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PubMedDate not supplied

The complete endodontic obturation of an avulsed immature permanent incisor with mineral trioxide aggregate: a case report.

The use of mineral trioxide aggregate (MTA) for complete endodontic obturation of an immature maxillary central incisor is reported. The injured tooth of a 9-year-old male was avulsed secondary to a sports-related traumatic event. Early attempts at pulpal revascularization of the replanted tooth proved unsuccessful, as evidenced by radiographic signs of external inflammatory root resorption in the middle to cervical thirds of the root. Calcium hydroxide apexification over a 1-year period promoted cessation of the resorptive process, but was unable to adequately form an apical root canal barrier. Due to the extent of external resorption and the lack of an apical stop, a novel endodontic treatment using mineral trioxide aggregate was utilized. At 865 days post-injury, the tooth remained asymptomatic with clinical and radiographic evidence of periodontal health.

Aluminum Compounds↗
PubMed2006

Endodontic techniques for scouting the apical thirds of root canals.

It might be said that there are as many endodontic instrumentation techniques as there are operators, although no two clinicians perform the procedure in exactly the same manner. Despite differences, there are basic principles (correct diagnosis, adequate access, adequate irrigation, removal of the entire pulp, instrumentation to the minor constriction of the apical foramen, three-dimensional obturation, etc.) whose observance are consistent with long-term endodontic success. As a subset of these time-honored principles, there are guidelines and techniques for apical third "scouting" and instrumentation, which can also be considered universal, irrespective of the particular instruments or technique used for canal preparation. The purpose of this paper is to describe a scouting technique that is designed to optimize the apical part of root canal preparation. The author first heard the word "scouting" used in the context described by Dr. Clifford J. Ruddle.

Dental Instruments↗
PubMed2006

Influence of the length of instrumentation and canal obturation on the success of endodontic therapy. A 10-year clinical follow-up.

PURPOSE: To clinically test the periapical healing of the method of recurrent electronic root canal measurement and the method of root canal obturation by the guttapercha-eucapercha method. METHODS: During 10 years of endodontic practice of the first author, endodontic interventions were performed on approximately 4500 patients, aged 12-75 years. The success of therapy was followed-up in 257 teeth with diagnosis K04.0 to K04.5 (according to the X international classification of diseases) for whom a preoperative and control radiograph during the investigation period existed. Root canal preparation started with the "crown-down pressureless technique" and proceeded with the method of recurrent electronic root canal measurement. Obturation was done by the guttapercha-eucapercha method up to the apical constriction. RESULTS: The result of therapy success was approximately 95% overall (t-test, ANOVA); for the diagnosis: necrosis and pulp gangrene (K04.1): 64%; for the acute apical periodontitis (K04.4): 88%; for the inflamed pulp (K04.0) and pulp degeneration (K04.2) 95%; chronic apical periodontitis (K04.5): 98%, and abnormally formed hard tissue in the pulp (K04.3):100%.

Adolescent↗
PubMed2006

Cyclic loading of endodontically treated teeth restored with glass fibre and titanium alloy posts: fracture resistance and failure modes.

The aims of this in-vitro investigation were to compare the fracture resistance and the failure modes of endodontically treated teeth restored with glass fibre-reinforced posts with those of teeth restored with titanium-alloy posts. A total of 60 single-rooted human mandibular premolars were endodontically treated. The teeth were divided into two experimental and one control group. Post spaces 9mm long were prepared in the roots of the experimental groups in which glass fibre-reinforced posts (Group A) and titanium-alloy posts (Group B) were cemented. In the control group (Group C), no post was inserted. The specimens were stored in normal saline for a period of three weeks before being intermittently loaded at an angle of 30 degrees degrees to the long axis of the tooth at a frequency of two loads of 40N per second. Log-rank test used for the overall analysis revealed that there was no significant difference of fracture resistance between teeth restored with glass fibre-reinforced posts (Group A) and titanium-alloy posts (Group B). The survival of the control group was found to be significantly inferior to that of the experimental groups. There was no significant difference in the number of failures between the two experimental groups. There was significantly more core and post failure for the glass fibre-reinforced posts, root and core failure for the titanium-alloy posts and core failure for the control group. The results suggest that post failures are more frequent in teeth restored with quartz fibre posts and root fractures are more frequent in teeth restored with titanium posts.

Bicuspid↗
PubMedDate not supplied

Surgical management of iatrogenic root perforation following endodontic therapy.

