Endodontic Dentistry Research Articles

СОВРЕМЕННЫЕ АСПЕКТЫ ЭНДОДОНТИЧЕСКИХ ТЕХНОЛОГИЙ

Endodontic treatment requires special manual skills from the dentist. The use of innovative treatment methods in endodontics helps to achieve conditions that ensure a successful treatment result, which, in turn, leads to a healthy state of periapical tissues. The paper presents an analysis of literature data on innovative methods in endodontic dentistry. provides information on the use of a dental microscope, the use of a modern irrigation solution for medicinal treatment of the root canal system, information on the concept of innovative technology of self-adapting files through selective laser melting, and a review of data on modern endoseal based on tricalcium silicate material.

In Vitro Analysis of Outcome Differences Between Repairing and Replacing Broken Dental Restorations.

Objective In light of several advancements and considerations in endodontic dentistry, there still remains a need to comprehensively evaluate the outcome disparities between repairing and replacing broken dental restorations. This study aims to compare the effectiveness of repairing dental restorations versus replacing them, focusing on how each method affects the structural strength and longevity of the restorations. Methods The study included 60 freshly removed human maxillary premolars. Initial processing involved rigorous washing, descaling, and polishing of the teeth. To ensure preservation, the specimens were stored in sterile, distilled water. To occlude the root canals, a self-hardening composite resin was used, and the roots were coated with two coats of clear nail polish to prevent moisture penetration. A 245 carbide bur attached to a high-speed dental handpiece with air and water spray cooling produced standardized Class II cavities on the occluso-proximal surfaces. Each cavity had a buccolingual breadth of 2 mm, an occluso-cervical length of 4 mm, and a gingival boundary that was 1 mm coronal to the cement-enamel junction. Following this preparation, the teeth were randomly separated into three groups (Group A, Group B, and Group C), each containing 20 teeth. Results Our analysis showed that teeth with entirely replaced restorations had a higher average fracture resistance than those with repaired restorations. However, the difference in fracture resistance between the repair and replacement groups for each type of material was not statistically significant. Conclusion Based on the findings, repairing a dental restoration can be a conservative and less invasive alternative to a full replacement without a significant compromise in the restoration's ability to withstand fracture. Therefore, dental professionals might consider full restoration as a viable option, taking into account the need to preserve dental tissue as well as the restoration's durability and structural integrity.

Endodontic Dentistry: Analysis of Dentinal Stress and Strain Development during Shaping of Curved Root Canals.

Endodontic shaping causes stress and strain in the root canal dentin. Dentin microcracks have the potential to be later followed by root fractures occurring under the occlusal load. The aim of our research was to theoretically determine the values of such dentinal states of stress and strain during the endodontic shaping of curved root canals using finite element analysis (FEA). To highlight the stress concentrations in dentin, two geometric models were created considering the volume of the curved dental root and the contact between the endodontic file and the root canal walls. The application of forces with different values was simulated both on a uniform curved root canal and on a root canal with an apical third curvature of 25° as they would be applied during the preparation of a root canal. In the case of the first model, which was acted upon with a force of 5 N, the deformations of the root canal appeared along the entire working length, reaching the highest values in the apical third of the root, although there were no geometric changes in the shape of the root canal. Regarding the second root model, with an apical third curvature of 25°, although the applied force was 2 N, the deformations were accompanied by geometric changes in the shape of the root, especially in the upper part of the apical third. At a higher force of 7 N exerted on the endodontic file, the geometric shape changed, and the deformation reached extreme critical values. The resulting tensile stresses appearing in the experimental structure varied similarly to the deformations. Significant stress and strain can develop, especially in the apical third of curved root canals during their shaping, and the risk of cracks is higher for endodontically treated teeth presenting severe curvatures in the apical third of the root.

Evaluation of the Diagnostic and Prognostic Accuracy of Artificial Intelligence in Endodontic Dentistry: A Comprehensive Review of Literature.

This comprehensive review is aimed at evaluating the diagnostic and prognostic accuracy of artificial intelligence in endodontic dentistry. Artificial intelligence (AI) is a relatively new technology that has widespread use in dentistry. The AI technologies have primarily been used in dentistry to diagnose dental diseases, plan treatment, make clinical decisions, and predict the prognosis. AI models like convolutional neural networks (CNN) and artificial neural networks (ANN) have been used in endodontics to study root canal system anatomy, determine working length measurements, detect periapical lesions and root fractures, predict the success of retreatment procedures, and predict the viability of dental pulp stem cells. Methodology. The literature was searched in electronic databases such as Google Scholar, Medline, PubMed, Embase, Web of Science, and Scopus, published over the last four decades (January 1980 to September 15, 2021) by using keywords such as artificial intelligence, machine learning, deep learning, application, endodontics, and dentistry. The preliminary search yielded 2560 articles relevant enough to the paper's purpose. A total of 88 articles met the eligibility criteria. The majority of research on AI application in endodontics has concentrated on tracing apical foramen, verifying the working length, projection of periapical pathologies, root morphologies, and retreatment predictions and discovering the vertical root fractures. In endodontics, AI displayed accuracy in terms of diagnostic and prognostic evaluations. The use of AI can help enhance the treatment plan, which in turn can lead to an increase in the success rate of endodontic treatment outcomes. The AI is used extensively in endodontics and could help in clinical applications, such as detecting root fractures, periapical pathologies, determining working length, tracing apical foramen, the morphology of root, and disease prediction.

