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Sample records for root canal apical

  1. 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...

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

    Science.gov (United States)

    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.

  3. 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.

  4. 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...

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

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    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.

  6. [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.

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

    Science.gov (United States)

    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.

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

    DEFF Research Database (Denmark)

    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...

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

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    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.

  10. 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...

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

    Science.gov (United States)

    Tanalp, J; Güngör, T

    2014-03-01

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

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

    Science.gov (United States)

    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.

  13. Root canal microbiota of teeth with chronic apical periodontitis.

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    Rôças, I N; Siqueira, J F

    2008-11-01

    Samples from infected root canals of 43 teeth with chronic apical periodontitis were analyzed for the presence and relative levels of 83 oral bacterial species and/or phylotypes using a reverse-capture checkerboard hybridization assay. Associations between the most frequently detected taxa were also recorded. The most prevalent taxa were Olsenella uli (74%), Eikenella corrodens (63%), Porphyromonas endodontalis (56%), Peptostreptococcus anaerobius (54%), and Bacteroidetes oral clone X083 (51%). When prevalence was considered only for bacteria present at levels >10(5), Bacteroidetes clone X083 was the most frequently isolated bacterium (37%), followed by Parvimonas micra (28%), E. corrodens (23%), and Tannerella forsythia (19%). The number of target taxa per canal was directly proportional to the size of the apical periodontitis lesion, with lesions >10 mm in diameter harboring a mean number of approximately 20 taxa. Several positive associations for the most prevalent taxa were disclosed for the first time and may have important ecological and pathogenic implications. In addition to strengthening the association of several cultivable named species with chronic apical periodontitis, the present findings using a large-scale analysis allowed the inclusion of some newly named species and as-yet-uncultivated phylotypes in the set of candidate pathogens associated with this disease.

  14. Apical extrusion of debris in primary molar root canals using mechanical and manual systems.

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    Buldur, B; Hascizmeci, C; Aksoy, S; Nur Aydin, M; Guvendi, O N

    2018-03-01

    Apical extrusion of debris in primary root canal treatment has not been well elucidated. The purpose of this study is to compare the amount of apically extruded debris during the preparation of primary molar root canals using ProTaper, ProTaper Next, Self-adjusting File (SAF) and hand files. One hundred sixty extracted primary mandibular molar teeth were assigned to 2 groups: Group 1: Resorbed (n=80) and Group 2: Non-resorbed (n=80) and randomly to four subgroups (n=20 teeth for each subgroup) according to the instruments used, ProTaper, ProTaper Next, SAF, and hand file. The apically extruded debris was collected and dried in preweighed Eppendof tubes. The dry weight was calculated by subtracting the preoperative weight from the postoperative weight. Data were analysed statistically using the ANOVA and the Bonferroni post hoc t-test. The amount of apically extruded debris was significantly less for the non-resorbed group compared to the resorbed group (PProTaper Next and SAF extruded significantly less debris than did the ProTaper and hand files (PProTaper Next and SAF (P>0.05). All instruments caused apically extruded debris in primary teeth.

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

    Directory of Open Access Journals (Sweden)

    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.

  16. Semiconductor laser irradiation improves root canal sealing during routine root canal therapy

    Science.gov (United States)

    Hu, Xingxue; Wang, Dashan; Cui, Ting; Yao, Ruyong

    2017-01-01

    Objective To evaluate the effect of semiconductor laser irradiation on root canal sealing after routine root canal therapy (RCT). Methods Sixty freshly extracted single-rooted human teeth were randomly divided into six groups (n = 10). The anatomic crowns were sectioned at the cementoenamel junction and the remaining roots were prepared endodontically with conventional RCT methods. Groups A and B were irradiated with semiconductor laser at 1W for 20 seconds; Groups C and D were ultrasonically rinsed for 60 seconds as positive control groups; Groups E and F without treatment of root canal prior to RCT as negative control groups. Root canal sealing of Groups A, C and E were evaluated by measurements of apical microleakage. The teeth from Groups B, D and F were sectioned, and the micro-structures were examined with scanning electron microscopy (SEM). One way ANOVA and LSD-t test were used for statistical analysis (α = .05). Results The apical sealing of both the laser irradiated group and the ultrasonic irrigated group were significantly different from the control group (pirrigated group (p>0.5). SEM observation showed that most of the dentinal tubules in the laser irradiation group melted, narrowed or closed, while most of the dentinal tubules in the ultrasonic irrigation group were filled with tooth paste. Conclusion The application of semiconductor laser prior to root canal obturation increases the apical sealing of the roots treated. PMID:28957407

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

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

    2017-07-01

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

  18. Effect of Maintaining Apical Patency on Irrigant Penetration into the Apical Two Millimeters of Large Root Canals : An In Vivo Study

    NARCIS (Netherlands)

    Vera, Jorge; Hernandez, Erick M.; Romero, Monica; Arias, Ana; van der Sluis, Lucas W. M.

    2012-01-01

    Introduction: Factors such as complex root canal anatomy and the vapor lock phenomenon have been shown to limit the penetration of irrigating solutions into the apical third in both in vivo and in vitro studies involving small and wide canals. Hence, the aim of this study was to determine whether

  19. Periapical repair after root canal filling with different root canal sealers.

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    Tanomaru-Filho, Mário; Tanomaru, Juliane Maria Guerreiro; Leonardo, Mario Roberto; da Silva, Lea Assed Bezerra

    2009-01-01

    The aim of this study was to evaluate periapical repair after root canal filling with different endodontic sealers. Sixty-four root canals from dog s teeth were filled, divided into 4 groups (n=16). Root canals were instrumented with K-type files and irrigated with 1% sodium hypochlorite solution. Root canals were filled in the same session by active lateral condensation of the cones and sealers: Intrafill, AH Plus, Roeko Seal and Resilon/Epiphany System. After 90 days, the animals were euthanized and the tissues to be evaluated were processed and stained with hematoxylin and eosin. For histopathological analysis, the following parameters were evaluated: inflammatory process, mineralized tissue resorption, and apical mineralized tissue deposition. Histopathological analysis demonstrated that Intrafill had less favorable results in terms of apical and periapical repair, compared to the other sealers (p0.05). In conclusion, AH Plus and the materials Roeko Seal and Epiphany are good options for clinical use in Endodontics.

  20. Ex vivo evaluation of coronal and apical microbial leakage of root canal - Filled with gutta-percha or Resilon/Epiphany root canal filling material

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    de Almeida-Gomes Fabio

    2010-01-01

    Full Text Available Objective: This ex vivo study compared coronal and apical microleakage of root canals filled with Resilon/Epiphany (RE or gutta-percha/Grossman sealer (GP, using either lateral condensation (LC or System B (SB technique. Materials and Methods: Specimens in eight experimental groups were obturated using the following materials and techniques: Groups 1 and 3 - GP and LC; groups 2 and 4 - GP and SB; groups 5 and 7 - RE and LC; groups 6 and 8 - RE and SB. Apical and coronal leakages were tested using bacterial methods. For coronal analysis, the number of days required for complete contamination of the root canals was recorded according to observation of the brain heart infusion broth turbidity for 15 weeks. For apical analysis, the teeth were cleaved and the leakage was measured at 30 days. Data were collected for each sample and analyzed statistically with the Chi-square and ANOVA tests. Results: Leakage was found in all groups. The difference between filling materials, obturation techniques, and median time of leakage was not statistically significant for coronal ( P=0.847 and apical ( P=0.5789 leakages. Conclusion: There were no differences between the different filling materials (gutta-percha/Grossman sealer and Resilon/Epiphany and obturation techniques (lateral condensation and system B technique in coronal or apical leakages.

  1. In Vitro Comparison of Apically Extruded Debris during Root Canal Preparation of Mandibular Premolars with Manual and Rotary Instruments

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    Sonal Soi

    2015-09-01

    Full Text Available Background and aims. During root canal preparation, debris extruded beyond the apical foramen may result in periapical inflammation and postoperative pain. To date no root canal preparation method has been developed that extrudes no peri-apical debris. The purpose of this study was to identify a system leading to minimal extrusion of debris from the apical fo-ramen. The study was conducted to comparatively evaluate the amount of apical extrusion of debris during root canal prepa-ration using hand ProTaper and GT rotary and RaCe rotary instruments using crown-down technique. Materials and methods. Ninety freshly extracted human single-rooted mandibular premolars were equally assigned to three groups (n=30. The root canals were instrumented using hand ProTaper, GT rotary and RaCe rotary systems. Debris and irrigant extruded from the apical foramen were collected into vials. The mean weight of the remaining debris was calcu-lated for each group and subjected to statistical analysis. Results. ANOVA was used to compare the mean dry weights of the debris extruded in the three groups, followedby post hoc Tukey tests for multiple comparisons the between groups. Highly significant differences were found in the amount of debris extruded among all the groups (P<0.001. The ProTaper group exhibited the highest mean debris weight (0.8293±0.05433 mg and the RaCe system exhibited the lowest mean debris weight (0.1280±0.01606 mg. Conclusion. All the systems tested resulted in apical extrusion of debris. However, the hand ProTaper files extruded a sig-nificantly higher amount of debris than GT and RaCe systems.

  2. In Vitro Comparison of Apically Extruded Debris during Root Canal Preparation of Mandibular Premolars with Manual and Rotary Instruments.

    Science.gov (United States)

    Soi, Sonal; Yadav, Suman; Sharma, Sumeet; Sharma, Mohit

    2015-01-01

    Background and aims. During root canal preparation, debris extruded beyond the apical foramen may result in periapical inflammation and postoperative pain. To date no root canal preparation method has been developed that extrudes no periapical debris. The purpose of this study was to identify a system leading to minimal extrusion of debris from the apical foramen. The study was conducted to comparatively evaluate the amount of apical extrusion of debris during root canal preparation using hand ProTaper and GT rotary and RaCe rotary instruments using crown-down technique. Materials and methods. Ninety freshly extracted human single-rooted mandibular premolars were equally assigned to three groups (n=30). The root canals were instrumented using hand ProTaper, GT rotary and RaCe rotary systems. Debris and irrigant extruded from the apical foramen were collected into vials. The mean weight of the remaining debris was calculated for each group and subjected to statistical analysis. Results. ANOVA was used to compare the mean dry weights of the debris extruded in the three groups, followedby post hoc Tukey tests for multiple comparisons the between groups. Highly significant differences were found in the amount of debris extruded among all the groups (PProTaper group exhibited the highest mean debris weight (0.8293±0.05433 mg) and the RaCe system exhibited the lowest mean debris weight (0.1280±0.01606 mg). Conclusion. All the systems tested resulted in apical extrusion of debris. However, the hand ProTaper files extruded a significantly higher amount of debris than GT and RaCe systems.

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

    Science.gov (United States)

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

    2011-01-01

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

  4. In Vitro Comparison of Apically Extruded Debris during Root Canal Preparation of Mandibular Premolars with Manual and Rotary Instruments

    Science.gov (United States)

    Soi, Sonal; Yadav, Suman; Sharma, Sumeet; Sharma, Mohit

    2015-01-01

    Background and aims. During root canal preparation, debris extruded beyond the apical foramen may result in periapical inflammation and postoperative pain. To date no root canal preparation method has been developed that extrudes no periapical debris. The purpose of this study was to identify a system leading to minimal extrusion of debris from the apical foramen. The study was conducted to comparatively evaluate the amount of apical extrusion of debris during root canal preparation using hand ProTaper and GT rotary and RaCe rotary instruments using crown-down technique. Materials and methods. Ninety freshly extracted human single-rooted mandibular premolars were equally assigned to three groups (n=30). The root canals were instrumented using hand ProTaper, GT rotary and RaCe rotary systems. Debris and irrigant extruded from the apical foramen were collected into vials. The mean weight of the remaining debris was calculated for each group and subjected to statistical analysis. Results. ANOVA was used to compare the mean dry weights of the debris extruded in the three groups, followedby post hoc Tukey tests for multiple comparisons the between groups. Highly significant differences were found in the amount of debris extruded among all the groups (P<0.001). The ProTaper group exhibited the highest mean debris weight (0.8293±0.05433 mg) and the RaCe system exhibited the lowest mean debris weight (0.1280±0.01606 mg). Conclusion. All the systems tested resulted in apical extrusion of debris. However, the hand ProTaper files extruded a significantly higher amount of debris than GT and RaCe systems. PMID:26697144

  5. Incidence of apical root cracks and apical dentinal detachments after canal preparation with hand and rotary files at different instrumentation lengths.

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    Liu, Rui; Kaiwar, Anjali; Shemesh, Hagay; Wesselink, Paul R; Hou, Benxiang; Wu, Min-Kai

    2013-01-01

    The aim of this study was to compare the incidence of apical root cracks and dentinal detachments after canal preparation with hand and rotary files at different instrumentation lengths. Two hundred forty mandibular incisors were mounted in resin blocks with simulated periodontal ligaments, and the apex was exposed. The root canals were instrumented with rotary and hand files, namely K3, ProTaper, and nickel-titanium Flex K files to the major apical foramen (AF), short AF, or beyond AF. Digital images of the apical surface of every tooth were taken during the apical enlargement at each file change. Development of dentinal defects was determined by comparing these images with the baseline image. Multinomial logistic regression test was performed to identify influencing factors. Apical crack developed in 1 of 80 teeth (1.3%) with hand files and 31 of 160 teeth (19.4%) with rotary files. Apical dentinal detachment developed in 2 of 80 teeth (2.5%) with hand files and 35 of 160 teeth (21.9%) with rotary files. Instrumentation with rotary files terminated 2 mm short of AF and did not cause any cracks. Significantly less cracks and detachments occurred when instrumentation with rotary files was terminated short of AF, as compared with that terminated at or beyond AF (P hand instruments; instrumentation short of AF reduced the risk of dentinal defects. Copyright © 2013 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  6. Incidence of apical root cracks and apical dentinal detachments after canal preparation with hand and rotary files at different instrumentation lengths

    NARCIS (Netherlands)

    Liu, R.; Kaiwar, A.; Shemesh, H.; Wesselink, P.R.; Hou, B.; Wu, M.K.

    2013-01-01

    Introduction The aim of this study was to compare the incidence of apical root cracks and dentinal detachments after canal preparation with hand and rotary files at different instrumentation lengths. Methods Two hundred forty mandibular incisors were mounted in resin blocks with simulated

  7. The Effect of Canal Contamination with Saliva on Apical Sealing

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    S Sabaghi

    2014-08-01

    Full Text Available Introduction: Root canal obturation aims at sealing the root canal system to prevent re-contamination of canal and periapical space. Presence of moisture in canal before obturation may posit a negative effect on the quality of canal sealing. Therefore, this study was conducted to investigate the effect of canal contamination with saliva on apical microleakage. Methods: In this laboratory study, 58 human uni-root teeth were cleaned and shaped for obturation with gutta percha and sealer AH26. In the case group, specimens were contaminated with human saliva immediately before obturation, whereas the teeth in the control group were kept dry. All canals were filled by lateral condensation technique. Moreover, the teeth were placed in methylene blue dye for 3 days. Dye penetration was measured using a stereomicrosope. As a matter of fact, the study data were analyzed via utilizing t-test. Results: A significant difference was found between the two groups in regard with the apical leakage(P<0.001. The microleakage mean of dye in the dry group was 3/48mm, whereas it was 6/36mm in the saliva contaminated group. Conclusion: The study findings revealed that complete drying of canal can improve apical sealing.

  8. Effect of four different intracanal medicaments on the apical seal of the root canal system: a dye extraction study.

    Science.gov (United States)

    Tandan, Monika; Hegde, Mithra N; Hegde, Priyadarshini

    2014-01-01

    The aim was to determine the effect of four different intracanal medicaments on the apical seal of the root canal system in vitro. Fifty freshly extracted intact human permanent maxillary central incisors were collected, stored and disinfected. The root canals were prepared to a master apical size of number 50 using step back technique. Depending upon the intracanal medicament used, the teeth were divided randomly into five groups of 10 teeth each including one control group and four experimental groups. Group A: No intracanal medicament. Group B: Calcium hydroxide powder mixed with distilled water. Group C: Calcium hydroxide gutta percha points (calcium hydroxide points). Group D: 1% chlorhexidine gel (hexigel). Group E: Chlorhexidine gutta percha points (Roeko Activ Points). The medication was left in canals for 14 days. Following removal of the intracanal medicament, all the groups were obturated with lateral compaction technique. The apical leakage was then evaluated using dye extraction method with the help of a spectrophotometer. RESULTS were statistically analyzed using Kruskal-Wallis and Mann-Whitney U-test, which showed statistically significant difference among the five groups tested. It can be concluded from this study that the control group showed least amount of leakage, whereas the 1% chlorhexidine gel group showed maximum amount of leakage. Apical leakage was observed with all the experimental groups with little variations in between them. Under the parameters of this study, it can be concluded that use of intracanal medicaments during endodontic treatment has a definite impact on the apical seal of the root canal system.

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

    Science.gov (United States)

    Liu, Xin-yang; Zhan, Fu-Liang

    2015-10-01

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

  10. Effect of coronal flaring on apical extrusion of debris during root canal instrumentation using single-file systems.

    Science.gov (United States)

    Topçuoğlu, H S; Üstün, Y; Akpek, F; Aktı, A; Topçuoğlu, G

    2016-09-01

    To evaluate the effect of coronal flaring on the amount of debris extruded apically during root canal preparation using the Reciproc, WaveOne (WO) and OneShape (OS) single-file systems. Ninety extracted single-rooted mandibular incisor teeth were randomly assigned to six groups (n = 15 for each group) for canal instrumentation. Endodontic access cavities were prepared in each tooth. In three of the six groups, coronal flaring was not performed; coronal flaring was performed with Gates-Glidden drills on all teeth in the remaining three groups. The canals were then instrumented with one or other of the following single-file instrument systems: Reciproc, WO and OS. Debris extruded apically during instrumentation was collected into pre-weighed Eppendorf tubes. The tubes were then stored in an incubator at 70 °C for 5 days. The weight of the dry extruded debris was established by subtracting the pre-instrumentation and post-instrumentation weight of the Eppendorf tubes for each group. Data were analysed using one-way analysis of variance (anova) and Tukey's post hoc tests (P = 0.05). Reciproc and WO files without coronal flaring produced significantly more debris compared with the other groups (P  0.05). All single-file systems caused apical extrusion of debris. Performing coronal flaring prior to canal preparation reduced the amount of apically extruded debris when using Reciproc or WO systems. © 2015 International Endodontic Journal. Published by John Wiley & Sons Ltd.

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

    Directory of Open Access Journals (Sweden)

    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.

  12. Apical extrusion of debris during root canal preparation using a novel nickel-titanium file system: WaveOne gold.

    Science.gov (United States)

    Dincer, Asiye Nur; Guneser, Mehmet Burak; Arslan, Dilara

    2017-01-01

    This study was intended to evaluate the amount of apically extruded debris following root canal preparation with three different instrumentation systems. Sixty mandibular incisor teeth were selected and randomly divided into three groups ( n = 20/group) according to the instrumentation system used: the ProTaper Next (PTN; Dentsply Maillefer, Ballaigues, Switzerland), the Twisted File Adaptive (TFA; SybronEndo, Orange, CA, USA), and the WaveOne Gold (WOG; Dentsply Maillefer, Ballaigues, Switzerland). All apically extruded debris was collected and dried in preweighed glass vials. The mean weight of the apically extruded debris was obtained using a microbalance. The time for root canal preparation was also recorded. The data were analyzed using a one-way analysis of variance. The mean weights of apically extruded debris were 0.00035 ± 0.00014 g (PTN); 0.00023 ± 0.0001 g (TFA); and 0.00019 ± 0.0001 g (WOG) ( P system extruded more debris than the TFA and WOG systems. The TFA and WOG systems were faster than the PTN system.

  13. Evaluation of apically extruded debris during root canal retreatment with two different rotary systems followed by a self-adjusting file.

    Science.gov (United States)

    Cakici, Fatih; Cakici, Elif B; Küçükekenci, Funda Fundaoglu

    2016-02-01

    To compare the amount of apically extruded debris during root canal retreatment using ProTaper retreatment system (Dentsply Maillefer, Ballaigues, Switzerland), ProTaper retreatment system with Self-Adjusting File (SAF) system (ReDent-Nova, Ra'anana, Israel), Mtwo retreatment system (VDW, Munich, Germany), Mtwo retreatment system with SAF instruments. In total, 72 extracted human mandibular incisor teeth were used. All root canals were prepared with ProTaper universal (Dentsply Maillefer) up to F2 file and filled with gutta percha and AH plus sealer using cold lateral condensation before being assembled randomly into 4 groups (n = 18 each). Root canal filling materials were removed using the ProTaper retreatment system, the ProTaper retreatment system followed by SAF system, Mtwo retreatment system and Mtwo retreatment system followed by SAF system. Debris extruded apically during the removal of canal filling material was collected into preweighed Eppendorf tubes. The tubes were then stored in an incubator at 70°C for 5 days. The weight of the dry extruded debris was established by subtracting the preretreatment and postretreatment weight of the Eppendorf tubes for each group. The data obtained were analyzed using Kruskal-Wallis test. All retreatment techniques caused the apical extrusion of debris. There was no significant difference between the groups statistically (p>0.05). The results of this study showed that SAF system after Mtwo retreatment system and ProTaper retreatment system for improving retreatment has no significant effect on the amount of debris extruded apically.

  14. [Deformations occurring in the apical third of curved root canals during biomechanical preparation using manual impulsion-traction techniques].

    Science.gov (United States)

    Roig Cayón, M; Basilio Monné, J; Canalda Sahli, C

    1990-01-01

    Apical deformations, specially zips and elbows, during instrumentation of the root canals, are studied. The authors study why do they appear, their effect on endodontic therapy, and the way of avoiding them.

  15. Effect of Nd:YAG and Diode Lasers on Apical Seal of Root Canals Filled with AH Plus and Mineral Trioxide Aggregate-Based Sealers

    Directory of Open Access Journals (Sweden)

    Elham Khoshbin

    2018-01-01

    Full Text Available Objectives: Laser irradiation, as an adjunct to root canal preparation, may increase the success rate of endodontic treatments. This study aimed to assess the effect of neodymium-doped yttrium aluminum garnet (Nd:YAG and diode lasers on the apical seal of the root canals filled with AH Plus® and mineral trioxide aggregate (MTA-based sealers.Materials and Methods: This in-vitro experimental study was conducted on 96 single-rooted, single-canal extracted human teeth with closed apices. The root canals were prepared by using ProTaper® rotary instruments and were randomly divided into six groups (n=16: 940-nm diode laser and AH Plus® sealer (group 1, Nd:YAG laser and AH Plus® sealer (group 2, AH Plus® sealer (group 3, 940-nm diode laser and MTA-based sealer (group 4, Nd:YAG laser and MTA-based sealer (group 5, MTA-based sealer (group 6, as well as positive and negative control groups. A bacterial leakage model was used for microleakage assessment. Qualitative assessment was done by using a scanning electron microscope (SEM. Data were analyzed by two-way analysis of variance (ANOVA at the significance level of 0.05.Results: There were statistically significant differences between the experimental and control groups (P=0.002. The laser-treated groups showed a lower apical microleakage compared to the non-laser-treated groups, although the difference was not statistically significant (P>0.05. No significant differences were noted between the two lasers in terms of the apical microleakage, irrespective of the type of sealer (P>0.05.Conclusions: Laser irradiation, as an adjunct to root canal preparation, has no significant effect on the level of apical microleakage.

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

    Science.gov (United States)

    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.

  17. Novel navigation technique for the endodontic treatment of a molar with pulp canal calcification and apical pathology.

    Science.gov (United States)

    Shi, Xilin; Zhao, Shiyong; Wang, Weidong; Jiang, Qianzhou; Yang, Xuechao

    2018-04-01

    Apical periodontitis, the inflammation of periapical tissue, commonly requires root canal treatment to achieve apical healing. However, if it is accompanied by pulp canal calcification, the treatment becomes complicated, and locating the root canal can be challenging. This case report describes a novel approach for treating a molar with pulp canal calcification and apical pathology. Due to the risk of perforation during treatment, a digitally printed template was used to assist in accurately locating the root canal. After six months, the patient was asymptomatic and the periradicular radiolucency was gradually reducing in size. © 2017 Australian Society of Endodontology Inc.

  18. 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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

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

    2017-10-01

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

  20. Assessment of periapical health, quality of root canal filling, and ...

    African Journals Online (AJOL)

    Sixty three teeth were found to have short root canal fillings, whereas 74 teeth had adequate root canal fillings, and the remaining 10 teeth had over extended root canal filling. A significant correlation was observed between the length of root filling and apical periodontitis (P = 0,023). Inadequately dense root canal filling was ...

  1. [The use of self-adapting system files (SAF) for controlling microbial biofilms of root canals in the treatment of apical periodontitis].

    Science.gov (United States)

    Tsarev, V N; Mamedova, L A; Siukaeva, T N; Podporin, M S

    The aim of this study was to conduct a clinical and laboratory study and evaluate the effectiveness of endodontic root canal treatment using a self-adapting files system (SAF) in the complex treatment of patients with chronic apical periodontitis. 3% sodium hypochlorite solution was used as irrigation agent in all groups which included 20 patients treated with conventional manual tools, 21 patients receiving treatment with ultrasonic activation of irrigant and 26 patients treated with SAF system. Root canal biofilm structure was studied by scanning electron microscopy (SEM) using a Quantum 3D microscope (USA). Clinical efficiency of the root canal treatment was assessed by complications frequency a year after treatment. SEM revealed the presence of high levels of microbial contamination of dentine tubules in the apical portion of the tooth. In standard method group the percentage of re-treatment and surgery was higher than in the studied groups. Use of SAF irrigation system was associated with a decrease in the number of identified pathogens. However, the study revealed high resistance of Enterococcus spp., Porphyromonas gingivalis, Candida albicans to all types of endodontic treatment, so the improvement of methods of root canal microbial biofilms removing need to be continued.

  2. Unpredictable Root Canal Morphology: Expect the Unexpected

    Directory of Open Access Journals (Sweden)

    Sohez J Makani

    2015-01-01

    Full Text Available Background: A maxillary first molar with more than four canals is an interesting example of anatomic variations, especially when two of these canals are detected, with separate apical foramen in the distal root. The inability to locate the unexpected canals of various anatomical configuration and subsequently treat them , may lead to therapeutic failures. Endodontic retreatment is usually the modality of choice in such cases. This report describes a case of a maxillary first molar with five canals (two mesial canals in mesial root, two distal canals in two distal roots and a palatal canal in palatal root. Additionally it shows a rare anatomic configuration and emphasizes the importance of identifying additional canals.

  3. 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...

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

    Science.gov (United States)

    Krastl, Gabriel; Zehnder, Marc S; Connert, Thomas; Weiger, Roland; Kühl, Sebastian

    2016-06-01

    To present a new treatment approach for teeth with pulp canal calcification (PCC) which require root canal treatment. A 15-year-old male patient presented with pain of his upper right central incisor. The tooth showed signs of apical periodontitis. Due to PCC, location of the root canal was judged to be difficult and associated with a high risk of perforation. A cone beam computed tomography (CBCT) and an intra-oral surface scan were performed and matched using software for virtual implant planning. After planning the position of the drill for root canal location, a virtual template was designed, and the data were exported as an STL file and sent to a 3D printer for template fabrication. The template was positioned on the anterior maxillary teeth. A specific drill was used to penetrate through the obliterated part of the root canal and obtain minimally invasive access to the apical part. The root canal was accessible at 9 mm distance from the apex. Further root canal preparation was carried out using an endodontic rotary instrumentation system. After an interappointment dressing for 4 weeks, the root canal was filled with vertically condensed gutta-percha using an epoxy sealer. The access cavity was restored with a composite material. After 15 months, the patient was clinically asymptomatic with no pain on percussion. The radiograph showed no apical pathology. The presented guided endodontic approach seems to be a safe, clinically feasible method to locate root canals and prevent root perforation in teeth with PCC. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  5. Evaluation of apically extruded debris during root canal retreatment with several NiTi systems.

    Science.gov (United States)

    Dincer, A N; Er, O; Canakci, B C

    2015-12-01

    To compare the amount of debris extruded apically during root canal retreatment using ProTaper, Mtwo and Reciproc instruments with hand H-files. In total, 60 freshly extracted human mandibular incisor teeth were used. All root canals were prepared with a Reciproc R25 file than filled with Gutta-percha and AH Plus sealer using cold lateral condensation before being assigned randomly to four groups (n = 15 each). In group 1, root fillings were removed with the Protaper Universal retreatment system; ProTaper Universal F3 and F4 instruments were used for the final preparation. In group 2, root fillings were removed with the Mtwo retreatment system; Mtwo size 30, .06 taper, size 35, .06 taper and size 40, .06 taper files were used for the final preparation. In group 3, root fillings were removed with Reciproc R25 instruments; Reciproc R40 instruments were used for the final preparation. In group 4, the root fillings were removed with Gates Glidden burs and sizes 35, 30 and 25 H-files; for final preparation, a size 40 H-file was used. Glass vials were used for debris collection. The vials were weighed before and after Gutta-percha removal. Additionally, the times required for the retreatment procedures were recorded. Data were analysed statistically using one-way analysis of variance. The Reciproc system produced significantly smaller amounts of apical extruded debris than the other groups (P ProTaper groups. The ProTaper and Reciproc groups required significantly less time than the Mtwo and H-file groups (P hand filing. Use of the ProTaper and Reciproc instruments required less time for retreatment procedures than use of the Mtwo or H-file. © 2014 International Endodontic Journal. Published by John Wiley & Sons Ltd.

  6. Comparative evaluation of apically extruded debris during root canal preparation using ProTaper™, Hyflex™ and Waveone™ rotary systems

    Science.gov (United States)

    Surakanti, Jayaprada Reddy; Venkata, Ravi Chandra Polavarapu; Vemisetty, Hari Kumar; Dandolu, Ram Kiran; Jaya, Nagendra Krishna Muppalla; Thota, Shirisha

    2014-01-01

    Background and Aims: Extrusion of any debris during endodontic treatment may potentially cause post-operative complications such as flare-ups. The purpose of this in vitro study was to assess the amount of apically extruded debris during the root canal preparation using rotary and reciprocating nickel-titanium instrumentation systems. Materials and Methods: In this study, 60 human mandibular first premolars were randomly assigned to 3 groups (n = 20 teeth/group). The root canals were instrumented according to the manufacturers’ instructions using the Reciprocating single-file system WaveOne™ (Dentsply Maillefer, Ballaigues, Switzerland) and full-sequence rotary Hyflex CM™ (Coltene Whaledent, Allstetten, Switzerland) and ProTaper™ (Dentsply Maillefer, Ballaigues, Switzerland) instruments. The canals were then irrigated using bidistilled water. The debris that was extruded apically was collected in preweighed eppendorf tubes and assessed with an electronic balance and compared. Statistical Analysis Used: The debris extrusion was compared and statistically analyzed using analysis of variance and the post hoc Student-Newman-Keuls test. Results: The WaveOne™ and ProTaper™ rotary instruments produced significantly more debris compared with Hyflex CM™ rotary instruments (P < 0.05). Conclusions: Under the conditions of this study, all systems that were used resulted in extrusion of apical debris. Full-sequence rotary instrumentation was associated with less debris extrusion compared with the use of reciprocating single-file systems. PMID:24778507

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

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

    2005-11-01

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

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  11. 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...

  12. Effect of immediate and delayed post space preparation on the apical seal of root canals obturated with different sealers and techniques

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    Hikmet Aydemir

    2009-12-01

    Full Text Available During mechanical preparation of the post space, the root canal filling may be twisted or vibrated, depending on several factors associated with the preparation technique and quality of filling. OBJECTIVE: The purpose of this study was to investigate the effect of immediate and delayed post space preparation on the integrity of the apical seal. MATERIAL AND METHODS: Sixty-four extracted human incisors were biomechanically prepared using the step-back technique. Sixty roots were randomly assigned to 6 experimental groups of 10 teeth each and the remaining 4 roots served as positive and negative controls (n=2. The root canals in the different groups were obturated with cold lateral and warm vertical condensation of gutta-percha and one of two sealers (Sealapex and Diaket. Post space was prepared either individually or simultaneously. An insulated copper wire was cut into 10-cm-long pieces. In each canal, one piece was inserted to maintain contact with gutta-percha and extended to the outside as one of two working electrodes. A stainless steel wire with the same dimensions of those of the copper wire, used as the other working electrode, was immersed into the background electrolyte from the center of the bottle. The electrical current between standard and experimental electrodes in canals was measured over a period of 10 days applying a conductivity meter. The Kruskal-Wallis test (p=0.05 determined whether there was a significant difference in microleakage among the groups and the Mann-Whitney U test (p=0.01 was used for multiple comparison grouping variables. RESULTS: The results suggest that only the differences between the root canal filling techniques were statistically significant (p0.01. CONCLUSION: The quality of the root canal filling is important for the integrity of the apical seal.

  13. Evaluation of Bacteriological Profile in the Apical Root Segment of the Patients with Primary Apical Periodontitis.

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    Tatikonda, Aravind; Sudheep, N; Biswas, Krishna P; Gowtham, K; Pujari, Sudarshan; Singh, Padam

    2017-01-01

    Apical periodontitis usually results from bacterial accumulation and contamination occurring in the root-canal system, and extending beyond the apical foramen to involve the periapical tissues. Literature has a paucity of the studies that stress on the division and analysis of the pulp canal segments. The reason for this disparity might be the technique used for collecting the samples from the pulp canals. Hence, we carried out the present study to evaluate the microbial flora in the apical part of the roots with necrotic pulp canals. The present study included the assessment of 40 freshly extracted teeth that had necrotized pulpal tissue along with the presence of periapical periodontal lesions. Removal of the soft tissue lesions attached to the root portion of the teeth along with apical periodontal lesions was done with the help of scalpel blade, after rinsing them with a sterile solution of saline. Thorough cleaning of the root surfaces was done with hydrogen peroxide followed by rapid disinfection with the help of sodium hypochlorite at varying concentrations. Sectioning of the root portion of all the specimens with the help of a disk was done perpendicular to the long axis of the teeth at a distance of roughly 5 to 6 mm from the teeth's apicalmost point. Cryotubes were used for transferring the specimens of apical portions containing 1 mL of buffer and were subjected to immediate frozen processing at a temperature of -20°C. A 10 K-type file was used for the initial collection of the samples followed by subsequent incubation of the files and paper pints in the incubation cabinet. Subsequent deoxyribonucleic acid (DNA) extraction from the samples was done following the procedure described by Siqueira et al. Paster et al's modification of the reverse-capture checkerboard assay was used in the present study. Semiquantitative data were used for overcoming the difficulties arising due to obtaining the counts of the polymerase chain reaction (PCR)-based analysis of

  14. Histological analysis of cleaning efficacy of hand and rotary instruments in the apical third of the root canal: A comparative study.

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    Arya, Ashtha; Bali, Dildeep; Grewal, Mandeep S

    2011-07-01

    To compare the cleaning efficiency of manual and rotary instrumentation in the apical third of the root canal system. In group 1 (n=10), instrumentation was performed with stainless steel K-file; in group 2 (n=10), it was done with hand ProTaper files; and in group 3 (n=10), instrumentation was done with ProTaper rotary. Distilled water was used for irrigation. The apical third was sectioned transversally and histologically processed. The cross sections were examined under optic microscope and debris was measured using Motic software. Instrumentation with stainless steel K-files showed minimum amount of debris, followed by ProTaper hand files, and rotary ProTaper files were least effective with maximum amount of debris; however, there were no significant differences between the three experimental groups. Both the manual and rotary instrumentation are relatively efficient in cleaning the apical third of the root canal system and the choice between manual and rotary instrumentation should depend on case to case basis.

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

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

    2014-01-01

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

  16. Effect of four different intracanal medicaments on the apical seal of the root canal system: A dye extraction study

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    Monika Tandan

    2014-01-01

    Conclusion: It can be concluded from this study that the control group showed least amount of leakage, whereas the 1% chlorhexidine gel group showed maximum amount of leakage. Apical leakage was observed with all the experimental groups with little variations in between them. Under the parameters of this study, it can be concluded that use of intracanal medicaments during endodontic treatment has a definite impact on the apical seal of the root canal system.

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

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    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...

  18. 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

  19. Microbiological examination of infected dental root canals.

    Science.gov (United States)

    Gomes, B P F A; Pinheiro, E T; Gadê-Neto, C R; Sousa, E L R; Ferraz, C C R; Zaia, A A; Teixeira, F B; Souza-Filho, F J

    2004-04-01

    The aim of this study was to investigate the root canal microbiota of primary and secondary root-infected canals and the association of constituent species with specific endodontic signs and symptoms. Microbial samples were taken from 60 root canals, 41 with necrotic pulp tissues (primary infection) and 19 with failed endodontic treatment (secondary infection). Strict anaerobic techniques were used for serial dilution, plating, incubation and identification. A total of 224 cultivable isolates were recovered belonging to 56 different bacterial species. Individual root canals yielded a maximum of 10 bacterial species. Of the bacterial isolates, 70% were either strict anaerobes or microphilic. The anaerobes most frequently isolated were: Peptostreptococcus micros (35%), Fusobacterium necrophorum (23.3%), Fusobacterium nucleatum (11.7%), Prevotella intermedia/nigrescens (16.7%), Porphyromonas gingivalis (6.7%) and Porphyromonas endodontalis (5%). The root canal microflora of untreated teeth with apical periodontitis was found to be mixed, comprising gram-negative and gram-positive and mostly anaerobic microorganisms and usually containing more than 3 species per canal. On the other hand, facultative anaerobic and gram-positive bacteria predominated in canals with failed endodontic treatment, which harbored 1-2 species per canal. Suggested relationships were found between anaerobes, especially gram-negatives, and the presence or history of pain, tenderness to percussion and swelling (PEubacterium spp. (both Pspp. (Pspp. (Pspp. (Pspp. (Pspp. (Pspp. (Pspp. (Pspp., P. micros, F. necrophorum (P<0.05). Our findings indicate potential complex interactions of species resulting in characteristic clinical pictures which cannot be achieved by individual species alone. They also indicate that the microbiota of primary infected canals with apical periodontitis differs in number and in species from the secondary infected canals by using the culture technique.

  20. 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.

  1. Evaluation and Comparison of the Position of the Apical Constriction in Single-root and Multiple-root Teeth

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    Alireza Farhad

    2017-12-01

    Full Text Available Introduction: Precise knowledge of the location of the apical constriction is essential to root canal treatment and long-term prognosis. Considering the differences in the apical constriction and size of the roots in single- and multiple-root teeth in various races, examination and comparison of the location of the apical constriction in single-root and multiple-root teeth are of paramount importance. The present studies aimed to measure and compare the distance of the apical constriction from the apical foramen and anatomical apex in single-root and multiple-root teeth. Materials and Methods: In this cross-sectional study, 60 roots of single-rooted teeth and 60 roots of multiple-rooted teeth were collected from the patients referring to the health centers in Isfahan, Iran. After cleansing and disinfecting the surface of the roots, the surface of the teeth was washed with hypochlorite. Based on the direction of the apical foramen, a longitudinal cut was made in the same direction, and the roots were examined microscopically at the magnification of 25. Following that, the distance of the apical constriction from the apical foramen and anatomical apex was measured using a digital camera. In addition, mean and standard deviation of the obtained distance values were determined. Distances in the single-root and multiple-root teeth were compared using independent t-test, at the significance level of Results: Mean distance between the apical constriction and apical foramen was 0.86±0.33 mm in the single-root teeth and 0.072±0.27 mm in the multiple-root teeth. Mean distance between the apical constriction and anatomical apex was 1.14±0.36 mm in the single-root teeth and 1.03±0.36 mm in the multiple-root teeth. Moreover, the results of independent t-test showed the distance of the apical constriction from the apical foramen to be significant between single-root and multiple-rooted teeth (P=0.013. However, the distance between the apical constriction

  2. Apical instrumentation in endodontic therapy

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    Kurniasri Darliana

    2007-07-01

    Full Text Available Cleaning and shaping of the root canal as the foundation for successful endodontic therapy. Cleaning of the root canal as the removal of all the contents of the root canal systems before and during shaping. Mechanical cleaning as the most important part of the root canal therapy. Instrumentation of the apical region has long been considered to be an essential component in the cleaning and shaping process. The apical area as the critical zone for instrumentation. The apical portion of the root canal system can retain microorganisms that could potentially cause periradicular inflammation. The nickel-titanium rotary instrumentation system to facilitate the cleaning and shaping process. Larger instrumentation sizes not only allow proper irrigation but also significantly decrease remaining bacteria in the canal system. How the larger apical sizes preparation must be achieved to clinical success. This paper will describe the major factors impacting the selection of final apical size, the factors are the anatomy of the apical constriction, root canal diameter, apical instrumentation, and bacteria in dentin tubuli.

  3. 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.

  4. Apically Extruded Debris during Root Canal Instrumentation with Reciproc Blue, HyFlex EDM, and XP-endo Shaper Nickel-titanium Files.

    Science.gov (United States)

    Uslu, Gülşah; Özyürek, Taha; Yılmaz, Koray; Gündoğar, Mustafa; Plotino, Gianluca

    2018-05-01

    The purpose of this study was to investigate the amount of apically extruded debris by Reciproc Blue (REC Blue; VDW, Munich, Germany), HyFlex EDM (HEDM; Coltene/Whaledent, Altstätten, Switzerland), and XP-endo Shaper (XPS; FKG Dentaire SA, La Chaux-de-Fonds, Switzerland) files during root canal preparation at body temperature. Sixty extracted single-rooted mandibular premolar human teeth were randomly assigned to 3 groups (n = 20). The canals were instrumented using 1 of the following instruments: REC Blue, HEDM, or XPS. Apically extruded debris during instrumentation was collected into preweighed Eppendorf tubes. All the procedures were performed at 35°C. The amount of extruded debris was calculated by subtracting the weight value of the tooth-free apparatus from the postpreparation weight value. The data were analyzed using the Kruskal-Wallis test at a 5% significance level. All the instruments tested caused extrusion of some debris from the apical foramen. XPS extruded significantly less debris from the apex than REC Blue (P  .05). Within the limitations of this in vitro study, the amount of apically extruded debris registered for the different files tested was REC Blue > HEDM > XPS, with a statistical difference only between XPS and REC Blue. Copyright © 2018 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  5. 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)

  6. Distances from the root apices of posterior teeth to the maxillary sinus and mandibular canal in patients with skeletal open bite: A cone-beam computed tomography study

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    Kosumarl, Werinpimol [Dental Division, Suan Phueng Hospital, Ratchaburi (Thailand); Patanaporn, Virush; Jotikasthira, Dhirawat; Janhom, Apirum [Faculty of Dentistry, Chiang Mai University, Chiang Mai (Thailand)

    2017-09-15

    This study determined and compared the distances from the maxillary root apices of posterior teeth to the floor of the maxillary sinus, or maxillary sinus distances (MSDs), and the distances from the mandibular root apices of the posterior teeth to the mandibular canal, or mandibular canal distances (MCDs), in Thai subjects with skeletal open bite and skeletal normal bite. Pretreatment cone-beam computed tomography (CBCT) images were obtained from 30 Thai orthodontic patients (15 patients with skeletal normal bite and 15 with skeletal open bite) whose ages ranged from 14 to 28 years. The CBCT images of the patients were processed and measured using the Romexis Viewer program. The MSDs and MCDs from the root apices of the maxillary and mandibular second premolar, first molar, and second molar to the maxillary sinus floor or the mandibular canal were measured perpendicularly to the occlusal plane. The Student t test was used for comparisons between the 2 groups. The greatest mean MSDs were from the root apex of the second premolars in both groups, whereas the least mean MSDs were from the mesiobuccal root apex of the second molars. The greatest mean MCDs were from the mesial root apex of the first molars, whereas the least mean MCDs were from the distal root apex of the second molars. There were no differences in the mean MSDs or the mean MCDs between the skeletal normal bite group and the skeletal open bite group.

  7. Distances from the root apices of posterior teeth to the maxillary sinus and mandibular canal in patients with skeletal open bite: A cone-beam computed tomography study

    International Nuclear Information System (INIS)

    Kosumarl, Werinpimol; Patanaporn, Virush; Jotikasthira, Dhirawat; Janhom, Apirum

    2017-01-01

    This study determined and compared the distances from the maxillary root apices of posterior teeth to the floor of the maxillary sinus, or maxillary sinus distances (MSDs), and the distances from the mandibular root apices of the posterior teeth to the mandibular canal, or mandibular canal distances (MCDs), in Thai subjects with skeletal open bite and skeletal normal bite. Pretreatment cone-beam computed tomography (CBCT) images were obtained from 30 Thai orthodontic patients (15 patients with skeletal normal bite and 15 with skeletal open bite) whose ages ranged from 14 to 28 years. The CBCT images of the patients were processed and measured using the Romexis Viewer program. The MSDs and MCDs from the root apices of the maxillary and mandibular second premolar, first molar, and second molar to the maxillary sinus floor or the mandibular canal were measured perpendicularly to the occlusal plane. The Student t test was used for comparisons between the 2 groups. The greatest mean MSDs were from the root apex of the second premolars in both groups, whereas the least mean MSDs were from the mesiobuccal root apex of the second molars. The greatest mean MCDs were from the mesial root apex of the first molars, whereas the least mean MCDs were from the distal root apex of the second molars. There were no differences in the mean MSDs or the mean MCDs between the skeletal normal bite group and the skeletal open bite group

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

    Science.gov (United States)

    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.

