Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “ENDODONTICS”

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 487 records · Page 27Linked to original sources

Physical and mechanical characterization and the influence of cyclic loading on the behaviour of nickel-titanium wires employed in the manufacture of rotary endodontic instruments.

AIM: To analyse the influence of cyclic loading on the mechanical behaviour of nickel-titanium (NiTi) wires employed in the manufacture of ProFile rotary endodontic instruments. METHODOLOGY: Nickel-titanium wires, 1.2 mm in diameter, taken from the production line of ProFile rotary endodontic instruments before the final machining step, were tensile-tested to rupture in the as-received condition and after 100 load-unload cycles in the superelastic plateau (4% elongation). The wires were characterized by X-ray energy-dispersive spectroscopy, X-ray diffraction and by differential scanning calorimetry and compared with new size 30, .06 taper ProFile instruments. The fracture surfaces of the wires were observed by scanning electron microscopy. RESULTS: The mechanical properties of the as-received wires, their chemical composition, the phases present and their transformation temperatures were consistent with their final application. Only small changes, which decreased after the first few cycles, took place in the mechanical properties of the cycled wires. The stress at maximum load and the plastic strain at breakage remained the same, while the critical stress for inducing the superelastic behaviour, which is related to the restoring force of the endodontic instruments, decreased by approximately 27%. CONCLUSIONS: The mechanical behaviour of the NiTi wires was modified slightly by cyclic tensile loading in the superelastic plateau. As the changes tended towards stabilization, the clinical use of rotary NiTi ProFile instruments does not compromise their superelastic properties until they fracture by fatigue or torsional overload, or are otherwise discarded.

Calorimetry, Differential Scanning↗

The role of preoperative prophylactic antibiotic administration in periapical endodontic surgery: a randomized, prospective double-blind placebo-controlled study.

AIM: To determine the value of clindamycin prophylaxis in the prevention of postoperative wound infections in patients undergoing endodontic surgery. METHODOLOGY: This study included 256 patients undergoing endodontic surgery in a prospective double-blind placebo-controlled trial comparing oral administration of an oral placebo versus a preoperative 600 mg dose of clindamycin. After randomization the study medication was administered orally 1 h before surgery in a double-blind fashion. For a period of 4 weeks the postoperative course was observed according to clinical parameters of infection. Primary end-point was infection at the surgical site. RESULTS: The mean age of the study population was 44.4 years (SD 11.4, range 18-82 years) with a sex distribution of 147 females (47.4%) and 109 males (42.6%). Mean age of the patients in the clindamycin group was 44.7 years (SD 12.0), and the mean age in the placebo group was 44.1 years (SD 10.8) (P = 0.49). In the clindamycin group, the mean duration of surgery was 32.3 min (SD 8.8) and in the placebo group the mean duration of surgery was 32.5 min (SD 8.4) (P = 0.89). Two infections [1.6%; 95 confidence interval (CI): 0.48-4.72] were identified in the clindamycin group and four (3.2%; 95 CI: 0.42-1.33) in the placebo group (P = 0.448). CONCLUSIONS: No statistically significant difference was found between clindamycin prophylaxis and placebo with regard to the prevention of postoperative infection in endodontic surgical procedures.

Adolescent↗

Influence of phase transformation on the torsional and bending properties of nickel-titanium rotary endodontic instruments.

AIM: To investigate the relationship between the functional properties and the phase transformation of nickel-titanium endodontic instruments. METHODOLOGY: Five types of rotary nickel-titanium endodontic instruments with a 0.30 mm diameter tip (EndoWave, HERO 642, K3, ProFile.06, and ProTaper) were selected to investigate torsional and bending properties, and phase transformation behaviour. A torsional test was performed according to ISO publication 3630-1, and maximum torque and angular deflection at fracture were measured. Bending load of the instruments was measured in a cantilever-bending test at 37 degrees C with the maximum deflection of 4.0 mm. A stainless steel K-file was used for reference. Phase transformation behaviour was measured by differential scanning calorimetry (DSC). From the DSC curve, transformation temperatures were calculated. Data were analysed by anova and the Tukey-Kramer's test. RESULTS: The maximum torsional torque values of HERO, K3 and ProTaper were significantly higher (P < 0.05) than those of EndoWave, ProFile and K-file. The K-files had the lowest torque value. Angular deflection at fracture was significantly higher (P < 0.05) for K-files than that for any nickel-titanium instrument. The bending load values of HERO and K3 were significantly higher (P < 0.05) than those of EndoWave, ProFile, ProTaper and K-file. The K-files had the lowest load value, although residual deflection remained. The transformation temperatures of HERO and K3 were significantly lower (P < 0.05) than those of EndoWave, ProFile and ProTaper. CONCLUSIONS: The functional properties of nickel-titanium endodontic instruments, especially their flexible bending load level, were closely related to the transformation behaviour of the alloys.

