Pulpless Teeth Research Articles

In vitro analysis of flowable and high viscosity bulk fill composite versus conventional composite in core build up of endodontically treated teeth.

This study aimed to test the load to fracture of flowable and high viscosity bulk-fill composites compared to a convetional (packable) composite used to build up pulpless teeth. 45 endodontically treated premolars were restored with fiber posts then divided into three groups (N = 15) according to the core build-up material. SDR group: (Smart Dentine Replacement), (BF): Filtek One Bulk Fill and (CC) Filtek Z350 packable composite. After core build up the teeth received full coverage crowns. Load to fracture (Newton) was recorded for each specimen. One-way ANOVA and Tukey multiple comparisons test were used. The highest load at fracture was shown by (CC) group (1067N), followed by (BF) group (879N), and the SDR group (838N). One way ANOVA and Tukey's multiple comparisons test demonstrated no significant differences between CC, SDR, and BF groups (p > 0.05). The three materials showed comparable load to fracture. Further studies with simulation to occlusal forces and oral temperature are required.

ASSESSMENT OF ORTHOPEDIC TREATMENT LATE RESULTS OF PATIENTS WITH FIXED PARTIAL DENTURES DUE TO THE FUNCTIONAL STATE OF ABUTMENT TEETH

The scientific work highlights the results of an index assessment of the periodontal condition of patients abutment teeth with dentition defects which were replaced with metal-ceramic fixed partial dentures due to partial teeth loss. Since during the preparation of abutment teeth there is sometimes a need for endodontic treatment of them due to medical indications, we investigated the state of the periodontium before, during and after treatment and compared index indicators of pulpless teeth with teeth in which the vascular-nerve bundle was preserved. It was established that the periodontium of the vital tooth recovers and functions much better in comparison with the surrounding dental tissues of a nonvital tooth. Where there are inflammatory changes, which are objectively caused by pronounced swelling and bleeding of the gingival papilla. It is caused due to rubber dam pressure, which in turn is confirmed by reliable data of index indicators determined in various the terms of the treatment.
 After conducting a detailed examination of patients with vital abutment teeth with defects in the hard tissues of the teeth, we found that in the age group of 30-39 years, the most common defect in the hard tissues of the teeth was caries damage, which was observed in 8 patients (72.7%), damage due to injuries was found in 2 patients (18.2%), enamel hypoplasia was found in 2 patients (18.2%).
 Treatment of partial adentia involves the preparation of abutment teeth followed by the manufacture of fixed bridge prostheses. However, the vitality of the abutment tooth should be taken into account and the reserve forces of the periodontium should be taken into account in order to prevent functional overload. It is also necessary to monitor the hygienic condition of the oral cavity during the treatment and at various times after its completion.
 The peculiarity of the proposed method of preparation of vital upper and lower abutment teeth consists in the creation of a champfer on the vestibular surface with the transition to an imitation of a champfer on the oral surface, under constant control of the thickness of the peripulpal dentin using a dentometer with the use of full water cooling and subsequent fixation of provisional crowns. The use of a complex of diagnostic techniques for full control of the effectiveness of treatment during and after prosthetics at different times is substantiated and proposed.
 The gnathodynamometric study was carried out using an advanced device, the VIZIR E1000 gnathodynamometer: the plates placed between the opposing teeth were bitten, as a result of which the load was digitized using a flexible connection through an analog-digital converter and displayed on the display of a computer program, displayed graphically in newtons (N), the time of the masticatory load was also recorded in seconds.
 Using data from clinical indices, it was determined that the preservation of vital teeth is a reliable criterion of the effectiveness of the use of partial fixed prostheses than the use of pulpless teeth. The absence of periapical trauma in vital teeth, which occurs in pulpless teeth due to extirpation of the neurovascular bundle, is demonstrated by the Russel index, and other indices also demonstrate mucosal irritation caused by the use of rubber dams due to the need for quality endodontic treatment.

One-year clinical observation of the effect of internal bleaching on pulpless discolored teeth.

