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Root Canals (root + canal)
Kinds of Root Canals Terms modified by Root Canals Selected AbstractsUltrasonic Debridement of Root Canals: Acoustic Cavitation and Its Relevance,INTERNATIONAL ENDODONTIC JOURNAL, Issue 5 2009M. Ahmad BDS First page of article [source] What We Leave Behind In Root Canals After Endodontic Treatment: Some Issues and ConcernsAUSTRALIAN ENDODONTIC JOURNAL, Issue 3 2005Dr. Chee Peng Sum The benefits of using sodium hypochlorite (NaOCl) and ethylenediaminetetraacetic acid (EDTA) as endodontic irrigants, and calcium hydroxide as an inter-appointment medicament, are well known to dentists. Many steps undertaken during endodontic treatment and retreatment are rather mechanical in nature, and less attention is committed to understanding the biological issues underlying endodontic treatment and retreatment. It should be noted that dentine is the fundamental substrate in endodontic treatment, and its properties and characteristics are the key determinant of nearly all disease and post-disease processes in the teeth. In this article the effects and counter-effects of NaOCl and EDTA on root canal dentine, and some other related issues are reviewed. This information will enable clinicians to use the beneficial effects of these chemicals, while necessary steps are considered to reduce their harmful effects on dentine substrate. [source] Engine-Driven Preparation Of Curved Root Canals: Measuring Cyclic Fatigue And Other Physical Parameters,AUSTRALIAN ENDODONTIC JOURNAL, Issue 1 2002Ove A. Peters Dr med dent An increasing number of engine-driven rotary systems are marketed to shape root canals. Although these systems may improve the quality of canal preparations, the risk for instrument fracture is also increased. Unfortunately, the stresses generated in rotary instruments when shaping curved root canals have not been adequately studied. Consequently, the aim of an ongoing project was to develop a measurement platform that could more accurately detail physical parameters generated in a simulated clinical situation. Such a platform was constructed by fitting a torque-measuring device between the rotating endodontic instrument and the motor driving it. Apically directed force and instrument insertion depth were also recorded. Additional devices were constructed to assess cyclic fatigue and static fracture loads. The current pilot study evaluated GT rotary instruments during the shaping of curved canals in plastic blocks as well as "ISO 3630,1 torque to fracture" and number of rotations required for fatigue fracture. Results indicated that torques in excess of 40Nmm were generated by rotary GT-Files, a significantly higher figure than static fracture loads (less than 13Nmm for the size 20. 12 GT-File). Furthermore, the number of rotations needed to shape simulated canals with a 5 mm radius of curvature in plastic blocks was 10 times lower than the number of rotations needed to fracture instruments in a "cyclic fatigue test". Apical forces were always greater than IN, and in some specimens, scores of 8N or more were recorded. Further studies are required using extracted natural teeth, with their wide anatomical variation, in order to reduce the incidence of fracture of rotary instruments. In this way, the clinical potential of engine-driven rotary instruments to safely prepare curved canals can be fully appreciated. [source] Leakage Along Apical Root Fillings In Curved Root Canals.AUSTRALIAN ENDODONTIC JOURNAL, Issue 2 2001Part I: Effects Of Apical Transportation On Seal Of Root Fillings No abstract is available for this article. [source] Endodontic and periodontal treatments of a geminated mandibular first premolarINTERNATIONAL ENDODONTIC JOURNAL, Issue 2 2002S. Aryanpour Abstract Aim, To describe a rare case of gemination involving a mandibular first premolar. Summary The complex morphology of geminated teeth renders their endodontic and periodontal management difficult. Root canal and periodontal treatments were performed on a geminated mandibular first premolar with three canals. Clinical examination showed two separated crowns with united roots. Radiographically, two distinct pulp chambers with two joined and a third independent canal were seen. Conventional root canal treatment resulted in complete healing of the apical lesion. However, the occurrence of a vertical fracture led to the extraction of the mesial segment. At the follow-up visit, the distal segment was clinically healthy and continued to satisfy functional demands. Key learning points ,Failure to diagnose the initial crack along a gemination groove resulted in further propagation and finally complete vertical fracture. ,Owing to the abnormal morphology of the crown and the complexity of the root canal system in geminated teeth, treatment protocols