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PubMed1994

A nationwide survey of contemporary philosophies and techniques of restoring endodontically treated teeth.

Contemporary endodontic therapy has allowed patients to retain severely damaged teeth. The restoration of most endodontically treated teeth involves complex and controversial procedures. There is a diversity of opinion about the need for coronoradicular stabilization, and numerous post systems and techniques have been described. It is not known what materials and techniques are most commonly used. To expand the knowledge of current philosophies and prevailing techniques, a comprehensive nationwide survey of 1525 dentists was conducted. Of the 1066 respondents, 909 (85%) reported restoring more than 30 endodontically treated teeth per year, and this subset became the focus group of the survey. Board-certified prosthodontists comprised 40% of this group, educationally qualified prosthodontists 28%, and general dentists 32%. Responses to questions were statistically analyzed. Statistical analysis revealed that philosophies and techniques varied significantly with the dentist's geographic location, age, specialty status, and dental school faculty status.

Adult↗
PubMed1977

Endodontic morphology. IV. A comparative study.

One hundred sixty-four extracted human teeth of all denominations were subjected to radiographic study after their canal systems were prepared with endodontic instruments and perfused with a water-soluble, radiopaque contrast medium. The same specimens had been studied prior to endodontic instrumentation by means of the same technique, and a comparison of the two sets of radiographs was made. Results of this comparative study were combined with information gained during the instrumentation procedures, and an analysis of the success rate for each group of specimens has been given. The over-all rate of success was high (92 per cent), being highest in the case of maxillary incisors and canines (100 per cent) and lowest in mandibular incisors and canines (81.8 per cent). The belief that the canals of molars present more difficulties than those of other teeth was not substantiated in this experiment, with the success rate for maxillary and mandibular molars being 92.1 per cent. Discussed were the potential for the packing of debris into the apical ends of root canals during instrumentation, the presence of residual traces of alloy within canals after canal preparation, and the known and unknown fracturing of endodontic instruments.

Contrast Media↗
PubMed1979

Scanning electron microscope study of a new irrigation method in endodontic treatment.

The effectiveness of a newly developed perforated endodontic irrigation needle, with its distal aperture sealed, was compared to conventional endodontic irrigation procedures. In all instances 5 percent sodium hypochlorite was used since the delivery system, rather than the irrigant, was being evaluated. A base line group in which all soft tissue was described was also included. The results indicate that the perforated endodontic irrigation needle is a very effective instrument for the cleansing of instrumented root canals.

Dental Instruments↗
PubMed1980

Use of the carbon dioxide laser in sterilization of endodontic reamers.

The object of this study was to test a new method of sterilizing endodontic instruments by using a carbon dioxide laser system. This was done by contaminating endodontic reamers with spores, exposing them to a CO2 laser beam, and checking for their viability by standard microbiologic techniques. It was found that 100 percent of the spores were killed by the CO2 laser. This holds promise as an effective method of sterilizing endodontic instruments in the future.

Bacillus subtilis↗
PubMed1983

Effective exposure level and diagnostic performance in endodontic radiography.

Image quality is limited by the information capacity of the image-forming system and can be computed from three parameters: contrast, resolution, and noise. These parameters can be combined to yield a single measure which determines the maximum amount of information obtainable from any x-ray system and is called the noise-equivalent number of quanta (NEQ) per unit area. The effects of image quality, expressed as noise-equivalent number of quanta (NEQ) per unit area, on the radiographic performance by dentists reading the position of an endodontic file in a root canal were studied. Three different speed films were used in conjunction with a fixed screen. NEQ values ranged between 0.64 x 10(4) and 14.3 x 10(4) per square millimeter. Components of variance associated with the position of the tooth apex and the tip of an endodontic file in a root canal were compared for the effect of different NEQs and observers. Results show that the standard deviation in locating a file tip and tooth apex may be a linear function of log NEQ. The estimated standard deviation associated with changes in NEQ was found to be relatively small compared to that observed among dentists. These findings indicate that a significant reduction in exposure would have a relatively small effect on the precision of endodontic distance measurements.

Dental Pulp Cavity↗
PubMed1984

Periapical condensing osteitis and endodontic treatment.

Forty-nine roots of thirty-six teeth with the diagnosis of condensing osteitis were followed up by means of radiographs and patient files after endodontic treatment. The mean observation period was 4.3 years. Prior to endodontic treatment the periodontal membrane was widened on thirty-eight roots but on follow-up only on twelve. The periapical condensing osteitis showed total regression on thirty-six of the forty-nine roots. No condensing osteitis showed progress. The results show rebuilding of bone structures to normal appearance after endodontic treatment of periapical condensing osteitis.

Adolescent↗
PubMed1985

Straight-line endodontic access to anterior teeth.

