Maxillary Single-rooted Teeth Research Articles

Efficacy of Periotome Versus Conventional Forceps Extraction in Socket Preservation and Reduction of Postoperative Pain: A Randomised Clinical Trial

Introduction: Atraumatic extraction is necessary when a patient undergoes dental implant rehabilitation. Various tooth extraction systems are used and regularly upgraded. The periotome is a tool that severes the Periodontal Ligaments (PDL) and aids in atraumatic extraction while preserving the socket. Aim: To evaluate the efficacy of conventional forceps versus periotome extractions of single-rooted maxillary teeth in terms of socket preservation, procedure duration, and postoperative pain. Materials and Methods: This was a single-blinded randomised clinical trial conducted at Department of Oral and Maxillofacial Surgery, Dr. D. Y. Patil Vidyapeeth, Pimpri, Pune, Maharastra, India from December 2020 to March 2021 involved 42 patients aged 18-60 years who required extraction of maxillary single-rooted teeth that had failed endodontic treatment. The patients were randomly divided into two groups: a periotome group and a conventional forceps group. Clinical assessment was conducted to evaluate socket preservation, extraction time, postoperative pain, and any complications related to the extraction procedure. Statistical analysis was performed using the Mann-Whitney U test, Chi-square test, and unpaired t-test. Results: The majority of patients were within the age group of 51-60 years, with 13 males and 29 females. The difference in extraction time between the two groups was not statistically significant (p=0.368). The periotome group exhibited a significantly lower incidence of buccal cortical plate fractures compared to the conventional forceps group (p=0.048). Regarding the severity of postoperative pain, the periotome group demonstrated a significantly lower value than the conventional forceps group (p=0.028). Conclusions: The periotome proved to be a more efficient choice for preserving the socket in endodontically non treatable teeth requiring extraction, as compared to conventional forceps.

Comparative Evaluation of Antibacterial Property of Bioactive Glass Alone and its Combination with Chlorhexidine against Enterococcus faecalis - An In vitro Study.

Context:One of the most common organisms responsible for root canal failure even after the usage of intracanal medicament is Enterococcus faecalis. Newer medicaments with higher antibacterial efficacy against E. faecalis need to be analyzed.Aim:The aim of this study was to compare the antibacterial property of bioactive glass (BAG) alone and its combination with chlorhexidine (CHX) against E. faecalis.Materials and Methods:Eighty permanent maxillary single-rooted teeth were included in the study. These teeth were randomly divided into three groups of ten teeth each. Dentin blocks were prepared. After debris and smear layer removal, dentin blocks were inoculated with E. faecalis and incubated for 7 days for biofilm formation. Medications including BAG alone and combination of CHX with BAG were placed into the dentin blocks and incubated at 37°C for 72 h. Dentinal shavings were collected, and the mean bacterial count was recorded.Statistical Analysis:The comparison of colony-forming unit (CFU) counts was done using one-way analysis of variance, Tukey's post hoc test, and unpaired t-test. The analysis was done using the Statistical Package for the Social Sciences version 20.0 for Windows.Results:Based on the CFU count obtained after 72 h, compared to the control group, both Group 1 and Group 2 reduced the bacterial load effectively. In comparison with Group 1, Group 2 (combination) was found to be more effective against E. faecalis.Conclusion:It can be concluded that although BAG was effective against E. faecalis, its efficacy increased significantly in combination with CHX.