require special attention. ,For asymptomatic cases without aesthetic or orthodontic problems and without associated pathosis, routine review and careful maintenance are required. [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] A 5-year review of teeth filled with the noninstrumentation technologyINTERNATIONAL ENDODONTIC JOURNAL, Issue 7 2009B. Suter Abstract Aim, The aim of this Case Series was to evaluate the radiographic quality of root fillings performed 5 years previously using the noninstrumentation technology (NIT)-obturation method and to assess radiographically the outcome of these root canal treatments. Methodology, Seventeen patients requiring root canal treatment participated in this study and were re-evaluated after 5 years. After instrumentation with K-Flexofiles, Calcium-Hydroxide inter-appointment dressing, re-entry and copious irrigation with NaOCl, the teeth were root filled using the NIT. Results, Immediately after obturation the root fillings were (,0.78 ± 0.11 mm) short when taking the radiographic apex as a reference point. After 60 months these values were ,0.85 ± 0.11 mm. No statistical difference was found (P > 0.05). In the periapical region, PAI rating 1 and 2 increased from 20.1% to 75.6% after 60 months. Conclusions, ,,This prospective Case Series demonstrated the performance of the NIT-obturation method in vivo. ,,Root canals filled by the reduced-pressure method using sealer combined with gutta-percha cones showed good radiographic quality. ,,Periapical healing after 5 years was comparable with conventional filling techniques. [source] Efficacy of ProTaper Universal rotary retreatment system for gutta-percha removal from root canalsINTERNATIONAL ENDODONTIC JOURNAL, Issue 4 2008L.-S. Gu Abstract Aim, To evaluate the efficacy of the ProTaper Universal rotary retreatment system for gutta-percha (GP) removal from root canals. Methodology, Root canals of 60 extracted human maxillary anterior teeth were prepared and filled with laterally condensed GP and AH Plus sealer. Teeth were divided into three groups: group A , GP removal completed with the ProTaper Universal rotary retreatment system and with further canal repreparation accomplished with ProTaper Universal rotary instruments; group B , GP removal was completed using Gates Glidden drills and Hedström files with chloroform as a solvent, followed with further canal repreparation with ProTaper Universal rotary instruments; group C , the same as group B for GP removal with further canal preparation with stainless steel K-flex files (Kerr). The operating time was recorded. Teeth were rendered transparent for the evaluation of the area of remaining GP/sealer in bucco-lingual and mesial,distal directions. Statistical analysis was performed by using repeated measures analysis of variance and anova. Results, The ProTaper Universal technique (group A) resulted in a smaller percentage of canal area covered by residual GP/sealer than in groups B and C, with a significant difference between groups A and C (P < 0.05). Mean operating time for group A was 6.73 min, which was significantly shorter (P < 0.05) than group B (10.86 min) and group C (13.52 min). Conclusions, In this laboratory study all test techniques left GP/sealer remnants within the root canal. The ProTaper Universal rotary retreatment system proved to be an efficient method of removing GP and sealer from maxillary anterior teeth. [source] Imaging of root canal fillings: a comparison of subjective image quality between limited cone-beam CT, storage phosphor and film radiographyINTERNATIONAL ENDODONTIC JOURNAL, Issue 3 2007E. So Abstract Aim, To compare the subjective quality of limited cone-beam computed tomography (LCBCT), storage phosphor plate (SPP) and F-speed film images for the evaluation of length and homogeneity of root fillings. Methodology, Root canals of 17 extracted permanent mandibular incisor teeth were filled. With the teeth placed in their jaws, images were obtained with Accu-I-Tomo LCBCT, Digora® Optime image plate system and F-speed film using exposure parameters yielding ,clinically' acceptable density and contrast. Three radiologists and three endodontists independently rated the quality of all images in respect to homogeneity and the length of root fillings using a 3-graded scale. Evaluations were undertaken in two sessions. In the first, the coronal LCBCT images were not included. In the second, both coronal and sagittal LCBCT images were rated along with F-speed film and SPP images. Results were compared using the Friedman test (P < 0.05). Pair-wise comparisons of systems were completed using the Wilxocon signed-ranks test (P < 0.05). Kappa was used to measure interobserver agreement. Results, Digora images were rated superior, consecutively followed by F-speed films and LCBCT images, for the evaluation of both