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At least 919 records · Page 51Linked to original sources
PubMed2001

Antifungal effects of endodontic medicaments.

The eradication of root canal infection is paramount in endodontic treatment. Because fungi are involved in some types of root canal infections, the purpose of this study was to investigate the antifungal effects of several medicaments against the following selected fungal species: Candida albicans, Candida glabrata, Candida guilliermondii, Candida parapsilosis, and Saccharomyces cerevisiae. The agar diffusion test was the method used. Calcium sulphate or zinc oxide in glycerin showed no inhibitory effects towards any selected fungal species. The pastes of calcium sulphate or calcium hydroxide in camphorated paramonochlorophenol (CPMC)/glycerin showed the most pronounced antifungal effects. Calcium hydroxide in glycerin or chlorhexidine, and chlorhexidine in a detergent also showed antifungal activity, which was, however, much lower than the pastes of calcium sulphate or calcium hydroxide in CPMC/glycerin. Strategies using medicaments that have antifungal effects may assist in the successful management of persistent or secondary endodontic infections caused by fungi.

Anti-Infective Agents, Local↗
PubMed2004

Combined endodontic and surgical treatment of a three-rooted maxillary first premolar.

A case is reported in which endodontic treatment of a maxillary first premolar was complicated by the fact that the tooth had three roots. One of the roots was completely calcified and therefore could not be negotiated with endodontic files. There was a large periapical lesion associated with the tooth and this was surgically removed. During the surgical procedure a retrograde cavity was prepared on the calcified root using ultrasonic instruments and this was filled using Super EBA cement. Twelve months later the tooth was asymptomatic and the periapical tissues had completely healed.

Aged↗
PubMed2004

Photo-activated disinfection of the root canal: a new role for lasers in endodontics.

Because micro-organisms play a crucial role in the development of pulpal and periapical disease, the prognosis of endodontic therapy is intimately related to the presence of bacteria within the root canal system. Micro-organisms may persist in the apical region of the root canal system despite chemomechanical preparation. The usefulness of Class IV lasers (such as Nd:YAG, diode, KTP and Er:YAG) for photo-thermal disinfection of the root canal has been demonstrated in numerous studies. An alternative approach to microbial killing in the root canal system by laser light involves the use of low-power lasers to drive a photochemical reaction that produces reactive oxygen species, a technique termed photo-activated disinfection (PAD). By using exogenous photosensitisers such as tolonium chloride, killing of all types of bacteria can be achieved. In vitro studies of PAD have demonstrated its ability to kill photosensitised oral bacteria (such as E. faecalis), and more recently microbial killing in vivo in the root canal system has been demonstrated. While PAD can be undertaken as part of the routine disinfection of the root canal system, it also has potential use for eradicating persistent endodontic infections for which conventional methods have been unsuccessful.

Bacteria↗
PubMed2004

Role of occlusion in endodontic management: report of two cases.

The two clinical cases reported demonstrate that traumatic occlusion can play a role in the initiation and progression of pulp and periradicular inflammation. The symptom of persistent pain did not subside after the commencement of endodontic treatment. Traumatic occlusion was identified in both cases to be the main cause and hence occlusal adjustment was performed. This resulted in the gradual resolution of the symptoms. The findings suggest that occlusal trauma is often overlooked in the diagnosis and management of endodontic diseases.

Adult↗
PubMed2005

An energy-dispersive X-ray analysis and SEM study of debris remaining on endodontic instruments after ultrasonic cleaning and autoclave sterilization.

This study was carried out to investigate metallic and non-metallic debris remaining on endodontic files after ultrasonic cleaning and autoclave processing. Forty-eight unused rotary and hand endodontic files, including eight different brands, were tested. Instruments were cleaned with ultrasound, autoclaved and before and after each step were observed by scanning electron microscopy (SEM). Adherent debris was analysed by energy-dispersive X-ray analysis (EDXA). All of the instruments before ultrasound cleaning were contaminated with metallic and non-metallic debris. Although most non-metallic debris was removed by ultrasonic cleaning, most of the metallic debris remained even after the final step of sterilization.

Decontamination↗
PubMed2006

Endodontic therapy on a dentition exhibiting multiple periapical radiolucencies associated with dentinal dysplasia Type 1.