  9. Root Canal Microorganisms Profiles of Upper Anterior Teeth with Periapical Lesion

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    Maria Tanumiharja

    2014-12-01

    Full Text Available 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. Methods: Samples were collected from patients referring to Endodontic Department of Hasanuddin University Dental Hospital from July 2013 to September 2013. Twenty two samples, aged 17-40 were collected from 16 patients with asymptomatic apical periodontitis, and 36 samples, aged 18-50 were collected from 36 patients with chronic apical abscess. Microorganisms were evaluated using cultural technique. Results: The results showed predominant bacteria in asymptomatic apical periodontitis is Porhyromonas spp while in chronic apical abscess both Streptococcus spp and Porhyromonas spp showed similar frequencies. Conclusion: This study shows Porhyromonas spp play dominant role in apical periodontitis either in asymptomatic apical periodontitis or chronic apical abscess.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

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

    2018-04-28

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

  12. 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.

  13. An evaluation of canal curvature at the apical one third in type II mesial canals of mandibular molars

    Directory of Open Access Journals (Sweden)

    Hye-Rim Yun

    2012-05-01

    Full Text Available Objectives The purpose of this study was to evaluate the buccolingual curvature at the apical one third in type II mesial canals of mandibular molars using the radius and angle of curvature. Materials and Methods Total 100 mandibular molars were selected. Following an endodontic access in the teeth, their distal roots were removed. #15 H- or K-files (Dentsply Maillefer were inserted into the mesiobuccal and mesiolingual canals of the teeth. Radiographs of the teeth were taken for the proximal view. Among them, type II canals were selected and divided into two subgroups, IIa and IIb. In type IIa, two separate canals merged into one canal before reaching the apex and in type IIb, two separate canals merged into one canal within the apical foramen. The radius and angle of curvature of specimens were examined. Results In type II, mean radius of curvature in mesiolingual and mesiobuccal canals were 2.82 mm and 3.58 mm, respectively. The radius of the curvature of mesiolingual canals were significantly smaller than that of mesiobuccal canals in type II, and especially in type IIa. However, there were no statistically significant differences in radius of curvature between mesiobuccal and mesiolingual canals in type IIb and there were no significant differences in angle of curvature between type IIa and IIb. Conclusion In this study, type II mesial canals of mandibular molars showed severe curvature in the proximal view. Especially, mesiolingual canals of type IIa had more abrupt curvature than mesiobuccal canals at the apical one third.

  14. 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)

  15. 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)

  16. The antimicrobial effect of apical box versus apical cone preparation using iodine potassium iodide as root canal dressing

    DEFF Research Database (Denmark)

    Markvart, Merete; Dahlén, Gunnar; Reit, Claes-Erik

    2013-01-01

    Abstract Purpose. The purpose was to study the reduction of intra-canal microflora in premolars with apical periodontitis instrumented with either apical box or apical cone preparation and to provide measurements of intervention effects to allow proper power calculation in future clinical trials.......-week post-sampling, a power calculation revealed that over 900 patients are needed to show a difference of 9% between the two protocols tested. Conclusions. Future trials should be conducted using stringent protocols and as multi-centre trials for reaching the required information size....

  17. Root canal treatment of mandibular second premolar tooth with taurodontism

    Directory of Open Access Journals (Sweden)

    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.

  18. 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

  19. Evaluation of the anatomical alterations of lower molars mesial root?s apical third

    OpenAIRE

    FRÖNER Izabel Cristina; IMPERADOR Cristina Aparecida; SOUZA Luiz Gustavo de

    1999-01-01

    The anatomical apex of the mesial root of the lower molars presents a morphological complexity related to the number and shape of the root canals as well as of the apical foramen and isthmus presence. The knowledge of the complexity of the endodontic system of the molar root area is essencial to select more carefully the best instrumentation and obturation technique, to obtain a more successful endodontic therapy.

  20. Evaluation of the anatomical alterations of lower molars mesial root?s apical third

    Directory of Open Access Journals (Sweden)

    FRÖNER Izabel Cristina

    1999-01-01

    Full Text Available The anatomical apex of the mesial root of the lower molars presents a morphological complexity related to the number and shape of the root canals as well as of the apical foramen and isthmus presence. The knowledge of the complexity of the endodontic system of the molar root area is essencial to select more carefully the best instrumentation and obturation technique, to obtain a more successful endodontic therapy.

  1. 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

  2. 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

    2015-06-20

    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.

  3. Histologic investigation of root canal-treated teeth with apical periodontitis: a retrospective study from twenty-four patients.

    Science.gov (United States)

    Ricucci, Domenico; Siqueira, José F; Bate, Anna L; Pitt Ford, Thomas R

    2009-04-01

    This study intended to examine histologically root canal-treated teeth evincing apical periodontitis lesions and correlate the findings with clinical observations. Specimens were obtained from 24 patients (12 asymptomatic and 12 symptomatic) by extraction or endodontic surgery and consisted of roots or root tips and the associated pathologic lesion. Specimens were processed for histologic analysis, and serial sections were evaluated. Findings were correlated with clinical observations according to the presence or absence of symptoms. The mean period elapsed from treatment to specimen retrieval in the asymptomatic group was 7.5 years, as compared with 2.2 years in the symptomatic group. All specimens exhibited periradicular inflammation. Bacteria were visualized in all cases, except for 1 specimen from the asymptomatic group in which a foreign body reaction to overfilled material was the probable reason for emergent disease in a previously vital case. Irrespective of the presence of symptoms, bacteria were always located within the root canal system, although they were also observed in the periradicular tissues in 1 asymptomatic and 4 symptomatic teeth. In general, intraradicular bacterial colonization was heavier in symptomatic failed teeth. The present findings support the role of intraradicular infections, usually in the form of biofilms, as the primary cause of endodontic treatment failure.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

  6. Calcium hydroxide induced apexification with apical root development: a clinical case report.

    Science.gov (United States)

    Soares, J; Santos, S; César, C; Silva, P; Sá, M; Silveira, F; Nunes, E

    2008-08-01

    To report the induction of apical root development by calcium hydroxide in teeth with pulp necrosis and periapical radiolucency. A 10-year-old male patient was admitted to the clinic complaining of an intense pain and oedema on the anterior facial region, compatible with an acute dentoalveolar abscess. There was a previous history of dental trauma; only tooth 11 was negative to pulp sensitivity tests. Radiographically, tooth 11 exhibited incomplete root formation, characterized by a wide root canal, thin and fragile dentinal walls, and an extensive, divergent foraminal opening associated with an apical radiolucency. The first appointment focused on urgent local and systemic treatment. Apexification treatment commenced at the second session after 7 days, by means of chemo-mechanical debridement throughout the entire root canal, using K-files and irrigation with a 2.5% sodium hypochlorite solution. Subsequently, a calcium hydroxide paste was applied and changed four times over 8 months, when radiographic examination revealed complete closure of the foraminal opening, resulting in resolution of the periapical radiolucency and associated with 5 mm of additional root development. The root canal was filled by thermomechanical compaction of gutta-percha and sealer. A 3-year follow-up revealed normal periapical tissues and the absence of symptoms. * In young patients, dental trauma may cause pulp necrosis and arrest of root formation. * Under certain circumstances, chemo-mechanical debridement, including the use of a calcium hydroxide paste, is a valid alternative to mineral trioxide aggregate and or surgery for root-end closure. * In teeth with incompletely formed roots associated with periapical lesions, calcium hydroxide can induce periapical repair through the closure of the foramen and apical root development.

  7. 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

  8. 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

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

  12. Evaluation of apically extruded debris during root canal preparation in primary molar teeth using three different rotary systems and hand files.

    Science.gov (United States)

    Topçuoğlu, Gamze; Topçuoğlu, Hüseyin Sinan; Akpek, Firdevs

    2016-09-01

    To assess the amount of debris extruded apically during root canal preparation using various nickel titanium instrumentation systems and hand files in primary molar teeth. Sixty extracted primary first mandibular molar human teeth were randomly assigned to four groups (n = 15 teeth for each group). The canals were then instrumented with the following instrument systems: Revo-S, Mtwo, ProTaper Next, and hand files. Apically extruded debris during instrumentation was collected into pre-weighed Eppendorf tubes. The Eppendorf tubes were then stored in an incubator at 70°C for 5 days. The weight of the dry extruded debris was established by subtracting the pre-instrumentation and post-instrumentation weight of the Eppendorf tubes for each group. The data were analyzed using one-way analysis of variance (anova) and Tukey's post hoc tests. ProTaper Next files were associated with less apically extruded debris than the Mtwo, Revo-S, and hand files (P Hand files extruded more debris than Mtwo and Revo-S instruments (P 0.05). All instruments were associated with apical extrusion of debris. ProTaper Next files caused less debris extrusion compared to the other systems used. © 2015 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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

    Science.gov (United States)

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

    2016-06-01

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

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

    Directory of Open Access Journals (Sweden)

    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%.

  15. Evaluation of apical microleakage of teeth sealed with four different root canal sealers Avaliação da microinfiltração apical em dentes obturados com quatro diferentes cimentos endodônticos

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    Fábio Dultra

    2006-10-01

    Full Text Available OBJECTIVES: to compare the apical sealing ability of four root canal sealers. MATERIAL AND METHODS: forty extracted human maxillary canines were instrumented 1 mm short of the anatomical apex and randomly assigned to four groups (n=10, according to the root canal sealer used for obturation: Endofill, AH Plus, EndoREZ and Epiphany. Root canals were obturated with gutta-percha points, except for the Epiphany group, in which resin points (Resilon were used. The teeth were immersed in India ink for seven days and clarified using methyl salicylate. The extent of apical dye penetration was measured with a measuroscope in all aspects of the canal. RESULTS: AH Plus (0.02 mm ± 0.07, Epiphany (0.00 mm ± 0.00 and EndoREZ (0.32 mm ± 0.62 did not differ statistically to each other (p>0.01. EndoFill presented the highest dye penetration mean (0.83 mm ± 0.73 and was statistically different from the other sealers (pOBJETIVOS: comparar a capacidade de selamento apical de quatro cimentos endodônticos. MÉTODOS: quarenta caninos superiores humanos extraídos foram instrumentados 1 mm aquém do ápice anatômico e distribuídos aleatoriamente em quatro grupos (n=10, de acordo com o cimento endodôntico utilizado para a obturação: Endofill, AH Plus, EndoREZ e Epiphany. Os canais radiculares foram obturados pela técnica da condensação lateral com os cimentos e com cones de guta-percha, exceto o grupo do Epiphany, no qual os cones de resina (Resilon foram utilizados. Os dentes foram imersos em nanquim por sete dias e submetidos ao processo de diafanização e, então, clarificados empregando-se o salicilato de metila. A extensão de penetração via apical do corante foi medida por meio de um microscópio de mensuração em todas as faces do terço apical. RESULTADOS: AH Plus (0,02 mm ± 0,07, Epiphany (0,00 mm ± 0,00 e EndoREZ (0,32 mm ± 0,62 não diferiram estatisticamente entre si (p>0,01. EndoFill apresentou a maior média de penetração do corante (0

  16. 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.

  17. Influence of apical enlargement and complementary canal preparation with the Self-Adjusting File on endotoxin reduction in retreatment cases.

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    Silva, E J N L; Ferreira, V M; Silva, C C; Herrera, D R; De-Deus, G; Gomes, B P

    2017-07-01

    To compare the effectiveness of large apical preparations and complementary canal preparation with the Self-Adjusting File (SAF) in removing endotoxins from the root canal of teeth with apical periodontitis. Ten single-rooted and single-canaled teeth with post-treatment apical periodontitis were selected. Endotoxin samples were taken after removal of the root filling (S1), after chemomechanical preparation (CMP) using 2.5% NaOCl and an R25 file (S2), after CMP using 2.5% NaOCl and an R40 file (S3) and after complementary CMP using the SAF system (S4). Limulus amebocyte lysate (LAL) was used to measure endotoxin levels. The Friedman and Wilcoxon tests were used to compare endotoxin levels at each clinical intervention (P file was able to significantly reduce endotoxin levels (P file (P  0.05) following the use of the R40 instrument. Apical enlargement protocols were effective in significantly reducing endotoxin levels. Complementary preparation with the SAF system failed to eliminate residual endotoxin contents beyond those obtained with the R40 instrument. © 2016 International Endodontic Journal. Published by John Wiley & Sons Ltd.

  18. The Effect of Canal Contamination with Saliva on Apical Sealing

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    S Sabaghi

    2014-08-01

    Methods: In this laboratory study, 58 human uni-root teeth were cleaned and shaped for obturation with gutta percha and sealer AH26. In the case group, specimens were contaminated with human saliva immediately before obturation, whereas the teeth in the control group were kept dry. All canals were filled by lateral condensation technique. Moreover, the teeth were placed in methylene blue dye for 3 days. Dye penetration was measured using a stereomicrosope. As a matter of fact, the study data were analyzed via utilizing t-test. Results: A significant difference was found between the two groups in regard with the apical leakage(P<0.001. The microleakage mean of dye in the dry group was 3/48mm, whereas it was 6/36mm in the saliva contaminated group. Conclusion: The study findings revealed that complete drying of canal can improve apical sealing.

  19. On the causes of persistent apical periodontitis: a review.

    Science.gov (United States)

    Nair, P N R

    2006-04-01

    Apical periodontitis is a chronic inflammatory disorder of periradicular tissues caused by aetiological agents of endodontic origin. Persistent apical periodontitis occurs when root canal treatment of apical periodontitis has not adequately eliminated intraradicular infection. Problems that lead to persistent apical periodontitis include: inadequate aseptic control, poor access cavity design, missed canals, inadequate instrumentation, debridement and leaking temporary or permanent restorations. Even when the most stringent procedures are followed, apical periodontitis may still persist as asymptomatic radiolucencies, because of the complexity of the root canal system formed by the main and accessory canals, their ramifications and anastomoses where residual infection can persist. Further, there are extraradicular factors -- located within the inflamed periapical tissue -- that can interfere with post-treatment healing of apical periodontitis. The causes of apical periodontitis persisting after root canal treatment have not been well characterized. During the 1990s, a series of investigations have shown that there are six biological factors that lead to asymptomatic radiolucencies persisting after root canal treatment. These are: (i) intraradicular infection persisting in the complex apical root canal system; (ii) extraradicular infection, generally in the form of periapical actinomycosis; (iii) extruded root canal filling or other exogenous materials that cause a foreign body reaction; (iv) accumulation of endogenous cholesterol crystals that irritate periapical tissues; (v) true cystic lesions, and (vi) scar tissue healing of the lesion. This article provides a comprehensive overview of the causative factors of non-resolving periapical lesions that are seen as asymptomatic radiolucencies post-treatment.

  20. Wear promoted in the apical third of simulated canals after instrumentation with protaper universal system

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    Kathrein Tapia da Silva

    2009-10-01

    Full Text Available OBJECTIVE: This study evaluated the wear in the apical third of simulate canals after preparation with ProTaper Universal Rotary System. MATERIAL AND METHODS: 24 sets of instruments were used in 24 simulated canals in transparent epoxy resin blocks with degree of curvature of either 20°or 40°. The canals were photographed preoperatively and after preparation of the apical stop with ProTaper F3, F4 and F5 instruments. The initial and final images were exported to Adobe Photoshop® software and superimposed to detect the root canal wall differences (in mm between them, in two points located 1 (A and 5 (B mm from the point where the working length was established. Data were subjected to analysis of variance to verify the existence of interaction among the factors: canal curvature, instrument size and curve location. Significant level was set at 5%. RESULTS: Regardless of the location and the canal curvature, F4 and F5 instruments produced the greatest wear (p<0.05. CONCLUSIONS: There was a deviation from the original pathway towards the outside of the root curvature in both analyzed points. All instruments produced canal transportation, but the F4 and F5 instruments produced more than the other instruments, and should thus be used with care in curved canals.

  1. Evaluation of debris extruded apically during the removal of root canal filling material using ProTaper, D-RaCe, and R-Endo rotary nickel-titanium retreatment instruments and hand files.

    Science.gov (United States)

    Topçuoğlu, Hüseyin Sinan; Aktı, Ahmet; Tuncay, Öznur; Dinçer, Asiye Nur; Düzgün, Salih; Topçuoğlu, Gamze

    2014-12-01

    The aim of this study was to evaluate the amount of debris extruded apically during the removal of root canal filling material using ProTaper (Dentsply Maillefer, Ballaigues, Switzerland), D-RaCe (FKG Dentaire, La Chaux-de-Fonds, Switzerland), and R-Endo (Micro-Mega, Besançon, France) nickel-titanium (NiTi) rotary retreatment instruments and hand files. Sixty extracted single-rooted mandibular premolar teeth were prepared with K-files and filled with gutta-percha and AH Plus sealer (Dentsply DeTrey, Konstanz, Germany). The teeth were then randomly assigned to 4 groups (n = 15 for each group) for retreatment. The removal of canal filling material was performed as follows: hand files, ProTaper, D-RaCe, and R-Endo retreatment instruments. Debris extruded apically during the removal of canal filling material was collected into preweighed Eppendorf tubes. The tubes were then stored in an incubator at 70°C for 5 days. The weight of the dry extruded debris was established by subtracting the preretreatment and postretreatment weight of the Eppendorf tubes for each group. The data obtained were analyzed using 1-way analysis of variance and Tukey post hoc tests. All retreatment techniques caused the apical extrusion of debris. Hand files produced significantly more debris when compared with ProTaper, D-RaCe, and R-Endo rotary systems (P ProTaper, D-RaCe, and R-Endo retreatment systems (P > .05). The findings showed that during the removal of root canal filling material, rotary NiTi retreatment instruments used in this study caused less apical extrusion of debris compared with hand files. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  2. Effects of sodium hypochlorite associated with EDTA and etidronate on apical root transportation.

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    Silva e Souza, P A R; das Dores, R S E; Tartari, T; Pinheiro, T P S; Tuji, F M; Silva e Souza, M H

    2014-01-01

    To evaluate the influence of sodium hypochlorite associated with EDTA and etidronate on apical root transportation. Forty-five roots of human mandibular molars with curvatures of 15-25° were embedded in acrylic resin to allow standardized angulation of the initial and final radiographs. The pre-instrumentation radiographs of the mesiobuccal canal of each root were taken using a radiograph digital sensor with a size 15 K-file in the canal. The canals were prepared with the ProTaper Universal system (Dentsply Maillefer, Ballaigues, Switzerland), using one of the following irrigation regimens during the instrumentation (n = 15): G1 - irrigation with 20 mL of saline solution (control); G2 - alternating irrigation with 2.5% hypochlorite solution (NaOCl) (15 mL); and 17% ethylenediaminetetraacetic acid (EDTA) (5 mL). During instrumentation, the canal was filled with NaOCl and then between each exchange of instrument filled with EDTA for 1 min, and G3 - irrigation with 20 mL of 5% NaOCl and 18% etidronate solution (HEBP) mixed in equal parts. The postinstrumentation radiographs were made with a F3 instrument in the canal. The images were magnified and superposed with Adobe Photoshop software (Adobe Systems, Mountain View, CA, USA). Apical transportation was determined with AutoCAD 2012 software (Autodesk Inc., San Rafael, CA, USA) by measuring the distance in millimetres between the tips of the instruments. The results were subjected to the nonparametric statistical Kruskal-Wallis test (α < 0.05). The median transportation and interquartile range values were 0.00 ± 0.05 for G1, 0.08 ± 0.23 for G2 and 0.13 ± 0.14 for G3. Comparison between groups showed that apical transportation in G3 was significantly greater than in G1 (P < 0.05). The use of NaOCl associated with etidronate increased apical transportation in the canals of extracted teeth. © 2013 International Endodontic Journal. Published by John Wiley & Sons Ltd.

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

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    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.

  4. 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.

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

    Science.gov (United States)

    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.

  6. Microflora of root filled teeth with apical periodontitis in Latvian patients.

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    Mindere, Anda; Kundzina, Rita; Nikolajeva, Vizma; Eze, Daina; Petrina, Zaiga

    2010-01-01

    The aim of the present study was to investigate the microbial flora of root filled teeth with apical periodontitis and to determine the prevalence of β-lactamase producing strains in isolated bacteria in Latvian patients. 33 root filled teeth with asymptomatic persisting periapical lesions were selected for the present study. During nonsurgical endodontic retreatment, the root filling material was removed and canals were sampled. Determination of microbial species was based on series of biochemical tests using identification kits. All strains of bacteria were tested for β-lactamase production by using chromogenic nitrocefin-impregnated slides. Bacteria were found in 32 (97%) of initial specimens from the teeth. The number of isolated microbial strains in the specimens ranged from one to six (mean 2.7). 79% of the isolated microbial species were Gram-positive bacteria. The most common isolates were Streptococcus (27%), Actinomyces (27%), Staphylococcus (18%), Enterococcus (18%) and Lactobacillus (18%) spp. Yeasts were found as four isolates in 3 cases (9%). β-lactamase-producing bacterial strains were detected in 12 specimens, 36% of the patients. The most common enzyme-producing bacteria belonged to Actinomyces and Staphylococcus spp. The microbial flora in previously treated root canals with apical periodontitis is limited to a small number of predominantly Gram-positive microbial species. The most common isolates are Streptococcus, Actinomyces, Staphylococcus, Enterococcus and Lactobacillus spp. A moderately high prevalence of β-lactamase producing bacterial strains was detected in patients with root filled teeth with apical periodontitis.

  7. 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.

  8. 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.

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

    Science.gov (United States)

    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.

  10. 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.

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

    Science.gov (United States)

    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.

  12. Cone-beam computed tomography evaluation of the association of cortical plate proximity and apical root resorption after orthodontic treatment.

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    Nakada, Tomoo; Motoyoshi, Mitsuru; Horinuki, Eri; Shimizu, Noriyoshi

    2016-01-01

    We investigated the effects of proximity of the root apex to the maxillary labial cortical plate, palatal cortical plate, and incisive canal cortical plate on apical root resorption. Cone-beam computed tomography was used to measure the amount of root resorption and root apex movement around maxillary right and left central incisors in 30 adults who underwent four-bicuspid extraction followed by treatment with multibracket appliances. The patients were divided into three groups on the basis of the direction of root apex movement, after which the correlation between the amount of root resorption and root apex movement was determined. Mean apical root resorption was 1.80 ± 0.82 mm (range, 0.18-3.96 mm). The amount of root apex movement was positively correlated with the amount of root resorption on the side of pressure. Root apex proximity to the maxillary labial cortical plate, palatal cortical plate, and incisive canal cortical plate was associated with apical root resorption. Orthodontic treatment plans should carefully consider root proximity to the maxillary cortical plate. (J Oral Sci 58, 231-236, 2016).

  13. 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.

  14. Root canal irrigants

    OpenAIRE

    Kandaswamy, Deivanayagam; Venkateshbabu, Nagendrababu

    2010-01-01

    Successful root canal therapy relies on the combination of proper instrumentation, irrigation, and obturation of the root canal. Of these three essential steps of root canal therapy, irrigation of the root canal is the most important determinant in the healing of the periapical tissues. The primary endodontic treatment goal must thus be to optimize root canal disinfection and to prevent reinfection. In this review of the literature, various irrigants and the interactions between irrigants are...

  15. 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.

  16. 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.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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

  20. 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)

  1. 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)

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

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

    2009-01-01

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

  4. 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

  5. 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.

  6. [Comparison of the differences in pain and the effect of ibuprofen in reducing endodontic flare-up after single-visit root canal therapy between Uyghur and Han patients with chronic apical periodontitis].

    Science.gov (United States)

    Yan, Lei; Wang, Xin-Ying; Wan, Na; Wu, Pei-Ling

    2017-04-01

    To compare the incidence of postoperative pain of chronic periapical periodontitis patients with root canal therapy between Han and Uygur, and the effect of ibuprofen in reducing endodontic flare-up after single-visit root canal therapy between Uyghur and Han patients with chronic apical periodontitis, in order to provide a basis for clinical administration. Two hundred and fifty Uyghur and 250 Han patients with chronic apical periodontitis in their incisor, canine and premolar were collected, and randomly divided into 2 groups: experimental group and control group. After single-visit root canal therapy, Uyghur patients in the experimental group (UEG) and Han patients in the experimental group (HEG) took ibuprofen capsules according to the drug instructions; while Uyghur patients in the control group (UCG) and Han patients in the control group(HCG) took placebo capsules. Both doctors and patient kept blind from the drug capsules and group of the patients. The incidence, degree of endodontic Flare-up at 6, 12, 24, 48, 72 hours and 1 week after root canal therapy were recorded and analyzed by χ 2 test using SPSS11.0 software package. During the experiment, the incidence of E flare-up in Uygur patients was higher than in Han patients; the incidence of E flare-up in different groups in orders from high to low was: UCG>HCG>UEG>HEG. Chi-square test showed that there were significant differences between the two groups. In view of time distribution, most of flare-up happened between 24~48 hours after root canal therapy with the highest degree in all 4 groups. Regardless of the incidence or degree of flare-up, HEG and HCG were significantly greater than UEG and UCG. Ibuprofen can reduce and prevent flare-up for both Uyghur and Han patients, but it has better effect on Han patients.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

  9. Isolation and identification of Enterococcus faecalis from necrotic root canals using multiplex PCR.

    Science.gov (United States)

    Mahmoudpour, Ali; Rahimi, Saeed; Sina, Mahmood; Soroush, Mohammad H; Shahi, Shahriar; Shahisa, Shahriar; Asl-Aminabadi, Naser

    2007-09-01

    This study was designed to survey the incidence of Enterococcus faecalis infection in symptomatic and asymptomatic root canals of necrotic teeth using PCR and to isolate the bacterium for further screening. Sixty patients categorized according to their clinical symptoms were used for sampling by insertion of paper points into the root canals and absorbing all the fluids present within them. The samples were incubated in 1.0 ml 2xYT (containing 16 g bacto tryptone, 10 g yeast extract and 5.0 g NaCl per liter) for 24 h at 37 degrees C without aeration prior to multiplex PCR analysis. To assist the isolation of E. faecalis, sub-samples were further grown in the same medium supplemented with 6.5% NaCl and back-inoculated into bile esculin. Using multiple cultivation-dependent and PCR analyses, 6 cases (10%) of E. faecalis were identified. Four isolates were obtained from asymptomatic cases of chronic apical periodontitis, and the other two were associated with phoenix abscess and acute apical abscess, respectively. No E. faecalis infection was found in 5 patients with acute apical periodontitis or in 9 with chronic suppurative periodontitis. Our results indicate that there is no significant difference in the incidence of E. faecalis between symptomatic and asymptomatic necrotic dental root canals (P > 0.05).

  10. Human teeth with periapical pathosis after overinstrumentation and overfilling of the root canals: a scanning electron microscopic study.

    Science.gov (United States)

    Gutiérrez, J H; Brizuela, C; Villota, E

    1999-01-01

    The aim of this study was to determine whether overinstrumentation followed by immediate overfilling could be a potential risk in the treatment of infected root canals. Thirty-five human teeth with infected root canals were overinstrumented and overfilled approximately 45 min after their extraction. The experimental teeth were enlarged up to size 40 and the overinstrumentation and overfilling were checked with the aid of a magnifying glass. The specimens were fixed in glutaraldehyde plus sodium cacodylate solution and prepared for scanning electron microscope examination. Bacteria were detected on the flute of the files and mostly at the root apices around the main foramen, remaining firmly attached to resorptive lacunae despite the fact that the apices had undergone great changes, including fracture or zipping. A control group consisting of 10 human teeth root canals containing vital pulps were also overinstrumented and overfilled. No bacteria were detected on the flutes of the files, at the apices or on the extruded master cone overfilling these samples. The high percentage of bacteria adhering to the resorptive lacunae or in the flutes of files used in overinstrumented human teeth with infected root canals carry a potential risk for postoperative pain, clinical discomfort and flare-ups. The hazards observed in these circumstances do not support the one-visit treatment of teeth having acute or chronic periapical abscesses.

  11. Evaluation of root canal morphology of human mandibular incisors in Yazd

    Directory of Open Access Journals (Sweden)

    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.

  12. Effect of reciprocating systems and working lengths on apical microcrack development: a micro-CT Study

    International Nuclear Information System (INIS)

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

    2017-01-01

    The objective of this study was to evaluate the effect of root canal preparation with single-file reciprocating systems at different working lengths on the development of apical microcracks using micro-computed tomographic (micro-CT) imaging. Forty extracted human mandibular incisors were randomly assigned to 4 groups (n=10) according to the systems and working length used to prepare the root canals: Group A - WaveOne Gold at apical foramen (AF), Group B - WaveOne Gold 1 mm short of the AF (AF-1 mm), Group C - Unicone (AF) and Group D - Unicone (AF-1 mm). Micro-CT scanning was performed before and after root canal preparation at an isotropic resolution of 14 μm. Then, three examiners assessed the cross-sectional images generated to detect microcracks in the apical portion of the roots. Apical microcracks were visualized in 3, 1, 1, and 3 specimens in groups A, B, C, and D, respectively. All these microcracks observed after root canal preparation already existed prior to instrumentation, and no new apical microcrack was detected. For all groups, the number of slices presenting microcracks after root canal preparation was the same as before canal preparation. Root canal preparation with WaveOne Gold and Unicone, regardless of the working length, was not associated with apical microcrack formation. (author)

  13. Effect of reciprocating systems and working lengths on apical microcrack development: a micro-CT Study

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira, Bruna Paloma de; Câmara, Andréa Cruz; Duarte, Daniel Amancio; Antonino, Antonio Celso Dantas; Aguiar, Carlos Menezes, E-mail: bruna_paloma@msn.com [Universidade Federal de Pernambuco (UFPE), Recife, PE (Brazil); Heck, Richard John [Department of Land Resource Science, University of Guelph (Canada)

    2017-11-15

    The objective of this study was to evaluate the effect of root canal preparation with single-file reciprocating systems at different working lengths on the development of apical microcracks using micro-computed tomographic (micro-CT) imaging. Forty extracted human mandibular incisors were randomly assigned to 4 groups (n=10) according to the systems and working length used to prepare the root canals: Group A - WaveOne Gold at apical foramen (AF), Group B - WaveOne Gold 1 mm short of the AF (AF-1 mm), Group C - Unicone (AF) and Group D - Unicone (AF-1 mm). Micro-CT scanning was performed before and after root canal preparation at an isotropic resolution of 14 μm. Then, three examiners assessed the cross-sectional images generated to detect microcracks in the apical portion of the roots. Apical microcracks were visualized in 3, 1, 1, and 3 specimens in groups A, B, C, and D, respectively. All these microcracks observed after root canal preparation already existed prior to instrumentation, and no new apical microcrack was detected. For all groups, the number of slices presenting microcracks after root canal preparation was the same as before canal preparation. Root canal preparation with WaveOne Gold and Unicone, regardless of the working length, was not associated with apical microcrack formation. (author)

  14. Histological Study of the Effects of Ibuprofen on Acute Apical Inflammation Following Root Canal Therapy in Cats

    Directory of Open Access Journals (Sweden)

    Ghoddusi J

    2000-05-01

    Full Text Available Postoperative pain following Root Canal Therapy (RCT is the common problem for patients,"ndentist and dental staff. Regardless of cause it appears that postoperative pain and discomfort is related to"nperiapical inflammation. The purpose of this study was to investigate histologically the effect of"nIbuprofen on acute apical inflammation following RCT. on cat. Fifty-six cuspids teeth of 14 cats were"ndivided into three groups, 6 cats for experimental group, 6 cats for positive control group and 2 cats for"nnegative control group. In first group, to anesthesize the animals each cat received 10 mg/kg Ibuprofen"n36 hours before RCT and repeated every 24 hours. In second group RCT was performed in 24 cat teeth"nwithout any prescription. In negative control groups 2 cats, no RCT were done."nFollowing vital perfusion, in interval of 6, 12, 24 hours, samples were post fixed in 10% formalin and"nfive micron sections were prepared, and stained with H&E and studied under the Mann Whitney"nparameter test. Infilteration of inflamatory cells in 6 hours interval in experimental group was"nsignificantly less than two control groups. In 12 hours samples, however, inflammation in experimental"ngroup reduced, but it was not significant. In 24 hours samples there was no significant difference"nbetween experimental groups and controls. The result of this in-vivo study shows prescription of"nIbuprofen before root canal therapy can reduce inflammatory reaction.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

  17. Canal shaping of different single-file systems in curved root canals

    Directory of Open Access Journals (Sweden)

    Maurizio D'Amario

    2017-12-01

    Full Text Available Background/Purpose: This study compared maintenance of canal anatomy, occurrence of apical transportation, and working time observed after instrumentation with One Shape New Generation rotary system (Micro-Mega, with those observed after instrumentation with Reciproc (VDW and WaveOne (Dentsply-Maillefer reciprocating systems. Materials and methods: The mesial canals of 45 mandibular molars (curvature angles between 35° and 45° were selected. Specimens were randomly divided into three groups, and canal preparations were performed using One Shape, Reciproc, or WaveOne systems (size #25. A digital double radiographic technique was used to determine apical transportation and change in angle of curvature. Also, working time and instrument failures were recorded. Data were statistically analyzed. Results: During preparation, no file fractured. No statistically significant differences were found among groups. No system showed a significantly faster preparation time than others (P>0.05. All instruments maintained the original canal curvature well and were safe to use. Conclusion: Both continuous rotary instrument and reciprocating systems did not have any influence on the presence of apical transportation or caused an alteration in angle of canal curvature. Keywords: canal curvature, canal straightening, endodontics, reciprocating motion, single file instrumentation

  18. Cone-beam computed tomography analysis of the apical third of curved roots after mechanical preparation with different automated systems

    International Nuclear Information System (INIS)

    Oliveira, Cesar Augusto Pereira; Pascoalato, Cristina; Meurer, Maria Ines; Silva, Silvio Rocha Correa

    2009-01-01

    The present study evaluated by cone-beam computed tomography (CBCT) the apical canal transportation and centralizing ability of different automated systems after root canal preparation. The mesiobuccal canals of maxillary first molars (n=10 per group) were prepared with: GI - reciprocating system with K-Flexofile; GII - reciprocating system with NiTiFlex files; GIII - rotary system with K3 instruments; GIV - rotary system with RaCe instruments. CBCT scans were taken before and after biomechanical preparation up to a 40.02 diameter. Canal transportation was determined by measuring the smallest distance between the inner canal walls and the mesial and distal sides of the root. The centralization ability corresponded to the difference between the measurements from transportation evaluation, using the linear voxel to voxel method of analysis. The mean transportation was 0.06 ± 0.14 mm, with a tendency to deviate to the mesial side of the root (n=22), with no statistically significant difference among the groups (p=0.4153). The mean centralization index was 0.15 ± 0.65 also without statistically significant difference among the groups (p=0.0881). It may be concluded that apical canal transportation and centralization ability were not influenced by the type of mechanical movement and instruments used. (author)

  19. Cone-beam computed tomography analysis of the apical third of curved roots after mechanical preparation with different automated systems

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira, Cesar Augusto Pereira; Pascoalato, Cristina [University of Southern Santa Catarina (UNISUL), Tubarao, SC (Brazil); Meurer, Maria Ines [Federal University of Santa Catarina (UFSC), Florianopolis, SC (Brazil); Silva, Silvio Rocha Correa, E-mail: silvio@foar.unesp.b [Sao Paulo State University (UNESP), Araraquara, SP (Brazil)

    2009-07-01

    The present study evaluated by cone-beam computed tomography (CBCT) the apical canal transportation and centralizing ability of different automated systems after root canal preparation. The mesiobuccal canals of maxillary first molars (n=10 per group) were prepared with: GI - reciprocating system with K-Flexofile; GII - reciprocating system with NiTiFlex files; GIII - rotary system with K3 instruments; GIV - rotary system with RaCe instruments. CBCT scans were taken before and after biomechanical preparation up to a 40.02 diameter. Canal transportation was determined by measuring the smallest distance between the inner canal walls and the mesial and distal sides of the root. The centralization ability corresponded to the difference between the measurements from transportation evaluation, using the linear voxel to voxel method of analysis. The mean transportation was 0.06 +- 0.14 mm, with a tendency to deviate to the mesial side of the root (n=22), with no statistically significant difference among the groups (p=0.4153). The mean centralization index was 0.15 +- 0.65 also without statistically significant difference among the groups (p=0.0881). It may be concluded that apical canal transportation and centralization ability were not influenced by the type of mechanical movement and instruments used. (author)

  20. 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)

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

    Science.gov (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    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.

  4. Effect of the size of the apical enlargement with rotary instruments, single-cone filling, post space preparation with drills, fiber post removal, and root canal filling removal on apical crack initiation and propagation.

    Science.gov (United States)

    Çapar, İsmail Davut; Uysal, Banu; Ok, Evren; Arslan, Hakan

    2015-02-01

    The purpose of this study was to investigate the incidence of apical crack initiation and propagation in root dentin after several endodontic procedures. Sixty intact mandibular premolars were sectioned perpendicular to the long axis at 1 mm from the apex, and the apical surface was polished. Thirty teeth were left unprepared and served as a control, and the remaining 30 teeth were instrumented with ProTaper Universal instruments (Dentsply Maillefer, Ballaigues, Switzerland) up to size F5. The root canals were filled with the single-cone technique. Gutta-percha was removed with drills of the Rebilda post system (VOCO, Cuxhaven, Germany). Glass fiber-reinforced composite fiber posts were cemented using a dual-cure resin cement. The fiber posts were removed with a drill of the post system. Retreatment was completed after the removal of the gutta-percha. Crack initiation and propagation in the apical surfaces of the samples were examined with a stereomicroscope after each procedure. The absence/presence of cracks was recorded. Logistic regression was performed to analyze statistically the incidence of crack initiation and propagation with each procedure. The initiation of the first crack and crack propagation was associated with F2 and F4 instruments, respectively. The logistic regression analysis revealed that instrumentation and F2 instrument significantly affected apical crack initiation (P .05). Rotary nickel-titanium instrumentation had a significant effect on apical crack initiation, and post space preparation with drills had a significant impact on crack propagation. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  8. Dynamic Torque and Vertical Force Analysis during Nickel-titanium Rotary Root Canal Preparation with Different Modes of Reciprocal Rotation.

    Science.gov (United States)

    Tokita, Daisuke; Ebihara, Arata; Nishijo, Miki; Miyara, Kana; Okiji, Takashi

    2017-10-01

    The purpose of the present study was to compare 2 modes of reciprocal movement (torque-sensitive and time-dependent reciprocal rotation) with continuous rotation in terms of torque and apical force generation during nickel-titanium rotary root canal instrumentation. A custom-made automated root canal instrumentation and torque/force analyzing device was used to prepare simulated canals in resin blocks and monitor the torque and apical force generated in the blocks during preparation. Experimental groups (n = 7, each) consisted of (1) torque-sensitive reciprocal rotation with torque-sensitive vertical movement (group TqR), (2) time-dependent reciprocal rotation with time-dependent vertical movement (group TmR), and (3) continuous rotation with time-dependent vertical movement (group CR). The canals were instrumented with TF Adaptive SM1 and SM2 rotary files (SybronEndo, Orange, CA), and the torque and apical force were measured during instrumentation with SM2. The mean and maximum torque and apical force values were statistically analyzed using 1-way analysis of variance and the Tukey test (α = 0.05). The recordings showed intermittent increases of upward apical force and clockwise torque, indicating the generation and release of screw-in forces. The maximum upward apical force values in group TmR were significantly smaller than those in group CR (P forces when compared with continuous rotation. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  9. Utilizing the GentleWave® System for Debridement of Undetected Apical Anatomy.

    Science.gov (United States)

    Ford, Michael W

    2018-03-01

    Debriding and disinfecting complex anatomies within the root canal system pose a major challenge during root canal therapy. Even with current chemomechanical techniques, debris and bacterial remnants are commonly left behind, which are generally believed to increase the risk of endodontic failure. This case details the use of a new technique to debride complex apical anatomy in a maxillary molar. A 48-year-old female presented to the clinic with a chief complaint of increasing pain in her tooth. Clinical examination of the right first maxillary molar (#3) revealed moderate sensitivity to percussion and mild sensitivity to palpation. A pulpal diagnosis of symptomatic irreversible pulpitis and a periapi-cal diagnosis of symptomatic apical periodontitis were made. Mechanical instrumentation was performed using rotary file size #25/.04 for the mesiobuccal and distobuccal canals and size #25/.06 for the palatal canal to create a fluid path and enable obturation of the root canal system following the GentleWave® Procedure. The GentleWave Procedure was completed using Multisonic Ultracleaning™ for complete debridement and disinfection of the root canal system. The tooth was obturated using a warm vertical continuous wave obturation technique. Postoperative radiographs revealed complex anatomy within the apical third that was undetected both during pre-operative radiography and mechanical instrumentation. The palatal canal exhibited a complex apical delta with multiple points of exit, and the mesiobuccal canal revealed an undetected lateral canal within the apical third that had a separate and distinct egress. Conclusion and clinical significance: It is important for the clinician to debride and disinfect complex anatomy within the root canal system to reduce the risk of endodontic failure. This case report highlights the clinical significance of utilizing the GentleWave Procedure for detecting complex apical anatomy during endodontic therapy.

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

    Directory of Open Access Journals (Sweden)

    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.

  11. Endoscopic root canal treatment.

    Science.gov (United States)

    Moshonov, Joshua; Michaeli, Eli; Nahlieli, Oded

    2009-10-01

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

  12. A comparative evaluation of root canal area increase using three different nickel-titanium rotary systems: An ex vivo cone-beam computed tomographic analysis

    Directory of Open Access Journals (Sweden)

    Adrija Deka

    2015-01-01

    Full Text Available Background and Objectives: The present study was undertaken to compare and evaluate the area increase of root canals with ProTaper, iRaCe and Revo-S systems using cone beam computed tomography for analysis. Materials and Methodology: Forty five extracted human mandibular premolars having single canal and straight root were collected. Teeth were randomly assigned to three groups (n=15. Samples were decoronized by maintaining root length at 14 mm. Pre-instrumentation cone beam computed tomography scan was done after stabilizing the samples on wax blocks. The working length was determined at 1 mm short from the apical foramen by using a ISO 15 K-file tip protruding at apical foramen. Preparation was carried out according to the manufacturer′s instructions. Finally, canals were instrumented upto 30/.06 apically for each group. After each instrumentation, root canals were irrigated with 2ml of 3% sodium hypochlorite solution followed by 2 ml of 17% EDTA solution. Final irrigation was done with 5ml of saline. Post instrumentation cone beam computed tomography scans of all samples in the 3 groups were acquired. Results: Mean percentage of area increase in different thirds of the canal was highest for ProTaper followed by i-RaCe and Revo-s system which was statistically significant. Interpretation and Conclusion: Root canal area increase was highest for ProTaper followed by i-Race and Revo-S systems.

  13. Highly diverse microbiota in dental root canals in cases of apical periodontitis (data of illumina sequencing).

    Science.gov (United States)

    Vengerfeldt, Veiko; Špilka, Katerina; Saag, Mare; Preem, Jens-Konrad; Oopkaup, Kristjan; Truu, Jaak; Mändar, Reet

    2014-11-01

    Chronic apical periodontitis (CAP) is a frequent condition that has a considerable effect on a patient's quality of life. We aimed to reveal root canal microbial communities in antibiotic-naive patients by applying Illumina sequencing (Illumina Inc, San Diego, CA). Samples were collected under strict aseptic conditions from 12 teeth (5 with primary CAP, 3 with secondary CAP, and 4 with a periapical abscess [PA]) and characterized by profiling the microbial community on the basis of the V6 hypervariable region of the 16S ribosomal RNA gene by using Illumina HiSeq2000 sequencing combinatorial sequence-tagged polymerase chain reaction products. Root canal specimens displayed highly polymicrobial communities in all 3 patient groups. One sample contained 5-8 (mean = 6.5) phyla of bacteria. The most numerous were Firmicutes and Bacteroidetes, but Actinobacteria, Fusobacteria, Proteobacteria, Spirochaetes, Tenericutes, and Synergistetes were also present in most of the patients. One sample contained 30-70 different operational taxonomic units; the mean (± standard deviation) was lower in the primary CAP group (36 ± 4) than in the PA (45 ± 4) and secondary CAP (43 ± 13) groups (P < .05). The communities were individually different, but anaerobic bacteria predominated as the rule. Enterococcus faecalis was found only in patients with secondary CAP. One PA sample displayed a significantly high proportion (47%) of Proteobacteria, mainly at the expense of Janthinobacterium lividum. This study provided an in-depth characterization of the microbiota of periapical tissues, revealing highly polymicrobial communities and minor differences between the study groups. A full understanding of the etiology of periodontal disease will only be possible through further in-depth systems-level analyses of the host-microbiome interaction. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  14. Influence of cervical preflaring on apical file size determination.

