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PubMed2004

An evaluation of sealing ability of endodontic materials as root canal sealers.

An in vitro dye leakage study was carried out to compare the apical microleakage of vitapex (calcium hydroxide based paste) when used with single gutta percha cone with that of dentalis KEZ (calcium hydroxide and zincoxide eugenol based sealer) and zincoxide-eugenol sealer when used with laterally condensed gutta percha obturation technique. One hundred single rooted human anterior teeth were instrumented and randomly divided into three experimental groups of 30 teeth each and two control groups of 5 teeth each. Teeth in the first group were obturated using a single master gutta percha cone and vitapex as root canal sealer and those of second group were obturated with laterally condensed gutta percha using dentalis KEZ as sealer. Third experimental group was filled with laterally condensed gutta-percha using zinc-oxide eugenol as sealer. Teeth were then suspended in 2% methylene blue. After this, teeth were demineralized dehydrated and cleared. Linear dye penetration was determined under stereomicroscope (x10) with calibrated eye piece. Results of this study showed that calcium hydroxide based endodontic material leaked comparatively less as compared to zinc oxide Eugenol sealer. Vitapex with single gutta-percha cone provided an adequate apical Seal against dye penetration.

Calcium Hydroxide↗
PubMed2004

[Effect of tinidazole-dexamethasone-iodoform paste on controlling endodontic interappointment emergencies].

PURPOSE: To compare the clinical effect of tinidazole-dexamethasone-iodoform paste on intracanal dressing medication for teeth with chronic periapical periodontitis with that of formocresol. METHODS: 520 permanent teeth with chronic periapical periodontitis were selected and divided randomly into tinidazole-dexamethasone-iodoform paste group (A group) and formocresol group (B group). The periapical signs and symptoms were recorded, radiographs were taken. After root canal preparation, the tinidazole-dexamethasone-iodoform paste was used as an intracanal dressing medication for one week in A group and the formocresol paper point was used in B group. During the course of canal treatment, the clinical findings were assessed with clinical periapical index (CPI), the cases were followed up for two years. RESULTS: There was significant difference between A and B group (P<0.01), group A was better than group B. There was no significant difference between two groups of the success rate after following up two years (P>0.05). CONCLUSION: As an intra-canal sterilization medication,tinidazole-dexamethasone-iodoform can reduce the occurrence of endodontic interappointment emergencies in teeth with chronic periapical periodontitis and has a good long-term result.

Adult↗
PubMed2004

Endodontic techniques defined by principles.

Traditional endodontics, limited to the use of K-files, has proven so inefficient in achieving predictable superior results that its deficiencies led to the development and adoption of rotary NiTi systems that produce far superior results, often with much less physical effort. However, in tight curved canals, the inherent weakness of rotary NiTi to both torsion and cyclic fatigue has led to a troubling number of fractured instruments lodged in the canals. The introduction of the SafeSider instrumentation system eliminates the problems of both traditional K-file instrumentation and the fractured instruments associated with rotary NiTi, while delivering superior results in a time-efficient manner.

Root Canal Preparation↗
PubMed2004

Treatment of endodontic perforations using guided tissue regeneration and demineralized freeze-dried bone allograft: two case reports with 2-4 year post-surgical evaluations.

Clinicians often have difficulty with the diagnosis and treatment of root perforation. This paper reports two patients with root perforation treated with periodontal surgery associated with guided tissue regeneration (GTR) and demineralized freeze-dried bone allograft (DFDBA). This combined treatment resulted in minimal probing depths, minimal attachment loss, and radiographic evidence of bone gain after follow-up evaluations that ranged from 2 to 4 years. These case reports show a correct diagnosis and removal of etiologic factors can restore both periodontal and endodontic health.

Adult↗
PubMed2001

Root canal filling of endodontically treated teeth by dentistry students in clinical offices from 1996 to 1998--radiological results.

UNLABELLED: THE PURPOSE of our study was to evaluate radiologically the degree of root canal filling of teeth treated by students. METHODS: 724 segment radiographs with an overall number of 1142 canals were examined. The level of root canal filling was measured from the radiographic apex. The objects of the study were divided into three groups: 1. canals filled to more than 2 mm from the apex; 2. canals filled up to 2 mm from the apex; 3. canals filled to the radiographic apex; 4. overfilled canals. The objects from the second and the third group were combined as a group of successfully filled canals. RESULTS: The results showed 62.90% of successfully filled canals, 27.80% of the canals were filled more than 2 mm from the radiological apex and 9.30% - with overfilling. The greatest percentage of canals filled more than 2 mm from the apex refers to the mesial and vestibular canals of the molars, and after them the most frequently obturated canals are those of single-root teeth (57.94%). CONCLUSIONS: The results obtained allow us to estimate the endodontic treatment of the students as good. The greatest difficulties are encountered in filling the vestibular and mesial canals of the molars.