Dentinal dysplasia (DD) Type I, is a hereditary disturbance in dentine formation. In this anomaly, teeth in both primary and secondary dentitions are affected, and radiographically show short and blunted roots with obliterated root canals and periapical pathosis. Management of patients with DD has presented dentists with problems. Extraction has been suggested as a treatment alternative for teeth with pulp necrosis and periapical abscess. Follow-up and routine conservative treatment is another choice of treatment plan in DD. Another approach for the treatment of teeth with DD has included periapical surgery and retrograde filling, which is recommended in the teeth with long roots. The purpose of this report is to present an unusual case of dentinal dysplasia Type I in a 22-year-old woman showing upper and lower teeth with obliterated root canals and periapical radiolucencies. In this case, conventional endodontic treatment was performed. Postoperative radiographs and clinical evaluation demonstrated periapical healing and successful results. Based on the results of this case report, conventional endodontic treatment for cases with pulp necrosis and periapical radiolucencies in dentinal dysplasia is highly recommended.

Adult↗
PubMed2006

Case assessment and treatment planning: what governs your decision to treat, refer or replace a tooth that potentially requires endodontic treatment?

Several factors determine whether a tooth will require treatment by a general dentist, treatment by an endodontist or whether prosthodontic care is necessary after the tooth in question is extracted. This paper will present and discuss those factors, which govern the decisions made by the general dentist, and the resultant treatment options ranging from conservative endodontic therapy to the extraction of the offending tooth and its prosthodontic replacement. The impact of prognosis during endodontic therapy will also be discussed.

Decision Making↗
PubMed1996

The effect of endodontic access cavity preparation and subsequent restorative procedures on molar crown retention.

Preparation of an endodontic access cavity through a full crown may affect its retention. This study was undertaken to investigate the effects on molar crown retention of endodontic access cavities and their subsequent restoration. Thirty human molars were mounted in resin, crown preparations were cut and their surface areas were determined. Vented metal copings were cemented with zinc phosphate and the forces required to displace each coping were measured using a tensile-testing machine. The copings were recemented, access cavities were cut and their surface areas determined prior to the displacement forces being re-measured. The copings were recemented, assigned to two groups, and the access cavities were restored--Group 1 with amalgam; Group 2 with glass ionomer (GIC). Displacement forces were re-measured and the copings were recemented. The occlusal margins of the access cavities were bevelled and restored again prior to displacement forces being remeasured. Mean displacement forces were - Group 1: Original (kg force), 37.86 +/- 3.97; After access cavity, 29.28 +/- 3.22; Amalgam, 50.21 +/- 4.71; Amalgam + bevel, 46.45 +/- 6.21. Group 2: Original, 42.77 +/- 4.49; After access cavity, 39.25 +/- 5.91; GIC, 48.11 +/- 3.55; GIC + bevel, 39.63 +/- 5.31. Statistical analyses with paired t tests showed that retentive values with access cavities were significantly lower than with intact crowns. Amalgam or GIC restorations increased retention beyond original values, significantly with amalgam. Bevelled occlusal margins decreased retention of crowns with restored access cavities but this was not significantly different from the original values. A significant relationship existed between total surface areas of the crown preparations, areas of the occlusal tables, and retentive values for crowns without access cavities. The access cavity area, as a proportion of the total area of the preparation, was related to the decrease in retention.

Cementation↗
PubMed1997

Serious complications of endodontic infections: some cautionary tales.

While endodontic (dentoalveolar) abscesses can cause significant morbidity, in susceptible individuals they can pose life-threatening problems. This paper provides an overview of the more serious sequelae of endodontic abscesses, and provides examples of 'high risk' situations in practice in which these serious complications are more likely to occur.

Abscess↗
PubMed1998

Sodium hypochlorite and its use as an endodontic irrigant.

Sodium hypochlorite has been used as an endodontic irrigant for more than 70 years, and is now one of the most common solutions for this purpose. The chemical properties and production of commercial sodium hypochlorite are reviewed. Domestic bleaches and an infant sanitizer are compared from the point of view of cost and ease of use--Milton being recommended where a 1% solution is required. The cost of syringes and needles for endodontic irrigation is many times greater than the hypochlorite they contain, and total annual practice costs for hypochlorite are low. Brief guidelines for clinical use, storage, handling and disposal are included.

