Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Retrograde Obturation”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 397 records · Page 22Linked to original sources
PubMed1996

Root-end cavity preparation using the MicroMega Sonic Retro-prep Tip. SEM analysis.

The objective of this laboratory study was to compare root-end cavities prepared with sonic Retro-prep tips in a MM1500 Sonic Air handpiece with those created by burs in a conventional handpiece. A total of 80 single-rooted extracted human teeth with mature apices and straight canals were included in the study. Four groups of 20 extracted teeth were prepared as follows: I, a 3-4 mm root-end resection perpendicular to the long axis of the root, with a size 40 sonic Retro-prep tip creating an apical cavity 3 mm into root canal system; II, a 45 degrees bevel of the root-face removing a 3-4 mm root segment and root-end preparation as per group I; III, root-end resection as per group I, with an apical cavity prepared using a size 010 inverted cone bur 3 mm down the long axis of the root; IV, resection as per group II, followed by an apical cavity preparation with a size 010 inverted cone bur 3 mm into the root canal system. The apical root portion and root-end cavities were replicated and prepared for SEM analysis at x 20 and x 80 magnification. The degree of chipping associated with the margin of the root-end cavities, as evaluated with a standard grading system, and the incidence of root-face cracks were noted. Marginal chipping of root-end cavities prepared using sonic instrumentation was significantly worse than that produced by burs (P < 0.001). Perpendicular root-end resections showed significantly better scores than bevelled root-end resections (P < 0.005). The incidence of root-face cracking was low with no significant difference between the experimental groups.

Dental Instruments↗
PubMed2004

Resolution of persistent periapical infection by endodontic surgery.

AIM: To examine the surfaces of a root tip removed during surgical endodontic treatment for the presence of microorganisms. SUMMARY: The present clinical case illustrates an endodontic retreatment of a maxillary premolar tooth with a fistula and periapical reaction. The case was under treatment for 1 year, during which an intracanal medicament was replaced several times. As the lesion did not decrease and exudate was persistent through the fistula and root canal, root end resection with root end filling was performed. Microbiological samples were collected from the fistula, where Propionibacterium acnes, a species associated with endodontic failures, was detected by appropriate anaerobic technique. The resected root apex was observed by scanning electron microscopy (SEM), which revealed cocci and fungal forms surrounding one of the foramina. After 12 months, the periapical lesion had reduced.

Adult↗
PubMed2004

The influence of root-end resection and root-end cavity preparation on microleakage of root filled teeth in vitro.

AIM: To investigate in vitro the influence of root-end resection and root-end cavity preparation on leakage of root filled teeth. METHODOLOGY: The root canals of 48 roots, 16 mandibular premolars (G1), 16 mandibular incisors (G2) and 16 maxillary incisors (G3), 12 mm in length, were enlarged using a modified 'balanced force' technique and filled with gutta-percha and sealer using lateral compaction. After setting, leakage along the canal was measured using a fluid transport model. Root-end resection and root-end cavity preparation were then performed, leaving roots 10 mm in length with root fillings of 7 mm (groups R1, R2 and R3, respectively). Fluid transport was measured again along the remaining root fillings of all groups using the same experimental conditions. Results of leakage before and after root-end resection were analysed statistically using the Kruskal-Wallis and Wilcoxon tests. RESULTS: A total of 31% of the roots leaked before and 54% after root-end preparation; the difference was significantly different (P < 0.001). No significant differences were found either among groups G1, G2, G3 (P = 0.565) or among groups R1, R2, R3 (P =0.2628). Significant differences, however, were shown between groups G1-R1 (P = 0.0053), G2-R2 (P =0.0089) and G3-R3 (P = 0.0461). CONCLUSIONS: Root-end resection and root-end cavity preparation compromised the seal of 7 mm root fillings in all tooth groups. Increased leakage was recorded in the following order: mandibular incisors > mandibular premolars > maxillary incisors.

Apicoectomy↗
PubMed2004

Comparison of long-term papilla healing following sulcular full thickness flap and papilla base flap in endodontic surgery.

