Micro-surgical endodontics.

Science.gov (United States)

Eliyas, S; Vere, J; Ali, Z; Harris, I

2014-02-01

Non-surgical endodontic retreatment is the treatment of choice for endodontically treated teeth with recurrent or residual disease in the majority of cases. In some cases, surgical endodontic treatment is indicated. Successful micro-surgical endodontic treatment depends on the accuracy of diagnosis, appropriate case selection, the quality of the surgical skills, and the application of the most appropriate haemostatic agents and biomaterials. This article describes the armamentarium and technical procedures involved in performing micro-surgical endodontics to a high standard.

Physicochemical and mechanical properties of zirconium oxide and niobium oxide modified Portland cement-based experimental endodontic sealers.

Science.gov (United States)

Viapiana, R; Flumignan, D L; Guerreiro-Tanomaru, J M; Camilleri, J; Tanomaru-Filho, M

2014-05-01

To evaluate the physicochemical and mechanical properties of Portland cement-based experimental sealers (ES) with different radiopacifying agents (zirconium oxide and niobium oxide micro- and nanoparticles) in comparison with the following conventional sealers: AH Plus, MTA Fillapex and Sealapex. The materials were tested for setting time, compressive strength, flow, film thickness, radiopacity, solubility, dimensional stability and formaldehyde release. Data were subjected to anova and Tukey tests (P 0.05) and lower solubility when compared with MTA Fillapex and Sealapex (P Portland cement-based experimental endodontic sealers presented physicochemical properties according to the specifications no 57 ANSI/ADA (ADA Professional Product Review, 2008) and ISO 6876 (Dentistry - Root Canal Sealing Materials, 2012, British Standards Institution, London, UK). The sealers had setting times and flow ability that was adequate for clinical use, satisfactory compressive strength and low solubility. Additional studies should be carried out with the purpose of decreasing the film thickness and to determine the ideal ratio of radiopacifying agents in Portland cement-based root canal sealers. © 2013 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Biocompatibility of two experimental scaffolds for regenerative endodontics

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Dephne Jack Xin Leong

2016-05-01

Full Text Available Objectives The biocompatibility of two experimental scaffolds for potential use in revascularization or pulp regeneration was evaluated. Materials and Methods One resilient lyophilized collagen scaffold (COLL, releasing metronidazole and clindamycin, was compared to an experimental injectable poly(lactic-co-glycolic acid scaffold (PLGA, releasing clindamycin. Human dental pulp stem cells (hDPSCs were seeded at densities of 1.0 × 104, 2.5 × 104, and 5.0 × 104. The cells were investigated by light microscopy (cell morphology, MTT assay (cell proliferation and a cytokine (IL-8 ELISA test (biocompatibility. Results Under microscope, the morphology of cells coincubated for 7 days with the scaffolds appeared healthy with COLL. Cells in contact with PLGA showed signs of degeneration and apoptosis. MTT assay showed that at 5.0 × 104 hDPSCs, COLL demonstrated significantly higher cell proliferation rates than cells in media only (control, p < 0.01 or cells co-incubated with PLGA (p < 0.01. In ELISA test, no significant differences were observed between cells with media only and COLL at 1, 3, and 6 days. Cells incubated with PLGA expressed significantly higher IL-8 than the control at all time points (p < 0.01 and compared to COLL after 1 and 3 days (p < 0.01. Conclusions The COLL showed superior biocompatibility and thus may be suitable for endodontic regeneration purposes.

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

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

2015-01-01

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

Endodontics Simplified

OpenAIRE

Kansal, Rohit; Talwar, Sangeeta; Yadav, Seema; Chaudhary, Sarika; Nawal, Ruchika

2014-01-01

The preparation of the root canal system is essential for a successful outcome in root canal treatment. The development of rotary nickel titanium instruments is considered to be an important innovation in the field of endodontics. During few last years, several new instrument systems have been introduced but the quest for simplifying the endodontic instrumentation sequence has been ongoing for almost 20 years, resulting in more than 70 different engine-driven endodontic instrumentation system...

Pulsed Nd-YAG laser in endodontics

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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.

Effect of different composite core materials on fracture resistance of endodontically treated teeth restored with FRC posts

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Prapaporn PANITIWAT

Full Text Available Abstract Objective This study evaluated the fracture resistance of endodontically treated teeth restored with fiber reinforced composite posts, using three resin composite core build-up materials, (Clearfil Photo Core (CPC, MultiCore Flow (MCF, and LuxaCore Z-Dual (LCZ, and a nanohybrid composite, (Tetric N-Ceram (TNC. Material and Methods Forty endodontically treated lower first premolars were restored with quartz fiber posts (D.T. Light-Post cemented with resin cement (Panavia F2.0. Samples were randomly divided into four groups (n=10. Each group was built-up with one of the four core materials following its manufacturers’ instructions. The teeth were embedded in acrylic resin blocks. Nickel-Chromium crowns were fixed on the specimens with resin cement. The fracture resistance was determined using a universal testing machine with a crosshead speed of 1 mm/min at 1350 to the tooth axis until failure occurred. All core materials used in the study were subjected to test for the flexural modulus according to ISO 4049:2009. Results One-way ANOVA and Bonferroni multiple comparisons test indicated that the fracture resistance was higher in the groups with CPC and MCF, which presented no statistically significant difference (p>0.05, but was significantly higher than in those with LCZ and TNC (p<0.05. In terms of the flexural modulus, the ranking from the highest values of the materials was aligned with the same tendency of fracture loads. Conclusion Among the cores used in this study, the composite core with high filler content tended to enhance fracture thresholds of teeth restored with fiber posts more than others.

One-visit endodontics.

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Ashkenaz, P J

1984-10-01

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

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

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

2014-11-01

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

Designing, preparing and evaluation of novel HA/Ti composite coating for endodontic dental implant

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Fathi MH.

2002-08-01

Full Text Available Nowadays, application of implants as a new method for replacing extracted teeth have been improved. So, many researches have been performed for improving the characteristics of implants. The aim of this study was to design and produce a desired coating in order to obtaining two goals including; improvement of the corrosion behavior of metallic endodontic implant and the bone osseointegration simultaneously. Stainless steel 316L (SS, cobalt-chromium alloy (Vit and commercial pure titanium (cpTi were chosen as metallic substrates and hydroxyapatite coating (HAC were performed by plasma-spraying (PS process on three different substrates. A novel double layer Hydroxyapatite/Titanium (HA/Ti composite coating composed of a HA top layer and a Ti under layer was prepared using PS and physical vapor deposition (PVD process respectively on SS. Structural characterization techniques including XRD, SEM and EDX were utilized to investigate the microstructure, morpholgy and crystallinity of the coatings. Electrochemical potentiodynamic tests were performed in physiological solutions in order to determine and compare the corrosion behavior of the coated and uncoated specimens behavior as an indication of biocmpatibility. Results indicated that the cpTi possesses the highest and SS the lowest corrosion resistance (highest corrosion current density between uncoated substrates. This trend was independent to the type of physiological environment. The HA coating decreased the corrosion current density of HA coated metallic implants but did not change that trend. HAC acted as a mechanical barrier on the metallic substrate but could not prevent the interaction between metallic substrate and environment completely. The HA/Ti composite coating improved the corrosion behavior of SS. The corrosion current density of HA/Ti coated SS decreased and was exactly similar to single HA coated cpTi in physiological solutions. The results indicated that HA/Ti composite coated SS

Summary of: Regenerative endodontics.

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Clark, Stephen J

2014-03-01

Significant advances in our understanding of the biological processes involved in tooth development and repair at the cellular and molecular levels have underpinned the newly emerging area of regenerative endodontics. Development of treatment protocols based on exploiting the natural wound healing properties of the dental pulp and applying tissue engineering principles has allowed reporting of case series showing preservation of tissue vitality and apexogenesis. To review current case series reporting regenerative endodontics. Current treatment approaches tend to stimulate more reparative than regenerative responses in respect of the new tissue generated, which often does not closely resemble the physiological structure of dentine-pulp. However, despite these biological limitations, such techniques appear to offer significant promise for improved treatment outcomes. Improved biological outcomes will likely emerge from the many experimental studies being reported and will further contribute to improvements in clinical treatment protocols.

Fracture Resistance and Failure Mode of Endodontically Treated Premolars Restored with Different Adhesive Restorations

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Nasrin Sarabi

2015-03-01

Full Text Available Introduction: The restoration of endodontically treated teeth is a topic that has been studied extensively but it is still a challenge for dental practitioners. The aim of this study was to evaluate fracture resistance, fracture patterns and fracture location of endodontically treated human maxillary premolars restored with direct and indirect composite resin and ceramic restoration. Methods: Eighty non-carious maxillary premolars were selected and divided into four groups (n=20. Endodontic treatment and mesio-occluso-distal preparations were carried out in all the groups except for the control group (group I. Subsequently, the prepared teeth were restored as follows: group II: indirect composite restoration; group III: ceramic restoration; group IV: direct composite restoration. The specimens were subjected to compressive axial loading until fracture occurred. The mode of failure was also recorded. Results: Group I had higher fracture resistance (1196.82±241.74 than the other groups (P

Antibacterial and antifungal activity of endodontic intracanal medications

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TONEA, ANDRADA; BADEA, MANDRA; OANA, LIVIU; SAVA, SORINA; VODNAR, DAN

2017-01-01

Background and aims The sterilization of the entire root canal system represents the main goal of every endodontist, given the fact that the control of the microbial flora is the key point of every root canal treatment. The diversity of microorganisms found inside the root canal and also the resistance of some bacterial species to intracanal medications led to a continuous development of new endodontic products. The present study focuses on the comparison of the antibacterial and antifungal properties of different endodontic products, two commercially available, one experimental plant based extract, and two control substances. Methods The disc diffusion assay was used to determine the antibacterial and antifungal properties of chlorhexidine, calcium hydroxide, a mix extract between Arctium lappa root powder and Aloe barbadensis Miller gel, Amoxicillin with clavulanic acid and Fluconazole (as control substances). Two of the most common microorganisms found in endodontic infections were chosen: Enterococcus faecalis (ATCC 29212) and Candida albicans ATCC(10231). Results All tested substances showed inhibition zones around the discs, for Enterococcus faecalis and Candida albicans, including the experimental mix extract of Arctium lappa root powder with Aloe vera gel. Conclusion The experimental mix extract of Arctium lappa root powder and Aloe vera gel is able to inhibit very resistant microorganisms, like Enterococcus faecalis and Candida albicans. PMID:28781531

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

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

2013-01-01

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

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

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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 Na

Resistance to fracture of endodontically treated premolars restored with glass ionomer cement or acid etch composite resin: An in vitro study

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B Ranga

2010-01-01

Full Text Available Aim: Due to the weakness of endodontically treated posterior teeth requires more strengthened restoration to withstand occlusal forces. The purpose of the present study was to determine and compare the resistance to fracture of endodontically treated maxillary 1 st premolars restored with different materials in mesio-occluso-distal (MOD cavity preparations. Materials and Methods: MOD cavity preparations in 80 endodontically treated maxillary 1 st premolars were restored using four different methods. Fiber rings were filled with stone plaster and the teeth were placed into the plaster up to the level of cemento-enamel junction. The teeth were grouped according to restorative method, mounted in an Instrom T.T. machine, and the buccal walls subjected to a slowly increasing compressive force until fracture occurred. Result: The force of fracture of the walls of each tooth was recorded and the results in the various groups compared. All teeth fractured in a similar manner irrespective of the restorative method used. Conclusion: The resistance to the fracture of the teeth was the same when they were stored with glass ionomer cement as a base over which composite resin was placed. When the entire cavities were filled with glass ionomer cement, the resistance to fracture of the teeth decreased significantly compared with the acid etch resin technique.

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

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

2018-04-30

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

Regenerative endodontics: a comprehensive review.

Science.gov (United States)

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

2018-05-19

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

Chemical properties of gutta-percha endodontic filling material: investigation of five commercial brands

International Nuclear Information System (INIS)

Silva Junior, Joao Batista A.; Paula, Regina C.M.; Feitosa, Judith P.A.; Gurgel Filho, Eduardo; Teixeira, Fabricio B

2001-01-01

Chemical composition e thermal stability of five brands of gutta-percha endodontic filling material were investigated. Samples with higher amount of organic materials possess higher thermal stability. Investigation of gutta-percha polymer extracted from the endodontic filling by IR and NMR shows that the polymer is predominantly trans-polyisoprene. The thermal stability and molar mass were similar for four brands, however the 'Tanari' brand has got lower molar mass value than the other ones. (author)

Endodontic applications of 3D printing.

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Anderson, J; Wealleans, J; Ray, J

2018-02-27

Computer-aided design (CAD) and computer-aided manufacturing (CAM) technologies can leverage cone beam computed tomography data for production of objects used in surgical and nonsurgical endodontics and in educational settings. The aim of this article was to review all current applications of 3D printing in endodontics and to speculate upon future directions for research and clinical use within the specialty. A literature search of PubMed, Ovid and Scopus was conducted using the following terms: stereolithography, 3D printing, computer aided rapid prototyping, surgical guide, guided endodontic surgery, guided endodontic access, additive manufacturing, rapid prototyping, autotransplantation rapid prototyping, CAD, CAM. Inclusion criteria were articles in the English language documenting endodontic applications of 3D printing. Fifty-one articles met inclusion criteria and were utilized. The endodontic literature on 3D printing is generally limited to case reports and pre-clinical studies. Documented solutions to endodontic challenges include: guided access with pulp canal obliteration, applications in autotransplantation, pre-surgical planning and educational modelling and accurate location of osteotomy perforation sites. Acquisition of technical expertise and equipment within endodontic practices present formidable obstacles to widespread deployment within the endodontic specialty. As knowledge advances, endodontic postgraduate programmes should consider implementing 3D printing into their curriculums. Future research directions should include clinical outcomes assessments of treatments employing 3D printed objects. Published 2018. This article is a U.S. Government work and is in the public domain in the USA.

[A clinical study of endodontic flare-ups].

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Yeh, S J; Lin, Y T; Lu, S Y

1994-06-01

The purpose of this study was to investigate the clinical variables influencing endodontic flare-ups. Three hundred and thirteen teeth receiving endodontic treatment at the Endodontic Department, Chang Gung Memorial Hospital were studied from December 1992 to February 1993. Among them, 21 teeth with significant pain and 9 with apical swelling were noted after the first appointment of treatment. Three teeth with persistent pain and one with apical swelling were also found one week after completion of endodontic therapy. The results showed significant improvement of clinical symptoms and signs one week after completion of endodontic treatment in comparison with pretreatment and after the first appointment (p endodontic flare-ups after the first appointment of treatment (P endodontic flare-ups.

Learning experience in endodontics: Brazilian students' perceptions.

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

2013-05-01

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

Antimicrobial Irrigants in the Endodontic Therapy

OpenAIRE

Iqbal, Azhar

2012-01-01

This paper highlights the importance of root canal disinfection. It discusses the different endodontic irrigants available and comments on how these can be used most effectively. Eliminating bacteria from the root canal system is an essential stage in endodontic therapy. An objective of endodontic treatment is removal of diseased tissue, elimination of bacteria from the canal system and prevention of recontamination. (1) Disinfection of the root canal system, as part of endodontic therapy, by...

Endo-periodontal lesion--endodontic approach.

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

2014-01-01

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

Lasers in endodontics: an overview

Science.gov (United States)

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.

21 CFR 872.3830 - Endodontic paper point.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Endodontic paper point. 872.3830 Section 872.3830...) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3830 Endodontic paper point. (a) Identification. An endodontic paper point is a device made of paper intended for use during endodontic therapy to dry...

Three-dimensional imaging modalities in endodontics

Science.gov (United States)

Mao, Teresa

2014-01-01

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

Three-dimensional imaging modalities in endodontics

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Mao, Teresa; Neelakantan, Prasanna [Dept. of Conservative Dentistry and Endodontics, Saveetha Dental College and Hospitals, Saveetha University, Chennai (India)

2014-09-15

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

Three-dimensional imaging modalities in endodontics

International Nuclear Information System (INIS)

Mao, Teresa; Neelakantan, Prasanna

2014-01-01

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

[Discussion on combined periodontic-endodontic lesion type].

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Wang, Kai; Zhou, Li

2008-02-01

Combined the elaboration on periodontic-endodontic lesion in the textbook Periodontics with the deficiencies existed in the clinical and teaching work and demonstrated the understanding on the type of the combined periodontic-endodontic lesion, and suggested the viewpoint of no sub-type of combined periodontic-endodontic lesion. Only regard the type of pulp disease that induced by periodontal disease as genuine combined periodontic-endodontic lesion.

Regenerative endodontics--Creating new horizons.

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Dhillon, Harnoor; Kaushik, Mamta; Sharma, Roshni

2016-05-01

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

Regenerative endodontics: A way forward.

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

2016-05-01

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

Curricular Guidelines for Endodontics.

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Journal of Dental Education, 1981

1981-01-01

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

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

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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

Endodontic treatment of a tiger

DEFF Research Database (Denmark)

Qvist, J.; Kortegaard, H.; Grøndahl, C.

The 84th Annual Meeting of NoF 2001, veterinary dentistry, endodontics, dental materials, animal case report......The 84th Annual Meeting of NoF 2001, veterinary dentistry, endodontics, dental materials, animal case report...

Endo-periodontal lesion – endodontic approach

Science.gov (United States)

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

2014-01-01

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

Endodontic flare-ups: a prospective study.

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Alves, Vanessa de Oliveira

2010-11-01

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

Comparison of mineral trioxide aggregate's composition with Portland cements and a new endodontic cement.

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Asgary, Saeed; Eghbal, Mohammad Jafar; Parirokh, Masoud; Ghoddusi, Jamileh; Kheirieh, Sanam; Brink, Frank

2009-02-01

The aim of this study was to compare the compositions of mineral trioxide aggregates (MTAs), Portland cements (PCs), and a new endodontic cement (NEC). Our study also investigated the surface characteristics of MTA and NEC root-end fillings when immersed in normal saline. For part I, we prepared samples of 9 brands of MTAs, PCs, and NEC. The materials were imaged and analyzed by scanning electron microscopy (SEM) and energy dispersive x-ray analysis (EDXA). In part II, 3-mm-deep root-end preparations were filled with MTA or NEC and stored in normal saline for 1 week. Samples were imaged and analyzed by SEM and electron probe microanalysis (EPMA). EDXA investigations revealed differences in the dominant compounds of NEC, PCs, and MTAs. The major components of MTA and PC are the same except for bismuth. The most significant difference was the presence of higher concentrations of Fe (minor element) in gray MTA and PC when compared with white ones. EPMA results revealed remarkably different elements in MTA compared with surrounding dentin, whereas in the NEC group the distribution patterns of calcium, phosphorous, and oxygen were comparable. NEC differs chemically from MTAs and PCs and demonstrates comparable surface composition with adjacent dentin as a root-end filling material.

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

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Gabriely Cristinni REZENDE

2016-01-01

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

The 'E' factor -- evolving endodontics.

Science.gov (United States)

Hunter, M J

2013-03-01

Endodontics is a constantly developing field, with new instruments, preparation techniques and sealants competing with trusted and traditional approaches to tooth restoration. Thus general dental practitioners must question and understand the significance of these developments before adopting new practices. In view of this, the aim of this article, and the associated presentation at the 2013 British Dental Conference & Exhibition, is to provide an overview of endodontic methods and constantly evolving best practice. The presentation will review current preparation techniques, comparing rotary versus reciprocation, and question current trends in restoration of the endodontically treated tooth.

Peregrination of endodontic tools-past to present

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Ashwini Tumkur Shivakumar

2016-01-01

Full Text Available The clinical practice of yesterday′s endodontics becomes the heresy of today, and today′s endodontic practice becomes the heresy of tomorrow. The history of endodontics begins in the 17 th century. Since then, there have been numerous advances and developments, and research has proceeded continuously without pause. The manufacture of the first instruments for endodontic use dates back to 1875. These early instruments were made by hand from thin steel wires, and they performed the function of modern barbed broaches. In 1955, Ingle was the first to express the need for standardization of canal instruments. In 1965, the American Association of Endodontists adopted the terminology and nomenclature of the proposed standardized system. For many years, the standard cutting instruments have been the reamer, the K-type file, and the Hedstroem file. Recent changes in both metallurgy and endodontic concepts have led to the introduction of a wide range of new instruments. An effort has been made here to present the journey of endodontic instruments from the past to the present.

One-appointment endodontic therapy: biological considerations.

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

2007-11-01

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

A review of the regenerative endodontic treatment procedure

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Bin-Na Lee,

2015-08-01

Full Text Available Traditionally, apexification has been used to treat immature permanent teeth that have lost pulp vitality. This technique promotes the formation of an apical barrier to close the open apex so that the filling materials can be confined to the root canal. Because tissue regeneration cannot be achieved with apexification, a new technique called regenerative endodontic treatment was presented recently to treat immature permanent teeth. Regenerative endodontic treatment is a treatment procedure designed to replace damaged pulp tissue with viable tissue which restores the normal function of the pulp-dentin structure. After regenerative endodontic treatment, continued root development and hard tissue deposition on the dentinal wall can occur under ideal circumstances. However, it is difficult to predict the result of regenerative endodontic treatment. Therefore, the purpose of this study was to summarize multiple factors effects on the result of regenerative endodontic treatment in order to achieve more predictable results. In this study, we investigated the features of regenerative endodontic treatment in comparison with those of other pulp treatment procedures and analyzed the factors that have an effect on regenerative endodontic treatment.

Establishing Apical Patency and its Effect on Endodontic Outcomes

Science.gov (United States)

2012-06-01

Endodontic  Outcomes   by Jason  S...Allen,  LT, DC, USN A thesis submitted to the Faculty of the Endodontics Graduate Program Naval Postgraduate Dental...Assistant Program Director, Endodontics Dept. Terry D. Webb, DDS, MS CAPT, DC, USN Chairman, Endodontics Dept. Glen M. Imamura, S, MS CAPT, DC,

Interaction between endodontics and periodontics.

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Rotstein, Ilan

2017-06-01

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

Endodontic treatment in geriatric patients

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Milly Armilya Andang

2007-11-01

Full Text Available With the increased number of geriatric population, it is predicted that the need for dental treatment also increases. The needs for esthetic factors and function of geriatric patient are maybe similar to young patient. The number of geriatric patients who refuse dental extraction is increasing if there are still other alternative. They can be more convinced when the clinician said that the dental disease experienced is a focal infection so that the loss of the tooth can be accepted as the best option. But if it is possible, they will prefer endodontic treatment, because they want to keep their teeth according to the treatment plan or based on patient's request, as a less traumatic alternative compared to extraction.Endodontic treatment consideration for geriatric patient is quite similar to younger patients. The technique is also the same, although the problem may be bigger. The problem or obstacle that may arise in endodontic treatment for geriatric patient relates to the visit duration, problems during x-ray, problems in defining root canal location, vertical root fracture, and in some cases, decreased pulp tissue recovery ability. Due to the fact that the challenge is quite big, the success of endodontic treatment in geriatric patients needs to be considered. This paper will explain the endodontic treatment prognosis for geriatric patients.

Worldwide pattern of antibiotic prescription in endodontic infections.

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

2017-08-01

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

Failure of endodontic treatment: The usual suspects.

Science.gov (United States)

Tabassum, Sadia; Khan, Farhan Raza

2016-01-01

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

Essentials of Endodontic Microsurgery

Science.gov (United States)

2010-04-01

Holtzman DJ, et al. Quality of root-end preparations using ultrasonic and rotary instrumentation in cadavers. J Endod 2000;26:281. 39. Peters CI...00-00-2010 to 00-00-2010 4. TITLE AND SUBTITLE Essentials of Endodontic Microsurgery 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT... Endodontic Program,Harvard School of Dental Medicine,Boston,MA 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING/MONITORING AGENCY NAME(S) AND

Molecular diagnostics in endodontics

OpenAIRE

Rechenberg, Dan-Krister; Zehnder, Matthias

2014-01-01

Recent systematic reviews have substantiated the fact that current testing methods to assess the inflammatory state of the pulp and the periapical tissues are of limited value. Consequently, it may be time to search for alternative routes in endodontic diagnostics. Molecular assessment methods could be the future. However, in the field of endodontics, the research in that direction is only about to evolve. Because pulpal and periradicular diseases are related to opportunistic infections, diag...

Biofilm in endodontics: A review

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

2015-01-01

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

[Theory and practice of minimally invasive endodontics].

Science.gov (United States)

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 therapy for a fused mandibular molar.

Science.gov (United States)

Rotstein, I; Moshonov, J; Cohenca, N

1997-06-01

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

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

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

2015-12-01

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

Regenerative endodontics: barriers and strategies for clinical translation.

Science.gov (United States)

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

2012-07-01

Regenerative endodontics has encountered substantial challenges toward clinical translation. The adoption by the American Dental Association of evoked pulp bleeding in immature permanent teeth is an important step for regenerative endodontics. However, there is no regenerative therapy for most endodontic diseases. Simple recapitulation of cell therapy and tissue engineering strategies that are under development for other organ systems has not led to clinical translation in regeneration endodontics. Recent work using novel biomaterial scaffolds and growth factors that orchestrate the homing of host endogenous cells represents a departure from traditional cell transplantation approaches and may accelerate clinical translation. Copyright © 2012 Elsevier Inc. All rights reserved.

Advances in endodontics: Potential applications in clinical practice

Science.gov (United States)

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

Imaging Techniques in Endodontics: An Overview

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

2012-01-01

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

Discoloration Potential of Endodontic Sealers: A Brief Review

Science.gov (United States)

Tour Savadkouhi, Sohrab; Fazlyab, Mahta

2016-01-01

Tooth discoloration induced by endodontic sealers, is a common finding that impairs aesthetic outcome of endodontic treatment. The aim of the present mini literature review, was to summarize the existing data on discoloration potential of different endodontic sealers. The research covered the article published in PubMed and Google Scholar from 2000 to 2015. The searched keywords included ‘tooth discoloration AND endodontic’, ‘tooth discoloration AND sealer, ‘tooth discoloration AND zinc-oxide eugenol sealer’, ‘tooth discoloration AND Calcium Hydroxide Sealer’, ‘tooth discoloration AND Glass Ionomer Sealer’, ‘tooth discoloration AND epoxy-resin Sealer’, ‘tooth discoloration AND Silicon Based Sealer’, ‘tooth discoloration AND Bioceramic Sealer’ and ‘Spectrophotometry’. Conclusion: A total number of 44 articles were gained which reduced to 11 after excluding the repetitive items. The available evidence for discoloration potential of endodontic sealers currently available on the market is scarce. However, it can be concluded that all endodontic sealers can potentially stain the tooth structure to different degrees. PMID:27790251

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

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Vinaya Kumar Kulkarni

2012-01-01

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

Regenerative Endodontics: Barriers and Strategies for Clinical Translation

OpenAIRE

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

2012-01-01

Despite a great deal of enthusiasm and effort, regenerative endodontics has encountered substantial challenges towards clinical translation. Recent adoption by the American Dental Association (ADA) of evoked pulp bleeding in immature permanent teeth is an important step for regenerative endodontics. However, there is no regenerative therapy for the majority of endodontic diseases. Simple recapitulation of cell therapy and tissue engineering strategies that are under development for other orga...

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

Directory of Open Access Journals (Sweden)

Wong AWY

2014-05-01

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

Endodontic microsurgery, presentation of a clinical case

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Zeledon Mayorga, Rodolfo

2009-01-01

A literature review is conducted on endodontic surgery. The report of a clinical case is facilitated. The technique chosen according to the clinical and radiographic examination was endodontic microsurgery, the case has presented a positive evolution of four years [es

The flare-up phenomenon in endodontics: a clinical perspective and review.

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Matusow, R J

1988-06-01

The acute endodontic cellulitis exacerbation, which can be potentially fatal, is a definitive entity in endodontic flare-ups. Aerobic microbes, particularly streptococci, are the predominant causative microbes isolated. There was a noticeable absence of obligate anaerobes. This is significant for the selection of an antibiotic for therapy. Treatment parameters were presented. An endodontic cellulitis exacerbation is most unlikely with obligate anaerobes. An endodontic flare-up perspective was attempted with some clinical parameters. The proponents of routine one-visit endodontic treatment with prophylactic drugs to prevent cellulitis exacerbations do not appear to offer any advantage to the more traditional approaches to endodontic treatment of the patient, which may be more beneficial.

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

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Sally Ali Tawfik

2018-01-01

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

Problems associated with the diagnosis and treatment of endodontic disease

International Nuclear Information System (INIS)

Emily, P.

1990-01-01

The diagnosis of endodontic lesions in animal dentistry is complicated and restricted by the use of objective diagnostic procedures. Human endodontics uses subjective symptoms to a large degree, as well as objective symptoms. Subjective symptoms include patient pain; sensitivity to hot or cold; percussion; and foul taste or odor. Veterinary dentists must receive input from clients, as well as using their own clinical and radiographic evaluation. Many endodontic lesions remain undetected because the client fails to notice broken or discolored teeth, facial swelling, drooling, difficulty in chewing, chewing only on one side, and general malaise. An increased awareness of the endodontic problems that can occur in animals increases the level of veterinary care. Numerous techniques, including apexogenesis, apexification, direct and indirect pulp capping, and conventional and surgical endodontic therapy, can be used to treat various endodontic problems successfully

Endodontics and the ageing patient.

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Johnstone, M; Parashos, P

2015-03-01

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

Current overview on challenges in regenerative endodontics

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Bansal, Ramta; Jain, Aditya; Mittal, Sunandan

2015-01-01

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

Cone beam computed tomography in endodontic

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Durack, Conor; Patel, Shanon [Unit of Endodontology, Department of Conservative Dentistry, King' s College London, London (United Kingdom)

2012-07-01

Cone beam computed tomography (CBCT) is a contemporary, radiological imaging system designed specifically for use on the maxillofacial skeleton. The system overcomes many of the limitations of conventional radiography by producing undistorted, three-dimensional images of the area under examination. These properties make this form of imaging particularly suitable for use in endodontic. The clinician can obtain an enhanced appreciation of the anatomy being assessed, leading to an improvement in the detection of endodontic disease and resulting in more effective treatment planning. In addition, CBCT operates with a significantly lower effective radiation dose when compared with conventional computed tomography (CT). The purpose of this paper is to review the current literature relating to the limitations and potential applications of CBCT in endodontic practice. (author)

Cone beam computed tomography in endodontic

International Nuclear Information System (INIS)

Durack, Conor; Patel, Shanon

2012-01-01

Cone beam computed tomography (CBCT) is a contemporary, radiological imaging system designed specifically for use on the maxillofacial skeleton. The system overcomes many of the limitations of conventional radiography by producing undistorted, three-dimensional images of the area under examination. These properties make this form of imaging particularly suitable for use in endodontic. The clinician can obtain an enhanced appreciation of the anatomy being assessed, leading to an improvement in the detection of endodontic disease and resulting in more effective treatment planning. In addition, CBCT operates with a significantly lower effective radiation dose when compared with conventional computed tomography (CT). The purpose of this paper is to review the current literature relating to the limitations and potential applications of CBCT in endodontic practice. (author)

Fatigue behavior of lubricated Ni-Ti endodontic rotary instruments

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A. Brotzu

2014-04-01

Full Text Available The use of Ni-Ti alloys in the practice of endodontic comes from their important properties such as shape memory and superelasticity phenomena, good corrosion resistance and high compatibility with biological tissues. In the last twenty years a great variety of nickel-titanium rotary instruments, with various sections and taper, have been developed and marketed. Although they have many advantages and despite their increasing popularity, a major concern with the use of Ni-Ti rotary instruments is the possibility of unexpected failure in use due to several reasons: novice operator handling, presence manufacturing defects, fatigue etc. Recently, the use of an aqueous gel during experimental tests showed a longer duration of the instruments. The aim of the present work is to contribute to the study of the fracture behavior of these endodontic rotary instruments particularly assessing whether the use of the aqueous lubricant gel can extend their operative life stating its reasons. A finite element model (FEM has been developed to support the experimental results. The results were rather contradictory, also because the Perspex (Poly-methyl methacrylate, PMMA cannot simulate completely the dentin mechanical behavior; however the results highlight some interesting points which are discussed in the paper.

An in vivo study evaluating lesion sterilization and tissue repair 3 MIX-MP noninstrumentation endodontic treatment as an alternative to conventional endodontic retreatment

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Vaishnavi Dasari

2016-01-01

Full Text Available Aim: To alleviate the patient's symptoms and promote periapical healing in teeth with failure of root canal treatment, without the removal of previous obturating material using lesion sterilization and tissue repair (LSTR 3 MIX-MP noninstrumentation endodontic treatment (NIET. Materials and Methods: Fifteen single-rooted teeth with a history of root canal treatment 1–2 years previously, requiring retreatment, with pain, sinus tract, swelling and periapical lesions, and having acceptable obturation were included in the study. The previous coronal restoration was removed, and a medication cavity was prepared for placement of 3MIX MP; this was followed by lining with Glass ionomer cement and a coronal restoration with composite resin. Results: At 8 weeks, all patients did not have either pain, tenderness on vertical percussion, pain on biting, or swelling (asymptomatic. Radiographically, the periapical lesions had reduced by 1 mm in five cases. In six patients, the lesion size remained unchanged. Conclusion: LSTR NIET is an excellent, inexpensive, less traumatic, and least time-consuming alternative to treat symptomatic teeth requiring endodontic retreatment.

Bisphosphonates and their clinical implications in endodontic therapy.

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

2013-05-01

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

3D Computer aided treatment planning in endodontics.

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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.

Effect of amalgam cuspal coverage on the fracture resistance of endodontically treated teeth

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Mahshid Mohammdi Basir

2013-05-01

Full Text Available   Background and Aims: Endodontically treated teeth are prone to fracture because they loose a big amount of their structure. The treatment plan of those teeth is completed when they are rehabilitated with a strong and functional restoration. The purpose of this study was to evaluate the fracture resistance of endodontically treated teeth restored with amalgam cuspal coverage in comparison with other restorative techniques.   Materials and Methods: 40 human healthy maxillary premolars were divided into 4 groups: group1 (S: sound teeth, group 2(Co: endodontically treated teeth with MOD cavity restored with bonding and composite, group 3(Am-B: endodontically treated teeth with MOD cavity restored with bonding and amalgam and group 4 (Am-CC: endodontically treated teeth with MOD cavity restored with amalgam cuspal coverage. Then the restorations were stored in water and room temperature for 100 days at then thermocycled for 500 cycles between water baths at (5.5 ± 1 and (55 ± 1 0 C. The fracture resistance was evaluated by universal testing machine (Instron, 1195 UK with the compressive force of about 2000 N in 0.5 mm/min. The fracture modes were evaluated in four groups by a stereomicroscope. Statistical analysis (Scheffe test was done for all groups (P0.05. The lowest fracture resistance was found in group 2 (Co (384 ± 137.4 N that had no significant difference with group 3 (Am-B (P>0.05. The fracture resistance in group 4 was significantly higher than group 2 (Co and 3 (Am-B. The fracture mode in group 1 was cohesive within tooth and in group 2 (Co and 3 (Am-B was mixed cohesive and adhesive, and in group 4 was cohesive within in restorative material.   Conclusion: The highest fracture resistance was found in teeth that received amalgam cuspal coverage.

Photodynamic therapy in endodontics: a literature review.

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

2015-03-01

Recently, several in vitro and in vivo studies demonstrated promising results about the use of photodynamic therapy during root canal system disinfection. However, there is no consensus on a standard protocol for its incorporation during root canal treatment. The purpose of this study was to summarize the results of research on photodynamic therapy in endodontics published in peer-reviewed journals. A review of pertinent literature was conducted using the PubMed database, and data obtained were categorized into sections in terms of relevant topics. Studies conducted in recent years highlighted the antimicrobial potential of photodynamic therapy in endodontics. However, most of these studies were not able to confirm a significant improvement in root canal disinfection for photodynamic therapy as a substitute for current disinfection methods. Its indication as an excellent adjunct to conventional endodontic therapy is well documented, however. Data suggest the need for protocol adjustments or new photosensitizer formulations to enhance photodynamic therapy predictability in endodontics.

