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The authors provide a pictorial review of technical errors in endodontic instrumentation. Examples of separated instruments, abrupt constriction, laceration, canal transportation, and control zone errors are provided. The potential problems and effect on prognosis associated with these errors are explained.
In this article, a statistical analysis describes 198 cases of post-endodontic failures referred from private practitioners for surgical retreatments. Biopsies of these lesions showed that 68.18 per cent of them were identified as apical granulomas, 3.5 per cent as cysts, 16.16 per cent as epitheliated granulomas and 12.12 per cent as "other" cases. The two main groups of causes associated with these failures are: technical errors (55.05 per cent of the cases) and procedural mistakes (17.68 per cent).
Fifty infected root canals were examined whether they had been in aseptic condition or not after endodontic treatment. PLADIA was used for the examination of bacteriologic culture. Twenty eight cases were positive, 22 cases were negative, and the percentage of positive was 56%. Of the anterior teeth, 13 cases were positive in 23 cases (57%), In the posterior teeth, 15 cases were positive in 27 cases (56%), 5 cases were positive in 17 cases (29%) with clinical symptoms before treatment, 23 cases were positive in 33 cases (70%) without clinical symptoms before treatment. These results showed that the treated root canals which had been well adapted to root canal filling by clinical symptoms had a high percentage of positive of bacteriological culture.
By individual cast constructions necessary for endodontic implantations the cold-formed post material (pure titanium/implant steel) has to be heat-treated by recasting (Sipal as construction material). Therewith are connected structure changes with distinct worsening of the material properties. By means of the potentiodynamic anodic polarization it can be proved that the silver-palladium alloy is the component with the highest susceptibility to corrosion. A suitable alternative to the individual cast construction is a fully ready-made implant construction system made from pure titanium which can solve the problems of bond, corrosion and strength.
An improved knowledge of anatomy and psysiology of the apical radicular region has made mandatory a better classical endodontic technique concerning the apical limit of instrumentation, and has stressed the importance of a precise determination of the cemento-dentinal junction as the apical limit of canal obturation. On the basis of these orientations a clinical and radiographic study was carried out on 120 teeth extracted form humans, in which the frequency was determined of the excentric position of the cement conus with regard to the apex, and the distance between the cemento-dentinal junction and the apex. In 45 teeth in situ, with pulpar inflammation, gangrene and apical parodontitis a clinical and radiological appraisal was done of the cemento-dentinal junction, and evolution was followed after canal obturation.
During root canal therapy, accidental fracture of endodontic instruments may occur. While in the majority of such cases the fragment concerned can be retrieved non-surgically, there are some occasions that surgical intervention is needed in order to remove the broken tip lodged within the root canal. In this paper the authors would like to suggest a management approach to this uncommon and extremely unpleasant complication in dental practice.
The porosity and the leakage properties of 13 temporary fillings used between each appointment during endodontic treatment were investigated by means of thermocycling and dye staining of the interface between the teeth and the filling material. A scanning electron microscope was also used for these observations. The 8 commercially produced temporary fillings seal adequately the cavity whereas the 5 materials prepared and mixed by the practitioner allowed wide staining diffusion and therefore were leaky.
Retrograde filling consists in sealing endodontics system directly at the apical zone after surgical approach. This article is studying the best approach by flap surgery adapted to anatomo-pathological data of each case.
Recently new instruments and methods have been developed in endodontics to clean, prepare and fill the root canal. In this article the new preparation-methods en techniques with the accompanying instruments will be discussed.
In case of an exposed pulp, the endodontic treatment of an immature tooth is directed to preservation of the vitality of the pulp, for reason of either the completion of the root genesis or the inducement of an apical constriction. The state of the pulp dictates the choice of treatment, which are, in order of most to least desired, pulp capping, vital (partial) pulpotomy and extirpation followed by obturation after an apexification procedure.
Methods and materials used in endodontic treatment of the deciduous teeth are discussed, in relation to the state of the pulp at the time of treatment.
Some types of tooth root resorption respond favourably to endodontic treatment. Sometimes compromising factors demand particular treatment approaches and techniques. These will be described, in connection with their genesis.
Presentation of one written exercise in endodontics done by the students of the fourth year of the graduation in Dental Medicine at the School of Dental Medicine of Lisbon in 1986/87.
A clinical case of apical injury on an upper lateral incisor with endodontical and surgical failures in its treatment is presented. Extraction of the incisor and its study at the stereoscopic microscope showed the existence of a developmental groove running from the cingulum to the end of the root, establishing a communication between the crevice and the apical part of the tooth. Bacterial infection through the groove could provide an explanation for treatment failure.
In order to treat the acute pulpal pain of the emergency patient, there are different methods and medicaments in the clinical practice. The aim of this study was to investigate the efficacy of variant treatment methods and medicaments used clinically to manage acute pulpal pain. The material of this method consisted of 100 patients who came in the clinic of endodontics of Athens university, with symptoms of acute pulpitis. The patients were divided in three groups. In the first group the carious dentin was excavated without exposuring the pulp and a cotton pellet with eugenol or comphorted p-chlorophenol was placed in the cavity. In the second group the carious dentin was also removed, a small pulp lesion was made and the same medicaments were placed in the cavity. In the third group pulpotomy was performed and the same drugs were placed in the cavity. The results indicated that the method of pulpotomy was the most effective one for pain alleviation. Furthermore eugenol was proved to be more effective as a sedative drug than comphorted p-monochlorophenol.
Basing of the clinical observations iatrogenic complications connected with endodontic treatment of the teeth have been discussed by presenting 5 cases chosen.
The A.A. examine the histopathologic variations of the enamel, pulp and dentin in the dentary element of the aged people. Besides the principal indications and contraindications to the endodontic therapy have been pointed out.
A method of endodontic treatment, using a modification of Maisto's paste, is suggested for preservation of infected primary teeth. Adding more zinc-oxide reagent and other anti-bacterial materials to the original Walkhoff's paste (Kri 1), for pulp canal medication and final filling, seems to improve the pharmacological effect of the paste by reducing the resorption rate. The literature is reviewed and a case with a follow-up time of three and a half years is described, in which the tooth remained stable.
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