Internal Root Research Articles

A Clinical and Radiographic Assessment of Sodium Hypochlorite Versus Formocresol Pulpotomy in Primary Molar Teeth: 12-month Follow-up.

Objective: The aim of this study was to compare the clinical and radiographic success rates of pulpotomy in primary molars using formocresol versus sodium hypochlorite.Methods: Twenty-three children aged 4-9 years with at least two primary molars requiring pulpotomy were randomly allocated into two groups. All teeth received stainless steel crown after conventional pulpotomy procedure with either NaOCl or formocresol. Clinical and radiographic signs/symptoms were recorded at six and 12 months. Outcomes were statistically analyzed using Fisher’s exact test and Chi-squaretest.Results: Clinical success rates at 6 and 12-month follow-up in both groups was 100%. At 6-month follow-up, radiographic success rate for NaOCl and formocresol groups was 100%. At 12-month recalls, in NaOCl group, 20 teeth (87%) and in formocresol group, 21 teeth (91.3%) had radiographic success. No significant difference was found in the radiographic success rates at 12 months (P=1.00). Internal root resorption was the most common radiographic pathologic finding in both groups.Conclusion:Clinical and radiographic success rates in NaOCl group was comparable with formocresol group, so NaOCL can be suggested as an alternative for primary teeth pulpotomies. However further clinical studies with long-term follow-ups are needed.

Intentional Replantation of a Second Premolar with Internal Resorption and Root Fracture: A Case Report

This case aims to detail intentional replantation as a last resort to save an otherwise hopeless premolar with perforated internal resorption and root fracture. Internal root resorption, progressive destruction of intraradicular dentin, is a condition that sometimes renders a tooth non-restorable. In the rare cases reported where severe internal resorption leads to root fracture, extraction of the tooth seemed to be a common treatment of choice, and a few literatures had reported endodontic surgery as an alternative treatment option. To date, there had been no report of treating internal root resorption using intentional replantation. A 20-year-old male presented swelling at the buccal region of his left maxillary second premolar (#13). Clinical examination revealed a sinus tract and fractured dens evaginatus at the occlusal surface of the tooth. Radiographically, a large area of radiolucency was detected within the middle third of the root, where root fracture was present, leaving a triangular-shaped mature root apex. The condition was diagnosed as internal root resorption and root fracture. Endodontic surgery was excluded from treatment choices due to potential damage of periodontal bone. Instead, intentional replantation was performed, with the application of biomaterials including mineral trioxide aggregate (MTA) and platelet-rich fibrin (L-PRF). The tooth achieved satisfactory healing and remained asymptomatic after 2 years of follow-up. The successful outcome of the case suggests that intentional replantation could preserve a fractured tooth caused by internal root resorption. Incorporated application of biomaterials, such as MTA and L-PRF, might as well improve the chances of saving this otherwise hopeless tooth. Through careful planning and execution, intentional replantation is a viable alternative treatment option to preserve a fractured tooth caused by internal root resorption, while leaving periodontal bone architecture almost intact. How to cite this article: Yang Y, Zhang B, Huang C, et al. Intentional Replantation of a Second Premolar with Internal Resorption and Root Fracture: A Case Report. J Contemp Dent Pract 2021;22(5):562-567.

Knowledge and treatment plan of root resorption

Root resorption is very rare disease in the dental field. However, when dentist faced root resorption in the clinic without knowledge, it is very difficult situation to solve. Root resorption can be classified into external root resorption and internal root resorption according to developing place of resorption. Also, root resorption is classified into surface resorption, inflammatory resorption, replacement resorption according to developing reason of resorption. In this article, we can understand the cause and reason of root resorption development and can know how to prevent and treat the root resorption

Assessment Of Internal Root Resorption Cases Reported To Private Dental Hospital - A Retrospective Study

Assessment Of Internal Root Resorption Cases Reported To Private Dental Hospital - A Retrospective Study

Analisis karakteristik aerodinamika telescopic wing dengan konfigurasi sayap flying wing dan glider menggunakan metode pendekatan simulasi CFD

A telescopic wing is a shape-changing method of the aircraft wing known as the morphing wing system. Wingspan extends capability on telescopic wing increasing the aspect ratio to get a high lift force. The telescopic wing on a flying wing configuration as an external wing and glider wing as an internal wing can be used to increase the coefficient lift (CL) when carrying out special missions. The aerodynamic characteristics using the Computational Fluid Dynamic (CFD) simulation approach is presented. For the 40% internal wingspan, the highest CL increment was 12.9% at a 10o angle of attack. For the 50% internal wingspan, the highest CL increment was 14.9% at a 10o angle of attack. on the 40% internal wing, the highest coefficient drag (CD) increment was 4.7%, and the largest CD increment on 50% internal was 9.5% at the angle of attack of 20o. The pressure distribution along the internal wingspan was uneven from an angle of attack of 15o due to the wing tip vortices of the external wing. Streamline pattern shown a bubble separation from the leading edge at an internal wing root by external wing tip vortices.Keywords: Morphing wing, telescopic wing, flying wing, glider