The effects of chelation on the adhesion of two different root canal sealers

Objective: This study aims to evaluate alterations in the root canal dentin after irrigation with EDTA, HEBP, and Chitosan in order to determine the push-out bond strengths of the different root canal sealers on altered dentin surfaces. Materials And Methods: Crowns of 70 maxillary single-rooted teeth were removed to obtain a standardized length of 16 mm. The canals were instrumented using rotary files and the step back technique. The master apical file used in this study was #40. The subgroups were determined based on the chelation agent and the material of the root canal sealer that was used (17% EDTA, 18% HEPB, 0.2% Chitosan, Well Root ST (WRST) or AH Plus). Three slices with 1 mm thickness were cut from the root thirds of each tooth and subjected to a push-out test. The data (MPa) were analyzed using a one-way ANOVA and a Duncan’s multiple comparison test at a level of α = 0.05. Finally, scanning electron microscope (SEM) photographs were taken. Results: Groups that used WRST exhibited significantly higher push-out bond strength values in all subgroups independent of the irrigant that was used (ANOVA, p < 0.05). Group 1 showed higher push-out bond strength than the other AH Plus subgroups. Conclusion: The EDTA improved the push-out bond strength of the AH Plus. The WRST root canal sealer had the highest push-out bond strength and did not depend on the irrigant used.

Effectiveness of XP‐endo Finisher and XP‐endo Finisher R in removing root filling remnants: a micro‐CT study

To evaluate the efficacy of filling material removal from oval-shaped canals after the use of supplementary files (XP-endo Finisher and XP-endo Finisher R) through microcomputed tomographic (micro-CT) analysis. The root canals of twenty maxillary single-rooted teeth were prepared with Reciproc R25 files and filled with gutta-percha and AH Plus sealer using the continuous wave of condensation technique. The root canals were then retreated using Reciproc R25 and R40 instruments. After this, the specimens were assigned to two groups according to the supplementary cleaning approach, using XP-endo Finisher and XP-endo Finisher R. The surface area and volume of removed filling material was assessed using micro-CT imaging before and after the use of the XP-endo instruments. Data were analysed statistically with a significance level of 5%. Removal of filling material at 66.8% and 59.4% in volume and 67.3% and 61.4% in surface area was seen for the XP-endo Finisher and the XP-endo Finisher R files, respectively. The amount of filling material removed by both supplementary files was highly significant (P=0.000). No significant difference in the percentage of removed filling material was detected for the XP-endo instruments (P=0.636 for volume and P=0.667 for surface area). Both XP-endo files were equally effective in the removal of remaining filling material from straight oval-shaped canals. None of the instruments were able to remove all the residual filling material.

Effect of Propylene Glycol on the Sealing Ability of Mineral Trioxide Aggregate and Calcium-Enriched Mixture Cement Apical Barriers.

Introduction:Propylene glycol (PG) improves the handling, physical, and chemical properties of mineral trioxide aggregate (MTA). This study aimed to evaluate the effect of PG on the sealing ability of MTA and calcium-enriched mixture (CEM) apical barriers. Methods and Materials: A total of 70 extracted human maxillary single-rooted teeth were prepared using ProTaper rotary system. The apical 3 mm of the root tips were resected and the root canals were enlarged with Peeso reamers up to #4, to create open apex teeth. The teeth were then randomly divided into four experimental (n=15) and two control (n=5) groups. Group1: MTA+ MTA liquid, group2; MTA+MTA liquid (80%) + PG (20%), group3; CEM+CEM liquid, group4; CEM+ liquid (80%) + PG (20%). Cements were mixed with their respective mixing agents and a 4-mm thick apical plug was fabricated. The microleakage was measured on day 1, 3, 7 and 21 using a fluid filtration technique. The repeated measures ANOVA and Sidak test were used to analyze the data. Results:All experimental groups demonstrated various amounts of microleakage. No significant difference was found between MTA and CEM cement (P=0.193), regardless of time and liquid components. There was no significant difference was observed between liquids (P=0.312) in all time intervals. The rate of microleakage decreased over time and a significant differences was observed between all intervals (P<0.05), except 3-7 and 7-21 (P=0.190) days. Conclusion:PG demonstrated neither a positive nor a negative effect on the sealing ability of Angelus MTA and CEM cement.

Site-specific treatment outcome in smokers following 12months of supportive periodontal therapy.

