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PubMed1997

Comparison between Sulphorhodamine-B dye staining and 51Cr-release method in cytotoxicity assay of endodontic sealers.

The aim of this study was to evaluate Sulphorhodamine-B (SRB) staining against 51Cr-release in cytotoxicity tests of six endodontic sealers, namely, MU sealer (Mahidol University) ROCANAL 2, ROCANAL 3, Apexit, Endomethasone, and AH-26. Monolayers (5 x 10(5) cells/ml) of the mouse cell line Mu-mu-1 were used as test cells. Following incubation at 37 degrees C in 5% CO2 for 24 h in the presence of each sealer, cells were stained with 0.4% SRB and the absorbance at 540 nm determined as measure of cell viability. For 51Cr-release assay, cells were labelled with 51Cr before testing with sealers, and radioactivity in the supernatant was measured in a liquid scintillation counter. Both techniques indicated that Apexit was the least toxic sealer. In view of the ease of conducting SRB staining for tests of cell viability, this may be the method of choice over 51Cr-release assay in the evaluation of endodontic sealer cytotoxicity.

Analysis of Variance↗
PubMed1997

The effect of endodontic materials on periodontal ligament cell proliferation, alkaline phosphatase activity, and extracellular matrix protein synthesis in vitro.

Recent studies have demonstrated that periodontal ligament-derived (PDL) cells have the potential to regenerate a complete periodontal connective tissue attachment apparatus on both root and artificial substrates. To study the characteristics of endodontic materials conducive to periodontal regeneration, we have established an experimental model using PDL cell cultures that express a 42 kDa protein (CP42) associated with cementum extracellular matrix. In this report, the effect of gutta percha, dental amalgam, composite and calcium hydroxide on PDL cell proliferation, collagen and noncollagen protein synthesis, alkaline phosphatase activity, and CP42 expression are presented. While all substrates supported PDL cell attachment and proliferation, highest levels of alkaline phosphatase activity, collagen and noncollagen protein synthesis were observed in control cultures. Lowest levels of the above parameters were observed with gutta percha while amalgam, composite and calcium hydroxide had intermediate levels. Only control PDL cultures demonstrated CP42 expression. These data suggest that culture substrate can markedly influence periodontal extracellular matrix gene expression in vitro and provide an experimental model to select and develop endodontic materials compatible with periodontal regeneration in vivo.

Alkaline Phosphatase↗
PubMed1998

Dental anxiety among patients undergoing endodontic treatment.

The purpose of this study was to evaluate the dental anxiety expressed among patients undergoing endodontic treatment with respect to some social and dental parameters. The dental records of 98 patients, 42 men and 56 women who were referred for root canal treatment to an endodontist, were examined. Patients completed a Dental Anxiety Scale (DAS). Dental experience, time of last visit to the dentist, and symptoms of tooth were recorded. The mean DAS scores were higher than scores reported in other countries (9.4 +/- 3.3). Women demonstrated higher dental anxiety than men. Patients with higher education demonstrated lower dental anxiety. No difference was found between patients experienced in endodontic treatment and those who were not, patients who suffered previous pain in the treated tooth and patients who did not. Women in their mid-thirties to mid-forties and men in their twenties expressed the highest DAS scores.

Adult↗
PubMed1998

The effect of occlusal reduction on pain after endodontic instrumentation.

One hundred seventeen patients with posterior teeth requiring endodontic treatment were studied. Specific clinical findings were recorded, including pulp, vitality, preoperative pain, sensitivity to percussion, and the presence of a periradicular radiolucency. Excluded from the study were teeth with restorations to be maintained, greater than class I mobility, pocket depths > 5 mm, endodontic retreatments, and patients taking pain altering medications. Teeth were randomly assigned to 1 of 3 groups: (i) total occlusal reduction, (ii) simulated occlusal reduction (nonfunctional cusp reduction), or (iii) control (occlusion untouched). After canal instrumentation, a questionnaire was used by patients to record pain responses over a 48-h post-operative period. Responses were tabulated using a chi(2) test (p = < 0.05), and a statistically valid profile of patients most likely to benefit from occlusal reduction was developed. Occlusal reduction should prevent postoperative pain in those patients whose teeth initially exhibit pulp vitality, percussion sensitivity, preoperative pain, and/or the absence of a periradicular radiolucency.

Chi-Square Distribution↗
PubMed1998

Flare-up rate in pulpally necrotic molars in one-visit versus two-visit endodontic treatment.

