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Treatment of endodontic perforations and the potential for repair.
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Surgical management of endodontic failures: indications and treatment results.
Two-hundred and twenty-four teeth with failures after conventional endodontic treatment were treated by periapical surgery by one surgeon and followed up for 1-8 years. Indications for surgery were: inaccessibility to the apical part of the root by a coronal approach due to posts, calcifications or procedural accidents. Cysts, a few acute cases and wide-open apices were also treated surgically. Healing was judged radiographically and classified into one of four healing groups: (1) complete healing, (2) incomplete healing (scar tissue); (3) uncertain healing, and (4) unsatisfactory healing. The grouping was performed separately by the oral surgeon and an endodontist. Deviating cases were then evaluated jointly, difficult cases and borderline cases were judged by an oral radiologist. Complete healing was observed for 76.6 per cent and incomplete healing (scar tissue) for 8.1 per cent of the teeth. The size of the latter group was strongly influenced by the number of cases with large preoperative rarefaction. A success/failure grouping of the material (success = complete and incomplete healing) revealed that 27 per cent of the retrofilled cases failed compared with 3.6 per cent in the orthograde group. The main conclusion is that retrofills should be avoided whenever possible.
Assessment of endodontically treated teeth for restorative procedures.
This article describes a case report in which cementation of cast posts and cores in endodontically treated upper central incisors resulted in extrusion of zinc phosphate cement into the periapical tissues. This case demonstrates the necessity for careful evaluation of existing endodontic therapy before proceeding with the restorative phase of treatment. Some primary indications for endodontic re-treatment are suggested.
Minor oral surgery for the general practitioner--apicoectomy.
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Bifid root and root canal in mandibular second premolar and its management--a case report.
Morphogically the mandibular second premolars present one root canal (97.5%). So far only a small percentage (2.5%) of cases were reported to have two root canals where they present the canals on the buccal and lingual direction of the root. Here an unusual case of two root canals, which are situated in mesial and distal direction is presented.
[Investigation of the microbiological variations at the empty root canals after retrograde histoacryl filling that is made with pulpectomy at the same time].
Many researchers defended the thesis of eradicating the apical foramen microleakage for a successful root canal treatment. This study has been designed to defect whether microorganisms will grow or not at the empty root canals as a result of the perfect obstruction of the apical foramen with histoacryl of least microleakage retrogradely. The study has been realized on 24 teeth of 6 adult dogs. Histoacryl was used to obstruct the apical foramens and the experimental animals were anesthetized with general anesthesia. Experimental animals were divided into three groups before the operation. At each group, eight teeth of two experimental animals were studied on. Consequently, a great amount of streptococcus kind, lactobacillus and staphylococcus were isolated at the cultures taken from the root canals of 15 days cases. At 30 day cases, peptostreptococus, lacto bacillus and staphylococcus were isolated while at 60 day cases streptococcus pneumonia, and lactobacillus were isolated and evaluated as meaningless.
[Apicoectomy and reverse filling procedure in posterior teeth].
In this paper, we present the apicoectomy with reverse filling procedure in posterior teeth, as an alternative surgical method, in those cases where conservative endodontic treatment is unable or fails to bring successful results (prosthetic restorations, broken instruments, calcified and tortuous root canals, dens in dente, unfinished root apex). We choose to restrict our presentation in posterior teeth where the surgical procedure is more difficult due to anatomical conditions (maxillary sinus, mandibular canal, number of root canals, inaccessible posterior oral cavity, etc). We analyse the indications of such an operation and the elements we examine to evaluate the cases. We are showing the different stages of the operation as well as the usage of original instruments for the retrograde amalgam procedure. There is a further discussion on problems from the usage of the filling material, the dental amalgam, and, the problems throughout the procedure (level and degree of the apical bevel, cavity preparation, etc).
[The significance of endodontic therapy before an endodontic surgery].
Conventional Endodontic therapy is the treatment of choice for pulp disease and periapical lesions due to pulp necrosis. Although the percentage of success of endodontic therapy is fairly high, in several cases endodontic therapy cannot perform accurately, or it is impossible to undertaken so as to avoid extraction of tooth. Before an endodontic surgery is performed a conventional endodontic therapy must be attempted because this increases prognosis and reduces the possibilities of failure. The possible presence of lateral canals, communication between periodontal ligament and infected canals through dentinal tubules and the potential hermetic reverse filling, are ones of the main factors which support the necessity of endodontic therapy. Apart from these, many cases have been reported where the basic factor of endodontic surgery failure was not the awkward operations, but the absence of the root canal filling. In this paper authors describe the basic steps and techniques which must be followed so as to avoid the failure of endodontic surgery.
Glass ionomer as a new retroseal in comparison with other retrofilling techniques.
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[Removal of root canal prefabricated posts for orthograde endodontic retreatment].
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[Glass ionomer cement used as a retrograde filling material after apicoectomy: a review].
When an apicoectomy is performed, using retrograde sealing with amalgam, the healing of the periapical area is not always perfect. In a number of cases the cause of this imperfect healing may be due to the improper sealing ability and the moderate tissue compatibility of amalgam. A literature study has been carried out, based on the assumption that glass ionomer cement will provide a better sealing and will cause less tissue reaction. It appeared that, at least in theory, glass ionomer cement is to be preferred to amalgam when it comes to apical sealing properties and tissue reaction. In terms of usability, resorption, hardness and costs no significant differences were found. The conclusion is drawn that glass ionomer cement is an equal or perhaps even better alternative for retrograde amalgam.
Apicoectomy surgical procedure using thermoplasticized injectable gutta-percha retrofillings.
Many materials have been used as retrograde fillings. Zinc oxide and eugenol, cavit, composite, gold foils, and other materials have been used in an attempt to seal the apical extent of the root canal. However, the most common material is amalgam.
[Effect of smear layer removal on bevelled and retrofilled teeth in vitro].
The "smear layer" is composed of debris that cover and insert into dentinal tubules. It is not really known if this form of debris may harbon viable bacterias or does form a barrier that enhances endodontic fillings by lining or plugging the tubules. The purpose of this study is to determine the role of the smear layer in leakage by using two groups of teeth in which the smear layer was removed of the root canals, in the first group and left into the roots in the second group. Some samples were beveled and all teeth were retrofilled after Root Canal Preparation, and then filled with India Ink. After examination of leakage under various conditions, it has been found a correlation between leakage and removal of smear layer.
In vitro quantification of the apical sealing ability of retrograde amalgam fillings.
Retrograde amalgam fillings were placed in 12 extracted human canines. The microleakage from the both directions (coronally and apically) was determined using pressurized fluid filtration at 90 min, 6 h, 1 day, 2 days, and 1,2,4, and 8 wk after amalgam filling. Leakage from either direction decreased markedly in the 90-min to 6-h interval after filling. At intervals between 1 day and 8 wk, only small changes in leakage were noted. After any time period, leakage from the coronal direction was greater than leakage from the apical direction. However, this difference was not statistically significant except at 90 min when the coronal leakage was significantly greater. This experimental system was shown to reliably measure microleakage in retrograde amalgam fillings.
[CO2 laser in dentistry. Chemico-physical and clinical aspects. 2].
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Fabrication of an expedient retrofill amalgam carrier.
A quick and easy to fabricate instrument to carry amalgam to a retrofill preparation was described. The carrier is made of two parts, a needle or angiocatheter and some appropriately sized orthodontic wire; both items are readily available in dispensaries and dental clinics worldwide. The instrument is sterilizable and reusable and may work better in certain compromised access situations.