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

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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.

Cone beam computed tomography in Endodontics - a review.

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

2015-01-01

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

Effect of Ibuprofen on masking endodontic diagnosis.

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

2014-08-01

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

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

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

2018-05-01

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

Methodological Quality Assessment of Meta-analyses in Endodontics.

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

2018-01-01

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

Nuclear Magnetic Resonance Imaging in Endodontics: A Review.

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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.

Argon laser application to endodontics

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

1993-07-01

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

Survival of extensively damaged endodontically treated incisors restored with different types of posts-and-core foundation restoration material.

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Lazari, Priscilla Cardoso; de Carvalho, Marco Aurélio; Del Bel Cury, Altair A; Magne, Pascal

2018-05-01

Which post-and-core combination will best improve the performance of extensively damaged endodontically treated incisors without a ferrule is still unclear. The purpose of this in vitro study was to investigate the restoration of extensively damaged endodontically treated incisors without a ferrule using glass-ceramic crowns bonded to various composite resin foundation restorations and 2 types of posts. Sixty decoronated endodontically treated bovine incisors without a ferrule were divided into 4 groups and restored with various post-and-core foundation restorations. NfPfB=no-ferrule (Nf) with glass-fiber post (Pf) and bulk-fill resin foundation restoration (B); NfPfP=no-ferrule (Nf) with glass-fiber post (Pf) and dual-polymerized composite resin core foundation restoration (P); NfPt=no-ferrule (Nf) with titanium post (Pt) and resin core foundation restoration; and NfPtB=no-ferrule (Nf) with titanium post (Pt) and bulk-fill resin core foundation restoration (B). Two additional groups from previously published data from the same authors (FPf=2mm of ferrule (F) and glass-fiber post (Pf) and composite resin core foundation restoration; and NfPf=no-ferrule (Nf) with glass-fiber post (Pf) and composite resin core foundation restoration), which were tested concomitantly and using the same experimental arrangement, were included for comparison. All teeth were prepared to receive bonded glass-ceramic crowns luted with dual-polymerized resin cement and were subjected to accelerated fatigue testing under submerged conditions at room temperature. Cyclic isometric loading was applied to the incisal edge at an angle of 30 degrees with a frequency of 5 Hz, beginning with a load of 100 N (5000 cycles). A 100-N load increase was applied every 15000 cycles. The specimens were loaded until failure or to a maximum of 1000 N (140000 cycles). The 6 groups (4 groups from the present study and 2 groups from the previously published study) were compared using the Kaplan-Meier survival

Currently used systems of dental posts for endodontic treatment

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Machado, Joana; Almeida, Paulo; Fernandes, Sampaio; Marques, Arcelina; Vaz, Mário

2017-01-01

An advanced stage of a tooth decay promotes an extremely damaged tooth that needs endodontic treatment to be restored. When satisfactory coronal tooth structure remains, an artificial crown can be placed without a post. On the other hand, the treatment of seriously damaged teeth often require an endodontic post. The main reason for using post is to enable rebuilding of the tooth structure prior to crown restoration. Dentists believe that endodontic posts provide a stable ...

Current trends in endodontic practice: emergency treatments and technological armamentarium.

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Lee, Michelle; Winkler, Johnathon; Hartwell, Gary; Stewart, Jeffrey; Caine, Rufus

2009-01-01

The current clinical practice of endodontics includes the utilization of a variety of new technological advances and materials. The last comprehensive survey that compared treatment modalities used in endodontic practices was conducted in 1990. The purpose of the current survey was to determine the frequency with which these new endodontic technologies and materials are being used in endodontic practices today. An e-mail questionnaire was sent to the 636 active diplomates of the American Board of Endodontics with current e-mail addresses. Two hundred thirty-two diplomates responded for a response rate of 35%. Calcium hydroxide was found to be the most frequently used intracanal medicament for all cases diagnosed with necrotic pulps. Ibuprofen was the most frequently prescribed medication for pain, and penicillin was the most frequently prescribed antibiotic when an active infection was present. Eighty-two percent of the respondents are still incorporating hand files in some fashion during the cleansing and shaping phase of treatment. Lateral condensation and continuous wave were the most common methods used for obturation. Digital radiography was reported as being used by 72.5% of the respondents, whereas 45.3% reported using the microscope greater than 75% of the patient treatment. Ultrasonics was used by 97.8% of the respondents. It appears from the results that new endodontic technology is currently being used in the endodontic offices of those who responded to the survey.

Rapid kill-novel endodontic sealer and Enterococcus faecalis.

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Nurit Beyth

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

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

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Montagnese, Thomas Anthony

2012-03-01

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

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

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

2016-01-01

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

The Relation of Endodontic-Periodontal Lesion and Therapy

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Trijani Suwandi

2013-07-01

Full Text Available The correlation between endodontic-periodontal lesion has been documented well be researches. Endodontic lesion originates from pulp, while periodontal lesion originates from periodontal tissues. Anatomically they are connected by apical foramen, lateral canal and accessories, as well as dentin tubules. The correlation appeared as the endodontic defect can be from periodontal lesion, or a periodontal defect is from a pulp tissue. Together they can emerge and form a combination lesion. Endodontic infections have been highly correlated with deeper periodontal pockets and furcation involvement in mandibular, the causal relationship between the two pathoses has not yet been established. This consensus supports the influence of degenerated or inflamed pulp that can happen on the periodontium; but not all researchers agree about the effect of periodontal disease on the pulp. Conclusion: The mechanism of endo-perio lesion need to taken care in order to have appropriate diagnostic so that the right therapy would be able to keep the teeth in the oral cavity.

Chlorhexidine in endodontics.

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

2013-01-01

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

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

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

2015-06-01

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

Endodontic cellulitis 'flare-up'. Case report.

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Matusow, R J

1995-02-01

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

Endodontic-related facial paresthesia: systematic review.

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

2014-01-01

Paresthesia is a neurosensitivity disorder caused by injury to the neural tissue. It is characterized by a burning or twinging sensation or by partial loss of local sensitivity. Paresthesia related to endodontic treatment can occur because of extravasation of filling material or the intracanal dressing, as a consequence of periapical surgery or because of periapical infection. A literature review of paresthesia in endodontics was undertaken, with a view to identifying and discussing the most commonly affected nerves, the diagnostic process and the treatment options. Among reported cases, the most commonly affected nerves were those passing through the jaw: the inferior alveolar nerve, the mental nerve and the lingual nerve. To diagnose paresthesia, the endodontist must carry out a complete medical history, panoramic and periapical radiography, and (in some cases) computed tomography, as well as mechanoceptive and nociceptive tests. To date, no specific treatment for endodontic-related paresthesia has been described in the literature, since the problem may be related to a variety of causes.

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

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Rosen, E; Tsesis, I

2016-01-01

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

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

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Mohapatra, Satyajit; Patro, Swadheena; Mishra, Sumita

2016-06-01

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

Application of forensic luminol for blood detection in endodontic files

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Rodrigo ARRUDA-VASCONCELOS

Full Text Available Abstract Introduction Blood is a biological material with high potential of infectious transmission in dental environments, including herpes simplex, hepatitis and AIDS. Aim To investigate the efficacy of luminol in detecting blood in endodontic files before and after the sterilization process. Material and method Luminol was used to investigate the presence or absence of traces of blood tissue in 50 endodontic files, visible to naked eye or not, after performing endodontic treatment and after the cleaning/sterilization process. The results obtained were tabulated and statistically analyzed by using the Friedman’s test at a significance level of 5% (p<0.05. Result By naked eye, it was found that 31/50 files showed no trace of blood, 8/50 showed a slight presence of blood and 11/50 showed a considerable presence of blood after endodontic treatment. After the use of luminol, however, 16/50 endodontic files showed no trace of blood, 19/50 showed a slight presence of blood and 15/50 showed a considerable presence of blood. After the cleaning and sterilization process, no blood was detected in the files. Conclusion It was concluded that the luminol solution is effective in detecting blood tissue in endodontic files as well as in validating the cleaning/sterilization process.

Restoration of Endodontically Treated Molars Using All Ceramic Endocrowns

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Roopak Bose Carlos

2013-01-01

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

Assessment of patients' awareness and factors influencing patients' demands for sedation in endodontics.

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Huh, Yoo Kyeom; Montagnese, Thomas A; Harding, Jarrod; Aminoshariae, Anita; Mickel, Andre

2015-02-01

Endodontic therapy is perceived by many as a procedure to be feared. Many studies have reported that fear and anxiety are major deterrents to seeking dental care in general, but only a few deal with the use of sedation in endodontic therapies. The purpose of this study was to assess patients' awareness of and factors influencing the potential demand for sedation in endodontics. We hypothesized that there is an association between demographic factors and the demand for sedation in endodontics. A survey consisting of 24 questions was given to patients 18 years and older who presented to the graduate endodontic clinic. Results were collected and statistically analyzed. Thirty-six percent of patients reported that their perception of sedation was being put to sleep, and 27% perceived it as related to or reducing pain. Concerns associated with endodontic therapy were the fear of pain (35%), fear of needles (16%), difficulty getting numb (10%), and anxiety (7%). The 2 major demographic factors that influenced the demand for sedation were cost and the level of anxiety (P endodontic therapy if the option of sedation was available. The demand for sedation in endodontics is high. Patients' understanding of sedation varies. More patients would consider having endodontic procedures if sedation was available. The provision of sedation by endodontists could result in more patients accepting endodontic therapies. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

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

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Zabalegui, B; Gil, J; Zabalegui, I

1989-01-01

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

Endodontic management of patients with systemic complications

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Kalaiselvam Rajeswari

2016-01-01

Full Text Available Successful endodontic practice requires complete knowledge about the various medical conditions and appropriateness in planning treatment as per the need with effective safety measures. This review focuses on a number of systemic complications encountered in endodontic practice and directions to be followed for avoiding potential complications. A detailed PubMed search was carried out using specific keywords, and 25 articles were referred for finalizing the content.

Survival Rates from Fracture of Endodontically Treated Premolars Restored with Full-coverage Crowns or Direct Resin Composite Restorations: A Retrospective Study.

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Suksaphar, Warattama; Banomyong, Danuchit; Jirathanyanatt, Titalee; Ngoenwiwatkul, Yaowaluk

2018-02-01

The aim of the present study was to compare the survival rates against fracture of premolar endodontically treated teeth (ETT) restored with resin composite or crowns and to identify risk factors associated with the fracture. Data from dental records and radiographs of premolar ETT with postendodontic restorations (ie, resin composite or crowns) were collected between 2012 and 2016 and selected following selected inclusion and exclusion criteria. Tooth location, type of restoration, number of proximal contacts, and amount of tooth surface loss were recorded. The incidence and restorability of postendodontic fractures were identified. Survival rates against fracture of the 2 restoration types were calculated using Kaplan-Meier survival analysis. Any potential factors associated with fractures were identified using Cox proportional hazards models. The survival rate against fracture of ETT restored with crowns (95.1%) was higher than resin composite (77.0%). ETT restored with resin composite with 1 or 2 tooth surface losses and 2 proximal contacts had a high survival rate of 88.5% that was not significantly different from ETT with crowns. A higher incidence of restorability after fracture was observed in teeth restored with resin composite than crowns. The type of restoration and number of proximal contacts were identified as potential risk factors associated with fracture incidence. The survival rate against fracture of ETT restored with crowns was higher than resin composite. However, ETT with 1 or 2 tooth surface losses and 2 proximal contacts and restored with resin composite showed a high survival rate that was comparable with ETT restored with crowns. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Non-invasive endodontic treatment of large periapical lesions

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Harry Huiz Peeters

2008-09-01

Full Text Available Background: In most cases of large periapical radiolucent lesions of pulpal origin, we often encounter a dilemmatic situation, such as whether to either treat these cases endodontically or surgically. Development of techniques, instruments and root medicaments as well as the tendency toward minimally invasive treatment, all support dentists to treat those cases using the minimal invasive principle (i.e. endodontically instead of surgically. Purpose: The purpose of this paper is to report and discuss the managing of periapical lesions by endodontic no invasive treatment. Case management: The patient with large periapical lesions were treated with noninvasive endodontic treatment. After 6 months, patients in this report were asymptomatic and radiolucencies had disappeared. When the root canal treatment is done according to accepted clinical principles and under aseptic condition, including cleaning, shaping, abturating as well as proper diagnosis, the healing process of the infected area will occur. Conclusion: Some lesions, however, may not be treated conservatively and may require surgical treatment for total elimination of the lesions.

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

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

2011-11-01

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

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

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

2001-01-01

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

Clinical considerations for regenerative endodontic procedures.

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Geisler, Todd M

2012-07-01

The management of a tooth with incomplete root maturation and a necrotic pulp is an endodontic and a restorative challenge. Apexification procedures alone leave the tooth in a weakened state and at risk for reinfection. Regenerative endodontic procedures potentially offer advantages, including the possibility of hard tissue deposition and continued root development. Case studies have reported regeneration of human pulplike tissues in vivo, but there is no protocol that reliably regenerates pulplike tissue. This article summarizes historical, current, and future regenerative treatment approaches. Copyright © 2012 Elsevier Inc. All rights reserved.

Antimicrobial Activity of Calcium Hydroxide in Endodontics: A Review

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Shalavi, S; Yazdizadeh, M

2012-01-01

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

Chemical properties of gutta-percha endodontic filling material: investigation of five commercial brands; Propriedades quimicas de cones de guta-percha: avaliacao de diferentes marcas comerciais

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Silva Junior, Joao Batista A.; Paula, Regina C.M.; Feitosa, Judith P.A. [Ceara Univ., Fortaleza, CE (Brazil). Dept. de Quimica Organica e Inorganica]. E-mail: juniorquim@yahoo.com.br; rpaula@dqoi.ufc.br; judith@dqoi.ufc.br; Gurgel Filho, Eduardo; Teixeira, Fabricio B [Universidade Estadual de Campinas, Piracicaba, SP (Brazil). Faculdade de Odontologia.Dept. de Odontologia Restauradora]. E-mail: gurgeleduardo@aol.com

2001-07-01

Chemical composition e thermal stability of five brands of gutta-percha endodontic filling material were investigated. Samples with higher amount of organic materials possess higher thermal stability. Investigation of gutta-percha polymer extracted from the endodontic filling by IR and NMR shows that the polymer is predominantly trans-polyisoprene. The thermal stability and molar mass were similar for four brands, however the 'Tanari' brand has got lower molar mass value than the other ones. (author)

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

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

2018-01-01

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

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

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

2017-04-01

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

Pulse oximetry: a potential aid in endodontic diagnosis?

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Caplan, Dan

2010-06-01

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

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

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

2015-09-21

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

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

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

1985-01-01

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

Periodontal and endodontic pathology delays extraction socket healing in a canine model

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2017-01-01

Purpose The aim of the present exploratory study was to evaluate extraction socket healing at sites with a history of periodontal and endodontic pathology. Methods The mandibular 4th premolar teeth in 5 adult beagle dogs served as experimental units. Periodontal and endodontic lesions were induced in 1 premolar site in each animal using wire ligatures and pulpal exposure over 3 months (diseased sites). The contralateral premolar sites served as healthy controls. The mandibular 4th premolar teeth were then extracted with minimal trauma, followed by careful wound debridement. The animals were sacrificed at days 1, 7, 30, 60, and 90 post-extraction for analysis, and the healing patterns at the healthy and diseased extraction sites were compared using radiography, scanning electron microscopy, histology, and histometry. Results During the first 7 days of healing, a significant presence of inflammatory granulation tissue was noted at the diseased sites (day 1), along with a slightly accelerated rate of fibrin clot resolution on day 7. On day 30, the diseased extraction sites showed a greater percentage of persistent fibrous connective tissue, and an absence of bone marrow formation. In contrast, healthy sites showed initial signs of bone marrow formation on day 30, and subsequently a significantly greater proportion of mature bone marrow formation on both days 60 and 90. Radiographs exhibited sclerotic changes adjoining apical endodontic lesions, with scanning electron microscopy showing collapsed Volkmann canals protruding from these regions in the diseased sites. Furthermore, periodontal ligament fibers exhibited a parallel orientation to the alveolar walls of the diseased sites, in contrast to a perpendicular arrangement in the healthy sites. Conclusions Within the limitations of this study, it appears that a history of periodontal and endodontic pathology may critically affect bone formation and maturation, leading to delayed and compromised extraction socket

A comparison between the effect of zirconia-coated FRC and glass fiber posts on the fracture resistance of endodontically treated teeth

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Ezatollah Jalalian

2014-04-01

Full Text Available   Background and Aims : The root fracture resistance of endodontically treated teeth depends on the types of posts. The aim of this study was to compare the effect of two types of bonded non-metallic posts with different elasticity modulus on the fracture resistance of endodontically treated teeth under compressive loads.   Materials and Methods: In this in vitro experimental study, 20 fresh extracted mandibular premolars were selected and sectioned adjacent to the CEJ and then were endodontically treated. The specimens were randomly divided into two groups (n=10. After post space preparations, the fiber RTD Light posts (R.T.D, France and zirconia coated fiber posts (ICE light, Danville were cemented into the root canals. Composite resin (Lumiglass R.T.D, France cores were built up. Aluminium foil was used to mimic the PDL, and the specimens were embedded in acrylic resin and tested in a Universal Testing Machine. A compressive load was applied at a 90 degree angle until fracture at a crosshead speed of 1mm/min. Data were analyzed using one-way ANOVA and T test .   Results: The mean fracture resistance of R.T.D group was (1083.11 ± 156.74 (N and the mean of ICE light group was (865.18 ± 106.24 (N. The highest mean fracture resistance was observed in RTD fiberglass and a statistically significant difference was observed between the two groups (P<0.001.   Conclusion: FRC posts with zirconia coating due to unfavorable fractures of the teeth should be used with caution, and thus, fiber posts are preferred.

Improving the quality of endodontic record keeping through clinical audit.

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King, E; Shekaran, L; Muthukrishnan, A

2017-03-10

Introduction Record keeping is an essential part of day-to-day practice and plays an important role in treatment, audit and dento-legal procedures. Creating effective endodontic records is challenging due to the scope of information required for comprehensive notes. Two audits were performed to assess the standards of endodontic record keeping by dentists in a restorative dentistry department and students on an endodontic MSc course.Methods Fifty sets of departmental records and 10 sets of student records were retrospectively evaluated against the European Society of Endodontology 2006 guidelines. Results of the first cycle of both audits were presented to departmental staff and MSc students, alongside an educational session. Additionally, departmental guidelines, consent leaflets and endodontic record keeping forms were developed. Both audits were repeated using the same number of records, thus completing both audit cycles.Results The most commonly absent records included consent, anaesthetic details, rubber dam method, working length reference point, irrigation details and obturation technique. Almost all areas of record keeping improved following the second audit cycle, with some areas reaching 100% compliance when record keeping forms were used. Statistically significant improvements were seen in 24 of the 29 areas in the departmental audit and 14 of the 29 areas in the MSc audit (P = 0.05).Conclusions Significant improvements in endodontic record keeping can be achieved through the provision of education, departmental guidelines, consent leaflets and endodontic record keeping forms.

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

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

2017-01-01

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

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

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

2016-12-01

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

A New Classification of Endodontic-Periodontal Lesions

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Khalid S. Al-Fouzan

2014-01-01

Full Text Available The interrelationship between periodontal and endodontic disease has always aroused confusion, queries, and controversy. Differentiating between a periodontal and an endodontic problem can be difficult. A symptomatic tooth may have pain of periodontal and/or pulpal origin. The nature of that pain is often the first clue in determining the etiology of such a problem. Radiographic and clinical evaluation can help clarify the nature of the problem. In some cases, the influence of pulpal pathology may cause the periodontal involvement and vice versa. The simultaneous existence of pulpal problems and inflammatory periodontal disease can complicate diagnosis and treatment planning. An endo-perio lesion can have a varied pathogenesis which ranges from simple to relatively complex one. The differential diagnosis of endodontic and periodontal diseases can sometimes be difficult, but it is of vital importance to make a correct diagnosis for providing the appropriate treatment. This paper aims to discuss a modified clinical classification to be considered for accurately diagnosing and treating endo-perio lesion.

A new classification of endodontic-periodontal lesions.

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Al-Fouzan, Khalid S

2014-01-01

The interrelationship between periodontal and endodontic disease has always aroused confusion, queries, and controversy. Differentiating between a periodontal and an endodontic problem can be difficult. A symptomatic tooth may have pain of periodontal and/or pulpal origin. The nature of that pain is often the first clue in determining the etiology of such a problem. Radiographic and clinical evaluation can help clarify the nature of the problem. In some cases, the influence of pulpal pathology may cause the periodontal involvement and vice versa. The simultaneous existence of pulpal problems and inflammatory periodontal disease can complicate diagnosis and treatment planning. An endo-perio lesion can have a varied pathogenesis which ranges from simple to relatively complex one. The differential diagnosis of endodontic and periodontal diseases can sometimes be difficult, but it is of vital importance to make a correct diagnosis for providing the appropriate treatment. This paper aims to discuss a modified clinical classification to be considered for accurately diagnosing and treating endo-perio lesion.

Activation of Alkaline Irrigation Fluids in Endodontics

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Laurence J. Walsh

2017-10-01

Full Text Available In conventional endodontic treatment, alkaline solutions of sodium hypochlorite (NaOCl and ethylenediaminetetraacetic acid (EDTA are used in combination to disinfect the root canal system and to eliminate debris and smear layers. An important concept that has emerged over recent years is the use of active physical methods for agitating these fluids to improve their penetration within areas that are not reached by endodontic instruments and to accelerate the chemical actions of these alkaline fluids against planktonic microorganisms, biofilms, soft tissue remnants and smear layers. Ultrasonic agitation and more recently pulsed lasers have emerged as two promising methods for activating endodontic irrigation fluids. Ultrasonic agitation with piezoelectric devices employs a moving tip, while laser agitation uses a stationary tip. Both methods cause cavitation, followed by implosions and shear forces which assist with debridement. Fluid streaming further enhances the activity of the fluids. While agitation enhances performance of irrigants, extrusion of fluids from the root canal during activation is a hazard that must be controlled.

Effects of endodontic post surface treatment, dentin conditioning, and artificial aging on the retention of glass fiber-reinforced composite resin posts.

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Albashaireh, Zakereyya S; Ghazal, Muhamad; Kern, Matthias

2010-01-01

Several post surface treatments with or without the application of a bonding agent have been recommended to improve the bond strength of resin cements to posts. A regimen that produces the maximum bond strength of glass fiber-reinforced composite resin posts has not been verified. The purpose of this study was to evaluate the influence of post surface conditioning methods and artificial aging on the retention and microleakage of adhesively luted glass fiber-reinforced composite resin posts. Seventy-two endodontically treated single-rooted teeth were prepared for glass fiber-reinforced composite resin posts. The posts were submitted to 3 different surface treatments (n=24), including no treatment, etching with phosphoric acid, and airborne-particle abrasion. Subgroups of the posts (n=8) were then allocated for 3 different experimental conditions: no artificial aging, no bonding agent; no artificial aging, bonding agent; or artificial aging, bonding agent. The posts were luted with resin cement (Calibra). Post retention was measured in tension at a crosshead speed of 2 mm/min. The posts assigned for microleakage investigation were placed in fuchsin dye for 72 hours. The dislodged posts and the post spaces were examined microscopically to evaluate the mode of failure and explore the microleakage. Data were analyzed by 2-way ANOVA followed by Tukey HSD test (alpha=.05). The mean (SD) retention values for test groups ranged from 269 (63.8) to 349 (52.2) N. The retention values of the airborne-particle-abrasion group were significantly higher than those of the acidic-treatment and no-treatment groups. The application of bonding agent on the post surface produced no significant influence on retention. The mean retention values after artificial aging were significantly higher than without artificial aging. Microscopic evaluation demonstrated that the failure mode was primarily mixed. Treating the surface of the posts with phosphoric acid for 15 seconds before cementation

Role of calcium-enriched mixture in endodontics

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Pradeep Kabbinale

2015-01-01

Full Text Available Calcium-enriched mixture (CEM has been recently introduced as a hydrophilic tooth-colored cement. The CEM cement powder is composed of calcium oxide, calcium sulfate, phosphorus oxide, and silica as major elements. CEM is alkaline cement (pH~11 that releases calcium hydroxide (CH during and after setting. The physical properties of CEM, such as flow, film thickness, and primary setting time are favorable. This cement is biocompatible and induces formation of cementum, dentin, bone and periodontal tissues. This novel cement has an antibacterial effect comparable to CH and superior to mineral trioxide aggregate (MTA and sealing ability similar to MTA. Its clinical applications include pulp capping, pulpotomy, root-end filling and perforation repair. This review describes the composition, properties and clinical applications of CEM in endodontics.

Experimental and numerical determination of the mechanical response of teeth with reinforced posts

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Papadopoulos, Triantafillos; Papadogiannis, Dimitris; Mouzakis, Dionysios E; Giannadakis, Konstantinos; Papanicolaou, George

2010-01-01

The aim of this study was to evaluate the mechanical behavior of endodontically treated teeth restored with fiber reinforced composite posts versus titanium posts, by both experimental testing and numerical simulation (finite element analysis (FEA)). Forty maxillary central incisors were endodontically treated to a size 45 file and then obturated using gutta-percha points and sealer with the lateral condensation technique. The teeth were divided into four groups of ten teeth each. All the posts were of similar dimensions. The first group was restored using carbon fiber reinforced posts (CB), the second and third groups were restored using glass fiber reinforced posts (DP and FW, respectively), and the fourth group (control group) was restored using conventional titanium posts (PP). Half of the specimens of every group were submitted to hydrothermal cycling (2000 cycles, at 5 0 C and 55 0 C, respectively). All specimens were loaded until failure at a 45 0 angle with respect to the longitudinal axis at a crosshead speed of 0.5 mm min -1 . A two-dimensional finite element model was designed in order to simulate the experimentally obtained results. Mechanical testing revealed that teeth restored with titanium posts exhibited the highest fracture strength. Debonding of the core was the main failure mode observed in glass fiber posts, whereas vertical root fractures were observed in the titanium posts. FEA revealed that the maximum stresses were developed at the interface between the post, dentin and the composite core critical regions in all three cases. Hydrothermal cycling had no significant effect on the fracture behavior of fiber reinforced composite posts.

Bioactive endodontic materials for everyday use: a review.

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Walsh, Ryan M; He, Jianing; Schweitzer, Jordan; Opperman, Lynne A; Woodmansey, Karl F

2018-01-01

Bioceramic materials are at the forefront of modern dentistry. Bioactive bioceramic endodontic materials promote pulpal and periapical tissue healing and are easy to use. Dentists can choose among many endodontic materials, depending on their needs. This article highlights the major differences among commercially available bioactive tricalcium silicate bioceramics, commonly known as mineral trioxide aggregate materials, to enable dentists to make appropriate decisions in the selection of these materials.

A Review of Antibacterial Agents in Endodontic Treatment

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

2014-01-01

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

Association of Endodontic Lesions with Coronary Artery Disease

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Liljestrand, J. M.; Mäntylä, P.; Paju, S.; Buhlin, K.; Kopra, K. A. E.; Persson, G. R.; Hernandez, M.; Nieminen, M. S.; Sinisalo, J.; Tjäderhane, L.; Pussinen, P. J.

2016-01-01

An endodontic lesion (EL) is a common manifestation of endodontic infection where Porphyromonas endodontalis is frequently encountered. EL may associate with increased risk for coronary artery disease (CAD) via similar pathways as marginal periodontitis. The aim of this cross-sectional study was to delineate the associations between EL and CAD. Subgingival P. endodontalis, its immune response, and serum lipopolysaccharide were examined as potential mediators between these 2 diseases. The Finn...

Diversity of spirochetes in endodontic infections.

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

2009-05-01

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

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

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Walker, I; Gilbert, D; Asimakopoulou, K

2015-12-01

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

Coronal microleakage of four temporary restorative materials in Class II-type endodontic access preparations

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Sang-Mi Yun

2012-02-01

Full Text Available Objectives The purpose of this study was to evaluate the microleakage of 4 temporary materials in teeth with Class II-type endodontic access preparations by using a glucose penetration model. Materials and Methods Glucose reaction test was performed to rule out the presence of any reaction between glucose and temporary material. Class II-type endodontic access preparations were made in extracted human premolars with a single root (n = 10. Each experimental group was restored with Caviton (GC, Spacer (Vericom, IRM (Dentsply-Caulk, or Fuji II(GC. Microleakage of four materials used as temporary restorative materials was evaluated by using a glucose penetration model. Data were analyzed by the one-way analysis of variance followed by a multiple-comparison Tukey test. The interface between materials and tooth were examined under a scanning electron microscope (SEM. Results There was no significant reaction between glucose and temporary materials used in this study. Microleakage was significantly lower for Caviton and Spacer than for Fuji II and IRM. SEM observation showed more intimate adaptation of tooth-restoration interfaces in Caviton and Spacer than in IRM and Fuji II. Conclusions Compared to IRM and Fuji II, Caviton and Spacer can be considered better temporary sealing materials in Class II-type endodontic access cavities.

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

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

2016-01-01

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

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

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Mina D. Fahmy

2016-01-01

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

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

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

2015-02-01

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

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

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Devi, Arpana A; Abbott, Paul V

2015-12-01

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

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

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

2017-01-01

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

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

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

2011-01-01

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

Use of Cone Beam Computed Tomography in Endodontics

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

2009-01-01

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

Role of herbs in endodontics

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Rajendra Kumar Tewari

2016-01-01

Full Text Available Medicinal plants and herbs have attracted a lot of attention since the past few years. The market for drugs extracted from these plants and made from herbal extracts has seen a significant rise. India is known for its rich stock of medicinal plants. Among many, some herbs are rich in phytochemical content. These phytochemicals are useful in generating phytomedicines which have effects on the human body. In the field of endodontics, phytomedicines are a boon. They have been popularly used as analgesic, anti-inflammatory, sedatives, and antibiotics. They are most significantly used as endodontic irrigants. Phytotherapy has been a grand entrant in the drug market. The reason why herbal extracts have the potential to be highly popular is due to the side effects of synthetic medicines which alter microbiota.

Pyrosequencing Analysis of Cryogenically Ground Samples from Primary and Secondary/Persistent Endodontic Infections.

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Keskin, Cangül; Demiryürek, Ebru Özsezer; Onuk, Ertan Emek

2017-08-01

This study aimed to characterize the microbial communities of primary and secondary/persistent endodontic infections using high-throughput pyrosequencing from the pulverized samples. The roots of 20 extracted human teeth with primary endodontic infection and 20 teeth with secondary/persistent endodontic infection were collected. The outer surfaces of the roots were disinfected, and whole roots were cryopulverized. 16S amplicon pyrosequencing data from the DNA extracted from the pulverized root powders were obtained, and microorganism abundance and diversity were calculated. Data were analyzed using statistical and bioinformatic methods. Pyrosequencing analysis resulted a total of 2,606,128 sequences from 40 samples. A total of 15 phyla, 160 genera, and 368 species were detected. No significant difference between primary and secondary/persistent endodontic infections was found regarding the diversity and richness of operational taxonomic units at the phyla, genera, and species levels (P > .005). The present study revealed that the microbial diversity of secondary/persistent endodontic infections did not differ than those of primary endodontic infections. A new archaeal species, Candidatus Nitrosoarchaeum limnia, was detected in root canals of 1 patient with primary endodontic infection for the first time. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Physical and mechanical properties of a thermomechanically treated NiTi wire used in the manufacture of rotary endodontic instruments.

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Pereira, E S J; Peixoto, I F C; Viana, A C D; Oliveira, I I; Gonzalez, B M; Buono, V T L; Bahia, M G A

2012-05-01

To compare physical and mechanical properties of one conventional and one thermomechanically treated nickel-titanium (NiTi) wire used to manufacture rotary endodontic instruments. Two NiTi wires 1.0 mm in diameter were characterized; one of them, C-wire (CW), was processed in the conventional manner, and the other, termed M-Wire (MW), received an additional heat treatment according to the manufacturer. Chemical composition was determined by energy-dispersive X-ray spectroscopy, phase constitution by XRD and the transformation temperatures by DSC. Tensile loading/unloading tests and Vickers microhardness measurements were performed to assess the mechanical behaviour. Data were analysed using analysis of variance (α = 0.05). The two wires showed approximately the same chemical composition, close to the 1 : 1 atomic ratio, and the β-phase was the predominant phase present. B19' martensite and the R-phase were found in MW, in agreement with the higher transformation temperatures found in this wire compared with CW, whose transformation temperatures were below room temperature. Average Vickers microhardness values were similar for MW and CW (P = 0.91). The stress at the transformation plateau in the tensile load-unload curves was lower and more uniform in the M-Wire, which also showed the smallest stress hysteresis and apparent elastic modulus. The M-Wire had physical and mechanical properties that can render endodontic instruments more flexible and fatigue resistant than those made with conventionally processed NiTi wires. © 2011 International Endodontic Journal.

Outcomes of endodontic therapy in general practice

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

2014-01-01

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

Progression of periapical cystic lesion after incomplete endodontic treatment

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Jong-Ki Huh

2016-05-01

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

Use of Cone Beam Computed Tomography in Endodontics

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William C. Scarfe

2009-01-01

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

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

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

2017-01-01

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

Possibilities and limits of imaging endodontic structures with CBCT.

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

2015-01-01

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

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

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Castellarin, M; Demitri, V; Politi, M

2001-01-01

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

Aspergillus in endodontic infection near the maxillary sinus

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Cinthya Cristina Gomes

2015-10-01

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

Infection and microleakage the caused of endodontic failure

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Kurniasri Amas Achiar

2008-03-01

Full Text Available The success of endodontic treatment depends on the quality of endodontic treatment and the final restoration. The mean reason for endodontic treatment failure is usually microleakage. That is why it becomes one of the priorities for dental research to prevent microleakage. Infection during the root canal treatment can be prevented. First, by employing strict aseptic clinical techniques follows by cleaning all bacteria and preoperative necrotic pulp-tissue remnants from the root canal. Irrigants are essential in this phase. The shaping of the canal is also an important prerequisite for endodontic success. Removal of the smear layer can enhance seal ability. Second, obturation of the root canal should leave the tooth in the most biological inert condition possible, and it must prevent reinfection as well as the growth of any microorganisms remaining in the canal. The application of an antibacterial dressing between appointments is absolutely necessary or the root canal has to be obturated at the first appointment in order to deprive the microorganisms of nutrients and space to multiply. The temporary filling must be at least 3.5 mm thick. Failure occurs because of missed canals, iatrogenic events and radicular fractures have to be avoided. At the end, clinicians have to confirm that the root canal is cleaned and hermetically obturated because hermetic root canal filling will prevent the leakage of an irritant to the apical area.

Endodontics and the irradiated patient

International Nuclear Information System (INIS)

Cox, F.L.

1976-01-01

With increasingly larger numbers of irradiated patients in our population, it seems likely that all dentists will eventually be called upon to manage the difficult problems that these patients present. Of utmost concern should be the patient's home care program and the avoidance of osteroradionecrosis. Endodontics and periodontics are the primary areas for preventing or eliminating the infection that threatens osteoradionecrosis. Endodontic treatment must be accomplished with the utmost care and maximum regard for the fragility of the periapical tissues. Pulpally involved teeth should never be left open in an irradiated patient, and extreme care must be taken with the between-visits seal. If one is called upon for preradiation evaluation, routine removal of all molar as well as other compromised teeth should be considered. Attention should be directed to the literature for further advances in the management of irradiated patients

Natural Therapeutic Options in Endodontics - A Review

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

2016-01-01

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

Periapical and endodontic status of permanent teeth in patients with hypophosphatemic rickets

DEFF Research Database (Denmark)

Andersen, Mette Guldbæk; Beck-Nielsen, Signe; Haubek, Dorte

2012-01-01

panoramic radiograph, which was scored for endodontically affected teeth (i.e. teeth with periapical radiolucencies and/or endodontically treated teeth). A total of 52 patients (age range: 5·7-74·5 years; 17 males and 35 females) were included. HR patients were characterised by a high number...... genetically. The aim of the present study was to describe the periapical and endodontic status of permanent teeth in patients with genetically and/or biochemically confirmed HR. The patients were recruited from a medical study on HR patients. The patients underwent a dental examination including a digital...... of endodontically affected teeth (mean: 4·2; s.d.: 5·0). The number of affected teeth rose significantly with age (P ...