This retrospective study compared one-visit versus two-visit endodontic treatment. The same technique and materials were used before and after making the sole change to one-visit endodontic treatment in 1991. Treatment records of 402 consecutive patients with pulpally necrotic first and second molars were compared. In 201 patients, treatment was provided by debridement and instrumentation, followed by obturation at a second visit; whereas the second group received single visit therapy. Flare-ups were defined as either patient reports of pain not controlled with over-the-counter medication or as increasing swelling. Sixteen flare-ups (8%) occurred in the two-visit group versus six flare-ups (3%) for the one-visit group. This showed an advantage for one-visit treatment at a 95% confidence level. In a second comparison, one-visit patients who had previously received two-visit treatment for a different pulpally necrotic molar served as their own control. No significant differences were present in this subgroup of 17 patients.

Acute Disease↗
PubMed1998

The C-shaped mandibular second molar: incidence and other considerations. Members of the Arizona Endodontic Association.

Although its most common configuration is two roots and three canals, the mandibular second molar may have many different combinations. Cooke and Cox were the first to describe a single-rooted mandibular second molar with a continuous slit connecting some or all of the canals. If sectioned horizontally through the main portion of the root, this slit had the shape of the letter "C." Other papers were written and lectures were presented on this and similar entities, but its frequency and significance have remained the object of speculation because large numbers of these teeth have not been categorized. By combining the efforts of an endodontic study club, 811 endodontically treated mandibular second molars were evaluated. Sixty-two of these (7.6%) were identified as C-shapes. Other aspects of this configuration were also investigated.

Dental Pulp Cavity↗
PubMed1998

Host mediators in endodontic exudates. II. Changes in concentration with sequential sampling.

Exudate is often found in the root canal of teeth requiring endodontic therapy. The aim of this study was to evaluate the relationship of sequential changes of different host mediators in endodontic exudates to clinical and radiographic findings. Thirty-two nonvital teeth with periapical symptoms were evaluated. Exudates were collected with filter paper strips every 3 min after opening of the pulp chamber. The concentrations of beta-glucuronidase, IgG, IgA, IgM, and interleukin-1 beta in the exudates were analyzed. In general, the concentration of the mediators in exudates from less involved lesions did not change over time. The exception was an increase in the IgM concentration when patients presented with percussion or palpation sensitivity. In contrast, in the more involved lesions, the concentrations of IgA and IgM increased as sampling progressed. The concentrations of beta-glucuronidase and interleukin-1 beta decreased over time in the more involved lesions. These data suggest that the amount of proinflammatory mediators in the canal and periapical lesion is limited. Furthermore, IgM seemed to be a marker for the severity of periapical lesions. This may relate to vascular permeability that allows passage of this larger molecule into the extravascular environment.

Exudates and Transudates↗
PubMed1998

Endodontic treatment of a fused maxillary lateral incisor.

A case report of endodontic treatment of a maxillary lateral incisor that fused with a supernumerary tooth is presented. The fused maxillary lateral incisor was in supraposition on the maxillary dental arch and required orthodontic treatment. The fused tooth was prepared for endodontic therapy. Cleaning and shaping of the root canals were performed. Then, the Ultrafil technique was used for obturation of the root canals. After orthodontic treatment, the teeth was mesiodistally reduced in size and restored with an anterior composite resin.

Adolescent↗
PubMed1999

Association of black-pigmented bacteria with endodontic infections.

Black-pigmented bacteria (BPB) have been associated with endodontic infections. The purpose of this study was to evaluate further the presence of BPB with the clinical signs and symptoms associated with endodontic infections. Microbial samples were collected from the root canals of 40 intact teeth with necrotic pulps and apical periodontitis. Conventional laboratory methods were used for identification of the strains of BPB isolated in pure culture. In addition, the polymerase chain reaction and specific primers for 16S r-RNA genes were used to differentiate Prevotella nigrescens from Prevotella intermedia. Twenty-two (55%) samples were positive for the growth of BPB. Of those, 11 of 22 (50%) were identified as P. nigrescens, 8 of 22 (36%) were P. intermedia, 2 of 22 (9%) were Porphyromonas gingivalis, and 1 of 22 (5%) was Prevotella melaninogenica. Sixteen of the 22 root canals positive for the growth of BPB were associated with purulent drainage either from the root canal or an associated sinus tract. Statistical analysis did not show a significant relationship for the presence of BPB with clinical signs and symptoms.

Bacterial Typing Techniques↗
PubMed1999

In vitro disinfection of dentinal tubules by various endodontics irrigants.

