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Apical Third (apical + third)
Selected AbstractsSEM evaluation of root canal debridement with Sonicare CanalBrush irrigationINTERNATIONAL ENDODONTIC JOURNAL, Issue 5 2010M. I. Salman Salman MI, Baumann MA, Hellmich M, Roggendorf MJ, Termaat S. SEM evaluation of root canal debridement with Sonicare CanalBrush irrigation. International Endodontic Journal, 43, 363,369, 2010. Abstract Aim, To determine the efficacy of Sonicare CanalBrush irrigation for root canal cleaning. Methodology, Fifty human molar root canals were shaped with sequential NiTi rotary instruments up to size F3 (size 30, 0.09 taper; ProTaper system) and then enlarged apically with a Profile size 40, 0.04 taper. Five different irrigation protocols were tested (n = 10 canals per group) with 2 mL of distilled water (control, group I) or 2.5% NaOCl (control group II and test groups III, IV and V) between instrument size changes. Group III,IV received a final rinse with 17% EDTA for one min. This was extended by 30 s in group IV, whereas group V received this additional 30 s of 17% EDTA sonically dispersed with a Sonicare CanalBrush. For cleanliness evaluations, roots were split longitudinally, examined with scanning electron microscopy and scored according to Hülsmann et al. (1997) for debris and smear layer on the surface of the root canal wall. Walls were assessed at the coronal, middle and apical thirds. Data were analysed with the Kruskal,Wallis and Mann,Whitney tests. Results, Irrigation with 17% EDTA significantly reduced debris and smear layer scores (P < 0.05) compared to controls. The coronal and middle thirds had lower debris and smear layer scores than the apical third (P < 0.05). In all thirds, sonic agitation of the irrigant with a CanalBrush (group V) resulted in significantly cleaner canal walls compared to all other groups (P < 0.05). Conclusions, Irrigation by agitation with the Sonicare CanalBrush improved root canal debridement in the coronal, middle and particularly the apical thirds of the root canal. [source] Micro-CT evaluation of residual material in canals filled with Activ GP or GuttaFlow following removal with NiTi instrumentsINTERNATIONAL ENDODONTIC JOURNAL, Issue 3 2010M. J. Roggendorf Roggendorf MJ, Legner M, Ebert J, Fillery E, Frankenberger R, Friedman S. Micro-CT evaluation of residual material in canals filled with Activ GP or GuttaFlow following removal with NiTi instruments. International Endodontic Journal, 43, 200,209, 2010. Abstract Aim, To assess the efficacy of removing Activ GP or GuttaFlow from canals using NiTi instruments. Methodology, Root canals in 55 extracted pre-molars were prepared to apical size 40, 0.04 taper. The teeth were imaged with micro-CT, and 30 teeth selected that had consistent apical size and taper of the shaped canals. They were randomly assigned to root filling with either the glass-ionomer-based ActivGP system (n = 15) or the polyvinylsiloxane-based GuttaFlow system (n = 15). After 2 weeks, canals were retreated stepwise with size 40,50 EndoSequence 0.04 taper instruments. Micro-CT scans (8 ,m) were taken after use of each instrument to detect root filling residue in the coronal, middle and apical segment, and the retreatment time recorded. Residue, expressed as percentage of canal surface area, was compared between groups with t -tests, and within groups with repeated measures anova and Bonferroni-adjusted pairwise comparisons. Retreatment time was analysed with one-way anova. Results, The percentage of sealer residue-coated canal surface was consistently highest (P < 0.001) in the apical third of canals, and it did not differ significantly between the two root filling groups. Stepwise enlargement from size 40 to 50 significantly decreased the amount of sealer residue in both groups (P < 0.001). Retreatment time did not differ significantly between groups. Conclusions, Both root fillings with ActivGP and GuttaFlow were removed with nickel-titanium rotary instruments. Enlargement of canals up to two sizes beyond the pre-retreatment size was necessary to minimize the amount of sealer remaining. [source] Effectiveness of HERO 642 versus Hedström files for removing gutta-percha fillings in curved root canals: an ex vivo studyINTERNATIONAL ENDODONTIC JOURNAL, Issue 11 2009B. Ayd Abstract Aim, To compare the effectiveness of gutta-percha removal and the maintenance of canal anatomy when using the HERO 642 system or Hedström files (H-files) in mandibular molar teeth. Methodology, The root canals of 40 mandibular molar teeth were instrumented using H-files and filled with gutta-percha and sealer. After 1 year in storage, the roots were sectioned horizontally to provide apical, middle and coronal root thirds. Sections were photographed, and an individual muffle was produced for each tooth. Teeth were randomly divided into four groups (n = 10) and the gutta-percha removed using either the HERO 642 system or H-files, with or without solvent. Digital images of the root canals were then re-taken. Root thirds were inspected for lateral perforations, and the percentage of the residual canal filling was determined on postoperative images. Transportation and centring ratio were calculated using preoperative and postoperative images of the cross-sections of root thirds. Results, H-files groups were associated with less filling material than the HERO 642 system (H-files,HERO 642 P = 0.056, H-files,HERO 642+solvent P = 0.041, H-files + solvent,HERO 642 P = 0.018, H-files + solvent,HERO 642 + solvent P = 0.016). The percentage of residual filling material was similar in the apical thirds, and the contribution of solvent to canal debridement was not statistically significant (P > 0.05). Perforation occurred mesiobuccally in 48% of specimens in the apical sections of mesial roots. There were no significant differences for centring ratio, transportation and perforation rate between groups. Conclusions, H-files left less gutta-percha overall; however, there was no difference in the apical third. The effect of solvent was not remarkable. Both instrument systems created a large number of perforations. [source] Analysis of the gutta-percha filled area in C-shaped mandibular molars obturated with a modified MicroSeal techniqueINTERNATIONAL ENDODONTIC JOURNAL, Issue 3 2009R. Ordinola-Zapata Abstract Aim, To analyse the gutta-percha filled area of C-shaped molar teeth root filled with the modified MicroSeal technique with reference to the radiographic features and the C-shaped canal configuration. Methodology, Twenty-three mandibular second molar teeth with C-shaped roots were classified according to their radiographic features as: type I , merging, type II , symmetrical and type III , asymmetrical. The canals were root filled using a modified technique of the MicroSeal system. Horizontal sections at intervals of 600 ,m were made 1 mm from the apex to the subpulpal floor level. The percentage of gutta-percha area from the apical, middle and coronal levels of the radiographic types was analysed using the Kruskal,Wallis test. Complementary analysis of the C-shaped canal configurations (C1, C2 and C3) determined from cross-sections from the apical third was performed in a similar way. Results, No significant differences were found between the radiographic types in terms of the percentage of gutta-percha area at any level (P > 0.05): apical third, type I: 77.04%, II: 70.48% and III: 77.13%, middle third, type I: 95.72%, II: 93.17%, III: 91.13% and coronal level, type I: 98.30%, II: 98.25%, III: 97.14%. Overall, the percentage of the filling material was lower in the apical third (P < 0.05). No significant differences were found between the C-shaped canal configurations apically; C1: 72.64%, C2: 79.62%, C3: 73.51% (P > 0.05). Conclusions, The percentage of area filled with gutta-percha was similar in the three radiographic types and canal configuration categories of C-shaped molars. These results show the difficulty of achieving predictable filling of the root canal system when this anatomical variation exists. In general, the apical third was less completely filled. [source] A novel technique for the removal of fractured instruments in the apical third of curved root canalsINTERNATIONAL ENDODONTIC JOURNAL, Issue 3 2009M. Rahimi Abstract Aim, To report on a conservative approach for removal of a fractured file in the severely curved apical portion of the distobuccal canal of a mandibular molar. Summary, With the assistance of stainless steel hand files and a chloroform-dipped gutta-percha cone, a fractured rotary NiTi instrument was successfully removed. The use of this technique may assist in removal of loose instrument fragments that are not easily accessible to other removal techniques. Key learning points, ,,Instrument fractures do not always lead to an unfavourable prognosis and their removal from the apical third of curved canals should not be routinely attempted. ,,The case highlights that it is possible to conservatively remove loosely bound objects from the hard-to-reach areas of the root canal system. [source] Changes in compaction stress distributions in roots resulting from canal preparationINTERNATIONAL ENDODONTIC JOURNAL, Issue 12 2006A. Versluis Abstract Aim, To examine if canal enlargement with instruments of controlled taper leads to more uniform stress distributions within a root, thereby reducing fracture susceptibility. Methodology, Finite element models of a mandibular incisor were constructed with round and oval canal profiles, based on measurements from extracted teeth. The shapes of rotary nickel,titanium instruments (ProTaper F1, F2, and F3 and ProFile size 30, 0.04 taper and size 30, 0.06 taper; Dentsply Maillefer) were superimposed on the canals. Equivalent stresses and circumferential stresses in the root were calculated for a compaction load. Results, The highest stresses were found at the canal wall. Round canals showed lower uniform distributions, whilst oval canals showed uneven distributions with high concentrations at the buccal and lingual canal extensions and greater stresses in the coronal and middle thirds than in the apical third. Preparation of round canals introduced only small circumferential stress increases in the apical half; preparation of oval canals produced substantial reductions where the canal was enlarged to a smooth round shape. Even where fins were not completely eliminated, the maximum stresses were still reduced by up to 15%. External distal and mesial surfaces of roots with oval canals showed moderate stress concentrations that were minimally affected by preparations, whilst stress concentrations emerged on roots with round canals when preparation sizes increased. Conclusions, The potential for reducing fracture susceptibility exists as a result of round canal profiles achieved and smooth canal taper. Even when fins were not contacted by the instrument, stresses within the root were lower and more evenly distributed than before preparation. [source] The