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PubMed2004

Comparison of hand-instrumented, heated gutta-percha and engine-driven, cold gutta-percha endodontic techniques.

An in vitro study compared two gutta-percha obturation techniques of the mandibular first molar in dogs. The mandibular first molars were instrumented and obturated using either K-files and the SuccessFil vertical compaction technique or rotary instruments and the Simplifill/guttapercha master cone technique. Instrumentation and obturation times were recorded for each tooth. Radiographs were used for evaluation of overall appearance of the final fill. A modified apical dye leakage technique was used to evaluate the ability of each method to provide an adequate barrier to apical leakage. The endodontic technique utilizing rotary instruments and Simplifill/gutta-percha master cone required less time and provided a better radiographic appearance to the endodontic fill. In addition, there was no apical dye leakage associated with this technique compared with a 44% leakage incidence in teeth treated with K-file instrumentation and SuccessFil.

Animals↗
PubMed1998

Dental health status and endodontic treatment of captive brown bears (Ursus arctos ssp.) living in the Bernese bear pit.

The teeth of five adult captive brown bears (Ursus arctos ssp.) were examined and radiographed for occlusion, loss of teeth, dental plaque and calculus, and attrition under general anesthesia. Deposits of dental calculus were found in various locations with an overall prevalence of 8% to 15% of all tooth surfaces. In all five animals, severe enamel and dentinal attrition defects were observed in canine teeth with exposed pulp. Cage-chewing behavior is probably the main cause for the dental attrition. The composition of the food and feeding management are most likely responsible for the lack of natural cleaning and the resulting plaque and calculus formation. All affected canine teeth were treated with endodontic procedures using several materials and techniques, and evaluated one- to two-and-a-half years later by clinical examination, radiography, and scanning electron microscopy of silicone casts of the treated teeth. All coronal fillings were tight. The apices were not completely sealed in two teeth. We conclude that the use of adequate and specialized instrumentation and techniques for the treatment of these long, curved, large diameter root canals is more important than the particular endodontic and restorative materials used. The dental health status of zoo animals is an indicator of their general well-being. Preventive measures should be taken in their environment and management to minimize the risk of dental conditions.

Animals↗
PubMed1999

Endodontic disease of the mandibular first molar tooth secondary to caudal crossbite in a young Shetland sheepdog.

A six month-old intact female Shetland sheepdog was referred to the University of Illinois Veterinary Dental Clinic with a left-sided mandibular deviation and a thickened left ventral mandible in the region of the first molar tooth. On oral examination, left caudal crossbite was diagnosed. Dental radiographs revealed endodontic disease of the mandibular first molar tooth involved in the crossbite. Because of the difficulty of treating caudal crossbite and the potential of a pathological mandibular fracture, the endodontically affected tooth was extracted. Ten months following the extraction, mandibular deviation and alveolar bone lysis were resolved, but alveolar ridge resorption was present. The abnormal occlusal relationship caused by the caudal crossbite may have led to movement of the tooth, resorption of the tooth alveolus, and irreversible pulpal damage. Although not employed in this case, use of alveolar ridge preservation techniques can prevent mandibular bone loss after extractions.

Alveolar Bone Loss↗
PubMed2005

In vivo fluid movement through dentin adhesives in endodontically treated teeth.

Fluid transudation through simplified dentin adhesives can occur in bonded vital crown dentin, since these adhesives behave as permeable membranes after polymerization. The effect of adhesive permeability in endodontically treated teeth is unknown. This study examined the hypothesis that in vivo fluid movement through simplified adhesives occurs when they are applied to root canals. Dowel spaces were prepared in endodontically treated teeth with single root canals. Six adhesives were applied to the intra-radicular dentin of canal walls. Impressions were obtained with polyvinyl siloxane, and replicas were fabricated with the use of polyether impression material. Replica hemisections were gold-coated for SEM examination. Fluid transudation was evident on the adhesive surfaces of all simplified total-etch and self-etch adhesives. Conversely, most of the specimens bonded with the control three-step total-etch adhesive were devoid of fluid droplets. Permeability of simplified adhesives results in water movement, even in root-treated dentin. This may adversely affect the coupling of auto-/dual-cured resin cements.

Acid Etching, Dental↗
PubMed2005

Novel bacterial phylotypes in endodontic infections.

Although molecular studies have revealed potential oral pathogens among the phyla Spirochaetes and Deferribacteres, their occurrence in endodontic infections has not been consistently investigated. In this study, we devised a nested PCR-DGGE approach to survey samples from infected root canals for the presence of members of these two phyla, and to examine their diversity. The primers used also amplified DNA from Atopobium species. Eight of 10 cases showed bands representative of the target bacterial groups. DGGE profiles revealed a mean number of 6.5 intense and faint bands. No single band occurred in all profiles. Sequences from intense bands excised from the gel showed similarities to species/phylotypes of all target groups--Flexistipes species (Deferribacteres phylum), uncharacterized spirochetes, and Atopobium species. Analysis of these data indicates that uncultivated Spirochaetes and Deferribacteres phylotypes are frequent members of the endodontic microbiota and may be potential pathogens involved with the etiology of periradicular diseases.