Effectiveness of endodontic irrigants within dentinal tubules of human teeth was evaluated. Mid-sections of single-rooted teeth were prepared into dentin wedges. The pulpal sides of the sections were exposed to Micrococcus luteus or Bacillus megaterium that grew into the tubules. Irrigants used in the study included: 0.525% NaOCl, 0.12% chlorhexidine, RC Prep, 0.5% betadine iodine, and sterile H2O (as a control). Pulpal surfaces were exposed to an irrigant and then rinsed in sterile water. The samples were then cracked, exposing a fresh surface. Culture of the exposed dentin surfaces showed that selected irrigants reached to the far ends of the dentinal tubules in a concentration sufficient to kill 100% of the M. luteus. However B. megaterium was neither killed nor apparently inhibited by any irrigant. We conclude that endodontic irrigants permeate throughout dentinal tubules, but their effectiveness is dependent on the type of bacteria found within the tubules.

Adult↗
PubMed1999

Survey for collagenase gene prtC in Porphyromonas gingivalis and Porphyromonas endodontalis isolated from endodontic infections.

Collagenase is a potential virulence factor shown to be expressed by Porphyromonas gingivalis associated with periodontal disease. The purpose of this study was to use the polymerase chain reaction (PCR) to detect the presence of the collagenase gene (prtC) in 21 strains of Porphyromonas species isolated from endodontic infections. Type strains for P. gingivalis (ATCC 33277), P. endodontalis (ATCC 35406), Prevotella intermedia (ATCC 25611), and Prevotella nigrescens (ATCC 33563) were used as controls. When PCR primers specific for the 16S ribosomal RNA gene of P. gingivalis or P. endodontalis were used, 16 of the strains were identified as P. gingivalis, and five strains were identified as P. endodontalis. The presence of the prtC gene for collagenase was detected using PCR. Amplicons were analyzed by agarose gel electrophoresis, with an 815 bp amplicon representing the presence of the collagenase gene. Type strain ATCC 33277 and all 16 clinical isolates of P. gingivalis produced the collagenase gene amplicon. Neither type strain ATCC 35406 nor the five strains from clinical isolates of P. endodontalis produced the collagenase gene amplicon. These results indicate that P. gingivalis from endodontic infections possesses the prtC gene. P. endodontalis does not seem to exhibit prtC. The virulence of P. gingivalis may be related to its production of collagenase.

Bacterial Proteins↗
PubMed1999

In vitro fracture strength of endodontically treated premolars.

The recent introduction of new bonding agents has led some authors to suggest that certain endodontically treated posterior teeth could be restored with a bonded restoration instead of a full-coverage crown or onlay. To test the fracture resistance of endodontically treated premolars restored with and without bonding agents, we randomly divided 56 intact and caries-free maxillary premolars into seven groups as follows: unaltered teeth; access only; MOD prep and RCT; MOD prep, RCT, and amalgam restoration; MOD prep, RCT, and amalgam with 4-META bonding agent; MOD prep, RCT, and composite resin restoration; and MOD prep, RCT, and composite resin with 4-META bonding agent. The teeth were subjected to compressive fracture tests in a Zwick 1435 Universal Testing Machine. Unaltered teeth and those with access only demonstrated similar fracture strengths. Under the conditions of this study, there was no significant difference in fracture strength between the experimental groups.

Acrylic Resins↗
PubMed2002

Adhesive post-endodontic restorations with fiber posts: push-out tests and SEM observations.

OBJECTIVES: Nowadays, the restoration of endodontically treated teeth is based on the use of materials with a modulus of elasticity similar to that of dentin (18.6 GPa). Fiber posts, resin cements and some composite resins all have this characteristic. This study evaluated the bond strength between luting materials, root dentin and fiber posts through push-out tests and examined the integration among these three components through scanning electron microscopy. METHODS: Endodontically treated extracted teeth and plastic plates were used to test the interface between luting agent and dentin and luting agent and post. RESULTS: Chemical affinity between different components (luting materials and fiber posts) is extremely important in achieving high bond strength. The bond strength tests and SEM observations showed that in vitro, composite resins perform better than resin cements. SIGNIFICANCE: The in vivo use of these materials may significantly reinforce residual tooth structure therefore reducing the risk for fracture and debonding.

Analysis of Variance↗
PubMed1999

Stiffness, elastic limit, and strength of newer types of endodontic posts.