AIM: To compare long-term loss of papilla height when using either the papilla base incision (PBI) or the standard papilla mobilization incision in marginal full thickness flap procedures in cases with no evidence of marginal periodontitis. METHODOLOGY: Twelve healthy patients, free of periodontal disease, who had intact interdental papillae were referred for surgical treatment of persisting apical periodontitis and included in the study. The flap design consisted of two releasing incisions connected by a horizontal incision. The marginal incision involved the complete mobilization of the entire papilla in one interproximal space but in the other interproximal space the PBI was performed. Further apically a full thickness flap was raised. Following flap retraction, standard apical root-end resection and root-end filling was performed. Flap closure was achieved with microsurgical sutures. The PBI was sutured with two to three interrupted sutures (size 7/0), the elevated papilla was reapproximated with vertical mattress sutures (size 7/0), which were removed 3-5 days after the surgery. The height of the interdental papilla was evaluated preoperatively and postoperatively after 1-, 3- and 12-month recall using plaster replicas. The loss of papilla height was measured using a laser scanner. Papilla paired sites were evaluated and statistically analysed. RESULTS: Most papilla recession took place within the first month after the surgery in the complete elevation of the papilla. Further small increase in loss of papilla height resulted at 3 months. After 1 year the loss of height diminished to 0.98 +/- 0.75 mm, but there was no statistical difference between the various recall intervals. In contrast, after PBI only minor changes could be detected at all times. There was a highly significant difference between the two incision techniques for all recall appointments (P < 0.001). CONCLUSIONS: In the short as well as long-term the PBI allows predictable recession-free healing of the interdental papilla. In contrast, complete mobilization of the papilla displayed a marked loss of the papilla height in the initial healing phase although this was less evident 1 year postoperatively. In aesthetically relevant areas the use of the PBI is recommended, to avoid opening of the interproximal space, when periradicular surgical treatment is necessary.

Adult↗
PubMed2004

Periosteal grafts as barriers in periradicular surgery: report of two cases.

AIM: To describe the usefulness of periosteal grafts as barriers for bone regeneration in periradicular surgery when advanced periodontal breakdown occurs. SUMMARY: The treatment of advanced periodontal breakdown as a result of an associated endodontic lesion constitutes a multifaceted challenge to the clinician. If the source of the irritation cannot be removed by orthograde endodontic treatment, nonsurgical and surgical endodontic/periodontal intervention may be required. Two cases with suppurative chronic apical periodontitis with apicomarginal communication are described. Clinical and radiological evaluations were completed immediately prior to surgery, a week later and every 2 months after surgery for 10 months. Both patients were treated using split-thickness flaps and lateral displacement of the periosteum prior to suturing, in order to close the communication between the oral and the periapical surroundings. A remission of the clinical signs and symptoms, and successful healing in the short-term were achieved in these cases. KEY LEARNING POINTS: Periapical and periodontal lesions are closely related through pathways of communication. Disruption of the cortical plate and the presence of dentoalveolar sinus tracts can have a deleterious effect on the regeneration process after periradicular surgery. The adoption of supplementary periodontal surgical techniques may help to solve some of the difficulties in the healing process in periradicular surgery. Periosteal grafts have been shown to have the potential to stimulate bone formation when used as a graft material.

Adult↗
PubMed2004

A comparative histological evaluation of the biocompatibility of materials used in apical surgery.

AIM: To evaluate the biological properties of a variety of materials that could be used in apical surgery. METHODOLOGY: The intraosseous implant technique recommended by the FDI (1980) and ADA (1982) was used to test the following materials: zinc oxide-eugenol (ZOE), mineral trioxide aggregate (MTA), and Z-100 light-cured composite resin. Thirty guinea-pigs, 10 for each material, divided into experimental periods of 4 and 12 weeks, received one implant on each side of the lower jaw symphysis. The connective tissue response alongside the lateral wall outside the cup served as a negative control for the technique. At the end of the observation periods, the animals were killed and the specimens prepared for routine histological examination to evaluate their biocompatibility. RESULTS: The reaction of the tissue to the materials diminished with time. The ZOE cement was highly toxic during the 4-week experimental period, but this profile changed significantly after 12 weeks, when it showed biocompatible characteristics. MTA and Z-100 showed biocompatibility in this test model at both time periods. CONCLUSIONS: MTA and Z-100 composite were biocompatible at 4 and 12 weeks in this experimental model.

Aluminum Compounds↗
PubMed2004

Survival of surgical endodontic treatment performed in a dental teaching hospital: a cohort study.