Actinobacteria↗
PubMed2006

Impact of endodontic treatments on the rigidity of the root.

The destabilizing effect of endodontic treatment upon teeth is still controversial. The purpose of this study was to investigate the effects of different steps of endodontic treatments upon the rigidity of teeth. Extracted untreated central maxillary anterior teeth were loaded (3.75 N), and deformations of the root were assessed by Speckle pattern interferometry. The following treatments (with subsequent determination of deformability) were conducted sequentially: access preparation, manual instrumentation (Kerr files ISO-40, ISO-60, ISO-80, ISO-110), and tapered and parallel-sided post preparation. It was found that the teeth were increasingly destabilized by any treatment. While the increased deformability was not significant with the manual enlargement (p > 0.05), we found a significant destabilization after access preparation and post preparation (p < 0.05). A corresponding difference was found after conversion of the post preparation from tapered to parallel-sided (p < 0.05). Both substance loss and modifications of the natural root canal geometry play an important role in tooth rigidity.

Bicuspid↗
PubMed2004

Virulence factors of Enterococcus faecalis: relationship to endodontic disease.

Enterococcus faecalis is a micro-organism that can survive extreme challenges. Its pathogenicity ranges from life-threatening diseases in compromised individuals to less severe conditions, such as infection of obturated root canals with chronic apical periodontitis. In the latter situation, the infecting organisms are partly shielded from the defense mechanisms of the body. In this article, we review the virulence factors of E. faecalis that may be related to endodontic infection and the periradicular inflammatory response. The most-cited virulence factors are aggregation substance, surface adhesins, sex pheromones, lipoteichoic acid, extracellular superoxide production, the lytic enzymes gelatinase and hyaluronidase, and the toxin cytolysin. Each of them may be associated with various stages of an endodontic infection as well as with periapical inflammation. While some products of the bacterium may be directly linked to damage of the periradicular tissues, a large part of the tissue damage is probably mediated by the host response to the bacterium and its products.

Adhesins, Bacterial↗
PubMed2004

Survey of attitudes, materials and methods employed in endodontic treatment by general dental practitioners in North Jordan.

BACKGROUND: General dental practitioners provide the majority of endodontic treatment in Jordan. The aim of this study was to gather information on the methods, materials and attitudes employed in root canal treatment by dentists in North Jordan, in order to evaluate and improve the quality of current practice. METHODS: A questionnaire was posted to all registered general dental practitioners working in private practice in Irbid Governate in North Jordan (n = 181). The questionnaire included information on methods, materials and techniques used in endodontic treatment. RESULTS: Reply rate was 72% (n = 131). The results demonstrated that only five dentists used rubber dam occasionally and not routinely. The majority used cotton rolls for isolation solely or in combination with a high volume saliva ejector (n = 116). The most widely used irrigants were sodium hypochlorite and hydrogen peroxide, which were used by 32.9% (n = 43) and 33.6% (n = 44) of the respondents, respectively. Forty eight percent of the respondents (n = 61) used the cold lateral condensation technique for canal obturation, 31.3% (n = 41) used single cone, 9.9% (n = 13) used vertical condensation and 12.2% (n = 16) used paste or cement only for the obturation. The majority used zinc oxide eugenol as a sealer (72.5%). All, but one, respondents used hand instruments for canal preparation and the technique of choice was step back (52.7%). More than 50% (n = 70) of the dentists took one radiograph for determining the working length, whilst 22.9% (n = 30) did not take any radiograph at all. Most practitioners performed treatment in three visits for teeth with two or more root canals, and in two visits for teeth with a single root canal. CONCLUSIONS: This study indicates that dentists practicing in North Jordan do not comply with international quality standards and do not use recently introduced techniques. Many clinicians never take a radiograph for determining the working length and never used rubber dam or intra-canal medicaments.

Journal Article↗
PubMed2000

Current practice in endodontics: 3. Access is success, and rubber dam is easy.

The prime aim of this series of articles is to improve the quality of endodontic treatment in general dental practice by considering what is currently being taught in dental schools. This, the third article, offers guidance and hints to ease the use of rubber dam, which should be mandatory for root canal therapy. It also considers the shape, position and extent of access cavities. The access cavity can make all the difference in success or failure of endodontic treatment.

Anesthesia, Dental↗
PubMed2001

Microscopic management of endodontic procedural errors: perforation repair.

