Endodontic Research Articles

New ecological endodontic cleaner

New ecological endodontic cleaner

A study of flare-ups following single-visit root canal treatment in endodontic patients.

To determine the frequency of flare-ups in single-visit endodontic treatment and the associated factors. Observational. Baqai Dental College Hospital, Karachi, from November 2005 to May 2006. One hundred patients were assigned for single-visit root canal treatment. Patients that defaulted after the first appointment (incomplete treatment) were excluded from the study. For each tooth treated, the clinical factors and conditions existing before and after the completion of treatment were recorded. This data included patient's age, gender, type of tooth, pre-operative status of pulp and periapical tissues and recording pain and swelling (flare-ups) postoperatively after 1 day, 7 days and 1 month. The significance of results was obtained by applying paired-sample t-test and Pearson X2 test. Three of one hundred cases showed flare-ups after treated in single appointment. On the other hand, a marked number (n=97) of cases did not show flare-ups during the study period. None of the studied variables showed any statistically significant bearing on rate of flare-ups in single appointment root canal treatment. The single-visit root canal treatment was safe in terms of endodontic flare-ups as far as results of this study are concerned. It was safer in both vital and non-vital teeth, and even in teeth with periapical pathosis.

Óleo de copaíba (Copaifera sp.): histórico, extração, aplicações industriais e propriedades medicinais

Este trabalho teve como objetivo realizar uma revisão de literatura sobre o gênero Copaifera sp. Foi realizado levantamento bibliográfico do período de 1792 a 2008 utilizando bibliotecas da Universidade de São Paulo, Universidade Federal de Viçosa, Universidade Federal de Alfenas e Universidade José do Rosário Vellano, pesquisas às bases de dados SCOPUS e PubMed, além de ferramentas de busca na web. Utilizou-se para a busca palavras chave como "Copaiba", "Copaifera", "Copaíba oil" "Óleo de Copaíba". Como resultado desta pesquisa obteve-se a seleção de 63 referências incluindo livros, artigos, cadernos técnicos, resumos de congressos, teses, dissertações e patentes. Estes dados apontaram o óleo de copaíba como um exsudato produzido pelas copaibeiras como defesa contra seus predadores, que vem sendo utilizado pela medicina tradicional popular e silvícola há mais de 500 anos. Ele é extraído destas árvores através de perfurações realizadas em seus troncos. Além das inúmeras aplicações do óleo em cosméticos e outras indústrias, ainda há uma série de indicações para seu uso na medicina. Existem hoje descritas algumas dezenas de propriedades medicinais diferentes, que vem sendo em alguns casos comprovadas cientificamente, como atividade antimicrobiana, antiinflamatória, anti-neoplásica entre outras. Estudos recentes têm demonstrado também grande potencial de uso do óleo de copaíba na odontologia, na composição de cimentos endodônticos e na prevenção e combate da doença periodontal. As informações contidas neste trabalho demonstram uma grande variabilidade de aplicações do óleo de copaíba. Entretanto uma quantidade limitada de pesquisas sobre suas propriedades medicinais tem sido realizada, apresentando assim a necessidade de novas pesquisas sobre estas.

Evaluation of the Clinical Success of Class I Cavities Prepared by an Er: YAG laser-2-year follow-up Study

The aim of this study was to evaluate the success of class Ⅰ occlusal restorations prepared by au Er: YAG laser after 24 mouths. Sixty-five teeth of 30 patients were iucluded in the study, and au Er: YAG laser emitting at a wavelength of 2.94 μn was used for the class Ⅰ cavity preparations with not more than 1/3 of the mesiodistal width of the occlusal surfaces of each tooth. All cavities were restored with a light-cured composite resin, following a single bond application. After the baseline examination, restorations were reevaluated by the same experienced clinician after 24 months, using modified Ryge criteria. After 2 years, 53 restorations were reviewed in 26 patients. None of the teeth showed signs of secondary caries. Except for 2 teeth subjected to endodontic treatment due to pulpal inflammation, all other restorations were present, and the teeth were vital. Slight marginal discoloration was observed in 5 restorations, having a beta score. With its satisfactory acceptance by patients, class Ⅰ cavity preparation with au Er: YAG laser would be a useful alternative for other couventional methods, especially for teeth which are to be restored with composite resins.

