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PubMedDate not supplied

[Radiographic and histological study of a case of apexification in a human molar].

A case of apexification in a lower right second molar is described. Radiographs demonstrate apical closure with a different morphological pattern from that of the lower left second molar. Following extraction, after 15 months, serial histologic sections show calcified tissue obturating the apical foramen, well adapted to the initial dentin and cementum walls. Inside some small areas containing connective tissue with capillaries can be observed. The histologic and radiographic observations indicate that apical closure occurs as a result of differentiation of periodontal apical cells.

Adolescent↗
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↗
PubMed1993

An in vitro study of the quality of root fillings in teeth obturated by lateral condensation of gutta-percha or Thermafil obturators.

The aim of this in vitro study was to assess the quality of root canal obturation and degree of linear apical dye penetration in teeth root filled with either laterally condensed gutta-percha or Thermafil obturators. A total of 150 teeth with single roots were included in the study. All canals were prepared using a standard step-back technique with anticurvature filing. Radiographs taken of the teeth to show the maximum degree of canal curvature were then exposed and the angle, radius and position of curvature determined. This information about the canals, together with their working length and diameter at end-point, was used to divide the teeth into two experimental and two control groups. A total of eight teeth were excluded because of technical difficulties, 65 were filled with Thermafil obturators, 63 were filled with laterally condensed gutta-percha whilst 14 teeth remained unfilled and acted as controls. Following obturation, the teeth were radiographed in two planes and the technical quality of fill assessed on a four-point scale. All access cavities were then sealed and the teeth immersed in dye for 48 h before being split longitudinally. Linear dye penetration via the apical foramen was then assessed. Canal obturation with Thermafil obturators (0.7 min) was significantly quicker (P < 0.001) than lateral condensation (6.4 min). Apical extrusion of sealer and gutta-percha occurred significantly more often with Thermafil obturators but there was little difference in the technical quality of the fillings and no significant difference in dye penetration. Under the conditions of this study. Thermafil obturators proved a satisfactory alternative to lateral condensation of gutta-percha.

Chi-Square Distribution↗
PubMed2004

MTA obturation of pulpless teeth with open apices: bacterial leakage as detected by polymerase chain reaction assay.

Polymerase chain reaction (PCR) followed by reverse dot blot was used to detect Enterococcus faecalis leakage through mineral trioxide aggregate (MTA) apical obturations of pulpless teeth with open apices. Prepared root canals of 34 extracted teeth were given a standard apical foramen opening and received orthograde apical obturation with MTA; three groups had 1-, 2-, or 3-mm thickness. Sterilized specimens were inoculated with E. faecalis and incubated in sterile medium. DNA extracted from the specimens was amplified by polymerase chain reaction, which yielded a specific segment of E. faecalis 16S rDNA. On day 10 of incubation, no specimens were contaminated. On day 50, almost 17% of specimens were contaminated, with no statistically significant difference between groups (Chi-square = 0.48; df = 2; p = 0.787). Therefore, MTA provides an adequate seal even in cases of orthograde apical obturation of pulpless teeth with open apices.

Aluminum Compounds↗
PubMed1994

Root canal ramifications in mandibular incisors and efficacy of low-temperature injection thermoplasticized gutta-percha filling.

The frequency of root canal ramifications in mandibular central and lateral incisors and the efficacy of low-temperature injection thermoplasticized gutta-percha in filling these canals were determined, and any evidence of apical leakage was evaluated. Forty mandibular incisors were instrumented; the external root surfaces were coated with nail polish except for the apical foramen, and the teeth were obturated with injection of gutta-percha and sealer. The teeth were centrifuged in India ink for 20 min at 3000 rpm before being suspended in ink for 30 days and then cleared. Under a stereomicroscope at x30 magnification, 62.5% of the teeth showed a simple main canal, 15.0% a bifurcated canal, 7.5% a lateral canal, and 25% accessory canals. Except for the two lateral and three accessory canals, the thermoplasticized gutta-percha was found to be highly effective in filling the root canal ramifications as well as the main canals. The extent of ink penetration was limited to the main canal in seven teeth showing leakage. However, the reliability of conventional apical leakage assessment by only exposing major foramen to dye needs to be reexamined with regard to the potential presence of multiple foramina on the root surfaces.

Adult↗
PubMed1994

An in-vitro evaluation of the influence of temperature of plasticization on the sealing ability of Thermafil.