    Science.gov (United States)

    Pecora, J D; Capelli, A; Guerisoli, D M Z; Spanó, J C E; Estrela, C

    2005-07-01

    To investigate the influence of cervical preflaring with different instruments (Gates-Glidden drills, Quantec Flare series instruments and LA Axxess burs) on the first file that binds at working length (WL) in maxillary central incisors. Forty human maxillary central incisors with complete root formation were used. After standard access cavities, a size 06 K-file was inserted into each canal until the apical foramen was reached. The WL was set 1 mm short of the apical foramen. Group 1 received the initial apical instrument without previous preflaring of the cervical and middle thirds of the root canal. Group 2 had the cervical and middle portion of the root canals enlarged with Gates-Glidden drills sizes 90, 110 and 130. Group 3 had the cervical and middle thirds of the root canals enlarged with nickel-titanium Quantec Flare series instruments. Titanium-nitrite treated, stainless steel LA Axxess burs were used for preflaring the cervical and middle portions of root canals from group 4. Each canal was sized using manual K-files, starting with size 08 files with passive movements until the WL was reached. File sizes were increased until a binding sensation was felt at the WL, and the instrument size was recorded for each tooth. The apical region was then observed under a stereoscopic magnifier, images were recorded digitally and the differences between root canal and maximum file diameters were evaluated for each sample. Significant differences were found between experimental groups regarding anatomical diameter at the WL and the first file to bind in the canal (P Flare instruments were ranked in an intermediary position, with no statistically significant differences between them (0.093 mm average). The instrument binding technique for determining anatomical diameter at WL is not precise. Preflaring of the cervical and middle thirds of the root canal improved anatomical diameter determination; the instrument used for preflaring played a major role in determining the

  15. 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

  16. Comparative evaluation of debris removal from root canal wall by using EndoVac and conventional needle irrigation: An in vitro study

    Directory of Open Access Journals (Sweden)

    Vandana J Gade

    2013-01-01

    Full Text Available Context: Microbial control is of paramount importance in Clinical Endodontics. Therefore, cleaning and disinfection of root canals are essential to achieve endodontic success. Aims: The purpose of this study is to compare the efficacy of EndoVac irrigation system and conventional needle (30 gauges side venting needle irrigation for removal of debris from the root canal walls at coronal, middle and apical third by using the scanning electron microscopy (SEM. Settings and Design: An in vitro randomized control trial study. Materials and Methods: A total of 20 mandibular premolars with completely formed roots were selected and randomly divided into two groups - Group 1: Irrigation with the Conventional system and Group 2: EndoVac irrigation. After access opening and working length determination biomechanical preparation completed up to a rotary protaper F4 file. Groupwise irrigation with sodium hypochlorite and ethylenediaminetetraacetic acid was done with each canal in between instrumentation. Then, the teeth were sectioned in buccolingual direction and the halves were sputter-coated with gold palladium and coronal, middle and apical third were examined by SEM at x2000 magnification. Statistical Analysis: Mann-Whitney test for comparison between methods, Kruskal-Wallis test for comparison among thirds and Miller test for individual comparisons. Results: The apical, middle and cervical root canal thirds were evaluated and the results were analyzed statistically by the Mann-Whitney test for comparison between methods, Kruskal-Wallis test for comparison among thirds and Miller test for individual comparisons. Conclusions: EndoVac group resulted in significantly less debris at apical third compared with the conventional needle irrigation group. There was no statistical significant difference found in debris removal at coronal and middle third of root canal wall between the EndoVac group and conventional needle irrigation group.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

  1. Clinical results with two different methods of root-end preparation and filling in apical surgery: mineral trioxide aggregate and adhesive resin composite

    DEFF Research Database (Denmark)

    von Arx, Thomas; Hanni, Stefan; Jensen, Simon Storgaard

    2010-01-01

    The aim of apical surgery is to hermetically seal the root canal system after root-end resection, thereby enabling periradicular healing. The objective of this nonrandomized prospective clinical study was to report results of 2 different root-end preparation and filling methods, ie, mineral triox...

  2. A method for three-dimensional analysis of the root canal system, before and after mechanical instrumentation, using X-ray Micro-computed tomography

    DEFF Research Database (Denmark)

    Markvart, Merete; Bjørndal, Lars; Larsen, Per

    . Extracted molar teeth were embedded in resin and kept moisturized. Each root canal was instrumented with NiTi instruments to #40. The teeth were scanned before and after instrumentation, using a microCT40 micro-tomography (SCANCO Medical AG, Bassersdorf, Switzerland). The reconstructed slices were imported......Clinical studies have shown a connection between the reduction of micro-organisms in the root canal and the degree of apical enlargement. The aim of this study was to create a non-invasive 3D model for monitoring the apical enlargement in molar teeth before and after mechanical instrumentation...

  3. Tissue response to silicone rubber when used as a root canal filling.

    Science.gov (United States)

    Kasman, F G; Goldman, M

    1977-04-01

    To test the tissue compatibility of silicone rubber when it is used as a root canal filler, excess material was intentionally forced into the apical tissues in primates. The tissue response was one of general acceptance, with the usual response being fibrotic encapsulation. A low degree of inflammation was noted. Further studies are in progress.

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

    Science.gov (United States)

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

    2017-01-01

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

  5. 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.

  6. 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

  7. 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.

  8. Osmolarity and root canal antiseptics.

    Science.gov (United States)

    Rossi-Fedele, G; Guastalli, A R

    2014-04-01

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

  9. 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.

  10. Assessment of Root Morphology and Apices of First and Second Maxillary Molars in Tehran Population

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    Mandana Naseri

    2015-12-01

    Full Text Available Introduction: Objective: This study aimed to assess the possible variations in root canal anatomy and topography of the apices of first and second maxillary molars. Materials and methods: A total of 67 first and second maxillary permanent molars were collected. Access cavity was prepared and 2% methylene blue was injected. The teeth were demineralized by 5% nitric acid and cleared with methyl salicylate. Specimens were evaluated under stereomicroscopy and analyzed using the sample t-test. Results: Based on Vertucci’s classification, the mesiobuccal root of maxillary first molars was type I in 87.5% and type IV in 12.5% of the cases. The mesiobuccal root of second maxillary molars was type I in 60%, type II in 8.6%, type IV in 25.7% and type V in 5.7% of cases. In maxillary first and second molars, the distobuccal and palatal roots were type I in 100% of the cases. The distance of the apical constriction from the apical foramen was 0.21±0.09 mm, the distance from the apical constriction tothe anatomic apex was 0.44±0.19 mm and the distance of the apical foramen from the anatomic apex was 0.15±0.15 mm. The mean percentage of delta prevalence was 3.2% in both teeth. Conclusion: The mean distance of the apical foramen and apical constriction from the anatomic apex was less than 0.6 and 1.2 mm, respectively. In maxillary first and second molars, the mean distance of the apical constriction from the apical foramen and anatomic apex was 0.21 and 0.44, respectively and the mean distance of the apical foramen from the anatomic apex was 0.15 mm

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

    Science.gov (United States)

    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.

  12. 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.

  13. 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

  14. Apical and periapical repair of dogs' teeth with periapical lesions after endodontic treatment with different root canal sealers Reparação apical e periapical de dentes de cães com lesão periapical crônica após tratamento endodôntico utilizando diferentes materiais obturadores

    Directory of Open Access Journals (Sweden)

    Mário Roberto Leonardo

    2003-03-01

    Full Text Available The aim of this study was to evaluate the apical and periapical repair after root canal treatment of dogs' teeth with pulp necrosis and chronic periapical lesion using different root canal sealers. After periapical lesion induction, forty-four root canals of 3 dogs were submitted to biomechanical preparation using 5.25% sodium hypochlorite as an irrigating solution. A calcium hydroxide dressing (Calen PMCC was applied for 15 days and the root canals were filled using the lateral condensation technique with gutta-percha points and Sealapex, AH Plus or Sealer Plus for sealing. After 180 days, the animals were sacrificed by anesthetic overdose and the obtained histological sections were stained with hematoxylin-eosin for optical microscopic analysis of the apical and periapical repair. The groups filled with Sealapex and AH Plus had better histological repair (p O objetivo do presente estudo foi avaliar a reparação apical e periapical pós-tratamento endodôntico de dentes de cães com necrose pulpar e reação periapical crônica, em que se utilizaram diferentes materiais obturadores. Foram utilizados 44 canais radiculares, nos quais, após indução das lesões periapicais, foi efetuado o preparo biomecânico empregando-se como solução irrigadora uma solução de hipoclorito de sódio a 5,25%. Após curativo de demora com pasta à base de hidróxido de cálcio (Calen PMCC, mantida no canal radicular durante 15 dias, os canais radiculares foram obturados pela técnica clássica complementada pela condensação lateral ativa, empregando-se os cimentos Sealapex, AH Plus ou Sealer Plus. Decorrido o período de 180 dias, os animais foram mortos e as peças submetidas ao processamento laboratorial. Os cortes histológicos obtidos foram corados com hematoxilina-eosina. A análise histopatológica demonstrou que nos canais radiculares obturados com os cimentos Sealapex e AH Plus ocorreu melhor reparação (p < 0,05 do que nos canais obturados com o

  15. 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.

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

    OpenAIRE

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

    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...

  17. Effectiveness of four different final irrigation activation techniques on smear layer removal in curved root canals : a scanning electron microscopy study.

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    Puneet Ahuja

    2014-02-01

    Full Text Available The aim of this study was to assess the efficacy of apical negative pressure (ANP, manual dynamic agitation (MDA, passive ultrasonic irrigation (PUI and needle irrigation (NI as final irrigation activation techniques for smear layer removal in curved root canals.Mesiobuccal root canals of 80 freshly extracted maxillary first molars with curvatures ranging between 25° and 35° were used. A glide path with #08-15 K files was established before cleaning and shaping with Mtwo rotary instruments (VDW, Munich, Germany up to size 35/0.04 taper. During instrumentation, 1 ml of 2.5% NaOCl was used at each change of file. Samples were divided into 4 equal groups (n=20 according to the final irrigation activation technique: group 1, apical negative pressure (ANP (EndoVac; group 2, manual dynamic agitation (MDA; group 3, passive ultrasonic irrigation (PUI; and group 4, needle irrigation (NI. Root canals were split longitudinally and subjected to scanning electron microscopy. The presence of smear layer at coronal, middle and apical levels was evaluated by superimposing 300-μm square grid over the obtained photomicrographs using a four-score scale with X1,000 magnification.Amongst all the groups tested, ANP showed the overall best smear layer removal efficacy (p < 0.05. Removal of smear layer was least effective with the NI technique.ANP (EndoVac system can be used as the final irrigation activation technique for effective smear layer removal in curved root canals.

  18. USAGE OF PASTE FOR TEMPORARY PLACEMENT IN THE TREATMENT OF CHRONIC APICAL PERIODONTITIS

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    A.V. Borysenko

    2012-03-01

    Full Text Available Summary: The aim of the present investigation was usage of medicamental paste with antibacterial and regeneration action for temporary placement in the treatment of chronic apical periodontitis. Materials and method: The medicamental paste for temporary placement of root canals consists of a mixture of metronidazole, Enterosgel (Silm and Alflutop (Biotehnos S.A., Romania. Thë paste was used for the treatment of 30 teeth with chronic apical periodontitis. Final obturation of the root canals was performed with gutta percha cones and sealer. The efficiency of the treatment was appreciated after examination on the basis of clinical and radiographic findings. Results: During the treatment of the 30 teeth, no exacerbations of the pathological process were recorded. Pain after obturation of the root canals was revealed in only 6 (20% of the treated teeth. No pain, pathologic changes of gingiva, good mastication efficiency in all teeth after treatment were revealed. Conclusions: The high clinical efficiency of the medicamental paste with antibacterial and regeneration action at the level of temporary root canals placement in the treatment of chronic apical periodontitis was shown. Keywords: chronic apical periodontitis, medicamental paste for temporary root canals placement, metronidazole, Enterosgel (Silm and Alflutop (Biotehnos S.A., Romania

  19. IN VITRO COMPARISON OF GUTTA-PERCHA-FILLED AREA PERCENTAGES IN ROOT CANALS INSTRUMENTED AND OBTURATED WITH DIFFERENT TECHNIQUES*

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    Ayça YILMAZ

    2017-04-01

    Full Text Available Purpose: To evaluate the efficacy of different obturation techniques in root canals instrumented either by hand or rotary instruments with regard to the percentage of gutta- percha-filled area (PGFA. Materials and Methods: One hundred and sixty extracted mandibular premolars with single, straight root canals were studied. Root canals were prepared to an apical size of 30 by hand with a modified crown-down technique or the ProTaper and HEROShaper systems. Teeth were divided into eight groups (n=20 according to the following instrumentation and obturation techniques: G1: Hand files+lateral condensation (LC, G2: Hand files+Thermafil, G3: ProTaper+LC, G4: ProTaper+single-cone, G5: ProTaper+ProTaper-Obturator, G6: HEROShaper+LC, G7: HEROShaper+single-cone, G8: HEROShaper+HEROfill. Horizontal sections were cut at 1, 3, 5, 7, 9, 11 and 13 mm from the apical foramen. A total of 1120 sections obtained were digitally photographed under a stereomicroscope set at 48X magnification. The cross-sectional area of the canal and the gutta-percha was measured by digital image analysis and the PGFA was calculated for each section. Results: The mean of the PGFA in Thermafil (G2, ProTaper-Obturator (G5 and HEROfill (G8 groups was significantly higher than the other groups. In G3 and G4, PGFA showed no significant difference in the apical segments whereas PGFA was significantly higher at the middle and coronal segments in G3. In G6 and G7, PGFA showed no significant difference in the apical and middle segments whereas PGFA was significantly higher at the coronal segments in G6. Conclusion: The carrier-based gutta-percha obturation systems revealed significantly higher PGFA in comparison to single-cone and lateral condensation techniques.

  20. In vitro comparison of gutta-percha-filled area percentages in root canals instrumented and obturated with different techniques.

    Science.gov (United States)

    Yilmaz, Ayca; Karagoz-Kucukay, Isil

    2017-01-01

    To evaluate the efficacy of different obturation techniques in root canals instrumented either by hand or rotary instruments with regard to the percentage of gutta- percha-filled area (PGFA). One hundred and sixty extracted mandibular premolars with single, straight root canals were studied. Root canals were prepared to an apical size of 30 by hand with a modified crown-down technique or the ProTaper and HEROShaper systems. Teeth were divided into eight groups (n=20) according to the following instrumentation and obturation techniques: G1: Hand files+lateral condensation (LC), G2: Hand files+Thermafil, G3: ProTaper+LC, G4: ProTaper+single-cone, G5: ProTaper+ProTaper-Obturator, G6: HEROShaper+LC, G7: HEROShaper+single-cone, G8: HEROShaper+HEROfill. Horizontal sections were cut at 1, 3, 5, 7, 9, 11 and 13 mm from the apical foramen. A total of 1120 sections obtained were digitally photographed under a stereomicroscope set at 48X magnification. The cross-sectional area of the canal and the gutta-percha was measured by digital image analysis and the PGFA was calculated for each section. The mean of the PGFA in Thermafil (G2), ProTaper-Obturator (G5) and HEROfill (G8) groups was significantly higher than the other groups. In G3 and G4, PGFA showed no significant difference in the apical segments whereas PGFA was significantly higher at the middle and coronal segments in G3. In G6 and G7, PGFA showed no significant difference in the apical and middle segments whereas PGFA was significantly higher at the coronal segments in G6. The carrier-based gutta-percha obturation systems revealed significantly higher PGFA in comparison to single-cone and lateral condensation techniques.

  1. Highly concentrated EDTA gel improves cleaning efficiency of root canal preparation in vitro.

    Science.gov (United States)

    Putzer, P; Hoy, L; Günay, H

    2008-12-01

    Debris and smear layer, as a product of mechanical root canal instrumentation, reduce the effectiveness of pharmacological substances to prevent post-treatment diseases and impair direct contact of filling materials with a clean dentinal surface. The aim of this in vitro study was to investigate the presence and localization of debris and smear layer via scanning electron microscope analysis after standardized root canal preparation with different chelating agents. Dentin surfaces received treatment with: (1) 15% ethylenediaminetetraacetic acid (EDTA), (2) 18.6% EDTA (3) and 24% EDTA or without any demineralizing chemicals as control. Forty vertically split human premolars were sputtered and divided into coronal, middle, and apical sections, followed by a randomized, blinded score evaluation using five scores. Pairwise comparisons of all treatment groups against a control group have been performed by Mann-Whitney U test and the Kruskal-Wallis test. Debris grades showed no significant difference between the three regions of the root canals, except for 18.6% EDTA in the central third. Smear layer and smear plug removal was concentration-dependent. Removal of the smear layer in the three areas showed that there was a statistically significant difference between all parts when using 18.6% and 24% EDTA concentrations compared with the control. The best smear layer removal in the apical region was observed using a 24% EDTA gel as chelating agent and lubricant. The usage of EDTA gel >/=18.6% presented a better cleaning regime when compared to the control group.

  2. In vitro comparison of apical microleakage following canal ...

    African Journals Online (AJOL)

    hope&shola

    2010-11-03

    Nov 3, 2010 ... The purpose of this study was to compare apical microleakage following canal obturation with lateral ..... heat-induced bone tissue injury: A vital microscopic study in the rabbit. J. Prosthet. ... In: Pathways of the Pulp. 9th Ed ...

  3. Curved canals: Ancestral files revisited

    Directory of Open Access Journals (Sweden)

    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.

  4. Evaluation of apical canal shapes produced sequentially during instrumentation with stainless steel hand and Ni-Ti rotary instruments using Micro-computed tomography

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    Woo-Jin Lee

    2011-05-01

    Full Text Available Objectives The purpose of this study was to determine the optimal master apical file size with minimal transportation and optimal efficiency in removing infected dentin. We evaluated the transportation of the canal center and the change in untouched areas after sequential preparation with a #25 to #40 file using 3 different instruments: stainless steel K-type (SS K-file hand file, ProFile and LightSpeed using microcomputed tomography (MCT. Materials and Methods Thirty extracted human mandibular molars with separated orifices and apical foramens on mesial canals were used. Teeth were randomly divided into three groups: SS K-file, Profile, LightSpeed and the root canals were instrumented using corresponding instruments from #20 to #40. All teeth were scanned with MCT before and after instrumentation. Cross section images were used to evaluate canal transportation and untouched area at 1- , 2- , 3- , and 5- mm level from the apex. Data were statistically analyzed according to' repeated nested design'and Mann-Whitney test (p = 0.05. Results In SS K-file group, canal transportation was significantly increased over #30 instrument. In the ProFile group, canal transportation was significantly increased after preparation with the #40 instrument at the 1- and 2- mm levels. LightSpeed group showed better centering ability than ProFile group after preparation with the #40 instrument at the 1 and 2 mm levels. Conclusions SS K-file, Profile, and LightSpeed showed differences in the degree of apical transportation depending on the size of the master apical file.

  5. In vitro evaluation of the root canal cleaning ability of plant extracts and their antimicrobial action

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    Edja Maria Melo de Brito Costa

    2012-06-01

    Full Text Available This in vitro study evaluated both the antimicrobial activity and the root canal cleaning ability of plant extracts used in irrigation solutions. The antimicrobial activities of the aroeira-da-praia (Schinus terebintifolius Raddi and the quixabeira (Syderoxylum obtusifolium Roem & Schult hydroalcoholic extracts, of 2.5% sodium hypochlorite (NaOCl and of 0.12% chlorhexidine (positive control against Enterococcus faecalis were tested with the agar well diffusion method. The level of root canal cleanliness was examined by scanning electron microscopy (SEM. Twenty one single-rooted human teeth were divided into three groups according to the irrigation solution applied: 1 50% aroeira-da-praia; 2 50% quixabeira and 3 a combination of 2.5% sodium hypochlorite + 17% EDTA. All solutions tested demonstrated antimicrobial activity against Enterococcus faecalis. The SEM analysis revealed that higher and lower degrees of surface cleaning were observed, in the three groups, respectively for the coronal and apical thirds, in that quixabeira showed the greatest efficiency in removing the smear layer in the apical third. All the agents tested presented antimicrobial activity against E. faecalis. None, however, was able to completely remove the smear layer of the dentinal surface in the different thirds of the root canal. The results suggest that the analyzed plant extracts may represent a new therapeutic option in the list of alternative agents available for endodontic treatment.

  6. Apical sealing of root canal fillings performed with five different endodontic sealers: analysis by fluid filtration

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    Bruno Carvalho de Vasconcelos

    2011-08-01

    Full Text Available OBJECTIVES: To evaluate the sealing ability of five root canal sealers, including two experimental cements (MBP and MTA-Obtura using the fluid filtration method. MATERIAL AND METHODS: Teeth were divided into 5 study groups: G1-AH Plus; G2-Acroseal; G3Sealapex; G4-MBP; G5-MTA-Obtura; and two controls. Chemical-mechanical preparation was performed with ProFile rotary nickel-titanium instruments 1 mm short of the apical foramen. The sealing ability was evaluated by fluid filtration at 15, 30, and 60 days. RESULTS: The statistical analysis showed significant difference between the materials at different periods (p<0.05. AH Plus and MBP had similar leakage values at 15 and 60 days, alternating with significant reduction at 30 days, while the other materials showed progressive increase in leakage values. Acroseal and Sealapex presented the best results at 15 days and the worst at 60 days. CONCLUSIONS: All sealers evaluated presented fluid leakage, with AH Plus and MBP showing the best results at the end of the experimental period. Acroseal, Sealapex, and MTA-Obtura presented increase in leakage values at longer observation periods.

  7. IN VIVO ANALYSIS OF SOME KEY CHARACTERISTICS OF THE APICAL ZONE IN TEETH WITH CHRONIC APICAL PERIODONTITIS.

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    Angela Gusiyska

    2014-11-01

    Full Text Available Introduction: The pathogenesis of internal and external resorptive processes in the dental tissues and those of the periapical zone is not fully understood, but the main purpose, either in teeth with internal resorption or in teeth with periapical lesions, is decontamination of the endodontic space and subsequent three-dimensional obturation in order to isolate periapical and oral tissues and prevent reinfection. Purpose: The aim of this article is to analyze in vivo some key characteristics of the apical zone in teeth with chronic apical periodontitis. Material and Methods: To facilitate the clinical protocol after the radiographic analysis and assessment of patency, the working lengths of 153 root canals (n = 153 in 106 teeth were determined. The clinical widths of the apical narrowing were measured by using the last instrument (ISO 0.02 tapered file, which can move freely through the apical narrowing after electrometric determination of the working length (Raypex 5 /VDW, Germany/. Results and Discussion: Determination of working width and working length is important for realizing the first stage of decontamination – maximum instrumentation of the endodontic space and choice of a clinical protocol. The classification of root canals in a particular group according to the relative patency or lysed apical opening is important for the selection of obturation technique, which is essential for reducing the microleakage in the zone. Conclusion: Since the target of this work were teeth with CAP, in the majority of the cases with clinical findings of root canals with preexisting filling, radicular pins, obliteration, separated canal instruments, perforations at different levels, via falsa or thresholds, the access to the apical zone was not subjected to a closely observed instrumental clinical protocol. In the treatment of each case, however, the clinical principles of modern endodontic treatment were closely observed.

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

    Science.gov (United States)

    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

  9. Analysis of symptomatic and asymptomatic primary root canal infections in adult Norwegian patients.

    Science.gov (United States)

    Rôças, Isabela N; Siqueira, José F; Debelian, Gilberto J

    2011-09-01

    This molecular study analyzed the microbiota of primary root canal infections from adult Norwegian patients. Samples were taken from the necrotic root canals of teeth with symptomatic (n = 13) or asymptomatic (n = 21) apical periodontitis and chronic apical abscesses (n = 9). DNA was extracted from samples, and bacterial identifications were performed by a closed-ended reverse-capture checkerboard approach targeting 50 candidate endodontic pathogens. Bacterial DNA was detected in all cases. In teeth with asymptomatic apical periodontitis, the most frequent taxa were Dialister invisus (71%), Fusobacterium nucleatum (62%), and Porphyromonas endodontalis (62%). In chronic apical abscesses, the most prevalent taxa were P. endodontalis (100%), D. invisus (89%), Parvimonas micra (78%), and Solobacterium moorei (78%). In teeth with symptomatic apical periodontitis, the most prevalent taxa were D. invisus, P. endodontalis, S. moorei, Propionibacterium acnes, and Streptococcus species (all in 69%). None of the targeted taxa were significantly associated with either sinus tract or pain (P > .05), except for Selenomonas sputigena, which was more frequently found in painful cases (P = .04). No taxa were found in significantly higher levels in any conditions (P > .05). Cluster analyses revealed bacterial groupings that differed between cases with and without pain. Although basically the same species were highly prevalent in the different conditions examined and none of the most prevalent taxa were positively associated with symptoms, results revealed that species formed different partnerships and associations in samples from teeth with or without pain. Therefore, it is possible that more virulent multispecies communities can form as a result of overall bacterial combinations and give rise to acute inflammation. Copyright © 2011 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  10. Influence of the rotary and/or oscillatory reciprocating systems in the morphological changes of narrow and curved molar root canals anatomy

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    Joedy Maria Costa Santa Rosa

    Full Text Available OBJECTIVE: This study evaluated four mechanized Endodontic systems, ProTaper Universal, K3 Endo, Twisted file (rotary and the oscillatory reciprocating system Endo - Eze TiLOS, in order to verify and measure alterations in original anatomy with deviations at cervical, medium and apical root canal thirds. MATERIAL AND METHOD: It was used MB root canals of 60 extract human lower molars, to produce a line of severe angles, according to the classification of Schneider. Samples were included in Ester vinyl resin, mounted in the Teflon Furnace, transversally sectioned at the cervical, middle and apical thirds, which were subsequently photographed using a digital camera Cyber Shot DSC-TX10,attached to an operating microscope 3101XY DFVasconcelos with 40× magnification in order to measure the anatomical transversal area of the root canal, using the software AutoCAD 2008, comparing pre and post-instrumentation. All samples assembled in the Furnace also were submitted to x-ray in a standardized way to enable the comparison of the angle of Schneider pre-and post-instrumentation. Once collected the data, they were compared statistically using the program BioEstat 5.0. RESULT: The analysis of the results showed that in the cervical third, rotary systems were more effective than Endo-Eze TiLOS System with statistically significant differences (p ≤ 0,05. Apical and middle third changes in anatomy were similar, but apically, the ProTaper system caused more deviations when comparing the angle of Schneider,and areas before and after instrumentation(p ≤ 0,05. CONCLUSION: It was concluded that all the systems caused alteration in the original anatomy of the root canal when parameters as angle of Schneider and areas before and after preparation were used.

  11. Effect of customization of master gutta-percha cone on apical control of root filling using different techniques: an ex vivo study.

    Science.gov (United States)

    van Zyl, S P; Gulabivala, K; Ng, Y-L

    2005-09-01

    (i) To compare the prevalence of extrusion of root filling material when placed using different root filling techniques, with or without customization of the master gutta-percha (GP) cone; and (ii) to investigate the effects of some factors influencing root filling extrusion and presence of voids. A total of 180 roots were selected, prepared and randomly allocated to three groups. Five general dental practitioners performed the root fillings; each filled one group of roots (n = 60) using each of three techniques; 'cold lateral compaction' (n = 20), 'warm vertical compaction' (n = 20) and 'continuous-wave' (n = 20) techniques. For each obturation technique, the master GP cone was customized using chloroform in 10 samples. Two groups of the roots were recycled to allow all five operators to fulfill their remit. Two observers, blind to operator and obturation technique, examined the radiographs (master apical file, post-obturation) to determine the presence of root filling extrusion and voids within the apical 5 mm, independently. Root filling extrusion was also confirmed by direct inspection of the root apex after obturation. The data were analysed using logistic regression models. A total of 300 root fillings were performed; nine were excluded from the analysis. Most of the root fillings (80%, n = 233) were placed within 0.5 mm of the working length; only 20% (n = 58) were placed >0.5 mm beyond the working length. The odds of prevalence of extrusion (>0.5 mm) were significantly reduced by about 50% when cold lateral compaction or customization of GP were used. One operator produced 2.5 times more extruded root fillings than others. Curvature & length of root canal, apical size of prepared canal, as well as operator's preferred obturation technique had no significant influence on the prevalence of extrusion. Customization of GP was the sole factor to significantly reduce the prevalence of voids within the apical 5 mm of working length. Root filling extrusion was

  12. The Comparative Efficacy of Different Files in The Removal of Different Sealers in Simulated Root Canal Retreatment- An In-vitro Study.

    Science.gov (United States)

    Kanaparthy, Aruna; Kanaparthy, Rosaiah

    2016-05-01

    Root canal treatment enjoys a high success rate all over the world and has saved billions of teeth from extraction. However, there are instances of failure, the main causes being insufficient cleaning and inadequate obturation. In such cases the most conservative treatment option would be non-surgical retreatment. It requires regaining access to the entire root canal system through removal of the original root canal filling thus permitting further cleaning and re- obturation. Removal of gutta-percha and sealer becomes a critical step to gain access to the root canal system, remove necrotic tissue debris, bacteria and infected dentin. To compare and evaluate the efficacy of manual hand Hedstrom files and two rotary retreatment file systems ProTaper Universal retreatment files and Mtwo(R) (retreatment) files in the removal of root canal filling material during root canal retreatment and the influence of the type of sealers zinc oxide eugenol and AH plus on the presence of remaining debris in the reinstrumented canals in the apical, middle and coronal third. Sixty single rooted human premolar teeth were divided into 3 Groups of 20 teeth each Group I (20 Teeth): prepared using hand K Files, Group II (20 Teeth): prepared using ProTaper rotary system and Group III (20 Teeth): prepared using Mtwo rotary system. In Groups- IA, IIA, IIIA: (10 teeth each) Obturation was done using Zinc Oxide Eugenol sealer and gutta percha. In Groups- IB, IIB, IIIB: (10 teeth each) obturation was done with AH Plus sealer and gutta percha. All the teeth were subjected to retreatment. Groups IA and IB with Hedstrom files, Groups IIA and IIB with ProTaper retreatment files and for Groups IIIA and IIIB with Mtwo retreatment Files. The roots were longitudinally split and were observed under a stereomicroscope for remaining amount of filling material on the canal walls. Statistical analysis was done using One-way ANOVA (Analysis of variance) test and Tukey HSD Test. Mtwo(R) files showed

  13. Efficacy of Different Methods for Removing Root Canal Filling Material in Retreatment - An In-vitro Study.

    Science.gov (United States)

    Kasam, Swetha; Mariswamy, Annapoorna Ballagere

    2016-06-01

    Although success of endodontic therapy has significantly improved in the last few decades due to the introduction of novel materials and techniques, failures of endodontic therapy requiring re-treatment still comprise a significant percentage of patients requiring root canal treatment. To evaluate and compare the effective removal of gutta percha and sealer, amount of apical debris extrusion and time required for gutta percha removal using various endodontic files. Total 48 extracted mandibular premolars were mounted on acrylic blocks and endodontic procedure was carried out using size 40 K file and obturated using guttapercha and zinc oxide eugenol sealer. After one month storage, samples were decoronated, mounted on screw capped vials and subjected to removal of obturated material by four instruments: H files, safe sided H files, protaper universal retreatment rotary system and ultrasonic retreatment tip, grouped as 1, 2, 3, and 4 respectively. Only 2mm of obturated material from the coronal part was removed using no. 3 Gates Glidden drill, guttapercha was softened with a drop of xylene for 2 mins for each canal and retreatment was performed. The retreatment procedure was said to be complete when no visible debris were observed on the instrument flutes. The samples split into two halves and examined under stereomicroscope, photographed, assessed using AUTOCAD software and percentage of remaining filling material in coronal, middle, apical thirds of the canal was calculated in mm(2). Retreatment time was recorded in seconds and apically extruded debris was assessed by microbalance in grams for each tooth. The data was analyzed by using descriptive statistics, ANOVA and Scheffe's post hoc test through SPSS for windows (v 16.0). The ultrasonic retreatment tip had less percentage of residual guttapercha/sealer, shorter mean operating time and little apical extrusion with a significant difference (p<0.05) between the other groups. All techniques retained guttapercha

  14. Healing of apical rarefaction of three nonvital open apex anterior teeth using a white portland cement apical plug

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    Amitabha Chakraborty

    2012-01-01

    Full Text Available The major challenge of performing root canal treatment in an open apex pulp-less tooth is to obtain a good apical seal. MTA has been successfully used to achieve a good apical seal, wherein the root canal obturation can be done immediately. MTA and White Portland Cement has been shown similarity in their physical, chemical and biological properties and has also shown similar outcome when used in animal studies and human trials. In our study, open apex of three non vital upper central incisors has been plugged using modified white Portland cement. 3 to 6 months follow up revealed absence of clinical symptoms and disappearance of peri-apical rarefactions. The positive clinical outcome may encourage the future use of white Portland cement as an apical plug material in case of non vital open apex tooth as much cheaper substitute of MTA.

  15. Floating retained root lesion mimicking apical periodontitis.

    Science.gov (United States)

    Chung, Ming-Pang; Chen, Chih-Ping; Shieh, Yi-Shing

    2009-10-01

    A case of a retained root tip simulating apical periodontitis on radiographic examination is described. The retained root tip, originating from the left lower first molar, floated under the left lower second premolar apical region mimicking apical periodontitis. It appeared as an ill-defined periapical radiolucency containing a smaller radiodense mass on radiograph. The differential diagnosis included focal sclerosing osteomyelitis (condensing osteitis) and ossifying fibroma. Upon exicisional biopsy, a retained root associated with granulation tissue was found. After 1-year follow-up, the patient was asymptomatic and the periradicular lesion was healing. Meanwhile, the associated tooth showed a normal response to stimulation testing.

  16. Comparative analysis of efficacy and cleaning ability of hand and rotary devices for gutta-percha removal in root canal retreatment: an in vitro study.

    Science.gov (United States)

    Reddy, Narender; Admala, Shilpa Reddy; Dinapadu, Sainath; Pasari, Srikanth; Reddy, Manoranjan P; Rao, M S Rama

    2013-07-01

    To evaluate the efficacy and cleaning ability of Hedstrom files, and ProTaper retreatment instruments in removing gutta-percha from root canals with and without xylene as solvent. Sixty extracted single rooted human teeth were selected and decoronated, straight access established working length determined 1 mm short of canal, chemomechanical preparation done and obturated with guttapercha and AH plus sealer. Samples were stored for 1 week in humidifier divided into four groups of 15 teeth each. • Group I: Hedstrom files without xylene. • Group II: Hedstrom files with xylene. • Group III: ProTaper retreatment instruments without xylene. • Group IV: ProTaper retreatment instruments with xylene. and the following criteria were assessed - Time taken for initial plunge of instrument into guttapercha. - Time taken for complete removal of gutta-percha to reach working length - Ability of H files and ProTaper retreatment files with/ without xylene to remove gutta-percha in coronal, middle and apical 1/3 of canal. The teeth were grooved in labiolingual cross section, observed under a steromicroscope and scored according to gutta-percha debris left in the canal. Results were evaluated using ANOVA test and multiple comparisons done using Scheffe test. The least time to reach working length was found with group IV followed by groups III, II and group I respectively. Also the fastest way to remove maximum gutta-percha was group IV followed by groups III, II, and I respectively with a statistically significant difference among all groups. Apical 1/3 has more amount of remaining gutta-percha debris than middle and coronal 1/3 in all groups. The amount of gutta-percha debris in apical 1/3 was least in group IV followed by groups III, II and I respectively. The better performance of ProTaper rotary instruments has been attributed to their special flute design which tends to pull gutta-percha coronally directing it toward orifice. Also the movements of engine driven

  17. Assessment Using AutoCAD Software of the Preparation of Dentin Walls in Root Canals Produced by 4 Different Endodontic Instrument Systems

    Directory of Open Access Journals (Sweden)

    Cristina Cabanillas

    2015-01-01

    Full Text Available Objectives. To compare the effectiveness of four instrument systems for preparing oval root canals: manual instrumentation (Step-Back technique, ProTaper Universal, ProTaper Next, and Wave One. Material and Methods. For the purpose of this assessment, 60 teeth extracted for orthodontic or periodontal reasons, specifically canines and premolars with full coronal and root anatomy, were used and 15 samples were assigned to each group. The section of the canals was compared before and after instrumenting and the section of untouched canal wall was measured using AutoCAD software. The data was analysed by means of Shapiro-Wilk, ANOVA, and Kruskal-Wallis tests. Results. In the apical third, 100% of the canals were prepared with all the systems. In the middle third, a p value of 0.5989 in the Kruskal-Wallis test was obtained, which indicates no significant difference between the groups. At the coronal third level, the results obtained revealed that Wave One had a significantly lower mean average than the rest (p<0.05. Conclusions. There are no differences between the various root canal instrument systems in the apical and middle thirds. At the coronal third level, Wave One system showed performance significantly worse than the rest, among which there were no differences.

  18. Assessment Using AutoCAD Software of the Preparation of Dentin Walls in Root Canals Produced by 4 Different Endodontic Instrument Systems.

    Science.gov (United States)

    Cabanillas, Cristina; Monterde, Manuel; Pallarés, Antonio; Aranda, Susana; Montes, Raquel

    2015-01-01

    Objectives. To compare the effectiveness of four instrument systems for preparing oval root canals: manual instrumentation (Step-Back technique), ProTaper Universal, ProTaper Next, and Wave One. Material and Methods. For the purpose of this assessment, 60 teeth extracted for orthodontic or periodontal reasons, specifically canines and premolars with full coronal and root anatomy, were used and 15 samples were assigned to each group. The section of the canals was compared before and after instrumenting and the section of untouched canal wall was measured using AutoCAD software. The data was analysed by means of Shapiro-Wilk, ANOVA, and Kruskal-Wallis tests. Results. In the apical third, 100% of the canals were prepared with all the systems. In the middle third, a p value of 0.5989 in the Kruskal-Wallis test was obtained, which indicates no significant difference between the groups. At the coronal third level, the results obtained revealed that Wave One had a significantly lower mean average than the rest (p < 0.05). Conclusions. There are no differences between the various root canal instrument systems in the apical and middle thirds. At the coronal third level, Wave One system showed performance significantly worse than the rest, among which there were no differences.

  19. Root canal treatment of a maxillary first premolar with three roots

    OpenAIRE

    Mathew, Josey; Devadathan, Aravindan; Syriac, Gibi; Shamini, Sai

    2015-01-01

    Successful root canal treatment needs a thorough knowledge of both internal and external anatomy of a tooth. Variations in root canal anatomy constitute an impressive challenge to the successful completion of endodontic treatment. Undetected extra roots and canals are a major reason for failed root canal treatment. Three separate roots in a maxillary first premolar have a very low incidence of 0.5?6%. Three rooted premolars are anatomically similar to molars and are sometimes called ?small mo...

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

    Science.gov (United States)

    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.

  1. The validity of cone-beam computed tomography in measuring root canal length using a gold standard

    NARCIS (Netherlands)

    Liang, Y.H.; Jiang, L.; Chen, C.; Gao, X.J.; Wesselink, P.R.; Wu, M.K.; Shemesh, H.

    2013-01-01

    Introduction The distance between a coronal reference point and the major apical foramen is important for working length determination. The aim of this in vitro study was to determine the accuracy of root canal length measurements performed with cone-beam computed tomographic (CBCT) scans using a

  2. Canal Centring Ability of ProTaper and Mtwo Rotary Systems in Curved Canals

    Directory of Open Access Journals (Sweden)

    Turkaydin Dilek Erbay

    2014-07-01

    Full Text Available The purpose of this investigation was to compare centring ratio of ProTaper and Mtwo rotary systems. 60 mandibular molar teeth which had 25, 30 and 35 degree curvature in mesio-buccal root canal were used. Group 1 had 25°, Group 2 had 30°, and Group 3 had 35° curvatures. The roots were sectioned horizontally at 2 mm away from the apex. The apical region was then observed under a stereo-microscope. In each group, teeth were instrumented using ProTaper and Mtwo systems. After canal preparation, digital images of apical part of canals were taken. These images were then superimposed by using Adobe Photoshop CS2 programme. The data were analyzed using ANOVA and Student’s t-test.

  3. Effect of the angle of apical resection on apical leakage, measured with a computerized fluid filtration device.

    Science.gov (United States)

    Garip, Hasan; Garip, Yıldız; Oruçoğlu, Hasan; Hatipoğlu, Seda

    2011-03-01

    We determined the effect of the angle of apical resection on apical leakage using a computerized fluid filtration meter with a laser system and a digital air pressure regulator in 46 extracted single-rooted human teeth. Orthograde endodontic treatment was performed. The root canals were prepared up to a size 50 K-type file with 17% EDTA solution (Roth International, Chicago, IL) and 5% NaOCl solution as the irrigant. Gates Glidden burs (Maillefer Instruments, Ballaigues, Switzerland) were used to flare the coronal two thirds of the canal. All canals were dried with paper points and then obturated using cold lateral condensation (except for the positive controls) of gutta-percha points and AH plus (Dentsply DeTrey, Konstanz, Germany). All 40 roots were sectioned 3 mm from the apex. Forty teeth were assigned randomly into 1 of 4 experimental groups of 10 teeth each: in group 1, the teeth were resected apically (90° angle) and the cavities were obturated with mineral trioxide aggregate (MTA); in group 2, after apical resection (90° angle), a root-end cavity was prepared using ultrasonic diamond retrotips and the cavities were obturated with MTA; in group 3, the teeth were resected apically (∼45° angle) and the cavities were obturated with MTA; and in group 4, after apical resection (∼45° angle), a root-end cavity was prepared using ultrasonic diamond retrotips and the cavities were obturated with MTA. An additional 6 teeth were used as controls (3 each, negative and positive controls). Apical leakage was measured using a computerized fluid filtration meter with a laser system. The mean apical microleakage was 2.0 ± 0.4 × 10(-4), 1.6 ± 0.6 × 10(-4), 1.6 ± 0.9 × 10(-4), and 1.8 ± 0.7 × 10(-4) μL/cmH(2)O/min(-1) at 1.2 atm, in groups 1 to 4, respectively. Although the mean apical microleakage was greater in group 1, the differences among the 4 groups were not statistically significant (P > .05). The results of these in vitro studies showed that when an

  4. Root canal treatment of bilateral three-rooted maxillary first premolars

    Directory of Open Access Journals (Sweden)

    Bhavana Gandhi

    2012-01-01

    Full Text Available In endodontics, several anatomic variations occur in teeth, both externally and in the internal root morphology, which play a very significant role in the diagnosis and treatment outcome. A thorough knowledge of the root canal anatomy, careful interpretation of the angled radiographs, proper endodontic access cavity preparation, and exploration of the root canal are the prerequisites for endodontic success. In a maxillary first premolar, it is rare to find extra roots and canals, and the aim of the present article is to report a case about the successful diagnosis and clinical management of bilateral three-rooted maxillary first premolars, with three independent root canals.

  5. 21 CFR 872.3810 - Root canal post.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Root canal post. 872.3810 Section 872.3810 Food... DEVICES DENTAL DEVICES Prosthetic Devices § 872.3810 Root canal post. (a) Identification. A root canal... of the platinum group intended to be cemented into the root canal of a tooth to stabilize and support...

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

    Science.gov (United States)

    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.

  7. Evaluation of smear layer removal and marginal adaptation of root canal sealer after final irrigation using ethylenediaminetetraacetic, peracetic, and etidronic acids with different concentrations.

    Science.gov (United States)

    Ulusoy, Özgür İlke; Zeyrek, Salev; Çelik, Bülent

    2017-07-01

    The purpose of this study was to investigate the effects of different irrigation solutions on the smear layer removal and marginal adaptation of a resin-based sealer to root canal dentine. A total of 152 instrumented roots were irrigated with the following irrigants: 9,18% etidronic acid (HEBP), 0.5, 1,2% peracetic acid (PAA), 17% ethylenediaminetetraacetic acid (EDTA), saline. The amount of smear layer was evaluated using scanning electron microscope (SEM) in seventy root samples. Eighty-two roots were filled with AH Plus and gutta-percha. Slices obtained from apical third of each specimen were viewed with SEM to assess marginal adaptation. Use of 9% and 18% HEBP resulted in more efficient smear layer removal in the apical third than the other chelators (p acid is a promising candidate for final irrigation of root canals. © 2017 Wiley Periodicals, Inc.

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

    Science.gov (United States)

    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.

  9. Quantitative assessment of apical debris extrusion and intracanal debris in the apical third, using hand instrumentation and three rotary instrumentation systems.