CALCIUM HYDROXIDE IN ENDODONTIC TREATMENT OF PERIAPICALLY INFECTED TEETH

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Rahmi Alma Farah Adang

2006-04-01

Full Text Available An inadequate endodontic treatment may affect the root canal system and spread beyond its apical foramina that elicit periodontal tissue developing into abscess, granuloma and radicular cyst. Periodical lesions can be treated with non surgical endodontic treatment using calcium hydroxide dressing. This case study is reporting teeth 11 with periodical lesions and infection. Evidence of a clinical healing and radiographic assessments were followed by a non surgical endodontic therapy. Successful treatment outcome is related to the elimination of infection agents from the root canal. This can activate a stimulation zone to promote regeneration. Calcium hydroxide used as a root canal dressing may promote alkalinity at the adjacent tissue , create favourable environmental condition in which hard tissue formation can occur, interfere the bactericidal activity, increase mineralization, and induce healing.

Experimental investigation of defect criticality in FRP laminate composites

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Joyce, Peter James

1999-11-01

This work examines the defect criticality of fiber reinforced polymer Composites. The objective is to determine the sensitivity of the finished composite to various process-induced defects. This work focuses on two different classes of process-induced defects; (1) fiber waviness in high performance carbon-fiber reinforced unidirectional composites and (2) void volume in low cost glass-fabric reinforced composites. The role of fiber waviness in the compressive response of unidirectional composites has been studied by a number of other investigators. Because of difficulties associated with producing real composites with varying levels of fiber waviness, most experimental studies of fiber waviness have evaluated composites with artificially induced fiber waviness. Furthermore, most experimental studies have been concentrated on the effects of out-of-plane fiber waviness. The objective of this work is to evaluate the effects of in-plane fiber waviness naturally occurring in autoclave consolidated thermoplastic laminates. The first phase of this project involved the development of a simple technique for measuring the resulting fiber waviness levels. An experimental investigation of the compression strength reduction in composites with in-plane fiber waviness followed. The experimental program included carbon-fiber reinforced thermoplastic composites manufactured from prepreg tape by hand layup, and carbon-fiber and glass-fiber reinforced composites manufactured from an experimental powder towpreg by filament winding and autoclave consolidation. The compression specimens exhibited kink band failure in the prepreg composite and varying amounts of longitudinal splitting and kink banding in the towpreg composites. The compression test results demonstrated the same trend as predicted by microbudding theory but the overall quantitative correlation was poor. The second thrust of this research evaluated void effects in resin transfer molded composites. Much of the existing

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

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

2014-03-01

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

Endodontic treatment associated with photodynamic therapy: Case report.

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

2016-09-01

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

Fracture resistance of endodontically-treated teeth: effect of combination bleaching and an antioxidant.

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Khoroushi, Maryam; Feiz, Atieh; Khodamoradi, Roghayeh

2010-01-01

This in vitro study assessed the fracture resistance of endodontically-treated teeth undergoing combination bleaching with 38% and 9.5% hydrogen peroxide gels as in-office and at-home bleaching techniques, respectively. In addition, the effect of an antioxidizing agent, sodium ascorbate, was investigated. Sixty maxillary premolars were endodontically-treated, received a glass ionomer barrier as a mechanical seal and were embedded in acrylic resin up to the cemento-enamel junction. The specimens were divided into four groups (n = 15) as follows: G I: no bleaching, access cavity restored with resin composite (negative control); G II: bleached for three weeks daily using 9.5% hydrogen peroxide for two hours and three sessions of in-office bleaching using 38% hydrogen peroxide every seven days, then restored (positive control); G III: bleached similar to G II and restored after one week; G IV: bleached similar to G II, along with the use of an antioxidizing agent for 24 hours, then restored. In each in-office and at-home bleaching session, the whitening gels were applied to the buccal surface of the tooth and placed inside the pulp chamber (inside/outside bleaching technique). Finally, the specimens underwent fracture resistance testing; the data were analyzed using ANOVA and Scheffé's test (alpha = 0.05). Significant differences were observed among the study groups (p 0.05). Within the limitations of the current study, it can be concluded that the fracture resistance of endodontically-treated teeth decreases after combination bleaching. The use of sodium ascorbate can reverse decreased fracture resistance.

Irrigation in endodontic treatment.

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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.

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

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Ramić Bojana

2012-01-01

Full Text Available Introduction. 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. Outline of Cases. 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. Conclusion. 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.

X-Ray diagnostics and their relation to a successful endodontic treatment

International Nuclear Information System (INIS)

Cecetkova, A.; Ondrasovicova, J.

2008-01-01

Radiography plays very major rule in endodontic. One of the most used method is intraoral radiography ( intraoral diagnostic x-ray, x-ray with hand root instrument, recall, after call and follow up x-ray ). These radiographic pictures help us detect the morphology of the root canal system, endodontic complications and periapical lessions. X-ray radiographs have to be isometric in the ortoradial projection. Some cases we may use the ex-centric projection (mesial and distal projection). Endodontic complications as broken hand root instrument, via falsa, intra-canal step may be confirmed by intraoral x-ray radiographs. (authors)

Clinically Enhancing Local Anesthesia Techniques for Endodontic Treatment.

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Bahcall, James; Xie, Qian

2017-02-01

Local anesthesia is one of the most important drugs given to patients who undergo endodontic treatment. Yet, clinicians often do not view local anesthetic agents as drugs and, therefore, struggle clinically to consistently achieve profound pulpal anesthesia. To improve the clinical effects of local anesthesia for endodontic treatment, in conjunction with selecting the correct type of local anesthesia, clinicians need to thoroughly understand how the local anesthetic process works and how to objectively test for clinical signs of pulpal anesthesia and integrate supplemental anesthesia when appropriate.

Endodontic medicine: connections between apical periodontitis and systemic diseases.

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

2015-10-01

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

Microbiologic endodontic status of young traumatized tooth.

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Baumotte, Karla; Bombana, Antonio C; Cai, Silvana

2011-12-01

Traumatic dental injuries could expose the dentin and, even the pulp, to the oral environment, making possible their contamination. The presence of microorganisms causes pulpal disease and further a tecidual clutter in the periradicular region. The therapy of periradicular pathosis is the consequence of a correct diagnoses which depends on the knowledge of the nature and complexity of endodontic infections. As there is no information on the microbiology of primary endodontic infection in young teeth, the aim of the current study was to investigate the microbiologic status of root canals from permanent young teeth with primary endodontic infection. Twelve patients with the need for endodontic treatment participated in the study. The selected teeth were uniradicular and had an incomplete root formation. They had untreated necrotic pulp. After the access preparation, nineteen microbiologic samples were obtained from the root canals with sterile paper points. Afterwards, the paper points were pooled in a sterile tube containing 2 ml of prereduced transport fluid. The samples were diluted and spread onto plates with selective medium for Enterococcus spp. and for yeast species and onto plates with non-selective medium. A quantitative analysis was performed. The mean number of cultivable bacterial cells in the root canals was 5.7 × 10(6). In four samples (21.05%) black pigmented species were recovered and the mean number of cells was 6.5 × 10(5). One specimen (5.25%) showed the growth of Enterococcus species and the mean number of cells in this case was of 1.5 × 10(4) . The results showed a root canal microbiota with similar design as seen in completely formed teeth. © 2011 John Wiley & Sons A/S.

Cleanliness of endodontic files after use and before sterilization

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Maria de Lourdes Portella

2008-01-01

Full Text Available Objectives: To evaluate the efficacy of two endodontic file cleaning methods: manual and with the use of ultrasonic vat Method: Sixty-six endodontic files were used for root canal preparations and afterwards divided into three groups: 1 manual cleaning; 2ultrasonic cleaning; 3 files used in patients, but were not cleaned (positive control.Results: Statistical analysis showed that in the case of manually cleaned files, the percentage of cleaning was 0.4% while in those that were dirty it was 99.6%. In the case of ultrasonic cleaning, the cleaning percentage was 49.21% while the percentage of dirt was 50.79%. Conclusion: The most satisfactory result was obtained with the use of ultrasound, and it is suggested that after ultrasound, brushing, the use of liquid soap and water, and drying should be performed for adequate cleaning of endodontic files.

Aspergillus in endodontic infection near the maxillary sinus.

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

2015-01-01

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

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

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Asgary, Saeed

2007-01-01

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

Endodontic Microbiology and Pathobiology: Current State of Knowledge.

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Fouad, Ashraf F

2017-01-01

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

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

Science.gov (United States)

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

2018-03-23

The aim of the present study was to investigate the effects of a calcium hydroxide-based intracanal medication (ICM) on periodontal and endodontic infectious/inflammatory contents and on periodontal clinical parameters in teeth with primary periodontal lesion and secondary endodontic involvement. Ten patients with abnormal pulp test results and deep probing depth derived from primary periodontal disease with secondary endodontic involvement were included. Samples were collected from root canals (RC) and periodontal pockets (PP) in order to investigate the microbiological status, levels of endotoxin (LPS), cytokines, and matrix metalloproteinases (MMP), before and after ICM. PCR was used for microbiological assessment. The kinetic-chromogenic LAL assay was used for LPS quantification. Quantikine ELISA kits were used for measurement of IL-1 α, IL-1 β, TNF-α, PGE 2 , MMP-2, MMP-3, MMP-8, MMP-9, and MMP-13 levels. The statistical analyses were made using the Friedman and Wilcoxon tests (p  0.05); however, the levels of the other MMPs and cytokines were reduced (p < 0.05). After 1 year of the root canal treatment, tooth mobility was significantly reduced (p ≤ 0.05). The use of a calcium hydroxide-based ICM showed positive effects for periodontal treatment prognosis, as it reduced LPS, cytokine, and MMP levels in periodontal pockets. Patients presenting deep probing depth and undergoing periodontal treatment for at least 6 months, with no positive response to periodontal therapy, might benefit with the endodontic treatment.

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

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Cohenca, Nestor; Shemesh, Hagay

2015-09-01

The use of cone beam computed tomography (CBCT) in endodontics has been extensively reported in the literature. Compared with the traditional spiral computed tomography, limited field of view (FOV) CBCT results in a fraction of the effective absorbed dose of radiation. The purpose of this manuscript is to review the application and advantages associated with advanced endodontic problems and complications, while reducing radiation exposure during complex endodontic procedures. The benefits of the added diagnostic information provided by intraoperative CBCT images in select cases justify the risk associated with the limited level of radiation exposure.

Comparison of the Effect of 800 mg Ibuprofen and 30 mg Predenisolone on Relief of Post Endodontic Pain

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S.M. Jalalzadeh

2009-04-01

Full Text Available Introduction & Objective: One of the important problems in dentistry is post endodontic pains .The purpose of this study was comparison of the effect of prophylactic oral ibuprofen 800mg and oral predenisolone 30mg on prevention of post endodontic pain.Materials & Methods: The present study is a double-blind, randomized and controlled trial. It was conducted on 60 patient (16men and 44 women between the ages of 18-63 who needed endodontic treatment. Inclusive criteria for selecting of patients were: need for root canal therapy in one of the posterior teeth, having no systemic problem, no evidence of abscess; not taking analgesic or similar drug for at least 6 hours before treatment. Patients were divided into three experimental groups randomly taking one of the drugs before the treatment {ibuprofen 800 mg, prednisolone30mg and placebo (oral dextrose}. Patients completed VAS at 6,12 and 24 hours post root canal therapy and analyzed using the spss15 by chi-square, ANOVA test and Tukey test.Results: During 24 hours after treatment post endodontic pain is 95%- 100% in the placebo group. The prevalence of no-pain was not significant 6, 12 and 24 hours after treatment between the ibuprofen and predenisolone groups. The mean scale of pain in ibuprofen and predenisolone groups was significantly lower than placebo group 6, 12 and 24 hours after treatment. Differences between the drug groups are significant only on 6 and 12 hours after treatment.Conclusion: Post endodontic pains are present 24 hours after treatment. 6 and 12 hours after treatment 30 mg predenisolone are significantly better for pain relief than 800 mg ibuprofen. But after 24 hours it is not significant.

Absorbed radiation by various tissues during simulated endodontic radiography

International Nuclear Information System (INIS)

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

1989-01-01

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

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

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

2015-12-21

Enterococci are able to survive endodontic procedures and contribute to the failure of endodontic therapy. Thus, it is essential to identify novel ways of eradicating them from infected root canals. One such approach may be the use of antimicrobials such as plant essential oils. Enterococcal strains were isolated from endodontically treated teeth by standard microbiological methods. Susceptibility to antibiotics was evaluated by the disc-diffusion method. The minimal inhibitory concentration (MIC) of geranium essential oil was investigated by microdilution in 96-well microplates in Mueller Hinton Broth II. Biofilm eradication concentrations were checked in dentin tests. Geranium essential oil inhibited enterococcal strains at concentrations ranging from 1.8-4.5 mg/mL. No correlation was shown between resistance to antibiotics and the MICs of the test antimicrobials. The MICs of the test oil were lower than those found to show cytotoxic effects on the HMEC-1 cell line. Geranium essential oil eradicated enterococcal biofilm at concentrations of 150 mg/mL. Geranium essential oil inhibits the growth of endodontic enterococcal species at lower concentrations than those required to reach IC50 against the HMEC-1 cell line, and is effective against bacteria protected in biofilm at higher concentrations. In addition, bacteria do not develop resistance to essential oils. Hence, geranium essential oil represents a possible alternative to other antimicrobials during endodontic procedures.

Comparative evaluation of four different sterilization methods on contaminated endodontic files

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Malathi Yenni

2017-01-01

Full Text Available Background: The reuse of instruments in the field of endodontics leads to cross infection due to contamination with microbes as the instruments come into direct contact with saliva, blood, and infected tissues. Since microbes are considered to be the major cause of endodontic failures, sterilization of endodontic instruments is mandatory for maintaining asepsis to prevent cross-contamination from one person to other. Hence, the present study was conducted to compare the effectiveness of four different methods of sterilizing contaminated endodontic files. Materials and Methods: A total of 48 stainless steel K files were divided into four groups based on the sterilization method followed – Group A: Autoclave, Group B: Glass bead sterilization, Group C: Glutaraldehyde, and Group D: Quitanet Plus (aldehyde-free solution. In all the tested groups, half of the files were contaminated with Escherichia coli and remaining with Enterococcus faecalis. Then, presterilization colony counts were recorded, followed by sterilization through respective methods. Later, the sterilized files were rinsed with distilled water and 100 ul of the diluted concentration was transferred and cultured onto the respective agar plates to determine the total microbial reduction. Results: Autoclave showed complete effectiveness in reducing the microbial count followed by Quitanet Plus, glass bead sterilizer, and glutaraldehyde. Conclusion: Autoclave is considered to be the best sterilization technique to prevent cross infection in endodontic therapy.

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

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Siqueira, José F; Rôças, Isabela N

2003-07-01

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

Culture-dependent approaches to explore the prevalence of root canal pathogens from endodontic infections

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Maryam Pourhajibagher

2017-12-01

Full Text Available Abstract: Endodontic infections are considered to be caused by the presence of various microorganisms within the root canal system. Recognition of this microbiota contributes to the successful treatment of infected root canals. This study investigated the microorganisms associated with primary and secondary endodontic infections via culture methods, biochemical tests, and molecular approaches in an Iranian population. Microbial specimens were collected from 36 patients with primary endodontic infection and 14 patients with a history of root canal therapy. Advanced microbiological culture techniques were used to isolate microbiota; subsequently, biochemical tests and 16S ribosomal RNA gene sequencing were performed to identify the microorganisms. Within the total 218 cultivable isolates, Veillonella parvula (20.6% was found to occur with the highest frequency in primary endodontic infection, followed by Porphyromonas gingivalis (14.1%, and Aggregatibacter actinomycetemcomitans (9.2%. Enterococcus faecalis (36.6% was the most predominant microorganism in secondary endodontic infections, followed by Candida albicans, Propionibacterium acnes, and V. parvula with frequencies of 20%, 2%, and 2%, respectively. It was concluded that V. parvula and E. faecalis was most frequently found in primary and secondary endodontic infections, respectively.

The etiology and symptoms of endodontic cases treated in a university clinic in Saudi Arabia

International Nuclear Information System (INIS)

AlYahya, A. S.; Selirn, H. A.; Guile, E. E.

1989-01-01

Endodontic patients treated at a University Dental Clinic over a two year period were studied. A total of 281 patients seen in a beginning endodontic course were analyzed to determine (1) the etiology of the pulpal disease presenting and (2) the signs and symptoms of pulpal disease. Results indicated that caries was the most prevalent reason for endodontic treatment. Most cases (40.6%) were asymptomatic. Lower molars were the most commonly affected and there was no significant difference in endodontic treatment distribution between males and females in the patient population studied. (author)

A survey of dental residents' expectations for regenerative endodontics.

Science.gov (United States)

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

2012-02-01

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

Experimental comparative study and fracture resistance simulation with irrigation solution of 0.2% chitosan, 2.5% NaOCl and 17% EDTA

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Ernani Ernani

2015-09-01

Full Text Available Background: Preparation in endodontic need irrigation materials as root canal debridement and disinfectant. However, irrigation materials is one of the factors that influence the tendency of fracture. Purpose: This study was aimed to see the resistance and fracture distribution if teeth irrigated with high molecular horseshoe crab chitosan at 0.2% concentration, 2.5% NaOCl solution and 17% EDTA solution in endodontic treatment with finite element method (FEM simulation study and experimental studies. Method: Endodontic treatment performed on 28 maxillary premolars with group A: irrigation solution of 17% EDTA and 2.5% NaOCl solution; group B: 2.5% NaOCl irrigation solution; group C: 2.5% NaOCl irrigation solution and 0.2% chitosan solution; group D: 0.2% chitosan solution irrigation. Final restoration was done using prefabricated glass fiber post. Cementation of post using resin cement then restored with direct composite resin restorations. Pressure test was performed with a Universal Testing Machine with a speed of 0.5 mm/min until fracture occurred. A three dimensional finite element analysis was performed for total deformation, equivalent (von-mises stress, and equivalent elastic strains. Result: Anova test showed significant differences in fracture resistance (p0.05. Statistical analysis showed no significant difference (p>0.05 between the results of experiment and FEM analysis results using the t-test. Conclusion: The results of this study demonstrated that there was effect of the use of high molecular 0.2% chitosan as a combined irrigation with NaOCl, but did not affect the fracture pattern distribution of endodontically treated teeth both experimentally and FEM analysis test.

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

Science.gov (United States)

2012-01-01

titanium endodontic files 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) J. B. King, H. W. Roberts, B. E... Endodontic Journal, doi:10.1111/j.1365- 2591.2011.01958.x 45, 156–161, 2012 doi:10.1111/j.1365-2591.2011.01958.x Wiley Blackwell Publishing, 111 River...autoclaving on torsional strength of two nickel–titanium (NiTi) rotary endodontic files: Twisted Files (SybronEndo, Orange, CA, USA) and GT Series X

Endodontic Treatment of a Maxillary Second Molar with Developmental Anomaly: A Case Report

OpenAIRE

Asgary, Saeed

2007-01-01

Fusion is a rare occurrence in molar teeth. The purpose of this rare case presentation is to describe the nonsurgical endodontic treatment of maxillary molar. A 28-year-old patient was referred for endodontic treatment of her chronic apical abscess of right maxillary second molar. In the clinical examination, a sinus tract adjacent to involved tooth and a small crown of supernumerary tooth fused to the buccal surface of the molar at gingival margin was observed. Endodontic treatment was decid...

Endodontic inter-appointment flare-ups: An example of chaos?

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Poorya Jalali

2015-01-01

Full Text Available Introduction: Pain and/or swelling after instrumentation of a root canal constitute a significant complication during endodontic treatment. Despite a large number of articles discussing the causative factors behind endodontic flare-ups, the exact mechanism is still not understood. The Hypothesis: The seemingly irrational behavior of endodontic inter-appointment flare-ups may be due to sensitive dependence on initial conditions. A model based on Lorenz′ chaos theory is presented as a possible explanation for the sudden emergence and unpredictability of flare-ups. Evaluation of the Hypothesis: All studies agree on some common traits regarding inter-appointment flare-ups: Careful instrumentation can still cause flare-up; the host inflammatory response behaves as a complex nonlinear network; and also the poly-etiologic nature of this phenomenon all illustrate the sensitive dependence on initial conditions of the system. Integrating more variables (e.g., different species of bacteria into this already complex system will make it increasingly chaotic reflecting its unpredictable behavior.

Evaluation of mechanical strength and hydrate products evolution of calcium aluminate cement, for endodontic applications

International Nuclear Information System (INIS)

Luz, A.P.; Borba, N.Z.; Pandolfelli, V.C.

2011-01-01

Mineral trioxide aggregate (MTA) is the most used retrograde filling cement in the endodontic area. Nevertheless, although its composition is similar to the conventional Portland cement, its high cost, long setting time and low mechanical strength have led to a continuous search for new alternative materials. Considering these aspects, the mechanical strength and crystalline phase evolution of a calcium aluminate cement (CAC), during its hydration process, have been evaluated in this work aiming to apply such material for endodontic treatments. Secar 71 cement samples were prepared and kept in contact with water or SBF (simulated body fluid) during 15 days at 37 deg C. Compressive strength, apparent porosity, X ray diffraction and thermogravimetric tests were carried out for the samples evaluation after 1, 3, 7 and 15 days. The main identified phases were CAH_1_0, C_2AH_8, C_3AH_6 and AH_3. Moreover, when in the presence of SBF, some changes in the amount of the hydrates in the CAC samples were observed, which affected the mechanical behavior of the cement. (author)

Relationship between crown placement and the survival of endodontically treated teeth.

Science.gov (United States)

Aquilino, Steven A; Caplan, Daniel J

2002-03-01

Crowns have been considered the restoration of choice for endodontically treated teeth, but their selection has been based primarily on anecdotal evidence. This study tested the hypothesis that crown placement (coronal coverage) is associated with improved survival of endodontically treated teeth when preaccess, endodontic, and restorative factors are controlled. A University of Iowa College of Dentistry treatment database was used to identify permanent teeth that had undergone initial obturation between July 1, 1985, and December 31, 1987. Study patients were restricted to persons with at least 1 dental visit in each 2-year interval from 1985 to 1996; a simple random sample of 280 patients (n = 400 teeth) was selected. Dental charts, radiographs, and computerized databases were examined to ascertain variables of interest and to verify study inclusion criteria. Kaplan-Meier survival estimates were generated for the 203 teeth that satisfied study inclusion criteria. Multivariate Cox proportional hazards regression models were developed, with standard errors adjusted to account for clustering of teeth within patients. When tooth type and radiographic evidence of caries at access were controlled, the final Cox model showed that endodontically treated teeth not crowned after obturation were lost at a 6.0 times greater rate than teeth crowned after obturation (95% confidence interval: 3.2 to 11.3). Within the limitations of this study, a strong association between crown placement and the survival of endodontically treated teeth was observed. These results may impact treatment planning if long-term tooth retention is the primary goal.

Endodontic applications of cone beam computed tomography: case series and literature review

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Francesc Abella

2015-11-01

Full Text Available Cone beam computed tomography (CBCT is a relatively new method that produces three-dimensional (3D information of the maxillofacial skeleton, including the teeth and their surrounding tissue, with a lower effective radiation dose than traditional CT scans. Specific endodontic applications for CBCT are being identified as the use of this technology becomes more common. CBCT has great potential to become a valuable tool for diagnosing and managing endodontic problems, as well as for assessing root fractures, apical periodontitis, resorptions, perforations, root canal anatomy and the nature of the alveolar bone topography around teeth. This article aims to review cone beam technology and its advantages over CT scans and conventional radiography, to illustrate current and future clinical applications in endodontic practice, and to highlight areas of further research of CBCT in endodontics. Specific case examples illustrate how treatment planning has changed with the images obtained with CBCT technology compared with only periapical radiography.

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

Science.gov (United States)

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

2015-03-01

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

Undergraduates’ opinion after 5-year experience with rotary endodontic instruments

OpenAIRE

Flávia Sens Fagundes Tomazinho; Gisele Aihara Haragushiku; Flares Baratto Filho; Denise Piotto Leonardi; Maria da Graça Kfouri Lopes; Alexandre Moro

2011-01-01

Introduction: Dentistry evolution in the past few years has revolutionized daily practice in some specialties. One of these revolutions has occurred in Endodontics due to the advancement of rotary techniques for root canal preparation and its subsequent incorporation into the teaching of Dentistry undergraduates. Objective: The aim of this study was to report a 5-year experience on the undergraduate laboratorial and clinical use of rotary endodontic preparation at a private university. Materi...

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

Science.gov (United States)

Ling, J Q

2016-04-09

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

A Naval Postgraduate Dental School Analysis of Initial Endodontic Treatment

Science.gov (United States)

2013-06-01

to prevent or heal disease , i.e. apical periodontitis . Accordingly, endodontic treatment outcomes can better be defined in reference to healing and...Janket S, Baird AE, Chuang S, Jones JA. Meta-analysis of periodontal disease risk and risk of coronary heart disease and stroke. Oral Surg Oral Med Oral...appointment endodontic therapy in dogs ’ teeth with apical periodontitis . J Endod 2003;29:121-4. 27. Penesis VA, Fitzgerald PI, Fayad MI, Wenckus

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

Science.gov (United States)

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

2010-08-01

The present study describes a case of endodontic sealer (AH Plus) penetration within and along the mandibular canal from the periapical zone of a lower second molar after endodontic treatment. The clinical manifestations comprised anesthesia of the left side of the lower lip, paresthesia and anesthesia of the gums in the third quadrant, and paresthesia and anesthesia of the left mental nerve, appearing immediately after endodontic treatment. The paresthesia and anesthesia of the lip and gums were seen to decrease, but the mental nerve paresthesia and anesthesia persisted after 3.5 years. This case illustrates the need to expend great care with all endodontic techniques when performing nonsurgical root canal therapy, especially when the root apices are in close proximity to vital anatomic structures such as the inferior alveolar canal. Copyright 2010 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Oral microbiota species in acute apical endodontic abscesses

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Noelle George

2016-03-01

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

Oral microbiota species in acute apical endodontic abscesses.

Science.gov (United States)

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

2016-01-01

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

Endodontic-periodontic bifurcation lesions: a novel treatment option.

Science.gov (United States)

Lin, Shaul; Tillinger, Gabriel; Zuckerman, Offer

2008-05-01

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

From stem to roots: Tissue engineering in endodontics

Science.gov (United States)

Kala, M.; Banthia, Priyank; Banthia, Ruchi

2012-01-01

The vitality of dentin-pulp complex is fundamental to the life of tooth and is a priority for targeting clinical management strategies. Loss of the tooth, jawbone or both, due to periodontal disease, dental caries, trauma or some genetic disorders, affects not only basic mouth functions but aesthetic appearance and quality of life. One novel approach to restore tooth structure is based on biology: regenerative endodontic procedure by application of tissue engineering. Regenerative endodontics is an exciting new concept that seeks to apply the advances in tissue engineering to the regeneration of the pulp-dentin complex. The basic logic behind this approach is that patient-specific tissue-derived cell populations can be used to functionally replace integral tooth tissues. The development of such ‘test tube teeth’ requires precise regulation of the regenerative events in order to achieve proper tooth size and shape, as well as the development of new technologies to facilitate these processes. This article provides an extensive review of literature on the concept of tissue engineering and its application in endodontics, providing an insight into the new developmental approaches on the horizon. Key words:Regenerative, tissue engineering, stem cells, scaffold. PMID:24558528

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

Science.gov (United States)

Sun, Jiang; Liu, Qiong

2009-09-01

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

A clarification on endodontic flare-ups.

Science.gov (United States)

Morse, D R; Esposito, J V

1990-09-01

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

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

Science.gov (United States)

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

2007-01-01

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

Fracture Resistance of Endodontically Treated Teeth Restored with Biodentine, Resin Modified GIC and Hybrid Composite Resin as a Core Material.

Science.gov (United States)

Subash, Dayalan; Shoba, Krishnamma; Aman, Shibu; Bharkavi, Srinivasan Kumar Indu; Nimmi, Vijayan; Abhilash, Radhakrishnan

2017-09-01

The restoration of a severely damaged tooth usually needs a post and core as a part of treatment procedure to provide a corono - radicular stabilization. Biodentine is a class of dental material which possess high mechanical properties with excellent biocompatibility and bioactive behaviour. The sealing ability coupled with optimum physical properties could make Biodentine an excellent option as a core material. The aim of the study was to determine the fracture resistance of Biodentine as a core material in comparison with resin modified glass ionomer and composite resin. Freshly extracted 30 human permanent maxillary central incisors were selected. After endodontic treatment followed by post space preparation and luting of Glass fibre post (Reforpost, Angelus), the samples were divided in to three groups based on the type of core material. The core build-up used in Group I was Biodentine (Septodont, France), Group II was Resin-Modified Glass Ionomer Cement (GC, Japan) and Group III was Hybrid Composite Resin (TeEconom plus, Ivoclar vivadent). The specimens were subjected to fracture toughness using Universal testing machine (1474, Zwick/Roell, Germany) and results were compared using One-way analysis of variance with Tukey's Post hoc test. The results showed that there was significant difference between groups in terms of fracture load. Also, composite resin exhibited highest mean fracture load (1039.9 N), whereas teeth restored with Biodentine demonstrated the lowest mean fracture load (176.66 N). Resin modified glass ionomer exhibited intermediate fracture load (612.07 N). The primary mode of failure in Group I and Group II was favourable (100%) while unfavourable fracture was seen in Group III (30%). Biodentine, does not satisfy the requirements to be used as an ideal core material. The uses of RMGIC's as a core build-up material should be limited to non-stress bearing areas. Composite resin is still the best core build-up material owing to its high fracture

Microbial causes of endodontic flare-ups.

Science.gov (United States)

Siqueira, Jose F

2003-07-01

Inter-appointment flare-up is characterized by the development of pain, swelling or both, following endodontic intervention. The causative factors of flare-ups encompass mechanical, chemical and/or microbial injury to the pulp or periradicular tissues. Of these factors, microorganisms are arguably the major causative agents of flare-ups. Even though the host is usually unable to eliminate the root canal infection, mobilization and further concentration of defence components at the periradicular tissues impede spreading of infection, and a balance between microbial aggression and host defences is commonly achieved. There are some situations during endodontic therapy in which such a balance may be disrupted in favour of microbial aggression, and an acute periradicular inflammation can ensue. Situations include apical extrusion of infected debris, changes in the root canal microbiota and/or in environmental conditions caused by incomplete chemo-mechanical preparation, secondary intraradicular infections and perhaps the increase in the oxidation-reduction potential within the root canal favouring the overgrowth of the facultative bacteria. Based on these situations, preventive measures against infective flare-ups are proposed, including selection of instrumentation techniques that extrude lesser amounts of debris apically; completion of the chemo-mechanical procedures in a single visit; use of an antimicrobial intracanal medicament between appointments in the treatment of infected cases; not leaving teeth open for drainage and maintenance of the aseptic chain throughout endodontic treatment. Knowledge about the microbial causes of flare-ups and adoption of appropriate preventive measures can significantly reduce the incidence of this highly distressing and undesirable clinical phenomenon.

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

Science.gov (United States)

Alsomadi, Leena; Al Habahbeh, Riyad

2015-12-01

To investigate the efficacy of using antibiotics in post endodontic treatment as a method to alleviate post-treatment pain. After completion of endodontic treatment 129 patients were randomly divided into two groups: Group A (65 patients) received Ibuprofen 400 mg one tablet before procedure and one tablet every 8 hours for the first day, then one tablet once indicated by pain. Group B (64 patients) received the same regimen as group A in addition to amoxicillin, clavulanic acid tablets (one tablet before the procedure, and then one tablet twice daily for a total of 3 days). Intensity of pain at 8 hours interval using visual analog scale (VAS) and total number of Ibuprofen tablets used was recorded by patients. Peak postoperative pain occurred at 16 hours post-treatment in both groups, there was a significant difference in the pain scale between the two groups in favor for group B over group A (3.8 vs 2.1 respectively). Pain scale was significantly lower in group B at 24, 32, 40, and 48 hours post-treatment with a p-value of Antibiotic prescription to manage post endodontic treatment pain results in less pain with less consumption of Ibuprofens. Pain management in endodontics is a real challenge, nonsteroidal anti-inflammatory drugs (NSAIDS) are used effectively in many patients to alleviate post endodontic pain. Nonsteroidal anti-inflammatory drugs may have adverse reactions or may be contraindicated. Short-term use of antibiotics to alleviate pain can be of clinical benefits in these patients.

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

Science.gov (United States)

Garcia-Godoy, Franklin; Murray, Peter E

2012-02-01

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

Comparison of three digital radiographic imaging systems for the visibility of endodontic files

International Nuclear Information System (INIS)

Park, Jong Won; Kim, Eun Kyung; Han, Won Jeong

2004-01-01

To compare three digital radiographic imaging sensors by evaluating the visibility of endodontic file tips with interobserver reproducibility and assessing subjectively the clarity of images in comparison with the x-ray film images. Forty-five extracted sound premolars were used for this study. Fifteen plaster blocks were made with three premolars each and 8, 10, 15 K-flexofiles were inserted into the root canal of premolars. They were radiographically exposed using periapical x-ray films (Kodak Insight Dental film, Eastmann Kodak company, Rochester, USA), Digora imaging plates (Soredex-Orion Co., Helsinki, Finland), CDX 2000HQ sensors (Biomedisys Co., Seoul, Korea), and CDR sensors (Schick Inc., Long Island, USA). The visibility of endodontic files was evaluated with interobserver reproducibility, which was calculated as the standard deviations of X, Y coordinated of endodontic file tips measured on digital images by three oral and maxillofacial radiologists. The clarity of images was assessed subjectively using 3 grades, i.e, plus, equal, and minus in comparison with the conventional x-ray film images. Interobserver reproducibility of endodontic file tips was the highest in CDR sensor (p<0.05) only except at Y coordinates of 15 file. In the subjective assessment of the image clarity, the plus grade was the most frequent in CDR sensor at all size of endodontic file (p<0.05). CDR sensor was the most superior to the other sensors, CDX 2000HQ sensor and Digora imaging plate in the evaluation of interobserver reproducibility of endodontic file tip and subjective assessment of image clarity.

Effective exposure level and diagnostic performance in endodontic radiography

International Nuclear Information System (INIS)

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

1983-01-01

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

Antimicrobial activity and pH of a endodontic sealer containing MTA

DEFF Research Database (Denmark)

Maliza, Amanda GA; de Andrade, Flaviana Bombarda; Arias, Marcela C

Objective: To investigate the antimicrobial activity, calcium release, and pH of a new mineral trioxide aggregate endodontic sealer when compared to endodontic sealers containing calcium hydroxide and/or epoxy resin. Method: Specimens were fabricated from MTA Fillapex, Sealer 26, Sealapex, and AH...... Plus immediately, 24 or 48 hours prior to the tests. The antimicrobial activity against Enterococcus faecalis and Candida albicans was evaluated by the direct contact and the agar diffusion methods. Calcium release was determined by atomic absorption spectrometry. The pH from solutions containing...... in solution with an alkaline pH. Conclusion: The new mineral trioxide aggregate endodontic sealer presented higher antimicrobial activity when compared to the sealers containing calcium hydroxide and/or epoxy resin. As for pH and calcium release, the sealers containing calcium hydroxide resulted in presented...

The acceptance of dental operating microscope among advance education specialty programs in endodontics in the middle east

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Mansour Alrejaie

2012-01-01

Full Text Available Aim: To present the current situation of dental operating microscopy (DOM training in the available Advance Specialty Education Programs in Endodontics in Arab Middle-Eastern countries. Materials and Methods: A web-based survey was sent to the electronic mail address of Advance Specialty Education programs of 15 Arab and middle east countries. The questions were limited to those who have an advanced specialty education program in Endodontics at their University if they are using an operating microscope? Results: Out of 15 countries, only 4 countries have microscopic technology in their Advance Education Programs in Endodontics. Conclusion: Few Arab Middle-Eastern countries have DOM in their advance education programs in endodontics. The highest authority in advancing endodontic education in the Arab Middle-East should consider in the near future the importance of this technology as standard care in teaching advance endodontics. An advance workshops should be organized regularly to provide enough knowledge about this standard educational technology.

