Quality Of Endodontic Treatment Research Articles

Retrospective study of endodontic treatment performed by undergraduate students using reciprocating instrumentation and single-cone obturation.

The aim of this cross-sectional retrospective study was to evaluate radiographically the technical quality of root canal treatment performed by undergraduate students using reciprocating NiTi instrumentation and single-cone obturation. Endodontic treatment on 1102 teeth performed by undergraduate students from the School of Dentistry of the University of Santa Cecilia (Brazil) was evaluated. All root canal preparations were performed using Reciproc files and were irrigated with 1% NaOCl. The root canal was filled with gutta-percha, along with AH Plus sealer, using the single-cone obturation technique. The technical quality of the root canal treatment was evaluated based on immediate postoperative radiographs. Distance between the end of the filling and the radiographic apex, the filling density, and the taper of the root filling was assessed. Inter-examiner agreement statistic (Kappa) and Chi-square statistic test were used for statistical evaluation of the results. Differences were considered statistically significant when p < 0.05. Anterior teeth, maxillary premolars, and molars presented better results than mandibular premolars and molars (p < 0.05). Mandibular premolars presented a high incidence of a short length of obturation (33.34%) and mandibular molars presented a high incidence of overfilling (6.55%). The majority of the treatment analyzed (62.46%) fulfilled all the criteria showing acceptable working length, taper, and density of obturation. Instrument fractures occurred in eighteen root canals (0.81%). The use of NiTi reciprocating instruments with the single-cone obturation technique provided an acceptable quality of endodontic treatment in the majority of the cases performed by undergraduate students.

EVALUATION OF ENDODONTIC TREATMENT IN THE PRACTICE OF THERAPEUTIC DENTISTRY

Aim of the study is to study the need for a qualitative diagnosis before endodontic treatment, as well as methods for determining additional root canals, ways of passing the root system of the tooth, irrigation and obturation methods and the frequency of possible complications during endodontic treatment. Materials and Method: The quality of endodontic treatment was studied using the social research method (questionnaire) among dentists from Penza and Penza Region (Russia). 140 practicing doctors participated in the study. Results and discussion: According to the results of the survey, most doctors note a favorable result of endodontic treatment and associate this with the use of X-ray imaging, especially computed tomography, which greatly contributes to the qualitative and accurate mapping of the root system and the surrounding bone structure. Conclusion: After the conducted research, we can assume that in the near future no intervention in the root system will be complete without preliminary X-ray diagnosis and without means of magnification.

Factors related to apical periodontitis in a southern Brazilian population: a multilevel analysis.

The aim of this cross-sectional study was to evaluate the effects of individual-level and tooth-level factors on apical periodontitis (AP) in an urban population in southern Brazil. A random sample of digital panoramic radiographs (n = 545) from a dental school database was evaluated. The diagnosis of AP was determined by using a dichotomous scale (yes/no). AP was assessed according to gender, age, presence and quality of endodontic treatment (ET), presence of an intracanal post, coronal condition, and dental group. Data were analyzed descriptively and through multilevel Poisson regression analysis, considering teeth characteristics (level 1) nested in individuals (level 2). In this sample of 545 participants, the prevalence of AP was 49.5% (n =2 70) and ET was 43.5% (n = 237). Considering 13,595 teeth, AP was identified in 596 (4.4%) and ET in 617 (4.5%). Of the teeth with ET, 153 (24.8%) presented AP. Among individual-level factors, the disease was not significantly associated with gender or age. For tooth-level factors, AP was significantly associated with ET quality: teeth with short fillings (< 3 mm) and teeth with over-fillings had 2.77 (CI: 1.95-3.94, p < 0.001) and 1.08 (CI: 0.39-2.98, p < 0.001) higher prevalence of AP, respectively. There was no association between AP and age, gender, dental group, coronal condition, or the presence of an intracanal post. AP was highly prevalent in this population, and multilevel analysis indicated a significant association with ET quality.