Calorimetry, Differential Scanning↗

The effect of pre-soaking and time in the ultrasonic cleaner on the cleanliness of sterilized endodontic files.

AIMS: To assess whether pre-soaking files in an enzymatic cleaner prior to ultrasonic cleaning had any effect on cleanliness and also to assess the effect of the time that endodontic files spend in an ultrasonic bath prior to sterilization on their overall cleanliness. METHODOLOGY: Twenty root canals in a total of ten patients were cleaned and shaped using conventional techniques. Following use, some of the files were pre-soaked and then ultrasonically cleaned for either 5, 10, 30 or 60 min. Other files had no pre-soaking and were then ultrasonically cleaned. There were two control groups, one where the files were pre-soaked and not ultrasonically cleaned and the other where the files were neither pre-soaked nor ultrasonically cleaned. All files were then subjected to a standard packing and autoclaving process. Following autoclaving, the files were examined using a light microscope at a magnification of 40x. The cutting section of each file was divided into two parts, the tip and the shaft, for visualization under the microscope. Any debris or cement on the files was scored using a modification of the scale used by Smith et al. (Journal of Hospital Infection, 51, 2002, 233). The data were analysed using one-way analysis of variance. RESULTS: Pre-soaking had no significant effect on the cleanliness of the files (P = 0.18 at the tip, P = 0.93 at the shaft). Ultrasonic cleaning had a significant effect on the cleanliness of the files (P < 0.00) but there was not a linear relationship between cleanliness and the ultrasonic cleaning time. There was little benefit in extending the ultrasonic cleaning time beyond 5 min. Calcium hydroxide deposits on two files were resistant to ultrasonic cleaning. CONCLUSIONS: There is no benefit in pre-soaking endodontic files prior to ultrasonic cleaning. The optimum time for ultrasonic cleaning was between 5 and 10 min. Further ultrasonic exposure, up to 60 min, did not improve cleanliness. Although a majority of files were free from debris following ultrasonic cleaning, a substantial minority still retained debris. This supports the case for endodontic files being single-use only.

Calcium Hydroxide↗

Porphyromonas gingivalis, Porphyromonas endodontalis, Prevotella intermedia and Prevotella nigrescens in endodontic lesions detected by culture and by PCR.

he aim of this study was to investigate the presence of four black-pigmented bacteria, Porphyromonas gingivalis, Porphyromonas endodontalis, Prevotella intermedia and Prevotella nigrescens, in endodontic infections by culture and polymerase chain reaction (PCR) analyses. Microbial samples were obtained from 50 teeth with untreated necrotic pulps (primary infection) and from 50 teeth with failing endodontic treatment (secondary infection). Microbiological strict anaerobic techniques were used for serial dilution, plating, incubation, and identification. For PCR detection, the samples were analyzed using species-specific primers of 16S rDNA and the downstream intergenic spacer region. Culture and PCR detected the test species in 13/100 and 50/100 of the study teeth, respectively. The organisms were cultured from 11/50 (22%) of primarily infected root canal samples and from 2/50 (4%) of secondary root canal samples. PCR detection identified the target species in 32/50 (64%) and 18/50 (36%) of primary and secondary infections, respectively. P. gingivalis was rarely isolated by culture methods (1%), but was the most frequently identified test species by PCR (38%). Similarly, P. endodontalis was not recovered by culture from any tooth studied, but was detected by PCR in 25% of the sampled teeth. PCR-based identification also showed higher detection rates of P. intermedia (33%) and P. nigrescens (22%) than culture (13%). In conclusion, P. gingivalis, P. endodontalis, P. intermedia, and P. nigrescens were identified more frequently in teeth with necrotic pulp than in teeth with failing endodontic treatment. Also, a higher frequency of black-pigmented species was detected by PCR than by culture.

Bacterial Typing Techniques↗

Retreatment of endodontic fillings.

