Endodontic Treatment Research Articles

Postoperative pain evaluation in patients undergoing endodontic treatment subsequent to working length determination with and without integrated apex locator endomotor: Randomized control trial

Abstract Introduction: Precise working length control during chemomechanical preparation is one of the primary factors for successful endodontic therapy. Aim: The study aims to evaluate the postoperative pain after determining working length with an integrated apex locator-endomotor and a separate apex locator-endomotor. Subjects and Methods: One hundred and twenty subjects with a diagnosis of symptomatic irreversible pulpitis and preoperative pain score Visual Analog Scale (VAS) >50 were allocated into Group I with nonintegrated apex locator and endomotor and Group II with integrated apex locator endomotor, further treated by single endodontist. Postoperative pain was assessed with a VAS chart on days 1, 3, and 7. The necessity of analgesic intake if required was considered as the highest VAS score. Statistical Analysis Used: Pre- and post-operative VAS scores between the groups were compared using the Mann–Whitney and one-way ANCOVA tests. Results: On days 1 and 3, Group II showed significantly lower values of postoperative pain and lesser frequency of rescue medication when compared with Group I (P < 0.05). On day 7, none of the patients reported postoperative pain. Conclusion: Simultaneous working length determination during instrumentation leads to significantly lesser postoperative pain.

Regenerative endodontic treatment of immature tooth with chronic lesion

Regenerative endodontic treatment of immature tooth with chronic lesion

Regenerative endodontic treatment with autologous platelet-rich plasma

Regenerative endodontic treatment with autologous platelet-rich plasma

Regenerative endodontic treatment of ımmature permanent tooth: Case report

Regenerative endodontic treatment of ımmature permanent tooth: Case report

Case Series of Regenerative Endodontic Treatment

Case Series of Regenerative Endodontic Treatment

Contemporary Applications and Future Perspectives of Robots in Endodontics: A Scoping Review.

In the era of modern advanced endodontics, the reduction of reliance on human hands and shifting towards robotics could benefit the precision and accuracy of endodontic treatment. This scoping review aims to describe current and emerging trends in the applications of robots in endodontics and highlight their limitations and future perspectives. This review followed the PRISMA Extension for Scoping Reviews (PRISMA-ScR) standards. A comprehensive search of internet databases was conducted until February 2024. Studies that specifically examined robots in the field of endodontics were included. The studies focused on root canal cleaning, shaping, surgical procedures, and other applications. Robotic systems demonstrated improved accuracy, precision, reduced errors, and time savings compared with manual techniques. Robotics in endodontics show promise, especially in surgical procedures, with AI integration enhancing accuracy and efficiency. Challenges such as cost, physical limitations, and absence of tactile feedback require further research and investment.

Endodontic Treatment of Persistent Primary Teeth with MTA

Endodontic Treatment of Persistent Primary Teeth with MTA

Regenerative Endodontic Treatment in Immature Permanent Teeth: Case Series

Regenerative Endodontic Treatment in Immature Permanent Teeth: Case Series

Healing of Large Periapical Lesions with Non-Surgical Endodontic Treatment

Healing of Large Periapical Lesions with Non-Surgical Endodontic Treatment

Non-Surgical Triumph: 8-Month Follow-Up on Managing a Large Periapical Abscess - A Case Report.

This case report presents a successful non-surgical management of a large periapical abscess with the use of combination of various conservative techniques.A 10 year-old female patient with large periapical abscess in lower left first permanent molar was treated with non- surgical endodontic treatment. Clinical and radiographic follow-ups over an 8-month period, revealed resolution of symptoms and significant reduction in periapical radiolucency.