Evaluation of Endodontic Treatment Quality and Periapical Health Status of Maxillary Molars Using Cone-Beam Computed Tomography

ÖZET Amaç: Bu çalışmanın amacı, retrospektif konik ışınlı bilgisayarlı tomografi (KIBT) görüntülerinde endodontik tedavi görmüş üst büyük azı dişlerinin endodontik tedavi kalitelerinin ve periapikal bölge sağlıklarının, periapikal ve endodontik durum indeksi (PEDİ) kullanılarak değerlendirilmesidir. Gereç ve Yöntem: Çalışmaya endodontik tedavi görmüş 80 adet üst büyük azı dişine (47 birinci, 33 ikinci azı) ait toplam 240 kök dahil edilmiştir. Endodontik tedavi kalitesi ve periapikal bölgenin sağlık durumu değerlendirilmiştir. Veriler istatistiksel olarak analiz edilmiştir (p 0.05). Kökler içerisindei se AP en çok meziobukkal kökte tespit edilmiştir. Dişlerin büyük bir çoğunluğunda AP’nin anatomik yapılar ile ilişkili (D2) olduğu (%53.2n=33) gözlenmiştir. Kök kanal dolgusu normal sınırlardan eksik (L2) veya taşkın (L3) olduğunda AP görülmesi anlamlı derecede yüksek bulunmuştur (p=0.001). Distal ve palatinal köklerde yetersiz obtürasyon (H2) ile AP varlığı arasında anlamlı ilişki gözlenmiştir (p=0.001). Dişlerin %16.2’sinde (n=13) komplikasyona rastlanırken, bunlar içerisinde en sık apikal rezorpsiyon (CF5) (n=59) ve tedavi edilmemiş kanal (CF2) (n=17) tespit edilmiştir. Sonuç: Kanal tedavili üst büyük azı dişlerinde AP yüksek oranda saptanmıştır. İncelenen kökler içerisinde AP en çok, kompleks bir anatomik yapı sergileyen meziobukkal kökte tespit edilmiştir. Eksik, taşkın ve/veya homojen olmayan kanal dolumları AP oluşumunda etkili olabilecek faktörler olarak tespit edilmiştir.

Comparison of Obturation Quality between Calcium Silicate-Based Sealers and Resin-Based Sealers for Endodontic Re-treatment.

Background: The objective of this micro-computed tomography (micro-CT)-based study was to compare the filling quality of endodontic treatment and endodontic Re-treatment between two sealers with matched obturation techniques: calcium silicate-based sealer (Endoseal TCS) with a single-cone technique (SCT) and resin-based sealer (AH Plus) with a continuous wave technique (CWT). Methods: Forty maxillary premolars were selected and assigned into four groups, according to the obturation methods of the first endodontic treatment and Re-treatment (n = 10). The AP/AP group was first treated with AH Plus/CWT, then re-treated with AH Plus/CWT. The AP/ET group was first treated with AH Plus/CWT, then re-treated with Endoseal TCS/SCT. The ET/AP group was first treated with Endoseal TCS/SCT, then re-treated with AH Plus/CWT, and the ET/ET group was first treated with Endoseal TCS/SCT, then re-treated with Endoseal TCS/SCT. The specimens were scanned using micro-CT at three time points: after the first endodontic treatment, after gutta-percha (GP) cone removal, and after Re-treatment. The void volume of root canal obturation and the volume of the remaining filling materials were calculated. Data were analyzed using Student’s t-tests and ANOVA. Results: The Endoseal TCS groups (ET/AP and ET/ET) showed a lower percentage of voids than the AH plus groups (AP/AP and AP/ET) on the whole canal and the apical third, after first obturation (p < 0.05). The AH plus group showed significantly fewer remnants than the Endoseal TCS group after GP removal (p < 0.05). Re-treated canals and initially treated canals had similar void volumes (p > 0.05). There was no significant difference in void volume after Re-treatment, regardless of whether the same or different sealers were used for the first treatment and Re-treatment (p < 0.05). Conclusions: Endoseal TCS sealer and AH Plus sealer had a similar Re-treatment efficacy, regardless of which sealer was used in the previous treatment.

