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PubMed2003

Validity of a three-dimensional public-domain system for contemporary endodontic research.

The purpose of this study was to evaluate the limits and benefits of a visualization system based on public-domain software for contemporary three-dimensional (3-D) endodontic research purposes. Three-dimensional bio-models of six human teeth and of one bone-implant specimen were generated using cross-sectional imaging. To evaluate the overall performance in processing large data sets and in reproducing accurate 3-D morphology, slices with a thickness varying from 100 microm to 10 microm were cut. Auto-outlining and segmenting techniques were tested. The 3-D bio-models represented in accurate detail the different morphological aspects of the specimen. Voxel volumes of 0.116 x 10(-5) mm3 could be realized and were only restricted by the computer hardware limitations. The system is not limited to dental hard tissues. Hypomineralized material and soft tissues as well as bone- and allogeneic-implant material could be visualized. The method presented is valid and meets current requirements applying to endodontic research. The broad-based use of high-quality, public-domain software and the resulting exchange of experience help to manage resources and may contribute to enhancing the in-process quality of research.

Anatomy, Cross-Sectional↗
PubMed2004

Questionnaire survey on the use of rotary nickel-titanium endodontic instruments by Australian dentists.

AIM: To ascertain the extent of the adoption and use of rotary nickel-titanium (NiTi) instruments and techniques in general dental practice and specialist endodontic practice in Australia in 2001. METHODOLOGY: A questionnaire survey comprising 43 questions was developed by first creating questions, then pilot testing with 10 postgraduate students in endodontics, followed by a final revision. The final series of questions covered demographics, patterns of rotary NiTi usage, issues associated with NiTi usage and training in NiTi use. The sampling frame was 908, comprising 64 endodontists and 844 general dentists. RESULTS: The overall response rate was 87%. Rotary NiTi instruments were used by 22% of general dentists and 64% of endodontists. The two main reasons for not using rotary NiTi were 'no perceived advantage' and 'too fragile'. Instrument fracture had been experienced by 74% of respondents, and 72% of these had fractured one to five files for the two main perceived reasons of 'excessive pressure on the file' and 'over-usage'. The next two most common problems encountered were 'binding' (53%) and 'ledging' (45%). Very high proportions of positive experiences were noted. Most respondents (73%) had attended one or more continuing education courses, most of which were provided by dental supply companies (64%). CONCLUSIONS: The results indicate a sensible and responsible approach to the incorporation of rotary NiTi instruments and techniques into root canal treatment. Dentists were aware of the limitations of the new technology, but were taking steps to become familiar with the properties and behaviour of the instruments. Instrument fracture was common, but it was of low frequency and did not deter dentists from using the technology.

Australia↗
PubMed2004

Undergraduate teaching and clinical use of rotary nickel-titanium endodontic instruments: a survey of French dental schools.

AIM: To evaluate the impact of rotary nickel-titanium (NiTi) instruments on undergaduate teaching and clinical use in French dental schools and to evaluate the impressions of dental students when learning and using these techniques. METHODOLOGY: A questionnaire was mailed to all 16 French undergraduate dental schools. Data were gathered on a range of issues concerning teaching and use of NiTi endodontic techniques. RESULTS: The response rate was 100%. The need for teaching NiTi techniques to dental students was agreed by all schools. Lectures and laboratory courses for rotary NiTi techniques were organized in all of the schools. In 13 of the 16 teaching hospitals, students could use rotary NiTi techniques for canal preparation under the supervision of teaching staff. Similarities were observed in the majority of responses, e.g. type of rotary system taught and used clinically. Some differences were also observed, e.g. the association of hand files to rotary NiTi instruments and at what stage in the undergraduate curriculum rotary instruments were introduced. CONCLUSION: There was a national consensus over the need for undergraduate teaching of rotary NiTi systems in France. These techniques had made a substantial impact in endodontic teaching and were widely taught and used in French dental schools.

Dental Alloys↗
PubMed1992

A survey of endodontic procedures performed by practitioners in limited practice.

Patients are sometimes referred for treatment to dentists who limit their practices to endodontics. A survey of consecutive referrals to seven such dentists was undertaken. The most common reasons for such referrals were (i) for the retreatment of a tooth with a previous root filling, (ii) because the referring dentist was unable to control pain and/or swelling, or (iii) because the referring dentist was unable to diagnose the endodontic problem. Only 60 (12.8%) of the 469 reasons reviewed were in teeth that were symptomless, uncomplicated and untouched by the referring dentist.

Dental Pulp Diseases↗
PubMed1994

Efficacy of sterilization of endodontic files after autoclaving in a synthetic sponge.

A common way of sterilizing endodontic files for clinical use is to insert them into synthetic sponges. The files are sterilized in the sponge, and the sponge is then used on the patient tray for ease of file retrieval. The ability to sterilize the files in a sponge has been questioned. The purpose of the present investigation was to evaluate the sterility of files and spore strips following autoclaving in a sponge. Commercial spore strips and contaminated endodontic files were inserted into sponges, sealed in sterilization pouches and autoclaved. The spore strips and the files were removed from the sponge and cultured for growth of microorganisms. Results show that no microbes were cultured from spore strips or contaminated files after autoclaving them in the sponges sealed in autoclave pouches. These results indicate that the insertion of files into the sponges used in this study does not obstruct the autoclaving process.