homogeneity and length of root fillings in both the evaluation sessions (P < 0.05). Kappa ranged from slight to moderate for the length evaluation of root fillings and from poor to fair for the evaluation of homogeneity of root fillings. Conclusion, Image quality of storage phosphor images was subjectively as good as conventional film images and superior to LCBCT images for the evaluation of both homogeneity and length of root fillings in single-rooted teeth. [source] Histological evaluation of the osteoinduction capability of human dentineINTERNATIONAL ENDODONTIC JOURNAL, Issue 11 2006M. E. L. Machado Abstract Aim, To assess whether human dentine has the potential to promote the development of calcified tissues when implanted in the muscle tissue of mice. Methodology, Root canals in extracted human teeth were instrumented to produce dentine fragments. The dentine fragments produced were divided into two. In group 1, fragments were demineralized and sterilized. In group 2, the fragments were not submitted to any additional treatment. The dentine fragments were then implanted in the muscle of mice. In group 3, the muscles were implanted with rehydrated lyophilized human bone powder. Animals were killed following test periods of 7, 15, 30, 60, 120 and 180 days, the fragments were removed together with adjacent muscle and examined under light microscopy to assess calcification. Results, Areas of calcification were observed in groups 1 and 3 after a period of 180 days. In group 2, the surrounding tissues displayed only chronic inflammatory infiltration. Conclusions, On the basis of the experimental model adopted in this study, fibroblast-rich connective tissue formed in groups 1 and 3, which could reflect an osteoinductive process. Further studies are suggested to identify which dentinal factors are capable of inducing the formation of a calcified matrix. [source] An in vitro comparison of pH changes in root dentine following canal dressing with calcium hydroxide points and a conventional calcium hydroxide pasteINTERNATIONAL ENDODONTIC JOURNAL, Issue 3 2002S. M. Ardeshna Abstract Aim This study aimed to measure and compare pH changes at apical and cervical sites on the external root surface of extracted teeth dressed with calcium hydroxide in two different formulations. Methodology Root canals of 45 single-rooted extracted human teeth were accessed and shaped using a step-down technique with rotary instrumentation. Standard cavities were prepared on the external root surface at specific apical and cervical sites. The teeth were randomly allocated to three groups. Teeth in group A were dressed with calcium hydroxide points, those in group B were dressed with an aqueous calcium hydroxide paste and teeth in group C were left unfilled. Following storage in humid conditions, the pH of the dentine at apical and cervical sites was measured at baseline and then at 24 h, 72 h, 1 week, 10 days, 2 weeks and 3 weeks. Results The pH of the root dentine at both apical and cervical sites was significantly greater (P < 0.001) in teeth dressed with aqueous calcium hydroxide paste compared with those dressed with calcium hydroxide points, when averaged out across all time periods. For all groups, there was a significant difference between the mean apical and cervical pH values for each tooth with lower values for the apical sites (P < 0.001). Conclusion The results of this study indicate that an aqueous calcium hydroxide paste was more effective than calcium hydroxide points at raising the pH on the external root surface of extracted teeth. [source] The standardized-taper root canal preparation , Part 6.INTERNATIONAL ENDODONTIC JOURNAL, Issue 3 2001GT file technique in abruptly curved canals Abstract Aim, To describe the application of GT files in roots with abrupt curvatures. Summary Most dentists interpret obstructions to instrument progress as calcification, rather than abrupt curvature. Basically, there are not any apically calcified canals, only clinicians who are not clever enough or patient enough to sneak to patency. Dentists should be on their guard and sensitive to the ,rubber band' sensation of residual pulp tissue, and the ,loose resistance' sensation of the curved or ledged canal. Residual pulp tissue should be removed and the canal lubricated. The ledged or curved canal will only be helped by file bending. The size 10 file test is the key to identify canals requiring pre-bent instruments. The canal should first be flared short of the obstruction, before shaping the canal after it with regular, pre-bent K-files. Pre-bent GT hand-files can then be used with care to blend the apical and more coronal regions for final shape. Cone-fit may then require chilling and pre-bending GP cones (pre-bend more than one), before packing the canal. Key learning points ,Root canals do not calcify