Straight-line access provides an unimpeded pathway for endodontic procedures. One hundred ninety-eight anterior teeth were examined to determine the location of the access preparation which would allow straight-line access for intracanal procedures. A radiographic analysis of these teeth indicated that a more labial orientation of the access opening would provide straight-line access to the canal more consistently than the "traditional" lingual access opening. The more labial placement of the access opening on maxillary or mandibular anterior teeth which will require full coverage will make endodontic treatment more efficient and may, therefore, increase endodontic success rates in these teeth.

Cuspid↗
PubMed1986

Acute pulpal-alveolar cellulitis syndrome. IV. Exacerbations during endodontic treatment: a clinical study of specific microbial isolates and their etiologic role. Part 1.

A statement has been made by Sundqvist that it has not been possible to isolate the specific bacteria that is responsible for acute exacerbations during endodontic treatment of existing periapical inflammation. This clinical study presents specific microbial isolates from 34 intact nonvital teeth involved with acute cellulitis exacerbations during endodontic therapy. No obligate anaerobes were isolated. Forty-seven aerobic and facultative microbes were isolated. Streptococci, primarily facultative, were the major group of microbes isolated (80%); alpha hemolytic streptococci and the group D enterococcus were predominant as mixed and pure culture specimens. Gram-negative microbes as strict aerobic and facultative microbes were also reported as specific isolates. The biological role of anaerobes were discussed in primary pulpal-periapical infections. The alteration of the tissue oxidation-reduction potential, (Eh) is proposed as an etiologic factor in cellulitis exacerbations during endodontic treatment. This is further substantiated in the Part 2 report. Attention is drawn to the pathogenic potential of streptococci and other microbes isolated in this study.

Acute Disease↗
PubMed1987

Re-treatment in endodontics.

In order to achieve success in endodontics, major emphasis is placed on judicious instrumentation, microbial control, and complete obturation of the root canal system. During re-treatment of previously endodontically treated teeth, one may encounter a variety of different materials, which must be removed before these objectives can be achieved. The intent of this article is to present various methods that the practitioner may use in an attempt to safely remove these materials while adhering to sound endodontic principles. The article further emphasizes that removal of the previous filling material is only the initial step, which, when successfully accomplished, provides access to the root canal system so that therapy objectives can be carried out.

Gutta-Percha↗
PubMed1988

Endodontics in veterinary medicine.

An animal's dental problems are a tremendous problem for the average dental practitioner. Diagnosis and treatment can be very difficult as a result of the number of animal specimens that may have dental disease. This study presents concepts in veterinary endodontics for members of the canine population, their anatomy, their dental development, and methods of obtaining anesthesia. A discussion of techniques in nonsurgical and surgical endodontics is included. It was concluded that conventional endodontic practices can be used with modifications in instrument length, filling materials, and surgical access, corresponding to the varied oral anatomy within the animal kingdom.

Anesthesia, Dental↗
PubMed1989

Management of endodontic pain with nonsteroidal anti-inflammatory agents: a double-blind, placebo-controlled study.

The ability of two nonsteroidal anti-inflammatory agents--piroxicam and diclofenac--to control endodontic pain was compared with that of a placebo control in a double-blind study of 267 patients requiring endodontic therapy. Endodontic treatment was carried out over three visits with an interval of 5 to 7 days between each two consecutive visits. All patients were clearly instructed to take the medication only if they experienced pain, between the visits or postoperatively, for 3 consecutive days. The patients subjectively rated their pain on a scale of 1 to 4 as none, mild, moderate, or severe. The ratings were done preoperatively and at 2, 4 and 8 hours after the initial dose of medication was taken, as well as on the second and third days. Statistical analysis of the data revealed that both piroxicam and diclofenac significantly reduced the mean pain score at the end of all observations and were significantly superior to the placebo until the end of the study. More than 90% of the patients treated with piroxicam and more than 80% of the patients treated with diclofenac showed complete relief of pain. Overall, piroxicam was clearly more effective than diclofenac or the placebo. It provided more consistent relief of pain, beginning 2 hours after the initial dose, and it continued to do so at every interval thereafter. Diclofenac required longer time to reach maximum effectiveness. Piroxicam's superiority was greater at the first and second days after the initial dose of medication was taken. With respect to side effects, piroxicam was better tolerated by the patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1990

Chronic facial pain associated with endodontic therapy.

Retrospective study was done on 118 patients who underwent nonsurgical endodontics and then surgical endodontics. Seventy-nine patients had pain before nonsurgical endodontics, and an additional 39 were pain free. After the open surgical procedure, six patients (5%) had continual pain and were considered failures. Three patients (2.5%) were thought to have had posttraumatic dysesthesia, and the other three (2.5%) were considered to have phantom tooth pain. Possible mechanisms for each chronic pain type are discussed.

Agnosia↗
PubMed1991

Clinical, radiographic, and histologic study of endodontic treatment failures.