effect of mineral trioxide aggregate on the apexification and periapical healing of teeth with incomplete root formationINTERNATIONAL ENDODONTIC JOURNAL, Issue 1 2006W. T. Felippe Abstract Aim, To evaluate the influence of mineral trioxide aggregate (MTA) on apexification and periapical healing of teeth in dogs with incomplete root formation and previously contaminated canals and to verify the necessity of employing calcium hydroxide paste before using MTA. Methodology, Twenty premolars from two 6-month old dogs were used. After access to the root canals and complete removal of the pulp, the canal systems remained exposed to the oral environment for 2 weeks. Canal preparation was then carried out using Hedström files, under irrigation with 1% sodium hypochlorite, 1 mm short of the radiographic apex. After drying, the canals of two premolars in each dog were left empty (control group). The other eight teeth in each animal were divided into two experimental groups. The apical thirds of the canals of group 1 were filled with MTA. In the teeth of group 2, the canals were dressed with a calcium hydroxide,propylene glycol paste. After 1 week, the paste was removed and the apical third was filled with MTA. All teeth were restored with reinforced zinc oxide cement (IRM) and amalgam. The animals were killed 5 months later, and blocks of the teeth and surrounding tissues were submitted to histological processing. The sections were studied to evaluate seven parameters: formation of an apical calcified tissue barrier, level of barrier formation, inflammatory reaction, bone and root resorption, MTA extrusion, and microorganisms. Results of experimental groups were analysed by Wilcoxon's nonparametric tests and by the test of proportions. The critical value of statistical significance was 5%. Results, Significant differences (P < 0.05) were found in relation to the position of barrier formation and MTA extrusion. The barrier was formed in the interior of the canal in 69.2% of roots from MTA group only. In group 2, it was formed beyond the limits of the canal walls in 75% of the roots. MTA extrusion occurred mainly in roots from group 2. There was similarity between the groups for the other parameters. Conclusions, Mineral trioxide aggregate used after root canal preparation favoured the occurrence of the apexification and periapical healing. The initial use of calcium hydroxide paste was not necessary for apexification to occur, and has shown to be strongly related to the extrusion of MTA and formation of barriers beyond the limits of the root canal walls. [source] The effect of application time of EDTA and NaOCl on intracanal smear layer removal: an SEM analysisINTERNATIONAL ENDODONTIC JOURNAL, Issue 5 2005C. S. Teixeira Abstract Aim, To verify, under the scanning electron microscope (SEM), the influence of irrigation time with ethylenediaminetetraacetic acid (EDTA) and sodium hypochlorite (NaOCl) on intracanal smear layer removal. Methodology, Twenty-one extracted human permanent teeth with single straight root canals were included. The root canals of the teeth were instrumented and, at the end of preparation, were irrigated with 3 mL of 15% EDTA, followed by 3 mL of 1% NaOCl for 1 min (group 1), for 3 min (group 2), and for 5 min (group 3). The canals of teeth in group 4 (control) did not receive the final irrigation. The teeth were sectioned longitudinally and prepared for an SEM. The dentinal wall of cervical, middle and apical thirds was graded according to the amount of debris and smear layer remaining on the walls. The results were analysed using the Kruskal,Wallis and Conover,Inman tests. Results, In all the canals of experimental groups irrigation with EDTA and NaOCl completely removed the smear layer from the cervical and middle thirds. In the apical third, the dentine surface were partially covered, particularly in the teeth of group 1, where there was significantly more smear layer when compared with the other thirds in the same group (P < 0.007). However, the Kruskal,Wallis test showed overall that there were no significant differences between groups 1, 2 and 3 (P > 0.05). Conclusion, In this limited laboratory study, canal irrigation with EDTA and NaOCl for 1, 3 and 5 min were equally effective in removing the smear layer from the canal walls of straight roots. [source] Effectiveness of different techniques for removing gutta-percha during retreatmentINTERNATIONAL ENDODONTIC JOURNAL, Issue 1 2005A. V. Masiero Abstract Aim, To evaluate the effectiveness of various techniques for removing filling material from root canals in vitro. Methodology, Eighty extracted mandibular premolar teeth were selected for the study. The teeth were root filled using thermomechanical compaction of gutta-percha. After 8 months, the filling material was removed and canals were reinstrumented using the following techniques: group I , hand instrumentation with K-type files (SybronEndo, Orange, CA, USA); group II , K3 Endo System (SybronEndo); group III , M4 system (SybronEndo) with K-type files (SybronEndo); and group IV , Endo-gripper system (Moyco Union Broach, York, PA, USA) with K-type files (SybronEndo). The amount of filling debris remaining on root canal walls was assessed radiographically; the images were digitized and analysed using AutoCAD 2000 software. Total canal area, area of the cervical, middle and apical thirds, and area of remaining filling material were outlined by one operator. The ratios between these areas were calculated as percentages