Technical Quality of Endodontic Treatment Performed by Underperforming Undergraduate Dental Students

Objectives: This study aimed to evaluate the technical quality of root canal treatment performed by fifth-year underperforming students, in the extra sessions of the 2018–2019 academic year.&#x0D; Methods: Periapical radiographs of teeth endodontically treated by underperforming undergraduate students at King Abdulaziz University Faculty of Dentistry, were collected. The quality of obturation was evaluated radiographically in relation to the length of obturation to root apex, homogeneity and density of obturation, root canal tapering, and incidence of mishaps (such as perforation, ledge, missed canal, separated instruments). The data were subjected to descriptive analysis.&#x0D; Results: The periapical radiographs of 70 treated teeth showed acceptable length, filling density and root canal taper in 96 (80%),50 (41.7%) and 66 (55%) root canals, respectively. Only four teeth were subjected to mishaps.&#x0D; Conclusion: Under the circumstances of this study, the quality of endodontic treatment performed by underperforming students at the extra session was low. More studies are needed to address the student underperformance source and hence amend the quality of root canal filling.

The quality of root canal treatment and periapical status of permanent teeth in Turkish children and teens: a retrospective CBCT study.

This study aimed to assess the quality of root canal fillings and the prevalence of periapical radiolucencies in the permanent teeth of 6-18year-old Turkish children. CBCT images of 150 patients' 235 teeth with a mean age of 16.0 ± 2.06years were included. Root development stage, quality of root canal filling, the presence and severity of periapical radiolucencies, and their relationship with anatomical structures were recorded. Correlations between the quality of root canal filling, periapical lesion, and lesion size were assessed using regression analyses. A total of 235 teeth (528 root canals) were evaluated. 65.5% of root canals had periapical lesions. Immature roots and mandibular teeth had the highest prevalence and the largest size of periapical radiolucencies (p < 0.05). Overfilling (n = 52), underfilling (n = 93), unfilled (n = 46), inhomogeneously filled (n = 113) root canals and poor coronal restoration (n = 85 teeth) were observed in terms of technical failures of endodontic treatment. The quality of endodontic treatment was associated with the presence of periapical lesion and lesion size (p < 0.05). Teeth with under-filled, overfilled or inhomogeneously filled root canals and poor coronal restoration had a periapical lesion larger than 5mm (p < 0.05). Immature teeth were most associated with the presence of lesion (OR = 4.07) and the lesion size > 5mm (OR = 3.71). The prevalence of periapical radiolucencies in young permanent teeth showed an increase when the tooth was an incisor, had incomplete root development, or the root filling had technical errors.

Морфологические особенности строения корневых каналов премоляров и моляров верхней челюсти на основании конусно-лучевой компьютерной томографии

The key issue for dentists of all specialties is the fight against foci of chronic odontogenic infection. Much attention is paid to the introduction of operations that preserve teeth performed at an outpatient surgical appointment, but specialists rarely use them and often remove teeth. The purpose of the study is to determine the morphological features of the structure of the root canals of the premolars and molars of the upper jaw on the basis of cone-beam computed tomography of the jaws, to assess the quality of previously performed endodontic treatment and the frequency of destructive processes in the long-term follow-up. Materials and methods. Anatomical features of the structure of the premolars and molars of the upper jaw were retrospectively studied on the basis of cone-beam computed tomography data in 97 patients aged 26-71 years. 97 teeth (premolars and molars) of the upper jaw were examined in this number of patients. Depending on the belonging to the jaw segments, all the teeth of patients whose anatomical features of the root canals were analyzed, were divided into 4 groups: the first premolars – n=6; the second premolars – n=15; the first molars – n=54; the second molars – n=22. Results and discussion. The study of the morphology of the root canals of the first and second premolars of the upper jaw did not reveal statistically significant differences in the angle of inclination of the root canals, the number of roots and root canals. The analysis of the morphology of the root canals of the first and second molars of the upper jaw also found no significant differences in the angle of inclination of the root canals. At the same time, the share of unsatisfactory endodontic treatment in the analyzed groups of teeth was 82.5%. In addition, destructive bone processes in the periapical region were detected in all molars and premolars of the upper jaw, regardless of the quality of endodontic treatment. Conclusion. Each of the above results as well as all of them together, convincingly demonstrate: 1) insufficient effectiveness of the use of endodontic treatment alone in order to sanitize the foci of chronic odontogenic infection located in the apices of the roots of the molars and premolars of the upper jaw which is largely justified by the features of the anatomical structure of the latter; 2) the need to develop a system of differentiated use of surgical methods of treatment for the rehabilitation of foci of chronic odontogenic infection of the specified localization, taking into account the variant anatomy of the root canals of the premolars and molars of the upper jaw