This study aimed to observe the color rebound and rebound rates of non-pulp discolored teeth within 1 year after routine internal bleaching to guide clinical practice and prompt prognosis. In this work, the efficacy of bleaching was observed in 20 patients. The color of discolored teeth was measured by using a computerized colorimeter before bleaching; immediately after bleaching; and at the 1st, 3rd, 6th, 9th, and 12th months after bleaching. The L*, a*, and b* values of the color of cervical, mesial, and incisal parts of the teeth were obtained, and the color change amounts ΔE*, ΔL*, Δa*, and Δb* were calculated. The overall rebound rate (P*) and the color rebound velocity (V*) were also analyzed over time. In 20 patients following treatment, the average ΔE* of tooth color change was 14.99. After bleaching, the neck and middle of the teeth ΔE* and ΔL* decreased in the 1st, 3rd, 6th, 9th, and 12th months, and the differences were statistically significant. Meanwhile, from the 9th month after bleaching, the rebound speed was lower than that in the 1st month, and the difference was statistically significant. The incisal end of the tooth ΔE* and ΔL* decreased in the 6th, 9th, and 12th months after bleaching, and the differences were statistically significant. No significant difference was found in the rebound speed between time points. However, this rate settled after the 9th month, with an average color rebound rate of 30.11% in 20 patients. The results indicated that internal bleaching could cause a noticeable color change on pulpless teeth. The color rebound after bleaching was mainly caused by lightness (L*), which gradually decreased with time, and it was slightly related to a* and b*. The color of the teeth after internal bleaching rebounded to a certain extent with time, but the color rebound speed became stable from the 9th month. Clinically, secondary internal bleaching can be considered at this time according to whether the colors of the affected tooth and the adjacent tooth are coordinated and depending on the patient's needs.

General Consideration of Post Systems

More often than not pulpless teeth remain relatively intact after conservative endodontic treatment. Although it hasn't been shown that endodontically treated teeth are more brittle than healthy ones, pulpless teeth are known to crack during mastication. As a result of this known phenomenon, dental professionals have been looking for strategies to prevent pulpless teeth from breaking. Restoration and reinforcement of pulpless teeth is a crucial preventative step in endodontic therapy. A post is cemented into the root canal to reinforce a healthy endodontically treated tooth. The post is supposed to reinforce the tooth and keep it from breaking. A widely used technique for repairing teeth that have undergone endodontic treatment is post and cores. Retention applied onto the root thorough final restoration using the post and core restoration as a substructure. Therefore, post placement in the root is crucial. In order to ensure retention for a fixed restoration, endodontically treated teeth are frequently treated with posts and cores. Teeth that had gone through endodontic treatment often suffer from severe coronal damage. In order to ensure retention for full or partial coverage restoration, these teeth may require a coronal substructure or core for retention of a full or partial bonding restoration. Generally, primary retention feature of a core is an intraradicular post. Posts and cores are routinely used for endodontical teeth restoration. This article provides a review presentation about utilization of post systems on the pulpless tooth.

Saving the pulpless teeth

Endodontically treated teeth become fragile unless optimally restored. Treatment planning of these teeth should take into account the remaining coronal tooth structure as well as the functional requirements. A successful treatment of these teeth with significant tooth structure loss requires not only an effective endodontic therapy but also prosthodontic rehabilitation of the tooth. Simple and successful procedures can be viable treatment options for conserving the endodontically treated teeth with severe coronal tooth structure loss. Hence, the aim of this case series was to present different approaches to restore endodontically treated teeth with minimal coronal structure.

Effect of Restorative Crown of Different Cuspal Inclination and Occlusal Contact on Stress Distribution in Mandibular Second Premolar with Different Ferrule Configuration and Peripheral Bone- 3D Finite Element Analysis

Background: Restoration of pulpless teeth have been difficult because of coronal loss from dental caries, diminished moisture content, endodontic therapy and fractures, resulting in prone to fracture of the tooth during function. Cast metallic band enclosing around cervical surface of a tooth is called ferrule. The role of ferrule is to assist in strengthening the endodontically treated tooth.
 Purpose: In case of ferrule less tooth, the post performs as a wedge and may result in root fracture. Therefore modification in design of ferrule is required. Presence or absence of ferrule of coronal dentin influenced stress distribution pattern within tooth structure. Failure or success of a restoration may be influenced by on how the stress is dispersed to the tooth structure so it is essential to study the stress dispersal pattern within tooth and associated structure.
 Materials and Methods: A three-dimensional FE method (FEM) will be carried out for study and finite element structural analysis programs will be HYPERMESH 11 and ANSYS 18.1 software. Eight 3D models will be created to simulate endodontically restored mandibular second premolar with different coronal dentin configurations. The complete crown will be modeled with a 20-degree, 33- degree, 45-degree facial cusp inclination. The oblique force of 200 N will be executed to the buccal cusp of mandibular second premolar. Analysis of results will be done by both color-coding and numerically. By using FEA software the von Mises equivalent stress (MPa) will be calculated.

