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PubMed1989

Evaluation of alternatives to chloroform in endodontic practice.

Chloroform is used in endodontics for plasticizing gutta-percha points and for facilitating removal of gutta-percha root canal fillings in need of re-treatment. Adverse health effects from exposure to chloroform have been reported, and to improve occupational health, it would be advantageous if a less hazardous solvent could replace chloroform. In this study, methylene chloride, methyl chloroform, tetrahydrofuran, xylol and eucalyptol were tested for their capacity to dissolve or soften gutta-percha points compared with chloroform. The effect of the test solvents was assessed by measuring the depth of penetration of a small indentor of fixed weight and shape into a gutta-percha disk covered with the test solution for various time periods. Chloroform showed the most pronounced effect, followed by methylene chloride, tetrahydrofuran, and methyl chloroform. When both occupational health and gutta-percha solvent capacity were considered, methyl chloroform seemed to be an interesting alternative to chloroform.

Chloroform↗
PubMed1989

Case of mistaken identity: periapical cemental dysplasia in an endodontically treated tooth.

A case of a patient with a history of root canal treatment and re-treatment and a persistent periapical radiolucency is reviewed. Following surgery, biopsy material was submitted and diagnosed as periapical cemental dysplasia (PCD). With careful diagnosis, PCD should be readily differentiated from endodontic pathosis, thus avoiding unnecessary root canal treatment. In this case, surgery was necessary to rule out other inflammatory disease or benign odontogenic entities.

Adult↗
PubMed1990

A systematic approach to preventing intracanal breakage of endodontic files.

This study was conducted to determine the effectiveness of a method to prevent intracanal breakage of endodontic files. An application schedule with a predetermined number of periods of use for K-files of all sizes was implemented at the author's clinic for a 3-year period. All the files used under this schedule were discarded after the predetermined periods of use, whether they displayed any deformity or not. During the 3-year period, 1933 files (53.7 per month) were discarded after preparation of 3269 root canals. There were 5 file fractures (0.1 per month) compared with 1.4 fractures per month before the adaptation of this system. The monthly average of files discarded during the 3-year research period was 53.7. Before the adoption of the trial system, the monthly average of discarded files was 76.5. It is concluded that the experimental system effectively reduced the incidence of intracanal instrument fractures and the total number of files consumed.

Dental Instruments↗
PubMed1990

Periapical bacterial plaque in teeth refractory to endodontic treatment.

It has recently been found that bacteria are able to survive and maintain an infectious disease process in periapical lesions of nonvital teeth. The purpose of this study was to examine the surfaces of root tips removed during surgical-endodontic treatment for the presence of microorganisms. A full thickness flap was reflected under strict surgical asepsis and the periapical lesions were enucleated and removed. About 2-3 mm of the root was cut off, rinsed in sterile saline and placed in 10% neutral-buffered formalin. Upon fixation, the root tips were dehydrated, air-dried and given an electrically conducting coat of gold in a vacuum evaporator. The root tips were then studied in a Jeol, JSM-U3 scanning electron microscope, usually operated at 20 kV. The root surfaces were covered with soft tissue, except at the apex of the roots, where a continuous, smooth and structureless coating was seen, apparently adjacent to the apical foramen. At higher magnification a variety of bacterial forms were recognized in the smooth coating. A bacterial plaque was observed in irregularities of the surfaces between fiber bundles and cells and in crypts and holes. The bacteria were held together by an extracellular material and the plaque was dominated by cocci and rods. Fibrillar forms were recognized as well, often with cocci attached to their surfaces.

Bacteria↗
PubMed1990

Microleakage of IRM used to restore endodontic access preparations.

The effect on microleakage of varying the powder-to-liquid ratio (P/L) of IRM used to restore endodontic access preparations was evaluated. Crowns of noncarious, nonrestored extracted human teeth were used in this study. Microleakage was measured using a fluid filtration technique prior to access preparation to obtain control measurements. After access preparation, IRM restorations were placed using P/L of 2, 3, 4, 5, and 6 g/ml, using the manufacturer's recommended dispensing scoop and dropper, and using 2 P/L in a new capsulated IRM delivery system (IRM CAPS). Microleakage measurements were made after various time intervals and after thermal stress. The results indicated that the lower P/L provided the best seals. All groups demonstrated significant microleakage measurements after thermal stress. Significantly greater microleakage measurements were obtained with the P/L of 6 g/ml and the manufacturer's recommended dispensing scoop and dropper. A P/L of 2 g/ml demonstrated less microleakage than the other groups tested.

Dental Leakage↗
PubMed1990

In vivo fractures of endodontically treated posterior teeth restored with enamel-bonded resin.