apically. ,File progress is prevented by pulp tissue, abrupt curvatures or ledging. ,Loose resistance to the passage of a size 10 file shows the canals that require instrument pre-bending. This test should be repeated at intervals during the preparation. ,Even NiTi GT files can be pre-bent for use in abrupt curves. ,Gutta percha cones can be pre-bent after chilling. [source] Microbiological analysis of infected root canals from symptomatic and asymptomatic teeth with periapical periodontitis and the antimicrobial susceptibility of some isolated anaerobic bacteriaMOLECULAR ORAL MICROBIOLOGY, Issue 5 2003R. C. Jacinto 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. [source] Influence of dentin on pH of 2% chlorhexidine gel and calcium hydroxide alone or in combinationDENTAL TRAUMATOLOGY, Issue 3 2010Laila Gonzales Freire Most of the times, these objectives are not achieved solely by chemomechanical preparation, and intracanal dressing may be necessary. In these cases, calcium hydroxide is used as a root canal dressing due to its well-known and recognized antimicrobial activity. Chlorhexidine has a wide spectrum of antimicrobial activity and its association with calcium hydroxide has been recommended in an attempt to amplify antimicrobial effects of calcium hydroxide. It is also known that dentin exerts a buffering effect under wide pH variations, and may be responsible for decreasing the antimicrobial activity of drugs inside the root canal. The objectives of this study were to assess the pH of 2% chlorhexidine gel and calcium hydroxide alone or in combination, as well as the influence of dentin on the pH of these compounds. Dentin powder was obtained from bovine teeth and added as 1.8% to the volume of the medications. All substances were individually stored in plastic flasks, in triplicate. A pH meter was used at five different moments to assess pH in viscous medium: immediately after preparation and after 24 h, and 7, 14, and 21 days. Results were analyzed by paired Student's t -test. Statistically significant differences were observed in the 2% chlorhexidine gel group alone or associated with calcium hydroxide and added of dentin powder (P < 0.05). Mean pH values indicated the influence of dentin powder because of a significant increase in pH. Calcium hydroxide with propylene glycol as the vehicle always showed high pH, demonstrating that this compound was not affected by the presence of dentin. [source] Severe periodontal damage by an ultrasonic endodontic device: a case reportDENTAL TRAUMATOLOGY, Issue 2 2007John D. Walters Abstract,,, Heat produced within a root canal during use of an ultrasonic instrument can be conducted through the dentin into periodontal ligament, bone and soft tissue. If severe in intensity or long in duration, it can induce damage to these tissues. This report describes a case in which an ultrasonic endodontic instrument apparently induced severe damage to alveolar bone, gingiva and nasal mucosa in a 42-year-old female. Overheating of a maxillary central incisor caused necrosis of soft tissue and bone on the facial and mesial aspects and triggered a protracted inflammatory response in the adjacent nasal cavity. To relieve the severe discomfort associated with this damage, the patient chose to have her maxillary incisors extracted and replaced by a removable partial denture. A defect in the soft tissue and bone was present at a follow-up visit 10 months after the extractions. While morbidity of this nature is rare, this case reinforces the need to maintain adequate cooling of ultrasonic instruments. [source] Immediate surgical repositioning following intrusive luxation: a case report and review of the literatureDENTAL TRAUMATOLOGY, Issue 6 2006H. Cem Güngör Abstract,,, This report presents a case of severe intrusive luxation of mature maxillary lateral incisor in a 10-year-old boy. The intruded tooth was immediately repositioned (surgical extrusion) and splinted within 2 h following injury. Tetracycline therapy was initiated at the time of repositioning and maintained for 10 days. Pulp removal and calcium hydroxide treatment of the root canal was carried out after repositioning. Splint was removed 1 month later. Definitive root canal treatment with gutta percha was accomplished at the second month recall. Clinical and radiographic examination 28 months after the surgical extrusion revealed satisfactory apical and periodontal healing. [source] Methods of filling root canals: principles and practicesENDODONTIC TOPICS, Issue 1 2005JOHN WHITWORTH Contemporary research points to infection control as the key determinant of endodontic success. While epidemiological surveys indicate that success is most likely in teeth which have been densely root-filled to within 2 mm of root-end, it is unclear whether the root canal filling itself is a key