Effects of endodontic retreatment on quality of seal and periapical healing were assessed among 660 previously root-filled roots. The roots were divided into either of two groups according to presence or absence of pathologic alterations in the periapical area. The retreatments, which were carried out by dental students, involved a thorough chemomechanical debridement of the root-canal system aiming to control infection. Following a 2-year observation period 556 roots were reexamined clinically and radiographically. The results showed that root-fillings with technical shortcomings could, following retreatment, be markedly improved as regards effectiveness of seal and distance to the apex. A large number of lumina discernible apical to root-filling could also be treated and filled. Seventy-eight percent of the cases with pathologic lesion present periapically prior to retreatment either completely healed or displayed an obvious size-reduction of the process. Retreatments carried out because of technical inadequacies alone were successful in 94% of the cases. It was concluded that renewed endodontic treatment whenever possible is the method of choice when treating defective endodontic fillings complicated with pathologic processes periapically. Apical surgery may be attempted if no signs of healing are apparent following observation.

Adult↗

Radiographic evaluation of endodontic therapy and the influence of observer variation.

In radiographic evaluation of the results of endodontic therapy the development or persistence of periapical radiolucencies often serve as criteria for therapeutic failure. In the present study the influence of inter- and intraexaminer variation on these results was investigated. Three endodontists and three radiologists interpreted periapical conditions and quality of root filling seal in radiographs of 119 endodontically treated roots. Consensus on the presence of periapical lesion was reached in 27% of cases classified as pathologic. In 6% reports of increased width of the periodontal membrane space accorded. The examiners agreed completely on normal periapical conditions in 37% of the cases. On assessing the quality of root filling seal the opinions of observers differed even more. Complete agreement on cases with adequate and defective seal was reached in 25% and 12%, respectively. For the individual examiner the widened periodontal membrane space was the diagnosis most difficult to reproduce. The present study indicates that the large variation noted among clinical and radiographic studies on the results of endodontic therapy could partly be explained by difficulties in defining and maintaining criteria for radiological evidence of periapical disease.

Clinical Competence↗

Image analysis of endodontic radiographs: digital subtraction and quantitative densitometry.

In this study computerized image analysis procedures were applied to endodontic radiographs. Kontron IBAS 2000 is a commercially available image analysis system with processing routines applicable to radiograph digitizing and transformations. The system was evaluated for: its ability to harmonize blackening and contrast in endodontic radiographs; its ability to compensate for angulation distortion of sequential exposures of individual teeth; its potential for application of digital subtraction methods; and its use in automated gray-level analyses of diseased and healthy bone areas in endodontic radiographs. The Kontron IBAS 2000 system proved suitable for all applications. However, the specificity of the subtraction procedure was limited by some inherent problems in the harmonization of blackening and in the subtraction process itself. On the other hand, automated gray level measurements proved to be a robust method for unbiased and quantitative assessment of healing of apical periodontitis.

Absorptiometry, Photon↗

Estimated radiation risks associated with endodontic radiography.

Endodontic patients are sometimes concerned about the risks of tumors or cataracts from radiation exposure during root canal therapy. By using established dose and risk information, we calculated the extent of these risks. The chance of getting leukemia from an endodontic x-ray survey using 90 kVp was found to be 1 in 7.69 million, the same as the risk of dying from cancer from smoking 0.94 cigarettes or from an auto accident when driving 3.7 km. Risk of thyroid gland neoplasia was 1 in 667,000 (smoking 11.6 cigarettes, driving 45 km) and risk of salivary gland neoplasia 1 in 1.35 million (smoking 5.4 cigarettes, driving 21.1 km). Use of 70 kVp radiography reduced these risks only slightly. To receive the threshold dose to eyes to produce cataract changes, a patient would have to undergo 10,900 endodontic surveys.

Cataract↗

In vivo fractures of endodontically treated posterior teeth restored with amalgam.