AimTo evaluate the effect of cigarette smoking on periodontal health at patient, tooth, and site levels following supportive therapy.Materials and MethodsEighty chronic periodontitis patients, 40 smokers and 40 non‐smokers, were recruited to a single‐arm clinical trial. Periodontal examinations were performed at baseline (T0), 3 months following active periodontal therapy (T1), and 12 months following supportive periodontal therapy (T2). Smoking status was validated measuring serum cotinine levels. Probing depth (PD) ≥ 5 mm with bleeding on probing (BoP) was defined as the primary outcome. Logistic regression analyses adjusted for clustered observations of patients, teeth, and sites and mixed effects models were employed to analyse the data.ResultsAll clinical parameters improved from T0 to T2 (p < 0.001), whereas PD, bleeding index (BI), and plaque index (PI) increased from T1 to T2 in smokers and non‐smokers (p < 0.001). An overall negative effect of smoking was revealed at T2 (OR = 2.78, CI: 1.49, 5.18, p < 0.001), with the most pronounced effect at maxillary single‐rooted teeth (OR = 5.08, CI: 2.01, 12.78, p < 0.001). At the patient level, less variation in treatment outcome was detected within smokers (ICC = 0.137) compared with non‐smokers (ICC = 0.051).ConclusionSmoking has a negative effect on periodontal health following 12 months of supportive therapy, in particular at maxillary single‐rooted teeth.

Effect of different adhesive systems and post surface treatments on the push-out bond strengths of fiber-reinforced post

Purpose: The purpose of this study was to evaluate the push-out bond strength of glass-fiber post cemented with different adhesive systems and surface treatments. Materials and methods: 160 tooth samples made from 48 human maxillary single-rooted teeth with similar root length were divided into 4 groups according to the adhesive system (no adhesive, Adper Single Bond 2, Clearfil SE Bond, Clearfil S3). Each group had 4 subgroups according to the post surface treatment methods (no treatment, sandblast, silane, sandblast and silane). Posts (Parapost Fiber White) were cemented with Rely X Unicem. The teeth were sectioned perpendicular to their long axis into 1-mm thick sections. The push-out tests was performed at a speed of 0.5 mm/min. The results were evaluated by 2-way ANOVA, 1-way ANOVA and multiple comparison procedures (Tukey test) (α =0.05). Results: Tukey test showed that the adhesive system significantly influenced the push-out strength. The Clearfil SE Bond group showed the highest value. Post surface treatments showed no significant effect. Conclusion: Bond strength of glass-fiber post cemented with self-adhesive resin cement using Clearfil SE Bond showed significantly higher values compared to other adhesive systems. (J Korean Acad Prosthodont 2016;54:218-25)

Comparative evaluation of demineralization of radicular dentin with 17% ethylenediaminetetraacetic acid, 10% citric acid, and MTAD at different time intervals: An in vitro study.

Background:The smear layer has the capability to protect the bacteria within the dentinal tubules from intracanal medicament. After removal of the smear layer from infected root canals, it allows disinfection of the entire root canal. The smear layer compromising the seal between the root canal sealer and root canal wall also decreases the penetration of irrigants into dentinal tubules.Aims:This study compares the amount of phosphorous liberated and demineralization of the radicular dentin with 17% ethylenediaminetetraacetic acid, 10% citric acid and mixture of doxycycline, citric acid, and a detergent at different time intervals.Materials and Methods:Extracted maxillary single-rooted teeth were prepared by using a combination of passive step-back and rotary 0.04 taper nickel-titanium files. Sodium hypochlorite 5.25% and sterile distilled water were used as an intracanal irrigant. The canals were then treated with 5 mL of one of the following solutions such as final rinse sterile distilled water, 5.25% sodium hypochlorite, 17% ethylenediaminetetraacetic acid (EDTA) or mixture of doxycycline, citric acid, and a detergent. The presence or absence of smear layer and the amount of erosion on the surface of the root canal walls at the coronal, middle, and apical portions of each canal were examined under a scanning electron microscope.Statistical Analysis:Data were analyzed by one-way analysis of variance (ANOVA) to determine whether there were significant differences between the groups.Results:The results show that mixture of doxycycline, citric acid, and a detergent is an effective solution for the removal of the smear layer and does not significantly change the structure of the dentinal tubules.Conclusions:In this study, 10% citric acid shows the maximum amount of dimeneralization of radicular dentine followed by mixture of doxycycline, citric acid, and a detergent, and 17% ethylenediaminetetraacetic acid. When all the subgroups were compared, it was seen that the maximum amount of phosphorus liberation was performed by 10% citric acid >mixture of doxycycline, citric acid, and a detergent >17% EDTA at a different time interval.

