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PubMed1993

Root invagination treatment: a conservative approach in endodontics.

The occurrence of dens invaginatus, a developmental anomaly, is reported to be 0.04 to 10%. Treatment modalities, such as extraction, endodontic surgery, and conventional instrumentation of the defect and/or the pulp canal, have been reported. Most suggested treatment modalities are based on the assumption that the tissue inside the invagination communicates with the pulp tissue. However, histological studies show that depending on the type of invagination, the entrapped tissue is mostly connective tissue which may or may not contain pulp tissue components. In situations where the invaginated tissue is contaminated and yet no communication with the pulp cavity exists, it is possible to instrument and disinfect the invagination without affecting the pulp and sacrificing tooth vitality. Such treatment will be referred to as "root invagination treatment." A case is described where tooth vitality was preserved when only the invagination was treated.

Adult↗

PubMed1992

Endodontic treatment of fused teeth.

A case is reported documenting successful treatment of suppurative periradicular periodontitis involving a maxillary central incisor fused with a supernumerary tooth. Endodontic therapy was performed and partial resolution of the lesion was evident at the 1-yr recall and further resolution at the 16-month recall.

Adult↗

PubMed1992

Modified endodontics for lengthy canals.

A review of the dental literature concerning lengths of maxillary cuspids and reports of cuspid gigantism are presented. Endodontic therapy in these cases requires variations and modifications in conventional therapy for successful treatment. A case report is presented which illustrates some of these treatment modifications.

Cuspid↗

PubMed1993

Endodontic anesthesia in mandibular molars: a clinical study.

Sixty-one mandibular molar teeth with clinically manifest pulpitis, which required endodontic therapy, were studied. Twenty-seven subjects received standard inferior alveolar nerve block (IANB) with 2% lidocaine HCI with 1:100,000 epinephrine and 34 subjects received IANB with 3% mepivacaine with no vasoconstrictor. Pulpal anesthesia was assessed with dichlorodifluormethane (DDM). Subjects who gave a positive response to DDM were given a periodontal ligament injection with 2% lidocaine with 1:100,000 epinephrine. This study showed that 3% mepivacaine HCI is as effective as 2% lidocaine HCI in achieving pulpal anesthesia in mandibular molars with IANB. Of a total 61 IANB with lip anesthesia, 23 subjects required periodontal ligament injection to achieve a negative response to DDM. It was concluded that lip anesthesia is not a reliable indicator of pulpal anesthesia. The use of DDM is a reliable method of determining true pulpal anesthesia.

Anesthesia, Dental↗

PubMed1993

Antibacterial effects of various endodontic medicaments on selected anaerobic bacteria.

This study was undertaken to determine the antibacterial effects of various endodontic medicaments against six selected anaerobic bacteria. The experiment involved the testing of the vapors of six medicaments using agar plates streaked with the bacteria. A zone of inhibition was recorded for each plate and the results were analyzed statistically. Formocresol produced significantly larger zones of inhibition than any of the other medicaments.

Analysis of Variance↗

PubMed1993

Microleakage of endodontic temporary restorative materials.

This study compared the sealing of Caviton, Cavit, and IRM at two powder to liquid ratios of 6 g/ml and 2 g/ml. Standard endodontic access preparations were made in 140 noncarious, nonrestored crowns of extracted human molars. They were divided into six groups, including positive and negative controls. Microleakage assessment was evaluated by basic fuchsin dye penetration after thermal cycling (5 to 55 degrees C for 100 cycles). The results indicated that Caviton provided the best seal, followed by Cavit. Cavit demonstrated better sealing than IRM at the powder to liquid ratio of 6 g/ml and 2 g/ml. There was a statistically significant difference in leakage between the Cavit group and IRM (powder to liquid = 6 g/ml), between the Cavit group and IRM (powder to liquid = 2 g/ml) group (p < 0.05). However, no statistically significant difference between the two different powder to liquid ratio groups of IRM was disclosed.

Analysis of Variance↗

PubMed1993

Patient empowerment--a strategy for pain management in endodontics.

In order to promote rapid resolution of symptoms associated with root canal treatment, a multifaceted program was implemented. One-visit endodontics was performed universally, antibiotics were prescribed when infection was detected within the root canal, and nonsteroidal anti-inflammatory drugs were widely used at the time of treatment. The centerpiece of the program was the integration of various behavioral strategies designed to strengthen the patient's inherent coping capacity. The combination of clinical, pharmacological, and psychological approaches was collectively called patient empowerment. Five hundred forty patients were asked to contact the office the day after treatment. Four hundred twenty (78%) called and 390 (93%) reported a reduction in symptoms. Twenty of the 30 (7%) who were not relieved within the first 24 h reported significant improvement 1 day later. No patients experienced a flare-up or a worsening of symptoms.

