Optimizing the chemical aspect of root canal irrigation

OpenAIRE

de Macedo, R.G.

2013-01-01

Root canal treatment is aimed at the removal of inflamed and infected tissue present in the root canal system. It will prevent the entrance of new microorganisms or nutrients in order to maintain or create a healthy environment around the root. There is sufficient evidence that shows that traditional endodontic therapy cannot make the root canal system completely free of bacteria. Moreover, it may not always result in complete healing of apical periodontitis, highlighting the need of optimizi...

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

Science.gov (United States)

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

2012-01-01

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

Clinical significance of dental root canal microflora.

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

1996-01-01

Previous work by this group has shown that a significant association exists between pain and the presence of either Prevotella or Peptostreptococcus spp. in dental root canals. The aim of this study was to examine a more extensive series of canals microbiologically, to determine whether any other particular endodontic symptoms or clinical signs showed specific associations with individual bacterial species. Seventy root canals were examined microbiologically and clinical data collected to investigate in detail such associations. Of the canals studied, 37 were associated with pain, 49 with tenderness to percussion, 23 with swelling, six with purulent exudate and 57 presented with wet root canals. Anaerobes were isolated from 70.3% of painful canals and from 29.7% of pain-free canals. Significant associations were found between (a) pain and either Prevotella spp. or peptostreptococci, both with P spp. (P Eubacterium spp. (P spp. or Pstr. micros, both with P spp. (each P Eubacterium, Peptostreptococcus, Prevotella or Propionibacterium (each P < 0.05). It was concluded that several different endodontic clinical signs and symptoms are significantly associated with specific bacterial species.

Mandibular molar with five root canals.

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

2008-12-01

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

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

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

2008-12-01

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

ROOT CANAL IRRIGANTS AND IRRIGATION TECHNIQUES: A REVIEW

OpenAIRE

Aniketh; Mohamed; Geeta; Nandakishore; Gourav Kumar; Patrick Timothy; Jayson Mathew; Sahle Abdul

2015-01-01

Root canal irrigation is not much emphasised in endodontic therapy. Most articles discussed are on root canal shaping and obturation not much emphasis is given for irrigation. There are many irrigation solutions which are introduced into market. The primary objective of root canal therapy is the ret ention of the pulpless or pulpally involved tooth with its associated periapical tissues in a healthy state. Achievement of this objective requires that the pulpal spaces and con...

Root canal treatment and special needs patients.

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Yap, E; Parashos, P; Borromeo, G L

2015-04-01

To identify current trends of root canal treatment for patients with special needs. A postal questionnaire was sent to General Dentists in Victoria, Australia and Endodontists and Special Needs Dentists across Australia to determine the extent of root canal treatment performed on special needs patients. Over a four-month period, 1120 questionnaires were distributed with an overall response rate of 63.9% (n = 716). Response rates were 63.2% (n = 655), 68.5% (n = 50) and 100.0% (n = 11) amongst General Dentists, Endodontists and Special Needs Dentists, respectively. Endodontists (95.7%) and Special Needs Dentists (100.0%) performed significantly more root canal treatment on adult patients with special needs compared with 51.2% of General Dentists, (P special needs patients compared with only 29.7% of General Dentists (P special needs patients was more likely to be carried out by specialist dental practitioners who were more likely to utilize a pharmacological approach for behaviour guidance and to perform single-visit root canal treatment compared with General Dentists. A multidisciplinary approach for special needs patients who require root canal treatment provides an opportunity for these patients to retain their dentition. © 2014 International Endodontic Journal. Published by John Wiley & Sons Ltd.

An endodontic management of mandibular third molar with five root canals

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Dakshita Joy Sinha

2014-01-01

Full Text Available The existence of several anatomical variations in the root canal system may contribute to failure of the root canal therapy. The planning and performing of endodontic therapy requires knowledge of the internal dental morphology. This paper reports the case of a left mandibular third molar that presented with five root canals; a case of unusual root canal morphology so as to demonstrate the anatomic variations in mandibular third molars. Root canal therapy and case management are described. This report highlights the importance of looking for additional roots and root canals so as to enable clinicians to treat a case successfully, which might have ended in failure.

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

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

2016-02-01

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

Radiographic evaluation of the quality of root canal obturation of single-matched cone Gutta-percha root canal filling versus hot lateral technique

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Randa Suleiman Obeidat

2014-01-01

Full Text Available Aim: The aim of this study is to evaluate radiographically the quality of root canal filling in mesiodistal and buccolingual view when comparing matched cone condensation and warm lateral Gutta-percha condensation using system B heating instrument in a low-heat warm lateral condensation technique in0 vitro. Materials and Methods: A total of 40 mandibular premolars with straight single canals were divided into two groups with 20 each. The root canals were shaped by hand file and Revo-S rotary files to size (25, 0.06 at the end point, then they filled by Gutta-percha cone and meta-seal sealer. In group A, a single matched cone technique was used to fill the root canals. In group B, a hot lateral condensation using system B instrument at 101°C was performed. Result: The result of this study showed no significant difference in density of Gutta-percha fill in apical and coronal two-third when comparing matched cone root canal filling and hot lateral technique (P > 0.05. The only significant difference (P < 0.05 was in matched cone between buccolingual and mesiodistal view in the coronal two-third. Conclusion: Within the limitation of this study, single matched cone technique has a good density in the apical one-third as that of the hot lateral technique so it may be used for filling narrow canals. In the coronal two-third of the root canal, single matched cone technique showed inferior density of root canal filling which can be improved by using accessory cones Gutta-percha in wide canal.

Optimizing the chemical aspect of root canal irrigation

NARCIS (Netherlands)

de Macedo, R.G.

2013-01-01

Root canal treatment is aimed at the removal of inflamed and infected tissue present in the root canal system. It will prevent the entrance of new microorganisms or nutrients in order to maintain or create a healthy environment around the root. There is sufficient evidence that shows that

An endodontic management of mandibular third molar with five root canals

OpenAIRE

Dakshita Joy Sinha; Ashish Amit Sinha

2014-01-01

The existence of several anatomical variations in the root canal system may contribute to failure of the root canal therapy. The planning and performing of endodontic therapy requires knowledge of the internal dental morphology. This paper reports the case of a left mandibular third molar that presented with five root canals; a case of unusual root canal morphology so as to demonstrate the anatomic variations in mandibular third molars. Root canal therapy and case management are described. Th...

Radiographic versus electronic root canal working length determination

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Lumnije Kqiku

2011-01-01

Conclusions: The present ex vivo study showed that electronic root canal working length determination is not superior to radiographic methods. Both methods provided a good performance in determining the root canal working length.

C-shaped root canal in a maxillary first molar: a case report.

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Yilmaz, Z; Tuncel, B; Serper, A; Calt, S

2006-02-01

This case report presents an unusual C-shaped root canal system in a maxillary first molar tooth. Although C-shaped root canals are most frequently seen in the mandibular second molar, they may also appear in maxillary molars. A literature search revealed only a few case reports of C-shaped root canal systems in maxillary molars. The present case describes a C-shaped canal in the buccal root of a maxillary first molar. The endodontic access cavity displayed two canal orifices, one leading to the canal system in the buccal root, the other into the palatal root canal system. In the buccal root, what appeared to be the mesial and distal canals joined to form a single C-shaped canal. --Careful examination of radiographs and the internal anatomy of teeth is essential.-- The location and morphology of root canals should be identified at high magnification under the microscope.

Laser scanning dental probe for endodontic root canal treatment

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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.

Variations in the Root Form and Root Canal Morphology of Permanent Mandibular First Molars in a Sri Lankan Population

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Roshan Peiris

2015-01-01

Full Text Available The present study was conducted to determine the number of roots and morphology of the root canal system of permanent mandibular first molars (M1 in a Sri Lankan population. Sample of 529 M1 teeth was used. The number of roots was examined and the lengths of the mesial and distal roots were measured to the nearest 0.01 mm. Vacuum injection protocol was used to inject China ink into the root canal system, making it transparent. Root canal morphology was recorded using Vertucci’s classification. Presence of furcation canals, position of lateral canals, intercanal communications, level of bifurcation, and convergence of the root canal system were recorded. M1 showed three roots in 4.1% of the sample. Commonest root canal morphology of the mesial root was type IV and the distal root was type I. The level of bifurcation of the root canals was commonly observed in the cervical one-third of the root while convergence was observed in the apical one-third in both roots. Prevalence of three rooted mandibular first molars is less than 5%. Mesial root showed the most variable canal morphology. Prevalence of furcation canals was 1.5% while that of middle mesial canals was 0.2%.

Maxillary second molar with four roots and five canals

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Xinjia Sha

2018-06-01

Full Text Available In this case report, we present a maxillary second molar variant, which had two palatal roots with two canals and two buccal roots with three canals, including a second mesiobuccal canal. A 44-year-old female patient complained about a tooth crown fracture and severe pain in her right maxillary second molar. A clinical intraoral inspection and radiography were carried out on the tooth, and a diagnosis of chronic apical periodontitis was made. Four roots (two buccal and two palatal and five canals (three buccal and two palatal were found. The anatomical variation of the tooth was further confirmed by cone-beam computed tomography, a cone-fit procedure, and a radiograph with a shifted projection angle. Root-canal treatment was performed under an endodontic microscope.

C-SHAPED CONFIGURATION OF THE ROOT CANAL SYSTEM – PROBLEMS AND SOLUTIONS.

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Janet Kirilova

2014-06-01

Full Text Available Introduction: The patients with C-shaped configuration of the root canal system are definitely a problem in the everyday dental practice. The C-shaped configuration of the root canal can be seen in the mandibular and maxillary molars. The treatment of these teeth is very difficult. Purpose: To trace the treatment of clinical cases with C-shaped configuration of the root canal system. Material and methods: There are some different cases that are described with a C-shaped configuration of the root canal system with one, two, three and four separate root canals. Careful exploration of the floor of the pulp chamber, inspection with magnification, use of ultrasonic irrigation and a modified filling technique are of particular use. Results and Discussion: Clinical cases of a C-shaped pulp chamber and root canal system shows that this root canal aberration occurs in a wide variety and variability with a single root canal up to two, three and four separate root canals. The diameter of the root canal themselves also varies from very wide to such with a small diameter. Conclusions: Knowledge of the different anatomical variations will improve the endododntic practice of the general dental practitioners.

The failures of root canal preparation with hand ProTaper

OpenAIRE

Bătăiosu, Marilena; Diaconu, Oana; Moraru, Iren; Dăguci, C.; Ţuculină, Mihaela; Dăguci, Luminiţa; Gheorghiţă, Lelia

2012-01-01

The failures of root canal preparation are due to some anatomical deviation (canal in “C” or “S”) and some technique errors. The technique errors are usually present in canal root cleansing and shaping stage and are the result of endodontic treatment objectives deviation. Objectives: Our study was made on technique errors while preparing the canal roots with hand ProTaper. Methodology: Our study was made “in vitro” on 84 extracted teeth (molars, premolars, incisors and canines). The canal roo...

Three root canals in the maxillary second premolar

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de Almeida-Gomes Fabio

2009-01-01

Full Text Available In this study, we report an endodontic treatment of the maxillary second premolar with three root canals and distinct foramens. The possibility of three root canals in this tooth is quite small; however, it must be taken into account in clinical and radiographic evaluation during endodontic treatment. Many times, their presence is noticed only after canal treatment due to continuing post-operative discomfort.

Root and Canal Morphology of Mandibular Third Molars in an Iranian Population

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Maryam Kuzekanani

2012-06-01

Full Text Available Background and aims. A through knowledge of the root canal morphology is required for successful endodontic therapy. The aim of this study was to investigate the root and canal morphology of mandibular third molars in Kerman, a province in southeast of Iran. Materials and methods. One-hundred-fifty extracted mandibular third molars were collected randomly from different dental clinics in Kerman. The root canal anatomy and morphology of each tooth was carefully studied using a clearing technique. Root number and morphology, number of canals per root, root canal configuration according to Vertucci classification, and incidence of dilacerated roots and C-shaped canals in mandibular third molars were evaluated under stereomicroscope with ×2 to ×3 magnifications. Results. From the total of 150 mandibular third molars studied, 21% had one root. The majority of teeth (73% had two roots. 5.5% of the teeth had three roots. The incidence of C-shaped canal was 3.5% in this study and 8% of the teeth had at least one dilacerated root. Conclusion. Although root canal anatomy and morphology of mandibular third molars is very variable having two roots seems to be the normal anatomy for these teeth.

Mandibular second premolar with three canals: Re-treatment of a case with unusual root canal anatomy

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Niranjan Desai

2011-01-01

Full Text Available A thorough knowledge of root canal anatomy along with the anatomical variations that may be present is essential for success of endodontic therapy. Unusual presentations in the number of the roots or the canals should be expected in every tooth. Mandibular second premolars are thought of as having a single root and canal. Studies have stated that the prevalence of three canals with three orifices in this tooth is 0.4%. The mandibular second premolar is particularly difficult to treat owing to the fact that a wide variation in the number, location and curvature of the roots and canals exist. Added to this is the fact that the access opening is restricted and location of the lingually placed orifices is difficult. This case report details the re-treatment of a mandibular second premolar with three canals and three separate orifices using the surgical microscope.

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

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

2015-01-01

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

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

Science.gov (United States)

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

2013-01-01

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

Two-Rooted Maxillary First Molars with Two Canals: A Case Series

OpenAIRE

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

2013-01-01

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

Adaptation and penetration of resin-based root canal sealers in root canals irradiated with high-intensity lasers

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Moura-Netto, Cacio; Mello-Moura, Anna Carolina Volpi; Palo, Renato Miotto; Prokopowitsch, Igor; Pameijer, Cornelis H.; Marques, Marcia Martins

2015-03-01

This research analyzed the quality of resin-based sealer adaptation after intracanal laser irradiation. Extracted teeth (n=168) were root canal treated and divided into four groups, according to dentin surface treatment: no laser; Nd:YAG laser (1.5 W, 100 mJ, 15 Hz) diode laser (2.5 W in CW), and Er:YAG laser (1 W, 100 mJ, 10 Hz). The teeth were divided into four subgroups according to the sealer used: AH Plus, EndoREZ, Epiphany, and EpiphanySE. For testing the sealing after root canal obturation, the penetration of silver nitrate solution was measured, whereas to evaluate the adaptation and penetration of the sealer into the dentin, environmental scanning electron microscopy (ESEM) was used. The ESEM images were analyzed using a four-grade criteria score by three evaluators. The inter-examiner agreement was confirmed by Kappa test and the scores statistically compared by the Kruskal-Wallis' test (p<0.05). Both adaptation and sealer penetration in root canals were not affected by the laser irradiation. Nd:YAG and diode laser decreased the tracer penetration for AH Plus, whereas EndoREZ and EpiphanySE performances were affected by Nd:YAG irradiation (p<0.05). It can be concluded that intracanal laser irradiation can be used as an adjunct in endodontic treatment; however, the use of hydrophilic resin sealers should be avoided when root canals were irradiated with Nd:YAG laser.

Strategies of Coping With Stress During Root Canal Therapy

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Zare Jahromi

2015-12-01

Full Text Available Background Endodontic treatment is one of the stress producing situations. Objectives The purpose of this article was to determine the most stressful stage of root canal therapy among endodontists, endodontic residents, and undergraduate dental students and offering some strategies for reducing stress during this treatment. Patients and Methods This descriptive survey comprised three groups. Thirty-six endodontists, 41 endodontic residents, and 47 undergraduate dental students selected by convenience sampling. Participants were asked about age, sex, the most stressful stage of root canal therapy and stress reducing strategies during the procedure. Results The most stressful stage of root canal therapy was endodontic treatment for children in male endodontists and residents, preparing access cavity on crowns in female endodontists, obturation of apically root Resorped canals in female residents, obturation in female students, and preparing access cavity on molar teeth in male students. The most suggested strategy for reducing stress during root canal therapy was related to experience, knowledge, enough study, and technical mastery. Conclusions It is required to consider the strategies during student education in dental schools for both under and post-graduation dental students and better to follow them in workshops for other dentists and even endodontists.

Review of root canal irrigant delivery techniques and devices

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Yeon-Jee Yoo

2011-05-01

Full Text Available Introduction Eliminating the residual debris and bacteria in the root canal system is one of the main purposes of the endodontic treatment. However, the complexity on the anatomy of the root canal system makes it difficult to eliminate the bacterial biofilm existing along the root canal surface and necrotic pulp tissue by mechanical instrumentation and chemical irrigation. Recently, more effective irrigant delivery systems for root canal irrigation have been developed. The purpose of this review was to present an overview of root canal irrigant delivery techniques and devices available in endodontics. Review The contents of this paper include as follows; - syringe-needle irrigation, manual dynamic irrigation, brushes - sonic and ultrasonic irrigation, passive ultrasonic irrigation, rotary brush, RinsEndo, EndoVac, Laser Conclusion Though technological advances during the last decade have brought to fruition new agitation devices that rely on various mechanisms, there are few evidence based study to correlate the clinical efficacy of these devices with improved outcomes except syringe irrigation with needle and ultrasonic irrigation. The clinicians should try their best efforts to deliver antimicrobial and tissue solvent solutions in predictable volumes safely to working length.

Three-dimensional analysis of mesiobuccal root canal of Japanese maxillary first molar using Micro-CT

International Nuclear Information System (INIS)

Yamada, Masashi; Ide, Yoshinobu; Matsunaga, Satoru; Kato, Hiroshi; Nakagawa, Kan-Ichi

2011-01-01

The objective of this study was to three-dimensionally observe the morphological characteristics of mesiobuccal root canals of Japanese maxillary first molars using microcomputed tomography (Micro-CT) and classify root canal variations. This study used 90 maxillary first molars. Three-dimensional reconstruction was performed using data obtained by Micro-CT, and cross-sections of the root canals were observed. Moreover, the root canal morphology was classified by the configuration and root canal diameter, and was evaluated for occurrence using the classification by Weine et al. (1969) as a reference. Overall, single root canals were observed in 44.4%, incomplete separation root canals in 22.3%, and completely separate root canals (upper and lower separation root canals) in 33.3%. Mesiobuccal root canals often had intricate configurations, and accessory root canals (lateral canals and apical ramifications) were observed in most of the mesiobuccal root canals (76.7%), irrespective of whether there were ramifications of the main root canals. While there were no marked differences in the incidence of root canal ramifications between this study and earlier reports, the incidence of accessory root canals was higher in this study. This result may be explained by the far more superior visualization ability of Micro-CT than conventional methods, which allowed the detection of microscopic apical ramifications previously difficult to observe. (author)

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

Science.gov (United States)

Celik, Davut; Taşdemir, Tamer; Er, Kürşat

2013-02-01

Some improvements have been developed with new generations of nickel-titanium (NiTi) rotary instruments that led to their successful and extensive application in clinical practice. The purpose of this in vitro study was to compare the root canal preparations performed by using GT Series X and Twisted File systems produced by innovative manufacturing process with Revo-S, RaCe, Mtwo, and ProTaper Universal systems manufactured directly from conventional nitinol and with stainless steel K-Flexofile instruments. The mesiobuccal root canals of 140 maxillary first permanent molars that had between 30°-40° curvature angle and 4- to 9-mm curvature radius of the root canal were used. After root canal preparations made by using GT Series X, Twisted File, Revo-S, RaCe, Mtwo, and ProTaper Universal NiTi rotary systems and stainless steel K-Flexofile instruments, transportation occurred in the root canal, and alteration of working length (WL) was assessed by using a modified double-digital radiographic technique. The data were compared by the post hoc Tukey honestly significant difference test. NiTi rotary systems caused less canal transportation and alteration of WL than K-Flexofile instruments (P .05) except 2.5 mm from the WL. At this level ProTaper Universal system caused significant canal transportation (P ProTaper Universal rotary systems manufactured by traditional methods. Copyright © 2013 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Comparison of Curved Root Canals Prepared with Various Chelating Agents

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2012-06-01

aqueous base (11). According to Bramante and Betti, instrumentation with NiTi hand files using EDTA caused greater deviation of the root canal from...15. Peters OA, Peters CI, Schonenberger K, Barbakow F. ProTaper rotary root canal preparation: effects of canal anatomy on final shape analysed by

Root canal preparation with Er:YSGG laser

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Benthin, Hartmut; Ertl, Thomas P.; Onal, B.; Schruender, Stephan; Mueller, Gerhard J.

1994-12-01

The high level of efficiency of hard tissue ablation with Er:YAG and Er:YSGG lasers is well known. Of these lasers it is possible only to transmit Er:YSGG laser radiation with OH reduced quartz fibers. Most of the fibers we use in this study were prepared as hemispherical fiber tips. Fifty single rooted teeth were divided into ten groups (n equals 5). After conventional opening of the pulp chamber, root canal preparation was performed in five groups under water only using the laser. In the other five groups preparation with K-files to size 35 was performed before treatment with laser radiation. All teeth were axially separated with direct access to the root canal and examined in SEM investigations. The groups were compared by measuring the areas with patent dentin tubules. Representative areas were examined by TEM. The temperature at the root surface was measured during laser irradiation with thermocouples positioned at several points. The in-vitro study of the effect of the high delivered energy (50 - 100 mJ per pulse) in the root canal showed a good ablation effect. Most of the dentin tubules were opened. The increase in temperature at the root surface was tolerable.

The fluid mechanics of root canal irrigation.

Science.gov (United States)

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

2010-12-01

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

The fluid mechanics of root canal irrigation

International Nuclear Information System (INIS)

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

2010-01-01

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

Diagnosis and root canal treatment in a mandibular premolar with three canals.

Science.gov (United States)

Soares, Lanuce Rosa; Arruda, Marcos; de Arruda, Marcos Pôrto; Rangel, Andréa Leão; Takano, Edson; de Carvalho Júnior, Jacy Ribeiro; Saquy, Paulo Cesar

2009-01-01

This paper presents a case report of a left mandibular second premolar with three canals and three different apical foramina. A 39-year-old male patient presented to our clinic with pain in the mandibular left second premolar. Initially, pain was caused by cold stimulus and later was spontaneously. The intraoral clinical examination revealed a fractured amalgam restoration with occlusal caries. Percussion and cold (Endo-Frost) tests were positive. The radiographic examination showed the presence of two roots. The probable diagnosis was an acute pulpitis. After access cavity, it was observed remaining roof of the pulp chamber and mild bleeding in the tooth lingual area, indicating the possible presence of a third canal. The endodontic treatment was completed in a single session using Root ZX apex locator and K3 NiTi rotary system with surgical diameter corresponding to a .02/45 file in the three canals and irrigation with 1% sodium hypochlorite. The canals were obtured with gutta-percha cones and Sealer 26 using the lateral condensation technique. After 1 year of follow-up, the tooth was asymptomatic and periapical repair was observed radiographically. Internal alterations should be considered during the endodontic treatment of mandibular second premolars. The correct diagnosis of these alterations by the analysis of preoperative radiographs can help the location of two or more canals, thereby avoiding root therapy failure.

Three distal root canals in mandibular first molar with different canal configurations: Report of two cases and literature review

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Parul Bansal

2015-01-01

Full Text Available With the increasing number of reports of aberrant root canal morphology, the clinician needs to be aware of the variable anatomy. Various case reports have been published with the finding of middle mesial canal in mandibular first molar, however finding of three distal canals in distal roots of mandibular first molar is rare. This article reports endodontic management of two mandibular first molars presented with three distal canals present in a single distal root (Sert and Bayirli type XVIII and distal and distolingual root.

Root canal preparation in endodontics: conventional versus laser methods

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Goodis, Harold E.; White, Joel M.; Marshall, Sally J.; Marshall, Grayson W.; Moskowitz, Emrey

1992-06-01

Conventional cleaning and shaping of root canal systems employs hand and/or rotary instrumentation to remove the contents of the canal and shape the canal to receive a filling material. With the advent of the Nd:YAG laser system another method of accomplishing proper cleaning and shaping is evaluated. Single rooted teeth were radiographed bucco- lingually and mesio-distally and were divided into 2 groups. The first group was accessed and the root canal systems cleaned and shaped with a step back technique utilizing hand files and gates glidden burs. At completion of the procedure the teeth were again radiographed at the same positions as those prior to the procedure. The teeth were split longitudinally and examined under scanning electron microscopy to assess cleaning. The second group of teeth were accessed, and cleaning and shaping was accomplished using the Nd:YAG laser in combination with hand files and rotary instruments. These teeth were subjected to the same analysis as those in the first group. The before and after radiographs of each group were subjected to image analysis to determine effectiveness of the two methods in shaping the canal systems. We will discuss the ability of Nd:YAG to clean and shape root canal spaces and remove smear layer and organic tissue remnants from those areas.

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

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

2010-12-01

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

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

Science.gov (United States)

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

2009-08-01

To observe the formation of canal aberrations in S-shaped root canals prepared by every file of hand-used ProTaper. Fifteen S-shaped simulated resin root canals were selected. Each root canal was prepared by every file of hand-used ProTaper following the manufacturer instruction. The images of canals prepared by S1, S2, F1, F2 and F3 were taken and stored, which were divided into group S1, S2, F1, F2 and F3. One image of canal unprepared was superposed with the images of the same root canal in these five groups respectively to observe the types and number of canal aberrations, which included unprepared area, danger zone, ledge, elbow, zip and perforation. SPSS12.0 software pakage was used for Fisher's exact probabilities in 2x2 table. Unprepared area decreased following preparation by every file of ProTaper, but it still existed when the canal preparation was finished. The incidence of danger zone, elbow and zip in group F1 was 15/15, 11/15, 4/15, respectively, which was significantly higher than that in group S2(2/15,0,0) (PProTaper.The presence of unprepared area suggests that it is essential to rinse canal abundantly during complicated canal preparation and canal antisepsis after preparation.

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

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

2014-10-01

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

Root canal filling using Resilon: a review.

LENUS (Irish Health Repository)

Shanahan, D J

2011-07-01

Root canal treatment is achieved by chemo-mechanical debridement of the root canal system followed by filling. The filling material \\'entombs\\' residual bacteria and acts as a barrier which prevents the entrance of oral microorganisms and reinfection of the root canal system through microleakage. However, filling with contemporary root filling materials such as gutta-percha offers limited long-term resistance to microorganisms; as a result other materials such as Resilon have been investigated as alternatives. The aim of this review was to analyse the literature to consider whether Resilon is a suitable root canal filling material. A MEDLINE and Cochrane library search including various keyword searches identified several papers which investigated or discussed Resilon or RealSeal\\/Epiphany. Analysis of the literature demonstrated that the bulk of the literature is in vitro in nature, based largely on leakage-type studies, and demonstrates a wide variety of methodologies with conflicting findings; as a result meaningful conclusions are difficult. Within the limit of these in vitro studies Resilon appears to perform adequately in comparison to gutta-percha, however, as a result of the questionable merit of such studies, it cannot presently be considered an evidence-based alternative to the current gold standard gutta-percha. It is imperative that before Resilon is considered as a replacement material, a better understanding of the physical properties of the resin sealer and the reality of the adhesive \\'monoblock\\' are elucidated. The literature also demonstrates a paucity of quality long-term clinical outcome studies which will need to be addressed before firm conclusions can be reached.

Root canal treatment of mandibular second premolar tooth with taurodontism

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Vujašković Mirjana

2008-01-01

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

Maxillary lateral incisors with two canals and two separate curved roots

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Ajit George Mohan

2012-01-01

Full Text Available Variation in the roots and root canal anatomy seems to be the norm rather than an exception. For a successful endodontic treatment, a clinician should have a thorough knowledge of the internal and external dental anatomy and its variations. Maxillary lateral incisors usually exhibit single canal with a single root. In this case, clinical examination and radiographs clearly demonstrates the presence of two root canals with two separate curved roots. This case report emphasizes the need for attention during endodontic management of maxillary lateral incisors.

Unusual root canal morphology of mandibular second premolars: A case series and review

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Snehal Sonarkar

2017-01-01

Full Text Available Mandibular second premolars (MSPs have varied anatomy ranging from 1 to 3 roots and 1–5 canals. Successful endodontic treatment is achieved by proper access opening, cleaning, and shaping and three-dimensional obturation. This case series describes five cases in which MSPs have been diagnosed with aberrant canal system. The Case 1 and 5 has one root with Vertucci's Type V canal configuration. The Case 2 has two roots with two canals, the Case 3 has one root with Vertucci's Type IV canal configuration, whereas the Case 4 has three roots with three canals. This case series also describes a classification for describing the root configuration. The clinical implications of this paper are first to reach at appropriate diagnosis of canal system using diagnostic aids (angulated radiographs and dental operating microscope. Second, to use advanced endodontic instruments for achieving successful endodontic therapy (NiTi rotary instruments.

Effectiveness of EDTA as the irrigation solution to remove smear layer in root canal

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Kurniasri Amas Achiar

2009-07-01

Full Text Available One of the objectives of successful endodontic treatment is the hermetic obturation of the root canal system. To achieve this, the root canal filling must seal the canal space both apically and coronally to prevent the ingress of microorganisms or tissue fluids into the canal space. Apical leakage is reported a common reason for the clinical failure of endodontic therapy. Leakage through an obturated root canal is expected to take place at interfaces between sealer and dentin or sealer and gutta-percha, or through voids within the sealer. Hence, the sealing quality of root canal filling depends much on the sealing ability of the sealer. Therefore, anything that may influence the adaptation of the root filling to the canal wall is can determine the degree and the extent of leakage, and ultimately the prognosis of the endodontic therapy. In endodontic therapy, the smear layer formation results from root canal preparation and may influence the effective seal of the root canal system. The smear layer formation is mainly composed of inorganic components (dentin debris and organic materials, such as pulp tissue remnant, bacteria, and blood cells. Removal of the smear layer from the root canal walls before the obturation can reduce the leakage of root canal sealer. To remove the smear layer use 10 ml 17% EDTA followed by 10 ml of 5.25% NaOCl as irrigating solution. This paper discribe about how the effectivity of EDTA as irigating solution to remove the smear layer especially in the apical root canal with many lateral canal to reduce the apical leakage.

Effects of irrigation solutions and Calcium hydroxide dressing on root canal treatments of periapical lesions

OpenAIRE

Nirmala, Vita

2006-01-01

The preparation of root canal in endodontic treatment plays an important role in treating non vital teeth with periapical lesion. Some factors influence the success of root canal treatment in short and long terms are the irrigation of root canal using antiseptic solution and the use of root canal medicament. The aim of this literature study is to determined the effect of irrigation solution and Calcium hydroxide dressing in root canal treatment of periapical lesions. The use of root canal med...

Retention of Root Canal Posts

DEFF Research Database (Denmark)

Sahafi, A; Benetti, Ana Raquel; Flury, S

2015-01-01

The aim of this study was to investigate the effect of the cement film thickness of a zinc phosphate or a resin cement on retention of untreated and pretreated root canal posts. Prefabricated zirconia posts (CosmoPost: 1.4 mm) and two types of luting cements (a zinc phosphate cement [DeTrey Zinc...... received tribochemical silicate coating according to the manufacturer's instructions. Posts were then luted in the prepared root canals (n=30 per group). Following water storage at 37°C for seven days, retention of the posts was determined by the pull-out method. Irrespective of the luting cement......, pretreatment with tribochemical silicate coating significantly increased retention of the posts. Increased cement film thickness resulted in decreased retention of untreated posts and of pretreated posts luted with zinc phosphate cement. Increased cement film thickness had no influence on retention...

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.

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

Science.gov (United States)

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

2014-09-01

The aim of this study was to compare the efficiency of sonic, ultrasonic, and hydrodynamic devices in the removal of a root canal sealer from the surface and from simulated irregularities of root canals. Fifty-three root canals with two standardized grooves in the apical and coronal parts of longitudinally split roots were covered with AH Plus root canal sealer. Compared were the effects of (control) syringe irrigation, (1) CanalBrush, (2) passive ultrasonic irrigation, (3) EndoActivator, and (4) RinsEndo on the removal of the sealer. The specimens were divided into four groups (N = 12) and one control group (N = 5) via randomization. The amount of remaining sealer in the root canal irregularities was evaluated under a microscope using a 4-grade scoring system, whereas the remaining sealer on the root canal surface was evaluated with a 7-grade scoring system. Passive ultrasonic irrigation is more effective than the other tested irrigation systems or syringe irrigation in removing sealer from root canal walls (p irrigation shows a superior effect on sealer removal from the root canal surface during endodontic retreatment. Cleaning of lateral grooves seems not to be possible with one of the techniques investigated. Incomplete removal of root canal sealer during re-treatment may cause treatment failure. Passive Ultrasonic irrigation seems to be the most effective system to remove sealer from a root canal.

Comparative Study of Three Rotary Instruments for root canal Preparation using Computed Tomography

International Nuclear Information System (INIS)

Mohamed, A.M.E.

2015-01-01

Cleaning and shaping the root canal is a key to success in root canal treatment. This includes the removal of organic substrate from the root canal system by chemo mechanical methods, and the shaping of the root canal system into a continuously tapered preparation. This should be done while maintaining the original path of the root canal. Although instruments for root canal preparation have been progressively developed and optimized, a complete mechanical debridement of the root canal system is rarely achievable. One of the main reasons is the geometrical dis symmetry between the root canal and preparation instruments. Rotary instruments regardless of their type and form produce a preparation with a round outline if they are used in a simple linear filing motion, which in most of the cases do not coincide with the outline of the root canal. Root canal preparation in narrow, curved canals is a challenge even for experienced endodontists. Shaping of curved canals became more effective after the introduction of nickel-titanium (Ni-Ti) endodontic instruments. Despite the advantages of Ni-Ti rotary instruments, intra canal fracture is the most common procedural accident that occurs with these instruments during clinical use. It is a common experience between clinicians that Ni-Ti rotary instruments may undergo unexpected fracture without any visible warning, such as any previous permanent defect or deformation. Pro Taper Ni-Ti instruments were introduced with a unique design of variable taper within one instrument and continuously changing helical angles. Pro Taper rotary instruments are claimed to generate lower torque values during their use because of their modified nonradial landed cross-section that increases the cutting efficiency and reduces contact areas. On the other hand, the variable taper within one instrument is believed to reduce the ‘taper lock’ effect (torsional failure) in comparison with similarly tapered instruments. Nevertheless, Pro Taper

Vertical Root Fracture initiation in curved roots after root canal preparation: A dentinal micro-crack analysis with LED transillumination.

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Miguéns-Vila, Ramón; Martín-Biedma, Benjamín; Varela-Patiño, Purificación; Ruíz-Piñón, Manuel; Castelo-Baz, Pablo

2017-10-01

One of the causative factors of root defects is the increased friction produced by rotary instrumentation. A high canal curvature may increase stress, making the tooth more susceptible to dentinal cracks. The purpose of this study was to evaluate dentinal micro-crack formation with the ProTaper NEXT and ProTaper Universal systems using LED transillumination, and to analyze the micro-crack generated at the point of maximum canal curvature. 60 human mandibular premolars with curvatures between 30-49° and radii between 2-4 mm were used. The root canals were instrumented using the Protaper Universal® and Protaper NEXT® systems, with the aid of the Proglider® system. The obtained samples were sectioned transversely before subsequent analysis with LED transillumination at 2 mm and 8 mm from the apex and at the point of maximum canal curvature. Defects were scored: 0 for no defects; and 1 for micro-cracks. Root defects were not observed in the control group. The ProTaper NEXT system caused fewer defects (16.7%) than the ProTaper Universal system (40%) ( P Universal system caused significantly more micro-cracks at the point of maximum canal curvature than the ProTaper NEXT system ( P Universal system. A higher prevalence of defects was found at the point of maximum curvature in the ProTaper Universal group. Key words: Curved root, Micro-crack, point of maximum canal curvature, ProTaper NEXT, ProTaper Universal, Vertical root fracture.

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

Science.gov (United States)

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

2013-01-01

Disinfection and subsequent obturation of the root canal space require adequate mechanical enlargement of the canals. The purpose of this in vitro study was to compare the shaping ability of Mtwo, RaCe and Medin rotary instruments during the preparation of curved root canals. Sixty mesiobuccal root canals of mandibular molars with severe curvatures between 25-35(°) and radius of 4-9 mm were randomly divided into three groups of 20 canals each. Using pre- and post-instrumentation radiographs, straightening of the canal and the apical transportation were determined with AutoCAD software. The data were analyzed using Chi square, analysis of variance, and post-hoc tests and the significance level was set at P0.05). Under the conditions of this in vitro study, Mtwo instruments seemed superior to the two other rotary instruments.

Adaptation and penetration of resin-based root canal sealers in root canals irradiated with high-intensity lasers.

