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The results of this study indicated that heat-sealed gutta-percha alone and when reinforced with Adaptic or a glass ionomer cement provided the most effective apical seal. It is therefore proposed to expand this study to include these materials and zinc-free Spheraloy and Cupralloy amalgams as retrofilling materials. The amalgams will be used with and without cavity varnish.
The placement of a retrograde filling is designed to seal the apex of a tooth when conventional procedures have either failed or cannot be performed. This case report describes the mechanical failure of this procedure, as well as the expulsion of the filling material from the oral cavity.
A patient developed postendodontic pain 3 years after undergoing root canal therapy in a maxillary first premolar tooth. Radiographic examination revealed that a recently extracted impacted second premolar had originally obscured the x-ray view of a third root on the first premolar. Endodontic therapy in the unfilled root was rejected because the tooth had been restored with full coverage. Apicoectomies and retroseals were performed on all roots, and the tooth became asymptomatic.
Opinions differ as to whether or not teeth with advanced marginal bone loss should be subjected to periapical surgery. The purpose of this retrospective investigation was to study the results after apicoectomy on teeth that showed total buccal bone loss at the time of the operation. The material consisted of twenty-seven teeth in 27 patients, fifteen males and twelve females, 23 to 63 years old at the time of the operation. The observation time varied from 0.5 to 7 years (mean, 3 years). Ten operations (37%) were regarded as successful, nine (33%) as uncertain, and eight (30%) as unsuccessful. The success rate was not so low that an apicomarginal communication should be regarded as a contraindication for apicoectomy. Apicoectomy should be performed, especially if the alternative is an otherwise unnecessary prosthetic reconstruction.
Apicoectomy with retrograde amalgam is an accepted procedure for treating teeth that cannot be treated by nonsurgical methods. Some of these fail to heal for no apparent reason. Evidence is presented that indicates that some of these failures are caused by corrosion of the apical amalgam. Two cases are described in which the sinus tract that was associated with the failing retrograde amalgam was resolved without further surgery. To bring about the resolution, a zinc-enriched amalgam was placed in the crown that through an intervening conductor, reduced the rate of corrosion at the apex.
A case of spontaneous repair of the fractured crown of an upper central incisor is reported, a brief account of the treatment is given, and the possible mechanism of repair is discussed.
This study compared two different dental materials used in endodontic retrosealing procedures. One of these materials was a new low-temperature gutta-percha product, manufactured by the Hygenic Corporation, that involved an injection technique. The second of these materials was silver amalgam. Silver amalgam was selected because it has been recognized by many clinicians as the most effective apical sealing material. Two groups of ten recently extracted teeth were endodontically prepared with one of each of the materials being tested, and the effectiveness of these materials as sealants was determined by their ability to inhibit the penetration of methylene blue dye for a predetermined period of time through the apically sealed root tips. Preliminary results obtained indicated that, although these materials were not 100% effective in inhibiting the dye penetration, each was as effective as the other when evaluated by two observers following completion of the study as determined by its experimental design. No significant difference was exhibited between the amalgam group and the gutta-percha group. The leakage of the dye that was observed in each of the groups might have been caused by the ineffectiveness of, or the ineffective use of, the nail polish or cyanoacrylate used to coat all but the apically sealed tips of the endodonticalled prepared teeth. The function of these coating materials was to prevent penetration of the dye through the surface of the body of the root.(ABSTRACT TRUNCATED AT 250 WORDS)
Tissue healing was compared after apicectomy and filling of ferret lower canines with glass ionomer (Ketacfil) or gutta-percha/sealer (Tubliseal). Both materials provoked an inflammatory response after 7 days, but the response to glass ionomer was less severe. The response after 28 days was different. Mild inflammation related to the gutta-percha was still present, but no inflammation was found in relation to the glass ionomer. Bone infill was quite advanced in all specimens at 28 days but was more complete in the glass ionomer specimens, with intimate contact between the bone and cement.
This article discusses surgical treatment of a maxillary second premolar with three roots. Conventional endodontic therapy was not possible because of complete calcification of the root canal systems. Apicoectomies and retrograde amalgam filling were performed on all roots, resulting in successful treatment.
Gold leaf, made of fine and pure gold, is considered to be an alternative retrograde filling material. Apical surgery was performed in three cases with the use of gold leaves as filling material. The radiographs showed the excellent bone healing in the apical region. The operative procedure was easy with the use of gold leaf as filling material.