AIM: To assess the survival function of surgical endodontic treatment performed at least 1 year before in a dental teaching hospital. METHODOLOGY: A total of 194 teeth surgically treated between 1991 and 2001 were recalled and examined clinically and radiographically using a set of strict criteria. The Kaplan-Meier method and log rank test were used to evaluate the survival time. Confounding factors were examined by Cox regression analysis. RESULTS: The median survival time of the 154 first-time surgically treated teeth was 92.1 months (95% CI: 40.9-143.4) and that of the 40 resurgery cases was 39.1 months (95% CI: 6.1-72.1) up to the date of recall. There was a significant difference in the length of survival between the two groups. For those first-time surgery cases, the preoperative marginal bone loss and the operator had a significant influence on the survival time (P < 0.05). CONCLUSIONS: The survival of surgical endodontic treatment declined nonlinearly with time. The preoperative marginal bone loss, operator and resurgery were important factors affecting the survival of this treatment modality.

Alveolar Bone Loss↗
PubMed2005

Frequency and type of canal isthmuses in first molars detected by endoscopic inspection during periradicular surgery.

AIM: To analyse the occurrence of canal isthmuses in molars following root-end resection. METHODOLOGY: The material consisted of 56 mandibular and 32 maxillary first molars subjected to periradicular surgery. Based on radiographic, clinical, as well as intraoperative status, only roots with associated pathological lesions were treated. In total, 124 roots were resected (80 mandibular and 44 maxillary molar roots). The cut root faces were inspected with a rigid endoscope following apical root-end resection. The number of canals as well as the presence and type of canal isthmuses were recorded. RESULTS: In maxillary first molars, 76% of resected mesio-buccal roots had two canals and an isthmus, 10% had two canals but no isthmus, and 14% had a single canal. All disto-buccal and palatal roots had one canal. In mandibular first molars, 83% of mesial roots had two canals with an isthmus. In 11%, two canals but no isthmus were present, and 6% demonstrated a single canal. Sixty-four per cent of distal roots had a single canal and 36% had two canals with an isthmus. CONCLUSIONS: This clinical study during periradicular surgery and intraoperative endoscopic examination of first permanent molars found a high frequency of canal isthmuses at the resection level. Endoscopic inspection also demonstrated that none of the isthmuses were filled, emphasizing the difficulty of orthograde instrumentation and root filling of canal isthmuses.

Apicoectomy↗
PubMed2005

Longitudinal study on microleakage of three root-end filling materials by the fluid transport method and by capillary flow porometry.

AIM: (i) To compare the root-end sealing ability of IRM Caps (IRM), Fuji IX Capsules (Fuji IX) and Pro Root MTA Tooth-Coloured Formula (MTA) in teeth obtained from cadavers. (ii) Further research on leakage study methodology by means of comparison of the fluid transport method (FTM) and capillary flow porometry (CFP). METHODOLOGY: Root canal treatment was performed on 33 cadaver teeth in situ 2 weeks prior to root resection and ultrasonic retropreparation (S12/90 degrees D-tip on Suni-Max), after which the teeth were retrieved from the cadavers. Two teeth were kept as positive and negative controls. The other teeth were divided in three different groups at random, with each group receiving one of the retrofill materials. Retrofills were exposed to water 5 min after placement. The teeth were stored at 37 degrees C for 12 h after which the root filling was removed. Microleakage (L in microL day(-1)) was measured for 24 h under a pressure of 1.2 atm using FTM and recorded as L = 0, 0 < L < or = 10, L > 10. The measurements were repeated after 1 and 6 months. After 6 months, leakage was also assessed by CFP in order to measure through pores and their diameters. Results were analysed statistically using nonparametric Kruskal-Wallis and Mann-Whitney U-tests, and Spearman correlation coefficients between the results of both methods were calculated. The level of significance was set at 0.05. RESULTS: (i) A statistically significant difference could be demonstrated between Fuji IX and IRM at 1 month with FTM. FTM revealed a significant difference between Fuji IX and the other materials at 6 months, whereas CFP did not. However, using both methods, Fuji IX showed the best result. (ii) When comparing both techniques, CFP demonstrated through pores in all teeth, whereas with FTM in only 14 of the 31 teeth could through pores be demonstrated. A positive correlation between both methods was demonstrated. CONCLUSIONS: Under the conditions of this study (i) the conventionally setting glass-ionomer cement Fuji IX showed the best results when used as a root-end material and (ii) CFP appeared to be a useful method for leakage evaluation of through pores in endodontics.

Aluminum Compounds↗
PubMed2005

SEM analysis of the integrity of resected root apices of cadaver and extracted teeth after ultrasonic root-end preparation at different intensities.