The effect of temperature of plasticization on the sealing ability of Thermafil obturators was evaluated. Forty-eight canals in roots of extracted human mandibular molar teeth were divided into four groups of 12. The root canals had curvatures of less than 25 degrees, as determined using the Schneider technique. Four canals were used as positive and negative controls. All canals were prepared using a step-back technique to size 30 at the working length. Roth's sealer was used in all canals. In one group the Thermafil obturators were thermoplasticized in an open flame, as recommended by the manufacturer. In the remaining three groups the obturators were thermoplasticized by immersion in water-baths maintained at constant temperatures of 60, 75 and 90 degrees C respectively. After immersion in Indian ink, the teeth were cleared and the depth of penetration of dye through the apical foramen was measured. In all specimens there was extrusion of sealer and sometimes gutta-percha beyond the apical stop. Sometimes, there was leakage up to the apical stop but not beyond. In view of this the measurements were divided into leakage from the apical foramen to the apical stop and from the apical stop coronally. It was found that in the zone between the apical foramen and the apical stop the Thermafil obturators plasticized at 60 degrees C produced a significantly better seal than those obturators plasticized in an open flame (P < 0.05). In the zone coronal to the apical stop there were no significant differences in leakage between the groups.

Dental Leakage↗
PubMedDate not supplied

[Pain after obturation of the root canals].

This study was conducted to determine the incidence and degree of postobturation pain and to determine whether there is a significant relationship between pain and any clinical factors or conditions existing before, during, or at the completion of the root canal therapy. Of the 239 patients included in the study, 203 (84.9%) had no pain during the first 48 hours, 26 (10.9%) had slight pain, 5 (2.1%) had moderate pain and 5 (2.1%) had severe pain. Thirty days after obturation 3 patients had slight pain, 2 patients moderate pain and only one patient had severe pain. Meanwhile, we had to repeat the root canal therapy in 3 cases. Significant relationships were found between postobturation pain and obturation of the root canal past the apical foramen.

Adolescent↗
PubMed2006

Aspergillus mycetoma of the maxillary sinus secondary to overfilling of a root canal.

In nonimmunocompromised patients aspergillosis of the paranasal sinuses is a relatively rare disease. Root canal treated teeth with overextension of the root canal sealer or solid materials such as gutta-percha or silver cones into the sinus might be the main etiological factor for aspergillosis of the maxillary sinus in healthy patients. Root-filling materials based zinc oxide-eugenol is considered to be a growth factor for aspergillus. Aspergillus fumigatus needs heavy metals such as zinc oxide for proliferation and metabolism. Prognostic and histological studies showed that instrumentation and obturation should not extend beyond the apical foramen. When the sealer and/or gutta-percha is extruded within the sinus, this produce an inflammatory reaction and then Aspergillus growth. We report one case of healthy 60-yr-old male with overextension of root canal sealer in maxillary sinus. After surgical procedure, microscopic examination revealed aspergillosis. Overextension into the maxillary sinus with root canal cements has to be avoided.

Aspergillosis↗
PubMed2000

Apical terminus location of root canal treatment procedures.

The apical termination of root canal treatment is considered an important factor in treatment success. The exact impact of termination is somewhat uncertain; most publications on outcomes are based on retrospective findings. After vital pulpectomy, the best success rate has been reported when the procedures terminated 2 to 3 mm short of the radiographic apex. With pulpal necrosis, bacteria and their byproducts, as well as infected dentinal debris may remain in the most apical portion of the canal; these irritants may jeopardize apical healing. In these cases, better success was achieved when the procedures terminated at or within 2 mm of the radiographic apex (0 to 2 mm). When the therapeutic procedures were shorter than 2 mm from or past the radiographic apex, the success rate for infected canals was approximately 20% lower than that when the procedures terminated at 0 to 2 mm. Clinical determination of apical canal anatomy is difficult. An apical constriction is often absent. Based on biologic and clinical principles, instrumentation and obturation should not extend beyond the apical foramen.

Dental Pulp Cavity↗
PubMed1994

A laboratory study of root fillings in teeth obturated by lateral condensation of gutta-percha or Thermafil obturators.

The aim of this in vitro study was to assess the quality of root canal obturation and degree of apical dye penetration in teeth root-filled with either laterally condensed cold gutta-percha or Thermafil obturators. A total of 144 extracted teeth with single roots were included in the study. All canals were prepared with a standard technique using a sonic handpiece with copious irrigation. Radiographs taken of the teeth to show the maximum degree of canal curvature were then exposed and the angle, radius and position of curvature determined. This information about the canals, together with their working length and diameter at end-point was used to divide the teeth into two experimental and two control groups. A total of 71 teeth were filled with Thermafil obturators, 69 with lateral condensation while four teeth remained unfilled and acted as controls. Following obturation, the teeth were radiographed in two planes and the technical quality of fill assessed on a four-point scale. All access cavities were then sealed and the teeth immersed in dye for 48 h before being split longitudinally. Linear dye penetration via the apical foramen was then assessed. In both straight and curved canals obturation with Thermafil obturators was significantly quicker (P < 0.001) then lateral condensation. Apical extrusion of gutta-percha occurred significantly more often in straight canals obturated with lateral condensation (P < 0.005) but there was no difference in curved canals. There was little difference in the radiographic quality of fill in the apical halves of the root fillings but Thermafil obturators were significantly better in the coronal halves when viewed from the proximal.(ABSTRACT TRUNCATED AT 250 WORDS)