Vascularized pulp regeneration via injecting simvastatin functionalized GelMA cryogel microspheres loaded with stem cells from human exfoliated deciduous teeth.

Dental pulp necrosis are serious pathologic entities that causes tooth nutrition deficiency and abnormal root development, while regeneration of functional pulp tissue is of paramount importance to regain tooth vitality. However, existing clinical treatments, which focus on replacing the necrotic pulp tissue with inactive filling materials, fail to restore pulp vitality and functions, thus resulting in a devitalized and weakened tooth. Currently, dental pulp regeneration via stem cell-based therapy for pulpless teeth has raised enormous attention to restore the functional pulp. Here, a novel design of injectable simvastatin (SIM) functionalized gelatin methacrylate (GelMA) cryogel microspheres (SMS) loaded with stem cells from human exfoliated deciduous teeth (SHEDs) was established to refine SHEDs biological behaviors and promote in vivo vascularized pulp-like tissue regeneration. In this system, SIM encapsulated poly (lactide-co-glycolide) (PLGA) nanoparticles were incorporated into GelMA cryogel microspheres via cryogelation and O1/W/O2 emulsion method. SMS with sustained release of SIM promoted SHEDs adhesion, proliferation and exhibited cell protection properties during the injection process. Furthermore, SMS enhanced SHEDs odontogenic differentiation and angiogenic potential, and SHEDs loaded SMS (SHEDs/SMS) are beneficial for human umbilical vein endothelial cells (HUVECs) migration and angiogenesis, demonstrating their potential for use in promoting vascularized tissue regeneration. SHEDs/SMS complexes were injected into cleaned human tooth root segments for subcutaneous implantation in nude mice. Our results demonstrated that SHEDs/SMS could induce vessel-rich pulp-like tissue regeneration in vivo and that such an injectable nano-in-micro multistage system for the controlled delivery of bioactive reagents would be suitable for clinical application in endodontic regenerative dentistry.

An Immature Traumatic Teeth Management With Apical Pathology Using the Novel Biodentine™ Obturation: A Case Report

Pulpal and periapical pathosis in an immature anterior tooth following traumatic injury is a frequent occurrence, and management of open apices in such cases poses a constant challenge to endodontists. This is due to the absence of apical constriction that would result in poor three-dimensional seal/adaptation of the obturated material within the canal system. Treatment of immature pulpless teeth with long-term calcium hydroxide may consequently weaken the dentin and increase the fracture susceptibility. Obturating the root canals completely with bioactive agents like Biodentine/mineral trioxide aggregate (MTA) has benefits like increased fracture resistance when compared to apexification. When used for obturation, Biodentine™, a new calcium silicate-based cement, performs superior to other Portland cement derivatives. This case report demonstrates a six-month follow-up result of an open apex and a periapical lesion involving maxillary right central incisor #11 with the Biodentine obturation that was previously subjected to triple antibiotic paste as an intra-canal medicament for three weeks. The satisfactory healing rate of tooth 11 with the reduction in the size of periapical radiolucency at the end of the six-month follow-up in this current article is highly considerable.

Fabricated CAD/CAM Post-Core Using Glass Fiber-Reinforced Resin Shows Innovative Potential in Restoring Pulpless Teeth.