Costs and Cost Analysis↗
PubMed2004

A SEM evaluation of debris removal from endodontic files after cleaning and steam sterilization procedures.

BACKGROUND: In recent times, it has been proposed to classify endodontic files as single-use items due to a perceived inability to adequately clean the instruments. The purpose of the present study was to quantify the surface debris on files removed from the manufacturer's packaging, and after cleaning using an ultrasonic bath or a thermal disinfector. METHODS: Stainless steel and rotary nickel-titanium files were examined after removal from the manufacturer's packaging, after instrumentation in broth-contaminated human teeth, and after various cleaning procedures. The cleaning procedures consisted of either a thermal disinfector cycle, ultrasonication with the files placed in a perforated container or ultrasonication with the files loosely placed in a beaker. The presence of manufacturing debris and biological debris was evaluated using scanning electron microscopy and quantified using image analysis software. RESULTS: The effectiveness of cleaning was not affected by variation in the size or taper of the files when an effective cleaning procedure was used. Cleaning the files in a thermal disinfector or by ultrasonication within a container did not consistently achieve complete removal of biological debris. Placing the files loosely in the ultrasonic bath achieved the most effective cleaning, an average of 98.33 per cent of the file surface area was freed of any biological debris. CONCLUSIONS: A conventional cleaning method is capable of effectively removing biological debris from endodontic files. The efficacy of ultrasonic cleaning was impaired when the files were placed within a perforated container.

Dental Alloys↗
PubMed2005

21st century endodontics. Part 2.

The first paper in this series considered the subject of diagnosis and treatment planning for patients with endodontic problems. One of the factors to be taken into consideration when deciding whether or not to prescribe root canal treatment is the morphology of the root canal system of the root in question. Some information may be gleaned from the pre-operative radiograph, but much will be part of the practitioner's own knowledge. An understanding of the root canal morphology is also essential when cutting efficient and effective access cavities, remembering the endodontic cliché that 'access is success'. This paper will review canal morphology and access cavities, and then consider how teeth under treatment may be isolated from the oral environment to maintain a sterile operating environment.

Bicuspid↗
PubMed2005

21st century endodontics: part 3.

Root canal treatment is often regarded as a simple technical exercise that results in a nice white line on the final radiograph. In fact nothing could be further from the truth, as may be seen from the case illustrated in Figure 1. It is hoped that the first two papers in this series have established that the rationale for modern root canal treatment is the removal of infection from the entire root canal system. This, of course, presumes correct diagnosis and treatment planning, and an essential knowledge of canal morphology. Endodontic preparation is a chemo-mechanical process and both the chemical and the mechanical components play an equal part. The term 'cleaning and shaping' may be associated with canal preparation from previous endodontic teaching. In the 21st century this has been subtly but essentially changed to 'shaping and cleaning'. Instruments are used to rapidly shape the canal to permit the ingress of chemical agents to the entire root canal system.

Dental Pulp Cavity↗
PubMed2002

Photomechanical investigations on post endodontically rehabilitated teeth.

An investigation of the stress distribution patterns in post-core restored teeth and the behavior of dentin material to fracture propagation was conducted using experimental techniques such as digital photoelasticity (on photoelastic models), mechanical testing and scanning electron microscopy (SEM) (on extracted teeth). Digital photoelastic experiments showed that endodontic post-core restoration resulted in regions of high tensile stress and of stress concentrations in the remaining dentin structure. It was observed from mechanical testing that the fracture resistance in post-core restored teeth is significantly lower (p<0.0001) than that in intact tooth. There was a significant correspondence between the plane of stress concentrations identified in the photoelastic models and in those of the plane of fracture exhibited by the rehabilitated tooth specimens. While the fracture of post-core rehabilitated teeth was consistent, that of control teeth was not as distinct. The SEM highlighted varying dentin response to fracture propagation at the inner core and the outer regions. The fractographs showed brittle and ductile response to fracture propagation in the outer and inner core dentin, respectively. These photomechanical studies highlighted that the stress concentrations, high tensile stress and loss of inner ductile dentin associated with post endodontic rehabilitation diminished their resistance to fracture.