Adaptation, Psychological↗

PubMed1990

Laser photopolymerization of dental materials with potential endodontic applications.

Photopolymerizing resins were exposed to three different wavelengths of light emanating from the argon laser. It was determined that the most efficient wavelengths for photopolymerization of camphorquinone-activated resins were at 477 and 488 nm. The 514.5-nm wavelength was relatively ineffective in activating polymerization. Four camphorquinone-activated resins were placed in the root canals of teeth and tested for polymerization depth using a 488-nm wavelength laser beam coupled to an optical fiber 200 microns in diameter. In regard to polymerization depth, these materials ranked as follows: Genesis greater than Prisma-Fil greater than Prisma Microfine greater than Prisma VLC Dycal. Alterations in the positions of the optical fiber and the surface of the resin in the canal made only minor differences in polymerization depth of the samples. The results indicate that an argon laser coupled to an optical fiber could become a useful modality in endodontic therapy.

Argon↗

PubMed1990

A comparison of techniques for cleaning endodontic files after usage: a quantitative scanning electron microscopic study.

One-hundred ten new endodontic files were used to prepare canals and were then cleaned using three different techniques: (a) gauze soaked with alcohol, (b) sponge soaked with alcohol, and (c) ultrasonic bath. The cleaning ability of each of these techniques immediately after use and after 1 h of delay were compared. Identical areas on each file were examined by using a custom-made jig. Morphometric analysis of debris was carried out using a Bioquant image analysis system. Sponge/alcohol was the worst cleaning method; this was significantly different from the other two techniques. The gauze/alcohol and ultrasonic bath were similar. The 1-h delay before instrument cleaning did not affect the ability of any of the techniques tested. None of the methods tested were able to totally clean the files.

Decontamination↗

PubMed1991

Torsional and metallurgical properties of rotary endodontic instruments. 2. Stainless steel Gates Glidden drills.

A laboratory study was performed on stainless steel Gates Glidden drills to determine their torsional and metallurgical properties. Samples of #1 to #6 drills from the two manufacturers that distribute these instruments in the United States were tested in incremental and continuous clockwise torsional loading by using a digital torque meter. The values of mean torque at fracture obtained with these tests generally showed no statistically significant differences for the same drill size and a given manufacturer. However, it was not possible to completely evaluate drill sizes #5 and #6 because the torsional moments developed during testing exceeded the capacity of the test instrument. Scanning electron microscope examination confirmed the occurrence of ductile torsional fracture processes, which were evident from visual observation of the instruments after fracture. This study is part of a continuing investigation to establish standards for all rotary endodontic instruments.

Dental Instruments↗

PubMed1991

Generic tricalcium phosphate plugs: an adjunct in endodontics.

Unusual endodontic situations may necessitate an immediate plug inside the tooth in order to dry the canal system and provide resistance to condensation. Generic tricalcium phosphate is a powder that when hydrated handles like silver amalgam and is condensable into a hard plug deep inside the tooth. It is fast, relatively technique insensitive, comfortable postoperatively, biocompatible, inexpensive, and readily available. A practical technique is presented and two case reports illustrate its use as an apical plug and a furcation perforation plug.

Adult↗

PubMed1991

Endodontic therapy in a mandibular second bicuspid with four canals.

Success in endodontic therapy often depends on the removal of the critical concentration of pulp tissue or necrotic debris within the root canal system. The best method to ensure this objective is to locate and instrument all of the canals in the root of the tooth. Therefore, a thorough knowledge of root canal morphology is essential to reduce the chances of failure. The purpose of this article is to report a case of mandibular second bicuspid with four distinct canals.

Bicuspid↗

PubMed1991

Resistance to fracture of endodontically treated premolars restored with glass ionomer cement or acid etch composite resin.

MOD cavity preparations in 64 endodontically treated premolars were restored using four different methods. Copper rings were filled with commercial hard-setting cement and the teeth were placed into the cement up to the level of the cementoenamel junction. The teeth were grouped according to restorative method, mounted in an Instrom T.T. machine, and the buccal walls subjected to a slowly increasing compressive force until fracture occurred. The force of fracture of the walls of each tooth was recorded and the results in the various groups compared. All teeth fractured in a similar manner irrespective of the restorative method used. The resistance to fracture of the teeth was the same when they were restored with glass ionomer cement as a base over which an amalgam or composite resin was placed or with acid-etched resin. When the entire cavities were filled with glass ionomer cement the resistance to fracture of the teeth decreased significantly compared with the acid etch resin technique.