Chi-Square Distribution↗
PubMed1991

[Prototype of an instrument for retrograde obturation].

Several instruments to carry and put the silver amalgam into de apical foramen for it's posterior condensation without spreading this material over the periodontal tissues, bone and adyacent mucosa, has been designed along the years. This article describes an easier and cheaper way to make an endodontic amalgam carrier by the adaptation between en 18 and 22 mm intravenous catheters into disposable syringes by the use of autopolymerizable acrilic, given the dentist the option of making a very easy instrument, at a low cost which can be used as a commercial endodontic amalgam carrier as well.

Acrylic Resins↗
PubMed1999

A method of adapting gutta-percha master cones for obturation of open apex cases using heat.

CLINICAL TECHNIQUE: It is generally accepted that the success of root-canal treatment is mainly dependent on the proper cleaning, shaping and hermetic obturation of root canals. Obturation of the root canal is of importance as 60% of endodontic failures are attributable to incomplete obliteration of the root-canal system. The clinical application of many obturation techniques used today demands the preservation of the natural apical construction or the preparation of an artificial equivalent during chemo-mechanical preparation. However, in clinical practice there are cases where the apical foramen is wide because of over-instrumentation, root-end resection during periradicular surgery, root resorption or because the apex of the root is incompletely formed. Thus the preparation of an artificial apical stop is very difficult to achieve. It is a common experience that performing usual gutta-percha condensation techniques in such canals often results in overfilling and therefore special obturation techniques are needed. Some clinical cases of teeth with wide apical foramen treated by a special obturation method are presented in this paper. In this method the end point of the primary gutta-percha cone is elasticized with a heated instrument and inserted into the root canal to record the internal morphology of the apical portion.

Gutta-Percha↗
PubMed1983

Spectrophotometric analysis of microleakage in the fine curved canals found in the mesial roots of mandibular molars.

Mesial roots from forty human mandibular first and second molar teeth were randomly assigned to two groups and obturated with laterally condensed gutta-percha or silver cones. Each group was divided into two subgroups. The first subgroup for each group consisted of specimens that had two canals with a common foramen. The second subgroup consisted of specimens with two canals and separate foramina. All specimens were obturated and exposed to 2 percent methylene blue dye at 37 degrees C. for a period of 30 days. A dye-recovery, spectrophotometric method was used to evaluate the apical microleakage. Results indicated no statistically significant difference in leakage between the groups or subgroups.

Dental Leakage↗
PubMed1985

Endodontic treatment for traumatized immature permanent incisors.

Endodontic treatment of traumatized permanent incisor teeth in young children may often present special problems not encountered in the adult patient. They are determined primarily by (a) the pulpal response of an immature tooth to trauma, and (b) the mechanical difficulties encountered when attempts are made to obturate the root canal of a tooth with a widely patent apical foramen. The most appropriate intermediate and long term treatment will only be possible in individual cases if the tooth response is continuously monitored from the time of the initial injury to the point where the definitive treatment has been judged as successful. Thus at each attendance, clinical examination including pulp testing should be supplemented by the taking of routine periapical radiographs. Essentially three main pulpal responses are possible: i) Recovery ii) Calcification iii) Necrosis. The outcome in each case may be influenced by treatment procedures.

Child↗
PubMed2000

Evaluation of apical sealing of three endodontic sealers.

AIM: The apical sealing ability of three different endodontic sealers was evaluated in extracted teeth using dye penetration. METHODOLOGY: The root canals of 99 extracted human maxillary central incisors were prepared sequentially 2 mm beyond the apical foramen with a size 55 Nitiflex file. The teeth were divided into three experimental groups and obturated by lateral condensation of cold gutta-percha and one of the following sealers: group 1, zinc oxide and eugenol sealer (Fill Canal); group 2, glass ionomer sealer (Ketac-Endo) and group 3, epoxy resin sealer (AH Plus). The teeth were covered with nail varnish to within 1 mm of the apical foramen and immersed in 2% methylene blue in a reduced pressure environment for 24 h. After this period, the teeth were washed and cut longitudinally for apical leakage analysis. The values were obtained from the maximum depth of leakage as well as the average between the maximum and minimum values observed for each group. RESULTS: Statistical evaluation of the results showed no significant difference in the leakage between Fill Canal and Ketac-Endo (P > 0.05). Leakage with AH Plus was significantly less (P < 0.01) than with the other sealers. CONCLUSIONS: All three sealers allowed some leakage to occur. Leakage with AH Plus was significantly different than with Fill Canal or Ketac-Endo.