    Science.gov (United States)

    H K, Sowmya; T S, Subhash; Goel, Beena Rani; T N, Nandini; Bhandi, Shilpa H

    2014-02-01

    Decreased apical extrusion of debris and apical one third debris have strong implications for decreased incidence of postoperative inflammation and pain. Thus, the aim of this study was to assess quantitatively the apical extrusion of debris and intracanal debris in the apical third during root canal instrumentation using hand and three different types of rotary instruments. Sixty freshly extracted single rooted human teeth were randomly divided into four groups. Canal preparation was done using step-back with hand instrumentation, crown-down technique with respect to ProTaper and K3, and hybrid technique with LightSpeed LSX. Irrigation was done with NaOCl, EDTA, and normal saline and for final irrigation, EndoVac system was used. The apically extruded debris was collected on the pre-weighed Millipore plastic filter disk and weighed using microbalance. The teeth were submitted to the histological processing. Sections from the apical third were analyzed by a trinocular research microscope that was coupled to a computer where the images were captured and analyzed using image proplus V4.1.0.0 software. The mean weight of extruded debris for each group and intracanal debris in the root canal was statistically analyzed by a Kruskal-Wallis one-way analysis of variance and Mann-Whitney U test. The result showed that, hand instrumentation using K files showed the highest amount of debris extrusion apically when compared to ProTaper, K3 and LightSpeed LSX. The result also showed that there was no statistically significant difference between the groups in relation to presence of intracanal debris in the apical one third. Based on the results, all instrumentation techniques produced debris extrusion. The engine driven Ni-Ti systems extruded significantly less apical debris than hand instrumentation. There was no statistically significant difference between the groups in relation to presence of intracanal debris in the apical one third.

  10. Apical Revascularization after Delayed Tooth Replantation: An Unusual Case

    Directory of Open Access Journals (Sweden)

    Marília Pacífico Lucisano

    2016-01-01

    Full Text Available The aim of this paper is to present the clinical and radiological outcome of the treatment involving a delayed tooth replantation after an avulsed immature permanent incisor, with a follow-up of 1 year and 6 months. An 8-year-old boy was referred after dental trauma that occurred on the previous day. The permanent maxillary right central incisor (tooth 11 had been avulsed. The tooth was hand-held during endodontic therapy and an intracanal medication application with calcium hydroxide-based paste was performed. An apical plug with mineral trioxide aggregate (MTA was introduced into the apical portion of the canal. When the avulsed tooth was replanted with digital pressure, a blood clot had formed within the socket, which moved the MTA apical plug about 2 mm inside of the root canal. These procedures developed apical revascularization, which promoted a successful endodontic outcome, evidenced by apical closure, slight increase in root length, and absence of signs of external root resorption, during a follow-up of 1 year and 6 months.

  11. Revascularization and Apical Plug in an Immature Molar

    Science.gov (United States)

    Roghanizadeh, Leyla; Fazlyab, Mahta

    2018-01-01

    Managing of necrotic permanent teeth with immature apices is a treatment challenges. Treatment of such teeth includes apexification, apical plug and more recently, revascularization technique with the probable advantage of continuation of root development. In the present case report the referred patient had discomfort with a necrotic immature mandibular first molar. Periapical radiography showed a rather large apical lesion around immature roots. Revascularization protocol using calcium-enriched mixture (CEM) cement was indicated for the mesial root. However, in distal canal apical plug technique was applied. At 2-year follow-up, both procedures were successful in relieving patient’s symptoms. Dentin formation and increase in length of the mesial root was obvious. Apical plug and revascularization technique proved to be successful in management of necrotic immature teeth; moreover, revascularization carried the advantage of continuation of root development. PMID:29692851

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

  15. One- versus two-visit endodontic treatment of teeth with apical periodontitis: a histobacteriologic study.

    Science.gov (United States)

    Vera, Jorge; Siqueira, José F; Ricucci, Domenico; Loghin, Simona; Fernández, Nancy; Flores, Belina; Cruz, Alvaro G

    2012-08-01

    This study analyzed the in vivo microbiological status of the root canal systems of mesial roots of mandibular molars with primary apical periodontitis after 1- or 2-visit endodontic treatment. Mesial root canals were instrumented by using either a combination of K3 and LightSpeed instruments (mesiobuccal canals) or the ProTaper system (mesiolingual canals), with 5% NaOCl irrigation. Patency files were used. Smear layer was removed, and a final rinse with 5 mL of 2% chlorhexidine was performed. In the 2-visit group (7 roots, 14 canals), canals were medicated with calcium hydroxide for 1 week and then obturated by using the continuous wave of compaction technique. In the 1-visit group (6 roots, 12 canals), canals were immediately obturated after chemomechanical procedures. Teeth were extracted 1 week after root canal instrumentation and processed for histobacteriologic analysis. In the 1-visit group, no case was completely free of bacteria; residual bacteria occurred in the main root canal (5 of 6 cases), isthmus (5 of 6), apical ramifications (4 of 6), and dentinal tubules (5 of 6). In the 2-visit group, 2 cases were rendered bacteria-free; residual bacteria were found in the main canal only in 2 cases (none of them with persistent dentinal tubule infection), in the isthmus (4 of 7 cases), and in ramifications (2 of 7). The 2 instrumentation techniques performed similarly. When filling material was observed in ramifications, it was usually intermixed with necrotic tissue, debris, and bacteria. The 2-visit protocol by using an interappointment medication with calcium hydroxide resulted in improved microbiological status of the root canal system when compared with the 1-visit protocol. Residual bacteria were more frequent and abundant in ramifications, isthmuses, and dentinal tubules when root canals were treated without an interappointment medication. Apical ramifications and isthmuses were never completely filled. The use of an antibacterial interappointment agent

  16. 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

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    Jussaro Alves DUQUE

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

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

    Science.gov (United States)

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

    2017-01-01

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

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

    Directory of Open Access Journals (Sweden)

    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.

  1. Changes of Root Length and Root-to-Crown Ratio after Apical Surgery

    DEFF Research Database (Denmark)

    von Arx, Thomas; Jensen, Simon S; Bornstein, Michael M

    2015-01-01

    INTRODUCTION: Apical surgery is an important treatment option for teeth with post-treatment periodontitis. Although apical surgery involves root-end resection, no morphometric data are yet available about root-end resection and its impact on the root-to-crown ratio (RCR). The present study assess...

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

    Directory of Open Access Journals (Sweden)

    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.

  3. Comparison of radiographic density and compaction index of root canal obturation using nickel titanium or stainless-steel spreaders

    Directory of Open Access Journals (Sweden)

    M. Adel

    2016-08-01

    Full Text Available Background: Both nickel titanium and stainless-steel spreaders are available. The obvious advantage of nickel titanium spreader over stainless steel spreaders is greater penetration in curved canals. Objective: To compare the radiographic density and compaction index of root canal obturation using nickel-titanium or stainless-steel spreaders in curved canals. Methods: In this experimental study the primary weight of 30 acrylic blocks with 45o degrees of apical curvature were measured by a scale (W1. After canals were prepared by step back master apical up to file #30 all blocks were weighed again (W2 and randomly divided in two groups of 15each. All canals were obturated by Cold lateral compaction technique (with nickel-titanium in one group and stainless-steel finger spreaders in another group. After all blocks were reweighed (W3, compaction index (W3-W2/W1-W2 was calculated. One radiograph was taken for each sample. Apical density of the apical third of each canal was measured by digital transmission densitometer. Data were analyzed statistically using T-test. Findings: Mean compaction index for nickel-titanium group was 7.67±2.38 and for stainless-steel group was 9.14±4.06. There was no significant difference between two groups. Mean radiographic density of obturation was 2.05±0.14 in nickel-titanium group and was 2.07±0.21 in stainless-steel group. There was no significant difference between two groups. Conclusion: It is concluded that nickel-titanium spreaders are not superior than stainless-steel spreaders in obturating curved canal.

  4. Comparison of the Effect of Canal Preparation by Step Back Technique Using Hand Instruments and Gates Glidden Drills with ProTaper Universal Rotary System on the Root Resistance to Vertical Fracture

    OpenAIRE

    A Abbaszadegan; Z Sadat Aleyasin; M Sedigh Shamsi; Sh Shahriari

    2013-01-01

    Introduction: Cleaning and shaping of the root canal system with an efficient and safe technique are the major goals of root canal treatment. The aim of this study was to compare the conventional root canal preparation technique by hand instruments and Gates Glidden drills with ProTaper Universal Rotary system on the root susceptibility to vertical fracture. Methods: Thirty extracted human mandibular premolars were randomly assigned to two groups. In group I, apical preparation was performed ...

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

    Science.gov (United States)

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

    2016-01-01

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

  6. Assessment of three root canal preparation techniques on root canal geometry using micro-computed tomography: In vitro study

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    Shaikha M Al-Ali

    2012-01-01

    Full Text Available Aim: To assess the effects of three root canal preparation techniques on canal volume and surface area using three-dimensionally reconstructed root canals in extracted human maxillary molars. Materials and Methods: Thirty extracted Human Maxillary Molars having three separate roots and similar root shape were randomly selected from a pool of extracted teeth for this study and stored in normal saline solution until used. A computed tomography scanner (Philips Brilliance CT 64-slice was used to analyze root canals in extracted maxillary molars. Specimens were scanned before and after canals were prepared using stainless steel K-Files, Ni-Ti rotary ProTaper and rotary SafeSiders instruments. Differences in dentin volume removed, the surface area, the proportion of unchanged area and canal transportation were calculated using specially developed software. Results: Instrumentation of canals increased volume and surface area. Statistical analysis found a statistically significant difference among the 3 groups in total change in volume (P = 0.001 and total change in surface area (P = 0.13. Significant differences were found when testing both groups with group III (SafeSiders. Significant differences in change of volume were noted when grouping was made with respect to canal type (in MB and DB (P < 0.05. Conclusion: The current study used computed tomography, an innovative and non destructive technique, to illustrate changes in canal geometry. Overall, there were few statistically significant differences between the three instrumentation techniques used. SafeSiders stainless steel 40/0.02 instruments exhibit a greater cutting efficiency on dentin than K-Files and ProTaper. CT is a new and valuable tool to study root canal geometry and changes after preparation in great details. Further studies with 3D-techniques are required to fully understand the biomechanical aspects of root canal preparation.

  7. Three-rooted premolar analyzed by high-resolution and cone beam CT.

    Science.gov (United States)

    Marca, Caroline; Dummer, Paul M H; Bryant, Susan; Vier-Pelisser, Fabiana Vieira; Só, Marcus Vinicius Reis; Fontanella, Vania; Dutra, Vinicius D'avila; de Figueiredo, José Antonio Poli

    2013-07-01

    The aim of this study was to analyze the variations in canal and root cross-sectional area in three-rooted maxillary premolars between high-resolution computed tomography (μCT) and cone beam computed tomography (CBCT). Sixteen extracted maxillary premolars with three distinct roots and fully formed apices were scanned using μCT and CBCT. Photoshop CS software was used to measure root and canal cross-sectional areas at the most cervical and the most apical points of each root third in images obtained using the two tomographic computed (CT) techniques, and at 30 root sections equidistant from both root ends using μCT images. Canal and root areas were compared between each method using the Student t test for paired samples and 95 % confidence intervals. Images using μCT were sharper than those obtained using CBCT. There were statistically significant differences in mean area measurements of roots and canals between the μCT and CBCT techniques (P < 0.05). Root and canal areas had similar variations in cross-sectional μCT images and became proportionally smaller in a cervical to apical direction as the cementodentinal junction was approached, from where the area then increased apically. Although variation was similar in the roots and canals under study, CBCT produced poorer image details than μCT. Although CBCT is a strong diagnosis tool, it still needs improvement to provide accuracy in details of the root canal system, especially in cases with anatomical variations, such as the three-rooted maxillary premolars.

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

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    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

  9. 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

  10. Calcium hydroxide as intracanal dressing for teeth with apical periodontitis

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    Sari Dewiyani

    2011-03-01

    Full Text Available Background: Root canal infection and periapical diseases are caused by bacteria and their products. Long term infection may spread bacteria throughout the root canal system. Apical periodontitis caused by infectious microbe that persistent in root canals can cause radiographic and histopathology periapical changes. Chemomechanical preparation and intracanal dressing then are recommended to be conducted and used in between visits to eliminate microbes in root canals. Calcium hydroxide (Ca(OH2 can be used as intracanal dressing since it can be used as musical physical defense barrier to eliminate re-infection in root canal and to disturb nutrition supply for bacterial development. Purpose: The aim of this study is observe the effectiveness of Ca(OH2 in treating endodontic teeth with apical periodontitis. Cases: Case 1 and 3 are about patients whose left posterior mandibular teeth had spontaneous intermittent pain. Case 2 is about a patient whose left posterior maxillary teeth had gingival abscess and fracture history. Based on the radiographic examination, it was known that the filling of root canal was incomplete and there was radiolucency in the apical area. Case management: The cases were treated with triad endodontics, which involves preparation, disinfection by using 2.5% NaOCl as irrigation substance and calcium hydroxide as intracanal dressing, and then the filling of root canal with gutta percha and endomethasone root canal cement. Evaluations were conducted one month, 12 months, and 24 months after the treatment. Conclusion: Calcium hydroxide is effective to be used as intracanal dressing in apical periodontitis cases.Latar belakang: Infeksi saluran akar dan penyakit periapeks disebabkan oleh mikroba dan produknya. Infeksi yang berlangsung lama memungkinkan bakteri masuk ke dalam seluruh sistem saluran akar. Periodontitis apikal disebabkan oleh infeksi persisten mikroba di dalam sistem saluran akar disertai perubahan radiografik dan

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

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    Nair, P N R

    2004-11-01

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

  12. How far is the root apex of a unilateral impacted canine from the root apices' arch form?

    Science.gov (United States)

    Kim, Sung-Hun; Kim, You-Min; Oh, Sewoong; Kim, Seong-Sik; Park, Soo-Byung; Son, Woo-Sung; Kim, Yong-Il

    2017-02-01

    The purpose of this study was to determine the arch form of the root apices of normally erupting teeth and then determine the differences in the location of the apex of impacted canines relative to normally erupting canines. In addition, we sought to determine whether the labiopalatal position of the impacted canines influences the position of the apices. The study included 21 patients with unerupted canines that subsequently had a normal eruption, 21 patients with palatally impacted canines, 27 patients with labially impacted canines, and 17 patients with midalveolus impacted canines. Images were obtained using cone beam computed tomography, and the x, y, and z coordinates of the root apices were determined using Ondemand3D software (Cybermed Co., Seoul, Korea). Two-dimensional coordinates were converted from acquired 3-dimensional coordinates via projection on a palatal plane, and the Procrustes method was used to process the converted 2-dimensional coordinates and to draw the arch forms of the root apices. Finally, we measured the extent of root apex deviation from the arch forms of the root apices. Normally erupting canines showed that even though calcifications may be immature, their positions were aligned with a normal arch form. The root apices of the impacted canines were an average of 6.572 mm away from the root apices' arch form, whereas those of the contralateral nonimpacted canines were an average distance of 2.221 mm away, a statistically significant difference. The palatally impacted canines' root apices distribution tended toward the first premolar root apices. Incompletely calcified, unerupted teeth with a subsequent normal eruption showed a normal arch form of the root apices. The root apices of impacted canines were farther from the arch forms than were the nonimpacted canines. Also, the root apices of impacted canines in the palatal area showed distributions different from those of the other impacted canine groups. Copyright © 2017 American

  13. Incidence of apical crack initiation and propagation during the removal of root canal filling material with ProTaper and Mtwo rotary nickel-titanium retreatment instruments and hand files.

    Science.gov (United States)

    Topçuoğlu, Hüseyin Sinan; Düzgün, Salih; Kesim, Bertan; Tuncay, Oznur

    2014-07-01

    The aim of this study was to determine the incidence of crack initiation and propagation in apical root dentin after retreatment procedures performed by using 2 rotary retreatment systems and hand files with additional instrumentation. Eighty extracted mandibular premolars with single canals were selected. One millimeter from the apex of each tooth was ground perpendicular to the long axis of the tooth, and the apical surface was polished. Twenty teeth served as the control group, and no preparation was performed. The remaining 60 teeth were prepared to size 35 with rotary files and filled with gutta-percha and AH Plus sealer. Specimens were then divided into 3 groups (n = 20), and retreatment procedures were performed with the following devices and techniques: ProTaper Universal retreatment files, Mtwo retreatment files, and hand files. After retreatment, the additional instrumentation was performed by using size 40 ProTaper, Mtwo, and hand files. Digital images of the apical root surface were recorded before preparation, after instrumentation, after filling, after retreatment, and after additional instrumentation. The images were then inspected for the presence of any new apical cracks and propagation. Data were analyzed with the logistic regression and Fisher exact tests. All experimental groups caused crack initiation and propagation after use of retreatment instruments. The ProTaper and Mtwo retreatment groups caused greater crack initiation and propagation than the hand instrument group (P ProTaper and Mtwo instruments after the use of retreatment instruments caused crack initiation and propagation, whereas hand files caused neither crack initiation nor propagation (P < .05). This study showed that retreatment procedures and additional instrumentation after the use of retreatment files may cause crack initiation and propagation in apical dentin. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

    Aguiar, Carlos M; Câmara, Andréa C

    2008-12-01

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

  15. Incidence of apical crack formation and propagation during removal of root canal filling materials with different engine driven nickel-titanium instruments

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    Taha Özyürek

    2017-11-01

    Full Text Available Objectives To determine the incidence of crack formation and propagation in apical root dentin after retreatment procedures performed using ProTaper Universal Retreatment (PTR, Mtwo-R, ProTaper Next (PTN, and Twisted File Adaptive (TFA systems. Materials and Methods The study consisted of 120 extracted mandibular premolars. One millimeter from the apex of each tooth was ground perpendicular to the long axis of the tooth, and the apical surface was polished. Twenty teeth served as the negative control group. One hundred teeth were prepared, obturated, and then divided into 5 retreatment groups. The retreatment procedures were performed using the following files: PTR, Mtwo-R, PTN, TFA, and hand files. After filling material removal, apical enlargement was done using apical size 0.50 mm ProTaper Universal (PTU, Mtwo, PTN, TFA, and hand files. Digital images of the apical root surfaces were recorded before preparation, after preparation, after obturation, after filling removal, and after apical enlargement using a stereomicroscope. The images were then inspected for the presence of new apical cracks and crack propagation. Data were analyzed with χ2 tests using SPSS 21.0 software. Results New cracks and crack propagation occurred in all the experimental groups during the retreatment process. Nickel-titanium rotary file systems caused significantly more apical crack formation and propagation than the hand files. The PTU system caused significantly more apical cracks than the other groups after the apical enlargement stage. Conclusions This study showed that retreatment procedures and apical enlargement after the use of retreatment files can cause crack formation and propagation in apical dentin.

  16. Incidence of apical crack formation and propagation during removal of root canal filling materials with different engine driven nickel-titanium instruments.

    Science.gov (United States)

    Özyürek, Taha; Tek, Vildan; Yılmaz, Koray; Uslu, Gülşah

    2017-11-01

    To determine the incidence of crack formation and propagation in apical root dentin after retreatment procedures performed using ProTaper Universal Retreatment (PTR), Mtwo-R, ProTaper Next (PTN), and Twisted File Adaptive (TFA) systems. The study consisted of 120 extracted mandibular premolars. One millimeter from the apex of each tooth was ground perpendicular to the long axis of the tooth, and the apical surface was polished. Twenty teeth served as the negative control group. One hundred teeth were prepared, obturated, and then divided into 5 retreatment groups. The retreatment procedures were performed using the following files: PTR, Mtwo-R, PTN, TFA, and hand files. After filling material removal, apical enlargement was done using apical size 0.50 mm ProTaper Universal (PTU), Mtwo, PTN, TFA, and hand files. Digital images of the apical root surfaces were recorded before preparation, after preparation, after obturation, after filling removal, and after apical enlargement using a stereomicroscope. The images were then inspected for the presence of new apical cracks and crack propagation. Data were analyzed with χ 2 tests using SPSS 21.0 software. New cracks and crack propagation occurred in all the experimental groups during the retreatment process. Nickel-titanium rotary file systems caused significantly more apical crack formation and propagation than the hand files. The PTU system caused significantly more apical cracks than the other groups after the apical enlargement stage. This study showed that retreatment procedures and apical enlargement after the use of retreatment files can cause crack formation and propagation in apical dentin.

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

    Science.gov (United States)

    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.

  18. Influence of a passive sonic irrigation system on the elimination of bacteria from root canal systems: a clinical study.

    Science.gov (United States)

    Huffaker, S Kirk; Safavi, Kamran; Spangberg, Larz S W; Kaufman, Blythe

    2010-08-01

    The present investigation evaluated the ability of a new passive sonic irrigation (sonic group) system (EndoActivator) to eliminate cultivable bacteria from root canals in vivo and compared it with that of standard syringe irrigation (control group). Data were obtained by using bacteriologic sampling of root canals treated by endodontic residents. Sampling results from 1 session of treatment were then compared with results obtained after intervisit calcium hydroxide disinfection and a second session of treatment. There was no significant difference in the ability of sonic group and control group to eliminate cultivable bacteria from root canals (P > .05). A second session and intervisit calcium hydroxide disinfection were able to eliminate cultivable bacteria from significantly more teeth than a single session of treatment (P treatment of apical periodontitis. Copyright 2010 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  19. The Accuracy of the Digital imaging system and the frequency dependent type apex locator in root canal length measurement

    International Nuclear Information System (INIS)

    Lee, Byoung Rib; Park, Chang Seo

    1998-01-01

    In order to achieve a successful endodontic treatment, root canals must be obturated three-dimensionally without causing any damage to apical tissues. Accurate length determination of the root canal is critical in this case. For this reason, I've used the conventional periapical radiography, Digora (digital imaging system) and Root ZX (the frequency dependent type apex locator) to measure the length of the canal and compare it with the true length obtained by cutting the tooth in half and measuring the length between the occlusal surface and the apical foramen. From the information obtained by these measurements, I was able to evaluate the accuracy and clinical usefulness of each systems, whether the thickness of files used in endodontic therapy has any effect on the measuring systems was also evaluated in an effort to simplify the treatment planning phase of endodontic treatment. 29 canals of 29 sound premolars were measured with no 15, no 20, no 25 files by 3 different dentists each using the periapical radiography, Digora and Root ZX. The measurements were then compared with the true length. The results were as follows ; 1. In comparing mean discrepancies between measurements obtained by using periapical radiography (mean error : -0.449 ± 0.444 mm), Digora (mean error : -0.417 ± 0.415 mm) and Root ZX (mean error : 0.123 ± 0.458 mm) with true length, periapical radiography and Digora system had statistically significant differences (p 0.05). 2. By subtracting values obtained by using periapical radiography, Digora and Root ZX from the true length and making a distribution table of their absolute values, the following analysis was possible. In the case of periapical film, 140 out of 261 (53.6%) were clinically acceptable satisfying the margin of error of less than 0.5 mm, 151 out of 261 (53,6%) were acceptable in the Digora system while Root ZX had 197 out of 261 (75.5%) within the limits of 0.5 mm margin of error. 3. In determining whether the thickness of

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

    Science.gov (United States)

    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.

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

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    Clarissa Teles Rodrigues

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

  2. Conservative treatment of immature teeth with apical periodontitis using triple antibiotic paste disinfection

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    Hsin-Ju Wang

    2016-06-01

    Full Text Available The purpose of this report is to present conservative treatment for two immature premolars with apical periodontitis. A triple antibiotic paste was used to disinfect the root canal systems for revascularization. In both cases, residual vital pulp tissue was noted in the root canal system after the opening of each premolar. The canals in both cases were irrigated with copious sodium hypochlorite solution and medicated with a paste consisting of ciprofloxacin, metronidazole, and minocycline. The teeth were sealed with mineral trioxide aggregate and restored with composite resin. There were satisfactory outcomes after 18 months. The patients were asymptomatic, with radiographic evidence of complete resolution of radiolucency, continual thickening of dentinal walls, apical closure, and increased root length.

  3. Effect of calcium hydroxide and double and triple antibiotic pastes on the bond strength of epoxy resin-based sealer to root canal dentin.

    Science.gov (United States)

    Akcay, Merve; Arslan, Hakan; Topcuoglu, Hüseyin Sinan; Tuncay, Oznur

    2014-10-01

    The aim of this study was to evaluate the effects of calcium hydroxide (CH) and triple (TAP) and double (DAP) antibiotic pastes on the bond strength of an epoxy resin-based sealer (AH Plus Jet; Dentsply DeTrey, Konstanz, Germany) to the root canal dentin. Sixty-four single-rooted human mandibular premolars were decoronated and prepared using the rotary system to size 40. The specimens were randomly divided into a control group (without intracanal dressing) and 3 experimental groups that received an intracanal dressing with either CH, DAP, or TAP (n = 16). The intracanal dressing was removed by rinsing with 10 mL 17% EDTA followed by 10 mL 2.5% sodium hypochlorite. The root canals were then obturated with gutta-percha and AH Plus Jet sealer. A push-out test was used to measure the bond strength between the root canal dentin and the sealer. The data were analyzed using 2-way analysis of variance and Tukey post hoc tests to detect the effect of the independent variables (intracanal medicaments and root canal thirds) and their interactions on the push-out bond strength of the root canal filling material to the root dentin (P = .05). The push-out bond strength values were significantly affected by the intracanal medicaments (P .05). In the middle and apical third, the bond strength of the TAP group was higher than those of the CH and DAP groups (P < .05). The DAP and CH did not affect the bond strength of the epoxy resin-based sealer. Additionally, the TAP improved the bond strength of the epoxy resin-based sealer in the middle and apical thirds. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  4. 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

    Directory of Open Access Journals (Sweden)

    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

  5. [A retrospective study of 180 cases of apical microsurgery].

    Science.gov (United States)

    Wang, Hanguo; Li, Dan; Tian, Yu; Yu, Qing

    2014-07-01

    To evaluate the outcome and the potential prognostic factors of apical microsurgery. The teeth with persistent periapical diseases were treated by microsurgery using micro instruments, ultrasonic retrotips and mineral trioxide aggregate (MTA) under dental operate microscope. The procedure includes incision and flap retraction, osteotomy, apicoectomy, retro- preparation and retro- filling of root canal. Patients were recalled at 1, 3, 6, and 12- month intervals. The outcome was evaluated by clinical and radiographic examinations, and the potential prognostic factors were analyzed. One hundred and eighty cases (240 teeth), including 132 upper anterior teeth, 22 lower anterior teeth, 31 upper premolars, 18 lower premolars, 19 upper molars and 18 lower molars, were treated by microsurgery between July 2010 and December 2012. A total of 152 cases (207 teeth) were recalled. The application of the apical microsurgery included failure of previous endodontic treatment, periapical lesion with post, periapical cyst, calcified canals, separated instruments, overfilling, open apex, root facture, failure of previous apical surgery, apical fenestration, and special root canal system. The success rate was 90.8% (188/207). Age, sex, tooth position, type of periapical radiolucency, fistula and clinical application type appeared to have a negative effect on the outcome. Endo-perio lesion was a significant factor. Eighteen cases (19 teeth) failed mainly because of periodontally involved lesion and vertical root fracture. Apical microsurgery, which combines the magnification and illumination provided by the microscope with the proper use of micro instruments, can treat the teeth with persistent periapical diseases precisely and less traumatically with high success rate. Case selection and standardized operations play a key role for success.

  6. Dental Pulp Revascularization of Necrotic Permanent Teeth with Immature Apices.

    Science.gov (United States)

    El Ashiry, Eman A; Farsi, Najat M; Abuzeid, Sawsan T; El Ashiry, Mohamed M; Bahammam, Hammam A

    The treatment of immature necrotic teeth with apical periodontitis presents challenges in endodontic and pediatric dentistry. Revascularization is a recent treatment for such cases as an alternative to conventional apexification. The purpose is to examine the effect of a pulpal revascularization procedure on immature necrotic teeth with apical periodontitis. Twenty patients were enrolled for pulp revascularization procedure by root canal disinfection using a triple antibiotic mixture for 1-2 weeks, followed by creating a blood clot, sealing the root canal orifice using white mineral trioxide aggregate and a coronal seal of composite resin. Patients were recalled periodically for up to 24 months. During follow-up, all patients were asymptomatic. Three cases of chronic apical periodontitis showed clinical disappearance of the sinus tract 2 weeks after treatment. Radiography revealed progressive periapical radiolucency resolution within the first 12 months. Within 12-24 months, the treated teeth showed progressive increases in dentinal wall thickness, root length and continued root development. Clinical and radiographic evidence showed successful revascularization treatments of immature necrotic permanent teeth with apical periodontitis. More studies are necessary to understand the underlying mechanisms and to perform histopathology of the pulp space contents after revascularization procedures.

  7. The cleanliness differences of root canal walls after irrigated with East Java propolis extract and sodium hypoclorite solutions

    Directory of Open Access Journals (Sweden)

    Tamara Yuanita

    2017-03-01

    (n=10. The specimens were prepared with ProTaper. During instrumentation, the root canals were irrigated with different solutions: Control Group irrigated with aquadest; Group 1 irrigated with 8% East Java propolis extract; Group 2 irrigated with 2.5% NaOCl and Group 3 irrigated with 5% NaOCl. The root canals were cut at apical third and SEM scores were tested by using Mann-Whitney test at the significance level of p=0.05 and Median Control test. Result: The results of Mann-Whitney Test, there were significant differences between control group with Group 1, 2 and 3 (p<0.05. Based on the Median Control test, the value of 8% East Java propolis extracts was 1,000, which was the best value compared to 2.5% NaOCl, 5% NaOCl and aquadest. Conclusion: It can be concluded that 8% East Java propolis extract is the most effective solution for cleaning root canal walls compared with 2.5% NaOCl and 5% NaOCl.

  8. Apical extrusion of debris using reciprocating files and rotary ...

    African Journals Online (AJOL)

    Procedure: Sixty extracted human mandibular premolars were used. The root canals were instrumented using reciprocating (WaveOne, Reciproc, SafeSider) or rotary ... and cross‑sections, and kinematics, and this situation may influence the amount of apically extruded debris through the apical foramen.[15]. The aim of this ...

  9. An in vitro comparison of root canal transportation by reciproc file with and without glide path.

    Science.gov (United States)

    Nazarimoghadam, Kiumars; Daryaeian, Mohammad; Ramazani, Nahid

    2014-09-01

    The aim of ideal canal preparation is to prevent iatrogenic aberrations such as transportation. The aim of this study was to evaluate the root canal transportation by Reciproc file with and without glide path. Thirty acrylic-resin blocks with a curvature of 60° and size#10 (2% taper) were assigned into two groups (n= 15). In group 1, the glide path was performed using stainless steel k-files size#10 and 15 at working length In group 2, canals were prepared with Reciproc file system at working length. By using digital imaging software (AutoCAD 2008), the pre-instrumentation and post-instrumentation digital images were superimposed over, taking the landmarks as reference points. Then the radius of the internal and external curve of the specimens was calculated at three α, β and γ points (1mm to apex as α, 3mm to apex as β, and 5mm to apex as γ). The data were statically analyzed using the independent T-test and Mann-Whitney U test by SPSS version 16. Glide path was found significant for only external curve in the apical third of the canal; that is, 5mm to apex (P=0.005). But in the other third, canal modification was not significant (P> 0.008). Canal transportation in the apical third of the canal seems to be significantly reduced when glide path is performed using reciprocating files.

  10. Ex vivo analysis of root canal cleaning using Endo-PTC associated to NaOCl and different irrigant solutions

    Directory of Open Access Journals (Sweden)

    Andrea Kanako Yamazaki

    2010-03-01

    Full Text Available The aim of this study was to assess qualitatively, by means of SEM images, the cleaning of the dentin walls of root canals after chemical-surgical preparation using Endo-PTC cream with 0.5% and 1% sodium hypochlorite and different final irrigating solutions. Seventy-two single-rooted human teeth were divided into eight groups and prepared using Endo-PTC cream with sodium hypochlorite (NaOCl at different concentrations, and irrigated with NaOCl at different concentrations. Final irrigation was performed with either EDTA-T or EDTA-C. The best results were obtained with Group 1, followed by Groups 5, 2, 7, 8, 3, 6 and 4. We can conclude that the use of 0.5% NaOCl during instrumentation and final flush of the root canals was more efficient in cleaning than was 1% sodium hypochlorite. EDTA-T was more efficient in removing smear layer than EDTA-C, and the cervical third presented better cleaning of the root canal walls than did the middle third, which showed cleaner dentin walls than the apical third.

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

    Science.gov (United States)

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

    2007-06-01

    To evaluate the relationship between IL-1beta and clinical findings of chronic apical periodontitis and to explore the function of IL-1beta during the endodontic interappointment flare-ups. Periapical exudates samples were obtained from 19 teeth suffering from endodontic flare-ups after root canal preparation and 20 teeth without any symptoms and signs at the second visit after root canal preparation. The levels of IL-1beta were determined by ELISA and the data was analyzed by SAS6.12 software package. Significantly higher levels of IL-1beta were found in periapical exudates from teeth suffering from endodontic flare-ups than that before canal preparation(Pendodontic therapy if there were no symptom at the second visit (Pendodontic interappointment flare-up.

  12. Morphological evaluation of maxillary second molars with fused roots: a micro-CT study.

    Science.gov (United States)

    Ordinola-Zapata, R; Martins, J N R; Bramante, C M; Villas-Boas, M H; Duarte, M H; Versiani, M A

    2017-12-01

    To evaluate the internal and external morphologies of fused-rooted maxillary second molars by means of micro-computed tomography (micro-CT) analysis. A total of 100 fused-rooted maxillary second molars from a Brazilian subpopulation were divided into six groups according to the root morphology. The samples were scanned at a resolution of 19.6 μm and evaluated with regard to the external morphology of the roots, the root canal configuration, the percentage frequency of C-shaped canals and isthmuses, as well as the morphology of the root canal system at 1, 2 and 3 mm from the anatomical apex of the fused roots. The most prevalent root canal fusions were type 1, mesiobuccal root fused with distobuccal root (32%), followed by type 3, DB root fused with P root (27%), and type 4, MB root fused with DB root, and P root fused with MB or DB roots (21%). The prevalence of C-shaped root canal systems were 22%. Depending on the type of root fusion, the percentage frequency of isthmuses in the apical level varied from 9.3% to 42.8%, whilst the presence of apical deltas ranged from 18.5% to 57.1% of teeth. The root canal system of maxillary second molars with fused roots may have a high incidence of merging canals, isthmuses, apical deltas and C-shaped configurations. © 2017 International Endodontic Journal. Published by John Wiley & Sons Ltd.

  13. Comparison of apical debris extrusion using a conventional and two rotary techniques.

    Science.gov (United States)

    Adl, Alireza; Sahebi, Safoora; Moazami, Fariborz; Niknam, Mahnaz

    2009-01-01

    Preparation techniques and instruments produce and push debris out of canals. This can induce inflammation within the periapical area. Therefore, instrumentation that causes less extrusion of debris is more desirable. The purpose of this in vitro study was to evaluate the quantity of debris extruded from the apical foramen during root canal preparation by using one hand, and two rotary instrumentation techniques. Three different groups each with 12 mesiobuccal roots of human maxillary first molar were instrumented using either step-back technique with hand instruments, FlexMaster or Mtwo rotary system. Debris extruded from the apical foramen during canal preparation was collected. The mean dry weights of debris were compared using one-way ANOVA. Step-back group had a significantly greater mean weight of debris compared to the other two groups (Pengine driven techniques were associated with less apical debris extrusion. [Iranian Endodontic Journal 2009;4(4):135-8].

  14. 21 CFR 872.3820 - Root canal filling resin.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Root canal filling resin. 872.3820 Section 872...) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3820 Root canal filling resin. (a) Identification. A root canal filling resin is a device composed of material, such as methylmethacrylate, intended...

  15. Assessing apical transportation in curved canals: comparison between cross-sections and micro-computed tomography

    Directory of Open Access Journals (Sweden)

    Laila Gonzales Freire

    2012-06-01

    Full Text Available The aim of this study was to compare two methods of assessing apical transportation in curved canals after rotary instrumentation, namely, cross-sections and micro-computed tomography (µCT. Thirty mandibular molars were divided into two groups and prepared according to the requirements of each method. In G1 (cross-sections, teeth were embedded in resin blocks and sectioned at 2.0, 3.5, and 5.0 mm from the anatomic apex. Pre- and postoperative sections were photographed and analyzed. In G2 (µCT, teeth were embedded in a rubber-base impression material and scanned before and after instrumentation. Mesiobuccal canals were instrumented with the Twisted File (TF system (SybronEndo, Orange, USA, and mesiolingual canals, with the EndoSequence (ES system (Brasseler, Savannah, USA. Images were reconstructed, and sections corresponding to distances 2.0, 3.5, and 5.0 mm from the anatomic apex were selected for comparison. Data were analyzed using Mann-Whitney's test at a 5% significance level. The TF and ES instruments produced little deviation from the root canal center, with no statistical difference between them (P > 0.05. The canal transportation results were significantly lower (0.056 mm in G2 than in G1 (0.089 mm (p = 0.0012. The µCT method was superior to the cross-section method, especially in view of its ability to preserve specimens and provide results that are more closely related to clinical situations.

  16. A comparative evaluation of the increase in root canal surface area and canal transportation in curved root canals by three rotary systems: A cone-beam computed tomographic study

    Science.gov (United States)

    Prasanthi, Nalam NVD; Rambabu, Tanikonda; Sajjan, Girija S; Varma, K Madhu; Satish, R Kalyan; Padmaja, M

    2016-01-01

    Aim: The aim of this study was to measure the increase in root canal surface area and canal transportation after biomechanical preparation at 1, 3, and 5 mm short of the apex with three different rotary systems in both continuous rotary and reciprocating rotary motions. Materials and Methods: Sixty freshly extracted human mandibular molars with mesial root canal curvatures between 20° and 30° were included in the study. Teeth were randomly distributed into three groups (n = 20). Biomechanical preparations were done in all the mesial canals. In Group 1, instrumentation was done with ProTaper universal rotary files, Group 2, with K3XF rotary files, and Group 3, with LSX rotary files. Each group was further subdivided into subgroups A and B (n = 10) where instrumentation was done by continuous rotary and reciprocating rotary techniques, respectively. Increase in root canal surface area and canal transportation was measured using the preoperative and postoperative cone-beam computed tomography scans. Statistical Analysis: The data were analyzed by one-way ANOVA followed by Tukey pairwise multiple comparison tests. Results: Increase in root canal surface area was significantly more (P 0.05) in increase of root canal surface area and canal transportation between continuous rotary and reciprocating rotary techniques for ProTaper Universal, K3XF and LSX groups. Conclusion: LSX rotary system showed minimal increase of root canal surface area and minimal canal transportation when compared to ProTaper and K3XF rotary systems. PMID:27656062

  17. Newer Root Canal Irrigants in Horizon: A Review

    Directory of Open Access Journals (Sweden)

    Sushma Jaju

    2011-01-01

    Full Text Available Sodium hypochloride is the most commonly used endodontic irrigant, despite limitations. None of the presently available root canal irrigants satisfy the requirements of ideal root canal irrigant. Newer root canal irrigants are studied for potential replacement of sodium hypochloride. This article reviews the potential irrigants with their advantages and limitations with their future in endodontic irrigation.

  18. The failures of root canal preparation with hand ProTaper.

    Science.gov (United States)

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

    2012-07-01

    The failures of root canal preparation are due to some anatomical deviation (canal in "C" or "S") and some technique errors. The technique errors are usually present in canal root cleansing and shaping stage and are the result of endodontic treatment objectives deviation. Our study was made on technique errors while preparing the canal roots with hand ProTaper. Our study was made "in vitro" on 84 extracted teeth (molars, premolars, incisors and canines). The canal root of these teeth were cleansed and shaped with hand ProTaper by crown-down technique and canal irrigation with NaOCl(2,5%). The dental preparation control was made by X-ray. During canal root preparation some failures were observed like: canal root overinstrumentation, zipping and stripping phenomenon, discarded and/or fractured instruments. Hand ProTaper represents a revolutionary progress of endodontic treatment, but a deviation from accepted rules of canal root instrumentation can lead to failures of endodontic treatment.

  19. Comparison of the rheological properties of four root canal sealers

    Institute of Scientific and Technical Information of China (English)

    Seok Woo Chang; Kwang Shik Bae; Young-Kyu Lee; Qiang Zhu; Won Jun Shon; Woo Cheol Lee; Kee Yeon Kum; Seung Ho Baek; In Bog Lee; Bum-Soon Lim

    2015-01-01

    The flowability of a root canal sealer is clinically important because it improves the penetration of the sealer into the complex root canal system. The purpose of this study was to compare the flowabilities of four root canal sealers, measured using the simple press method (ISO 6876), and their viscosities, measured using a strain-controlled rheometer. A newly developed, calcium phosphate-based root canal sealer (Capseal) and three commercial root canal sealers (AH Plus, Sealapex and Pulp Canal Sealer EWT) were used in this study. The flowabilities of the four root canal sealers were measured using the simple press method (n55) and their viscosities were measured using a strain-controlled rheometer (n55). The correlation between these two values was statistically analysed using Spearman’s correlation test. The flow diameters and the viscosities of the root canal sealers were strongly negatively correlated (r520.8618). The viscosity of Pulp Canal Sealer EWT was the lowest and increased in the following order:AH Plus,Sealapex,Capseal (P,0.05). All of the tested root canal sealers showed characteristic time-and temperature-dependent changes in their rheological properties. The viscosities measured using the strain-controlled rheometer were more precise than the flowabilities measured using the simple press method, suggesting that the rheometer can accurately measure the rheological properties of root canal sealers.

  20. 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.

  1. Incidence of Apical Crack Initiation during Canal Preparation using Hand Stainless Steel (K-File) and Hand NiTi (Protaper) Files.

    Science.gov (United States)

    Soni, Dileep; Raisingani, Deepak; Mathur, Rachit; Madan, Nidha; Visnoi, Suchita

    2016-01-01

    To evaluate the incidence of apical crack initiation during canal preparation with stainless steel K-files and hand protaper files (in vitro study). Sixty extracted mandibular premo-lar teeth are randomly selected and embedded in an acrylic tube filled with autopolymerizing resin. A baseline image of the apical surface of each specimen was recorded under a digital microscope (80×). The cervical and middle thirds of all samples were flared with #2 and #1 Gates-Glidden (GG) drills, and a second image was recorded. The teeth were randomly divided into four groups of 15 teeth each according to the file type (hand K-file and hand-protaper) and working length (WL) (instrumented at WL and 1 mm less than WL). Final image after dye penetration and photomicrograph of the apical root surface were digitally recorded. Maximum numbers of cracks were observed with hand protaper files compared with hand K-file at the WL and 1 mm short of WL. Chi-square testing revealed a highly significant effect of WL on crack formation at WL and 1 mm short of WL (p = 0.000). Minimum numbers of cracks at WL and 1 mm short of WL were observed with hand K-file and maximum with hand protaper files. Soni D, Raisingani D, Mathur R, Madan N, Visnoi S. Incidence of Apical Crack Initiation during Canal Preparation using Hand Stainless Steel (K-File) and Hand NiTi (Protaper) Files. Int J Clin Pediatr Dent 2016;9(4):303-307.

  2. Evaluation of technical quality and periapical health of root-filled teeth by using cone-beam CT

    Directory of Open Access Journals (Sweden)

    Bilge Gülsüm NUR

    2014-12-01

    Full Text Available Objective This study aimed to assess the quality of root fillings, coronal restorations, complications of all root-filled teeth and their association with apical periodontitis (AP detected by cone-beam computed tomography (CBCT images from an adult Turkish subpopulation. Material and Methods The sample for this study consisted of 242 patients (aging from 15 to 72 years with 522 endodontically treated teeth that were assessed for technical quality of the root canal filling and periapical status of the teeth. Additionally, the apical status of each root-filled tooth was assessed according to the gender, dental arch, tooth type and age classification, undetected canals, instrument fracture, root fracture, apical resorption, apical lesion, furcation lesion and type and quality of the coronal structure. Statistical analysis was performed using percentages and chi-square test. Results The success rate of the root canal treatment was of 54.4%. The success rates of adequate and inadequate root canal treatment were not significantly different (p>0.05. Apical periodontitis was found in 228 (45.6% teeth treated for root canals. Higher prevalence of AP was found in patients aging from 20 to 29 years [64 (27% teeth] and in anterior (canines and incisors teeth [97 (41% teeth]. Conclusions The technical quality of root canal filling performed by dental practitioners in a Turkish subpopulation was consistent with a high prevalence of AP. The probable reasons for this failure are multifactorial, and there may be a need for improved undergraduate education and postgraduate courses to improve the clinical skills of dental practitioners in endodontics.

  3. Clinical significance of dental root canal microflora.

    Science.gov (United States)

    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.

  4. Technical quality of root canal treatment performed by undergraduate students using hand instrumentation: a meta-analysis.