OBJECTIVES: To determine the stiffness, elastic limit, and strength of a selection of endodontic posts recently introduced onto the market. METHODS: Endodontic posts of zirconia (Biopost, Cerapost), titanium (PCR), and carbon fiber (Composipost) were cemented in a brass block and loaded at an angle of 45 degrees in an Instron Testing Machine. From the recorded relationship between force and deflection the three mechanical properties were determined (n = 10 in each group). RESULTS: The ceramic posts were very stiff and strong, with no plastic behavior. The PCR post was as strong as, but less stiff than, the ceramic posts. Composipost had the lowest values for stiffness, elastic limit, and strength of the posts investigated. CONCLUSION: The posts under investigation differed significantly with respect to mechanical properties.

Carbon↗
PubMed1998

Microbiologic analysis of teeth with failed endodontic treatment and the outcome of conservative re-treatment.

OBJECTIVE: The purposes of this study were to determine what microbial flora were present in teeth after failed root canal therapy and to establish the outcome of conservative re-treatment. STUDY DESIGN: Fifty-four root-filled teeth with persisting periapical lesions were selected for re-treatment. After removal of the root filling, canals were sampled by means of advanced microbiologic techniques. The teeth were then re-treated and followed for up to 5 years. RESULTS: The microbial flora was mainly single species of predominantly gram-positive organisms. The isolates most commonly recovered were bacteria of the species Enterococcus faecalis. The overall success rate of re-treatment was 74%. CONCLUSIONS: The microbial flora in canals after failed endodontic therapy differed markedly from the flora in untreated teeth. Infection at the time of root filling and size of the periapical lesion were factors that had a negative influence on the prognosis. Three of four endodontic failures were successfully managed by re-treatment.

Dental Pulp Cavity↗
PubMed1999

Radiographic features of vertically fractured, endodontically treated maxillary premolars.

OBJECTIVE: The purpose of this study was to evaluate the most frequent radiographic appearance of bony lesions associated with vertically fractured roots of endodontically treated maxillary premolars. STUDY DESIGN: The radiographic features of 102 endodontically treated teeth and their periradicular areas (51 with and 51 without vertically fractured roots) were evaluated and compared. RESULTS: The predominant appearance of the periradicular area in the teeth with vertically fractured roots was the "halo" lesion (57%); by contrast, in the non-vertically fractured roots group, a "periapical" radiolucent lesion was most frequently found (55%). Angular bone loss (14%) and periodontal radiolucency (14%) were also typical radiolucent lesions in the vertically fractured teeth. CONCLUSIONS: "Halo" lesion, perilateral radiolucency, and angular resorption of the crestal bone, combined with diffuse or defined but not corticated borders, indicated a high probability of vertical root fracture in maxillary premolars.

Bicuspid↗
PubMed1999

Persistent periapical radiolucencies of root-filled human teeth, failed endodontic treatments, and periapical scars.

OBJECTIVE: This report describes 6 cases that demonstrate persistent periapical radiolucent lesions after conventional root canal treatment. STUDY DESIGN: Six teeth that had conventional root canal treatment or re-treatment with nonresolving periapical radiolucencies underwent periapical surgery. Biopsies were obtained and analyzed descriptively by correlative light and transmission electron microscopy for general features and microbial findings. RESULTS: Three findings were identified: periapical lesions with persisting infection in the apical root canal system (2 cases); a cyst (1 case); and periapical healing by scar tissue formation (2 cases). CONCLUSIONS: These results confirm previous observations that associated factors in the failure of endodontic treatment include persistent intraradicular infection and periapical cysts. In addition, unresolved periapical radiolucencies may occasionally be due to healing by scar tissue, which may be mistaken as a sign of failed endodontic treatment.

Adult↗
PubMed2000

Detection of Treponema denticola in endodontic infections by 16S rRNA gene-directed polymerase chain reaction.

A 16S rDNA-based polymerase chain reaction (PCR) method was used to detect the occurrence of Treponema denticola in root canal infections. Samples were collected from 21 single-root teeth having carious lesions, necrotic pulps and radiographic evidences of periradicular bone loss. DNA extracted from the samples was amplified using the PCR assay, which yielded specific fragment of T. denticola 16S rDNA. T. denticola was detected in 11 of 21 cases (52.4%), regardless of the presence or absence of symptoms. Since this spirochete was found in a relatively high percentage of the endodontic infections examined and because it is a pathogenic microorganism involved in periodontal diseases, there are reasons to believe that T. denticola can also participate in the pathogenesis of periradicular lesions of endodontic origin.

Adult↗