Science.gov (United States)

Moura-Netto, Cacio; Mello-Moura, Anna Carolina Volpi; Palo, Renato Miotto; Prokopowitsch, Igor; Pameijer, Cornelis H; Marques, Marcia Martins

2015-03-01

This research analyzed the quality of resin-based sealer adaptation after intracanal laser irradiation. Extracted teeth (n = 168) were root canal treated and divided into four groups, according to dentin surface treatment: no laser; Nd:YAG laser (1.5 W, 100 mJ, 15 Hz); diode laser (2.5 W in CW), and Er:YAG laser (1 W, 100 mJ, 10 Hz). The teeth were divided into four subgroups according to the sealer used: AH Plus, EndoREZ, Epiphany, and EpiphanySE. For testing the sealing after root canal obturation, the penetration of silver nitrate solution was measured, whereas to evaluate the adaptation and penetration of the sealer into the dentin, environmental scanning electron microscopy (ESEM) was used. The ESEM images were analyzed using a four-grade criteria score by three evaluators. The inter-examiner agreement was confirmed by Kappa test and the scores statistically compared by the Kruskal-Wallis' test (p laser irradiation. Nd:YAG and diode laser decreased the tracer penetration for AH Plus, whereas EndoREZ and EpiphanySE performances were affected by Nd:YAG irradiation (p laser irradiation can be used as an adjunct in endodontic treatment; however, the use of hydrophilic resin sealers should be avoided when root canals were irradiated with Nd:YAG laser.

Root Canal Configuration of Mandibular First and Second Premolars in an Iranian Population

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Nemat Eskandarzadeh

2007-08-01

Full Text Available

Background and aims. It is critical to have a proper knowledge of the normal anatomy of the pulp and its variations for the success of endodontic treatment. The aim of this study was to determine the canal configuration and the prevalence of C-shaped canals in mandibular first and second premolars in a North-Western Iranian population.

Materials and methods. A total of 163 extracted mandibular first and 103 mandibular second premolars were injected with India ink and demineralized . They were made clear and transparent with methyl salicylate and the anatomy of their canal(s was studied.

Results. The results showed that 98% of mandibular first premolars had one root, 2% had two roots, 70.6% had one canal, 27.8% had two canals, 1.2% had three canals and the prevalence of C-shaped canals was 2.4%. All mandibular second premolars had one root, 80.5% had one canal, 17.5% had two canals and the prevalence of C-shaped canals was 2%.

Conclusion. It is important that clinicians, before treatment of mandibular first and second premolars, pay complete attention to radiographs, have a true concept of the number of root(s and canal(s, and prepare a correct access cavitiy.

Additional disinfection with a modified salt solution in a root canal model.

Science.gov (United States)

van der Waal, Suzette V; Oonk, Charlotte A M; Nieman, Selma H; Wesselink, Paul R; de Soet, Johannes J; Crielaard, Wim

2015-10-01

The aim of this study is to investigate the disinfecting properties of a modified salt solution (MSS) and calcium hydroxide (Ca(OH)2) in a non-direct-contact ex-vivo model. Seventy-four single-canal roots infected with Enterococcus faecalis were treated with 1% sodium hypochlorite (NaOCl) irrigation or with NaOCl irrigation with subsequent dressing with MSS or Ca(OH)2. After removal of the dressings, the roots were filled with bacterial growth medium and incubated for seven days to enable the surviving bacteria to repopulate the root canal lumen. Growth was determined by sampling the root canals with paper points before treatment (S1), after treatment (S2) and incubation after treatment (S3). The colony forming units were counted at S1 and S2. At S3, growth was determined as no/yes regrowth. The Kruskal-Wallis, McNemar and χ(2) test were used for statistical analyses. At S2, in the NaOCl group, growth was found in 5 of 19 root canals. After the removal of MSS or Ca(OH)2 bacteria were retrieved from one root canal in both groups. At S3, repopulation of the root canals had occurred in 14 of 19 roots after sole NaOCl irrigation, 6 of 20 roots after MSS-dressing and in 14 of 20 roots after Ca(OH)2-dressing. MSS was more effective in preventing regrowth than Ca(OH)2 (P=0.009). The modified salt solution prevented regrowth in roots which indicates that it can eliminate persistent bacteria. Dressing the root canals with Ca(OH)2 did not provide additional disinfection after NaOCl irrigation. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

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Ivica Anić

2014-01-01

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

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

Science.gov (United States)

Holderrieth, Silke; Gernhardt, Christian Ralf

2009-07-01

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

Effectiveness of Various Irrigation Protocols in Removing Calcium Hydroxide from Root Canals

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Hakan Göktürk

2018-04-01

Full Text Available Objective: The purpose of this study was to investigate the removal efficiency of calcium hydroxide (CH by CanalBrush, Vibringe, laser-activated irrigation (LAI, conventional syringe irrigation (CSI, XP-endo Finisher, and passive ultrasonic irrigation (PUI in the root canal walls. Materials and Methods: Ninety-eight human mandibular premolar teeth were prepared. Root canals were filled with CH. The roots were divided into six experimental groups (n=15/group according to the irrigation protocol used: group 1 (CSI, group 2 (Vibringe, group 3 (CanalBrush, group 4 (XP-endo Finisher, group 5 (PUI, and group 6 (LAI. The amount of residual CH in the canal walls for each canal third was scored. Data were analysed by using Kruskal-Wallis and Bonferroni-correction Mann-Whitney U tests. Results: None of the investigated protocols renders the root canal walls free of CH remnants. Significant differences were found between tooth regions in terms of CH removal (p<0.05, and all groups except group 6 (LAI showed more residual CH in the apical region. PUI and LAI eliminated significantly more CH than CSI from the middle and apical thirds of the root canal, respectively. Conclusion: The activation of sodium hypochlorite with various devices increased CH removal at the apical and middle part of the canal. LAI and PUI produce better results in the apical and middle thirds, respectively.

Research progress of antagonistic interactions among root canal irrigations disease

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Chen QU

2013-07-01

Full Text Available Root canal therapy is the most effective way to treat various pulposis and periapical disease. Simple mechanical apparatus can not clean root canal thoroughly, but may affect tight filling instead. It can achieve a satisfactory cleansing effect only when it is combined with a chemical solution. Irrigation fluid for root canal should possess the properties of tissue dissolution, antimicrobial, lubrication, and removal of smear layer. So far, no solution is able to fulfill all these functions. Therefore, a combined use of multiple irrigation solutions is suggested. It can not only achieve good effect in cleaning and disinfection, also it can lower the concentration of different solutions, thus reducing the side effects. Nevertheless, some experiments proved that antagonism existed among the chemicals used for irrigations. The purpose of present article is to review the antagonistic effect among the chemicals used for irrigation when they are used together for root canal treatment.

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

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Gaddala, Naresh; Veeramachineni, Chandrasekhar; Tummala, Muralidhar

2015-05-01

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

Premolar root and canal variation in extant non-human hominoidea.

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Moore, N Collin; Hublin, Jean-Jacques; Skinner, Matthew M

2015-08-11

The premolar sub-cervical region in four non-human extant ape genera are examined to: 1) define a classification scheme for the premolar root system in order to rigorously characterize, quantify and document variation in root and canal, form, number and configuration; 2) compare this variation within and between genera; and 3) test the hypotheses that sex and size (i.e., the "size/number continuum," Shields, ) of the premolar are determinants of root/canal form and/or number. Microtomography and 3D visualization software are utilized to examine a large sample of Hylobates, Pan, Gorilla, and Pongo (n = 951 teeth). Each premolar root system is examined to ascertain the expected level of variability for each taxon. Cervical surface area (mm 2 ) serves as a metric proxy for tooth size. A Chi-square test of independence is used to assess for variability differences between and within each taxon, and Mann-Whitney U tests are employed to assess the predicted relationship between tooth size and variation within each taxon. Our findings indicate that root and canal configurations, non-metric root traits and tooth size can distinguish between extant ape genera. Within the four ape taxa, premolar size variation is generally, but not always, correlated with canal/root number. Our results indicate that males and females within genera differ in tooth size but not in canal/root form and number. We report previously undocumented variation in the study taxa. Our results are discussed within the context of Miocene Apes as well as the developmental and systematic implications. Am J Phys Anthropol, 2015. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

Evaluation of the root canal shaping ability of two rotary nickel-titanium systems.

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Al-Manei, K K; Al-Hadlaq, S M S

2014-10-01

The aim was to investigate the canal shaping abilities of the twisted file (TF) and GT series X file (GTX) systems. Sixty mesial root canals of mandibular molars with curvatures of 15-50° were divided randomly into two groups of 30 canals each. The teeth were sectioned horizontally at 3, 6 and 9 mm from the apex. Root canals were prepared with TF and GTX files, respectively, and the shaping abilities of the systems were evaluated at three levels (coronal, middle and apical) based on the comparison of pre- and post-instrumentation photographs using AutoCAD software. Preparation time was also assessed. Data from the two groups were compared statistically using the Student's t-test. There was no significant difference between the rotary systems in terms of change in root canal cross-sectional area, root canal transportation, centring ability or minimum dentine thickness. Remaining dentine thickness at the coronal and middle levels was similar in the TF and GTX groups, but GTX instruments left significantly less dentine than TF instruments on the mesial aspects of root canals at the apical level. Root canal preparation with TF instruments required significantly less time than with GTX instruments. The TF and GTX NiTi rotary instruments showed similar shaping abilities, but root canal preparation was more rapid with the TF than with the GTX system. © 2014 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Management of foreign object in the root canal of central incisor tooth

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Mothanna Alrahabi

2014-01-01

Full Text Available There are several reports describing the impaction of foreign objects into the exposed pulp chambers and canals by patients, especially children as they often have the habit of inserting foreign objects in the oral cavity. These objects will become a potent source of infection.This case report describes the retrieval of a foreign object impacted into the root canal of a 12-year-old male patient who was referred to the endodontic specialty clinic at Taibah University College of Dentistry. The patient′s chief complaint was a pain in the upper left central tooth. Clinical examination revealed a complicated enamel-dentin fracture with a large caries cavity. A periapical radiographic image showed a radiopaque object in the root canal system. Stainless steel Hedstrom files were used to retrieve the object from the canal. Following a proper cleaning and shaping of the root canal system, an intra-canal calcium hydroxide dressing was placed for 1 week. The root canal system was then filled with sealer and gutta-percha using the lateral compaction technique and the tooth received an aesthetic restoration.

Apical Root Canal Morphology of Mesial Roots of Mandibular First Molar Teeth with Vertucci Type II Configuration by Means of Micro-Computed Tomography.

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Keleş, Ali; Keskin, Cangül

2017-03-01

The aim of this study was to assess the features of the apical root canal anatomy and its relation to the level at which 2 separate root canals merge in the mesial roots of the mandibular first molars with Vertucci type II canal configuration by using micro-computed tomography analysis. The anatomic features of the apical 3 mm of root canals in 83 mesial roots of mandibular first molar teeth were investigated by micro-computed tomography and software imaging according to the level at which 2 separate root canals merge. The most apical slice where a visible root canal was detectable was recorded as 0 level. The specimens from where 2 root canals rejoin at within 3 mm from the 0 level were then assigned to group 1 (n = 37), whereas the specimens from where root canals rejoin 3-9 mm from the 0 level were assigned to group 2 (n = 46). Data were presented by using descriptive statistics and Mann-Whitney U tests, with the significance level set at 5%. In all specimens the long oval type of cross-sectional shape increased from 50.9% at 1 mm to 80.5% at 3 mm. Group 1 presented significantly higher major diameter values compared with group 2 (P  .05) between groups. Group 2 displayed significantly higher roundness values than group 1 (P < .05). A long oval root cross section of apical root canal anatomy is more prevalent in roots for which 2 root canals merge within apical 3 mm of root canals. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

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

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

2017-08-01

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

Effects of irrigation solutions and Calcium hydroxide dressing on root canal treatments of periapical lesions

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Vita Nirmala

2006-03-01

Full Text Available The preparation of root canal in endodontic treatment plays an important role in treating non vital teeth with periapical lesion. Some factors influence the success of root canal treatment in short and long terms are the irrigation of root canal using antiseptic solution and the use of root canal medicament. The aim of this literature study is to determined the effect of irrigation solution and Calcium hydroxide dressing in root canal treatment of periapical lesions. The use of root canal medicament during the endodontic treatment could sterilized and decreased the number of pathogenic microorganism of root canal. An effective root canal irrigation solution must be able to dissolve organic and anorganic debris, lubricate endodontic instruments, disinfect microorganisms, non toxic and economical. The best irrigation solution has maximum antimicrobial effect with minimum toxicity. Division of calcium hydroxide into Calcium and hydroxyl ions is responsible for alkalinization of cavity, subsequently it makes the condition of cavity to be inappropriate for bacterial endotoxin in vitro as well as in vivo, and considered as the only clinically effective medicament in inactivating bacterial endotoxin. Calcium hydroxide is the only medication which has the ability to clinically inactive bacterial endotoxin in vitro in vivo and accepted as the best of root canal medication.

Root canal debris removal using different irrigating needles: An SEM study

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Sheetal Ghivari

2011-01-01

Full Text Available Aim: This study was carried out to compare the efficacy of three irrigating needle designs in removal of debris from different parts of the root canal. Materials and Methods: Thirty human maxillary canines were prepared using HERO Shaper rotary system and irrigated with 1 ml of 5.25% sodium hypochlorite (NaOCl after each instrument change. Three 25-gauge irrigation needle designs - brush-covered Navi Tip FX (Group I, side-vented needle RC Twents (Group II and single-beveled (Group III irrigating needles - were tested for their efficiency in debris removal in three different parts of the root canal (n=10 canals per group. Following instrumentation, the roots were vertically sectioned and divided into coronal, middle and apical thirds for observation under scanning electron microscope (×200 magnification. Debris on the canal wall was evaluated by using a four-scale scoring system described by Paque and his co-workers. Results: The canals irrigated with brush-covered needle Navi Tip FX (Group I showed lower average debris score, indicating greater removal of debris in coronal third as compared to middle and apical thirds, whereas the canals irrigated with side-vented needle (Group II and single-beveled needle (Group III exhibited lower average score in the middle third than coronal and apical thirds. All the three needle designs exhibited higher debris score in apical third of the root canal. Tukey multiple comparisons test was applied at a significance level of P>0.05. A statistically significant difference (P<0.05 was observed in the debris removal in the coronal and middle thirds of root canals irrigated with brush-covered Navi Tip FX (Group I and side-vented (Group II needles, respectively, when compared with other needle design groups. Conclusion: Within the limitations of this study, it can be concluded that all the needle designs tested were effective in certain regions of the root canal with apical third uncleaned. Side-vented needle by

Comparison of antimicrobial activity of traditional and new developed root sealers against pathogens related root canal

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Joo-Hee Shin

2018-03-01

Full Text Available Background/purpose: Bacterial infection is closely associated with the failure of endodontic treatment, and use of endodontic sealer with antimicrobial activity and biological compatibility is necessary for the success of root canal treatment. The purpose of this study was to investigate and to compare the antibacterial effect of two calcium silicate-based root canal sealers (Endoseal and EndoSequence BC sealer as recent development sealers and with three conventional root canal sealers (AH Plus, Sealapex, and Tubli-Seal, before or after setting, on Porphyromonas endodontalis, Porphyromonas gingivalis, and Enterococcus faecalis. Materials and methods: The sealers were soaked in phosphate buffered saline to elute its compositions after and before setting, and the elutes were performed the antimicrobial assay. Also, X-ray fluorescence analysis was carried out to compare compositions of two calcium silicate-based sealers. Results: The conventional root canal sealers have strong antibacterial activity against the Gram-negative bacteria, P. endodontalis and P. gingivalis. Endoseal sealer showed antibacterial activity against not only the Gram-negative bacteria, but also against the Gram-positive bacteria, E. faecalis. However, Endosequence BC sealer exhibited a weak antibacterial effect on all bacteria in this study. X-ray fluorescence analysis exhibited that Endoseal contained more types and more amount of the oxide compound known to have strong antimicrobial activity such as Al2O3, Fe2O3, MgO, Na2O, NiO, and SO2 than Endoseqeunce BC. Conclusion: Endoseal, which contains various types of oxide compounds, seems to be a suitable sealer for preventing bacterial infection in both treated and untreated root canals. Keywords: Root canal sealer, Antimicrobial activity, Oxide compound, E. faecalis

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

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

2015-06-20

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

Evaluation of Root and Canal Morphology of Mandibular First Molars: A Clearing Method in an Iranian Population

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Shirkavand

2016-07-01

Full Text Available Background Successful endodontic treatment is dependent on the knowledge of root canal anatomy. Objectives This study aims to investigate the root canal anatomy of mandibular first molars in an Iranian population. Materials and Methods One hundred human mandibular first molars were collected and stored in 5.25% NaOCl. Radiographic images of the teeth were taken in mesial, distal, and buccal aspects using digital radiography. The root numbers were recorded, and the teeth were covered with lacquer. Access cavities were prepared, pulp tissue was dissolved, the apex was covered with liquid glue, and the root canals were injected with methylene blue. Decalcification of the teeth meant they were kept in 10% nitric acid, and final dehydration meant they were kept in 100% Isopropyl alcohol for 72 hours and rendered clear by immersion in methyl salicylate. The number of root canals per tooth, the number of canals per root, and canal configuration in each tooth were recorded. Results Ninety-nine of the 100 teeth had two roots and the other had three roots. The teeth were classified based on the number of canals; there were 2% with two canals, 59% with three canals, and 39% with four canals. Based on the Vertucci classification, the most prevalent canal configurations in the mesial root were types II and IV, and type I in the distal root. Conclusions The most common root morphology is the two rooted morphology with three canals. Both the mesial and distal roots show wide variations in canal anatomy with type IV and type I canal configuration predominating in the mesial and distal roots, respectively. Iranian mandibular first molar teeth exhibit features close to the average Caucasian, Jordanian, and Kuwaiti’s root and canal morphology.

Mineral content analysis of root canal dentin using laser-induced breakdown spectroscopy

Science.gov (United States)

2018-01-01

Objectives This study aimed to introduce the use of laser-induced breakdown spectroscopy (LIBS) for evaluation of the mineral content of root canal dentin, and to assess whether a correlation exists between LIBS and scanning electron microscopy/energy dispersive spectroscopy (SEM/EDS) methods by comparing the effects of irrigation solutions on the mineral content change of root canal dentin. Materials and Methods Forty teeth with a single root canal were decoronated and longitudinally sectioned to expose the canals. The root halves were divided into 4 groups (n = 10) according to the solution applied: group NaOCl, 5.25% sodium hypochlorite (NaOCl) for 1 hour; group EDTA, 17% ethylenediaminetetraacetic acid (EDTA) for 2 minutes; group NaOCl+EDTA, 5.25% NaOCl for 1 hour and 17% EDTA for 2 minutes; a control group. Each root half belonging to the same root was evaluated for mineral content with either LIBS or SEM/EDS methods. The data were analyzed statistically. Results In groups NaOCl and NaOCl+EDTA, the calcium (Ca)/phosphorus (P) ratio decreased while the sodium (Na) level increased compared with the other groups (p LIBS and SEM/EDS analyses (r = 0.84, p LIBS method proved to be reliable while providing data for the elemental composition of root canal dentin. PMID:29487841

Frequency of enterococcus faecalis in saliva and root canals with treatment failure

International Nuclear Information System (INIS)

Khan, I.; Shan, T.; Manzoor, M.A.

2015-01-01

To compare the frequency of E. faecalis in the saliva and root canals of teeth associated with apical periodontitis due to endodontic treatment failure in the same patient. Study Design: Cross-sectional comparative study. Place and Duration of Study: Samples were collected from Operative Dentistry Department, AFID, while laboratory processing was done at AFIP, Rawalpindi. Study duration was one year. Patients and Methods: Fifty patients, both males and females with failed endodontic treatment were selected. Saliva and root canal samples were collected from each patient, inoculated on MacKonkey agar plate and incubated at 35-37 degree C for 48 hrs. E. faecalis colonies were identified by colony morphology, gramstain, catalase, bile asculin test, arabinose fermentation and growth in 6% NaCl nutrient broth. Results: The frequency of E. faecalis in saliva was 34% and in root canal it was 58%. Frequency between the presence of E. faecalis in root canals and saliva was found to be statistically different (p = 0.001). Conclusion: The presence of E. faecalis in root canal was not associated with their presence in saliva. (author)

Frequency of enterococcus faecalis in saliva and root canals with treatment failure

International Nuclear Information System (INIS)

Shan, T.; Manzoor, M.A.; Hussain, W.

2014-01-01

To compare the frequency of E.faecalis in the saliva and root canals of teeth associated with apical periodontitis due to endodontic treatment failure Study. Design: Cross-sectional comparative. Place and Duration of Study: Samples were collected from Operative Dentistry department, AFID, while laboratory processing was done at AFIP, Rawalpindi. Duration of this study was one year. Patients and Method: Fifty patients, both males and females with failed endodontic treatment were selected. Saliva and root canal samples were collected from each patient, inoculated on MacKonkey agar plate and incubated at 35-370 C for 48 hours. E.faecalis colonies were identified by colony morphology, Gram stain, catalase, bile asculin test, arabinose fermentation and growth in 6% NaCl nutrient broth. Results: The frequency of E.faecalis in saliva was 34% and 58% in root canal samples. Frequency of the presence of E.faecalis in root canals and saliva was found to be statistically different (p=0.000). Conclusion: The presence of E.faecalis in root canal was not associated with their presence in saliva. (author)

Effectiveness of EDTA as the irrigation solution to remove smear layer in root canal

OpenAIRE

Kurniasri Amas Achiar; Endang Sukartini

2009-01-01

One of the objectives of successful endodontic treatment is the hermetic obturation of the root canal system. To achieve this, the root canal filling must seal the canal space both apically and coronally to prevent the ingress of microorganisms or tissue fluids into the canal space. Apical leakage is reported a common reason for the clinical failure of endodontic therapy. Leakage through an obturated root canal is expected to take place at interfaces between sealer and dentin or sealer and gu...

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

Science.gov (United States)

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

2015-01-01

Background Complete mechanical preparation of the root canal system is rarely achieved. Therefore, the purpose of this study was to evaluate and compare the root canal shaping efficacy of ProTaper rotary files and standard stainless steel K-files using micro-computed tomography. Material/Methods Sixty extracted upper second premolars were selected and divided into 2 groups of 30 teeth each. Before preparation, all samples were scanned by micro-computed tomography. Thirty teeth were prepared with the ProTaper system and the other 30 with stainless steel files. After preparation, the untouched surface and root canal straightening were evaluated with micro-computed tomography. The percentage of untouched root canal surface was calculated in the coronal, middle, and apical parts of the canal. We also calculated straightening of the canal after root canal preparation. Results from the 2 groups were statistically compared using the Minitab statistical package. Results ProTaper rotary files left less untouched root canal surface compared with manual preparation in coronal, middle, and apical sector (protary techniques completely prepared the root canal, and both techniques caused slight straightening of the root canal. PMID:26092929

[Bond strengths of absorbable polylactic acid root canal post with three different adhesives].

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Pan, Hui; Cheng, Can; Hu, Jia; Liu, He; Sun, Zhi-hui

2015-12-18

To find absorbable adhesives with suitable bonding properties for the absorbable polylactic acid root canal post. To test and compare the bond strengths of absorbable polylactic acid root canal post with three different adhesives. The absorbable polylactic acid root canal posts were used to restore the extracted teeth, using 3 different adhesives: cyanoacrylates, fibrin sealant and glass ionomer cement. The teeth were prepared into slices for micro-push-out test. The bond strength was statistically analyzed using ANOVA. The specimens were examined using microscope and the failure mode was divided into four categories: cohesive failure between absorbable polylactic acid root canal posts and adhesives, cohesive failure between dentin and adhesives, failure within the adhesives and failure within the absorbable polylactic acid root canal posts. The bond strength of cyanoacrylates [(16.83 ± 6.97) MPa] and glass ionomer cement [(12.10 ± 5.09) MPa] were significantly higher than fibrin sealant [(1.17 ± 0.50) MPa], Padhesives was 25.0%, the cohesive failure between the dentin and the adhesives was 16.7%, the failure within the adhesives was 33.3%, and the failure within the absorbable polylactic acid root canal posts was 25.0%. In the group of fibrin sealant, the cohesive failure between the absorbable polylactic acid root canal posts and the adhesives was 66.7%, the cohesive failure between the dentin and the adhesives was 22.2%, the failure within the adhesives was 11.1%. In the group of glass ionomer cement, the cohesive failure between the absorbable polylactic acid root canal posts and the adhesives was 87.5%, the failure within the adhesives was 12.5%. The major failure mode in fibrin sealant and glass ionomer cement was the cohesive failure between the absorbable polylactic acid root canal posts and the adhesives. No major failure modes were found in the group of cyanoacrylates. The bond strength of fibrin sealant is low, which cannot meet the requirement of

Role of the confinement of a root canal on jet impingement during endodontic irrigation

NARCIS (Netherlands)

Verhaagen, B.; Boutsioukis, C.; Heijnen, G. L.; van der Sluis, L. W. M.; Versluis, M.

2012-01-01

During a root canal treatment the root canal is irrigated with an antimicrobial fluid, commonly performed with a needle and a syringe. Irrigation of a root canal with two different types of needles can be modeled as an impinging axisymmetric or non-axisymmetric jet. These jets are investigated

Root and Canal Morphology of Mandibular Third Molars in an Iranian Population

OpenAIRE

Maryam Kuzekanani; Jahangir Haghani; Hossein Nosrati

2012-01-01

Background and aims A through knowledge of the root canal morphology is required for successful endodontic ther-apy. The aim of this study was to investigate the root and canal morphology of mandibular third molars in Kerman, a prov-ince in southeast of Iran. Materials and methods One-hundred-fifty extracted mandibular third molars were collected randomly from different dental clinics in Kerman. The root canal anatomy and morphology of each tooth was carefully studied using a clearing tech-ni...

Root Canal Configuration of Maxillary First Permanent Molars in an Iranian Population

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Saeed Rahimi

2007-06-01

Full Text Available

Background and aims. It is critical to have a proper knowledge of the normal anatomy of the pulp and its variations for the success of endodontic treatment. The purpose of this study was to investigate variations in the root canal system of maxillary first permanent molars in an Iranian population.

Materials and methods. In this study, 137 maxillary first molars were decalcified, dye-injected, cleared and studied.

Results. The results demonstrated that 37.96% of the maxillary first molars under study had three canals, 58.4% had four canals and 3.64% had five canals.

Conclusion. According to the results of this study and considering variations in the root canal systems of maxillary first molars, it seems that great care should be taken in the root canal treatment of these teeth.

Micro-CT evaluation of root and canal morphology of mandibular first premolars with radicular grooves

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Boschetti, Emanuele; Mazzi-Chaves, Jardel Francisco; Versiani, Marco Aurélio; Pécora, Jesus Djalma; Saquy, Paulo Cesar; Sousa Neto, Manoel Damião de, E-mail: sousanet@forp.usp.br [Universidade de São Paulo (USP), Ribeirao Preto, SP (Brazil). Departamento de Odontologia Restauradora; Silva-Sousa, Yara Terezinha Correa; Leoni, Graziela Bianchi [Universidade de Ribeirão Preto (UNAERP), Ribeirão Preto, SP (Brazil). Departmento de Endodontia

2017-09-15

The aim of this study was to evaluate morphological features of 70 single-rooted mandibular first premolars with radicular grooves (RG) using micro-CT technology. Teeth were scanned and evaluated regarding the morphology of the roots and root canals as well as length, depth and percentage frequency location of the RG. Volume, surface area and Structure Model Index (SMI) of the canals were measured for the full root length. Two-dimensional parameters and frequency of canal orifices were evaluated at 1, 2, and 3 mm levels from the apical foramen. The number of accessory canals, the dentin thickness, and cross-sectional appearance of the canal at different root levels were also recorded. Expression of deep grooves was observed in 21.42% of the sample. Mean lengths of root and RG were 13.43 mm and 8.5 mm, respectively, while depth of the RG ranged from 0.75 to 1.13 mm. Mean canal volume, surface area and SMI were 10.78 mm{sup 3}, 58.51 mm{sup 2}, and 2.84, respectively. Apical delta was present in 4.35% of the sample and accessory canals were observed mostly at the middle and apical thirds. Two-dimensional parameters indicated an oval-shaped cross-sectional appearance of the root canal with a high percentage frequency of canal divisions (87.15%). Canal configuration type V (58.57%) was the most prevalent. C-shaped configuration was observed in 13 premolars (18.57%), whereas dentin thickness ranged from 1.0 to 1.31 mm. Radicular grooves in mandibular first premolars was associated with the occurrence of several anatomical complexities, including C-shaped canals and divisions of the main root canal. (author)

Micro-CT evaluation of root and canal morphology of mandibular first premolars with radicular grooves

International Nuclear Information System (INIS)

Boschetti, Emanuele; Mazzi-Chaves, Jardel Francisco; Versiani, Marco Aurélio; Pécora, Jesus Djalma; Saquy, Paulo Cesar; Sousa Neto, Manoel Damião de; Silva-Sousa, Yara Terezinha Correa; Leoni, Graziela Bianchi

2017-01-01

The aim of this study was to evaluate morphological features of 70 single-rooted mandibular first premolars with radicular grooves (RG) using micro-CT technology. Teeth were scanned and evaluated regarding the morphology of the roots and root canals as well as length, depth and percentage frequency location of the RG. Volume, surface area and Structure Model Index (SMI) of the canals were measured for the full root length. Two-dimensional parameters and frequency of canal orifices were evaluated at 1, 2, and 3 mm levels from the apical foramen. The number of accessory canals, the dentin thickness, and cross-sectional appearance of the canal at different root levels were also recorded. Expression of deep grooves was observed in 21.42% of the sample. Mean lengths of root and RG were 13.43 mm and 8.5 mm, respectively, while depth of the RG ranged from 0.75 to 1.13 mm. Mean canal volume, surface area and SMI were 10.78 mm 3 , 58.51 mm 2 , and 2.84, respectively. Apical delta was present in 4.35% of the sample and accessory canals were observed mostly at the middle and apical thirds. Two-dimensional parameters indicated an oval-shaped cross-sectional appearance of the root canal with a high percentage frequency of canal divisions (87.15%). Canal configuration type V (58.57%) was the most prevalent. C-shaped configuration was observed in 13 premolars (18.57%), whereas dentin thickness ranged from 1.0 to 1.31 mm. Radicular grooves in mandibular first premolars was associated with the occurrence of several anatomical complexities, including C-shaped canals and divisions of the main root canal. (author)

Maxillary first molar with 7 root canals diagnosed using cone-beam computed tomography

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Evaldo Rodrigues

2017-02-01

Full Text Available Root canal anatomy is complex, and the recognition of anatomic variations could be a challenge for clinicians. This case report describes the importance of cone beam computed tomographyic (CBCT imaging during endodontic treatment. A 23 year old woman was referred by her general dental practitioner with the chief complaint of spontaneous pain in her right posterior maxilla. From the clinical and radiographic findings, a diagnosis of symptomatic irreversible pulpitis was made and endodontic treatment was suggested to the patient. The patient underwent CBCT examination, and CBCT scan slices revealed seven canals: three mesiobuccal (MB1, MB2, and MB3, two distobuccal (DB1 and DB2, and two palatal (P1 and P2. Canals were successfully treated with reciprocating files and filled using single-cone filling technique. Precise knowledge of root canal morphology and its variation is important during root canal treatment. CBCT examination is an excellent tool for identifying and managing these complex root canal systems.

Application of microcomputed tomography for quantitative analysis of dental root canal obturations

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Anna Kierklo

2014-03-01

Full Text Available Introduction: The aim of the study was to apply microcomputed tomography to quantitative evaluation of voids and to test any specific location of voids in tooth’s root canal obturations. Materials and Methods: Twenty root canals were prepared and obturated with gutta-percha and Tubli-Seal sealer using the thermoplastic compaction method (System B + Obtura II. Roots were scanned and three-dimensional visualization was obtained. The volume and Feret’s diameter of I-voids (at the filling/dentine interface and S-voids (surrounded by filling material were measured.Results: The results revealed that none of the scanned root canal fillings were void-free. For I-voids, the volume fraction was significantly larger, but their number was lower (P = 0.0007, than for S-voids. Both types of voids occurred in characteristic regions (P < 0.001. I-voids occurred mainly in the apical third, while S-voids in the coronal third of the canal filling.Conclusions: Within the limitations of this study, our results indicate that microtomography, with proposed semi-automatic algorithm, is a useful tools for three-dimensional quantitative evaluation of dental root canal fillings. In canals filled with thermoplastic gutta-percha and Tubli-Seal, voids at the interface between the filling and canal dentine deserve special attention due to of their periapical location, which might promote apical microleakage. Further studies might help to elucidate the clinical relevance of these results.

Sealing ability of a new polydimethylsiloxane-based root canal filling material

NARCIS (Netherlands)

Özok, A.R.; van der Sluis, L.W.M.; Wu, M.K.; Wesselink, P.R.

2008-01-01

We tested the null hypothesis that there is no difference in the sealing ability of GuttaFlow, RoekoSeal, and AH26 in root canals. Sixty extracted mandibular premolars were filled with AH26 (lateral compaction), RoekoSeal, or GuttaFlow (modified single-cone). The sealing ability of the root canal

Sealing ability of a new polydimethylsiloxane-based root canal filling material

NARCIS (Netherlands)

Ozok, Ahmet R.; van der Sluis, Lucas W. M.; Wu, Min-Kai; Wesselink, Paul R.

We tested the null hypothesis that there is no difference in the sealing ability of GuttaFlow, RoekoSeal, and AH26 in root canals. Sixty extracted mandibular premolars were filled with AH26 (lateral compaction), RoekoSeal, or GuttaFlow (modified single-cone). The sealing ability of the root canal

Type III apical transportation of root canal

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Shiv P Mantri

2012-01-01

Full Text Available Procedural accidents leading to complications such as canal transportation have been ascribed to inapt cleaning and shaping concepts. Canal transportation is an undesirable deviation from the natural canal path. Herewith a case of apical transportation of root canal resulting in endodontic retreatment failure and its management is presented. A healthy 21-year-old young male presented discomfort and swelling associated with painful endodontically retreated maxillary incisor. Radiograph revealed periradicular radiolucency involving underfilled 11 and overfilled 12. Insufficiently obturated 11 exhibited apical transportation of canal. This type III transportation was treated by periradicular surgery and repair using white mineral trioxide aggregate (MTA. Comfortable asymptomatic patient presented uneventful healing at third and fourth month recall visits. A decrease in the size of radiolucency in radiograph supported the clinical finding. In the present case, MTA is useful in repairing the transportation defect. The result of these procedures is predictable and successful.

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

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

2012-01-01

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

Retreatment of a mandibular second premolar with two canals in two roots

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Chiara Fossati

2018-06-01

Full Text Available Aim: To present a case of retreatment in mandibular second premolar with two canals in two roots. Summary: Locating, cleaning and shaping the entire root canal system may represent a difficult challenge particularly in mandibular premolars, because of their complex canal systems.For this reason mandibular premolars are often considered the most difficult of all teeth on which to perform successful endodontic treatment. Vertucci stated that the second premolar has one root canal at the apex in 97.5% of the teeth studied and two canals in only 2.5%.1 The following case report describes the diagnosis and retreatment of a second premolar with two canal in two roots.Key learning points: (1 The major cause of failure in root canal therapy is the inability to localize and treat all of the canals of the root canal system. (2 Mandibular premolars have complex canal systems. (3 Mandibular premolars have a high risk of missed anatomy. (4 Preoperative radiograph interpretation is essential to evaluate and detect uncommon anatomies. (5 The operating microscope and CBCT interpretation are fundamental in confirming and preventing mistakes about the configuration of mandibular premolars. Riassunto: Obiettivi: Presentare un caso clinico di ritrattamento canalare di un secondo premolare mandibolare con due canali e due radici. Riassunto: Individuare, sagomare, detergere l’intero sistema radicolare presenta una sfida difficile in ambito endodontico e in particolar modo nei premolari mandibolari per il loro complesso sistema canalare. I premolari mandibolari sono spesso considerati i denti più difficili in cui effettuare una terapia endodontica.Vertucci riscontrò che i secondi premolari mandibolari hanno una radice e un canale nel 97.5% e due canali in solo il 2.5%.1Il case report seguente descrive la diagnosi e il ritrattamento di un secondo premolare con due canali in due radici.Punti chiave di apprendimento: 1. La maggior causa di fallimento endodontico �

Root canal adhesive filling in dogs' teeth with or without coronal restoration: a histopathological evaluation.

