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[Irrigants and intracanal medicaments in endodontics].

Modern, biologic root canal therapy should be performed with suitable irrigating solutions and intracanal medicaments. The goal of endodontic treatment is to free the treated tooth from infection and prevent reinfection as thoroughly as possible by means which do not put the organism at risk. In this review of the literature, an evidence-based concept for irrigation and medication of root canal systems is presented. Irrigants and medicaments are discussed with respect to their antimicrobial, tissue-dissolving and endotoxin-decontaminating capacity in relation to their systemic toxicity. Recent findings pertaining to interactions of root canal medicaments and irrigating solutions and their impact on a sound irrigating and medicating concept are discussed.

Anti-Infective Agents, Local↗

Why endodontic retreatment is less successful than primary root canal therapy.

Endodontic retreatment has been proven less effective than conventional root treatment. Factors dictating this include difficulty in accessing the root canal system in retreatment cases, problems in negotiating a highly resistant micro flora and unfavourable anatomy. Patients should, therefore, be counselled on the possibility of failure necessitating surgical procedures and possibly extraction. However, despite these mitigating factors success is still a realistic goal in the majority of cases.

Dental Restoration Failure↗

[Determination of tooth length in endodontics].

Determination of the exact tooth length and subsequent working length remains a corner stone of proper endodontic treatment. Up to now, no system has proven to provide the exact location of the apical constriction under all circumstances. Several possibilities of determining tooth length are discussed. Factors influencing the outcome of the different techniques are described. A simple and rather accurate way for calculating tooth length on X-rays is elaborated. Apparently, electronic devices are becoming increasingly accurate, and may become a challenge for the radiographic tooth length determination. Actually, dentists have most of all to rely on X-rays for tooth length determination.

Humans↗

Cermet reinforcement of a weakened endodontically treated root: a case report.

Many clinical applications have been recommended for glass-cermet cement because of its improved properties compared to the original glass-ionomer cements. It has also been accepted as a dentinal substitute that can strengthen teeth. In this paper, an additional clinical application for glass-cermet cement, the reinforcement of weakened endodontically treated roots, is suggested. This technique is in keeping with the trends of tooth conservation and the use of an adhesive restorative material in the restoration of severely damaged teeth by a conservative approach.

Cermet Cements↗

Can we fulfil even the basics of endodontic therapy?

Micro-organisms and lipopolysaccharides (LPS) are involved in inducing periapical inflammation. Therefore, it is important to eliminate them from the complex root canal system and seal the endodontic space as accurately as possible. This is possible with a combination of the following: instrumentation of the canal, eventually with new, motor driven instruments, abundant rinsing with NaOCl, dressing preferably with Ca(OH)2, sealing the root canal and incorporating the permanent restoration within three months after root canal filling to avoid reinfection.

Humans↗

Fiber post adhesion to resin luting cements in the restoration of endodontically-treated teeth.

Fiber posts are widely used in the restoration of endodontically treated teeth. Scientific evidence demonstrates that the mechanical performance of teeth restored with fiber posts in combination with resin luting cements is improved with respect to metallic post restorations. The post is cemented inside the root canal using low modulus elastic polymer resins. In this study, the mechanical resistance of four different post-cement systems was assessed by means of a micro-mechanical pull-out test assisted by a simulation using the finite element methodology. This in vitro test is specifically designed to accurately characterize the post-cement interface. The results show no significant difference among the adhesion properties of the various types of post-cement systems used.

Analysis of Variance↗

Post design and the optimally restored endodontically treated tooth.

The basics for the sound restoration of endodontically treated teeth have not changed despite the advent of new materials and techniques. Adequate retention for posts and crowns, resistance to cyclic shearing forces, minimal insertional stresses, and even distribution of functional stresses are prime requirements that cannot be compromised without jeopardizing the longevity of the final restoration.

Crowns↗

Endodontic retreatment: explaining success rates and illustrated cases.

Endodontic retreatment is less successful than conventional root treatment. Factors governing this include difficulty in accessing the root canal system in retreatment cases, problems in negotiating a highly resistant microflora and unfavourable anatomy. However, despite these mitigating factors success is still a realistic goal in the majority of cases.

Dental Instruments↗

Effect of endodontic agents on cytotoxicity induction by sodium fluoride.

