PubMed

Pinheiro, S R; Alcalde, M P; Vivacqua-Gomes, N; Bramante, C M; Vivan, R R; Duarte, M A H; Vasconcelos, B C

2018-06-01

To evaluate apical transportation and centring ability during root canal preparation in mesial root canals of mandibular molars associated with ProTaper Gold (PTG), ProDesign S (PDS), Hyflex CM (HCM), Hyflex EDM and ProDesign Logic (PDL). Sixty mandibular first molars with two separate canals in the mesial root were selected after root anatomy pairing by microcomputed tomography (microCT). The teeth were randomly divided into five groups (n = 24); the root canal volume was calculated to ensure sample homogeneity. All the root canals were prepared up to size 25 in accordance with the instructions of each rotary system manufacturer. After root canal preparation, the teeth were scanned by microCT to analyse apical transportation, root canal centralization and the pre- and post-preparation root canal volume at the apical and cervical levels. Kruskal-Wallis and Dunn tests were used for comparisons amongst groups for transportation values. For volume changes, the parametric ANOVA and Tukey's tests were used RESULTS: There were no significant differences in apical transportation amongst the rotary systems (P > 0.05). All the systems created apical transportation; values ranging from 0.031 mm (PDL) to 0.072 mm (PTG), and enlargements between 39% (HCM) and 91.1% (PDS) were observed. In relative to cervical transportation, significant differences were observed amongst the systems (P < 0.05). Mean transportation values between 0.07 mm (HCM) and 0.172 mm (PTG) were found, with enlargements between 35.4% (HCM) and 51.5% (PDS). All the thermally treated systems resulted in similar apical transportation. In the cervical region, the Hyflex CM and Prodesign Logic systems were associated with more centred preparations. © 2017 International Endodontic Journal. Published by John Wiley & Sons Ltd.

[Cause and regulation of pain during root canal therapy].

PubMed

Buling, Wu; Zhao, Liu

2016-10-01

In stomatology, root canal therapy is a commonly used and effective treatment for dental pulp diseases and periapical diseases. However, pain may occur during or after treatment and may severely affect patients. This article aimed to analyze the mechanism and cause of pain during root canal therapy, which may reduce or relieve pain.

Model assessing thermal changes during high temperature root canal irrigation

PubMed Central

Bartolo, Analise; Koyess, Edmond; Micallef, Christopher

2016-01-01

The main aim of root canal irrigation is to eliminate micro-organisms. Sodium hypochlorite (NaOCl) is considered to be the ideal material and raising its temperature potentiates the antimicrobial activity. NaOCl may lead to localised tissue necrosis when extruded past the root apex. This study analyses the use of high temperature root canal irrigation as an alternative process for the elimination of microorganisms from the root canal system. An experimental set-up was designed where a constant supply of heat was passed from a heat source through a copper wire inside the root canal. The data acquired together with known constants pertaining to enamel and dentine was used to numerically model the thermal changes in a tooth using a finite element method. Results obtained from the finite element thermal model of the tooth were repeatable and were validated with the experimental results. The thermo-physical properties of the tooth were varied and convergence criteria met. The temperatures reached were below what has been reported to cause irreversible damage to the bone. This was further confirmed from a series of simulations that were undertaken. The temperatures achieved were suitable for the elimination of microorganisms during root canal therapy. PMID:27733934

Radiographic technical quality of root canal treatment performed by a new rotary single-file system.

PubMed

Colombo, Marco; Bassi, Cristina; Beltrami, Riccardo; Vigorelli, Paolo; Spinelli, Antonio; Cavada, Andrea; Dagna, Alberto; Chiesa, Marco; Poggio, Claudio

2017-01-01

The aim of the present study was to evaluate radiographically the technical quality of root canal filling performed by postgraduate students with a new single-file Nickel-Titanium System (F6 Skytaper Komet) in clinical practice. Records of 74 patients who had received endodontic treatment by postgraduate students at the School of Dentistry, Faculty of Medicine, University of Pavia in the period between September 2015 and April 2016 were collected and examined: the final sample consisted 114 teeth and 204 root canals. The quality of endodontic treatment was evaluated by examining the length of the filling in relation to the radiographic apex, the density of the obturation according to the presence of voids and the taper of root canal filling. Chi-squared analysis was used to determine statistically significant differences between the technical quality of root fillings according to tooth's type, position and curvature. The results showed that 75,49%, 82,84% and 90,69% of root filled canals had adequate length, density and taper respectively. Overall, the technical quality of root canal fillings performed by postgraduates students was acceptable in 60,78% of the cases.

Large Reactional Osteogenesis in Maxillary Sinus Associated with Secondary Root Canal Infection Detected Using Cone-beam Computed Tomography.

PubMed

Estrela, Carlos; Porto, Olavo César Lyra; Costa, Nádia Lago; Garrote, Marcel da Silva; Decurcio, Daniel Almeida; Bueno, Mike R; Silva, Brunno Santos de Freitas

2015-12-01

Inflammatory injuries in the maxillary sinus may originate from root canal infections and lead to bone resorption or regeneration. This report describes the radiographic findings of 4 asymptomatic clinical cases of large reactional osteogenesis in the maxillary sinus (MS) associated with secondary root canal infection detected using cone-beam computed tomographic (CBCT) imaging. Apical periodontitis, a consequence of root canal infection, may lead to a periosteal reaction in the MS and osteogenesis seen as a radiopaque structure on imaging scans. The use of a map-reading strategy for the longitudinal and sequential slices of CBCT images may contribute to the definition of diagnoses and treatment plans. Root canal infections may lead to reactional osteogenesis in the MS. High-resolution CBCT images may reveal changes that go unnoticed when using conventional imaging. Findings may help define initial diagnoses and therapeutic plans, but only histopathology provides a definitive diagnosis. Surgical enucleation of the periapical lesion is recommended if nonsurgical root canal treatment fails to control apical periodontitis. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Smear layer production by 3 rotary reamers with different cutting blade designs in straight root canals: a scanning electron microscopic study.

PubMed

Jeon, In-Soo; Spångberg, Larz S W; Yoon, Tai-Cheol; Kazemi, Reza B; Kum, Kee-Yeon

2003-11-01

The design of the cutting blade of rotary instruments may affect the outcome of root canal instrumentation in terms of cleanliness. The aim of this scanning electron microscopic study was to compare the quality and amount of smear layer generated in the apical third of straight root canals by 2 rotary nickel-titanium reamers and 1 rotary steel reamer with different cutting blade designs. Seventy intact, single-rooted human mandibular premolars with straight, fully developed roots were selected for this study. Before instrumentation, the cervical portion of all teeth was removed by using a microtome (Isomet), leaving 13-mm-long roots. Automated preparation was performed with ProFile (n = 20) and Hero 642 (n = 20) reamers by using the crown-down technique and with a stainless steel engine reamer (Mani; n = 20) by using a reaming motion. All root canals were instrumented to No. 40. A control group (pulp extirpation with barbed broaches; n = 10) was also included. Irrigation with 3 mL of a 1% sodium hypochlorite (NaOCl) solution was performed after each instrumentation. After the instrumentation, each root was split longitudinally, and a scanning electron microscope was used to examine the selected areas of the canal walls at the apical third from 2 different perspectives. A 4-category scoring system for smear layer was used, and the resulting scores were statistically analyzed. The least smear layer remained in the Hero 642 group at the selected apical third of straight root canals (P < .05). However, all instruments left a smear layer. The surface texture of the smear layer, in addition to the depth and the frequency of packed materials into the dentinal tubules, varied with instrument type. These data revealed that the design of the cutting blade of rotary instruments can affect root canal cleanliness in straight root canals. This information may be useful in the selection of nickel-titanium rotary reamers.

Thermal effects and antibacterial properties of energy levels required to sterilize stained root canals with an Nd:YAG laser.

PubMed

Ramsköld, L O; Fong, C D; Strömberg, T

1997-02-01

Thermal effects and antibacterial properties of an Nd:YAG laser were studied to establish clinically safe levels of energy to deliver into the root canal and to determine the energy level needed to sterilize infected root canals. The results indicate that lasing cycles of 3 J-s for 15 s followed by a 15-s recovery interval can be continued for prolonged periods without risk of thermal damage to surrounding tissues. In vitro lasing of root canals inoculated with dark stained bacteria showed that two such lasing cycles sterilized only two out of eight canals, whereas when four cycles were used seven out of eight canals were sterilized. Guidelines for energy levels in endodontic Nd:YAG laser work are discussed, and base data for calculating appropriate energy levels are given.

In-depth morphological study of mesiobuccal root canal systems in maxillary first molars: review

PubMed Central

Chang, Seok-Woo; Lee, Jong-Ki; Lee, Yoon

2013-01-01

A common failure in endodontic treatment of the permanent maxillary first molars is likely to be caused by an inability to locate, clean, and obturate the second mesiobuccal (MB) canals. Because of the importance of knowledge on these additional canals, there have been numerous studies which investigated the maxillary first molar MB root canal morphology using in vivo and laboratory methods. In this article, the protocols, advantages and disadvantages of various methodologies for in-depth study of maxillary first molar MB root canal morphology were discussed. Furthermore, newly identified configuration types for the establishment of new classification system were suggested based on two image reformatting techniques of micro-computed tomography, which can be useful as a further 'Gold Standard' method for in-depth morphological study of complex root canal systems. PMID:23493453

Microorganism penetration in dentinal tubules of instrumented and retreated root canal walls. In vitro SEM study

PubMed Central

Al-Sulaiman, Alaa; Al-Rasheed, Fellwa; Alnajjar, Fatimah; Al-Abdulwahab, Bander; Al-Badah, Abdulhakeem

2014-01-01

Objectives This in vitro study aimed to investigate the ability of Candida albicans (C. albicans) and Enterococcus faecalis (E. faecalis) to penetrate dentinal tubules of instrumented and retreated root canal surface of split human teeth. Materials and Methods Sixty intact extracted human single-rooted teeth were divided into 4 groups, negative control, positive control without canal instrumentation, instrumented, and retreated. Root canals in the instrumented group were enlarged with endodontic instruments, while root canals in the retreated group were enlarged, filled, and then removed the canal filling materials. The teeth were split longitudinally after canal preparation in 3 groups except the negative control group. The teeth were inoculated with both microorganisms separately and in combination. Teeth specimens were examined by scanning electron microscopy (SEM), and the depth of penetration into the dentinal tubules was assessed using the SMILE view software (JEOL Ltd). Results Penetration of C. albicans and E. faecalis into the dentinal tubules was observed in all 3 groups, although penetration was partially restricted by dentin debris of tubules in the instrumented group and remnants of canal filling materials in the retreated group. In all 3 groups, E. faecalis penetrated deeper into the dentinal tubules by way of cell division than C. albicans which built colonies and penetrated by means of hyphae. Conclusions Microorganisms can easily penetrate dentinal tubules of root canals with different appearance based on the microorganism size and status of dentinal tubules. PMID:25383343

Influence of apical patency and filling material on healing process of dogs' teeth with vital pulp after root canal therapy.

PubMed

Holland, Roberto; Sant'Anna Júnior, Arnaldo; Souza, Valdir de; Dezan Junior, Eloi; Otoboni Filho, José Arlindo; Bernabé, Pedro Felício Estrada; Nery, Mauro Juvenal; Murata, Sueli Satomi

2005-01-01

The purpose of this study was to investigate the periapical healing process of dogs' teeth with or without apical patency and after root canal filling with two types of sealers. Forty roots of premolars and incisors were utilized. The root canals were over-instrumented and dressed with a corticosteroid-antibiotic solution for 7 days to obtain ingrowth of periapical connective tissue into the canals. After this period, the tissue was removed in half of the specimens (groups with patency) and preserved in the other half (groups without patency). Canals were filled by lateral condensation technique with gutta-percha points and either a calcium hydroxide-based sealer (Sealer Plus) or a Grossman's cement (Fill Canal). The animals were killed by anesthetic overdose 60 days after the endodontic treatment and anatomic pieces were obtained and prepared for histologic examination. Data were evaluated in a blind analysis on the basis of several histomorphologic parameters. The groups without patency had better results (p=0.01) than those in which the ingrown connective tissue was removed. Comparing the sealers, Sealer Plus had significantly better results (p=0.01) than Fill Canal. In conclusion, both the apical patency (presence or absence) and the type of root canal filling material influenced the periapical healing process in dogs' teeth with vital pulp after root canal treatment. The use of a calcium hydroxide-based sealer in teeth without apical patency yielded the best results among the experimental conditions proposed.

Evaluation of photodynamic therapy using a light-emitting diode lamp against Enterococcus faecalis in extracted human teeth.

PubMed

Rios, Alejandro; He, Jianing; Glickman, Gerald N; Spears, Robert; Schneiderman, Emet D; Honeyman, Allen L

2011-06-01

Photodynamic therapy (PDT) with high-power lasers as the light source has been proven to be effective in disinfecting root canals. The aim of this study was to evaluate the antimicrobial effect of PDT using toluidine blue O (TBO) and a low-energy light-emitting diode (LED) lamp after the conventional disinfection protocol of 6% NaOCl. Single-rooted extracted teeth were cleaned, shaped, and sealed at the apex before incubation with Enterococcus faecalis for 2 weeks. Roots were randomly assigned to five experimental groups and three control groups. Dentin shavings were collected from the root canals of all groups with a #50/.06 rotary file, colony-forming units were determined, and the bacterial survival rate was calculated for each treatment. The bacterial survival rate of the NaOCl/TBO/light group (0.1%) was significantly lower (P < .005) than the NaOCl (0.66%) and TBO/light groups (2.9%). PDT using TBO and a LED lamp has the potential to be used as an adjunctive antimicrobial procedure in conventional endodontic therapy. Copyright © 2011 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Comparative evaluation of antimicrobial effect of herbal root canal irrigants (Morinda citrifolia, Azadirachta indica, Aloe vera) with sodium hypochlorite: An in vitro study.