The prevention of root fractures of pulpless teeth is an important clinical issue to maintain healthy teeth through lifetime. The aim of this study was to examine a clinically effective treatment method for strengthening vulnerable pulpless teeth using CAD/CAM (computer-aided design/computer-aided manufacturing) fiber-reinforced post-core by conducting a fracture resistance test. A post-core made with a fiber-reinforced resin disk TRINIA (TR, SHOFU, Kyoto, Japan) was fabricated using a CAD/CAM system. The fiber-layer orientation of the CAD/CAM post-core was parallel to the axis of the restored tooth. A post-core using a conventional composite and a fiber post (CF) was also prepared. A fracture resistance test of teeth restored with the post-cores and zirconia crowns was conducted using a universal testing machine, and fracture patterns were identified by micro-CT observation. The fracture load of the roots restored with TR was 1555.9 ± 231.8 N, whereas that of CF was 1082.1 ± 226.7 N. The fracture load of TR was 43.8% that was significantly higher than that of CF (Student’s t-test, p < 0.05). The restored teeth with CAD/CAM resin post-core were found to be repairable even after fracture. These results suggest that the CAD/CAM indirect fiber post-core has the potential to strengthen the vulnerable pulpless teeth.

Fabrication of Vascularized DPSC Constructs for Efficient Pulp Regeneration

Dental pulp regeneration is a promising approach to restore the vitality of necrotic teeth. We have previously reported the fabrication of scaffold-free cell constructs containing only dental pulp stem cells (DPSCs) and their ability to form pulp-like tissue in the pulpless tooth. However, the DPSC construct could not build pulp-like tissue with a full root length because it is difficult to induce blood vessels from a small root canal foramen. Therefore, we hypothesized that vascular structure could be preformed in the DPSC construct by employing endothelial differentiation capability of DPSCs, and vascularized constructs might facilitate dental pulp regeneration in the pulpless tooth. In this study, vascularized DPSC constructs were fabricated by inducing endothelial differentiation, and then we investigated the behavior of differentiated DPSCs, the internal structure of cell constructs, and their pulp regenerative ability in vivo. We observed that DPSCs positive for CD31 and von Willebrand factor were localized at the outer layer of constructs and formed a reticulated lumen structure. The cells constituting the outer layer of the construct expressed endothelial differentiation markers at higher levels than cells in the inner part. These results indicated that DPSCs in the outer layer differentiated into endothelial cells and formed vascular-like structures in the cell construct. Next, a vascularized DPSC construct was transplanted into the human pulpless tooth that was implanted into immunodeficient mice in the subcutaneous space. After 6 wk of implantation, the vascularized construct formed pulp-like tissues with higher density of human CD31-positive blood vessels when compared with specimens implanted with a DPSC construct without prevascularization. These results suggest that the vascular structure formed in the DPSC construct facilitated the blood supply and enhanced pulp regeneration. This study demonstrates that a vascularized DPSC construct is a prospective biomaterial as an implant for novel dental pulp regeneration.

Mechanisms Involved in Apice Closure of Pulpless Teeth – Literature Review

Background: Unfinished root formation has always offered challenges in endodontics due to technical difficulties and weakened teeth resistance during the lifetime of an individual. Pulp revascularization therapy appeared as a solution for apical closure and root maturation. The existence of oral stem cells involved in the process associated with traditional resident cells requires adequate blood supply given by induced controlled injury deliberately accomplished into the periapical zone. Objective: The aim of this work was to research, through literature review, the main mechanisms involved in the process of apical closure through the technique of pulp revascularization. Conclusion: Apice closure in pulpless teeth seems to happen as a result of professional intervention and biological activity. The success rate depends on the role of traditional local immune cells and stem cells associated with adequate blood supply to finish root formation.