Dental Pulp Cavity↗
PubMed2004

[An unnecessary endodontic treatment and extraction due to defective diagnosis].

A 22-year-old male patient was referred by his dentist to a department of Oral and Maxillofacial Surgery because of recurrent swelling of the oral mucosa of unknown origin in region 17. One year before, molar 17, although clinically sound but showing an apical radiolucency, was endodontically treated. Eight months ago, molar 17 was removed because of recurrent complaints. Clinical examination revealed a fistula with purulent drainage in region 17. Radiographic examination revealed the cause, viz. a follicular cyst originating from the right wisdom tooth located in the maxillary sinus. Thus, the persisting complaints in region 17 were not related to molar 17, but related to a chronically inflamed follicular cyst originating from an impacted third molar.

Adult↗
PubMed2004

[Pre-septal orbital cellulitis from odentogenic origin--combined surgical and endodontic approach: a case report].

Orbital abscesses are common infectious diseases. The etiology of orbital abscesses may vary from common sinusitis in most of the cases, to cocaine sniffing. As a result of the proximity to the brain, orbital abscesses may complicate to life threatening situations. The infectious process spreads to the orbit in several ways: hematogenous, via anatomic spaces in the maxillofacial region, direct invasion. The treatment philosophy combines surgical and Antibiotic therapy to resolve the acute phase of the disease, followed by elimination of the source. The purpose of this paper is to report a case of pre septal orbital cellulitis, that was treated surgically combined with endodontic therapy. To describe the different subtypes of orbital abscesses, differential diagnosis, imaging and treatment options.

Adolescent↗
PubMedDate not supplied

Current concepts in gutta-percha removal in endodontic retreatment.

Effective removal of gutta-percha (GP) in endodontic retreatment is a significant factor in creating successful outcomes from failed procedures. Ideally, gutta-percha removal must be efficient, not predispose the tooth to subsequent failure through iatrogenic events, and clean the existing canals so that subsequent irrigants can effectively and biomechanically cleanse the root canal system. All things being equal, it is recommended that GP be removed without solvents in the coronal two-thirds of canals as much as possible and with solvents in the apical third. Rotary nickel titanium files and the SystemB heat source (SybronEndo, Orange, CA) are significant adjuncts in effective GP removal.

Chloroform↗
PubMed2004

Treatment selection for anterior endodontically involved teeth.

Innovations in material science and clinical techniques have expanded the number of treatment options available for nonvital anterior teeth. These options include the use of composite to fill the access opening with no additional treatment, crown placement, orthodontic extrusion, crown lengthening with or without orthodontic extrusion, dowel restorations with crown placement, and fixed bridge or implant therapy when extraction is necessary. Clinicians need to understand the benefits and limitations of each option in order to provide their patients with optimum function and aesthetics. Using case presentations, this article describes predictable approaches for the diagnosis, treatment planning, and restoration or replacement of endodontically treated teeth in the anterior region.

Adult↗
PubMedDate not supplied

Clinical success of zirconium oxide posts with resin composite or glass-ceramic cores in endodontically treated teeth: a 4-year retrospective study.

PURPOSE: This study retrospectively evaluated zirconium oxide posts with either direct resin composite cores or indirect glass-ceramic cores after several years of clinical service. MATERIALS AND METHODS: One hundred forty-five endodontically treated teeth in 88 patients were restored with zirconium oxide posts; 87 teeth were restored with direct composite cores, and 58 were restored with Empress cores prior to crowning. Seventy-nine posts with direct composite cores in 52 patients and 34 posts with glass-ceramic cores in 19 patients were reevaluated clinically and radiographically after a mean clinical service of 57.7 months and 46.3 months, respectively. RESULTS: Periodontal probing depths remained on a healthy clinical level, and esthetics were judged excellent for the majority of teeth in both groups. In the group with direct composite cores, no failures were observed in the 79 posts that were reevaluated. In the group with indirect glass-ceramic cores, three failures were observed after 42, 43, and 55 months of clinical service. All failures were due to loss of retention. In a best-case scenario posts that could not be reevaluated were considered successful, and in a worst-case scenario they were considered failures; respective success rates were 100% and 91% in the direct group and 95% and 53% in the indirect group. CONCLUSION: The observed clinical success of zirconium oxide posts with direct composite cores suggests that this method of post-and-core reconstruction is clinically promising. Zirconium oxide posts with indirect glass-ceramic cores displayed a significantly higher failure rate and a high dropout rate that precludes valid conclusions.

Adolescent↗
PubMed2004

Know when to say "when" in endodontics: smoke on the water.