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Leonardo, Mario Roberto; Barnett, Frederick; Debelian, Gilberto J; de Pontes Lima, Regina Karla; Bezerra da Silva, Léa Assed

2007-11-01

The purpose of this study was to evaluate in vivo the response of the periradicular tissues after endodontic treatment and root filling with Epiphany/Resilon (Penntron Clinical Technologies, LLC, Wallingford, CT) or gutta percha and new Sealapex (SybronEndo, Glendora, CA) in dogs' teeth with or without coronal restoration. Teeth without coronal restorations were used to assess the influence of continuous exposure to the oral environment on the periradicular tissues. Sixty root canals with vital pulps in three dogs were instrumented and obturated in a single session and randomly assigned to one of four groups as follows. group 1: root canal filling with Epiphany/Resilon with coronal restoration, group 2: root canal filling with Sealapex sealer and gutta percha with restoration, group 3: root canal filling with Epiphany/Resilon without restoration, and group 4: root canal filling with Sealapex sealer and gutta percha without coronal restoration. After 90 days, the animals were euthanized, and the maxillas and mandibles were removed and submitted for histologic processing. Longitudinal sections were obtained and stained with hematoxylin and eosin, Mallory's trichrome, and Brown and Brenn stains and examined under light microscopy. There were significant differences found between the four groups (p < 0.05). The results showed that roots canals filled with Epiphany/Resilon, with coronal restoration, had significantly less periradicular inflammation than roots canals filled with gutta percha and Sealapex, with coronal restoration (p = 0.021). No significant difference was observed in the intensity of inflammation between roots canals filled with Epiphany/Resilon with no restoration and roots filled with gutta percha and Sealapex with restoration (p = 0.269). Roots canals filled with gutta percha and Sealapex sealer without coronal restoration showed the greatest degree of periradicular inflammation.

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.

Influence of root canal sealer on the radiographic appearance of filling voids in maxillary single-rooted teeth.

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Bodanezi, Augusto; Munhoz, Etiene Andrade; Capelozza, Ana Lúcia Álvares; Bernardineli, Norberti; Moraes, Ivaldo Gomes de; Garcia, Roberto Brandão; Bramante, Clovis Monteiro

2012-01-01

This study compared the influence of three epoxy resin-based sealers with distinct radiopacities on the observers' ability to detect root canal filling voids during radiographic analysis. The root canals of 48 extracted maxillary canines were prepared and divided into three groups. Each group was laterally condensed with one sealer (AH Plus®, Acroseal® or a non-radiopaque sealer), and a longitudinal void was simulated in half of the specimens from each group (n=8). Buccolingual radiographs were obtained and randomly interpreted for voids by a radiologist and an endodontist in a blinded fashion. Teeth were cut and inspected under a microscope to confirm the position of void. Differences in sensitivity and specificity between groups and examiners were compared using the Fisher's Exact and McNemar tests, respectively (α=0.05). Significantly lower sensitivity levels (p<0.05) were observed in the coronal portion of fillings performed with both radiopaque sealers. Specificity values for Acroseal® were significantly higher (p<0.05) in the coronal and apical portions of fillings. The type of root canal sealer can affect the observers' ability to detect root canal filling voids during radiographic analysis of upper single-rooted teeth.

Evaluation of complications of root canal treatment performed by undergraduate dental students.

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AlRahabi, Mothanna K

2017-12-01

This study evaluated the technical quality of root canal treatment (RCT) and detected iatrogenic errors in an undergraduate dental clinic at the College of Dentistry, Taibah University, Saudi Arabia. Dental records of 280 patients who received RCT between 2013 and 2016 undertaken by dental students were investigated by retrospective chart review. Root canal obturation was evaluated on the basis of the length of obturation being ≤2 mm from the radiographic apex, with uniform radiodensity and good adaptation to root canal walls. Inadequate root canal obturation included cases containing procedural errors such as furcal perforation, ledge, canal transportation, strip perforation, root perforation, instrument separation, voids in the obturation, or underfilling or overfilling of the obturation. In 193 (68.9%) teeth, RCT was adequate and without procedural errors. However, in 87 (31.1%) teeth, RCT was inadequate and contained procedural errors. The frequency of procedural errors in the entire sample was 31.1% as follows: underfilling, 49.9%; overfilling, 24.1%; voids, 12.6%; broken instruments, 9.2%; apical perforation, 2.3%; and root canal transportation, 2.3%. There were no significant differences (p > 0.05) in the type or frequency of procedural errors between the fourth- and fifth-year students. Lower molars (43.1%) and upper incisors (19.2%) exhibited the highest and lowest frequencies of procedural errors, respectively. The technical quality of RCT performed by undergraduate dental students was classified as 'adequate' in 68.9% of the cases. There is a need for improvement in the training of students at the preclinical and clinical levels.

Comparison of root canal lathing measurement by conventional and digital radiology

International Nuclear Information System (INIS)

Mitrova, N.; Slavik, J.; Cecetkova, A.; Jenca, A.; Hanusinova, V.; Ondrasovicova, J.

2006-01-01

A correct working length is a critical factor within the endodontic treatment. The length of the root canal can be measured by different methods. The aim of this study was to compare methods used for measuring the length of root canals using conventional and digital radiology. The measurement was provided in both - in vitro and in vivo conditions. (authors)

Evaluation of root canal morphology of human mandibular incisors in Yazd

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Tabrizi-zadeh M. Assistant Professor

2003-06-01

Full Text Available Statement of Problem: The main objective of endodontic therapy is chemomechanical cleansing of entire pulp cavity and its complete obturation with an inert material. During this procedure, the failure of detection and inadequate cleaning of a canal will result in failed endodontic therapy. Therefore, the dentist must have enough knowledge of root canal morphology to treat a tooth successfully."nAim: The aim of this study was to determine the number and type of root canals of mandibular incisor teeth."nMaterials and Methods: In order to do this in-vitro, descriptive study, 68 non-carious mandibular incisor teethj collected from different clinics in Yazd, were immersed in indian ink, decalcified and cleared."nResults: It was found that 55.9% of the teeth had two separate canals that in 5.5% of them, the canals"nmerged before' apical foramen. In 4.4% of these samples, two separate canals existed along the whole"nroot."nConclusion: Considering high percentage of two canals in lower mandibular incisors, during access preparation, more attempts in detection of the second canal, is emphasized.

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

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

2015-06-01

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

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

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

2016-01-01

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

Optodynamic Phenomena During Laser-Activated Irrigation Within Root Canals

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Lukač, Nejc; Gregorčič, Peter; Jezeršek, Matija

2016-07-01

Laser-activated irrigation is a powerful endodontic treatment for smear layer, bacteria, and debris removal from the root canal. In this study, we use shadow photography and the laser-beam-transmission probe to examine the dynamics of laser-induced vapor bubbles inside a root canal model and compare ultrasonic needle irrigation to the laser method. Results confirm important phenomenological differences in the two endodontic methods with the laser method resulting in much deeper irrigation. Observations of simulated debris particles show liquid vorticity effects which in our opinion represents the major cleaning mechanism.

Cone beam computed tomography evaluation of maxillary molar root canal morphology in a Turkish Cypriot population

International Nuclear Information System (INIS)

Kalender, Atakan; Aksoy, Umut; Basmaci, Fatma; Celikten, Berkan; Tufenkci, Pelin; Kelahmet, Umay; Orhan, Kaan

2016-01-01

The aim of this retrospective study was to review, analyse and characterize the root canal morphology of maxillary molars, using cone beam computed tomography (CBCT), in a group of the Turkish Cypriot population. The sample for this cross-sectional study consisted of retrospective evaluation of CBCT scans of 290 adult patients (age range 1680). The number of roots and their morphology, the number of canals per tooth and the root canal configurations were also classified according to the method of Vertucci. Pearson’s chi-square test was performed for canal configurations, sides and gender (p < 0.05). Among the 373 first molars, there was no single-rooted specimen, 2 (0.53%) teeth had 2 roots, 365 (97.8%) teeth had 3 roots and 6 ones (1.6%) had 4 roots. Among the 438 second molars, 14 (3.1%) were single-rooted, 26 (5.9%) teeth had 2 roots, 392 (89.4%) teeth had 3 roots and 6 teeth (1.3%) had 4 roots. No sex difference was found in the frequency of additional canals both in the maxillary first and second molars. Occurrence of additional canals did not differ with age. These results provide detailed knowledge of the root canal anatomy of the maxillary molar teeth in this particular population, which is of clinical importance for dental professionals when performing endodontic treatment

Root Anatomy and Root Canal Configuration of Human Permanent Mandibular Premolars: A Systematic Review

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Jojo Kottoor

2013-01-01

Full Text Available Introduction. Mandibular premolars have been reported with complex anatomical aberrations, making them one of the most difficult teeth to manage endodontically. Methodology. An exhaustive search was undertaken to identify associated anatomic studies of mandibular premolars through MEDLINE/PubMed database using keywords, and a systematic review of the relevant articles was performed. Chi-square test with Yates correction was performed to assess the statistical significance of any anatomic variations between ethnicities and within populations of the same ethnicity. Documented case reports of variations in mandibular premolar anatomy were also identified and reviewed. Results. Thirty-six anatomic studies were analyzed which included 12,752 first premolars and nineteen studies assessing 6646 second premolars. A significant variation in the number of roots, root canals, and apical foramen was observed between Caucasian, Indian, Mongoloid, and Middle Eastern ethnicities.The most common anatomic variation was C-shaped canals in mandibular first premolars with highest incidence in Mongoloid populations (upto 24% while dens invaginatus was the most common developmental anomaly. Conclusions. A systematic review of mandibular premolars based on ethnicity and geographic clusters offered enhanced analysis of the prevalence of number of roots and canals, their canal configuration, and other related anatomy.

Evaluation of Root Canal Morphology of Human Primary Mandibular ...

African Journals Online (AJOL)

2018-04-04

Apr 4, 2018 ... Keywords: Primary teeth, root canal, Vertucci classification. Evaluation of Root .... Radiology using CBCT; Veraviewepocs 3D R100/F40. (J Morita Mfg. Corp., .... maxillofacial structures by CBCT on a high resolution, and this ...

Ultrastructural investigation of root canal dentine surface after application of active ultrasonic method

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Mitić Aleksandar

2008-01-01

Full Text Available INTRODUCTION The basic work principle of all ultrasonic techniques is the piezoelectric effect of producing high frequency ultrasounds of small length, which are transmitted over the endodontic extensions or canal instruments into the root canal. When in contact with the tissue, ultrasonic vibrations are converted into mechanical oscillations. Ultrasonic waves and the obtained oscillations along with the synergic effect of irrigation bring about the elimination of smear layer from the root canal walls. OBJECTIVE The aim of the study was to ultrastucturally examine the effect of smear layer removal from the walls of canals by the application of the active ultrasonic method without irrigation, that is by the application of ultrasound and irrigation using distilled water and 2.5% NaOCl. METHOD The investigation comprised 35 single-canal, extracted human teeth. After removal of the root canal content, experimental samples were divided into three groups. According to the procedure required, the first group was treated by ultrasound without irrigation; the second one by ultrasound with irrigation using distilled water; and the third group was treated by ultrasound and irrigation using 2.5% NaOCl solution. The control samples were treated by machine rotating instruments (Pro-File and were rinsed by distilled water. RESULTS The obtained results showed that the ultrasonic treatment of the root canal without irrigation did not remove the smear layer. The dentine canals are masked, and big dentine particles are scattered on the intertubular dentine. The ultrasonic treatment by using irrigation with distilled water provides cleaner dentine walls and open dentine tubules but with smaller particles on the intertubular dentine. The ultrasound treatment by using irrigation with 2.5% NaOCl solution provides a clean intertubular dentine surface without a smear layer and clearly open dentine tubules. CONCLUSION Instrumentation of the root canal by application of

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

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

2014-01-01

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

Nd:YAG Lasers Treating of Carious Lesion and Root Canal In Vitro

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Danqing Xia

2012-01-01

Full Text Available Dental caries is a transmissible bacterial disease process, with cavities at the end, and caused by acids from bacterial metabolism. The essence of dental treatment is to clean and disinfect bacterial contamination from the tooth. In this work, we tried to demonstrate the cleaning and disinfecting effects of Nd:YAG laser irradiation on dental carious lesion and root canal in vitro. Acousto-optic Q-switched quasicontinuous and Cr3+:YAG crystal Q-switched pulse Nd:YAG lasers were employed to treat caries lesion and the root canal, respectively. Results showed that acousto-optic Q-switched quasicontinuous Nd:YAG laser irradiation and Cr3+:YAG crystal Q-switched pulse Nd:YAG laser irradiation could rapidly clean decayed material and bacterial contamination from dental carious lesion and the narrow tail end of root canal with minimally invasive in vitro, respectively. It was concluded that acousto-optic Q-switched quasicontinuous laser irradiation may be a rapid and effective alternative caries treatment, and Cr3+:YAG crystal Q-switched pulse Nd:YAG laser irradiation may be an effective method for canal cleaning and disinfecting during root canal therapy.

Nonsurgical root canal therapy of large cyst-like inflammatory periapical lesions and inflammatory apical cysts.

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

2009-05-01

It is a general belief that large cyst-like periapical lesions and apical true cysts caused by root canal infection are less likely to heal after nonsurgical root canal therapy. Nevertheless, there is no direct evidence to support this assumption. A large cyst-like periapical lesion or an apical true cyst is formed within an area of apical periodontitis and cannot form by itself. Therefore, both large cyst-like periapical lesions and apical true cysts are of inflammatory and not of neoplastic origin. Apical periodontitis lesions, regardless of whether they are granulomas, abscesses, or cysts, fail to heal after nonsurgical root canal therapy for the same reason, intraradicular and/or extraradicular infection. If the microbial etiology of large cyst-like periapical lesions and inflammatory apical true cysts in the root canal is removed by nonsurgical root canal therapy, the lesions might regress by the mechanism of apoptosis in a manner similar to the resolution of inflammatory apical pocket cysts. To achieve satisfactory periapical wound healing, surgical removal of an apical true cyst must include elimination of root canal infection.

Influence of root canal sealer on the radiographic appearance of filling voids in maxillary single-rooted teeth

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Augusto Bodanezi

2012-08-01

Full Text Available OBJECTIVE: This study compared the influence of three epoxy resin-based sealers with distinct radiopacities on the observers' ability to detect root canal filling voids during radiographic analysis. MATERIAL AND METHODS: The root canals of 48 extracted maxillary canines were prepared and divided into three groups. Each group was laterally condensed with one sealer (AH Plus®, Acroseal® or a non-radiopaque sealer, and a longitudinal void was simulated in half of the specimens from each group (n=8. Buccolingual radiographs were obtained and randomly interpreted for voids by a radiologist and an endodontist in a blinded fashion. Teeth were cut and inspected under a microscope to confirm the position of void. Differences in sensitivity and specificity between groups and examiners were compared using the Fisher's Exact and McNemar tests, respectively (α=0.05. RESULTS: Significantly lower sensitivity levels (p<0.05 were observed in the coronal portion of fillings performed with both radiopaque sealers. Specificity values for Acroseal® were significantly higher (p<0.05 in the coronal and apical portions of fillings. CONCLUSIONS: The type of root canal sealer can affect the observers' ability to detect root canal filling voids during radiographic analysis of upper single-rooted teeth.

Cone-beam computed tomography study of root and canal morphology of mandibular premolars in a western Chinese population

International Nuclear Information System (INIS)

Yu, Xuan; Guo, Bin; Li, Ke-Zeng; Zhang, Ru; Tian, Yuan-Yuan; Wang, Hu; DDS, Tao Hu

2012-01-01

Traditional radiography is limited in its ability to give reliable information on the number and morphology of root canals. The application of cone-beam computed tomography (CBCT) provides a non-invasive three-dimensional confirmatory diagnosis as a complement to conventional radiography. The aim of this study was to evaluate the root and canal morphology of mandibular premolars in a western Chinese population using CBCT scanning. The sample included 149 CBCT images comprising 178 mandibular first premolars and 178 second premolars. The tooth position, number of roots and canals, and canal configuration according to Vertucci’s classification were recorded. The results showed that 98% of mandibular first premolars had one root and 2% had two roots; 87.1% had one canal, 11.2% had two canals and 0.6% had three canals. The prevalence of C-shaped canals was 1.1%. All mandibular second premolars had one root; 97.2% had one canal and 2.2% had two canals. The prevalence of C-shaped canals was 0.6%. The prevalence of multiple canals in mandibular first premolars was mainly of Type V, and mandibular second premolars had a low rate of canal variation in this western Chinese population. Root canal bifurcation occurred at the middle or apical third in most bicanal mandibular premolars. CBCT scanning can be used in the management of mandibular premolars with complex canal morphology

A central incisor with 4 independent root canals: a case report

NARCIS (Netherlands)

Aznar Portoles, C.; Moinzadeh, A.T.; Shemesh, H.

2015-01-01

The maxillary central incisor is the tooth with the least anatomic variations. Despite the fact that several studies have reported a prevalence of 100% for the presence of a single canal, root canal aberrations of maxillary central incisors with up to 3 canals have also been reported. Such cases

Roentgenographic study of two root canal incidence in mandibular first premolars

International Nuclear Information System (INIS)

Leite, H.F.; Simoes, S.; Niccoli Filho, W.D.; Madeira, M.C.; Oliveira, J.A. de; Martins, Ariovaldo A.

1984-01-01

The root canal number in 1,632 mandibular first premolars were studied by roentgenograms taken from mesiodistal direction. A second canal exists in at least 27.08 per cent of all the teeth examined. Two comprehensive tables were taken: one was prepared to summarize all the data which were classified by root morphology. The second compares the results taken by other authors. (M.A.C.) [pt

Knowledge of General Dentists of Kermanshah about Root Canal Therapy in 2012

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Roohollah Sharifi

2014-04-01

Full Text Available Introduction: The present study was conducted to analyze the knowledge of general dentists of Kermanshah about root canal therapy in 2012. Methods: In this descriptive cross-sectional study, a two-part questionnaire was designed and given to 93 general dentists in Kermanshah to complete. The first part of the questionnaire comprised of personal and professional information of the participant dentists and the second part of the questionnaire determined the awareness of the dentists about root canal therapy. Data were analyzed by SPSS software (version 20 using Pearson correlation coefficient, one-way analysis of variance (ANOVA and independent t-test. Results: A total of 84 dentists with the mean age of 39.3±7.1 completed the questionnaires. The mean for 12 correct responses was 63.3%. The highest number of correct responses (86.2% belonged to using proper intra-canal medication (calcium hydroxide and the lowest number of correct responses (41.4% was associated with the number of root canals in maxillary first molar (four canals. There was a reverse correlation between awareness and work experience (P=0.002, r=-0.337. Also, participation in retraining courses did not have significant impact on the knowledge of the dentists (P =0.82. Conclusion: General dentists have average knowledge about root canal therapy. Higher quality regular training is recommended to promote the knowledge of the dentists about endodontic therapies.

Cytotoxicity of 5% Tamarindus indica extract and 3% hydrogen peroxide as root canal irrigation

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Erawati Wulandari

2008-09-01

Full Text Available Background: Preparation of root canal is an important stage in endodontic treatment. During conducting preparation, it is always be followed with root canal irrigation that has aim to clean root canal from necrotic tissue remains, grind down dentin powder, micro organism, wet the root canal to make preparation process of root canal easier, and solute root canal content at area that can not be reached by equipment. Flesh of Tamarindus indica (pulpa tamarindorum is used as traditional medicine and it contains vitamin C (antioxidant, protein, fat, glucose, etc. Previous research shows that 5% tamarindus indica extract can clean smear layer but it is more cytotoxicity to cell line BHK–21 than sterilized aquabides. Purpose: This research is to compare cytotoxicity between 5% Tamarindus indica extract with 3% H2O2 as root canal irrigation material. Method: Four teen culture cell line BHK 21 divides into 2 groups. Group 1 is treated with 3% H2O2 and Group 2 is treated with 5% Tamarindus indica extract, for about 2.5 minutes in every group. Then, living and death cell percentage is measured. Data is analyzed with independent t test with significant level of 0.05%. Result: The research showed that death cell in group 1 was 29.3% and in group 2 was 21.1%. There was a significant different (p < 0.05 between group 1 and group 2. Conclusion: Cytotoxicity of 5% Tamarindus indica extract to the cell line BHK–21 is lower than 3% H2O2.

Hand and nickel-titanium root canal instrumentation performed by dental students: a micro-computed tomographic study.

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Peru, M; Peru, C; Mannocci, F; Sherriff, M; Buchanan, L S; Pitt Ford, T R

2006-02-01

The aim of this study was to evaluate root canals instrumented by dental students using the modified double-flared technique, nickel-titanium (NiTi) rotary System GT files and NiTi rotary ProTaper files by micro-computed tomography (MCT). A total of 36 root canals from 18 mesial roots of mandibular molar teeth were prepared; 12 canals were prepared with the modified double-flared technique, using K-flexofiles and Gates-Glidden burs; 12 canals were prepared using System GT and 12 using ProTaper rotary files. Each root was scanned using MCT preoperatively and postoperatively. At the coronal and mid-root sections, System GT and ProTaper files produced significantly less enlarged canal cross-sectional area, volume and perimeter than the modified double-flared technique (P ProTaper (P ProTaper and System GT were able to prepare root canals with little or no procedural error compared with the modified double-flared technique. Under the conditions of this study, inexperienced dental students were able to prepare curved root canals with rotary files with greater preservation of tooth structure, low risk of procedural errors and much quicker than with hand instruments.

Independent and Confluent Middle Mesial Root Canals in Mandibular First Molars: A Report of Four Cases

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Mohanavelu Deepalakshmi

2012-01-01

Full Text Available Mandibular molars demonstrate considerable variations with respect to number of roots and root canals. The possibility of additional root canals should be considered even in teeth with a low frequency of abnormal root canal anatomy. This paper discusses the endodontic management of the rare anatomical complexity middle mesial canals in mandibular first molar and also serves to remind the clinicians that such anatomical variations should be taken into account during the endodontic treatment of the mandibular molars.

The accuracy of the radiographic method in root canal length measurement

International Nuclear Information System (INIS)

Jo, Eun Young; Park, Chang Seo

1998-01-01

For the successful endodontic treatment, root canal should be cleaned thoroughly by accurate mechanical and chemical canal preparation and sealed completely with canal filling material without damaging the periapical tissues. The accuracy of the root canal length measurement is a prerequisite for the success of the endodontic treatment, and the root canal length is often determined by the standard periapical radiographs and digital tactile sense. In this study, the accuracy and the clinical usefulness of Digora, an intraoral digital imaging processor and the conventional standard radiographs were compared by measuring the length from the top of the file to the root apex. 30 single rooted premolars were invested in a uniformly sized blocks and No.25 K-file was inserted into and fixed in each canal. Each block was placed in equal distance and position to satisfy the principle of the bisecting angle and paralleling techniques and Digora system's image and standard periapical radiographs were taken. Each radiograph was examined by 3 different observers by measuring the length from top of the file to the root apex and each data was compared and analyzed. The results were as follows; 1. In the bisecting angle technique, the average difference between the Digora system and standard periapical radiograph was 0.002 mm and the standard deviation was 0.341 mm which showed no statistically significant difference between the two systems (p>0.05). Also, in the paralleling technique, the average difference between these two system was 0.007 mm and the standard deviation was 0.323 mm which showed no statistically significant difference between the two systems (p>0.05). 2. In Digora system, the average difference between the bisecting angle and paralleling technique was -0.336 mm and the standard deviation was 0.472 mm which showed a statistically significant difference between the two techniques (p 0.05). In conclusion, the determination of the root canal length by using the

Canal Configuration of Mesiobuccal Roots in Permanent Maxillary First Molars in Iranian Population: A Systematic Review.

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Naseri, Mandana; Kharazifard, Mohammad Javad; Hosseinpour, Sepanta

2016-11-01

It is essential for clinicians to have adequate knowledge about root canal configurations; although its morphology varies largely in different ethnicities and even in different individuals with the same ethnic background. The current study aims to review the root canal configurations of mesiobuccal roots of maxillary first molars in an Iranian population based on different epidemiological studies. A comprehensive search was conducted to retrieve articles related to root canal configuration and prevalence of each type of root canal based on Vertucci's classification for the mesiobuccal root of maxillary first molars. An electronic search was conducted in Medline, Scopus and Google Scholar from January 1984 to September 2015. The articles were evaluated and methods, population, number of teeth and percentage of each root canal type evaluated in each study were summarized in the data table. Websites such as http://www.magiran.com/ , http://health.barakatkns.com/journal-internal-list and www.sid.ir were used to search all related studies published in Persian. Totally, out of nine studies conducted on the Iranian populations in nine provinces of Iran and 798 teeth, the Vertucci's type I was the most common type (35.70%), followed by type II (30.37%), type IV (16.66%), type III (7.93%) and type V (2.61%). From this review article, it is concluded that the root canal morphology of mesiobuccal roots of maxillary first molars in the Iranian population predominantly has more than one canal. Therefore, careful evaluation of radiographs and anatomy of the pulp chamber is essential in order to achieve a successful root canal therapy.

Unusual Root Canal Morphology of the Maxillary Second Molar: A Case Report

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Neslihan Şımşek

2013-01-01

Full Text Available Introduction. This clinical case report presents the successful endodontic treatment of a maxillary second molar that has a mandibular molar-like anatomy with no palatal root and with each of its roots containing two separate root canals. Cone-beam computed tomography (CBCT was used to confirm this unusual anatomy. Methods. A 34-year-old male patient was referred to the Department of Endodontics at Inonu University’s Faculty of Dentistry because of severe pain in his right maxillary second molar. Clinical and radiographic examinations identified unusual roots and root canals anatomy, and CBCT was planned in order to understand the nature of these variations. Cleaning and shaping procedures were performed using the crown down technique with Sybron Endo (Glendora, CA, USA rotary instruments, and endodontic treatment was completed with gutta-percha cones and AH Plus resin sealers using the cold lateral compaction technique. Conclusions. The maxillary second molar exhibits aberrations and variations in terms of the numbers and configurations of its roots and root canals, and CBCT can be a useful imaging technique in endodontics.

[Association between Bacteroides forsythus in the infected root canals and clinical symptoms of chronic apical periodontitis].

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Huang, Ding-ming; Fu, Chun-hua; Zhou, Xue-dong

2005-01-01

To investigate the distribution of Bacteroides forsythus in root canals with chronic apical periodontitis and to determine its associations with clinical symptoms. Thirty-eight tooth root canals from 31 subjects were studied with a 16S rDNA-directed polymerase chain reaction (PCR). These teeth were classified into symptomatic and asymptomatic groups according to the clinical symptoms and signs, including spontaneous pain, percussion pain, sinus tract and swelling, respectively. Ten of the 38 root canal samples were positive for B. forsythus. The prevalence of B. forsythus was 26.3% for 38 root canals, 45.5% for spontaneous pain group, 39.1% for percussion pain group, 29.4% for sinus tract group, 42.9% for swelling group, respectively. Significant positive associations were observed between B. forsythus in infected root canals and the spontaneous pain, percussion pain, and swelling of apical periodontitis, respectively (OR=infinity, 9, 12; Papical periodontitis (OR=1.33). B. forsythus colonized in the infected root canals. It is the putative pathogen of apical periodontitis.

[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.

Prevalence of two root canals in human mandibular anterior teeth in an Iranian population

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Saeed Rahimi

2013-01-01

Full Text Available Background: Complete debridement and obturation of the root canal system is a key factor in successful endodontic treatment and the operator should therefore have thorough knowledge of the root canal morphology of the teeth. Numerous studies have been carried out to investigate the canal configuration of different tooth types in various populations. Aims: The aim of the present study was to investigate the internal anatomy of mandibular incisors and canines in an Iranian population. Materials and Methods: A total of 463 mandibular anterior teeth, including 186 centrals, 128 laterals, and 149 canines, were examined. A standard clearing technique was used to make the teeth transparent. India ink was injected into the canals of the teeth and the samples were examined with a magnifying glass. The root canal configurations were categorized according to the Vertucci classification. Results: All the incisors in this study had one root, and 12.08% of the canines had two roots. We found a slightly higher prevalence of the second canal in incisors than in canines (36.62% vs. 20.48%. However, the probability of canines having two separate apical foramina was higher than that for incisors (12.08% vs. 0.64%. Conclusions: In view of the high prevalence of two-canaled mandibular anterior teeth found in this study, it would be prudent to assume that any mandibular anterior tooth being treated is two-canaled until a thorough search proves otherwise.

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

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

2018-04-01

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

Endodontic management of mandibular second premolar with three roots and three root canals: A case report

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Nidhi Shrivastava

2014-01-01

Full Text Available High level of success in endodontic treatment requires an understanding of root canal anatomy and morphology. The clinician must be prepared to identify those teeth that tend to vary generally from norm. Thorough debridement and obturation of such teeth can be challenging and failing to do so can lead to treatment failure. Mandibular premolars have earned the reputation for having aberrant anatomy. However, the occurrence of three separate canals with three separate foramina in mandibular premolars is very rare. The incidence of three canals is as high as 23% in mandibular first premolars, whereas in second premolars incidence is as low as 0.4%. Three rooted mandibular second premolar is reported to be 0.2%. This case report describes endodontic management of one such tooth with unusual morphological variations in canal anatomy of mandibular second premolar.

Root canal morphology of mandibular first premolar in a Gujarati population - An in vitro study

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Atul Jain

2011-01-01

Full Text Available Background: Knowledge about root canal morphology and its frequent variations can exert considerable influence on the success of endodontic treatment. The aim of this study was to survey the root canal morphology of mandibular first premolar teeth in a Gujarati population by decalcification and clearing technique. Methods : One hundred thirty eight extracted mandibular first premolar teeth were collected from a Gujarati population. After decalcifying and clearing, the teeth were examined for tooth length, number of cusps and roots, number and shape of canal orifices and canal types. Results: The average length of mandibular first premolar teeth was 21.2 mm. All the teeth had 2 cusps. One hundred thirty four teeth (97.1% had one root, and just 4 teeth (2.89% had two roots. Mesial invagination of root was found in 21 teeth (15.21%. One canal orifice was found in 122 teeth (88.4% and two canal orifices in 16 teeth (11.59%. Shape of orifices was found to be round in 46 teeth (33.33%, oval in 72 teeth (52.17% and flattened ribbion in 20 teeth (14.49%. According to Vertucci′s classification, Type I canal system was found in 93 teeth (67.39%, Types II,III,IV,V,and VI in 11 teeth (7.97%, 5 teeth (3.62%, 4 teeth (2.89%, 24 teeth (17.39%, and 1 tooth (0.72% respectively. Conclusion: Mandibular first premolar teeth were mostly found to have one root and Type I canal system.

Root Canal Microorganism Profiles on Upper Anterior Teeth of Apical Periodontitis

OpenAIRE

Riuwpassa, E. Irene

2013-01-01

Microorganisms are the main causative agents on the development of apical periodontitis. Microorganisms infecting the root canal system are colonized in communities as biofilm. These bacterial communities show distinct pattern related to the different forms of apical periodontitis which are determined by species richness and abundance.this study is aimed to examine the root canal microorganisms on upper anterior teeth of asymptomatic apical periodontitis and chronic apical abscess. Samples we...

Root Canal Microorganisms Profiles of Upper Anterior Teeth with Periapical Lesion

OpenAIRE

Maria Tanumiharja; Irene E. Riewpassa; Mansjur Nasir; Burhanuddin D. Pasiga

2014-01-01

Microorganisms are the main causative agents on the development of apical periodontitis. Microorganisms infecting the root canal system are colonized in communities as biofilm. These bacterial communities show distinct pattern related to the different forms of apical periodontitis which are determined by species richness and abundance. Objective: This study is aimed to examine the root canal microorganisms on upper anterior teeth of asymptomatic apical periodontitis and chronic apical abscess...

Pulp revascularization after root canal decontamination with calcium hydroxide and 2% chlorhexidine gel.

Science.gov (United States)

Soares, Adriana de Jesus; Lins, Fernanda Freitas; Nagata, Juliana Yuri; Gomes, Brenda Paula Figueiredo de Almeida; Zaia, Alexandre Augusto; Ferraz, Caio Cezar Randi; de Almeida, José Flávio Affonso; de Souza-Filho, Francisco José

2013-03-01

Pulp revascularization may be considered a promising alternative for necrotic immature teeth. Many studies have accomplished passive decontamination associated with an antibiotic paste. To date, there is no report evaluating calcium hydroxide associated with 2% chlorhexidine gel for revascularization therapy. The aim of this case report was to describe a new proposal for pulp revascularization with mechanical decontamination and intracanal medication composed of calcium hydroxide and 2% chlorhexidine gel. The patient, a 9-year-old girl, suffered an intrusion associated with pulp exposure caused by an enamel-dentin fracture in her maxillary left central incisor. After diagnosis, treatment consisted of revascularization therapy with gentle manual instrumentation of the cervical and medium thirds of the root in addition to intracanal medication with calcium hydroxide and 2% chlorhexidine gel for 21 days. In the second session, a blood clot was stimulated up to the cervical third of the root canal. Mineral trioxide aggregate (MTA; Angelus, Londrina, Paraná, Brazil) was used for cervical sealing of the canal. Coronal sealing was performed with temporary filling material and composite resin. During the follow-up period, the root canal space showed a progressive decrease in width, mineralized tissue deposition on root canal walls, and apical closure. A cone-beam computed tomography scan taken at the 2-year follow-up confirmed these findings and did not show complete root canal calcification. This new proposal for revascularization therapy with 2% chlorhexidine gel may be used for the treatment of necrotic immature root canals. Copyright © 2013 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Role of the confinement of a root canal on jet impingement during endodontic irrigation

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Verhaagen, B.; Boutsioukis, C.; Heijnen, G. L.; van der Sluis, L. W. M.; Versluis, M.

2012-12-01

During a root canal treatment the root canal is irrigated with an antimicrobial fluid, commonly performed with a needle and a syringe. Irrigation of a root canal with two different types of needles can be modeled as an impinging axisymmetric or non-axisymmetric jet. These jets are investigated experimentally with high-speed Particle Imaging Velocimetry, inside and outside the confinement (concave surface) of a root canal, and compared to theoretical predictions for these jets. The efficacy of irrigation fluid refreshment with respect to the typical reaction time of the antimicrobial fluid with a biofilm is characterized with a non-dimensional Damköhler number. The pressure that these jets induce on a wall or at the apex of the root canal is also measured. The axisymmetric jet is found to be stable and its velocity agrees with the theoretical prediction for this type of jet, however, a confinement causes instabilities to the jet. The confinement of the root canal has a pronounced influence on the flow, for both the axisymmetric and non-axisymmetric jet, by reducing the velocities by one order of magnitude and increasing the pressure at the apex. The non-axisymmetric jet inside the confinement shows a cascade of eddies with decreasing velocities, which at the apex does not provide adequate irrigation fluid refreshment.

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

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Ankit Arora

2013-08-01

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

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

Science.gov (United States)

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

2013-08-01

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

Bacterial action of carbon dioxide laser radiation in experimental dental root canals

International Nuclear Information System (INIS)

Zakariasen, K.L.; Dederich, D.N.; Tulip, John; DeCoste, Sandra; Jensen, S.E.; Pickard, M.A.

1986-01-01

The ability of a carbon dioxide laser to sterilize the root canal of human teeth has been investigated. Three oral bacteria, Streptococcus sanguis, Streptococcus mutans, and Actinomyces viscosus, and three other bacteria, Bacillus cereus, Staphyloccus aureus, and Pseudomonoas aeruginosa were used as experimental organisms. Exposure of cells on glass slides to laser radiation showed there was little difference in the exposure required to kill these six organisms. Complete recovery of bacteria from the root canal was initially a problem and was only achieved when bacterial manipulations and removal were carried out in rapid succession, within 5 min of inoculation. However, the geometry of the instrumented canal and the laser alignment were major factors in achieving consistent cell death of oral bacteria in the root canals. Using sets of 10 teeth, four repeated exposures of 10 W for 1 s was found to sterilize 4 or more of the teeth

Endodontic implications of the variability of the root canal systems of posterior teeth.

Science.gov (United States)

Biggs, J T; Benenati, F W

1995-01-01

Variations in the morphology of roots and root canal systems create challenges which the dental practitioner must be able to recognize. Endodontic therapy is predictable and successful only to the extent that the root canal system can be debrided, disinfected and sealed against future contamination. In order to accomplish these goals it is necessary to become familiar with the variability of the system we seek to treat.