Stalagmites in karst cave inspired construction: lotus root-type adsorbent with porous surface derived from CO2-in-water Pickering emulsion for selective and ultrafast uranium extraction

Simultaneous construction of porous and hollow adsorbent, especially from gas-in-water Pickering emulsion (PE) reactor, is vital for improving mass transfer kinetics and uptake amount. Inspired by the formation process of stalagmites in karst cave, amino and amidoxime bifunctionalized lotus root-type microsphere with porous surface (NH2@AO-PLRMS) is prepared by the silica nanoparticles (SPs)-stabilized CO2-in-water Pickering emulsion reactor and subsequent two-step grafting polymerization. The important roles of SPs acting as Pickering emulsifier, surface pore-forming agent, and adjusting internal lotus root structure are confirmed. Lotus root-type pores are dependent on the interface intensity and the permeability for compressed CO2 bubbles in PE droplets. Benefitting from the lotus root-type structure and abundant affinity sites, the maximum uranium adsorption capacity of NH2@AO-PLRMS is 1214.5 mg·g−1 at 298 k, and an ultrafast uptake process can be achieved in the first 30 min. Both thermodynamic and kinetic studies indicate a spontaneous, entropy increased, and exothermic chemisorption process, and the synergies of amidoxime and amino groups can enhance the adsorption selectivity. Remarkably, NH2@AO-PLRMS displays a high uranium adsorption capacity and desorption efficiency after seven cycles. These findings provide a way to obtain adsorbents with enhanced uranium extraction performance from gas-in-water PE reactor.

Effect of Willow extract, Bistep and their combination on some quality parameters of lettuce (Lactuca sativa L.)

The research described in this paper was conducted at the University of Debrecen, Farm and Regional Research Institute in its Botanical and Exhibition Garden, Hungary. The aim was to investigate the influence of plant biostimulants on the morphological parameters of three lettuce varieties (May King, Kobak and Great Lakes). Willow bark extract and Bistep were used through irrigation and spray onto the plant leaves with the amount of 5% Willow and 0,5% Bistep. Vegetative parameters like head structure (1….10), head weight (g head-1), head closing (1….10), number of leaves, head diameter (cm), internal stem size (cm) and root weight (g head-1) were measured in 2019 and 2020. According to our results, vegetative parameters are significantly affected by plant varieties and treatments. In the experiment of 2019, important vegetative parameters were influenced by the Willow extract, while in the season of 2020 the most influenced parameters were under the impact of Bistep biostimulants followed by Willow+Bistep. However, the most favourable vegetative growth was recorded in the Kobak variety in the season of 2019 followed by May King and Great Lakes varieties in the season of 2020. On the other hand, the interaction effect of plant varieties and plant biostimulants on the vegetative parameters were varied from seasons. For example, for the season 2019, significantly the highest vegetative value was recorded for the interaction of May King variety treated with Willow extract, whereas in 2020, significantly the most influenced vegetative parameters were under the influence of the interaction of Bistep and May King variety followed by the interaction of Willow+Bistep and Kobak variety.

Cr, Ni, and Zn removal from landfill leachate using vertical flow wetlands planted with Typha domingensis and Canna indica

Chromium (Cr), Nickel (Ni), and zinc (Zn) removal from landfill leachate using mesocosm-scale vertical flow wetlands, the effect of recirculation, and the ability of macrophytes to retain metals were evaluated. Wetlands were filled with coarse sand and light expanded clay aggregates and planted with Typha domingensis or Canna indica. Wetlands were operated using intermittent loading, with and without recirculation. Raw leachate was diluted and spiked with metals to reach the following concentrations: 0.2 mg L−1 Cr , 0.2 mg L−1 Ni, and0.2 mg L−1 Zn and 1.0 mg L−1 Cr, 1.0 mg L−1 Ni, and 1.0 mg L−1 Zn. Wetlands planted with T. domingensis presented higher metal removal than those planted with C. indica. Recirculation enhanced metal removal efficiencies significantly, being for T. domingensis/C. indica: 60/54, 49/47, 61/47% for Cr, Ni, and Zn at 0.2 mg L−1, and 80/71, 76/62, 73/59% for Cr, Ni, and Zn at 1.0 mg L−1, respectively. Metals were efficiently retained by macrophytes. Plant biomass and metal concentrations in roots were significantly higher than in shoots. Scanning electron microscopy and X-ray microanalysis showed that metals were absorbed by internal root tissues. A hybrid wetland planted with T. domingensis may be implemented to improve not only metal but also chemical oxygen demand and total nitrogen removals.