Barium Sulfate↗
PubMed2005

An evaluation of .06 tapered gutta-percha cones for filling of .06 taper prepared curved root canals.

AIM: To compare the area occupied by gutta-percha, sealer, or void in standardized .06 tapered prepared simulated curved canals and in mesio-buccal canals of extracted maxillary first molars filled with a single .06 gutta-percha point and sealer or lateral condensation of multiple .02 gutta-percha points and sealer. METHODOLOGY: Simulated canals in resin blocks with either a 30 degrees curve and radius of 10.5 mm (n = 20) or a 58 degrees curve and 4.7 mm radius (n = 20) and curved mesio-buccal canals of extracted maxillary first molars (n = 20) were prepared using .06 ProFiles in a variable tip crown-down sequence to an apical size 35 at 0.5 mm from the canal terminus or apical foramen. Ten 30 degrees and 58 degrees curved resin canals and 10 canals in the extracted teeth group were obturated with .02 taper gutta-percha cones and AH 26 sealer using lateral condensation. The time required to obturate was recorded. The remaining canals were obturated with a single .06 taper gutta-percha cone and AH 26 sealer. Excess gutta-percha was removed from the specimens using heat and the warm mass vertically condensed. Horizontal sections were cut at 0.5, 1.5, 2.5, 4.5, 7.5 and 11.5 mm from the canal terminus or apical foramen. Colour photographs were taken using an Olympus 35 mm camera attached to a stereomicroscope set at x40 magnification, and then digitized using a flatbed scanner. The cross-sectional area of the canal contents was analysed using Adobe PhotoShop. The percentage of gutta-percha, sealer or voids to the total root canal area were derived and data analysed using unpaired Student's t-test and the Mann-Whitney U-test. RESULTS: In the 30 degrees curved canals the levels had between 94 and 100% of the area filled with gutta-percha with no significant difference (P > 0.05) between the lateral condensation and single cone techniques. In the 58 degrees curved canals the levels had 92-99% of the area filled with gutta-percha, with the single cone technique having significantly (P < 0.05) more gutta-percha fill at the 2.5 mm level only. In the mesio-buccal canals of the teeth the levels had between 72 and 96% of the area filled with gutta-percha with no significant difference (P > 0.05) between the lateral condensation and single cone technique. The time for obturation was significantly (P < 0.05) greater for lateral condensation compared with the single cone technique in all groups. CONCLUSIONS: The .06 taper single cone technique was comparable with lateral condensation in the amount of gutta-percha occupying a prepared .06 tapered canal. The .06 single cone technique was faster than lateral condensation.

Dental Pulp Cavity↗
PubMed2002

Effects of Nd:YAG and Er:YAG lasers on the sealing of root canal fillings.

OBJECTIVE: The ability of the laser irradiation to promote the cleaning and disinfection of the radicular canal system has become this type of treatment in a viable and real alternative in endodontics. The purpose of this study was to evaluate the apical marginal sealing of root canal fillings after the irradiation with the laser of Nd:YAG or of Er:YAG. MATERIALS AND METHODS: Forty-two human, extracted single-rooted teeth had their crowns sectioned and the root canals prepared with a no. 70 K-file. Then, they were dried and divided into three groups according to canal wall treatment: group 1: the canals were filled with EDTA for 3 min, followed by irrigation with 1% sodium hypochlorite solution; group 2: the canal walls were irradiated with Nd:YAG laser; and group 3: the canal walls were irradiated with Er:YAG laser. Afterwards, the root canals were obturated by the lateral condensation technique. The roots were externally waterproof, except in the apical foramen and immersed in 2% methylene blue aqueous solution during 48 hours. RESULTS: The results showed that the largest infiltrations happened in the group 3-Er:YAG (7.3 mm), proceeded by the group 1-EDTA (1.6 mm) and by the group 2-Nd:YAG (0.6 mm). The group Er:YAG differed statistically of the others (p < 0.05). CONCLUSION: It was concluded that the Er:YAG laser intracanal irradiation previously to the root canal filling must be used with caution until future research is define the best parameters for it's use.

Humans↗