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PubMed2004

Prevalence of and factors affecting post-obturation pain in patients undergoing root canal treatment.

AIM: This longitudinal, prospective study (1) investigated the prevalence of post-obturation pain after root canal treatment and (2) evaluated the influence of factors affecting the pain experience. METHODOLOGY: Twenty practitioners, comprising general dental practitioners, MSc graduates and Endodontists, participated in this study. The patient sample (n = 415) was derived from consecutive patients attending the practitioners' surgeries for root canal treatment on a single tooth. Demographic, medical history, preoperative and intra-operative data as well as pain experience on day 1 and day 2 after root canal obturation were recorded. Intensity of pain experienced was recorded on a visual analogue scale (VAS) of 0-5. The data were analysed using logistic regression models. RESULTS: The prevalence of post-obturation pain within 48 h after treatment was 40.2% (n = 167) but less than 12% of patients experienced severe pain (VAS 4 or 5) on either day 1 or day 2. The factors that significantly influenced post-obturation pain experience were: gender (OR = 0.434, P < 0.001), tooth type (OR = 1.733, P = 0.007), size of periapical lesion (OR = 0.493, P = 0.004), history of post-preparation pain (OR = 4.110, P = <0.001) or generalized swelling (OR = 3.435, P = 0.005) and number of treatment visits (OR = 2.604, P < 0.001). CONCLUSIONS: The prevalence of post-obturation pain was high (40.2%). The important prognostic determinants of post-obturation pain were female, molar tooth, size of periapical lesion smaller than 3 mm, history of post-preparation pain or generalized swelling and single-visit treatment.

Adult↗
PubMed1982

Comparison of calcium hydroxide and zinc oxide and eugenol pulpectomies in primary teeth of dogs.

The purpose of this investigation was to compare calcium hydroxide with zinc oxide and eugenol (ZOE) as root canal obturants in the pulpectomy procedure for irreversibly inflamed primary pulps of dogs. Clinical, radiographic, and histologic comparisons of calcium hydroxide and ZOE root canal filling materials were made in forty-two primary premolars of seven mongrel puppies. When the animals were 6 weeks of age, the pulps of all samples teeth were extirpated and the canals left open to the oral environment. The root canals were assigned to calcium hydroxide, ZOE, and control groups, instrumented, and filled 2 weeks later. The animals were killed 1 day, 1 week, 4 weeks, and 12 weeks after filling. Statistical analysis of all categories for comparison at 4 weeks indicated that calcium hydroxide gave significantly more favorable results than ZOE. Canals treated with calcium hydroxide exhibited less inflammation, less resorption, and more hard-tissue apposition than ZOE-treated and control groups.

Animals↗
PubMed2002

Treatment of replacement resorption with Emdogain--a prospective clinical study.

The present clinical study investigated the outcome of intentional replantation using Emdogain for periodontal healing following trauma-related ankylosis. Sixteen ankylosed teeth affected by replacement resorption were treated as follows: After tooth extraction, the root canal was obturated with a retrograde titanium post. Emdogain was applied to the root surface and into the extraction socket with subsequent replantation of the tooth. Evaluation parameters included horizontal and vertical Periotest scores, percussion sound and periapical radiographs. All findings were compared to those of the adjacent teeth. The mean follow-up period was 15 months (range 4-24 months). Eleven teeth showed no signs of recurrence of ankylosis: they were in full function and exhibited no pathological clinical findings. Four severely traumatized teeth demonstrated a recurrence of ankylosis after a mean period of 6 months, one tooth was lost in a second accident after 7 months. The estimated probability of 1 year without recurrence of ankylosis was P=0.66 (95% confidence interval [0.40; 0.94]). The mean survival time was 10.2 months (SD 1.1). The results indicate that treatment of replacement resorption following light to moderate trauma with replantation and Emdogain appears to prevent or delay recurrence of ankylosis in many cases.

Adolescent↗
PubMed1989

Use of an electronic apex locator in the treatment of teeth with incomplete root formation.

An electronic apex locator was used to determine length and control apical bridge formation in the treatment of teeth with incomplete root formation. Measurements were taken in 10 teeth in which apexification therapy had just started and in 11 teeth where the formation of the apical barrier was considered to be complete. In the beginning of the apexification therapy, when the apical foramen was still open, endometric measurements gave incorrect results in all instances. After apical closure had occurred and definite obturation of the root canal seemed possible, the apex locator in all teeth gave correct results and complete agreement was obtained between the radiographs and the electronic tests. Even in teeth in which complete apical closure could not be obtained, the results of electronic measurements were correct. Electronic apex locators may be used as auxilliary devices in controlling apical hard tissue closure in the treatment of teeth with incomplete root formation.

Adolescent↗
PubMed1978

Paresthesia from N2. Report of a case.

A number of cases of paresthesia following the use of N2 or other paraformaldehyde-containing root canal cements have been reported. Since paresthesia is longlasting and not only an inconvenience but also disabling at times, such cements should not be used for obturating root canals.