English

Traumatic injuries to an immature permanent tooth may result in cessation of dentin deposition and root maturation. Novel revascularisation endodontic procedure (REP) has been considered as an option for treatment of immature teeth with damaged pulp tissue. The continuous development of the root and the root canal has been recognised as a major advantage of this technique over traditional apexification approach. Traditional apexification procedures may resolve pathology but have not been able to prove tooth survival due to absence of continued root development and risk of root fracture. A successful REP results in resolution of signs and symptoms of pathology, radiographic signs of healing, proof of continued root development as well as presence of pulp vitality due to the regeneration of pulp tissue in the root canal. Currently, repair rather than true regeneration of the ‘pulp-dentine complex’ is achieved and further root maturation is variable. According to Glossary of Endodontic terms published by American Association of Endodontists, REP’s are biologically based procedures designed to physiologically replace damaged tooth structures, including dentin and root structures, as well as cells of the pulp-dentin complex.1,2 Apexification treatment has been a routine procedure to treat and preserve such teeth for many decades.3 Apexification is the process by which a suitable environment is created within the root canal and periapical tissue to allow for the formation of a calcific barrier across the open apex. Calcium hydroxide [Ca(OH)2] has been the material of choice for apexification as Frank reported its capacity to induce physiological closure of immature pulpless teeth in 1966.4 However, this technique has several disadvantages, including the unpredictability of apical barrier formation and the long duration of treatment, which often requires multiple visits.5 A retrospective study by Jeruphuaan et al.6 has shown a higher survival rate with regenerative endodontic treatment when compared to both mineral trioxide aggregate (MTA) and Ca(OH)2 apexification. The first evidence of regeneration of dental tissues was in 1932 by G.L. Feldman, who showed evidence of regeneration of dental pulp under certain optimal biological conditions.7 In 1971, a pioneer study in regenerative endodontics conducted by Nygaard-Ostby concluded that bleeding induced within a vital or necrotic canal led to resolution of signs and symptoms of necrotic cases and in certain cases, apical closure.8 According to Windley et al. (2005), the successful revascularisation of immature teeth with apical periodontitis is mainly dependent upon: 1. Canal disinfection 2. Scaffold placement in the canal for the growing tissues 3. Bacteria-tight sealing of the access opening.9 The purpose of this case report is to illustrate the outcome of a revascularisation endodontic procedure in a non-vital immature young permanent central incisor.

Comparison of fracture resistance of endodontically treated maxillary first premolar with mesio-occlusal-distal access restored with composite resin, fiber post, and prefabricated metal posts restored with/without full-coverage metal crowns.

Background:A myriad of materials and procedures have been recommended for restoring the root-filled teeth with significant loss of tooth structure and the most common method being the use of “posts.”Material and Methods:A mesio-occluso-distal preparation was done on eighty intact maxillary first premolars, followed by access preparation and cleaning and shaping with rotary files. All samples were obturated and divided into four groups (n = 20). In Group 1, 3-mm gutta-percha was removed and restored using composite resin; Group 2 – Group 1 + crowns; Group 3 – prefabricated fiber post + crowns; and Group 4 – prefabricated metal post + crowns. All the groups were subdivided into eight groups (n = 10), fractured with 90° vertical and 45° oblique loading by a universal testing machine.Statistical Analysis:Fracture resistance was analyzed and compared by means of two-factorial two-way analysis of variance and Scheffe's post hoc test.Results:Under 90° loading, the fracture load of teeth restored with the Nayyar's composite resin core and crown was greatest. Under 45° loading, the fracture load of teeth restored with prefabricated metallic posts was significantly (P < 0.05) less than that in other groups. Under 45° load, group with fiber post exhibited significantly (P < 0.05) more number of favorable fractures than other groups.Conclusion:Under the conditions of vertical and oblique loadings, fiber post and composite resin core with a full-coverage crown is the most effective restorative modality for protecting the remaining tooth structure in pulpless teeth.

Root fractures in seniors: Consequences of acute embrittlement of dentin

Dentin undergoes irreversible changes in microstructure with aging that involve gradual filling of the tubule lumens with mineral. Known as dental sclerosis, this process begins at the root apex, progresses coronally, and is associated with a degradation in the resistance to fracture of dentin. ObjectiveTo determine i) age-related changes of intertubular dentin with aging, particularly within the root, and ii) the differences in age-related degradation between vital and pulpless (i.e. non-vital) teeth. MethodsWe performed nanoscopic dynamic mechanical analysis (nanoDMA) in scanning mode on the intertubular and peritubular dentin of teeth from young and old adults. The complex, loss and storage moduli, as well as the tan delta parameter were evaluated for teeth with no restorations and teeth with root canal treatment (non-vital). ResultsThere were significant changes in the dynamic moduli of intertubular dentin with age, which were most substantial in the apical third of the root. The storage modulus of the intertubular dentin, which quantifies the purely elastic resistance to deformation, was significantly (p < 0.0005) larger for both the old vital and non-vital teeth than that of the young teeth, over the entire root length. However, the tan delta parameter, which quantifies the relative capacity for viscous deformation, was significantly lower in these two groups (p < 0.005). SignificanceRadicular dentin undergoes an embrittlement with aging, involving reduced capacity for viscous deformation. The extent of degradation is largest in the apical third. Removal of the pulp appears to accelerate the aging process or compound the extent of degradation.

