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At least 595 records · Page 33Linked to original sources
PubMed2000

Persistent pain related to root canal filling and apical fenestration: a case report.

Endodontic treatments may give rise to persistent pain whose origin is sometimes difficult to determine. Although it is unusual, pain may occur due to apical fenestrations following endodontic treatment. If this occurs, the solution is surgical intervention. This surgical procedure consists of raising a flap to expose the fenestration, followed by curettage of any overextended canal filling materials that may be potentially irritating to the underlying mucosa, remodeling of the apex, and its repositioning below the level of the cortical bone. A case is described that illustrates this clinical situation. The case also demonstrates information that can be obtained from tomodensitometric films.

Apicoectomy↗
PubMed2000

Quality of root-end preparations using ultrasonic and rotary instrumentation in cadavers.

Prior investigations have demonstrated dentinal cracking and chipping during ultrasonic preparation of the root-end. This study compared the frequency of cracking and chipping in two groups, cadaver and extracted teeth, using an indirect resin technique. Preparations were performed using either a 33 1/2 inverted cone bur in a high-speed handpiece, or with ultrasonics using a CT-2 tip at either high or low intensity. After replication of the root-end in epoxy resin, all teeth were evaluated for cracking and chipping under scanning electron microscopy. Statistical analysis using a general contingency table or ANOVA with Scheffé post-hoc analysis (p = 0.05) revealed no significant difference between all groups in terms of root-end cracking. In extracted teeth (n = 15), rotary instrumentation produced less chipping than either ultrasonic technique. Varying the intensity was not significant. There was no significant difference between any instrumentation group in cadaver teeth (n = 10) related to the amount of chipping.

Analysis of Variance↗
PubMed2000

Accessory branch of the mental nerve.

This case report presents a surgical case in which an accessory branch of the mental nerve exited the mandible distal and slightly superior to the mental foramen. Careful manipulation of the surgical site allowed proper identification of the mental nerve, and the accessory branch and permanent nerve damage was avoided.

Aged↗
PubMed2000

Charcot-Leyden crystals within a periapical lesion.

Transmission electron microscopy revealed the presence of Charcot-Leyden crystals within a periapical lesion, which was assessed histopathologically as consistent with a periapical granuloma that failed to resolve after conventional endodontic treatment. This paper presents the clinical, radiographic, histological, and ultrastructural findings of this case and discusses their potential clinical significance.

Apicoectomy↗
PubMed2001

A comparative evaluation of three root-end filling materials: an in vitro leakage study using Prevotella nigrescens.

This study used Prevotella nigrescens to evaluate the sealing ability of Geristore, Super-EBA, and ProRoot when used as root-end filling materials. One hundred single-canal, extracted, human teeth were cleaned and shaped with Gates-Glidden burs and .04 Taper (ProFile Series 29) rotary instruments. The root-ends were resected, and a 3-mm deep root-end preparation was made with ultrasonic tips. After steam sterilization, the teeth were randomly divided into three groups of 30. Each group was root-end-filled with a different material. Five root-end cavities were left open and served as positive controls; another five root-end cavities filled with sticky wax and covered with two layers of nail polish acted as negative controls. The teeth were attached to presterilized snap-on plastic caps; the root-ends submerged into 12-ml vials of chopped meat carbohydrate broth and placed in an anaerobic chamber. Twice a week, a sterile micropipette was used to inoculate 0.1 ml of a broth culture of Prevotella nigrescens into the root canal of each tooth. Results after 47 days indicated there were no significant differences between the three root-end filling materials against penetration of Prevotella nigrescens.

Aluminum Compounds↗
PubMed2001

Histologic assessment of healing after the use of a bioresorbable membrane in the management of buccal bone loss concomitant with periradicular surgery.