Rotary endodontics in primary teeth - A review.

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

2016-01-01

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

Management pain and anxiety in endodontic treatment

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Andi Sumidarti

2016-06-01

Full Text Available Dental pain is a common symptom that most often causes patient to seek dentist. A survey conducted by the American Association of Endodontics revealed that more than half patients who come to dentist have experienced pain, which originate from the teeth or of the surrounding tissue, can causes difficulties in handling, also the anxiety of the patient. Understanding the pain experienced by patient will help dentist to determine when to make an action. Most patient being fear with pain, so they delay to getting treatment from dentist, and led to the development of further infection and inflammation. Aim of this paper is to improve the understanding of pharmacology and procedures for pain and anxiety management in endodontic treatment. So, it was importance of determining accurate diagnosis, management and drug administration.

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

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Nazzal, H; Duggal, M S

2017-02-01

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

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

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Ling, J Q

2016-08-01

In order to promote the use of dental operating microscope in endodontics, Society of Cariology and Endodontology of Chinese Stomatological Association formulated these guidelines, after extensive consultation with related authorities and careful reference to the available published materials and literatures. It is hoped that these guidelines will be useful for dental practitioners embarking on microscopic endodontics.

Regenerative endodontics--biologically-based treatment for immature permanent teeth: a case report and review of the literature.

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Thomson, A; Kahler, B

2010-12-01

A paradigm shift in the treatment of immature, necrotic teeth has occurred with biologically-based principles and regenerative endodontic protocols replacing traditional 'apexification' procedures. Preliminary research suggests that stem and progenitor cells from the pulp and/or periodontium contribute to continued root development when regenerative procedures are followed. A mandibular premolar tooth with a chronic periapical abscess was irrigated with sodium hypochlorite with minimal instrumentation and then dressed with tri-antibiotic paste consisting of ciprofloxacin, metronidazole and amoxicillin. At a subsequent visit a blood clot was evoked in the canal by irritating periapical tissues and the canal sealed with mineral trioxide aggregate, glass ionomer cement and composite resin. Resolution of apical periodontitis and the draining sinus, continued root maturation and apical closure occurred over an 18-month period. The tooth became responsive to pulp sensibility testing. It is important that dentists recognize the potential of regenerative endodontics in the treatment of necrotic, immature teeth. Initial management should involve irrigation with sodium hypochlorite only. Intra-canal medicaments, such as calcium hydroxide, are contraindicated as they inhibit further root growth. This report uses a variation of the tri-antibiotic paste currently recommended for regenerative procedures that avoided the discolouration of the crown associated with current protocols. Regenerative endodontics with continued root growth may reduce the risk of fracture and premature tooth loss associated with traditional 'apexification' procedures where the root remains thin and weak. © 2010 Australian Dental Association.

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

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Zabalegui, B

1990-01-01

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

Diagnosis demystified: CT as diagnostic tool in endodontics

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

2013-01-01

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

Regenerative Endodontic Treatment of a Maxillary Mature Premolar

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Qingan Xu

2018-01-01

Full Text Available Regenerative endodontic treatment was performed on a mature maxillary premolar diagnosed as chronic pulpitis. The root canals were chemomechanically prepared and placed intracanal medicaments at the first appointment. Then 2 weeks later, a blood clot was created in the canals, over which mineral trioxide aggregate was placed. At 6-month follow-up, cementum-like tissue seemed to be formed in the root canal along with nearly recovered pulp vitality. At 12-month recall, the radiographic results revealed evidence of root wall thickening. At 30-month recall, no periapical lesion was found. This case report indicates that regenerative endodontic treatment for the mature premolar is feasible. More cases are needed for further validation.

Regenerative endodontics and tissue engineering: what the future holds?

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

2012-07-01

The work performed by researchers in regenerative endodontics and tissue engineering over the last decades has been superb; however, many questions remain to be answered. The basic biologic mechanisms must be elucidated that will allow the development of dental pulp and dentin in situ. Stress must be placed on the many questions that will lead to the design of effective, safe treatment options and therapies. This article discusses those questions, the answers to which may become the future of regenerative endodontics. The future remains bright, but proper support and patience are required. Copyright © 2012 Elsevier Inc. All rights reserved.

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

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Schipper, M; Peters, L B

2015-12-01

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

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

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Siqueira, José F; Rôças, Isabela N

2003-08-01

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

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

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

2006-10-01

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

Musical Auditory Stimulation Influences Heart Rate Autonomic Responses to Endodontic Treatment

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Milana Drumond Ramos Santana

2017-01-01

Full Text Available We aimed to evaluate the acute effect of musical auditory stimulation on heart rate autonomic regulation during endodontic treatment. The study included 50 subjects from either gender between 18 and 40 years old, diagnosed with irreversible pulpitis or pulp necrosis of the upper front teeth and endodontic treatment indication. HRV was recorded 10 minutes before (T1, during (T2, and immediately (T3 and T4 after endodontic treatment. The volunteers were randomly divided into two equal groups: exposed to music (during T2, T3, and T4 or not. We found no difference regarding salivary cortisol and anxiety score. In the group with musical stimulation heart rate decreased in T3 compared to T1 and mean RR interval increased in T2 and T3 compared to T1. SDNN and TINN indices decreased in T3 compared to T4, the RMSSD and SD1 increased in T4 compared to T1, the SD2 increased compared to T3, and LF (low frequency band increased in T4 compared to T1 and T3. In the control group, only RMSSD and SD1 increased in T3 compared to T1. Musical auditory stimulation enhanced heart rate autonomic modulation during endodontic treatment.

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

Science.gov (United States)

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

2007-01-01

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

The use of cone-beam computed tomography and virtual reality simulation for pre-surgical practice in endodontic microsurgery.

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Suebnukarn, S; Rhienmora, P; Haddawy, P

2012-07-01

To design and evaluate the impact of virtual reality (VR) pre-surgical practice on the performance of actual endodontic microsurgery.   The VR system operates on a laptop with a 1.6-GHz Intel processor and 2 GB of main memory. Volumetric cone-beam computed tomography (CBCT) data were acquired from a fresh cadaveric porcine mandible prior to endodontic microsurgery. Ten inexperienced endodontic trainees were randomized as to whether they performed endodontic microsurgery with or without virtual pre-surgical practice. The VR simulator has microinstruments to perform surgical procedures under magnification. After the initial endodontic microsurgery, all participants served as their own controls by performing another procedure with or without virtual pre-surgical practice. All procedures were videotaped and assessed by two independent observers using an endodontic competency rating scale (from 6 to 30). A significant difference was observed between the scores for endodontic microsurgery on molar teeth completed with virtual pre-surgical practice and those completed without virtual presurgical practice, median 24.5 (range = 17-28) versus median 18.75 (range = 14-26.5), P = 0.041. A significant difference was observed between the scores for osteotomy on a molar tooth completed with virtual pre-surgical practice and those completed without virtual pre-surgical practice, median 4.5 (range = 3.5-4.5) versus median 3 (range = 2-4), P = 0.042. Pre-surgical practice in a virtual environment using the 3D computerized model generated from the original CBCT image data improved endodontic microsurgery performance. © 2012 International Endodontic Journal.

An animal model to study regenerative endodontics.

Science.gov (United States)

Torabinejad, Mahmoud; Corr, Robert; Buhrley, Matthew; Wright, Kenneth; Shabahang, Shahrokh

2011-02-01

A growing body of evidence is demonstrating the possibility for regeneration of tissues within the pulp space and continued root development in teeth with necrotic pulps and open apices. There are areas of research related to regenerative endodontics that need to be investigated in an animal model. The purpose of this study was to investigate ferret cuspid teeth as a model to investigate factors involved in regenerative endodontics. Six young male ferrets between the ages of 36-133 days were used in this investigation. Each animal was anesthetized and perfused with 10% buffered formalin. Block sections including the mandibular and maxillary cuspid teeth and their surrounding periapical tissues were obtained, radiographed, decalcified, sectioned, and stained with hematoxylin-eosin to determine various stages of apical closure in these teeth. The permanent mandibular and maxillary cuspid teeth with open apices erupted approximately 50 days after birth. Initial signs of closure of the apical foramen in these teeth were observed between 90-110 days. Complete apical closure was observed in the cuspid teeth when the animals were 133 days old. Based on the experiment, ferret cuspid teeth can be used to investigate various factors involved in regenerative endodontics that cannot be tested in human subjects. The most appropriate time to conduct the experiments would be when the ferrets are between the ages of 50 and 90 days. Copyright © 2011. Published by Elsevier Inc.

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

Science.gov (United States)

Haueisen, H; Heidemann, D

2002-06-01

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

Submergence of Roots for Alveolar Bone Preservation. I. Endodontically Treated Roots.

Science.gov (United States)

1977-05-10

With Endodontic Submerged Roots Scale 0 1 2 3 Periapical 15 0 1 0 Pericoronal 7 3 3 3 (3 cysts ) = 1 _ _ _ _ _ _ _ _ _ = REFERENCES 1. Lam, R.: Contour...with coronal portions of the roots. These epithe lial-lined cysts prevented the formation of osteo- cementum over the coronal surface . In this study...the endodontically treated roots appeared to be primarily a response to the excess root cana l sealer that was expressed coronally and periapically

Influence of endodontic instrument-holder on sterilization efficacy. A pilot in-vitro study.

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Angelo Carrizo

2013-08-01

Full Text Available Infection control is crucial in dentistry and various methods have been designed to assure its efficacy. However, little information exists regarding the influence it could have the instrument-holder of endodontic files. The aim of this research was to determine the influence of three instruments-holders on sterilization efficacy of endodontic files. Methods: A pilot in-vitro study. 60 endodontic files were contaminated by biomechanical preparation of extracted molars with periapical abscess, then processed according to the standard washing method. The endodontic files were divided into 3 groups (n=20 and assigned to 3 instrument-holders: Metallic box (MB, surgical gauze (SG and synthetic sponge (SS. Then, the files were packaged and sterilized by autoclaving (134°C/45min. Microbiological culture was performed in thioglycolate solution for each endodontic file (37ºC/5days. Results: The overall sterilization efficacy was 91.7%, 80% for MB, 100% for SS, and 95% for SG, with no statistically significant differences (p=0.06 between the groups. Conclusions: The lack of differences in the efficacy of sterilization may be due to the reduced sample; therefore, a full-size study is necessary to confirm this outcomes. The results of this study discourage the use of the MB as instrument-holder until a full-size study can confirm this data.

Fibre reinforcement in a structurally compromised endodontically treated molar: a case report

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Renita Soares

2016-05-01

Full Text Available The reconstruction of structurally compromised posterior teeth is a rather challenging procedure. The tendency of endodontically treated teeth (ETT to fracture is considerably higher than vital teeth. Although posts and core build-ups followed by conventional crowns have been generally employed for the purpose of reconstruction, this procedure entails sacrificing a considerable amount of residual sound enamel and dentin. This has drawn the attention of researchers to fibre reinforcement. Fibre-reinforced composite (FRC, designed to replace dentin, enables the biomimetic restoration of teeth. Besides improving the strength of the restoration, the incorporation of glass fibres into composite resins leads to favorable fracture patterns because the fibre layer acts as a stress breaker and stops crack propagation. The following case report presents a technique for reinforcing a badly broken-down ETT with biomimetic materials and FRC. The proper utilization of FRC in structurally compromised teeth can be considered to be an economical and practical measure that may obviate the use of extensive prosthetic treatment.

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

Science.gov (United States)

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

2013-05-01

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

Endodontic Treatment of a Mandibular Second Premolar with Three Roots and Three Canals

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Bonny Paul

2014-01-01

Full Text Available Complex root canal system with atypical variations is a common finding among mandibular premolars. Endodontic treatment in these teeth may not be successful due to the failure to recognise and treat multiple canals. This paper presents endodontic treatment of a mandibular second premolar with three roots and three canals.

In Vitro Biocompatibility of Endodontic Sealers Incorporating Antibacterial Nanoparticles

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Itzhak Abramovitz

2012-01-01

Full Text Available The main cause of endodontic disease is bacteria. Disinfection is presently achieved by cleaning the root canal system prior to obturation. Following setting, root canal filling is devoid of any antibacterial effect. Endodontic sealers with antimicrobial properties yet biocompatible may enhance root canal therapy. For this purpose, quaternized polyethylenimine nanoparticles which are antibacterial polymers, biocompatible, nonvolatile, and stable may be used. The aim of the present study was to examine the impact of added QPEI on the cytotoxicity of AH Plus, Epiphany, and GuttaFlow endodontic sealers. The effect of these sealers on the proliferation of RAW 264.7 macrophage and L-929 fibroblast cell lines and on the production of TNFα from macrophages was examined. Cell vitality was evaluated using a colorimetric XTT assay. The presence of cytokines was determined by two-site ELISA. Results show that QPEI at 1% concentration does not impair the basic properties of the examined sealers in both macrophages and fibroblast cell lines. Incorporation of 1% QPEI into the sealers did not impair their biocompatibility. QPEI is a potential clinical candidate to improve antibacterial activity of sealers without increasing cytotoxicity.

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

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Rôças, Isabela N; Siqueira, José F

2012-04-01

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

Features of clinical course and treatment principles of endodontic-periodontal lesions

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P I Moroz

2018-06-01

Full Text Available Aim. To study the characteristic differences in the clinical course of chronic generalized periodontitis in the presence of periapical infection focus and the principles of combined treatment of endodontium and periodontium. Methods. A clinical and X-ray examination of 1525 patients of different age groups was performed. As a result, a clinical group of 68 patients with chronic generalized moderate and severe periodontitis was formed, who were divided into two groups depending on the presence or absence of periapical destruction. In group 1, 32 patients with the presence of chronic generalized periodontitis and signs of chronic apical periodontitis were united. Group 2 included 36 patients with chronic generalized periodontitis and no periapical infection and damage. The index estimation of the periodontal tissues state in the dynamics of combined endodontic and periodontal treatment was performed. Results. The initial task of treating endodontic periodontal lesions, regardless of the localization of the primary lesion focus, is the elimination or reversal of chronic periapical inflammatory processes of the teeth. The proposed monitoring system in the course of treatment and dynamic follow-up for 18 months for patients suffering from endodontic periodontal lesions using clinical and radiological methods of examination involves: (1 interim epicrisis or conclusion about negative or positive compliance 1-2 months after the completion of endodontic treatment and hygiene procedures; (2 periodontal treatment (according to indications with the assessment of clinical efficacy 6 and 12 months after the start of treatment; (3 epicrisis after 18 months. Conclusion. The use of proposed concept of complex treatment of endodontic-periodontal lesions, monitoring system in the course of dental therapeutic and preventive measures and dynamic follow-up for 18 months allows achieving positive compliance in 85% of patients according to the clinical examination and

Critical Assessment of Search Strategies in Systematic Reviews in Endodontics.

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Yaylali, Ibrahim Ethem; Alaçam, Tayfun

2016-06-01

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

An endodontic practice profile amongst general dental practitioners in Kathmandu: A questionnaire survey

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D Shrestha

2014-04-01

Full Text Available Objective To investigate the endodontic practice profile of general dental practitioners. To explore the materials and methods employed by them in Kathmandu valley. To compare these findings with well acknowledged international academic standards. Methods Questionnaires with 18 closed-ended questions were distributed among randomly chosen 120 general dental practitioners of Kathmandu, working in various government or private hospital or clinics.The data were collected and descriptive statistical analysis was done. Results Out of 120 questionnaires, only 110 that were completely filled were included in the study .Most general dental practitioners (97% regularly did multi-rooted root canal treatments and followed multivisit root canal treatment.. Radiograph with instrument in canal was used by 80% of general dental practitioners to determine the working length while only 36% used electronic apex locator which is considered to be more reliable. Half of them (57% used nickel-titanium files for cleaning and shaping but only 23% used crown down technique. Sodium hypochlorite and calcium hydroxide was the most popular irrigation solution and intra-canal medicament respectively. Majority of general dental practitioners (91% used lateral compaction technique for root canal obturation. Sixty three percent used zinc oxide eugenol as root canal sealer and 46% used endomethasone. They seem to overuse antibiotics in cases requiring endodontic therapy. Only 48% used autoclave for sterilization of endodontic files while 86% never used rubber dam. Eight three percent of them felt the need of further endodontic training and 42% of them preferred post-graduate dental program. Conclusion This study shows that the standard guidelines and new technologies for endodontic treatments are not implemented by many general dental practitioners of Kathmandu and require further endodontic trainings. Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-4, 40-50 DOI

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

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

2014-12-01

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

Syringe irrigation: blending endodontics and fluid dynamics

NARCIS (Netherlands)

Boutsioukis, Christos; van der Sluis, Lucas; Basrani, Bettina

2015-01-01

This book reviews the available information on bacterial disinfection in endodontics, with emphasis on the chemical treatment of root canals based on current understanding of the process of irrigation. It describes recent advances in knowledge of the chemistry associated with irrigants and delivery

Composite Higgs under LHC Experimental Scrutiny

Directory of Open Access Journals (Sweden)

Mühlleitner M.

2012-06-01

Full Text Available The LHC has been built to understand the dynamics at the origin of the breaking of the electroweak symmetry. Weakly coupled models with a fundamental Higgs boson have focused most of the attention of the experimental searches. We will discuss here how to reinterpret these searches in the context of strongly coupled models where the Higgs boson emerges as a composite particle. In particular, we use LHC data to constrain the compositeness scale. We also briefly review the prospects to observe other bosonic and fermionic resonances of the strong sector.

Regenerative endodontics: A state of the art

Directory of Open Access Journals (Sweden)

Rashmi Bansal

2011-01-01

Full Text Available Scientific advances in the creation of restorative biomaterials, in vitro cell culture technology, tissue grafting, tissue engineering, molecular biology and the human genome project provide the basis for the introduction of new technologies into dentistry. Non-vital infected teeth have long been treated with root canal therapy (for mature root apex and apexification (for immature root apex, or doomed to extraction. Although successful, current treatments fail to re-establish healthy pulp tissue in these teeth. But, what if the non-vital tooth could be made vital once again? That is the hope offered by regenerative endodontics, an emerging field focused on replacing traumatized and diseased pulp with functional pulp tissue. Restoration of vitality of non-vital tooth is based on tissue engineering and revascularization procedures. The purpose of this article is to review these biological procedures and the hurdles that must be overcome to develop regenerative endodontic procedures.

Antibacterial Nanoparticles in Endodontics: A Review.

Science.gov (United States)

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.

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

Science.gov (United States)

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

2012-05-25

This is the first of a series of articles, which will summarise new or updated clinical guidelines produced by the Clinical Standards Committee of the Faculty of Dental Surgery, Royal College of Surgeons of England (FDSRCS). Important developments for the dental profession from a number of clinical guidelines will be presented, commencing with the Guidelines for surgical endodontics. The impact of recent evidence relating to the outcome of surgical endodontics and techniques such as cone beam computed tomography and microsurgical techniques are considered.

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

OpenAIRE

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

2016-01-01

Case Description. This case report describes the successful management of a left mandibular first molar with a combined periodontic-endodontic lesion in a 35-year-old Caucasian woman with aggressive periodontitis using a concerted approach including endodontic treatment, periodontal therapy, and a periodontal regenerative procedure using an enamel matrix derivate. In spite of anticipated poor prognosis, the tooth lesion healed. This case report also discusses the rationale behind different tr...

Experimental investigation of cyclic hygrothermal aging of hybrid composite

KAUST Repository

El Yagoubi, Jalal

2013-04-05

This work provides an experimental investigation of the cyclic hygrothermal aging of a hybrid composites. We aimed to propose a general framework in the view to further optimize polymer-based composites. It reports experimental data and relevant observations collected during an aging campaign (up to 2000 cycles) where anhydride-cured epoxy samples as well as composites samples are exposed to environmental conditions. The data gathered during the whole campaign reveals that (1) the polymer displays a non-classical sorption behavior (2) the volume change is correlated to the mass uptake (3) the elastic modulus is correlated to the glass transition temperature. Matrix and interface degradation of the hybrid composite is monitored by means of microstructural observations. © 2013 by the American Institute of Aeronautics and Astronautics, Inc. All rights reserved.

Experimental investigation of cyclic hygrothermal aging of hybrid composite

KAUST Repository

El Yagoubi, Jalal; Lubineau, Gilles; Saghir, Shahid; Selvakumaran, Lakshmi; Askari, Abe H.; Brown, Arlene M.

2013-01-01

This work provides an experimental investigation of the cyclic hygrothermal aging of a hybrid composites. We aimed to propose a general framework in the view to further optimize polymer-based composites. It reports experimental data and relevant observations collected during an aging campaign (up to 2000 cycles) where anhydride-cured epoxy samples as well as composites samples are exposed to environmental conditions. The data gathered during the whole campaign reveals that (1) the polymer displays a non-classical sorption behavior (2) the volume change is correlated to the mass uptake (3) the elastic modulus is correlated to the glass transition temperature. Matrix and interface degradation of the hybrid composite is monitored by means of microstructural observations. © 2013 by the American Institute of Aeronautics and Astronautics, Inc. All rights reserved.

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

Science.gov (United States)

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

2015-01-01

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

[Application of hand-use ProTaper instruments in endodontic treatment of molar canals].

Science.gov (United States)

Ma, Sui-qi; Xie, Qian; Zhou, Yin-feng

2010-07-01

To evaluate the application of hand-use ProTaper instruments in endodontic treatment of molar canals. A total of 203 permanent molars were randomly divided into the experimental group (99 molars) and control group (104 molars) prepared by hand-use ProTaper instruments and standard stainless steel K-file, respectively. The molars in the two groups were obturated by cold lateral condensation technique. The root canal preparation and obturation were evaluated by radiograph, and the working time of preparation and post-operative emergencies were analyzed. The preparation time in the experimental group was obviously shorter than that in the control group (Phand-use ProTaper instruments may improve the effect of root canal treatment of the molars and shorten the working time and reduce the post-operative emergencies.

Endotoxin content in endodontically involved teeth. 1975.

Science.gov (United States)

Schein, Benjamin; Schilder, Herbert

2006-04-01

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

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

Science.gov (United States)

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 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.

Rotary endodontics in primary teeth – A review

Science.gov (United States)

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

2015-01-01

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

Rotary endodontics in primary teeth – A review

Directory of Open Access Journals (Sweden)

Sageena George

2016-01-01

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

Chlorhexidine gluconate, its properties and applications in endodontics

Science.gov (United States)

Mohammadi, Zahed

2008-01-01

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

Platelet-rich fibrin: a boon in regenerative endodontics.

Science.gov (United States)

Rebentish, Priyanka D; Umashetty, Girish; Kaur, Harpreet; Doizode, Trupthi; Kaslekar, Mithun; Chowdhury, Shouvik

2016-12-01

Research into regenerative dentistry has contributed momentum to the field of molecular biology. Periapical surgery aims at removing periapical pathology to achieve complete wound healing and regeneration of bone and periodontal tissue. Regenerative endodontic procedures are widely being added to the current armamentarium of pulp therapy procedures. The regenerative potential of platelets has been deliberated. Platelet-rich fibrin (PRF) is a wonderful tissue-engineering product and has recently gained much popularity due its promising results in wound healing bone induction. The features of this product are an attribute of platelets which, after cellular interactions, release growth factors and have shown application in diverse disciplines of dentistry. This paper is intended to shed light onto the various prospects of PRF and to provide clinical insight into regenerative endodontic therapy.

Endodontic treatment completion following emergency pulpectomy.

LENUS (Irish Health Repository)

Lynch, C D

2010-06-01

Emergency pulpectomy is frequently performed to relieve pain experienced by patients following acute episodes of endodontic pain, or to limit the risks of infection or possible root resorption following traumatic pulpal exposures. The aim of this study was to examine subsequent patient attendance for completion of root canal treatment following pulpectomy procedures in a dental emergency unit.

Platelet rich fibrin - a novel acumen into regenerative endodontic therapy

Directory of Open Access Journals (Sweden)

Kavita Hotwani

2014-02-01

Full Text Available Research into regenerative dentistry has added impetus onto the field of molecular biology. It can be documented as a prototype shift in the therapeutic armamentarium for dental disease. Regenerative endodontic procedures are widely being added to the current armamentarium of pulp therapy procedures. The regenerative potential of platelets has been deliberated. A new family of platelet concentrates called the platelet rich fibrin (PRF has been recently used by several investigators and has shown application in diverse disciplines of dentistry. This paper is intended to add light on the various prospects of PRF and clinical insights to regenerative endodontic therapy.

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

Science.gov (United States)

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

2016-01-01

Quoting an article in well-known textbooks is held as a credit for that paper. The numbers of Iranian publications mentioned in endodontic textbooks have increased during recent years. The aim of this investigation was to evaluate the number of Iranian articles quoted in eminent endodontic textbooks. Three known textbooks (Ingle's Endodontics, Seltzer and Bender's Dental Pulp and Cohen's Pathways of the Pulp) were chosen and all the editions of the textbooks since 2000 were investigated for quoted Iranian publications. Only Iranian authors with affiliations from a domestic university were chosen. All references at the end of each chapter were read by hand searching, and results were noted. The trend and percentage of Iranian publications in different editions of the textbooks were also calculated. The number of citations of these publications in Google Scholar and Scopus databases were also obtained. The number of Iranian publications in all well-known textbooks have notably increased since 2000. The number and percentage of Iranian publications in the latest edition of Cohen's Pathways of the Pulp was higher compared to other textbooks as well as the previous edition of the same text. Number and percentage of Iranian publications in the field of endodontics in all three textbooks have remarkably increased since 2000.

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

Science.gov (United States)

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

2012-08-01

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

Experimental and Numerical Study of FRP Encased Composite Concrete Columns

Directory of Open Access Journals (Sweden)

Mohsen Ishaghian

2017-02-01

Full Text Available A new type of composite column is presented and assessed through experimental testing and numerical modeling. The objective of this research is to investigate design options for a composite column without the use of ferrous materials. This is to avoid the current problem of deterioration of concrete due to expansion of rusting reinforcement members. Such a target can be achieved by replacing the steel reinforcement of concrete columns with pultruded I-shape glass FRP structural sections. The composite column utilizes a glass FRP tube that surrounds a pultruded I-section glass FRP, which is subsequently filled with concrete. The GFRP tube acts as a stay-in-place form in addition to providing confinement to the concrete. A total of four composite columns were tested under monotonic axial loading. The experimental ultimate capacity of each of the tested composite column was compared to the predicted numerical capacity using ANSYS program. The comparison showed that the predicted numerical values were in good agreement with the experimental ones.

Diagnosis and decision making in endodontics with the use of cone beam computed tomography

NARCIS (Netherlands)

Metska, M.E.

2014-01-01

In the current thesis the use of cone beam computed tomography (CBCT) in endodontics has been evaluated within the framework of ex vivo and in vivo studies. The first objective of the thesis was to examine whether CBCT scans can be used for the detection of vertical root fractures in endodontically

Medico-legal aspects of altered sensation following endodontic treatment: a retrospective case series

DEFF Research Database (Denmark)

Givol, Navot; Rosen, Eyal; Bjørndal, Lars

2011-01-01

The objective of this study was to analyze cases of liability claims related to persistent altered sensation following endodontic treatments so as to characterize the medico-legal aspects of this complication.......The objective of this study was to analyze cases of liability claims related to persistent altered sensation following endodontic treatments so as to characterize the medico-legal aspects of this complication....

A resin composite material containing an eugenol derivative for intracanal post cementation and core build-up restoration.

Science.gov (United States)

Almaroof, A; Rojo, L; Mannocci, F; Deb, S

2016-02-01

To formulate and evaluate new dual cured resin composite based on the inclusion of eugenyl methacrylate monomer (EgMA) with Bis-GMA/TEGDMA resin systems for intracanal post cementation and core build-up restoration of endodontically treated teeth. EgMA was synthesized and incorporated at 5% (BTEg5) or 10% (BTEg10) into dual-cure formulations. Curing properties, viscosity, Tg, radiopacity, static and dynamic mechanical properties of the composites were determined and compared with Clearfil™DC Core-Plus, a commercial dual-cure, two-component composite. Statistical analysis of the data was performed with ANOVA and the Tukey's post-hoc test. The experimental composites were successfully prepared, which exhibited excellent curing depths of 4.9, 4.7 and 4.2 mm for BTEg0, BTEg5 and BTEg10 respectively, which were significantly higher than Clearfil™DC. However, the inclusion of EgMA initially led to a lower degree of cure, which increased when measured at 24 h with values comparable to formulations without EgMA, indicating post-curing. The inclusion of EgMA also lowered the polymerization exotherm thereby reducing the potential of thermal damage to host tissue. Both thermal and viscoelastic analyses confirmed the ability of the monomer to reduce the stiffness of the composites by forming a branched network. The compressive strength of BTEg5 was significantly higher than the control whilst flexural strength increased significantly from 95.9 to 114.8 MPa (BTEg5) and 121.9 MPa (BTEg10). Radiopacity of the composites was equivalent to ∼3 mm Al allowing efficient diagnosis. The incorporation of EgMA within polymerizable formulations provides a novel approach to prepare reinforced resin composite material for intracanal post cementation and core build-up and the potential to impart antibacterial properties of eugenol to endodontic restorations. Copyright © 2015 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

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

Science.gov (United States)

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

2012-07-01

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

Intraradicular Splinting with Endodontic Instrument of Horizontal Root Fracture

Directory of Open Access Journals (Sweden)

Ersan Çiçek

2015-01-01

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

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

Science.gov (United States)

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

2017-07-01

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

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

Science.gov (United States)

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

2017-11-01

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

A cost-effective simulation curriculum for preclinical endodontics.

Science.gov (United States)

Pileggi, Roberta; Glickman, Gerald N

2004-02-01

A challenge in contemporary dental education is to achieve a smooth transition from preclinical teaching environments to patient-care clinics in a cost-effective manner. The preclinical endodontic courses at The University of Texas, Dental Branch at Houston provide a unique learning environment that enables the student to perform endodontic treatment on extracted teeth in a typodont, and be involved in diagnosis and treatment-planning discussions. The specially designed stone typodont used has built-in radiographic capability, and is mounted at each chair in the clinic. During each preclinical session, students are assigned clinical cubicles and proper aseptic protocol is followed. Students are required to wear gloves, masks and eyewear, and place a rubber dam during treatment. Written self-assessment evaluations based upon prescribed criteria are utilised; feedback is given by faculty composed of both full-time endodontists and graduate students who periodically rotate and are calibrated on a regular basis. In the lecture phase, clinical case scenarios are presented to reinforce concepts of diagnosis and emergency care and to help integrate endodontics with other disciplines; a Socratic-like teaching style is established by the faculty facilitator to create an environment for developing critical-thinking and problem-solving skills. The overall feedback from graduating students has been very positive. Advantages of this format are an easier transition to patient management, a more keen interest in specialsation and a perceived increase in levels of confidence.

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

Science.gov (United States)

Seltzer, Samuel; Naidorf, Irving J

2004-07-01

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

Experimental Investigations on Thermal Conductivity of Fenugreek and Banana Composites

Science.gov (United States)

Pujari, Satish; Venkatesh, Talari; Seeli, Hepsiba

2018-04-01

The use of composite materials in manufacturing has significantly increased in the past decade. Research is being done to identify natural fibers that can be used as composites. Several natural fibers are already being used in the industry as composites. The appealing advantages of using natural fibers are reflected in lower density when compared to synthetic fibers and also in saving costs. This research paper highlights the experiment that analyses the use of biodegradable fenugreek composite as natural fiber and concludes that fenugreek natural fibers are an excellent substitute to the synthetic fibers in terms of reinforcement properties for the polymers. These fenugreek fibers are naturally sourced, renewable, cost effective and bio-friendly. In thermal energy storage systems as well as in air conditioning systems, thermal insulators are predominantly used to enhance the storage properties. An experiment was created to investigate the thermal properties of fenugreek banana composites for different fiber concentrations. The experimental results showed that the thermal conductivity of the composites decrease with an increase in the fiber content. The experimental results were compared with the theoretical models to describe the variation of thermal conductivity with the volume fraction of the fiber. Good agreement between theoretical and experimental results was observed.

Management of curved root canals in endodontics: clinical case of retreatment

International Nuclear Information System (INIS)

Meneses Guzman, Jose Pablo

2005-01-01

The management of curved root canals in endodontics therapy has required time, patience and skill of the operator, and lots collaboration by the patient. Proper cleaning, disinfection, conformation and root canal filling, in most cases, has prevented the appearance of lesions of bacterial origin to apical or maintenance of these lesions in teeth that are portrayed level. A clinical case is described of retreatment of a first mandibular molar by conventional endodontic treatment with their respective steps, to achieve signs of tissue repair at the apical level. (author) [es

Polymerization kinetics of experimental bioactive composites containing bioactive glass.

Science.gov (United States)

Par, Matej; Tarle, Zrinka; Hickel, Reinhard; Ilie, Nicoleta

2018-06-21

To investigate the polymerization kinetics and the degree of conversion (DC) of experimental resin composites with varying amount of bioactive glass 45S5 (BG). Experimental resin composites based on a photo-curable Bis-GMA/TEGDMA resin system were prepared. The composite series contained 0, 5, 10, 20, and 40 wt% of BG and reinforcing fillers up to the total filler amount of 70 wt%. Composite specimens were light cured with 1,219 mW/cm 2 for 20 or 40 s and their DC was monitored during 5 min at the data collection rate of 2 s -1 using attenuated total reflectance Fourier transform infrared spectroscopy (ATR-FTIR). The 5-min DC values for experimental composites were in the range of 42.4-55.9% and 47.3-57.9% for curing times of 20 and 40 s, respectively. The differences in the 5-min DC between curing times of 20 s or 40 s became more pronounced in materials with higher BG amount. Within both curing times, a decreasing trend of the 5-min DC values was observed with the increasing percentage of BG fillers. The maximum polymerization rate also decreased consistently with the increasing BG amount. Unsilanized BG fillers showed a dose-dependent inhibitory effect on polymerization rate and the DC. Extending the curing time from 20 to 40 s showed a limited potential to improve the DC of composites with higher BG amount. The observed inhibitory effect of BG fillers on the polymerization of resin composites may have a negative influence on mechanical properties and biocompatibility. Copyright © 2018. Published by Elsevier Ltd.

Pathogenesis of apical periodontitis and the causes of endodontic failures.

