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[Dens in dente: apicoectomy and retrograde obturation].

Dens in dente is a developmental anomaly, which, in some advanced cases, requires a combination of conventional and surgical endodontic treatment. The purpose of this article is to suggest how to treat a Type 3 (Oehlers classification) dens in dente.

Apicoectomy↗

[Prototype of an instrument for retrograde obturation].

Several instruments to carry and put the silver amalgam into de apical foramen for it's posterior condensation without spreading this material over the periodontal tissues, bone and adyacent mucosa, has been designed along the years. This article describes an easier and cheaper way to make an endodontic amalgam carrier by the adaptation between en 18 and 22 mm intravenous catheters into disposable syringes by the use of autopolymerizable acrilic, given the dentist the option of making a very easy instrument, at a low cost which can be used as a commercial endodontic amalgam carrier as well.

Acrylic Resins↗

Marginal adaptation and sealability of orthograde and retrograde amalgam obturation. An in vitro study.

60 recently extracted anterior teeth were subjected to an endodontic protocol and obturated with either orthograde or retrograde amalgam (n = 30). Specimens were evaluated for microleakage and marginal adaptation using 2% methylene blue dye and scanning electron microscopy respectively. Chi-square analysis of data showed significantly better (p < 0.001) marginal adaptation and sealability in orthograde amalgam apical fillings.

Chi-Square Distribution↗

[Retrograde root obturations using resin and a dentin bonding agent: a preliminary histologic study of tissue reactions in monkeys].

The histologic response to a new retrograde root filling procedure using composite and a dentin bonding agent (Gluma) was examined in two monkeys (Cercopithecus aethiops). Infected root canals in canines and incisors were retrograde sealed and a histologic examination performed after 1 year. Among three canines, two showed epithelial proliferation on the resected root surface, apparently originating from the incision which had been placed very close to the level of resection. In the third canine, filled with a composite containing tricalciumphosphate, there was not only reformation of new Sharpey's fibers, but also, seen for the first time, regeneration of new cementum directly upon the retrograde filling material (Fig. 1). Two incisors were extracted, the apices resected, a retrofilling applied, and the incisors replanted. In this way any interference by epithelium could be avoided. After 1 year, both teeth showed a narrow fibrous zone without inflammation opposite the filling material (Fig. 2). The surprising finding that a composite could allow complete PDL regeneration including cementum upon the retrograde material implies that a new biologic retrograde root filling principle is at hand. Experiments are now in progress to further characterize the necessary condition for cementum repair upon composite used as a retrograde root filling material.

Animals↗

Apicectomy with the Er:YAG laser or bur, followed by retrograde root filling with zinc oxide/eugenol or sealer 26.

OBJECTIVE: This study evaluated the influence of root resection, by means of the use of erbium:YAG laser in sealing two different materials, OZE and Sealer 26, in retrograde obturations. BACKGROUND DATA: Few studies with sufficient data have been conducted in this area. METHODS: Forty uniradicular teeth were used. They were biomechanically prepared using the step-back technique and obturated using the lateral condensation technique. The teeth were divided into two groups of 20 teeth, one group using the erbium:YAG laser (350 mJ and 6 Hz) for the resection process and the other using the Zekrya Drill, in high rotation. Then, the retrograde cavities were prepared using a micro counter-angle with a number 2 spherical bur. After preparing the cavities, the teeth were impermeabilized and divided into two subgroups. One subgroup used the retrograde obturation technique with Sealer 26 cement, and the other subgroup used OZE. After completing the retrograde obturation, the teeth were immersed in 2% methylene blue for a 7-day period. Teeth were then removed from the dye, washed, scraped, and sectioned in the vestibule-lingual direction. RESULTS: The results were analyzed with the aid of a magnifying lens, and scores were attributed based on the magnitude of infiltration. The data were then submitted to statistical analysis. CONCLUSIONS: No statistical difference was noticed regarding the root resection methods; however, in comparing materials, Sealer 26 was statistically superior to OZE. In the subgroup comparison, a significant difference was noticed in the Laser and Sealer 26 and the Laser and OZE and bur and OZE.

Apicoectomy↗

[Retrograde root obturations employing composite and a dentin bonding agent: adaptions of the filling materials and bond strength].

Composite resin containing silver for radiopacity bonds to the dentin surface of a resected and slightly concave root pretreated with a dentin bonding agent (Gluma). The bond strength between composite and apical dentin is about 18 MPa and is not affected by a preceding root canal filling with eugenol-containing sealer. Contamination with saliva or serum of the Gluma-treated dentin surface reduced the bond strength significantly. No reduction in bond strength is observed when the contamination of the surface is performed before Gluma-application. Microscopy of the borderline between composite and dentin as well as SEM of the composite surface adjacent to dentin revealed a good adaptation which presumably does not allow bacterial penetration.

Composite Resins↗

Treatment of replacement resorption with Emdogain--preliminary results after 10 months.

Ankylosis of traumatized teeth in children and adolescents may inhibit further development and growth of the corresponding jawbone. Therefore, ankylosed teeth should be removed. As an alternative treatment option to autotransplantation of a premolar, intentional replantation using Emdogain may be considered, provided the ankylosis is detected at an early stage or has only affected a small area of the root. Eleven ankylosed teeth presenting with replacement resorption were treated as follows: after tooth extraction, the root canal was treated extraorally and obturated by retrograde insertion of a titanium post. Emdogain was applied to the root surface and into the extraction socket with subsequent replantation of the tooth. During a mean follow-up period of 6.3 months, no signs of recurrence of ankylosis were noted. The horizontally and vertically measured Periotest scores were identical to those obtained on the adjacent teeth. These results suggest that intentional replantation using Emdogain may prevent or delay ankylosis of these replanted teeth.

Adolescent↗