A Breakthrough in the Era of Calcium Silicate-Based Cements: A Critical Review.

Calcium silicate-based cements (CSCs) or mineral trioxide aggregate (MTA) lookalike materials are blocks of cement or root canal sealers produced from calcium (Ca) and silicate. They have superior sealing ability, bioactivity, and marginal adaptability, making them appropriate for various dental treatment applications. Mineral trioxide aggregate is widely used in numerous endodontic repair techniques. The capacity of this cement to promote tissue regeneration and stimulate mineralization accounts for its widespread usage in pulp capping, apexification, apical surgeries, and revascularization. Several studies have been conducted to investigate changes in the components of MTA-based types of cement directed to improve their presentation clinically. To improve flowability, new Ca silicate-based formulations have been introduced commercially. In these new formulations, essential features such as adequate radiopacity and setting time, color stability, alkaline pH, and calcium ion release and biocompatibility must be considered. Owing to an increased range of indications of CSCs, including some for restorative dentistry, and with the emergence of novel silicate calcium-based materials with considerable changes in their compositions, it is necessary to examine the available scientific literature that evaluates their usage in these applications. Therefore, this review paper aims to assess the existing knowledge of CSCs, emphasizing their potential uses in restorative and endodontic dentistry. This report strives to update doctors' understanding of CSCs, allowing for a better therapeutic approach.

Green synthesis of silver nanoparticles using artichoke flower petals and application in endodontic dentistry

Green synthesis of silver nanoparticles using artichoke flower petals and application in endodontic dentistry

A review of the Application of Additive Manufacturing in Endodontic access opening using SLM process

3D Printing refers to a class of technology that can automatically construct 3-dimensional physical models from Computer Aided Design (CAD) data. Reduction of product development cycle time is a major concern in industries for achieving competitive advantage. Endodontic dentistry is the dental specialty concerned with the study and treatment of the dental pulp, and generally diagnose tooth pain and perform root canal treatment and other procedures relating to the interior of the tooth. This article, therefore, aims on being an assistive methodology in endodontics by applying 3D printing in order to reduce the strain involved in the tooth restoration process.

Perception, knowledge, and practice of endodontists and general dental practitioners toward evidence-based practice and factors associated with it—A cross-sectional study

Background:Evidence-based practice is the cornerstone of dentistry and especially endodontics. Diagnosis, treatment planning, and treatment with recent advancement based on evidence would be a great help for the patent satisfaction and treatment prognosis; hence, the aim of present study was to explore difference between perception, knowledge, and practice of endodontists and general dental practitioners (GDPs) towards evidence-based practice and factors associated with it.Materials and Methods:The present study is a cross-sectional descriptive questionnaire study conducted among specialists in the subject of conservative and endodontic dentistry and GDPs working in private clinics in Modinagar city, Uttar Pradesh. The study was conducted in October 2019. In the present study, a close-ended questionnaire was prepared to determine the perception and practice of dental specialists.Results:The majority of endodontists (31 [35.22%]) belonged to the age group of 36–45 years of age while most of the GDPs (32 [36.36%]) belonged to 25–35 years of age group. The majority of endodontists were females (56[63.64%]) and most of the GDPs were males (50 (56.81]). More endodontists (47 [53.42]) had a positive perception of evidence-based practice than GDPs (15[16.42]). Practice toward evidence was fair among most of the endodontists (49 [55.68%]) and GDPs (54 [61.36%]).Conclusion:There was a more positive perception regarding evidence-based practice among endodontists than GDPs, knowledge was high among endodontists regarding evidence-based practice and practice was also good among endodontists. Factors associated with perception, knowledge, and practice among endodontists and GDPs were age in years, gender, year of practice, number of endodontic patients treating per month.