AIM: To compare the integrity of root apices of cadaver and extracted teeth after resection, ultrasonic root-end cavity preparation at medium and low ultrasonic power settings and retrieval. METHODOLOGY: Root canal treatment, perpendicular root-end resection and root-end preparation were performed on single-rooted anterior and premolar teeth (49 teeth in situ in maxillary and mandibular jaws from cadavers and 45 extracted teeth). Apical root-end cavities were prepared with the S12/90 degrees D tip and the Suni-Max ultrasonic unit (Satelec, Merignac, France) at the intensity prescribed by the manufacturer (power 7 at power mode S) (34 cadaver teeth, 30 extracted teeth) and at a lower intensity (power 4 at power mode S) (15 cadaver teeth, 15 extracted teeth). After ultrasonic preparation the cadaver teeth were retrieved from the jaws. Exaflex impressions (GC Corporation, Tokyo, Japan) were made of the root apices after resection, root-end preparation and retrieval. These impressions were processed for SEM analysis, and the recordings evaluated for cracks and marginal chipping. RESULTS: In general, extracted teeth showed significantly more cracks and chipping than cadaver teeth. Lowering the ultrasonic power from medium to low intensity resulted in equal scores for cracks on extracted teeth and for chipping on cadaver teeth, in higher scores for cracks on cadavers and in lower scores for chipping on extracted teeth. Complete cracks and cracks originating from the root surface occurred only in extracted teeth. CONCLUSIONS: The number of cracks and degree of chipping caused by ultrasonic root-end preparation was higher on extracted teeth than on cadaver teeth. Lowering the ultrasonic power from medium to low intensity cannot be recommended as it resulted in more cracks and equal chipping on cadaver teeth. Investigation of techniques and materials should be conducted in situ and not on extracted teeth.

Apicoectomy↗
PubMed2005

Periapical resurgery versus periapical surgery: a 5-year longitudinal comparison.

AIM: To monitor and compare the outcome of periradicular surgery in teeth that had previously undergone surgical treatment versus teeth that were undergoing a surgical procedure for the first time. METHODOLOGY: A total of 164 patients with 231 roots with previously unresolved periapical lesions were followed for up to 5 years following surgery. In all, 162 roots had received unsuccessful conventional root canal treatment (group AS) and 69 had been treated previously using apical surgery (group RS). The surgical procedure was completed using ultrasonic retrotips to prepare the apical root-end cavity, and a zinc-oxide EBA reinforced material was used to fill the apical root-end cavities. Lesions were radiologically examined from 1 to 5 years following the surgical procedure. Radiographs were independently analysed, according to a previously published classification. RESULTS: In all the roots examined after 5 years, the overall healing rate was 78%; in group AS, 140 (86%) healed with complete bone filling of the surgical cavity, 12 (7%) were considered to have incompletely healed and 10 (6%) were associated with post-treatment disease. In group RS, 41 (59%) healed completely, 12 (17%) were considered to have incompletely healed and 16 (23%) were associated with post-treatment disease. The difference between a second surgical procedure and a first surgical procedure was statistically significant (Mann-Whitney U-test, P=0.001). CONCLUSION: Surgical retreatment of teeth previously treated with surgery is a valid alternative to extraction. However, association with post-treatment disease was greater than after a primary surgical approach.

Adolescent↗
PubMed2006

Long-term assessment of the seal provided by root-end filling materials in large cavities through capillary flow porometry.

AIM: To evaluate the long-term sealing ability of a variety of materials when used as root-end fillings. METHODOLOGY: A total of 140 standardized horizontal bovine root sections (external diameter: 7 mm, height: 3 mm; internal diameter: 2.5 mm) were divided into seven groups, filled with either gutta-percha with AH26, Ketac Fil, Fuji IX, Tooth-Colored MTA, IRM, Ketac Fil with conditioner or Fuji IX with conditioner and submitted to capillary flow porometry at 1 and 6 months to assess minimum, mean flow and maximum pore diameters. Results of the different materials and results by material were analysed statistically using non-parametric tests; the level of significance was set at 0.05. RESULTS: There were no significant differences between the minimum pore diameters associated with the materials at each time. At 1 month the mean flow pore diameters of Ketac Fil were significantly larger than those of gutta-percha, Ketac Fil with conditioner, Fuji IX with conditioner and IRM. There were significant differences between the maximum pore diameters at 1 month (all>IRM; Fuji IX>gutta-percha, Ketac Fil with conditioner, Fuji IX with conditioner) and 6 months (Fuji IX>gutta-percha, IRM; Ketac Fil>gutta-percha, IRM). There were significant differences in the minimum pore diameters between the different points in time for each material except IRM, in the mean flow pore diameters for each material and in the maximum pore diameters for each material except MTA. CONCLUSIONS: All materials were associated with capillary flow. IRM root-end fillings had through pores that were smaller than those associated with other materials. Conventionally setting glass-ionomer cements had the largest pores, although dentine conditioning improved their performance. The seal of all materials improved after 6 months.