Evaluation of Effects on the Adhesion of Various Root Canal Sealers after Er:YAG Laser and Irrigants Are Used on the Dentin Surface

IntroductionThe aim of this study was to evaluate the bond strength of various root canal sealers after various irrigation solutions and Er:YAG laser irradiation were used on root canal dentin. MethodsOne hundred fifty freshly extracted human maxillary single-rooted teeth were used in this study. Teeth were sectioned transversally 4 mm below the cementoenamel junction. The root canal of each specimen was prepared using a tapered bur. Teeth were divided into 3 main groups by sealer (AH Plus Jet [Dentsply DeTrey, Konstanz, Germany], EndoSequence BC Sealer [Brasseler, Savannah, GA], and Real Seal [SybronEndo, Orange, CA]) and then divided into 5 subgroups by dentin treatment (distilled water, calcium hydroxide, sodium hypochlorite, EDTA, and Er:YAG laser). The specimens were placed immediately at 37°C and 100% humidity for 1 week. Then, the push-out test was applied. The maximum failure load was recorded in newtons and was used to calculate the push-out bond strength in MPa. Then, 3 random specimens from each group were examined under scanning electron microscopy. ResultsThe resin root canal sealers had higher push-out bond strength than the bioceramic sealer, and the differences were statistically significant (P < .05) except in the sodium hypochlorite groups. The EDTA and Er:YAG laser applications removed the smear layer and increased the bond strength. The highest adhesion was observed in EDTA groups when each sealer was evaluated in itself. ConclusionsThe bonding strength of root canal sealers is influenced by their properties and various dentin surface treatments. The scanning electron microscopic study showed that although the dentinal tubules were open, at the profile examination the sealers did not penetrate into the dentin canals in all specimens.

Intentional replantation of adhesively reattached vertically fractured maxillary single‐rooted teeth

To evaluate the clinical outcomes of intentionally replanted maxillary single-rooted teeth with vertical root fractures (VRFs) after being repaired extraorally using 4-methacryloxyethyl trimellitate anhydride/methacrylate-tri-n-butyl borane (4-META/MMA-TBB) resin cement. Twenty-one root filled maxillary single-rooted teeth with VRFs were evaluated. After atraumatic extraction, fractured fragments were adhesively cemented. The teeth were then replanted and splinted to the neighbouring teeth for 2 weeks. Plaque index (PI), gingival index (GI), probing depth (PD) and clinical attachment level (CAL) were assessed at baseline, 6 and 12 months, and radiographic evaluations were made using PAI scores at baseline and 12 months. Mobility was evaluated using periotest values (PTV) at baseline, 1, 3, 6 and 12 months. Replanted teeth, contralateral teeth (control teeth) and adjacent teeth were analysed statistically using repeated measures one-way anova, unpaired t-tests and Wilcoxon matched-pairs signed-rank tests. Two teeth were extracted in the first month after surgery. PI, GI, CAL and PD scores of the replanted teeth were significantly lower at 6 month (P < 0.0001 for all) and 12 month (P < 0.0001 for all) postoperatively when compared to baseline, but the values were not significantly different from those of the control and adjacent teeth. PTV of the test teeth increased significantly (P < 0.0001) after the intervention and decreased to baseline levels by month 12. PTVs were significantly higher (P < 0.05) at baseline, 1, 3 and 6 months in the test teeth when compared with the control teeth, but were not significantly different at month 12. PAI scores of teeth with VRF were significantly lower (P < 0.05) at 12 months compared with baseline. Adhesive cementation and intentional replantation were an effective treatment modality for this group of vertically fractured maxillary single-rooted teeth. The clinical periodontal parameters decrease by month 6, and the mobility returned to the physiological limits of natural teeth 12 months after replantation.