Single visit vs multiple visit endodontic treatment

Single visit vs multiple visit endodontic treatment

Single Visit Root Canal Treatment of Teeth with Chronic Periapical Periodontitis

The treatment of periodontitis aims to eliminate the etiological factor, i.e. microorganisms and their toxins; to influence the inflammatory process in the periapical tissues and to stimulate the healing process; to provide an airtight filling of the root canal to isolate the apical periodontium from contact with saliva in the oral cavity. The removal of the etiological factor is associated with mechanical and chemical treatment of the root canal. Since most endodontic problems are of microbial origin, their removal is considered the most important step in root canal therapy. The number of visits for treatment of infected root canals is one of the most discussed topics in endodontics. Endodontic treatment through multiple visits is a traditionally accepted method. However, an alternative protocol involving one visit has been proposed. The aim of this study was to determine the degree of clinical success in teeth diagnosed with chronic asymptomatic apical periodontitis treated by a single-visit method. Thirty one patients aged 16 to 69 years with a confirmed diagnosis of chronic asymptomatic apical periodontitis were included in the study. All proven cases are subject to treatment in a single stage. Based on the data obtained from this task, it is clear that adequate isolation and adherence to the simplified generally accepted irrigation protocol are sufficient to obtain good healing results.

Three-dimensional finite element analysis of the impact of access cavity preparation on first molar fracture resistance: A scoping review.

Access cavity preparation represents the initial step in root canal treatment. Minimally invasive approaches have gained increasing attention and involve advancements in the traditional access cavity preparation. Simultaneously, the development of three-dimensional finite element analysis (3D-FEA) has provided a theoretical foundation for evaluating the merits and drawbacks of various access cavity preparations. Studies using static loading 3D-FEA have suggested that conservative access cavity preparation reduces the concentration of stress in the cervical region, thereby strengthening fracture resistance. However, the lack of support from clinical data raises concerns about the validity of this suggestion. Conversely, studies involving cyclic loading 3D-FEA and dynamic loading 3D-FEA have challenged the prevailing perspectives by taking into account additional factors such as filling materials, thus providing a more comprehensive understanding of the impact of access cavity preparation on fracture resistance. Existing research lacks a comprehensive comparison of the different 3D-FEA methods, and this review fills this gap by providing a systematic assessment of different 3D-FEA methods and their applications in access cavity preparation.

Approach for evaluating the effectiveness of ex vivo root canal instrumentation using microtomography

Endodontic treatment of a tooth involves effective elimination of the infectious process localized in the tooth cavity and root canals. The process of root canal treatment is carried out using specialized rotary instruments (files). In this paper, an approach is proposed for evaluating the effectiveness of root canal treatment using the ProTaper Next file system ex vivo using computed X-ray microtomography and VGSTUDIO MAX 3.5 software. This approach involves comparison of three-dimensional tooth models before and after the endodontic instrumentation procedure, segmentation, calculation of the root canal volume using software according to a specially developed protocol, as well as a study of their microgeometry. As an example of using the approach, a study of the features of root canal instrumentation of two- and three-rooted human molars is presented. The developed approach demonstrated high effectiveness in the process of examining human teeth, while the endodontic procedure was effective for both two- and three-rooted molars in terms of removing the internal biological content of the canals, which indicates the reliability of the applied method. The developed approach can be applied to evaluate the effectiveness of liquid dental materials and antibacterial solutions used during endodontic treatment of teeth.

