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New aspects of restoring the endodontically treated tooth.

It is common practice to 'reinforce' the endodontically treated tooth with a post-and-core combination (either custom or prefabricated) and ultimately restore it with a crown. Many studies have looked at the post, treatment of the post surface, the cements and other factors. It appears that, regardless of the treatment of the post surface, current post cementing technology enables the practitioner to achieve higher retention than previously possible.

Cementation↗

Endodontic follow up of proximal restorations in primary molars.

Proximal restorations in primary molars were assessed according to surface, teeth affected, and the need for subsequent follow up. All primary molars demonstrated a similar incidence of proximal surface restorative intervention, but the distal surface of the first primary molar and the mesial surface of the second primary molar showed the highest incidence of proximal restorations. The patient's age at initial restorative intervention did not appear to influence the need for subsequent endodontic treatment in restored teeth, indicating that early diagnosis and treatment of the carious lesion was critical for long-term pulpal health.

Child↗

[Extraoral accidents with endodontic rotary instruments. Report of two cases].

A serious warning against the possibility of extra-oral accidents caused by endodontic mechanically driven instruments is made. Some critical characteristics of such instruments are described, as well as physical, technical, ergonomic and human reasons conducting to these accidents, two cases of which are related. Finally, colleagues are invited to think critically upon their own rhythm of labour and some preventive measures are proposed.

Accidents, Occupational↗

[Restoration of endodontically treated teeth].

The existing literature on the criteria and conditions for the restoration of endodontically treated teeth has been reviewed. This review shows a consensus among the various authors that the restoration depends on: the dental structure which remains, the position of the tooth in the arch, and whether or not it has been used as a support for fixed or removable partial prosthesis. When the remaining dental structure is sufficient, the tooth can be restored, aesthetically and functionally in the usual way. If the structure is inadequate it will be necessary to reinforce the crown with the help of intra-crown pins, that can be of amalgam or pre-fabricated metal, after which the crown can be reconstructed with amalgam or cast restoration metal. If the tooth to be restored has been used as a support for partial prosthesis or is located in the arch where horizontal forces are present, an intra-root reinforcement with metallic pins will be necessary. These pins can be cast or pre-fabricated and crown core. In this review are discussed also some advantages and disadvantages of the use of the two types of pins and also the criteria for preparing cast-metal post and for the use of pre-fabricated pins.

Dental Amalgam↗

[Flap designs for surgical endodontics].

The correct approach to surgery is the first step towards a successful surgical result. Care must be taken in flap design to facilitate visibility by the dentist, reduce haemorrhages, produce a good blood stain of the flap and allow for quick healing. There are many flap designs for the surgeon to choose from including a combination of two or three together. This reference described the most common flap designs for surgical Endodontics.

Apicoectomy↗

[Amalgam build-up for endodontically treated posterior teeth with intraradicular extension].

Prosthetic treatment of endodontically treated teeth usually involves the use of pins, prefabricated or cast posts that basically aim to protect the tooth from horizontal or vertical fractures. Nevertheless, according to the current way of thinking, the most important factors against tooth fractures are the preservation of as much as possible sound tooth structure as well as the use of full coverage. The amalgam coronal-radicular dowel and core technique is described in this paper. The method has been tested successfully in recent studies, both in vitro and in vivo. Its advantages are that it requires less sound tooth structure removal, involves uniform material for both the dowel and the core, is accomplished in a single chair side session and can be easily removed. It can accordingly be used as a complete crown build up in cases where prosthetic treatment has to be postponed for various reasons.

Crowns↗

[Restoration of badly-broken down and endodontically treated teeth].

Restorations of badly-broken down and endodontically treated teeth are composite resin; pin-retained amalgam or composite resin; casting onlay; prefabricated post with amalgam/composite resin/glass ionomer cement with silver powder core, and cast post & core with crown. The appropriated material and method depend on type, function and remaining tooth structure as well as tooth prognosis and economic status of the patients.

Composite Resins↗

[Ultrasound in endodontics: S.E.M. verification].

After giving a brief illustration of the complex morphology of the root canal system, the Authors discuss the use of ultrasound in Endodontics. Following a critical evaluation of the literature and of the mechanisms of ultrasonic instruments, they illustrate their experience through a wide selection of S.E.M. photographs of teeth treated in vitro with sodium hypochlorite at various concentrations and for different lengths of time. They demonstrate the synergistic action between ultrasound and irrigation solutions, and conclude that the best results are with 2.5% hypochlorite for 1 minute.

Dental Pulp Cavity↗

Local anesthesia failure in endodontic therapy: the acute inflammation factor.

The attainment of clinically acceptable local anesthesia is often problematic in the treatment of symptomatic pulpitis and symptomatic apical periodontitis. This article reviews the literature to identify the extent of this problem and to understand the organic components involved with this condition. Inflammation, infection, pH changes, alteration in nerve cell membranes, and anatomic variations are all possible causes for failure of local anesthesia during emergency endodontic therapy.

Anesthesia, Dental↗

[Sodium hypochlorite in endodontics].

Sodium hypochlorite is still today the most popular irrigating solution used in endodontics. History, chemical and bactericidal properties, effect on periapical tissue, dissolution of pulp tissue, removal of debris and depth of penetration and attempts to improve its activity are discussed in this article.

Root Canal Irrigants↗

[Efficiency factors in endodontic instruments. Study of linear movement].

This study of the efficiency of endodontic tools in a linear motion values different parameters. The cross section seems to be the most important factor. The triangular section instruments are more efficient than the square section ones, but are more easily worn. The helical angle, the outline and the diameter have no influence on the efficiency.

Efficiency↗

[Study on the causes of post-endodontic failures: a descriptive analysis of 198 cases of reoperation].

In this article, a statistical analysis describes 198 cases of post-endodontic failures referred from private practitioners for surgical retreatments. Biopsies of these lesions showed that 68.18 per cent of them were identified as apical granulomas, 3.5 per cent as cysts, 16.16 per cent as epitheliated granulomas and 12.12 per cent as "other" cases. The two main groups of causes associated with these failures are: technical errors (55.05 per cent of the cases) and procedural mistakes (17.68 per cent).

Adolescent↗

[Fundamental biologic considerations in endodontics].

Over the years a substantial body of scientific data has accumulated suggesting that most pulpal and periapical disease processes are induced and maintained by bacterial organisms. On the basis of this knowledge, this review paper discusses rationales and essential steps in endodontic therapy. It is concluded that the focus in pulpectomy procedures (vital pulp therapy) is on preventing bacteria from establishing themselves in the root canal. In cases of infected pulp necrosis, treatment is geared towards the complete elimination of pathogenic organisms that are already present in the root canal system. In both instances, vital or necrotic pulp, it is important that such conditions be established to avoid recurrence of infection following treatment.

Dental Pulp Diseases↗

[Digital image processing in endodontics].

Digital image processing methods were applied to improve the analysis of endodontic follow-up radiographs. After the individual radiographs had been digitized with a videocamera, different standard image processing procedures, such as histogram-equilisation, histogram-matching and noise reduction were performed. In some cases the use of those techniques facilitated the comparison of radiographs taken at long intervals under nonstandardized conditions. As a result, diagnosis of the development of periapical lesions or hard tissue formation in teeth with incomplete root formation was improved.

Dental Pulp Cavity↗