Sealing ability of three hydrophilic single-cone obturation systems: An in vitro glucose leakage study.

Aim:The aim of this study is to compare the corono-apical sealing ability of three single-cone obturation systems using a glucose leakage model.Materials and Methods:A total of 90 freshly extracted human maxillary single-rooted teeth was selected, and their crowns were cut. The root canal of each sample was instrumented using a rotary crown down technique and then divided into four experimental (n = 20 each) and two control groups (n = 5 each). Samples in the experimental groups were filled as follows: Group 1, cold lateral condensation using gutta-percha/AH Plus; group 2, single-cone C-points/smart-paste bio-sealer; group 3, single-cone bio-ceramic (BC) impregnated gutta-percha/endo-sequence BC sealer; group 4, single-cone Resilon/RealSeal SE after 7 days, the sealing ability of root canal fillings was tested at different time intervals using glucose leakage model. Glucose leakage values were measured using a spectrophotometer and statistically analyzed.Results:The four experimental groups presented significantly different glucose leakage values at all test periods (P < 0.05). At the end of the observation period, the cumulative glucose leakage values of groups 2 and 3 were significantly lower than those of groups 1 and 4 (P < 0.05).Conclusion:C-points/smart-paste Bio and BC impregnated gutta-percha/endo-sequence BC sealer combinations provided the superior sealing ability over the lateral condensation technique.

Comparative evaluation of different techniques used to obturate experimental internal resorptive defects – An In Vitro Study

Background: Forty, human, maxillary single-rooted teeth with mature apices were selected. The access cavities were prepared and the working length was determined by placing a 15 K file 1mm short of the apex. All teeth were instrumented at the working length to a 50K file and were irrigated with 2mL of 2.5 % sodium hypochlorite solution. Following instrumentation, the experimental IRC were created. The mounted specimens were randomly separated according to the obturation technique into two groups, Group I-lateral condensation, group II- thermoplasticized obturation. Teeth were sectioned at 7 mm from the apex. Then sectioned root were examined under a dissecting stereomicroscope.(10X magnification) and evaluated by Wardhan India Make with image analysis system MVIG 2005. Results: It is seen that teeth obturated with Hot-Shot obturating technique Shows show better results then lateral condensation technique. Conclusion: Within the limitations of my study I like to conclude that to obturate internal resorption cavities thermoplasticized obturartion technique are superior then that of traditional lateral condensation technique.

Influence of root canal sealer on the radiographic appearance of filling voids in maxillary single-rooted teeth

ObjectiveThis study compared the influence of three epoxy resin-based sealers with distinct radiopacities on the observers' ability to detect root canal filling voids during radiographic analysis. Material and methodsThe root canals of 48 extracted maxillary canines were prepared and divided into three groups. Each group was laterally condensed with one sealer (AH PlusTM, Acroseal® or a non-radiopaque sealer), and a longitudinal void was simulated in half of the specimens from each group (n=8). Buccolingual radiographs were obtained and randomly interpreted for voids by a radiologist and an endodontist in a blinded fashion. Teeth were cut and inspected under a microscope to confirm the position of void. Differences in sensitivity and specificity between groups and examiners were compared using the Fisher's Exact and McNemar tests, respectively (α=0.05).ResultsSignificantly lower sensitivity levels (p<0.05) were observed in the coronal portion of fillings performed with both radiopaque sealers. Specificity values for Acroseal® were significantly higher (p<0.05) in the coronal and apical portions of fillings.ConclusionsThe type of root canal sealer can affect the observers' ability to detect root canal filling voids during radiographic analysis of upper single-rooted teeth.