Female↗
PubMed1995

The adaptation of mechanically softened gutta-percha to the canal walls in the presence or absence of smear layer: a scanning electron microscopic study.

The objective of this study was to compare the adaptation of mechanically softened gutta-percha to the root canal wall in the presence and absence of smear layer. The root canals of 20 freshly extracted human maxillary incisors were cleaned and shaped. Prior to obturation, 10 root canals were irrigated with 20 ml of 50% citric acid followed by 20 ml of 5.25% sodium hypochlorite. All canals were obturated with mechanical compaction of gutta-percha and AH-26 sealer. After 72 h, each tooth was fractured in half. Scanning electron microscopy demonstrated that the sealer had formed a continuous layer in contact with the canal walls, becoming progressively thinner towards the apex. The sealer penetrated into the dentinal tubules along with projections of gutta-percha only in those teeth without smear layer.

Bismuth↗
PubMed1993

Methods for removing metal obstructions from the root canal.

The removal of metallic obstructions is an important part of endodontic retreatment procedures and encounters a number of serious problems. Sometimes removal procedures are extremely easy and can be performed in rather short time, but often it is a very tedious and time-consuming operation with a high number of failures, especially with fractured instruments. Using special devices such as the Masserannkit, the Canal-Finder-System, or ultrasonic systems some fractured instrument cases can be managed successfully. The retreatment of dowel-obturated root canals or failing silver cone cases has a good prognosis and a fairly good success rate. The Masserannkit, post pullers, the Canal-Finder-System and ultrasonic systems have been shown to be helpful devices in removal of root posts and silver cones. Additionally a large number of special devices and techniques for the removal of metal obstructions from the root canal have been described in the literature and will be critically reviewed.

Dental Debonding↗
PubMed1991

Halothane and eucalyptol as alternatives to chloroform for softening gutta-percha.

Because chloroform was identified as a potential carcinogen by the Food and Drug Administration, interest has been revived to identify an alternative solvent to soften gutta-percha for removal from obturated root canals. This study compared the effectiveness of halothane, eucalyptol, and chloroform in softening gutta-percha in simulated root canals. One milliliter of a solvent was placed into a small glass funnel whose stem was obturated with a 30-mm column of gutta-percha. After 30 s, softening was evaluated for each solvent by recording the time required to reach a depth of 10 mm by hand filing with a #100 Hedstrom file. The depth of penetration of a #40 finger plugger under constant weight for 15 min was also determined for each solvent. By using a one-way analysis of variance and Scheffe's test, all comparisons were not significant except for the depth of penetration with constant weight between chloroform and halothane (p less than 0.05). The results indicate that halothane and eucalyptol are suitable alternatives to chloroform as gutta-percha softening solvents.

Analysis of Variance↗
PubMed1990

The antibacterial effect of SPAD.

The antibacterial effect of SPAD, a root canal obturation paste containing paraformaldehyde, was examined and compared with that of calcium hydroxide apexification paste (Pulpdent). Both materials were either immediately placed in cultures containing streptococci group D, isolated from infected root canals, stored in an incubator for 3, 7 and 15 days before their testing, Evaluation of the antibacterial effect was carried out by measuring the diameter of bacterial inhibition zone after incubation of the materials in cultures, for 24, 48 and 27 hours. Wide inhibition zones formed around SPAD, denoting it's strong antibacterial effect, were recorded. This effect decreased with time as a result of the decrease in the amount of formaldehyde released from the hardened material into culture. On the contrary, calcium hydroxide was unable to cause inhibition of bacterial growth throughout the period of the study.

Calcium Hydroxide↗
PubMed1988

Cyanoacrylate as a retrofilling material.

The sealing ability of cyanoacrylate as a retrograde root canal filling material was evaluated in vitro. Fifty roots were cleansed, shaped, and assigned to five groups of ten roots each. The root canals were obturated with gutta-percha and Grossman's sealer. The apical 2 mm of each root in the five groups was resected. In groups I, II, and III, retrofilling preparation was made and filled with amalgam, varnish and then amalgam, and cyanoacrylate, respectively. In group IV, a hot instrument was used to seal the gutta-percha, and in group V, a cold burnisher was used for the same purpose. All of the teeth were immersed in 1% methylene blue dye for 24 hours and sectional longitudinally; dye penetration was then measured. One-way analysis of variance performed on the means of the groups indicated that group III had the least amount of leakage (p less than 0.05). This study indicates that cyanocrylate may have potential as a retrograde filling material.

Apicoectomy↗
PubMed1989

Use of glass ionomers as retrofilling materials.