Three-Dimensional Volumetric/ Linear Analysis and Axial Classification of Root Resorptions Using Cone Beam Computed Tomography: A Retrospective Study

Objectives: The purpose of this study was to investigate the volumetric-linear analysis and to present a new axial classification of root resorptions using cone-beam computed tomography (CBCT). 
 Materials and Methods: A total of 43 teeth with root resorption (external cervical resorption (ECR) (n=27), external replacement resorption (ERR) (n=4) and internal root resorption (IRR) (n=12)) from 34 patients were included in this study. On CBCT images of teeth, the volume of total tooth and resorption for the volumetric analysis, the widest lengths of resorptions and the amount of thinnest dentin thickness around them for the linear analysis were measured, and volumetric/linear measurements were compared according to age and gender. In addition, the eight regional axial classification was performed, and these regions were compared. Data were evaluated using Shapiro-Wilk, Pearson’s r., Kruskal-Wallis and Dwass-Steel-Critchlow-Fligner post-hoc tests. Significance was set at p=0.05 for statistical analysis.
 Results: No significant difference was found between the volumetric and linear measurements of ECRs, ERRs, and IRRs. No difference between genders in volumetric and linear measurements of ECRs and IRRs, except total tooth volume, was higher in males than in females in ECRs (p

Management of internal root resorption in primary mandibular right first molar: A case report with four-year follow-up

Internal inflammatory root resorption in primary teeth is a well-known entity with unknown prevalence. The diagnosis and conservative treatment of such a lesion has perplexed practitioners for decades. The management of a non-perforating internal root resorption is long been debated by general dentists and paediatric dentists alike. This case presentation describes the case of a 4-year old boy with non-perforating internal root resorption in a primary molar treated successfully with endodontic procedure and monitored routinely for four years. The objective here was to suggest a minimally-invasive treatment alternative to conventional treatment practices.

Evaluation of Different Root Canal Obturation Techniques in Internal Root Resorption of Three-Dimensional Printed Teeth Manufactured Using Computer Software.

The objective of this study was to evaluate and compare the filling ability of various root canal obturation techniques on the internal root resorption (IRR) cavities of replicated tooth samples manufactured using computer software and a three-dimensional (3D) printer. Orthographic images and root structures of a healthy upper maxilla central incisor in determined volumes and sizes were drawn as a prototype with the aid of computer software. Using the same software, an IRR defect was also modeled. These two images were then transferred to the AutoDesk Fusion 360 3D modeling program (AutoDesk, San Rafael, CA) for meshing. Afterward, the tooth model was transferred to a 3D modeling and prototyping program (RhinoCeros 3D; Robert McNells & Assoc., New York) and printed on a 3D printer. Eighty replicas with IRR were manufactured and divided into four groups (n = 20 per group) according to the obturating techniques as follows: Group 1: Cold lateral compaction (CLC), Group 2: Core Carrier System (GuttaCore), Group 3: Injectable Cold Filling (GuttaFlow® BioSeal), and Group 4: Continuous Wave Obturation System (Elements Free). After root canal filling, replicas were scanned with a high-resolution micro-computed tomography system (SkyScan 1172; Bruker-microCT, Kontich, Belgium), data regarding voids (unobturated areas) inside the IRR defects were statistically analyzed using nonparametric Kruskal-Wallis tests. A pairwise comparison between the tested groups showed that Groups 3 and 4 had significantly fewer voids compared with Groups 1 and 2 in IRR defects (p < 0.05). Group 1/Group 2 and Group 3/Group 4 had similar results in terms of voids and there were no statistically significant differences (p > 0.05). The injectable cold filling system (GuttaFlow BioSeal) and the injectable continuous wave obturation system (Elements Free) successfully obturated the pathological IRR irregularities when compared with CLC and core carrier (GuttaCore) systems.

A Unique Syndrome of Gemination and External/ Internal Root Resorptions in One Dental Arch: A Case Report

A Unique Syndrome of Gemination and External/ Internal Root Resorptions in One Dental Arch: A Case Report

Comparison of digital image displays performance in the detection of artificial internal root resorptions lesions.