A right maxillary central incisor and an adjacent lateral incisor with a dens invaginatus were identified as requiring endodontic treatment. Both teeth were treated by nonsurgical means. Thirteen months postoperatively the central incisor showed evidence of periapical resolution, whereas the lateral incisor did not. The lateral incisor was then treated with apical curettage, an apicoectomy, and retrograde amalgam filling. One year after the surgical procedure the periapical tissues of both the lateral and central incisors exhibited satisfactory resolution. This case demonstrates that certain cases of dens invaginatus can be successfully treated only with a surgical approach.
Sixty-four teeth were treated by means of apicoectomy with retrograde gutta-percha filling with the use of new instruments that we devised. The new instruments consisted of a biangle explorer, angle reamers, and angle files. Operations with this technique showed a success rate of 95.3% (61/64 teeth). We conclude that our technique for apicoectomy with retrograde gutta-percha filling is not only simple in procedure, but also shows excellent results.
After an initial clinical test phase, the new method of replantation and transplantation with the use of aluminum oxide ceramic for retrograde root filling may be viewed as possible differential indications to other methods, even to apicectomy in the molar region. Twenty-three of the twenty-five replantations and eight of the nine transplantations may be regarded as having been successful. Contraindications are cases of wide apical foramina and oval or octagonal root canal cross sections.
In this investigation the effect of increasing the thickness of amalgam retrofilling on its sealing ability was studied and compared with the sealing ability of the laterally condensed gutta-percha with a sealer. The apical two thirds of the canals of 118 upper central incisors, filled with laterally condensed gutta-percha, were sealed with amalgam. Amalgam retrofills were also used to seal the apices of the roots of six teeth that had no other filling in their canals. The effectiveness of both techniques was determined by their ability to inhibit the penetration of methylene blue dye for the periods of 24 hours, 1 week, and 1, 3, and 6 months. At 24 hours both materials showed comparable sealing ability. However, the sealing ability of laterally condensed gutta-percha was significantly better than that of amalgam from the 1-week period until the end of the study. The depth of marginal penetration around both materials increased with time. The amount of the dye penetration increased acutely around amalgam, whereas its increase around gutta-percha was more uniform. At the end of the study, specimens retrofilled with amalgam exhibited total dye penetration that exceeded the full thickness of amalgam (6 mm) and spread into the root canal space. On the other hand, the mean value for marginal penetration of the dye around the laterally condensed gutta-percha was 2.6 mm at the end of the study. The present investigation proved beyond doubt that the use of any thickness of retrograde amalgam to seal the apex, with no other filling within the canal, invites failure.
In this study, the sealing behavior of apical (retrograde) amalgam fillings was evaluated with particular regard to the nature of the amalgam and the manipulative procedures used. With the use of an in vitro air pressure test, four high-copper alloys and one traditional composition low-copper alloy were selected for determination of their microleakage characteristics. Measurements were made on both normal and water-contaminated mixes, and the effect of mix plasticity was evaluated. In addition, both setting and postsetting dimensional changes of these alloys were determined. The results showed that amalgams differ in their ability to provide a complete seal and that low plasticity mixes result in greater microleakage. All zinc-containing alloys that were contaminated with water exhibited a postsetting or delayed expansion. However, only the low-copper alloy exhibited a delayed expansion of a magnitude that might induce root fracture.
The purpose of this case report is to demonstrate the importance of radiographic examination before suturing in periapical surgery. Corrective surgery was performed to eliminate excess amalgam left in the periapical region 6 years before. The result was favorable and demonstrates the importance of radiographic examination before flap repositioning and suturing. A roentgenogram should always be made before suturing and dismissal to verify the removal of amalgam particles and to confirm that no alteration is needed.
Retrograde root filling is, under certain conditions, the last chance to keep the functional ability of the teeth. With a new method using aluminum oxide ceramic pins for retrograde root filling, we believe that this aim may be achieved with greater success than with other methods. A success rate of 95% (out of a total of 164 teeth) after 1 year is the result of our investigation. The requirements of retrograde root filling are met in a high degree because of the excellent biologic compatibility of the ceramic material and the high marginal tightness with the use of conical pins.
Healing capacity after apicectomy was investigated in a randomized clinical study of 105 teeth apically sealed with either amalgam or glass ionomer cement. The results were evaluated clinically and radiographically after 1 year. The success rate was high for both materials: 91% for amalgam and 89% for glass ionomer cement. Contamination with moisture and blood adversely affected the outcome for both materials and was significantly more frequent in unsuccessful cases.