Acrylic Resins↗
PubMed2007

Calcium hydroxide barrier over the apical root-end of a type III dens invaginatus after endodontic and surgical treatment.

AIM: To report the simultaneous endodontic and surgical treatment of a tooth associated with Oehlers type III dens invaginatus and a persistent periapical lesion, which comprised root-end resection, root-end filling and application of a calcium hydroxide barrier placed on the resected dentine surface. SUMMARY: Three root canals were identified in a tooth with a type III dens invaginatus, which presented with a necrotic pulp, wide foraminal opening and extensive periapical lesion, and with a previous history of acute abscess, intracanal exudate and fistula. After root canal preparation followed by intracanal application of calcium hydroxide pastes, the clinical-pathological status persisted. After periapical curettage and root-end resection, the root canals were filled, followed by root-end filling with Sealer 26 mixed with zinc oxide powder to a clay-like consistency. Calcium hydroxide paste was then applied over the exposed dentinal surface forming a covering over the root apex. At the 20-month follow-up examination the patient had no symptoms and no fistula; advanced periapical bone repair was obvious on the radiograph. KEY LEARNING POINTS: Because of the variable morphology and extent of invagination, type III dens invaginatus represents a challenge for conventional treatment, often leading to the need for a surgical approach. Sealer 26 thickened with zinc oxide powder provided satisfactory clinical properties for use as a root-end filling material. Application of a calcium hydroxide barrier over the resected root-end is a potential treatment option to encourage tissue repair.

Adolescent↗
PubMed1985

Study of titanium screws as retrograde fillings using bacteria and dye.

The tightness of retrograde titanium screw fillings and retrograde amalgam fillings was compared in 17 human, single-rooted teeth using Serratia marcescens bacteria in vitro. The root canals were subjected to instrumentation and irrigation, after which 2 mm was cut off from the apical end. Eight of the teeth were sealed using retrograde titanium screw fillings and nine using retrograde amalgam fillings. The teeth were suspended by means of wires in test tubes, with the crowns upwards and the roots immersed in trypticase soy broth. Suspensions of Serratia marcescens bacteria were placed in the root canals, and samples from the broth were plated daily. The bacteria penetrated the apical titanium screw seals in 2 to 7 days, and the retrograde amalgam fillings readily on the first day. Thus, the titanium screws seemed to provide a tighter seal. Staining with India ink showed that penetration had occurred at the tooth-filling margin and that the instrumentation had not caused any fractures to the roots.

Apicoectomy↗
PubMed1991

Effect of immediate calcium hydroxide treatment and permanent root-filling on periodontal healing in contaminated replanted teeth.

The effect of immediate permanent root-filling and immediate intracanal calcium hydroxide treatment on experimentally contaminated and necrotized periodontal membranes (PDM) in avulsed and subsequently replanted monkey teeth was studied. Almost the entire root surface in the non-endodontically treated control teeth were covered with inflammatory resorption. A significant shift towards ankylosis not associated with root resorption (greater than 80% of the total root surface area) was noted following calcium hydroxide treatment. About two thirds of the root surfaces from the teeth with permanent root fillings showed surface resorptions or ankylosis preceded by root resorption. The root surface area which would have been covered by inflammatory resorption, unless endodontic treatment had been implemented, were instead predominantly covered by either surface resorption (permanent root filling) or ankylosis (calcium hydroxide treatment). Ankylosis compared with surface resorption may in the long term lead to progressive loss of root substance due to replacement resorption. It was concluded that calcium hydroxide may be an excellent initial intracanal treatment in teeth with healthy PDM, but care should be taken not to risk unnecessary development of ankylosis by prolonged treatment of teeth with compromised PDM.

Alveolar Process↗