    Science.gov (United States)

    Ribeiro, D M; Réus, J C; Felippe, W T; Pacheco-Pereira, C; Dutra, K L; Santos, J N; Porporatti, A L; De Luca Canto, G

    2018-03-01

    The technical quality of root canal treatment (RCT) may impact on the outcome. The quality of education received during undergraduate school may be linked to the quality of treatment provided in general dental practice. In this context, the aim of this systematic review was to answer the following focused questions: (i) What is the frequency of acceptable technical quality of root fillings, assessed radiographically, performed by undergraduate students? (ii) What are the most common errors assessed radiographically and reported in these treatments? For this purpose, articles that evaluated the quality of root fillings performed by undergraduate students were selected. Data were collected based on predetermined criteria. The key features from the included studies were extracted. GRADE-tool assessed the quality of the evidence. MAStARI evaluated the methodological quality, and a meta-analysis on all studies was conducted. At the end of the screening, 24 articles were identified. Overall frequency of acceptable technical quality of root fillings was 48%. From this total, 52% related to anterior teeth, 49% to premolars and 26% to molars. The main procedural errors reported were ledge formation, furcation perforation, apical transportation and apical perforation. The heterogeneity amongst the studies was high (84-99%). Five studies had a high risk of bias, eight had a moderate risk, and 11 had low risk. The overall quality of evidence identified was very low. The conclusion was that technical quality of root fillings performed by undergraduate students is low, which may reveal that endodontic education has limited achievement at undergraduate level. A plan to improve the quality of root fillings, and by extrapolation the overall quality of root canal treatment, should be discussed by the staff responsible for endodontic education and training. © 2017 International Endodontic Journal. Published by John Wiley & Sons Ltd.

  5. A Comparative SEM Investigation of Smear Layer Remaining on Dentinal Walls by Three Rotary NiTi Files with Different Cross Sectional Designs in Moderately Curved Canals

    Science.gov (United States)

    Kakkar, Pooja; Vats, Asit

    2015-01-01

    Objective: The objective of this study was to compare the smear layer formed on root canal walls during canal preparation of extracted human teeth by Twisted, Mtwo, and ProTaper rotary nickel titanium instruments. Materials and Methods: Sixty single rooted human premolar teeth with root curvature rotary nickel titanium instruments were used, Twisted (SybronEndo, Orange, CA, USA), Mtwo (VDW, Munich, Germany) and ProTaper (Dentsply Maillefer, Ballaigues, Switzerland) according to manufacturer’s instructions to instrument the root canals. Irrigation for all groups was performed after each instrument change with 3ml of 3% sodium hypochlorite followed by Glyde (File Prep, Dentsply, Maillefer, Ballaigues, Switzerland) as chelator paste and lubricant. Three different areas (coronal, middle and apical thirds) of the root canal were evaluated using scanning electron microscopy (SEM). The canal wall of each sample was assessed and compared using a predefined scale for the presence or absence of smear layer. Data were analysed statistically using ANOVA and Tukey HSD test Results: All three groups showed statistically significant more smear layer in the apical thirds of the canal as compared to the coronal and middle thirds (protary file system produced significantly less smear layer (protary instruments in the apical portion. Twisted Files resulted in less smear layer formation in the apical thirds of the canal compared to ProTaper rotary instruments but were statistically insignificant. Conclusion: Completely clean root canals were not found after instrumentation with any of the three instruments. Under the confines of this study Mtwo instruments produced significantly cleaner dentin wall surfaces throughout the canal length in comparison to Twisted and ProTaper rotary files. Twisted Files proved to be comparable to ProTaper rotary instruments with respect to canal cleanliness in the apical thirds of the root canal. PMID:25954704

  6. Frequency and levels of candidate endodontic pathogens in acute apical abscesses as compared to asymptomatic apical periodontitis

    OpenAIRE

    Rôças, Isabela N.; Siqueira, José F.

    2018-01-01

    Introduction Acute apical abscess is caused by bacteria that leave the infected dental root canal to invade the periodontal tissues. Most species occurring in abscesses are also found in asymptomatic infections; therefore, the possibility exists that not only the presence of certain species but also their specific counts influence the appearance of symptoms. This molecular study compared the frequency and levels of several candidate endodontic pathogens in teeth with acute apical abscesses an...

  7. Conservative treatment of immature teeth with apical periodontitis using triple antibiotic paste disinfection

    OpenAIRE

    Wang, Hsin-Ju; Chen, Yea-Huey Melody; Chen, Kuan-Liang

    2016-01-01

    The purpose of this report is to present conservative treatment for two immature premolars with apical periodontitis. A triple antibiotic paste was used to disinfect the root canal systems for revascularization. In both cases, residual vital pulp tissue was noted in the root canal system after the opening of each premolar. The canals in both cases were irrigated with copious sodium hypochlorite solution and medicated with a paste consisting of ciprofloxacin, metronidazole, and minocycline. Th...

  8. Mandibular molar with five root canals.

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

  10. Efficacy of NiTi rotary instruments in removing calcium hydroxide dressing residues from root canal walls

    Directory of Open Access Journals (Sweden)

    Milton Carlos Kuga

    2012-02-01

    Full Text Available The aim of this study was to evaluate the efficacy of three rotary instrument systems (K3, ProTaper and Twisted File in removing calcium hydroxide residues from root canal walls. Thirty-four human mandibular incisors were instrumented with the ProTaper System up to the F2 instrument, irrigated with 2.5% NaOCl followed by 17% EDTA, and filled with a calcium hydroxide intracanal dressing. After 7 days, the calcium hydroxide dressing was removed using the following rotary instruments: G1 - NiTi size 25, 0.06 taper, of the K3 System; G2 - NiTi F2, of the ProTaper System; or G3 - NiTi size 25, 0.06 taper, of the Twisted File System. The teeth were longitudinally grooved on the buccal and lingual root surfaces, split along their long axis, and their apical and cervical canal thirds were evaluated by SEM (×1000. The images were scored and the data were statistically analyzed using the Kruskall Wallis test. None of the instruments removed the calcium hydroxide dressing completely, either in the apical or cervical thirds, and no significant differences were observed among the rotary instruments tested (p > 0.05.

  11. Evaluation of three instrumentation techniques at the precision of apical stop and apical sealing of obturation

    Directory of Open Access Journals (Sweden)

    Özgür Genç

    2011-08-01

    Full Text Available OBJECTIVE: The aim of this study was to investigate the ability of two NiTi rotary apical preparation techniques used with an electronic apex locator-integrated endodontic motor and a manual technique to create an apical stop at a predetermined level (0.5 mm short of the apical foramen in teeth with disrupted apical constriction, and to evaluate microleakage following obturation in such prepared teeth. MATERIAL AND METHODS: 85 intact human mandibular permanent incisors with single root canal were accessed and the apical constriction was disrupted using a #25 K-file. The teeth were embedded in alginate and instrumented to #40 using rotary Lightspeed or S-Apex techniques or stainless-steel K-files. Distance between the apical foramen and the created apical stop was measured to an accuracy of 0.01 mm. In another set of instrumented teeth, root canals were obturated using gutta-percha and sealer, and leakage was tested at 1 week and 3 months using a fluid filtration device. RESULTS: All techniques performed slightly short of the predetermined level. Closest preparation to the predetermined level was with the manual technique and the farthest was with S-Apex. A significant difference was found between the performances of these two techniques (p<0.05. Lightspeed ranked in between. Leakage was similar for all techniques at either period. However, all groups leaked significantly more at 3 months compared to 1 week (p<0.05. CONCLUSIONS: Despite statistically significant differences found among the techniques, deviations from the predetermined level were small and clinically acceptable for all techniques. Leakage following obturation was comparable in all groups.

  12. Microbiology and Treatment of Acute Apical Abscesses

    Science.gov (United States)

    Rôças, Isabela N.

    2013-01-01

    SUMMARY Acute apical abscess is the most common form of dental abscess and is caused by infection of the root canal of the tooth. It is usually localized intraorally, but in some cases the apical abscess may spread and result in severe complications or even mortality. The reasons why dental root canal infections can become symptomatic and evolve to severe spreading and sometimes life-threatening abscesses remain elusive. Studies using culture and advanced molecular microbiology methods for microbial identification in apical abscesses have demonstrated a multispecies community conspicuously dominated by anaerobic bacteria. Species/phylotypes commonly found in these infections belong to the genera Fusobacterium, Parvimonas, Prevotella, Porphyromonas, Dialister, Streptococcus, and Treponema. Advances in DNA sequencing technologies and computational biology have substantially enhanced the knowledge of the microbiota associated with acute apical abscesses and shed some light on the etiopathogeny of this disease. Species richness and abundance and the resulting network of interactions among community members may affect the collective pathogenicity and contribute to the development of acute infections. Disease modifiers, including transient or permanent host-related factors, may also influence the development and severity of acute abscesses. This review focuses on the current evidence about the etiology and treatment of acute apical abscesses and how the process is influenced by host-related factors and proposes future directions in research, diagnosis, and therapeutic approaches to deal with this disease. PMID:23554416

  13. 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...

  14. Root canal treatment and special needs patients.

    Science.gov (United States)

    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.

  15. An endodontic management of mandibular third molar with five root canals

    Directory of Open Access Journals (Sweden)

    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.

  16. Single-visit endodontic treatment of mature teeth with chronic apical abscesses using mineral trioxide aggregate cement: a randomized clinical trial.

    Science.gov (United States)

    Alsulaimani, Reem Siraj

    2016-08-23

    Mature teeth with chronic apical abscesses characterized by intermittent discharge of pus through an associated sinus tract. This communication between oral mucosa and periapical inflammation is challenging for the sealing ability of root canal obturation material. Therefore, the study aim was to compare the outcomes of endodontic treatment using mineral trioxide aggregate (MTA) cement to the conventional gutta-percha cone and root canal sealer as an obturation material in mature teeth with chronic apical abscesses. Mature teeth with chronic apical abscesses referred to our clinic for root canal treatment between 2010 and 2012 were treated in a single visit and distributed among treatment (T) and control (C) groups using a predetermined randomization block (TCTC). After chemo-mechanical preparation, teeth in group T received MTA cement mixed in a 0.26 water to powder ratio, and teeth group C received gutta-percha and root canal sealer using the warm vertical technique. The treatment outcomes were defined as obturation length, periapical healing, resorption of extruded material, and survival rate at least 2.5 years after treatment. Three endodontists blinded to the type of obturation material documented treatment outcomes. Statistical analysis at P chronic apical abscesses using MTA cement were better, but not statistically significant, compared to conventional treatment. ISRCTN15285974 . Registered retrospectively 23 June 2015.

  17. Revitalization of open apex teeth with apical periodontitis using a collagen-hydroxyapatite scaffold.

    Science.gov (United States)

    Nevins, Alan J; Cymerman, Jerome J

    2015-06-01

    An enhanced revision of the revitalization endodontic technique for immature teeth with apical periodontitis has been described. It includes the addition of collagen-hydroxyapatite scaffold to the currently practiced revascularization technique. Four cases treated in series are presented in this report, 1 case involving 2 teeth. Periapical diagnoses of immature teeth included "asymptomatic apical periodontitis," "symptomatic apical periodontitis," and "acute apical abscess." Additionally, 1 fully developed tooth that had undergone root canal treatment that failed had a periapical diagnosis of acute apical abscess. An established revascularization protocol was used for all teeth. In addition to stimulating blood clots, all teeth were filled with collagen-hydroxyapatite scaffolds. Periapical radiolucencies healed in all teeth, and diffuse radiopacity developed within the coronal portions of canal spaces. Root development with root lengthening occurred in the immature nonvital maxillary premolar that had not undergone prior treatment. The technique of adding a collagen-hydroxyapatite scaffold to the existing revitalization protocol has been described in which substantial hard tissue repair has occurred. This may leave teeth more fully developed and less likely to fracture. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  18. 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

  19. Maxillary first molar with an O-shaped root morphology:report of a case

    Institute of Scientific and Technical Information of China (English)

    Yooseok Shin; Yemi Kim; Byoung-Duck Roh

    2013-01-01

    This case report is to present a maxillary first molar with one O-shaped root, which is an extended C-shaped canal system. Patient with chronic apical periodontitis in maxillary left first molar underwent replantation because of difficulty in negotiating all canals. Periapical radiographs and cone-beam computed tomography (CBCT) were taken. All roots were connected and fused to one root, and all canals seemed to be connected to form an O-shape. The apical 3 mm of the root were resected and retrograde filled with resin-modified glass ionomer. Intentional replantation as an alternative treatment could be considered in a maxillary first molar having an unusual O-shaped root.

  20. Maxillary first molar with an O-shaped root morphology: report of a case.

    Science.gov (United States)

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

    2013-12-01

    This case report is to present a maxillary first molar with one O-shaped root, which is an extended C-shaped canal system. Patient with chronic apical periodontitis in maxillary left first molar underwent replantation because of difficulty in negotiating all canals. Periapical radiographs and cone-beam computed tomography (CBCT) were taken. All roots were connected and fused to one root, and all canals seemed to be connected to form an O-shape. The apical 3 mm of the root were resected and retrograde filled with resin-modified glass ionomer. Intentional replantation as an alternative treatment could be considered in a maxillary first molar having an unusual O-shaped root.

  1. Thermal effects from modified endodontic laser tips used in the apical third of root canals with erbium-doped yttrium aluminium garnet and erbium, chromium-doped yttrium scandium gallium garnet lasers.

    Science.gov (United States)

    George, Roy; Walsh, Laurence J

    2010-04-01

    To evaluate the temperature changes occurring on the apical third of root surfaces when erbium-doped yttrium aluminium garnet (Er:YAG) and erbium, chromium-doped yttrium scandium gallium garnet (Er,Cr:YSGG) laser energy was delivered with a tube etched, laterally emitting conical tip and a conventional bare design optical fiber tip. Thermal effects of root canal laser treatments on periodontal ligament cells and alveolar bone are of concern in terms of safety. A total of 64 single-rooted extracted teeth were prepared 1 mm short of the working length using rotary nickel-titanium Pro-Taper files to an apical size corresponding to a F5 Pro-Taper instrument. A thermocouple located 2 mm from the apex was used to record temperature changes arising from delivery of laser energy through laterally emitting conical tips or plain tips, using an Er:YAG or Er,Cr:YSGG laser. For the Er:YAG and Er,Cr:YSGG systems, conical fibers showed greater lateral emissions (452 + 69% and 443 + 64%) and corresponding lower forward emissions (48 + 5% and 49 + 5%) than conventional plain-fiber tips. All four combinations of laser system and fiber design elicited temperature increases less than 2.5 degrees C during lasing. The use of water irrigation attenuated completely the thermal effects of individual lasing cycles. Laterally emitting conical fiber tips can be used safely under defined conditions for intracanal irradiation without harmful thermal effects on the periodontal apparatus.

  2. 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

  3. 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...

  4. The Effect of Calcium Hydroxide As an Intracanal Medication of The Apical Microleakage

    Directory of Open Access Journals (Sweden)

    Heshmat Mohajer AR

    2011-12-01

    Full Text Available Background and Aims: Nowadays, calcium hydroxide is used as a dressing for canal sterilization and repair progression of apical lesions. The aim of this study was to investigate the effect of calcium hydroxide as an intracanal medicament on the apical microleakage of root filling.Materials and Methods: In this experimental study, 46 extracted single-rooted human teeth were instrumented with step-back technique to master apical file (MAF size 35. Specimens were randomly divided into 2 groups (n = 20. In group 1, the specimens were treated with calcium hydroxide intracanal medication; and in group 2, the samples did not receive any medication. The teeth were incubated in 100% humidity at 37°C for one week. After that, calcium hydroxide was removed using irrigation with normal saline and reaming with MAF. The root canals were obturated with gutta- percha and AH26 sealer using lateral compaction technique. Specimens were incubated in 100% humility at 37°C for 72 hours and then immersed in India ink for 1 week. Finally, the teeth were cleared and the maximum linear dye penetration was measured under a stereomicroscope at 4X magnification. The data were analyzed by T-test and Chi-square.Results: There was no significant difference between the two experimental groups (P=0.068. Conclusion: The findings of this study indicated that using calcium hydroxide as an intracanal medicament did not influence the apical microleakage after final obturation of the root canal system.

  5. Radiographic versus electronic root canal working length determination

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    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.

  7. Guided endodontics: accuracy of a novel method for guided access cavity preparation and root canal location.

    Science.gov (United States)

    Zehnder, M S; Connert, T; Weiger, R; Krastl, G; Kühl, S

    2016-10-01

    To present a novel method utilizing 3D printed templates to gain guided access to root canals and to evaluate its accuracy in vitro. Sixty extracted human teeth were placed into six maxillary jaw models. Preoperative CBCT scans were matched with intra-oral scans using the coDiagnostix(™) software. Access cavities, sleeves and templates for guidance were virtually planned. Templates were produced by a 3D printer. After access cavity preparation by two operators, a postoperative CBCT scan was superimposed on the virtual planning. Accuracy was measured by calculating the deviation of planned and prepared cavities in three dimensions and angle. Ninety-five per cent confidence intervals were calculated for both operators. All root canals were accessible after cavity preparation with 'Guided Endodontics'. Deviations of planned and prepared access cavities were low with means ranging from 0.16 to 0.21 mm for different aspects at the base of the bur and 0.17-0.47 mm at the tip of the bur. Mean of angle deviation was 1.81°. Overlapping 95% confidence intervals revealed no significant difference between operators. 'Guided Endodontics' allowed an accurate access cavity preparation up to the apical third of the root utilizing printed templates for guidance. All root canals were accessible after preparation. © 2015 International Endodontic Journal. Published by John Wiley & Sons Ltd.

  8. Laser scanning dental probe for endodontic root canal treatment

    Science.gov (United States)

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

    2011-03-01

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

  9. The effect of warm air-blowing on the microtensile bond strength of one-step self-etch adhesives to root canal dentin.

    Science.gov (United States)

    Taguchi, Keita; Hosaka, Keiichi; Ikeda, Masaomi; Kishikawa, Ryuzo; Foxton, Richard; Nakajima, Masatoshi; Tagami, Junji

    2018-02-01

    The use of warm air-blowing to evaporate solvents of one-step self-etch adhesive systems (1-SEAs) has been reported to be a useful method. The purpose of this study was to evaluate the effect of warm air-blowing on root canal dentin. Four 1-SEAs (Clearfil Bond SE ONE, Unifil Core EM self-etch bond, Estelink, BeautiDualbond EX) were used. Each 1-SEA was applied to root canal dentin according to the manufacturers' instructions. After the adhesives were applied, solvent was evaporated using either normal air (23±1°C) or warm air (80±1°C) for 20s, and resin composite was placed in the post spaces. The air from the dryer, which could be used in normal- or hot-air-mode, was applied at a distance of 5cm above the root canal cavity in the direction of tooth axis. The temperature of the stream of air from the dryer in the hot-air-mode was 80±1°C, and in the normal mode, 23±1°C. After water storage of the specimens for 24h, the μTBS were evaluated at the coronal and apical regions. The μTBSs were statistically analyzed using three-way ANOVA and Student's t-test with Bonferroni correction (α=0.05). The warm air-blowing significantly increased the μTBS of all 1-SEAs at the apical regions, and also significantly increased the μTBS of two adhesives (Estelink and BeautiDualBond EX) at coronal regions. The μTBS of 1-SEAs to root canal dentin was improved by using warm air-blowing. Copyright © 2017 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

  10. Apical root resorption in orthodontically treated adults.

    Science.gov (United States)

    Baumrind, S; Korn, E L; Boyd, R L

    1996-09-01

    This study analyzed the relationship in orthodontically treated adults between upper central incisor displacement measured on lateral cephalograms and apical root resorption measured on anterior periapical x-ray films. A multiple linear regression examined incisor displacements in four directions (retraction, advancement, intrusion, and extrusion) as independent variables, attempting to account for observed differences in the dependent variable, resorption. Mean apical resorption was 1.36 mm (sd +/- 1.46, n = 73). Mean horizontal displacement of the apex was -0.83 mm (sd +/- 1.74, n = 67); mean vertical displacement was 0.19 mm (sd +/- 1.48, n = 67). The regression coefficients for the intercept and for retraction were highly significant; those for extrusion, intrusion, and advancement were not. At the 95% confidence level, an average of 0.99 mm (se = +/- 0.34) of resorption was implied in the absence of root displacement and an average of 0.49 mm (se = +/- 0.14) of resorption was implied per millimeter of retraction. R2 for all four directional displacement variables (DDVs) taken together was only 0.20, which implied that only a relatively small portion of the observed apical resorption could be accounted for by tooth displacement alone. In a secondary set of univariate analyses, the associations between apical resorption and each of 14 additional treatment-related variables were examined. Only Gender, Elapsed Time, and Total Apical Displacement displayed statistically significant associations with apical resorption. Additional multiple regressions were then performed in which the data for each of these three statistically significant variables were considered separately, with the data for the four directional displacement variables. The addition of information on Elapsed Time or Total Apical Displacement did not explain a significant additional portion of the variability in apical resorption. On the other hand, the addition of information on Gender to the

  11. [Glide path management of rotary nickel-titanium instruments in simulated root canals].

    Science.gov (United States)

    Han, Y; Bai, Y H; Hou, X M

    2018-02-18

    To compare the shaping ability of ProGlider, HyFlex EDM Glidepath File and RaCe ISO 10 with that of PathFile and stainless steel K-file hand instruments in simulated root canals. A total of 60 simulated resin blocks were divided randomly into five groups (n=12), each group prepared with each instrument, respectively. Preparation time was recorded. Pre- and post-operative images were obtained using a scanner and superimposed using Photoshop. The material removal from the inner and outer canal walls beginning from 0 mm at the end point of the canal were measured using ImageJ. Centering ability was determined, accordingly. The data were analyzed using the One-Way ANOVA at a significance level of P0.05). The removal of resin from the outer wall at the apical portion was significantly lower for HyFlex EDM Glidepath File than for ProGlider (PEDM Glidepath File the second most, and the other 3 groups among the same levels. As far as the centering ability was concerned, at the apical portion, HyFlex EDM Glidepath File was the best, ProGlider the second best, no significant difference identified among the other 3 groups. At the curvature portion, ProGlider and HyFlex EDM Glidepath File were the best, PathFile the second, RaCe ISO 10 the third, the worst was the SS K-file. At the straight portion, the difference amongt the 5 groups was not significant. The shaping abilities of ProGlider, HyFlex EDM Glidepath File and RaCe ISO 10 were better or comparable to that of PathFile, while the preparation time for ProGlider reduced significantly, and HyFlex EDM Glidepath File and RaCe ISO 10 removed significantly more resin at the straight portion of the canal.

  12. In vitro comparison rate of dental root canal transportation using two single file systems on the simulated resin blocks

    Directory of Open Access Journals (Sweden)

    Mohammad Javad Etesami

    2016-07-01

    Full Text Available Background and Aims: Cleaning and shaping is one of the most important stages in endodontic treatment. Single-file systems save time and reduce the risk of transmission of pathogens. This in vitro study was aimed to compare the rate of canal transportation after the preparation of the stimulated resin root canal with two single-file systems, namely Waveone and Reciproc. Materials and Methods: Thirty stimulated resin root canal blocks with size 8/0. 02 K file were randomly divided into two study groups. The preparation in Group A and Group B was performed using Reciproc and Waveone files, respectively. Pre and post- preparation photographs were taken and the images were superimposed to evaluate the inner and outer wall’s curvature tendency at three points (apical, middle and coronal using AutoCad pragram. Data were analyzed using T-test. Results: Based on the results, the degree of transportation in the inner and outer walls of the canal was less at the level of 3 millimeters (P0.05. Conclusion: Waveone showed better performance in the middle third of canal and this system maybe recommended.

  13. Sealing ability of grar MTA AngelusTM, CPM TM and MBPc used as apical plugs.

    Science.gov (United States)

    Orosco, Fernando Accorsi; Bramante, Clovis Monteiro; Garcia, Roberto Brandão; Bernadineli, Norberti; Moraes, Ivaldo Gomes de

    2008-01-01

    This study evaluated the sealing ability of apical plugs fabricated with gray MTA Angelus sealer, CPM TM sealer and MBPc sealer. The root canals of 98 extracted single-rooted human teeth were instrumented with #5 to #1 Gates Glidden drills according to the crown-down technique until the #1 drill could pass through the apical foramen. The specimens were then prepared with K-files, starting with an ISO 50 until an ISO 90 could be visualized 1 mm beyond the apex. After root canal preparation, the external surface of each root was rendered impermeable and roots were assigned to 3 experimental groups (n = 30), which received a 5-mm thick apical plug of gray MTA Angelus, CPM and MBPc, and two control groups (n=4). The remaining portion of the canal in the experimental groups was filled by the lateral condensation technique. The teeth of each group, properly identified, were fixed on utility wax by their crowns and were placed in plastic flasks, leaving the apex free and facing upward. The flasks were filled with 0.2% Rhodamine B solution, pH 7.0, so as to completely cover the root apex of all teeth. The sealing ability was analyzed by measuring 0.2% Rhodamine B leakage after all groups had been maintained in this solution for 48 hours. Data were analyzed statistically by Kruskal-Wallis test and Dunn test with a=5%. The results showed that, among the tested materials used for fabrication of apical plugs, MBPc sealer had the least amount of leakage with statistically significant difference (p<0.05).

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

    Directory of Open Access Journals (Sweden)

    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.

  15. Revascularization procedure in an open apex tooth with external root resorption: A case report

    Directory of Open Access Journals (Sweden)

    Mahsa Dastpak

    2017-06-01

    Full Text Available External inflammatory root resorption (EIR represents a challenge in endodontic practice. EIR commonly occurs after dental trauma that results in periodontal ligament injury, pulp necrosis and subsequent infection.  Treatment of EIR is based on disinfecting the root canal system through chemomechanical procedures and then filling it with calcium hydroxide or triple antibiotic paste. Dental trauma commonly occurs in young patients whose teeth are not fully formed and have thin dentinal walls and open apices. Revascularization therapy has proven to be suitable for treatment of root canals of teeth with pulp necrosis and open apices. This case report presents successful revascularization treatment of a permanent immature tooth with external root resorption and chronic apical periodontitis. The tooth was treated by the protocol suggested by the American Association of Endodontics (AAE, consisted of disinfecting the root canal system, filling it with blood clot and sealing the root canal with mineral trioxide aggregate followed by bonded resin restoration. The symptoms disappeared, the size of the periapical lesion reduced and the tooth was asymptomatic during the 12 month follow up period.

  16. 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...

  17. Three root canals in the maxillary second premolar

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  19. Scanning Electron Microscopic Evaluation of Residual Smear Layer Following Preparation of Curved Root Canals Using Hand Instrumentation or Two Engine-Driven Systems.

    Science.gov (United States)

    Khademi, Abbasali; Saatchi, Masoud; Shokouhi, Mohammad Mehdi; Baghaei, Badri

    2015-01-01

    In this experimental study, the amount of smear layer (SL) remnants in curved root canals after chemomechanical instrumentation with two engine-driven systems or hand instrumentation was evaluated. Forty-eight mesiobuccal roots of mandibular first molars with curvatures ranging between 25 and 35 degrees (according to Schneider's method) were divided into three groups (n=16) which were prepared by either the ProTaper Universal file series, Reciproc single file system or hand instrumentation. The canals were intermittently irrigated with 5.25% NaOCl and 17% (ethylenediaminetetraacetic acid) EDTA, followed by distilled water as the final rinse. The roots were split longitudinally and the apical third of the specimens were evaluated under 2500× magnification with a scanning electron microscope (SEM). The mean scores of the SL were calculated and analyzed using the non-parametric Kruskal-Wallis and Mann-Whitney U tests. The mean scores of the SL were 2.00±0.73, 1.94±0.68 and 1.44±0.63 µm for the ProTaper Universal, Reciproc and hand instrumentation, respectively. Mean score of SL was significantly less in the hand instrumentation group than the ProTaper (P=0.027) and Reciproc (P=0.035) groups. The difference between the two engine-driven systems, however, was not significant (P=0.803). The amount of smear layer in the apical third of curved root canals prepared with both engine-driven systems was similar and greater than the hand instrumentation technique. Complete cleanliness was not attained.

  20. Evaluation of the amount of apically extruded debris during ...

    African Journals Online (AJOL)

    2015-04-06

    Apr 6, 2015 ... Objective: To evaluate the amount of apically extruded debris during retreatment (with or without solvent) of root canals filled by two ... These filling materials can be used with several obturation .... The tip of the master cone.

  1. An evaluation of .06 tapered gutta-percha cones for filling of .06 taper prepared curved root canals.

    Science.gov (United States)

    Gordon, M P J; Love, R M; Chandler, N P

    2005-02-01

    To compare the area occupied by gutta-percha, sealer, or void in standardized .06 tapered prepared simulated curved canals and in mesio-buccal canals of extracted maxillary first molars filled with a single .06 gutta-percha point and sealer or lateral condensation of multiple .02 gutta-percha points and sealer. Simulated canals in resin blocks with either a 30 degrees curve and radius of 10.5 mm (n = 20) or a 58 degrees curve and 4.7 mm radius (n = 20) and curved mesio-buccal canals of extracted maxillary first molars (n = 20) were prepared using .06 ProFiles in a variable tip crown-down sequence to an apical size 35 at 0.5 mm from the canal terminus or apical foramen. Ten 30 degrees and 58 degrees curved resin canals and 10 canals in the extracted teeth group were obturated with .02 taper gutta-percha cones and AH 26 sealer using lateral condensation. The time required to obturate was recorded. The remaining canals were obturated with a single .06 taper gutta-percha cone and AH 26 sealer. Excess gutta-percha was removed from the specimens using heat and the warm mass vertically condensed. Horizontal sections were cut at 0.5, 1.5, 2.5, 4.5, 7.5 and 11.5 mm from the canal terminus or apical foramen. Colour photographs were taken using an Olympus 35 mm camera attached to a stereomicroscope set at x40 magnification, and then digitized using a flatbed scanner. The cross-sectional area of the canal contents was analysed using Adobe PhotoShop. The percentage of gutta-percha, sealer or voids to the total root canal area were derived and data analysed using unpaired Student's t-test and the Mann-Whitney U-test. In the 30 degrees curved canals the levels had between 94 and 100% of the area filled with gutta-percha with no significant difference (P > 0.05) between the lateral condensation and single cone techniques. In the 58 degrees curved canals the levels had 92-99% of the area filled with gutta-percha, with the single cone technique having significantly (P 0.05) between

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

    Directory of Open Access Journals (Sweden)

    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.

  3. A Comparison of Profile, Race and FKG Systems in Eliminating Enterococcus Faecalis from the Apical Third of Mandibular Premolars

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    K. Nazari Moghaddam

    2006-12-01

    Full Text Available Statement of problem: Microorganisms are essential for the development of periradicular diseases and are one of the major causative factors associated with endodontic treatment failures. Different instruments and preparation techniques have been developed in Endodontics to eliminate or reduce intracanal bacteria.Purpose: The aim of this study was to compare the amount of remaining E. faecalis in the apical third of root canals following instrumentation with Profile, Race and FKG files.Materials and Methods: Ninety freshly extracted mandibular single canal premolars were selected. A horizontal groove was made circumferentially around the roots at a depth of 0.5mm and a distance of 5 mm from the anatomic apex. All the equipments were sterilized overnight by ethylene oxide gas. Root canals, inoculated with E. faecalis suspension, were prepared using Profile, Race or FKG instruments in a step-back technique. Master apical file, amount of irrigant for each canal and working length were similar in all specimens groups. Following preparation, the apical portions of the roots were separated from the previously made grooves and were sampled by sterile paper points. Statistical analysis was performed using ANOVA and Duncan’s multiple range tests.Results: Profile was significantly more effective in eliminating E. faecalis as compared to Race. A significant difference was not observed between FKG and the other two studied instrumentation techniques.Conclusions: Neither of the methods could completely eliminate E. faecalis from the root canals.

  4. Technical Quality of Root Fillings Performed by Undergraduate Students: A Radiographic Study

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    Tatjana Vukadinov

    2014-01-01

    Full Text Available Aim. The aim of this study was to evaluate the radiographic technical quality of endodontic treatment performed by undergraduate students at the School of Dentistry, Faculty of Medicine, University of Novi Sad, Serbia. Materials and Methods. Electronic records of 220 patients treated by final-year undergraduate students during the school year 2011/2012 were examined, and the final sample consisted of 212 patients, 322 teeth, and 565 root canals. The criteria for overall radiographic adequacy of root canal fillings were defined as the presence of adequate length and density and absence of iatrogenic errors (ledge, fractured instrument, untreated canal, and apical transportation. Chi-square test was used to determine statistical significance between different parameters. Results. Adequate root canal fillings were found in 74.22% of the teeth. The percentage of root fillings with adequate length and density was 89.73% and 92.6%, respectively. Fractured instruments and ledges were present in 16 root canals (2.8%, while the presence of missed canal and apical transportation was observed in 2 cases, each (0.3%. Conclusions. Overall, the technical quality of root canal fillings performed by undergraduate students was satisfactory.

  5. Evaluation of the anatomical alterations of lower molars mesial root’s apical third

    OpenAIRE

    FRÖNER, Izabel Cristina; IMPERADOR, Cristina Aparecida; SOUZA, Luiz Gustavo de

    1999-01-01

    The anatomical apex of the mesial root of the lower molars presents a morphological complexity related to the number and shape of the root canals as well as of the apical foramen and isthmus presence. The knowledge of the complexity of the endodontic system of the molar root area is essencial to select more carefully the best instrumentation and obturation technique, to obtain a more successful endodontic therapy. A presente pesquisa analisa in vitro as alterações anatômicas dos 4 mm apic...

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

    Science.gov (United States)

    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.

  7. Apically-extruded debris using the ProTaper system.

    Science.gov (United States)

    Azar, Nasim Gheshlaghi; Ebrahimi, Gholamreza

    2005-04-01

    The purpose of this in vitro study was to determine the quantity of debris and irrigant extruded apically using the ProTaper system compared to ProFiles and K-Flexofiles. Thirty-six mesio-buccal root canals of human mandibular molars were selected and divided into three groups of twelve canals. Two groups were instrumented with ProFiles and ProTapers according to the manufacturer's instructions. The other group was instrumented with K-Flexofiles using the step-back technique. A standard amount of irrigant was used for each canal. Apically-extruded debris and irrigant was collected in pre-weighed vials. The mean weight of extruded debris and irrigant for each group was statistically analysed using Student's t-test and one-way ANOVA. All instrumentation techniques produced extruded debris and irrigant. Although the mean amount of extrusion with the step-back technique was higher than the two rotary systems, there was no significant difference between the three groups (p > 0.05). NiTi rotary systems were associated with less apical extrusion, but were not significantly better than hand file instrumentation. All techniques extruded debris.

  8. 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.

  9. 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...

  10. Thermal analysis of different application techniques on Nd:YAG laser after root canal preparation of single-rooted teeth; Analise termica de diferentes tecnicas de utilizacao do laser de Nd:YAG apos o preparo quimico-cirurgico de dentes unirradiculares

    Energy Technology Data Exchange (ETDEWEB)

    Archilla, Jose Ricardo de F

    2001-07-01

    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{sup 2}, average potency 1,25 W, pulse width 300 {mu}s, fiber core diameter 300 {mu}s 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)

  11. Thermal analysis of different application techniques on Nd:YAG laser after root canal preparation of single-rooted teeth; Analise termica de diferentes tecnicas de utilizacao do laser de Nd:YAG apos o preparo quimico-cirurgico de dentes unirradiculares

    Energy Technology Data Exchange (ETDEWEB)

    Archilla, Jose Ricardo de F

    2001-07-01

    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{sup 2}, average potency 1,25 W, pulse width 300 {mu}s, fiber core diameter 300 {mu}s 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)

  12. Laser induced explosive vapor and cavitation resulting in effective irrigation of the root canal. Part 1: a visualization study.

    Science.gov (United States)

    Blanken, Jan; De Moor, Roeland Jozef Gentil; Meire, Maarten; Verdaasdonk, Rudolf

    2009-09-01

    Limited information exists regarding the induction of explosive vapor and cavitation bubbles in an endodontic rinsing solution. It is also not clear whether a fiber has to be moved in the irrigation solution or can be kept stationary. No information is available on safe power settings for the use of cavitation in the root canal. This study investigates the fluid movements and the mechanism of action caused by an Er,Cr:YSGG laser in a transparent root model. Glass models with an artificial root canal (15 mm long, with a 0.06 taper and apical diameter of 400 microm) were used for visualization and registration with a high-speed imaging technique (resolution in the microsecond range) of the creation of explosive vapor bubbles with an Er,Cr:YSGG laser at pulse energies of 75, 125, and 250 mJ at 20 Hz using a 200 microm fiber (Z2 Endolase). Fluid movement was investigated by means of dyes and visualization of the explosive vapor bubbles, and as a function of pulse energy and distance of the fiber tip to the apex. The recordings in the glass model show the creation of expanding and imploding vapor bubbles with secondary cavitation effects. Dye is flushed out of the canal and replaced by surrounding fluid. It seems not necessary to move the fiber close to the apex. Imaging suggests that the working mechanism of an Er,Cr:YSGG laser in root canal treatment in an irrigation solution can be attributed to cavitation effects inducing high-speed fluid motion into and out the canal.

  13. Microcomputed tomography analysis of mesiobuccal orifices and major apical foramen in first maxillary molars.

    Science.gov (United States)

    Spagnuolo, Gianrico; Ametrano, Gianluca; D'Antò, Vincenzo; Formisano, Anna; Simeone, Michele; Riccitiello, Francesco; Amato, Massimo; Rengo, Sandro

    2012-01-01

    Aim of the study was to determined by microcomputed tomography (µCT) the horizontal distance between the main (MB1) and the second mesiobuccal canal (MB2) orifices, the vertical distance between the MB1 and MB2 orifices planes, and the distance between the anatomic apex and major apical foramen (AF). Furthermore, we characterized the entire internal and external anatomy of the MB, distalbuccal (DB) and palatal (P) maxillary first molars roots. Twenty-two intact extracted first maxillary molars were scanned by X-ray computed transaxial µCT and then 2D and 3D images were processed and analyzed. The results showed that 77.27% of the mesiobuccal (MB) roots presented a second MB canal, and 29.41% of the MB2 were independent from the MB1 canals. In 15 teeth, there were three root canal orifices on the chamber floor, and 10 of these teeth presented MB2 canals. The mean vertical distance between the MB1 and MB2 planes was 1.68 ± 0.83 mm. Seven teeth had four orifices. The mean horizontal interorificial distance between the MB1 and MB2 orifices was 1.21 ± 0.5 mm. Accessory canals were observed in 33.33% of the roots, loops in 6.06%, while isthmuses were found in 15 of the 22 MB roots. Of the total roots, 74.24% presented one foramen, while all of the roots showed a major apical foramen that was not coincident with the anatomic apex. Our µCT analysis provided interesting features on the horizontal and vertical distance between the MB1 and MB2 orifices and on the distance of AF and anatomic apex. These results have an important clinical value because might support the endodontist in the recruitment, negotiation and obturation of maxillary first molar canal system.

  14. Effect of polymerization mode of two adhesive systems on push-out bond strength of fiber post to different regions of root canal dentin

    Directory of Open Access Journals (Sweden)

    Shahram Farzin Ebrahimi

    2014-01-01

    Full Text Available Background: A few studies have investigated the effect of the activation mode of adhesive systems on bond strength of fiber posts to root canal dentin. This study investigated the push-out bond strengths of a glass fiber post to different root canal regions with the use of two adhesives with light- and dual-cure polymerization modes. Materials and Methods: In this in vitro study, 40 maxillary central incisors were decoronated at cement-enamel junction with 15 ± 1 mm root length. After root canal therapy and post space preparations, they were randomly divided into four groups. Post spaces were treated with four different adhesives: Excite, Excite Dual cure Single Component (DSC, self-etch adhesive (AdheSE, and AdheSE dual-cure. Then the fiber-reinforced composite (FRC post, Postec Plus, was cemented with dual-cure resin cement, Variolink II. The roots were cut into three 2-mm-thick slices. Push-out tests were performed with a universal testing machine at a crosshead speed of 0.5 mm/min. The mode of failures was determined under a stereomicroscope. Data were analyzed by three-way analysis of variance (ANOVA and Tukey test was conducted to compare post hoc with P < 0.05 as the level of significance. Results: The highest bond strength was obtained for AdheSE dual-cure (15.54 ± 6.90 MPa and the lowest was obtained for Excite light-cure (10.07 ± 7.45 MPa and only the bond strength between these two adhesives had significant difference (P = 0.02. Bond strength decreased from the coronal to the apical in all groups and this was significant in Excite (group 1 and AdheSE (group 3 (P < 0.001. In apical regions, bond strength of dual-cure adhesives was significantly higher than light-cure adhesives (P < 0.001. Conclusion: Push-out bond strength of fiber post to different regions of root canal dentin was affected by both adhesive systems and their polymerization modes.

  15. Sealing ability of grar MTA AngelusTM, CPM TM and MBPc used as apical plugs

    Directory of Open Access Journals (Sweden)

    Fernando Accorsi Orosco

    2008-02-01

    Full Text Available This study evaluated the sealing ability of apical plugs fabricated with gray MTA AngelusTM sealer, CPM TM sealer and MBPc sealer. The root canals of 98 extracted single-rooted human teeth were instrumented with #5 to #1 Gates Glidden drills according to the crown-down technique until the #1 drill could pass through the apical foramen. The specimens were then prepared with K-files, starting with an ISO 50 until an ISO 90 could be visualized 1 mm beyond the apex. After root canal preparation, the external surface of each root was rendered impermeable and roots were assigned to 3 experimental groups (n = 30, which received a 5-mm thick apical plug of gray MTA AngelusTM, CPM TM and MBPc, and two control groups (n=4. The remaining portion of the canal in the experimental groups was filled by the lateral condensation technique. The teeth of each group, properly identified, were fixed on utility wax by their crowns and were placed in plastic flasks, leaving the apex free and facing upward. The flasks were filled with 0.2% Rhodamine B solution, pH 7.0, so as to completely cover the root apex of all teeth. The sealing ability was analyzed by measuring 0.2% Rhodamine B leakage after all groups had been maintained in this solution for 48 hours. Data were analyzed statistically by Kruskal-Wallis test and Dunn test with a=5%. The results showed that, among the tested materials used for fabrication of apical plugs, MBPc sealer had the least amount of leakage with statistically significant difference (p<0.05.

  16. Prevalence of Enterococcus faecalis and Porphyromonas gingivalis in infected root canals and their susceptibility to endodontic treatment procedures: A molecular study

    OpenAIRE

    Stojanović Nikola; Krunić Jelena; Popović Branka; Stojičić Sonja; Živković Slavoljub

    2014-01-01

    Introduction. Because apical periodontitis is recognizably an infectious disease, elimination or reduction of intracanal bacteria is of utmost importance for optimum treatment outcome. Objective. The prevalence of Enterococcus faecalis and Porphyromonas gingivalis in infected root canals was studied Also, the effect of endodontic therapy by using intracanal medicaments, calcium hydroxide paste (CH) or gutta-percha points containing calcium hydroxide (CH-GP)...

  17. Effect of different light curing methods on the push-out bond strength of glass fiber post to different root canal regions

    Directory of Open Access Journals (Sweden)

    Ali Eskandarizadeh

    2016-07-01

    Full Text Available Background and Aims: Slow polymerization rate in early stage of light curing process leads to higher monomers movement and entering in polymer network that cause higher mechanical properties.The aim of this study was to evaluate the effect of light activation methodes (immediate, 5 and 10 minutes delay on the push-out bond strength of cemented fiber posts in different regions of root canal with two types of resin cements. Materials and Methods: In sixty extracted human single canal, the teeth were decoronated from cement enamel junction and after root canal therapy, FRC postec plus were cemented with two resin cements, Duolink and Variolink 2, in three curing methods; immediate, 5 and 10 minutes of delay. After storing in a dark place for 24 hours, they were cut into three sections: coronal, middle and apical. The push-out bond strength test was performed using a universal testing machine. The failure modes were observed using a stereomicroscope. Data were analyzed using ANOVA and Tukey post hoc test (P0.05. In immediate light curing method, regardless of root region, Duolink had higher push-out bond strength than that of Variolink 2 (P=0.02. In all subgroups, there were reductions in the bond strengths from coronal to apical. Mixed failure at the cement-fiber post interface was predominent in all groups. Conclusion: 5 and 10 minutes delay caused reduction in the push-out bond strength for Variolink 2 but did not have significant effect for Duolink resin cement.