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Nair, P N R

2004-11-01

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

Er:YAG laser for endodontics: efficiency and safety

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

1997-12-01

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

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

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

2017-11-01

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

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

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Shah, Pratik; Chong, B S

2018-03-01

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

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

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José Blanco Méndez

2011-08-01

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

Effect of gamma radiation and endodontic treatment on mechanical properties of human and bovine root dentin

Energy Technology Data Exchange (ETDEWEB)

Novais, Veridiana Resende; Soares, Priscilla Barbosa Ferreira; Guimaraes, Carlla Martins; Schliebe, Lais Rani Sales Oliveira; Braga, Stella Sueli Lourenco; Soares, Carlos Jose, E-mail: carlosjsoares@ufu.br [Universidade Federal de Uberlandia (UFU), MG (Brazil)

2016-11-15

This study evaluated the effect of gamma radiation and endodontic treatment on the microhardness and flexural strength of human and bovine root dentin. Forty single rooted human teeth and forty bovine incisor teeth were collected, cleaned and stored in distilled water at 4 °C. The human and bovine teeth were divided into 4 groups (n=10) resulting from the combination of two study factors: first, regarding the endodontic treatment in 2 levels: with or without endodontic treatment; and second, radiotherapy in two levels: with or without radiotherapy by 60 Gy of Co-60 gamma radiation fractioned into 2 Gy daily doses five days per week. Each tooth was longitudinally sectioned in two parts; one-half was used for the three-point bending test and the other for the Knoop hardness test (KHN). Data were analyzed by 3-way ANOVA and Tukey HSD test (α=0.05). No significant difference was found for flexural strength values. The human dentin had significantly higher KHN than the bovine. The endodontic treatment and radiotherapy resulted in significantly lower KHN irrespective of tooth origin. The results indicated that the radiotherapy had deleterious effects on the microhardness of human and bovine dentin and this effect is increased by the interaction with endodontic therapy. The endodontic treatment adds additional negative effect on the mechanical properties of radiated tooth dentin; the restorative protocols should be designed taking into account this effect. (author)

Effect of gamma radiation and endodontic treatment on mechanical properties of human and bovine root dentin

International Nuclear Information System (INIS)

Novais, Veridiana Resende; Soares, Priscilla Barbosa Ferreira; Guimaraes, Carlla Martins; Schliebe, Lais Rani Sales Oliveira; Braga, Stella Sueli Lourenco; Soares, Carlos Jose

2016-01-01

This study evaluated the effect of gamma radiation and endodontic treatment on the microhardness and flexural strength of human and bovine root dentin. Forty single rooted human teeth and forty bovine incisor teeth were collected, cleaned and stored in distilled water at 4 °C. The human and bovine teeth were divided into 4 groups (n=10) resulting from the combination of two study factors: first, regarding the endodontic treatment in 2 levels: with or without endodontic treatment; and second, radiotherapy in two levels: with or without radiotherapy by 60 Gy of Co-60 gamma radiation fractioned into 2 Gy daily doses five days per week. Each tooth was longitudinally sectioned in two parts; one-half was used for the three-point bending test and the other for the Knoop hardness test (KHN). Data were analyzed by 3-way ANOVA and Tukey HSD test (α=0.05). No significant difference was found for flexural strength values. The human dentin had significantly higher KHN than the bovine. The endodontic treatment and radiotherapy resulted in significantly lower KHN irrespective of tooth origin. The results indicated that the radiotherapy had deleterious effects on the microhardness of human and bovine dentin and this effect is increased by the interaction with endodontic therapy. The endodontic treatment adds additional negative effect on the mechanical properties of radiated tooth dentin; the restorative protocols should be designed taking into account this effect. (author)

Endodontic misdiagnosis of periapical central giant cell granuloma: Report of case with 2 years of follow-up

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Rahul Kumar

2012-01-01

Full Text Available Central giant cell granuloma is considered as reactive lesion of jaws possibly to intramedullary hemorrhage or trauma. It may manifest as radiolucencies anywhere in the mandible or maxilla. In rare cases, it can appear as a localized periapical area and mimic an endodontic lesion. This report presents a case where central giant cell granuloma was misdiagnosed as a periapical cyst in 20-year-old male and was treated by conventional endodontic treatment. However the lesion was refractory to endodontic treatment and proved to be central giant cell granuloma after surgical intervention and histopathological examination. The purpose of this case report is to emphasize on periodic follow-up of periapical lesions after endodontic treatment and surgical intervention if required.

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

OpenAIRE

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

2014-01-01

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

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

Science.gov (United States)

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

2014-11-01

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

Calcium aluminates potential for endodontics and orthopedics applications

International Nuclear Information System (INIS)

Santos, G.L. dos; Andrade, T.L.; Oliveira, I.R.; Pandolfelli, V.C.

2011-01-01

The mostly used material in the areas of endodontics (MTA, mineral trioxide aggregate) and bone reconstruction (PMMA, polymethyl methacrylate) present some limiting properties requiring thus changes in their compositions as well as the development of alternative materials. In this context, a novel biomaterial-based calcium aluminate cement (CAC) has been studied in order to keep the positive properties and clinical applications of MTA and PMMA, overcoming some their disadvantages. Recent studies involving the use of CAC are based on commercial products consisting of a mixture of phases. Improvements can be attained by searching the synthesis routes of CAC aiming the proper balance between the phases and the control of impurities that may impair its performance in applications in the areas of health. By the optimization of the CAC phases production, this article aims to present their characterization based on hydration temperature; working time and setting time; pH, ions solubilization and dissolution in contact with water and different solutions of simulated body fluid. The results indicated the CA phase as the most suitable for application in the areas of health. (author)

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

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Dana T. Graves

2011-01-01

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

Biofilm in endodontics: a review

OpenAIRE

Zambrano de la Peña, Sonia; Salcedo-Moncada, Doris; Petkova- Gueorguieva, Marieta; Ventocilla Huasupoma, María

2017-01-01

It is demonstrated the efforts made endodontic microbiology and science to get to decipher the secrets of this unique structure although every day new questions arise. We need the treatments we use to combat biofilm achieve oxygenate the periapical ecosystem and basically scrape and loosen the tightly adhering bacteria Knowing the process of biofilm formation, microbial metabolism and strategies that they use to resist and remain hidden but active , we know why we observe refractory periapica...

The effect of LED illumination on endodontic biofilms

DEFF Research Database (Denmark)

Markvart, Merete

Within endodontics photodynamic therapy (PDT) has been suggested as a disinfectant procedure during root canal treatment. A photoactive dye (photosensitizer), methylene blue or toluidine blue, are activated by a light source, usually lasers or light emitting diodes (LEDs), thereby forming free...

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

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

2016-02-01

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

Scaffolds in regenerative endodontics: A review

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Gathani, Kinjal M.; Raghavendra, Srinidhi Surya

2016-01-01

Root canal therapy has enabled us to save numerous teeth over the years. The most desired outcome of endodontic treatment would be when diseased or nonvital pulp is replaced with healthy pulp tissue that would revitalize the teeth through regenerative endodontics. ‘A search was conducted using the Pubmed and MEDLINE databases for articles with the criteria ‘Platelet rich plasma’, ‘Platelet rich fibrin’, ‘Stem cells’, ‘Natural and artificial scaffolds’ from 1982–2015’. Tissues are organized as three-dimensional structures, and appropriate scaffolding is necessary to provide a spatially correct position of cell location and regulate differentiation, proliferation, or metabolism of the stem cells. Extracellular matrix molecules control the differentiation of stem cells, and an appropriate scaffold might selectively bind and localize cells, contain growth factors, and undergo biodegradation over time. Different scaffolds facilitate the regeneration of different tissues. To ensure a successful regenerative procedure, it is essential to have a thorough and precise knowledge about the suitable scaffold for the required tissue. This article gives a review on the different scaffolds providing an insight into the new developmental approaches on the horizon. PMID:27857762

Scaffolds in regenerative endodontics: A review

Directory of Open Access Journals (Sweden)

Kinjal M Gathani

2016-01-01

Full Text Available Root canal therapy has enabled us to save numerous teeth over the years. The most desired outcome of endodontic treatment would be when diseased or nonvital pulp is replaced with healthy pulp tissue that would revitalize the teeth through regenerative endodontics. ′A search was conducted using the Pubmed and MEDLINE databases for articles with the criteria ′Platelet rich plasma′, ′Platelet rich fibrin′, ′Stem cells′, ′Natural and artificial scaffolds′ from 1982-2015′. Tissues are organized as three-dimensional structures, and appropriate scaffolding is necessary to provide a spatially correct position of cell location and regulate differentiation, proliferation, or metabolism of the stem cells. Extracellular matrix molecules control the differentiation of stem cells, and an appropriate scaffold might selectively bind and localize cells, contain growth factors, and undergo biodegradation over time. Different scaffolds facilitate the regeneration of different tissues. To ensure a successful regenerative procedure, it is essential to have a thorough and precise knowledge about the suitable scaffold for the required tissue. This article gives a review on the different scaffolds providing an insight into the new developmental approaches on the horizon.

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

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Olcay, Keziban; Ataoglu, Hanife; Belli, Sema

2018-01-01

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

The influence of FRCs reinforcement on marginal adaptation of CAD/CAM composite resin endocrowns after simulated fatigue loading.

Science.gov (United States)

Rocca, Giovanni Tommaso; Saratti, Carlo Massimo; Poncet, Antoine; Feilzer, Albert J; Krejci, Ivo

2016-05-01

To evaluate the marginal adaptation of endodontically treated molars restored with CAD/CAM composite resin endocrowns either with or without reinforcement by fibre reinforced composites (FRCs), used in different configurations. 32 human endodontically treated molars were cut 2 mm over the CEJ. Two interproximal boxes were created with the margins located 1 mm below the CEJ (distal box) and 1 mm over the CEJ (mesial box). All specimens were divided in four groups (n = 8). The pulp chamber was filled with: group 1 (control), hybrid resin composite (G-aenial Posterior, GC); group 2, as group 1 but covered by 3 meshes of E-glass fibres (EverStick NET, Stick Tech); group 3, FRC resin (EverX Posterior, GC); group 4, as group 3 but covered by 3 meshes of E-glass fibres. The crowns of all teeth were restored with CAD/CAM composite resin endocrowns (LAVA Ultimate, 3M). All specimens were thermo-mechanically loaded in a computer-controlled chewing machine (600,000 cycles, 1.6 Hz, 49 N and simultaneously 1500 thermo-cycles, 60 s, 5-55 °C). Marginal analysis before and after the loading was carried out on epoxy replicas by SEM at 200× magnification. For all the groups, the percentage values of perfect marginal adaptation after loading were always significantly lower than before loading (p marginal adaptation before and after loading was not significantly different between the experimental groups (p > 0.05). Within the limitations of this in vitro study, the use of FRCs to reinforce the pulp chamber of devitalized molars restored with CAD/CAM composite resin restorations did not significantly influenced their marginal quality.

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

Science.gov (United States)

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). 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.

Endodontic radiology, practice, and knowledge of radiation biology, hazard, and protection among clinical dental students and interns

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Joan Emien Enabulele

2015-01-01

Full Text Available Objective: To evaluate the practice and knowledge of endodontic radiology as well as assess the knowledge of radiation biology, hazard, and protection among clinical dental students and interns. Materials and Methods: Cross-sectional study of clinical dental students and interns at University of Benin and University of Benin Teaching hospital respectively. Data was collected using a questionnaire which covered practice and knowledge of endodontic radiography, knowledge of radiation biology, hazard, and protection. Data was analyzed using Statistical Package for Social Sciences (SPSS version 17.0. Result: Seventy participants were included in the study, 40% were final year students and 24.3% house officers. Majority (95.7% agreed that they exposed radiographs as part of endodontic treatment. Only 18.6% knew that the apices of teeth should be 3mm from the border of the X-ray film, while 24.3% knew that 3mm of periapical bone should be visible on X-ray. Less than half (31.4% knew that paralleling technique was the technique of choice for endodontic radiography and this was statistically Significant in relationship to the status of the of the respondents. A few (4.3% of the respondents had knowledge of new horizons in endodontic imaging. Half of the respondents knew that damage by X-rays is mainly due to formation of free radicals. The most frequently reported radiation hazards was reduced salivary flow, while the least reported was rampant caries. Most knew how to protect patients, themselves, and other persons while exposing radiographs. Conclusion: There is need for inclusion of endodontic radiography in the undergraduate curriculum to ensure proper and correct radiographs during endodontic procedure.

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

Science.gov (United States)

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

2010-04-01

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

Antimicrobial Agents Used in Endodontic Treatment

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Marina George Kudiyirickal

2008-01-01

Full Text Available Biomechanical preparation alone does not completely eradicate microorganisms from the root canal, hence the next logical step is to perform root canal procedures in conjunction with antimicrobials. The use of an antimicrobial agent improves the efficacy and prognosis of endodontic treatment. This review enumerates the most widely used antimicrobial agents, their mechanism of action and their potential use in reducing the microbial load.

Laser scanning dental probe for endodontic root canal treatment

Science.gov (United States)

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

2011-03-01

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

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

Science.gov (United States)

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

1996-03-01

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

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

Science.gov (United States)

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

2015-08-01

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

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

Science.gov (United States)

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.

Physical characterisation of endodontic instruments in NiTi alloy

International Nuclear Information System (INIS)

Torrisi, L.

2000-01-01

NiTi based endodontic instruments are investigated in functionality and wear. The instrument surfaces have been studied applying Auger electron spectroscopy, mechanical analysis, differential-scanning calorimetry, wear tests, and scanning electron microscopy. (orig.)

A quality assessment of randomized controlled trial reports in endodontics.

Science.gov (United States)

Lucena, C; Souza, E M; Voinea, G C; Pulgar, R; Valderrama, M J; De-Deus, G

2017-03-01

To assess the quality of the randomized clinical trial (RCT) reports published in Endodontics between 1997 and 2012. Retrieval of RCTs in Endodontics was based on a search of the Thomson Reuters Web of Science (WoS) database (March 2013). Quality evaluation was performed using a checklist based on the Jadad criteria, CONSORT (Consolidated Standards of Reporting Trials) statement and SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials). Descriptive statistics were used for frequency distribution of data. Student's t-test and Welch test were used to identify the influence of certain trial characteristics upon report quality (α = 0.05). A total of 89 RCTs were evaluated, and several methodological flaws were found: only 45% had random sequence generation at low risk of bias, 75% did not provide information on allocation concealment, and 19% were nonblinded designs. Regarding statistics, only 55% of the RCTs performed adequate sample size estimations, only 16% presented confidence intervals, and 25% did not provide the exact P-value. Also, 2% of the articles used no statistical tests, and in 87% of the RCTs, the information provided was insufficient to determine whether the statistical methodology applied was appropriate or not. Significantly higher scores were observed for multicentre trials (P = 0.023), RCTs signed by more than 5 authors (P = 0.03), articles belonging to journals ranked above the JCR median (P = 0.03), and articles complying with the CONSORT guidelines (P = 0.000). The quality of RCT reports in key areas for internal validity of the study was poor. Several measures, such as compliance with the CONSORT guidelines, are important in order to raise the quality of RCTs in Endodontics. © 2016 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Innovations in endodontic filling materials: guttapercha vs Resilon.

Science.gov (United States)

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

2012-01-01

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

Restoration of the endodontically treated posterior tooth

Directory of Open Access Journals (Sweden)

Andrea Polesel

2014-06-01

Results and conclusions: Direct adhesive restorations, indirect bonded restorations and traditional full crown are three therapeutic options for the single posterior endodontically treated teeth. The amount of remaining sound tooth structure is the most significant factor influencing the therapeutic approach. The clinician's operative skill is a determining aspect for long-term success of adhesive inlays.

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

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

2016-10-01

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

Factors associated with endodontic flare-ups: a prospective study.

Science.gov (United States)

Imura, N; Zuolo, M L

1995-09-01

The purpose of this prospective study was to assess the incidence of flare-ups (a severe problem requiring an unscheduled visit and treatment) among patients who received endodontic treatment by the two authors in their respective practices during a period of one year, and also to examine the correlation with pre-operative and operative variables. The results showed an incidence of 1.58% for flare-ups from 1012 endodontically treated teeth. Statistical analysis using the chi-square test (Pflare-ups were found to be positively correlated with multiple appointments, retreatment cases, periradicular pain prior to treatment, presence of radiolucent lesions, and patients taking analgesic or anti-inflammatory drugs. In contrast, there was no correlation between flare-up, and age, sex, different arch/tooth groups and the status of the pulp.

Alkaline Materials and Regenerative Endodontics: A Review

Directory of Open Access Journals (Sweden)

Bill Kahler

2017-12-01

Full Text Available Periapical health is the primary goal of endodontic treatment in mature and immature teeth. In addition, the goals of treatment of immature teeth with arrested root development include root growth to length and maturation of the apex, as well as thickening of the canal wall. These goals are valid for immature teeth that have been subjected to trauma and dental caries or that are the result of developmental anomalies that expose the tooth to the risk of pulp necrosis and consequently result in the cessation of root maturation. Regenerative endodontic procedures (REPs have been described as a “paradigm shift” in the treatment of immature teeth with pulp necrosis and underdeveloped roots, as there is the potential for further root maturation and return of vitality. Treatment with REPs is advocated as the treatment of choice for immature teeth with pulp necrosis. REP protocols involve the use of alkaline biomaterials, primarily sodium hypochlorite, calcium hydroxide, mineral trioxide aggregates and Biodentine, and are the essential components of a successful treatment regimen.

Radiographic evaluation of cases referred for surgical endodontics

NARCIS (Netherlands)

Doornbusch, H.; Broersma, L.; Boering, G.; Wesselink, P.R.

Aim The aim of this study is to test the hypothesis that more patients with failed root-canal treatment or other endodontic problems are referred for periradicular surgery rather than nonsurgical re-treatment. Methodology Three sets of 100 periapical radiographs representing typical cases referred

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

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

2015-05-01

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

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

Science.gov (United States)

Tomazinho, Luiz Fernando; Avila-Campos, Mario J

2007-02-01

Black-pigmented anaerobic rods such as Prevotella spp. and Porphyromonas spp. are involved in the etiology and perpetuation of endodontic infections. The aim of this study was to evaluate the prevalence of these species in chronic endodontic infections by using culture and polymerase chain reaction (PCR) techniques. Samples of 100 patients with root canals displaying chronic endodontic infections were obtained by sterilized paper points. Bacterial identification was performed by using culture and PCR techniques. By culture, in 33% of the samples, P. intermedia-P. nigrescens (75.8%), P. gingivalis (27.3%), and P. endodontalis (9.1%) were identified, and by PCR 60% of the samples harbored P. nigrescens (43.3%), P. gingivalis (43.3%), P. intermedia (31.7%), and P. endodontalis (23.3%). The presence of these black-pigmented anaerobic rods alone or in association in chronic endodontic infections seems to be frequent. PCR is a very sensitive technique for detecting DNA from bacterial cells. Culturing is only able to reveal living bacteria and is less sensitive for the identification of low numbers of bacterial cells.

Sudden improvement of insulin sensitivity related to an endodontic treatment.

Science.gov (United States)

Schulze, A; Schönauer, M; Busse, M

2007-12-01

Inflammation contributes to the pathogenesis of diabetes. A reciprocal relationship exists between diabetes and chronic periodontitis. This report describes the effects of an acute focal dental inflammation and subsequent endodontic treatment on the required insulin dosage of a 70-year-old man who had moderately controlled diabetes. Following an exacerbation of a combined endodontic-periodontic (endo-perio) lesion of tooth #3, the patient noticed a sudden increase in his insulin demand. After 3 weeks, the required dosage was approximately 100% greater. In association with hyperglycemic incidents, he reported a prickling sensation in this tooth. The radiograph showed circular bone loss around the tooth. Just 1 day after the root-canal preparation, the insulin need decreased to approximately 50% of that required prior to treatment. Subsequently, an incision and systemic antibiotics were necessary because of the formation of a periodontal abscess. The insulin demand remained low despite this complication. Forty days after endodontic treatment, the insulin dosage was at a level comparable to that taken 4 weeks before the root-canal preparation. This clinical case revealed a highly relevant correlation between insulin resistance and a local dental inflammation. To avoid an increase in insulin resistance, it seems important to attend to radically non-vital teeth as well as any other dental inflammation in diabetic patients.

Catonella morbi and Granulicatella adiacens: new species in endodontic infections.

Science.gov (United States)

Siqueira, José F; Rôças, Isabela N

2006-08-01

This study intended to examine samples from primary endodontic infections for the presence of Catonella morbi and Granulicatella adiacens, 2 species that have been recently suggested to be involved with infections in other oral sites. Genomic DNA was isolated directly from samples taken from teeth with different forms of apical periodontitis, and a devised culture-independent 16S rRNA gene-based heminested PCR assay was used to determine the prevalence of these 2 target species. Species-specific primers were developed by aligning closely related 16S rRNA gene sequences. Species-specificity for each primer pair was confirmed by running PCR against a panel of oral bacteria and by sequencing of DNA from representative positive samples. C morbi and G adiacens were detected in 33% and 19%, respectively, of the root canals associated with chronic apical periodontitis; 30% and 10%, respectively, of the cases diagnosed as acute apical periodontitis, and 16% and 11%, respectively, of the pus samples taken from acute apical abscesses. Overall, C morbi occurred in 26% and G adiacens in 14% of the samples taken from primary endodontic infections. Our findings demonstrate that C morbi and G adiacens can take part in the microbiota associated with primary endodontic infections, and their specific role in the disease process warrants further elucidation.

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

Science.gov (United States)

Bernardi, Anarela; Teixeira, Cleonice Silveira

2015-01-01

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

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

Science.gov (United States)

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

2013-09-01

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

Mechanical properties of experimental composites with different calcium phosphates fillers.

Science.gov (United States)

Okulus, Zuzanna; Voelkel, Adam

2017-09-01

Calcium phosphates (CaPs)-containing composites have already shown good properties from the point of view of dental restorative materials. The purpose of this study was to examine the crucial mechanical properties of twelve hydroxyapatite- or tricalcium phosphate-filled composites. The raw and surface-treated forms of both CaP fillers were applied. As a reference materials two experimental glass-containing composites and one commercial dental restorative composite were applied. Nano-hardness, elastic modulus, compressive, flexural and diametral tensile strength of all studied materials were determined. Application of statistical methods (one-way analysis of variance and cluster agglomerative analysis) allowed for assessing the similarities between examined materials according to the values of studied parameters. The obtained results show that in almost all cases the mechanical properties of experimental CaPs-composites are comparable or even better than mechanical properties of examined reference materials. Copyright © 2017 Elsevier B.V. All rights reserved.

Etiopathogenesis of post-endodontic periapical scar formation

Czech Academy of Sciences Publication Activity Database

Horká, E.; Foltán, R.; Hanzelka, T.; Pavlíková, G.; Klíma, K.; Šedý, Jiří

2012-01-01

Roč. 3, č. 1 (2012), s. 5-15 ISSN 2155-8213 R&D Projects: GA MŠk 1M0538; GA MŠk(CZ) LC554; GA ČR GAP304/10/0320 Grant - others:UK(CZ) UNCE 204021 Institutional research plan: CEZ:AV0Z50390703 Keywords : postendodontic scar * endodontics * tooth Subject RIV: FH - Neurology

The historical aspects, principles and philosophy of endodontics: A syllabus

Directory of Open Access Journals (Sweden)

A. Ghazinori

1987-08-01

Full Text Available The area of endodontics has expanded in recent years to include operations that formerly were not done. e.g hemisection, intentional or unintentional replantations and treatment of periodontally-endodontically involved teeth. However, treatment of pulpitis and infected root canals occupy the major part of endodontic practice. The radical treatment of pulpless teeth by extraction which was so prevalent a few decades ago has given away to conservative treatment and retention of such teeth. What was brought about this change? Essentially, it has been due to a gradual veering away from the focal infection theory, simplification of strategic pulpless teeth as abutments. Research studies that indicated the pulpless tooth were either bacteriologic or roentgenologic in most of them the method of study was erroneous and unscientific. Roentgenologic studies condemned the pulpless tooth even more than the bacteriologic studies.It remained for an Englishman, E.W.Fish, to clarify the dark points of endodontic treatments by his experiments. he cauterized the gingiva and gingival sulcuses of extracted teeth and proved that contamination of root surfaces was due to above sources.Fish carried out an even more important experiment by establishing foci of infection in the jaws of guinia pigs and found four distinct areas around the focus of infection. These areas are called as zone of infection, zone of contamination, zone of irritation and zone of stimulation, with their special characteristics.From an endodontic stand point this study has considerable significance, as it explains both the disease process occurring in bone and repair following endodntic treatment. The focus of infection is always in the root canal. The periapical tissue is essentially strile except for occasional inroads, despite this focus. As the microorganisms grow out of the root canal and into the periapical tissue they are destroyed by the polymorphonuclear  leucocytes. In such cases where

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

Science.gov (United States)

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

2015-01-01

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

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

Science.gov (United States)

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

2016-01-01

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

Pain and flare-up after endodontic treatment procedures.

Science.gov (United States)

Sipavičiūtė, Eglė; Manelienė, Rasmutė

2014-01-01

Flare-ups can occur after root canal treatment and consist of acute exacerbations of an asymptomatic pulpal and/or periradicular pathologic condition. The causative factors of interappointment pain encompass mechanical, chemical, and/or microbial injury to the pulp or periradicular tissues. Microorganisms can participate in causation of interappointment pain in the following situations: apical extrusion of debris; incomplete instrumentation leading to changes in the endodontic microbiota or in environmental conditions; and secondary intraradicular infections. Interappointment pain is almost exclusively due to the development of acute inflammation at the periradicular tissues in response to an increase in the intensity of injury coming from the root canal system. The mechanical irritation of apical periodontal tissue is caused by overinstrumentation of the root canal and filling material extrusion through the apical foramen. Incorrectly measured working length of the root canal has inherent connection with these causative factors of endodontic flare - up. This review article discusses these many facets of the flare-up: definition, incidence causes and predisposing factors.

Biofilms in Endodontics-Current Status and Future Directions.

Science.gov (United States)

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.

Black-pigmented gram-negative anaerobes in endodontic infections.

Science.gov (United States)

Haapasalo, M

1993-03-01

Necrotic dental root canal infections are polymicrobial infections dominated by anaerobic bacteria. The number of different species in one canal is usually low, approx. 4-7 species. The species isolated most frequently belong to the genera Prevotella, Porphyromonas, Fusobacterium, Peptostreptococcus, Eubacterium and Streptococcus. The frequency of isolation of black-pigmented Gram-negative anaerobes in endodontic infections varies from 25% to > 50%. Pr. intermedia is the most commonly found pigmented species, followed by Pr. denticola and two Porphyromonas species, P. gingivalis and P. endodontalis. Several studies have shown that P. gingivalis and P. endodontalis are closely related to the presence of acute symptoms in endodontic infections, whereas other black-pigmented Gram-negative anaerobes are not. However, several other species may also be involved in acute infections. Moreover, Porphyromonas species have occasionally been isolated from cases with no symptoms. Although Porphyromonas spp. are clearly related to symptoms at the beginning of therapy, they are not important for the prognosis of the treatment.

Experimental study on thermophysical properties of C/C composites at high temperature

Institute of Scientific and Technical Information of China (English)

ZHANG Wei; YI Fa-jun; HAN Jie-cai; MENG Song-he

2006-01-01

The coefficient of thermal expansion, thermal diffusivity and specific heat of C/C composites from room temperature to ultra high temperature were experimentally investigated. Thermal conductivity and thermal stress resistance of the composites were therefore computed based on experimental results. The results show that the composite has a very low thermal expansion coefficient. Thermal diffusivity decreases exponentially with temperature increase. The specific heat increases linearly as the temperature rises, and the variation trend of thermal conductivity is similar to that of thermal diffusivity. The thermal stress coefficient of C/C composite has little change with temperature variation, and thermal stress resistance of the composite at high temperature is stable.

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

Science.gov (United States)

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

2016-01-01

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

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

Science.gov (United States)

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

2016-01-01

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

Endodontic retreatment decisions: no consensus.

Science.gov (United States)

Aryanpour, S; Van Nieuwenhuysen, J P; D'Hoore, W

2000-05-01

The objectives of the present study were to: (i) evaluate the consensus, if any, amongst dental schools, students and their instructors managing the same clinical cases, all of which involved endodontically treated teeth; and (ii) determine the predominant proposed treatment option. Final year students, endodontic staff members and instructors of 10 European dental schools were surveyed as decision makers. Fourteen different radiographic cases of root canal treated teeth accompanied by a short clinical history were presented to them in a uniform format. For each case the decision makers were requested to: (i) choose only one out of nine treatment alternatives proposed, from 'no treatment' to 'extraction' via 'retreatment' and 'surgery' (ii) assess on two 5-point scales: the difficulty of making a decision, and the technical complexity of the retreatment procedure. The results indicate wide inter- and also intra-school disagreements in the clinical management of root canal treated teeth. Analysis of variance showed that the main source of variation was the 'school effect', explaining 1.8% (NS) to 18.6% (P < 0.0001) of the treatment variations. No other factor explained as much variance. Decision difficulty was moderately correlated to technical complexity (Pearsons' r ranging from 0.19 to 0.35, P < 0.0001). No clear consensus occurred amongst and within dental schools concerning the clinical management of the 14 cases. The lack of consensus amongst schools seems to be due mainly to chance or uncertainty, but can be partly explained by the 'school effect'.

The Origin of Mercury's Surface Composition, an Experimental Investigation

Science.gov (United States)

Boujibar, A.; Righter, K.; Rapp, J. F.; Ross, D. K.; Pando, K. M.; Danielson, L. R.; Fontaine, E.

2016-01-01

Introduction: Results from MESSENGER spacecraft have confirmed the reduced nature of Mercury, based on its high core/mantle ratio and its FeO-poor and S-rich surface. Moreover, high resolution images revealed large volcanic plains and abundant pyroclastic deposits, suggesting major melting stages of the Mercurian mantle. In addition, MESSENGER has provided the most precise data to date on major elemental compositions of Mercury's surface. These results revealed considerable chemical heterogeneities that suggested several stages of differentiation and re-melting processes. This interpretation was challenged by our experimental previous study, which showed a similar compositional variation in the melting products of enstatite chondrites, which are a possible Mercury analogue. However, these experimental melts were obtained over a limited range of pressure (1 bar to 1 gigapascal) and were not compared to the most recent elemental maps. Therefore, here we extend the experimental dataset to higher pressures and perform a more quantitative comparison with Mercury's surface compositions measured by MESSENGER. In particular, we test whether these chemical heterogeneities result from mixing between polybaric melts. Our experiments and models show that the majority of chemical diversity of Mercury's surface can result from melting of a primitive mantle compositionally similar to enstatite chondrites in composition at various depths and degrees of melting. The high-Mg region's composition is reproduced by melting at high pressure (3 gigapascals) (Tab. 1), which is consistent with previous interpretation as being a large degraded impact basin based on its low elevation and thin average crust. While low-Mg NVP (North Volcanic Plains) are the result of melting at low pressure (1 bar), intermediate-Mg NVP, Caloris Basin and Rachmaninoff result from mixing of a high-pressure (3 gigapascals) and low-pressure components (1 bar for Rachmaninoff and 1 gigapascal for the other regions

Overview on the Current Antibiotic Containing Agents Used in Endodontics

Science.gov (United States)

Bansal, Ramta; Jain, Aditya

2014-01-01

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

Experimental and theoretical assessment of flexural properties of hybrid natural fibre composites

DEFF Research Database (Denmark)

Raghavalu Thirumalai, Durai Prabhakaran; Toftegaard, Helmuth Langmaack; Markussen, Christen Malte

2014-01-01

The concept of hybridization of natural fibre composites with synthetic fibres is attracting increasing scientific attention. The present study addresses the flexural properties of hybrid flax/glass/epoxy composites to demonstrate the potential benefits of hybridization. The study covers both...... experimental and theoretical assessments. Composite laminates with different hybrid fibre mixing ratios and different layer configurations were manufactured, and their volumetric composition and flexural properties were measured. The relationship between volume fractions in the composites is shown to be well...... predicted as a function of the hybrid fibre mixing ratio. The flexural modulus of the composites is theoretically assessed by using micromechanical models and laminate theory. The model predictions are compared with the experimentally determined flexural properties. Both approaches show that the flexural...

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

Science.gov (United States)

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 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.

Stem cells in endodontic therapy

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Sita Rama Kumar M, Madhu Varma K, Kalyan Satish R, Manikya kumar Nanduri.R, Murali Krishnam Raju S, Mohan rao

2014-11-01

Full Text Available Stem cells have the remarkable potential to develop into many different cell types in the body. Serving as a sort of repair system for the body, they can theoretically divide without limit to replenish other cells as long as the person or animal is still alive. However, progress in stem cell biology and tissue engineering may present new options for replacing heavily damaged or lost teeth, or even individual tooth structures. The goal of this review is to discuss the potential impact of dental pulp stem cells on regenerative endodontics.

Model-Based Experimental Development of Passive Compliant Robot Legs from Fiberglass Composites

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Shang-Chang Lin

2015-01-01

Full Text Available We report on the methodology of developing compliant, half-circular, and composite robot legs with designable stiffness. First, force-displacement experiments on flat cantilever composites made by one or multifiberglass cloths are executed. By mapping the cantilever mechanics to the virtual spring model, the equivalent elastic moduli of the composites can be derived. Next, by using the model that links the curved beam mechanics back to the virtual spring, the resultant stiffness of the composite in a half-circular shape can be estimated without going through intensive experimental tryouts. The overall methodology has been experimentally validated, and the fabricated composites were used on a hexapod robot to perform walking and leaping behaviors.

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

Science.gov (United States)

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

2014-06-01

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

Experimental study of optical fibers influence on composite

Science.gov (United States)

Liu, Rong-Mei; Liang, Da-Kai

2010-03-01

Bending strength and elasticity modulus of composite, with and without embedded optical fibers, were experimentally studied. Two kinds of laminates, which were denoted as group 1 and group 2, were fabricated from an orthogonal woven glass/epoxy prepreg. Since the normal stress value becomes the biggest at the surface of a beam, the optical fibers were embedded at the outmost layer and were all along the loading direction. Four types of materials, using each kind of laminated prepreg respectively, were manufactured. The embedded optical fibers for the 4 material types were 0, 10, 30 and 50 respectively. Three-point bending tests were carried out on the produced specimens to study the influence of embedded optical fiber on host composite. The experimental results indicated that the materials in group 2 were more sensitive to the embedded optical fibers.

Outcome of Endodontically Treated Cracked Teeth

Science.gov (United States)

2016-06-01

directed by: CAPT Te!Ty Webb, D.D.S., M.S. A " cracked tooth" is defined as a thin surface enamel and dentin disruption of unknown depth, and is often...OUTCOME OF ENDODONTICALL Y TREATED CRACKED TEETH by David Michael Dow II, D.D.S. Lieutenant Commander, Dental Corps United States Navy A thesis...copyrighted material in the thesis manuscript titled: "Outcome ofEndodontically Treated Cracked Teeth" is appropriately acknowledged and, beyond

endodontic treatment of unusually long discolored maxillary central ...

African Journals Online (AJOL)

a few cases of dual–rooted maxillary central incisor have been reported in literature1-5. Maxillary central incisors vary in root ... The following case report describes the endodontic management of a patient with an unusually long maxillary central incisor in our environment. CASE PROFILE. A 31 year-old male was referred ...

Mandibular Bone and Soft Tissues Necrosis Caused by an Arsenical Endodontic Preparation Treated with Piezoelectric Device

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A. Giudice

2013-01-01

Full Text Available This paper describes a case of wide mandibular bone necrosis associated with significant soft tissues injury after using an arsenical endodontic preparation in the right lower second molar for endodontic purpose. Authors debate about the hazardous effects of the arsenic paste and the usefulness of piezosurgery for treatment of this drug related bone necrosis.

Clinical applications of cone beam computed tomography in endodontics: a comprehensive review. Part 2: applications associated with advanced endodontic problems and complications

NARCIS (Netherlands)

Cohenca, N.; Shemesh, H.

2015-01-01

The use of cone beam computed tomography (CBCT) in endodontics has been extensively reported in the literature. Compared with the traditional spiral computed tomography, limited field of view (FOV) CBCT results in a fraction of the effective absorbed dose of radiation. The purpose of this manuscript

Single Versus Multi-visit Endodontic Treatment of Teeth with Apical ...

African Journals Online (AJOL)

endodontic treatment, healed rate in teeth with preoperative radiolucency is significantly .... sensor and Gnatus X-ray machine operating at (70 KVp-7 .... oil based calcium hydroxide is effective in the elimination of .... Essential Endodontology.

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

Science.gov (United States)

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

2014-01-01

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

One-visit endodontic retreatment of combined external/internal root resorption using a calcium-enriched mixture.

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Asgary, Saeed; Ahmadyar, Maryam

2012-01-01

Combined external and internal root resorption (ERR/IRR) is a rare endodontic disease that leads to alteration of the root canal anatomy. This report describes the management of an endodontically failed molar that was severely affected by ERR/IRR. Radiographic examination demonstrated inadequate obturation of the root canals associated with ERR/IRR and a large periradicular lesion. During nonsurgical endodontic retreatment, the root canals were subjected to conventional chemomechanical debridement. In the same session, the entire distal root canal was obturated using a calcium-enriched mixture (CEM) cement, and the mesial canals were obturated with gutta-percha/sealer. The clinical findings and follow-up radiographs indicated favorable treatment outcomes after 12 months. One-visit application of CEM cement could be a successful approach for the management of combined ERR/IRR.