PubMed

Babaji, Prashant; Jagtap, Kiran; Lau, Himani; Bansal, Nandita; Thajuraj, S; Sondhi, Priti

2016-01-01

Successful root canal treatment involves the complete elimination of microorganism from the root canal and the three-dimensional obturation of the canal space. Enterococcus faecalis is the most commonly found bacteria in failed root canal. Chemical irrigation of canals along with biomechanical preparation helps in the elimination of microorganisms. The present study was aimed to evaluate the antimicrobial effect of herbal root canal irrigants (Morinda citrifolia, Azadirachta indica extract, Aloe vera) with sodium hypochlorite (NaOCl). The bacterial E. faecalis (ATCC) culture was grown overnight in brain heart infusion (BHI) broth and inoculated in Mueller-Hinton agar plates. Antibacterial inhibition was assessed using agar well diffusion method. All five study irrigants were added to respective wells in agar plates and incubated at 37°C for 24 h. Bacterial inhibition zone around each well was recorded. Results were tabulated and statistically analyzed using Statistical Package for the Social Sciences software for Windows, version 19.0. (IBM Corp., Armonk, NY. Highest inhibitory zone against E. faecalis was seen in NaOCl fallowed by M. citrifolia and A. indica extract, and the least by A. vera extract. Tested herbal medicine (A. indica extract, M. citrifolia, A. vera) showed inhibitory zone against E. faecalis. Hence, these irrigants can be used as root canal irrigating solutions.

In vitro antimicrobial efficacy of MTAD and sodium hypochlorite.

PubMed

Shabahang, Shahrokh; Pouresmail, Manouchehr; Torabinejad, Mahmoud

2003-07-01

The purpose of this study was to compare the ability of a mixture of a tetracycline isomer, an acid, and a detergent (MTAD) with that of sodium hypochlorite (NaOCI) to disinfect human root canals that had been contaminated with whole saliva. One hundred and thirty-two root canals of extracted human teeth were cleaned and shaped using the passive step-back technique and rotary NiTi files. The smear layer was removed, and the teeth were autoclaved. Six autoclaved samples were transferred to sterile broth without contamination with saliva to serve as negative controls. Whole saliva was used to contaminate the root canals of the rest of the samples for 48 h. Six of these contaminated samples were irrigated with Brain Heart Infusion (BHI) broth and served as positive controls. The rest of the contaminated specimens were then divided into two experimental groups of 60 teeth each. In one group, the canals were irrigated with 1 ml MTAD, and the samples were immersed in 2 ml of the same solution for 5 min. In the second group, the specimens were similarly treated with 5.25% NaOCl. All samples were washed in BHI broth and then placed in another tube containing BHI broth and incubated for 96 h. Disinfection of the samples was determined based on presence or absence of turbidity in the broth 96 h later. Twenty-three of 60 teeth treated with NaOCl remained infected. Only one of 60 teeth treated with MTAD remained infected. Statistical analysis of the data using the Chi-square test showed a significant difference between the two groups (p < 0.0001).

Nuclear Magnetic Resonance Imaging in Endodontics: A Review.

PubMed

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

2018-04-01

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

The influence of the Q-switched and free-running Er:YAG laser beam characteristics on the ablation of root canal dentine

NASA Astrophysics Data System (ADS)

Papagiakoumou, Eirini; Papadopoulos, Dimitrios N.; Khabbaz, Marouan G.; Makropoulou, Mersini I.; Serafetinides, Alexander A.

2004-06-01

Laser based dental treatment is attractive to many researchers. Lasers in the 3 μm region, as the Er:YAG, are suitable especially for endodontic applications. In this study a pulsed free-running and Q-switched laser was used for the ablation experiments of root canal dentine. The laser beam was either directly focused on the dental tissue or delivered to it through an infrared fiber. For different spatial beam distributions, energies, number of pulses and both laser operations the quality characteristics (crater's shape formation, ablation efficiency and surface characteristics modification) were evaluated using scanning electron microscopy (SEM). The craters produced, generally, reflect the relevant beam profile. Inhomogeneous spatial beam profiles and short pulse duration result in cracks formation and lower tissue removal efficiency, while longer pulse durations cause hard dentine fusion. Any beam profile modification, due to laser characteristics variations and the specific delivering system properties, is directly reflected in the ablation crater shape and the tissue removal efficiency. Therefore, the laser parameters, as fluence, pulse repetition rate and number of pulses, have to be carefully adjusted in relation to the desirable result.

Prevalence of apical periodontitis and quality of root canal treatment in an adult Palestinian sub-population

PubMed Central

Mukhaimer, Raed; Hussein, Emad; Orafi, Ibtesam

2012-01-01

Purpose The aim of this study was to determine the prevalence of apical periodontitis and the technical quality of root canal fillings in a Palestinian sub-population. Methods The panoramic radiographs of 258 patients (142 females, 116 males) attending dental clinics in 2010 were examined to identify the presence of apical lesions associated with any remaining teeth, excluding third molars. The technical quality of root canal fillings was also evaluated by assessing apical extension from the radiographic apex. The panoramic radiographs were taken by a well-trained radiology assistant and evaluated by a radiologist and an endodontist. Statistical analysis was performed with the chi-square test with a significant level set at P < 0.05%. Results Of 6482 teeth examined radiographically, 978 (15.1%) had radiographic signs of apical periodontitis (AP). The prevalence of AP was 8.3% in teeth without filled roots and 59.5% (509/855) in root canal-treated teeth. The prevalence of AP and endodontic treatment increased with age and differed significantly (p < 0.05) between males and females. The majority (74.5%) of root canal fillings was performed inadequately, and most (77.2%) inadequate fillings were >2 mm short of the radiographic apex. The presence of AP was correlated significantly with poorly executed root canal fillings (p < 0.05). Conclusions The present study found a high prevalence and incidence of AP in association with root-filled teeth. The technical quality of many root canal treatments was unacceptable. PMID:23960544

The Tubular Penetration Depth and Adaption of Four Sealers: A Scanning Electron Microscopic Study

PubMed Central

Chen, Huan; Zhao, Xinyuan; Qiu, Yu; Xu, Dengyou

2017-01-01

Background. The tubular penetration and adaptation of the sealer are important factors for successful root canal filling. The aim of this study was to evaluate the tubular penetration depth of four different sealers in the coronal, middle, and apical third of root canals as well as the adaptation of these sealers to root canal walls. Materials and Methods. 50 single-rooted teeth were prepared in this study. Forty-eight of them were filled with different sealers (Cortisomol, iRoot SP, AH-Plus, and RealSeal SE) and respective core filling materials. Then the specimens were sectioned and scanning electron microscopy was employed to assess the tubular penetration and adaptation of the sealers. Results. Our results demonstrated that the maximum penetration was exhibited by RealSeal SE, followed by AH-Plus, iRoot SP, and Cortisomol. As regards the adaptation property to root canal walls, AH-Plus has best adaptation capacity followed by iRoot SP, RealSeal SE, and Cortisomol. Conclusion. The tubular penetration and adaptation vary with the different sealers investigated. RealSeal SE showed the most optimal tubular penetration, whereas AH-Plus presented the best adaptation to the root canal walls. PMID:29479539

Influence of irrigation and obturation techniques on artificial lateral root canal filling capacity.

PubMed

Silva, Emmanuel J; Herrera, Daniel R; Souza-Júnior, Eduardo J; Teixeira, João M

2013-01-01

The aim of this study was to evaluate the influence of two different irrigation protocols on artificial lateral root canal filling capacity using different obturation techniques. Sixty single-root human teeth were used. Two artificial lateral canals were created in the apical third. Root canals were instrumented up to a 45 K-file to the working length. Before each file, root canals were irrigated either with 2 mL of 2.5% NaOCl or 2% chlorhexidine gel with further irrigation with saline solution and 3 mL of 17% EDTA. Specimens were randomly divided into three groups according to the obturation technique: (1) lateral compaction technique; (2) Tagger hybrid technique; and (3) thermoplasticized technique using BeeFill 2 in 1. All groups used AH Plus as the root canal sealer. The specimens were decalcified and cleared in methyl salicylate. The total length of lateral canals was observed under X30 magnification with a stereomicroscope and measured on the buccal and lingual root surfaces using Leica IM50 software. The data were submitted to ANOVA and Tukey test (p < 0.05). Among the obturation techniques, BeeFill 2 in 1 showed deeper penetration into all lateral canals than the lateral compaction or Tagger hybrid techniques (p < 0.05). The lateral compaction group showed the worst results (p < 0.05). Irrigants did not affect the outcome; there was no difference between NaOCl and chlorhexidine when the same obturation technique was used (p > 0.05). Regardless of the irrigant used during endodontic procedures, the thermoplasticized techniques showed higher penetration behavior for filling artificial lateral canals than the lateral compaction technique.

Comparison of the cleaning capacity of Mtwo and Pro Taper rotary systems and manual instruments in primary teeth

PubMed Central

Azar, Mohammad Reza; Safi, Laya; Nikaein, Afshin

2012-01-01

Background: Root canal cleaning is an important step in endodontic therapy. In order to develop better techniques, a new generation of endodontic instruments has been designed. The aim of this study was to compare the effectiveness of manual K-files (Mani Co, Tokyo, Japan) and two rotary systems–Mtwo (Dentsply-Maillefer, Ballaigues, Switzerland) and ProTaper (VDW, Munich, Germany)–for root canal preparation in primary molars. Materials and Methods: India ink was injected to 160 mesiobuccal and distal root canals of mandibular primary molars. The teeth were randomly divided into three experimental groups and one control group. In each experimental group, either manual instruments (K-files) or rotary instruments (Mtwo or ProTaper) were used to prepare root canals. After cleaning the canals and clearing the teeth, ink removal was evaluated with a stereomicroscope. Statistical analysis was done with Kruskal–Wallis and Friedman tests. Results: There were no significant differences in cleaning efficiency between manual and rotary instruments. Only ProTaper files performed significantly better in the coronal and middle thirds than in the apical third of the root canal. Conclusion: Manual K-files and the Mtwo and ProTaper rotary systems showed equally acceptable cleaning ability in primary molar root canals. PMID:22623929

Endodontic implications of the variability of the root canal systems of posterior teeth.

PubMed

Biggs, J T; Benenati, F W

1995-01-01

Variations in the morphology of roots and root canal systems create challenges which the dental practitioner must be able to recognize. Endodontic therapy is predictable and successful only to the extent that the root canal system can be debrided, disinfected and sealed against future contamination. In order to accomplish these goals it is necessary to become familiar with the variability of the system we seek to treat.

[Influence of the root canal instrumentation size on the disinfection of intracanal microbe by Er:YAG laser].

PubMed

Xu, Xue-song; Zhu, Ya-qin

2015-12-01

To evaluate the influence of different root canal instrumentation size on disinfection of intracanal microbe of dental root canal. 368 extracted human anterior teeth with single straight root were randomly divided into 8 groups of 46 roots in each. They were instrumented with K3 Ni-Ti files as follows: group A1 and group B1(#25/0.06), group A2 and group B2(#30/0.06), group A3 and group B3(#35/0.06), group A4 and group B4(#40/0.06). After being prepared and sterilized by autoclaving, group A was inoculated with Enterococcus faecalis, and group B was inoculated with Candida albicans. All groups were irrigated with Er:YAG laser combination of 3% NaOCl, 17% EDTA and 0.9% saline, and then the numbers of microbe on the surface of root canal walls were counted after the treatment, the absolute reduction of counting colony forming units(CFUs) and the relative residual rate of CFUs in the individual group was determined. The Date was analyzed with GraphPad Prism 5.02 software package by one-way analysis of variance. Levels of disinfection on E.faecalis and C.albicans increased when root canals were enlarged; #40/0.06 showed the best disinfection, #35/0.06 showed a significantly better disinfection than #30/0.06 and #25/0.06. Substantial reduction of microbe was obtained in #35/0.06 and #40/0.06 compared with #25/0.06 and #30/0.06(P<0.05). Within the root canal size of #25/0.06-#40/0.06, under the conditions of Er:YAG laser combination of 3% NaOCl, 17% EDTA and 0.9% saline, it was concluded that the reduction of E.faecalis and C.albicans of the anterior straight root canals could be predicted by increasing the root canal instrumentation size large than #30/0.06.

Impact of the quality of coronal restoration and root canal filling on the periapical health in adult syrian subpopulation

PubMed Central

Alafif, Hisham

2014-01-01

Background: The purpose of this study was to determine the status of periapical tissues of endodontically treated teeth according to coronal restorations and root canal fillings separately and in concomitant in adult Syrian subpopulation. Methods: 784 endodontically treated teeth from two hundred randomly selected Syrian adult patients were radiographically evaluated. According to predetermined criteria, the quality of coronal restorations and root canal filling of each tooth was scored as adequate or inadequate. The status of periapical tissues was also classified as healthy or diseased. Results were analyzed using Chi-squared test. Results: Adequate coronal restorations were determined in 58.54% of cases which was accompanied with less periapical pathosis than that in teeth with inadequate restorations (P < 0.01). 14% of teeth were restored by posts which showed no significant impact on the periapical tissues health. 18.5% of endodontic treatments were evaluated as adequate with less number of periapical radiolucencies than that of inadequate root canal fillings (P < 0.01). Absence of periapical pathosis was 96.6% in cases with both adequate coronal restorations and root canals fillings. The rate was 88.5% in cases with only adequate root canals fillings, and about 70% in cases with only adequate coronal restorations. When the treatment was inadequate in both coronal and root canals fillings, success rate was only observed in 48.8%. Conclusion: The most important factor with regard to the periradicular tissue health is the quality of root canal filling without neglecting the influence of coronal restoration (regardless of its type). There is a high prevalence rate of periapical pathosis in Syrian subpopulation due to poor dental practice. PMID:25565729

Mandibular molar with five root canals.

PubMed

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

2008-12-01

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

Experimental root canal infections in conventional and germ-free mice.