determinant of outcome. It is also unclear how different materials and methods employed in achieving a ,satisfactory' root filling may impact on outcome. This article provides an overview of current principles and practices in root canal filling and strives to untangle the limited and often contradictory research of relevance to clinical practice and performance. [source] Life as an endodontic pathogenENDODONTIC TOPICS, Issue 1 2003Ecological differences between the untreated, root-filled root canals This review describes the type of microbial flora in the untreated root canal and the root-filled canal with persistent infection. Recent contributions of molecular methods of microbial identification are outlined along with a discussion of advantages and limitations of these methods. Ecological and environmental factors are the prime reasons for differences in the microbial flora in these distinct habitats. Shared phenotypic traits and an ability to respond to the modified environment select for the species that establish a persistent root canal infection. [source] Persistent, recurrent, and acquired infection of the root canal system post-treatmentENDODONTIC TOPICS, Issue 1 2003Markus Haapasalo Apical periodontitis is an inflammatory process in the periradicular tissues caused by microorganisms in the necrotic root canal. Accordingly, to achieve healing of apical periodontitis, the main goal of the treatment must be elimination of the infection and prevention of re-infection. As shown by recent epidemiological studies in several countries around the world, post-treatment endodontic disease is a far too common finding. To understand the reasons for survival of resistant bacteria in the filled root canal, it is important to know in detail the interaction between treatment procedures and the root canal flora in primary apical periodontitis. Therefore, in the first half of this review, the focus is placed on control of infection in primary apical periodontitis. This is followed by a detailed description of the resistant root canal microflora and a discussion about the present and future strategies to eliminate even the most resistant microbes in post-treatment disease. [source] Effect of post-space treatment on retention of fiber posts in different root regions using two self-etching systemsEUROPEAN JOURNAL OF ORAL SCIENCES, Issue 3 2008Ling Zhang The effect of post-space treatment on the retention of fiber posts in different root regions was evaluated using two self-etching systems. Post spaces were prepared in extracted premolars and then the root canals were subjected to one of the following post-space treatments: (i) water irrigation (control); (ii) etching with 35% phosphoric acid for 30 s; (iii) irrigation with 17% EDTA followed by 5.25% sodium hypochlorite (NaOCl); and (iv) ultrasonic agitation associated with 17% EDTA and 5.25% NaOCl irrigating solutions. The dentin surfaces were examined under scanning electron microscopy (SEM) after different post-space treatments. Fiber posts were then luted in the treated roots using resin cement with either Clearfil SE Bond or Clearfil DC Bond, and the thin-slice push-out test was performed. Scanning electron microscopy showed that all the post-space treatments tested were effective in removal of the smear layer of debris, or sealer/gutta-percha remnants, on the root canal. The apical push-out strength was affected by post-space treatment. Both 35% phosphoric acid etching and ultrasonic agitation in combination with EDTA/NaOCl irrigation improved the apical push-out strength of the fiber post, regardless of the type of self-etching system. A solo irrigation with an EDTA/NaOCl solution resulted in a lower apical push-out strength compared with the other two experimental groups. [source] Endodontic considerations in the elderlyGERODONTOLOGY, Issue 4 2004P. Finbarr Allen Tooth retention has increased significantly in older adults, and dentists are now challenged by the need to preserve critical teeth. There will be a need to consider endodontic therapy, and this paper describes how successful endodontics can be provided for elderly patients. Strategic treatment planning is essential, and preservation of key teeth will facilitate satisfactory oral function for elderly patients. These teeth may be important in achieving and maintaining an intact anterior dental arch, for removable partial denture retention or preservation of alveolar bone. In some cases, this can only be achieved if endodontic procedures are undertaken. When infection of a root canal is present, there is no reason why good quality endodontic therapy should not work in a healthy elderly patient. Elimination of infection can be challenging in narrow root canals, and a systematic approach for improving access into and negotiating these canals is