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

    Science.gov (United States)

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

    2017-03-01

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

  19. Effect of photon-initiated photoacoustic streaming on removal of apically placed dentinal debris.

    Science.gov (United States)

    Arslan, H; Capar, I D; Saygili, G; Gok, T; Akcay, M

    2014-11-01

    To compare the efficacy of photon-induced photoacoustic streaming (PIPS) technique with conventional, sonic and ultrasonic irrigation on the removal of apically placed dentinal debris from an artificial groove created in a root canal. Root canal preparation was performed up to size 40 on 48 extracted single-rooted teeth using ProTaper rotary instruments. The specimens were then split longitudinally, and a standardized groove was prepared in the apical part of each segment. Each groove was filled with dentinal debris mixed with 5% NaOCl. Each tooth was reassembled and irrigated as follows: (i) conventional irrigation with 1% NaOCl, (ii) sonic, (iii) ultrasonic irrigation, and (iv) PIPS. The root segments were disassembled, and the amount of remaining dentinal debris was evaluated under a stereomicroscope at 20× magnification, using a four-grade scoring system. The data were evaluated statistically using Kruskal-Wallis and Mann-Whitney U-tests with a 95% confidence level (P = 0.05). Photon-induced photoacoustic streaming removed significantly more dentinal debris than conventional irrigation (P streaming was more effective than conventional, sonic and ultrasonic irrigation in the removal of apically placed dentinal debris. © 2014 International Endodontic Journal. Published by John Wiley & Sons Ltd.

  20. 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<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.

  1. FISHing for gutta-percha-adhered biofilms in purulent post-treatment apical periodontitis.

    Science.gov (United States)

    Zehnder, M; Rechenberg, D-K; Thurnheer, T; Lüthi-Schaller, H; Belibasakis, G N

    2017-06-01

    This study investigated the possibility of depicting individual taxa in clinically relevant biofilms using fluorescent in situ hybridization (FISH). Gutta-percha samples were collected from the apical aspect of root canals associated with a chronic apical abscess (test samples, n = 8). Corresponding control samples were obtained from previously filled root canals with apparently normal periapical tissues (n = 3). The transport medium was investigated for detached biofilm fragments using FISH staining and conventional epifluorescence microscopy. Gutta-percha samples were stained by multiplex FISH, and inspected using confocal laser scanning microscopy. FISH of the transport medium confirmed the presence of the main species formerly identified by conventional methods in post-treatment purulent endodontic infections, most prominently Fusobacterium spp., Bacteroidetes and Prevotellaceae. Treponemes were identified in five of eight cases associated with purulent infections, but Enterococcus faecalis and Staphylococcus spp. were not identified. The biofilms on gutta-percha from root canals associated with apical periodontitis showed dense aggregates of variable composition. Control samples contained few, if any, bacteria in the transport medium, and featured no biofilms on the respective gutta-percha specimens. The current study revealed some direct, visual in situ information on the nature of biofilms associated with purulent periapical infections in man. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Review of root canal irrigant delivery techniques and devices

    Directory of Open Access Journals (Sweden)

    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.

  3. An in vitro comparative study of the adaptation and sealing ability of two carrier-based root canal obturators.

    Science.gov (United States)

    Alkahtani, Ahmed; Al-Subait, Sara; Anil, Sukumaran

    2013-01-01

    The study was done to assess the sealing ability and adaptation of RealSeal 1, and to compare it with Thermafil. 65 single-rooted extracted teeth were selected and root canal treatment was performed. Root canals were obturated with RealSeal 1 or Thermafil. A double chamber bacterial leakage model using E. faecalis was developed to assess the sealing ability. Samples were monitored daily for 60 days. After the bacterial leakage test, samples were embedded in resin and sectioned horizontally at 2 and 4 mm from the apical foramen. Specimens were examined under scanning electron microscope and digitally photographed. AutoCAD software was used to measure the gap between the canal surface and obturation material. Results were statistically analyzed using nonparametric Kaplan-Meier survival analysis for the bacterial leakage and t-test to compare the means of gap in RealSeal 1 and Thermafil at 2 and 4 mm. There was no significant difference between the RealSeal 1 and Thermafil with respect to leakage over time. At 2 mm and 4 mm, RealSeal 1 had significantly more gaps than Thermafil. From the observations it can be concluded that RealSeal 1 and Thermafil have comparable performance in terms of adaptation and sealing ability.

  4. An In Vitro Comparative Study of the Adaptation and Sealing Ability of Two Carrier-Based Root Canal Obturators

    Directory of Open Access Journals (Sweden)

    Ahmed Alkahtani

    2013-01-01

    Full Text Available The study was done to assess the sealing ability and adaptation of RealSeal 1, and to compare it with Thermafil. 65 single-rooted extracted teeth were selected and root canal treatment was performed. Root canals were obturated with RealSeal 1 or Thermafil. A double chamber bacterial leakage model using E. faecalis was developed to assess the sealing ability. Samples were monitored daily for 60 days. After the bacterial leakage test, samples were embedded in resin and sectioned horizontally at 2 and 4 mm from the apical foramen. Specimens were examined under scanning electron microscope and digitally photographed. AutoCAD software was used to measure the gap between the canal surface and obturation material. Results were statistically analyzed using nonparametric Kaplan-Meier survival analysis for the bacterial leakage and t-test to compare the means of gap in RealSeal 1 and Thermafil at 2 and 4 mm. There was no significant difference between the RealSeal 1 and Thermafil with respect to leakage over time. At 2 mm and 4 mm, RealSeal 1 had significantly more gaps than Thermafil. From the observations it can be concluded that RealSeal 1 and Thermafil have comparable performance in terms of adaptation and sealing ability.

  5. 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.

  6. Comparison of Curved Root Canals Prepared with Various Chelating Agents

    Science.gov (United States)

    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

  7. Root canal preparation with Er:YSGG laser

    Science.gov (United States)

    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.

  8. Root canal morphology and variations of mandibular premolars by clearing technique: an in vitro study.

    Science.gov (United States)

    Parekh, Vaishali; Shah, Nimisha; Joshi, Hardik

    2011-07-01

    The aim of this study was to compare internal anatomy between first and second mandibular premolars and to study different percentage variations of root canal morphology of mandibular premolars in Gujarat population based on Vertucci's classification by clearing technique. A total of 80 extracted intact permanent mandibular premolars (40 each mandibular first premolar and mandibular second premolar) with fully formed apices were collected. Access cavity was prepared with endo access kit, all samples were placed in 2.5% sodium hypochlorite for 48 hours, after that all samples were washed in running water for 2 hours. After washing, all samples were transferred to 5% nitric acid, for decalcification, for 72 hours, with the acid being changed every 24 hours and stirred once every 8 hours. All samples were washed in running water and dehydrated using ascending grades (70%, 80%, 90% and 100%) of isopropyl alcohol for 2 days. Finally, they were rendered transparent by immersion in methyl salicylate for 15 minutes and then India ink dye was injected into the access cavity. The anatomy of the root canal was observed and classified based on the Vertucci's classification. Parametric Z-test was used to compare the variation between mandibular first and second premolars. In mandibular first premolar, type 1 was found in 20%, type 2 was 5%, type 3 was 5%, type 4 was 25%, type 5 was 12.5% and type 6 was 2.5% of total samples. Whereas, in mandibular second premolar, type 1 was found in 80% out of all samples, type 4 was 2.5%, type 5 was 17.5%. Type 2, type 3, type 6, type 7 and type 8 were not found in this study. Mandibular first premolar showed higher variation (75%) compared to mandibular second premolar (37.5%). The knowledge of variations in the root canal morphology of the mandibular premolars can enhance the level of endodontic treatment of mandibular premolars. Root canal morphology, Vertucci's classification, Clearing technique. How to cite this article: Parekh V, Shah N

  9. An in vitro Evaluation on a Novel Root Canal Cleansing Method by Using Nylon Fibers

    Directory of Open Access Journals (Sweden)

    Shiqian Gao

    2015-07-01

    Full Text Available Despite traditional metal-based dental files, such as NiTi being demonstrated effective in root cleaning, the tooth structure is always damaged. Thus, to fulfill the need for a minimally invasive tool for contemporary endodontics and dentistry, the use of polymer fibers might provide a good option, as it is soft, fabricable, and disposable. In this study, two types of nylon fibers with respective average diameters of 206.9 µm (fiber W and 156.4 µm (fiber B, respectively, were used as dental files, and mounted onto either a reciprocating or a low-speed rotary hand-piece. In vitro, simulated root canal models were colored red using nail varnish, and then cleaned by the fiber files mounted on the hand-pieces. Three parts of the simulated models, i.e., the apical third, the medium third, and the coronal third, were chosen to assess the cleaning the efficiency (CE of each specimen by calculating the ratio of the cross-sectional area changes, before and after cleansing, using micro-Computer Tomography (CT. A NiTi file with a low-speed hand-piece was used as a control. SEM was used to observe the nylon fiber surfaces before and after the cleansing. Micro-CT results showed that for both the nylon fibers, W and B, an average CE of 82.11% ± 9.68% for the medium third could be achieved, which is statistically higher (p < 0.01 than the coronal third and apical third. The cleansing efficiency was not affected by, the types of fibers, nor the hand-pieces according to student’s t-test. Most of the nylon fibers could withstand deformation after the cleansing. To conclude, nylon fiber files have demonstrated a certain cleansing efficiency in simulated root canals, and micro-CT is a promising method to assess CE.

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

    Science.gov (United States)

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

    2013-08-01

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

  11. Reduction in bacterial counts in infected root canals after rotary or hand nickel-titanium instrumentation--a clinical study.

    Science.gov (United States)

    Rôças, I N; Lima, K C; Siqueira, J F

    2013-07-01

    To compare the antibacterial efficacy of two instrumentation techniques, one using hand nickel-titanium (NiTi) instruments and the other using rotary NiTi instruments, in root canals of teeth with apical periodontitis. Root canals from single-rooted teeth were instrumented using either hand NiTi instruments in the alternated rotation motion technique or rotary BioRaCe instruments. The irrigant used in both groups was 2.5% NaOCl. DNA extracts from samples taken before and after instrumentation were subjected to quantitative analysis by real-time polymerase chain reaction (qPCR). Qualitative analysis was also performed using presence/absence data from culture and qPCR assays. Bacteria were detected in all S1 samples by both methods. In culture analysis, 45% and 35% of the canals were still positive for bacterial presence after hand and rotary NiTi instrumentation, respectively (P > 0.05). Rotary NiTi instrumentation resulted in significantly fewer qPCR-positive cases (60%) than hand NiTi instrumentation (95%) (P = 0.01). Intergroup comparison of quantitative data showed no significant difference between the two techniques. There was no significant difference in bacterial reduction in infected canals after instrumentation using hand or rotary NiTi instruments. In terms of incidence of positive results for bacteria, culture also showed no significant differences between the groups, but the rotary NiTi instrumentation resulted in more negative results in the more sensitive qPCR analysis. © 2013 International Endodontic Journal. Published by John Wiley & Sons Ltd.

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

    Directory of Open Access Journals (Sweden)

    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.

  13. Root canal preparation in endodontics: conventional versus laser methods

    Science.gov (United States)

    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.

  14. [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.

  15. Comparison of apical transportation and change of working length in K3, NRT AND PROFILE rotary instruments using transparent resin block

    Directory of Open Access Journals (Sweden)

    Min-Jung Yoon

    2011-01-01

    Full Text Available Objectives The purpose of this study is to compare the apical transportation and working length change in curved root canals created in resin blocks, using 3 geometrically different types of Ni-Ti files, K3, NRT, and Profile. Materials and Methods The curvature of 30 resin blocks was measured by Schneider technique and each groups of Ni-Ti files were allocated with 10 resin blocks at random. The canals were shaped with Ni-Ti files by Crown-down technique. It was analyzed by Double radiograph superimposition method (Backman CA 1992, and for the accuracy and consistency, specially designed jig, digital X-ray, and CAD/CAM software for measurement of apical transportation were used. The amount of apical transportation was measured at 0, 1, 3, 5 mm from 'apical foramen - 0.5 mm' area, and the alteration of the working length before and after canal shaping was also measured. For statistics, Kruskal-Wallis One Way Analysis was used. Results There was no significant difference between the groups in the amount of working length change and apical transportation at 0, 1, and 3 mm area (p = 0.027, however, the amount of apical transportation at 5 mm area showed significant difference between K3 and Profile system (p = 0.924. Conclusions As a result of this study, the 3 geometrically different Ni-Ti files showed no significant difference in apical transportation and working length change and maintained the original root canal shape.

  16. The Effect of Diode Laser Treatment for Root Canal Disinfection on Fracture Resistance and Micro-hardness of the Tooth

    International Nuclear Information System (INIS)

    Elmiligy, H.H; Diab, A.H.; Sabet, N.E.; Saafan, A.M.

    2014-01-01

    This study evaluated the effect of diode laser treatment for root canal disinfection on fracture resistance and micro-hardness of the tooth. Sixty freshly extracted mandibular and maxillary premolars were accessed under coolant then root canals were flared up to apical preparation size 40 MFA coupled with 5.25% NaOCl as an irrigant. Teeth were divided into two groups, control group (group I) and lased group (group II) that was lased by diode laser with average power 2 w through fibrooptic into the canal 2 mm shorter than the apex. Each tooth was embedded in acrylic block, and then subjected to the fracture resistance test. Each root was then sectioned transversely and polished to record dentin Vickers hardness. Data was analysed with student t-test then with linear regression test. The Lased samples presented a significantly higher resistance to fracture than unlased samples. There was no statistically significant differences found between Vickers hardness (HV) of lased and unlased samples and there was no relation between fracture resistance and microhardness. Diode laser (980 nm) treatment had no adverse effect on dentin microhardness, also it increased the fracture resistance of dentin. Diode laser (980 nm) treatment could attain better function ability and maintenance of tooth after endodontic treatment.

  17. 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.

  18. Prevalence of ciliated epithelium in apical periodontitis lesions.

    Science.gov (United States)

    Ricucci, Domenico; Loghin, Simona; Siqueira, José F; Abdelsayed, Rafik A

    2014-04-01

    This article reports on the morphologic features and the frequency of ciliated epithelium in apical cysts and discusses its origin. The study material consisted of 167 human apical periodontitis lesions obtained consecutively from patients presenting for treatment during a period of 12 years in a dental practice operated by one of the authors. All of the lesions were obtained still attached to the root apices of teeth with untreated (93 lesions) or treated canals (74 lesions). The former were obtained by extraction and the latter by extraction or apical surgery. Specimens were processed for histopathologic and histobacteriologic analyses. Lesions were classified, and the type of epithelium, if present, was recorded. Of the lesions analyzed, 49 (29%) were diagnosed as cysts. Of these, 26 (53%) were found in untreated teeth, and 23 (47%) related to root canal-treated teeth. Ciliated columnar epithelium was observed partially or completely lining the cyst wall in 4 cysts, and all of them occurred in untreated maxillary molars. Three of these lesions were categorized as pocket cysts, and the other was a true cyst. Ciliated columnar epithelium-lined cysts corresponded to approximately 2% of the apical periodontitis lesions and 8% of the cysts of endodontic origin in the population studied. This epithelium is highly likely to have a sinus origin in the majority of cases. However, the possibility of prosoplasia or upgraded differentiation into ciliated epithelium from the typical cystic lining squamous epithelium may also be considered. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  19. Relationship between the Apical Preparation Diameter and the Apical Seal: An In Vitro Study

    Directory of Open Access Journals (Sweden)

    Kaoutar Laslami

    2018-01-01

    Full Text Available Objectives. The aim of the study is to define the relationship between the apical preparation diameter and the apical sealing ability to highlight the importance of the preservation of the diameter and the original position of the apical foramen. Materials and Methods. 50 extracted maxillary incisors were randomly allocated into three groups of 15 teeth each (n = 15 according to the apical preparation size: Group 1: finishing file F1 corresponding to size 20 reached the working length (ProTaper Universal system Dentsply®; Group 2: prepared up to size 30 corresponding to finishing file F30; Group 3: prepared up to size 50 corresponding to finishing file F5. Five teeth were assigned to positive and negative control groups. After the filling of the root canals, the teeth were isolated and immersed in a dye solution, then cut longitudinally, photographed, and the dye penetration were calculated using a computer software. Results. Comparison of the three different apical preparation sizes showed no statistically significant differences regarding the apical microleakage. Conclusion. The most important value of the dye penetration was observed in the group with the largest apical diameter.

  20. Maxillary lateral incisors with two canals and two separate curved roots

    Directory of Open Access Journals (Sweden)

    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.

  1. Assessment of the nonoperated root after apical surgery of the other root in mandibular molars

    DEFF Research Database (Denmark)

    Kraus, Riccardo D; von Arx, Thomas; Gfeller, David

    2015-01-01

    INTRODUCTION: If a surgical approach is chosen to treat a multirooted tooth affected by persistent periapical pathosis, usually only the affected roots are operated on. The present study assessed the periapical status of the nonoperated root 5 years after apical surgery of the other root in mandi...

  2. "In vitro" evaluation of the apical sealing of root canals obturated with different techniques Avaliação "in vitro" do selamento apical dos canais radiculares em função de diferentes técnicas de obturação

    Directory of Open Access Journals (Sweden)

    Viviane Haiub Brosco

    2003-09-01

    Full Text Available The purpose of this study was to compare the apical sealing of root canals obturated with different techniques. One hundred-six human mandibular incisors were submitted to instrumentation by means of the step-back technique. After instrumentation, one hundred teeth received an impermeable coating on the external surfaces of the crown and root (except for the area nearby the apical foramen. Afterwards, they were divided in five groups containing twenty elements each, according to the obturation technique employed: 1. lateral condensation with Kerr file; 2. continuous wave of condensation technique with System B; 3. thermoplasticized injectable gutta-percha technique with the Ultrafil system; 4. mechanically thermoplasticized gutta-percha with the JS Quick-Fill system and 5. thermoplasticized gutta-percha associated to a master cone with the Microseal system. The six remaining teeth were employed as negative and positive controls. After obturation, the access cavities were sealed and the teeth were immersed in aqueous 2% methylene blue dye for 72 hours at 37ºC. After that, the teeth were longitudinally sectioned and the apical microleakage was evaluated in a stereomicroscope. The Microseal system presented the best apical sealing ability, followed by System B, JS Quick-Fill, Ultrafil and the lateral condensation technique. The statistical analysis of the results demonstrated that: 1. the Microseal system presented an apical sealing similar to System B and better than the other groups; 2. System B presented better apical sealing than the lateral condensation technique, being similar to the other groups; and 3. the lateral condensation, Ultrafil and JS Quick-Fill groups demonstrated similar sealing ability.Este estudo teve como objetivo avaliar o selamento apical de canais radiculares obturados por diferentes técnicas. Cento e seis incisivos inferiores humanos tiveram seus canais instrumentados através da técnica escalonada regressiva. Após a

  3. Absorbable Suture as an Apical Matrix in Single Visit Apexification with Mineral Trioxide Aggregate

    Directory of Open Access Journals (Sweden)

    Ayush Goyal

    2016-01-01

    Full Text Available Several procedures have been recommended to induce the root end barrier formation in teeth with open apices. Conventional treatment for such cases will require many appointments with an average duration of 12.9 months. During this period, the root canal is susceptible to reinfection from around the provisional restoration, which may promote apical periodontitis and arrest of apical repair. Mineral trioxide aggregate (MTA has been successfully used for one visit apexification wherein the root canal can be obturated within 24 hours after placement of MTA. Using a matrix prior to the placement of MTA avoids its extrusion, reduces leakage in the sealing material, and allows favorable response of the periapical tissues. This report presents a case of apexification where an absorbable suture was used as an apical matrix. Use of an absorbable suture circumvents all the problems associated with other conventional materials. Conclusion. Placement of the matrix made from the suture material is predictable and is easily positioned at the apex and the length can be adjusted as required. 10-month follow-up of the case shows resorbed matrix and bone healing in the periapical region. The patient was asymptomatic during the whole follow-up period and tooth exhibited mobility within physiologic limits and was functioning normally.

  4. Absorbable Suture as an Apical Matrix in Single Visit Apexification with Mineral Trioxide Aggregate.

    Science.gov (United States)

    Goyal, Ayush; Nikhil, Vineeta; Jha, Padmanabh

    2016-01-01

    Several procedures have been recommended to induce the root end barrier formation in teeth with open apices. Conventional treatment for such cases will require many appointments with an average duration of 12.9 months. During this period, the root canal is susceptible to reinfection from around the provisional restoration, which may promote apical periodontitis and arrest of apical repair. Mineral trioxide aggregate (MTA) has been successfully used for one visit apexification wherein the root canal can be obturated within 24 hours after placement of MTA. Using a matrix prior to the placement of MTA avoids its extrusion, reduces leakage in the sealing material, and allows favorable response of the periapical tissues. This report presents a case of apexification where an absorbable suture was used as an apical matrix. Use of an absorbable suture circumvents all the problems associated with other conventional materials. Conclusion . Placement of the matrix made from the suture material is predictable and is easily positioned at the apex and the length can be adjusted as required. 10-month follow-up of the case shows resorbed matrix and bone healing in the periapical region. The patient was asymptomatic during the whole follow-up period and tooth exhibited mobility within physiologic limits and was functioning normally.

  5. Cone beam computed tomography study of apical root resorption induced by Herbst appliance

    Science.gov (United States)

    SCHWARTZ, João Paulo; RAVELI, Taísa Boamorte; ALMEIDA, Kélei Cristina de Mathias; SCHWARTZ-FILHO, Humberto Osvaldo; RAVELI, Dirceu Barnabé

    2015-01-01

    Objective This study evaluated the frequency of root resorption during the orthodontic treatment with Herbst appliance by Cone Beam Computed Tomography (CBCT). Material and Methods The sample comprised 23 patients (11 men, 12 women; mean ages 15.76±1.75 years) with Class II division 1 malocclusion, treated with Herbst appliance. CBCT was obtained before treatment (T0) and after Herbst treatment (T1). All the dental roots, except third molars, were evaluated, and apical root resorption was determined using the axial guided navigation method. Paired t-tests and Wilcoxon T Test were used to compare the dependent samples in parametric and nonparametric cases, respectively. Chi-Square Test with Yates’ correction was used to evaluate the relationship between apical root resorption and gender. Results were considered at a significance level of 5%. Results Apical resorption was detected by CBCT in 57.96% of 980 roots that underwent Herbst appliance treatment. All patients had minimal resorption and there was no statistical significance between the genders. Conclusion CBCT three-dimensional evaluation showed association between Herbst appliance and minimal apical root resorption, mostly in the anchoring teeth, without clinical significance. PMID:26537718

  6. Cone beam computed tomography study of apical root resorption induced by Herbst appliance

    Directory of Open Access Journals (Sweden)

    João Paulo SCHWARTZ

    2015-10-01

    Full Text Available Objective This study evaluated the frequency of root resorption during the orthodontic treatment with Herbst appliance by Cone Beam Computed Tomography (CBCT.Material and Methods The sample comprised 23 patients (11 men, 12 women; mean ages 15.76±1.75 years with Class II division 1 malocclusion, treated with Herbst appliance. CBCT was obtained before treatment (T0 and after Herbst treatment (T1. All the dental roots, except third molars, were evaluated, and apical root resorption was determined using the axial guided navigation method. Paired t-tests and Wilcoxon T Test were used to compare the dependent samples in parametric and nonparametric cases, respectively. Chi-Square Test with Yates’ correction was used to evaluate the relationship between apical root resorption and gender. Results were considered at a significance level of 5%.Results Apical resorption was detected by CBCT in 57.96% of 980 roots that underwent Herbst appliance treatment. All patients had minimal resorption and there was no statistical significance between the genders.Conclusion CBCT three-dimensional evaluation showed association between Herbst appliance and minimal apical root resorption, mostly in the anchoring teeth, without clinical significance.

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

    Directory of Open Access Journals (Sweden)

    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.

  8. Influence of Heat Treatment of Nickel-Titanium Rotary Endodontic Instruments on Apical Preparation: A Micro-Computed Tomographic Study.

    Science.gov (United States)

    de Almeida, Bernardo Corrêa; Ormiga, Fabíola; de Araújo, Marcos César Pimenta; Lopes, Ricardo Tadeu; Lima, Inayá Corrêa Barbosa; dos Santos, Bernardo Camargo; Gusman, Heloisa

    2015-12-01

    The aim of this study was to make a 3-dimensional comparison of the canal transportation and changes in apical geometry using micro-computed tomographic imaging after canal preparation with K3 (SybronEndo, Orange, CA) and K3XF (SybronEndo) file systems. Twenty-eight mandibular molars were randomly divided into 2 groups according to the rotary system used in instrumentation: K3 or K3XF. The specimens were scanned by micro-computed tomographic imaging before and after instrumentation. Images before and after instrumentation from each group were compared with regard to canal volume, surface area, and structure model index (SMI) (paired t test, P instrumentation, the canals from each group were compared regarding the changes in volume, surface area, SMI, and canal transportation in the last 4 apical mm (t test, P Instrumentation with the 2 rotary systems significantly changed the canal volume, surface area, and SMI (P instrument types concerning these parameters (P > .05). There were no significant differences between the 2 groups with regard to canal transportation in the last 4 apical mm (P > .05). Both rotary systems showed adequate canal preparations with reduced values of canal transportation. Heat treatment did not influence changes in root canal geometry in the apical region. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  9. Apical extrusion of debris and irrigants using hand and three rotary instrumentation systems − An in vitro study.

    Science.gov (United States)

    Madhusudhana, Koppolu; Mathew, Vinod Babu; Reddy, Nelaturi Madhusudhan

    2010-10-01

    Sterilization of the root canal is a prime aim of successful endodontics. The cleaning and shaping of the canal is directed as achieving this goal. The extrusion of apical debris has a deleterious effect on the prognosis of root canal treatment. Several instrument designs and instrumentation techniques have been developed to prevent this. Forty caries free single rooted human mandibular premolar teeth were divided in four groups of ten teeth each. Teeth in each group were instrumented until the working length with rotary ProTaper, K3, Mtwo systems, and hand K-type stainless steel files. Debris and irrigant extruded from the apical foramen were collected into vials and the amounts were quantitatively determined. The data obtained were analyzed using Kruskal-Wallis one-way analysis of variance and Mann-Whitney U tests. The results show that all instrumentation techniques produced significant amount of extruded debris and irrigant. The engine-driven nickel-titanium systems showed less apical extrusion of debris and irrigant than manual technique. No statistically significant difference was found between the groups at [P > 0.05]. Maximum apical debris and irrigant extrusion was seen with K-file group and least in the Mtwo group. The use of rotary files and techniques to perform instrumentation does show less extrusion of the debris and irrigant from the apex. This can contribute to more successful endodontic therapy.

  10. Antibacterial effect of root canal preparation and calcium hydroxide paste (Calen intracanal dressing in primary teeth with apical periodontitis Efeito antibacteriano do preparo biomecânico e do curativo de demora com pasta à base de hidróxido de cálcio (Calen em dentes decíduos com lesão periapical

    Directory of Open Access Journals (Sweden)

    Gisele Faria

    2005-12-01

    Full Text Available The aim of this study was to evaluate the antibacterial action of root canal mechanical preparation using 2.5% sodium hypochlorite as the irrigating solution and a calcium hydroxide paste as the antibacterial intracanal dressing in human primary teeth root canals with pulp necrosis and apical periodontitis by means of microbial culture. A total of 26 root canals of human primary teeth with pulp necrosis and apical periodontitis were used. Samples were collected before, 72h after biomechanical treatment and 72h after removal of the intracanal dressing. Comparison by Wilcoxon test showed that root canal mechanical preparation effectively eliminated all microorganisms in 20% of the root canals, and the intracanal dressing in 62.5%; however, the cumulative action of biomechanical treatment and intracanal dressing eliminated the microorganisms of 70% of the root canals (pO objetivo do presente estudo foi avaliar, por meio de cultura bacteriológica, a ação antibacteriana do preparo biomecânico utilizando como solução irrigadora o hipoclorito de sódio a 2,5% e da pasta Calen utilizada como curativo de demora em canais radiculares de dentes decíduos de humanos com necrose pulpar e lesão periapical. Foram selecionados 26 dentes decíduos de humanos portadores de necrose pulpar e lesão periapical. As colheitas microbiológicas foram efetuadas antes e 72 horas após o preparo biomecânico e 72 horas após a remoção do curativo de demora. A comparação por meio do teste de Wilcoxon mostrou que o preparo biomecânico foi eficaz na eliminação dos microrganismos dos canais radiculares em 20% dos casos e o curativo de demora em 62,5%, enquanto que a ação cumulativa do preparo biomecânico e do curativo de demora eliminou os microrganismos em 70,0% dos casos (p<0.001. Pôde-se concluir que o preparo biomecânico, isoladamente, apresentou resultados microbiológicos inferiores àqueles obtidos quando o mesmo foi associado ao curativo de demora

  11. 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...

  12. Microbiological analysis of infected root canals from symptomatic and asymptomatic teeth with periapical periodontitis and the antimicrobial susceptibility of some isolated anaerobic bacteria.

    Science.gov (United States)

    Jacinto, R C; Gomes, B P F A; Ferraz, C C R; Zaia, A A; Filho, F J Souza

    2003-10-01

    The purpose of the present study was to investigate the correlation between the composition of the bacterial flora isolated from infected root canals of teeth with apical periodontitis with the presence of clinical signs and symptoms, and to test the antibiotic susceptibility of five anaerobic bacteria mostly commonly found in the root canals of symptomatic teeth against various substances using the E-test. Microbial samples were taken from 48 root canals, 29 symptomatic and 19 asymptomatic, using adequate techniques. A total of 218 cultivable isolates were recovered from 48 different microbial species and 19 different genera. Root canals from symptomatic teeth harbored more obligate anaerobes and a bigger number of bacterial species than the asymptomatic teeth. More than 70% of the bacterial isolates were strict anaerobes. Statistical analysis used a Pearson Chi-squared test or a one-sided Fisher's Exact test as appropriate. Suggested relationships were found between specific microorganisms, especially gram-negative anaerobes, and the presence of spontaneous or previous pain, tenderness to percussion, pain on palpation and swelling amoxicillin, amoxicillin + clavulanate and cephaclor were effective against all the strains tested. The lowest susceptibility rate was presented by Prevotella intermedia/nigrescens against Penicillin G. Our results suggested that specific bacteria are associated with endodontic symptoms of infected teeth with periapical periodontitis and the majority of the anaerobic bacterial species tested were susceptible to all antibiotics studied.

  13. Prevalence of Enterococcus faecalis and Porphyromonas gingivalis in infected root canals and their susceptibility to endodontic treatment procedures: a molecular study.

    Science.gov (United States)

    Stojanović, Nikola; Krunić, Jelena; Popović, Branka; Stojičić, Sonja; Zivković, Slavoljub

    2014-01-01

    Because apical periodontitis is recognizably an infectious disease, elimination or reduction of intracanal bacteria is of utmost importance for optimum treatment outcome. The prevalence of Enterococcus faecalis and Porphyromonas gingivalis in infected root canals was studied Also, the effect of endodontic therapy by using intracanal medicaments, calcium hydroxide paste (CH) or gutta-percha points containing calcium hydroxide (CH-GP) or chlorhexidine (CHX-GP) on these microorganisms was assessed by polymerase chain reaction (PCR) assay. Fifty-one patients with chronic apical periodontitis were randomly allocated in one of the fol- lowing groups according to the intracanal medicament used: CH, CH-GP and CHX-GP group. Bacterial samples were taken upon access (S1), after chemomechanical instrumentation (S2) and after 15-day medication (S3). PCR assay was used to detect the presence of selected bacteria. E. faecalis was detected in 49% (25/51) and P. gingivalis in 17.6% (9/51) of the samples. Samples which showed no bacterial presence at S1 were excluded from further analysis. Overall analysis of all 29 samples revealed significant differences between S1 and S2 (p endodontic infection. Intracanal medication in conduction with instrumentation and irrigation efficiently eliminates E. faecalis and P. gingivalis from infected root canals.

  14. The effect of peracetic acid on removing calcium hydroxide from the root canals.

    Science.gov (United States)

    Sağsen, Burak; Ustün, Yakup; Aslan, Tuğrul; Canakçi, Burhan Can

    2012-09-01

    The goal of this study was to evaluate the efficiencies of different irrigation solutions in the removal of calcium hydroxide (CH). Forty-eight maxillary central incisor teeth were used. Root canals were prepared with the ProTaper system (Dentsply Maillefer, Baillagues, Switzerland). Five milliliters 2% NaOCl, 5 mL 17% EDTA, and 10 mL saline were used for final irrigation. The canals were filled with CH paste. Specimens were randomly divided into 4 experimental groups (n = 10) according to irrigation protocols. Positive and negative control groups (n = 4) were used. Group 1 used 2.5 mL 17% EDTA, group 2 used 2.5 mL 2.5% NaOCl + 2.5 mL 17% EDTA, group 3 used 2.5 mL 1% peracetic acid (PAA), and group 4 used 2.5 mL 0.5% PAA. The specimens were evaluated with scanning electron microscope analysis and scored. Kruskal-Wallis and Student Newman-Keuls post hoc tests were used for statistical analysis. In the apical thirds, 1% PAA was superior to the other groups (P .05). In the middle thirds, no significant differences were found among the groups (P > .05). In the coronal thirds, 1% PAA was superior to the other groups. There were significant differences among all the other groups (P < .05). According to the findings of the present study, 1% PAA could be recommended for the removal of CH from the root canals. Crown Copyright © 2012. Published by Elsevier Inc. All rights reserved.

  15. 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...

  16. 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.

  17. Effect of diode laser irradiation on the apical sealing of MTA retrofillings Efeito da irradiação de laser de diodo no selamento apical em retrobturações com MTA

    Directory of Open Access Journals (Sweden)

    Eliana Barbosa de Souza

    2006-09-01

    Full Text Available Apical sealing is essential for the success of paraendodontic surgery, so any procedure that may favor an adequate sealing of the apical remainder should be performed. The purpose of this study was to evaluate the influence of diode laser irradiation on the apical sealing of root-end cavities with MTA retrofillings. Root canals in twenty extracted human teeth were shaped with K-files and filled with gutta-percha. The apexes were cut off and root-end preparations were performed. The roots were divided randomly in 2 groups. Group 1 (ten specimens was retrofilled with MTA. Group 2 was irradiated with diode laser, with 1 W for 20 seconds, on the apical surface and root end cavity before retrofilling with MTA. The specimens had their external surfaces impermeabilized with cyanoacrylate, except for the apical surface, and were then immersed in 1% rhodamine B dye for 72 h and placed in plaster stone. After that, the specimens were submitted to longitudinal abrasion until half of the root remained. The linear dye leakage was observed in these mid-roots between the root canal wall and retrofilling. The linear dye leakage was measured with Image Lab software, and the results were statistically analyzed with Student's t test. There were no statistically significant differences between the two groups (p > 0.05. The diode laser irradiation did not improve the apical sealing of MTA retrofillings under the conditions of this in vitro study.O selamento apical é fundamental para o sucesso da cirurgia parendodôntica. Assim, procedimentos que melhorem o selamento do remanescente apical devem ser utilizados. O objetivo deste estudo foi verificar se a irradiação de laser de diodo poderia aumentar o selamento apical em cavidades retrógradas obturadas com MTA. Foram utilizadas 20 raízes de dentes humanos extraídos que, após preparo com lima tipo K, tiveram seus canais obturados com guta-percha. Os ápices foram cortados e sofreram preparo de cavidades retr

  18. Postoperative quality of life following single-visit root canal treatment performed by rotary or reciprocating instrumentation: a randomized clinical trial.

    Science.gov (United States)

    Pasqualini, D; Corbella, S; Alovisi, M; Taschieri, S; Del Fabbro, M; Migliaretti, G; Carpegna, G C; Scotti, N; Berutti, E

    2016-11-01

    To compare the impact of rotary and reciprocating instrumentation on postoperative quality of life (POQoL) after single-visit primary root canal treatment. A randomized controlled clinical trial was designed and carried out in a University endodontic practice in northern Italy. Healthy subjects with asymptomatic irreversible pulpitis, symptomatic irreversible pulpitis or pulp necrosis with or without apical periodontitis (symptomatic or asymptomatic) scheduled for primary root canal treatment were enrolled. Single-visit root canal treatment was performed with ProTaper ™ S1-S2-F1-F2 (rotary group, n = 23) and WaveOne ™ Primary (reciprocating group, n = 24). Irrigation was performed with 5% NaOCl and 10% EDTA. Root canal filling was performed with the continuous-wave technique and ZOE sealer. POQoL indicators were evaluated for 7 days post-treatment. The variation of each indicator over time was compared using anova for repeated measures (P rotary group (mean, P = 0.077; maximum, P = 0.015). Difficulty in eating (P = 0.017), in performing daily activities (P = 0.023), in sleeping (P = 0.021) and in social relations (P = 0.077), was more evident in the reciprocating group. Patients' perception of the impact of treatment on POQoL was more favourable in the rotary group (P = 0.006). Multirooted tooth type and pre-existing periradicular inflammation were associated with a decrease in POQoL. Reciprocating instrumentation affected POQoL to a greater extent than rotary instrumentation. © 2015 International Endodontic Journal. Published by John Wiley & Sons Ltd.

  19. Novel use of platelet-rich fibrin matrix and MTA as an apical barrier in the management of a failed revascularization case.

    Science.gov (United States)

    Yadav, Pankaj; Pruthi, Preeti Jain; Naval, Ruchika Roongta; Talwar, Sangeeta; Verma, Mahesh

    2015-08-01

    We report management of a failed revascularization/revitalization case, which could be due to inadequate removal of biofilm and bacteria in dentinal tubules. The use of an apical matrix barrier in form of a platelet-rich fibrin (PRF) membrane for stabilization of MTA in root end apexification procedure is described. The canal was cleansed of old MTA present in the cervical third using H files, irrigated using saline and finally irrigated with 2.5% NaOCl and saline. To obtain canal disinfection, calcium hydroxide paste was temporized in the canal. In subsequent appointments, PRF was placed at the root tip followed by 5-mm apical plug with mineral trioxide aggregate. One week later, the root canal was obturated with thermoplasticized gutta-percha. A 6-month and a 2-year follow ups showed reduction of periapical radiolucency and adequately functional tooth. One-visit apexification techniques provide an alternative treatment for failed revascularization cases. Follow up confirmed complete healing periradicularly. Apexification in one step using an apical barrier of PRF and a plug of MTA can be considered a predictable treatment and may be an alternative to long-term revascularization failures. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. Frequency and levels of candidate endodontic pathogens in acute apical abscesses as compared to asymptomatic apical periodontitis

    Science.gov (United States)

    Rôças, Isabela N.

    2018-01-01

    Introduction Acute apical abscess is caused by bacteria that leave the infected dental root canal to invade the periodontal tissues. Most species occurring in abscesses are also found in asymptomatic infections; therefore, the possibility exists that not only the presence of certain species but also their specific counts influence the appearance of symptoms. This molecular study compared the frequency and levels of several candidate endodontic pathogens in teeth with acute apical abscesses and asymptomatic apical periodontitis. Methods Samples were taken from the root canals of teeth with asymptomatic apical periodontitis (n = 73) and by aspiration of purulent exudate from acute abscesses (n = 55). DNA was extracted from samples and bacterial identifications were performed by a closed-ended semi-quantitative reverse-capture checkerboard approach targeting 40 bacterial species/phylotypes. Results Bacterial DNA was detected in all cases. In abscesses, the most prevalent taxa were Fusobacterium nucleatum (60%), Porphyromonas endodontalis (53%), Parvimonas micra (51%), and Streptococcus species (45%). The most frequently detected taxa in asymptomatic teeth were P. endodontalis (63%), Dialister invisus (58%), Olsenella uli (56%), and F. nucleatum (51%). None of the targeted taxa were significantly associated with abscesses when only mere presence was evaluated (p>0.05). However, semi-quantitative data demonstrated that P. endodontalis, Prevotella baroniae, Treponema denticola and Streptococcus species were significantly more frequent at levels >105 in abscesses than in asymptomatic cases (pabscesses in terms of frequency. However, some taxa were significantly found in higher levels in abscesses. Presence of a potentially virulent pathogen in high counts may increase the collective pathogenicity of the bacterial community and give rise to symptoms. PMID:29293651

  1. Frequency and levels of candidate endodontic pathogens in acute apical abscesses as compared to asymptomatic apical periodontitis.

    Science.gov (United States)

    Rôças, Isabela N; Siqueira, José F

    2018-01-01

    Acute apical abscess is caused by bacteria that leave the infected dental root canal to invade the periodontal tissues. Most species occurring in abscesses are also found in asymptomatic infections; therefore, the possibility exists that not only the presence of certain species but also their specific counts influence the appearance of symptoms. This molecular study compared the frequency and levels of several candidate endodontic pathogens in teeth with acute apical abscesses and asymptomatic apical periodontitis. Samples were taken from the root canals of teeth with asymptomatic apical periodontitis (n = 73) and by aspiration of purulent exudate from acute abscesses (n = 55). DNA was extracted from samples and bacterial identifications were performed by a closed-ended semi-quantitative reverse-capture checkerboard approach targeting 40 bacterial species/phylotypes. Bacterial DNA was detected in all cases. In abscesses, the most prevalent taxa were Fusobacterium nucleatum (60%), Porphyromonas endodontalis (53%), Parvimonas micra (51%), and Streptococcus species (45%). The most frequently detected taxa in asymptomatic teeth were P. endodontalis (63%), Dialister invisus (58%), Olsenella uli (56%), and F. nucleatum (51%). None of the targeted taxa were significantly associated with abscesses when only mere presence was evaluated (p>0.05). However, semi-quantitative data demonstrated that P. endodontalis, Prevotella baroniae, Treponema denticola and Streptococcus species were significantly more frequent at levels >105 in abscesses than in asymptomatic cases (p<0.05). None of the target species/phylotypes were associated with abscesses in terms of frequency. However, some taxa were significantly found in higher levels in abscesses. Presence of a potentially virulent pathogen in high counts may increase the collective pathogenicity of the bacterial community and give rise to symptoms.

  2. Management of immature teeth with apical infections using mineral trioxide aggregate

    Directory of Open Access Journals (Sweden)

    Sivakumar Nuvvula

    2010-01-01

    Full Text Available Traumatic injuries to the young permanent teeth lead to devitalization of the pulp with concomitant arrest in further development of the immature root of the involved tooth. Hermetic seal of the root canal system during obturation is not possible in such cases, due to the lack of an apical constriction. The traditional management technique in such cases has been apexification involving induction of a calcific barrier at the apex using calcium hydroxide, which in turn facilitates obturation of the root canal. However this becomes complicated when there is persistent infection leading to periapical changes. This case report describes the use of mineral trioxide aggregate (MTA for management of a periapically compromised immature tooth.

  3. Revascularization and periapical repair after endodontic treatment using apical negative pressure irrigation versus conventional irrigation plus triantibiotic intracanal dressing in dogs' teeth with apical periodontitis.

    Science.gov (United States)

    da Silva, Lea Assed Bezerra; Nelson-Filho, Paulo; da Silva, Raquel Assed Bezerra; Flores, Daniel Silva Herzog; Heilborn, Carlos; Johnson, James D; Cohenca, Nestor

    2010-05-01

    The objective of this study was to evaluate in vivo the revascularization and the apical and periapical repair after endodontic treatment using 2 techniques for root canal disinfection (apical negative pressure irrigation versus apical positive pressure irrigation plus triantibiotic intracanal dressing) in immature dogs' teeth with apical periodontitis. Two test groups of canals with experimentally induced apical periodontitis were evaluated according to the disinfection technique: Group 1, apical negative pressure irrigation (EndoVac system), and Group 2, apical positive pressure irrigation (conventional irrigation) plus triantibiotic intracanal dressing. In Group 3 (positive control), periapical lesions were induced, but no endodontic treatment was done. Group 4 (negative control) was composed of sound teeth. The animals were killed after 90 days and the maxillas and mandibles were subjected to histological processing. The sections were stained with hematoxylin and eosin and Mallory Trichrome and examined under light microscopy. A description of the apical and periapical features was done and scores were attributed to the following histopathological parameters: newly formed mineralized apical tissue, periapical inflammatory infiltrate, apical periodontal ligament thickness, dentin resorption, and bone tissue resorption. Intergroup comparisons were done by the Kruskal-Wallis and Dunn's tests (alpha = 0.05). Although statistically significant difference was found only for the inflammatory infiltrate (P irrigation with the EndoVac system can be considered as a promising disinfection protocol in immature teeth with apical periodontitis, suggesting that the use of intracanal antibiotics might not be necessary. Copyright (c) 2010 Mosby, Inc. All rights reserved.

  4. 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

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

    Science.gov (United States)

    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.

  6. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  8. Apical extrusion of debris and irrigants using hand and three rotary instrumentation systems- An in vitro study

    Directory of Open Access Journals (Sweden)

    Koppolu Madhusudhana

    2010-01-01

    Full Text Available Introduction: Sterilization of the root canal is a prime aim of successful endodontics. The cleaning and shaping of the canal is directed as achieving this goal. The extrusion of apical debris has a deleterious effect on the prognosis of root canal treatment. Several instrument designs and instrumentation techniques have been developed to prevent this. Materials and Methods: Forty caries free single rooted human mandibular premolar teeth were divided in four groups of ten teeth each. Teeth in each group were instrumented until the working length with rotary ProTaper, K3, Mtwo systems, and hand K-type stainless steel files. Debris and irrigant extruded from the apical foramen were collected into vials and the amounts were quantitatively determined. The data obtained were analyzed using Kruskal-Wallis one-way analysis of variance and Mann-Whitney U tests. Results: The results show that all instrumentation techniques produced significant amount of extruded debris and irrigant. The engine-driven nickel-titanium systems showed less apical extrusion of debris and irrigant than manual technique. No statistically significant difference was found between the groups at [P > 0.05]. Maximum apical debris and irrigant extrusion was seen with K-file group and least in the Mtwo group. Conclusions: The use of rotary files and techniques to perform instrumentation does show less extrusion of the debris and irrigant from the apex. This can contribute to more successful endodontic therapy.