Histological and morphometric assessment of periradicular wound healing was made after the use of a bioresorbable membrane over a buccal dehiscence. The third and fourth premolar teeth of nine dogs were resected and buccal defects created. Teeth were assigned randomly to the membrane or control group. One tooth in each quadrant received a membrane, covering both roots. The other tooth received no further treatment and served as a control. The animals were killed and specimens were assessed at two time periods: 9 wk and 27 wk. The 27-wk membrane group exhibited significantly more (p = 0.004) connective tissue height than the control group or either of the 9-wk groups. The amount of regenerated alveolar bone was significantly greater for the 27-wk membrane group than for the control (p = 0.001) and 9-wk groups. Mean junctional epithelium measurements were significantly greater (p = 0.012) for the control. The use of a bioresorbable membrane enhances bone regeneration when a buccal defect exists at the time of periradicular surgery.

Absorbable Implants↗
PubMed2001

Sealing ability of Dyract, Geristore, IRM, and super-EBA as root-end filling materials.

The purpose of this study was to evaluate the apical sealing ability of two compomers (Dyract and Geristore), IRM, and Super-EBA. Forty single canal roots from human teeth were instrumented until a size 40 file extended 1 mm beyond the apex. One millimeter of root apex was removed and a preparation 3-mm deep was prepared. Roots were divided into 4 groups of 10 roots each and filled with IRM, Super-EBA, Dyract, or Geristore. Canals were not obturated to ensure that any leakage was due to the apical filling material alone. Each root was then affixed to a fluid filtration device and subjected to a pressure of 14 cm of H2O, which has been determined to be the normal pulpal tissue pressure. The integrity of the seal was evaluated for 5 min at 1, 7, 30, and 180 days. Data were analyzed at each time point using one-way analysis of variance on ranks. The results of this study suggest that the new compomers Dyract and Geristore are equal or superior to IRM and equivalent to Super-EBA in their ability to reduce apical leakage when used as retrofilling materials.

Analysis of Variance↗
PubMed2002

Hemostatic efficacy and cardiovascular effects of agents used during endodontic surgery.

The hemostatic efficacy, as well as the cardiovascular effects, of two hemostatic agents currently used during endodontic surgery was examined. The hemostatic agents used were epinephrine pellets (Racellet pellets) or 20% ferric sulfate (Viscostat). Patients were assigned to one of two experimental groups. Blood pressure and pulse rate were recorded pre- and postoperatively and at three additional times during the surgery (root-end resection, root-end preparation, and filling). The adequacy of hemostasis was rated by the surgical operator. Results indicated that there is no significant change in cardiovascular effects when using either of these hemostatic agents. Except in one case where ferric sulfate was the agent, both agents produced surgical hemostasis that allowed for a dry field for root-end filling.

Administration, Topical↗
PubMed2002

Root-end fracture during retropreparation: a comparison between zirconium nitride-coated and stainless steel microsurgical ultrasonic instruments.

The purpose of this study was to evaluate a stainless steel (CT-5) and zirconium nitride coated (KiS) microsurgical ultrasonic instrument with regard to possible root-end fracture production during retropreparation. Forty extracted human central incisors were prepared in a crown-down fashion. Canals were obturated with gutta-percha by lateral condensation. Root-ends were resected. Teeth were placed in methylene blue for 48 h and evaluated by three independent evaluators under microscope. Teeth with existing fractures were eliminated from the study. The remaining teeth were randomly divided into two equal groups. Group A was prepared with the CT-5 tip and Group B with the KiS tip. Preparation time was recorded for all roots. The teeth were again immersed in methylene blue for 48 h and reevaluated. No root-end fractures were produced by either the KiS or CT-5 microsurgical ultrasonic instruments.

Apicoectomy↗
PubMed2002

The effect of a bioresorbable matrix barrier in endodontic surgery on the rate of periapical healing: an in vivo study.