Evaluation of Shears Strength of Dowel Amalgam and Post-amalgam in Root Canal-treated Teeth

Introduction: Amalgam, which can be applied with or without dowel, is one of the commonly used restorative materials for core restoration in pulpless teeth. The current study aimed to compare the shear strength of amalgam cores with and without dowel. Methods: A total number of 20 recently extracted mandibular premolars were assigned to two groups of 10 equal specimens, including group I: dowel amalgam restored with prefabricated dowel and amalgam core and group II: post-amalgam restored with amalgam as a post and core. All Specimens were stored at humidity and room temperature prior to testing. Each specimen was carefully placed in a special jig at a 90-degree angle to the axis of teeth and subjected to a load that was recorded in kgf on a Zwick/material testing machine at a crosshead speed of 0.5 mm/min until failure. Independent T-test was used to compare the results. Results: Based on the obtained results, the mean shear strengths were reported as 37.7±10.49 and 16.8±6.37 kgf for dowel amalgam and post-amalgam, respectively. There was a statistically significant difference between the two groups (P<0.0001). Conclusions: The obtained results demonstrated a significant difference between the two groups. Accordingly, the use of dowel with amalgam to restore pulpless teeth has higher compressive strength, as compared to the use of post-amalgam

Does microgravity effect on oral and maxillofacial region?

AbstractSince the beginning of the era of space travel, there have been mentions of related health effects. Various studies have described the effect of space travel and microgravity on health. Some of these studies involved short and extended follow-ups of the effect of microgravity on the head and neck of astronauts. Therefore, we aimed to analyse the oral and maxillofacial health effects associated with this sophisticated mission. It is essential to identify relevant problems and address microgravity complications. Humans have long dreamed of flying and in recent years, the dream has evolved to exploring space and creating new habitats on other planets such as Mars. This led to an increase in the need for dental treatment of the flight crew members, which led to the creation of aviation dentistry for the screening and treatment of the oral cavity of the flight crew. We are moving towards a more conservative approach than before, such as removing pulpless teeth in aircrew patients or extracting roots that had a fracture or incomplete extraction. With all the advancements in aerospace knowledge, the aviation dentistry has rarely or briefly been discussed in dental textbooks. Dentists must screen each flight crew member thoroughly and impose flight restrictions and ground them if necessary; the reasons will be discussed later within this paper. It is the duty of dentists and surgeons to notify their patients (aircrew members) about the postoperative flight consequences and restrictions.

Decision making and restorative planning for adhesively restoring endodontically treated teeth: An update

Restoration of pulpless teeth presents a clinical challenge and a controversial topic of debate even today. The preservation of coronal tooth structure is crucial for clinical success and for maintaining biomechanical, adhesive, functional, and esthetic balance. The advent of adhesive dentistry and advancement in dental materials have resulted in mechanical properties close to the dental tissues, thereby offering a conservative treatment option to restore, reinforce, and protect endodontically treated teeth (ETT). Directly bonded restorations are indicated for teeth with the minimal loss of coronal tooth structure and can be considered effective for short-term success of root canal treated teeth. However, indirect restorations could be considered for the strengthening of the tooth with moderate loss of tooth structure, following the adequate adhesive protocols. The present review assesses literature on direct versus indirect adhesive restorations such as endocrowns, adhesive onlays, and overlays for restoring ETT. Furthermore, the article attempts to present clinical guidelines and decision-making for restoring endodontically treated anterior and posterior teeth.