P.180 Endodontic microsurgical reoperation using an endoscope

P.180 Endodontic microsurgical reoperation using an endoscope

Evaluation of the Antimicrobial Action of Propolis and Substances Used in Endodontics against Enterococcus faecalis

Objetivo: Avaliar a atividade antimicrobiana da propolis e de outras substâncias ja utilizadas na protecao pulpar de dentes deciduos, contra cepas de Enterococcus faecalis. Metodo: Utilizou-se a tecnica de difusao em agar, pelo metodo do poco, sendo analisadas 11 substâncias: 1) Extrato de propolis verde; 2) Pasta Guedes-Pinto (Iodoformio + PMCC + Rifocort®); 3) Extrato de propolis verde + Rifocort® + Iodoformio; 4) Rifocort® + Extrato de propolis verde; 5) Hidroxido de calcio + Extrato de propolis verde; 6) Hidroxido de calcio + Soro fisiologico; 7) Iodoformio + Extrato de propolis verde; 8) Iodoformio + Soro fisiologico; 9) Rifocort®; 10) Paramonoclorofenol canforado e 11) Soro fisiologico (controle negativo). Resultados: O Rifocort®; o Rifocort® com extrato de propolis verde; a pasta Guedes-Pinto; a pasta de propolis verde com Rifocort® e iodoformio; e o paramonoclorofenol canforado apresentaram acao antimicrobiana contra o E. faecalis significativamente superior quando comparadas com as demais substâncias testadas. A pasta de hidroxido de calcio com propolis verde, a solucao de extrato de propolis verde, a pasta de iodoformio com solucao de propolis verde apresentaram menor atividade antimicrobiana, nao havendo diferenca estatisticamente significativa entre estas tres formulacoes. O soro fisiologico, a pasta de hidroxido de calcio com soro fisiologico e a pasta de iodoformio com soro fisiologico nao apresentaram atividade antimicrobiana. Conclusao: A solucao de extrato de propolis verde apresentou baixa atividade antimicrobiana contra o E. faecalis e, dentre as substâncias testadas, o Rifocort® apresentou maior acao antimicrobiana.

Effect of Water Ratio in Alginate-mounted Endodontic Models on Electronically Determined Working Length of Root Canals

Background/Purpose. To evaluate whether the water content in alginate endodontic models affects the accuracy of the Root ZX apex locator in determining the working length of root canals. Methods. Twenty-nine extracted single-rooted teeth were embedded in alginate models and divided into two groups. Group A (15 teeth) was stored in a completely sealed box and placed in an incubator so that the humidity level would reach 100%. Group B (14 teeth) was stored in a box without a cover to simulate natural humidity. Models in both groups were stored in a 27℃ incubator for up to 120 hours. The percentage of water content in alginate was measured by weighing the invested models at different measuring time points. The distance from the incisor edge or cusp tip to the major foramen of the root apex indicated the actual tooth length (AL).The electronically determined length (EDL) was measured by a K file advanced into the root canal to just beyond the major foramen, and then withdrawn counter-clockwise until a flashing bar appeared at the ”APEX” of the Root ZX. The measurements were performed at different time intervals. The subtraction difference (SD) between AL and EDL was recorded for each tooth in each group. The SD values at five different measuring time points in each group were then compared by a Student's t-test. Results. No significant difference in SD was observed in either group when the water content of alginate remained within the range of 73% to 62.5%. An average constant subtraction difference of 0.30 mm was found in group B. Conclusion. The Root ZX apex locator provided accurate and stable working length measurements when the water content in the alginate invested models remained within the range of 73% to 62.5%.

Help to explain endodontics

Help to explain endodontics

歯内治療に於ける水酸化カルシウム療法

歯内治療に於ける水酸化カルシウム療法

Endodontics focus

Endodontics focus

Clinical and Radiological Performance of Three Endodontic Sealers

Calcium hydroxide is commonly used in endodontics as an interappointment root canal dressing. The object of this study was to compare the clinical/radiographic treatment of 3 sealers, 2 of which contain calcium hydroxide. The clinical/radiological performance of three endodontic sealers was assessed in a prospective study of endodontic treatment in 150 roots. The roots were treated by undergraduate students according to a standardized procedure, and were filled with laterally condensed guttapercha and sealer. The patients were recalled yearly for 4 years for a clinical and radiographic control examination, and the radiographs were scored using the periapical index (PAI) scoring system. The difference was significant after 1 year and persisted through the 4-year observation period. The difference was also evident after stratification of the material with regard to preoperative pulpal and periapical diagnosis. The influence of the sealer on treatment outcome was small.

Root canal treatment of maxillary second premolar with three roots and three canals: clinical cases

An accurate diagnosis of the anatomy of the root canal system is a prerequisite for successful root canal treatment. According to the endodontic literature, maxillary second premolars usually have one root and one canal. The possibility of three roots and three canals in maxillary second premolars is quite small. Diagnostic means such as preoperative radiographs and examination of the pulp chamber floor aid the location of root canal orifices. The aim of this clinical article is to describe the unusual anatomy that was detected in two maxillary second premolars during routine endodontic treatment.