The purpose of this prospective clinical study was to assess the rate of healing of periapical bony defects created at the time of endodontic periapical surgery by measuring the densitometric ratio change in periapical osseous tissues, after periapical endodontic surgery was performed, by using or not using Guidor bioresorbable membrane material. Periapical surgeries were performed on 25 patients where nonsurgical root canal therapy had failed and a periapical lesion was present. For inclusion in the study, the osseous defect to be analyzed had to be confined to the apical area, with bone covering the entire root surface coronally, and an intact lingual cortical plate had to be present. A series of radiographs at the 3-, 6-, and 12-month recalls were compared with the radiograph taken immediately after surgery by using digital imaging and a densitometric ratio that gave a numerical estimation of osseous healing. Using repeated-measure ANOVA, it was shown that there was no statistical difference between the rate of healing in those cases where a Guidor resorbable membrane was used and those cases where no membrane was used. The results suggest that placement of a guided tissue membrane over the bony opening created during an endodontic periapical surgical procedure has no beneficial effect on the rate of healing and the added expense to the patient would not be warranted in these cases.

Absorbable Implants↗
PubMed2002

Microleakage of resected MTA.

Forty-six single rooted extracted human teeth were used in this study. After cleaning and shaping, twenty canals were randomly selected for obturation with MTA placed in an orthograde manor (Group 1). Another twenty roots were obturated with gutta-percha and Kerr EWT sealer, using warm vertical compaction (Group 2). The apical 3 mm of each root in both groups were resected at approximately 45 degrees to its long axis. The teeth were aged for 48 h in a humidor. The root-ends of the teeth in Group 2 were then prepared and received MTA as a root-end filling material to a depth of 3 mm. Six roots were used as positive and negative controls. The roots of all teeth were placed in contact with India ink for 48 h. The roots were split and examined for dye leakage. There was no discernible leakage in teeth with resected MTA or those with MTA placed as a retrograde root-end filling material. We found no significant difference in dye leakage between resected MTA (Group 1) and non-resected MTA (Group 2). Based on these results it appears that the resection of set MTA does not affect its sealing ability.

Aluminum Compounds↗
PubMed2002

Effect of sonic and ultrasonic retrograde cavity preparation on the integrity of root apices of freshly extracted human teeth: scanning electron microscopy analysis.

Sonic and ultrasonic root-end preparation devices permit the preparation of conservative and straight cavities. However, microfractures and marginal chipping can occur due to the vibratory action of such instruments. The purpose of this study was to evaluate the effect of retrograde preparations by using sonic and ultrasonic tips on the integrity of root-end surfaces. Eighty, human anterior teeth were grouped according to size and treated as follows: treatment 1: root-end resection (RR) and root-end cavity preparation (RP) with KIS ultrasonic retrotip; treatment 2: RR and RP with Satelec S12/90 (no diamond coating) ultrasonic retrotip; treatment 3: RR and RP with a diamond-coated retrotip attached to a sonic device (Sonics); treatment 4: RR and RP with Satelec S12/90D (diamond coated) ultrasonic retrotip. The root-end surface topographies were assayed by means of polyvinylsiloxane impressions and epoxy resin replicas. SEM pictures of each sample were taken before and after preparation, and the images were evaluated by using an image processing and analysis system. The parameters evaluated were shape quality, presence of cracks, and marginal chipping. The results showed no statistically significant differences among anatomic groups, treatments, or tooth sizes (p > 0.05). Because treatment 3 removed more dental structure than the others did, its use on small teeth is inadvisable.

Apicoectomy↗
PubMed2003

The effect of irrigation with doxycycline or citric acid on leakage and osseous wound healing.

This study investigated the effect of doxycycline irrigation on wound healing and the apical seal of three filling materials. Part 1: 220 extracted teeth received root canal therapy followed by root resection (2 mm) and ultrasonic root end preparations (3 mm). Groups of 20 were irrigated with saline, citric acid, or doxycycline and filled with amalgam, Super EBA, or MTA. Leakage was measured (mm) after decalcification and clearing. Part 2: two defects were made on each side of the mandible of 10 New Zealand rabbits. On each side, one defect was irrigated with saline and one with either citric acid or doxycycline. The animals were killed in groups of five at 9 and 18 days. Sections of each defect were stained with hematoxylin and eosin for evaluation of healing and bone fill. Super EBA and MTA leaked significantly less than amalgam, regardless of irrigant. Leakage after irrigation with doxycycline compared to citric acid or saline was not significantly different for Super EBA or MTA but was lower for amalgam. There was no significant difference in healing or bone fill among irrigants at 9 or 18 days.