EFFECT OF INTRACANAL CRYOTHERAPY ON THE POST ENDODONTIC PAIN IN TEETH WITH SYMPTOMATIC APICAL PERIODONTITIS

Objectives: To compare the effect of cryotherapy, room temperature saline and no saline as final root canal irrigants on post-endodontic pain in patients with symptomatic apical periodontitis.Materials and Methods: An observational study was done at the Endodontics Department of Rehman College of Dentistry, Peshawar from August 2023 to January 2024. Ninety patients were selected via purposive sampling technique and underwent root canal treatment. After root canal preparation, patients were equally divided into three groups using the lottery method: Cryotherapy group, room temperature saline group and no saline group. Pain on percussion was recorded pre-operatively and 24hours post-operatively for every patient using the visual analogue scale. Wilcoxon Signed ranks test was used to assess the signifi cant difference between mean pre-endodontic and post-endodontic pain levels. Post hoc analysis was used to compare the significant difference (p value<0.05) between each group. Results: At 24 hour post-operatively, the mean post-endodontic pain scores on visual analogue scale were 2.50± 1.253 for cryotherapy group, 2.70±2.261 for room temperature saline group and 3.63±1.938 for no saline group. The result shows that the post-endodontic pain reduces signifi cantly in all the three groups(p<0.05). However, cryotherapy as the final irrigant was found to be significantly more eff ective in reducing the post-endodontic pain than no saline as the final irrigant (p value 0.029). No significant difference was found in between the cryotherapy group and the room temperature saline groups (p value 0.964).Conclusion: Cryotherapy as the final root canal irrigant is the most effective method of reducing post-endodontic pain as compared to when no saline was used as the final irrigant. Room temperature saline is also as useful as cryotherapy in reducing post-endodontic pain. The findings of the study will be helpful for the dentists to minimize post-endodontic pain.

Testing the Inhibitory Activity of Bajakah Tampala (Spatholobus littoralis Hassk) Wood Extract from South Kalimantan on the Growth of Pseudomonas aeruginosa Bacteria

Background: Dental root canal treatment aims to eliminate microorganisms that cause infection in the tooth root canal, one of which is Pseudomonas aeruginosa bacteria. Disinfection of dental root canals with 0.5% - 5.25% NaOCl irrigation solution is still constrained so it is necessary to look for alternatives. The bajakah tampala plant (Spatholubus littoralis Hassk) is known to contain antibacterial compounds, namely flavonoids, saponins, tannins, and polyphenols. Objective: To evaluate the inhibitory activity of bajakah tampala wood extract (Spatholobus littoralis Hassk) from South Kalimantan against the growth of Pseudomonas aeruginosa bacteria. Method: Post test-only with control group design. The test groups were 100%, 75%, 50% bajakah tampala wood extract solution and positive control 2.5% NaOCL solution. Extraction using maceration method. Bacterial growth inhibition was tested by well diffusion method. Inhibition zone was measured using a caliper. Results: The growth inhibition from the largest to the smallest was shown by 75%, 100% and 50% bajakah wood extracts with mean inhibition zone diameters of 5.05 mm, 3.84 mm and 2.02 mm respectively, meanwhile the positive control was 16.14 mm. One Way Anova test showed significant difference in inhibition (p<0.05) in all groups. Post hoc test showed no significant difference in the inhibition of 75% bajakah tampala wood extract with 100% extract. The inhibition of 100% and 75% extracts was significantly greater than 50% extract. The inhibition of NaOCL 2.5% was significantly greater than all groups of test extracts. Conclusion: Bajakah tampala wood extract has inhibitory activity against the growth of Pseudomonas aeruginosa bacteria.

Antimicrobial Efficacy of a Novel Herbal Endodontic Irrigant Against Enterococcus Faecalis in Root Canals of Permanent Teeth: An in Vitro Study

Background: A successful endodontic treatment is aimed at the sterilization of the entire pulp space. The use of extracts from Rhamnus prinoides as a novel irrigating material for root canal has not been studied . Hence, the antimicrobial efficacy of the alcoholic extract of Rhamnus prinoides as an irrigation material against E. faecalis was evaluated in comparison with the 2.5% sodium hypochlorite (NaOCL) solution used for root canals of permanent teeth. Methods: A total of 30 single-rooted human permanent teeth were thoroughly cleaned, shaped, and disinfected. Then, each tooth was subjected to a two-week infection with Enterococcus faecalis at 37 °C . Afterward, the samples were divided into three groups (10 teeth per group): 0.9% normal saline, 2.5% sodium hypochlorite, and 250 µg/ml Rhamnus prinoides. Paper points were used before and after irrigation to collect samples. Bacterial growth was evaluated after 24 h. Bacterial colonies were counted. The data were examined statistically via one-way analysis of variance, Dunnett’s T3 post hoc test, and Shapiro–Wilk test. The level of significance was set at p<0.05. Results: The 2.5% sodium hypochlorite and 250 µg/ml Rhamnus prinoides demonstrated higher effectiveness against biofilm of Enterococcus faecalis than normal saline (p<0.05). The percentage of antibacterial effectiveness were 94.094 ±3.342, 93.685 ±5.280, and 25.603 ±3.912. Conclusions: Rhamnus prinoides, when used as root canal irrigant solution, was effective the sodium hypochlorite against the E. faecalis biofilm.