АНАЛИЗ КОМПЛЕКСНЫХ СУДЕБНО-МЕДИЦИНСКИХ ЭКПСЕРТИЗ ПРИ НЕДОСТАТКАХ И НЕБЛАГОПРИЯТНЫХ ИСХОДАХ ЭНДОДОНТИЧЕСКОГО ЛЕЧЕНИЯ ЗУБОВ

Subject. One of the urgent problems of modern health care is to provide quality and effective dental care. The percentage of complications as a result of deficiencies in the provision of dental care, leading to the development of serious pathologies and deteriorating the quality of life of patients is growing every year. High rates of emergence of new technologies in dentistry, new dental materials and equipment do not always allow each practicing dentist to achieve a high professional level of assistance when working with new methods and means of treatment of caries and its complications. In this regard, endodontic care is not provided at the proper level. Goal. A retrospective analysis of medical documentation (comprehensive examinations) was conducted to identify the incidence of medical care deficiencies and adverse outcomes in endodontic dentistry. Methodology. A retrospective analysis of 19 complex forensic examinations was carried out to identify the frequency of deficiencies in medical care and adverse outcomes in endodontic treatment of teeth. Results. It was found that the most common shortcomings in the endodontic treatment of teeth are the lack of x-rays before and after endodontic treatment, removal of filling material for the apex of the tooth, non-compliance with the rules of asepsis and antiseptics in the treatment of patients, unjustified removal of dental pulp. Findings. A retrospective analysis of adverse outcomes in endodontic dentistry according to comprehensive examinations revealed significant deficiencies at the stages of diagnosis and treatment, which led to medical errors and further legal proceedings.

ПУЛЬПОТОМИЯ ПРИ ПРОТЕЗИРОВАНИИ ЗУБОВ. ПИЛОТНОЕ ИССЛЕДОВАНИЕ

The subject. Significant preparation of the teeth for metal-ceramic or ceramic crowns in most cases is accompanied by a preliminary devitalization of the teeth, which shortens the period of their survival. The problem of ensuring the vitality of supporting teeth can be solved by amputating only the coronal pulp, which inevitably overheats during preparation, while retaining the root pulp. The skeptical attitude of dentists to vital pulpotomy may be explained by the often unsuccessful (ineffective) use of this method for teeth with already affected pulp. The hope for success in this study is based on the choice of intact teeth for vital pulpotomy of subsequent prosthetics. Urgency. The amputation method of endodontic dentistry is not used for prosthetic purposes. This can be explained by its low efficiency when using teeth with inflamed pulp. The aim of the work is to confirm the effectiveness of vital pulpotomy in a typical dental situation and subsequent prosthetics. Methodology. Clinical observation of the patient before and during 1 year after treatment, with the use of clinical and modern paraclinical methods of examination. Diagnosed. Treatment is planned: removable denture on the upper jaw with a preliminary shortening of the tooth 46 and subsequent use of a metal-ceramic crown. Significant sosotoyanie hard tissues of the tooth 46 and the subsequent preparation for artificial crowns required endodontic-specific training. It was supposed to preserve the root pulp (vital pulpotomy). As a result, there were no complaints at the control examination 1 year after pulpotomy. The pain threshold from the electrode was 11 µa. Summary. The vital pulpotomy of the tooth with intact pulp showed the possibility of its effective prosthetics with an artificial crown while maintaining the viability of the root pulp. The technique of introduction of the electrode into the cavity of the tooth allowed to conduct direct measurements of the pain threshold of the root pulp in the dynamics of (application for invention No. 2017115518/17(026915) from 02.05.2017).

APPLYING HIGH FREQUENCY MONOPOLAR DIATHERMOCOAGULATION OF THE ENDODONTIC TREATMENT OF TEETH

After studying literature on the problems and complications associated with endodontic dentistry, necessity for studying clinical effectiveness of high-frequency monopolar diathermocoagulation for endodontic treatment of teeth with chronic forms of pulpitis is justified, the necessity for developing recommendations for the use of high-frequency monopolar diathermocoagulation in endodontic dentistry with the use of modern safe coagulator DC-35 MS intended for ambulatory practice is justified. The use of high-frequency monopolar diathermocoagulation in endodontic treatment of teeth with chronic forms of pulpitis will improve the quality and effectiveness of endodontic treatment of pulpal diseases.