We investigated six endodontic agents for their ability to induce apoptosis and modify the cytotoxic activity of NaF against human squamous cell carcinoma (HSC-2) and human promyelocytic leukemia (HL-60) cell lines. Four Group I agents (Form Cresol, Cam Phenic, Eucaly Soft, GC Fuji Varnish), but not two Group II agents (Caviton, Canals-N), induced internucleosomal DNA fragmentation and activated caspases 3, 8 and 9 in HL-60 cells. Only Cam Phenic among these agents additively enhanced the cytotoxic activity of NaF in HSC-2 and HL-60 cells. Form Cresol and Cam Phenic reduced the glucose consumption at early stage, possibly due to their toxic effect. Amino acid analysis suggests that the higher cytotoxicity of Form Cresol may be derived, at least in part, from its oxidizing action.

Apoptosis↗

Radicular cyst associated with endodontically treated deciduous tooth: a case report.

This article presents a case report of radicular cyst associated with an endodontically treated deciduous second molar causing displacement of the permanent successor, with accompanying buccal expansion. Cystic sac was removed surgically along with the involved tooth under general anesthesia. Healing was uneventful. Histopathologically the cystic sac was consistent with the features of radicular cyst. Unusual amorphous, eosinophilic, atubular material incorporated within the cystic epithelium was observed.

Child↗

Long-term observation of endodontic surgical intervention to treat root perforation and apical periodontitis: a case report of an amalgam-restored tooth.

A case of crestal root perforation and periapical lesion in a maxillary left lateral incisor is reported. Teeth with root perforation present technical difficulties in their clinical management because of their complex defects. In the present case, surgical endodontic treatment was chosen. The apical and lateral pathology was curetted, the tooth root was resected, and a retrograde root restoration of amalgam was placed in a root-end cavity and perforation site. A 10-year follow-up clinical and radiographic examination showed an asymptomatic tooth with osseous healing proceeding.

Adult↗

[Postobturation pain associated with endodontic treatment].

Postobturation pain of different origin after endodontic treatment was studied in 100 patients after treatment of 151 teeth with filling of 264 channels. 34.4% patients complained of pain. The incidence and intensity of pain were scored. Postobturation pain clearly depended on the number of treatment sessions, number of channels filled in one tooth, and excessive filling "beyond the apex". The method of "crown down" preparation using completely rotating profile instruments and GT rotary files proved to be most effective as regards prevention of postoperative pain.

Adult↗

Endodontic treatment of reimplanted avulsed teeth.

By using an appropriate storage system such as a Save-A-Tooth and having knowledge of appropriate treatment options, an avulsed tooth can be reimplanted with the greatest chance of success. Using the different categories of avulsed teeth discussed in this article as a guide, the clinician can determine the most applicable course of treatment. If endodontic treatment is based on the clinical condition of the pulp and PDL cells, the chance of success following reimplantation is improved.

Follow-Up Studies↗

Post and core restoration of endodontically treated teeth.

This review discusses the multifactorial nature of tooth strength and concludes that endodontic treatment alone does not weaken intact anterior teeth. Therefore, restoration of such teeth does require post placement or full-coverage restorations. Posterior teeth, however, require full-coverage protection. It appears that the full-crown restoration "covers up" some of the disadvantages or deficiencies of some post and core restorations. The literature supports the use of the amalgam coronal-radicular core or the post-retained amalgam core, as well as the composite post and core. The literature does not support use of the glass ionomer post and cores. As to which post system to select, the literature indicates that the parallel-sided, serrated Para-Post or Para-Post plus is a safe post when seated passively in the canal and cemented with zinc phosphate cements or composite resin cement, or when retained with amalgam. Dentin-retained, stress-producing posts such as the threaded posts should be avoided.

Carbon↗

[Clinical and bacteriological studies with metronidazol in endodontic therapy (author's transl)].

Metronidazol was employed in the endodontic treatment of 200 gangrenous teeth, with symptoms of acute and chronic periodontitis. In 50 cases aerobic and anaerobic microbiological cultivations have been performed. The number of the necessary treatments was less, symptoms of irritation in the periapical region could not be observed. The favourable clinical and microbiological results in the course of the Metronidazol treatment point to the role of the anaerobic microorganisms in connection with the inflammatory symptoms of the gangrenous pulp.

Aerobiosis↗