Endodontic management of multiple roots and root canals in mandibular canine: A case report series

Successful endodontic treatment depends upon the clinician’s precise knowledge and ability to manage complex internal anatomy in order to avoid failure during endodontic treatment. Mandibular canines normally have single root with centrally placed single canal and internal anatomy as simple as could be expected, but there are such canines with a single root with two canals, two roots or fused roots. The occurrence of two canal joining to one for a men may be a rare entity with 4-15% prevalence. Canine is the cornerstone of mouth due to its position and very important as abutment for any type of restoration, so long term success of the restorative depend directly on the quality of endodontic treatment. This article presents a case series of successful endodontic management of mandibular canine with two canals which merge into one canal with one foramina and mandibular canine with two roots and two canals.

Adaptation of a microCT facility for automatic recognition of bioceramic‐based sealers in molar root canals aimed at endodontic treatment quality control

Computed tomography (CT) technology has seen tremendous growth since its first medical applications in the early 1970s. Nowadays, high‐spatial‐resolution digital detectors enable the micro‐computed tomography (μCT) technique, which has been introduced to a wide variety of applications, including biomedical sciences like odontological applications. Endodontic treatments stand as one of the most common dental procedures, and the quality of the treatment is essential to prevent and control any potential infection of root canals. This treatment is typically achieved by careful cleaning, shaping, and sealing steps. Often, endodontic treatments fail due to a poor seal, even if a meticulous root canal preparation is carried out. The present work reports on the spectrometric adaptation of a μCT facility for accurate quantification of root canal sealing with bioceramics, aimed at assessing the sealing performance of the new Bio‐C Sealer product. A dedicated irradiation setup along with digital image processing techniques have been developed for the accurate and automatic recognition of dental samples root canal anatomy and bioceramic‐based sealers. The performance of the proposed approaches has proved to be qualitatively and quantitatively robust for automatic characterization of the endodontic treatment sealing quality, satisfactorily identifying and segmenting canal root, gutta‐percha cone, and bioceramics.

Technical and biological causes of periapical surgery: Retrospective analysis of 301 apical surgical cases

Aim: Endodontic surgery is a treatment for persistent peri-radicular pathological conditions that do not improve after endodontic treatment. The aim of this study was to evaluate the quality of endodontic treatment, technical error types seen in root canals and the periapical condition of the teeth in patients undergoing periapical surgery, and thus to analyze the reasons leading to periapical surgery.&#x0D; Methodology: Clinical and radiographic data of 301 periapical surgery cases were retrospectively evaluated in this study. The causes of periapical surgery were classified into technical and biological reasons.&#x0D; Results: In this study, 51.8 % of periapical surgery cases were related to biological factors and 48.2 % were related to technical factors. Maxillary anterior teeth were the most common teeth undergoing apical surgery with a rate of 66,8 %. The most common technical reasons were non-homogeneous filling (15,6 %), underfilling (12,0 %) and overfilling (9,6 %). The most common biological reasons were cysts (30,2 %), traumas (16,6 %) and apical abscess (5,0 %). 37.5% of cases undergoing periapical surgery, the diameter of the cystic lesion was 10mm or more.&#x0D; Conclusion: The number of cases of apical periodontitis is increasing in the community due to insufficiently filled root canals. Increasing the quality of root canal treatments applied by dentists will reduce the need for periapical surgery by reducing the incidence of apical periodontitis.&#x0D; &#x0D; How to cite this article: Ekici Ö. Technical and biological causes of periapical surgery: Retrospective analysis of 301 apical surgical cases. Int Dent Res 2021;11(1):38-45. &#x0D; https://doi.org/10.5577/intdentres.2021.vol11.no1.7&#x0D; &#x0D; Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.&#x0D;

Prevalence and risk factors of Apical periodontitis in endodontically treated teeth: cross-sectional study in an Adult Moroccan subpopulation