of remaining debris. Thereafter, data were analysed by means of one-way anova and the post-hoc Duncan test to identify differences between the four techniques. Results, Multiple comparisons of the percentages of remaining filling material in the entire canal did not reveal any significant differences between the methods of removal. However, when each third was analysed separately, significant differences for remaining debris were present between groups. The apical third had the most remaining material, whilst the cervical and middle thirds were significantly cleaner (P = 0.002). Comparison of the techniques revealed that teeth instrumented with K3 rotary instruments had a lower ratio of remaining filling material in the apical third (P = 0.012). Conclusion, In the apical third, K3 rotary instruments were more efficient in removing gutta-percha filling material than the other techniques, which were equally effective for the other thirds. [source] A scanning electron microscopic study of debris and smear layer remaining following use of GT rotary instrumentsINTERNATIONAL ENDODONTIC JOURNAL, Issue 5 2002G. Gambarini Abstract Aim The aim of the present study was to assess debris and smear layer remaining following canal preparation with GT rotary instruments. Methodology Sixteen freshly extracted single-rooted premolar teeth were instrumented with GTÔ rotary instruments using a crown-down preparation technique. All specimens were flushed with 2 mL of 5% NaOCl between each rotary instrument. At the end of instrumentation the following final irrigation sequence was repeated two times: 2 mL of EDTA + Cetrimide for 1 min (Largal Ultra, Septodont, France) and 2 mL of 5% NaOCl for 5 min. A final flush with saline solution was made to halt any chemical activity. Two other uninstrumented teeth that were not irrigated served as controls. All teeth were split longitudinally and prepared for SEM evaluation. The presence of debris and smear layer was evaluated from photomicrographs at ×200 and ×1000 magnification taken in the apical, middle and coronal thirds of the canals. Blind evaluation was performed by two trained observers and scores were compiled separately. A five category scoring system for debris and smear layer was used. Values obtained were tabulated and statistical analysis was carried out using a parametric chi-squared test. Results Statistical analysis showed that there was no significant difference between the three regions of the root canals (P > 0.05) for debris. Comparison of the removal of the smear layer between the three regions showed that there was a statistically significant difference between all parts, especially between the coronal and apical thirds (P < 0.001). Overall, the coronal sections were cleaner than the middle and apical sections. The uninstrumented canals showed walls completely covered with tissue, confirming that specimen preparation alone did not remove tissue. Conclusions Under the conditions of the present study GTÔ rotary instruments removed debris effectively, but left root canal walls covered with smear layer, particularly in the apical third. [source] Cleaning effectiveness of root canal irrigation with electrochemically activated anolyte and catholyte solutions: a pilot studyINTERNATIONAL ENDODONTIC JOURNAL, Issue 6 2000A. M. Solovyeva Abstract Aim The aim of this study was to evaluate the potential of electrochemically activated (ECA) anolyte and catholyte solutions to clean root canals during conventional root canal preparation. Methodology Twenty extracted single-rooted human mature permanent teeth were allocated randomly into four groups of five teeth. The pulp chambers were accessed and the canals prepared by hand with conventional stainless steel endodontic instruments using a double-flared technique. One or other of the following irrigants was used during preparation: distilled water, 3% NaOCl, anolyte neutral cathodic (ANC) (300 mg L,1 of active chlorine), and a combination of anolyte neutral cathodic (ANC) (300 mg L,1 of active chlorine) and catholyte. The teeth were split longitudinally and the canal walls examined for debris and smear layer by scanning electron microscopy. SEM photomicrographs were taken separately in the coronal, middle and apical parts of canal at magnification of ×800 to evaluate the debridement of extra-cellular matrix and at a magnification of ×2500 to evaluate the presence of smear layer. Results Irrigation with distilled water did not remove debris in the apical part of canals and left a continuous and firm smear layer overlying compressed low-mineralized predentine. All chemically active irrigants demonstrated improved cleaning potential compared to distilled water. The quality of loose debris elimination was similar for NaOCl and the anolyte ANC solution. The combination of anolyte ANC and catholyte resulted in improved cleaning, particularly in the apical third of canals. The evaluation of smear layer demonstrated that none of the irrigants were effective in its total removal; however, chemically active irrigants affected its surface and thickness. Compared to NaOCl, the ECA solutions left a thinner smear layer with a smoother and more even surface. NaOCl enhanced the opening of tubules predominantly in the coronal and middle thirds of canals, whereas combination of ANC and catholyte resulted in more numerous open dentine tubules throughout the whole length of canals. Conclusions Irrigation with electrochemically activated solutions cleaned root canal walls and