PubMed

Sobrinho, A P; Barros, M H; Nicoli, J R; Carvalho, M A; Farias, L M; Bambirra, E A; Bahia, M G; Vieira, E C

1998-06-01

A small animal model was evaluated to study the interrelationships between microorganisms after their implantation in root canals (inferior central incisors) using germ-free (GF) and conventional (CV) mice. The selected microorganisms were: Porphyromonas endodontalis (ATCC 35406), Eubacterium lentum (ATCC 25559), Peptostreptococcus anaerobius (ATCC 27337), Fusobacterium nucleatum (ATCC 10953), Escherichia coli (ATCC 25922), and Enterococcus faecalis (ATCC 4083). Only P. anaerobius, E. coli, and E. faecalis, respectively, were able to colonize when inoculated alone into the root canal of both CV and GF mice. E. lentum, when inoculated alone colonized only in CV animals. P. endodontalis and F. nucleatum were unable to colonize in CV and GF animals after single inoculation. It is concluded that the experimental animal model presented herein is valuable for ecological studies of root canal infections and that only some strict anaerobic bacteria are able to colonize mice root canals when inoculated by themselves alone in pure culture.

Photodynamic treatment of endodontic polymicrobial infection in vitro

PubMed Central

Fimple, Jacob Lee; Fontana, Carla Raquel; Foschi, Federico; Ruggiero, Karriann; Song, Xiaoqing; Pagonis, Tom C.; Tanner, Anne C. R.; Kent, Ralph; Doukas, Apostolos G.; Stashenko, Philip P.; Soukos, Nikolaos S.

2008-01-01

We investigated the photodynamic effects of methylene blue (MB) on multi-species root canal biofilms comprising Actinomyces israelii, Fusobacterium nucleatum subspecies nucleatum, Porphyromonas gingivalis and Prevotella intermedia in experimentally infected root canals of extracted human teeth in vitro. The four test microorganisms were detected in root canals using DNA probes. Scanning electron microscopy (SEM) showed the presence of biofilms in root canals prior to therapy. Root canal systems were incubated with MB (25 µg/ml) for 10 minutes followed by exposure to red light at 665 nm with an energy fluence of 30 J/cm2. Light was delivered from a diode laser via a 250 µm diameter polymethyl methacrylate optical fiber that uniformly distributed light at 360°. Photodynamic therapy (PDT) achieved up to 80% reduction of colony-forming unit counts. We conclude that PDT can be an effective adjunct to standard endodontic antimicrobial treatment when the PDT parameters are optimized. PMID:18498901

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

PubMed

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

2003-01-01

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

Comparison of effects of ProTaper, HeroShaper, and Gates Glidden Burs on cervical dentin thickness and root canal volume by using multislice computed tomography.

PubMed

Mahran, Abeer H; AboEl-Fotouh, Mona M

2008-10-01

The purpose of this study was to compare the effects of 3 different instruments used to prepare curved root canals on the remaining cervical dentin thickness and total amount of dentin removed from root canals during instrumentation by using multislice computed tomography. Mesiobuccal canals of 45 mandibular first molars with curvature between 30-40 degrees were divided into 3 equal groups: ProTaper, Hero Shaper, and Gates Glidden Bur with Flex-R hand file. Cervical dentin thickness and canal volume were measured before and after instrumentation by using multislice computed tomography and image analysis software. The results indicated that ProTaper removed significantly less cervical dentin from distal wall of the root (dangerous zone) than HeroShaper and Gates Glidden Bur (P < .05). The total dentin removed during canal instrumentation was significantly more with ProTaper system (P < .05).

Apical extrusion of debris and irrigants using hand and three rotary instrumentation systems − An in vitro study.

PubMed

Madhusudhana, Koppolu; Mathew, Vinod Babu; Reddy, Nelaturi Madhusudhan

2010-10-01

Sterilization of the root canal is a prime aim of successful endodontics. The cleaning and shaping of the canal is directed as achieving this goal. The extrusion of apical debris has a deleterious effect on the prognosis of root canal treatment. Several instrument designs and instrumentation techniques have been developed to prevent this. Forty caries free single rooted human mandibular premolar teeth were divided in four groups of ten teeth each. Teeth in each group were instrumented until the working length with rotary ProTaper, K3, Mtwo systems, and hand K-type stainless steel files. Debris and irrigant extruded from the apical foramen were collected into vials and the amounts were quantitatively determined. The data obtained were analyzed using Kruskal-Wallis one-way analysis of variance and Mann-Whitney U tests. The results show that all instrumentation techniques produced significant amount of extruded debris and irrigant. The engine-driven nickel-titanium systems showed less apical extrusion of debris and irrigant than manual technique. No statistically significant difference was found between the groups at [P > 0.05]. Maximum apical debris and irrigant extrusion was seen with K-file group and least in the Mtwo group. The use of rotary files and techniques to perform instrumentation does show less extrusion of the debris and irrigant from the apex. This can contribute to more successful endodontic therapy.

Internal and external morphology of mandibular molars: An original micro-CT study and meta-analysis with review of implications for endodontic therapy.

PubMed

Tomaszewska, Iwona M; Skinningsrud, Bendik; Jarzębska, Anna; Pękala, Jakub R; Tarasiuk, Jacek; Iwanaga, Joe

2018-03-25

The aim of this radiological micro-CT study and meta-analysis was to determine the morphological features of the root canal anatomy of the mandibular molars. The radiological study included micro-CT scans of 108 mandibular first, 120 mandibular second, and 146 mandibular third molars. For our meta-analysis, an extensive search was conducted through PubMed, Embase, and Web of Science to identify articles eligible for inclusion. Data extracted included investigative method (cadaveric, intraoperative, or imaging), Vertucci type of canal configuration, presence/number of canals, roots, apical foramina, apical deltas, and intercanal communications. In the mesial roots of mandibular molars, the most frequent Vertucci type of canal configuration was type IV, except for the mandibular third molar where type I was most common. Type I was most common in the distal root. There were usually two canals in the mesial root and one in the distal root. Two was the most common number of roots, and a third root was most prevalent in Asia. One apical foramen was most common in the distal root and two apical foramina in the mesial root. Intercanal communications were most frequent in the mesial root. Knowledge of the complex anatomy of the mandibular molars can make root canal therapy more likely to succeed. We recommend the use of cone-beam computed tomography before and after endodontic treatment to enable the root anatomy to be accurately described and properly diagnosed, and treatment outcome to be assessed. Clin. Anat. 00:000-000, 2018. © 2018 Wiley Periodicals, Inc. © 2018 Wiley Periodicals, Inc.

Periapical inflammation subsequent to coronal inoculation of dog teeth root filled with resilon/epiphany in 1 or 2 treatment sessions with chlorhexidine medication.

PubMed

Santos, João M; Palma, Paulo J; Ramos, João C; Cabrita, António S; Friedman, Shimon

2014-06-01

Therapeutic methods that inhibit microbial ingress into filled root canals are desirable. This in vivo study assessed the inhibition of periapical inflammation subsequent to coronal inoculation in canals medicated with 2% chlorhexidine gel and filled with Resilon/Epiphany (Pentron Clinical Technologies, Wallingford, CT). Six Beagle dogs each had 10 two-rooted premolars treated. In group 1 (n = 36 roots), 1 root/tooth had the canal conditioned with Primer Epiphany, filled with Epiphany sealer and Resilon core in 1 session, and coronally sealed with PhotacFil. In group 2 (n = 36 roots), the second root/tooth had the canal medicated with 2% chlorhexidine gel for 1 week and then filled and coronally sealed as in group 1. After 3 weeks, canals were exposed to the oral environment for 7 days, inoculated with isologous plaque, and coronally sealed. Negative controls treated as groups 1 and 2 remained sealed. Positive controls had canals unfilled and exposed. Seven months after inoculation, dogs were euthanized; jaw blocks processed for histologic examination; and periapical inflammation (PI) recorded as none, mild, or severe. In groups 1 and 2, severe PI occurred in 5 of 65 roots (8%) and mild PI in 18 of 65 roots (28%) with a significantly higher (P = .031) PI incidence in group 2 than in group 1. Negative controls had only mild PI in 9 of 29 roots (31%). Roots medicated with 2% chlorhexidine gel had mild PI significantly more (P = .009) than roots filled in 1 session (more than 2-fold). Intracanal medication with 2% chlorhexidine gel and root filling with Resilon/Epiphany did not effectively inhibit apical periodontitis subsequent to coronal inoculation. Copyright © 2014 American Association of Endodontists. All rights reserved.

[A prognostic model for assessment of outcome of root canal treatment in teeth with pulpitis or apical periodontitis].

PubMed

Zhang, M M; Zheng, Y D; Liang, Y H

2018-02-18

To present a prognostic model for evaluating the outcome of root canal treatment in teeth with pulpitis or apical periodontitis 2 years after treatment. The implementation of this study was based on a retrospective study on the 2-year outcome of root canal treatment. A cohort of 360 teeth, which received treatment and review, were chosen to build up the total sample size. In the study, 143 teeth with vital pulp and 217 teeth with apical periodontitis were included. About 67% of the samples were selected randomly to derive a training date set for modeling, and the others were used as validating date set for testing. Logistic regression models were used to produce the prognostic models. The dependent variable was defined as absence of periapical lesion or reduction of periapical lesion. The predictability of the models was evaluated by the area under the receiver-operating characteristic (ROC) curve (AUC). Four predictors were included in model one (absence of apical lesion): pre-operative periapical radiolucency, canal curvature, density and apical extent of root fillings. The AUC was 0.802 (95%CI: 0.744-0.859). And the AUC of the testing date was 0.688. Only the density and apical extent of root fillings were included to present model two (reduction of apical lesion). The AUC of training dates and testing dates were 0.734 (95%CI: 0.612-0.856) and 0.681, respectively. As predicted by model one, the probability of absence of periapical lesion 2 years after endodontic treatment was 90% in pulpitis teeth with sever root-canal curvature and adequate root canal fillings, but 51% in teeth with apical periodontitis. When using prognostic model two for prediction, in teeth with apical periodontitis, the probability of detecting lesion reduction with adequate or inadequate root fillings was 95% and 39% 2 years after treatment. The pre-operative periapical status, canal curvature and quality of root canal treatment could be used to predict the 2-year outcome of root canal treatment.

CT evaluation of canal preparation using rotary and hand NI-TI instruments: An in vitro study

PubMed Central

Nagaraja, Shruthi; Sreenivasa Murthy, B V

2010-01-01

Background: Controlled, uniformly tapered radicular preparation is a great challenge in endodontics. Improper preparation can lead to procedural errors like transportation of foramen, uneven dentine thickness, stripping of root canal, formation of ledge, zip, and elbow in curved canals. These procedural errors and their sequel can adversely affect the prognosis of treatment. Aim/Objectives: The present in vitro study aims to evaluate canal preparation based on the following factors: canal transportation, remaining dentine thickness and comparing centering ability between hand Ni-Ti K files and ProTaper rotary Ni-Ti instruments using computed tomography (CT). Materials and Methods: For evaluation, 30 mesiobuccal roots of maxillary molars were selected. Of these, 15 roots were distributed into two groups where Group 1 included hand instrumentation with Ni-Ti K-files; and Group 2 comprised ProTaper NiTi rotary system. Pre instrumentation and post instrumentation three-dimensional CT images were obtained from root cross-sections that were 1 mm thick from apex to the canal orifice; scanned images were then superimposed and compared. Result: It was observed that the manual technique using hand Ni-Ti K-file produced lesser canal transportation and maintained greater dentine thickness than the rotary ProTaper technique at middle and coronal third and this difference was statistically significant. No significant difference was seen with regard to canal transportation and remaining root dentine at apical levels. With regard to centering ratio, no significant difference was seen between both the groups at all levels. Conclusion: ProTaper should be used judiciously, especially in curved canals, as it causes higher canal transportation and thinning of root dentine at middle and coronal levels. None of the groups showed optimal centering ability. PMID:20582214

CT evaluation of canal preparation using rotary and hand NI-TI instruments: An in vitro study.

PubMed

Nagaraja, Shruthi; Sreenivasa Murthy, B V

2010-01-01

Controlled, uniformly tapered radicular preparation is a great challenge in endodontics. Improper preparation can lead to procedural errors like transportation of foramen, uneven dentine thickness, stripping of root canal, formation of ledge, zip, and elbow in curved canals. These procedural errors and their sequel can adversely affect the prognosis of treatment. The present in vitro study aims to evaluate canal preparation based on the following factors: canal transportation, remaining dentine thickness and comparing centering ability between hand Ni-Ti K files and ProTaper rotary Ni-Ti instruments using computed tomography (CT). For evaluation, 30 mesiobuccal roots of maxillary molars were selected. Of these, 15 roots were distributed into two groups where Group 1 included hand instrumentation with Ni-Ti K-files; and Group 2 comprised ProTaper NiTi rotary system. Pre instrumentation and post instrumentation three-dimensional CT images were obtained from root cross-sections that were 1 mm thick from apex to the canal orifice; scanned images were then superimposed and compared. It was observed that the manual technique using hand Ni-Ti K-file produced lesser canal transportation and maintained greater dentine thickness than the rotary ProTaper technique at middle and coronal third and this difference was statistically significant. No significant difference was seen with regard to canal transportation and remaining root dentine at apical levels. With regard to centering ratio, no significant difference was seen between both the groups at all levels. ProTaper should be used judiciously, especially in curved canals, as it causes higher canal transportation and thinning of root dentine at middle and coronal levels. None of the groups showed optimal centering ability.