Many materials have been used as retrofillings. Because of the bonding property of glass ionomer cement, this study was conducted to evaluate its possible use as a retrofilling material. Seventy human maxillary anterior teeth were chosen. The root canal systems were cleansed and shaped, and the teeth were assigned to six groups of 10 each. The root canals were obturated with gutta-percha and Grossman sealer, and the apical 2 mm of each root was resected. In all groups a retrofilling preparation was made to a depth of a number 331 bur. The apical preparations were filled in the following manner: silver amalgam (group I), silver amalgam plus two layers of varnish (group II), Ketac-Silver plus two layers of varnish (group III), Ketac-Silver without varnish (group IV), Ketac-Fil plus two layers of varnish (group V), Ketac-Fil without varnish (group VI), and Ketac-Bond (group VII). All the root surfaces with the exception of 2 mm from the resected line were coated with two layers of clear varnish. All the teeth were immersed in methylene blue for 24 hours. After vertical sectioning, dye penetration was measured under a dissecting microscope. The mean apical leakage (in millimeters) was as follows: I = 0.57, II = 0.39, III = 0.22, IV = 0.54, V = 0.11, VI = 0.46, and VII = 0.17. One-way analysis of variance performed on the group means indicated that Ketac-Fil with varnish (group V) and Ketac-Bond (group VII) had significantly less leakage than other groups (p less than 0.05). This study indicates that Ketac-Fil and Ketac-Bond may have potential as retrofilling materials.

Cermet Cements↗
PubMed2002

Clinical evaluation of audiometric control root canal treatment: a retrospective case study.

OBJECTIVE: The purpose of this study was to retrospectively assess the success of endodontic treatment that had been guided by audiometric (electronic) measurement. METHOD AND MATERIALS: The lengths of 66 infected root canals that demonstrated periapical pathosis were accurately measured by the Sono-Explorer before root canal obturation. The results over time intervals of 1 month to 20 years were evaluated on the basis of radiographic examinations. RESULTS: The rate of successful treatment was 90.4% for short-filled root canals, 94.5% for flush-filled root canals, and a low 50.0% for long-filled root canals. The rate of successful endodontic therapy was 87.8% for restorations that did not exceed the apical foramen but reached the apical constriction and 95.3% if cases in which the apical radiolucencies were disappearing were included as successes. If cases of unintentional long-filling (overextension) were excluded, the success rate was as high as 98.4%. CONCLUSION: The poor performance of overfilled root canals indicates that practitioners should not overextend these restorations. Use of the Sono-Explorer aided successful treatment of infected root canals.

Adult↗
PubMed1995

Chronic sinusitis and zinc-containing endodontic obturating pastes.

Several researchers have reported a link between the development of a solitary antral aspergillus sinusitis and the presence of zinc-containing root canal obturating paste within the antrum. If diagnosed correctly, it is generally accepted that this type of sinusitis can be treated effectively using surgical techniques alone. However, previous reports have shown that this is not always the case and may result in prolonged and inappropriate treatment of the condition. It is hoped that the reported case and literature review will assist both dental and medical practitioners in identifying affected patients and in the subsequent instigation of correct treatment regimes.

Adult↗
PubMed2004

Effect of obturation technique on sealer cement thickness and dentinal tubule penetration.

AIM: To compare the average sealer cement film thickness and the extent and pattern of sealer penetration into dentinal tubules in association with four obturation techniques in curved root canals. METHODOLOGY: Mesial canals of 44 extracted mandibular molars were randomly divided among the SimpliFill, continuous wave, Thermafil and 0.04 matched taper (master cones) lateral compaction obturation groups (22 canals per group). AH26 sealer cement was coloured blue-black using Sudan Black B dye. Roots were sectioned 1, 3 and 5 mm from the working length. Specimens were photographed under 25x magnification, mounted as 35 mm slides and projected. Average sealer cement thickness (measured at 10 points around the canal wall), depth of dentinal tubule penetration and frequency of voids were determined at the 1, 3 and 5 mm levels. Data were analysed statistically for effect of obturation technique and level of section on sealer thickness and on the depth and distribution of tubule penetration. RESULTS: Thermafil demonstrated superior GP adaptation at all levels with a mean overall sealer cement thickness of 2.2 microm, followed by lateral compaction (11.1 microm), continuous wave (12.2 microm) and SimpliFill (47.6 microm). SimpliFill also demonstrated the highest frequency of voids (P < 0.05). Sealer cement penetrated dentinal tubules as far as the outer one-third of dentine, with greater penetration observed buccally or lingually (P < 0.001). Penetration was not significantly affected by obturation technique, but on average was deeper and more frequent at the 3 and 5 mm levels than at the 1 mm level (P < 0.001). CONCLUSIONS: Sealer thickness was strongly dependent on obturation technique. Assuming that minimal sealer thickness and fewer voids are good measures of long-term sealing ability, Thermafil resulted in the best outcome. Consistent, extensive sealer penetration into dentinal tubules was seen and was unrelated to the obturation technique.

Bismuth↗
PubMed1991

Endodontic therapy of traumatized incisors with crown and transverse intra-alveolar root fractures.

A case involving traumatic injury to the maxillary anterior teeth with crown and transverse intra-alveolar root fractures is reported. The patient did not seek immediate treatment after trauma. Treatment included pulpectomy, fixation of a fractured root, root canal obturation, endodontic therapy of the coronal segment, and postoperative observation. Follow-up showed good results. Thus effective nonsurgical endodontic therapy of traumatized anterior teeth can result in a good prognosis in cases involving crown and intra-alveolar root fractures.

Adolescent↗