Colony Count, Microbial↗
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

An assessment of endodontic re-treatment decision-making in an educational setting.

AIM: To test the applicability of Praxis Concept (PC) theory in endodontic re-treatment decision-making amongst dental students of similar backgrounds, but from two dental schools. METHODOLOGY: A total of 172 students from two dental schools (n = 97 and n = 75) were asked to select their management choices (from five possible options) for each of six variations on quality (by way of adequacy of root filling) and complexity (by way of absence or presence of a post) of a simulated radiograph of an anterior tooth. The six variations each had five possible levels of periapical condition, giving a total of 30 cases for which management choices were sought. Individual re-treatment preference scores (RPS) were obtained, from which school and gender differences were compared by t-test. The association between students' stated re-treatment propensities and the different cases was expressed as odds ratios using unconditional logistic regression analysis. RESULTS: There were large inter-individual variations in RPS within the cases at both schools. Mean RPS for the group was 0.62 (SD 0.14), and did not differ between the schools (P = 0.44), but was significantly lower for males than females (P = 0.01). For all participants and a given case, if re-treatment was proposed for a particular size of lesion, then all larger lesions for that case were also marked for re-treatment. Presence of a defective root filling or overfilling reflected a greater propensity for re-treatment than when the root filling was adequate, whilst the absence/presence of a post had no clear effect on re-treatment choices. CONCLUSIONS: The findings support the explanatory potential of PC theory in endodontic re-treatment decision-making in the group investigated, and suggest that factors besides disease status alone, may contribute to the choices that clinicians make.

Attitude of Health Personnel↗
PubMed1997

The effect of a multimedia interactive tutorial on learning endodontic problem-solving.

New technology may create additional opportunities for learning in dental education. One of these new features is a multimedia approach, courseware combining sound, text, stills and video with interactive learning. A multimedia program was developed to train dental students and dental practitioners in decision making and problem solving in endodontics. This study compared the effects of the multimedia program with a more traditional approach consisting of written information, without interaction. 28, 4th-year dental students at the University of Kentucky in Lexington, KY, USA were randomly assigned to the multimedia or the text-based groups. They were given a written pre-test using 2 cases of dental pain and were instructed to study independently using either the multimedia program (group A) or the written information (group B). No restrictions were imposed on the amount of time to be invested, and the total study time was recorded for each student. 3 weeks after the pre-test, the students completed the post-test. A total of 18 students completed both the pre-test and the post-test and their scores were included in the final data. Statistical analysis of the average scores using paired t-tests revealed no significant difference between the performance of the students in either group, indicating that the multimedia approach to learning endodontic problem solving may successfully replace traditional learning strategies.

CD-I↗
PubMed1999

The role of direct intraoral sensors in the provision of endodontic services.

The recent commercial success of intraoral sensor systems largely reflects the quest to improve the quality assurances for endodontic services. The many advantages of these systems include reduced radiation exposures, real-time images, resolution improvements after initial image capture and archival benefits, although their diagnostic benefits over conventional film based radiographs remain a concern. For instance, the images from either charge-coupled device or storage phosphor sensors have yet to exceed the potential 50 microns spatial and 12-bit contrast resolutions obtained from the 1.75-6.40 microns silver grain emulsions of conventional films or the potential improvements derived from smaller (1 micron) grains. Intraoral sensor systems alone are therefore unlikely to improve the quality assurances for endodontic services.

Endodontics↗
PubMed1999

Biomechanics of endodontic endosseous implants--a comparative photoelastic evaluation.

Dental biomechanics is an interdisciplinary study wherein engineering principles are used for the better understanding of clinical dentistry. The present biomechanical study was done to understand the mechanism by which an endodontic implant transmits occlusal forces to the surrounding bone. In this experimental study, photoelastic techniques were utilized to compare stress distribution patterns in the supporting bone of an intact tooth, a tooth with supporting bone loss, and a tooth stabilized using an endodontic endosseous implant. It was concluded that there were distinct variations in the biomechanics underlying various dental clinical conditions. Further, the implant did not appear to improve the stress distribution.

Alveolar Bone Loss↗
PubMed2000

Review of One-Visit Endodontic Treatment.

Like the proverbial curate's egg, this CD-ROM is good in parts. I plan to use some sections in preclinical teaching, because the three-dimensional animations clarify descriptions for students unfamiliar with endodontic concepts. The rationale for single-visit endodontics is too inclusive for Australian audiences, and not adequately based on scientific evidence.

CD-ROM↗
PubMed1999

Finite element analysis of anterior tooth root stresses developed during endodontic treatment.