A Comparative SEM Investigation of Smear Layer Remaining on Dentinal Walls by Three Rotary NiTi Files with Different Cross Sectional Designs in Moderately Curved Canals

PubMed Central

Kakkar, Pooja; Vats, Asit

2015-01-01

Objective: The objective of this study was to compare the smear layer formed on root canal walls during canal preparation of extracted human teeth by Twisted, Mtwo, and ProTaper rotary nickel titanium instruments. Materials and Methods: Sixty single rooted human premolar teeth with root curvature <250 were selected and randomly divided into three Groups (n= 20 teeth per Group). Three types of rotary nickel titanium instruments were used, Twisted (SybronEndo, Orange, CA, USA), Mtwo (VDW, Munich, Germany) and ProTaper (Dentsply Maillefer, Ballaigues, Switzerland) according to manufacturer’s instructions to instrument the root canals. Irrigation for all groups was performed after each instrument change with 3ml of 3% sodium hypochlorite followed by Glyde (File Prep, Dentsply, Maillefer, Ballaigues, Switzerland) as chelator paste and lubricant. Three different areas (coronal, middle and apical thirds) of the root canal were evaluated using scanning electron microscopy (SEM). The canal wall of each sample was assessed and compared using a predefined scale for the presence or absence of smear layer. Data were analysed statistically using ANOVA and Tukey HSD test Results: All three groups showed statistically significant more smear layer in the apical thirds of the canal as compared to the coronal and middle thirds (p<0.001). Mtwo rotary file system produced significantly less smear layer (p<0.001) compared to Twisted and ProTaper rotary instruments in the apical portion. Twisted Files resulted in less smear layer formation in the apical thirds of the canal compared to ProTaper rotary instruments but were statistically insignificant. Conclusion: Completely clean root canals were not found after instrumentation with any of the three instruments. Under the confines of this study Mtwo instruments produced significantly cleaner dentin wall surfaces throughout the canal length in comparison to Twisted and ProTaper rotary files. Twisted Files proved to be comparable to ProTaper rotary instruments with respect to canal cleanliness in the apical thirds of the root canal. PMID:25954704

Impact of root canal preparation size and taper on coronal-apical micro-leakage using glucose penetration method

PubMed Central

Tabrizizadeh, Mehdi; Hekmati-Moghadam, Seyed-Hossein; Hakimian, Roqayeh

2014-01-01

Objectives: The purpose of this in vitro study was to assess the effect of root canal preparation size and taper on the amounts of glucose penetration. Material and Methods: For conducting this experimental study, eighty mandibular premolars with single straight canals were divided randomly into 2 experimental groups of 30 samples each and 2 control groups. Using K-files and the balance force technique, canals in group 1 were prepared apically to size 25 and coronally to size 2 Peesoreamer. Group 2 were instrumented apically and coronally to size 40 and size 6 Peesoreamer, respectively. Rotary instrumentation was accomplished in group 1; using size 25 and .04 tapered and in group 2, size 35 and .06 tapered Flex Master files. Canals were then obturated by lateral compaction of cold gutta-percha. Glucose penetration through root canal fillings was measured at 1, 8, 15, 22 and 30 days. Data were recorded as mmol/L and statistically analyzed with Mann-Whitney U test (P value=. 05). Results: In comparison to group 1, group 2 showed significant glucose leakage during the experimental period (P value < .0001). Also, in each experimental group, the amount of micro-leakage was significantly increased at the end of the study. Conclusions: Under the condition of this study, the amounts of micro-leakage through root canal fillings are directly related to the size and taper of root canal preparation and reducing the preparation size may lead to less micro-leakage. Key words:Dental leakage, root canal preparation, endodontics. PMID:25593654

Effect of 95% Ethanol as a Final Irrigant before Root Canal Obturation in Primary Teeth: An in vitro Study.

PubMed

Thiruvenkadam, G; Asokan, Sharath; John, Baby; Priya, Pr Geetha

2016-01-01

Successful obturation in the primary teeth demands complete dryness of the root canal system. The purpose of this study was to determine the effect of 95% ethanol as the final irrigant before root canal obturation in primary teeth. A total of 20 extracted primary mandibular canines were biomechanically prepared and pre-obturated volume of each tooth was assessed using spiral computed tomography (CT). The specimens were divided into two groups (n = 10): group 1, Metapex group; group 2, zinc oxide eugenol group. Each group was further divided randomly into two subgroups (n = 5): subgroup 1, canals were dried with 95% ethanol; subgroup 2, canals were blot dried with paper points with the last one appearing dry. All canals were obturated and the postobturated volume of each tooth was measured. The percentage of obturated volume (POV) was calculated using the formula: (postobturated volume/preobturated volume) × 100. The POV between the groups was statistically analyzed using Mann-Whitney test and Wilcoxon Signed rank test appropriately. Root canals that were dried with ethanol showed better obturation than using paper points alone and the difference was statistically significant in both group 1 (p < 0.001) and group 2 (p < 0.002). Drying of the root canal system with 95% ethanol can result in better obturation in the primary teeth. How to cite this article: Thiruvenkadam G, Asokan S, John B, Geetha Priya PR. Effect of 95% Ethanol as a Final Irrigant before Root Canal Obturation in Primary Teeth: An in vitro Study. Int J Clin Pediatr Dent 2016;9(1):21-24.

Ability of New Obturation Materials to Improve the Seal of the Root Canal System – A Review

PubMed Central

Zhang, Wei; Olsen, Mark; De-Deus, Gustavo; Eid, Ashraf A.; Chen, Ji-hua; Pashley, David H.; Tay, Franklin R.

2014-01-01

Objectives New obturation biomaterials have been introduced over the past decade to improve the seal of the root canal system. However, it is not clear whether they have really produced a three-dimensional impervious seal that is important for reducing diseases associated with root canal treatment. Methods A review of the literature was performed to identify models that have been employed for evaluating the seal of the root canal system. Results and Significance In-vitro and in-vivo models are not totally adept at quantifying the seal of root canals obturated with classic materials. Thus, one has to resort to clinical outcomes to examine whether there are real benefits associated with the use of recently-introduced materials for obturating root canals. However, there is no facile answer because endodontic treatment outcomes are influenced by a host of other predictors that are more likely to take precedence over the influence of obturation materials. From the perspective of clinical performance, classic root filling materials have stood the test of time. Because many of the recently-introduced materials are so new, there is not enough evidence yet to support their ability to improve clinical performance. This emphasizes the need to translate anecdotal information into clinically relevant research data on new biomaterials. PMID:24321349

Prevalence of the middle mesial canal in non surgical root canal treated mandibular first and second molars in a local military population

DTIC Science & Technology

2016-06-13

unless the clinician is careful to identify it. Missing this canal can contribute to a sequelae of persistent disease that may require the retreatment of...likelihood of finding MM canals. This is likely due to the fact that root canal retreatments are done on an older patient at a higher rate in the...canal. However, missing a canal can lead to continued pain and discomfort to the patient and other sequelae that may require nonsurgical retreatment

Macrophage cell activation with acute apical abscess contents determined by interleukin-1 Beta and tumor necrosis factor alpha production.

PubMed

Sousa, Ezilmara L R; Martinho, Frederico C; Leite, Fabio R M; Nascimento, Gustavo G; Gomes, Brenda P F A

2014-11-01

This clinical study has investigated the antigenic activity of bacterial contents from exudates of acute apical abscesses (AAAs) and their paired root canal contents regarding the stimulation capacity by levels of interleukin (IL)-1 beta and tumor necrosis factor alpha (TNF-α) throughout the root canal treatment against macrophage cells. Paired samples of infected root canals and exudates of AAAs were collected from 10 subjects. Endodontic contents were sampled before (root canal sample [RCS] 1) and after chemomechanical preparation (RCS2) and after 30 days of intracanal medication with calcium hydroxide + chlorhexidine gel (Ca[OH]2 + CHX gel) (RCS3). Polymerase chain reaction (16S rDNA) was used for detection of the target bacteria, whereas limulus amebocyte lysate was used to measure endotoxin levels. Raw 264.7 macrophages were stimulated with AAA exudates from endodontic contents sampled in different moments of root canal treatment. Enzyme-linked immunosorbent assays were used to measure the levels of TNF-α and IL-1 beta. Parvimonas micra, Porphyromonas endodontalis, Dialister pneumosintes, and Prevotella nigrescens were the most frequently detected species. Higher levels of endotoxins were found in samples from periapical exudates at RCS1 (P < .005). In fact, samples collected from periapical exudates showed a higher stimulation capacity at RCS1 (P < .05). A positive correlation was found between endotoxins from exudates with IL-1 beta (r = 0.97) and TNF-α (r = 0.88) production (P < .01). The significant reduction of endotoxins and bacterial species achieved by chemomechanical procedures (RCS2) resulted in a lower capacity of root canal contents to stimulate the cells compared with that at RCS1 (P < .05). The use of Ca(OH)2 + CHX gel as an intracanal medication (RCS3) improved the removal of endotoxins and bacteria from infected root canals (P < .05) whose contents induced a lower stimulation capacity against macrophages cells at RCS1, RCS2, and RCS3 (P < .05). AAA exudates showed higher levels of endotoxins and showed a greater capacity of macrophage stimulation than the paired root canal samples. Moreover, the use of intracanal medication improved the removal of bacteria and endotoxins from infected root canals, which may have resulted in the reduction of the inflammatory potential of the root canal content. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Comparison among manual instruments and PathFile and Mtwo rotary instruments to create a glide path in the root canal preparation of curved canals.

PubMed

Alves, Vanessa de Oliveira; Bueno, Carlos Eduardo da Silveira; Cunha, Rodrigo Sanches; Pinheiro, Sérgio Luiz; Fontana, Carlos Eduardo; de Martin, Alexandre Sigrist

2012-01-01

Nickel-titanium rotary instruments reduce procedural errors and the time required to finish root canal preparation. The goal of this study was to evaluate the occurrences of apical transportation and canal aberrations produced with different instruments used to create a glide path in the preparation of curved root canals, namely manual K-files (Dentsply Maillefer, Ballaigues, Switzerland) and PathFile (Dentsply Maillefer) and Mtwo (Sweden and Martina, Padua, Italy) nickel-titanium rotary files. The mesial canals of 45 mandibular first and second molars (with curvature angles between 25° and 35°) were selected for this study. The specimens were divided randomly into 3 groups with 15 canals each, and canal preparation was performed by an endodontist using #10-15-20 K-type stainless steel manual files (group M), #13-16-19 PathFile rotary instruments (group PF), and #10-15-20 Mtwo rotary instruments (group MT). The double digital radiograph technique was used, pre- and postinstrumentation, to assess whether apical transportation and/or aberration in root canal morphology occurred. The initial and final images of the central axis of the canals were compared by superimposition through computerized analysis and with the aid of magnification. The specimens were analyzed by 3 evaluators, whose calibration was checked using the Kendall agreement test. No apical transportation or aberration in root canal morphology occurred in any of the teeth; therefore, no statistical analysis was conducted. Neither the manual instruments nor the PathFile or Mtwo rotary instruments used to create a glide path had any influence on the occurrence of apical transportation or produced any canal aberration. Copyright © 2012 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

On the causes of persistent apical periodontitis: a review.

PubMed

Nair, P N R

2006-04-01

Apical periodontitis is a chronic inflammatory disorder of periradicular tissues caused by aetiological agents of endodontic origin. Persistent apical periodontitis occurs when root canal treatment of apical periodontitis has not adequately eliminated intraradicular infection. Problems that lead to persistent apical periodontitis include: inadequate aseptic control, poor access cavity design, missed canals, inadequate instrumentation, debridement and leaking temporary or permanent restorations. Even when the most stringent procedures are followed, apical periodontitis may still persist as asymptomatic radiolucencies, because of the complexity of the root canal system formed by the main and accessory canals, their ramifications and anastomoses where residual infection can persist. Further, there are extraradicular factors -- located within the inflamed periapical tissue -- that can interfere with post-treatment healing of apical periodontitis. The causes of apical periodontitis persisting after root canal treatment have not been well characterized. During the 1990s, a series of investigations have shown that there are six biological factors that lead to asymptomatic radiolucencies persisting after root canal treatment. These are: (i) intraradicular infection persisting in the complex apical root canal system; (ii) extraradicular infection, generally in the form of periapical actinomycosis; (iii) extruded root canal filling or other exogenous materials that cause a foreign body reaction; (iv) accumulation of endogenous cholesterol crystals that irritate periapical tissues; (v) true cystic lesions, and (vi) scar tissue healing of the lesion. This article provides a comprehensive overview of the causative factors of non-resolving periapical lesions that are seen as asymptomatic radiolucencies post-treatment.