Comparison of the Impact of Long-Term Applications of MTAD and EDTA Irrigation Agents on Dentin Structure: A Scanning Electron Microscope Study

Aim: The purpose of this study was to compare the effects of 20-min applications of MTAD and 15% ethylenediaminetetraacetic acid (EDTA) solutions during final irrigation on the demineralization of root canal dentin.&#x0D; Methodology: Forty mandibular and maxillary single-rooted teeth were randomly divided into two groups. During initial irrigation following the use of each file, 2 mL of 2.5% sodium hypochloride (NaOCl) solution was applied to all teeth. During final irrigation, 5 mL of EDTA solution was applied to the teeth in Group 1 and 5 mL MTAD solution was applied to the teeth in Group 2. Both solutions were applied for 20 min. All teeth were then washed with 5 mL distilled water and dried with paper points. The teeth were buccolingually bisected along the long axes using hammers and chisels. Scanning electron microscopic (SEM) images were then obtained and scored.&#x0D; Results: Mann–Whitney U tests revealed significant differences between the MTAD and EDTA groups (p &lt; 0.001).&#x0D; Conclusions: The EDTA solution produced more demineralized areas in the dentin tubules than the MTAD solution.&#x0D; How to cite this article: Kaya S, Ayaz SG, Uysal İ, Akkuş Z. Comparison of the Impact of Long-Term Applications of MTAD and EDTA Irrigation Agents on Dentin Structure: A Scanning Electron Microscope Study. Int Dent Res 2011;2:60-64.&#x0D; Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

Clinical Evaluation of Periodontal Surgical Treatment With an Er:YAG Laser: 5‐Year Results

The aim of the present study was to evaluate and compare the long-term clinical outcomes of erbium-doped:yttrium, aluminum, and garnet (Er:YAG) laser-assisted periodontal flap surgery versus conventional treatment with the modified Widman flap procedure. A total of 146 single-rooted periodontally involved teeth from 25 patients were included in this study. In each patient, left or right maxillary single-rooted teeth were assigned randomly to one of two groups: group A (Er:YAG laser) and group B (modified Widman flap surgery). Er:YAG laser was used to debride the bone pockets, scale the root surface, and trim the periodontal flap. Recession, probing depth (PD), clinical attachment level (CAL), plaque index (PI), gingival index (GI), and bleeding on probing (BOP) scores were recorded at baseline and at 3, 6, 12, 24, 36, 48, and 60 months. Both treatments resulted in decreases in PD, PI, GI, and BOP, increases in gingival recession, and gains in CAL. PD reduction in group A versus group B was statistically significant at 6, 12, 24, and 36 months (P < 0.05). Gains in CAL were significantly greater in group A versus group B at 6, 12, 24, and 36 months. BOP scores were significantly lower in group A versus group B at 3 and 6 months (P < 0.05). All other differences between treatment groups were not statistically significant. Surgical treatment of single-rooted teeth with chronic periodontitis using the Er:YAG laser yields greater PD reduction and gains in CAL for up to 3 years compared to conventional Widman flap surgery. The short-term results obtained with both treatments can be maintained over 5 years.

Endodontic abutments and complete dentures

In this in vitro study, 90% of maxillary single-rooted teeth, 89% of maxillary multirooted teeth, 82% of mandibular single-rooted teeth, and 92.5% of mandibular molars had root canals that terminated short of the radiographic root apex. dimensional variability was considerable. Mean measurements provide acceptable levels for underfilling canals and dictate generally applicable levels at which root canal fillings are best terminated. These measurements indicate that, when filling maxillary teeth and mandibular molars, the termination point of the filling should be approximately 0.89 mm short of the radiographic root apex. When filling mandibular single-rooted teeth, the terminal point of the filling material should be approximately 0.69 mm short of the radiographic root apex. Complete overdentures are a valuable alternative to extraction and conventional denture placement. The nonvital teeth that are used for stability, retention, preservation of alveolar bone, proprioception, and psychological support are of critical importance. Failure in endodontic selection and procedure immediately negates the concept of overdentures.