Root canal obturation of primary teeth: Disposable injection technique

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S K Bhandari

2012-01-01

Full Text Available The aim of the study was to outline a simple, cost-effective technique for obturation of primary tooth root canals. A total of 75 primary teeth were treated in 52 subjects by the technique discussed, i.e. injecting plastic flowable material into the root canals after desired preparation, using disposable needle and syringe. All the patients were followed up for 3 years and 6 months, with no clinical or radiologic evidence of pathology or need for untimely extraction. In conclusion, the technique described is simple, economical, can be used with almost all filling materials used for the purpose, and is easy to master with minimal chances of failure.

A quantitative analysis of rotary, ultrasonic and manual techniques to treat proximally flattened root canals

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Fabiana Soares Grecca

2007-04-01

Full Text Available OBJECTIVE: The efficiency of rotary, manual and ultrasonic root canal instrumentation techniques was investigated in proximally flattened root canals. MATERIAL AND METHODS: Forty human mandibular left and right central incisors, lateral incisors and premolars were used. The pulp tissue was removed and the root canals were filled with red die. Teeth were instrumented using three techniques: (i K3 and ProTaper rotary systems; (ii ultrasonic crown-down technique; and (iii progressive manual technique. Roots were bisected longitudinally in a buccolingual direction. The instrumented canal walls were digitally captured and the images obtained were analyzed using the Sigma Scan software. Canal walls were evaluated for total canal wall area versus non-instrumented area on which dye remained. RESULTS: No statistically significant difference was found between the instrumentation techniques studied (p<0.05. CONCLUSION: The findings of this study showed that no instrumentation technique was 100% efficient to remove the dye.

In-depth morphological study of mesiobuccal root canal systems in maxillary first molars: review

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Seok-Woo Chang

2013-02-01

Full Text Available A common failure in endodontic treatment of the permanent maxillary first molars is likely to be caused by an inability to locate, clean, and obturate the second mesiobuccal (MB canals. Because of the importance of knowledge on these additional canals, there have been numerous studies which investigated the maxillary first molar MB root canal morphology using in vivo and laboratory methods. In this article, the protocols, advantages and disadvantages of various methodologies for in-depth study of maxillary first molar MB root canal morphology were discussed. Furthermore, newly identified configuration types for the establishment of new classification system were suggested based on two image reformatting techniques of micro-computed tomography, which can be useful as a further 'Gold Standard' method for in-depth morphological study of complex root canal systems.

Effects of liquid- and paste-type EDTA on smear-layer removal during rotary root-canal instrumentation

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Gin Chen

2011-03-01

Conclusions: The use of paste/gel-type chelators during rotary nickel–titanium instrumentation resulted in improved cleanliness in the coronal and middle parts of the root canal. We recommend using liquid EDTA as a final flushing solution during root-canal preparation because it provides a better smear layer-free condition before 3-dimensional root-canal obturation.

Prevalence of the middle mesial canal in non surgical root canal treated mandibular first and second molars in a local military population

Science.gov (United States)

2016-06-13

or second mandibular molar), sex, and age. Materials and Methods Approximately 7, 000 dental records in paper chart format were reviewed at a...Army Post Graduate Dental School Douglas D. Lancaster, COL, DC 3 August 2016 Prevalence of the middle mesial canal in non-surgical root canal...Methods: 7000 dental records were reviewed for non-surgical root canals performed from October 1970 to October 2015. The data collected included

Scanning electron microscopic evaluation of root canal surfaces ...

African Journals Online (AJOL)

Scanning electron microscopic evaluation of root canal surfaces prepared with three rotary endodontic systems: Lightspeed, ProTaper and EndoWave. ... fracture with LightSpeed (LS), ProTaper (PT) and EndoWave (Ew) rotary instruments.

Root canal shaping using rotary nickel-titanium files in preclinical dental education in Turkey.

Science.gov (United States)

Ünal, Gül Çelik; Maden, Murat; Orhan, Ekim Onur; Sarıtekin, Erdal; Teke, Anıl

2012-04-01

The purposes of this study were to evaluate the ability of a group of third-year dental students without any endodontic clinical experience to use the ProTaper Instruments (Dentsply Maillefer) to decrease the amount of straightening of curved canals on human molar teeth and to determine the incidence of instrument fractures and instrumentation time. Thirty-one undergraduate dental students in Turkey received a training session. The students prepared a total of 144 root canals in human mandibular or maxillary molar teeth with ProTaper. Fifty-six teeth were excluded due to unreadable image, misinformation, or straight or severe curve. Using pre- and post-preparation digital radiographs, the straightening of curved root canals was investigated. Loss of working length and incidence of fracture were also noted. A total of eighty-eight curved root canals were selected. Mesiobuccal or mesiolingual roots with curvatures of between 20° and 43° as assessed by Schneider's method and working length of between 15 mm and 22.5 mm were included in the study. The means of the curved root canals before and after the instrumentation were 29.5° ± 6° and 27° ± 6.3°, respectively. The means of the working length before and after the instrumentation were 19 mm ± 2.1 mm and 18.3 mm ± 1.9 mm, respectively. A statistically significant difference between straightening of curved root canals and loss of working length was found between before and after instrumentation (psession.

Endodontic Management of a Maxillary Lateral Incisor with 4 Root Canals and a Dens Invaginatus Tract.

Science.gov (United States)

Nosrat, Ali; Schneider, S Craig

2015-07-01

Dens invaginatus (DI) is associated with complex internal anatomy. This article represents a maxillary lateral incisor with 5 root canals including DI. The treatment was planned and performed using cone-beam computed tomographic (CBCT) imaging. After clinical and radiographic evaluations, tooth #7 was diagnosed with DI and pulp necrosis with symptomatic apical periodontitis. Periapical radiographs of the tooth showed 2 roots and complex internal anatomy. CBCT evaluation revealed tooth #7 had 5 separate canals (4 root canals and 1 DI canal extending through the root to the periodontal ligament), communication between DI and the root canal system, and severe and multiple curvatures of the palatal canals. Root canal treatment was completed in 2 visits. Modified access openings were required to safely treat the dilacerated palatal canals. At the 6-month re-evaluation, the patient reported he had remained asymptomatic and his tooth had remained functional since the treatment was completed. Clinical examination showed tooth #7 had no sensitivity to percussion or palpation, probe depths within normal limits (≤3 mm), and no mobility. Radiographic assessment of the tooth showed significant osseous healing of the preoperative lesion. Three-dimensional imaging is a valuable tool for endodontic management of teeth with complex internal anatomy. Three-dimensional imaging is recommended for evaluating and treatment planning cases with DI. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Cleaning and shaping curved root canals: Mtwo® vs ProTaper® instruments, a lab comparison

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Kuzekanani Maryam

2009-01-01

Full Text Available Objectives: The purpose of this study was to compare root canal preparation in curved canals in molar teeth with the rotary NiTi Mtwo and ProTaper systems in terms of canal shape and smear layer. Materials and Methods: Mesiobuccal canals of 60 molar teeth with angles of curvature between 25 and 35 degrees were prepared with a torque controlled low speed engine; 30 canals for each system. Each individual instrument was used to prepare four root canals and the time required for preparation was recorded. Standardized radiographs were taken before and following instrumentation and used to determine changes in canal curvature. Results: There was no significant difference in preparation time between the two systems. No instruments separated during use. The Mtwo system gave a statistically smaller change in canal curvature and thus was better for maintaining the original shape of the root canal, with less transportation (P less than 0.05. The greatest difference was seen for maxillary molar teeth. When prepared root canals were examined by SEM there was no difference between the two systems at the coronal, middle or apical thirds. Conclusion: Overall, the results of this study suggest that Mtwo instruments are preferable for situations where canals are curved, particularly for maxillary molars.

A STUDY OF ROOT CANAL MORPHOLOGY OF Cebus apella TEETH ESTUDO ANATÔMICO DO CANAL RADICULAR DE DENTES DE Cebus apella

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Priscilla Rocha Afonso

2008-12-01

Full Text Available Realizou-se um estudo anatômico em dentes do Cebus apella, para análise da anatomia interna do canal radicular dessa espécie, normatizando seu uso como modelo experimental. Utilizaram-se doze animais adultos. Após a remoção do tecido orgânico, os dentes foram removidos, seccionados e fotografados, sendo analisados com um estereomicroscópio. Os resultados mostraram que os dentes apresentaram características semelhantes às dos seres humanos, mas com algumas peculiaridades, tais como: a anatomia do canal radicular variou de oval para circular; nos caninos inferiores, os canais são semelhantes a um rim, o que reflete o contorno externo da raiz; nos molares superiores, os canais mesiobucal e distobucal são ovais, seguindo o contorno geral do dente. Os autores concluem que esta espécie pode ser utilizada como modelo em pesquisas odontológicas, principalmente em estudos do tratamento do sistema de canal radicular.

PALAVRAS-CHAVES: Anatomia, dentes, Cebus apella. An anatomic study of Cebus apella root teeth was performed to analyze the internal anatomy of permanent dentition, normalizing its use as experimental model endodontic research. Twelve adult animals were used in this study. After the removal of the organic tissue, the all teeth were removed, sectioned, analyzed and photographed with a stereomicroscope. The results showed that the anatomy of root canal of this species are similar to human dental anatomy, considering the shape, pathway and number of canals, but with some peculiarities, such as: the root canal anatomy varied from oval to circular; in the lower canines, the canals are resembled a kidney, reflecting the outside contour of the root; in the upper molars, the mesiobuccal and distobuccal canals are oval, following the general contour of the tooth. The authors conclude that this primate can be applied as models for study of root canal treatment in human beings, in special the upper central and lateral incisors

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

Science.gov (United States)

Keles, Ali; Keskin, Cangül

2018-04-19

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

Identification of dental root canals and their medial line from micro-CT and cone-beam CT records

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Benyó Balázs

2012-10-01

Full Text Available Abstract Background Shape of the dental root canal is highly patient specific. Automated identification methods of the medial line of dental root canals and the reproduction of their 3D shape can be beneficial for planning endodontic interventions as severely curved root canals or multi-rooted teeth may pose treatment challenges. Accurate shape information of the root canals may also be used by manufacturers of endodontic instruments in order to make more efficient clinical tools. Method Novel image processing procedures dedicated to the automated detection of the medial axis of the root canal from dental micro-CT and cone-beam CT records are developed. For micro-CT, the 3D model of the root canal is built up from several hundred parallel cross sections, using image enhancement, histogram based fuzzy c-means clustering, center point detection in the segmented slice, three dimensional inner surface reconstruction, and potential field driven curve skeleton extraction in three dimensions. Cone-beam CT records are processed with image enhancement filters and fuzzy chain based regional segmentation, followed by the reconstruction of the root canal surface and detecting its skeleton via a mesh contraction algorithm. Results The proposed medial line identification and root canal detection algorithms are validated on clinical data sets. 25 micro-CT and 36 cone-beam-CT records are used in the validation procedure. The overall success rate of the automatic dental root canal identification was about 92% in both procedures. The algorithms proved to be accurate enough for endodontic therapy planning. Conclusions Accurate medial line identification and shape detection algorithms of dental root canal have been developed. Different procedures are defined for micro-CT and cone-beam CT records. The automated execution of the subsequent processing steps allows easy application of the algorithms in the dental care. The output data of the image processing procedures

Effects of self-adjusting file, Mtwo, and ProTaper on the root canal wall.

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Hin, Ellemieke S; Wu, Min-Kai; Wesselink, Paul R; Shemesh, Hagay

2013-02-01

The purpose of this ex vivo study was to observe the incidence of cracks in root dentin after root canal preparation with hand files, self-adjusting file (SAF), ProTaper, and Mtwo. One hundred extracted mandibular premolars with single canals were randomly selected. Two angulated radiographs were taken for each tooth, and the width of the canal was measured at 9 mm from the apex. Five groups of 20 teeth each were comparable in canal width. The control group was left unprepared. Four experimental groups were instrumented with hand files, ProTaper, Mtwo, and SAF. Roots were then sectioned horizontally and observed under a microscope. The presence of dentinal cracks and their location were noted. The difference between the experimental groups was analyzed with a χ(2) test. No cracks were observed in the control group. In the experimental groups, ProTaper, Mtwo, and SAF caused cracks in 35%, 25%, and 10% of teeth, respectively. The hand-file group did not show any dentinal cracks (P ProTaper and Mtwo caused more cracks than hand files (P .05). Instrumentation of root canals with SAF, Mtwo, and ProTaper could cause damage to root canal dentin. SAF has a tendency to cause less dentinal cracks as compared with ProTaper or Mtwo. Copyright © 2013 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Evaluation of Root Canal Morphology of Human Primary Mandibular ...

African Journals Online (AJOL)

2018-04-04

Apr 4, 2018 ... solution (Omnipaque; Novaplus, Cork, Ireland) to clarify the view of the root canals during CBCT imaging. Each and every root apex was covered with a soft modeling wax to prevent any microleakage of solution, and all teeth were placed in a silicone‑based impression material (Zetaplus, Zhermack, Rovigo, ...

Radiographic technical quality of root canal treatment performed by a new rotary single-file system.

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Colombo, Marco; Bassi, Cristina; Beltrami, Riccardo; Vigorelli, Paolo; Spinelli, Antonio; Cavada, Andrea; Dagna, Alberto; Chiesa, Marco; Poggio, Claudio

2017-01-01

The aim of the present study was to evaluate radiographically the technical quality of root canal filling performed by postgraduate students with a new single-file Nickel-Titanium System (F6 Skytaper Komet) in clinical practice. Records of 74 patients who had received endodontic treatment by postgraduate students at the School of Dentistry, Faculty of Medicine, University of Pavia in the period between September 2015 and April 2016 were collected and examined: the final sample consisted 114 teeth and 204 root canals. The quality of endodontic treatment was evaluated by examining the length of the filling in relation to the radiographic apex, the density of the obturation according to the presence of voids and the taper of root canal filling. Chi-squared analysis was used to determine statistically significant differences between the technical quality of root fillings according to tooth's type, position and curvature. The results showed that 75,49%, 82,84% and 90,69% of root filled canals had adequate length, density and taper respectively. Overall, the technical quality of root canal fillings performed by postgraduates students was acceptable in 60,78% of the cases.

Radiographic evaluation of root canal fillings accomplished by undergraduate dental students.

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Yavari, Hamidreza; Samiei, Mohammad; Shahi, Shahriar; Borna, Zahra; Abdollahi, Amir Ardalan; Ghiasvand, Negar; Shariati, Gholamreza

2015-01-01

The purpose of this study was to evaluate the radiographic quality of root canal fillings by fourth-, fifth-, and sixth-year undergraduate students at Tabriz Faculty of Dentistry between 2006 and 2012. A total of 1183 root canal fillings in 620 teeth were evaluated by two investigators (and in case of disagreement by a third investigator) regarding the presence or absence of under-fillings, over-fillings and perforations. For each tooth, preoperative, working and postoperative radiographs were checked. The Pearson's chi-square test was used for statistical evaluation of the data. Inter-examiner agreement was measured by Cohen's kappa (k) values. The level of significance was set at 0.05. Total frequencies of over-filling, under-filling and perforation were 5.6%, 20.4% and 1.9%, respectively. There were significant differences between frequencies of over- and under-fillings (P<0.05). Unacceptable quality, under- and over-fillings were detected in 27.9% of 1183 evaluated canals. The technical quality of root canal therapies performed by undergraduate dental students using step-back preparation and lateral compaction techniques was unacceptable in almost one-fourth of the cases.

Evaluation of interference of calcium hydroxide-based intracanal medication in filling root canal systems.

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Vilela, Deyla Duarte; Neto, Manoel Matos; Villela, Alexandre Mascarenhas; Pithon, Matheus Melo

2011-09-01

To evaluate the interference of the intracanal medication Calen® (SSWhite, Sao Paulo, Brazil) on the filling of simulated lateral canals. Twenty human anterior teeth were used. Before the endodontic filling procedures the access of cavity was made, and after this root canals were made in all the teeth to simulate the presence of lateral canals. After preparation, the teeth were randomly divided into two groups (n=10). In group I, the root canal system was filled directly after chemicalmechanical preparation; in group II, endodontic treatment was performed in multiple sessions, and after preparation the calcium hydroxide-based intracanal medication Calen® was inserted. After the period of 7 days, the root canals were vigorously irrigated and then they were filled. Next, the teeth were radiographed to verify the quality of the filling. The results demonstrated that the teeth treated in a single session, without calcium hydroxide medication, presented 47 canals out of 60 with radiographic evidence of filling, whereas the teeth in which intracanal medication was used, only 07 presented a radiographic image compatible with filling (p < 0.05). The use of the calcium hydroxide-based medication Calen made it difficult to obtain a hermetic filling of the root canal system. The clinical significance of this work basing on the fact that once the dentist knowing that property obliteration of calcium hydroxide can be taken care when they are used in the presence of lateral canals.

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

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

2006-08-01

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

ROOT CANAL MICROORGANISMS PROFILES O F UPPER ANTERIOR TEETH WITH APICAL PERIODONTITIS

OpenAIRE

Tanumihardja, Maria; Riewpassa, Irene E; Mansjurnasir; Burhanuddin, DP

2013-01-01

Microorganisms are the main causative agents on the development of apical periodontitis. Microorganisms infecting the root canal system are colonized in communities as biofilm. These bacterial communities show distinct pattern related to the different forms of apical periodontitis which are determined by species richness and abundance. This study is aimed to examine the root canal microorganisms on upper anterior teeth of asymptomatic apical periodontitis and ch ronic api...

Antimicrobial residual effects of irrigation regimens with maleic acid in infected root canals

OpenAIRE

Ferrer-Luque, Carmen Mar?a; Gonz?lez-Castillo, Silvia; Ruiz-Linares, Matilde; Arias-Moliz, Mar?a Teresa; Rodr?guez-Archilla, Alberto; Baca, Pilar

2015-01-01

Background The success of endodontic treatment depends largely on the control of microorganisms present in infected root canals. The aim of this study was to determine the residual antimicrobial activity of several final irrigation protocols with 7% maleic acid (MA) alone and combined with chlorhexidine (CHX), cetrimide (CTR) or both, in root canals infected with Enterococcus faecalis. Biofilms of E. faecalis were grown in uniradicular roots for 4 weeks. A total of 72 specimens were divided i...

Incidence of dentinal defects after root canal preparation: reciprocating versus rotary instrumentation.

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Bürklein, Sebastian; Tsotsis, Polymnia; Schäfer, Edgar

2013-04-01

The purpose of this study was to evaluate the incidence of dentinal defects after root canal preparation with reciprocating instruments (Reciproc and WaveOne) and rotary instruments. One hundred human central mandibular incisors were randomly assigned to 5 groups (n = 20 teeth per group). The root canals were instrumented by using the reciprocating single-file systems Reciproc and WaveOne and the full-sequence rotary Mtwo and ProTaper instruments. One group was left unprepared as control. Roots were sectioned horizontally at 3, 6, and 9 mm from the apex and evaluated under a microscope by using 25-fold magnification. The presence of dentinal defects (complete/incomplete cracks and craze lines) was noted and analyzed by using the chi-square test. No defects were observed in the controls. All canal preparation created dentinal defects. Overall, instrumentation with Reciproc was associated with more complete cracks than the full-sequence files (P = .021). Although both reciprocating files produced more incomplete cracks apically (3 mm) compared with the rotary files (P = .001), no statistically significant differences were obtained concerning the summarized values of all cross sections (P > .05). Under the conditions of this study, root canal preparation with both rotary and reciprocating instruments resulted in dentinal defects. At the apical level of the canals, reciprocating files produced significantly more incomplete dentinal cracks than full-sequence rotary systems (P < .05). Copyright © 2013 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Effects of Self-Adjusting File, Mtwo, and ProTaper on the root canal wall

NARCIS (Netherlands)

Hin, E.S.; Wu, M.K.; Wesselink, P.R.; Shemesh, H.

2013-01-01

Introduction The purpose of this ex vivo study was to observe the incidence of cracks in root dentin after root canal preparation with hand files, self-adjusting file (SAF), ProTaper, and Mtwo. Methods One hundred extracted mandibular premolars with single canals were randomly selected. Two

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

Science.gov (United States)

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

2009-05-01

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

A mathematical model for describing the mechanical behaviour of root canal instruments.

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Zhang, E W; Cheung, G S P; Zheng, Y F

2011-01-01

The purpose of this study was to establish a general mathematical model for describing the mechanical behaviour of root canal instruments by combining a theoretical analytical approach with a numerical finite-element method. Mathematical formulas representing the longitudinal (taper, helical angle and pitch) and cross-sectional configurations and area, the bending and torsional inertia, the curvature of the boundary point and the (geometry of) loading condition were derived. Torsional and bending stresses and the resultant deformation were expressed mathematically as a function of these geometric parameters, modulus of elasticity of the material and the applied load. As illustrations, three brands of NiTi endodontic files of different cross-sectional configurations (ProTaper, Hero 642, and Mani NRT) were analysed under pure torsion and pure bending situation by entering the model into a finite-element analysis package (ANSYS). Numerical results confirmed that mathematical models were a feasible method to analyse the mechanical properties and predict the stress and deformation for root canal instruments during root canal preparation. Mathematical and numerical model can be a suitable way to examine mechanical behaviours as a criterion of the instrument design and to predict the stress and strain experienced by the endodontic instruments during root canal preparation. © 2010 International Endodontic Journal.

In vitro comparative study of manual and mechanical rotary instrumentation of root canals using computed tomography.

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Limongi, Orlando; de Albuquerque, Diana Santana; Baratto Filho, Flares; Vanni, José Roberto; de Oliveira, Elias P Motcy; Barletta, Fernando Branco

2007-01-01

This in vitro study compared, using computed tomography (CT), the amount of dentin removed from root canal walls by manual and mechanical rotary instrumentation techniques. Forty mandibular incisors with dental crown and a single canal were selected. The teeth were randomly assigned to two groups, according to the technique used for root canal preparation: Group I - manual instrumentation with stainless steel files; Group II - mechanical instrumentation with RaCe rotary nickel-titanium instruments. In each tooth, root dentin thickness of the buccal, lingual, mesial and distal surfaces in the apical, middle and cervical thirds of the canal was measured (in mm) using a multislice CT scanner (Siemens Emotion, Duo). Data were stored in the SPSS v. 11.5 and SigmaPlot 2001 v. 7.101 softwares. After crown opening, working length was determined, root canals were instrumented and new CT scans were taken for assessment of root dentin thickness. Pre- and post-instrumentation data were compared and analyzed statistically by ANOVA and Tukey's post-hoc test for significant differences (p=0.05). Based on the findings of this study, it may be concluded that regarding dentin removal from root canal walls during instrumentation, neither of the techniques can be considered more effective than the other.

Apical sealing ability of two novel root canal sealers: An ex-vivo study

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Priyanka Setia

2013-01-01

Full Text Available Objective: The objective was to compare the sealing ability of two root canal sealers viz.: Hybrid Root SEAL (Sun Medical, Tokyo, Japan and iRoot SP (Innovative BioCeramix Inc., Vancouver, Canada. Materials and Methods: A sample of 60 permanent single rooted, human maxillary central incisors of similar sizes was selected for the study. The teeth were decoronated and randomly divided into two groups viz.: Group A and Group B, comprising of thirty teeth each. In Group A, Hybrid Root SEAL and Group B, iRoot SP were used as root canal sealers along with Gutta-percha cones using lateral condensation technique to obturate the canals. After obturation roots were covered with nail paint except 2.0 mm of root and stored in 0.5% methylene blue dye for 1 week. The teeth were immersed in 10 ml of 65% nitric acid for complete dissolution and subsequently subjected to UV spectrophotometer to quantify the concentration of the dye in each sample. The data were analyzed using the unpaired t-test. Results: The mean dye leakage value in Group B (0.368 was less as compared to Group A (0.408. However, statistically the difference was nonsignificant (P = 0.053. Conclusion: There was no statistically significant difference among the two groups.

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

Comparison among manual instruments and PathFile and Mtwo rotary instruments to create a glide path in the root canal preparation of curved canals.

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Alves, Vanessa de Oliveira; Bueno, Carlos Eduardo da Silveira; Cunha, Rodrigo Sanches; Pinheiro, Sérgio Luiz; Fontana, Carlos Eduardo; de Martin, Alexandre Sigrist

2012-01-01

Nickel-titanium rotary instruments reduce procedural errors and the time required to finish root canal preparation. The goal of this study was to evaluate the occurrences of apical transportation and canal aberrations produced with different instruments used to create a glide path in the preparation of curved root canals, namely manual K-files (Dentsply Maillefer, Ballaigues, Switzerland) and PathFile (Dentsply Maillefer) and Mtwo (Sweden and Martina, Padua, Italy) nickel-titanium rotary files. The mesial canals of 45 mandibular first and second molars (with curvature angles between 25° and 35°) were selected for this study. The specimens were divided randomly into 3 groups with 15 canals each, and canal preparation was performed by an endodontist using #10-15-20 K-type stainless steel manual files (group M), #13-16-19 PathFile rotary instruments (group PF), and #10-15-20 Mtwo rotary instruments (group MT). The double digital radiograph technique was used, pre- and postinstrumentation, to assess whether apical transportation and/or aberration in root canal morphology occurred. The initial and final images of the central axis of the canals were compared by superimposition through computerized analysis and with the aid of magnification. The specimens were analyzed by 3 evaluators, whose calibration was checked using the Kendall agreement test. No apical transportation or aberration in root canal morphology occurred in any of the teeth; therefore, no statistical analysis was conducted. Neither the manual instruments nor the PathFile or Mtwo rotary instruments used to create a glide path had any influence on the occurrence of apical transportation or produced any canal aberration. Copyright © 2012 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Phage therapy against Enterococcus faecalis in dental root canals

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Leron Khalifa

2016-09-01

Full Text Available Antibiotic resistance is an ever-growing problem faced by all major sectors of health care, including dentistry. Recurrent infections related to multidrug-resistant bacteria such as methicillin-resistant Staphylococcus aureus, carbapenem-resistant Enterobacteriaceae, and vancomycin-resistant enterococci (VRE in hospitals are untreatable and question the effectiveness of notable drugs. Two major reasons for these recurrent infections are acquired antibiotic resistance genes and biofilm formation. None of the traditionally known effective techniques have been able to efficiently resolve these issues. Hence, development of a highly effective antibacterial practice has become inevitable. One example of a hard-to-eradicate pathogen in dentistry is Enterococcus faecalis, which is one of the most common threats observed in recurrent root canal treatment failures, of which the most problematic to treat are its biofilm-forming VRE strains. An effective response against such infections could be the use of bacteriophages (phages. Phage therapy was found to be highly effective against biofilm and multidrug-resistant bacteria and has other advantages like ease of isolation and possibilities for genetic manipulations. The potential of phage therapy in dentistry, in particular against E. faecalis biofilms in root canals, is almost unexplored. Here we review the efforts to develop phage therapy against biofilms. We also focus on the phages isolated against E. faecalis and discuss the possibility of using phages against E. faecalis biofilm in root canals.

Antibiotic resistance genes in anaerobic bacteria isolated from primary dental root canal infections.

Science.gov (United States)

Rôças, Isabela N; Siqueira, José F

2012-12-01

Fourty-one bacterial strains isolated from infected dental root canals and identified by 16S rRNA gene sequence were screened for the presence of 14 genes encoding resistance to beta-lactams, tetracycline and macrolides. Thirteen isolates (32%) were positive for at least one of the target antibiotic resistance genes. These strains carrying at least one antibiotic resistance gene belonged to 11 of the 26 (42%) infected root canals sampled. Two of these positive cases had two strains carrying resistance genes. Six out of 7 Fusobacterium strains harbored at least one of the target resistance genes. One Dialister invisus strain was positive for 3 resistance genes, and 4 other strains carried two of the target genes. Of the 6 antibiotic resistance genes detected in root canal strains, the most prevalent were blaTEM (17% of the strains), tetW (10%), and ermC (10%). Some as-yet-uncharacterized Fusobacterium and Prevotella isolates were positive for blaTEM, cfxA and tetM. Findings demonstrated that an unexpectedly large proportion of dental root canal isolates, including as-yet-uncharacterized strains previously regarded as uncultivated phylotypes, can carry antibiotic resistance genes. Copyright © 2012 Elsevier Ltd. All rights reserved.

Comparison of different retreatment techniques and root canal sealers: a scanning electron microscopic study

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Neslihan Simsek

2014-05-01

Full Text Available The aim of this study was to evaluate the effectiveness of two retreatment techniques, in terms of the operating time and scanning electron microscopy (SEM results, in removing three different root canal sealers from root canals that were previously filled with gutta-percha. Sixty extracted single-rooted human premolars were divided into three groups and filled with iRoot SP, MM Seal, and AH Plus sealers, along with gutta-percha, through a lateral compaction technique. Root canal fillings of the samples were removed by ESI ultrasonic tips or R-Endo files. The time to reach the working length was recorded. Longitudinally sectioned samples were examined under SEM magnification. Each picture was evaluated in terms of the residual debris. Data were statistically analyzed with the Kruskall-Wallis test. No statistically significant differences were found in terms of operating time (p>0.05. Significant differences in the number of debris-free dentinal tubules were found among the root canal thirds, but this finding was not influenced by the experimental group (p < 0.05. Resin sealer tags were observed inside the dentinal tubules in the MM Seal group. Under the conditions of this study, it may be established that there was no difference among the sealers and retreatment techniques.

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

Science.gov (United States)

Kumari, Manju Raj; Krishnaswamy, Manjunath Mysore

2016-07-01

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

K-file vs ProFiles in cleaning capacity and instrumentation time in primary molar root canals: An in vitro study

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N Madan

2011-01-01

Full Text Available Objectives: This study compares the efficiency of manual K-files and rotary ProFiles in cleaning capacity and instrumentation time in primary molar root canals. Materials and Methods: Seventy-five maxillary and mandibular primary molar root canals were instrumented with ProFiles and K-files in the step-back manner from size #10 to #40. The teeth were decalcified, dehydrated and cleared, and analyzed for the presence of dye remaining on the root canal walls, which served as an evidence of cleaning capacity of both the techniques. Results: The results showed a significant difference in the cleaning capacity of the root canals with ProFiles and K-files, in apical and coronal thirds of the root canal. ProFiles have been found to be more efficient in cleaning the coronal thirds and K-files in cleaning apical thirds of the root canals. Both the techniques were almost equally effective in cleaning the middle thirds of the canals. The time taken during the cleaning of the root canals appeared to be statistically shorter with K-files than profiles.

Choice of root canal irrigants by Serbian dental practitioners

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Tošić Goran

2016-01-01

Full Text Available Background/Aim. Root canal treatment is considered to be the one of the most important procedures in endodontic treatment. To irrigate the root canal it is most common to use sodium hypochlorite (NaOCl, chlorhexodine, ethylenediami-netetraacetic acid (EDTA, local anesthetic solution, while the most used in Serbia is hydrogen peroxide (H2O2. The aim of this survey was to reveal the preferred root canal irrigants used by general dental practitioners in Serbia and to determine the influence of the continuing education program, delivered over the 3-year observation period, on work habits of dental practitioners. This was the first comprehensive survey of this nature carried out in Serbia. Methods. The survey was conducted in two instances, a 4-month observation period each, from November 1, 2009 to March 1, 2010 and from November 1, 2012 to March 1, 2013. Internet Web Page Survey was posted on the official web site of the Serbian Association of Private Dentists. In the first survey, 569 completed questionnaires were subjected to analysis. In the next attempt (3 years later, the survey was launched again and 615 completed questionnaires were analyzed using the same criteria. The statistical analysis was carried out with simple descriptive statistics applying the χ2 test, at a significance level of p < 0.05. Results. The first survey included 569 dental practitioners, while 3 years later the number of them was 615. Analyzing the questionnaires revealed the number of 10 to 30 interventins on the root canal montly. The most commonly used irrigant solution was H2O2 in 2009, while in 2012 it was yet H2O2, but also NaOCl, chlorhexodine, and a little less EDTA. Conclusion. This study shows significant changes in the irrigation protocol applied in Serbian dental community. After 3 years of observation, NaOCl became widely accepted as the irrigant of choice, whereas H2O2 lost its popularity.

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

Science.gov (United States)

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

2006-07-01

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

LPS levels in root canals after the use of ozone gas and high frequency electrical pulses

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Tiago André Fontoura de MELO

2016-01-01

Full Text Available Abstract The present study aims to verify the effect of ozone gas (OZY® System and high frequency electric pulse (Endox® System systems on human root canals previously contaminated with Escherichia colilipopolysaccharide (LPS. Fifty single-rooted teeth had their dental crowns removed and root lengths standardized to 16 mm. The root canals were prepared up to #60 hand K-files and sterilized using gamma radiation with cobalt 60. The specimens were divided into the following five groups (n = 10 based on the disinfection protocol used: OZY® System, one 120-second-pulse (OZY 1p; OZY® System, four 24-second-pulses (OZY 4p; and Endox® System (ENDOX. Contaminated and non-contaminated canals were exposed only to apyrogenic water and used as positive (C+ and negative (C- controls, respectively. LPS (O55:B55 was administered in all root canals except those belonging to group C-. After performing disinfection, LPS samples were collected from the canals using apyrogenic paper tips. Limulus Amoebocyte Lysate (LAL was used to quantify the LPS levels, and the data obtained was analyzed using one-way ANOVA. The disinfection protocols used were unable to reduce the LPS levels significantly (p = 0.019. The use of ozone gas and high frequency electric pulses was not effective in eliminating LPS from the root canals.

YouTube as a patient-information source for root canal treatment.

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Nason, K; Donnelly, A; Duncan, H F

2016-12-01

To assess the content and completeness of Youtube ™ as an information source for patients undergoing root canal treatment procedures. YouTube ™ (https://www.youtube.com/) was searched for information using three relevant treatment search terms ('endodontics', 'root canal' and 'root canal treatment'). After exclusions (language, no audio, >15 min, duplicates), 20 videos per search term were selected. General video assessment included duration, ownership, views, age, likes/dislikes, target audience and video/audio quality, whilst content was analysed under six categories ('aetiology', 'anatomy', 'symptoms', 'procedure', 'postoperative course' and 'prognosis'). Content was scored for completeness level and statistically analysed using anova and post hoc Tukey's test (P YouTube ™ videos for endodontic search terms varied significantly by source and content and were generally incomplete. The danger of patient reliance on YouTube ™ is highlighted, as is the need for endodontic professionals to play an active role in directing patients towards alternative high-quality information sources. © 2015 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Analysis of C-shaped root canal configuration in maxillary molars in a Korean population using cone-beam computed tomography

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Hyoung-Hoon Jo

2016-02-01

Full Text Available Objectives The purpose of this study was to investigate the incidence of root fusion and C-shaped root canals in maxillary molars, and to classify the types of C-shaped canal by analyzing cone-beam computed tomography (CBCT in a Korean population. Materials and Methods Digitized CBCT images from 911 subjects were obtained in Chosun University Dental Hospital between February 2010 and July 2012 for orthodontic treatment. Among them, a total of selected 3,553 data of maxillary molars were analyzed retrospectively. Tomography sections in the axial, coronal, and sagittal planes were displayed by PiViewstar and Rapidia MPR software (Infinitt Co.. The incidence and types of root fusion and C-shaped root canals were evaluated and the incidence between the first and the second molar was compared using Chi-square test. Results Root fusion was present in 3.2% of the first molars and 19.5% of the second molars, and fusion of mesiobuccal and palatal root was dominant. C-shaped root canals were present in 0.8% of the first molars and 2.7% of the second molars. The frequency of root fusion and C-shaped canal was significantly higher in the second molar than the first molar (p < 0.001. Conclusions In a Korean population, maxillary molars showed total 11.3% of root fusion and 1.8% of C-shaped root canals. Furthermore, root fusion and C-shaped root canals were seen more frequently in the maxillary second molars.

One-session root canal treatment with antimicrobial photodynamic therapy (aPDT): an in vivo study.

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Borsatto, M C; Correa-Afonso, A M; Lucisano, M P; Bezerra da Silva, R A; Paula-Silva, F W G; Nelson-Filho, P; Bezerra da Silva, L A

2016-06-01

To evaluate the response of the apical and periapical tissues of dog teeth with apical periodontitis after one-session root canal treatment with and without antimicrobial photodynamic therapy (aPDT) compared with the use of an intracanal dressing. Sixty root canals with an induced periapical lesion were instrumented and assigned to three groups: I, two-session root canal treatment using antibacterial dressing with calcium hydroxide-based paste; II, one-session root canal treatment using aPDT; and III, one-session root canal treatment in which the root canals were filled immediately after biomechanical preparation. The animals were euthanized after a 90-day experimental period. The maxillas and mandibles with teeth were submitted to histotechnical processing and haematoxylin-eosin staining. Descriptive microscopic analysis of the apical and periapical region characteristics was performed, as well as morphometric assessment of the periapical lesion areas in fluorescence microscopy. Quantitative data were analysed statistically by the nonparametric Kruskal-Wallis test and Dunn's post-test (α = 0.05). Group I was characterized by progressive repair, with the presence of fibres, cells and blood vessels. Group II had periodontal ligaments with the presence of collagen fibres and residual inflammatory cells. Group III had a dense inflammatory infiltrate with extensive oedematous areas and fibrillar dissociation, suggesting a persistent inflammatory and resorptive condition. Regarding periapical lesion size, group I had significantly smaller lesions (P session root canal treatment using a calcium hydroxide-based dressing was associated with significantly smaller periapical lesions at 90 days and characterized by progressive repair. © 2015 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Assessment of Marginal Adaptation and Sealing Ability of Root Canal Sealers: An in vitro Study.