The cumulative survival rate of 190 endodontically treated posterior teeth were assessed in a retrospective study; all teeth had an MO/DO or an MOD cavity restored with a composite resin without cuspal overlays after previous acid-etching of the enamel. In contrast to our previous study on endontically treated posterior teeth restored with amalgam, the survival rate of the MOD resin-restored teeth was equal to that of MO/DO teeth. Teeth restored with a light-activated resin had a much lower survival rate than teeth restored with a chemically-activated material, the cause presumably being that the light-activated resins were insufficiently irradiated. Nearly 25% of the teeth had been restored with a microfilled resin for anterior use and these teeth had a lower survival rate than had teeth restored with a macrofilled or hybrid resin. It was also found that a beveling technique did not decrease the fracture rate while the use of an intermediate layer of low-viscosity resin resulted in a significant improvement.

Bicuspid↗
PubMed1990

Relationship of intracanal medicaments to endodontic flare-ups.

The purpose of the study was to compare the effect of three intracanal medicaments on the incidence of post-instrumentation flare-ups. All teeth were instrumented to a predetermined minimum size using a 0.5% solution of sodium hypochlorite as the irrigant. Formocresol, Ledermix, and calcium hydroxide were placed in strict sequence irrespective of the presence or absence of symptoms or radiographic signs of apical periodontitis. The patients were given written post-operative instructions and a prescription for 600 mg ibuprofen to be taken if mild to moderate pain developed. If severe pain and/or swelling developed the patient was instructed to call the office immediately and was considered to have had a flare-up. Twelve flare-ups occurred in teeth with radiographic signs of apical periodontitis; none in teeth without periapical radiolucencies. Six of the twelve flare-ups occurred in retreatment cases and the other six occurred in teeth without previous endodontic treatment. No significant difference was found in the flare-up rate among the three intracanal medicaments.

Acute Disease↗
PubMed1991

Prevalence of apical periodontitis and results of endodontic treatment in middle-aged adults in Norway.

The present investigation based on a random sample of 50-year-olds from Oslo, Norway, indicate a prevalence of apical periodontitis of 3.5% of the teeth present. Forty-four percent of the endodontically treated teeth presented with a radiographically detectable periapical radiolucency. There was a statistically significant negative correlation between the quality of the root fillings evaluated and prevalence of apical periodontitis.

Humans↗
PubMed1991

A study of endodontically apexified teeth.

This study was undertaken to determine the clinical and radiographic success of calcium hydroxide apexification in a group of 48 patients requiring endodontic therapy because of pulpal necrosis prior to root-end closure. The study examined tooth number, etiology of pulpal necrosis, age, sex, size of root-end opening, size of radiolucency, crown discoloration, interappointment symptoms, and total treatment time from initial instrumentation to completion of apexification. Apexification required an average of 1 year +/- 7 months. A statistically significant relationship was found between: the presence of a radiolucency and development of interappointment symptoms (p less than 0.04); and the size of apex opening and development of interappointment symptoms (p less than 0.02). If symptoms did develop, apexification was delayed an additional 5 months when compared to patients who did not have symptoms. Calcium hydroxide apexification was found to be statistically highly successful regardless of the clinical variables encountered.

Age Factors↗
PubMed1991

Conservative management of a combined endodontic-orthodontic lesion.

Pulp injury may occur during orthodontic tooth movement particularly in previously traumatized teeth. Therefore the management of such cases requires specific therapeutic considerations. An extensive periradicular lesion was detected in an orthodontically treated maxillary incisor with an uncertain history of a previous traumatic incident. Conservative endodontic therapy resolved the periradicular lesion thus enabling the orthodontic treatment to continue uneventfully. It is essential to closely monitor the patients undergoing orthodontic treatment and those who are in retention, particularly if a history of trauma is suspected.

Adolescent↗
PubMed1992

Effectiveness of different endodontic files for preparing curved root canals: a scanning electron microscopic study.

In this study, the effect of using four endodontic files from different manufacturers on the final shape of 80 prepared curved root canals of extracted single-rooted teeth were comparatively analyzed with scanning electron microscopy. The instruments tested were Tri-files, Flex-R files, Flexofiles and conventional K-type files. All files were used with in and out linear movements with a circumferential motion starting with a size 15 file. Final preparation of the apical thirds was performed with a size 30 file. Shaping effectiveness of the tested files was qualitatively evaluated in terms of respect for conservation of the apical constriction and the presence or absence of ledging, specially in the apical third of the root canals. A well-centered and tapered preparation without apical transportation or ledging was detected when Tri-file or Flex-R files were used. Conversely, the use of Flexofile or conventional K-type files resulted in frequent alteration of the initial pattern of the root canals, showing an hour-glass preparation with alteration of the apical constriction and ledge formations.