BackgroundThe present study aimed at investigating the prevalence of Apical periodontitis in a Moroccan Adult subpopulation with a non-surgical root canal treatment and to assess associated risk factors including endodontic treatment quality, periodontal health status, coronal restoration cavity design and quality.MethodsA total of 358 endodontically treated teeth were evaluated after more than 1-year period in a Moroccan subpopulation according to predetermined criteria. Studied parameters were assessed clinically and radiographically. The association between coronal restoration quality, cavity design, periodontal status, root canal filling quality, coronal restoration related features, presence or absence of the opposing dentition and the periapical status was determined. Data were analyzed using chi-square test, odds ratio and logistic regression.ResultsThe present study revealed that gingival health, coronal restoration with CL II cavity design, and root canal filling quality influenced periapical status of endodontically treated teeth. Multivariate analysis showed that this association was statistically significant for gingival inflammation (95% CI 1.08–3.91, OR 2.05, p = 0.02), inadequate coronal restoration (95% CI 1.16–4.04, OR 2.16, p = 0.01), inadequate root canal filling length and homogeneity (95% CI 1.24–3.01, OR 1.93, P = 0.004), (95% CI 1.41–4.44, OR 2.50, p = 0.002) respectively.ConclusionsThe present study revealed that inadequate coronal restorations especially with large proximal margins (CL II cavity design) and gingival inflammation increased the risk of apical periodontitis in endodontically treated teeth. Prevalence of Apical periodontitis in the present study was 72.1%.

Quality of Endodontic Treatment and Prevalence of Apical Radiolucencies in a Bulgarian Subpopulation: a CBCT Analysis.

The advent of Cone Beam Computed Tomography (CBCT) in endodontics has enhanced the diagnosis of periapical radiolucencies and the assessment of endodontically treated teeth. The purpose of this study was to assess the prevalence of periapical radiolucencies in a Bulgarian subpopulation and the quality of previous endodontic treatment using CBCT scans. This study included 2795 roots from 160 Large FOV CBCT which were evaluated by two independent examiners using two scoring systems: CBCT-PAI and PESS. The inter-examiner agreement spanned from strong to almost perfect (0.892 and 0.983). The prevalence of periapical lesions according to the two scoring systems was 23.1% and 12.9 %, respectively. The prevalence of endodontically treated teeth was high (34.1%). Sixty-five percent of them presented with signs of periapical radiolucencies, while only 1.4% of all non-treated roots had a periapical lesion. A significant association between periapical disease, poor quality of the root canal filling and inadequate coronal seal was found (p<0.001). The prevalence of periapical disease in endodontically-treated teeth in the Bulgarian subpopulation was high. Poor qual-ity of the root canal filling and inadequate coronal seal were assessed as prognostic determinants of treatment failure. CBCT techniques can augment conventional diagnostic techniques in the field of endodontics.

Qualitative Analysis of Root Canal Treatments performed by Undergraduate Students: A Retrospective Study

Objective: Toanalyze the technical quality of endodontic treatment carried out at the undergraduate dental clinics. Material and Methods: Random radiographic records of 92 patients’ were selected who received endodontic treatment by the undergraduate students from June 2018 to July 2019. The quality of root canal filling was determined in relation to the adequate density, length, and taper. Statistical analysis was performed by using GraphPad (Prism 5), and to determine the association between different variables Chi-square test was used. Results: Adequate technical quality of canal obturation conducted by the undergraduate students was found in less than 65% of the cases. The frequency of adequate root canal taper was significantly greater in maxillary teeth (75%) as compared to mandibular teeth (33%); however, adequacy of acceptable density was found more in maxillary teeth (62%) as compared to mandibular teeth (55%).A statistically significant difference was seen in the quality of root canal fillings between anterior and posterior teeth (p=0.001). Conclusion: The root canal therapy performed by undergraduate students was less than optimum in terms of technical quality. Hence, it is suggested that the endodontic training courses delivered at pre-clinical and clinical levelsfor undergraduate students must be thoroughly revised.