Efficacy of ProTaper and Mtwo Retreatment Files in Removal of Gutta-percha and GuttaFlow from Root Canals

PubMed Central

Khedmat, Sedigheh; Azari, Abbas; Shamshiri, Ahmad Reza; Fadae, Mehdi; Bashizadeh Fakhar, Hoorieh

2016-01-01

Introduction: The aim of this in vitro study was to compare the efficacy of ProTaper retreatment (ProTaper R) and Mtwo retreatment (Mtwo R) files in removing gutta-percha and GuttaFlow from endodontically treated straight root canals. Methods and Materials: The root canals of 60 human mandibular single-rooted premolars were prepared and randomly divided into two groups (n=30). In groups A and B the root canals were obturated using lateral condensation of gutta-percha plus AH 26 and GuttaFlow, respectively. The canal orifices were temporarily sealed and the roots were incubated for 3 months at 37ºC and 100% humidity. Primary cone-beam computed tomography (CBCT) images were taken after incubation period. The specimens in each group were randomly divided into two subgroups (n=15). ProTaper R files (D1, D2, and D3) were used in groups A1 and B1 while Mtwo R files (25/0.05 and 15/0.05) were used in groups A2 and B2. The time required to extirpate the root filling was also recorded. After retreatment, another CBCT scan was taken at the same position. The volume of remaining filling materials inside the canals was calculated before and after retreatment. The data was analyzed using the two-way ANOVA and independent t-test. Results: The remaining filling materials in the canals treated with ProTaper were less than Mtwo. The remaining volume of GuttaFlow was less than gutta-percha regardless of the system applied. Mtwo R files removed root fillings faster than ProTaper R. Conclusion: ProTaper R removed filling material more efficiently compared to Mtwo R which required less time to remove root filling material. PMID:27471528

Vertical Root Fracture initiation in curved roots after root canal preparation: A dentinal micro-crack analysis with LED transillumination

PubMed Central

Martín-Biedma, Benjamín; Varela-Patiño, Purificación; Ruíz-Piñón, Manuel; Castelo-Baz, Pablo

2017-01-01

Background One of the causative factors of root defects is the increased friction produced by rotary instrumentation. A high canal curvature may increase stress, making the tooth more susceptible to dentinal cracks. The purpose of this study was to evaluate dentinal micro-crack formation with the ProTaper NEXT and ProTaper Universal systems using LED transillumination, and to analyze the micro-crack generated at the point of maximum canal curvature. Material and Methods 60 human mandibular premolars with curvatures between 30–49° and radii between 2–4 mm were used. The root canals were instrumented using the Protaper Universal® and Protaper NEXT® systems, with the aid of the Proglider® system. The obtained samples were sectioned transversely before subsequent analysis with LED transillumination at 2 mm and 8 mm from the apex and at the point of maximum canal curvature. Defects were scored: 0 for no defects; and 1 for micro-cracks. Results Root defects were not observed in the control group. The ProTaper NEXT system caused fewer defects (16.7%) than the ProTaper Universal system (40%) (P<0.05). The ProTaper Universal system caused significantly more micro-cracks at the point of maximum canal curvature than the ProTaper NEXT system (P<0.05). Conclusions Rotary instrumentation systems often generate root defects, but the ProTaper NEXT system generated fewer dentinal defects than the ProTaper Universal system. A higher prevalence of defects was found at the point of maximum curvature in the ProTaper Universal group. Key words:Curved root, Micro-crack, point of maximum canal curvature, ProTaper NEXT, ProTaper Universal, Vertical root fracture. PMID:29167712

In vitro evaluation of the sealing ability of three newly developed root canal sealers: A bacterial microleakage study

PubMed Central

Sobhani, Ehsan; Samadi-Kafil, Hossein; Pirzadeh, Ahmad; Jafari, Sanaz

2016-01-01

Background The purpose of this study was to compare the sealing ability of MTA Fillapex, Apatite Root Canal Sealer and AH26 sealers. Material and Methods The present in vitro study was carried out on 142 extracted single-rooted human mature teeth. The teeth were randomly divided into three experimental groups (n=44) and two control groups (n=5). Three root canal sealers were MTA Fillapex, Apatite Root Canal Sealer and AH26. The teeth in the control groups were either filled with no sealer or made completely impermeable. The root canals were prepared and obturated with gutta-percha and one of the sealers. The teeth were sterilized with ethylene oxide gas prior to the bacterial leakage assessment using Enterococcus faecalis. Leakage was evaluated every 24 hours for 90 days. Data were analyzed with descriptive statistical methods and chi-squared test. If the data were significant, a proper post hoc test was used. Statistical significance was set at P<0.05. Results The positive control specimens exhibited total bacterial penetration whilst the negative control specimens showed no evidence of bacterial penetration. At the end of the study, the analysis of microleakage with chi-squared test showed no significant differences between the experimental groups (P<0.05). The results of chi-squared test analyzing the pair-wise differences between the groups considering the numerical values for leakage day indicated the lowest leakage with AH26 and the highest with Apatite root sealer. Conclusions According to the results of the present study, sealing ability of AH26 was significantly higher than that of MTA Fillapex and Apatite Root Canal Sealer. Key words:Mineral Trioxide aggregate, root canal obturation, dental seal. PMID:27957271

Comparison of two techniques for assessing the shaping efficacy of repeatedly used nickel-titanium rotary instruments.

PubMed

Ounsi, Hani F; Franciosi, Giovanni; Paragliola, Raffaele; Al-Hezaimi, Khalid; Salameh, Ziad; Tay, Franklin R; Ferrari, Marco; Grandini, Simone

2011-06-01

The shaping capacity of nickel-titanium (NiTi) rotary instruments is often assessed by photographic or micro-computed tomography (micro-CT) measurements, and these instruments are often used more than once clinically. This study was conducted to compare photographic and micro-CT measurements and to assess if the repeated use of NiTi instruments affected the shape of canal preparation. Ten new sets of ProTaper Universal instruments (Dentsply-Maillefer, Ballaigues, Switzerland) were used in 60 resin blocks simulating curved root canals. Groups 1 to 6 (n=10) represented the first to sixth use of the instrument, respectively. Digitized images of the prepared blocks were taken in both mesiodistal (MD) and buccolingual (BL) directions and area measurements (mm(2)) were calculated using AutoCAD (Autodesk Inc, San Rafael, CA). The volumes of the same prepared canals were measured using micro-CT (mm(3)). Statistical analysis was performed to detect differences between photographic and volumetric measurements and differences between uses. Two-way repeated-measures analysis of variance revealed significant differences between groups (P < .001). Regarding measurement type, there were no significant differences between BL and MD measurements, but there were significant differences between micro-CT and BL measurements (P < .001) and micro-CT and MD measurements (P=.001). Significant differences were also noted between uses. Within the limitations of the present study, micro-CT scanning is more discriminative of the changes in canal space associated with repeated instrument use than photographic measurements. Canal preparations are significantly smaller after the third use of the same instrument. Copyright © 2011 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

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

PubMed

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

2010-04-01

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

Molecular identification and quantification of bacteria from endodontic infections using real-time polymerase chain reaction.

PubMed

Blome, B; Braun, A; Sobarzo, V; Jepsen, S

2008-10-01

It was the aim of the present study to evaluate root canal samples for the presence and numbers of specific species as well as for total bacterial load in teeth with chronic apical periodontitis using quantitative real-time polymerase chain reaction (PCR). Forty adult patients with one radiographically documented periapical lesion were included. Twenty teeth presented with primary infections and 20 with secondary infections, requiring retreatment. After removal of necrotic pulp tissue or root canal filling, a first bacterial sample was obtained. Following chemo-mechanical root canal preparation a second sample was taken and a third sample was obtained after 14 days of intracanal dressing with calcium hydroxide. Analysis by real-time PCR enabled the quantification of total bacterial counts and of nine selected species. Root canals with primary infections harbored significantly more bacteria (by total bacterial count) than teeth with secondary infections (P < 0.05). Mean total bacterial count in the retreatment group was 2.1 x 10(6) and was significantly reduced following root canal preparation (3.6 x 10(4)) and intracanal dressing (1.4 x 10(5)). Corresponding values for primary infections were: 4.6 x 10(7), 3.6 x 10(4), and 6.9 x 10(4). The numbers of the selected bacteria and their detection frequency were also significantly reduced. Root canals with primary infections contained a higher bacterial load. Chemo-mechanical root canal preparation reduced bacterial counts by at least 95%.

Performance of CAD/CAM fabricated fiber posts in oval-shaped root canals: An in vitro study.

PubMed

Tsintsadze, Nino; Juloski, Jelena; Carrabba, Michele; Tricarico, Marella; Goracci, Cecilia; Vichi, Alessandro; Ferrari, Marco; Grandini, Simone

2017-10-01

To assess the push-out strength, the cement layer thickness and the interfacial nanoleakage of prefabricated fiber posts, CAD/CAM fiber posts and metal cast posts cemented into oval-shaped root canals. Oval-shaped post spaces were prepared in 30 single-rooted premolars. Roots were randomly assigned to three groups (n=10), according to the post type to be inserted: Group 1: Prefabricated fiber post (D.T. Light-Post X-RO Illusion); Group 2: Cast metal post; Group 3: CAD/CAM-fabricated fiber post (experimental fiber blocks). In Group 3, post spaces were sprayed with scan powder (VITA), scanned with an inEos 4.2 scanner, and fiber posts were milled using an inLab MC XL CAD/CAM milling unit. All posts were cemented using Gradia Core dual-cure resin cement in combination with Gradia core self-etching bond (GC). After 24 hours, the specimens were sectioned perpendicular to the long axis into six 1 mm-thick sections, which were differentiated by the root level. Sections from six roots per group were used to measure the cement thickness and subsequently for the thin-slice push-out test, whereas the sections from the remaining four teeth were assigned to interfacial nanoleakage test. The cement thickness around the posts was measured in micrometers (µm) on the digital images acquired with a digital microscope using the Digimizer software. Thin-slice push-out test was conducted using a universal testing machine at the crosshead speed of 0.5 mm/minute and the bond strength was expressed in megaPascals (MPa). The interfacial nanoleakage was observed under light microscope and quantified by scoring the depth of silver nitrate penetration along the post-cement-dentin interfaces. The obtained results were statistically analyzed by Kruskal-Wallis ANOVA, followed by the Dunn's Multiple Range test for post hoc comparisons. The level of significance was set at P< 0.05. Statistically significant differences were found among the groups in push-out bond strength, cement thickness and interfacial nanoleakage (P< 0.05). CAD/CAM-fabricated fiber posts achieved retention that was comparable to that of cast metal posts and significantly higher than that of prefabricated fiber posts. The cement layer thickness around CAD/CAM-fabricated fiber posts was significantly lower than around prefabricated fiber posts, but higher than that around cast metal posts. Root level was not a significant factor for push-out strength in any of the groups, whereas it significantly affected cement layer thickness only in the prefabricated fiber post group. No differences were observed in interfacial nanoleakage between CAD/CAM fabricated and prefabricated fiber posts, while nanoleakage recorded in cast metal posts was significantly lower. CAD/CAM fabricated fiber posts could represent a valid alternative to traditionally used posts in the restoration of endodontically-treated teeth with oval or wide root canals, offering the advantages of better esthetics, retention, and cement thickness values that are comparable to cast post and cores.

Quantitative three-dimensional analysis of root canal curvature in maxillary first molars using micro-computed tomography.

PubMed

Lee, Jong-Ki; Ha, Byung-Hyun; Choi, Jeong-Ho; Heo, Seok-Mo; Perinpanayagam, Hiran

2006-10-01

In endodontic therapy, access and instrumentation are strongly affected by root canal curvature. However, the few studies that have actually measured curvature are mostly from two-dimensional radiographs. The purpose of this study was to measure the three-dimensional (3D) canal curvature in maxillary first molars using micro-computed tomography (microCT) and mathematical modeling. Extracted maxillary first molars (46) were scanned by microCT (502 image slices/tooth, 1024 X 1024 pixels, voxel size of 19.5 x 19.5 x 39.0 microm) and their canals reconstructed by 3D modeling software. The intersection of major and minor axes in the canal space of each image slice were connected to create an imaginary central axis for each canal. The radius of curvature of the tangential circle was measured and inverted as a measure of curvature using custom-made mathematical modeling software. Root canal curvature was greatest in the apical third and least in the middle third for all canals. The greatest curvatures were in the mesiobuccal (MB) canal (0.76 +/- 0.48 mm(-1)) with abrupt curves, and the least curvatures were in the palatal (P) canal (0.38 +/- 0.34 mm(-1)) with a gradual curve. This study has measured the 3D curvature of root canals in maxillary first molars and reinforced the value of microCT with mathematical modeling.

Evaluation of technical quality and periapical health of root-filled teeth by using cone-beam CT

PubMed Central

Bilge Gülsüm, NUR; Evren, OK; ALTUNSOY, Mustafa; AĞLARCI, Osman Sami; ÇOLAK, Mehmet; GÜNGÖR, Enes

2014-01-01

Objective This study aimed to assess the quality of root fillings, coronal restorations, complications of all root-filled teeth and their association with apical periodontitis (AP) detected by cone-beam computed tomography (CBCT) images from an adult Turkish subpopulation. Material and Methods The sample for this study consisted of 242 patients (aging from 15 to 72 years) with 522 endodontically treated teeth that were assessed for technical quality of the root canal filling and periapical status of the teeth. Additionally, the apical status of each root-filled tooth was assessed according to the gender, dental arch, tooth type and age classification, undetected canals, instrument fracture, root fracture, apical resorption, apical lesion, furcation lesion and type and quality of the coronal structure. Statistical analysis was performed using percentages and chi-square test. Results The success rate of the root canal treatment was of 54.4%. The success rates of adequate and inadequate root canal treatment were not significantly different (p>0.05). Apical periodontitis was found in 228 (45.6%) teeth treated for root canals. Higher prevalence of AP was found in patients aging from 20 to 29 years [64 (27%) teeth] and in anterior (canines and incisors) teeth [97 (41%) teeth]. Conclusions The technical quality of root canal filling performed by dental practitioners in a Turkish subpopulation was consistent with a high prevalence of AP. The probable reasons for this failure are multifactorial, and there may be a need for improved undergraduate education and postgraduate courses to improve the clinical skills of dental practitioners in endodontics. PMID:25591019

Effects of self-adjusting file, Mtwo, and ProTaper on the root canal wall.