  9. Apical extrusion of debris and irrigants using hand and three rotary instrumentation systems– An in vitro study

    Science.gov (United States)

    Madhusudhana, Koppolu; Mathew, Vinod Babu; Reddy, Nelaturi Madhusudhan

    2010-01-01

    Introduction: Sterilization of the root canal is a prime aim of successful endodontics. The cleaning and shaping of the canal is directed as achieving this goal. The extrusion of apical debris has a deleterious effect on the prognosis of root canal treatment. Several instrument designs and instrumentation techniques have been developed to prevent this. Materials and Methods: Forty caries free single rooted human mandibular premolar teeth were divided in four groups of ten teeth each. Teeth in each group were instrumented until the working length with rotary ProTaper, K3, Mtwo systems, and hand K-type stainless steel files. Debris and irrigant extruded from the apical foramen were collected into vials and the amounts were quantitatively determined. The data obtained were analyzed using Kruskal-Wallis one-way analysis of variance and Mann-Whitney U tests. Results: The results show that all instrumentation techniques produced significant amount of extruded debris and irrigant. The engine-driven nickel-titanium systems showed less apical extrusion of debris and irrigant than manual technique. No statistically significant difference was found between the groups at [P > 0.05]. Maximum apical debris and irrigant extrusion was seen with K-file group and least in the Mtwo group. Conclusions: The use of rotary files and techniques to perform instrumentation does show less extrusion of the debris and irrigant from the apex. This can contribute to more successful endodontic therapy. PMID:22114427

  10. 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.

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

    Science.gov (United States)

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

    2014-01-01

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

  12. 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.

  13. Evaluation of Apical Vapor Lock Formation and comparative Evaluation of its Elimination using Three different Techniques: An in vitro Study.

    Science.gov (United States)

    Agarwal, Anand; Deore, Rahul B; Rudagi, Kavitarani; Nanda, Zinnie; Baig, Mirza Osman; Fareez, Md Adil

    2017-09-01

    The aim of this study was (i) to evaluate the formation of air bubbles in the apical region of root canal (apical vapor lock) during syringe irrigation, using cone beam computed tomography (CBCT) and (ii) comparative evaluation of the elimination of an established vapor lock by EndoActivator, ultrasonics, and manual dynamic agitation (MDA), using CBCT. A total of 60 extracted human single-rooted teeth were equally divided into three groups of 20 teeth each. The samples were decoronated 17 mm from the apex, cleaned, and shaped to size F4 Protaper using 3% sodium hypochlorite. Samples were irrigated with 3% sodium hypochlorite + cesium chloride radiopaque dye, and preoperative CBCT images were obtained. After formation of apical vapor lock in the scanned teeth, EndoActivator (group I), passive ultrasonic irrigation (group II), and MDA with K-file (group III) were performed and the teeth were again placed in CBCT scanner and results analyzed using the chi-square test. The apical vapor lock was formed in all the samples. Out of the 20 teeth in each group, the apical vapor lock was eliminated in 18 samples of EndoActivator group (90%), 16 samples of ultrasonic group (80%), while it was eliminated in 10 samples by MDA (50%). It is concluded that (1) apical vapor lock is consistently formed during endodontic irrigation in closed canal systems and (2) sonic activation performs better than the ultrasonics and MDA in eliminating the apical vapor lock, with statistically significant difference between all the three groups (p < 0.05). The results suggest that the apical vapor lock (dead water zone) is consistently formed during routine endodontic irrigation which impedes irrigant penetration till the working length, thereby leading to inefficient debridement. Hence, to eliminate this vapor lock, techniques, such as sonics or ultrasonics should be used along with the irrigant after shaping and cleaning of the root canal.

  14. 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.

  15. Endodontic complications of root canal therapy performed by dental students with stainless-steel K-files and nickel-titanium hand files.

    Science.gov (United States)

    Pettiette, M T; Metzger, Z; Phillips, C; Trope, M

    1999-04-01

    Straightening of curved canals is one of the most common procedural errors in endodontic instrumentation. This problem is commonly encountered when dental students perform molar endodontics. The purpose of this study was to compare the effect of the type of instrument used by these students on the extent of straightening and on the incidence of other endodontic procedural errors. Nickel-titanium 0.02 taper hand files were compared with traditional stainless-steel 0.02 taper K-files. Sixty molar teeth comprised of maxillary and mandibular first and second molars were treated by senior dental students. Instrumentation was with either nickel-titanium hand files or stainless-steel K-files. Preoperative and postoperative radiographs of each tooth were taken using an XCP precision instrument with a customized bite block to ensure accurate reproduction of radiographic angulation. The radiographs were scanned and the images stored as TIFF files. By superimposing tracings from the preoperative over the postoperative radiographs, the degree of deviation of the apical third of the root canal filling from the original canal was measured. The presence of other errors, such as strip perforation and instrument breakage, was established by examining the radiographs. In curved canals instrumented by stainless-steel K-files, the average deviation of the apical third of the canals was 14.44 degrees (+/- 10.33 degrees). The deviation was significantly reduced when nickel-titanium hand files were used to an average of 4.39 degrees (+/- 4.53 degrees). The incidence of other procedural errors was also significantly reduced by the use of nickel-titanium hand files.

  16. Single Versus Multi‑visit Endodontic Treatment of Teeth with Apical ...

    African Journals Online (AJOL)

    Background: Apical periodontitis (AP) is one of the most prevalent diseases of the teeth. Treatment of AP is based on the removal of the cause, i.e., bacteria from the root canals. Achievement of adequate bacterial eradication in one appointment treatment remains a controversy. Aim: This prospective study was conducted ...

  17. 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.

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

    Science.gov (United States)

    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.

  19. Extrusion of Debris from Primary Molar Root Canals following Instrumentation with Traditional and New File Systems.

    Science.gov (United States)

    Thakur, Bhagyashree; Pawar, Ajinkya M; Kfir, Anda; Neelakantan, Prasanna

    2017-11-01

    To assess the amount of debris extruded apically during instrumentation of distal canals of extracted primary molars by three instrument systems [ProTaper Universal (PTU), ProTaper NEXT (PTN), and self-adjusting file (SAF)] compared with conventional stainless steel hand K-files (HF, control). Primary mandibular molars (n = 120) with a single distal canal were selected and randomly divided into four groups (n = 30) for root canal instrumentation using group I, HF (to size 0.30/0.02 taper), group II, PTU (to size F3), group III, PTN (to size X3), and group IV, SAF. Debris extruded during instrumentation was collected in preweighed Eppendorf tubes, stored in an incubator at 70°C for 5 days and then weighed. Statistical analysis was performed by one-way analysis of variance (ANOVA), followed by Turkey's post hoc test (p = 0.05). All the groups resulted in extrusion of debris. There was statistically significant difference (p < 0.001) in the debris extrusion between the three groups: HF (0.00133 ± 0.00012), PTU (0.00109 ± 0.00005), PTN (0.00052 ± 0.00008), and SAF (0.00026 ± 0.00004). Instrumentation with SAF resulted in the least debris extrusion when used for shaping root canals of primary molar teeth. Debris extrusion in primary teeth poses an adverse effect on the stem cells and may also alter the permanent dental germ. Debris extrusion is rarely reported for primary teeth and it is important for the clinician to know which endodontic instrumentation leads to less extrusion of debris.

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

    Science.gov (United States)

    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.

  1. Distribution of Porphyromonas gingivalis fimA genotypes in chronic apical periodontitis associated with symptoms.

    Science.gov (United States)

    Wang, Qian; Zhou, Xue-dong; Zheng, Qing-hua; Wang, Yao; Tang, Lu; Huang, Ding-ming

    2010-11-01

    Porphyromonas gingivalis (P. gingivalis) is an anaerobic bacterium involved in root canal infections whose fimbriae are classified into six genotypes (types I-V and Ib) based on nucleotide sequence. Accumulated evidence suggests there is significant association between P. gingivalis and some clinical symptoms of periodontal diseases. The present study aims to determine the prevalence of P. gingivalis fimA genotypes in apical periodontitis and to investigate the correlation between P. gingivalis fimA genotypes and clinical symptoms. Samples were obtained from 158 infected root canals with apical periodontitis. DNA was extracted and analyzed with a polymerase chain reaction-based identification assay. Odds ratios, 95% confidence intervals, and contingency coefficient were calculated for associating the fimA-specific genes with clinical symptoms. P. gingivalis was detected in 39.9% of the inflected root canal samples and was found in 44.5% of P. gingivalis-positive specimens with symptoms. Types II (69.4%) were the most frequent in the symptomatic cases followed by type IV (32.7%). The occurrence of type I (64.3%) was significantly higher than any other genotypes in the asymptomatic apical periodontitis, whereas type II and type Ib were not identified. Statistical analysis revealed that the occurrences of types II, IV, and Ib fimA were associated with greater risk of clinical signs (swelling, sinus tract, or intracanal exudates) than type I. Results from this study reinforce the association between P. gingivalis-specific fimA genotypic clones and apical periodontitis, indicating that fimA genotypes (types II, IV, and Ib) were related to the etiology of symptomatic periradicular diseases. Copyright © 2010 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  2. Pain following foraminal enlargement in mandibular molars with necrosis and apical periodontitis: A randomized controlled trial.

    Science.gov (United States)

    Saini, H R; Sangwan, P; Sangwan, A

    2016-12-01

    This randomized controlled trial was conducted to evaluate the effect of foraminal enlargement during chemomechanical root canal preparation on postoperative pain. Seventy mandibular first molars with asymptomatic pulp necrosis and chronic apical periodontitis were randomized into two groups - foraminal enlargement (FE) and conventional nonforaminal enlargement (NFE). Canals were prepared according to the respective protocols, and the teeth were restored temporarily. Postoperatively, the patients were prescribed ibuprofen 400 mg, to be taken if required. Pain experience and analgesic intake were recorded for 7 days following chemomechanical preparation. The data were analysed using Mann-Whitney U-test and chi-square tests. Pain experience was higher with foraminal enlargement than when using a conventional technique. A significant difference was observed in postoperative pain during the first 4 days and the sixth day (P  0.05). Enlargement of the apical foramen during root canal treatment increased the incidence and intensity of postoperative pain. © 2015 International Endodontic Journal. Published by John Wiley & Sons Ltd.

  3. 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.

  4. A cone-beam computed tomography study of orthodontic apical root resorption

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    Jian-Hong Yu

    2013-03-01

    Conclusion: Results show that larger tooth movement after orthodontic treatment may be associated with increased severity of root resorption. This study has demonstrated that CBCT is a useful approach for evaluating apical root resorption after orthodontic treatment.

  5. Comparison of Apical Extrusion of Debris by Using Single-File, Full-Sequence Rotary and Reciprocating Systems

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    Maryam Ehsani

    2017-01-01

    Full Text Available Objectives: During root canal preparation, apical extrusion of debris can cause inflammation, flare-ups, and delayed healing. Therefore, instrumentation techniques that cause the least extrusion of debris are desirable. This study aimed to compare apical extrusion of debris by five single-file, full-sequence rotary and reciprocating systems.Materials and Methods: One hundred twenty human mandibular premolars with similar root lengths, apical diameters, and canal curvatures were selected and randomly assigned to six groups (n=20: Reciproc R25 (25, 0.08, WaveOne Primary (25, 0.08, OneShape (25, 0.06, F360 (25, 0.04, Neoniti A1 (25, 0.08, and ProTaper Universal. Instrumentation of the root canals was performed in accordance with the manufacturers’ instructions. Each tooth's debris was collected in a pre-weighed vial. After drying the debris in an incubator, the mass was measured three times consecutively; the mean was then calculated. The preparation time by each system was also measured. For data analysis, one-way ANOVA and Games-Howell post hoc test were used.Results: The mean masses (±standard deviation of the apical debris were as follows: 2.071±1.38mg (ProTaper Universal, 1.702±1.306mg (Neoniti A1, 1.295±0.839mg (OneShape, 1.109±0.676mg (WaveOne, 0.976±0.478mg (Reciproc and 0.797±0.531mg (F360. Compared to ProTaper Universal, F360 generated significantly less debris (P=0.02. The ProTaper system required the longest preparation time (mean=88.6 seconds; the Reciproc (P=0.008, OneShape (P=0.006, and F360 (P=0.001 required significantly less time (P<0.05.Conclusions: All instruments caused extrusion of debris through the apex. The F360 produced significantly less debris than did the ProTaper Universal.Keywords: Dentistry; Endodontics; Root Canal Preparation; Instrumentation

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

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    Živković Slavoljub

    2010-01-01

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

  7. 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.

    Science.gov (United States)

    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.

  8. 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.

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

    Directory of Open Access Journals (Sweden)

    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

  10. Effects of loxoprofen on the apical root resorption during orthodontic tooth movement in rats.

    Science.gov (United States)

    Yamamoto, Taeko; Kaku, Masato; Sumi, Hiromi; Yashima, Yuka; Izumino, Jin; Tanimoto, Kotaro

    2018-01-01

    Studies have revealed that severe apical root resorption during tooth movement is caused by the noninfective inflammatory reaction of apical root tissues. We hypothesized that loxoprofen can suppress apical root resorption during tooth movement. Cyclic tensile force (CTF) of 10 kPa was applied to the human pulp cells for 48 hours by the Flexcell Strain Unit. Loxoprofen (10 and 100 μM) was added to the culture cells, and expression of cyclooxygenase (COX)-1, COX-2, interleukin (IL)-1β, receptor activator of nuclear factor kappa-B ligand (RANKL), tumor necrosis factor (TNF)-α, and macrophage colony-stimulating factor (M-CSF) were examined. To determine the effects of loxoprofen sodium on apical root reabsorption during tooth movement, the upper first molars of 7-week-old rats were subjected to mesial movement by 10g force for 30 days with or without the oral administration of loxoprofen. Gene expression and protein concentration of COX-1, COX-2, IL-1β, TNF-α, RANKL and M-CSF were significantly higher in the CTF group than in the control group. However, these levels were decreased by loxoprofen administration. After orthodontic tooth movement, the expression of IL-1β, TNF-α, RANKL and M-CSF decreased in the loxoprofen group than in the control group by immunohistochemical staining. In comparison to control group, less number of odontoclasts and a decrease in the amount of apical root resorption was observed in the loxoprofen group. Many osteoclasts became visible on the pressure side of the alveolar bone in the both groups, and the amount of tooth movement did not show a significant difference. These findings demonstrate that severe apical root resorption may be suppressed by loxoprofen administration, without a disturbance of tooth movement.

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

    Directory of Open Access Journals (Sweden)

    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.

  12. The relationship between apical root resorption and orthodontic tooth movement in growing subjects.

    Science.gov (United States)

    Xu, Tianmin; Baumrind, S

    2002-07-01

    To investigate the relationship between apical root resorption and orthodontic tooth movement in growing subjects. 58 growing subjects were collected randomly into the study sample and another 40 non-treated cases were used as control. The apical resoption of the upper central incisors was measured on periapical film and the incisor displacement was measured on lateral cephalogram. Using multiple linear regression analysis to examine the relationship between root resoption and the displacement of the upper incisor apex in each of four direction (retraction, advancement, intrusion and extrusion). The statistically significant negative association were found between resorption and both intrusion (P < 0.001) and extrusion (P < 0.05), but no significant association was found between resorption and both retraction and advancement. The regression analysis implied an average of 2.29 mm resorption in the absence of apical displacement. The likelihood that the magnitude of displacement of the incisor root is positively associated with root resoption in the population of treated growing subjects is very small.

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

    Science.gov (United States)

    Alrahabi, Mothanna

    2015-01-01

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

  14. 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

  15. Prognostic factors in apical surgery with root-end filling: a meta-analysis

    DEFF Research Database (Denmark)

    von Arx, Thomas; Peñarrocha, Miguel; Jensen, Simon Storgård

    2010-01-01

    Apical surgery has seen continuous development with regard to equipment and surgical technique. However, there is still a shortage of evidence-based information regarding healing determinants. The objective of this meta-analysis was to review clinical articles on apical surgery with root-end fill...

  16. A scanning electron microscopic evaluation of different root canal irrigation regimens Avaliação por microscopia eletrônica de varredura de diferentes regimes irrigantes no canal radicular

    Directory of Open Access Journals (Sweden)

    Chaves Medici Mônika

    2006-09-01

    Full Text Available The purpose of this study was to assess the effectiveness of endodontic irrigants in removing the smear layer from instrumented root canal walls using Scanning Electron Microscopy (SEM. The endodontic irrigants used were: 1% sodium hypochlorite (NaOCl; 1% NaOCl mixed to 17% EDTAC; 2% chlorhexidine gel; and Ricinus communis gel. Photomicrographs of the middle and apical thirds were evaluated with the aid of the Fotoscore - v. 2.0 software. The results indicated that the mixture of sodium hypochlorite and EDTAC completely removed the smear layer from dentinal walls. The other endodontic irrigants were not as efficient in cleansing the root canals.A proposta deste estudo foi avaliar, por meio de microscopia eletrônica de varredura (MEV, a efetividade dos irrigantes endodônticos na remoção da "smear layer" das paredes dos canais radiculares instrumentados. Os irrigantes endodônticos utilizados foram: solução de hipoclorito de sódio a 1%; solução de hipoclorito de sódio a 1% misturado ao EDTAC a 17%, gel de clorexidina a 2% e gel de Ricinus communis. Fotomicrografias dos terços médio e apical foram avaliadas com o auxílio do software Fotoscore - versão 2.0. Os resultados indicaram que a mistura da solução de hipoclorito de sódio e EDTAC removeu eficientemente a "smear layer" das paredes dentinárias. Os demais irrigantes endodônticos não foram tão eficientes na limpeza dos canais.

  17. Histologic study of a human immature permanent premolar with chronic apical abscess after revascularization/revitalization.

    Science.gov (United States)

    Becerra, Patricia; Ricucci, Domenico; Loghin, Simona; Gibbs, Jennifer L; Lin, Louis M

    2014-01-01

    Histologic studies of teeth from animal models of revascularization/revitalization are available; however, specimens from human studies are lacking. The nature of tissues formed in the canal of human revascularized/revitalized teeth was not well established. An immature mandibular premolar with infected necrotic pulp and a chronic apical abscess was treated with revascularization/revitalization procedures. At both the 18-month and 2-year follow-up visits, radiographic examination showed complete resolution of the periapical lesion, narrowing of the root apex without root lengthening, and minimal thickening of the canal walls. The revascularized/revitalized tooth was removed because of orthodontic treatment and processed for histologic examination. The large canal space of revascularized/revitalized tooth was not empty and filled with fibrous connective tissue. The apical closure was caused by cementum deposition without dentin. Some cementum-like tissue was formed on the canal dentin walls. Inflammatory cells were observed in the coronal and middle third of revascularized/revitalized tissue. In the present case, the tissue formed in the canal of a human revascularized/revitalized tooth was soft connective tissue similar to that in the periodontal ligament and cementum-like or bone-like hard tissue, which is comparable with the histology observed in the canals of teeth from animal models of revascularization/revitalization. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

    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

  19. Orthograde retreatment failure with extruded MTA apical plug in a large periradicular lesion followed by surgical intervention: case report.

    Science.gov (United States)

    Brito-Junior, Manoel; Faria-e-Silva, Andre Luis; Quintino, Alex Carvalho; Moreira-Junior, Gil; Geber, Mauro; Camilo, Carla Cristina; Soares, Janir Alves

    2012-01-01

    Absence of periapical healing after orthograde retreatment using an apical plug with mineral trioxide aggregate (MTA) can require surgical intervention. A patient with a root-filled maxillary central incisor with chronic apical periodontitis and sinus tract was referred for endodontic retreatment. Excessive apical enlargement was verified, indicating an MTA apical plug placement; however, an unintentional extrusion of MTA occurred during this step. The root canal was filled with gutta-percha and sealer, and periodic recalls were scheduled. The sinus tract was observed after six months and the lesion remained unaltered, although the extruded MTA had resorbed; therefore, an apicoectomy and retrograde root-end filling with MTA were performed. Absence of sinus tract, normal clinical aspect, and complete repair of the lesion were observed at the two-year follow-up.

  20. 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

  1. Inhibition of Apical Root Resorption by Calcium Hydroxide During Orthodontic Treatment: A Case Report

    OpenAIRE

    Pacheco, Cinthia Mara da Fonseca; Pacheco, Daniela da Fonseca; Motta, Patrícia Gonçalves da

    2016-01-01

    Apical root resorption is a common outcome of orthodontic treatment. The present article reports a case of absence of apical root resorption in a left maxillary lateral incisor filled with calcium hydroxide paste throughout orthodontic movement. After orthodontic treatment was completed the tooth was subsequently obturatedwith gutta-percha and the patient followed for 18 months. The presence of a periapical lesion and the properties of calcium hydroxide as a root resorption inhibitor were dec...

  2. 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...

  3. Comparison of the amount of apical debris extrusion associated with different retreatment systems and supplementary file application during retreatment process.

    Science.gov (United States)

    Çiçek, Ersan; Koçak, Mustafa Murat; Koçak, Sibel; Sağlam, Baran Can

    2016-01-01

    The type of instrument affects the amount of debris extruded. The aim of this study was to compare the effect of retreatment systems and supplementary file application on the amount of apical debris extrusion. Forty-eight extracted mandibular premolars with a single canal and similar length were selected. The root canals were prepared with the ProTaper Universal system with a torque-controlled engine. The root canals were dried and were obturated using Gutta-percha and sealer. The specimens were randomly divided into four equal groups according to the retreatment procedures (Group 1, Mtwo retreatment files; Group 2, Mtwo retreatment files + Mtwo rotary file #30 supplementary file; Group 3, ProTaper Universal retreatment (PTUR) files; and Group 4, PTUR files + ProTaper F3 supplementary file). The extruded debris during instrumentation were collected into preweighed Eppendorf tubes. The amount of apically extruded debris was calculated by subtracting the initial weight of the tube from the final weight. Three consecutive weights were obtained for each tube. No statistically significant difference was found in the amount of apically extruded debris between Groups 1 and 3 (P = 0.590). A significant difference was observed between Groups 1 and 2 (P file significantly increased the amount of apically extruded debris.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  6. Comparing the bacterial diversity of acute and chronic dental root canal infections.

    Directory of Open Access Journals (Sweden)

    Adriana L Santos

    Full Text Available This study performed barcoded multiplex pyrosequencing with a 454 FLX instrument to compare the microbiota of dental root canal infections associated with acute (symptomatic or chronic (asymptomatic apical periodontitis. Analysis of samples from 9 acute abscesses and 8 chronic infections yielded partial 16S rRNA gene sequences that were taxonomically classified into 916 bacterial species-level operational taxonomic units (OTUs (at 3% divergence belonging to 67 genera and 13 phyla. The most abundant phyla in acute infections were Firmicutes (52%, Fusobacteria (17% and Bacteroidetes (13%, while in chronic infections the dominant were Firmicutes (59%, Bacteroidetes (14% and Actinobacteria (10%. Members of Fusobacteria were much more prevalent in acute (89% than in chronic cases (50%. The most abundant/prevalent genera in acute infections were Fusobacterium and Parvimonas. Twenty genera were exclusively detected in acute infections and 18 in chronic infections. Only 18% (n = 165 of the OTUs at 3% divergence were shared by acute and chronic infections. Diversity and richness estimators revealed that acute infections were significantly more diverse than chronic infections. Although a high interindividual variation in bacterial communities was observed, many samples tended to group together according to the type of infection (acute or chronic. This study is one of the most comprehensive in-deep comparisons of the microbiota associated with acute and chronic dental root canal infections and highlights the role of diverse polymicrobial communities as the unit of pathogenicity in acute infections. The overall diversity of endodontic infections as revealed by the pyrosequencing technique was much higher than previously reported for endodontic infections.

  7. A comparison of apical transportation between FlexMaster and Twisted Files rotary instruments.

    Science.gov (United States)

    Duran-Sindreu, Fernando; García, Marc; Olivieri, Juan Gonzalo; Mercadé, Montse; Morelló, Sergio; Roig, Miguel

    2012-07-01

    The aim of this study was to evaluate apical transportation in root canals after the use of Twisted Files (TF; SybronEndo, Orange, CA) and FlexMaster (VDW, Munich, Germany) #40/04 rotary files. A double-digital radiographic technique was used to compare apical transportation between the TF and FlexMaster systems. Each rotary system was used to instrument mesial canals from 80 extracted mandibular molars. The central axes of the file imaged before instrumentation (#15 K-file) and the master apical rotary file (#40/04) were superimposed digitally. AutoCAD 2008 (Autodesk Inc, San Rafael, CA) was used to measure apical transportation at 0.5 mm from the working length (WL). The data were analyzed using the Student's t test, and significance was set at P < .05. The mean amount of apical transportation at 0.5 mm from the WL was 0.17 ± 0.09 mm for the FlexMaster group and 0.19 ± 0.12 mm for the TF group. No statistically significant differences in apical transportation were found between the 2 groups. Under the conditions of the study, no statistically significant differences in apical transportation were observed between FlexMaster and TF rotary files. Copyright © 2012 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  8. 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

  9. 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

  10. A prospective study of the factors affecting outcomes of nonsurgical root canal treatment: part 1: periapical health.

    Science.gov (United States)

    Ng, Y-L; Mann, V; Gulabivala, K

    2011-07-01

    To investigate the probability of and factors influencing periapical status of teeth following primary (1°RCTx) or secondary (2°RCTx) root canal treatment. This prospective study involved annual clinical and radiographic follow-up of 1°RCTx (1170 roots, 702 teeth and 534 patients) or 2°RCTx (1314 roots, 750 teeth and 559 patients) carried out by Endodontic postgraduate students for 2-4 (50%) years. Pre-, intra- and postoperative data were collected prospectively on customized forms. The proportion of roots with complete periapical healing was estimated, and prognostic factors were investigated using multiple logistic regression models. Clustering effects within patients were adjusted in all models using robust standard error. proportion of roots with complete periapical healing after 1°RCTx (83%; 95% CI: 81%, 85%) or 2°RCTx (80%; 95% CI: 78%, 82%) were similar. Eleven prognostic factors were identified. The conditions that were found to improve periapical healing significantly were: the preoperative absence of a periapical lesion (P = 0.003); in presence of a periapical lesion, the smaller its size (P ≤ 0.001), the better the treatment prognosis; the absence of a preoperative sinus tract (P = 0.001); achievement of patency at the canal terminus (P = 0.001); extension of canal cleaning as close as possible to its apical terminus (P = 0.001); the use of ethylene-diamine-tetra-acetic acid (EDTA) solution as a penultimate wash followed by final rinse with NaOCl solution in 2°RCTx cases (P = 0.002); abstaining from using 2% chlorexidine as an adjunct irrigant to NaOCl solution (P = 0.01); absence of tooth/root perforation (P = 0.06); absence of interappointment flare-up (pain or swelling) (P =0.002); absence of root-filling extrusion (P ≤ 0.001); and presence of a satisfactory coronal restoration (P ≤ 0.001). Success based on periapical health associated with roots following 1°RCTx (83%) or 2°RCTx (80%) was similar, with 10 factors having a common effect

  11. Incidence of dentinal defects after preparation of severely curved root canals using the Reciproc single-file system with and without prior creation of a glide path.

    Science.gov (United States)

    Saber, S E D M; Schäfer, E

    2016-11-01

    To investigate the incidence of dentinal defects after preparation of severely curved root canals using the Reciproc single-file system with and without prior creation of a glide path. Mesial roots from extracted mandibular first molars were collected and scanned with CBCT to assess the morphology of the root canal systems. Three groups of 20 anatomically comparable specimens were generated. The control group was left unprepared, whilst the experimental groups were prepared with Reciproc R25 with and without a glide path (groups RG and R, respectively). Roots were then sectioned perpendicular to the long axis at 2, 4, 6, 8 and 10 mm from the apex, and coloured photographs of the sections at 40× were obtained. Two blinded examiners registered the presence of dentinal defects twice at 2-week interval. Data were statistically analysed using the Fisher exact and Cochran's Q tests. No defects were observed in the control group. The overall incidence of dentinal defects was 26% in group R and 24% in group RG, with no significant differences between them (P > 0.05). Dentinal defects occurred significantly more often in the middle and coronal thirds compared to the apical third of the canals (P files. © 2015 International Endodontic Journal. Published by John Wiley & Sons Ltd.

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

    Directory of Open Access Journals (Sweden)

    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

  13. Single visit root canal treatment: A prospective study

    African Journals Online (AJOL)

    2013-08-31

    Aug 31, 2013 ... periodontitis were included in the study. ... Conclusion: Single visit RCT is a viable treatment option for teeth having irreversible pulpitis or apical periodontitis ... been previously root treated, required surgical endodontic.

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

    Science.gov (United States)

    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.

  15. Smear layer removal capacity of disinfectant solutions used with and without EDTA for the irrigation of canals: a SEM study

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    Menezes Ana Carolina Silveira Cardoso de

    2003-01-01

    Full Text Available The purpose of this study was to carry out a scanning electron microscopic (SEM analysis of the cleaning qualities and smear layer removal from root canal walls, instrumented and irrigated with 2.5% NaOCl, 2.0% chlorhexidine and saline solutions. Fifty extracted teeth were used in this study. All teeth were radiographed to determine the existence of a single canal. The crowns were cut at the cervical limit and the root canals were instrumented with K-type files up to size 45. During root canal preparation, irrigations were made with the different solutions being evaluated: Group 1: 2.5% NaOCl (10 roots; Group 2: 2.5% NaOCl and 17% EDTA for 2 minute (10 roots; Group 3: 2.0% chlorhexidine (10 roots; Group 4: 2.0% chlorhexidine and 17% EDTA for 2 minutes (10 roots; Group 5: saline solution (5 roots; Group 6: saline solution and 17% EDTA for 2 minutes (5 roots. After instrumentation, the canals were irrigated with each one of the solutions and the roots were cut in the buccolingual direction for SEM analysis, at the cervical, middle and apical thirds, to ascertain the presence or absence of smear layer and debris. SEM analysis was performed by three calibrated examiners and scores were submitted to Kruskal-Wallis test at the significance level of p = 5%. Results showed that the use of 17% EDTA decreased the smear layer significantly (p < 0.05 for all evaluated solutions in all thirds. When EDTA was not used, a significantly higher quantity of smear layer on the apical third was observed only in the NaOCl groups. The use of 17% EDTA was significant for debris removal except for the chlorhexidine groups. The following conclusion could be drawn: the use of 17% EDTA was necessary to enhance cleanness of the root canals.

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

    Directory of Open Access Journals (Sweden)

    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.

  17. Strategies to reduce the apical necrosis in vitro multiplication and rooting of Pistachio

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    Mariela Cid

    2016-07-01

    Full Text Available The pistachio (Pistacia sp. is one of the least exploited fruit among the main causes is the high cost of plant material by the difficulties of propagation of the species. The propagation in vitro offers great potential for the industry of this species by multiplication scale of selected clones. The aim of this study was to control the apical necrosis of outbreaks in the in vitro propagation Pistachio. From young shoots of plants of this species kept in growing houses, proceeded to disinfection with sodium hypochlorite 1% for different times. The apical and axillary buds were established in the culture medium Murashige and Skoog (1962 modified and supplemented with 1 mg/L Metatopolina. Different types of bottles, number and type of explants and culture media formulations for two subcultures multiplication and rooting were evaluated. Glass flask of 200 ml capacity, and line proliferates DKW medium achieved the lowest values apical necrosis. In the multiplication phase values were low in all treatments tested no statistical difference between them compared to rooting where apical necrosis reached higher values. The average DKW and prolific lines obtained lower values. MS medium modified crop, favored the number of segments rooted and DKW (Driver and Kuniyuki, 1984 the number of segments that sprouted, the latter having lower incidence of apical necrosis.

  18. Association analysis of clinical aspects and vitamin D receptor gene polymorphism with external apical root resorption in orthodontic patients.

    Science.gov (United States)

    Fontana, Maria Luiza S Simas Netta; de Souza, Cleber Machado; Bernardino, José Fabio; Hoette, Felix; Hoette, Maura Levi; Thum, Lotario; Ozawa, Terumi O; Capelozza Filho, Leopoldino; Olandoski, Marcia; Trevilatto, Paula Cristina

    2012-09-01

    Vitamin D is responsible for the regulation of certain genes at the transcription level, via interaction with the vitamin D receptor, and influences host immune responses and aspects of bone development, growth, and homeostasis. Our aim was to investigate the association of TaqI vitamin D receptor gene polymorphism with external apical root resorption during orthodontic treatment. Our subjects were 377 patients with Class II Division 1 malocclusion, divided into 3 groups: (1) 160 with external apical root resorption ≤1.43 mm, (2) 179 with external apical root resorption >1.43 mm), and (3) 38 untreated subjects. External apical root resorption of the maxillary incisors was evaluated on periapical radiographs taken before and after 6 months of treatment. After DNA collection and purification, vitamin D receptor TaqI polymorphism analysis was performed by polymerase chain reaction-restriction fragment length polymorphism. Univariate and multivariate analyses were performed to verify the association of clinical and genetic variables with external apical root resorption (P root resorption in orthodontically treated patients compared with the untreated subjects. In patients orthodontically treated, age higher than 14 years old, initial size of the maxillary incisor root superior to 30 mm, and premolar extraction were associated with increased external apical root resorption. Genotypes containing the C allele were weakly associated with protection against external apical root resorption (CC + CT × TT [odds ratio, 0.29; 95% confidence interval, 0.07-1.23; P = 0.091]) when treated orthodontic patients were compared to untreated individuals. Clinical factors and vitamin D receptor TaqI polymorphism were associated with external apical root resorption in orthodontic patients. Copyright © 2012 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  19. A comparison of the shaping ability of reciprocating NiTi instruments in simulated curved canals

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    Young-Sil Yoo

    2011-11-01

    Full Text Available Objectives The study was to compare the shaping ability of Reciproc (VDW and WaveOne (Dentsply Maillefer instruments compared with ProTaper, Profile and hand instrument during the preparation of simulated root canals. Materials and Methods Five groups (n = 5 were established. Reciproc, WaveOne, ProTaper, Profile and K file (K-flexo file were used to prepare the resin simulated canals. A series of preoperative and postoperative images were taken by a microscope and superimposed in 2 different layers. The amount of resin removed from both the inner and the outer sides of the canal was measured to the level of 10 mm from the apical tip, with a 1 mm increment. Results The mean of resin removal from the inner canal wall was not different from the outer canal wall for Reciproc and WaveOne groups at apical third (1 - 3 mm level. There was no difference in the change of working length and maintenance of canal curvature. NiTi instruments are superior to stainless-steel K file in their shaping ability. Conclusions Within the limitation of this present study, Reciproc and WaveOne instruments maintained the original canal curvature in curved canals better than ProTaper and Profile, which tend to transport towards the outer canal wall of the curve in the apical part of the canal.

  20. Wizard CD Plus and ProTaper Universal: analysis of apical transportation using new software.

    Science.gov (United States)

    Giannastasio, Daiana; Rosa, Ricardo Abreu da; Peres, Bernardo Urbanetto; Barreto, Mirela Sangoi; Dotto, Gustavo Nogara; Kuga, Milton Carlos; Pereira, Jefferson Ricardo; Só, Marcus Vinícius Reis

    2013-01-01

    This study has two aims: 1) to evaluate the apical transportation of the Wizard CD Plus and ProTaper Universal after preparation of simulated root canals; 2) to compare, with Adobe Photoshop, the ability of a new software (Regeemy) in superposing and subtracting images. Twenty five simulated root canals in acrylic-resin blocks (with 20º curvature) underwent cone beam computed tomography before and after preparation with the rotary systems (70 kVp, 4 mA, 10 s and with the 8×8 cm FoV selection). Canals were prepared up to F2 (ProTaper) and 24.04 (Wizard CD Plus) instruments and the working length was established to 15 mm. The tomographic images were imported into iCAT Vision software and CorelDraw for standardization. The superposition of pre- and post-instrumentation images from both systems was performed using Regeemy and Adobe Photoshop. The apical transportation was measured in millimetres using Image J. Five acrylic resin blocks were used to validate the superposition achieved by the software. Student's t-test for independent samples was used to evaluate the apical transportation achieved by the rotary systems using each software individually. Student's t-test for paired samples was used to compare the ability of each software in superposing and subtracting images from one rotary system per time. The values obtained with Regeemy and Adobe Photoshop were similar to rotary systems (P>0.05). ProTaper Universal and Wizard CD Plus promoted similar apical transportation regardless of the software used for image's superposition and subtraction (P>0.05). Wizard CD Plus and ProTaper Universal promoted little apical transportation. Regeemy consists in a feasible software to superpose and subtract images and appears to be an alternative to Adobe Photoshop.

  1. Wizard CD Plus and ProTaper Universal: analysis of apical transportation using new software

    Science.gov (United States)

    GIANNASTASIO, Daiana; da ROSA, Ricardo Abreu; PERES, Bernardo Urbanetto; BARRETO, Mirela Sangoi; DOTTO, Gustavo Nogara; KUGA, Milton Carlos; PEREIRA, Jefferson Ricardo; SÓ, Marcus Vinícius Reis

    2013-01-01

    Objective This study has two aims: 1) to evaluate the apical transportation of the Wizard CD Plus and ProTaper Universal after preparation of simulated root canals; 2) to compare, with Adobe Photoshop, the ability of a new software (Regeemy) in superposing and subtracting images. Material and Methods Twenty five simulated root canals in acrylic-resin blocks (with 20º curvature) underwent cone beam computed tomography before and after preparation with the rotary systems (70 kVp, 4 mA, 10 s and with the 8×8 cm FoV selection). Canals were prepared up to F2 (ProTaper) and 24.04 (Wizard CD Plus) instruments and the working length was established to 15 mm. The tomographic images were imported into iCAT Vision software and CorelDraw for standardization. The superposition of pre- and post-instrumentation images from both systems was performed using Regeemy and Adobe Photoshop. The apical transportation was measured in millimetres using Image J. Five acrylic resin blocks were used to validate the superposition achieved by the software. Student's t-test for independent samples was used to evaluate the apical transportation achieved by the rotary systems using each software individually. Student's t-test for paired samples was used to compare the ability of each software in superposing and subtracting images from one rotary system per time. Results The values obtained with Regeemy and Adobe Photoshop were similar to rotary systems (P>0.05). ProTaper Universal and Wizard CD Plus promoted similar apical transportation regardless of the software used for image's superposition and subtraction (P>0.05). Conclusion Wizard CD Plus and ProTaper Universal promoted little apical transportation. Regeemy consists in a feasible software to superpose and subtract images and appears to be an alternative to Adobe Photoshop. PMID:24212994

  2. Wizard CD Plus and ProTaper Universal: analysis of apical transportation using new software

    Directory of Open Access Journals (Sweden)

    Daiana Giannastasio

    2013-09-01

    Full Text Available OBJECTIVE: This study has two aims: 1 to evaluate the apical transportation of the Wizard CD Plus and ProTaper Universal after preparation of simulated root canals; 2 to compare, with Adobe Photoshop, the ability of a new software (Regeemy in superposing and subtracting images. MATERIAL AND METHODS: Twenty five simulated root canals in acrylic-resin blocks (with 20º curvature underwent cone beam computed tomography before and after preparation with the rotary systems (70 kVp, 4 mA, 10 s and with the 8×8 cm FoV selection. Canals were prepared up to F2 (ProTaper and 24.04 (Wizard CD Plus instruments and the working length was established to 15 mm. The tomographic images were imported into iCAT Vision software and CorelDraw for standardization. The superposition of pre- and post-instrumentation images from both systems was performed using Regeemy and Adobe Photoshop. The apical transportation was measured in millimetres using Image J. Five acrylic resin blocks were used to validate the superposition achieved by the software. Student's t-test for independent samples was used to evaluate the apical transportation achieved by the rotary systems using each software individually. Student's t-test for paired samples was used to compare the ability of each software in superposing and subtracting images from one rotary system per time. RESULTS: The values obtained with Regeemy and Adobe Photoshop were similar to rotary systems (P>0.05. ProTaper Universal and Wizard CD Plus promoted similar apical transportation regardless of the software used for image's superposition and subtraction (P>0.05. CONCLUSION: Wizard CD Plus and ProTaper Universal promoted little apical transportation. Regeemy consists in a feasible software to superpose and subtract images and appears to be an alternative to Adobe Photoshop.

  3. 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)

  4. Effect of apical clearing technique on the treatment outcome of teeth with asymptomatic apical periodontitis: A randomized clinical trial.

    Science.gov (United States)

    Mittal, Priya; Logani, Ajay; Shah, Naseem; Pandey, R M

    2016-01-01

    This study aims to compare the periapical healing of teeth with asymptomatic apical periodontitis treated either by conventional apical preparation (CAP) or apical clearing technique (ACT). Twenty subjects with bilateral nonvital similar teeth exhibiting comparable periapical index (PAI) score were enrolled and randomly allocated. Group I (CAP, n = 20): Apical preparation three sizes greater (master apical file [MAF]) than the first binding file at the established working length. Group II (ACT, n = 20): Apical preparation three sizes greater than the MAF that was followed by dry reaming. Root canal therapy was accomplished in single-visit for all the teeth. They were pursued radiographically at 3, 6, 9 and 12 months. Pre- and post-treatment PAI scores were compared. To ascertain the proportion of healed teeth between the two groups, McNemar Chi-square test was applied. At 3, 6, and 9 months' time interval the proportion of healed teeth for Group II (ACT) was greater in comparison to Group I (CAP) (P < 0.05). However, at 12 months follow-up period this difference was not significant (P = 0.08). ACT enhanced the healing kinetics. However, the long-term (12 months) radiographic outcome was similar for either technique.

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

    Science.gov (United States)

    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

  6. Optodynamic Phenomena During Laser-Activated Irrigation Within Root Canals

    Science.gov (United States)

    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.

  7. Comparison of the in vivo antimicrobial effectiveness of sodium hypochlorite and chlorhexidine used as root canal irrigants: a molecular microbiology study.

    Science.gov (United States)

    Rôças, Isabela N; Siqueira, José F

    2011-02-01

    The purpose of this clinical study was to compare the antimicrobial effects of 2.5% sodium hypochlorite (NaOCl) and 0.12% chlorhexidine digluconate (CHX) when used as irrigants during treatment of teeth with apical periodontitis. Forty-seven single-rooted single-canal teeth with necrotic pulps and asymptomatic apical periodontitis were selected for this study according to stringent inclusion/exclusion criteria. Bacterial samples were taken at the baseline (S1) and after (S2) chemomechanical preparation using 2.5% NaOCl (n = 30) or 0.12% CHX (n = 17) as the irrigant. Bacterial, archaeal, and fungal presence was evaluated by broad-range polymerase chain reaction (PCR), whereas bacterial identifications were performed by a closed-ended reverse-capture checkerboard approach targeting 28 candidate endodontic pathogens. All S1 samples were PCR positive for bacterial presence but negative for both archaea and fungi. Both NaOCl- and CHX-based protocols were significantly effective in reducing the bacterial levels and number of taxa. No significant differences were observed between them in all tested parameters including the incidence of negative PCR results in S2 (40% for NaOCl vs 47% for CHX, p = 0.8), reduction in the number of taxa per canal (p = 0.3), and reduction in the bacterial levels (p = 0.07). The most prevalent taxa in S2 samples from the NaOCl group were Propionibacterium acnes, Streptococcus species, Porphyromonas endodontalis, and Selenomonas sputigena. In the CHX group, the most prevalent taxa in S2 were Dialister invisus, Actinomyces israelii, Prevotella baroniae, Propionibacterium acidifaciens, and Streptococcus species. Treatment protocols using irrigation with either NaOCl or CHX succeeded in significantly reducing the the number of bacterial taxa and their levels in infected root canals, with no significant difference between these substances. Copyright © 2011 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  8. External apical root resorption diagnosis by using FII human dentine fraction and salivary IGg.

    Science.gov (United States)

    Da-Costa, Tânia Maris Pedrini Soares; Hidalgo, Mirian Marubayashi; Consolaro, Alberto; Lima, Carlos Eduardo de Oliveira; Tanaka, Evelise Ono; Itano, Eiko Nakagawa

    2018-06-01

    External apical root resorption as a consequence of orthodontic treatment is an inflammatory pathological process that results in permanent loss of tooth structure from the root apex. This study aimed to investigate the diagnostic potential of human dentine fractions and salivary IgG in external apical root resorption. Saliva samples were collected from 10 patients before (T0) and after 3 (T3), 6 (T6) and 12 (T12) months of orthodontic treatment. The total dentinal extract, obtained from human third molars, was fractioned by gel filtration chromatography in three fractions denominated FI, FII and FIII. The root resorption analysis of the upper central incisors was performed by digital image subtraction method. Reactivity of salivary IgG to antigenic fractions of dentine was determined by enzyme-linked immunosorbent assay (Elisa). Regardless of treatment, FI dentin fraction with high MM (root resorptions were detected. Our results suggest that FII human dentine fraction and salivary IgG have potential to be used in diagnosis and monitoring of external apical root resorption. The development of a practical and accessible biochemical test using saliva and FII dentine fraction may help in the prevention of severe root resorption. Copyright © 2018. Published by Elsevier Masson SAS.