Injuries to permanent teeth. Part 3: Therapy of root fractures

Diagnostic and therapeutic interventions following dental injuries are not part of the routine practice in the dental office. Quite often, these patients are emergency cases who seek treatment after normal office hours. The objective of this and the future papers is to present the current treatment concepts in dental traumatology at the School of Dental Medicine, University of Berne. The fruitful cooperation in the field of dental traumatology between the Department of Oral Surgery and Stomatology, and the Department of Conservative Dentistry (including pediatric dentistry and endodontology), is based on the interdisciplinary approach that has been established four years ago. Following discussion and evaluation of such treated cases, and considering current clinical and experimental studies, the said concepts have been worked out. The present paper describes the therapeutic approach for root fractures.

Frequency of two canals in maxillary second premolar tooth.

To determine the frequency of two canals in relation to age and gender as well as role of shift cone angle radiographic technique in maxillary second premolar tooth. A cross-sectional study. The study was conducted in Operative Department (Endodontic Department), Hamdard University Dental Hospital, Karachi, from January 2004 to February 2005. One hundred and twenty patients were selected for the study, based on non-probability purposive sampling technique. Twenty patients were dropped out of the study and the data was analyzed for 100 patients. All patients were examined clinically as well as radiographically. Then the canals were opened to further confirm and treat the tooth. The findings were noted on a performa and then cross-tabbed for the significant difference. One hundred patients {43 males (43%) and 57 females (57%)} whose mean age was 36.2 (SD +/- 7.3} were treated. Forty (40) years was the age limit for dividing the patients into two groups. Out of 43 males, 27 (63%) were below 40 years and out of 57 females, 38 (67%) were below 40 years. Statistical analysis with Chi-square revealed no significant difference. Out of 43 males, 27 (63%) had two canals and out of 57 females, 30 (53%) had two canals with no significant difference between the two groups. Results of parallel X-ray were cross tabbed with shift cone angle technique and the difference was highly significant (Chi-square value 9.61 and p-value 0.002). Frequency of two canals was high is not age or gender dependant. Shift cone angle technique should be used as radiographic support for the clinical examination to identify the number of canals. The second canal became apparent with shift cone technique in 78% cases where additional periapical radiographs with shift cone angle technique were taken.

The influence of different root canal medicaments on the tensile bond strength of composite resin to coronal dentin.

Background: Intra canal medicaments are routinely used during endodontic procedure and may influence the bond strength of resin materials to the dentin. The purpose of this in vitro study was to assess the adherence of composite resin to dentin conditioned with different intracanal medicaments by using the 7th generation bonding agent. Materials and Methods: Superficial dentin of 60 human premolars was used as substrate. The following irrigants solutions were applied to dentin surface for 60 seconds- Distilled water, 2% NaOCl, 2% CHX and 17% EDTA with 2% NaOCl. The FC and CMCP were maintained in contact with the dentin for 3 days. Gluma-BOND was applied to the conditioned dentin and the test specimens were built with composite resin (Cavex). After storage in distilled water at 37oC for 24 hours the specimens were thermocycled for 500 cycle, then tested to failure for tensile bond strength (MPa) in an Instron machine and examined the mode of failure under the stereomicroscope Results: The TBS did not differ significantly among those conditioned with DDW, FC and CMCP. The mean scores were significantly higher after conditioning with CHX group and 17% EDTA with 2% NaOCl group, while the mean scores were significantly lower after conditioning with 2% NaOCl group. Conclusion: The intracanal medicaments differently influence the adhesion of composite resin to coronal dentin bonded with Gluma-BOND and on the mode of failure.

Application of a Copper Band in Complex Endodontic Access Preparations

Complex access in endodontic therapy may compromise proper isolation of the teeth and the sealing ability of a temporary restoration between appointments. Without proper isolation and pretreatment of these teeth, particularly badly mutilated ones, the root canal systems may be contaminated, and success of endodontic treatment can be reduced. Using a copper band to pretreat a broken-down tooth had been mentioned in the literature; however, none of those reports provided detailed clinical procedures. A step-by-step technique for using a copper band as pretreatment for endodontic procedures is described and illustrated, and its advantages are discussed as well.

Safety first in endodontics

Safety first in endodontics

Silver restorative

Silver restorative

Cutting costs not corners

Cutting costs not corners

Disinfection on demand

Disinfection on demand