outlined. [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] Ex vivo evaluation of the accuracy and coefficient of repeatability of three electronic apex locators using a simple mounting model: a preliminary reportINTERNATIONAL ENDODONTIC JOURNAL, Issue 4 2010F. L. C. D'Assunção D'Assunção FLC, Albuquerque DS, Salazar-Silva JR, Dos Santos VC, Sousa JCN.Ex vivo evaluation of the accuracy and coefficient of repeatability of three electronic apex locators using a simple mounting model: a preliminary report. International Endodontic Journal, 43, 269,274, 2010. Abstract Aim, To compare ex vivo the accuracy and coefficient of repeatability of three electronic apex locators in locating the apical constriction. Methodology, Thirty-one single-rooted teeth were used. The teeth were sectioned at the cement,-enamel junction. A mounting model was used for the measurement of electronic length (EL). The Root ZX-II, the Mini Apex Locator and the Novapex were used for electronic measurements. Each electronic measurement was obtained and repeated. After the last measurement, the file was cemented in place, and the apical 4 mm of each root canal was exposed. The distance from the tip of the file to the apical constriction was determined by three investigators and compared with the corresponding ELs. Results, The coefficient of repeatability of all devices was acceptable: Root ZX-II, 0.04 mm; Mini Apex Locator, 0.10 mm; and Novapex, 0.08 mm. There was little variation in inter-examiner agreement; the ,C (Lin) correlation coefficient was 0.83 for examiners 1 and 2, 0.88 for examiners 1 and 3 and 0.99 for examiners 2 and 3. Using the Root ZX-II, 13 of 31 electronic measurements were located at the apical constriction (42%). Otherwise, the tip of the file was not located at the apical constriction in any of the electronic measurements with the other two devices. The Wilcoxon signed rank test did not reveal any statistical difference between the Root ZX-II measurements and the actual length (P = 0.628), but there was a statistical difference between the Mini Apex Locator and Novapex measurements and the actual length position (P < 0.05). Conclusions, The devices tested in this study had a high coefficient of repeatability. The Root ZX-II was accurate, but the Mini Apex Locator and Novapex were not accurate in locating the apical constriction. [source] The smear layer in endodontics , a reviewINTERNATIONAL ENDODONTIC JOURNAL, Issue 1 2010D. R. Violich Abstract Root canal instrumentation produces a layer of organic and inorganic material called the smear layer that may also contain bacteria and their by-products. It can prevent the penetration of intracanal medicaments into dentinal tubules and influence the adaptation of filling materials to canal walls. This article provides an overview of the smear layer, focusing on its relevance to endodontics. The PubMed database was used initially; the reference list for smear layer featured 1277 articles, and for both smear layer dentine and smear layer root canal revealed 1455 publications. Smear layer endodontics disclosed 408 papers. A forward search was undertaken on selected articles and using some author names. Potentially relevant material was also sought in contemporary endodontic texts, whilst older books revealed historic information and primary research not found electronically, such that this paper does not represent a ,classical' review. Data obtained suggests that smear layer removal should enhance canal disinfection. Current methods of smear removal include chemical, ultrasonic and laser techniques , none of which are totally effective throughout the length of all canals or are universally accepted. If smear is to be removed, the method of choice seems to be the alternate use of ethylenediaminetetraacetic acid and sodium hypochlorite solutions. Conflict remains regarding the removal of the smear layer before filling root canals, with investigations required to determine the role of the smear layer in the outcomes of root canal treatment. [source] Apexogenesis after initial root canal treatment of an immature maxillary incisor , a case reportINTERNATIONAL ENDODONTIC JOURNAL, Issue 1 2010S. R. Kvinnsland Abstract Aim, To present a case where a traumatized, immature tooth still showed capacity for continued root development and apexogenesis after root canal treatment was initiated based on an inaccurate pulpal diagnosis. Summary, Traumatic dental injuries may result in endodontic complications. Treatment strategies for traumatized, immature teeth should aim at preserving pulp vitality to ensure further root development and tooth maturation. A 9-year-old boy, who had suffered a concussion injury to the maxillary anterior teeth, was referred after endodontic treatment was initiated in tooth 21 one week earlier. The tooth had incomplete root length, thin dentinal walls and