Biomechanical Phenomena↗
PubMed1997

Increased susceptibility of RAG-2 SCID mice to dissemination of endodontic infections.

Specific immunity has been implicated in the pathogenesis of periapical lesions, although the extent to which these mechanisms are actually involved in either protection or destruction of the pulp-periapex complex is yet to be established. To investigate this question we compared periapical-lesion pathogenesis in RAG-2 severe combined immunodeficient (SCID) mice with immunocompetent control mice following surgical pulp exposure. In order to equalize the bacterial challenge, an infection protocol using Prevotella intermedia, Fusobacterium nucleatum, Peptostreptococcus micros, and Streptococcus intermedius was devised. The results demonstrated that after infection, the proportion of the root canal flora represented by the four pathogens was almost identical in both groups (39.9 and 42.2% for RAG-2 and immunocompetent control mice, respectively). The effects of abrogation of T- and B-cell mechanisms on periapical pathogenesis were then assessed. Approximately one-third of the RAG-2 mice developed endodontic abscesses, while no immunocompetent controls had abscesses, results which indicated regional dissemination of the infection. A similar incidence of abscesses was found in two additional experiments. Abscessed RAG-2 teeth had significantly larger periapical lesions than did nonabscessed RAG-2 teeth (P < or = 0.05) and exposed immunocompetent controls (P < or = 0.01), whereas nonabscessed RAG-2 teeth were not significantly different from those of exposed immunocompetent controls in periapical-lesion size. We conclude that B- and T-cell-mediated immunity protects the host from the dissemination of endodontic infections and that RAG-2 mice are more susceptible to infection-induced pulp-periapex destruction.

Animals↗
PubMed1989

Stiffness of endodontically-treated teeth related to restoration technique.

Endodontically-treated posterior teeth are susceptible to fracture; consequently, full-occlusal-coverage restorations are recommended. We designed this study to examine the potential for alternative restorative techniques for pulpless teeth, using strain gauges mounted on extracted maxillary second premolars to measure strains generated by nondestructive occlusal loading. Cuspal stiffness was evaluated on the following sequentially performed procedures: unaltered tooth, completion of all endodontic procedures, appropriate restorative preparation, and restoration. The restorative procedures evaluated were: (1) amalgam, (2) cast gold onlay, (3) composite restoration with enamel etch, and (4) composite restoration with enamel and dentin etch. Finally, all teeth were loaded to fracture. Cast gold was the strongest restorative material tested (2.11 relative stiffness, compared with that of the unaltered tooth at 1.00), and amalgam was the weakest (0.35 relative stiffness). Composite restoration and enamel plus dentin etch were almost as strong as the unaltered tooth (0.87 relative stiffness), while enamel-etch-only yielded lower stiffness (0.51).

Acid Etching, Dental↗
PubMed2002

Molecular and cultural analysis of the microflora associated with endodontic infections.

Cultural studies have indicated that a subset of the oral microflora is responsible for endodontic infections. Approximately 50% of oral bacteria are unculturable, so it is likely that currently unknown bacteria are present in such infections. In this study, cultural and molecular analyses were performed on the microflora in aspirate samples collected from 5 infected root canals. 16S rDNA sequences from 261 isolates and 624 clones were identified by comparison with database sequences. Sixty-five taxa were identified, of which 26 were found by the molecular method alone. A mean of 20.2 taxa was found in each sample. A new species of Dialister was the only organism present in all 5 samples. Twenty-seven novel taxa were detected, 18 of which belonged to the phylum Firmicutes and 8 to Bacteroidetes. Culture-independent, molecular analysis has revealed a more diverse microflora associated with endodontic infections than that revealed by cultural methods alone.

Adult↗
PubMed2001

Treatment of mandibular first molar teeth with endodontic-periodontal lesions in a dog.

A two-year-old spayed/female Miniature Pinscher was treated for mobility of the left and right mandibular first molar teeth. Periodontal probing and intraoral dental radiographs indicated severe periodontal attachment loss. It was determined that both teeth had endodontic-periodontal lesions based on restoration of periodontal attachment and partial resolution of radiolucent periapical lesions following treatment which emphasized endodontic therapy.

Animals↗