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Remy, Vimal; Krishnan, Vineesh; Job, Tisson V; Ravisankar, Madhavankutty S; Raj, C V Renjith; John, Seena

2017-12-01

This study aims to compare the marginal adaptation and sealing ability [mineral trioxide aggregate (MTA)-Fillapex, AH Plus, Endofill sealers] of root canal sealers. In the present study, the inclusion criteria include 45 single-rooted extracted mandibular premolar teeth, with single canal and complete root formation. The sectioning of the samples was done at the cementoenamel junction using a low-speed diamond disc. Step-back technique was used to prepare root canals manually. The MTA-Fillapex, AH Plus, and Endofill sealers were the three experimental sealer groups to which 45 teeth were distributed. Under scanning electron microscope (SEM), marginal gap at sealer and root dentin interface were examined at coronal and apical halves of root canal. Among the three maximum marginal adaptations were seen with AH Plus sealer (4.10 ± 0.10) which is followed by Endofill sealer (1.44 ± 0.18) and MTA-Fillapex sealer (0.80 ± 0.22). Between the coronal and apical marginal adaptation, significant statistical difference (p = 0.001) was seen in AH Plus sealer. When a Mann-Whitney U-test was done on MTA-Fillapex sealer vs AH Plus sealer and AH Plus sealer vs Endofill sealer, there was a statistically significant difference (p marginal adaptation when compared with other sealers used. For sealing space of crown wall and main cone in root canal treatment, sealers play an important role. The other advantages of sealers are that they are used to fill voids and irregularities in root channel, secondary, lateral channels, and space between applied gutta-percha cones and also act as tripper during filling.

Evaluation of complications of root canal treatment performed by ...

African Journals Online (AJOL)

Mothanna K. AlRahabi

2017-07-05

Jul 5, 2017 ... treatment performed by undergraduate dental students, Libyan Journal of Medicine, 12:1, 1345582, .... mass could be detected on X-ray radiographs. Overfilling was ... of tooth structure on root canal obturation and anatomical.

Root canal treatment of pulpless immature teeth using calcium hydroxide paste. Roentgenographic study

International Nuclear Information System (INIS)

Leite, R.M.G.V.; Abbud, R.

1986-01-01

Calcium hydroxide paste was used as a temporary dressing and the renewal was done each three months in the root treatment of immature teeth with open apex and necrotic pulps. Clinical and radiographic controls were made to observe foraminal closure. After that, the root canals were filled, employing the conventional technique with gutta-percha cones and zinc oxide eugenol cements. The calcium hydroxide paste was applied in the apical region before the root canal filling. The follow-up was done periodically and the cases have more than two years of control. (author) [pt

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

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van der Sluis, L W M

2015-10-01

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

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

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

2013-01-01

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

Root Canal Cleaning Efficacy of Rotary and Hand Files Instrumentation in Primary Molars

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Nazari Moghaddam, Kiumars; Mehran, Majid; Farajian Zadeh, Hamideh

2009-01-01

INTRODUCTION: Pulpectomy of primary teeth is commonly carried out with hand files and broaches; a tricky and time consuming procedure. The purpose of this in vitro study was to compare the cleaning efficacy and time taken for instrumentation of deciduous molars using hand K-files and Flex Master rotary system. MATERIALS AND METHODS: In this study, 68 canals of 23 extracted primary molars with at least two third intact roots and 7-12 mm length were selected. After preparing an access cavity, K-file size #15 was introduced into the root canal and India ink was injected with an insulin syringe. Sixty samples were randomly divided in to experimental groups in group I (n=30), root canals were prepared with hand K-files; in group II (n=30), rotary Flex Master files were used for instrumentation, and in group III 8 remained samples were considered as negative controls. After clearing and root sectioning, the removal of India ink from cervical, middle, and apical thirds was scored. Data was analyzed using student's T-test and Mann-Whitney U test. RESULTS: There was no significant difference between experimental groups cleaning efficacy at the cervical, middle and apical root canal thirds. Only the coronal third scored higher in the hand instrumented group (PInstrumentation with Flex Master rotary files was significantly less time consuming (Protary technique. PMID:23940486

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

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Razmi, Hasan; Shokouhinejad, Noushin; Hooshyar, Mohsen

2008-01-01

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

Comparative evaluation of fracture and defect in reciproc and rotary files in severe curved root canals

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Mahdis Bagherian

2015-03-01

Full Text Available Introduction: Root canal instrumentation is an important phase in root canal therapy. Since success in endodontic treatment depends on file defect and fracture, the aim of this study was to compare the evaluation of defect and fracture in rotary and reciproc files in severe curved root canals. Materials & Methods: In this experimental study, 60 mesial canals of human closed apex molars with more than 30° canal curvature were randomly divided into two groups. In first group M-two rotary files number# 15, 20, and 25 and in second group R25 reciproc file were used for filing, respectively. A ×8 magnifier was applied to evaluate the defect or fracture presence in each side and if it were observed, a new file would be replaced. Therefore, the number of prepared canals with each file and fractured or defective files and the place of fracture in root canal were recorded. Kaplan Meier curve and log rank test were done by using SPSS v.22. Results: In rotary group, seven and two files were fractured and defected, respectively and four files were fractured and no defect was observed in reciproc group. Although the mean of the number of prepared canals until fracture or defect in rotary and reciproc groups was 3.3 and 7.06, respectively, there were no significant differences between two systems. All file’s fractures occurred in apical regions . Conclusion: The results showed that there was no significant difference in defects or fractures of rotary and reciproc systems. Reciproc instruments can be more effective than rotary ones because the root canal preparation in rotary instruments is longer than in reciproc system.

Exploiting the potential of free software to evaluate root canal biomechanical preparation outcomes through micro-CT images.

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Neves, A A; Silva, E J; Roter, J M; Belladona, F G; Alves, H D; Lopes, R T; Paciornik, S; De-Deus, G A

2015-11-01

To propose an automated image processing routine based on free software to quantify root canal preparation outcomes in pairs of sound and instrumented roots after micro-CT scanning procedures. Seven mesial roots of human mandibular molars with different canal configuration systems were studied: (i) Vertucci's type 1, (ii) Vertucci's type 2, (iii) two individual canals, (iv) Vertucci's type 6, canals (v) with and (vi) without debris, and (vii) canal with visible pulp calcification. All teeth were instrumented with the BioRaCe system and scanned in a Skyscan 1173 micro-CT before and after canal preparation. After reconstruction, the instrumented stack of images (IS) was registered against the preoperative sound stack of images (SS). Image processing included contrast equalization and noise filtering. Sound canal volumes were obtained by a minimum threshold. For the IS, a fixed conservative threshold was chosen as the best compromise between instrumented canal and dentine whilst avoiding debris, resulting in instrumented canal plus empty spaces. Arithmetic and logical operations between sound and instrumented stacks were used to identify debris. Noninstrumented dentine was calculated using a minimum threshold in the IS and subtracting from the SS and total debris. Removed dentine volume was obtained by subtracting SS from IS. Quantitative data on total debris present in the root canal space after instrumentation, noninstrumented areas and removed dentine volume were obtained for each test case, as well as three-dimensional volume renderings. After standardization of acquisition, reconstruction and image processing micro-CT images, a quantitative approach for calculation of root canal biomechanical outcomes was achieved using free software. © 2014 International Endodontic Journal. Published by John Wiley & Sons Ltd.

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.

Ex vivo evaluation of three instrumentation techniques on E. faecalis biofilm within oval shaped root canals

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Vitor Cesar NAKAMURA

2015-01-01

Full Text Available The objective of the present study was to assess the effectiveness of reciprocating instrumentation in disinfecting oval-shaped root canals infected with Enterococcus faecalis. Forty-five human lower premolars were infected with a culture of E. faecalis (ATCC 29212 for 28 days. Five other teeth that were neither contaminated nor instrumented were used as controls. The 45 specimens were divided into three experimental groups (n = 15 based on the root canal preparation technique used: manual (K-type, Dentsply Maillefer, Ballaigues, Switzerland; rotary (MTwo, VDW GmbH, Munich, Germany; and reciprocating (Reciproc R50, VDW GmbH, Munich, Germany instruments. During chemomechanical preparation, 21 mL of 2.5% NaOCl was used as the irrigating solution. Microbiological sampling was performed before (S1 and immediately after (S2 the chemomechanical preparation using sterilized paper points. Specimens were then cleaved, and 0.02 g of dentine chips was collected from the root thirds to verify the presence of microorganisms in dentinal tubules. All three preparation techniques reduced the number of microorganisms in the root canal lumen and dentine chips from the root thirds, but no significant differences were observed between the three groups (p > 0.05. Reciprocating instrumentation with Reciproc R50 was effective in reducing the number of microorganisms within the root canal system. Although this technique involves the use of only one file to perform the root canal therapy, it is as effective as conventional rotary instrumentation in reducing theE. faecalis biofilm from the root canal system. However, further clinical investigations are warranted in order to ratify these results.

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

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

2016-01-01

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

Evaluation of the radiopacities of four different root canal sealers by digital radiographic technique

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Özgür Özdemir

2016-05-01

Full Text Available OBJECTIVE: The aim of this study was to compare the radiopacities of four different root canal sealers and gutta-percha. MATERIALS AND METHOD: AH Plus, iRootSP, MTA Fillapex and Sealapex as root canal sealers and gutta-percha cones were tested. Standardized discs of the root canal sealers and the gutta-percha were prepared. Digital radiographs of the discs and an aluminum penetrometer were obtained by using a phosphor plate. The radiographic density of the sealers and the gutta-percha were measured by using the digital radiographic system’s own measurement tool, and equivalent aluminum thicknesses were determined by using an image editing software. Differences among radiopacities of the root canal sealers and the gutta-percha were analyzed using One-way ANOVA and Tukey post-hoc tests. RESULTS: Aluminum thickness equivalents of the radiopacity values of the samples, in descending order, were: AH Plus, Sealapex, iRootSP, MTA Fillapex and gutta-percha. No significant difference was found between the radiopacity values of AH Plus and Sealapex (p>0.05. There were statistically significant differences between these two groups (AH Plus and Sealapex and all other experimental groups (p<0.05. CONCLUSION: AH Plus and Sealapex exhibited the highest radiopacity values among tested groups. In addition, all tested materials fulfilled the minimum standard value requirements suggested by International Standardization Organization and American National Standards Institute.

Sodium hypochlorite accident resulting in life-threatening airway obstruction during root canal treatment: a case report

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Al-Sebaei MO

2015-03-01

Full Text Available Maisa O Al-Sebaei,1 Omar A Halabi,2 Ibrahim E El-Hakim3 1Department of Oral and Maxillofacial Surgery, King Abdulaziz University – Faculty of Dentistry, Jeddah, Kingdom of Saudi Arabia; 2Saudi Board of Oral and Maxillofacial Surgery, Al-Noor Specialist Hospital, Makkah, Kingdom of Saudi Arabia; 3Department of Oral and Maxillofacial Surgery, Riyadh Colleges of Dentistry and Pharmacy, Riyadh, Kingdom of Saudi Arabia Aim: This case report describes a serious and life-threatening complication of the use of sodium hypochlorite as an irrigation solution in root canal therapy. Summary: This case report describes a hypochlorite accident that occurred in a healthy 42-year-old female who was undergoing routine root canal therapy for the lower right central incisor (tooth #41. After approximately 1 hour of irrigation with 3% sodium hypochlorite (for a total of 12 cc, the patient complained of severe pain and burning in the lip. The swelling progressed over the next 8 hours to involve the sublingual and submental fascial spaces with elevation of the tongue and resultant upper airway obstruction. The patient was intubated and remained on mechanical ventilation for 3 days. She recovered without any skin necrosis or nerve deficits. Key learning points: This case report highlights the importance of carefully performing root canal irrigation with sodium hypochlorite to avoid complications. Careful injection without pressure, the use of proper rubber dam isolation, and the use of the endodontic needle are necessary to avoid this type of complication. Although it is a safe root canal irrigation solution, its use may lead to life-threatening complications. Early recognition and management of the untoward effects of sodium hypochlorite are vital for the patient's safety. Keywords: complications of root canal, facial edema, root canal irrigation, root canal therapy, sodium hypochlorite, upper airway obstruction

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

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Vivek Gaurav

2013-01-01

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

Inhibition effect of calcium hydroxide point and chlorhexidine point on root canal bacteria of necrosis teeth

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Andry Leonard Je

2006-03-01

Full Text Available Calcium Hydroxide point and Chlorhexidine point are new drugs for eliminating bacteria in the root canal. The points slowly and controly realease Calcium Hydroxide and Chlorhexidine into root canal. The purpose of the study was to determined the effectivity of Calcium hydroxide point (Calcium hydroxide plus point and Chlorhexidine point in eleminating the root canal bacteria of nescrosis teeth. In this study 14 subjects were divided into 2 groups. The first group was treated with Calcium hydroxide point and the second was treated with Chlorhexidine poin. The bacteriological sampling were measured with spectrofotometry. The Paired T Test analysis (before and after showed significant difference between the first and second group. The Independent T Test which analysed the effectivity of both groups had not showed significant difference. Although there was no significant difference in statistical test, the result of second group eliminate more bacteria than the first group. The present finding indicated that the use of Chlorhexidine point was better than Calcium hydroxide point in seven days period. The conclusion is Chlorhexidine point and Calcium hydroxide point as root canal medicament effectively eliminate root canal bacteria of necrosis teeth.

Irrigant flow in the root canal: experimental validation of an unsteady Computational Fluid Dynamics model using high-speed imaging.

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Boutsioukis, C; Verhaagen, B; Versluis, M; Kastrinakis, E; van der Sluis, L W M

2010-05-01

To compare the results of a Computational Fluid Dynamics (CFD) simulation of the irrigant flow within a prepared root canal, during final irrigation with a syringe and a needle, with experimental high-speed visualizations and theoretical calculations of an identical geometry and to evaluate the effect of off-centre positioning of the needle inside the root canal. A CFD model was created to simulate irrigant flow from a side-vented needle inside a prepared root canal. Calculations were carried out for four different positions of the needle inside a prepared root canal. An identical root canal model was made from poly-dimethyl-siloxane (PDMS). High-speed imaging of the flow seeded with particles and Particle Image Velocimetry (PIV) were combined to obtain the velocity field inside the root canal experimentally. Computational, theoretical and experimental results were compared to assess the validity of the computational model. Comparison between CFD computations and experiments revealed good agreement in the velocity magnitude and vortex location and size. Small lateral displacements of the needle inside the canal had a limited effect on the flow field. High-speed imaging experiments together with PIV of the flow inside a simulated root canal showed a good agreement with the CFD model, even though the flow was unsteady. Therefore, the CFD model is able to predict reliably the flow in similar domains.

Release of Growth Factors into Root Canal by Irrigations in Regenerative Endodontics.

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Zeng, Qian; Nguyen, Sean; Zhang, Hongming; Chebrolu, Hari Priya; Alzebdeh, Dalia; Badi, Mustafa A; Kim, Jong Ryul; Ling, Junqi; Yang, Maobin

2016-12-01

The aim of this study was to investigate the release of growth factors into root canal space after the irrigation procedure of regenerative endodontic procedure. Sixty standardized root segments were prepared from extracted single-root teeth. Nail varnish was applied to all surfaces except the root canal surface. Root segments were irrigated with 1.5% NaOCl + 17% EDTA, 2.5% NaOCl + 17% EDTA, 17% EDTA, or deionized water. The profile of growth factors that were released after irrigation was studied by growth factor array. Enzyme-linked immunosorbent assay was used to validate the release of transforming growth factor (TGF)-β1 and basic fibroblast growth factor (bFGF) at 4 hours, 1 day, and 3 days after irrigation. The final concentrations were calculated on the basis of the root canal volume measured by cone-beam computed tomography. Dental pulp stem cell migration on growth factors released from root segments was measured by using Transwell assay. Total of 11 of 41 growth factors were detected by growth factors array. Enzyme-linked immunosorbent assay showed that TGF-β1 was released in all irrigation groups. Compared with the group with 17% EDTA (6.92 ± 4.49 ng/mL), the groups with 1.5% NaOCl + 17% EDTA and 2.5% NaOCl + 17% EDTA had significantly higher release of TGF-β1 (69.04 ± 30.41 ng/mL and 59.26 ± 3.37 ng/mL, respectively), with a peak release at day 1. The release of bFGF was detected at a low level in all groups (0 ng/mL to 0.43 ± 0.22 ng/mL). Migration assay showed the growth factors released from root segments induced dental pulp stem cell migration. The root segment model in present study simulated clinical scenario and indicated that the current irrigation protocol released a significant amount of TGF-β1 but not bFGF. The growth factors released into root canal space induced dental pulp stem cell migration. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Technical quality of root canal fillings performed in a dental school and the associated retention of root-filled teeth: a clinical follow-up study over a 5-year period.

LENUS (Irish Health Repository)

Burke, F M

2009-07-01

The aim of this study was to examine the technical quality of root canal fillings performed in a dental school and to investigate the associated effect on the survival\\/retention of root-filled teeth. A review of case notes of patients who had root canal treatment performed in the department of Restorative Dentistry, University Dental School and Hospital, Cork, Ireland was carried out. The technical quality of the root canal filling was described according to its relationship with the radiographic apex on a post-treatment radiograph. Tooth status at review was defined as \\'tooth present\\' or \\'tooth absent\\' based on the presence or absence of the root-filled tooth recorded in the treatment records at a review appointment following placement of the root canal filling. One hundred and forty-eight teeth (129 patients) were considered. Of these, 69.6% (n = 103) were of acceptable technical quality, 23.6% (n = 35) were under-extended, and 6.8% (n = 10) were overextended. An increased number of intra-treatment radiographs to confirm the relationship of the canal preparation to the radiographic apex and operator experience were significant predictors of adequate root canal fillings (P < 0.05). Eighty-three per cent (n = 123) of teeth were present at a review appointment held an average of 40 months following completion of treatment (12-60 months). The technical quality of the root canal filling was the only significant factor in predicting tooth survival (P < 0.05), while the presence of pre-treatment periapical pathology had no significant effect on survival of the root-filled tooth. Determination and maintenance of the working length of the canal system is an important feature in producing good quality root canal fillings, which in turn, is associated with increased likelihood of survival\\/retention of root-filled teeth.

The effect of immediate and delayed post-space preparation using extended working time root canal sealers on apical leakage

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G. Chen

2013-03-01

Conclusion: Extended working time root canal sealers do not affect microleakage results using a warm gutta-percha vertical compaction technique. The sealing ability of extended working time root canal sealers on high heat conditions is as good as the standard working time root canal sealer during post-space preparation of different intervals.

Four canals in the mesial root of a mandibular first molar. A case report under the operating microscope.

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Kontakiotis, Evangelos G; Tzanetakis, Giorgos N

2007-08-01

In this era of microscope-assisted endodontics, finding variations in root canal system anatomy is not uncommon. Operating microscopes combined with careful clinical examination and radiographic interpretation can aid the clinician to successfully treat cases with such internal anatomy. The understanding of this view enables the possible location of additional canals in any tooth requiring endodontic treatment. The present clinical article demonstrates a rare anatomical complexity in the mesial root of a mandibular first molar. Four independent root canal orifices were found in this root by clinical detection with the aid of a dental operating microscope. This case shows that additional canals can be located in any root undergoing endodontic treatment and clinicians should always be aware of aberrant internal anatomy.

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

OpenAIRE

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

2013-01-01

The mesiobuccal root of the maxillary molars is well known to pose a hindrance during endodontic therapy. Presented here is a case of a maxillary left second molar where three canals were located in its mesiobuccal root with the use of visual and diagnostic aids. Difficulties encountered during the process of unveiling the tooth's internal anatomy were discussed. The dilemmas encountered pertained to the root canal configuration, the nomenclature of the extra canals, and the justification for...

Primary mandibular first molar with single root and single canal: a case report of a rare morphology.

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Zahra Bahrololoomi

2014-06-01

Full Text Available Single rooted primary mandibular first molar is a rare developmental anomaly. Literatures reveal that failure of invagination of Hertwig's epithelial root sheath leads to this unusual root form. Thorough knowledge of root canal morphology and anatomical variations of primary teeth can help a pediatric dentist in successful root canal treatment. Hereby, we describe two cases of primary mandibular first molars with an unusual morphology as a single root called pyramidal molar.

Classification of root canal microorganisms using electronic-nose and discriminant analysis

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Özbilge Hatice

2010-11-01

Full Text Available Abstract Background Root canal treatment is a debridement process which disrupts and removes entire microorganisms from the root canal system. Identification of microorganisms may help clinicians decide on treatment alternatives such as using different irrigants, intracanal medicaments and antibiotics. However, the difficulty in cultivation and the complexity in isolation of predominant anaerobic microorganisms make clinicians resort to empirical medical treatments. For this reason, identification of microorganisms is not a routinely used procedure in root canal treatment. In this study, we aimed at classifying 7 different standard microorganism strains which are frequently seen in root canal infections, using odor data collected using an electronic nose instrument. Method Our microorganism odor data set consisted of 5 repeated samples from 7 different classes at 4 concentration levels. For each concentration, 35 samples were classified using 3 different discriminant analysis methods. In order to determine an optimal setting for using electronic-nose in such an application, we have tried 3 different approaches in evaluating sensor responses. Moreover, we have used 3 different sensor baseline values in normalizing sensor responses. Since the number of sensors is relatively large compared to sample size, we have also investigated the influence of two different dimension reduction methods on classification performance. Results We have found that quadratic type dicriminant analysis outperforms other varieties of this method. We have also observed that classification performance decreases as the concentration decreases. Among different baseline values used for pre-processing the sensor responses, the model where the minimum values of sensor readings in the sample were accepted as the baseline yields better classification performance. Corresponding to this optimal choice of baseline value, we have noted that among different sensor response model and

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

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

2016-10-01

The aim of this study was to compare the effectiveness of TRUShape (TS) instruments with ProFile Vortex Blue (VB) instruments for the removal of obturation materials during retreatment of single-canal mandibular premolars performed through 2 access outlines. Initial root canal treatment was completed through a contracted endodontic cavity (CEC) design. Canals were instrumented to an F2 ProTaper instrument, obturated with warm lateral condensation of gutta-percha with AH Plus sealer, and allowed to set for 30 days at 37°C and 100% humidity. For retreatment, specimens were divided into 2 groups (n = 24) on the basis of access outline, CEC or traditional endodontic cavity (TEC). Retreatment was initiated by using ProTaper Retreatment instruments (D1-D3). Specimens were then stratified, further divided (n = 12), and reinstrumented up to TS 40 .06v or 40 .06 VB. Irrigation was performed by using 8.25% NaOCl and QMix 2in1. Retreatment time was recorded. Teeth were sectioned and photographed, and the percentage of remaining obturation materials was measured. Data were analyzed with Kruskal-Wallis analysis of variance for two-factor tests (α canal surface when compared with TEC-VB, CEC-TS, and TEC-TS (P ≤ .05). None of these other combinations were different from each other (P > .05). Significantly more time was required for retreatment with CEC-TS (27.68 ± 1.4 minutes) than the other groups (P root canal surface of mandibular premolars. However, in the presence of a CEC access design, using TS instruments removed more obturating material in single-rooted, oval-shaped canals. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

An unusual presentation of all the mandibular anterior teeth with two root canals - A case report

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Tiku A

2005-01-01

Full Text Available A rare case of two root canals in all mandibular anterior teeth is presented. The patient initially reported for the treatment of mandibular right central and lateral incisors. However, radiographic evaluation revealed variant root canal and apical foramen patterns.

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

Science.gov (United States)

Monsarrat, Paul; Arcaute, Bertrand; Peters, Ove A; Maury, Elisabeth; Telmon, Norbert; Georgelin-Gurgel, Marie; Maret, Delphine

2016-01-01

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

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

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Paul Monsarrat

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

Quantitative three-dimensional analysis of root canal curvature in maxillary first molars using micro-computed tomography.

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Lee, Jong-Ki; Ha, Byung-Hyun; Choi, Jeong-Ho; Heo, Seok-Mo; Perinpanayagam, Hiran

2006-10-01

In endodontic therapy, access and instrumentation are strongly affected by root canal curvature. However, the few studies that have actually measured curvature are mostly from two-dimensional radiographs. The purpose of this study was to measure the three-dimensional (3D) canal curvature in maxillary first molars using micro-computed tomography (microCT) and mathematical modeling. Extracted maxillary first molars (46) were scanned by microCT (502 image slices/tooth, 1024 X 1024 pixels, voxel size of 19.5 x 19.5 x 39.0 microm) and their canals reconstructed by 3D modeling software. The intersection of major and minor axes in the canal space of each image slice were connected to create an imaginary central axis for each canal. The radius of curvature of the tangential circle was measured and inverted as a measure of curvature using custom-made mathematical modeling software. Root canal curvature was greatest in the apical third and least in the middle third for all canals. The greatest curvatures were in the mesiobuccal (MB) canal (0.76 +/- 0.48 mm(-1)) with abrupt curves, and the least curvatures were in the palatal (P) canal (0.38 +/- 0.34 mm(-1)) with a gradual curve. This study has measured the 3D curvature of root canals in maxillary first molars and reinforced the value of microCT with mathematical modeling.

Hand and ultrasonic instrumentation for orthograde root canal treatment of permanent teeth

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Vinícius Pedrazzi

2010-06-01

Full Text Available Root canal treatment is a frequently performed dental procedure and is carried out on teeth in which irreversible pulpitis has led to necrosis of the dental pulp. Removal of the necrotic tissue remnants and cleaning and shaping of the root canal are important phases of root canal treatment. Treatment options include the use of hand and rotary instruments and methods using ultrasonic or sonic equipment. OBJECTIVES: The objectives of this systematic review of randomized controlled trials were to determine the relative clinical effectiveness of hand instrumentation versus ultrasonic instrumentation alone or in conjunction with hand instrumentation for orthograde root canal treatment of permanent teeth. MATERIAL AND METHODS: The search strategy retrieved 226 references from the Cochrane Oral Health Group Trials Register (7, the Cochrane Central Register of Controlled Trials (CENTRAL (12, MEDLINE (192, EMBASE (8 and LILACS (7. No language restriction was applied. The last electronic search was conducted on December 13th, 2007. Screening of eligible studies was conducted in duplicate and independently. RESULTS: Results were to be expressed as fixed-effect or random-effects models using mean differences for continuous outcomes and risk ratios for dichotomous outcomes with 95% confdence intervals. Heterogeneity was to be investigated including both clinical and methodological factors. No eligible randomized controlled trials were identifed. CONCLUSIONS: This review illustrates the current lack of published or ongoing randomized controlled trials and the unavailability of high-level evidence based on clinically relevant outcomes referring to the effectiveness of ultrasonic instrumentation used alone or as an adjunct to hand instrumentation for orthograde root canal treatment. In the absence of reliable research-based evidence, clinicians should base their decisions on clinical experience, individual circumstances and in conjunction with patients

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

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

2018-04-01

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

Vitality of Enterococcus faecalis inside dentinal tubules after five root canal disinfection methods

OpenAIRE

Vatkar, Niranjan Ashok; Hegde, Vivek; Sathe, Sucheta

2016-01-01

Aim: To compare the vitality of Enterococcus faecalis within dentinal tubules after subjected to five root canal disinfection methods. Materials and Methods: Dentin blocks (n = 60) were colonized with E. faecalis. After 4 weeks of incubation, the dentin blocks were divided into one control and five test groups (n = 10 each). The root canals of test groups were subjected to one of the disinfection methods, namely, normal saline (NS), sodium hypochlorite (NaOCl), chlorhexidine digluconate (C...

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

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

2011-06-01

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

Predictors, prevention, and management of postoperative pain associated with nonsurgical root canal treatment: A systematic review

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Mothanna K. AlRahabi, PhD

2017-10-01

Full Text Available Postoperative pain after root canal treatment can be reduced by applying recent advances in endodontic techniques and equipment. This systematic review includes current knowledge about pain after nonsurgical root canal treatment, including predictors, related factors, effects of recent advances, and management. A literature search was performed using the PubMed, ScienceDirect, and Cochrane Library databases for articles published between 1990 and 2016. Search keywords included postoperative pain, nonsurgical treatment, single visit, recent advances in endodontics, and management of postoperative pain with endodontic treatment. Only original research studies were included; editorials, reviews, brief notes, conference proceedings, and letters to the editor were excluded. The initial search yielded 4941 articles, which were assessed and filtered using the selection criteria. Sixty-five studies met the inclusion criteria and were included in the review. The findings showed that pain after nonsurgical root canal treatment occurred in 3–69.3% of patients. Microorganisms were identified as the primary contributors to postoperative pain, and there was no significant difference in postoperative pain between single- and multiple-visit treatments. Postoperative pain after root canal treatment ranges from mild to moderate and occurs even after optimally performed procedures. Furthermore, adequate management of postoperative pain is often considered an indicator of clinical excellence. Application of recently developed endodontic techniques and devices will reduce postoperative pain. Furthermore, a flexible, severity-based drug administration plan can be used to control and manage pain after root canal treatment. Application of the current research findings will reduce pain following root canal treatment and improve patient outcomes.

The antimicrobial effectiveness of 25% propolis extract in root canal irrigation of primary teeth.

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Verma, Manjesh Kumar; Pandey, Ramesh Kumar; Khanna, Richa; Agarwal, Jyotsna

2014-01-01

The choice of irrigating solution used in root canals of primary teeth is complicated by their complex morphology and paucity of associated literature. Propolis is a natural product that has gained interest in this context due to its antibacterial effectiveness against several endodontic pathogens. The present study was undertaken to assess the potential of water-soluble 25% propolis extract against microorganisms present in root canals of primary teeth during endodontic procedures. The child patients in the age group of 4-7 years with radiographic evidence of carious pulp exposure were included in the study. Definitive selection was done after gaining access into the pulp chamber and root canals of the selected teeth. The clinical and radiographic evidence of pathosis was ruled out for inclusion in the study. The selected teeth were divided into two groups randomly. In Group A 0.9% isotonic saline and in Group B 25% extract water-soluble propolis were used as irrigating solution, respectively. The bacterial samples were collected both pre- and post-irrigation and were transferred for microbial assay. STAISTISTICAL ANALYSIS: Wilcoxon matched signed rank test was used to compare the pre-and post-irrigation bacterial counts. Mann-Whitney test was used to compare the mean change (pre-post) in bacterial colony counts of groups in the study. Antimicrobial effectiveness of 25% water-soluble extract of propolis in the root canals of primary teeth was confirmed in the present study. The reduction in the mean bacterial colony counts of all the isolated bacteria was noticed higher in Group B than Group A. The results of the present study have confirmed that the antibacterial effectiveness of water-soluble extract of propolis in the root canals of primary teeth in vivo. Considering the low toxicity concerns and antibacterial effectiveness, water-soluble extract of 25% propolis can be advocated as a root canal irrigant in endodontic treatment of primary teeth.

The antimicrobial effectiveness of 25% propolis extract in root canal irrigation of primary teeth

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Manjesh Kumar Verma

2014-01-01

Full Text Available Context: The choice of irrigating solution used in root canals of primary teeth is complicated by their complex morphology and paucity of associated literature. Propolis is a natural product that has gained interest in this context due to its antibacterial effectiveness against several endodontic pathogens. Aim: The present study was undertaken to assess the potential of water-soluble 25% propolis extract against microorganisms present in root canals of primary teeth during endodontic procedures. Settings and Design: The child patients in the age group of 4-7 years with radiographic evidence of carious pulp exposure were included in the study. Definitive selection was done after gaining access into the pulp chamber and root canals of the selected teeth. The clinical and radiographic evidence of pathosis was ruled out for inclusion in the study. Materials and Methods: The selected teeth were divided into two groups randomly. In Group A 0.9% isotonic saline and in Group B 25% extract water-soluble propolis were used as irrigating solution, respectively. The bacterial samples were collected both pre- and post-irrigation and were transferred for microbial assay. Staististical Analysis: Wilcoxon matched signed rank test was used to compare the pre-and post-irrigation bacterial counts. Mann-Whitney test was used to compare the mean change (pre-post in bacterial colony counts of groups in the study. Results: Antimicrobial effectiveness of 25% water-soluble extract of propolis in the root canals of primary teeth was confirmed in the present study. The reduction in the mean bacterial colony counts of all the isolated bacteria was noticed higher in Group B than Group A. Conclusion: The results of the present study have confirmed that the antibacterial effectiveness of water-soluble extract of propolis in the root canals of primary teeth in vivo. Considering the low toxicity concerns and antibacterial effectiveness, water-soluble extract of 25% propolis

Efficacy of Reciproc(®) and Profile(®) Instruments in the Removal of Gutta-Percha from Straight and Curved Root Canals ex Vivo.

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Marfisi, Karem; Mercadé, Montserrat; Plotino, Gianluca; Clavel, Tatiana; Duran-Sindreu, Fernando; Roig, Miguel

2015-01-01

To compare the efficacy of Reciproc(®) (VDW GmbH) and ProFile(®) (Dentsply Maillefer) instruments at removing gutta-percha from straight and curved root canals ex vivo filled using the cold lateral condensation and GuttaMaster(®) (VDW GmbH) techniques. Forty mesial roots of mandibular molars with two curved canals and 80 single-rooted teeth with straight root canals, a total of 160 root canals, were randomly assigned to eight groups (canals per group = 20) according to filling technique, retreatment instrument and root canal curvature as follows: Group I, cold lateral condensation/ProFile(®)/straight; Group II, cold lateral condensation/ProFile(®)/curved; Group III, cold lateral condensation/Reciproc(®)/straight; Group IV, cold lateral condensation/Reciproc(®)/curved; Group V, GuttaMaster(®)/ProFile(®)/straight; Group VI, GuttaMaster(®)/ProFile(®)/curved; Group VII, GuttaMaster(®)/Reciproc(®)/straight; and Group VIII, GuttaMaster(®)/Reciproc(®)/curved. The following data were recorded: procedural errors, retreatment duration and canal wall cleanliness. Means and standard deviations were calculated and analysed using the Kruskal-Wallis test, one-way analysis of variance and Tukey's test (P straight (P = 0.0001) and curved (P = 0.0003) root canals. Reciproc(®) were statistically more effective than ProFile(®) instruments in removing GuttaMaster(®) from straight root canals (P = 0.021). Regardless of filling technique or retreatment instrument, gutta-percha was removed more rapidly from curved than from straight root canals (P = 0.0001). Neither system completely removed filling material from the root canals. Compared with ProFile(®) instruments, Reciproc(®) instruments removed GuttaMaster(®) filling material from straight and curved root canals more rapidly.

A cost-minimization analysis of root canal treatment before and after education in nickel-titanium rotary technique in general practice.

Science.gov (United States)

Koch, M; Tegelberg, A; Eckerlund, I; Axelsson, S

2012-07-01

To compare root canal treatments performed before and after education in a nickel-titanium rotary technique (NiTiR) with respect to costs for instrumentation and number of instrumentation sessions in a County Public Dental Service in Sweden.   Following education, 77% of the general dental practitioners adopted completely the NiTiR. The randomly selected sample comprised 850 root canal treatments: 425 performed after the education, mainly using the NiTiR-technique (group A) and 425 performed before, using mainly stainless steel hand instrumentation (SSI) (group B). The number of instrumentation sessions in root canal treatments in group A and B was calculated. A CMA was undertaken on the assumption that treatment outcome was identical in group A and B. Direct costs associated with SSI and NiTiR were estimated and compared. Investment costs required for implementation of NiTiR were calculated, but not included in the CMA. Instrumentation sessions were counted in 418 (98%) root canal treatments performed in group A and 419 (99%) in group B. The number of instrumentation sessions in group A was significantly lower; 2.38, compared with 2.82 in group B (P session was saved. Root canal treatments in teeth with one canal, and three or more canals, were completed in significantly fewer instrumentation sessions after the education (P sessions were SEK 2587 (USD 411) for group A and SEK 2851 (USD 453) for group B, for teeth with one canal, and SEK 2946 (USD 468) for group A and SEK 3510 (USD 558) for group B, for teeth with three or more canals (year 2011). Root canal treatments of teeth with two canals showed no significant difference with respect to number of instrumentation sessions and costs. Significantly fewer instrumentation sessions were required in group A, and root canal instrumentation therefore costs less than in group B. On the assumption that treatment outcome is identical in group A and B, root canal instrumentation performed after the education was more

Gram-positive rods prevailing in teeth with apical periodontitis undergoing root canal treatment.