may be an alternative to NaOCl in conventional root canal treatment. Further investigation of ECA solutions for root canal irrigation is warranted. [source] A biomechanical assessment of the relation between the oral implant stability at insertion and subjective bone quality assessmentJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 4 2007Ghada Alsaadi Abstract Aim: The study was set to evaluate the validity of subjective jaw bone quality assessment. Materials and Methods: A total of 298 patients (198 females, mean age 56.4) were treated with oral implants at the Periodontology Department at the University Hospital of KUL. A total of 761 TiUniteÔ implants have been installed. Subjective bone quality assessment was performed on radiographs and by the surgeon's tactile sensation and was compared with torque measurements. In a subset of patients, implant stability was also assessed by implant stability quotient and/or periotest values. Results: Subjective assessment of bone quality was related to the PTV, ISQ and placement torque [in the crestal, the second and the apical third (N cm)], respectively; in grade 1: ,5.3, 73.3 (4.2, 9.6, 15.2), and grade 3 or 4: ,1.6, 55 (3.3, 5.5, 8.4). For the surgeon's tactile sensation, a good correlation was noted for the presence of a thick cortex: ,4.6, 70.3 (4.2, 9.7, 15.1), or a thin one: ,0.3, 65.9 (3.6, 6.9, 10.1). For dense trabecular bone, the values were ,2.8, 69.4 (4.4, 9.7,14.8), while for poor trabecular bone, the values were,1.7, 66.4 (3.6, 6.4, 9.8). Conclusions: Subjective assessment of bone quality is related to PTV, ISQ and placement torque measurements at implant insertion. [source] The Effect of Dowel Space on the Bond Strengths of Fiber PostsJOURNAL OF PROSTHODONTICS, Issue 3 2007Jorge Perdigão DMD Purpose: The purpose of this study was to evaluate the effect of the degree of mismatch between post space and post diameters on the bond strength of a fiber-reinforced resin post. Materials and Methods: Thirty-two extracted human maxillary central incisors and canines were endodontically treated and assigned to four groups: Group 1 - Canal prepared with a D.T. Light Post #1 drill (control); Group 2 - Canal prepared with a D.T. Light Post #2 drill; Group 3 - Canal prepared with a D.T. Light Post #3 drill; Group 4 - Canal prepared with a Gates Glidden #6 drill. A D.T. Light Post size 1 was then luted into the canal using One-Step Adhesive and Post Cement Hi-X. A push-out test was performed on three sections of each root to measure push-out bond strengths. Data were analyzed with ANOVA and Bonferroni's test at p < 0.05. Two extra teeth for each group were restored in the same fashion and processed for SEM observation. Results: (in MPa): Group 1: 15.7 ± 6.9; Group 2: 14.7 ± 6.5; Group 3: 14.0 ± 5.0; Group 4: 14.0 ± 5.1. The variable "post space" resulted in no statistically significant difference in mean bond strengths (p > 0.05). For the variable "root region," the coronal third (17.5 ± 6.0) resulted in statistically greater mean bond strengths than the apical third (12.3 ± 6.0) at p < 0.008. The middle third (14.0 ± 5.3) resulted in no statistically significant different mean bond strengths from the coronal third at p > 0.119 and from the apical third at p > 0.999. Under the SEM, some areas of the canal system still displayed residual gutta-percha, which resulted in debonding of the interface between the resin cement and dentin. Areas with incomplete dentin hybridization were observed in localized areas of all groups. Conclusions: The diameter of the post space did not affect the push-out bond strengths. Bonding at the coronal level of the root canal is more reliable than bonding at the apical level. The presence of residual gutta-percha and the deficient dentin hybridization may result in deficient seal of the resin,dentin interface. [source] Removal of intracanal smear layer by doxycycline: SEM analysisAUSTRALIAN ENDODONTIC JOURNAL, Issue 2 2010Mara Cristina Santos felippe Abstract The aim of this study was to verify the efficacy of doxycycline used alone or in association with sodium hypochlorite on smear layer removal. The canals of extracted human teeth were instrumented using a stepback technique. At the end of preparation, they were irrigated with doxycycline (Group 1), ethylenediaminetetraacetic acid + sodium hypochlorite (Group 2), doxycycline + sodium hypochlorite (Group 3) and water (Group 4). The dentinal wall of the cervical, middle and apical thirds was graded according to the amount of remaining debris and smear layer. The results were analysed using the Kruskal,Wallis test (P < 0.05). In Groups 2 and 4, the dentine was completely free and covered with smear layer, respectively. The results from the cervical and middle thirds of Group 3 were worse than those in Groups 1 and 2 (P < 0.05). In relation to apical third, there were differences (P < 0.05) between all groups with best results for Group 2. Doxycycline was effective in removing smear layer from cervical and middle thirds. The use of doxycycline + sodium hypochlorite was partially effective in the cervical and middle thirds, but ineffective in the apical third. [source] Dentin strain induced by laser irradiationAUSTRALIAN ENDODONTIC JOURNAL, Issue 2 2010Satoshi Watanabe dds Abstract The purpose of this study was to investigate the strain and temperature change in dentin induced by laser irradiation of human root canals with or without water cooling. Twenty-eight palatal roots of extracted human maxillary first