Comparative Analysis of NiTi Instruments with Different Alloy Treatments.

This study aims to compare the cyclic fatigue resistance of nickel-titanium (NiTi) endodontic instruments, focusing on the impact of various alloy treatments and manufacturing processes across different generations of these instruments; Twenty instrumentation systems from different generations, comprising both continuous and reciprocating motion designs, were tested. Four hundred instruments underwent cyclic fatigue testing using an INSTRON machine, with the time and number of cycles to fracture (NCF) recorded for each instrument. Statistical analyses were performed to compare the fatigue resistance between systems, generations, and motion types; Instruments treated with advanced thermal processing, such as Excalibur, Reciproc Blue, and TruNatomy, demonstrated superior resistance to fracture, whereas systems like Protaper Universal, K3XF, and 2Shape showed the lowest resistance. Reciprocating instruments generally exhibited higher cyclic fatigue resistance than continuously rotating instruments; Technological advancements in NiTi instrument design, especially the implementation of heat-treated alloys, have improved cyclic fatigue resistance, enhancing the safety and efficiency of endodontic treatments. Reciprocating systems, in particular, exhibit superior fracture resistance, suggesting their greater utility in challenging clinical conditions.

Morphology and root canal configuration of maxillary lateral incisors: a systematic review and meta-analysis.

The purpose of this study was to explore maxillary lateral incisors (MxLI) intern morphology by analyzing existing literature. We searched five electronical databases (Cochrane, Embase, LILACS, Scopus, MEDLINE via PubMed) using keywords and predefined search terms. Additional studies were identified by cross-referencing and reviewing bibliographies of relevant articles. From 92 initial studies, 27 duplicates were removed, and 65 records screened. After full-text review and hand searching were 19 studies included. The most reported root canal configurations (RCC) of MxLI were Vertucci (Ve) I (1-1-1/1; 78.1-100%), Ve II (2-2-1/1; 0.2-5%), Ve III (1-2-1/1; 0.1-14.6%), Ve IV (2-2-2/2; 0.5%), and Ve V (1-1-2/2; 0.5-4.9%). A meta-analysis of six studies from Europe and Asia indicated sex-differentiated patterns in RCC prevalence: higher occurrences of Ve II (2-2-1/1; OR [95%CI] = 1.19 [0.51, 2.73]), Ve III (1-2-1/1; (OR [95%CI] = 1.72 [0.61, 4.85]), and Ve V (1-1-2/2; (OR [95%CI] = 2.95 [1.02, 8.55]) configurations were noted in males, whereas females predominantly exhibited Ve I (1-1-1/1; [95%CI] = 0.99 [0.97, 1.02]), and Ve IV (2-2-2/2; (OR [95%CI] = 0.11 [0.01, 2.02]). Examination methods varied, with cone beam computed tomography (CBCT) being most commonly (n = 11), followed by staining & clearing (n = 5), and radiographic analysis (n = 1). The predominant RCC in MxLI is type Vertucci I. CBCT is the most common method for assessing the morphology of root canals. However, up to 20% of cases may present with complex and sex-specific patterns, highlighting the need for clinicians to be aware of these differences to prevent complications during endodontic treatments.

PERMANENT MANDIBULAR CANINE WITH TWO ROOTS AND TWO CANALS

Mandibular canines are documented as frequently having one root and one canal in most cases, although around 15% may have two canals and two roots. Thus, anatomic variation exists therefore knowledge and keen observation during root canal can help to identify the less frequent variation morphology of tooth and play a pivotal role in the success of root canal treatment. This case report discusses a mandibular canine with two roots and two canals.