One hundred fifty cases of endodontic treatment failures were studied clinically, radiographically, and histologically. Fifty-seven percent of the teeth were asymptomatic. Pain alone and/or associated with swelling was present in 21% of the teeth. There was no correlation between the size of periradicular rarefaction and the occurrence or severity of clinical signs and/or symptoms. Stainable bacteria were demonstrated in 69% of the teeth and were present mostly in the canal. The severity of periradicular inflammation was related to presence of stainable bacteria in the canal. Swelling and pain or a draining sinus tract was often associated with stainable bacteria inside the canal. The development of a radicular cyst associated with an endodontically treated tooth that has failed is not necessarily the cause of endodontic treatment failure.

Dental Pulp Cavity↗
PubMed1991

Radiographic evaluation of intraosseous implants of endodontic materials.

Following several case reports of cyst development after endodontic treatment of decidous teeth, the osseous response to formaldehyde- or phenol-based materials was evaluated by a standardized radiographic technique. Endodontic medicaments contained in Teflon carriers were implanted between feline deciduous canine and molar teeth and the permanent successional teeth. Persistent radiolucency surrounding formocresol implants and sequestration of Kri-paste implants were noted in contrast to apparent bony healing around the zinc oxide-eugenol controls and those implants containing glutaraldehyde. These results suggest a greater tissue tolerance to glutaraldehyde-containing agents in contrast to the more traditional endodontic agents used in deciduous teeth.

Animals↗
PubMed1993

Use of dental operating microscope in endodontic surgery.

Endodontic surgery is an alternative therapeutic approach to endodontic treatment. The outcome of the technique is affected by several factors, some of which can be eliminated by the use of a dental operating microscope. The microscope was used during the performance of 50 apicoectomies, with or without retrograde fillings. For clinical evaluation cases treated with the dental operating microscope were compared to cases treated without it. The postoperative evaluation showed a reduced incidence of symptoms in the cases treated with the dental operating microscope. More important, the dental operating microscope enhanced and facilitated each phase of endodontic surgery. Its use is highly recommended.

Apicoectomy↗
PubMed1994

Assessment of marginal stability and permeability of an interim restorative endodontic material.

The purpose of this study was to assess the marginal stability and permeability of a new interim restorative endodontic material, Tempit (Centrix Inc., Milford, Conn.), and to compare the findings with the results of two commonly used restorative endodontic materials, Cavit (Premier Dental Products Co., Philadelphia, Pa.) and IRM (Intermediate Restorative Material Capsules, The Caulk Co., Division of Dentsply International Inc., Milford, Del.) This study was performed in several steps. First, the endodontic access cavities were prepared and restored on 80 extracted mandibular molars. The samples were exposed to methylene blue dye solution for 6 days, thermocycled, and sectioned; the dye penetration and diffusion were measured along the margins and into the body of the materials. The second experiment was a special study performed in standardized glass tubes to better evaluate the marginal and body dye penetration into the materials by increasing the length of the fillings. To eliminate the possibility of hygroscopic setting mechanisms of materials, samples were first allowed to set under water before dye was introduced. Cavit and Tempit showed a substantial amount of dye diffusion into the body of the materials. Cavit exhibited the best sealing ability at all times. The marginal and body dye penetration were significantly different for the Tempit material in all experiments than Cavit (p < 0.001). IRM demonstrated the least body penetration of all three materials (p < 0.001) but had a substantial marginal leakage not significantly different from the results of the Tempit material (p = 0.6 and p = 0.1).(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance↗
PubMed1994

Factors that affect the rate of retakes for endodontic treatment radiographs.

The purpose of this study was to determine the most accurate method of taking radiographs during endodontic treatment to minimize the number of retakes. To accomplish this, the rate of retakes in an endodontic clinic at a dental school was measured. Then the effect that two factors, anatomic location and type of film holder, had on this rate were calculated and analyzed. Criteria for acceptability were that radiographs have adequate coverage and minimal distortion. Two endodontists evaluated endodontic treatment radiographs taken by undergraduate dental students to determine if these criteria were met. Of 402 films evaluated 77% were considered to be acceptable. A significantly higher rate of acceptability occurred with films taken in the mandible compared with those taken in the maxilla. The EndoRay (Rinn Corp., Elgin, Ill.) and hemostat were the only types of film holders compared. Films taken with the EndoRay in the maxilla had a significantly higher acceptability rate than those taken in the maxilla with a hemostat. No difference in acceptability existed between the two film holders when radiographs were taken in the mandible.

Clinical Competence↗
PubMed2004

The microscope and endodontics.

The incorporation of the microscope in clinical endodontics has had profound effects on the way endodontics is done and has changed the field fundamentally. This article outlines the key prerequisites for the use of the microscope in nonsurgical endodontic procedures, discusses which procedures benefit from using the microscope, and addresses the issue of cost versus patient benefit.

Cost-Benefit Analysis↗