Endodontic mishaps still occur despite technological advancements in the field of dental instrumentation and materials. Iatrogenic root perforations during access preparation, canal instrumentation or preparation of post space are not uncommon, and instrument fractures during filing or reaming, as well as root fractures during condensation, are also encountered. Many of these mishaps are hard to avoid because of the extreme variability in root canal anatomy, canal calcification, abnormal root shapes and curvatures. They occur most often during access preparation, root cleaning, shaping and preparation of post space, or when attempting to bypass fractured instruments. Procedural errors impede endodontic therapy, thus increasing the risk of treatment failure, especially in teeth with necrotic pulps and periradicular lesions. Clinicians often have difficulty diagnosing and treating root perforations and the treatment of such mishaps is very difficult, especially in posterior teeth and in the area of the mandibular furcation. We report on a case of root perforation in a mandibular first molar that was successfully treated by surgery without the use of additional biomaterials.

Adult↗
PubMed2006

Fracture strength of custom-fabricated Celay all-ceramic post and core restored endodontically treated teeth.

BACKGROUND: The increased use of all-ceramic crown provides a rationale for tooth-colored core. Due to superior mechanical properties, Vita Celay infiltration ceramic developed for crown and bridge works presents the potential for fabricating all-ceramic posts and cores in one piece. This study was conducted to compare the fracture strength of endodontically treated teeth which were thereafter given different types of posts and cores and crowns restoration, respectively. The evaluated post-and-core systems are: custom-fabricated Celay all-ceramic post-core, custom cast metal post-core, and prefabricated stainless steel post (Parapost) with and without 2.0 mm dentine ferrule. METHODS: Sixty freshly extracted human maxillary central incisors were endodontically treated and randomly divided into five groups with 12 samples each. Group A: Celay ceramic post-cores restored teeth with 2.0 mm dentine ferrule. Group B: Celay ceramic post-cores restored teeth with no dentine ferrule. Group C: cast metal post-cores restored teeth with 2.0 mm dentine ferrule. Group D: cast metal post-cores restored teeth with no dentine ferrule. Group E: prefabricated post and composite cores restored teeth with 2.0 mm dentine ferrule. All teeth were restored with Celay ceramic crowns. Each specimen was subjected to a load at a 45-degree angle to the long axis on MTS 810 material testing machine until failure, at crosshead speed of 0.02 cm/minute. Analysis of variance followed by the Newman-Keuls pairwise multiple comparison tests were used to compare the results of the groups tested. RESULTS: There was a statistically significant difference among the five groups (P < 0.01). Celay ceramic post-cores restored teeth with 2.0 mm dentine ferrule [(758.35+/-19.26) N] and cast metal post-cores restored teeth with 2.0 mm dentine ferrule [(756.63+/-66.22) N] had a significantly greater mean fracture strength than the other three groups in which no significant difference was observed. The 2.0 mm dentine ferrule could cause significant fracture resistance alteration of Celay post-core restored teeth. CONCLUSIONS: When covered with Celay ceramic crowns, Celay post-cores restored teeth with 2.0 mm dentine ferrule and cast metal post-cores restored teeth with 2.0 mm dentine ferrule have similar fracture strength. There was a statistically significant difference between the fracture resistance of Celay post-core restored teeth with and without 2.0 mm dentine ferrule.

Ceramics↗
PubMed2006

[A short-term clinical study of one-visit endodontic treatment for infected root canals].

OBJECTIVE: To clinically evaluate the postoperative pain level and short-term healing of one-visit endodontic treatment for infected root canals. METHODS: 100 infected cases were included in one-visit root canal therapy group and 42 infected cases in two-visit group using calcium hydroxide as an interappointment medicament. A comparison of the clinical results was done between the two groups. The main assessments included postoperative pain evaluated by patients and by clinical examination, and the six months' healing response. RESULTS: There was no statistically significance between the groups regarding pain 7 days after operation (one visit 60.0%, two visit 57.1%, P > 0.05) and six months' healing response (one visit 67.9%, two visit 61.5%, P > 0.05). The pain in the one-visit group was quickly relaxed postoperatively, as the pain in the two-visit group was given a rise because of the second treatment. CONCLUSIONS: One-visit endodontic treatment for infected root canals has the same clinical efficacy as two-visit in regarding to postoperative pain level and short-term healing.

Adult↗
PubMedDate not supplied

Endodontic treatment of a three-rooted maxillary first premolar: a case report.

Identifying and accessing all pulp canals is particularly challenging in the endodontic treatment of teeth with atypical canal configurations. This report describes the nonsurgical endodontic treatment of a maxillary first premolar with three root canals. The prevalence of this unusual morphology is reviewed and suggestions are offered to help dentists identify and treat such teeth. This case reminds dentists to be alert for variations in the root canal anatomy of maxillary first premolars.

Adult↗
PubMed2006

Avoiding perforations in endodontics.

PRECIS: While it will be impossible to eliminate all iatrogenic errors in endodontics, by focusing on key areas during the endodontic process, we can reduce the potential for problems for ourselves and our patients.

Bicuspid↗
PubMed1991

[In vitro and in vivo biocompatibility tests of some endodontic cements].