СOMPLICATIONS OF ENDODONTIC TREATMENT: PECULIARITIES OF CLINICAL SIGNS, DIAGNOSIS

Endodontic lesions take leading positions in the structure of modern dentistry. General areas of the displacement of filling material or instruments because of the poor quality of endodontic treatment have been established, and the features of clinicoroentgenological and neurological manifestations of the complications of endodontic dentistry have also been determined.
 Due to the poor quality of endodontic treatment, general areas of the displacement of filling material or instruments have been identified, they are the mandibular canal, the maxillary sinus and periapical bone tissue.
 We have performed the examination of 32 patients with various complications after endodontic treatment during 2017 to 2018.
 The majority of patients were adults – 28(87,5%), over the age of 60 – 4(12,5%), there were 84,4% females and 15,6% males within the group.
 The patients were divided into 3 groups according to localization of foreign bodies: the first group contained patients with foreign bodies present in the area of mandibular canal – 5(15,6%); the patients represented by the material in the maxillary sinus cavity made up the second group – 9(28,1%); the group of patients whose material was localized behind the tooth apex in the bone tissue included 18(56,2%)persons. The greatest number of complications after endodontic therapy was observed during the treatment of molars– 67,9%.
 Duration of disease (from the end of endodontic treatment to the hour of addressing the clinic) varied from 1 to 6 months.
 For the purpose of identification, the foreign material localization along with traditional clinic examination, which includes complaints analysis, anamnesis data, estimation of general health status and local manifestations of the disease, the dental intraoral X-ray, plain roentgenography and computed tomography of the bones of the jaws were performed. Assessment of the tissues sensitivity was conducted by the method of comparative palpation of the skin and mucosa at the areas of innervation of the trigeminal nerve branches.
 As a result of the investigation we have determined that regardless of exact localization of the foreign material, surgical complications after endodontic treatment were always accompanied with pain syndrome of different intensity, reduction of sensitivity during the placement of the filling material in the area of mandibular canal (extra- or intracanal), signs of inflammation development (bounded or generalized adjacently to mucosa of maxillary sinus) or persistent pain syndrome during displacement of filling material into the bone tissue behind the tooth apex.
 To specify areas and borders of the localization of the foreign body, the findings of the roentgenological investigations, in particular computed tomography, were critical.

Perception of teachers regarding dental student's classroom behavior: A qualitative study

Introduction: Effective teaching is critical for student learning, especially in professional fields such as dentistry and dental hygiene and further, the effective behavior of educator must include organization, enthusiasm, empathy, rapport, clarity, general knowledge, and being available for students. Aim: The aim of this study is to assess teachers' perception regarding the final-year dental students' classroom behavior. Materials and Methods: Data for this qualitative study came from three focus group discussions (FGDs) with teachers teaching final-year BDS students. Participants (n = 15) represented the department of pedodontics, prosthodontics, and conservative and endodontic dentistry. FGD was conducted department wise with participation of five teachers each. A conceptual framework was prepared with seven questions for conducting FGD. Data from the FGD were analyzed by combining similar quotes into categories. Results: The data from the FGD led to the formation of seven categories with similar quotes in each category. Teachers reported about different behaviors of students depicting their lack of attention in lectures with the most common reason being: engaging in electronic gadgets, chatting with each other, yawning, and getting bored after 5 min of commencement of lecture. Teachers also mentioned the hectic schedule of students being one of the reasons for lack of attention. Suggestions of improving students' behavior were also reported which included different meditation techniques and change in classroom structure. Conclusion: The study reveals that teachers face a lot of inappropriate behavior from the students' side while delivering a lecture in the classroom. Different ways can be employed to increase the concentration of the students.

Management of Riga-Fede disease: A Case Report

Riga-fede disease is a rare pediatric condition in which chronic lingual ulceration results from repetitive trauma. Ventral surface of tongue is often the most common site affected. The natal and neonatal teeth have often beaning reported to cause ulceration on the ventral surface of the tongue in neonates and infants. In the present case report 20 days Old female infant presented by parents to the department of endodontic dentistry with Chief complain of an ulcerated area on the ventral surface of tongue, and difficulty in Suckling. Clinical examination revealed a tooth with sharp incisor edge and grade two Mobility. The ventral surface of the tongue showed a 5 × 8 mm ulcer extending from under border of the tongue to lingual frenulum. Feeding and nutrition of the baby was getting affected. Conservative treatment was not effective and was causing delay in the healing In the present case, the extraction of neonatal teeth was selected as treatment of choice, which gave improvement and normalization of feeding. At the follow-up, we confirmed that the lesion was resolved and infant was feeding normally.

Synthesis of CaO-SiO<sub>2</sub> Compounds Using Materials Extracted from Industrial Wastes

Mineral trioxide aggregate (MTA) cement is an attractive material in endodontic dentistry. The purpose of this study was to produce calcium silicate, which is a major component of MTA, from waste materials. A dental alginate impression gel and used chalks were selected and mixed in a suitable ratio (Code: EXP). As a control, CaCO3 and a commercial diatomite were used (Code: CON). Each powder was heated to 850。C and 1000。C, and then kneaded with water. TG-DTA, compressive tests, SEM observations, elemental mapping analyses, and XRD analyses were performed. TG-DTA indicated that weight reduction of CaCO3 started at 600。C, and it completely decomposed on heating at 850。C. The strength was affected by the temperature. After heating, CaCO3 was transformed into CaO and/or Ca2SiO4, and Ca(OH)2 was formed by mixing with water. There were no differences between EXP and CON. These data suggested that recycled wastes might be promising MTA sources.