To compare the diagnostic efficacy of different devices for visualizing digital images in detecting simulated internal root resorption (IRR). 26 uniradicular human teeth were sectioned along its long axis and randomly divided into two groups. Then, they were submerged in hydrochloric acid (HCl) P.A 37% at different times to make two types of defects: Type 1 (2 hours), and type 2 (3 hours). Digital periapical radiographs were acquired in three moments: before section, after section and after immersion in acid. The images were evaluated on three different devices: 27-inch iMac Desktop, 8-inch Android Tablet, and 5.5-inch iPhone 8 Plus using a 5-point scale. The sensitivity and accuracy values were higher with the use of the Android Tablet, for both types of defects. For the values of the area under ROC curve, higher results were observed with the Android Tablet and lower results with the iMac, showing a significant difference (p < 0.05) when comparing the use of the iMac with the Android Tablet and iPhone 8, for type 1 defects. When comparing the different devices, in the evaluation of images of type 2 defects, the values showed no statistical difference, regardless of the device evaluated (p > 0.05). The size of the lesion interferes with the detection capacity in the image. However, the use of portable devices does not impair the diagnosis of IRR, regardless of size and the dental practioners may use different devices/display, under optimal viewing conditions, to detect IRR lesions, without jeopardizing the diagnostic ability.

Evaluation of the efficacy of XP-endo Finisher, Easy Clean, Passive ultrasonic irrigation, and conventional irrigation in the removal of calcium hydroxide in simulated internal root resorption cavities

This study aimed to evaluate the efficacy of 5 irrigation protocols in removing calcium hydroxide in simulated internal root resorption cavities. Eighteen extracted human teeth, upper anterior and uniradicular, were prepared up to size 50. The teeth were divided longitudinally, and internal root resorption cavities were made by acid demineralization using nitric acid. The same sample was submitted to the five irrigation protocols. The cavities and root canals were filled with Ultracal XS (Ultradent, South Jordan, UT, USA) and stored in an incubator at 37ºC for one week. Afterward, the irrigation protocols were carried out: XP-endo Finisher (XPF; FKG, La Chaux-de-Fonds, Switzerland), passive ultrasonic irrigation (PUI), Easy Clean (Bassi/Easy Equipamentos Odontológicos, Belo Horizonte, Brazil) with reciprocating movement (ECR), Easy Clean with continuous rotation (ECC) and conventional irrigation with a syringe (CI). The solutions used, 2.5% NaOCl, and 17% EDTA, were warmed. The total volume of irrigant used for each sample was 20 mL (10 mL of 2.5% NaOCl, 5 mL of 17% EDTA and 5 mL of distilled water). The amount of calcium hydroxide remaining in the internal resorption after irrigation was assessed using scores. The data were analyzed using the Pearson and Kruskal-Wallis (Dunn) tests. Significantly more calcium hydroxide was removed in the XPF group than all other sample groups (P &lt; 0.0001). XPF was superior to the other methods tested to remove calcium hydroxide in teeth with simulated internal resorptions.

The impact of cone beam computed tomography in diagnosis and endodontic treatment planning decisions - case reports

Conventional radiographic techniques have limitations, showing a two-dimensional image of a three-dimensional object, making it difficult to recognize the internal root anatomy in endo-dontic therapy. Cone-beam computed tomography (CBCT) is a diagnostic method that allows the visualization of all structures three-dimensionally, showing promising results compared to periapical radiographs. The objective of this study was to report two clinical cases where CBCT was fundamental to the diagnosis and a better treatment planning of the steps that were taken during the endodontic intervention. The CBCT were performed prior to the treat-ments, the volume of the exams were dynamically analyzed in specific software. The data were interpreted and together with the radiographic image and clinical examination data, the diagnosis and treatment planning were carried out. Given the report and discussion of the two clinical cases, it can be concluded that CBCT proved to be an impacting resource to support diagnosis and decision-making in the treatment of complex endodontic cases. CBCT ensured greater reliability in the diagnosis and treatment plan adopted, increasing the predictability of the endodontic therapy.

Influence of the image file format of digital periapical radiographs on the diagnosis of external and internal root resorptions.