PubMed

Hin, Ellemieke S; Wu, Min-Kai; Wesselink, Paul R; Shemesh, Hagay

2013-02-01

The purpose of this ex vivo study was to observe the incidence of cracks in root dentin after root canal preparation with hand files, self-adjusting file (SAF), ProTaper, and Mtwo. One hundred extracted mandibular premolars with single canals were randomly selected. Two angulated radiographs were taken for each tooth, and the width of the canal was measured at 9 mm from the apex. Five groups of 20 teeth each were comparable in canal width. The control group was left unprepared. Four experimental groups were instrumented with hand files, ProTaper, Mtwo, and SAF. Roots were then sectioned horizontally and observed under a microscope. The presence of dentinal cracks and their location were noted. The difference between the experimental groups was analyzed with a χ(2) test. No cracks were observed in the control group. In the experimental groups, ProTaper, Mtwo, and SAF caused cracks in 35%, 25%, and 10% of teeth, respectively. The hand-file group did not show any dentinal cracks (P < .0001). ProTaper and Mtwo caused more cracks than hand files (P < .05), but SAF did not (P > .05). Instrumentation of root canals with SAF, Mtwo, and ProTaper could cause damage to root canal dentin. SAF has a tendency to cause less dentinal cracks as compared with ProTaper or Mtwo. Copyright © 2013 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Monitoring the effectiveness of root canal procedures on endotoxin levels found in teeth with chronic apical periodontitis

PubMed Central

MARINHO, Ariane Cassia Salustiano; MARTINHO, Frederico Canato; ZAIA, Alexandre Augusto; FERRAZ, Caio Cezar Randi; GOMES, Brenda Paula Figueiredo de Almeida

2014-01-01

Objective: The aim of this study was to monitor the effectiveness of root canal procedures by using different irrigants and intracanal medication on endotoxin levels found in root canals of teeth with chronic apical periodontitis. Material and Methods: Thirty root canals of teeth with pulpal necrosis associated with periapical lesions were selected and randomly divided into groups according to the irrigants used: GI - 2.5% NaOCl, GII - 2% chlorhexidine (CHX) gel, and GIII - saline solution (SS) (all, n=10). Samples were collected with sterile/apyrogenic paper points before (S1) and after root canal instrumentation (S2), after use of 17% ethylenediaminetetraacetic acid (EDTA) (S3), and after 30 days of intracanal medication (Ca(OH)2+SS) (S4). A turbidimetric kinetic Limulus Amebocyte Lysate assay was used for endotoxin measurement. Results: Endotoxins were detected in 100% of the root canals investigated (30/30), with a median value of 18.70 EU/mL. After S2, significant median percentage reduction was observed in all groups, irrespective of the irrigant tested: 2.5% NaOCl (99.65%) (GI), 2% CHX (94.27%) (GII), and SS (96.79%) (GIII) (all p<0.05). Root canal rinse with 17% EDTA (S3) for a 3-minute period failed to decrease endotoxin levels in GI and a slight decrease was observed in GII (59%) and GIII (61.1%) (all p>0.05). Intracanal medication for 30 days was able to significantly reduce residual endotoxins: 2.5% NaOCl (90%) (GI), 2% CHX (88.8%) (GII), and SS (85.7%) (GIII, p<0.05). No differences were found in the endotoxin reduction when comparing s2 and s4 treatment groups. Conclusion: Our findings demonstrated the effectiveness of the mechanical action of the instruments along with the flow and backflow of irrigant enduring root canal instrumentation for the endotoxin removal from root canals of teeth with chronic apical periodontitis. Moreover, the use of intracanal medication for 30 days contributed for an improvement of endotoxin reduction. PMID:25075670

Ultrasonic irrigation of a maxillary lateral incisor with perforation of the apical third of the root.

PubMed

Tsurumachi, Tamotsu; Takita, Toshiya; Hashimoto, Kazuhiro; Katoh, Takeshi; Ogiso, Bunnai

2010-12-01

We describe the successful use of a combination of nonsurgical root canal treatment and ultrasonic irrigation for collaborative management of a maxillary left lateral incisor with perforation of the apical third of the root. During the endodontic treatment procedure, the ultrasonically activated tip was used for intracanal irrigation. The area of perforation in the apical third of the root and the main root canal space were obturated with gutta-percha and root canal sealer, using a lateral condensation method. A follow-up clinical and radiographic examination at 5 years after treatment showed an asymptomatic tooth with excellent osseous healing.

Maxillary first molar with aberrant canal configuration: a report of 3 cases.

PubMed

Poorni, Saravanan; Kumar, Anil; Indira, Rajamani

2008-12-01

The prognosis for endodontic treatment in teeth exhibiting morphological aberrations is unfavorable if the clinician fails to recognize extra root canals. This report demonstrates 3 clinical cases of maxillary first molars that presented 2 canals in the palatal root merging at the apical third (Vertucci's type II canal morphology), a pattern that is rare and seldom encountered.

A comparative assessment of the accuracy of electronic apex locator (Root ZX) in the presence of commonly used irrigating solutions

PubMed Central

Raidullah, Ebadullah; Francis, Maria L.

2014-01-01

Objectives: This study aimed to evaluate the accuracy of Root ZX in determining working length in presence of normal saline, 0.2% chlorhexidine and 2.5% of sodium hypochlorite. Material and Methods: Sixty extracted, single rooted, single canal human teeth were used. Teeth were decoronated at CEJ and actual canal length determined. Then working length measurements were obtained with Root ZX in presence of normal saline 0.9%, 0.2% chlorhexidine and 2.5% NaOCl. The working length obtained with Root ZX were compared with actual canal length and subjected to statistical analysis. Results: No statistical significant difference was found between actual canal length and Root ZX measurements in presence of normal saline and 0.2% chlorhexidine. Highly statistical difference was found between actual canal length and Root ZX measurements in presence of 2.5% of NaOCl, however all the measurements were within the clinically acceptable range of ±0.5mm. Conclusion: The accuracy of EL measurement of Root ZX within±0.5 mm of AL was consistently high in the presence of 0.2% chlorhexidine, normal saline and 2.5% sodium hypochlorite. Clinical significance: This study signifies the efficacy of ROOT ZX (Third generation apex locator) as a dependable aid in endodontic working length. Key words:Electronic apex locator, working length, root ZX accuracy, intracanal irrigating solutions. PMID:24596634

Sealing ability of lateral compaction and tapered single cone gutta-percha techniques in root canals prepared with stainless steel and rotary nickel titanium instruments.

PubMed

Koçak, Mustafa M; Darendeliler-Yaman, Sis

2012-07-01

The aim of this study was to evaluate the sealing ability of lateral compaction and tapered single cone gutta-percha techniques in root canals prepared with stainless steel and rotary nickel titanium root canal instruments by fluid filtration method. The root canals were prepared with stainless steel (SS) and nickel titanium (NiTi) instruments. The canals prepared with SS were obturated with lateral compaction technique using .02 tapered cones and the canals prepared with NiTi instruments were obturated with lateral compaction technique using .02 tapered cones or 06 tapered single cones. The amount of leakage was evaluated by fluid filtration model. The results were statistically analyzed with one-way ANOVA. The group prepared with NiTi instruments and filled with lateral compaction technique showed significantly less coronal leakage than the group prepared with SS instruments and filled with lateral compaction technique (p<0.05). There was no statistically difference between apical leakages of groups (p>0.05). Obturation with lateral compaction of gutta-percha provides a superior coronal seal whilst canal instrumentation with engine-driven NiTi files reduces the extent of microleakage in root canals when compared with stainless steel hand instruments. Tapered single cone technique was comparable with lateral compaction technique because of easier application. Key words:Apical leakage, coronal leakage, lateral compaction technique, single cone technique.

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. © 2015 Australian Society of Endodontology.

A rare variant of internal anatomy of a third mandibular molar: a case report.

PubMed

Nimigean, V; Nimigean, Vanda Roxana; Sălăvăstru, D I

2011-01-01

The several anatomical variations existing in the root canal system may contribute to failure of the root canal therapy. Knowledge of the internal dental morphology is a complex and extremely important point for planning and performing endodontic therapy. This paper reports the case of a left mandibular third molar that presented only one dental conical root and only one aberrant radicular canal with an initial annular portion situated in the coronar third of the root and a linear portion at the level of the other two thirds of the dental root, which opened through an apical foramen. Root canal therapy and case management are described. Features like wide crown access, adequate illumination and use of exploring files where important for successful completion of the endodontic treatment. The treatment was performed through conventional methods. This clinical case constitutes a rare anatomical variant of internal radicular morphology.

Setting time and sealing ability of alpha-tricalcium phosphate cement containing titanic oxide.

PubMed

Yoshikawa, M; Terada, Y; Toda, T

1998-10-01

We developed a new type of calcium phosphate cement for clinical use in endodontics as a root canal sealer or pulp cupping agent. The solid phase of the sealer is composed of 70% of alpha-tricalcium phosphate (alpha-TCP) and 30% of titanic oxide (TiO2), and the liquid phase is 37% citric acid, 5% tannic acid and 58% distilled water. TiO2 was added to control setting time and handling of the cement. We used commercially available calcium phosphate root canal sealer as a control. ISO standards specify that new endodontic products should be examined thoroughly before clinical use. It is important to carry out in vitro cytotoxicity and in vivo histocompatibility tests. We first did in vitro test of setting time and root canal sealing ability of the cement. We found that this developed calcium phosphate cement had an appropriate setting time and excellent sealing ability as a root canal sealer, and concluded that it was suitable for clinical use as a root canal sealer.

Biofilms in Endodontics-Current Status and Future Directions.

PubMed

Neelakantan, Prasanna; Romero, Monica; Vera, Jorge; Daood, Umer; Khan, Asad U; Yan, Aixin; Cheung, Gary Shun Pan

2017-08-11

Microbiota are found in highly organized and complex entities, known as biofilms, the characteristics of which are fundamentally different from microbes in planktonic suspensions. Root canal infections are biofilm mediated. The complexity and variability of the root canal system, together with the multi-species nature of biofilms, make disinfection of this system extremely challenging. Microbial persistence appears to be the most important factor for failure of root canal treatment and this could further have an impact on pain and quality of life. Biofilm removal is accomplished by a chemo-mechanical process, using specific instruments and disinfecting chemicals in the form of irrigants and/or intracanal medicaments. Endodontic research has focused on the characterization of root canal biofilms and the clinical methods to disrupt the biofilms in addition to achieving microbial killing. In this narrative review, we discuss the role of microbial biofilms in endodontics and review the literature on the role of root canal disinfectants and disinfectant-activating methods on biofilm removal.

Live Helicobacter pylori in the root canal of endodontic-infected deciduous teeth.

PubMed

Hirsch, Christian; Tegtmeyer, Nicole; Rohde, Manfred; Rowland, Marion; Oyarzabal, Omar A; Backert, Steffen

2012-08-01

Many polymerase chain reaction (PCR)-based studies have shown that Helicobacter pylori DNA is prevalent in the oral cavity, but reports on the isolation of live bacteria are extremely rare. Thus, it is still unclear whether H. pylori can indeed survive in the oral environment. Here we used electron microscopy, selective growth techniques, urease assays, 16S rRNA PCR, and western blotting to investigate the possible presence of live H. pylori in 10 root canal and corresponding plaque samples of endodontic-infected deciduous teeth in three children. Although H. pylori DNA was verifiable by PCR in several plaque and root canal samples, bacterial colonies could only be grown from two root canals, but not from plaque. These colonies were unequivocally identified as H. pylori by microscopic, genetic, and biochemical approaches. Our findings show that root canals of endodontic-infected teeth may be a reservoir for live H. pylori that could serve as a potential source for transmission.

Biofilms in Endodontics—Current Status and Future Directions

PubMed Central

Neelakantan, Prasanna; Romero, Monica; Vera, Jorge; Daood, Umer; Khan, Asad U.; Yan, Aixin; Cheung, Gary Shun Pan

2017-01-01

Microbiota are found in highly organized and complex entities, known as biofilms, the characteristics of which are fundamentally different from microbes in planktonic suspensions. Root canal infections are biofilm mediated. The complexity and variability of the root canal system, together with the multi-species nature of biofilms, make disinfection of this system extremely challenging. Microbial persistence appears to be the most important factor for failure of root canal treatment and this could further have an impact on pain and quality of life. Biofilm removal is accomplished by a chemo-mechanical process, using specific instruments and disinfecting chemicals in the form of irrigants and/or intracanal medicaments. Endodontic research has focused on the characterization of root canal biofilms and the clinical methods to disrupt the biofilms in addition to achieving microbial killing. In this narrative review, we discuss the role of microbial biofilms in endodontics and review the literature on the role of root canal disinfectants and disinfectant-activating methods on biofilm removal. PMID:28800075

Analyzing endosonic root canal file oscillations: an in vitro evaluation.

PubMed

Lea, Simon C; Walmsley, A Damien; Lumley, Philip J

2010-05-01

Passive ultrasonic irrigation may be used to improve bacterial reduction within the root canal. The technique relies on a small file being driven to oscillate freely within the canal and activating an irrigant solution through biophysical forces such as microstreaming. There is limited information regarding a file's oscillation patterns when operated while surrounded by fluid as is the case within a canal root. Files of different sizes (#10 and #30, 27 mm and 31 mm) were connected to an ultrasound generator via a 120 degrees file holder. Files were immersed in a water bath, and a laser vibrometer set up with measurement lines superimposed over the files. The laser vibrometer was scanned over the oscillating files. Measurements were repeated 10 times for each file/power setting used. File mode shapes are comprised of a series of nodes/antinodes, with thinner, longer files producing more antinodes. The maximum vibration occurred at the free end of the file. Increasing generator power had no significant effect on this maximum amplitude (p > 0.20). Maximum displacement amplitudes were 17 to 22 microm (#10 file, 27 mm), 15 to 21 microm (#10 file, 31 mm), 6 to 9 microm (#30 file, 27 mm), and 5 to 7 microm (#30, 31 mm) for all power settings. Antinodes occurring along the remaining file length were significantly larger at generator power 1 than at powers 2 through 5 (p < 0.03). At higher generator powers, energy delivered to the file is dissipated in unwanted vibration resulting in reduced vibration displacement amplitudes. This may reduce the occurrence of the biophysical forces necessary to maximize the technique's effectiveness. Copyright (c) 2010 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

FP core carrier technique: thermoplasticized gutta-percha root canal obturation technique using polypropylene core.

PubMed

Kato, Hiroshi; Nakagawa, Kan-Ichi

2010-01-01

Core carrier techniques are unique among the various root canal filling techniques for delivering and compacting gutta-percha in the prepared root canal system. Thermafil (TF), considered the major core carrier device, is provided as an obturator consisting of a master core coated with thermoplasticized gutta-percha. We have devised a thermoplasticized gutta-percha filling technique using a polypropylene core, FlexPoint® NEO (FP), which was developed as a canal filling material that can be sterilized in an autoclave. Therefore, FP can be coated onto thermoplasticized gutta-percha and inserted into the prepared canal as a core carrier. The FP core carrier technique offers many advantages over the TF system: the core can be tested in the root canal and verified radiographically; the core can be adjusted to fit and surplus material easily removed; furthermore the core can be easily removed for retreatment. The clinical procedure of the FP core carrier technique is simple, and similar that with the TF system. Thermoplasticized gutta-percha in a syringe is heated in an oven and extruded onto the FP core carrier after a trial insertion. The FP core carrier is inserted into the root canal to the working length. Excess FP is then removed with a red-hot plastic instrument at the orifice of the root canal. The FP core carrier technique incorporates the clinical advantages of the existing TF system while minimizing the disadvantages. Hence the FP core carrier technique is very useful in clinical practice. This paper describes the FP core carrier technique as a new core based method.