The cumulative survival rate (retention of both cusps) and the fracture pattern of 1639 endodontically treated posterior teeth were assessed in a retrospective study. All teeth had an MO/DO or an MOD cavity restored with amalgam without cuspal overlays. The 20-year survival rate of teeth with an MO/DO cavity was markedly higher than that of teeth with an MOD cavity. The lowest survival rate was found for the upper premolars with an MOD cavity: 28% of these teeth fractured within 3 years after endodontic therapy, 57% were lost after 10 years, and 73% after 20 years. Generally, the cusp most prone to fracture was the lingual one, and lingual fractures caused significantly more damage to the periodontal tissues than did facial or total crown fractures. The severity of periodontal damage increased with posterior location of the tooth. By far the most serious failures, irrespective of the cavity type, were found for the upper second molar, as 10 of 29 fractures led to extraction. It is concluded that amalgam, especially in MOD cavities, is an unacceptable material for restoration of endodontically treated posterior teeth if used without cuspal overlays.

Analysis of Variance↗

Moisture content of vital vs endodontically treated teeth.

The moisture content of vital and endodontically treated teeth was compared in matched pairs of contralateral human teeth extracted for prosthodontic reasons. Samples from each tooth were weighed then placed in an oven to remove the unbound water from the dentin. Weighing was carried out daily until a constant weight was achieved for three days. The moisture content was then calculated and expressed as a percentage of the initial sample weight. It was found that vital dentin had a moisture content of 12.35% whilst dentin from endodontically treated teeth had a moisture content of 12.10%. These results indicated that there was no significant difference in the moisture content between endodontically treated teeth and vital teeth.

Adult↗

Risk of endodontic treatment after insertion of conical crown retained dentures: a longitudinal study.

A longitudinal study was performed to assess the frequency of endodontic treatment after incorporation of conical crown retained dentures. The study population consisted of all patients being treated with conical crowns at the Academy of Advanced Dental Studies Karlsruhe during the years 1983-1989. The material comprised 655 patients with 1983 vital abutment teeth. The cases were included in a computer based documentation system for recording clinical relevant events. Event analysis by use of the Kaplan-Meier method revealed, that the probability of not being involved in endodontic treatment decreased to 0.67 within an observation period of five years. Patients in the oldest age-group (above 65 years) showed a significantly higher risk of endodontic complications than younger patients. Molars exhibited a less pronounced risk than premolars and anterior teeth. The results confirmed the necessity of regular follow-up examinations after prosthetic procedures.

Adult↗

Endodontic management of a rare combination (intrusion and avulsion) of dental trauma.

Combined trauma involving intrusive luxation of one tooth and avulsion of another is rare. A case is presented involving the endodontic management of two traumatised maxillary central incisors, one of which was intrusively luxated and the other avulsed. Spontaneous re-eruption of the intruded tooth occurred, thereby avoiding the need to further traumatise the periodontal ligament with either orthodontic or surgical repositioning, and allowing endodontic therapy to be carried out uneventfully. Endodontic therapy of the avulsed tooth was completed and its prognosis is considered good.

Child↗

Radiological assessment of the effects of potential root-end filling materials on healing after endodontic surgery.

The effects of three root-end filling materials on healing following endodontic surgery were assessed radiologically and correlated with histological findings reported elsewhere. The materials compared were a light-cured glass ionomer cement (Vitrebond), a reinforced zinc oxide-eugenol cement (Kalzinol) and amalgam. The root canals of 27 two-rooted mandibular premolar teeth of six beagle dogs were inoculated with endodontic pathogenic bacteria to induce periradicular lesions. The roots were apicected and root-end cavities filled with the tested filling materials. The teeth and surrounding jaw were removed after 4 weeks (30 roots) or 8 weeks (24 roots). Radiographs were taken of each jaw section and subjected to image analysis. Healing was evaluated based on measurements of the size of the periradicular radiolucent areas. ANOVA disclosed no statistically significant differences in the size of the periradicular areas either between time periods or between materials. These results did not correlate with the tissue responses in the same material as assessed histologically and previously reported. The use of radiographs alone to assess healing after endodontic surgery in the dog mandible is unsatisfactory, and should not be regarded as a substitute for histological examination for the determination of healing.

Analysis of Variance↗

Endodontic treatment and prevalence of apical periodontitis in an adult population of Vilnius, Lithuania.

Apical periodontitis is prevalent in many Western populations and is frequently detected in connection with inferior quality of endodontic treatment. However, information about endodontic conditions from eastern European countries is limited. The aim of the present investigation was to study the prevalence of apical periodontitis and the quality of endodontic treatment in 35-44-year-old Lithuanians. The prevalence of apical periodontitis was 70%. An overall success rate of 65% was found for root-filled teeth while 56% of pulp amputations (pulpotomies) were considered successful based on a radiographic evaluation. The quality of the root fillings showed little impact on the treatment results, except for over-extended fillings, which were associated with a high number of failures.