An In Vivo Comparative Evaluation of Postoperative Complications in Single- versus Multiple-Visit Endodontic Therapy: 18-Month Follow-Up

Abstract Objective The goal of root canal therapy is thorough disinfection and obturation of the root canal system in all its dimensions. Success of endodontic treatment is highly related to the elimination of postendodontic pain, tenderness, and swelling.Single-visit endodontic therapy has several advantages such as increased patient acceptance, less overhead costs, and only single time local anesthesia administration is required.Multiple-visit endodontic (MVE) treatment allows the clinician to determine the effect of the therapy on the inflamed tissues and shorter appointments.This in vivo study was undertaken to compare the postoperative incidence of pain, swelling, tenderness, and radiographic evaluation of periapical pathology following single- versus multiple-visit endodontic therapy in vital as well as nonvital teeth. Materials and Methods A total of 60 subjects in the age group of 15 to 50 years were selected for the study. The patients were divided into four groups:• Group 1 (n = 15): Single-visit endodontic (SVE) therapy with vital pulp involvement without periapical rarefaction.• Group 2 (n = 15): SVE therapy of asymptomatic pulpless teeth with periapical rarefaction as observed in radiographic evaluation.• Group 3 (n = 15): MVE of vital pulp involvement without periapical rarefactions.• Group 4 (n = 15): MVE therapy of asymptomatic pulpless teeth with periapical rarefaction as observed radiographically.Access cavity was prepared, working length was taken. Biomechanical preparation was done with Protaper universal rotary file system and obturation was done immediately in single-visit cases.In multivisit cases, Ca (OH)2 is placed as an intracanal medicament and obturation was done with the help of AH plus sealer and gutta-percha.Postobturation pain levels, swelling, and tenderness on percussion were assessed till 6 weeks. The radiographic parameter was studied till 18 months follow-up. Results Among the different experimental groups, maximum patients in MVE without periapical rarefaction showed no pain according to visual analog scale (VAS) scale, swelling, and tenderness and in SVE with periapical rarefaction showed maximum number of patients reported with pain, tenderness, and swelling.At 4 and 6 weeks postoperatively, patients in all the groups exhibited no pain, swelling, and tenderness to percussion.As periapical rarefaction, healing of periapical lesion was evident in all the patients after 18 months.

Investigation of different sodium hypochlorite volumes, concentrations and times of irrigation in endodontic therapy: a systematic review

Investigation of different sodium hypochlorite volumes, concentrations and times of irrigation in endodontic therapy: a systematic review

РЕЗУЛЬТАТЫ ВНУТРИКОРОНКОВОГО ОТБЕЛИВАНИЯ ДЕПУЛЬПИРОВАННЫХ ЗУБОВ

&#x0D; Изменение в цвете депульпированного зуба – весьма распространенное и многофакторное по этиологии явление, являющееся частой причиной обращения к стоматологу, особенно если потемневший зуб находится в линии улыбки. Цвет зубов, в свою очередь, наряду с их формой и оптическими свойствами, является важнейшим эстетическим критерием современного человека. Одним из способов исправления цвета таких зубов является внутрикоронковое отбеливание. Целью исследования было оценить эффективность внутрикоронкового отбеливания и восстановления флуоресцентных свойств депульпированных зубов в зависимости от типа используемого силлера при эндодонтическом лечении и причин депульпирования. Для изучения эффективности внутрикоронкового отбеливания депульпированных зубов провели отбеливание 194 зубов 190 пациентам, обратившихся в Клинику ВГМУ и на кафедру терапевтической стоматологии с курсом ФПК и ПК УО «ВГМУ» в период 2014–2018 гг. с жалобами на изменение в цвете зубов после эндодонтического лечения. Средний возраст пациентов составил 34,6±8,2 года. Результаты полученных данных свидетельствуют о том, что эффект отбеливания с восстановлением цвета и флуоресцентных свойств до исходных характеристик витального зуба был достигнут у 72 зубов из 194 (37,11%). У 122 зубов (62,89%) необходимого отбеливания и восстановления флуоресценции не произошло. Из них частично отбелилось 68 зубов (35,05%), не отбелилось 54 зуба (27,84%). В зубах, корневые каналы которых были обтурированы материалами на основе эвгенола, цветовые и флуоресцентные параметры восстановлены в 50% случаев. При обтурации корневых каналов депульпированных зубов силлером на основе резорцин-формалина восстановления цвета и флуоресценции не произошло ни в одном из случаев. Зависимости эффективности отбеливания депульпированных зубов от причины, вызвавшей дисколорит, не выявлено. Однако наиболее частой причиной возникновения изменения в цвете депульпированного зуба был осложненный кариес.&#x0D;