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

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Saeed Asgary

2014-05-01

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

The impact of loupes and microscopes on vision in endodontics.

Science.gov (United States)

Perrin, P; Neuhaus, K W; Lussi, A

2014-05-01

To report on an intraradicular visual test in a simulated clinical setting under different optical conditions. Miniaturized visual tests with E-optotypes (bar distance from 0.01 to 0.05 mm) were fixed inside the root canal system of an extracted maxillary molar at different locations: at the orifice, a depth of 5 mm and the apex. The tooth was mounted in a phantom head for a simulated clinical setting. Unaided vision was compared with Galilean loupes (2.5× magnification) with integrated light source and an operating microscope (6× magnification). The influence of the dentists' age within two groups was evaluated: endodontic instruments. Dentists over 40 years of age were dependent on the microscope to inspect the root canal system. © 2013 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Recent considerations in regenerative endodontic treatment approaches

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Hacer Aksel

2014-09-01

Conclusion: Although the regenerative treatment approaches have good clinical outcomes in the majority of case reports, the outcomes are unpredictable. Since the current clinical protocols for regenerative endodontics do not fully fulfill the triad of tissue engineering ((growth factors, scaffold and stem cells, further translational studies are required to achieve more pulp- and dentin-like tissue in the root canal system to achieve pulp regeneration.

Prescription pattern of antibiotic and analgesic in endodontic treatment in Kuwaiti population: A self-administered Survey

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Manal J Al-Maslamani

2014-01-01

Full Text Available Introduction: Surgical and non-surgical endodontic treatment of involved teeth can necessitate prescription of analgesics and antimicrobials. The literature suggests confusion amongst practitioners regarding the need for adjunctive medication, mainly during non-surgical endodontic treatment, often leading to over-prescription. Aim: The aim of this study was to determine the current clinical practice of dentists participated in this study with respect to antibiotic and analgesic prescription patterns in their endodontic treatment management in Kuwait. Materials and Methods: Prescription patterns for antibiotics and analgesics were analyzed based on the responses to self-administered questionnaire (n = 169. Information was collected based on different clinical endodontic diagnostic scenarios. Statistical analysis was performed with SPSS software version 17.0 to determine relationships between prescription patterns, age, gender, and dental qualification (specialists and general dentists. Results: Ninety-two percent of dentists prescribed analgesics for the management of endodontic pain. While 16% prescribed antibiotics for severe dental pain; 62% prescribed antibiotics for acute apical abscesses. Significantly more male dentists prescribed antibiotics for dental pain than female dentists. No significant difference was found between general dental practitioners′ and specialists′ attitude toward drug prescriptions. Amoxicillin and ibuprofen were the most commonly prescribed medications. Conclusion: While the majority of dentists appeared to prescribe antibiotics and analgesics appropriately, some did not. This research confirmed previous studies and established a need for imparting information of evidence-based prescriptions protocols for the dentists surveyed in this study in Kuwait.

Operator-related aspects in endodontic malpractice claims in Finland.

Science.gov (United States)

Vehkalahti, Miira M; Swanljung, Outi

2017-04-01

We analyzed operator-related differences in endodontic malpractice claims in Finland. Data comprised the endodontic malpractice claims handled at the Patient Insurance Centre (PIC) in 2002-2006 and 2011-2013. Two dental advisors at the PIC scrutinized the original documents of the cases (n = 1271). The case-related information included patient's age and gender, type of tooth, presence of radiographs, and methods of instrumentation and apex location. As injuries, we recorded broken instrument, perforation, injuries due to root canal irrigants/medicaments, and miscellaneous injuries. We categorized the injuries according to the PIC decisions as avoidable, unavoidable, or no injury. Operator-related information included dentist's age, gender, specialization, and service sector. We assessed level of patient documentation as adequate, moderate, or poor. Chi-squared tests, t-tests, and logistic regression modelling served in statistical analyses. Patients' mean age was 44.7 (range 8-85) years, and 71% were women. The private sector constituted 54% of claim cases. Younger patients, female dentists, and general practitioners predominated in the public sector. We found no sector differences in patients' gender, dentists' age, or type of injured tooth. PIC advisors confirmed no injury in 24% of claim cases; the advisors considered 65% of injury cases (n = 970) as avoidable and 35% as unavoidable. We found no operator-related differences in these figures. Working methods differed by operator's age and gender. Adequate patient documentation predominated in the public sector and among female, younger, or specialized dentists. Operator-related factors had no impact on endodontic malpractice claims.

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

Science.gov (United States)

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

2015-07-01

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

A new device to test cutting efficiency of mechanical endodontic instruments

Science.gov (United States)

Rubini, Alessio Giansiracusa; Plotino, Gianluca; Al-Sudani, Dina; Grande, Nicola M.; Putorti, Ermanno; Sonnino, GianPaolo; Cotti, Elisabetta; Testarelli, Luca; Gambarini, Gianluca

2014-01-01

Background The purpose of the present study was to introduce a new device specifically designed to evaluate the cutting efficiency of mechanically driven endodontic instruments. Material/Methods Twenty new Reciproc R25 (VDW, Munich, Germany) files were used to be investigated in the new device developed to test the cutting ability of endodontic instruments. The device consists of a main frame to which a mobile plastic support for the hand-piece is connected and a stainless-steel block containing a Plexiglas block against which the cutting efficiency of the instruments was tested. The length of the block cut in 1 minute was measured in a computerized program with a precision of 0.1mm. The instruments were activated by using a torque-controlled motor (Silver Reciproc; VDW, Munich, Germany) in a reciprocating movement by the “Reciproc ALL” program (Group 1) and in counter-clockwise rotation at 300 rpm (Group 2). Mean and standard deviations of each group were calculated and data were statistically analyzed with a one-way ANOVA test (P0.05). Conclusions The cutting testing device evaluated in the present study was reliable and easy to use and may be effectively used to test cutting efficiency of both rotary and reciprocating mechanical endodontic instruments. PMID:24603777

A comparative study of pain following endodontic treatment under general anesthesia

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Feizi Ghader

2015-01-01

Full Text Available   Background and Aims: Postoperativee endodontic pain is an outstanding problem for dental patients. Therefore, a successful management of endodontic pain has become as one of the main dental objectives. The aim of the present study was to compare the postoperative endodontic pain in patients under general anesthesia versus local anesthesia.   Materials and Methods: For conducting this clinical trial study, 50 patients having mandibular molars candidate for root canal therapy were selected. Twenty-five patients treated under general anesthesia because of their fear, anxiety or gag reflex. Other 25 patients treated under local anesthesia. All teeth were prepared using engine-driven rotary system in a crown-down technique and filled using lateral condensation technique. Heft- parker visual analog scale was used to measure the degree of pain at 6, 12, 24, and 48 hours after the treatment. Mann-Whitney, Chi-square, and T-tests were used to compare the intensity of postoperative pain between the groups.   Results: The mean intensity of postoperative pain in local and general anesthesia groups at 6, 12 and 24 hours had statistically significant difference (P<0.05.   Conclusion: Postoperative pain in patients who treated under general anesthesia was significantly less than the patients who treated under local anesthesia.

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

Science.gov (United States)

Mozo, Sandra; Llena, Carmen

2012-01-01

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

Oxidative stress in patients with endodontic pathologies.

Science.gov (United States)

Vengerfeldt, Veiko; Mändar, Reet; Saag, Mare; Piir, Anneli; Kullisaar, Tiiu

2017-01-01

Apical periodontitis (AP) is an inflammatory disease affecting periradicular tissues. It is a widespread condition but its etiopathogenetic mechanisms have not been completely elucidated and the current treatment options are not always successful. To compare oxidative stress (OxS) levels in the saliva and the endodontium (root canal [RC] contents) in patients with different endodontic pathologies and in endodontically healthy subjects. The study group of this comparison study included 22 subjects with primary chronic apical periodontitis (pCAP), 26 with posttreatment or secondary chronic apical periodontitis (sCAP), eight with acute periapical abscess, 13 with irreversible pulpitis, and 17 healthy controls. Resting saliva samples were collected before clinical treatment. Pulp samples (remnants of the pulp, tooth tissue, and/or previous root filling material) were collected under strict aseptic conditions using the Hedström file. The samples were frozen to -80°C until analysis. OxS markers (myeloperoxidase [MPO], oxidative stress index [OSI], 8-isoprostanes [8-EPI]) were detected in the saliva and the endodontium. The highest MPO and 8-EPI levels were seen in pCAP and pulpitis, while the highest levels of OSI were seen in pCAP and abscess patients, as well as the saliva of sCAP patients. Controls showed the lowest OxS levels in both RC contents and saliva. Significant positive correlations between OxS markers, periapical index, and pain were revealed. Patients with pain had significantly higher OxS levels in both the endodontium (MPO median 27.9 vs 72.6 ng/mg protein, p =0.004; OSI 6.0 vs 10.4, p <0.001; 8-EPI 50.0 vs 75.0 pg/mL, p <0.001) and saliva (MPO 34.2 vs 117.5 ng/mg protein, p <0.001; 8-EPI 50.0 vs 112.8 pg/mL, p <0.001) compared to pain-free subjects. OxS is an important pathomechanism in endodontic pathologies that is evident at both the local (RC contents) and systemic (saliva) level. OxS is significantly associated with dental pain and bone

Influence of intracanal irrigants on coronal fracture resistance of endodontically treated and bleached teeth: An In vitro Study

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Maryam Khoroushi

2017-01-01

Full Text Available Background: Irrigation has a key role in the success of endodontic treatment. Intracanal irrigant solutions have adverse effects on the physical properties of dentin. Aim: The present study aimed to evaluate the effect of different irrigation protocols on coronal fracture resistance of endodontically treated teeth undergoing bleaching treatment. Design and Materials and Methods: Access cavities were prepared in 120 maxillary premolars which were divided into two groups (n = 60 – Group A: nonbleached, Group B: bleached (B. Each group was subdivided into five subgroups based on irrigation protocol (n = 12; G1: normal saline (NS, G2: 2.5% sodium hypochlorite (NaOCl, G3: 10% citric acid (CA, G4: 17% ethylene diamine tetra acetic acid, and G5: NaOCl plus CA. In Group B, the teeth were bleached using 38% hydrogen peroxide and 20% carbamide peroxide gels as in-office and at-home bleaching techniques for 3 weeks. All the teeth were restored with composite resin, thermocycled, and incubated for 24 h. The specimens underwent fracture resistance tests. Data were analyzed with ANOVA, Tukey honestly significant difference test, t-test, and Chi-squared test (α =0.05. Results: T-test showed significant differences between each two corresponding subgroups (P < 0.0001. In Group A, NS demonstrated significantly higher fracture resistance compared to others; however, minimum fracture resistance recorded in G2. In Group B, the maximum fracture resistance was recorded in G1, with the minimum being recorded in G5. Samples irrigated with NaOCl and NaOCl plus CA exhibited significantly lower fracture resistance compared to NS subgroup (P < 0.05. Conclusions: Within the limitations of this study, it can be concluded that the irrigation protocol used during endodontic treatment with/without bleaching can affect the coronal fracture resistance.

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

Science.gov (United States)

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

1991-01-01

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

Fusobacterium nucleatum in endodontic flare-ups.

Science.gov (United States)

Chávez de Paz Villanueva, Luis Eduardo

2002-02-01

The extent to which Fusobacterium nucleatum is recovered from root canals of teeth that present with an interappointment flare-up following endodontic instrumentation was investigated. Included in the study were 28 patients that sought emergency treatment after initiation of root canal therapy. Only non-painful teeth that had been treated because of a necrotic pulp and periapical inflammatory lesion were studied. Root canal samples for bacterial analysis were taken, transported to a bacteriological laboratory, and processed for a semiquantitative assessment of bacterial isolates. Bacterial findings were correlated with self-assessed pain intensity as recorded by means of a Visual Analogue Scale. Clinical presentation of swelling and presence of exudate in the treated root canals were also linked. Bacteria were recovered from all teeth examined. Gram-negative anaerobic coccoid rods (Prevotella species and Porphyromonas species) were frequent isolates. All teeth in patients who were reported to be in severe pain (Visual Analogue Scale > or = 6) displayed F nucleatum. Nine out of 10 of these teeth also had swelling and exudate in the root canals. Samples from the remaining patients that had teeth with less pain score showed a variable bacterial recovery. None of these teeth displayed F nucleatum. F nucleatum appears to be associated with the development of the most severe forms of interappointment endodontic flare-ups.

Evaluation of the endodontic apical seal after post insertion by synchrotron radiation microtomography

International Nuclear Information System (INIS)

Contardo, L.; De Luca, M.; Biasotto, M.; Longo, R.; Olivo, A.; Pani, S.; Di Lenarda, R.

2005-01-01

The commonly used methods for evaluating the endodontic apical seal, such as longitudinal and transversal section and diaphanization, show some operative difficulties and intrinsic limitation. This study suggests and describes a new method of analysis using a synchrotron radiation microtomography to analyse the root apex after post insertion, creating a three-dimensional image and analysing sections of the specimen every 5μm. The study was performed at SYRMEP beam line at the Electra Synchrotron in Trieste using monochromatic X-rays of 32KeV. Eleven monoradicular teeth were prepared using NiTi GT Rotary files instruments to an apical size 20 with conicity .06 and divided in four groups: in G1 (n=4) and G2 (n=2), the specimens were endodontically filled with guttapercha and a zinc-oxide sealer, in G3 (n=3) and G4 (n=2) guttapercha and a silicon-based sealer were used. An endodontic post was inserted in specimens of groups 1 and 3 following the manufacturer's instructions. Specimens were analysed using monochromatic X-rays of 32KeV. A CCD detector with pixel dimension pf 5x5μm 2 was used for the acquisition process. Seven hundred and twenty projections were performed over 180 o range using a high-resolution rotator. The projections were reconstructed using standard algorithms for tomographic reconstruction. The apical infiltration was evaluated by verifying if black spots were detectable on the images. The specimens of groups 3 and 4 showed a better apical seal than the ones of groups 1 and 2. Post insertion, when a ZOE-based sealer is used, increases the apical gap even if it does not seem to be clinically relevant and sufficient to be a cause of endodontic failure. The new method for analysis appeared to be effective to detect small defects in endodontic obturation, analysing guttapercha-sealer and sealer-dentin interfaces

Utilization of blended learning to teach preclinical endodontics.

Science.gov (United States)

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

2014-08-01

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

Diabetes mellitus, periapical inflammation and endodontic treatment outcome.

Science.gov (United States)

Segura-Egea, J-J; Castellanos-Cosano, L; Machuca, G; López-López, J; Martín-González, J; Velasco-Ortega, E; Sánchez-Domínguez, B; López-Frías, F-J

2012-03-01

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

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

Science.gov (United States)

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

2015-01-01

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

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

Science.gov (United States)

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

2015-01-01

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

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

Science.gov (United States)

Lababidi, Emad Aldin

2013-12-01

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

Establishment and maintenance of asepsis in endodontics - a review of the literature.

Science.gov (United States)

Malmberg, Leona; Björkner, Annika Elisabeth; Bergenholtz, Gunnar

2016-08-01

Successful endodontic treatment depends on effective measures to eliminate and prevent infection of root canals. Initially treatment should start with isolation and disinfection of the operating field. This review makes an inventory of the available knowledge regarding its establishment and maintenance. A literature search was conducted in the PubMed database in order to identify clinical trials examining disinfection or unintentional contamination of the endodontic operative field. A list of 115 articles was obtained and screened. Five relevant articles were identified. These articles were read in full text. The reference lists from these articles were checked manually for additional studies and three studies were obtained. A total of eight articles met the inclusion criteria. There was a great variety in terms of aim, method, and material of the included studies. None could prove a totally reliable aseptic operative field and not one chemical, or combination of chemicals, were found in more than one study. No study documented complete asepsis following initial disinfection, and no study could document predictable maintenance of an established bacteria-free surface. Critical appraisal and standardization of the disinfection and aseptic procedures in endodontics are needed.

Optimal mechanical design of anatomical post-systems for endodontic restoration.

Science.gov (United States)

Maceri, Franco; Martignoni, Marco; Vairo, Giuseppe

2009-02-01

This paper analyses the mechanical behaviour of a new reinforced anatomical post-systems (RAPS) for endodontic restoration. The composite restorative material (CRM) completely fills the root canal (as do the commonly used cast metal posts) and multiple prefabricated composite posts (PCPs) are employed as reinforcements. Numerical simulations based on 3D linearly elastic finite element models under parafunctional loads were performed in order to investigate the influence of the stiffness of the CRM and of the number of PCPs. Periodontal ligament effects were taken into account using a discretised anisotropic nonlinearly elastic spring system, and the full discrete model was validated by comparing the resulting stress fields with those obtained with conventional restorations (cast gold-alloy post, homogeneous anatomical post and cemented single PCP) and with the natural tooth. Analysis of the results shows that stresses at the cervical/middle region decrease as CRM stiffness increases and, for large and irregular root cavities that apical stress peaks disappear when multiple PCPs are used. Accordingly, from a mechanical point of view, an optimal RAPS will use multiple PCPs when CRM stiffness is equal to or at most twice that of the dentin. This restorative solution minimises stress differences with respect to the natural tooth, mechanical inhomogeneities, stress concentrations on healthy tissues, volumes subject to shrinkage phenomena, fatigue effects and risks of both root fracture and adhesive/cohesive interfacial failure.

[The application of laser in endodontics].

Science.gov (United States)

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

2016-08-01

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

Experimental and numerical study of the micro-mechanical failure in composites

DEFF Research Database (Denmark)

Ashouri Vajari, Danial; Martyniuk, Karolina; Sørensen, Bent F.

2013-01-01

The fibre/matrix interfacial debonding is found to be the first microscale failure mechanism leading to subsequent macroscale transverse cracks in composite materials under tensile load. In this paper, the micromechanical interface failure in fiber-reinforced composites is studied experimentally ...

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

Science.gov (United States)

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

2016-01-01

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

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

Science.gov (United States)

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.

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

Science.gov (United States)

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

2016-02-01

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

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

Science.gov (United States)

Silberman, Adrian; Heilborn, Carlos; Cohenca, Nestor

2009-06-01

Endodontic treatment of third molars often becomes part of comprehensive treatment plans, as it represents a more conservative and less invasive approach than its therapeutic alternatives. The frequency of anatomic variations in mandibular molars, particularly root canal configuration, requires 2 periapical radiographs from different angles. Upon reading and interpretation of the radiographs, the clinician should consider the anatomy and level of difficulty of the endodontic procedure and refer the patient to an endodontist, if deemed necessary. The present article discusses the successful treatment and preservation of a mandibular third molar with 5 root canals, as well as methods for its clinical management.

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

Science.gov (United States)

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

2015-06-01

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

Evolution of Nickel-titanium Alloys in Endodontics.

Science.gov (United States)

Ounsi, Hani F; Nassif, Wadih; Grandini, Simone; Salameh, Ziad; Neelakantan, Prasanna; Anil, Sukumaran

2017-11-01

To improve clinical use of nickel-titanium (NiTi) endodontic rotary instruments by better understanding the alloys that compose them. A large number of engine-driven NiTi shaping instruments already exists on the market and newer generations are being introduced regularly. While emphasis is being put on design and technique, manufacturers are more discreet about alloy characteristics that dictate instrument behavior. Along with design and technique, alloy characteristics of endodontic instruments is one of the main variables affecting clinical performance. Modification in NiTi alloys is numerous and may yield improvements, but also drawbacks. Martensitic instruments seem to display better cyclic fatigue properties at the expense of surface hardness, prompting the need for surface treatments. On the contrary, such surface treatments may improve cutting efficiency but are detrimental to the gain in cyclic fatigue resistance. Although the design of the instrument is vital, it should in no way cloud the importance of the properties of the alloy and how they influence the clinical behavior of NiTi instruments. Dentists are mostly clinicians rather than engineers. With the advances in instrumentation design and alloys, they have an obligation to deal more intimately with engineering consideration to not only take advantage of their possibilities but also acknowledge their limitations.

Retreatment of failed regenerative endodontic of orthodontically treated immature permanent maxillary central incisor: a case report

Directory of Open Access Journals (Sweden)

Musaed Fahad Al-Tammami

2017-02-01

Full Text Available A revascularization procedure was shown to be the best alternative therapy for immature teeth with necrotic pulp and apical infection. A 12 year old female with a history of trauma to her upper central incisor and a sinus tract was referred for endodontic treatment. She was an active orthodontic patient and had undergone regenerative endodontic treatment for the past 2 years. Clinical examination revealed no response to sensibility, percussion, and palpation tests. The preoperative radiograph showed an open apex and apical rarefaction. The case was diagnosed as previously treated tooth with asymptomatic apical periodontitis. Regenerative endodontic retreatment was performed, and the case was followed for 3 years. Clinical, radiographic, and cone-beam computed tomography follow-up examination revealed an asymptomatic tooth, with evidence of periapical healing and root maturation.

Evaluation of dental students' perception and self-confidence levels regarding endodontic treatment.

Science.gov (United States)

Tanalp, Jale; Güven, Esra Pamukçu; Oktay, Inci

2013-04-01

The aim of this study was to obtain information about senior dental students' perceptions and self-confidence levels regarding endodontic practice. Anonymous survey forms were handed out to senior students at Yeditepe University, Faculty of Dentistry. The students were asked to score their level of confidence using a 5-point scale and comment about future practices. The response rate of the survey was 88%. 11.9% expressed endodontics as the first branch in terms of difficulty. The majority (90.5%) indicated they would perform root canal treatments within their expertise limit in the future but refer difficult cases to an endodontist. Bleaching of endodontically treated teeth, managing flare-ups, placement of a rubber dam were procedures in which students reported the lowest confidence (2.55 ± 1.17, 3.24 ± 0.96, 3.24 ± 1.19, respectively). On the other hand, students felt the lowest confidence in the treatment of maxillary molars followed by mandibular molars (3.43 ± 1.02 and 3.93 ± 0.97, respectively). Students also reported the lowest confidence in root resorptions, endo-perio lesions, traumas, retreatments and apexifications (2.93 ± 1.16, 3.07 ± 0.89, 3.24 ± 0.85, 3.33 ± 1.7 and 3.36 ± 1.1, respectively). The results showing students' lower confidence in more challenging aspects of dentistry may be related with the attitude of dental schools to refer these cases to post graduate students and instilling information about these cases on a theoretical basis only. Though there seems to be a tendency for students to refer challenging cases to a specialist in future, authorities should give priority to enhance the way information and experience is conveyed regarding various aspects of endodontic treatment.

Evaluation of dental students’ perception and self-confidence levels regarding endodontic treatment

Science.gov (United States)

Tanalp, Jale; Güven, Esra Pamukçu; Oktay, Inci

2013-01-01

Objectives: The aim of this study was to obtain information about senior dental students’ perceptions and self-confidence levels regarding endodontic practice. Materials and Methods: Anonymous survey forms were handed out to senior students at Yeditepe University, Faculty of Dentistry. The students were asked to score their level of confidence using a 5-point scale and comment about future practices. Results: The response rate of the survey was 88%. 11.9% expressed endodontics as the first branch in terms of difficulty. The majority (90.5%) indicated they would perform root canal treatments within their expertise limit in the future but refer difficult cases to an endodontist. Bleaching of endodontically treated teeth, managing flare-ups, placement of a rubber dam were procedures in which students reported the lowest confidence (2.55 ± 1.17, 3.24 ± 0.96, 3.24 ± 1.19, respectively). On the other hand, students felt the lowest confidence in the treatment of maxillary molars followed by mandibular molars (3.43 ± 1.02 and 3.93 ± 0.97, respectively). Students also reported the lowest confidence in root resorptions, endo-perio lesions, traumas, retreatments and apexifications (2.93 ± 1.16, 3.07 ± 0.89, 3.24 ± 0.85, 3.33 ± 1.7 and 3.36 ± 1.1, respectively). Conclusions: The results showing students’ lower confidence in more challenging aspects of dentistry may be related with the attitude of dental schools to refer these cases to post graduate students and instilling information about these cases on a theoretical basis only. Though there seems to be a tendency for students to refer challenging cases to a specialist in future, authorities should give priority to enhance the way information and experience is conveyed regarding various aspects of endodontic treatment. PMID:24883030

Endodontic Treatment in Single and Multiple Visits: An Overview of Systematic Reviews.

Science.gov (United States)

Moreira, Maria Stella; Anuar, Anuar Sadat Neres-Santiago; Tedesco, Tamara Kerber; Dos Santos, Marcelo; Morimoto, Susana

2017-06-01

The effectiveness of endodontic treatment regarding the number of sessions to complete the therapy is still controversial. The aim of this study was to conduct an overview of published systematic reviews (SRs) comparing endodontic treatment in single and multiple visits. A systematic search was performed in the electronic databases MEDLINE/PubMed and Cochrane Central Register of Controlled Trials until August 18, 2016, without language restriction. The eligibility criteria were as follows: (1) SRs and (2) a focus on endodontic techniques in single or multiple visits. The phases of eligibility and analysis of risk of bias were conducted by 2 or 3 independent and calibrated examiners, and a fourth examiner was consulted to resolve inconsistencies. Assessment of Multiple Systematic Reviews was used to evaluate the risk of bias of the included SRs, which were assessed according to the risk to develop knowledge and the existing knowledge gap. The main characteristics including healing rates, success, and clinical complications during and after endodontic treatment were extracted from the SRs. From the 20 SRs initially identified, 8 were included in the analysis. Of these, 6 SRs showed low to moderate risk of bias and were suitable as strong clinical evidence on the topic. Overall analysis indicated that single and multiple visits showed similar repair or success rates regardless of the precondition of the pulp and periapex. The apical periodontitis subgroup showed a slight positive trend toward a decreased incidence of postoperative complications and a higher effectiveness and efficiency for a single session. Based on the risk of bias, the current level of evidence for this clinical approach is high. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Endodontic Management of Maxillary Second Molar with Two Palatal Roots: A Report of Two Cases

OpenAIRE

Patel, Surbhi; Patel, Pawan

2012-01-01

Endodontic treatment may sometimes fail because morphological features of the tooth adversely affect the treatment protocol. Maxillary second molars are recognized as usually having a single palatal root with a single palatal canal. The incidence of second palatal root in the maxillary second molar is very rare. Two cases are presented in this paper describing the endodontic management of a four-rooted maxillary second molar with two distinct palatal roots and canals and two distinct buccal r...

Interpretation of Endodontic File Length Adjustments Using Radiovisiography

Science.gov (United States)

1993-01-01

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

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

Science.gov (United States)

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

2012-01-01

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

Study of the bismuth oxide concentration required to provide Portland cement with adequate radiopacity for endodontic use.

Science.gov (United States)

Bueno, Carlos Eduardo da Silveira; Zeferino, Eduardo Gregatto; Manhães, Luiz Roberto Coutinho; Rocha, Daniel Guimarães Pedro; Cunha, Rodrigo Sanches; De Martin, Alexandre Sigrist

2009-01-01

The purpose of this study was to determine the ideal concentration of bismuth oxide in white Portland cement to provide it with sufficient radiopacity for use as an endodontic material (ADA specification #57). 2-mm thick standardized test specimens of white MTA and of white Portland cement, as controls, and of white Portland cement with the experimental addition of 5%, 10%, 15%, 20%, 25% or 30% of bismuth oxide were radiographed and compared with various thicknesses of pure aluminum, using optic density to determine the observed grayscale levels of radiopacity in a scale ranging from 0 to 255. The data was submitted to ANOVA (pcement with 0%, 5%, 10%, 15%, 20%, 25% and 30% of bismuth oxide presented mean readings of 63.3, 95.7, 110.7, 142.7, 151.3, 161.0 and 180.0 respectively. MTA presented a mean reading of 157.3. The readings of MTA and white Portland cement with 15% bismuth oxide did not differ significantly from the reading observed for a thickness of 4 mm of aluminum (145.3), which is considered ideal for a test specimen by ADA specification #57 (2 mm above the thickness of the test specimen). White MTA and white Portland cement with 15% bismuth oxide presented the radiopacity required for an endodontic cement.

Patterns of bone loss around teeth restored with endodontic posts

NARCIS (Netherlands)

Katsamakis, S.; Timmerman, M.; van der Velden, U.; de Cleen, M.; van der Weijden, F.

2009-01-01

Objectives: This retrospective study described the pattern of bone loss around teeth with endodontic posts in periodontitis patients, and compared it with contra-lateral teeth without posts. Material and Methods: From full-mouth radiographic surveys of 146 periodontitis patients (35 years), 194

Flare-ups in endodontics and their relationship to various medicaments.

Science.gov (United States)

Ehrmann, Ernest H; Messer, Harold H; Clark, Robert M

2007-12-01

The purpose of this research is to investigate the frequency of endodontic flare-ups using a visual analogue scale. Definitions of flare-ups vary widely as does their reported frequency. A flare-up was defined as an increase of 20 or more points on the visual analogue scale for a given tooth, within the periods of 4 h and 24 h after the initial treatment appointment. The data from a previous study were used to determine the incidence of flare-ups after using three modalities (Ledermix, calcium hydroxide and no medication) to manage patients presenting for relief of pain of endodontic origin. A statistical analysis showed that there were no significant differences in flare-up rates at both the 4-h and 24-h periods between the three modalities. Further research is required using the above definition of a flare-up and standardising treatment protocols.

Evaluation of bioactivity in vitro of endodontic calcium aluminate cement

International Nuclear Information System (INIS)

Oliveira, I.R.; Andrade, T.L.; Santos, G.L.; Pandolfelli, V.C.

2011-01-01

Bioactivity is referred to as the capacity of a material to develop a stable bond with living tissue via the deposition of hydroxyapatite. Materials which exhibit this property can be used to repair diseased or damaged bone tissue and can be designed to remain in situ indefinitely. An indication of bioactivity can be obtained by the formation of a hydroxyapatite layer on the surface of a substrate in simulated body fluids (SBF) in vitro. Therefore, set samples of calcium aluminate endodontic cement were maintained in contact with SBF solutions (Kokubo and Rigo) and their surfaces were later evaluated by means of SEM, EDX and DRX. Measurements of pH and ionic conductivity were also carried out for SBF solutions in contact with set samples of endodontic cement. The ideal conditions of precipitation were obtained in SBF Rigo been observed a surface layer with spherical morphology characteristic of stoichiometric hydroxyapatite.(author)

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

Science.gov (United States)

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

2014-01-01

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

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

Directory of Open Access Journals (Sweden)

Ajinkya M Pawar

2014-01-01

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

An innovative approach in microscopic endodontics

Science.gov (United States)

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

2014-01-01

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

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

Science.gov (United States)

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

2014-12-01

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

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

Science.gov (United States)

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

2016-01-01

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

Effect of Endodontic Retreatment on Push-out Bond Strength and Quality of Fiber Postbonding Interface of Resin Cements.

Science.gov (United States)

Pelegrine, Rina Andréa; Paulillo, Luís Alexandre Maffei Sartini; Kato, Augusto Shoji; Fontana, Carlos Eduardo; Pinheiro, Sérgio Luiz; De Martin, Alexandre Sigrist; Bueno, Carlos Eduardo da Silveira

2016-01-01

The aim of this study is to evaluate the impact of endodontic retreatment on push-out bond strength and dentin interface of two resin cements used for fiber postcementation during endodontic retreatment. The root canals of 40 extracted human canines were prepared, obturated and divided into four groups (n = 10). Gutta-percha was partially removed and fiber posts were immediately cemented in groups 1 and 2 using Panavia F with ED Primer and RelyX™ U200, respectively. In groups 3 and 4, the root canal access was sealed with temporary restorative cement, specimens were stored for 30 days, endodontically retreated, and fiber posts were cemented using the resin cements applied to groups 1 and 2, respectively. Push-out tests and scanning electron microscopy analyses of different areas were performed. Data from push-out bond strengths were analyzed by one-way analysis of variance and Tukey's tests. Higher bond strength values were detected in the apical third for group 1 than group 3 (p 0.05). Comparisons between different thirds in the same group revealed a higher bond strength in the apical third for group 1. Scanning electron microscopy showed formation of hybrid layer and extensive resin tags in group 1. No hybrid layer was observed in groups 2 and 4. Endodontic retreatment had adverse effects on the push-out bond strength and dentinal interface of Panavia F with ED Primer when used for fiber postcementation specifically in the apical third, but not on RelyX™ U200. A significant interaction was detected between endodontic retreatment and resin cement, which indicated that endodontic retreatment might adversely affect the push-out bond strength and dentinal interface of Panavia F with ED Primer when used for fiber postcementation specifically in the apical third.

An experimental study on thermal properties of composite insulation

Energy Technology Data Exchange (ETDEWEB)

Choi, Gyoung-Seok [Building and Urban Research Department, Korea Institute of Construction Technology, 2311 Daehwa-Dong, Ilsanseo-Gu, Goyang-Si, Gyeonggi-Do 411-712 (Korea); College of Architecture, Hanyang University, 17, Hangdang-Dong, Sungdong-Gu, Seoul 133-791 (Korea); Kang, Jae-Sik; Jeong, Young-Sun; Lee, Seung-Eon [Building and Urban Research Department, Korea Institute of Construction Technology, 2311 Daehwa-Dong, Ilsanseo-Gu, Goyang-Si, Gyeonggi-Do 411-712 (Korea); Sohn, Jang-Yeul [College of Architecture, Hanyang University, 17, Hangdang-Dong, Sungdong-Gu, Seoul 133-791 (Korea)

2007-04-01

In accordance with the insulation standards reinforced since 2001 and the compulsory standards on floor impact sound insulation that have been enforced since 2004, insulation materials for actual buildings have been converted to composite materials and new insulation materials have been released in the market. However, Korea is lagging behind the world in fundamental experimental studies and resources. In case of some composite insulation materials, there also have been problems of distorted performance occurring as a result of tests being conducted without having verification and evaluation on the accuracy and inaccuracy of such tests. Therefore, this study grasped the thermal properties of composite insulation materials using thermal conductivity test equipment by heat flux method, and performed quantitative evaluation on the measurement precision and uncertainty of composite materials. (author)

Effect of digital noise reduction on the accuracy of endodontic file length determination

International Nuclear Information System (INIS)

Mehdizadeh, Mojdeh; Khademi, Abbas Ali; Shokraneh, Ali; Farhadi, Nastaran

2013-01-01

The aim of the present study was to evaluate the measurement accuracy of endodontic file length on periapical digital radiography after application of noise reduction digital enhancement. Thirty-five human single-rooted permanent teeth with canals measuring 20-24 mm in length were selected. ISO no.08 endodontic files were placed in the root canals of the teeth. The file lengths were measured with a digital caliper as the standard value. Standard periapical digital images were obtained using the Digora digital radiographic system and a dental X-ray unit. In order to produce the enhanced images, the noise reduction option was applied. Two blinded radiologists measured the file lengths on the original and enhanced images. The measurements were compared by repeated measures ANOVA and the Bonferroni test (a=0.05). Both the original and enhanced digital images provided significantly longer measurements compared with the standard value (P 0.05). Noise reduction digital enhancement did not influence the measurement accuracy of the length of the thin endodontic files on the digital periapical radiographs despite the fact that noise reduction could result in the elimination of fine details of the images.

Is stopping of anticoagulant therapy really required in a minor dental surgery? - How about in an endodontic microsurgery?

Directory of Open Access Journals (Sweden)

Yong-Wook Cho

2013-08-01

Full Text Available Nowadays, oral anticoagulants are commonly prescribed to numerous patients for preventing cardiovascular accident such as thromboembolism. An important side effect of anticoagulant is anti-hemostasis. In a major surgery, the oral anticoagulant therapy (OAT regimen must be changed before the surgery for proper post-operative bleeding control. However, in a minor dental surgery and endodontic surgery, the necessity for changing or discontinuing the OAT is open to debate. In this study, risks of the consequences were weighed and analyzed. In patients who stop the OAT, the occurrence of thromboembolic complication is rare but the result is fatal. In patients who continuing the OAT, post-operative bleeding can be controlled well with the local hemostatic measures. In the endodontic surgery, there are almost no studies about this issue. The intra-operative bleeding control is particularly important in the endodontic surgery because of its delicate and sensitive procedures such as inspection of resected root surface using dental microscope and retrograde filling. Further studies are necessary about this issue in the viewpoint of endodontic surgery.