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Chávez de Paz, L E; Molander, A; Dahlén, G

2004-09-01

To identify Gram-positive rods from root canals of teeth with apical periodontitis and to examine their associations with other species. Consecutive root canal samples (RCSs) from 139 teeth undergoing root canal treatment were analyzed prospectively for cultivable microbes. Gram-positive rods in the first RCS submitted after chemo-mechanical preparation were categorised to genus level by selective media and gas-liquid chromatography (GLC), and identified to species level by sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE). Associations between organisms were measured by odds ratios (OR). In the first samples submitted a total of 158 Gram-positive rods, 115 Gram-positive cocci, 26 Gram-negative rods and 9 Gram-negative cocci, were identified. At genus levels Gram-positive rods were classified into: Lactobacillus spp. (38%), Olsenella spp. (18%), Propionibacterium spp. (13%), Actinomyces spp. (12%), Bifidobacterium spp. (13%) and Eubacterium spp. (6%). The most frequent species were Olsenella uli, Lactobacillus paracasei and Propionibacterium propionicum. In subsequent samples taken during treatment, Gram-positive rods were also identified, although the number of strains was considerably reduced. Positive associations were observed between members of the genus lactobacilli and Gram-positive cocci (OR>2). Olsenella uli and Lactobacillus spp. predominated over other Gram-positive rods. A possible association exists between Lactobacillus spp. and Gram-positive cocci in root canals of teeth with apical periodontitis receiving treatment.

Various Strategies for Pain-Free Root Canal Treatment

Science.gov (United States)

Parirokh, Masoud; V. Abbott, Paul

2014-01-01

Introduction: Achieving successful anesthesia and performing pain-free root canal treatment are important aims in dentistry. This is not always achievable and therefore, practitioners are constantly seeking newer techniques, equipments, and anesthetic solutions for this very purpose. The aim of this review is to introduce strategies to achieve profound anesthesia particularly in difficult cases. Materials and Methods: A review of the literature was performed by electronic and hand searching methods for anesthetic agents, techniques, and equipment. The highest level of evidence based investigations with rigorous methods and materials were selected for discussion. Results: Numerous studies investigated to pain management during root canal treatment; however, there is still no single technique that will predictably provide profound pulp anesthesia. One of the most challenging issues in endodontic practice is achieving a profound anesthesia for teeth with irreversible pulpitis especially in mandibular posterior region. Conclusion: According to most investigations, achieving a successful anesthesia is not always possible with a single technique and practitioners should be aware of all possible alternatives for profound anesthesia. PMID:24396370

Non-destructive, preclinical evaluation of root canal anatomy of human teeth with flat-panel detector volume CT (FD-VCT)

International Nuclear Information System (INIS)

Heidrich, G.; Hassepass, F.; Dullin, C.; Grabbe, E.; Attin, T.; Hannig, C.

2005-01-01

Purpose: Successful endodontic diagnostics and therapy call for adequate depiction of the root canal anatomy with multimodal diagnostic imaging. The aim of the present study is to evaluate visualization of the endodont with flat-panel detector volume CT (FD-VCT). Materials and methods: 13 human teeth were examined with the prototype of a FD-VCT. After data acquisition and generation of volume data sets in volume rendering technology (VRT), the findings obtained were compared to conventional X-rays and cross-section preparations of the teeth. Results: The anatomical structures of the endodont such as root canals, side canals and communications between different root canals as well as dentricles could be detected precisely with FD-VCT. The length of curved root canals was also determined accurately. The spatial resolution of the system is around 140 μm. Only around 73% of the main root canals detected with FD-VCT and 87% of the roots could be visualized with conventional dental X-rays. None of the side canals, shown with FD-VCT, was detectable on conventional X-rays. In all cases the enamel and dentin of the teeth could be well delineated. No differences in image quality could be discerned between stored and freshly extracted teeth, or between primary and adult teeth. (orig.)

Accuracy of CBCT as modality to identify the presence of secondary mesiobuccal root canal in the maxillary first molar

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Haikal Halil

2017-11-01

Full Text Available Introduction: A successful endodontic treatment requires the clinician to be able to locate, disinfect, and obturate all canals presence in the root canal system to remove the infection and prevent re-infection. However, there are canals that often missed upon examination and the treatment, for example, the secondary mesiobuccal (MB root canal. The success of locating these canals is determined by the methods used, for example, a periapical radiograph and Cone Beam Computed Tomography (CBCT. The purpose of this study was to examine the sensitivity and accuracy of the periapical radiograph (PA and CBCT on determining the presence of the secondary MB root canal. Methods: As much as 40 intact crown and intact radicular of the maxillary first molars, without root caries, root restoration, and endodontic treated, were taken as the samples. The presence of a secondary MB root canal was evaluated by a PA radiograph, CBCT and clinical sectioning. All of the samples were undergone each test and sectioned after being completed the radiographic evaluation steps. The results from each test were then documented and analyzed by using SPSS® version 16. Results: CBCT radiograph was successfully identifying 62.5% secondary MB root canal presence, whilst the PA radiograph has detected only 20% of the samples. The sensitivity of CBCT and PA radiograph was compared with the gold standard method, resulting 86.2% and 27.6% respectively. The statistical analysis showed that there was no significant difference between CBCT test and the gold standard (p=0.00. Conclusion: CBCT was proven to be a reliable method to detect the presence of secondary MB root canals due to its sensitivity and accuracy as high as the clinical sectioning compared to the PA radiograph.

Comparative study of six rotary nickel-titanium systems and hand instrumentation for root canal preparation.

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Guelzow, A; Stamm, O; Martus, P; Kielbassa, A M

2005-10-01

To compare ex vivo various parameters of root canal preparation using a manual technique and six different rotary nickel-titanium (Ni-Ti) instruments (FlexMaster, System GT, HERO 642, K3, ProTaper, and RaCe). A total of 147 extracted mandibular molars were divided into seven groups (n = 21) with equal mean mesio-buccal root canal curvatures (up to 70 degrees), and embedded in a muffle system. All root canals were prepared to size 30 using a crown-down preparation technique for the rotary nickel-titanium instruments and a standardized preparation (using reamers and Hedströem files) for the manual technique. Length modifications and straightening were determined by standardized radiography and a computer-aided difference measurement for every instrument system. Post-operative cross-sections were evaluated by light-microscopic investigation and photographic documentation. Procedural errors, working time and time for instrumentation were recorded. The data were analysed statistically using the Kruskal-Wallis test and the Mann-Whitney U-test. No significant differences were detected between the rotary Ni-Ti instruments for alteration of working length. All Ni-Ti systems maintained the original curvature well, with minor mean degrees of straightening ranging from 0.45 degrees (System GT) to 1.17 degrees (ProTaper). ProTaper had the lowest numbers of irregular post-operative root canal diameters; the results were comparable between the other systems. Instrument fractures occurred with ProTaper in three root canals, whilst preparation with System GT, HERO 642, K3 and the manual technique resulted in one fracture each. Ni-Ti instruments prepared canals more rapidly than the manual technique. The shortest time for instrumentation was achieved with System GT (11.7 s). Under the conditions of this ex vivo study all Ni-Ti systems maintained the canal curvature, were associated with few instrument fractures and were more rapid than a standardized manual technique. Pro

APICAL SEAL BETWEEN ADHESIVE ROOT CANAL OBTURATION SYSTEM AND GUTTA-PERCHA/AH-PLUS SEALER: AN IN VITRO COMPARISON STUDY

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Girish

2016-03-01

Full Text Available BACKGROUND Three dimensional obturation of the root canal is important for success of root canal treatment. Microleakage is one of the reason for root canal failure. Numerous materials have been used for obturation of which Gutta-percha is the most successful with variety of sealers. One of the recent material to further improve root canal treatment success rate is use of Resilon with Epiphany root canal sealer to apply adhesive concepts in to endodontics. An adhesive bond forms between Epiphany sealer, Resilon and dentin, making it monolithic hence less microleakage if any significantly. METHODS 60 single rooted mandibular premolars were dissected at cement enamel junction with diamond disc. Root canals were explored and working length measured using K file. Root canals of all 60 samples were prepared with ProTaper and irrigated with 5% sodium hypochlorite and 17% EDTA solution. Teeth were divided in to group A and B, each having 30 samples. Group A teeth obturated with Resilon Epiphany obturation system and group B with Gutta-percha and AH-plus sealer. All specimens were stored in incubator for 30 days. Clearing process of samples done with Robertson’s technique to make them transparent. All the specimens were immersed in 2% methylene blue dye solution for 7 days. Specimens were then examined under stereomicroscope with 10x magnification to measure dye penetration in mm with image analysis software. The data collected were analysed statistically. RESULTS This study showed that Resilon Epiphany group has a mean leakage of 1.2307, while the Gutta-percha/AH-plus had a mean leakage of 3.6133. There was statistically significant differences between Resilon and Gutta-percha groups. CONCLUSIONS 1. Resilon Epiphany group showed less apical microleakage than Gutta-percha/AH-plus obturation. 2. Based on result obtained it is suggested that Resilon Epiphany can be recommended for root canal obturation.

Effectiveness of castor oil extract on Escherichia coli and its endotoxins in root canals.

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Valera, Marcia Carneiro; Maekawa, Lilian Eiko; Chung, Adriana; de Oliveira, Luciane Dias; Carvalho, Claudio Antonio Talge; Koga-Ito, Cristiane Yumi; Jorge, Antonio Olavo Cardoso

2012-01-01

This in vitro study sought to evaluate the effectiveness of castor oil extract used as an irrigating solution on Escherichia coli and its endotoxins in root canals. Sixty single-rooted teeth were prepared (using castor oil extract as irrigating solution) and divided into five groups (n = 12): Group 1 samples were treated with calcium hydroxide (Ca(OH)2), Group 2 samples were treated with polymyxin B, Group 3 samples were treated with Ca(OH)2 and 2% chlorhexidine gel (CHX), and Group 4 samples were treated with castor oil extract. A control group used physiological saline solution as an irrigant. Canal content samples were collected at four different times: immediately after instrumentation, seven days after instrumentation, after 14 days of intracanal medication, and seven days after removal of intracanal medication. A plating method was used to assess antimicrobial activity and the quantification of endotoxins was evaluated by the chromogenic Limulus lysate assay. Data were submitted to ANOVA and a Dunn test (a = 5%). Irrigation with castor oil extract decreased E. coli counts but had no effect on the level of endotoxins. Samples taken seven days after removal of medication revealed a significant reduction in endotoxin levels in Groups 3 and 4. Compared to the saline solution irrigation, castor oil extract decreased microorganism counts in root canals immediately after canal preparation. None of the medications used completely eliminated endotoxins in the root canal.

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

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

2013-01-01

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

Effects of canal enlargement and irrigation needle depth on the cleaning of the root canal system at 3 mm from the apex

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Ho-Jin Moon

2012-02-01

Full Text Available Objectives The aim of this study was to test the hypothesis, that the effectiveness of irrigation in removing smear layer in the apical third of root canal system is dependent on the depth of placement of the irrigation needle into the root canal and the enlargement size of the canal. Materials and Methods Eighty sound human lower incisors were divided into eight groups according to the enlargement size (#25, #30, #35 and #40 and the needle penetration depth (3 mm from working length, WL-3 mm and 9 mm from working length, WL-9 mm. Each canal was enlarged to working length with Profile.06 Rotary Ni-Ti files and irrigated with 5.25% NaOCl. Then, each canal received a final irrigation with 3 mL of 3% EDTA for 4 min, followed by 5 mL of 5.25% NaOCl at different level (WL-3 mm and WL-9 mm from working length. Each specimen was prepared for the scanning electron microscope (SEM. Photographs of the 3mm area from the apical constriction of each canal with a magnification of ×250, ×500, ×1,000, ×2,500 were taken for the final evaluation. Results Removal of smear layer in WL-3 mm group showed a significantly different effect when the canal was enlarged to larger than #30. There was a significant difference in removing apical smear layer between the needle penetration depth of WL-3 mm and WL-9 mm. Conclusions Removal of smear layer from the apical portion of root canals was effectively accomplished with apical instrumentation to #35/40 06 taper file and 3 mm needle penetration from the working length.

Influence of antimicrobial solutions in the decontamination and adhesion of glass-fiber posts to root canals

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HARAGUSHIKU, Gisele Aihara; BACK, Eduardo Donato Eing Engelke; TOMAZINHO, Paulo Henrique; BARATTO, Flares; FURUSE, Adilson Yoshio

2015-01-01

Objective This study evaluated the effect of root canal disinfectants on the elimination of bacteria from the root canals, as well as their effect on glass-fiber posts bond strength. Material and Methods Fifty-three endodontically treated root canals had post spaces of 11 mm in length prepared and contaminated with E. faecalis. For CFU/ml analysis, eight teeth were contaminated for 1 h or 30 days (n=4). Teeth were decontaminated with 5% NaOCl, 2% CHX, or distilled water. As control, no decontamination was conducted. After decontamination, sterile paper points were used to collect samples, and CFU/ml were counted. For push-out, three groups were evaluated (n=15): irrigation with 2.5% NaOCl, 2% CHX, or sterile distilled water. A bonding agent was applied to root canal dentin, and a glass-fiber post was cemented with a dual-cured cement. After 24 h, 1-mm-thick slices of the middle portion of root canals were obtained and submitted to the push-out evaluation. Three specimens of each group were evaluated in scanning electron microscopy (SEM). Data were analyzed with one-way ANOVA and Dunnett’s T3 test (α=0.05). Results The number of CFU/ml increased from 1 h to 30 days of contamination in control and sterile distilled water groups. Decontamination with NaOCl was effective only when teeth were contaminated for 1 h. CHX was effective at both contamination times. NaOCl did not influence the bond strength (p>0.05). Higher values were observed with CHX (pcontaminated root canals both in reducing the bacterial contamination and in improving the glass-fiber post bonding. PMID:26398518

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

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Thikamphaa Bertrand

2016-02-01

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

Large Reactional Osteogenesis in Maxillary Sinus Associated with Secondary Root Canal Infection Detected Using Cone-beam Computed Tomography.

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Estrela, Carlos; Porto, Olavo César Lyra; Costa, Nádia Lago; Garrote, Marcel da Silva; Decurcio, Daniel Almeida; Bueno, Mike R; Silva, Brunno Santos de Freitas

2015-12-01

Inflammatory injuries in the maxillary sinus may originate from root canal infections and lead to bone resorption or regeneration. This report describes the radiographic findings of 4 asymptomatic clinical cases of large reactional osteogenesis in the maxillary sinus (MS) associated with secondary root canal infection detected using cone-beam computed tomographic (CBCT) imaging. Apical periodontitis, a consequence of root canal infection, may lead to a periosteal reaction in the MS and osteogenesis seen as a radiopaque structure on imaging scans. The use of a map-reading strategy for the longitudinal and sequential slices of CBCT images may contribute to the definition of diagnoses and treatment plans. Root canal infections may lead to reactional osteogenesis in the MS. High-resolution CBCT images may reveal changes that go unnoticed when using conventional imaging. Findings may help define initial diagnoses and therapeutic plans, but only histopathology provides a definitive diagnosis. Surgical enucleation of the periapical lesion is recommended if nonsurgical root canal treatment fails to control apical periodontitis. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

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

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

2018-01-01

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

Antimicrobial activity of sodium hypochlorite associated with intracanal medication for Candida albicans and Enterococcus faecalis inoculated in root canals

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Marcia Carneiro Valera

2009-12-01

Full Text Available OBJECTIVE: The purpose of this study was to evaluate the action of sodium hypochlorite (NaOCl associated with an intracanal medication against Candida albicans and Enterococcus faecalis inoculated in root canals. MATERIAL AND METHODS: Thirty-six human single-rooted teeth with single root canals were used. The canals were contaminated with C. albicans and E. faecalis for 21 days and were then instrumented with 1% NaOCl. The roots were divided into 3 groups (n=12 according to the intracanal medication applied: calcium hydroxide paste, 2% chlorhexidine (CHX gel, and 2% CHX gel associated with calcium hydroxide. The following collections were made from the root canals: a initial sample (IS: 21 days after contamination (control, b S1: after instrumentation, c S2: 14 days after intracanal medication placement; S3: 7 days after intracanal medication removal. The results were analyzed statistically by the Kruskal-Wallis test at 5% significance level. RESULTS AND CONCLUSIONS: Both 1% NaOCl irrigation and the intracanal medications were effective in eliminating E. faecalis and C. albicans inoculated in root canals.

Effect of a calcium hydroxide-based root canal dressing on periapical repair in dogs: a histological study.

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Leonardo, Mario R; Hernandez, Maria E F T; Silva, Léa A B; Tanomaru-Filho, Mário

2006-11-01

To compare the periapical repair of teeth with periapical lesion following root canal treatment by using a calcium hydroxide-based intracanal dressing for several time periods or filling in a single visit. After induction of periapical lesions in 4 dogs, the root canals were prepared using 5.25% sodium hypochlorite for irrigation, and animals were separated into 4 experimental groups; in group I, root canals were filled in a single session; in groups II, III, and IV, a calcium hydroxide-based dressing was kept in place for 15, 30, or 180 days, respectively. Root canals from groups I, II, and III were filled with gutta-percha cones and AH Plus sealer. After 180 days, animals were killed and histological sections were stained with hematoxylin-eosin to evaluate periapical repair. Periapical repair was better in groups II, III, and IV (intracanal dressing) compared with group I (single session; P session treatment.

Effect of Lengthy Root Canal Therapy Sessions on Temporomandibular Joint and Masticatory Muscles

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Sahebi, Safoora; Moazami, Fariborz; Afsa, Masoomeh; Nabavi Zade, Mohammad Reza

2010-01-01

Background and aims Trauma is one of the major factors associated with temporomandibular joint disorders (TMD). These disorders result from macro-trauma or micro-trauma. Macro-trauma might be iatrogenic; for example, from intuba-tion procedures, third molar extraction procedures, and lengthy dental appointments. The aim of this study was to evaluate the effect of lengthy root canal therapy (more than 2 hours) on TMJ and its supporting structures. Materials and methods Eighty patients whose root canal therapy session lasted more than 2 hours were examined for the status of TMJ and masticatory muscles. After one week the second part of the examination was carried out for TMJ problems and pain and tenderness levels of masticatory muscles. Data was analyzed using Wilcoxon statistical test. Results Women showed more pain compared to men. There was a significant increase in pain in the external acoustic meatus examination one week after root canal therapy. Patients who were treated for their posterior teeth suffered more pain than those who were treated for the anteriors and premolars. Other aspects of the examination were not affected significantly by lengthy root canal therapy. Conclusion Lengthy dental treatments can harm TMJ and masticatory muscles and wide opening of the mouth during such appointments can worsen the situation. Therefore, it is wise to break the appointment into shorter intervals and let the patients rest during treatment to close their mouth to prevent iatrogenic damage to TMJ. PMID:22991607

Effect of Lengthy Root Canal Therapy Sessions on Temporomandibular Joint and Masticatory Muscles

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Safoora Sahebi

2010-09-01

Full Text Available Background and aims. Trauma is one of the major factors associated with temporomandibular joint disorders (TMD. These disorders result from macro-trauma or micro-trauma. Macro-trauma might be iatrogenic; for example, from intubation procedures, third molar extraction procedures, and lengthy dental appointments. The aim of this study was to evaluate the effect of lengthy root canal therapy (more than 2 hours on TMJ and its supporting structures. Materials and methods. Eighty patients whose root canal therapy session lasted more than 2 hours were examined for the status of TMJ and masticatory muscles. After one week the second part of the examination was carried out for TMJ problems and pain and tenderness levels of masticatory muscles. Data was analyzed using Wilcoxon statistical test. Results. Women showed more pain compared to men. There was a significant increase in pain in the external acoustic meatus examination one week after root canal therapy. Patients who were treated for their posterior teeth suffered more pain than those who were treated for the anteriors and premolars. Other aspects of the examination were not affected significantly by lengthy root canal therapy. Conclusion. Lengthy dental treatments can harm TMJ and masticatory muscles and wide opening of the mouth during such appointments can worsen the situation. Therefore, it is wise to break the appointment into shorter intervals and let the patients rest during treatment to close their mouth to prevent iatrogenic damage to TMJ.

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

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

2016-01-01

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

Morphology of root canal surface: A reflection on the process of cementation of the composite relined glass fiber post

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Yasmine Mendes Pupo

2017-01-01

Full Text Available Background: The present study was conducted to evaluate the bond strength in the different root thirds (premolars and maxillary central incisors of composite relined glass fiber posts compared to untreated glass fiber posts cemented with dual- or chemical-cure cements. Materials and Methods: Sixty human single-rooted premolars (flat canal (n = 15 and 12 maxillary central incisors were used (round canal (n = 3. The teeth were sectioned, and the roots received endodontic treatment. The standardized preparation of the canals was carried out, and the roots were randomly divided into four groups according to the cementation systems: G1: cemented posts (dual: Ambar/Allcem; G2: relined posts (dual: Ambar/Allcem; G3: cemented posts (chemical: Fusion Duralink/Cement Post; and G4: relined posts (chemical: Fusion Duralink/Cement Post. The roots were cut to give two slices of each third of the root canal per specimen. Push-out test was conducted at a speed of 0.5 mm/min. Data were analyzed by analysis of variance and Tukey's post hoc test (α = 0.05. Results: There was no statistically significant difference between groups for the premolars (flat canal (P = 0.959. There was a significant difference in the central incisors between the middle and apical thirds in the cemented group when using the dual system (P = 0.04 and between the middle and apical thirds (P = 0.003 and cervical and apical thirds (P = 0.033 when using the chemical system. Conclusion: Due to the anatomy of the root canal, flat canal of the premolars does not require relining, but round canal of the maxillary central incisors demands it for more secure in the bond strength.

Anatomical study of the relationship of impacted mandibular third molar root apex to inferior alveolar canal in Kurdistan population using orthopantomogram

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Fedil Andraws Yalda

2017-12-01

Full Text Available Background and objective: Extraction of an impacted mandibular third lower molar tooth is one of the common surgical procedures that may lead to the damage of inferior alveolar nerve due to roots proximity to the mandibular canal. This study aimed to know the relative relationship and proximity of the mandibular third molar roots to the inferior alveolar canal in relation to gender, age, depth of impaction, relation with ramus, and type of angulation of the impacted tooth in Kurdistan population. Methods: A sample of 366 digital panoramic radiographs of patients with impacted mandibular third molar was studied. Panoramic radiographic signs images were evaluated for the presence of root contact with the superior border of the mandibular canal, darkening of the roots apex, deflected roots, narrow root, superimposition of the canal, interruption of the white line, diversion of the inferior alveolar canal, and narrowing of the inferior alveolar canal. The depths of impaction, relation with ramus, and type of angulation were also studied. Results: Significant relation of the proximity of the mandibular third molar roots to the inferior alveolar canal with the gender (P = 0.001 and age (P <0.001 were seen. A significant relation of the proximity of the mandibular third molar roots to the inferior alveolar canal with the depth of impaction (P <0.001, relation with the ramus (P =0.004, and angulation of impaction were also seen (P <0.001. Conclusion: Significant relation of the proximity of the mandibular third molar roots to the inferior alveolar canal with gender, age, depth of impaction, relation with the ramus, and angulation of impaction were seen.

A method for retrieving endodontic or atypical nonendodontic separated instruments from the root canal: a report of two cases.

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Monteiro, Jardel Camilo do Carmo; Kuga, Milton Carlos; Dantas, Andrea Abi Rached; Jordão-Basso, Keren Cristina Fagundes; Keine, Katia Cristina; Ruchaya, Prashant Jay; Faria, Gisele; Leonardo, Renato de Toledo

2014-11-01

This clinical report presents a new method for retrieving separated instruments from the root canal with minimally invasive procedures. The presence of separated instrument in root canal may interfere in the endodontic treatment prognosis. There are several recommended methods to retrieve separated instruments, but some are difficult in clinically practice. This study describes two cases of separated instrument removal from the root canal using a stainless-steel prepared needle associated with a K-file. Case 1 presented a fractured gutta-percha condenser within the mandibular second premolar, it was separated during incorrect intracanal medication calcium hydroxide placement. Case 2 had a fractured sewing needle within the upper central incisor that the patient used to remove food debris from the root canal. After cervical preparation, the fractured instruments were fitted inside a prepared needle and then an endodontic instrument (#25 K-file) was adapted with clockwise turning motion between the needle inner wall and the fragment. The endodontic or atypical nonendodontic separated instrument may be easily pull on of the root canal using a single and low cost device. The methods for retrieving separated instruments from root canal are difficult and destructive procedures. The present case describes a simple method to solve this problem.

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

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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.

Laser dentistry: A new application of excimer laser in root canal therapy

International Nuclear Information System (INIS)

Pini, R.; Salimbeni, R.; Vannini, M.; Barone, R.; Clauser, C.

1989-01-01

We report the first study of the application of excimer lasers in dentistry for the treatment of dental root canals. High-energy ultraviolet (UV) radiation emitted by an XeCl excimer laser (308 nm) and delivered through suitable optical fibers can be used to remove residual organic tissue from the canals. To this aim, UV ablation thresholds of dental tissues have been measured, showing a preferential etching of infiltrated dentin in respect to healthy dentin, at laser fluences of 0.5-1.5 J/cm 2 . This technique has been tested on extracted tooth samples, simulating a clinical procedure. Fibers of decreasing core diameters have been used to treat different sections of the root canal down to its apical portion, resulting in an effective, easy, and fast cleaning action. Possible advantages of excimer laser clinical applications in respect to usual procedures are also discussed

Computed tomography assessment of the efficiency of different techniques for removal of root canal filling material

International Nuclear Information System (INIS)

Dall'agnol, Cristina; Barletta, Fernando Branco; Hartmann, Mateus Silveira Martins

2008-01-01

This study evaluated the efficiency of different techniques for removal of filling material from root canals, using computed tomography (CT). Sixty mesial roots from extracted human mandibular molars were used. Root canals were filled and, after 6 months, the teeth were randomly assigned to 3 groups, according to the root-filling removal technique: Group A - hand instrumentation with K-type files; Group B - reciprocating instrumentation with engine-driven K-type files; and Group C rotary instrumentation with engine-driven ProTaper system. CT scans were used to assess the volume of filling material inside the root canals before and after the removal procedure. In both moments, the area of filling material was outlined by an experienced radiologist and the volume of filling material was automatically calculated by the CT software program. Based on the volume of initial and residual filling material of each specimen, the percentage of filling material removed from the root canals by the different techniques was calculated. Data were analyzed statistically by ANOVA and chi-square test for linear trend (α=0.05). No statistically significant difference (p=0.36) was found among the groups regarding the percent means of removed filling material. The analysis of the association between the percentage of filling material removal (high or low) and the proposed techniques by chi-square test showed statistically significant difference (p=0.015), as most cases in group B (reciprocating technique) presented less than 50% of filling material removed (low percent removal). In conclusion, none of the techniques evaluated in this study was effective in providing complete removal of filling material from the root canals. (author)

Computed tomography assessment of the efficiency of different techniques for removal of root canal filling material

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Dall' agnol, Cristina; Barletta, Fernando Branco [Lutheran University of Brazil, Canoas, RS (Brazil). Dental School. Dept. of Dentistry and Endodontics]. E-mail: fbarletta@terra.com.br; Hartmann, Mateus Silveira Martins [Uninga Dental School, Passo Fundo, RS (Brazil). Postgraduate Program in Dentistry

2008-07-01

This study evaluated the efficiency of different techniques for removal of filling material from root canals, using computed tomography (CT). Sixty mesial roots from extracted human mandibular molars were used. Root canals were filled and, after 6 months, the teeth were randomly assigned to 3 groups, according to the root-filling removal technique: Group A - hand instrumentation with K-type files; Group B - reciprocating instrumentation with engine-driven K-type files; and Group C rotary instrumentation with engine-driven ProTaper system. CT scans were used to assess the volume of filling material inside the root canals before and after the removal procedure. In both moments, the area of filling material was outlined by an experienced radiologist and the volume of filling material was automatically calculated by the CT software program. Based on the volume of initial and residual filling material of each specimen, the percentage of filling material removed from the root canals by the different techniques was calculated. Data were analyzed statistically by ANOVA and chi-square test for linear trend ({alpha}=0.05). No statistically significant difference (p=0.36) was found among the groups regarding the percent means of removed filling material. The analysis of the association between the percentage of filling material removal (high or low) and the proposed techniques by chi-square test showed statistically significant difference (p=0.015), as most cases in group B (reciprocating technique) presented less than 50% of filling material removed (low percent removal). In conclusion, none of the techniques evaluated in this study was effective in providing complete removal of filling material from the root canals. (author)

Influence of antimicrobial solutions in the decontamination and adhesion of glass-fiber posts to root canals

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Gisele Aihara HARAGUSHIKU

2015-08-01

Full Text Available AbstractObjective This study evaluated the effect of root canal disinfectants on the elimination of bacteria from the root canals, as well as their effect on glass-fiber posts bond strength.Material and Methods Fifty-three endodontically treated root canals had post spaces of 11 mm in length prepared and contaminated with E. faecalis. For CFU/ml analysis, eight teeth were contaminated for 1 h or 30 days (n=4. Teeth were decontaminated with 5% NaOCl, 2% CHX, or distilled water. As control, no decontamination was conducted. After decontamination, sterile paper points were used to collect samples, and CFU/ml were counted. For push-out, three groups were evaluated (n=15: irrigation with 2.5% NaOCl, 2% CHX, or sterile distilled water. A bonding agent was applied to root canal dentin, and a glass-fiber post was cemented with a dual-cured cement. After 24 h, 1-mm-thick slices of the middle portion of root canals were obtained and submitted to the push-out evaluation. Three specimens of each group were evaluated in scanning electron microscopy (SEM. Data were analyzed with one-way ANOVA and Dunnett’s T3 test (α=0.05.Results The number of CFU/ml increased from 1 h to 30 days of contamination in control and sterile distilled water groups. Decontamination with NaOCl was effective only when teeth were contaminated for 1 h. CHX was effective at both contamination times. NaOCl did not influence the bond strength (p>0.05. Higher values were observed with CHX (p<0.05. SEM showed formation of resin tags in all groups.Conclusion CHX showed better results for the irrigation of contaminated root canals both in reducing the bacterial contamination and in improving the glass-fiber post bonding.

Root Canal Retreatment menggunakan Kombinasi Kalsium Hidroksida dan Chlorhexidine sebagai Medikamen Intra Kanal Insisivus Sentral Kiri Maksila

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Andina Novita Sari

2014-12-01

retreatment dengan cleaning dan shaping ulang yang baik dengan menggunakan medikasi intrakanal berupa kombinasi kalsium hidroksida dan chlorhexidine 2% diharapkan mempunyai efek antimikroba yang sinergis untuk mencapai kesuksesan root canal retreatment.   Root Canal Retreatment Using Calcium Hydroxide as Intra Canal Medicament On The Maxillary Left Incisor. Enterococcus faecalis bacteria is most abundant in the root canal infection treated endodontically. Chlorhexidine has a broad antibacterial spectrum and has been used as an endodontic irrigant and intracanal medication. Chlorhexidine has a bactericidal and fungicidal effect as chlorhexidine absorbed into the bacterial cell surface and cause damage to the integrity of the cell membrane. Calcium hydroxide is a biocompatible, antimicrobial agents with high pH effects and stimulates hard tissue formation. A mixture of calcium hydroxide and chlorhexidine is used to control bacteria Enterococcus faecalis alternative. The purpose of this case report is to report on the success of root canal treatment in the left maxillary central incisor with acute periapical periodontitis using a combination of calcium hydroxide and chlorhexidine as intracanal A 24 years old female patient presents with left upper central incisor tooth ache since 4 years ago. The tooth was hurt to percussion, but normal to pulpation as well as the mobility. The tooth has a history of previous trauma and broken 6 years ago and has performed endodontic treatment. Radiographic examination showed obturation teeth 21 are not hermetic with periapical radiolucency in diffuse boundaries, widening of the periodontal ligament and the dissolution of the lamina dura. Root canal re-treatment using a combination of calcium hydroxide and chlorhexidine as intracanal medicaments were performed. In conclussion, the root canal cleaning and shaping retreatment can be performed using a combination of calcium hydroxide and chlorhexidine as intracanal

Clinical effect of calcium hydroxide paste combined with triple antibiotic paste on root canal disinfection

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Chen QU

2014-03-01

Full Text Available Objective　To compare the efficacy in disinfection and pain control of calcium hydroxide paste and triple antibiotic paste (ornidazole, ciprofloxacin and minocycline used individually or jointly for root canal disinfection. Methods　Two hundred and thirty-five patients with chronic apical periodontitis (235 teeth were involved in the present study and divided into 2 groups: fistula group (n=118 and no fistula group (n=117. Each group was then randomly divided into 4 subgroups: calcium hydroxide paste group, triple antibiotic paste group, calcium hydroxide + triple antibiotic paste group, and camphor phenol group. After regular root canal preparation, root canals of patients in 4 groups were filled with tiny paper ends impregnated with fore 4 different drugs respectively. Visual analogue scales (VAS of pain were given to the patients with a guide for filling the scale. One week later, both the data of the scales and the effects of root canal disinfection were recorded and analyzed. Results　Seven days after treatment, the clinical efficacy of calcium hydroxide paste, triple antibiotic paste and calcium hydroxide + triple antibiotic paste was similar (P>0.05 either in fistula group or in no fistula group, but all better than that of camphor phenol (P<0.05. VAS score analysis showed that, at least on the first 3 days after sealing medicine in the root canal, calcium hydroxide + triple antibiotic paste achieved better result of pain control than the other three groups (P<0.05 no matter with or without fistula. Conclusions 　Calcium hydroxide paste, triple antibiotic paste, calcium hydroxide + triple antibiotic paste are effective in treatment of chronic apical periodontitis whether with or without fistula. However, the combined use of calcium hydroxide and three antibiotic pastes is better for controlling the pain after root canal preparation than other treatments, which is therefore worthy of clinical application. DOI: 10.11855/j.issn.0577-7402.2014.02.12

Computed tomography evaluation of rotary systems on the root canal transportation and centering ability

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André PAGLIOSA

2015-01-01

Full Text Available Abstract : The endodontic preparation of curved and narrow root canals is challenging, with a tendency for the prepared canal to deviate away from its natural axis. The aim of this study was to evaluate, by cone-beam computed tomography, the transportation and centering ability of curved mesiobuccal canals in maxillary molars after biomechanical preparation with different nickel-titanium (NiTi rotary systems. Forty teeth with angles of curvature ranging from 20° to 40° and radii between 5.0 mm and 10.0 mm were selected and assigned into four groups (n = 10, according to the biomechanical preparative system used: Hero 642 (HR, Liberator (LB, ProTaper (PT, and Twisted File (TF. The specimens were inserted into an acrylic device and scanned with computed tomography prior to, and following, instrumentation at 3, 6 and 9 mm from the root apex. The canal degree of transportation and centering ability were calculated and analyzed using one-way ANOVA and Tukey’s tests (α = 0.05. The results demonstrated no significant difference (p > 0.05 in shaping ability among the rotary systems. The mean canal transportation was: -0.049 ± 0.083 mm (HR; -0.004 ± 0.044 mm (LB; -0.003 ± 0.064 mm (PT; -0.021 ± 0.064 mm (TF. The mean canal centering ability was: -0.093 ± 0.147 mm (HR; -0.001 ± 0.100 mm (LB; -0.002 ± 0.134 mm (PT; -0.033 ± 0.133 mm (TF. Also, there was no significant difference among the root segments (p > 0.05. It was concluded that the Hero 642, Liberator, ProTaper, and Twisted File rotary systems could be safely used in curved canal instrumentation, resulting in satisfactory preservation of the original canal shape.