Comparison of mandibular first molar mesial root canal morphology using micro-computed tomography and clearing technique.

PubMed

Kim, Yeun; Perinpanayagam, Hiran; Lee, Jong-Ki; Yoo, Yeon-Jee; Oh, Soram; Gu, Yu; Lee, Seung-Pyo; Chang, Seok Woo; Lee, Woocheol; Baek, Seung-Ho; Zhu, Qiang; Kum, Kee-Yeon

2015-08-01

Micro-computed tomography (MCT) with alternative image reformatting techniques shows complex and detailed root canal anatomy. This study compared two-dimensional (2D) and 3D MCT image reformatting with standard tooth clearing for studying mandibular first molar mesial root canal morphology. Extracted human mandibular first molar mesial roots (n=31) were scanned by MCT (Skyscan 1172). 2D thin-slab minimum intensity projection (TS-MinIP) and 3D volume rendered images were constructed. The same teeth were then processed by clearing and staining. For each root, images obtained from clearing, 2D, 3D and combined 2D and 3D techniques were examined independently by four endodontists and categorized according to Vertucci's classification. Fine anatomical structures such as accessory canals, intercanal communications and loops were also identified. Agreement among the four techniques for Vertucci's classification was 45.2% (14/31). The most frequent were Vertucci's type IV and then type II, although many had complex configurations that were non-classifiable. Generally, complex canal systems were more clearly visible in MCT images than with standard clearing and staining. Fine anatomical structures such as intercanal communications, accessory canals and loops were mostly detected with a combination of 2D TS-MinIP and 3D volume-rendering MCT images. Canal configurations and fine anatomic structures were more clearly observed in the combined 2D and 3D MCT images than the clearing technique. The frequency of non-classifiable configurations demonstrated the complexity of mandibular first molar mesial root canal anatomy.

Bacterial analysis of combined periodontal-endodontic lesions by polymerase chain reaction-denaturing gradient gel electrophoresis.

PubMed

Xia, Minghui; Qi, Qingguo

2013-01-01

We used denaturing gradient gel electrophoresis (DGGE) to compare bacterial profiles in periodontium and root canals of teeth with combined periodontal-endodontic lesions. Samples of dental plaque and necrotic pulp were collected from thirteen extracted teeth with advanced periodontitis. Genomic DNA was extracted for polymerase chain reaction (PCR) analysis using universal bacterial primers. The PCR products were then loaded onto DGGE gels to obtain fractionated bands. Characteristic DGGE bands were excised and DNA was cloned and sequenced. The number of bands, which indicates the number of bacterial species, was compared between dental plaques and necrotic pulp tissues from the same tooth. Although the difference was statistically significant (P < 0.01), there was no positive correlation; similarity (Dice coefficient) was 13.1% to 62.5%. Some bacteria species were present in both the periodontal pockets and root canals of the same tooth; however, periodontal bacteria did not always invade the root canals, and some bacteria in root canals were not present in periodontal pockets of the same tooth. In some teeth, unique bacteria in root canals had not passed from periodontal pockets. A basic local alignment search tool (BLAST) sequence search in Genbank indicated that new bacteria species were present in periodontal pockets and root canals. Their characteristics must thus be further analyzed.

Complex Apical Intraradicular Infection and Extraradicular Mineralized Biofilms as the Cause of Wet Canals and Treatment Failure: Report of 2 Cases.

PubMed

Ricucci, Domenico; Candeiro, George T M; Bugea, Calogero; Siqueira, José F

2016-03-01

This article describes 2 cases that showed persistent intracanal exudation (wet canal) even after several visits of antimicrobial endodontic treatment. Histologic and histobacteriologic investigation was conducted for determination of the cause. The 2 cases involved teeth with apical periodontitis lesions, which presented persistent exudation refractory to treatment after several visits. In case 1, it was not possible to achieve a dry canal, and surgery had to be performed. In case 2, attempts to dry the canal succeeded and the canal was filled, but follow-up examination showed an enlarged apical periodontitis lesion and extraction was performed. Biopsy specimens consisting of the root apex and apical periodontitis lesion for case 1 and the whole root for case 2 were subjected to histologic and histobacteriologic analyses. Both cases showed complex bacterial infection in the apical root, affecting both the intraradicular space and the outer root surface. Case 1 showed bacterial biofilms in ramifications, on untouched walls, and extending to the external root surface to form a thick and partially mineralized structure with high bacterial density. Different bacterial morphotypes were evidenced. Case 2 had a ledge on the apical canal wall created during instrumentation, which was filled with necrotic debris, filling material, and bacteria. The walls of the apical portion of the canal were covered by a bacterial biofilm, which was continuous with a thick extraradicular biofilm covering the cementum and dentin in resorptive defects. The extraradicular biofilm showed areas of mineralization and was dominated by filamentous bacteria. The 2 cases with wet canals and treatment failure were associated with complex persistent infection in the apical part of the root canal system extending to form thick and partially mineralized biofilm structures (calculus) on the outer apical root surface. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Effects of NaOCl, EDTA and MTAD when applied to dentine on stress distribution in post-restored roots with flared canals.

PubMed

Belli, S; Eraslan, O; Eraslan, O; Eskitascioglu, M; Eskitascioglu, G

2014-12-01

To evaluate the effect of NaOCl, EDTA and MTAD on the stress distribution and levels in roots with flared canals and three different aesthetic post systems using finite element stress analysis (FEA). Three-dimensional (3D) FEA models simulating a maxillary incisor with excessive structural loss and flared root canals were created. The dentine of the first models of each post group was assumed as homogenous, whereas the others were deemed as having their elastic modulus affected up to 100 μm deep as a result of irrigation protocol (5.25 NaOCl, 17% EDTA and MTAD for 2 h). A sound incisor tooth model was used as the control. Restorations were created according to the post system used (pre-fabricated fibre post (PFP)), polyethylene fibre (Ribbond) post and core build-up (RBP), and one-piece milled zirconia post and core (ZP). Ceramic crowns were added to the models. A 300-N static load was applied at the centre of the palatal surface of the models to calculate the stress distributions. The SolidWorks/Cosmosworks structural analysis programmes were used for FEA analysis. Results were presented by considering von Mises criteria. The analysis of the von Mises stresses revealed that RBP created less stress in the remaining root dentine when compared to PFP and ZP. ZP maintained the stresses inside its body and reduced stress on the palatal surface of the root; however, it forwarded more stress towards the apical area. NaOCl-, EDTA- and MTAD-treated dentine increased the stresses within the root structure regardless of the effect of the post system used (11-15.4 MPa for PFP, 9.5-13.02 MPa for RBP and 14.2 MPa for ZP). Amongst the irrigation solutions used, EDTA and MTAD increased the stresses more than NaOCl in all models. All the irrigation solutions showed the same stress levels and distributions in the ZP model. NaOCl-, EDTA- and MTAD- treated dentine and a rigid post with high elastic modulus may increase fracture risk in roots with flared canals by increasing the stresses within root dentine. Therefore, solutions that alter the elastic modulus of dentine less (such as NaOCl) or an individually shaped post-core system constructed with a material that has an elastic modulus close to dentine (polyethylene fibre) should be used in weak roots. © 2014 International Endodontic Journal. Published by John Wiley & Sons Ltd.

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

PubMed Central

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

2016-01-01

Caries is the most common cause of pulp-periapical disease. When the pulp tissue involved in caries becomes irreversibly inflamed and progresses to necrosis, the treatment option is root canal therapy because the infected or non-infected necrotic pulp tissue in the root canal system is not accessible to the host's innate and adaptive immune defense mechanisms and antimicrobial agents. Therefore, the infected or non-infected necrotic pulp tissue must be removed from the canal space by pulpectomy. As our knowledge in pulp biology advances, the concept of treatment of pulpal and periapical disease also changes. Endodontists have been looking for biologically based treatment procedures, which could promote regeneration or repair of the dentin-pulp complex destroyed by infection or trauma for several decades. After a long, extensive search in in vitro laboratory and in vivo preclinical animal experiments, the dental stem cells capable of regenerating the dentin-pulp complex were discovered. Consequently, the biological concept of ‘regenerative endodontics’ emerged and has highlighted the paradigm shift in the treatment of immature permanent teeth with necrotic pulps in clinical endodontics. Regenerative endodontics is defined as biologically based procedures designed to physiologically replace damaged tooth structures, including dentin and root structures, as well as the pulp-dentin complex. According to the American Association of Endodontists’ Clinical Considerations for a Regenerative Procedure, the primary goal of the regenerative procedure is the elimination of clinical symptoms and the resolution of apical periodontitis. Thickening of canal walls and continued root maturation is the secondary goal. Therefore, the primary goal of regenerative endodontics and traditional non-surgical root canal therapy is the same. The difference between non-surgical root canal therapy and regenerative endodontic therapy is that the disinfected root canals in the former therapy are filled with biocompatible foreign materials and the root canals in the latter therapy are filled with the host's own vital tissue. The purpose of this article is to review the potential of using regenerative endodontic therapy for human immature and mature permanent teeth with necrotic pulps and/or apical periodontitis, teeth with persistent apical periodontitis after root canal therapy, traumatized teeth with external inflammatory root resorption, and avulsed teeth in terms of elimination of clinical symptoms and resolution of apical periodontitis. PMID:29563445

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

PubMed

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

2016-02-27

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

[Shaping ability of two nickel-titanium rotary systems in simulated S-shaped canals].

PubMed

Luo, Hong-xia; Huang, Ding-ming; Zhang, Fu-hua; Tan, Hong; Zhou, Xue-dong

2008-01-01

To evaluate the shaping ability of two nickel-titanium rotary systems (ProTaper and Hero642) in simulated S-shaped canals. Thirty simulated S-shaped canals were randomly divided into three groups and prepared by ProTaper, Hero642, ProTaper combined with Hero642 respectively. All the canals were scanned before and after instrumentation, and the amount of material removed in the inner and outer wall and the canal width after instrumentation were measured with a computer image analysis program. There was significant difference in the amount of material removed at the inner side of apical curvature and outer side of apex between ProTaper combined with Hero642 and ProTaper files (P < 0.05) at the same tip size. The inner and outer wall of the canals were evenly prepared by ProTaper combined with Hero642, and the taper of canals were better than those prepared by Hero642. ProTaper combined with Hero 642 had better shaping ability to maintain the original shape and could create good taper canals in the simulated S-shaped canal model.

Matrix Metalloproteinase Expression in Teeth with Apical Periodontitis Is Differentially Modulated by the Modality of Root Canal Treatment

PubMed Central

Paula-Silva, Francisco Wanderley Garcia; da Silva, Léa Assed Bezerra; Kapila, Yvonne Lorraine

2009-01-01

Objectives To investigate the expression of matrix metalloproteinases (MMPs) in apical periodontitis and during the periapical healing phase following root canal treatment. Methods Apical periodontitis was induced in dog teeth and root canal treatment was performed in a single visit or using an additional calcium hydroxide root canal dressing. One hundred and eighty days following treatment the presence of inflammation was examined and tissues were stained to detect bacteria. Bacterial status was correlated to the degree of tissue organization, and to further investigate molecules involved in this process, tissues were stained for MMP-1, MMP-2, MMP-8, and MMP-9. Data were analyzed using one-way ANOVA followed by Tukey test or Kruskal-Wallis followed by Dunn. Results Teeth with apical periodontitis that had root canal therapy performed in a single visit presented an intense inflammatory cell infiltrate. Periapical tissue was extremely disorganized, and this was correlated with the presence of bacteria. Higher MMP expression was evident, similar to teeth with untreated apical periodontitis. In contrast, teeth with apical periodontitis submitted to root canal treatment using calcium hydroxide presented a lower inflammatory cell infiltrate. This group had a moderately organized connective tissue, a lower prevalence of bacteria, and a lower number of MMP-positive cells, similar to healthy teeth submitted to treatment. Conclusion Teeth treated with calcium hydroxide root canal dressing exhibited a lower percentage of bacterial contamination, a lower MMP expression, and a more organized ECM, unlike those treated in a single visit. This suggests that calcium hydroxide may be beneficial in tissue repair processes. PMID:20113780

Apical Extrusion of Debris after Canal Preparation with Hand-Files Used Manually or Installed on Reciprocating Air-Driven Handpiece in Straight and Curved Canals.

PubMed

Labbaf, Hossein; Shakeri, Leila; Orduie, Reza; Bastami, Farshid

2015-01-01

Apical debris extrusion (DE) subsequent to root canal instrumentation, is one of the most important causes of endodontic flare-ups. The aim of this study was to compare the amount of DE after root canal instrumentation using nickel-titanium (NiTi) hand files with step-back manual technique or installed on reciprocating handpiece. This study was conducted on mesiobuccal (MB) roots of extracted maxillary first molars (n=20) and roots of mandibular premolars (n=20) that were randomly divided into two groups (n=20) according to the armamentarium used for canal preparation (air-driven reciprocating handpiece or hand instrumentation). In each group, the MB and premolar roots were prepared with the main apical sizes of 35 and 40, respectively. The extruded debris were collected and weighed. Finally, the mean dry weights were compared using ANOVA and t-test, and Tukey's Multiple Comparisons Procedures were used to determine the significant differences in amounts of DE. The level of significance was set at 0.05. Regardless of the type of teeth, the mean values of DE, were significantly lower in the handpiece group (P<0.0001). In addition, significantly lower amounts of DE was observed in premolars in similar group (P<0.001). However, this difference was not significant in MB roots of molars (P=0.20). Root canal preparation with reciprocating handpiece can lead to significantly lower debris extrusion than the manual step-back technique. In handpiece-prepared canals, the amount of extruded debris was significantly lower in premolar teeth.

Comparison of the antibacterial effect of sodium hypochlorite and aloe vera solutions as root canal irrigants in human extracted teeth contaminated with enterococcus faecalis.