molars were used. The strain in dentin was measured using strain gauges fixed on the apical third of the buccal root surface. The temperature change of the root dentin was monitored using thermocouples embedded into dentin near the apex. The root canal was irradiated with Er:YAG or Nd:YAG laser at an output of 1 W (100 mJ, 10 pps) for 5 s. The tip of the irradiation fibre was located 2.0 mm from the root apex. With water cooling, the mean maximum strain induced by Er:YAG laser was significantly lower than that by Nd:YAG laser (P < 0.05). However, without water cooling, no significant difference between the two lasers (P > 0.05) was found. The results suggest that the strain induced by Er:YAG laser irradiation in dentin with water cooling may be minimal, but there still might be a risk of root micro-fracture if cooling is not sufficient. [source] Effect of 17% EDTA and MTAD on intracanal smear layer removal: A scanning electron microscopic studyAUSTRALIAN ENDODONTIC JOURNAL, Issue 1 2009Mohammad Ali Mozayeni dds Abstract The purpose of this study was to determine the effectiveness of MTAD as the final irrigant to remove the smear layer, compared with that of 17% EDTA, both following root canal irrigation with 5.25% sodium hypochlorite (NaOCl). Fifty-five extracted maxillary and mandibular single-rooted human teeth were prepared by a crown-down technique using rotary 0.04 and 0.06 taper nickel-titanium files. 5.25% sodium hypochlorite was used as the intracanal irrigant. The canals were then treated with 5 mL of one of the following solutions as final rinse: 5.25% sodium hypochlorite, 17% EDTA or MTAD. The presence or absence of smear layer in the coronal, middle and apical portion of each canal was examined with a scanning electron microscope. The results showed that MTAD is an effective final rinse solution for removing the smear layer in canals irrigated with sodium hypochlorite. When 17% EDTA was used as a final rinse, the smear layer was removed from the middle and coronal thirds of canal preparations, but it was less effective in the apical third of the canals. [source] Radiological evaluation of the morphological changes of root canals shaped with ProTaperÔ for hand use and the ProTaperÔ and RaCeÔ rotary instrumentsAUSTRALIAN ENDODONTIC JOURNAL, Issue 3 2008Carlos M. Aguiar dds Abstract 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 ProTaperÔ (Dentsply/Maillefer, Ballaigues, Switzerland) for hand use, group 2 with ProTaperÔ and group 3 with RaCeÔ. 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 ProTaperÔ for hand use showed 25% of the canals with a deviation in the apical third, as did the ProTaperÔ, while the corresponding figure for the RaCeÔ (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. [source] SEM evaluation of root canal debridement with Sonicare CanalBrush irrigationINTERNATIONAL ENDODONTIC JOURNAL, Issue 5 2010M. I. Salman Salman MI, Baumann MA, Hellmich M, Roggendorf MJ, Termaat S. SEM evaluation of root canal debridement with Sonicare CanalBrush irrigation. International Endodontic Journal, 43, 363,369, 2010. Abstract Aim, To determine the efficacy of Sonicare CanalBrush irrigation for root canal cleaning. Methodology, Fifty human molar root canals were shaped with sequential NiTi rotary instruments up to size F3 (size 30, 0.09 taper; ProTaper system) and then enlarged apically with a Profile size 40, 0.04 taper. Five different irrigation protocols were tested (n = 10 canals per group) with 2 mL of distilled water (control, group I) or 2.5% NaOCl (control group II and test groups III, IV and V) between instrument size changes. Group III,IV received a final rinse with 17% EDTA for one min. This was extended by 30 s in group IV, whereas group V received this additional 30 s of 17% EDTA sonically dispersed with a Sonicare CanalBrush. For cleanliness evaluations, roots were split longitudinally, examined with scanning electron microscopy and scored according to Hülsmann et al. (1997) for debris and smear layer on the surface of the root canal wall. Walls were assessed at the coronal, middle and apical thirds. Data were analysed with the Kruskal,Wallis and Mann,Whitney tests. Results, Irrigation with 17% EDTA significantly reduced debris and smear layer scores (P < 0.05) compared to controls. The coronal and middle thirds had lower debris and smear layer scores than the apical third (P < 0.05). In all thirds, sonic agitation of the irrigant with a CanalBrush (group V) resulted in significantly cleaner canal walls compared to all other groups (P < 0.05). Conclusions, Irrigation by agitation with the Sonicare CanalBrush improved root canal debridement in the coronal, middle and particularly the apical thirds of the root canal. [source] Effectiveness of HERO 642 versus Hedström files for removing gutta-percha fillings in curved root canals: an ex vivo studyINTERNATIONAL ENDODONTIC JOURNAL, Issue 11 2009B. Ayd Abstract Aim, To compare the effectiveness of gutta-percha removal and the maintenance of canal anatomy when using the HERO 642 system or Hedström files (H-files) in mandibular molar teeth. Methodology, The root canals of 40 mandibular molar teeth were instrumented using H-files and filled with gutta-percha and sealer. After 1 year in storage, the roots were sectioned horizontally to provide apical, middle and coronal root thirds. Sections were photographed, and an individual muffle was produced for each tooth. Teeth were randomly divided into four groups (n = 10) and the gutta-percha removed