a wide open apex. The pulp chamber had been accessed, and the pulp canal instrumented to size 100. According to the referral, bleeding from the root made it difficult to fill the root canal with calcium hydroxide. No radiographic signs of apical breakdown were recorded. Based on radiographic and clinical findings, a conservative treatment approach was followed to allow continued root development. Follow-up with radiographic examination every 3rd month was performed for 15 months. Continued root formation with apical closure was recorded. In the cervical area, a hard tissue barrier developed, which was sealed with white mineral trioxide aggregate (MTA). Bonded composite was used to seal the access cavity. At the final 2 years follow-up, the tooth showed further root development and was free from symptoms. Key learning points, ,,Endodontic treatment of immature teeth may result in a poor long-term prognosis. ,,The pulp of immature teeth has a significant repair potential as long as infection is prevented. ,,Treatment strategies of traumatized, immature permanent teeth should aim at preserving pulp vitality to secure further root development and tooth maturation. ,,Radiographic interpretation of the periapical area of immature teeth may be confused by the un-mineralized radiolucent zone surrounding the dental papilla. [source] Distance from file tip to the major apical foramen in relation to the numeric meter reading on the display of three different electronic apex locatorsINTERNATIONAL ENDODONTIC JOURNAL, Issue 12 2009R. A. Higa Abstract Aim, To establish and compare the relationship between the distance from the file tip to the apical foramen and the numeric meter reading on the display of three different electronic apex locators (EALs). Methodology, A total of 12 extracted intact, straight, single-rooted human teeth with complete roots were used. The actual root canal length (AL) was determined after access preparation. For the electronic measurements with each EAL, silicon stops were fixed with auto-polymerizing resin to size 15 K-files at AL and 0.5, 1, 2, 3, 4 mm short of AL. The data was analysed by two-way anova and Tukey's honestly significant difference (HSD) test for multiple comparisons amongst EALs. Additionally, one-way anova and Tukey's HSD test were carried out for multiple comparisons amongst the measurements of each EAL. Results, There was a statistically significant difference amongst all EALs in indicating the position of file tips in relation to the major foramen (P < 0.05). The correlation between the meter reading and the position of the file tip from the apical foramen was statistically significant in the three EALs. There were significant differences amongst the measurements at distances from 0 to 2 mm in Justy III. In Dentaport, significant differences were found from 0 to 1 mm. However, the E-Magic Finder showed significant differences from 0 to 0.5 mm. Conclusions, Justy III was more capable of displaying the intracanal position of the file tip from the major foramen in mm whilst advancing through the root canal during electronic measurements than the Dentaport and E-Magic Finder Deluxe. [source] Influence of tooth age and root section on root dentine dye penetrationINTERNATIONAL ENDODONTIC JOURNAL, Issue 12 2008A. Thaler Abstract Aim, To investigate dye permeability of root dentine according to patients' age, root section and dye penetration time. Methodology, A total of 96 extracted human single-rooted teeth, assigned to four age groups (<30, 30,45, 45,60 and >60 years) were separated at the cemento,enamel junction and root canals were enlarged. The root surfaces were coated with cyanocrylate to prevent external dye penetration and centrifuged in distilled water to eliminate air. For dye penetration the root canals were filled with methylene blue 5%. After 1, 30 and 60 days eight roots per age group were cross-sectioned in 1 mm slices. Dye penetrated areas and the complete dentine areas were digitized and measured. Differences between groups were judged with anova and LSD, P < 0.05 or P < 0.01. Results, The root section, the patients' age and the penetration time influenced significantly the penetrated areas (P < 0.05). After 1 and 30 days significant differences could be found only in the apical root sections between all age groups (P < 0.05). Dye penetration areas systematically decreased with increasing age and also from coronal to apical (P < 0.01). Conclusions, Age influenced dye penetration significantly. Dye penetration also depended on the location (coronal, middle and apical) within the root canal. These findings indicate that there may be a correlation between the tooth age and permeability of root dentine, which may influence the distribution and effectiveness of drugs used for root canal disinfection. [source] Foreign body in the