A cone beam computed tomographic evaluation of root canal treatment quality using periapical and endodontic status scale

Background: Cone beam computed tomography (CBCT) is a three-dimensional digital imaging which provides an image that can be viewed in multiple planes thus providing a better understanding of the anatomy of the root canal. Aim: This study aimed to evaluate the endodontic treatment quality of root-filled teeth and to determine the relationship between endodontic technical errors and complications. Materials and Methods: One hundred and fifty-two root canals were evaluated by CBCT from December 2017 to January 2019. Three endodontists assessed the root canals for the presence of technical errors and treatment complications using the periapical and endodontic status scale. Chi-square test and descriptive analyses were performed. Results: Sixty-one (40.4%) root canals had periapical radiolucency followed by 45 (29.8%) root canals with short obturations. Sixty-nine root canals (45.7%) and 45 (29.8%) root canals had nonhomogenous root canal filling and coronal seal (CS), respectively. Statistically significant association was seen with the length of the root canal filling, homogeneity, CS, and complications (P

Systematization of expert approaches and problematic aspects of endodontic treatment quality assessment

Annotation. The lack of unified approach or algorithm for expert assessment of the endodontic treatment quality is the reason for registration of various prevalence indicators considering unsuccessful outcomes of pulpitis and periodontitis treatment, misinterpretation of the results and occurrence of problematic situations during the process of forensic dental assessment of iatrogenic dental status changes. Objective – to systematize and analyze the existing problematic aspects of expert assessment of the endodontic treatment quality and identify the most reasoned approaches for objectification of the endodontic interventions consequences. During provided research the calculation methodologies of indexes designed for assessing the consequences and results of endodontic treatment were studied. Additionally, a retrospective analysis of publications with described cases of complex and commission forensic medical and forensic dental examinations of dental care defects was provided, including endodontic treatment cases, cases with errors during endodontic interventions, and also relevant expert conclusions. Revealed that following index indicators could be used as the most expedient approaches for the objectification of endodontic interventions consequences: Peri-Apical Index (PAI), CBCT-PAI, Complex Periapical Index (COPI), Endodontically Treated Tooth Index (ETTI) and PESS (Periapical and Endodontic Status Scale); however, such indexes do not fully assess the quality of iatrogenic manipulations in the structure of the endodont. Thus, for a comprehensive assessment of the derived parameters associated with the dental treatment quality, and quality of endodontic interventions in particular, it is advisable to include in the forensic dental evaluation protocol the main domains, such as technical characteristics, level of patient satisfaction, level of service provided, additional components of the treatment process, and also additional ones, such as verification of experience, quantification of quality of life associated with changes in dental status, and stratification of the effectiveness of treatment.

Is the technical quality of root fillings associated with socioeconomic status?

Abstract Background Socioeconomically better-off tend to receive better care, and to benefit more from care they receive, than the less well-off. The technical quality of root fillings can be assessed radiographically. Our aim was to investigate differences in the technical quality of root fillings according to socioeconomic status not studied before. Methods In the Finnish Health 2000 Survey, a sample of 8 028 over 29-year-old adults was selected by a stratified two-staged cluster sampling. Of these, 6 115 (76%) underwent panoramic radiography. A total of 7 986 endodontically treated teeth were detected among 3 905 participants. The criterion for a technically inadequate root filling was a distance from the root filling to the root apex of over 3 mm or material over the apex. Education, employment status and household income were used as measures of socioeconomic status. Differences in the quality of root fillings according to socioeconomic status were investigated using the Multiple Additive Regression Tree mediation analysis, taking into account age, gender and tooth type of the root filled tooth. Results Almost half (47%) of the root fillings were inadequate. Root filling quality was associated particularly with age of the participant and type of tooth. Mediation analysis showed that among the over 64-year-olds, higher education or income were associated with a slightly higher probability of inadequate root filling quality (ORs 1.15-1.20, p &amp;lt; 0.05). Among the under 65-year-olds, age of the participant and type of tooth explained the observed variations in root filling quality according to socieconomic status, and socioeconomic status had no influence (ORs 0.99-1.02, p &amp;gt; 0.05). Conclusions Those in a lower socioeconomic status had not received poorer endodontic treatment quality. It seems that those in a lower socioeconomic status are not prone to receive poorer quality care in endodontic setting, that they tend to receive in longer and more socially complex treatments. Key messages Variations in the technical quality of root fillings by socioeconomic status has not been studied. Lower socioeconomic status was not associated with poorer technical quality of root fillings.

An In Vitro Evaluation Study of the Geometric Changes of Root Canal Preparation and the Quality of Endodontic Treatment.