  9. 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

  10. Comparison of the Effect of Canal Preparation by Step Back Technique Using Hand Instruments and Gates Glidden Drills with ProTaper Universal Rotary System on the Root Resistance to Vertical Fracture

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    A Abbaszadegan

    2013-06-01

    Full Text Available Introduction: Cleaning and shaping of the root canal system with an efficient and safe technique are the major goals of root canal treatment. The aim of this study was to compare the conventional root canal preparation technique by hand instruments and Gates Glidden drills with ProTaper Universal Rotary system on the root susceptibility to vertical fracture. Methods: Thirty extracted human mandibular premolars were randomly assigned to two groups. In group I, apical preparation was performed with k-files up to #40 utilizing step back technique and coronal flaring was done with Gates Glidden drills. In group II, ProTaper Universal Rotary instruments were used up to the file F4. All teeth were obturated with lateral compaction technique using gutta-percha and AH26 sealer. A simulated periodontal ligament was fabricated, and the teeth were mounted. A stainless steel finger spreader #35 was mounted in an Instron testing machine and the necessary load to cause a root fracture was inserted and recorded. The obtained data were analyzed statistically using T-test. Results: The force required to fracture was significantly lower for the roots prepared by ProTaper instruments in comparison with the specimens prepared by hand instruments and Gates Glidden drills (P< 0.001. Conclusion: Canal preparation with ProTaper rotary instruments can make the roots more susceptible to vertical fracture than traditional instrumentation with k-files and Gates Glidden drills.

  11. 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 ...

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

    Directory of Open Access Journals (Sweden)

    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

  13. Comparison of Apical Extrusion of Debris by Using Single-File, Full-Sequence Rotary and Reciprocating Systems.

    Science.gov (United States)

    Ehsani, Maryam; Farhang, Robab; Harandi, Azadeh; Tavanafar, Saeid; Raoof, Maryam; Galledar, Saeedeh

    2016-11-01

    During root canal preparation, apical extrusion of debris can cause inflammation, flare-ups, and delayed healing. Therefore, instrumentation techniques that cause the least extrusion of debris are desirable. This study aimed to compare apical extrusion of debris by five single-file, full-sequence rotary and reciprocating systems. One hundred twenty human mandibular premolars with similar root lengths, apical diameters, and canal curvatures were selected and randomly assigned to six groups (n=20): Reciproc R25 (25, 0.08), WaveOne Primary (25, 0.08), OneShape (25, 0.06), F360 (25, 0.04), Neoniti A1 (25, 0.08), and ProTaper Universal. Instrumentation of the root canals was performed in accordance with the manufacturers' instructions. Each tooth's debris was collected in a pre-weighed vial. After drying the debris in an incubator, the mass was measured three times consecutively; the mean was then calculated. The preparation time by each system was also measured. For data analysis, one-way ANOVA and Games-Howell post hoc test were used. The mean masses (±standard deviation) of the apical debris were as follows: 2.071±1.38mg (ProTaper Universal), 1.702±1.306mg (Neoniti A1), 1.295±0.839mg (OneShape), 1.109±0.676mg (WaveOne), 0.976±0.478mg (Reciproc) and 0.797±0.531mg (F360). Compared to ProTaper Universal, F360 generated significantly less debris (P=0.02). The ProTaper system required the longest preparation time (mean=88.6 seconds); the Reciproc (P=0.008), OneShape (P=0.006), and F360 (P=0.001) required significantly less time (P<0.05). All instruments caused extrusion of debris through the apex. The F360 produced significantly less debris than did the ProTaper Universal.

  14. In vitro evaluation of apical extrusion of bacteria following use of new rotary instrumentation system.

    Science.gov (United States)

    Mohammadi, Zahed

    2009-04-01

    The aim of this study was to evaluate the number of bacteria extruded apically from extracted teeth ex vivo after canal instrumentation using two engine-driven nickel-titanium instruments (Flex Master and V-Taper). Seventy extracted maxillary central incisor teeth were used. After preparing access cavities, root canals were contaminated with a suspension of Enterococcus faecalis, then dried. The contaminated roots were divided into two experimental groups of 30 teeth each and one control group of 10 teeth. Bacteria extruded from the apical foramen during instrumentation were collected into vials. The microbiological samples from the vials were incubated in culture media for 24 hours. Colonies of bacteria were counted, and the results were given as number of colony-forming units. The data obtained were analyzed using the Kruskal-Wallis one-way analysis of variance and Mann-Whitney U-tests, with alpha = 0.05 as the level for statistical significance. Results showed that there was no significant difference as to the number of extruded bacteria between the two engine-driven systems (P > 0.05). Both engine-driven nickel-titanium systems extruded bacteria through the apical foramen.

  15. Efficacy of CM-Wire, M-Wire, and Nickel-Titanium Instruments for Removing Filling Material from Curved Root Canals: A Micro-Computed Tomography Study.

    Science.gov (United States)

    Rodrigues, Clarissa Teles; Duarte, Marco Antonio Hungaro; de Almeida, Marcela Milanezi; de Andrade, Flaviana Bombarda; Bernardineli, Norberti

    2016-11-01

    The aim of this ex vivo study was to evaluate the removal of filling material after using CM-wire, M-wire, and nickel-titanium instruments in both reciprocating and rotary motions in curved canals. Thirty maxillary lateral incisors were divided into 9 groups according to retreatment procedures: Reciproc R25 followed by Mtwo 40/.04 and ProDesign Logic 50/.01 files; ProDesign R 25/.06 followed by ProDesign Logic 40/.05 and ProDesign Logic 50/.01 files; and Gates-Glidden drills, Hedström files, and K-files up to apical size 30 followed by K-file 40 and K-file 50 up to the working length. Micro-computed tomography scans were performed before and after each reinstrumentation procedure to evaluate root canal filling removal. Statistical analysis was performed with Kruskal-Wallis, Friedman, and Wilcoxon tests (P < .05). No significant differences in filling material removal were found in the 3 groups of teeth. The use of Mtwo and ProDesign Logic 40/.05 rotary files did not enhance filling material removal after the use of reciprocating files. The use of ProDesign Logic 50/.01 files significantly reduced the amount of filling material at the apical levels compared with the use of reciprocating files. Association of reciprocating and rotary files was capable of removing a large amount of filling material in the retreatment of curved canals, irrespective of the type of alloy of the instruments. The use of a ProDesign Logic 50/.01 file for apical preparation significantly reduced the amount of remnant material in the apical portion when compared with reciprocating instruments. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

    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

  17. Ossifying fibroma misdiagnosed as chronic apical periodontitis.

    Science.gov (United States)

    de Moraes Ramos-Perez, Flávia Maria; Soares, Ulysses Nicida; Silva-Sousa, Yara Teresinha Corrêa; da Cruz Perez, Danyel Elias

    2010-03-01

    Ossifying fibroma mimicking chronic apical periodontitis is extremely rare. This report describes a case of ossifying fibroma located in the periapical region of the mandibular right canine that was misdiagnosed as chronic apical periodontitis. A 40-year-old woman complained of slight pain in the right anterior mandibular region without mucosal abnormalities or swelling. Radiographically, a well-circumscribed, unilocular, radiolucent lesion was observed that was located in the periapical region of the mandibular right canine, which presented an endodontically treated root canal. Under local anesthesia, the lesion was fully excised. Microscopically, there was fibrocellular connective tissue associated with a mineralized component, which consisted of lamellar or trabecular and woven bone, compatible with the diagnosis of ossifying fibroma. Although it is very rare, ossifying fibroma should be considered in the differential diagnosis of unusual or persistent apical radiolucencies. Copyright (c) 2010 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    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.

  19. Properties of a novel polysiloxane-guttapercha calcium silicate-bioglass-containing root canal sealer.

    Science.gov (United States)

    Gandolfi, M G; Siboni, F; Prati, C

    2016-05-01

    Root canal filling sealers based on polymethyl hydrogensiloxane or polymethyl hydrogensiloxane-guttapercha--introduced to improve the quality of conventional guttapercha-based and resin-based systems--showed advantages in handiness and clinical application. The aim of the study was to evaluate the chemical-physical properties of a novel polysiloxane-guttapercha calcium silicate-containing root canal sealer (GuttaFlow bioseal). GuttaFlow bioseal was examined and compared with GuttaFlow2, RoekoSeal and MTA Fillapex sealers. Setting times, open and impervious porosity and apparent porosity, water sorption, weight loss, calcium release, and alkalinizing activity were evaluated. ESEM-EDX-Raman analyses of fresh materials and after soaking in simulated body fluid were also performed. Marked differences were obtained among the materials. GuttaFlow bioseal showed low solubility and porosity, high water sorption, moderate calcium release and good alkalinizing activity. MTA Fillapex showed the highest calcium release, alkalinizing activity and solubility, RoekoSeal the lowest calcium release, no alkalinizing activity, very low solubility and water sorption. Only GuttaFlow bioseal showed apatite forming ability. GuttaFlow bioseal showed alkalinizing activity together with negligible solubility and slight calcium release. Therefore, the notable nucleation of apatite and apatite precursors can be related to the co-operation of CaSi particles (SiOH groups) with polysiloxane (SiOSi groups). The incorporation of a calcium silicate component into polydimethyl polymethylhydrogensiloxane guttapercha sealers may represent an attractive strategy to obtain a bioactive biointeractive flowable guttapercha sealer for moist/bleeding apices with bone defects in endodontic therapy. Copyright © 2016 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

  20. Adjunctive Steps for Disinfection of the Mandibular Molar Root Canal System: A Correlative Bacteriologic, Micro-Computed Tomography, and Cryopulverization Approach.

    Science.gov (United States)

    Alves, Flávio R F; Andrade-Junior, Carlos V; Marceliano-Alves, Marília F; Pérez, Alejandro R; Rôças, Isabela N; Versiani, Marco A; Sousa-Neto, Manoel D; Provenzano, José C; Siqueira, José F

    2016-11-01

    This study evaluated the disinfecting ability of chemomechanical preparation with rotary nickel-titanium instruments, followed by 2 distinct adjunctive procedures in the root canals of extracted mandibular molars by means of a correlative analytical approach. Twenty-two extracted mandibular molars were selected and anatomically matched between groups on the basis of micro-computed tomographic analysis. In the first phase of the experiment, root canals were contaminated with Enterococcus faecalis and subjected to chemomechanical preparation with BT RaCe instruments and 2.5% NaOCl irrigation. Then either XP-Endo Finisher instrument or passive ultrasonic irrigation was used to supplement disinfection. Micro-computed tomography was used to show whether the percentage of unprepared areas correlated to bacterial counts. In the second phase, the same teeth were contaminated once again, and the adjunctive procedures were used. Samples from the isthmus area of mesial roots and the apical 5-mm fragment of distal roots were obtained by cryopulverization. Samples taken before and after treatment steps in both phases were evaluated by quantitative polymerase chain reaction and statistically analyzed. In phase 1, preparation in both groups resulted in substantial decrease of bacterial counts (P  .05). In phase 2, both methods had significant antibacterial effects in the main canal, but none of them could predictably disinfect the isthmus/recess areas. Both XP-Endo Finisher and passive ultrasonic irrigation exhibited antibacterial effectiveness, but only the former caused a significant reduction in the bacterial counts after chemomechanical preparation. None of them were effective in predictably disinfecting the isthmus/recess areas. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  1. Effect of Instrumentation Length and Instrumentation Systems: Hand Versus Rotary Files on Apical Crack Formation - An In vitro Study.

    Science.gov (United States)

    Devale, Madhuri R; Mahesh, M C; Bhandary, Shreetha

    2017-01-01

    Stresses generated during root canal instrumentation have been reported to cause apical cracks. The smaller, less pronounced defects like cracks can later propagate into vertical root fracture, when the tooth is subjected to repeated stresses from endodontic or restorative procedures. This study evaluated occurrence of apical cracks with stainless steel hand files, rotary NiTi RaCe and K3 files at two different instrumentation lengths. In the present in vitro study, 60 mandibular premolars were mounted in resin blocks with simulated periodontal ligament. Apical 3 mm of the root surfaces were exposed and stained using India ink. Preoperative images of root apices were obtained at 100x using stereomicroscope. The teeth were divided into six groups of 10 each. First two groups were instrumented with stainless steel files, next two groups with rotary NiTi RaCe files and the last two groups with rotary NiTi K3 files. The instrumentation was carried out till the apical foramen (Working Length-WL) and 1 mm short of the apical foramen (WL-1) with each file system. After root canal instrumentation, postoperative images of root apices were obtained. Preoperative and postoperative images were compared and the occurrence of cracks was recorded. Descriptive statistical analysis and Chi-square tests were used to analyze the results. Apical root cracks were seen in 30%, 35% and 20% of teeth instrumented with K-files, RaCe files and K3 files respectively. There was no statistical significance among three instrumentation systems in the formation of apical cracks (p=0.563). Apical cracks were seen in 40% and 20% of teeth instrumented with K-files; 60% and 10% of teeth with RaCe files and 40% and 0% of teeth with K3 files at WL and WL-1 respectively. For groups instrumented with hand files there was no statistical significance in number of cracks at WL and WL-1 (p=0.628). But for teeth instrumented with RaCe files and K3 files significantly more number of cracks were seen at WL than

  2. Evaluation of the delivery of mesenchymal stem cells into the root canal space of necrotic immature teeth after clinical regenerative endodontic procedure.

    Science.gov (United States)

    Lovelace, Tyler W; Henry, Michael A; Hargreaves, Kenneth M; Diogenes, Anibal

    2011-02-01

    Immature teeth with open apices treated with conventional nonsurgical root canal treatment often have a poor prognosis as a result of the increased risk of fracture and susceptibility to recontamination. Regenerative endodontics represents a new treatment modality that focuses on reestablishment of pulp vitality and continued root development. This clinical procedure relies on the intracanal delivery of a blood clot (scaffold), growth factors (possibly from platelets and dentin), and stem cells. However, to date, the clinical presence of stem cells in the canal space after this procedure has not been demonstrated. The purpose of this clinical study was to evaluate whether regenerative endodontic procedures are able to deliver stem cells into the canal space of immature teeth in young patients and to identify the possible tissue origin for these cells. After informed consent, the first appointment consisted of NaOCl irrigation and treatment with a triple antibiotic paste. One month later, the root canal space was irrigated with sterile saline, and bleeding was evoked with collection of samples on paper points. Real-time reverse-transcription polymerase chain reaction and immunocytochemistry were conducted to compare the gene transcripts and proteins found in the root canal sample with levels found in the systemic circulation. Molecular analyses of blood collected from the canal system indicated the significant accumulation of transcripts for the stem cell markers CD73 and CD105 (up to 600-fold), compared with levels found in the systemic blood. Furthermore, this effect was selective because there was no change in expression of the differentiation markers ALK-P, DSPP, ZBTB16, and CD14. Histologic analyses demonstrated that the delivered cells expressed both CD105 and STRO-1, markers for a subpopulation of mesenchymal stem cells. Collectively, these findings demonstrate that the evoked-bleeding step in regenerative procedures triggers the significant accumulation of

  3. Comparison of the amount of apically extruded debris produced by four retreatment techniques: an ex vivo study

    Directory of Open Access Journals (Sweden)

    Cristiane Ferreira Alfenas

    2017-12-01

    Full Text Available Objective: the aim of this study was to compare the amount of apically extruded debris during the removal of root canal filling material using nickel-titanium rotary retreatment instruments and Hedström files. Material and Methods: sixty mandibular incisors with a single canal were instrumented and obturated by cold lateral compaction. For retreatment, specimens were randomly divided into four groups (n = 15: Hedström files with or without solvent; D-RaCe system and Mtwo retreatment system. Debris extruded apically during the removal of canal filling material was collected into preweighed Eppendorf tubes. The tubes were then stored in an incubator at 70°C for 5 days. The weight of the dry extruded debris was established by subtracting the preretreatment and postretreatment weight of the Eppendorf tubes for each group. The mean weights of extruded material were analyzed by one-way ANOVA. Results: the results showed that all retreatment techniques caused apical extrusion of debris, but no statistically significant difference was observed between groups (p>0.05. Conclusion: under the conditions of this study, all retreatment techniques caused apical debris extrusion.

  4. 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

  5. Pulp Revascularization on Permanent Teeth with Open Apices in a Middle-aged Patient.

    Science.gov (United States)

    Wang, Yu; Zhu, Xiaofei; Zhang, Chengfei

    2015-09-01

    Pulp revascularization is a promising procedure for the treatment of adolescents' immature permanent teeth with necrotic pulp and/or apical periodontitis. However, the ability to successfully perform pulp revascularization in a middle-aged patient remains unclear. A 39-year-old woman was referred for treatment of teeth #20 and #29 with necrotic pulp, extensive periapical radiolucencies, and incomplete apices. Pulp revascularization procedures were attempted, including root canal debridement, triple antibiotic paste medication, and platelet-rich plasma transplantation to act as a scaffold. Periapical radiographic and cone-beam computed tomographic examinations were used to review the changes in the apical lesions and root apex configuration. The patient remained asymptomatic throughout the 30-month follow-up. Periapical radiographic examination revealed no change in the apical lesions of either tooth at 8 months. The periapical radiolucency disappeared on tooth #20 and significantly decreased on tooth #29 by the 30-month follow-up, findings that were also confirmed by cone-beam computed tomographic imaging. No evidence of root lengthening or thickening was observed. Successful revascularization was achieved in a middle-aged patient's teeth. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  6. 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

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    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.

  10. An investigation on the effects of resection angle on apical sea!

    Directory of Open Access Journals (Sweden)

    Razmi H

    2003-08-01

    Full Text Available Statement of Problem: The goal of a successful endodontic surgery is to establish an adequate seal in apical region. Therefore during surgery, root-end resection is essential for an appropriate situation and proper access."nPurpose: The aim of this study was to determine the most appropriate root-end resection angle to establish adequate apical seal in periapical surgery,"nMaterials and Methods: Forty-five intact extracted human maxillary central incisors were randomly divided into three 15-tooth groups. The root canals were instrumented and then obturated using lateral condensation technique. AM roots were resected at 3mm from apical portion. Angles of root resection for each group were 0, 30 and 45 degrees. Then all teeth surfaces, except the cut ones, were covered with nail polish and immersed in methylen blue for 7 days. After 7 days, nail polish was removed from the surfaces and samples were split in buccolingual direction. Then, dye penetration (mm was measured using a stereozoom microscope (Loupe [X4 magnification] and eye lens. In order to analyze the data, unilateral variance analysis was used."nResults: The values of dye penetration were: 7.23±3.34 (0°, 8.46±3.01(30° and 9.74±4.11 (45°. There"nwas no significant difference between three groups (P>0.05. Conclusion: It is suggested that the angle of root-end resection put a limited effect on apical seal if retrograde cavity depth is increased.

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

    Directory of Open Access Journals (Sweden)

    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.

  12. 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

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

    Science.gov (United States)

    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.

  14. 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.

  15. Assessment of Apical Extrusion of Debris during Endodontic Retreatment with 3 Rotary Nickel-Titanium Retreatment Systems and Hand Files

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    Gkampesi S.

    2016-03-01

    Full Text Available Aim: to evaluate the amount of debris extruded apically as well as the time needed for removal of root canal filling material using ProTaper, MTwo, REndo NiTi rotary retreatment systems and hand files.

  16. Duration for Apical Barrier Formation in Necrotic Immature Permanent Incisors Treated With Calcium Hydroxide Apexification Using Ultrasonic or Hand Filing

    Directory of Open Access Journals (Sweden)

    Li-Wan Lee

    2010-08-01

    Conclusion: Ultrasonic filing with 0.2% chlorhexidine as an irrigant is effective for disinfection of the root canal and can shorten the duration for apical barrier formation in necrotic permanent incisors treated with calcium hydroxide apexification.

  17. The effect of high-frequency electrical pulses on organic tissue in root canals.

    Science.gov (United States)

    Lendini, M; Alemanno, E; Migliaretti, G; Berutti, E

    2005-08-01

    To evaluate debris and smear layer scores after application of high-frequency electrical pulses produced by the Endox Endodontic System (Lysis Srl, Nova Milanese, Italy) on intact pulp tissue and organic and inorganic residues after endodontic instrumentation. The study comprised 75 teeth planned for extraction. The teeth were randomly divided into two groups (60 teeth) and a control group (15 teeth): group 1 (30 teeth) was not subjected to instrumentation; group 2 (30 teeth) was instrumented by Hero Shaper instruments and apical stops were prepared to size 40. Each group was subdivided into subgroups A and B (15 teeth); two electrical pulses were applied to subgroups 1A and 2A (one in the apical third and one in the middle third, respectively, at 3 and 6 mm from the root apices); four electrical pulses were applied to subgroups 1B and 2B (two in the apical third, two in the middle third). The control group (15 teeth) was prepared with Hero Shapers and irrigated with 5 mL of EDTA (10%) and 5 mL of 5% NaOCl at 50 degrees C but not subjected to the electrical pulse treatment. Roots were split longitudinally and canal walls were examined at 80x, 200x, 750x, 1500x and 15,000x magnifications, using a scanning electron microscope. Smear layer and debris scores were recorded at the 3 and 6 mm levels using a five-step scoring scale and a 200-microm grid. Means were tested for significance using the one-way anova model and the Bonferroni post-hoc test. The differences between groups were considered to be statistically significant when P < 0.05. The mean value for debris scores for the three groups varied from 1.80 (+/-0.77) to 4.50 (+/-0.68). The smear layer scores for group 2 and the control specimens varied from 2.00 (+/-0.91) to 2.33 (+/-0.99). A significant difference was found in mean debris scores at the 3 and 6 mm levels between the three groups (P < 0.001). The Bonferroni post-hoc test confirmed that the difference was due to group 1. In the two subgroups treated

  18. Radiographic evaluation of apical root resorption following fixed orthodontic treatment

    OpenAIRE

    Sina Haghanifar; Valiollah Arash; Farhad Soboti; Nasim Jafari

    2012-01-01

    Background and Aims: Apical root resorption is an adverse side effect of fixed orthodontic treatment which cannot be repaired. The aim of this study was to use panoramic radiographs to compare the root resorption before and after the orthodontic treatment with standard edgewise .018 appliance.Materials and Methods: The before and after treatment panoramic views of sixty-three patients needed fixed orthodontic treatment included 1520 teeth were categorized into 3 Grades (G0: without resorption...

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

    Directory of Open Access Journals (Sweden)

    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.

  20. 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.

  1. Efficacy of chlorhexidine as a final irrigant in one-visit root canal treatment: a prospective comparative study.

    Science.gov (United States)

    Miçooğullar Kurt, S; Çalışkan, M K

    2018-03-30

    To evaluate postoperative pain and radiographic evidence of periapical healing in teeth with apical periodontitis treated in one visit with an additional final irrigation using 2% chlorhexidine (CHX) and to compare the results with conventional two-visit root canal treatment (RCT) with an intracanal calcium hydroxide (CH) dressing as a control group. Ninety asymptomatic maxillary anterior teeth with periapical lesions were treated by a single operator. Root canals were prepared using the step-back technique with manual instrumentation with 2.5% NaOCl and 5% EDTA as irrigants. Half of the teeth were randomly assigned to the one-visit (OV) group and received an additional final rinse with 2% CHX before canal filling. The other teeth were treated in two visits (TV) with a CH paste made by mixing CH powder and distilled water as an interappointment dressing. All patients were recalled and investigated clinically and radiographically for 24 months. Postoperative pain at 24-48 h and changes in apical bone density indicating radiographic healing were evaluated statistically using the Mann-Whitney U-test followed by the Friedman and the Wilcoxon tests (α = 0.05). There were no significant differences between two groups regarding the incidence of postoperative pain at 24 h (OV group 50% no pain, 47.6% mild, 2.4% moderate pain/TV group 55% no pain, 42.5% mild, 2.5% moderate pain) and at 48 h (OV group 95% no pain, 5% mild pain/TV group 98% no pain, 2% mild pain). None of the patients reported severe postoperative pain, swelling and/or flare-ups during the follow-up period. There was no significant difference in the radiographic healing rates (OV group 97.6% PAI 1 and/or PAI 2 and 2.4% PAI 3/TV group 95% PAI 1 and/or PAI 2 and 5% PAI 3; P > 0.05). Both groups provided favourable and similar postoperative pain and periapical healing rates at 24 months. Thus, one-visit RCT with a final rinse with 2% CHX is an acceptable alternative to two-visit RCT with CH as

  2. Effect of Instrumentation Length and Instrumentation Systems: Hand Versus Rotary Files on Apical Crack Formation – An In vitro Study

    Science.gov (United States)

    Mahesh, MC; Bhandary, Shreetha

    2017-01-01

    Introduction Stresses generated during root canal instrumentation have been reported to cause apical cracks. The smaller, less pronounced defects like cracks can later propagate into vertical root fracture, when the tooth is subjected to repeated stresses from endodontic or restorative procedures. Aim This study evaluated occurrence of apical cracks with stainless steel hand files, rotary NiTi RaCe and K3 files at two different instrumentation lengths. Materials and Methods In the present in vitro study, 60 mandibular premolars were mounted in resin blocks with simulated periodontal ligament. Apical 3 mm of the root surfaces were exposed and stained using India ink. Preoperative images of root apices were obtained at 100x using stereomicroscope. The teeth were divided into six groups of 10 each. First two groups were instrumented with stainless steel files, next two groups with rotary NiTi RaCe files and the last two groups with rotary NiTi K3 files. The instrumentation was carried out till the apical foramen (Working Length-WL) and 1 mm short of the apical foramen (WL-1) with each file system. After root canal instrumentation, postoperative images of root apices were obtained. Preoperative and postoperative images were compared and the occurrence of cracks was recorded. Descriptive statistical analysis and Chi-square tests were used to analyze the results. Results Apical root cracks were seen in 30%, 35% and 20% of teeth instrumented with K-files, RaCe files and K3 files respectively. There was no statistical significance among three instrumentation systems in the formation of apical cracks (p=0.563). Apical cracks were seen in 40% and 20% of teeth instrumented with K-files; 60% and 10% of teeth with RaCe files and 40% and 0% of teeth with K3 files at WL and WL-1 respectively. For groups instrumented with hand files there was no statistical significance in number of cracks at WL and WL-1 (p=0.628). But for teeth instrumented with RaCe files and K3 files

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

    Science.gov (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  5. 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.

  6. Antimicrobial photodynamic therapy for the treatment of teeth with apical periodontitis: a histopathological evaluation.

    Science.gov (United States)

    Silva, Lea Assed Bezerra; Novaes, Arthur B; de Oliveira, Rafael R; Nelson-Filho, Paulo; Santamaria, Milton; Silva, Raquel Assed Bezerra

    2012-03-01

    This study evaluated the in vivo response of apical and periapical tissues of dogs' teeth with apical periodontitis after one-session endodontic treatment with and without antimicrobial photodynamic therapy (aPDT). Sixty root canals with experimentally induced apical periodontitis were instrumented and assigned to 4 groups receiving aPDT and root canal filling (RCF) or not: group aPDT+/RCF+ (n = 20): aPDT (photosensitizer phenothiazine chloride at 10 mg/mL for 3 minutes and diode laser [λ = 660 nm, 60 mW/cm(2)] for 1 minute) and RCF in the same session; group aPDT+/RCF- (n = 10); group aPDT-/RCF+ (n = 20), and group aPDT-/RCF- (n = 10). Teeth were restored, and the animals were killed after 90 days. Sections from the maxillas and mandibles were stained with hematoxylin-eosin and Mallory trichrome and examined under light microscopy. Descriptive (ie, newly formed apical mineralized tissue, periapical inflammatory infiltrate, apical periodontal ligament thickness, and mineralized tissue resorption) and quantitative (ie, periapical lesion size and number of inflammatory cells) microscopic analysis was performed. Quantitative data were analyzed by the Kruskal-Wallis and Dunn tests (α = .05). In the aPDT-treated groups, the periapical region was moderately/severely enlarged with no inflammatory cells, moderate neoangiogenesis and fibrogenesis, and the smallest periapical lesions. Although apical closure by mineralized tissue deposition was not achieved, the absence of inflammatory cells, moderate neoangiogenesis, and fibrogenesis in the periapical region in the groups treated with aPDT indicate that this can be a promising adjunct therapy to cleaning and shaping procedures in teeth with apical periodontitis undergoing one-session endodontic treatment. Copyright © 2012 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2011-12-01

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

  8. 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

  9. Determination of the Apical Sealing Abilities of Mineral Trioxide Aggregate, Portland Cement, and Bioaggregate After Irrigation with Different Solutions.

    Science.gov (United States)

    Bayram, H Melike; Saklar, Feridun; Bayram, Emre; Orucoglu, Hasan; Bozkurt, Alperen

    2015-06-01

    The purpose of this study was to investigate the sealing ability of root-end filling materials such as mineral trioxide aggregate (MTA), Portland cement, and bioaggregate (BA) after irrigation with different solutions. We examined 130 human maxillar central teeth. After cutting the teeth at the cementoenamel junction, the root canals were expanded using nickel-titanium rotary instruments. Root canals were filled with AH-plus and gutta-percha. Then, the roots were cut apically, and 3 mm deep retrograde cavities were prepared. The roots were divided 12 experimental groups, consisting 10 teeth each; the positive and negative control groups contained five teeth each. The retrograde cavities were rinsed using ethylenediaminetetraacetic acid (EDTA), chlorhexidine (CHX), BioPure(™) mixture of a tetracycline isomer, an acid, and a detergent (MTAD), or distilled water. Next, groups 1, 2, 3, and 4 were sealed with MTA; groups 5, 6, 7, and 8 were sealed with Portland cement; and groups 9, 10, 11, and 12 were sealed with BA. Then, apical microleakage was evaluated by using a computerized fluid filtration method. The results of the leakage test were statistically evaluated by the post-hoc Tukey's test. MTA, Portland cement, and BA root-end filling materials showed the least leakage in the CHX and distilled water groups. The highest leakage was observed in the EDTA and MTAD groups. The sealing ability of BA was as good as that of MTA. EDTA and MTAD increased the apical leakage and CHX and distilled water decreased the leakage of the root-end filling materials examined in this study.

  10. 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.

  11. Root canal obturation of primary teeth: Disposable injection technique

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

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

    2018-01-01

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

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

    Directory of Open Access Journals (Sweden)

    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.

  16. 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

  17. Histopathological, Microbiological, and Radiographic Analysis of Antimicrobial Photodynamic Therapy for the Treatment of Teeth with Apical Periodontitis: A Study in Rats' Molars.

    Science.gov (United States)

    Trindade, Alessandra Cesar; de Figueiredo, José Antônio Poli; de Oliveira, Sílvia Dias; Barth Junior, Valdir Cristóvão; Gallo, Stephanie Wagner; Follmann, Carina; Wolle, Carlos Frederico Brilhante; Steier, Liviu; Morgental, Renata Dornelles; Weber, João Batista Blessmann

    2017-07-01

    The aim of this study was to evaluate in vivo, by histological and radiographic analysis, the response of apical tissues of rats' teeth with experimentally induced apical periodontitis, after one- and two-session endodontic treatment with and without photodynamic therapy (PDT). A microbiological analysis was also performed to verify bacterial reduction after each treatment. Studies carried out in recent years highlighted the antibacterial potential of PDT when associated with conventional endodontic therapy in vitro. Although the antimicrobial effect of PDT is well-established, tissue response to PDT in teeth with apical periodontitis lacks studies. Thirty-two rats' root canals were assigned to four groups: one session/PDT-[chemomechanical preparation (CMP)+root canal filling (RCF)]; two sessions/PDT- [CMP+calcium hydroxide (CH) for 14 days+RCF]; one session/PDT+ [CMP+PDT+RCF], and two sessions/PDT+ [CMP+PDT+CH for 14 days+RCF]. For microbiological evaluation, samples were collected before and after proposed treatments. For radiographic and histological analysis, the animals were euthanized after 28 days and the mandibles surgically removed. PDT associated with conventional endodontic therapy was able to promote significant bacterial reduction in root canals with induced apical periodontitis, but this reduction was not significantly different to conventional endodontic therapy alone. Although radiographic evaluation showed no significant differences, histological analysis showed lower scores for neutrophils/eosinophils in PDT-treated groups and macrophages/giant cells in CH groups. The use of low-level laser as light source did not promote major improvement on radiographic and histological repair, but since the number of inflammatory cells slightly decreased, it may optimize repair by modulating inflammatory process. PDT may be indicated as an adjunct to conventional endodontic therapy for teeth with apical periodontitis, in association with an interappointment

  18. Clinical, radiographic, and histological observation of a human immature permanent tooth with chronic apical abscess after revitalization treatment.

    Science.gov (United States)

    Shimizu, Emi; Ricucci, Domenico; Albert, Jeffrey; Alobaid, Adel S; Gibbs, Jennifer L; Huang, George T-J; Lin, Louis M

    2013-08-01

    Revitalization procedures have been widely used for the treatment of immature permanent teeth with apical periodontitis. The treatment procedures appear to be capable of encouraging continued root development and thickening of the canal walls. The nature of tissues formed in the canal space and at the root apex after revitalization has been shown histologically in several animal studies; similar studies in humans were recently reported. A 9-year-old boy had a traumatic injury to his upper anterior teeth. Tooth #9 suffered a complicated crown fracture with a pulp exposure, which was restored with a composite resin. The tooth developed a chronic apical abscess. Revitalization procedures were performed on tooth #9 because it was an immature permanent tooth with an open apex and thin canal walls. Twenty-six months after revitalization, the tooth had a horizontal crown fracture at the cervical level and could not be restored. The tooth was extracted and processed for routine histological and immunohistochemical examination to identify the nature of tissues formed in the canal space. Clinically and radiographically, the revitalization of the present case was successful because of the absence of signs and symptoms and the resolution of periapical lesion as well as thickening of the canal walls and continued root development. The tissue formed in the canal was well-mineralized cementum- or bone-like tissue identified by routine histology and immunohistochemistry. No pulp-like tissue characterized by the presence of polarized odontoblast-like cells aligning dentin-like hard tissue was observed. The tissues formed in the canal of revitalized human tooth are similar to cementum- or bone-like tissue and fibrous connective tissue. Copyright © 2013 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  19. 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.

  20. 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.

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

    Directory of Open Access Journals (Sweden)

    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

  2. Prevalence and features of distolingual roots in mandibular molars analyzed by cone-beam computed tomography

    International Nuclear Information System (INIS)

    Choi, Mi Ree; Moon, Young Mi; Seo, Min Seock

    2015-01-01

    This study evaluated the prevalence of distolingual roots in mandibular molars among Koreans, the root canal system associated with distolingual roots, and the concurrent appearance of a distolingual root in the mandibular first molar and a C-shaped canal in the mandibular second molar. Cone-beam computed tomographic images of 264 patients were screened and examined. Axial sections of 1056 mandibular molars were evaluated to determine the number of roots. The interorifice distances from the distolingual canal to the distobuccal canal were also estimated. Using an image analysis program, the root canal curvature was calculated. Pearson's chi-square test, the paired t-test, one-way analysis of variance, and post-hoc analysis were performed. Distolingual roots were observed in 26.1% of the subjects. In cases where a distolingual root was observed in the mandibular molar, a significant difference was observed in the root canal curvature between the buccolingual and mesiodistal orientations. The maximum root canal curvature was most commonly observed in the mesiodistal orientation in the coronal portion, but in the apical portion, maximum root canal curvature was most often observed in the buccolingual orientation. The canal curvature of distolingual roots was found to be very complex, with a different direction in each portion. No correlation was found between the presence of a distolingual root in the mandibular first molar and the presence of a C-shaped canal in the mandibular second molar

  3. Quantitative evaluation of apical extrusion of intracanal bacteria using rotary ProTaper, K3XF, twisted and hand K-file system: An ex vivo study.

    Science.gov (United States)

    Ghogre, Priyanka; Chourasia, Hemant Ramesh; Agarwal, Manish; Singh, M P; Gurav, Sandeep; Ghogre, Rahul

    2015-01-01

    The aim of this study was to evaluate the number of intracanal bacteria extruded apically during root canal preparation using rotary ProTaper, K3XF, twisted, and hand K-file system. Seventy extracted single-rooted human mandibular premolar teeth were used. Access cavities were prepared and the teeth were mounted in glass vials. Root canals were then contaminated with a pure culture of Enterococcus faecalis (ATCC 29212) and incubated at 37°C for 24 h. The contaminated roots were divided into four experimental groups of 15 teeth each and one control group of 10 teeth. Group 1: ProTaper; Group 2: K3XF; Group 3: Twisted file; Group 4: Hand K-file; Group 5: Control group. Bacteria extruded from the apical foramen during instrumentation were collected into vials. The microbiological samples were incubated in culture media for 24 h. Colonies of bacteria were counted and the results were given as number of colony-forming units (CFU)/ml. The obtained data were analyzed using the Kruskal-Wallis one-way analysis of variance and Mann-Whitney U-tests. There was a significant difference between the rotary and hand instrumentation system related to the apically extruded intracanal bacteria. Both the rotary and hand instrumentation systems extruded intracanal bacteria through the apical foramen. K3XF file system showed least bacterial extrusion amongst all instrumentation groups.

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

    Directory of Open Access Journals (Sweden)

    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

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

    Science.gov (United States)

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

    2015-10-01

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

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

    Science.gov (United States)

    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.

  7. 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, ...

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

  11. Comparative evaluation of apically extruded debris with V-Taper, ProTaper Next, and the Self-adjusting File systems.

    Science.gov (United States)

    Vyavahare, Nishant K; Raghavendra, Srinidhi Surya; Desai, Niranjan N

    2016-01-01

    Complete cleaning of the root canal is the goal for ensuring success in endodontics. Removal of debris plays an important role in achieving this goal. In spite of advancements in instrument design, apical extrusion of debris remains a source of inflammation in the periradicular region. To comparatively evaluate the amount of apically extruded debris with V-Taper, ProTaper Next, and the self-adjusting File (SAF) system. Sixty-four extracted human mandibular teeth with straight root canals were taken. Access openings were done and working length determined. The samples were randomly divided into three groups: Group I - V-Taper files (n = 20), Group II - ProTaper Next (n = 20), Group III - SAF (n = 20). Biomechanical preparation was completed and the debris collected in vials to be quantitatively determined. The data obtained was statistically analyzed using ANOVA and post hoc Tukey's test. All the specimens showed apical debris extrusion. SAF showed significantly less debris extrusion compared to V-Taper and ProTaper Next (P endodontic instruments. This indicates that the incidence of inter-treatment flare-ups due to debris extrusion would be less with the SAF.

  12. Apically extruded debris with three contemporary Ni-Ti instrumentation systems: An ex vivo comparative study

    OpenAIRE

    Logani Ajay; Shah Naseem

    2008-01-01

    Aim: To comparatively evaluate the amount of apically extruded debris when ProTaper hand, ProTaper rotary and ProFile systems were used for the instrumentation of root canals. Materials and Methods: Thirty minimally curved, mature, human mandibular premolars with single canals were randomly divided into three groups of ten teeth each. Each group was instrumented using one of the three instrumentation systems: ProTaper hand, ProTaper rotary and ProFile. Five milliliters of sterile water wer...

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

    Science.gov (United States)

    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.

  14. Taurodontism: A case report of successful treatment of root and crown

    Directory of Open Access Journals (Sweden)

    Abdolsamadi HR.

    2006-08-01

    Full Text Available Taurodontism is a rare dental anomaly in which the involved tooth has enlarged and elongated body and pulp chamber with apical displacement of the pulpal floor. Endodontic treatment of these teeth is challenging because it requires identifying the number of root canals. A case of bilateral involvement of maxillary first molar teeth is presented. Endodontic treatment of the right maxillary first molar with taurodontism was indicated due to irreversible pulpitis. In this article, we described the procedure of root canal therapy for this case.

  15. 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...

  16. A comparative evaluation of gutta percha removal and extrusion of apical debris by rotary and hand files.

    Science.gov (United States)

    Chandrasekar; Ebenezar, A V Rajesh; Kumar, Mohan; Sivakumar, A

    2014-11-01

    The aim of this study was to evaluate the efficacy of Protaper retreatment files in comparison with RaCe, K3 and H-files for removal of gutta-percha and apically extruded debris using volumetric analysis. Forty extracted single rooted maxillary incisor teeth with straight canals and mature apices were selected for the study. After access cavity preparation, apical patency was confirmed with a size 10 K-file extending 1mm beyond the point at which it was first visible at the apical end. Working lengths were determined with the use of size 15 K-file. The canals were prepared in a step-back technique and the master apical file was size 30 for all teeth. 3% sodium hypochlorite was used as an irrigant after each instrumentation. Before final rinse, size 20 K-file was passed 1mm beyond the apex to remove any dentinal shaving plugs and maintain the apical patency. Then the canals were dried with paper points. The root canal was filled using standard gutta-percha points and zinc oxide eugenol sealer under lateral condensation technique. The teeth were then randomly divided into four groups of ten teeth each based on the instrument used for gutta percha removal. All the rotary instruments used in this study were rotated at 300rpm. The instruments used were: Group 1 - RaCe Files, Group 2 - ProTaper retreatment Files, Group 3 - K3 Files and Group 4 - H Files. The volume of the obturating material was calculated before and after removal using volumetric analysis with spiral CT. The removal efficacy with each instrument was calculated and statistically analysed. The results of the study show that the ProTaper retreatment files (Group 2) (97.4%) showed the highest efficiency in the removal of obturating material, which was followed by RaCe (95.74%), K3 (92.86%) and H files (90.14%) with the efficiency in the decreasing order. Similarly the mean apical extrusion in H files (0.000 ± 0.002) was significantly lower than all the rotary instruments. However, the difference among the

  17. Micro-computed tomography and bond strength analysis of different root canal filling techniques

    Directory of Open Access Journals (Sweden)

    Juliane Nhata

    2014-01-01

    Full Text Available Introduction: The aim of this study was to evaluate the quality and bond strength of three root filling techniques (lateral compaction, continuous wave of condensation and Tagger′s Hybrid technique [THT] using micro-computed tomography (CT images and push-out tests, respectively. Materials and Methods: Thirty mandibular incisors were prepared using the same protocol and randomly divided into three groups (n = 10: Lateral condensation technique (LCT, continuous wave of condensation technique (CWCT, and THT. All specimens were filled with Gutta-percha (GP cones and AH Plus sealer. Five specimens of each group were randomly chosen for micro-CT analysis and all of them were sectioned into 1 mm slices and subjected to push-out tests. Results: Micro-CT analysis revealed less empty spaces when GP was heated within the root canals in CWCT and THT when compared to LCT. Push-out tests showed that LCT and THT had a significantly higher displacement resistance (P < 0.05 when compared to the CWCT. Bond strength was lower in apical and middle thirds than in the coronal thirds. Conclusions: It can be concluded that LCT and THT were associated with higher bond strengths to intraradicular dentine than CWCT. However, LCT was associated with more empty voids than the other techniques.

  18. 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

  19. Evaluation in vitro of effects of Er:YAG and Nd:YAG lasers irradiation on root canal wall, by stereoscopy, scanning electron micrography and thermographic camera

    International Nuclear Information System (INIS)

    Goya, Claudia

    2001-01-01

    This study was carried out to evaluate in vitro the effects of Nd:YAG laser and Er:YAG laser irradiation in the root canal wall by SEM, evaluating the apical leakage and the temperature changes during the laser irradiation. Seventy four extracted human teeth were used, they were instrumented and divided into seven groups of 10 teeth each. The teeth were evaluated through stereoscopy, by SEM, and with the thermographic camera. The Nd:YAG laser irradiation parameters were 100 mJ/p, 15 Hz, and Er:YAG laser were 160 mJ/p and 10 Hz, the irradiation was 4 times at 2 mm/sec speed, with 20 sec interval. The apical leakage was not observed in the teeth irradiated by Nd:YAG laser alone or in association with Er:YAG laser. However in the teeth irradiated only by the Er:YAG laser we observed a little leakage. By SEM observation the Nd:YAG laser irradiation showed melting and recrystallization in the dentin surface closing dentinal tubules, and in the samples irradiated by Er:Y AG laser a clean surface, opened dentinal tubules, and the combination by two lasers, showed melting covering some dentinal tubules The thermographic study found the temperature increase was not more than 6 deg C. This study showed the safety parameters applications of Er:YAG laser in association with Nd:YAG laser in root canal treatment, in order to not cause thermal damages to the periodontal tissues. (author)

  20. [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.