apical portion of a root canal in a tooth with an immature apex: a case reportINTERNATIONAL ENDODONTIC JOURNAL, Issue 10 2008A. R. Prabhakar Abstract Aim, To describe the successful retrieval of a foreign object located in the apical portion of an immature root canal by simple orthograde techniques, avoiding the need for surgery or intentional reimplantation. Summary, A radio-opaque foreign object lodged in the apical portion of an immature root canal was discovered on radiographic examination of a patient with a complicated crown fracture. Attempts to retrieve it resulted in displacement into the periapical area. Eventually, the object was retrieved by a simple technique, followed by successful apexification, root canal filling and jacket crown placement. Key learning points ,,Foreign bodies in root canals should be carefully evaluated to determine their nature, position, size and the degree of difficulty that may be encountered during retrieval. ,,Patience, care and appropriate techniques may be helpful in retrieving foreign bodies and avoiding periapical surgery. ,,Complicated crown fractures should be managed promptly, and prolonged open drainage avoided in children if the risks of foreign body impaction are to be minimized. [source] Residual bacteria in root apices removed by a diagonal root-end resection: a histopathological evaluationINTERNATIONAL ENDODONTIC JOURNAL, Issue 6 2008S. Lin Abstract Aim, To assess bacteria in the apical portion of the root end after 45° root-end resection in teeth with persistent periapical lesions. Methodology, The study included 27 apical root segments from patients with persistent periapical lesions. Histological sections of the coronal part of the amputated root segment were stained with Brown and Brenn to detect the presence of bacteria in the main root canal and/or in irregular root spaces and dentinal tubules. The quality of each root canal filling was evaluated using preoperative radiographs of filling, length of root filling as assessed from the distance between its apical end and the radiographic apex, diameter of apical preparation, and presence of apical perforations or deviations from the root canal. Two endodontists, blinded to the bacteriological results, independently evaluated the radiographs. Results, Bacteria were present in 23 (85.2%) specimens: five in only the main canal (21.7%), 10 in only the dentinal tubules and irregular spaces (43.5%), and eight in both irregular spaces and dentinal tubules and in the main root canal (34.8%). No correlation was found between the technical quality of the root filling assessed radiographically and bacterial presence in the central canal or irregular areas. Conclusions, Infected irregular areas were found in the root tips of teeth with persistent periapical lesions. This was found regardless of the radiographic quality of the root filling. Diagonal, 45° root-end resection may expose such contaminated irregularities to the periapical tissue. [source] Efficacy of ProTaper Universal rotary retreatment system for gutta-percha removal from root canalsINTERNATIONAL ENDODONTIC JOURNAL, Issue 4 2008L.-S. Gu Abstract Aim, To evaluate the efficacy of the ProTaper Universal rotary retreatment system for gutta-percha (GP) removal from root canals. Methodology, Root canals of 60 extracted human maxillary anterior teeth were prepared and filled with laterally condensed GP and AH Plus sealer. Teeth were divided into three groups: group A , GP removal completed with the ProTaper Universal rotary retreatment system and with further canal repreparation accomplished with ProTaper Universal rotary instruments; group B , GP removal was completed using Gates Glidden drills and Hedström files with chloroform as a solvent, followed with further canal repreparation with ProTaper Universal rotary instruments; group C , the same as group B for GP removal with further canal preparation with stainless steel K-flex files (Kerr). The operating time was recorded. Teeth were rendered transparent for the evaluation of the area of remaining GP/sealer in bucco-lingual and mesial,distal directions. Statistical analysis was performed by using repeated measures analysis of variance and anova. Results, The ProTaper Universal technique (group A) resulted in a smaller percentage of canal area covered by residual GP/sealer than in groups B and C, with a significant difference between groups A and C (P < 0.05). Mean operating time for group A was 6.73 min, which was significantly shorter (P < 0.05) than group B (10.86 min) and group C (13.52 min). Conclusions, In this laboratory study all test techniques left GP/sealer remnants within the root canal. The ProTaper Universal rotary retreatment system proved to be an efficient method of removing GP and sealer from maxillary anterior teeth. [source] | |||||||||||||||||||||||||