Acid Etching, Dental↗

PubMed1990

Physical dimensions and torsional properties of rotary endodontic instruments. 1. Gates Glidden drills.

A laboratory study was performed on Gates Glidden drills to determine their physical dimensions and torsional properties. Five samples of sizes #1 to #6 drills from two brands distributed in the United States were measured for physical dimensions. Five samples of the most commonly used sizes #1, #2, and #3 drills from these two brands were tested at failure in both the clockwise and counterclockwise directions using an analog torque meter. The values for the bur head dimensions of both brands correspond closely to those established by the ISO. The mean values for torque at failure for both the clockwise and counterclockwise directions showed no statistically significant difference for each brand-size combination. However, some instrument groups had separation or fracture sites near the bur head, while other groups underwent failure near the hand-piece end. This study is the first part of a continuing investigation to establish standards for rotary endodontic instruments.

Dental Instruments↗

PubMed1990

Dentin permeability: effects of endodontic procedures on root slabs.

The permeability of human radicular dentin was measured as a hydraulic conductance before and after treatment with K files and before and after subsequent treatment of the endodontic smear layer with NaOCl, 50% citric acid, or 3% monopotassium-monohydrogen oxalate. Filing reduced dentin permeability 25 to 49%, respectively, depending upon whether outer or inner root dentin was filed. The permeability of these smear layers was unaffected by 5% NaOCl but increased many times after treatment with 50% citric acid for 2 min. Oxalate treatment lowered root dentin permeability to levels below that produced by creation of smear layers due to the production of a crystalline precipitate.

Adult↗

PubMed1990

Machining efficiency of endodontic K files and Hedstrom files.

Methods for the objective evaluation of the machining property of endodontic files were described earlier. These methods were used in this investigation to assess the characteristics of machining of 7 different brands of K files and 10 brands of Hedstrom files. The results show that there are large variations in amounts of material removed by the files. These variations are large between brands of instruments as well as between files of the same brand. Thus, among the 510 files evaluated, the file with the highest machining quality was more than 40 times as effective as the least effective instrument. The highest values among K files were obtained with files manufactured by Maillefer followed by Antaeos, Healthco, JS Dental, Brasseler, and Miltex. Among the Hedstrom files, the most efficient brands were Antaeos and Zipperer followed by Healthco, Hygenic, JS Dental, Miltex, Maillefer, Union Broach, and the least efficient Brasseler. The files did not wear noticeably during these testing procedures. These results clearly indicate that the provider needs more information from the manufacturer in regard to machining and cutting in order to intelligently select instruments. It is suggested that procedures be agreed upon to evaluate machining and cutting of root canal files in order to provide the endodontist with better information about instruments.

Dental Instruments↗

PubMed1991

Dynamic fracture of hybrid endodontic hand instruments compared with traditional files.

The purpose of this study was to analyze in vitro the dynamic fracture of some endodontic hand instruments. The K file and H file were tested as reference traditional files; the K-Flex, Flexofile, Unifile, and Helifile were tested as newly developed hybrid instruments. The files were mounted in a lathe and rotated with cyclical axial motion in the lumen of a curved tempered steel groove until failure occurred. The results showed that the life span of instruments, the distance between the instrument tip and the rupture point, and the resistance to fracture were dependent on the size and design of the instruments. Moreover, scanning electron microscopic photographs revealed two types of breakage patterns. The K file, H file, Unifile, and Helifile showed a distinct fracture starting point with crack striations and ductile fractures. The K-Flex and Flexofile showed only plastic deformations and axial fissures.

Equipment Failure↗

PubMed1991

A comparison of strains generated during placement of five endodontic posts.

Twenty-five extracted human maxillary central incisors were randomly divided into five equal groups. Crowns were removed 1 mm incisal to the cementoenamel junction. Endodontic treatment was carried out and each tooth was affixed with two strain gauges. The strain gauge wires were connected to a Wheatstone Bridge circuit. Each group of five teeth was restored with either a Para-Post Plus (the control post), Flexi-Post, Vlock post, Kurer Fin Lock Anchor, or a Radix Anchor. Strains generated during post placement were recorded and compared for the five groups using a one-way analysis of variance. The maximum strains accompanying placement of the Kurer Fin Lock Anchor and the Radix Anchor were significantly higher than those induced by placement of the other posts. Also, when the threaded posts were allowed to contact the bottom of the prepared channel, high strains resulted.

Analysis of Variance↗