Computed tomography evaluation of rotary systems on the root canal transportation and centering ability

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Pagliosa, Andre; Raucci-Neto, Walter; Silva-Souza, Yara Teresinha Correa; Alfredo, Edson; Sousa-Neto, Manoel Damiao; Versiani, Marco Aurelio

2015-01-01

The endodontic preparation of curved and narrow root canals is challenging, with a tendency for the prepared canal to deviate away from its natural axis. The aim of this study was to evaluate, by cone-beam computed tomography, the transportation and centering ability of curved mesiobuccal canals in maxillary molars after biomechanical preparation with different nickel-titanium (NiTi) rotary systems. Forty teeth with angles of curvature ranging from 20° to 40° and radii between 5.0 mm and 10.0 mm were selected and assigned into four groups (n = 10), according to the biomechanical preparative system used: Hero 642 (HR), Liberator (LB), ProTaper (PT), and Twisted File (TF). The specimens were inserted into an acrylic device and scanned with computed tomography prior to, and following, instrumentation at 3, 6 and 9 mm from the root apex. The canal degree of transportation and centering ability were calculated and analyzed using one-way ANOVA and Tukey’s tests (α = 0.05). The results demonstrated no significant difference (p > 0.05) in shaping ability among the rotary systems. The mean canal transportation was: -0.049 ± 0.083 mm (HR); -0.004 ± 0.044 mm (LB); -0.003 ± 0.064 mm (PT); -0.021 ± 0.064 mm (TF). The mean canal centering ability was: -0.093 ± 0.147 mm (HR); -0.001 ± 0.100 mm (LB); -0.002 ± 0.134 mm (PT); -0.033 ± 0.133 mm (TF). Also, there was no significant difference among the root segments (p > 0.05). It was concluded that the Hero 642, Liberator, ProTaper, and Twisted File rotary systems could be safely used in curved canal instrumentation, resulting in satisfactory preservation of the original canal shape. (author)

Computed tomography evaluation of rotary systems on the root canal transportation and centering ability

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Pagliosa, Andre; Raucci-Neto, Walter; Silva-Souza, Yara Teresinha Correa; Alfredo, Edson, E-mail: ysousa@unaerp.br [Universidade de Ribeirao Preto (UNAERP), SP (Brazil). Fac. de Odontologia; Sousa-Neto, Manoel Damiao; Versiani, Marco Aurelio [Universidade de Sao Paulo (USP), Ribeirao Preto, SP (Brazil). Fac. de Odoentologia

2015-03-01

The endodontic preparation of curved and narrow root canals is challenging, with a tendency for the prepared canal to deviate away from its natural axis. The aim of this study was to evaluate, by cone-beam computed tomography, the transportation and centering ability of curved mesiobuccal canals in maxillary molars after biomechanical preparation with different nickel-titanium (NiTi) rotary systems. Forty teeth with angles of curvature ranging from 20° to 40° and radii between 5.0 mm and 10.0 mm were selected and assigned into four groups (n = 10), according to the biomechanical preparative system used: Hero 642 (HR), Liberator (LB), ProTaper (PT), and Twisted File (TF). The specimens were inserted into an acrylic device and scanned with computed tomography prior to, and following, instrumentation at 3, 6 and 9 mm from the root apex. The canal degree of transportation and centering ability were calculated and analyzed using one-way ANOVA and Tukey’s tests (α = 0.05). The results demonstrated no significant difference (p > 0.05) in shaping ability among the rotary systems. The mean canal transportation was: -0.049 ± 0.083 mm (HR); -0.004 ± 0.044 mm (LB); -0.003 ± 0.064 mm (PT); -0.021 ± 0.064 mm (TF). The mean canal centering ability was: -0.093 ± 0.147 mm (HR); -0.001 ± 0.100 mm (LB); -0.002 ± 0.134 mm (PT); -0.033 ± 0.133 mm (TF). Also, there was no significant difference among the root segments (p > 0.05). It was concluded that the Hero 642, Liberator, ProTaper, and Twisted File rotary systems could be safely used in curved canal instrumentation, resulting in satisfactory preservation of the original canal shape. (author)

Root canal configuration of human permanent mandibular first molars of an indo-dravidian population based in Southern India: An In vitro study

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J V Karunakaran

2017-01-01

Full Text Available Aim: This study aims to analyze root canal configuration of human permanent mandibular first molars of an indo-Dravidian population based in southern India. Materials and Methods: A total of 1147 mandibular first permanent molars were collected, cleansed, and stored. The number of roots was recorded, access preparations made, pattern of orifices recorded after pulpal floor debridement, dye injected into the canals using apical negative pressure and subjected to a clearing technique. They were then analyzed using a stereo microscope and the canal configurations recorded (Vertucci. The number of roots, the pattern of orifices and canal configuration were recorded. Results: The pattern of orifices was triangular (87.9%, rectangular (8.5%, C-shaped (3.0%, and two orifice pattern (0.6%. About 95.6% of teeth had two roots, and 4.4% had three roots. The most common canal system configuration in mesial root was Vertucci type IV (52.3%, followed by type II (35%. Root canal configuration of the distal root revealed type I configuration in 62.7%, followed by types II (14.5% and IV (12.4%. The distolingual root had a type I configuration. Conclusion: Awareness of canal configuration, adequate clinical skills, use of specialized techniques of diagnosis, debridement and obturation will pave the way for successful treatment outcomes.

Root Canal Configuration of Human Permanent Mandibular First Molars of an Indo-Dravidian Population Based in Southern India: An In vitro Study.

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Karunakaran, J V; Samuel, Leo Sujith; Rishal, Yousef; Joseph, M Derick; Suresh, K Rahul; Varghese, Sam T

2017-11-01

This study aims to analyze root canal configuration of human permanent mandibular first molars of an indo-Dravidian population based in southern India. A total of 1147 mandibular first permanent molars were collected, cleansed, and stored. The number of roots was recorded, access preparations made, pattern of orifices recorded after pulpal floor debridement, dye injected into the canals using apical negative pressure and subjected to a clearing technique. They were then analyzed using a stereo microscope and the canal configurations recorded (Vertucci). The number of roots, the pattern of orifices and canal configuration were recorded. The pattern of orifices was triangular (87.9%), rectangular (8.5%), C-shaped (3.0%), and two orifice pattern (0.6%). About 95.6% of teeth had two roots, and 4.4% had three roots. The most common canal system configuration in mesial root was Vertucci type IV (52.3%), followed by type II (35%). Root canal configuration of the distal root revealed type I configuration in 62.7%, followed by types II (14.5%) and IV (12.4%). The distolingual root had a type I configuration. Awareness of canal configuration, adequate clinical skills, use of specialized techniques of diagnosis, debridement and obturation will pave the way for successful treatment outcomes.

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

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

2013-01-01

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

Characterization of mandibular molar root and canal morphology using cone beam computed tomography and its variability in Belgian and Chilean population samples

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Torres, Andres; Jacobs, Reinhilde; Lambrechts, Paul; Brizuela, Claudia; Cabrera, Carolina; Concha, Guillermo; Pedemonte, Maria Eugenia

2015-01-01

This study used cone-beam computed tomography (CBCT) to characterize mandibular molar root and canal morphology and its variability in Belgian and Chilean population samples. We analyzed the CBCT images of 515 mandibular molars (257 from Belgium and 258 from Chile). Molars meeting the inclusion criteria were analyzed to determine (1) the number of roots; (2) the root canal configuration; (3) the presence of a curved canal in the cross-sectional image of the distal root in the mandibular first molar and (4) the presence of a C-shaped canal in the second mandibular molar. A descriptive analysis was performed. The association between national origin and the presence of a curved or C-shaped canal was evaluated using the chi-squared test. The most common configurations in the mesial root of both molars were type V and type III. In the distal root, type I canal configuration was the most common. Curvature in the cross-sectional image was found in 25% of the distal canals of the mandibular first molars in the Belgian population, compared to 11% in the Chilean population. The prevalence of C-shaped canals was 10% or less in both populations. In cases of unclear or complex root and canal morphology in the mandibular molars, CBCT imaging might assist endodontic specialists in making an accurate diagnosis and in treatment planning

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

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Aminsobhani, Mohsen; Razmi, Hasan; Nozari, Solmaz

2015-07-01

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

Effect of ultrasonic activation on the reduction of bacteria and endotoxins in root canals: a randomized clinical trial.

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Nakamura, V C; Pinheiro, E T; Prado, L C; Silveira, A C; Carvalho, A P L; Mayer, M P A; Gavini, G

2018-01-01

This randomized clinical trial aimed to compare the effectiveness of ultrasonic activation with that of nonactivated irrigation on the removal of bacteria and endotoxin from root canals. Fifty patients with necrotic pulps and asymptomatic apical periodontitis were randomly allocated into two groups according to the final irrigation protocol after root canal preparation: Group UI - ultrasonic irrigation (n = 25) and Group NI - needle irrigation (n = 25). The root canals were medicated with calcium hydroxide for 14 days. Microbiological sampling was performed before (S1) and after the root canal preparation (S2), after the irrigation protocols (S3) and after the removal of the intracanal medication (S4). Total bacteria counts were determined by qPCR and the endotoxin levels by the limulus amebocyte lysate assay. Intragroup analyses were performed using the Wilcoxon test for related samples, whereas intergroup analyses were performed using the Mann-Whitney U-test (P  0.05). Ultrasonic activation was more effective than nonactivated irrigation for reducing the number of bacteria but not the endotoxin levels in root canals of teeth with apical periodontitis. © 2017 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Root canal treatment of a periradicular lesion caused by unintentional root damage after orthodontic miniscrew placement: a case report.

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Er, K; Bayram, M; Taşdemir, T

2011-12-01

To present the successful endodontic management of a maxillary lateral incisor tooth with a periradicular lesion caused by unintentional root damage after orthodontic miniscrew placement. A 22-year-old female was diagnosed with a skeletal Class II, Division 2 malocclusion with Class II molar and canine relationships on both sides. The treatment plan included distalization of the maxillary first molars bilaterally followed by full fixed appliance therapy. For the maxillary molar distalization, an appliance in conjunction with a miniscrew anchorage system was designed. Two months later, the patient came to the clinic with complaints of pain in the maxillary right lateral incisor region. On intraoral examination, intraoral sinus tracts were detected in the maxillary right buccal sulcus and palate. A large radiolucent lesion with a well-defined margin around the root of the maxillary right lateral incisor was seen. Root canal treatment was performed on the maxillary right lateral incisor tooth. The root canal was filled with gutta-percha and AH Plus sealer, using a lateral compaction technique. The final restoration of the tooth was completed using composite, and the tooth was reviewed after 10 months. The tooth was asymptomatic and radiographically showed repair of the lesion. Healing was achieved without any need for further endodontic or surgical intervention. Key learning points • This case illustrates the need to take care with miniscrews when performing orthodontic treatment, especially when the miniscrews are in close proximity to root apices. • The periradicular lesion as a result of miniscrew damage was successfully treated with root canal treatment. © 2011 International Endodontic Journal.

Effectiveness of rotatory and reciprocating movements in root canal filling material removal

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Emmanuel João Nogueira Leal SILVA

2015-01-01

Full Text Available The purpose of this study was to compare the efficacy of reciprocating and rotary techniques for removing gutta-percha and sealer from root canals. Forty straight and oval single-rooted premolars were prepared up to size 30, filled with gutta-percha and sealer, and then randomly allocated to two experimental retreatment groups: ProTaper Retreatment System (PTRS and WaveOne System (WS. Procedural errors, time of retreatment and apically extruded material were recorded for all the roots. The roots were radiographed after retreatment. The percentage of residual material was calculated using image analysis software. The data were analyzed by Kolmogorov-Smirnov and t tests, with a significance level set at 5%. No system completely removed the root filling material from the root canal. No significant differences were observed between the systems, in terms of residual filling material in any tested third (p > 0.05. WS was faster in removing filling material than PTRS (p< 0.05. Extrusion was observed in 4 cases in PTRS and in 5 cases in WS. No procedural errors were observed in either group. It can be concluded that although no differences were observed in the efficacy of PTRS and WS for removing root filling material, WS was faster than PTRS.

Microstructure and wettability of root canal dentine and root canal filling materials after different chemical irrigation

International Nuclear Information System (INIS)

Antonijevic, Djordje; Milovanovic, Petar; Brajkovic, Denis; Ilic, Dragan; Hahn, Michael; Amling, Michael; Rakocevic, Zlatko; Djuric, Marija; Busse, Björn

2015-01-01

Graphical abstract: - Highlights: • Different irrigation solutions and disinfectants were used for treatment of root canal dentine and gutta-percha points. • Materials surface characteristics were assessed using quantitative backscattered electron imaging, reference point indentation, and contact angle analyzer. • The most significant differences in mineralization, indentation, and adhesive outcomes were observed after ethylenediaminetetraacetic acid treatment. • Irrigation solutions confer to superior sealing ability of endodontic filling materials. • Micromechanical characteristics of dentine after irrigation are considerable reduced. - Abstract: The objective of this study was to determine the effects of various irrigation solutions on root canal dentine and gutta-percha surface properties. In addition, the effects of disinfectant chemicals on the wettability and surface morphological properties of the filling materials were evaluated. Ethylenediaminetetraacetic acid (EDTA), citric acid, and ozone were employed as irrigation solutions for dentine and gutta-percha treatment. Thereafter, the samples’ microstructure, degree of mineralization, and mechanical properties were assessed by means of quantitative backscattered electron imaging (qBEI) and reference point indentation (RPI). A contact angle analyzer was used to measure adhesion on the tested materials. Here, EDTA had the most significant affect on both the mechanical properties and the adhesive behavior of dentine. Citric acid did not affect dentine wettability, whereas the indentation properties and the mineralization were reduced. Similar effects were observed when ozone was used. The dentinal tubules were significantly widened in citric acid compared to the ozone group. EDTA causes considerable micromechanical surface alteration of dentine and gutta-percha, but represents the best option in clinical cases where a high adhesiveness of the filling materials is desired.

Microstructure and wettability of root canal dentine and root canal filling materials after different chemical irrigation

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Antonijevic, Djordje; Milovanovic, Petar [Laboratory for Anthropology, Institute for Anatomy, Faculty of Medicine, University of Belgrade, Belgrade (Serbia); Brajkovic, Denis [Department of Dentistry, Faculty of Medical Sciences, University of Kragujevac, Kragujevac (Serbia); Ilic, Dragan [Department of Restorative Medicine, School of Dental Medicine, University of Belgrade, Belgrade (Serbia); Hahn, Michael; Amling, Michael [Department of Osteology and Biomechanics (IOBM), University Medical Center Hamburg-Eppendorf, Lottestr. 55A, 22529 Hamburg (Germany); Rakocevic, Zlatko [Laboratory for Atomic Physics, Institute for Nuclear Science “Vinca”, University of Belgrade, Belgrade (Serbia); Djuric, Marija [Laboratory for Anthropology, Institute for Anatomy, Faculty of Medicine, University of Belgrade, Belgrade (Serbia); Busse, Björn, E-mail: b.busse@uke.uni-hamburg.de [Department of Osteology and Biomechanics (IOBM), University Medical Center Hamburg-Eppendorf, Lottestr. 55A, 22529 Hamburg (Germany)

2015-11-15

Graphical abstract: - Highlights: • Different irrigation solutions and disinfectants were used for treatment of root canal dentine and gutta-percha points. • Materials surface characteristics were assessed using quantitative backscattered electron imaging, reference point indentation, and contact angle analyzer. • The most significant differences in mineralization, indentation, and adhesive outcomes were observed after ethylenediaminetetraacetic acid treatment. • Irrigation solutions confer to superior sealing ability of endodontic filling materials. • Micromechanical characteristics of dentine after irrigation are considerable reduced. - Abstract: The objective of this study was to determine the effects of various irrigation solutions on root canal dentine and gutta-percha surface properties. In addition, the effects of disinfectant chemicals on the wettability and surface morphological properties of the filling materials were evaluated. Ethylenediaminetetraacetic acid (EDTA), citric acid, and ozone were employed as irrigation solutions for dentine and gutta-percha treatment. Thereafter, the samples’ microstructure, degree of mineralization, and mechanical properties were assessed by means of quantitative backscattered electron imaging (qBEI) and reference point indentation (RPI). A contact angle analyzer was used to measure adhesion on the tested materials. Here, EDTA had the most significant affect on both the mechanical properties and the adhesive behavior of dentine. Citric acid did not affect dentine wettability, whereas the indentation properties and the mineralization were reduced. Similar effects were observed when ozone was used. The dentinal tubules were significantly widened in citric acid compared to the ozone group. EDTA causes considerable micromechanical surface alteration of dentine and gutta-percha, but represents the best option in clinical cases where a high adhesiveness of the filling materials is desired.

Hermetizing ability of the new obturating material for root canals «Real Seal» with «Resilon» technology

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Makedonova Y.A.

2012-03-01

Full Text Available Simple, reliable and predictable obturation of root canals side by side with their cleaning and forming is an essential part of the endodontic treatment. The aim of this research is investigation of obturation density of root canals. Canals filled by means of lateral condensation of the new obturative system «Real Seal/Resilon» and by means of traditional method of canals obturation with the help of gutta-percha and sealer АН-plus. The results of the research proved a ligher hermetizing ability of the new experimental material «Real Seal» in comparison with obturation by means of gutta-percha pins. The obtained data reflects an objective picture and can be applied as a unique quality monitoring obturation of root canals.

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

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

2012-07-01

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

The use of plastic models for teaching root canal cleansing and shaping

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Eftekhar B

2004-02-01

Full Text Available The use of root canal models in endodontics education is of high importance. So, in this article"na new method is presented that the students can produce these models with simple and low cost"ninstruments."nThese plastic models are made of polyester which is low cost, available and has the approximate cutting"nproperties of dentin. The best molds were disposable syringes due to their low cost, availability and"nproducing smooth surfaces on polyester models. A spreader with desired curve and tapering is used for"nproducing canals. Rockwell A hardness coefficient of polyester is "33", which is near dentin "31" and"nforeign made models "35.5". Since these polyester models can tolerate up to 280°C and have acceptable"nresistance to chloroform, all root canal therapy techniques such as vertical condensation and retreatments"nare practicable. Their transparency encourage the students to work on them. As a result, the use of these"nmodels is recommended for endodontics training.

Working Length Determination of Root Canal of Young Permanent ...

African Journals Online (AJOL)

Working Length Determination of Root Canal of Young Permanent Tooth: An In Vitro Study. A Diwanji, AS Rathore, R Arora, V Dhar, A Madhusudan, J Doshi. Abstract. Background: Determination of correct working length is one of the keys to success in endodontic therapy. Aim: The aim of this study was to evaluate the ...

Digital subtraction radiography evaluation of the bone repair process of chronic apical periodontitis after root canal treatment.

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Benfica e Silva, J; Leles, C R; Alencar, A H G; Nunes, C A B C M; Mendonça, E F

2010-08-01

To monitor radiographically the progress of bone repair within chronic periapical lesions after root canal treatment using digital subtraction radiography (DSR). Twelve patients with 17 single-rooted teeth with chronic apical periodontitis associated with an infected necrotic pulp were selected for root canal treatment. Periapical radiographs were taken before treatment (baseline) and immediately post-treatment, 45, 90, 135 and 180 days after treatment. The radiographic protocol included the use of individualized film holders with silicone bite blocks. The six radiographic images were digitized and submitted to digital subtraction using DSR software, resulting in five subtracted images (SI). Quantitative analysis of these SI was performed using Image Tool software to assess pixel value changes, considering a step-wedge as the gold standard and a cut-off value of 128 pixels. The aim was to identify any increase or decrease in mineral density in the region of the periapical lesion. A minor decrease in mineral density at the canal filling session and a significant progressive mineral gain in the following evaluations (P < 0.001) occurred. Pairwise comparison of pixel grey values revealed that only the 180-day follow-up differed significantly from the previous SI. Digital subtraction radiography is a useful method for evaluating the progress of bone repair after root canal treatment. Noticeable mineral gain was observed approximately 90 days after root canal filling and definite bone repair after 180 days.

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

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Muñoz, Estefanía; Forner, Leopoldo; Llena, Carmen

2014-04-01

The aim of this study was to evaluate the influence of the operator's experience on the shaping of double-curvature simulated root canals with a nickel-titanium single-file reciprocating motion system. Sixty double-curvature root canals simulated in methacrylate blocks were prepared by 10 students without any experience in endodontics and by 10 professionals who had studied endodontics at the postgraduate level. The Reciproc-VDW system's R25 file was used in the root canal preparation. The blocks were photographed before and after the instrumentation, and the time of instrumentation was also evaluated. Changes in root canal dimensions were analyzed in 6 positions. Significant differences (P file reciprocating motion system Reciproc is not seen to be influenced by the operator's experience regarding the increase of the canal area. Previous training and the need to acquire experience are important in the use of this system, in spite of its apparent simplicity. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Present and future in the use of micro-CT scanner 3D analysis for the study of dental and root canal morphology.

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Grande, Nicola M; Plotino, Gianluca; Gambarini, Gianluca; Testarelli, Luca; D'Ambrosio, Ferdinando; Pecci, Raffaella; Bedini, Rossella

2012-01-01

The goal of the present article is to illustrate and analyze the applications and the potential of microcomputed tomography (micro-CT) in the analysis of tooth anatomy and root canal morphology. The authors performed a micro-CT analysis of the following different teeth: maxillary first molars with a second canal in the mesiobuccal (MB) root, mandibular first molars with complex anatomy in the mesial root, premolars with single and double roots and with complicated apical anatomy. The hardware device used in this study was a desktop X-ray microfocus CT scanner (SkyScan 1072, SkyScan bvba, Aartselaar, Belgium). A specific software ResolveRT Amira (Visage Imaging) was used for the 3D analysis and imaging. The authors obtained three-dimensional images from 15 teeth. It was possible to precisely visualize and analyze external and internal anatomy of teeth, showing the finest details. Among the 5 upper molars analyzed, in three cases, the MB canals joined into one canal, while in the other two molars the two mesial canals were separate. Among the lower molars two of the five samples exhibited a single canal in the mesial root, which had a broad, flat appearance in a mesiodistal dimension. In the five premolar teeth, the canals were independent; however, the apical delta and ramifications of the root canals were quite complex. Micro-CT offers a simple and reproducible technique for 3D noninvasive assessment of the anatomy of root canal systems.

Present and future in the use of micro-CT scanner 3D analysis for the study of dental and root canal morphology

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Nicola M. Grande

2012-01-01

Full Text Available The goal of the present article is to illustrate and analyze the applications and the potential of microcomputed tomography (micro-CT in the analysis of tooth anatomy and root canal morphology. The authors performed a micro-CT analysis of the following different teeth: maxillary first molars with a second canal in the mesiobuccal (MB root, mandibular first molars with complex anatomy in the mesial root, premolars with single and double roots and with complicated apical anatomy. The hardware device used in this study was a desktop X-ray microfocus CT scanner (SkyScan 1072, SkyScan bvba, Aartselaar, Belgium. A specific software ResolveRT Amira (Visage Imaging was used for the 3D analysis and imaging. The authors obtained three-dimensional images from 15 teeth. It was possible to precisely visualize and analyze external and internal anatomy of teeth, showing the finest details. Among the 5 upper molars analyzed, in three cases, the MB canals joined into one canal, while in the other two molars the two mesial canals were separate. Among the lower molars two of the five samples exhibited a single canal in the mesial root, which had a broad, flat appearance in a mesiodistal dimension. In the five premolar teeth, the canals were independent; however, the apical delta and ramifications of the root canals were quite complex. Micro-CT offers a simple and reproducible technique for 3D noninvasive assessment of the anatomy of root canal systems.

Comparison of the removal of calcium hydroxide medicaments on the root canal treatment irrigated with manual and sonic agitation technique

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Anna Muryani

2017-11-01

Full Text Available Introduction: Irrigation of the root canal system is an important part of the endodontic treatment principle which aims to improve the hygiene of the root canal system from any debris and medicament residue with the hydrodynamic system. Root irrigation technique can be done with the manual and sonic system by using 2.5% NaOCI irrigation solution. Calcium hydroxide is used as a medicament for root canal sterilization. Root canal treatment will fail due to the imperfect removal of calcium hydroxide residue. The objective of this research was to analyze the comparison of the removal of calcium hydroxide medicaments on the root canal treatment irrigated with manual and sonic agitation technique using 2.5% sodium hypochlorite solution. Methods: The methods used in this study was experimental laboratory. The sample used was 30 maxillary incisors. The teeth were then divided into two groups randomly, then the root canal preparation was done by the crown down technique with manual irrigation using 2.5% NaOCI solution. The radicular part of the teeth was then split longitudinally, given a standardized groove in the one-third of the apical part, then applied with water-solved calcium hydroxide. The teeth were unified afterwards by using flowable composites, then soaked in the artificial saliva at the temperature of 37ºC. The sample of the 1st group was irrigated by manual agitation technique, and the sample of the 2nd group 2 was irrigated by sonic agitation technique, then both were viewed by stereo microscope. The data results were analyzed by Kruskal-Wallis and Mann-Whitney tests. Results: The results of calcium hydroxide removal were different between the root canals that were irrigated using 2.5% sodium hypochlorite irrigation solution by manual agitation technique compared to the sonic agitation technique. Irrigation using 2.5% sodium hypochlorite irrigation solution with the sonic agitation techniques were proven to be more effective in lifting Ca

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

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

2013-12-01

The aim of this study was to determine the root and canal morphology of the mandibular first molars in a Korean population of Mongolian origin by retrospective analysis of a large number of cone-beam computed tomography (CBCT) images. A total of 976 subjects with bilateral mandibular first molars were examined by using in vivo CBCT methods. The number and configuration of roots, the number of root canals, and the canal configuration based on Vertucci's classification were determined. Overall, 25.82% of examined molars had 3 roots, 73.51% had 2 roots, and 0.67% had 1 root. The incidence of fourth canal was 50.36%. A right-sided predominance was noted for extra distal roots (P population. CBCT is a useful tool for determining root and canal morphology. Copyright © 2013 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Evaluation of the Root and Canal Morphology of Mandibular Permanent Anterior Teeth in an Iranian Population by Cone-Beam Computed Tomography

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Mohsen Aminsobhani

2013-01-01

Full Text Available Objective: To evaluate differences in the root and canal configurations of mandibular permanent anterior incisors and canines in an Iranian population by means of Cone Beam CT (CBCT images.Materials and Methods: Four hundred CBCT images of mandibular permanent incisors and canines that met the inclusion criteria were evaluated. Vertucci´s classification was used to evaluate the number of roots, number of root canals, root lengths, root curvatures and canal types.Results: Totally 632 central incisors, 614 lateral incisors and 608 canines were evaluated. The average length of the mandibular central, lateral incisors and canines was 21.3±0.10, 21.9± 0.13 and 25.1± 0.11 mm, respectively. All of the mandibular central and lateral incisors had one root, but the incidence of single-rooted mandibular canines and two-rooted mandibular canines was 96.3% and 4.7%, respectively. The majority of mandibular central, lateral incisors and canines had one canal (72.7%, 70.6% and 71.8%, respectively. Five types of Vertucci canal configurations were seen in the evaluated teeth. Type 1 Vertucci configuration was the most prevalent configuration (72.3%, 70.6% and 71.8% for the central, lateral incisors and canines, respectively, and type 5 Vertucci canal configuration was the least prevalent type seen (3.3%, 3.2% and 2.3% for the central, lateral incisors and canines, respectively. The most frequent root curvatures in these teeth were distally and buccally. No significant difference was seen between male and female patients regarding any of the parameters evaluated in this study (p>0.05.Conclusion: More attention should be given to the detection of additional canals and the recognition of canal curvature in Iranian patients.

Micro-computed tomography study of the internal anatomy of mesial root canals of mandibular molars.

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Villas-Bôas, Marcelo Haas; Bernardineli, Norberti; Cavenago, Bruno Cavalini; Marciano, Marina; Del Carpio-Perochena, Aldo; de Moraes, Ivaldo Gomes; Duarte, Marco H; Bramante, Clovis M; Ordinola-Zapata, Ronald

2011-12-01

The aim of this study was to determine the mesiodistal and buccolingual diameter, apical volume, and the presence of isthmuses at the apical level of mesial root canals of mandibular molars. Sixty extracted first and second mandibular molars were scanned by using a SkyScan 1076 micro-computed tomography system with a voxel size of 18 μm. The apical thirds of the samples were reconstructed to allow a perpendicular section of the apical third by using the multiplanar reconstruction tool of the OsiriX software. The mesiodistal and the buccolingual distances of root canals were measured between the 1- to 4-mm levels. The type of root canal isthmuses present at these levels was classified by using modified criteria of Hsu and Kim. The volume of the root canal anatomy between the 1- to 3-mm apical levels was obtained by using the CTAN-CTVOL software. The medians of the mesiodistal diameter at the 1-, 2-, 3-, and 4-mm levels in the mesiobuccal and mesiolingual canals were 0.22 and 0.23 mm, 0.27 and 0.27 mm, 0.30 and 0.30 mm, and 0.36 and 0.35 mm, respectively. The buccolingual lengths at the 1-, 2-, 3-, and 4-mm levels were 0.37-0.35 mm, 0.55-0.41 mm, 0.54-0.49 mm, and 0.54 and 0.60 mm, respectively. The presence of isthmuses was more prevalent at the 3- to 4-mm level. However, 27 cases presented complete or incomplete isthmuses at the 1-mm apical level. The mean of the volume of the apical third was 0.83 mm(3), with a minimum value of 0.02 and a maximum value of 2.4 mm(3). Mesial root canals of mandibular molars do not present a consistent pattern. A high variability of apical diameters exists. The presence of isthmuses at the apical third was not uncommon even at the 1-mm apical level. Copyright © 2011 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

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

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Helvacioglu-Yigit, Dilek

2015-01-01

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

Accuracy of two root canal length measurement devices integrated into rotary endodontic motors when removing gutta-percha from root-filled teeth.

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Uzun, O; Topuz, O; Tinaz, C; Nekoofar, M H; Dummer, P M H

2008-09-01

To evaluate ex vivo the accuracy of the integrated electronic root canal length measurement devices within TCM Endo V and Tri Auto ZX motors whilst removing gutta-percha and sealer from filled root canals. Forty freshly extracted maxillary and mandibular incisor teeth with mature apices were selected. Following access cavity preparation, the length of the root canals were measured visually 0.5 mm short of the major foramen (TL). The canals were prepared using the HERO 642 system and then filled with gutta-percha and AH26 sealer using a lateral compaction technique. After 7 days the coronal temporary filling was removed and the roots mounted in an alginate experimental model. The roots were then randomly divided in two groups. The access cavities were filled with chloroform to soften the gutta-percha and allow its penetration using the Tri Auto ZX and the TCM Endo V devices in groups 1 and 2, respectively. The 'automatic apical reverse function' (ARL) of both devices was set to start at the 0.5 setting and the rotary instrument inserted inside the root canal until a beeping sound was heard and the rotation of the file stopped automatically. Once the auto reverse function had been initiated, the foot pedal of the motor was inactivated and the rubber stop placed against the reference point. The distance between the file tip and rubber stop was measured using a digital calliper to 0.01 mm accuracy (ARL). Then, a size 20, 0.02 taper instrument was attached to each device and inserted into the root canals without rotary motion until the integrated ERCLMDs positioned the instrument tips at the 0.5 setting as suggested by the devices. This length was again measured using a digital calliper (EL). The Mann-Whitney U-test was used to investigate statistical differences between the true canal length and those indicated by the two devices when used in 'automatic ARL and when inserted passively (EL). In the presence of gutta-percha, sealer and chloroform, the auto

Efficacy of ProTaper retreatment system in root canals filled with gutta-percha and two endodontic sealers.

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Só, Marcus Vinícius Reis; Saran, Caroline; Magro, Miriam Lago; Vier-Pelisser, Fabiana Vieira; Munhoz, Marcelo

2008-10-01

This study evaluated the efficacy of ProTaper Universal rotary retreatment system and hand files for filling material removal during retreatment and the influence of sealer type on the presence of filling debris in the reinstrumented canals. The canals of 60 palatal roots of first molars were obturated with gutta-percha and either a zinc oxide-eugenol-based or a resin-based sealer and reinstrumented: G1, EndoFill/hand files; G2, AH Plus/hand files; G3, EndoFill/ProTaper; G4, AH Plus/ProTaper. Roots were cleaved and examined with an optical microscope, and the amount of filling debris on canal walls was analyzed on digitized images. There was no significant difference (P > .05) among the root canal thirds within each group. G3 presented significantly more filling debris than G1 in the cervical third (P = .04). In the middle third, G2/G3/G4 showed more debris than G1 (P = .03). The techniques were similar (P = .64) in the apical third. All groups presented filling debris in the 3 canal thirds after reinstrumentation.

A comparison of three rotary systems and hand instrumentation technique for the elimination of Enterococcus faecalis from the root canal.

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Gorduysus, Melahat; Nagas, Emre; Torun, Ozgur Yildirim; Gorduysus, Omer

2011-12-01

The aim of this study was to compare the in vitro reduction of a bacterial population in a root canal by mechanical instrumentation using three rotary systems and hand instrumentation technique. The root canals contaminated with a suspension of Enterococcus faecalis were instrumented using ProTaper, K3, HeroShaper and K-file hand instrumentation technique. Later the root canals were sampled. After serial dilutions, samples were incubated in culture media for 24 h. Bacterial colonies were counted and the results were given as number of colony-forming units per millilitre. The results showed that all the canal instrumentation systems reduced the number of bacterial cells in the root canals. Statistically, ProTaper instruments were more effective in reducing the number of bacteria than the other rotary files or hand instruments. © 2010 The Authors. Australian Endodontic Journal © 2010 Australian Society of Endodontology.

Effect of Corticosteroids on Pain Relief Following Root Canal Treatment: A Systematic Review.

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Iranmanesh, Foad; Parirokh, Masoud; Haghdoost, Ali Akbar; Abbott, Paul V

2017-01-01

Post-operative pain and flare-up may occur in up to 58% of patients following root canal treatment. The aim was to conduct a systematic review and a possible meta-analysis to determine the effect of glucocorticosteroid (GCS) on pain following root canal treatment. Scopus, MEDLINE and CENTRAL databases were searched up to 30 th January 2017 with broad key words. In addition, the reference lists in eligible papers and text books were hand-searched. Assessment of the eligibility of papers and data extraction were performed by two independent reviewers. Of 9891 articles, 18 were recruited as eligible papers. Most of these papers showed pain reducing effect of GCS on post-endodontic pain. Because of wide heterogeneity among the recruited papers, it was not possible to perform meta-analysis. Based on the results of this systematic review, there is a vast heterogeneity amongst articles regarding the use of GCS and their effect on post-operative pain after endodontic treatment. Further investigations with similar methods and materials are needed before meta-analysis on the effect of GCS on post-operative pain following root canal treatment can be performed .

Comparison of Endoflas and Zinc oxide Eugenol as root canal filling materials in primary dentition

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Nivedita Rewal

2014-01-01

Full Text Available Background: Zinc oxide eugenol has long been the material of choice of pediatric dentists worldwide, although it fails to meet the ideal requirements of root canal filling material for primary teeth. Endoflas, a mixture of zinc oxide eugenol, calcium hydroxide, and iodoform, can be considered to be an effective root canal filling material in primary teeth as compared with zinc oxide eugenol. This study was carried out to compare zinc oxide eugenol with endoflas for pulpectomy in primary dentition. Aim: The objective of the study was to compare clinically and radiographically success rates of zinc oxide eugenol with endoflas for the root canal filling of primary teeth at 3, 6, and 9 months. Design: Fifty primary molars were included in the study with 26 teeth in Group I (Endoflas and 24 in Group II (zinc oxide eugenol. A single visit pulpectomy was carried out. Results: The overall success rate of zinc oxide eugenol was 83% whereas 100% success was found in the case of endoflas. The obtained results were compiled and subjected to statistical analysis using the chi-square test. The difference in the success rate between the two was statistically significant (P < 0.05. Conclusion: Endoflas has shown to have better results than zinc oxide eugenol. It should therefore be the material of choice for root canal treatment in deciduous dentition.