PubMed

Sahebi, S; Khosravifar, N; Sedighshamsi, M; Motamedifar, M

2014-03-01

The main purpose of a root canal treatment is to eliminate the bacteria and their products from the pulp space. Sodium hypochlorite has excellent antibacterial properties, but also some negative features. The aim of the present study is to compare the antimicrobial effect of Aloe Vera solution with sodium hypochlorite on E.faecalis in the root canals of human extracted teeth. Sixty human extracted single rooted teeth were selected for this in vitro study. The teeth recruited in this study had no cracks, internal resorption, external resorption and calcification. Enterococcus faecalis was injected in the root canals of all teeth. The teeth were then divided into three groups randomly. Each group consisted of 20 teeth that were all rinsed with one of the following solutions: sodium hypochlorite 2.5%, Aloe vera and normal saline. Subsequent to rinsing, root canals of all teeth were sampled. The samples were cultured and growth of the bacteria was assessed after 48 hours. The number of colonies of the bacteria was then counted. The difference between the inhibitory effect of Aloe vera and normal saline on E.faecalis was not significant according to independent t-test (p= 0.966). The inhibitory effect of sodium hypochlorite on E.faecalis was much greater than that of Aloe vera and normal saline (p< 0.001). Aloe vera solution is not recommended as a root canal irrigator, but future studies are suggested to investigate the antibacterial effect of Aloe vera with longer duration of exposure and as an intra canal medicament.

Radiographic technical quality of root canal treatment performed ex vivo by dental students at Valencia University Medical and Dental School, Spain

PubMed Central

Faus-Matoses, Vicente; Alegre-Domingo, Teresa; Faus-Llácer, Vicente J.

2014-01-01

Objectives: To evaluate radiographically the quality of root canal fillings and compare manual and rotary preparation performed on extracted teeth by undergraduate dental students. Study Design: A total of 561 premolars and molars extracted teeth were prepared using nickel-titanium rotary files or manual instrumentation and filled with gutta-percha using a cold lateral condensation technique, by 4th grade undergraduate students. Periapical radiographs were used to assess the technical quality of the root canal filling, evaluating three variables: length, density and taper. These data were recorded, scored and used to study the “technical success rate” and the “overall score”. The length of each root canal filling was classified as acceptable, short and overfilled, based on their relationship with the radiographic apex. Density and taper of filling were evaluated based on the presence of voids and the uniform tapering of the filling, respectively. Statistical analysis was used to evaluate the quality of root canal treatment, considering p < 0.05 as a statistical significant level. Results: The percentage of technical success was 44% and the overall score was 7.8 out of 10. Technical success and overall score were greater with rotary instruments (52% against 28% with a manual one, p < 0.001; 8.3 against 6.7 respectively, p < 0.001). Conclusions: It appears that inexperienced operators perform better root canal treatment (RCT) with the use of rotary instrumentation. Key words:Dental education, endodontics, rotary instrumentation, radiographs, root canal treatment, undergraduate students. PMID:24121911

Evaluation of complications of root canal treatment performed by undergraduate dental students.

PubMed

AlRahabi, Mothanna K

2017-12-01

This study evaluated the technical quality of root canal treatment (RCT) and detected iatrogenic errors in an undergraduate dental clinic at the College of Dentistry, Taibah University, Saudi Arabia. Dental records of 280 patients who received RCT between 2013 and 2016 undertaken by dental students were investigated by retrospective chart review. Root canal obturation was evaluated on the basis of the length of obturation being ≤2 mm from the radiographic apex, with uniform radiodensity and good adaptation to root canal walls. Inadequate root canal obturation included cases containing procedural errors such as furcal perforation, ledge, canal transportation, strip perforation, root perforation, instrument separation, voids in the obturation, or underfilling or overfilling of the obturation. In 193 (68.9%) teeth, RCT was adequate and without procedural errors. However, in 87 (31.1%) teeth, RCT was inadequate and contained procedural errors. The frequency of procedural errors in the entire sample was 31.1% as follows: underfilling, 49.9%; overfilling, 24.1%; voids, 12.6%; broken instruments, 9.2%; apical perforation, 2.3%; and root canal transportation, 2.3%. There were no significant differences (p > 0.05) in the type or frequency of procedural errors between the fourth- and fifth-year students. Lower molars (43.1%) and upper incisors (19.2%) exhibited the highest and lowest frequencies of procedural errors, respectively. The technical quality of RCT performed by undergraduate dental students was classified as 'adequate' in 68.9% of the cases. There is a need for improvement in the training of students at the preclinical and clinical levels.

Evaluation of 4% Sodium Hypochlorite in eliminating Enterococcus faecalis from the Root Canal when Used with Three Irrigation Methods: An in vitro Study.

PubMed

Priyank, Harsh; Pandey, Vinisha; Bagul, Abhishek; Majety, Kishore Kumar; Verma, Parul; Choudhury, Basanta Kumar

2017-03-01

Endodontic treatment removes all pathogens, such as Enterococcus faecalis from pulp and root canals. The aim of this study is to assess the usefulness of sodium hypo-chlorite (NaOCl) in removing E. faecalis from the root canal used with three different irrigation methods. This study was conducted on freshly extracted maxillary incisors. After biomechanical preparation, root canals were injected with E. faecalis. Three groups were made which contained 30 teeth in each group; 2 mL of NaOCl solution was used for irrigation followed by agitation with K-files in group I; 2 mL of NaOCl solution was used for irrigation and ultrasonic agitation was done in group II. In group III, an alternate irrigation with NaOCl and 3% hydrogen peroxide was done. The fourth group (control) was irrigated with sterile saline solution. E. fae-calis bacteria were sampled to the root canals with paper points and were transferred to tubes that contained 5 mL of brain heart infusion broth. Tubes were incubated and the presence of broth turbidity was suggestive of bacteria remaining in the root canal. All three groups showed no statistically significant difference. However, difference existed between experimental groups and control groups. The author concluded that all three methods of application of NaOCl were effective in disinfecting the root canal than the saline solution. No single irrigant has 100% efficiency. Thus by this study, a best irrigating solution with maximum properties can be established.

A Comparison of Apical Bacterial Extrusion in Manual, ProTaper Rotary, and One Shape Rotary Instrumentation Techniques.

PubMed

Mittal, Rakesh; Singla, Meenu G; Garg, Ashima; Dhawan, Anu

2015-12-01

Apical extrusion of irrigants and debris is an inherent limitation associated with cleaning and shaping of root canals and has been studied extensively because of its clinical relevance as a cause of flare-ups. Many factors affect the amount of extruded intracanal materials. The purpose of this study was to assess the bacterial extrusion by using manual, multiple-file continuous rotary system (ProTaper) and single-file continuous rotary system (One Shape). Forty-two human mandibular premolars were inoculated with Enterococcus faecalis by using a bacterial extrusion model. The teeth were divided into 3 experimental groups (n = 12) and 1 control group (n = 6). The root canals of experimental groups were instrumented according to the manufacturers' instructions by using manual technique, ProTaper rotary system, or One Shape rotary system. Sterilized saline was used as an irrigant, and bacterial extrusion was quantified as colony-forming units/milliliter. The results obtained were statistically analyzed by using one-way analysis of variance for intergroup comparison and post hoc Tukey test for pair-wise comparison. The level for accepting statistical significance was set at P < .05. All the instrumentation techniques resulted in bacterial extrusion, with manual step-back technique exhibiting significantly more bacterial extrusion than the engine-driven systems. Of the 2 engine-driven systems, ProTaper rotary extruded significantly more bacteria than One Shape rotary system (P < .05). The engine-driven nickel-titanium systems were associated with less apical extrusion. The instrument design may play a role in amount of extrusion. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Relevance of the clustered regularly interspaced short palindromic repeats of Enterococcus faecalis strains isolated from retreatment root canals on periapical lesions, resistance to irrigants and biofilms

PubMed Central

Tong, Zhongchun; Du, Yu; Ling, Junqi; Huang, Lijia; Ma, Jinglei

2017-01-01

A high prevalence of Enterococcus faecalis (E. faecalis) is observed in teeth with root canal treatment failures. Clustered regularly interspaced short palindromic repeats (CRISPR) are widely distributed in prokaryotes that have adaptive immune systems against mobile elements, including pathogenic genes. The present study investigated the relevance of the CRISPR in E. faecalis strains isolated from retreated root canals on biofilms, periapical lesions and drug resistance. A total of 20 E. faecalis strains were extracted from the root canals of teeth referred for root canal retreatment. CRISPR-Cas loci were identified by two pairs of relevant primers and polymerase chain reaction. The susceptibility of the 20 isolated strains to intracanal irrigants was evaluated by 1- and 5-minute challenges with a mixture of a tetracycline isomer, an acid and a detergent (MTAD), 2% chlorhexidine (CHX) and 5.25% sodium hypochlorite (NaOCl). The microtiter plate assay and crystal violet staining were used to compare the biofilm formation of the E. faecalis isolate strains. Out of the 20 E. faecalis isolate strains, 5 strains that lacked CRISPR-cas determinants exhibited significant periapical lesions. Among the 15 strains containing CRISPR-cas determinants, 8 were isolated from root canals with inadequate fillings and 7 were isolated from root canals without any fillings. The five strains lacking CRISPR-cas loci were observed to be more resistant to MTAD and 2% CHX than the 15 strains that had CRISPR-cas loci. All of the strains exhibited the same susceptibility to 5.25% NaOCl. Furthermore, the 5 strains lacking CRISPR-cas determinants generated more biofilm than the other 15 strains. Thus, the results of the present study suggested that E. faecalis root canal isolates lacking CRISPR-cas exhibit higher resistance to intracanal irrigants, stronger biofilm formation and generate significant periapical lesions. PMID:29285081

Relevance of the clustered regularly interspaced short palindromic repeats of Enterococcus faecalis strains isolated from retreatment root canals on periapical lesions, resistance to irrigants and biofilms.

PubMed

Tong, Zhongchun; Du, Yu; Ling, Junqi; Huang, Lijia; Ma, Jinglei

2017-12-01

A high prevalence of Enterococcus faecalis ( E. faecalis ) is observed in teeth with root canal treatment failures. Clustered regularly interspaced short palindromic repeats (CRISPR) are widely distributed in prokaryotes that have adaptive immune systems against mobile elements, including pathogenic genes. The present study investigated the relevance of the CRISPR in E. faecalis strains isolated from retreated root canals on biofilms, periapical lesions and drug resistance. A total of 20 E. faecalis strains were extracted from the root canals of teeth referred for root canal retreatment. CRISPR-Cas loci were identified by two pairs of relevant primers and polymerase chain reaction. The susceptibility of the 20 isolated strains to intracanal irrigants was evaluated by 1- and 5-minute challenges with a mixture of a tetracycline isomer, an acid and a detergent (MTAD), 2% chlorhexidine (CHX) and 5.25% sodium hypochlorite (NaOCl). The microtiter plate assay and crystal violet staining were used to compare the biofilm formation of the E. faecalis isolate strains. Out of the 20 E. faecalis isolate strains, 5 strains that lacked CRISPR-cas determinants exhibited significant periapical lesions. Among the 15 strains containing CRISPR-cas determinants, 8 were isolated from root canals with inadequate fillings and 7 were isolated from root canals without any fillings. The five strains lacking CRISPR-cas loci were observed to be more resistant to MTAD and 2% CHX than the 15 strains that had CRISPR-cas loci. All of the strains exhibited the same susceptibility to 5.25% NaOCl. Furthermore, the 5 strains lacking CRISPR-cas determinants generated more biofilm than the other 15 strains. Thus, the results of the present study suggested that E. faecalis root canal isolates lacking CRISPR-cas exhibit higher resistance to intracanal irrigants, stronger biofilm formation and generate significant periapical lesions.

Effect of Er:YAG laser-activated irrigation solution on Enterococcus Faecalis biofilm in an ex-vivo root canal model.

PubMed

Sahar-Helft, Sharonit; Stabholtz, Adam; Moshonov, Joshua; Gutkin, Vitaly; Redenski, Idan; Steinberg, Doron

2013-07-01

Abstract Objective: The purpose of this study was to evaluate mineral content and surface morphology of root canals coated with Enterococcus faecalis biofilm after treatment with several endodontic irrigation solutions, with and without Er:YAG laser-activated irrigation (LAI). LAI has been introduced as a powerful method for root canal irrigation resulting in smear-layer removal from the root canal wall. Distal and palatal roots from 60 freshly extracted human molars were used in this study. The coronal of each tooth was removed. Roots were split longitudinally and placed in an ultrasonic bath to remove the smear layer, creating conditions for the formation of E. faecalis biofilm. After incubation, the two halves were reassembled in impression material to simulate clinical conditions. Specimens were divided into two main groups: roots rinsed with irrigation solutions and roots subjected to laser irradiation combined with irrigation solutions. Solutions tested were 2% chlorhexidine and 17% ethylenediaminetetraacetic acid (EDTA) and saline. Surface morphology: 17% EDTA irrigant solution combined with Er:YAG laser showed the best results for removing bacteria from the root canal walls. Chemical analysis: all samples treated with combined laser irradiation and irrigation solution had low surface levels of Ca compared with samples treated with irrigation alone. The Ca/P ratio was highest in the laser-EDTA group. Overall, mineral changes caused by laser with irrigation solutions were minimal, and statistically nonsignificant. In vitro irrigation solutions, combined with Er:YAG laser irradiation, were effective in removing E. faecalis biofilm from root canal walls. Irrigation solutions without laser irradiation were less effective, leaving a layer of biofilm on the dentin surface.

Morphologic study of the maxillary molars. Part II: Internal anatomy.

PubMed

Pécora, J D; Woelfel, J B; Sousa Neto, M D; Issa, E P

1992-01-01

The internal anatomy of three hundred and seventy (370) decalcified and cleared human maxillary molars was studied. Seventy-five percent of the first molars, 58% of the second molars and 68% of the third molars studied presented three (3) root canals and 25% of the first molars, 42% of the second molars and 32% of the third molars presented four (4) root canals. The authors observed that the incidence of two root canals in the mesiobuccal root was higher in second maxillary molars than in first maxillary molars.