The major goal of endodontic therapy has been achieved by condensing filling materials into the root canal. It is not uncommon to find excess material in the periapical tissue. It therefore becomes obligatory to use filling materials that have acceptable biocompatibility. The purpose of this investigation was to obtain a "toxicity profile" of some root canal materials and to compare our observations to study results found in literature. Gutta-percha and five endodontic filling cements were tested in vivo and in vitro. The in vivo biocompatibility involved the placement of the test material in 10 mm teflon tubes with an outer diameter of 1,3 mm which were then implanted subcutaneously into rats. The implants were left in situ for periods of 30 and 90 days. The hemolysis test was used for in vitro evaluations. The histological examination showed cellular responses of different intensity and extent. In some cases severe infiltration of inflammatory cells and areas with necrostis were observed. As a result, the root canal materials evaluated showed slight, moderate, and severe reactions, therefore, a different pattern in tissue response.

Animals↗
PubMed1991

[Mechanical resistance of endodontically treated upper first premolar crowns].

This work shows the results of mechanical strength tests effected over first superior bicuspids before endodontically treated. The Authors show the strength differences, in connection to the access-cavity, between endodontically treated and non-treated teeth. Finally it was found that the demolition of only one marginal ridge reduces the tooth strength to withstand the occlusal forces.

Adolescent↗
PubMed1991

Microbiologic and pathologic aspects of endodontics.

Oral microorganisms, either directly or indirectly, produce the majority of cases of pulpal and periapical disease. Because microorganisms play such an important role in the pathogenesis of pulpal and periapical disease, a fundamental understanding of the disease process is important. Culture studies have identified infections of endodontic origin as being polymicrobial and predominantly anaerobic. Although several species of bacteria have been associated with infections of endodontic origin, there is no absolute correlation with signs and symptoms. The use of immunologic studies in addition to traditional microbiologic studies provides a better understanding of the mechanisms involved in the pathogenesis of pulpal and periapical disease.

Animals↗
PubMed1991

[Biological aspects of endodontics in advanced old age].

The traditional rules of endodontics are basing on scientific results and clinical experiences, collected in the first half of our century investigating the teeth of teens and young adults with respect to the epidemiologic situation. Prevention, preserving vitality and teeth have caused a transfer of endodontics in elder persons, but there are other biological conditions, as post-eruptive maturation of enamel, regressive metamorphosis of the pulp, transparency of the dentine of the root, apical apposition of cementum. They are of influence for diagnostic and therapy. Proposals are made.

Adult↗
PubMed1991

[Dentinal lesions caused by the use of endodontic posts].

An endodontic treatment has been effected on 36 extracted teeth, using drills; certain endodontic posts presently on the market have been successively inserted inside 18 teeth: Flexipost (Essential Dental System); Parapost Plus (Whaledent); dentatus (Dentatus). The teeth have been sectionized and watched through a photomicroscope to check an eventual presence of dentinal damages.

Dental Implants↗
PubMed1991

[Determination of working length in endodontics. 2. Endometric determination of canal length].

Electronic determination of endodontic working length has become very popular in the past few years. Nevertheles it has shown that the use of electronic apex locators cannot replace radiographic length determination, but can be a useful additional device in endodontics. Indication, benefits and limits of electronic length determination are described in this paper.

Dental Pulp Cavity↗
PubMedDate not supplied

[Intraperiodontal anaesthesia in endodontic treatment].

The intraperiodontal anaesthesia was applied in 120 patients as primary or additional injection during endodontic treatment. The exposed pulp tissue explored by dental probe to establish the effect of anaesthesia, was checked immediately after the injection. The endodontic treatment gave no side effect. There was no postinjection injury of the periodontal tissue. No patient complained about post-treatment discomfort.

Anesthesia, Dental↗
PubMed1991

Polymer implantation in periodontic endodontic lesions. Two case reports.

A polymethylmethacrylate polymer was used in an attempt to fill periodontal osseous defects. Healing was within normal limits, probing depth and mobility were decreased, and there were no adverse post-operative sequelae. Although there were periapical radio-lucencies that appeared to be endodontic in origin, endodontic therapy did not result in osseous defect fill. The non-resorbable, radiopaque polymer particles appeared to become incorporated within the radiodense tissue of the osseous defects. The alveolar bone within the defects was seen to increase in radiopacity, consistent with osteogenesis.

Alveolar Bone Loss↗
PubMed1991

Restorative and endodontic management of an anomalous mandibular molar.

Morphologic variations of dental hard tissue should be recognized and considered during restorative procedures. Overlooking anomalies increases the potential for clinical complications. Amalgam was used erroneously in a patient when the presence of a paramolar structure was overlooked. The clinical complications that resulted from overlooking the anomaly led to restorative, endodontic, and periodontal failures. The present report describes the use of conservative endodontics and a cast restoration, taking into account the presence of the paramolar structure, to correct the case.

Adult↗