CT study of the performance of reciprocating and oscillatory motions in flattened root canal areas

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Moura-Netto, Cacio; Palo, Renato Miotto; Pinto, Larissa Fernanda; Daltoe, Gisele; Mello-Moura, Anna Carolina Volpi

2015-01-01

Abstract: Root canal preparation is an important step in endodontic treatment. The anatomical complexity of the middle third of the root compromises the effective cleaning of this area. Thus, advances have been made in instrumentation techniques and instruments for this purpose. The aim of this study was to evaluate the effects of three different instrumentation systems on the enlargement of the middle thirds of root canals in mandibular incisors. The preparation methods used were the reciprocating systems Reciproc (Group I) and WaveOne (Group II) and the oscillatory system Tilos (Group III). Comparisons were made by three-dimensional image reconstruction with cone-beam computed tomography before and after instrumentation. Changes in area, perimeter, centering ability, and pattern of preparation were analyzed. The results were subjected to ANOVA complemented by the Tukey’s test. Changes in area, perimeter, and tendency of transportation showed similar results among groups. The transportation index of the Tilos system was significantly lower than that of the other groups. Qualitative analysis of the preparation pattern showed that the Tilos system had a more uniform preparation, although Reciproc and WaveOne preparations appeared more rounded, incompatible with the original canal anatomy. There was similarity in the systems’ performance on flattened areas, although the Tilos system presented a better pattern of root canal preparation and a lower index of transportation. (author)

CT study of the performance of reciprocating and oscillatory motions in flattened root canal areas

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Cacio MOURA-NETTO

2015-01-01

Full Text Available Root canal preparation is an important step in endodontic treatment. The anatomical complexity of the middle third of the root compromises the effective cleaning of this area. Thus, advances have been made in instrumentation techniques and instruments for this purpose. The aim of this study was to evaluate the effects of three different instrumentation systems on the enlargement of the middle thirds of root canals in mandibular incisors. The preparation methods used were the reciprocating systems Reciproc (Group I and WaveOne (Group II and the oscillatory system Tilos (Group III. Comparisons were made by three-dimensional image reconstruction with cone-beam computed tomography before and after instrumentation. Changes in area, perimeter, centering ability, and pattern of preparation were analyzed. The results were subjected to ANOVA complemented by the Tukey’s test. Changes in area, perimeter, and tendency of transportation showed similar results among groups. The transportation index of the Tilos system was significantly lower than that of the other groups. Qualitative analysis of the preparation pattern showed that the Tilos system had a more uniform preparation, although Reciproc and WaveOne preparations appeared more rounded, incompatible with the original canal anatomy. There was similarity in the systems’ performance on flattened areas, although the Tilos system presented a better pattern of root canal preparation and a lower index of transportation.

CT study of the performance of reciprocating and oscillatory motions in flattened root canal areas

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Moura-Netto, Cacio, E-mail: caciomn@usp.br [Universidade Cruzeiro do Sul (UNICSUL), Sao Paulo, SP (Brazil). Fac. de Odontologia; Palo, Renato Miotto [Universidade Estadual Paulista Julio de Mesquita Filho (ICT/UNESP), Sao Jose dos Campos, SP (Brazil). Instituto de Ciencia e Tecnologia; Pinto, Larissa Fernanda; Daltoe, Gisele; Mello-Moura, Anna Carolina Volpi [Universidade Ibirapuera (UNIB), Sao Paulo, SP (Brazil). Fac. de Odontologia

2015-03-01

Abstract: Root canal preparation is an important step in endodontic treatment. The anatomical complexity of the middle third of the root compromises the effective cleaning of this area. Thus, advances have been made in instrumentation techniques and instruments for this purpose. The aim of this study was to evaluate the effects of three different instrumentation systems on the enlargement of the middle thirds of root canals in mandibular incisors. The preparation methods used were the reciprocating systems Reciproc (Group I) and WaveOne (Group II) and the oscillatory system Tilos (Group III). Comparisons were made by three-dimensional image reconstruction with cone-beam computed tomography before and after instrumentation. Changes in area, perimeter, centering ability, and pattern of preparation were analyzed. The results were subjected to ANOVA complemented by the Tukey’s test. Changes in area, perimeter, and tendency of transportation showed similar results among groups. The transportation index of the Tilos system was significantly lower than that of the other groups. Qualitative analysis of the preparation pattern showed that the Tilos system had a more uniform preparation, although Reciproc and WaveOne preparations appeared more rounded, incompatible with the original canal anatomy. There was similarity in the systems’ performance on flattened areas, although the Tilos system presented a better pattern of root canal preparation and a lower index of transportation. (author)

Radiographic prevalence of root canal ramifications in a sample of root canal treatments in a Brazilian Dental School Prevalência radiográfica de ramificações do canal radicular em uma amostra de tratamentos endodônticos em uma Faculdade de Odontologia Brasileira

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Iadasa de Quadros

2007-06-01

Full Text Available The aim of this study was to radiographically investigate the presence of root canal ramifications found after endodontic treatment, and to determine any relationship between their presence and the type of the auxiliary chemical substance used. The study evaluated 1,470 endodontic treatments performed by final year undergraduate students at the Dental School of Piracicaba, State University of Campinas (UNICAMP, SP, Brazil, during the period from 1998 to 2000. The X-rays taken during treatment were evaluated in order to establish the presence of ramifications of the root canal system. The initial X-ray did not show the presence of any canal ramifications. After filling, X-rays showed only 3 ramification types: 3.06% of lateral canals, 2.99% of apical deltas, and 0.1% of interradicular canals. The maxillary premolars showed the highest number of lateral canals (n = 13, followed by mandibular premolars (n = 10 and maxillary incisors (n = 10. Apical deltas were mostly found in mandibular molars (n = 14, followed by maxillary incisors (n = 9. Only mandibular molars had interradicular canals. The detection of ramifications increased with the use of EDTA. However, no statistically significant relationship was found between the type of auxiliary chemical substance used and the number of root canal ramifications detected after root canal filling. It was concluded that the frequency of root canal ramifications found radiographically was low in treatments performed by undergraduate students.O objetivo deste estudo foi investigar radiograficamente a presença de ramificações do canal radicular encontrada depois do tratamento endodôntico, e determinar qualquer relação entre a presença destas e do tipo de substância química auxiliar usada. O estudo avaliou 1.470 tratamentos endodônticos executados pelos estudantes do último ano da Faculdade de Odontologia de Piracicaba, Universidade Estadual de Campinas (UNICAMP, SP, Brasil, no período de 1998 a

[In vitro comparison of root canal preparation with step-back technique and GT rotary file--a nickel-titanium engine driven rotary instrument system].

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Krajczár, Károly; Tóth, Vilmos; Nyárády, Zoltán; Szabó, Gyula

2005-06-01

The aim of the authors' study was to compare the remaining root canal wall thickness and the preparation time of root canals, prepared either with step-back technique, or with GT Rotary File, an engine driven nickel-titanium rotary instrument system. Twenty extracted molars were decoronated. Teeth were divided in two groups. In Group 1 root canals were prepared with step-back technique. In Group 2 GT Rotary File System was utilized. Preoperative vestibulo-oral X-ray pictures were taken from all teeth with radiovisiograph (RVG). The final preparations at the mesiobuccal canals (MB) were performed with size #30 and palatinal/distal canals with size #40 instruments. Postoperative RVG pictures were taken ensuring the preoperative positioning. The working time was measured in seconds during each preparation. The authors also assessed the remaining root canal wall thickness at 3, 6 and 9 mm from the radiological apex, comparing the width of the canal walls of the vestibulo-oral projections on pre- and postoperative RVG pictures both mesially and buccally. The ratios of the residual and preoperative root canal wall thickness were calculated and compared. The largest difference was found at the MB canals of the coronal and middle third level of the root, measured on the distal canal wall. The ratio of the remaining dentin wall thickness at the coronal and the middle level in the case of step-back preparation was 0.605 and 0.754, and 0.824 and 0.895 in the cases of GT files respectively. The preparation time needed for GT Rotary File System was altogether 68.7% (MB) and 52.5% (D/P canals) of corresponding step-back preparation times. The use of GT Rotary File with comparison of standard step-back method resulted in a shortened preparation time and excessive damage of the coronal part of the root canal could be avoided.

The Effects of NiTi Hand and Rotary Canal Master U and K-Flex Instrumentation of Root Canal Morphology

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1992-09-01

Rotary Canal Master "U" and K-Flex Instrumentation of Root Canal Morphology 6. AUTHOR(S) Robert H. Haller 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES... endodontic failure. B. STATET OF THE PREL]2U Conventional endodontic instruments have re.nained basically unchanged since the introduction of the K-type...F;hcw"e that this nO𔃾 instruneent destim tended ti- produce rounder pr rMticns with • t!-rnnVortaticn than c rnvrnticnal 4 endodontic instruments

Evaluation of the Apical Sealability of Mineral Trioxide Aggregate and Portland Cement as Root Canal Filling Cements: An in Vitro Study

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M.S. Rekab

2010-12-01

Full Text Available Objective: One of the principle purposes of root canal obturation is to obtain hermetic sealing of the root canal system. According to the development of technology, many materials are now used in root canal filling. An in vitro dye leakage study was performed toevaluate the apical sealability of White-colored Mineral Trioxide Aggregate (WMTA and Gray-colored Portland Cement (GPC when used alone or as a sealer with gutta-percha points in root canal filling.Materials and Methods: Seventy-five single-rooted extracted human teeth were used in this study. After cleaning and shaping, the teeth were randomly divided into five equal groups of 15 teeth each based on the root canal filling material used; Group 1, (WMTAalone; Group 2, (GPC alone; Group 3, (Gutta-percha points + WMTA; Group 4,(Guttapercha points + GPC; Group 5, (Gutta-percha points + AH26. Methylene blue was used to determine the apical leakage. After sectioning the teeth longitudinally, linear dye penetrationwas measured with a caliper under the stereomicroscope. Data were analyzed by Kruskal-Wallis and one-way ANOVA tests with (P 0.05 as the level of significance.Results: The results showed that there were no statistically significant differences among the materials of five groups.Conclusion: (WMTA alone, (Gutta-percha points + WMTA, (GPC alone and (Guttapercha points + GPC may be used in the root canal filling.

A comparison of the effectiveness of chloroform and eucalyptus oil in dissolving root canal sealers.

Science.gov (United States)

Schäfer, Edgar; Zandbiglari, Tannaz

2002-05-01

The solubility of 8 different root canal sealers in chloroform and in eucalyptus oil was compared. For standardized samples (n=12), ring molds were filled with mixed sealers based on epoxy resin, silicone, calcium hydroxide, zinc oxide-eugenol, glass ionomer, and polyketone. These samples were immersed in chloroform or eucalyptus oil for 30 seconds, 1 minute, 2 minutes, 5 minutes, 10 minutes, and 20 minutes. Then, the mean weight loss was determined and statistically analyzed. With the exception of the silicone, all the sealers showed significantly higher solubilities (P <.05) in chloroform than in eucalyptus oil. Epoxy resin was the most soluble sealer in chloroform. In eucalyptus oil, calcium hydroxide, and zinc oxide-eugenol showed the highest solubility. Under the conditions of this study, chloroform was a far more effective solvent of root canal sealers than eucalyptus oil. Because of the potential hazards of chloroform, further studies on the dissolution of root canal sealers in different solvents seem to be necessary.

Assessment of facultative anaerobes from the root canals of deciduous molars: An in vivo study

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Manisha Chandwani

2017-06-01

Full Text Available Background. The current research aimed to assess the prevalence of facultative anaerobes isolated from the root canals of deciduous molars. Methods. The present research enrolled 60 children in the 6‒9-year age group based on clinical and radiographic findings. Under aseptic conditions, access cavities were prepared followed by collection of samples from infected root canals with the help of sterile paper points. The samples thus obtained were subjected for microbial assay. Results. It was found that Enterococcus faecalis was isolated in 30% of cases, Escherichia coli in 28.4%, Staphylococcus aureus in 25%, α-hemolytic Streptococci in 15% and Proteus mirabilis in 1.6% of cases. Conclusion. It was concluded from the results of the present study that the root canals of deciduous molars had predominance of facultative anaerobes, confirming its polymicrobial nature. This identification of microbes is crucial as it aids in understanding the pathogenesis of pulpal and periradicular diseases to provide effective antimicrobial irrigation and medicament for endodontic treatment.

Marginal adaptation of newer root canal sealers to dentin: A SEM study.

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Polineni, Swapnika; Bolla, Nagesh; Mandava, Pragna; Vemuri, Sayesh; Mallela, Madhusudana; Gandham, Vijaya Madhuri

2016-01-01

This in vitro study evaluated and compared the marginal adaptation of three newer root canal sealers to root dentin. Thirty freshly extracted human single-rooted teeth with completely formed apices were taken. Teeth were decoronated, and root canals were instrumented. The specimens were randomly divided into three groups (n = 10) based upon the sealer used. Group 1 - teeth were obturated with epoxy resin sealer (MM-Seal). Group 2 - teeth were obturated with mineral trioxide aggregate (MTA) based sealer (MTA Fillapex), Group 3 - teeth were obturated with bioceramic sealer (EndoSequence BC sealer). Later samples were vertically sectioned using hard tissue microtome and marginal adaptation of sealers to root dentin was evaluated under coronal and apical halves using scanning electron microscopy (SEM) and marginal gap values were recorded. The data were statistically analyzed by two-way ANOVA and Tukey's multiple post hoc test. The highest marginal gap was seen in Group 2 (apical-16680.00 nm, coronal-10796 nm) and the lowest marginal gap was observed in Group 1 (apical-599.42 nm, coronal-522.72 nm). Coronal halves showed superior adaptation compared to apical halves in all the groups under SEM. Within the limitations of this study epoxy resin-based MM-Seal showed good marginal adaptation than other materials tested.

The Effect of Gaseous Ozone in Infected Root Canal

Science.gov (United States)

Ajeti, Nova Nexhmije; Pustina-Krasniqi, Teuta; Apostolska, Sonja

2018-01-01

OBJECTIVES: During the treatment of chronic apical periodontitis and pulp necrosis the main role is to irrigate the root canal. AIM: The aim of this in vivo study was to irrigate with 0.9% NaCl (Natrium Chloride), 2.5 % NaOCl (Sodium Hypochlorite Solution, Sigma Aldrich - Germany) and 2% CHX (Chlorhexidine Digluconate Solution, Sigma Aldrich - Spain) combined with Gaseous Ozone (Prozone WH, Austria). MATERIAL AND METHODS: This study was realised in the University Dentistry Clinical Centre of Kosovo (UDCCK), respectively in the Department of Endodontic and Dental Pathology, Dental Branch, Faculty of Medicine, Prishtina, Kosovo. The 40 subjects involved in this study belonged to both genders, in age between 15 -65 years. The sample selection was randomised. The retroalveolar radiography for each patient was taken in the suspected tooth. As a therapeutic plan the authors decided to disinfect the root canal with the irrigants, as follows: 2.5 % NaOCl, 2 % CHX and gaseous ozone. RESULTS: The statistical analyses were based on Kruskal - Vallis test, X - test, DF = 3, r irrigants 0.9%, 2.5 % NaOCl and 2% CHX, it was concluded that the number of colonies of aerobic and anaerobic bacteria was reduced. PMID:29531611

Sonochemical and high-speed optical characterization of cavitation generated by an ultrasonically oscillating dental file in root canal models

NARCIS (Netherlands)

Macedo, R.G.; Verhaagen, B.; Fernandez Rivas, D.; Gardeniers, J.G.E.; van der Sluis, L.W.M.; Wesselink, P.R.; Versluis, M.

2014-01-01

Ultrasonically Activated Irrigation makes use of an ultrasonically oscillating file in order to improve the cleaning of the root canal during a root canal treatment. Cavitation has been associated with these oscillating files, but the nature and characteristics of the cavitating bubbles were not yet

Effect of Er:YAG laser-activated irrigation solution on Enterococcus Faecalis biofilm in an ex-vivo root canal model.

Science.gov (United States)

Sahar-Helft, Sharonit; Stabholtz, Adam; Moshonov, Joshua; Gutkin, Vitaly; Redenski, Idan; Steinberg, Doron

2013-07-01

Abstract Objective: The purpose of this study was to evaluate mineral content and surface morphology of root canals coated with Enterococcus faecalis biofilm after treatment with several endodontic irrigation solutions, with and without Er:YAG laser-activated irrigation (LAI). LAI has been introduced as a powerful method for root canal irrigation resulting in smear-layer removal from the root canal wall. Distal and palatal roots from 60 freshly extracted human molars were used in this study. The coronal of each tooth was removed. Roots were split longitudinally and placed in an ultrasonic bath to remove the smear layer, creating conditions for the formation of E. faecalis biofilm. After incubation, the two halves were reassembled in impression material to simulate clinical conditions. Specimens were divided into two main groups: roots rinsed with irrigation solutions and roots subjected to laser irradiation combined with irrigation solutions. Solutions tested were 2% chlorhexidine and 17% ethylenediaminetetraacetic acid (EDTA) and saline. Surface morphology: 17% EDTA irrigant solution combined with Er:YAG laser showed the best results for removing bacteria from the root canal walls. Chemical analysis: all samples treated with combined laser irradiation and irrigation solution had low surface levels of Ca compared with samples treated with irrigation alone. The Ca/P ratio was highest in the laser-EDTA group. Overall, mineral changes caused by laser with irrigation solutions were minimal, and statistically nonsignificant. In vitro irrigation solutions, combined with Er:YAG laser irradiation, were effective in removing E. faecalis biofilm from root canal walls. Irrigation solutions without laser irradiation were less effective, leaving a layer of biofilm on the dentin surface.

Curved canals: Ancestral files revisited

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Jain Nidhi

2008-01-01

Full Text Available The aim of this article is to provide an insight into different techniques of cleaning and shaping of curved root canals with hand instruments. Although a plethora of root canal instruments like ProFile, ProTaper, LightSpeed ® etc dominate the current scenario, the inexpensive conventional root canal hand files such as K-files and flexible files can be used to get optimum results when handled meticulously. Special emphasis has been put on the modifications in biomechanical canal preparation in a variety of curved canal cases. This article compiles a series of clinical cases of root canals with curvatures in the middle and apical third and with S-shaped curvatures that were successfully completed by employing only conventional root canal hand instruments.

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

DEFF Research Database (Denmark)

Markvart, Merete; Darvann, Tron Andre; Larsen, Per

2012-01-01

AIM: To compare the effectiveness of two rotary hybrid instrumentation techniques with focus on apical enlargement in molar teeth and to quantify and visualize spatial details of instrumentation efficacy in root canals of different complexity. METHODOLOGY: Maxillary and mandibular molar teeth wer...

Positive and negative associations between bacterial species in dental root canals.

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

1994-01-01

Significant associations have been previously reported between certain pairs of bacterial species isolated from human dental root canals. The aim of this study was to examine microbiologically a more extensive series of cases, with particular reference to obligate anaerobes which accounted for 64% of total isolations. A total of 65 different species was isolated and individual root canals yielded a maximum of eleven bacterial species. Highly significant positive associations (p spp. and Prevotella spp., between Peptostreptococcus spp. and P. melaninogenica, between P. micros and Prevotella spp., P. micros and P. melaninogenica and between Prevotella spp. and Eubacterium spp., all with an ODDS ratio of > 9.0. In contrast, negative and highly significant associations (p spp., B. gracilis/F. nucleatum and between B. gracilis/Fusobacterium spp.; all with an ODDS ratio of < 0.5. Some previously published associations were confirmed and some new associations were found, while some negative associations became apparent.

The cleanliness differences of root canal irrigated with 0.002% saponin of mangosteen peel extract and 2.5% NaOCl

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Anis Sakinah

2015-06-01

Full Text Available Background: Root canal treatment consists of preparation, sterilization, and obturation. During root canal preparation, debris is smeared over the dentinal surface forming a smear layer. Smear layer will reduce the attachment of root canal filling materials. Organic material in smear layer can be substrated for microorganism. Preparation of root canal should be followed by irrigation. NaOCl is common irrigation solution in endodontics. It has been very effective for their disinfecting and tissue-dissolving properties, but it is incapable of removing the smear layer. On the other hand, saponin of mangosteen peel extract has an ability as a surfactant to lower the surface tension, and it can dissolve debris containing of anorganic and organic materials. Purpose: This study aims to know the differences between 2.5% NaOCl and 0.002% saponin of mangosteen peel extract in removing the debris in the root canal after the preparation procedure. Method: Three groups of teeth (7 teeth in each were instrumented with K-file and irrigated as follow: group 1 (control with aquadest; group 2 with 2.5% NaOCl; and group 3 with 0.002% saponin of mangosteen peel extract. Furthermore, those teeth were split horizontally and longitudinally 4mm above the apical. The apical third of root canal walls was observed by a scanning electron microscope (SEM. Result: There were significant differences between each group (p<0.05. Median value of the group 3 was score 1 considered as the smallest value. It indicates that Group 3 with 0.002% saponin of mangosteen peel extract was the cleanest group. Conclusion:It can be concluded that 0.002% saponin of mangosteen peel extract can clean the smear layer of the root canal better than 2.5% NaOCl.

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

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Shenoi, R Pratima; Ghule, Hrishikesh M

2012-07-01

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

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

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R Pratima Shenoi

2012-01-01

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

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

OpenAIRE

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

2013-01-01

Background: Variations in morphology of root canals in primary teeth usually leads to complications during and after endodontic therapy. To improve the success in endodontics, a thorough knowledge of the root canal morphology is essential. Aim: The aim of this study was to assess the variation in number and morphology of the root canals of primary incisors and molars and to study the applicability of cone beam computerized tomography (CBCT) in assessing the same. Settings and Design: A total ...

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

Science.gov (United States)

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

2016-01-01

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

Cone beam computed tomography analysis of root and canal morphology of mandibular premolars in a Spanish population

International Nuclear Information System (INIS)

Llena, Carmen; Ortolani, Pablo Sebastian; Forner, Leopoldo; Fernandez, Jaime

2014-01-01

This study aimed to investigate the clinical anatomy of lower premolar roots in a Spanish population by using cone-beam computed tomography (CBCT), correlating findings with patient gender and tooth type. Using 70 CBCT images, we evaluated 126 healthy, untreated, well-developed lower premolars. The number and morphology of roots and root canals, and the foramina number were assessed. Results for gender and tooth type were compared using the chi-squared and ANOVA tests. The average length of teeth and roots was significantly higher in men (p=0.00). All 126 premolars had a single root. One canal was found in 83.3% of the premolars, with no gender or tooth type differences; Vertucci configuration types I and V were the most prevalent. The first premolars showed significantly greater variability than the second premolars (p=0.03). A single apical foramen was found in 89.7% of the premolars, with no differences by tooth type. Women had a significantly higher prevalence of two apical foramina than men (p=0.04). Some degree of curvature was observed in 65% of the premolars, with no differences by gender or tooth type. A root angle of more than 20 degrees was found in 12.98% of the premolars, without any differences by gender or tooth. All premolars were single-rooted. One canal had the most prevalent morphology. More variability in canal anatomy was found in the first premolars. Curvatures greater than 20 degrees were found at less than 5 mm from the apex.

Histobacteriologic Conditions of the Apical Root Canal System and Periapical Tissues in Teeth Associated with Sinus Tracts.

Science.gov (United States)

Ricucci, Domenico; Loghin, Simona; Gonçalves, Lucio S; Rôças, Isabela N; Siqueira, José F

2018-03-01

This histobacteriologic study described the pattern of intraradicular and extraradicular infections in teeth with sinus tracts and chronic apical abscesses. The material comprised biopsy specimens from 24 (8 untreated and 16 treated) roots of teeth associated with apical periodontitis and a sinus tract. Specimens were obtained by periradicular surgery or extraction and were processed for histobacteriologic and histopathologic methods. Bacteria were found in the apical root canal system of all specimens, in the main root canal (22 teeth) and within ramifications (17 teeth). Four cases showed no extraradicular infection. Extraradicular bacteria occurred as a biofilm attached to the outer root surface in 17 teeth (5 untreated and 12 treated teeth), as actinomycotic colonies in 2 lesions, and as planktonic cells in 2 lesions. Extraradicular calculus formation (mineralized biofilm) was evident in 10 teeth. Teeth with chronic apical abscesses and sinus tracts showed a very complex infectious pattern in the apical root canal system and periapical lesion, with a predominance of biofilms. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Photodynamic therapy with water-soluble phtalocyanines against bacterial biofilms in teeth root canals

Science.gov (United States)

Gergova, Raina; Georgieva, Tzvetelina; Angelov, Ivan; Mantareva, Vanya; Valkanov, Serjoga; Mitov, Ivan; Dimitrov, Slavcho

2012-06-01

The study presents the PDT with metal phthalocyanines on biofilms grown in root canals of ten representatives of the Gram-positive and the Gram-negative bacterial species and a fungus Candida albicans which cause aqute teeth infections in root canals.. The extracted human single-root teeth infected for 48 h with microorganisms in conditions to form biofilms of the above pathogens were PDT treated. The stage of biofilm formation and PDT effect of the samples of the teeth were determined by the scaning electron microscopy and with standard microbial tests. The PDT treating procedure included 10 min incubation with the respected phthalocyanine and irradiated with 660 nm Diode laser for 10 min. The most strongly antibacterial activity was achieved with zinc(II) phthalocyanine (ZnPc) against Enterococcus faecalis, Staphylococcus aureus and Moraxella catarrhalis. The other Gram-negative bacteria and Candida albicans were 10-100 times more resistant than the Gram-positive species. The Gram-negative Moraxella catarrhalis and Acinetobacter baumannii were more sensitive than the enterobacteria, but eradication of Pseudomonas aeruginosa in biofilm was insignificant. The influence of the stage of biofilm formation and the initial conditions (bacterial density, photosensitizer concentration and energy fluence of radiation) to the obtained level of inactivation of biofilms was investigated. The PDT with ZnPc photosensitizers show a powerful antimicrobial activity against the most frequent pathogens in endodontic infections and this method for inactivation of pathogens may be used with sucsses for treatment of the bacterial biofilms in the root canals.

Factors affecting irrigant extrusion during root canal irrigation: a systematic review

NARCIS (Netherlands)

Boutsioukis, C.; Psimma, Z.; van der Sluis, L.W.M.

2013-01-01

The aim of the present study was to conduct a systematic review and critical analysis of published data on irrigant extrusion to identify factors causing, affecting or predisposing to irrigant extrusion during root canal irrigation of human mature permanent teeth. An electronic search was conducted

Localization of root canal orifices in mandibular second molars in relation to occlusal dimension.

Science.gov (United States)

Gorduysus, O; Nagas, E; Cehreli, Z C; Gorduysus, M; Yilmaz, Z

2009-11-01

To evaluate the localization and distribution of canal orifices of mandibular second molar teeth in relation to the mesio-distal and bucco-lingual dimensions of coronal tissue. Fifty extracted mandibular second molar teeth were embedded into plaster blocks with their vertical axes aligned perpendicular to the horizontal plane. The teeth were photographed digitally from the occlusal aspect under 12 x magnification. Thereafter, the occlusal halves of crowns were sectioned off to expose the root canal orifices. The teeth were than photographed under the same magnification, after which the pre- and post-sectioning images of each specimen were stacked into a single file. To plot the coordinate of each canal orifice, a 0.5-mm grid analytical plane was mounted digitally on the stack so that the x- and y-axes of the plane were superimposed on the mesiodistal and buccolingual axes (bisectors) of the tooth crowns. Localization and distribution of the coordinates of the canal orifices were evaluated using the chi-square test (P = 0.05). Only one tooth displayed a single root canal orifice, located in the mesiobuccal-distolingual 'centre' of the occlusal surface. The majority of mandibular second molars had three orifices (72%), followed by those with two (16%) and four (10%). The distal canal was located lingual to the centre of the occlusal plane. The distal canal was located lingual to the centre of the occlusal plane of mandibular second molars. The possibility of observing more divergent localizations and orifice numbers should not be overlooked in clinical practice.

Thermal analysis of different application techniques on Nd:YAG laser after root canal preparation of single-rooted teeth

International Nuclear Information System (INIS)

Archilla, Jose Ricardo de F.

2001-01-01

The experiment objective is to analyze temperature variation, by means of three different application techniques of Nd:YAG laser in the root canals of singlerooted anterior teeth. Three root canals were instrumented, irrigated, X-rayed to measure the remaining dentin in the apical area and submitted to laser irradiation techniques used by Gutknecht, Matsumoto and a new technique with oscillatory movement. The used laser parameters were: pulse energy 250 mJ, frequency 5 Hz, pulse fluency 354 J/cm 2 , average potency 1,25 W, pulse width 300 μs, fiber core diameter 300 μs and interval of thermal relaxation of 20 s. After temperature evaluation and interpretation of the obtained data, it was concluded: 1) the oscillatory technique provided a better heat distribution during the laser application, when analyzing the graphs separately; 2) all the used techniques are within a pattern of safety, analyzing the average and highest temperatures of the apical area and the middle third, even so, disrespecting the last application day and the middle third of root 'C'.(author)

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 difference of 17% ethylenediaminetetraacetic acid irrigation material contact time of 60 seconds and 30 seconds toward of cleanliness of apical third root canal wall

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Yunita Wijaya

2011-11-01

Full Text Available Root canal preparation is one important step in endodontic treatment, involves the cleaning and the shaping of the root canal debris. Root canal cleaning effectiveness depends on the preparation bio-mechanical and irrigation. Purpose of this study was to evaluate the cleanliness of apical third of root canal wall from of debris, with the contact time of 17% EDTA irrigation material for 60 seconds and 30 seconds after root canal preparation using rotary NiTi instruments. This quasi-experimental study was carried out invitro, with random sampling technique. The sample used was 20 central maxillary incisors that have been extracted and divided into two experimental groups of 10 teeth each. The results were analyzed using student t statistics, showed that the average value of the debris of the two groups differed significantly. The contact time of 60 seconds of 17% EDTA showed cleaner root canal than the 30 seconds. The conclusion of this study was there were the differences of the cleanliness of apical third of the root canal with the 60 seconds contact time of 17% EDTA irrigation materials than 30 seconds contact time.

Clonality of bacterial consortia in root canals and subjacent gingival crevices.

Science.gov (United States)

Parahitiyawa, Nipuna B; Chu, Frederick C S; Leung, Wai K; Yam, Wing C; Jin, Li Jian; Samaranayake, Lakshman P

2015-02-01

No oral niche can be considered to be segregated from the subjacent milieu because of the complex community behavior and nature of the oral biofilms. The aim of this study was to address the paucity of information on how these species are clonally related to the subjacent gingival crevice bacteria. We utilized a metagenomic approach of amplifying 16S rDNA from genomic DNA, cloning, sequencing and analysis using LIBSHUFF software to assess the genetic homogeneity of the bacterial species from two infected root canals and subjacent gingival crevices. The four niches studied yielded 186 clones representing 54 phylotypes. Clone library comparisons using LIBSHUFF software indicated that each niche was inhabited by a unique flora. Further, 42% of the clones were of hitherto unknown phylotypes indicating the extent of bacterial diversity, especially in infected root canals and subjacent gingival crevices. We believe data generated through this novel analytical tool shed new light on understanding oral microbial ecosystems. © 2014 Wiley Publishing Asia Pty Ltd.

Efficacy of ProTaper universal retreatment files in removing filling materials during root canal retreatment.

Science.gov (United States)

Giuliani, Valentina; Cocchetti, Roberto; Pagavino, Gabriella

2008-11-01

The aim of this study was to evaluate the efficacy of the ProTaper Universal System rotary retreatment system and of Profile 0.06 and hand instruments (K-file) in the removal of root filling materials. Forty-two extracted single-rooted anterior teeth were selected. The root canals were enlarged with nickel-titanium (NiTi) rotary files, filled with gutta-percha and sealer, and randomly divided into 3 experimental groups. The filling materials were removed with solvent in conjunction with one of the following devices and techniques: the ProTaper Universal System for retreatment, ProFile 0.06, and hand instruments (K-file). The roots were longitudinally sectioned, and the image of the root surface was photographed. The images were captured in JPEG format; the areas of the remaining filling materials and the time required for removing the gutta-percha and sealer were calculated by using the nonparametric one-way Kruskal-Wallis test and Tukey-Kramer tests, respectively. The group that showed better results for removing filling materials was the ProTaper Universal System for retreatment files, whereas the group of ProFile rotary instruments yielded better root canal cleanliness than the hand instruments, even though there was no statistically significant difference. The ProTaper Universal System for retreatment and ProFile rotary instruments worked significantly faster than the K-file. The ProTaper Universal System for retreatment files left cleaner root canal walls than the K-file hand instruments and the ProFile Rotary instruments, although none of the devices used guaranteed complete removal of the filling materials. The rotary NiTi system proved to be faster than hand instruments in removing root filling materials.

Comparison between syringe irrigation and RinsEndo in reduction of Enterococcus faecalis in experimentally infected root canal

Directory of Open Access Journals (Sweden)

Sharareh Mousavi Zahed

2015-05-01

Full Text Available Background and Aims: To ensure root canal treatment success, endodontic microbiota should be efficiently reduced. Several irrigation devices have been recently introduced with the main objective of improving root canal disinfection.The purpose of this study was to evaluate the rinsing effect of RinsEndo system in reduction of enterococcus faecalis in comparison with conventional hand syringe in infected root canals.   Materials and Methods: 60 extracted single canal anterior teeth were infected with enterococcus faecalis and divided into 3 groups: RinsEndo system, conventional hand syringe and control group. The enterococcus faecalis colonies were counted in each group before and after rinsing. Data were analyzed using Variance and Kruskal Wallis test.   Results: The mean of enterococcus faecalis growth after rinsing was 3.50×103 in group with conventional syring rinsing, 2.04×103 in group with RinsEndo washing and 6.11×103 in control group. Reduction of enterococcus faecalis after rinsing was statistically significant in each group (P<0.001. The amount of reduction in number of colonies with RinsEndo and conventional syringe rinsing was higher in comparison with control group and this difference was significant (P<0.001. RinsEndo rinsing effect was statistically significantly higher in comparison to conventional syringe as well (P<0.001.   Conclusion: Rinsing with RinsEndo system was significantly more efficient in reduction of enterococcus faecalis from root canal in comparison with hand syringe washing.

The best radiographic method for determining root canal morphology in mandibular first premolars: A study of Chinese descendants in Taiwan

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Yu Sun

2016-06-01

Conclusion: Combined X-ray analyses, such as performing the buccolingual view for identification of canal bifurcation and canal continuity, may increase the accuracy of identifying complex root canal morphology.

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

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

2014-12-01

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

[Effect of compound Chinese traditional medicine on infected root canal bacteria biofilm].

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Ma, Rui; Huang, Li-li; Xia, Wen-wei; Zhu, Cai-lian; Ye, Dong-xia

2010-08-01

To assess the efficacy of compound Chinese traditional medicine(CTM), which composed of gallic acid, magnolol and polysaccharide of Blettila striata, against the infected root canal bacterial biofilm. Actinomyces viscosus (Av), Enterococcus faecalis (Ef), Fusobacterium nucleatum (Fn) were composed to form biofilm, then confocal laser scan microscope (CLSM) was used to observe and study the bacterial activity. SAS6.12 software package was used for statistical analysis. The biofilm thickness reduced after treatment by both CTM and ZnO (P>0.05),while there was a significant decrease of the percentage of vital bacterias after treatment by CTM (Pcompound Chinese traditional medicine is effective on biofilm control, so that it would be an effective disinfecting drug for root canal sealers. Supported by Research Fund of Bureau of Traditional Chinese Medicine of Shanghai Municipality (Grant No.2008L008A).

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

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Wigler, Ronald; Koren, Tal; Tsesis, Igor

2015-11-01

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

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

International Nuclear Information System (INIS)

Li, Ke-Zeng; Gao, Yuan; Zhang, Ru; Hu, Tao; Guo, Bin

2011-01-01

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

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

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Hu Tao

2011-06-01

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

Micro‐CT analyses of apical enlargement and molar root canal complexity

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Markvart, M.; Darvann, Tron Andre; Larsen, P.

2012-01-01

Markvart M, Darvann TA, Larsen P, Dalstra M, Kreiborg S, Bjørndal L. Micro‐CT analyses of apical enlargement and molar root canal complexity. International Endodontic Journal, 45, 273–281, 2012. Aim To compare the effectiveness of two rotary hybrid instrumentation techniques with focus on apical...

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.

Radiographic technical quality of root canal treatment performed ex vivo by dental students at Valencia University Medical and Dental School, Spain

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Faus-Matoses, Vicente; Alegre-Domingo, Teresa; Faus-Llácer, Vicente J.

2014-01-01

Objectives: To evaluate radiographically the quality of root canal fillings and compare manual and rotary preparation performed on extracted teeth by undergraduate dental students. Study Design: A total of 561 premolars and molars extracted teeth were prepared using nickel-titanium rotary files or manual instrumentation and filled with gutta-percha using a cold lateral condensation technique, by 4th grade undergraduate students. Periapical radiographs were used to assess the technical quality of the root canal filling, evaluating three variables: length, density and taper. These data were recorded, scored and used to study the “technical success rate” and the “overall score”. The length of each root canal filling was classified as acceptable, short and overfilled, based on their relationship with the radiographic apex. Density and taper of filling were evaluated based on the presence of voids and the uniform tapering of the filling, respectively. Statistical analysis was used to evaluate the quality of root canal treatment, considering p rotary instruments (52% against 28% with a manual one, p rotary instrumentation. Key words:Dental education, endodontics, rotary instrumentation, radiographs, root canal treatment, undergraduate students. PMID:24121911