Experimental Assessment of Tensile Failure Characteristic for Advanced Composite Laminates

Energy Technology Data Exchange (ETDEWEB)

Lee, Myoung Keon [Agency for Defense Development, Daejeon (Korea, Republic of); Lee, Jeong Won; Yoon, Dong Hyun; Kim, Jae Hoon [Chungnam Nat’l Univ., Daejeon (Korea, Republic of)

2017-10-15

In recent years, major airplane manufacturers have been using the laminate failure theory to estimate the strain of composite structures for airplanes. The laminate failure theory uses the failure strain of the laminate to analyze composite structures. This paper describes a procedure for the experimental assessment of laminate tensile failure characteristics. Regression analysis was used as the experimental assessment method. The regression analysis was performed with the response variable being the laminate failure strain and with the regressor variables being two-ply orientation (0° and ±45°) variables. The composite material in this study is a carbon/epoxy unidirectional (UD) tape that was cured as a pre-preg at 177°C(350°F). A total of 149 tension tests were conducted on specimens from 14 distinct laminates that were laid up at standard angle layers (0°, 45°, -45°, and 90°). The ASTM-D-3039 standard was used as the test method.

Experimental Assessment of Tensile Failure Characteristic for Advanced Composite Laminates

International Nuclear Information System (INIS)

Lee, Myoung Keon; Lee, Jeong Won; Yoon, Dong Hyun; Kim, Jae Hoon

2017-01-01

In recent years, major airplane manufacturers have been using the laminate failure theory to estimate the strain of composite structures for airplanes. The laminate failure theory uses the failure strain of the laminate to analyze composite structures. This paper describes a procedure for the experimental assessment of laminate tensile failure characteristics. Regression analysis was used as the experimental assessment method. The regression analysis was performed with the response variable being the laminate failure strain and with the regressor variables being two-ply orientation (0° and ±45°) variables. The composite material in this study is a carbon/epoxy unidirectional (UD) tape that was cured as a pre-preg at 177°C(350°F). A total of 149 tension tests were conducted on specimens from 14 distinct laminates that were laid up at standard angle layers (0°, 45°, -45°, and 90°). The ASTM-D-3039 standard was used as the test method.

EXPERIMENTAL SENSOR OF THE BENZOETHANOL COMPOSITION FOR ENGINE FUEL SYSTEM

Directory of Open Access Journals (Sweden)

V. Bgantsev

2017-12-01

Full Text Available An important aspect of the economy of internal combustion engine on benzoethanol is the accuracy of regulation of the fuel-air mixture composition. This task is complicated by fluctuations in the composition of benzoethanol, depending on the refueling of the vehicle at various filling stations. In this connection, there is a need to control the composition of benzoethanol in the fuel system of the engine and adjust the fuel supply system. With this purpose, fuel systems are equipped with special sensors that generate a signal, depending on the alcohol content of the mixed fuel. In the article one of the design solutions of the experimental sensor of the benzoethanol composition and the results of its testing with fuels of various composition are given.

Experimental Study of the Hygrothermal Effect on Wear Behavior of Composite Materials

OpenAIRE

Fadhel Abbas. Abdulla; Katea L. Hamid

2017-01-01

The hygrothermal effect on the wear behavior of composite material (fiberglass and polyester resin vf=40%) was investigated experimentally in this work. The study includes manufacturing of test device (pin on disc) according to ASTM G 99. In order to study the hygrothermal effect on wear behavior of composite materials the hygrothermal chamber was manufactured. The experimental results show that the wear of glass fiber/polyester increased with increasing the load, sliding speed and sliding di...

Squamous cell carcinoma presenting as an endodontic-periodontic lesion.

Science.gov (United States)

Levi, Paul A; Kim, David M; Harsfield, Scott L; Jacobson, Erica R

2005-10-01

Regardless of advances in diagnosis and treatment during the past 40 years, the overall 5-year survival rates for oral and oropharyngeal squamous cancers have only slightly improved and remain around 50%. Thus, the early diagnosis and treatment of carcinoma by health care providers are essential in achieving a good prognosis. We report a case of invasive squamous cell carcinoma that presented as a benign endodontic-periodontic lesion with a 7-mm periodontal pocket on tooth #15 in a 40-year-old, non-smoking woman. The subsequent management of the case is also discussed. The study was conducted in accordance with the Helsinki Declaration of 1975, as revised in 2000. Our patient was seen for a comprehensive periodontal examination including a periodontal charting, occlusal analysis, study casts, electronic pulp test for tooth #15, and complete mouth periapical radiographs. As there was a periapical radiolucency, an endodontic consultation was obtained. A periodontal flap surgical procedure was performed on teeth #13 to #15, and as there was bone erosion into the maxillary sinus, a biopsy of the soft tissue was submitted to the local hospital for histological analysis. The biopsied lesion was diagnosed as invasive, moderately differentiated squamous cell carcinoma with focal spindle and clear cell differentiation (grade II to III of IV). Bone invasion was also identified. The treatment of the carcinoma involved a hemimaxillectomy with the removal of the maxillary left posterior teeth. The patient remained free of tumor for 5 years after the initial presentation. Patient education and periodic oral cancer examinations by dental professionals are necessary to reduce diagnostic delay and improve prognosis. This case report emphasizes the important role of dental professionals, especially periodontists and endodontists, of being aware that squamous cell carcinoma may manifest itself clinically and/or radiographically as a common periodontal or endodontic lesion.

A web-based endodontic case difficulty assessment tool.

Science.gov (United States)

Shah, P K; Chong, B S

2018-01-25

To develop a web-based tool to facilitate identification, evaluation and management of teeth requiring endodontic treatment. Following a literature search and thorough analysis of existing case difficulty assessment forms, the web-based tool was developed using an online survey builder (Qualtrics, Qualtrics Lab, UT, USA). Following feedback from a pilot study, it was refined and improved. A study was performed, using the updated version (EndoApp) on a cohort (n = 53) of dental professionals and dental students. The participants were e-mailed instructions detailing the assessment of five test cases using EndoApp, followed by completion of a structured feedback form. Analysis of the EndoApp responses was used to evaluate usage times, whereas the results of the feedback forms were used to assess user experience and relevance, other potential applications and comments on further improvement/s. The average usage time was 2 min 7 s; the average times needed for the last three (Cases 3-5) were significantly less than the preceding two (Cases 1 & 2) test cases. An overwhelming majority of participants expressed favourable views on user experience and relevance of the web-based case difficulty assessment tool. Only two participants (4%) were unlikely or very unlikely to use EndoApp again. The potential application of EndoApp as an 'educational tool' and for 'primary care triage' was deemed the most popular features and of greater importance than the secondary options of 'fee setting' and as a 'dento-legal justification tool'. Within the study limitations, owing to its ability to quantify the level of difficulty and provide guidance, EndoApp was considered user-friendly and helped facilitate endodontic case difficulty assessment. From the feedback, further improvements and the development of a Smartphone App version are in progress. EndoApp may facilitate treatment planning, improve treatment cost-effectiveness and reduce frequency of procedural errors by providing

Association of Endodontic Lesions with Coronary Artery Disease.

Science.gov (United States)

Liljestrand, J M; Mäntylä, P; Paju, S; Buhlin, K; Kopra, K A E; Persson, G R; Hernandez, M; Nieminen, M S; Sinisalo, J; Tjäderhane, L; Pussinen, P J

2016-11-01

An endodontic lesion (EL) is a common manifestation of endodontic infection where Porphyromonas endodontalis is frequently encountered. EL may associate with increased risk for coronary artery disease (CAD) via similar pathways as marginal periodontitis. The aim of this cross-sectional study was to delineate the associations between EL and CAD. Subgingival P. endodontalis, its immune response, and serum lipopolysaccharide were examined as potential mediators between these 2 diseases. The Finnish Parogene study consists of 508 patients (mean age, 62 y) who underwent coronary angiography and extensive clinical and radiographic oral examination. The cardiovascular outcomes included no significant CAD ( n = 123), stable CAD ( n = 184), and acute coronary syndrome (ACS; n = 169). EL was determined from a panoramic tomography. We combined data of widened periapical spaces (WPSs) and apical rarefactions to a score of EL: 1, no EL ( n = 210); 2, ≥1 WPS per 1 apical rarefaction ( n = 222); 3, ≥2 apical rarefactions ( n = 76). Subgingival P. endodontalis was defined by checkerboard DNA-DNA hybridization analysis, and corresponding serum antibodies were determined by ELISA. In our population, 50.4% had WPSs, and 22.8% apical rarefactions. A total of 51.2% of all teeth with apical rarefactions had received endodontic procedures. Subgingival P. endodontalis levels and serum immunoglobulin G were associated with a higher EL score. In the multiadjusted model (age, sex, smoking, diabetes, body mass index, alveolar bone loss, and number of teeth), having WPSs associated with stable CAD (odds ratio [OR] = 1.94, 95% confidence interval [95% CI] = 1.13 to 3.32, P = 0.016) and highest EL score were associated with ACS (OR = 2.46, 95% CI = 1.09 to 5.54, P = 0.030). This association was especially notable in subjects with untreated teeth with apical rarefactions ( n = 59, OR = 2.72, 95% CI = 1.16 to 6.40, P = 0.022). Our findings support the hypothesis that ELs are independently

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

Science.gov (United States)

Al-Salehi, S K; Horner, K

2016-10-01

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

Regenerative Endodontics in light of the stem cell paradigm

Science.gov (United States)

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

2013-01-01

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

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

Science.gov (United States)

Sánchez-Sanhueza, Gabriela; Cisterna Cabrera, Francisco

2015-01-01

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

Experimental Characterization of Aluminum-Based Hybrid Composites Obtained Through Powder Metallurgy

Science.gov (United States)

Marcu, D. F.; Buzatu, M.; Ghica, V. G.; Petrescu, M. I.; Popescu, G.; Niculescu, F.; Iacob, G.

2018-06-01

The paper presents some experimental results concerning fabrication through powder metallurgy (P/M) of aluminum-based hybrid composites - Al/Al2O3/Gr. In order to understand the mechanisms that occur during the P/M processes of obtaining Al/Al2O3/Gr composite, we correlated the physical characteristics with their micro-structural characteristics. The characterization was performed using analysis techniques specific for P/M process, SEM-EDS and XRD analyses. Micro-structural characterization of the composites has revealed fairly uniform distribution this resulting in good properties of the final composite material.

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

Science.gov (United States)

Smadi, Leena

2017-05-01

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

Guided Endodontics: a novel treatment approach for teeth with pulp canal calcification and apical pathology.

Science.gov (United States)

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.

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

Science.gov (United States)

Turell, I L; Zmener, O

1999-05-01

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

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

Science.gov (United States)

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

2017-02-24

Objective To explore the experiences of primary care dentists following training to enhance endodontic skills and their views on the implications for the NHS.Design Qualitative study using anonymised free text questionnaires.Setting Primary care general dental services within the National Health Service (NHS) in London, United Kingdom.Subjects and methods Eight primary care dentists who completed this training were asked about factors affecting participant experience of the course, perceived impact on themselves, their organisation, their patients and barriers/facilitators to providing endodontic treatment in NHS primary care. Data were transferred verbatim to a spreadsheet and thematically analysed.Intervention 24-month part-time educational and service initiative to provide endodontics within the NHS, using a combination of training in simulation lab and treatment of patients in primary care.Results Positive impacts were identified at individual (gains in knowledge, skills, confidence, personal development), patient (more teeth saved, quality of care improved) and system levels (access, value for money). Suggested developments for future courses included more case discussions, teaching of practical skills earlier in the course and refinement of the triaging processes. Barriers to using the acquired skills in providing endodontic treatment in primary care within the NHS were perceived to be resources (remuneration, time, skills) and accountability. Facilitators included appropriately remunerated contracts, necessary equipment and time.Conclusion This novel pilot training programme in endodontics combining general practice experience with education/training, hands-on experience and a portfolio was perceived by participants as beneficial for extending skills and service innovation in primary dental care. The findings provide insight into primary dental care practitioners' experience with education/training and have implications for future educational initiatives in

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

Directory of Open Access Journals (Sweden)

Bonny Paul

2015-01-01

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

Clinical and pharmacological management of endodontic flare-up

OpenAIRE

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

2012-01-01

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

Oral microbiota species in acute apical endodontic abscesses

OpenAIRE

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

2016-01-01

Background and objectives: Acute apical abscesses are serious endodontic diseases resulting from pulpal infection with opportunistic oral microorganisms. The objective of this study was to identify and compare the oral microbiota in patients (N=18) exhibiting acute apical abscesses, originating from the demographic region in Portland, Oregon. The study hypothesis is that abscesses obtained from this demographic region may contain unique microorganisms not identified in specimens from other re...

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

Science.gov (United States)

Rôças, I N; Siqueira, J F

2005-12-01

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

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

Science.gov (United States)

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

2011-01-01

Long-term predictability of restored endodontically treated teeth is important for the decision of tooth retention versus extraction and implant placement. The purpose of this study was to validate the hypothesis that preoperative factors can predict the long-term prognosis of molars requiring endodontic and restorative treatment for future prognostic investigations. A clinical database was searched for molar endodontic treatments with crown placement and a minimum of 4-year follow-up. Charts of 42 patients with 50 individual treatments were randomly selected. Information concerning crown lengthening; periodontal diagnosis; attachment loss; furcation involvement; mobility; and internal, external, or periradicular resorption was recorded. Radiographs from treatment initiation and follow-up were digitalized. The presence of apical periodontitis was evaluated. Available ferrule was calculated from bitewing radiographs using CAD software (AutoCAD; Autodesk, Cupertino, CA). The resulting data, age, sex, and times of restoration and follow-up were analyzed for correlation with the presence of apical radiolucency at follow-up and the following four possible outcome scenarios: "no event," "nonsurgical retreatment," "surgical retreatment," or "extraction" using Spearman rank order correlation analysis. Patients' ages ranged from 19 to 87 years, 22 were male and 20 female, and 48 teeth (96.0%) were retained at follow-up. Of those, 44 (88.0%) were without intervention ("no event"), and four (8.0%) underwent surgical or nonsurgical retreatment. Two teeth (4.0%) had been extracted. Significant positive correlations existed between "untoward events" (any form of retreatment or extraction) and "prognostic value according to periodontal status" (p = 0.047) and "attachment loss" (p = 0.042). The only preoperative factors significant for the prognosis of restored endodontically treated molars were related to periodontal prognostic value and attachment loss. It can be concluded that

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

Science.gov (United States)

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.

Cell attachment properties of Portland cement-based endodontic materials: biological and methodological considerations.

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Ahmed, Hany Mohamed Aly; Luddin, Norhayati; Kannan, Thirumulu Ponnuraj; Mokhtar, Khairani Idah; Ahmad, Azlina

2014-10-01

The attachment and spreading of mammalian cells on endodontic biomaterials are an area of active research. The purpose of this review is to discuss the cell attachment properties of Portland cement (PC)-based materials by using scanning electron microscope (SEM). In addition, methodological aspects and technical challenges are discussed. A PubMed electronic search was conducted by using appropriate key words to identify the available investigations on the cell attachment properties of PC-based endodontic materials. After retrieving the full text of related articles, the cross citations were also identified. A total of 23 articles published between January 1993 and October 2013 were identified. This review summarizes the cell attachment properties of commercial and experimental PC-based materials on different cell cultures by using SEM. Methodological procedures, technical challenges, and relevance of SEM in determining the biological profile of PC-based materials are discussed. SEM observations demonstrate that commercial MTA formulations show favorable cell attachment properties, which is consistent with their successful clinical outcomes. The favorable cell attachment properties of PC and its modified formulations support its potential use as a substitute for mineral trioxide aggregate. However, researchers should carefully select cell types for their SEM investigations that would be in contact with the proposed PC-based combinations in the clinical situation. Despite being a technical challenge, SEM provides useful information on the cell attachment properties of PC-based materials; however, other assays for cell proliferation and viability are essential to come up with an accurate in vitro biological profile of any given PC-based formulation. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

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

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José Leonardo Barbosa Melgaço-Costa

2016-04-01

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

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

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

2015-04-01

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

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

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

2015-08-01

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

Rotary endodontics in primary teeth – A review

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

2016-01-01

Endodontic treatment in primary teeth can be challenging and time consuming, especially during canal preparation, which is considered one of the most important steps in root canal therapy. The conventional instrumentation technique for primary teeth remains the “gold-standard” over hand instrumentation, which makes procedures much more time consuming and adversely affects both clinicians and patients. Recently nickel–titanium (Ni–Ti) rotary files have been developed for use in pediatric endod...

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

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

2016-05-01

Dental pulp stem cells (DPSCs) offer significant potential for use in regenerative endodontics, and therefore, identifying cellular regulators that control stem cell fate is critical to devising novel treatment strategies. Stem cell lineage commitment and differentiation are regulated by an intricate range of host and environmental factors of which epigenetic influence is considered vital. Epigenetic modification of DNA and DNA-associated histone proteins has been demonstrated to control cell phenotype and regulate the renewal and pluripotency of stem cell populations. The activities of the nuclear enzymes, histone deacetylases, are increasingly being recognized as potential targets for pharmacologically inducing stem cell differentiation and dedifferentiation. Depending on cell maturity and niche in vitro, low concentration histone deacetylase inhibitor (HDACi) application can promote dedifferentiation of several post-natal and mouse embryonic stem cell populations and conversely increase differentiation and accelerate mineralization in DPSC populations, whilst animal studies have shown an HDACi-induced increase in stem cell marker expression during organ regeneration. Notably, both HDAC and DNA methyltransferase inhibitors have also been demonstrated to dramatically increase the reprogramming of somatic cells to induced pluripotent stem cells (iPSCs) for use in regenerative therapeutic procedures. As the regulation of cell fate will likely remain the subject of intense future research activity, this review aims to describe the current knowledge relating to stem cell epigenetic modification, focusing on the role of HDACi on alteration of DPSC phenotype, whilst presenting the potential for therapeutic application as part of regenerative endodontic regimens. © 2015 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Manual versus mechanical endodontic glidepath.

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West, John

2011-01-01

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

Experimental Study of the Hygrothermal Effect on Wear Behavior of Composite Materials

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Fadhel Abbas. Abdulla

2017-07-01

Full Text Available The hygrothermal effect on the wear behavior of composite material (fiberglass and polyester resin vf=40% was investigated experimentally in this work. The study includes manufacturing of test device (pin on disc according to ASTM G 99. In order to study the hygrothermal effect on wear behavior of composite materials the hygrothermal chamber was manufactured. The experimental results show that the wear of glass fiber/polyester increased with increasing the load, sliding speed and sliding distance. The load and sliding distance were more effective on the wear of the composite rather than sliding speed. Also, it has been revealed that, the hygrothermal is considerable effect that, the wear rate of glass fiber/polyester without hygrothermal effect is lower than wear with hygrothermal effect. Applied load is the wear factor that has the highest physical influence on the wear of composites materials than other wear factors. Also, the wear of glass fiber/polyester without hygrothermal effect is lower than wear with hygrothermal effect.

Endodontic management of a haemophilic patient- a clinical perspective.

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

2014-07-01

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

Bactericidal effect of Nd:YAG laser irradiation in endodontics

Science.gov (United States)

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

1999-05-01

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

3D printed replicas for endodontic education.

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Reymus, M; Fotiadou, C; Kessler, A; Heck, K; Hickel, R; Diegritz, C

2018-06-14

To assess the feasibility of producing artificial teeth for endodontic training using 3D printing technology, to analyse the accuracy of the printing process, and to evaluate the teeth by students when used during training. Sound extracted human teeth were selected, digitalized by cone beam computed tomography (CBCT) and appropriate software and finally reproduced by a stereolithographic printer. The printed teeth were scanned and compared with the original ones (trueness) and to one another (precision). Undergraduate dental students in the third and fourth years performed root canal treatment on printed molars and were subsequently asked to evaluate their experience with these compared to real teeth. The workflow was feasible for manufacturing 3D printed tooth replicas. The absolute deviation after printing (trueness) ranged from 50.9μm to 104.3μm. The values for precision ranged from 43.5μm to 68.2μm. Students reported great benefits in the use of the replicated teeth for training purposes. The presented workflow is feasible for any dental educational institution who has access to a CBCT unit and a stereolithographic printer. The accuracy of the printing process is suitable for the production of tooth replicas for endodontic training. Undergraduate students favoured the availability of these replicas and the fairness they ensured in training due to standardization. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Haptic virtual reality for skill acquisition in endodontics.

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Suebnukarn, Siriwan; Haddawy, Peter; Rhienmora, Phattanapon; Gajananan, Kugamoorthy

2010-01-01

Haptic virtual reality (VR) has revolutionized the skill acquisition in dentistry. The strength of the haptic VR system is that it can automatically record the outcome and associated kinematic data on how each step of the task is performed, which are not available in the conventional skill training environments. The aim of this study was to assess skill acquisition in endodontics and to identify process and outcome variables for the quantification of proficiency. Twenty novices engaged in the experimental study that involved practicing the access opening task with the haptic VR system. Process (speed, force utilization, and bimanual coordination) and outcome variables were determined for assessing skill performance. These values were compared before and after training. Significant improvements were observed through training in all variables. A unique force used pattern and bimanual coordination were observed in each step of the access opening in the posttraining session. The novices also performed the tasks considerably faster with greater outcome within the first two to three training sessions. The study objectively showed that the novices could learn to perform access opening tasks faster and with more consistency, better bimanual dexterity, and better force utilization. The variables examined showed great promise as objective indicators of proficiency and skill acquisition in haptic VR.

Undergraduate Confidence When Undertaking Root Canal Treatment and Their Perception of the Quality of Their Endodontic Education

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James Puryer

2016-12-01

Full Text Available The General Dental Council expects graduating dentists to be competent at treating pulpal disease. Previous studies have found dental undergraduates to have low levels of confidence with respect to endodontic treatments. The aim of this study was to investigate the confidence of undergraduate dental students at the University of Bristol when performing root canal treatment, and to investigate their perception of the quality of their endodontic education. An anonymous questionnaire, based upon one used in a 2015 study at Cardiff University, was distributed to all (n = 204 undergraduate students in Years 3–5 at the University of Bristol. The results were analysed using the Statistical Package for the Social Sciences software (SPSS. There was a 59% (n = 120 response rate and a significant (p < 0.01 difference in confidence levels for root canal treatments (RCTs completed between these students. All (100% Year-5 students felt confident in completing anterior RCTs, and 91% felt confident in completing posterior RCTs. The majority (93% of Year-4 students felt confident in completing anterior RCTs, and 77% felt confident in completing posterior RCTs. Over one-half (56% of Year-3 students felt confident in anterior RCTs and 17% in posterior RCTs. With respect to the individual stages of RCT (access cavity, cleaning and shaping of root canal system, and obturation/filling, results showed that there was a significant difference (p < 0.01 in confidence levels between year groups. Many students thought the amount of time spent on endodontic teaching and the quality of teaching to be satisfactory. Improvements suggested for future endodontic teaching included higher numbers of staff supervision and additional endodontic practice on extracted teeth before seeing patients. There was a strong association between students’ clinical experience and their levels of confidence when completing RCT. Increasing the amount of clinical experience of RCTs could

Possibility of magnetic resonance imaging application in teaching preclinical dentistry - endodontic and prosthetic treatment prognosis

International Nuclear Information System (INIS)

Tanasiewicz, T.

2010-01-01

Background. The necessary condition for successful both endodontic and prosthetic reconstruction treatment is the precise mapping of the shape of dental cavities. The aim of this work is an elaboration and verification of the possibility of using 3D Spin Echo MRI techniques in teaching preclinical dentistry both in endodontic and prosthetics specialty. Objectives. Author' aim was to obtain an elaboration and a verification, whether there exists a possibility to use, at the level of in vitro analysis, techniques of the Magnetic Resonance Imaging, which are based on the 3D sequence of the Spin Echo that may in the future find employment in the teaching of preclinical dentistry, clinical dental therapy and diagnostics within the scope of: a dimensional imaging of the inner topography of teeth and spatial structure of a chamber and root canals of teeth for the therapeutic and didactic aims; introduction of a nondestructive and a non-impressional method of reconstruction of the topography of the inner spaces of the human teeth for the purposes of the reconstructive dentistry. Material and Methods. 6 extracted molar teeth were used for measurements without additional preparation, after endodontic and prosthetic preparation. MR measurements were carried out on a 4.7 T research MRI system equipped with Maran DRX console. Results. Figures show 3D images of outer surface, inner space of the teeth before and after endodontic preparation and internal tooth fixation constructed using both classical methods (polymer mass impression) and non-impressional methods (MRI representation). The sizes of the presented volumes were calculated. Internal tooth volumes were determined before and after endodontic treatment; total tooth volumes were also measured. Research proceedings made it possible to compare the quality of internal tooth space after preparation for inner root canals fixations constructed using both classical methods and non-impressional MRI method. Conclusions. The results

Endodontic periapical lesion-induced mental nerve paresthesia

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Shadmehr, Elham; Shekarchizade, Neda

2015-01-01

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

Effects of dentin on the antimicrobial properties of endodontic medicaments.

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Haapasalo, Markus; Qian, Wei; Portenier, Isabelle; Waltimo, Tuomas

2007-08-01

Successful treatment of apical periodontitis is dependent on the elimination of the infective microflora from the necrotic root canal system. Antimicrobial irrigating solutions and other locally used disinfecting agents and medicaments have a key role in the eradication of the microbes. While most if not all presently used disinfecting agents rapidly kill even the resistant microbes when tested in vitro in a test tube, the effectiveness of the same agents is clearly weaker in the in vivo conditions. Recent studies have given valuable information about the interaction of endodontic disinfecting agents with dentin and other compounds present in the necrotic root canal. As a result of such interactions the antimicrobial effectiveness of several of our key disinfectants may be weakened, or even eliminated under certain circumstances. Different disinfectants show different sensitivity to the action by the various potential inactivators, such as dentin, serum proteins, hydroxyapatite, collagen derived from different sources, and microbial biomass. This review is a summary of our present knowledge of the mostly negative interactions between endodontic disinfecting agents and the various compounds present in the root canal environment.

CAD/CAM Preparation Design Effects on Endodontically Treated and Restored Molars

Science.gov (United States)

2016-05-24

teeth remains a challenge for clinicians, as endodontic treatment results in a tooth that represents a stark biomechanical difference compared to...using a LED-based visible light curing ( VLC ) unit (Bluephase G2, lvoclar-Vivadent, Amherst, NY, USA) whose irradiance was periodically verified (1000 mW

The evaluation of cultivable microbiota profile in patients with secondary endodontic infection before and after photo-activated disinfection.

Science.gov (United States)

Pourhajibagher, Maryam; Ghorbanzadeh, Roghayeh; Parker, Steven; Chiniforush, Nasim; Bahador, Abbas

2017-06-01

Secondary/persistent endodontic infection can be the outcome of failure of endodontic treatment. Photo-activated disinfection (PAD) can be a useful adjunct to mechanical and antimicrobial agents in eliminating endopathogenic microorganisms. In this study, we evaluated the effect of PAD on diversity and count of microbiota related to secondary/persistent endodontic infections. Root canal samples were taken using sterile paper points from the root canals of 14 patients with secondary/persistent endodontic infections after removing the root-canal filling materials. PAD was performed on teeth with toluidine blue O (TBO) in combination with diode laser. Then re-sampling was conducted from the canal root using sterile paper points and transferred to transport medium. The samples were plated and pure cultures of the target microorganisms were then isolated and identified by analytical profile index (API ® 20A) assays and 16S ribosomal RNA gene sequencing. Before TBO-PAD, a total of 31 cultivable isolates could be retrieved; 25.8% of the isolated species were obligate anaerobic or microphilics including Veillonella parvula, Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Propionibacterium acnes, and Lactobacillus acidophilus, and 74.2% of the isolated species were facultative anaerobic such as Enterococcus faecalis, Actinomyces naeslundii, L. rhamnosus, L. casei, Streptococcus sanguinis, S. mitis, and Candida albicans. According to this in vivo study, the diversity and count of microbiota in root canal-treated teeth were decreased after TBO-PAD, so that E. faecalis, V. parvula, and C. albicans were the microorganisms that recovered after PAD. TBO-PAD is an effective approach that exhibited anti-microbial potential activity against microbiota involved in secondary/persistent endodontic infection. Copyright © 2017 Elsevier B.V. All rights reserved.

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

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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.

[Irrigants and intracanal medicaments in endodontics].

Science.gov (United States)

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

2003-01-01

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

The theoretical and experimental researches of Pb-Al composite materials extrusion

Directory of Open Access Journals (Sweden)

G. Ryzińska

2012-07-01

Full Text Available The work presents the analysis of the character of a simultaneous plastic flow of composite material of a hard core-soft sleeve structure. Experimental research work using model composite material Aluminium-Lead and theoretical analysis allowed to identify the initial cracking conditions, its character and localization, depending on geometrical parameters of the composite materials and the extrusion ratio value. It has been shown that the higher the parameters’ values are, the longer the flawless extruded product is (cracking appears in the further stages of the process.

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

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Mohamad Kashefinejad

2016-08-01

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

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

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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.

Chlorhexidine gluconate, its properties and applications in endodontics

OpenAIRE

Mohammadi, Zahed

2008-01-01

The major objective in endodontic therapy is to disinfect the entire root canal system. This requires that the pulpal content be eliminated as sources of infection. This goal may be accomplished by mechanical instrumentation and chemical irrigation, in conjunction with medication of the root canal between treatment sessions. Microorganisms and their by-products are considered to be the major cause of pulpal and periradicular pathosis. In order to reduce or eliminate bacteria from the root can...

Optimization of fast disintegration tablets using pullulan as diluent by central composite experimental design

OpenAIRE

Patel, Dipil; Chauhan, Musharraf; Patel, Ravi; Patel, Jayvadan

2012-01-01

The objective of this work was to apply central composite experimental design to investigate main and interaction effect of formulation parameters in optimizing novel fast disintegration tablets formulation using pullulan as diluents. Face centered central composite experimental design was employed to optimize fast disintegration tablet formulation. The variables studied were concentration of diluents (pullulan, X1), superdisintigrant (sodium starch glycolate, X2), and direct compression aid ...

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

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Oginni, Ao; Udoye, C I

2004-12-01

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

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

Science.gov (United States)

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 (pendodontic treatment and aPDT was statistically more effective (proot 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.

Survey of Endodontic Irrigants Used by Dentists With Varying Years of Professional Experience

Directory of Open Access Journals (Sweden)

Sharkov Nikolai

2018-03-01

Full Text Available Background/Aim: The aim of the present study was to describe the use of irrigants by dentists in Bulgaria in relation to their years of professional experience. Material and Methods: The data were collected with the help of a questionnaire. The survey included questions concerning frequency of irrigants applied, their respective concentrations, as well as spectrum of disinfectants used in endodontics. In addition, information about respondents’ age, years of professional experience, gender, and main areas of continuing education was collected. The statistical analysis was performed with the help of IBM SPSS Statistics 22.0. Results: 219 replies were analysed (response rate 27,3%. The majority of the respondents (31.1% had 21 to 30 years of professional experience. 18.7% had over 30 years. Most of the practitioners reported their continuing education to be in the area of general dentistry - 52%, while about 1.2 % had specialised in endodontics. Dentists with long-standing professional experience use predominantly H2O2 - 78%. Dentists with least experience use 17% EDTA - 53.6%. No significant differences were established for the use of sodium hypochlorite and 2% chlorhexidine. 82% of the respondents use conventional needle 27G for intracanal irrigation; 60% never use ultrasonic irrigation. Conclusions: The analysis of the usage of irrigants shows that many general dental practitioners do not follow the quality recommended protocols for endodontic irrigation protocols.

Guided Modern Endodontic Surgery: A Novel Approach for Guided Osteotomy and Root Resection.

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Strbac, Georg D; Schnappauf, Albrecht; Giannis, Katharina; Moritz, Andreas; Ulm, Christian

2017-03-01

Continuous improvements in techniques, instruments, and materials have established modern endodontic microsurgery as a state-of-the-art treatment method. The purpose of this approach was to introduce a new surgical endodontic technique by using a three-dimensional printed template for guided osteotomy and root resection. A 38-year-old patient was diagnosed with periapical lesions of teeth #3 and #4 and extruded gutta-percha material. Three-dimensional radiographic and optical scan files were imported into surgical planning software designed for guided implant surgery. Within the adapted software program the periapical lesions and the extruded gutta-percha were visualized and marked. With the aid of virtually positioned surgical pins and piezoelectric instruments, the osteotomy size, the apical resection level, and the bevel angle were defined before treatment. Three-dimensional surgical templates for each tooth were designed within the software program for a guided treatment approach. This approach comprised the treatment of periapical lesions of teeth #3 and #4 with root-end fillings and the detection and complete removal of the extruded gutta-percha material without perforation of sinus membrane. There were no postoperative complications, and clinical and radiologic assessments verified complete healing of the teeth. The guided microsurgical endodontic treatment presented appears to be a viable technique that allows for predefined osteotomies and root resections. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Orthodontic Movement after Regenerative Endodontic Procedure: Case Report and Long-term Observations.

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Chaniotis, Antonis

2018-03-01

Although regenerative treatment approaches in teeth with incomplete root formation and pulp necrosis have become part of the suggested therapeutic endodontic spectrum, little is known about the effect of orthodontic movement in the tissue that has been regenerated. Furthermore, as the number of adults undergoing orthodontic treatment increases, there is an increasing need to investigate the changes that these tissues may undergo during orthodontic movement. Here we describe the alterations observed after the application of orthodontic forces in a case of an apically root-fractured necrotic immature root that had been managed with regenerative endodontic procedures in the past. A 9-year-old male patient was referred after suffering the third incidence of trauma in the anterior maxilla. Radiographic evaluation revealed a periapical rarefaction associated with an apically root-fractured immature central incisor. Clinical evaluation revealed a buccal abscess and grade 3 tooth mobility. Periodontal probing was within normal limits. The tooth was accessed and disinfected by using apical negative pressure irrigation of 6% NaOCl. Intracanal dentin conditioning was achieved by using 17% EDTA for 5 minutes. A blood clot was induced from the periapical area, and calcium silicate-based cement was placed in direct contact with the blood clot at the same visit. The composite resin restoration was accomplished in the same appointment. Recall radiographic examination after 24 months revealed healing of the periapical lesion and signs of continuous root development despite the apical root fracture. Clinical evaluation revealed normal tooth development, normal mobility, and a resolving buccal infection. The tooth was subjected to orthodontic treatment because of Class II division 1 malocclusion with an overjet of 11 mm. After completion of the orthodontic treatment, 5.5 years after the initial intervention, the radiographic image revealed marked remodeling of the periapical

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

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

2008-12-01

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

An experimental approach to free vibration analysis of smart composite beam

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Yashavantha Kumar, G. A.; Sathish Kumar, K. M.

2018-02-01

Experimental vibration analysis is a main concern of this study. In designing any structural component the important parameter that has to be considered is vibration. The present work involves the experimental investigation of free vibration analysis of a smart beam. Smart beam consists of glass/epoxy composite as a main substrate and two PZT patches. The PZT patches are glued above and below the main beam. By experimentation the natural frequencies and mode shapes are obtained for both with and without PZT patches of a beam. Finally through experimentation the response of the smart beam is recorded.

Bacteria community study of combined periodontal-endodontic lesions using denaturing gradient gel electrophoresis and sequencing analysis.

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Li, Hong; Guan, Rui; Sun, Jinghua; Hou, Benxiang

2014-10-01

The entire microbial population and predominant microflora of root canals (RCs) and adjacent periodontal pockets (PPs) from teeth with combined periodontal-endodontic lesions were determined and compared. Pooled RC and PP samples were collected from the molars of 20 patients diagnosed with combined periodontal-endodontic lesions. DNA was extracted for polymerase chain reaction-based denaturing gradient gel electrophoresis (PCR-DGGE), cloning, and sequence analysis. A coefficient of similarity (Cs) was used to determine the similarity of the bacterial profiles from RCs and PPs. Significantly fewer bands were produced by PCR-DGGE from RCs (5.9 ± 1.7) than from PPs (8.0 ± 1.8) (P bacteria in both the RC and PP samples were (in descending order) Filifactor alocis, Parvimonas micra, Porphyromonas gingivalis, and Tannerella forsythia. The high similarity in the sets of organisms present in both RC and PP samples in this study suggests that the pocket could be a source of RC infection. The data also demonstrate that combined periodontal-endodontic lesions consist of a diverse and complex microbial community.