Vertical tooth root fractures are diagnostically challenging, frustrating, and an increasingly common cause of failure of tooth restoration. These vertical root fractures have been associated with many causes, including the endodontic process itself. To investigate these endodontic causes, various phases of crown replacement for an anterior tooth were modeled using nonlinear, plane strain finite element (FE) analysis. Stresses developed during obturation, post positioning, crown placement, and masticatory and occlusal loading of the restored tooth were estimated using this analysis method. The minimum (compressive) principal stress was greatest during obturation of cones 1 and 2, and during mastication of the restored tooth. Although these stresses were significant (-150 to -280 MPa), they did not exceed the compressive strength of dentin. The maximum (tensile) principal stresses, 160 to 300 MPa, were also observed during obturation of cones 1 and 2. These peak stresses exceed the dentin tensile strength.

Crowns↗
PubMed2006

Identification and quantification of archaea involved in primary endodontic infections.

Members of the domain Archaea, one of the three domains of life, are a highly diverse group of prokaryotes, distinct from bacteria and eukaryotes. Despite their abundance and ubiquity on earth, including their close association with humans, animals, and plants, so far no pathogenic archaea have been described. As some archaea live in close proximity to anaerobic bacteria, for instance, in the human gut system and in periodontal pockets, the aim of our study was to assess whether archaea might possibly be involved in human endodontic infections, which are commonly polymicrobial. We analyzed 20 necrotic uniradicular teeth with radiographic evidence of apical periodontitis and with no previous endodontic treatment. Using real-time quantitative PCR based on the functional gene mcrA (encoding the methyl coenzyme M reductase, specific to methanogenic archaea) and on archaeal 16S rRNA genes, we found five cases to be positive. Direct sequencing of PCR products from both genes showed that the archaeal community was dominated by a Methanobrevibacter oralis-like phylotype. The size of the archaeal population at the diseased sites ranged from 1.3 x 10(5) to 6.8 x 10(5) 16S rRNA gene target molecule numbers and accounted for up to 2.5% of the total prokaryotic community (i.e., bacteria plus archaea). Our findings show that archaea can be intimately connected with infectious diseases and thus support the hypothesis that members of the domain Archaea may have a role as human pathogens.

Archaea↗
PubMed2000

Current practice in endodontics.

The aim of this series of six articles is to improve the quality of endodontic treatment in general dental practice by considering what is currently being taught in dental schools. This first article considers the rationale behind endodontic treatment, what we are aiming to achieve and why. It looks at the dental and medico-legal issues which dictate the standards of our practice, and sets out the programme for the series.

Dental Pulp Cavity↗
PubMed2000

Current practice in endodontics: 2. Diagnosis and treatment planning.

The aim of this series of six articles is to improve the quality of endodontic treatment in general dental practice by considering what is currently being taught in dental schools. This second article considers the accurate diagnosis of endodontic lesions, which frequently present as emergencies requiring prompt, rapid and efficient attention. The paper then presents the treatment normally indicated once a correct and accurate diagnosis has been made.

Acute Disease↗
PubMed2001

The assessment of the endodontically treated tooth.

This paper reviews the assessment of success and failure following endodontic treatment and highlights the fact that many referrals for specialist management of endodontic failure do not take into consideration established guidelines in this important area.

Endodontics↗
PubMed1990

[Experimental study on apatite ceramics used as endodontic endosseous implant].

UNLABELLED: The purpose of this study was to investigate the possibility of applying hydroxyapatite ceramics as endodontic-endosseous implants. The upper medial incisors of 3 monkeys (Macaca fuscatae) were used. To prepare the implant cavity, the teeth were extracted and drilled from the apex by steel burns under water-cooling. Then, dense hydroxyapatite implants, 10mm in length, 2mm in maximum diameter and 1/20 tapered, were inserted into the cavity to have the implant project 3-4mm above the apex. When the teeth with the implants were replanted, the bone around the apex was removed. The teeth were splinted to the neighbouring teeth for 1 month. Five months after the operation, the specimens were taken out and fixed by 10% formalin alcohol. They were embedded in polyester resin and undecalcified sections were prepared. The sections were stained with toluidine blue and observed under light microscope. RESULTS: 1) At 5 months, no ankylosis between the tooth and the surrounding alveolar bone was observed. 2) There was newly formed hard tissue which extended from the cementum, on the surface of the implant. 3) Fiber bundles were observed around the implants which connected the newly formed hard tissue to the surrounding bone tissue. The results suggest that the application of hydroxyapatite ceramics as an endodontic-endosseous implant is effective.

Animals↗
PubMed1975

[Apex and periapical periodontium of teeth with endodontic-endosseal pin fixation].

Teeth with endodontic-endosteal pin fixation were observed for several years and radiolucencies that could be interpreted as chronic inflammation, were found in the periapical region of these teeth. The cause is sought in the iatrogenic noxa of the originally applied method. It is recommended to expose the apex of teeth to be provided with endodontic-endosteal pin fixation and to shorten the apex by grinding off 2-3 mm.

Dental Implantation, Endosseous, Endodontic↗