Ultimately, this article is a challenge to assess preoperatively both the patient and tooth and ask several important questions before a handpiece is ever picked up: (1) Can this tooth be restored? (2) Should this tooth be restored? (3) Does the patient want to save the tooth, and will the patient have the needed follow-up treatment? (4) If this tooth cannot be restored as it is now, can it be made restorable through periodontal procedures? (5) If the tooth is restorable and the patient was my mother, am I the doctor to bring about the best long-term prognosis for the tooth endodontically? (6) Can this patient tolerate the contemplated treatment physically, mentally, emotionally, and financially? The long-term goal for the patient should be the maintenance of the tooth in asymptomatic function. In 30 years, like the Deep Purple rendition of Highway Star and Smoke on the Water, which had appeal to me in Seattle, someone will hopefully look at a given root canal and say that the treatment was originally performed well, for the right reasons, and stood the test of time.

Attitude to Health↗
PubMed1992

Clinical, radiographic, and histologic perspectives on success and failure in endodontics.

There is a tremendous impact of multiple variables on the decision-making process in determining success or failure. The best approach to quality outcomes is to minimize the variables that can affect case adversity. Therefore, it behooves the clinician, who chooses to do endodontic therapy, to fully understand the level of treatment that is necessary to achieve success and to attain that level on a consistent basis. Additionally, the wise and prudent clinician should be able to assess completed treatment, with the proper integration of clinical and radiographic factors, in an environment that minimizes the shackles of bias and the dictates of cognitive dissonance.

Decision Making↗
PubMed1992

Pain control in endodontics.

Pain control in endodontics is paramount to patient acceptance of this special area of dental care. Alleviating existing pain is the primary objective of root canal therapy. This paper focuses on the control of pulp and periradicular pain at initial presentation and subsequent to the first visit.

Analgesics↗
PubMed1992

Restoring endodontically treated teeth. Two different post systems.

One of the greatest challenges to the clinician in restorative dentistry is restoration of an endodontically treated tooth. He or she is faced with many options in materials and techniques, with more than 20 prefabricated post systems currently available. These systems include a variety of post designs, different cements, and core materials, to be used in conjunction with pins and posts for the coronal restoration. An integral cast post and core is another restorative option, as is the use of prefabricated posts.

Denture Design↗
PubMed2005

Retention of quartz-fibre endodontic posts with a self-adhesive dual cure resin cement.

This study examines retention of a quartz-fibre endodontic post cemented in extracted human teeth using two cement types. Fifty-four extracted buman central incisor teeth were prepared for a tapered quartz-fibre post. Posts were cemented in 28 teeth using conventional resin cement (RelyX ARC), and 26 teeth using self-adhesive resin cement (RelyX Unicem). Posts were cyclically-loaded. Bond strengths were tested and dependability assessment was carried out. Although there was no significant difference in Weibull modulus between groups (p < 0.05), greater dependability was displayed by RelyX Unicem group. Easy application and greater dependability of self-adhesive cement may improve bonding of fibre-based posts in root canals.

Bisphenol A-Glycidyl Methacrylate↗
PubMed2005

[Determination of canal length in endodontics].

Although the reliability of the electronic apex locator is agreed upon in the endodontic literature, the general practitioner has difficulties to integrate the device in his daily practice. The authors of this paper conclude that the apex locator should be used to confirm the information obtained from the pre-operatory radiograph (imperatively taken with the parallel technique) and they assert that the data obtained electronically have still to be interpretated. The apex locator can be considered an essential tool as long as its limitations are known.

Calibration↗
PubMedDate not supplied

Surgical resolution of chronic tissue irritation caused by extruded endodontic filling material.

Controversy remains regarding the relative toxicity versus inertness of endodontic filling materials, including gutta-percha, in vital tissues.We discuss reaction to and possible toxicity of gutta-percha and sealers and present 2 cases of symptomatic chronic inflammatory reaction where gutta-percha and associated filling materials were found to have extruded past the confinement of the root structure and were embedded in soft tissue and bone. Successful surgical removal of the extruded gutta-percha with surrounding granulation tissue prompted proper healing and resolution of the long-term symptoms.

Adult↗
PubMed2005

Efficient correction of endodontic obturation and single-appointment CAD/CAM restoration.

Endodontic treatment, when performed with proper instrumentation, canal disinfection, and obturation can be a tremendous service to a dental patient and a key component of any restorative practice. It can be complicated by factors such as poor diagnosis, incomplete canal debridement, ineffective obturation, bacterial invasion, and insufficient restorative treatment. Retreatment or even tooth loss can occur when the canal space is not handled properly. This article demonstrates a procedure for the correction of pre-existing obturation and subsequent treatment with an all-ceramic restoration in a single visit.

Adult↗