Experimental and numerical characterization of scalable cellulose nano-fiber composite

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Barari, Bamdad

Fiber-reinforced polymer composites have been used in recent years as an alternative to the conventional materials because of their low weight, high mechanical properties and low processing temperatures. Most polymer composites are traditionally made using reinforcing fibers such as carbon or glass fibers. However, there has been recent interest in making these reinforcing fibers from natural resources. The plant-derived cellulose nano-fibers (CNF) are a material with remarkable mechanical properties at the nano-scale that are much superior to the mechanical properties of the traditional natural fibers (such as jute, hemp, kenaf, etc) used in the natural-fiber based polymer composites. Because CNF is bio-based and biodegradable, it is an attractive 'green' alternative for use in automotive, aerospace, and other engineering applications. However, efforts to produce CNF based nano-composites, with successful scaling-up of the remarkable nanoscale properties of CNF, have not met with much success and form an active area of research. The main goals of this research are to characterize the scalable CNF based nano composites using experimental methods and to develop effective models for flow of polymeric resin in the CNF-based porous media used during the proposed manufacture of CNF nano-composites. In the CNF composite characterization section, scalable isotropic and anisotropic CNF composites were made from a porous CNF preforms created using a freeze drying process. Formation of the fibers during freeze-drying process can change the micro skeleton of the final preform structure as non-aligned or isotropic and aligned or anisotropic CNF. Liquid Composite Molding (LCM) processes form a set of liquid molding technologies that are used quite commonly for making the conventional polymer composites. An improvised vacuum-driven LCM process was used to make the CNF-based nanocomposites from CNF preforms using a 'green' epoxy resin with high bio-content. Under the topic of

Antimicrobial activity of Arctium lappa constituents against microorganisms commonly found in endodontic infections.

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Pereira, Juliana Vianna; Bergamo, Débora Cristina Baldoqui; Pereira, José Odair; França, Suzelei de Castro; Pietro, Rosemeire Cristina Linhares Rodrigues; Silva-Sousa, Yara T Corrêa

2005-01-01

This study evaluated in vitro the antimicrobial activity of rough extracts from leaves of Arctium lappa and their phases. The following microorganisms, commonly found in the oral cavity, specifically in endodontic infections, were used: Enterococcus faecalis, Staphylococcus aureus, Pseudomonas aeruginosa, Bacillus subtilis and Candida albicans. The agar-diffusion method allowed detection of the hexanic phase as an inhibitor of microbial growth. Bioautographic assays identified antimicrobial substances in the extract. The results showed the existence, in the rough hexanic phase and in its fractions, of constituents that have retention factors (Rf) in three distinct zones, thereby suggesting the presence of active constituents with chemical structures of different polarities that exhibited specificity against the target microorganisms. It may be concluded that the Arctium lappa constituents exhibited a great microbial inhibition potential against the tested endodontic pathogens.

Clinical and pharmacological management of endodontic flare-up.

Science.gov (United States)

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

2012-08-01

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

Effect of cobalt-60 radiation on response to endodontic therapy in monkeys

International Nuclear Information System (INIS)

Matson, J.E.; Patterson, S.S.; Kafrawy, A.H.; Hornback, N.B.; Shidnia, H.

1978-01-01

Response of teeth that had received therapeutic doses of Cobalt-60 radiation to endodontic therapy were investigated in three monkeys. The results indicated no appreciable effect of the irradiation on the response to root canal treatment aside from reduction in osteoblastic activity

Influence of different adhesive systems on bond strength of carbon fiber posts used to restore endodontically treated teeth

OpenAIRE

Silva, Lorena dos Santos; Reis, Kátia Rodrigues; Ambrosano, Glaucia Maria Bovi; Chuí, Fabíola Mendonça da Silva; Sena, Neylla Teixeira; Carvalhal, Cintia Iara Oda; Oliveira, Jonas Alves de

2013-01-01

The aim of this study was to evaluate the influence of three adhesive systems on resinous bonding of carbon fiber posts on roots of endodontically treated bovine incisors. Thirty bovine lower incisors with similar dimensions were selected for this study. The roots were endodontically treated and subsequently prepared for post cementation. The posts were treated with adhesive systems Scotchbond MultiPurpose Plus – 3M chemical cure (Group I), light cure (Group II) and dual cure (Group III). Car...

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

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

2017-09-01

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

Laser Doppler flowmetry in endodontics: a review.

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Jafarzadeh, H

2009-06-01

Vascular supply is the most accurate marker of pulp vitality. Tests for assessing vascular supply that rely on the passage of light through a tooth have been considered as possible methods for detecting pulp vitality. Laser Doppler flowmetry (LDF), which is a noninvasive, objective, painless, semi-quantitative method, has been shown to be reliable for measuring pulpal blood flow. The relevant literature on LDF in the context of endodontics up to March 2008 was reviewed using PubMed and MEDLINE database searches. This search identified papers published between June 1983 and March 2008. Laser light is transmitted to the pulp by means of a fibre optic probe. Scattered light from moving red blood cells will be frequency-shifted whilst that from the static tissue remains unshifted. The reflected light, composed of Doppler-shifted and unshifted light, is returned by afferent fibres and a signal is produced. This technique has been successfully employed for estimating pulpal vitality in adults and children, differential diagnosis of apical radiolucencies (on the basis of pulp vitality), examining the reactions to pharmacological agents or electrical and thermal stimulation, and monitoring of pulpal responses to orthodontic procedures and traumatic injuries. Assessments may be highly susceptible to environmental and technique-related factors. Nonpulpal signals, principally from periodontal blood flow, may contaminate the signal. Because this test produces no noxious stimuli, apprehensive or distressed patients accept it more readily than current methods of pulp vitality assessment. A review of the literature and a discussion of the application of this system in endodontics are presented.

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

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

2013-01-01

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

An application framework of three-dimensional reconstruction and measurement for endodontic research.

Science.gov (United States)

Gao, Yuan; Peters, Ove A; Wu, Hongkun; Zhou, Xuedong

2009-02-01

The purpose of this study was to customize an application framework by using the MeVisLab image processing and visualization platform for three-dimensional reconstruction and assessment of tooth and root canal morphology. One maxillary first molar was scanned before and after preparation with ProTaper by using micro-computed tomography. With a customized application framework based on MeVisLab, internal and external anatomy was reconstructed. Furthermore, the dimensions of root canal and radicular dentin were quantified, and effects of canal preparation were assessed. Finally, a virtual preparation with risk analysis was performed to simulate the removal of a broken instrument. This application framework provided an economical platform and met current requirements of endodontic research. The broad-based use of high-quality free software and the resulting exchange of experience might help to improve the quality of endodontic research with micro-computed tomography.

Using condition and usefulness of dental cone-beam CT in endodontic treatment

International Nuclear Information System (INIS)

Kimura, Yuichi; Araki, Kazuyuki; Yamada, Yoshishige; Tagaya, Atsuko; Seki, Kenji; Okano, Tomohiro; Endo, Atsushi

2009-01-01

This study evaluated the condition and usefulness of the dental cone-beam CT (3DX) in clinical endodontic treatments. Images from 55 examinations of 49 patients obtained using 3DX during an 11-month period were evaluated retrospectively to identify the usefulness of this modality compared with periapical or panoramic radiographs. The main indication for using of 3DX was diagnosis of root fracture in 65% of the examinations, second was the presence and expansion of periapical lesion in 22%, and third was to detect the canal system or root abnormality in 13%. The 3DX visualizes bony anatomical structures precisely and detects the presence and expansion of periapical lesions and the canal system of each root of mulirooted teeth that cannot easily be observed by intraoral radiography or panoramic radiography. The results of this study suggest that 3DX is a useful and reliable tool for endodontic treatments. (author)

Mechanical Behaviour of 3D Multi-layer Braided Composites: Experimental, Numerical and Theoretical Study

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Deng, Jian; Zhou, Guangming; Ji, Le; Wang, Xiaopei

2017-12-01

Mechanical properties and failure mechanisms of a newly designed 3D multi-layer braided composites are evaluated by experimental, numerical and theoretical studies. The microstructure of the composites is introduced. The unit cell technique is employed to address the periodic arrangement of the structure. The volume averaging method is used in theoretical solutions while FEM with reasonable periodic boundary conditions and meshing technique in numerical simulations. Experimental studies are also conducted to verify the feasibility of the proposed models. Predicted elastic properties agree well with the experimental data, indicating the feasibility of the proposed models. Numerical evaluation is more accurate than theoretical assessment. Deformations and stress distributions of the unit cell under tension shows displacement and traction continuity, guaranteeing the rationality of the applied periodic boundary conditions. Although compression and tension modulus are close, the compressive strength only reaches 70% of the tension strength. This indicates that the composites can be weakened in compressive loading. Additionally, by analysing the micrograph of fracture faces and strain-stress curves, a brittle failure mechanism is observed both in composites under tension and compression.

Evidence of the protein content of bovine and human dental pulps by the action of endodontic irrigation solutions through electrophoretic patterns

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María E López

2013-01-01

Full Text Available Background: Sodium dodecyl sulfate polyacrylamide gel electrophoresis let to show the protein content of different tissues. Dental pulp contains connective tissue which is removed during the endodontic treatment. Many studies consider bovine rather than human pulp tissue because of its size. Aim: To evidence the protein content of bovine and human dental pulps and the action of endodontic irrigation solutions through electrophoretic patterns. Materials and Methods: Extracts of human and bovine dental pulps were prepared. Sodium hypochlorite, calcium hydroxide, chlorhexidine and ethylenediamine tetraacetic acid were used as irrigating solutions. Results: Bovine and human pulps have a small difference in two bands of proteins present between 74 kDa and 80 kDa. The denaturizing capacity of sodium hypochlorite and the washing action of calcium hydroxide and chlorhexidine were evidenced. Ethylenediamine tetraacetic acid solution was shown to contain proteins continuously during the endodontic root canal washing. Conclusions: Differences in pulp tissues and the action of irrigating solutions on their protein content would help on the understanding of the biological process of the endodontic treatment.

Microbial analysis in primary and persistent endodontic infections by using pyrosequencing.

Science.gov (United States)

Hong, Bo-Young; Lee, Tae-Kwon; Lim, Sang-Min; Chang, Seok Woo; Park, Joonhong; Han, Seung Hyun; Zhu, Qiang; Safavi, Kamran E; Fouad, Ashraf F; Kum, Kee Yeon

2013-09-01

The aim of this study was to investigate the bacterial community profile of intracanal microbiota in primary and persistent endodontic infections associated with asymptomatic chronic apical periodontitis by using GS-FLX Titanium pyrosequencing. The null hypothesis was that there is no difference in diversity of overall bacterial community profiles between primary and persistent infections. Pyrosequencing analysis from 10 untreated and 8 root-filled samples was conducted. Analysis from 18 samples yielded total of 124,767 16S rRNA gene sequences (with a mean of 6932 reads per sample) that were taxonomically assigned into 803 operational taxonomic units (3% distinction), 148 genera, and 10 phyla including unclassified. Bacteroidetes was the most abundant phylum in both primary and persistent infections. There were no significant differences in bacterial diversity between the 2 infection groups (P > .05). The bacterial community profile that was based on dendrogram showed that bacterial population in both infections was not significantly different in their structure and composition (P > .05). The present pyrosequencing study demonstrates that persistent infections have as diverse bacterial community as primary infections. Copyright © 2013 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Detection and clonal analysis of anaerobic bacteria associated to endodontic-periodontal lesions.

Science.gov (United States)

Pereira, Cássio V; Stipp, Rafael N; Fonseca, Douglas C; Pereira, Luciano J; Höfling, José F

2011-12-01

Microbial agents in root canal systems can induce periodontal inflammation. The aims of this study are to detect anaerobic microorganisms in endodontic-periodontal lesions, determine the genetic diversity among them, and assess the simultaneous colonization of the pulp and periodontal microenvironments by a single clone. Twenty-seven teeth of patients with endodontic-periodontal lesions were selected. Samples were spread on an agar-blood medium, the detection of each species was performed using a polymerase chain reaction, and the determination of the simultaneous presence of the same species in the microenvironments by one or more clones was determined using arbitrarily primed PCR. Prevotella intermedia (Pi) was the most prevalent species of the colonies in periodontal pockets, whereas Porphyromonas gingivalis (Pg) and Pi were the more prevalent in root canals. Isolates of Pi and Pg were simultaneously identified in root canals and periodontal pockets. Eighteen percent of teeth exhibited the simultaneous colonization by Pg, Tannerella forsythia (previously T. forsythensis), and Porphyromonas endodontalis in the pulp and periodontal microenvironments. The presence of these species was noted even in niches from which no colonies were isolated. Seventeen different genotypes were found in periodontal and pulp sites, with the majority of sites colonized by one or two different genotypes. A high degree of genotype similarity was found for samples of Pg isolated from only one site as well as for those isolated from both microenvironments. Different clones of Pi and Pg with a high intraspecific genotype similarity were found to colonize the same anatomic sites in endodontic-periodontal infections.

Regenerative Endodontics: A Road Less Travelled

Science.gov (United States)

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

2014-01-01

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

Oxidative stress in patients with endodontic pathologies

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Vengerfeldt V

2017-08-01

Full Text Available Veiko Vengerfeldt,1 Reet Mändar,2,3 Mare Saag,1 Anneli Piir,2 Tiiu Kullisaar2 1Institute of Dental Sciences, Faculty of Medicine, University of Tartu, 2Institute of Biomedicine and Translational Medicine, Faculty of Medicine, University of Tartu, 3Competence Centre on Health Technologies, Tartu, Estonia Background: Apical periodontitis (AP is an inflammatory disease affecting periradicular tissues. It is a widespread condition but its etiopathogenetic mechanisms have not been completely elucidated and the current treatment options are not always successful.Purpose: To compare oxidative stress (OxS levels in the saliva and the endodontium (root canal [RC] contents in patients with different endodontic pathologies and in endodontically healthy subjects.Patients and methods: The study group of this comparison study included 22 subjects with primary chronic apical periodontitis (pCAP, 26 with posttreatment or secondary chronic apical periodontitis (sCAP, eight with acute periapical abscess, 13 with irreversible pulpitis, and 17 healthy controls. Resting saliva samples were collected before clinical treatment. Pulp samples (remnants of the pulp, tooth tissue, and/or previous root filling material were collected under strict aseptic conditions using the Hedström file. The samples were frozen to −80°C until analysis. OxS markers (myeloperoxidase [MPO], oxidative stress index [OSI], 8-isoprostanes [8-EPI] were detected in the saliva and the endodontium. Results: The highest MPO and 8-EPI levels were seen in pCAP and pulpitis, while the highest levels of OSI were seen in pCAP and abscess patients, as well as the saliva of sCAP patients. Controls showed the lowest OxS levels in both RC contents and saliva. Significant positive correlations between OxS markers, periapical index, and pain were revealed. Patients with pain had significantly higher OxS levels in both the endodontium (MPO median 27.9 vs 72.6 ng/mg protein, p=0.004; OSI 6.0 vs 10.4, p<0

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

Science.gov (United States)

Fabra Campos, H; Millet Part, J

1989-01-01

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

Management of an Endodontic Infection with an Extra Oral Sinus Tract in a Single Visit: A Case Report

OpenAIRE

Satish Kumar, Krishnamurthy; Subbiya, Arunajatesan; Vivekanandhan, Paramasivam; Prakash, Venkatachalam; Tamilselvi, Ramachandran

2013-01-01

Chronic apical periodontitis can drain through a sinus tract, which may be intra-oral or extra-oral, though an intra-oral drainage is more common. Though such cases can be treated in a single visit, there is no report on a single visit endodontic treatment for a chronic apical periodontitis with a draining sinus. This case report demonstrates that the apical periodontitis with a cutaneous sinus tract can be successfully treated endodontically as a single visit procedure, if the patient is in ...

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

Science.gov (United States)

Natera, Marianella; Mukherjee, Padma M

2018-06-01

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

Clinical and pharmacological management of endodontic flare-up

Directory of Open Access Journals (Sweden)

Harikaran Jayakodi

2012-01-01

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

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

Science.gov (United States)

Mohammadi, Z; Abbott, P V

2009-07-01

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

Single versus multiple visits for endodontic treatment of permanent teeth.

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Manfredi, Maddalena; Figini, Lara; Gagliani, Massimo; Lodi, Giovanni

2016-12-01

Root canal treatment (RoCT), or endodontic treatment, is a common procedure in dentistry. The main indications for RoCT are irreversible pulpitis and necrosis of the dental pulp caused by carious processes, tooth cracks or chips, or dental trauma. Successful RoCT is characterised by an absence of symptoms (i.e. pain) and clinical signs (i.e. swelling and sinus tract) in teeth without radiographic evidence of periodontal involvement (i.e. normal periodontal ligament). The success of RoCT depends on a number of variables related to the preoperative condition of the tooth, as well as the endodontic procedures. This review updates the previous version published in 2007. To determine whether completion of root canal treatment (RoCT) in a single visit or over two or more visits, with or without medication, makes any difference in term of effectiveness or complications. We searched the following electronic databases: Cochrane Oral Health's Trials Register (to 14 June 2016), Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2016, Issue 5), MEDLINE Ovid (1946 to 14 June 2016), and Embase Ovid (1980 to 14 June 2016). We searched ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform for ongoing trials to 14 June 2016. We did not place any restrictions on the language or date of publication when searching the electronic databases. We included randomised controlled trials (RCTs) and quasi-RCTs of people needing RoCT. We excluded surgical endodontic treatment. The outcomes of interest were tooth extraction for endodontic problems; radiological failure after at least one year, i.e. periapical radiolucency; postoperative pain; swelling or flare-up; painkiller use; sinus track or fistula formation; and complications (composite outcome including any adverse event). We collected data using a specially designed extraction form. We contacted trial authors for further details where these were unclear. We

C-shaped root canal configuration in mandibular second premolar: Report of an unusual case and its endodontic management

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Dipali Y Shah

2012-01-01

Full Text Available The C-shaped root canal system is an aberration of the root canal system in which a characteristic fin or web connects individual canals, resulting in a C-shaped cross section. This configuration has been rarely reported in the mandibular second premolar. The only other known reported case of a C-shaped canal, with its configuration, in relation to mandibular second premolar is of an extracted tooth. The purpose of this report is to describe the diagnosis, configuration and endodontic management of C-shaped root canal in mandibular second premolar. Clinical techniques to addresses the challenges in endodontic disinfection as well as cleaning and shaping of the C-shaped canal, which is prone to endodontic mishaps, are also discussed in this case report. Reporting of this case emphasizes the need and added advantage of using the dental operating microscope hand in hand with conventional radiography in management of the C-shaped root canal configuration.

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

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José Claudio Provenzano

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

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

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

2013-01-01

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

[Endodontic treatment in one or several sessions? Review of the literature].

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Darbinyan, M; Bogaerts, P; Van Nieuwenhuysen, J P

2005-01-01

This literature review compares the endodontic treatment in one or more appointments on the healing of periapical lesions and the occurrence of postoperative pain and flare-ups. It turns out that the root canal treatment completed in one session has many advantages and may he considered the prime option in the majority of clinical cases.

Endodontic Management of Maxillary Second Molar with Two Palatal Roots: A Report of Two Cases

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Surbhi Patel

2012-01-01

Full Text Available Endodontic treatment may sometimes fail because morphological features of the tooth adversely affect the treatment protocol. Maxillary second molars are recognized as usually having a single palatal root with a single palatal canal. The incidence of second palatal root in the maxillary second molar is very rare. Two cases are presented in this paper describing the endodontic management of a four-rooted maxillary second molar with two distinct palatal roots and canals and two distinct buccal roots and canals. Clinical examination and radiographs showed the presence of two palatal roots during the root canal procedure. The canals were biomechanically prepared with crown-down technique and obturated using lateral condensation technique with AH-Plus sealer.

Through-transmission laser welding of glass fibre composite: Experimental light scattering identification

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Cosson, Benoit; Asséko, André Chateau Akué; Dauphin, Myriam

2018-05-01

The purpose of this paper is to develop a cost-effective, efficient and quick to implement experimental optical method in order to predict the optical properties (extinction coefficient) of semi-transparent polymer composites. The extinction coefficient takes into account the effects due to the absorption and the scattering phenomena in a semi-transparent component during the laser processes, i.e. TTLW (through-transmission laser welding). The present method used a laser as light source and a reflex camera equipped with a macro lens as a measurement device and is based on the light transmission measurement through different thickness samples. The interaction between the incident laser beam and the semi-transparent composite is exanimated. The results are presented for the case of a semi-transparent composite reinforced with the unidirectional glass fiber (UD). A numerical method, ray tracing, is used to validate the experimental results. The ray tracing method is appropriate to characterize the light-scattering phenomenon in semi-transparent materials.

Properties of calcium silicate-monobasic calcium phosphate materials for endodontics containing tantalum pentoxide and zirconium oxide.

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Zamparini, Fausto; Siboni, Francesco; Prati, Carlo; Taddei, Paola; Gandolfi, Maria Giovanna

2018-05-08

The aim of the study was to evaluate chemical-physical properties and apatite-forming ability of three premixed calcium silicate materials containing monobasic calcium phosphate (CaH 4 P 2 O 8 ) bioceramic, tantalum pentoxide and zirconium oxide, recently marketed for endodontics (TotalFill BC-Sealer, BC-RRM-Paste, BC-RRM-Putty). Microchemical and micromorphological analyses, radiopacity, initial and final setting times, calcium release and alkalising activity were tested. The nucleation of calcium phosphates (CaPs) and/or apatite after 28 days ageing was evaluated by ESEM-EDX and micro-Raman spectroscopy. BC-Sealer and BC-RRM-Paste showed similar initial (23 h), prolonged final (52 h) setting times and good radiopacity (> 7 mm Al); BC-RRM-Putty showed fast initial (2 h) and final setting times (27 h) and excellent radiopacity (> 9 mm Al). All materials induced a marked alkalisation (pH 11-12) up to 28 days and showed the release of calcium ions throughout the entire test period (cumulative calcium release 641-806 ppm). After 28 days ageing, a well-distributed mineral layer was present on all samples surface; EDX demonstrated relevant calcium and phosphorous peaks. B-type carbonated apatite and calcite deposits were identified by micro-Raman spectroscopy on all the 28-day-aged samples; the deposit thickness was higher on BC-RRM-Paste and BC-RRM-Putty, in agreement with calcium release data. These materials met the required chemical and physical standards and released biologically relevant ions. The CaSi-CaH 4 P 2 O 8 system present in the materials provided Ca and OH ions release with marked abilities to nucleate a layer of B-type carbonated apatite favoured/accelerated by the bioceramic presence. The ability to nucleate apatite may lead many clinical advantages: In orthograde endodontics, it may improve the sealing ability by the deposition of CaPs at the material-root dentine interface, and in endodontic surgery, it could promote bone and

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

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

2003-05-01

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

Accuracy of digital radiography and cone beam computed tomography on periapical radiolucency detection in endodontically treated teeth.

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Venskutonis, Tadas; Daugela, Povilas; Strazdas, Marijus; Juodzbalys, Gintaras

2014-04-01

The aim of the present study was to compare the accuracy of intraoral digital periapical radiography and cone beam computed tomography in the detection of periapical radiolucencies in endodontically treated teeth. Radiographic images (cone beam computed tomography [CBCT] scans and digital periapical radiography [PR] images) from 60 patients, achieved from September 2008 to July 2013, were retrieved from databases of the Department of Oral Diseases, Lithuanian University of Health Sciences. Twenty patients met inclusion criteria and were selected for further evaluation. In 20 patients (42.4 [SD 12.1] years, 65% men and 35% women) a total of 35 endodontically treated teeth (1.75 [SD 0.91]; 27 in maxilla and 8 in mandible) were evaluated. Overall, it was observed a statistical significant difference between the number of periapical lesions observed in the CBCT (n = 42) and radiographic (n = 24) examinations (P cone beam computed tomography scans were more accurate compared to digital periapical radiographs for detecting periapical radiolucencies in endodontically treated teeth. The difference was more pronounced in molar teeth.

Propriedades e bioatividade de um cimento endodôntico à base de aluminato de cálcio Properties and bioactivity of endodontic calcium aluminate cement

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I. R. Oliveira

2011-09-01

Full Text Available Desde sua introdução na endodontia como um material retro-obturador e selador de defeitos da raiz dental, o agregado de trióxido mineral (MTA tem sido considerado como um material endodôntico revolucionário. Apesar disso, este material apresenta algumas propriedades limitantes, necessitando alterações em sua composição bem como desenvolvimento de novos materiais. Assim, o objetivo desse trabalho foi mostrar a influência de aditivos no desenvolvimento de um cimento endodôntico à base de cimento de aluminato de cálcio (ECAC. Além disso, foram avaliadas as propriedades do ECAC em comparação com o MTA, quando em contato com solução de fluido corporal simulado (SBF. Testes de manipulação e medidas de resistência à compressão, porosidade aparente, tempo de endurecimento, pH e condutividade iônica, foram realizados para os materiais MTA puro e ECAC contendo aditivos. Considerando as propriedades apresentadas pelo ECAC, este material alternativo pode ser indicado para múltiplas aplicações em endodontia.The mineral trioxide aggregate (MTA, a material primarily developed as a root-end filling has been extensively investigated as an innovative product for endodontic applications. However, changes in its formulation/composition involving its mineral aggregates and the development of alternatives of materials have been proposed in an attempt to overcome its negative physical-chemical characteristics. In this work, the influence of additives addition on the development of a novel endodontic cement based on calcium aluminate, has been evaluated. In addition, the properties of endodontic calcium aluminate cement (ECAC were compared with the gold standard mineral-trioxide-aggregate in contact with simulated body fluid (SBF. Manipulation tests and measurements of compressive strength, apparent porosity, setting time, pH and ionic conductivity were carried out on plain MTA and calcium aluminate cement with and without various additives

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

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

2017-01-01

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

Experimental data on the properties of natural fiber particle reinforced polymer composite material.

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Chandramohan, D; Presin Kumar, A John

2017-08-01

This paper presents an experimental study on the development of polymer bio-composites. The powdered coconut shell, walnut shells and Rice husk are used as reinforcements with bio epoxy resin to form hybrid composite specimens. The fiber compositions in each specimen are 1:1 while the resin and hardener composition 10:1 respectively. The fabricated composites were tested as per ASTM standards to evaluate mechanical properties such as tensile strength, flexural strength, shear strength and impact strength are evaluated in both with moisture and without moisture. The result of test shows that hybrid composite has far better properties than single fibre glass reinforced composite under mechanical loads. However it is found that the incorporation of walnut shell and coconut shell fibre can improve the properties.

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

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

2012-05-01

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

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

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

2018-02-01

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

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

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

2013-05-01

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

Uncertainty Quantification in Experimental Structural Dynamics Identification of Composite Material Structures

DEFF Research Database (Denmark)

Luczak, Marcin; Peeters, Bart; Kahsin, Maciej

2014-01-01

for uncertainty evaluation in experimentally estimated models. Investigated structures are plates, fuselage panels and helicopter main rotor blades as they represent different complexity levels ranging from coupon, through sub-component up to fully assembled structures made of composite materials. To evaluate......Aerospace and wind energy structures are extensively using components made of composite materials. Since these structures are subjected to dynamic environments with time-varying loading conditions, it is important to model their dynamic behavior and validate these models by means of vibration...

Identification of material properties of orthotropic composite plate using experimental frequency response function data

Science.gov (United States)

Tam, Jun Hui; Ong, Zhi Chao; Ismail, Zubaidah; Ang, Bee Chin; Khoo, Shin Yee

2018-05-01

The demand for composite materials is increasing due to their great superiority in material properties, e.g., lightweight, high strength and high corrosion resistance. As a result, the invention of composite materials of diverse properties is becoming prevalent, and thus, leading to the development of material identification methods for composite materials. Conventional identification methods are destructive, time-consuming and costly. Therefore, an accurate identification approach is proposed to circumvent these drawbacks, involving the use of Frequency Response Function (FRF) error function defined by the correlation discrepancy between experimental and Finite-Element generated FRFs. A square E-glass epoxy composite plate is investigated under several different configurations of boundary conditions. It is notable that the experimental FRFs are used as the correlation reference, such that, during computation, the predicted FRFs are continuously updated with reference to the experimental FRFs until achieving a solution. The final identified elastic properties, namely in-plane elastic moduli, Ex and Ey, in-plane shear modulus, Gxy, and major Poisson's ratio, vxy of the composite plate are subsequently compared to the benchmark parameters as well as with those obtained using modal-based approach. As compared to the modal-based approach, the proposed method is found to have yielded relatively better results. This can be explained by the direct employment of raw data in the proposed method that avoids errors that might incur during the stage of modal extraction.

Experimental data on the properties of natural fiber particle reinforced polymer composite material

Directory of Open Access Journals (Sweden)

D. Chandramohan

2017-08-01

Full Text Available This paper presents an experimental study on the development of polymer bio-composites. The powdered coconut shell, walnut shells and Rice husk are used as reinforcements with bio epoxy resin to form hybrid composite specimens. The fiber compositions in each specimen are 1:1 while the resin and hardener composition 10:1 respectively. The fabricated composites were tested as per ASTM standards to evaluate mechanical properties such as tensile strength, flexural strength, shear strength and impact strength are evaluated in both with moisture and without moisture. The result of test shows that hybrid composite has far better properties than single fibre glass reinforced composite under mechanical loads. However it is found that the incorporation of walnut shell and coconut shell fibre can improve the properties.

Effect of chlorhexidine application on the bond strength of resin core to axial dentin in endodontic cavity

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Yun-Hee Kim

2012-11-01

Full Text Available Objectives This study evaluated the influence of chlorhexidine (CHX on the microtensile bonds strength (µTBS of resin core with two adhesive systems to dentin in endodontic cavities. Materials and Methods Flat dentinal surfaces in 40 molar endodontic cavities were treated with self-etch adhesive system, Contax (DMG and total-etch adhesive system, Adper Single Bond 2 (3M ESPE after the following surface treatments: (1 Priming only (Contax, (2 CHX for 15 sec + rinsing + priming (Contax, (3 Etching with priming (Adper Single Bond 2, (4 Etching + CHX for 15 sec + rinsing + priming (Adper Single Bond 2. Resin composite build-ups were made with LuxaCore (DMG using a bulk method and polymerized for 40 sec. For each condition, half of specimens were submitted to µTBS after 24 hr storage and half of them were submitted to thermocycling of 10,000 cycles between 5℃ and 55℃ before testing. The data were analyzed using ANOVA and independent t-test at a significance level of 95%. Results CHX pre-treatment did not affect the bond strength of specimens tested at the immediate testing period, regardless of dentin surface treatments. However, after 10,000 thermocycling, all groups showed reduced bond strength. The amount of reduction was greater in groups without CHX treatments than groups with CHX treatment. These characteristics were the same in both self-etch adhesive system and total-etch adhesive system. Conclusions 2% CHX application for 15 sec proved to alleviate the decrease of bond strength of dentin bonding systems. No significant difference was shown in µTBS between total-etching system and self-etching system.

DIFFICULTY IN BREATHING DUE TO ACCIDENTAL EXPOSURE TO HYPOCHLORITE SOLUTION IN ENDODONTIC TREATMENTREATHING DUE TO ACCIDENTAL EXPOSURE TO HYPOCHLORITE SOLUTION IN ENDODONTIC TREATMENT

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Buddiwati Punta

2006-04-01

Full Text Available An important phase of endodontic treatment is the irrigation of the root canal system. Desirable functions of irrigation are antimicrobial activity, dissolution of necrotic tissue, and non toxicity to the periradicular tissue. Toxicity of NaOCl solution on vital tissue is still controversial. Severe complications may occur if this solution is inadvertently exposed to the oral mucosa, and it is very hazardous. The purpose of this paper is to caution dentists on the hazards of using NaOCl irrigation in endodontic treatment. A case is presented in which 2.5% NaOCl solution was accidentally streaming into the patient's throat because the irrigating needle was not securely attached to the syringe, with the result that the patient had difficulty in breathing. The patient was promptly taken to a pulmonologist, internist, and ENT. The patient was given dexamethasone 10 mg iv injection, delladryl 1 cc iv, and nebulizer with 1 ampoule of steroid, 1 ampoule of ventolin and 5 cc NaCl 3x within 24 hours, and after 24 hours the condition was increased. From this case it is concluded that the 2.5% NaOCl solution is very alkaline and irritating, resulting in deem of the larynx and plugging up of the respiratory system. Clinicians need to be cautious in using NaOCl solution to avoid endangering the patient's life.

Behavior of single lap composite bolted joint under traction loading: Experimental investigation

Science.gov (United States)

Awadhani, L. V.; Bewoor, Anand

2018-04-01

Composite bolted joints are preferred connection in the composite structures to facilitate the dismantling for the replacements/ maintenance work. The joint behavior under tractive forces has been studied in order to understand the safety of the structure designed. The main objective of this paper is to investigate the behavior of single-lap joints in carbon fiber reinforced epoxy composites under traction loading conditions. The experiments were designed to identify the effect of bolt diameter, stacking sequence and loading rate on the properties of the joint. The experimental results show that the parameters influence the joint performance significantly.

Applying liquid chromatography-tandem mass spectrometry to assess endodontic sealer microleakage

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André Luiz da Costa MICHELOTTO

2015-01-01

Full Text Available The objective of this study was to describe a new method for the quantitative analysis of a microleakage of endodontic filling materials. Forty extracted single-rooted teeth were randomly divided into three experimental groups. After root canal shaping, the experimental groups were filled using the lateral condensation technique with the Epiphany system (G1, with gutta-percha + Sealapex (G2, and with gutta-percha + AH Plus (G3. Each root was mounted on a modified leakage testing device, and caffeine solution was used as a tracer (2000 ng mL-1, pH 6.0, applied in the coronal direction towards the tooth apex, creating a hydrostatic pressure of 2.55 kPa. Presence of caffeine in the receiving solution was measured after 10, 30, and 60 days, using high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS. None of the groups presented microleakage at 10 days. At 30 days, G2 and G3 showed similar infiltration patterns (means: 16.0 and 13.9 ng mL-1, respectively, whereas G1 showed significantly higher values (mean: 105.2 ng mL-1. At 60 days, leakage values were 182.6 ng mL-1for G1, 139.0 ng mL-1 for G2, and 53.5 ng mL-1 for G3. AH Plus showed the best sealing ability and HPLC-MS/MS showed high sensitivity and specificity for tracer quantification.

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

Science.gov (United States)

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

2015-10-01

A growing body of evidence exists showing the possibility of growing vital tissues in the root canal spaces of teeth with necrotic pulps and open apices. However, there is very limited histologic information regarding characteristics of tissues formed in the root canal space of human teeth after regenerative endodontics. The aim of this study was to examine clinically and histologically the outcomes of human immature teeth treated with regenerative endodontics. Two healthy birooted human maxillary first premolar teeth scheduled for extraction were included. Preoperative radiographs confirmed that these teeth had immature apices. Vitality tests showed the presence of vital pulps in these teeth. After receiving consent forms, the teeth were isolated with a rubber dam, and the pulps were completely removed. After the formation of blood clots in the canals, the teeth were covered with mineral trioxide aggregate. Four months later, the teeth were clinically and radiographically evaluated, extracted, and examined histologically. Both patients remained asymptomatic after treatment. Radiographic examination of the teeth showed signs of root development after treatment. Histologic examination of tissues growing into the root canal space of these teeth shows the presence of connective tissue, bone and cementum formation, and thickening of roots. Based on our findings, it appears that when canals of teeth with open apices are treated with regenerative endodontics, tissues of the periodontium grow into the root canals of these teeth. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.