Aluminum Compounds↗
PubMed2003

Conventional and surgical treatment of a two-rooted maxillary central incisor.

Conventional and surgical endodontic management were performed on a two-rooted maxillary central incisor with a periapical lesion. Anatomical complexity of the tooth lead to perforation in the distal root during conventional treatment, thus a surgical approach was taken. A 4-month postoperative radiograph shows repair.

Adult↗
PubMed2004

The effect of calcium sulfate on hard-tissue healing after periradicular surgery.

The purpose of this study was to determine the effect of calcium sulfate (CS) on cementum deposition and osseous healing after periradicular surgery. The root canals of 24 mandibular premolars in four 2-yr-old beagle dogs were endodontically treated, followed 2 weeks later by periradicular surgery. Mineral trioxide aggregate (MTA) was used as root-end-filling material. The right or left side was assigned at random to receive CS alpha-hemihydrate or no material in the osteotomy sites before closure. The animals were killed after 4 months. Hard-tissue healing was analyzed histomorphometrically. All samples displayed evidence of cementum deposition adjacent to the root-end fillings and bone regeneration in the osteotomy sites. The data was analyzed using the Mann-Whitney U test, comparing the scores for cementum and osseous healing of the two groups at significance level of alpha = 0.05. The results indicated that placement of CS in osteotomy sites after periradicular surgery does not significantly affect periradicular healing.

Aluminum Compounds↗
PubMed2004

Hard-tissue healing after application of fresh or set MTA as root-end-filling material.

The purpose of this study was to compare the effect of fresh mineral trioxide aggregate (MTA) with set MTA on hard-tissue healing after periradicular surgery. The root canals of 24 mandibular premolars in four 2-yr-old beagle dogs were filled with MTA. Two weeks later the root ends of half of the samples were surgically exposed and resected to the set MTA within the canals. After exposing and resecting the other 12 root ends, they were prepared with ultrasonic instrumentation and preparations were filled with fresh MTA. After 4 months, the animals were killed. Hard-tissue healing was analyzed histomorphometrically. The results indicated that although freshly placed MTA resulted in a significantly higher incidence of cementum formation (12 of 12 versus 8 of 12, p = 0.028), there is no significant difference in the quantity of cementum or osseous healing associated with freshly placed or set MTA when used as root-end-filling material.

Aluminum Compounds↗
PubMed2004

MTA for obturation of mandibular central incisors with open apices: case report.

The case reported demonstrates dramatic healing of the periapical region of retreated root canals with open apices by the successful use of mineral trioxide aggregate (MTA). Unsuccessful conventional root canal therapy for the mandibular central incisors had been followed by surgical treatment. The severely damaged root canals were obturated using MTA in anticipation of the formation of artificial apical plugs. The treated teeth were asymptomatic, and radiographic examination demonstrated apparent regeneration of periradicular tissue 2 years after the obturation. MTA can be considered a very effective material to promote regeneration of apical tissue, even in teeth with large open apices.

Aluminum Compounds↗
PubMed2004

Use of self-etching adhesives to seal resected apices.

The purpose of this study was to evaluate the sealing ability of four self-etching adhesives placed over blood-contaminated/uncontaminated resected root apices without root-end preparation. Extracted maxillary incisors and canines were randomly divided into four groups of 10 teeth each. After canal preparation and resection of the apex, four self-etching adhesives (Clearfil SE Bond, One-Up Bond F, Unifil Bond, and ABF) were applied over the control and contaminated surfaces. The roots were then subjected to 15 cm of water pressure to simulate periapical microleakage stress. Data were analyzed using a two-way repeated measures, ANOVA. Positive and negative controls responded as expected. Statistical analysis indicated that there were no significant differences in the sealing effectiveness among the adhesives applied to contaminated or uncontaminated groups. All contaminated groups had significantly higher leakage (p < 0.003) than their uncontaminated pairs.

Analysis of Variance↗