To evaluate the influence of different image file formats of digital radiographic images on the diagnosis of external (ERR) and internal root resorption (IRR). Thirty-four human teeth were selected. For ERR, 20 teeth were used (10 control and 10 with simulated ERR), and for IRR, 14 teeth were used (before and after IRR simulation). Digital periapical radiographs were acquired using the Digora Toto system and exported in four different image file formats: TIFF, BMP, PNG, and JPEG, totaling 192 radiographs. Five examiners evaluated the images using the JPEGView software and scored the detection of ERR or IRR on a 5-point scale. Sensitivity, specificity, accuracy, and the area under the ROC curve were obtained for the diagnosis of ERR and IRR in the different image file formats. Two-way ANOVA compared the diagnostic values between the file formats and the Kappa test assessed intra- and inter-examiner agreement. The significance level was set at 5% (α = 0.05). The mean values of intra-examiner agreement were substantial (0.740) for ERR and almost perfect (0.836) for IRR and, inter-examiner was fair (0.263) and moderate (0.421), respectively. No statistically significant differences were found among the different file formats for the diagnostic values of ERR and IRR. The file format of digital radiographs does not influence the diagnosis of ERR and IRR. Digital radiographic images may be susceptible to computational factors; however, they can be stored in multiple file formats without affecting the diagnosis of dental root resorptions.

Traumatic Dental Injuries: A seven-year evaluation of peadiatric cases seen in a tertiary hospital

Early presentation, prompt and adequate interventions of Traumatic Dental Injuries (TDIs) are necessary to prevent unwanted sequelae/complications. To assess the pattern of TDIs among the affected children, identify the treatments received and the resultant complications/sequelae. This was a retrospective review of dental records of all paediatric patients from December 2011 to December 2018. TDIs were recorded according to the WHO classification (1995). Information on the treatment received, clinical and radiographic sequelae of trauma were also retrieved. Data were analyzed using IBM SPSS software Version 22. A total of 776 teeth (208 primary, 568 permanent) were traumatized in 513 patients (314 males, 199 females, mean age = 8.86 ± 4.04 years). The peak age at occurrence of trauma was 8 years. The majority of patients complained of broken teeth (51.5%), sustained injury at home (47.6%), had trauma due to a fall (88.7%) and presented after one year of trauma (27.3%). Three quarters of motorcycle accidents occurred in 6–12 year–old children. More young age groups sustained injuries at home compared with older age group (p = 0.000). Avulsion (26.1%) and uncomplicated crown fracture (38.2%) were the commonest injuries to primary and permanent dentitions respectively. The most common sequelae of trauma were pulpal necrosis followed by internal root resorption. Tooth extraction (42.8%) and root canal treatment (37.0%) were the commonest treatments given in both dentitions respectively. The pattern of TDIs appeared not to have changed considerably but motorcycle accidents contributed to the aetiology and pulpal necrosis was a major complication due to late presentation.

Survey based assessment of diagnosis through periapical radiograph and CBCT and treatment of root resorption with Brazilian and American dentists and endodontists.

BackgroundThis study assesses and compares the knowledge level of endodontists (ENDs) and general dental practitioners (GPs) from Brazil and United States of America (USA) in the diagnosis and treatment of internal and external inflammatory root resorptions through periapical radiographic (PA) and cone beam computed tomography (CBCT) examinations. Material and MethodsA cross-sectional online questionnaire-based survey was presented to the volunteers containing questions regarding personal and professional profile, as well as three clinical cases of internal and external inflammatory root resorption. A series of multiple-choice questions about the diagnosis and treatment options were surveyed. The data collected was analysed by the Chi-square test with Yates correction with a significance level of 5 %. ResultsMost answers were considered adequate when all three questions about the diagnosis and all two questions relating to the treatment were answered accurately. A total of 374 dentists answered the survey (n: 229 from Brazil vs. 145 from USA) being 41% END and 59% GP. END presented higher level of knowledge than GP regarding to diagnosis and treatment of inflammatory root resorptions both in Brazil and USA (p<0.05); USA presented higher level of adequate responses than Brazil (p<0.05). ConclusionsEND achieved a level of knowledge of the diagnosis and treatment of root resorption superior to the GP. Comparing the results obtained in both countries, it was observed that the USA had a higher correct response rate than Brazil. Key words:Internal root resorption, external root resorption, management, diagnosis, treatment.

Morphological Variations In Mandibular Anterior: Case Studies

Endodontic treatment mainly aims at chemomechanical debriding and filling the root canal space three-dimensionally. Post-treatment complications may arise due to failure to detect all the root canals. Teeth identified as having a single root canal are considered uncomplicated to treat. Literature reports suggest several variations in internal and external root canal anatomies. The case studies present cases of mandibular anterior with two canals and with different canal morphologies. Radiographs

İnternal Kök Rezorpsiyonları ve Tedavi Yaklaşımları

İnternal Kök Rezorpsiyonları ve Tedavi Yaklaşımları