Introduction The geometry of root canals differs in different parts, especially in the apical region, and it is affected by different preparation techniques. The aim of this study was to evaluate the geometric changes of root canal preparation by general dentists regardless of the endodontic instrumentation systems and to study the quality of endodontic treatment by evaluating the untouched areas after mechanical preparation and the smear layer removal. Materials and Methods 100 extracted maxillary canines were collected for the in vitro study from 10 dentists, and the dentists were asked to treat the teeth endodontically. The teeth then were separated and examined under an optical microscope to evaluate the root canal final diameter and the untouched areas. Then, the teeth were examined under a scanned electronic microscope to evaluate the smear layer in coronal, middle, and third parts of the canal. Statistical significance was set as P < 0.05. Results The mean diameter of the root canal after instrumentation in the coronal and middle thirds was 2.50 ± 1.12 and 1.75 ± 1.24 mm, respectively, and the untouched area percentage observed in the apical thirds was 71%. For smear layer removal, it was better in the coronal and middle thirds than in the apical (P < 0.05). Conclusion The changes in the diameter of the root canal, the percentage of untouched areas after mechanical preparation, and the percentage of smear layer were observed in a higher percent in the apical third than in the coronal and middle thirds, and this raises the question of changing the technique of processing the root canal, especially in the apical third.

Is the technical quality of root fillings associated with socioeconomic status? A cross-sectional study among Finnish adults.

We investigated differences in the technical quality of root fillings according to socioeconomic status. In the Finnish Health 2000 Survey, which comprised a sample of 8,028 adults aged over 29yr, 6,115 underwent panoramic radiography. A total of 7,986 endodontically treated teeth were detected among 3,095 participants. The criterion for a technically inadequate root filling was a distance from the root filling to the root apex of over 3mm or a filling extruding beyond the apex. Educational level, employment status, and income were the measures of socioeconomic status. Differences in the frequency of inadequate root fillings according to socioeconomic status were investigated using a multilevel logistic mixed-effects model taking into account age, gender, number of teeth, and type of root filled tooth. Almost half (46%) of the root fillings were inadequate. Among the over 64-yr-olds, higher education and higher income were associated with a higher probability of having an inadequate root filling. Among the under 65-yr-olds, socioeconomic status was not associated with root filling quality. Contrary to expectation, lower socioeconomic status was not associated with poorer endodontic treatment quality; however, higher income and higher education was associated with higher odds for inadequate root fillings among the over 64-yr-olds.

Comparative effectiveness of root canal machining with modern ni-ti tools

The quality of endodontic treatment largely depends on the mechanical cleaning of the root canal, which is carried out in most cases by machine nickel-titanium instruments. Despite their great diversity, there is no universal system that is simple and effective, allowing you to work in the root canal with complex anatomy. Therefore, new tools are being created. Aim . Compare the effectiveness of root canal treatment with three different systems (Reciproc Blue, Mtwo-tile and Soco SC Pro). Perform an analysis of the results using scanning electronic microscopy, assess the quality of mechanical cleaning of the root canal when using these tools. Materials and methods . The study used 30 extracted teeth (with root curvature greater than 25 degrees), divided into 3 groups (10 in each group). In group 1, mechanical processing was performed using Reciproc Blue. The second group used Soco SC Pro system tiles, and the third control group used the Mtwo-tile. Then, thin sections were made and the results evaluated using an electronic scanning microscope. Results . According to the results of scanning electronic microscopy of 15 sections in each group, it was revealed that the maximum number of open dentinal tubes is observed working with Reciproc Blue in 60% of cases, while Soco SC Pro - in 27% of cases and Mtwo-file - in 40%. Based on this study, it can be concluded that the Reciproc Blue system has the best cleaning mechanical ability.As a result, it was found that the time spent working with nickel- titanium tools subjected to heat treatment (Reciproc Blue, Soco SC PRO) is less than when working with Mtwo-fiie. Conclusions . 1. Scanning electronic microscopy studies have shown that the quality of mechanical cleaning when processing the root canal of Reciproc Blue and Mtwo-file is higher compared to Soco SC Pro. 2. The time taken to process the root canal with Reciproc Blue tools is less than when working with Soco SC Pro and Mtwo-fiie. S.Nickel- titanium instruments from M-Wire alloy (Reciproc Blue and Soco SC Pro) allow machining in curved root canals with preservation of their anatomy and the time spent processing the root canal with Reciproc Blue and Soco SC Pro tools is less than with Mtwo-fiie.