Iatrogenic root perforation is a procedural error that complicates treatment and can lead to loss of the tooth. A number of new instruments and techniques have been introduced into endodontic practice over the last few years to address this problem. The recent addition of the operating microscope to improve the field of vision has provided the operator with the benefit of magnification and enhanced illumination. Although there are few studies evaluating objectively the use of the operating microscope, its clinical application demonstrates the possibility of achieving more precise endodontic practice. The use of the operating microscope in the non-surgical management of a mid-root perforation is reported in this paper.

Calcium Hydroxide↗
PubMed2006

Adhesive restoration of endodontically treated teeth--current research.

UNLABELLED: Restoring endodontically-treated teeth using adhesively cemented fibre posts is becoming popular in general practice. Clinical studies have been promising, however failures can occur, usually because of de-bonding of the post. Current research, aimed at identifying factors that could improve the adhesion of fibre posts, is described. CLINICAL RELEVANCE: Adhesively-retained fibre posts are becoming a popular choice for the restoration of endodontically treated teeth. Dental practitioners should be knowledgeable on the rationale behind these restorations, factors that can lead to failure, and ongoing developments.

Adhesives↗
PubMed1976

Evaluation and restoration of endodontically treated posterior teeth.

The increasing acceptance and utilization of endodontic therapy for the preservation of broken-down posterior teeth presents the practitioner with many difficult restoration problems. If 25% or more of the coronal tooth structure is lost, some form of artificial dentin augmentation is required to provide adequate support and retention for the final restoration. Criteria to be used in the prerestorative evaluation of endodontically treated teeth are presented. Various methods and techniques to protect the remaining toth structure from fracture and to provide support and retention for the final restoration are described.

Composite Resins↗
PubMed1981

Single-visit endodontic therapy: a preliminary clinical study.

A clinical investigation was conducted to compare the incidence and severity of postoperative pain in single-visit and multiple-visit conventional endodontic therapy. Although the single-visit patients seemed to experience more discomfort than did the multiple-visit patients after the first postobturation day, the differences were not statistically significant. When the total number of pain days was considered, there were no significant differences between the two groups. Thus, single-visit endodontic therapy appears at least equal in desirability to multiple-visit therapy from the point of view of painfulness to the patient.

Humans↗
PubMed1984

Effect of occlusal relief on endodontic pain.

It has been suggested that removal of occlusion contacts will prevent or reduce postoperative endodontic pain during treatment. However, this theory has not been tested in clinical experiments. In this study, after endodontic instrumentation, the treated posterior tooth randomly received occlusal relief or mock-occlusal relief. Mean pain levels and the incidence of pain to occlusal pressure at various time intervals were recorded on questionnaire postcards by all patients, as was the duration of discomfort. Comparison of pain experienced by the occlusal treatment groups through statistical analysis gave the following conclusions: Spontaneous pain levels in the mock-occlusal relief and occlusal relief groups were not significantly different; Spontaneous pain levels in the mock-occlusal relief and occlusal relief groups did significantly relate to preoperative pain; Pain incidence from occlusal pressure in the mock-occlusal relief and occlusal relief groups did not significantly differ; Pain from occlusal pressure in both occlusal treatment groups did not significantly relate to preoperative pain; Duration of discomfort was not related to the occlusal treatment provided. The theory may be invalid that prophylactic removal of occlusal contacts is a pain preventive measure.

Dental Occlusion, Balanced↗
PubMed1990

Removal of restorative posts for the purpose of nonsurgical endodontic retreatment: report of cases.

Nonsurgical endodontic retreatment can be a successful treatment option, especially if the existing root canal therapy is technically deficient. It is the preferred treatment for most endodontic failures unless iatrogenic, restorative, or morphological factors dictate otherwise. A restorative post in the involved canal is usually considered an indication for apical surgery; however, in cases where nonsurgical retreatment is preferable to surgical management, many posts can be removed.

Crowns↗
PubMed1990

Guidelines for the restoration of endodontically treated teeth.

Much confusion exists in the dental community regarding the restoration of endodontically treated teeth; few review articles present succinct guidelines for the restoration of these teeth. This article reviews the literature and presents guidelines for restoration of endodontically treated teeth.

Crowns↗
PubMed1990

Dental implant reconstruction after endodontic failure: report of case.

Avulsion of natural teeth caused by trauma may present an unusual problem for the general practitioner. Endodontic therapy and replantation of the tooth into the socket have a relatively low long-term prognosis because of internal or external root resorption. Dental implants can provide proper support and function for missing teeth with excellent esthetic results without preparation of natural dentition. In this case report, an implant system is used to restore an anterior space created by the loss of endodontically treated central and lateral incisors.

Adult↗
PubMed1992

Endodontic case selection: to treat or to refer.

Endodontic treatment in the United States is delivered primarily by general dentists. A dilemma often arises as to which cases should be treated and which should be referred for specialty care. The case selection system described here rates endodontic cases so that practitioners can assess those cases they are best qualified to treat.

Anesthesia, Dental↗