Dental Cavity Preparation↗
PubMed1993

Antibacterial effects of various endodontic irrigants on selected anaerobic bacteria.

This study was undertaken to determine the antibacterial effects of various endodontic irrigants against six selected anaerobic bacteria. The organisms were mixed separately with dilutions of each of the irrigants in tubes containing fluid thioglycollate broth and allowed to remain in contact for specific time periods before being evaluated for growth. Of the six irrigants tested, chlorhexidine appeared to be the most effective antibacterial substance. Hydrogen peroxide, sodium hypochlorite and REDTA were less effective while the calcium hydroxide and saline solutions proved to be totally ineffective.

Bacteria, Anaerobic↗
PubMed1993

Influence of endodontic materials on the bonding of glass ionomer cement to dentin.

We assessed the bond strength of a glass ionomer cement to dentin that had been in contact with different materials. Flat dentin surfaces in freshly extracted human teeth were covered for 48 h with a 1 mm layer of a variety of materials that are used for temporary filling or root canal sealing. The products were mechanically removed and a glass ionomer cement cylindrical specimen bonded to the dentin surface. After 7-days immersion in 37 degrees C water the tensile bond strength was tested. The results were compared with those on dentin surfaces not in contact with any endodontic material. The statistical analysis showed that none of the materials used interfered with the bonding of the glass ionomer to dentin.

Analysis of Variance↗
PubMed1993

Tactile sensitivity of three endodontic instrument handles.

Three currently available endodontic instrument handles, introduced over the past four decades, were investigated for tactility. Larger handles have been promoted to overcome sensitivity loss from wearing gloves. Smaller handles were preferred in this experiment. While the largest diameter handle appeared to give enhanced tactility, significance was not reached in any of the tests.

Dental Cavity Preparation↗
PubMed1995

Endodontic management of mandibular lateral incisor fused with supernumerary tooth.

In this article we report a case of a mandibular lateral incisor in which 3 separate root canals were located. Clinical and radiographic examinations suggested that fusion had occurred between the mandibular incisor and a supernumerary tooth. The endodontic management of the tooth is described, and repair of an apical periodontitis had occurred after 9 months.

Adolescent↗
PubMed1995

Importance of anatomic variables in endodontic treatment outcomes: case report.

Surgical endodontic treatment was performed after a large periradicular lesion failed to resolve following nonsurgical intervention. The subsequent periradicular surgery resulted in healing with scar formation. Assessment of the resected root apex revealed a complex anatomy. The ramifications of these anatomical findings and the periradicular tissue response in healing are discussed relative to prognosis and ultimate treatment outcomes.

Adult↗
PubMed1996

Taper and stiffness of sonic endodontic files.

The aims of this investigation were to measure the thickness and taper of the different files (Heliosonic 15-40. Shaper 15-40 and Rispisonic 1-6) supplied with the MM1500 sonic instrument and relate this to their stiffness. The diameter of the files (n = 5 for each file type) was measured at 2 mm intervals using light microscopy and a calibrated graticule (mag x 120). A model system was developed for the stiffness testing. The file was held 3 mm from its tip and the load in g required to produce a 45 degrees deflection of the file was recorded. Measurements of file diameter showed that the width of the Heliosonic and Shaper increased in a linear manner and that the file taper was the same for increasing file sizes in accordance with ISO recommendations. The Rispisonic files however showed differing widths and degrees of taper which were not consistent with ISO standards. The stiffness testing results showed the Heliosonic files to be less flexible than the Rispisonic and Shaper files for all sizes (ANOVA, p < 0.001). The differences in stiffness of the Heliosonic, Shaper and Rispisonic files were due to the variation in cross sectional area of metal. In conclusion sonic endodontic files do not have the same taper and stiffness.

Analysis of Variance↗
PubMed1996

Impact resistance of crowned endodontically treated central incisors with internal composite cores.

The impact fracture resistance of crowned endodontically treated teeth with composite cores but without posts, that had either no coronal dentin remaining or a 1 mm dentin collar was compared to that of unrestored caries free teeth. The teeth were struck mid-labially to simulate a common trauma situation using a pendulum device and fracture resistance determined by calculation of absorbed energies. No significant difference was found between the intact teeth and the crowned root treated teeth with composite core and a 1 mm dentin collar. Crowned root treated teeth with a composite core but no coronal dentin had significantly reduced fracture resistance (p < 0.05). Teeth with the dentin collar mainly fractured obliquely from the buccal crown margin to a point coincident with the simulated alveolus, representing a clinical situation which would allow retention rather than extraction of the tooth.

Crowns↗