using either the HERO 642 system or H-files, with or without solvent. Digital images of the root canals were then re-taken. Root thirds were inspected for lateral perforations, and the percentage of the residual canal filling was determined on postoperative images. Transportation and centring ratio were calculated using preoperative and postoperative images of the cross-sections of root thirds. Results, H-files groups were associated with less filling material than the HERO 642 system (H-files,HERO 642 P = 0.056, H-files,HERO 642+solvent P = 0.041, H-files + solvent,HERO 642 P = 0.018, H-files + solvent,HERO 642 + solvent P = 0.016). The percentage of residual filling material was similar in the apical thirds, and the contribution of solvent to canal debridement was not statistically significant (P > 0.05). Perforation occurred mesiobuccally in 48% of specimens in the apical sections of mesial roots. There were no significant differences for centring ratio, transportation and perforation rate between groups. Conclusions, H-files left less gutta-percha overall; however, there was no difference in the apical third. The effect of solvent was not remarkable. Both instrument systems created a large number of perforations. [source] The effect of application time of EDTA and NaOCl on intracanal smear layer removal: an SEM analysisINTERNATIONAL ENDODONTIC JOURNAL, Issue 5 2005C. S. Teixeira Abstract Aim, To verify, under the scanning electron microscope (SEM), the influence of irrigation time with ethylenediaminetetraacetic acid (EDTA) and sodium hypochlorite (NaOCl) on intracanal smear layer removal. Methodology, Twenty-one extracted human permanent teeth with single straight root canals were included. The root canals of the teeth were instrumented and, at the end of preparation, were irrigated with 3 mL of 15% EDTA, followed by 3 mL of 1% NaOCl for 1 min (group 1), for 3 min (group 2), and for 5 min (group 3). The canals of teeth in group 4 (control) did not receive the final irrigation. The teeth were sectioned longitudinally and prepared for an SEM. The dentinal wall of cervical, middle and apical thirds was graded according to the amount of debris and smear layer remaining on the walls. The results were analysed using the Kruskal,Wallis and Conover,Inman tests. Results, In all the canals of experimental groups irrigation with EDTA and NaOCl completely removed the smear layer from the cervical and middle thirds. In the apical third, the dentine surface were partially covered, particularly in the teeth of group 1, where there was significantly more smear layer when compared with the other thirds in the same group (P < 0.007). However, the Kruskal,Wallis test showed overall that there were no significant differences between groups 1, 2 and 3 (P > 0.05). Conclusion, In this limited laboratory study, canal irrigation with EDTA and NaOCl for 1, 3 and 5 min were equally effective in removing the smear layer from the canal walls of straight roots. [source] Effectiveness of different techniques for removing gutta-percha during retreatmentINTERNATIONAL ENDODONTIC JOURNAL, Issue 1 2005A. V. Masiero Abstract Aim, To evaluate the effectiveness of various techniques for removing filling material from root canals in vitro. Methodology, Eighty extracted mandibular premolar teeth were selected for the study. The teeth were root filled using thermomechanical compaction of gutta-percha. After 8 months, the filling material was removed and canals were reinstrumented using the following techniques: group I , hand instrumentation with K-type files (SybronEndo, Orange, CA, USA); group II , K3 Endo System (SybronEndo); group III , M4 system (SybronEndo) with K-type files (SybronEndo); and group IV , Endo-gripper system (Moyco Union Broach, York, PA, USA) with K-type files (SybronEndo). The amount of filling debris remaining on root canal walls was assessed radiographically; the images were digitized and analysed using AutoCAD 2000 software. Total canal area, area of the cervical, middle and apical thirds, and area of remaining filling material were outlined by one operator. The ratios between these areas were calculated as percentages of remaining debris. Thereafter, data were analysed by means of one-way anova and the post-hoc Duncan test to identify differences between the four techniques. Results, Multiple comparisons of the percentages of remaining filling material in the entire canal did not reveal any significant differences between the methods of removal. However, when each third was analysed separately, significant differences for remaining debris were present between groups. The apical third had the most remaining material, whilst the cervical and middle thirds were significantly cleaner (P = 0.002). Comparison of the techniques revealed that teeth instrumented with K3 rotary instruments had a lower ratio of remaining filling material in the apical third (P = 0.012). Conclusion, In the apical third, K3 rotary instruments were more efficient in removing gutta-percha filling material than the other techniques, which were equally effective for the other thirds. [source] Evaluation of smear layer removal by EDTAC and sodium hypochlorite with ultrasonic agitationINTERNATIONAL ENDODONTIC JOURNAL, Issue 5 2002D. M. Z. Guerisoli Abstract Aim To evaluate smear layer removal by different irrigating solutions under ultrasonic agitation. Methodology Twenty recently extracted mandibular incisors with a single root canal were divided into four equal groups. Three