Adult↗

Molecular evaluation of residual endodontic microorganisms after instrumentation, irrigation and medication with either calcium hydroxide or Septomixine.

BACKGROUND AND OBJECTIVE: The correct choice of antimicrobial agents as inter-appointment medicaments is as important as the instrumentation and irrigation to remove pathogens from infected root canals. Calcium hydroxide [Ca(OH)2] and framycetin sulfate (Septomixine) are common endodontic medicaments. Therefore, we evaluated the efficacy of either calcium hydroxide or Septomixine in eliminating residual intra-canal bacteria, particularly Actinomyces spp., during inter-appointment interval in endodontic therapy using molecular methods. METHODS: A total of 31 single-rooted teeth with primary root canal infections were studied immediately after opening the canals and subsequently after instrumentation, irrigation with sterile saline and 1-week medication with either Ca(OH)2 (n = 25) or Septomixine (n = 6). Whole bacterial genomic DNA was isolated directly from samples and PCR with universal primers performed to detect total intra-canal bacteria. The variable regions of 16S rDNA of bacteria were amplified and labeled with digoxigenin for further hybridization to detect Actinomyces spp. A total of seven oligonucleotide probes specific for A. bovis, A. gerencseriae, A. israelii, A. meyeri, catalase-negative A. naeslundii (genospecies 1 and 2), catalase-positive A. naeslundii genospecies 2 and A. odontolyticus were used to detect Actinomyces spp. in 22 of 31 medicated root canals [Ca(OH)2: n = 17; Septomixine: n = 5]. RESULTS: The PCR results showed that 25 of 31 examined canals were positively detected with residual microorganisms after instrumentation, irrigation with sterile saline and 1-week medication with either Ca(OH)2 (n = 20) or Septomixine (n = 5). Thus, only six canals [Ca(OH)2: n = 5, Septomixine: n = 1] were aseptic after treatment. Hybridization results showed higher detection frequency of both A. odontolyticus and A. gerencseriae after treatment. Significant correlation was found between exposed pulp before treatment and positive detection of Actinomyces spp., particularly A. odontolyticus on the second visit (P < 0.05). CONCLUSION: The conventional, 1-week medication of either Ca(OH)2 or Septomixine in endodontic therapy may not effectively inhibit residual bacterial growth in all root canals during inter-appointment intervals. Further investigations using, for instance quantitative real-time PCR analyses, are required to substantiate the present findings.

Actinomycosis↗

Management of post-treatment endodontic disease: a current concept of case selection.

Over 30% of root filled teeth in the population present with endodontic infective disease, which has either persisted or emerged after treatment. Management of these "failed" cases is a challenge to the clinician, at the levels of diagnosis, case selection, communication and decision, and that is even before techniques are considered. Diagnosis should differentiate between endodontic and other aetiologies, and focus on the site of infection. Case selection should be based on how best to control the infection, but also on the benefit-risk balance of the alternative treatment modalities, the attitudes of the patient and the capability of the clinician. All of the above must be communicated to the patient, who then should make the informed decision regarding the selected treatment. This article discusses the treatment rationale, diagnosis, case selection and communication related to post-treatment endodontic disease.

Bacterial Infections↗

Advantages and disadvantages of new torque-controlled endodontic motors and low-torque NiTi rotary instrumentation.

The main problem with the NiTi rotary instrumentation technique is instrument failure. During shaping procedures, rotary instruments might lock and/or screw into canals and, consequently, be subjected to high levels of stress. This may frequently lead to instrument separation or deformation. If a high-torque motor is used, the applied forces are usually very high and the instrument-fracture limit is often exceeded, thus increasing the risk of intracanal failure. A possible solution of this problem is to use a low-torque endodontic motor, which operates below the maximum permissible torque limit of each and every rotary instrument. During clinical instrumentation of root canals, if a torque-controlled motor is loaded right up to the instrument-specific torque, the motor stops momentarily and/or starts rotating counter-clockwise (auto-reverse function) to disengage the locked instrument. These safety mechanisms were developed to reduce the risk of instrument fracture. The author fully discusses the rationale for selecting lower torque values in everyday endodontic practice, and provides clinicians with useful information on the advantages and disadvantages of new endodontic motors with torque control.

Dental Instruments↗