groups were instrumented using the modified double-flared technique, the fourth remained unprepared. Each group was irrigated with either distilled water, 1.0% sodium hypochlorite alone or associated with 15% EDTAC between each file size. The final group was not instrumented but irrigated with 1.0% sodium hypochlorite and 15% EDTAC. A size 15 file energised by ultrasound was used with small amplitude filing movements against the canal walls in all groups. The teeth were split longitudinally and the roots measured to provide three sections of the same size (cervical, middle and apical). Samples were examined under the scanning electron microscope and assessed for the amount of smear layer by three independent and calibrated examiners. The scoring system ranged from 1 (no smear layer) to 4 (all areas covered by smear layer). Due to the non-parametric nature of the data, Friedman's test was used for statistical analysis. Results Canal walls were covered with smear layer in the group irrigated with 1% sodium hypochlorite alone and the group irrigated with distilled water. Canals irrigated with 1.0% sodium hypochlorite associated with 15% EDTAC had less smear layer throughout the canal (P < 0.001). There were no statistical differences for the amount of smear layer found on the cervical, middle and apical thirds when each group was analysed separately. Conclusions Under ultrasonic agitation, sodium hypochlorite associated with EDTAC removed the smear layer from root canal walls, whereas irrigation with distilled water or 1.0% sodium hypochlorite alone did not remove smear layer. [source] A scanning electron microscopic study of debris and smear layer remaining following use of GT rotary instrumentsINTERNATIONAL ENDODONTIC JOURNAL, Issue 5 2002G. Gambarini Abstract Aim The aim of the present study was to assess debris and smear layer remaining following canal preparation with GT rotary instruments. Methodology Sixteen freshly extracted single-rooted premolar teeth were instrumented with GTÔ rotary instruments using a crown-down preparation technique. All specimens were flushed with 2 mL of 5% NaOCl between each rotary instrument. At the end of instrumentation the following final irrigation sequence was repeated two times: 2 mL of EDTA + Cetrimide for 1 min (Largal Ultra, Septodont, France) and 2 mL of 5% NaOCl for 5 min. A final flush with saline solution was made to halt any chemical activity. Two other uninstrumented teeth that were not irrigated served as controls. All teeth were split longitudinally and prepared for SEM evaluation. The presence of debris and smear layer was evaluated from photomicrographs at ×200 and ×1000 magnification taken in the apical, middle and coronal thirds of the canals. Blind evaluation was performed by two trained observers and scores were compiled separately. A five category scoring system for debris and smear layer was used. Values obtained were tabulated and statistical analysis was carried out using a parametric chi-squared test. Results Statistical analysis showed that there was no significant difference between the three regions of the root canals (P > 0.05) for debris. Comparison of the removal of the smear layer between the three regions showed that there was a statistically significant difference between all parts, especially between the coronal and apical thirds (P < 0.001). Overall, the coronal sections were cleaner than the middle and apical sections. The uninstrumented canals showed walls completely covered with tissue, confirming that specimen preparation alone did not remove tissue. Conclusions Under the conditions of the present study GTÔ rotary instruments removed debris effectively, but left root canal walls covered with smear layer, particularly in the apical third. [source] Identification of root canals in molars by tuned-aperture computed tomographyINTERNATIONAL ENDODONTIC JOURNAL, Issue 4 2000R. Nance Abstract Aim To compare the tuned-aperture computed tomography system of imaging to conventional D-speed film for their ability to identify root canals in extracted human molars. Methodology Thirteen maxillary and six mandibular human molars were mounted in acrylic blocks to simulate clinical conditions by surrounding the teeth with a radiodense structure. The teeth were then imaged with conventional D-speed film using a standard paralleling technique, and with a modified orthopantomograph OP100 machine using a Schick no. 2 size CCD sensor as the image receptor. The source images were registered and TACT slices were generated using TACT WorkbenchÔ Software. Three observers were asked to identify the number of canals in the conventional film group and the TACT image group using specific criteria. Ground truth was established by cross-sectioning the teeth at the coronal, middle, and apical thirds of the roots and directly visualizing the root canal morphology. Results TACT imaging detected 36% of 4th canals in maxillary molars and 80% of third canals in mandibular molars. Conventional film detected 0% of fourth canals in maxillary molars and 0% of third canals in mandibular molars. The differences in canal detection between the two techniques were statistically significant (Wilcoxon matched pair sign rank test, P = 0.001). Conclusions In this study, the TACT system of digital imaging was superior to conventional film in the detection of root canals in human molars and may be useful for the detection of root canals that will probably be missed upon conventional X-ray examination. [source] |