root canal obturation

The main issue to be faced to get size estimates of 3D modification of the dental canal after endodontic treatment is the co-registration of the image stacks obtained through micro computed tomography (micro-CT) scans before and after treatment. Here quantitative analysis of micro-CT images have been performed by means of new dedicated software targeted to the analysis of root canal after endodontic instrumentation. This software analytically calculates the best superposition between the pre and post structures using the inertia tensor of the tooth. This strategy avoid minimization procedures, which can be user dependent, and time consuming. Once the co-registration have been achieved dimensional measurements have then been performed by contemporary evaluation of quantitative parameters over the two superimposed stacks of micro-CT images. The software automatically calculated the changes of volume, surface and symmetry axes in 3D occurring after the instrumentation. The calculation ...

Severe pain and/or swelling following a root canal treatment appointment are serious sequelae. Information varies or is incomplete as to the incidence of these conditions and related factors. In this study, data were collected at root canal treatment appointments on demographics, pulp/periapical diagnoses, presenting symptoms, treatment procedures, and number of appointments. Patients that then experienced a flare-up (a severe problem requiring an unscheduled visit and treatment) had the correlating factors examined. Statistical determinations were by chi-square analysis with significance at 0.05 or less. Nine hundred forty-six visits resulted in an incidence of 3.17% flare-ups. Flare-ups were positively correlated with more severe presenting symptoms, pulp necrosis with painful apical pathosis, and patients on analgesics. Fewer flare-ups occurred in undergraduate patients and following obturation procedures. There was no correlation between patient demographics or systemic conditio...

Aim To investigate the attitudes of general dental practitioners (GDPs) and endodontists in the UK towards management of fractured endodontic instruments.Methodology A questionnaire was sent to 330 systemically selected GDPs and all endodontists working in the UK (170). It was accompanied by a covering letter explaining the aims of the study and indicating that all the information given would remain confidential. Those who did not respond to the first mailing were sent another two mailings. Data were analysed using chi-square test at P ≤ 0.05.Results The overall response rate was 75%. Only 18.5% of respondents reported that they would retrieve instruments located in the apical third of root canals with a significantly higher proportion of endodontists (25.9%) compared with that of GDPs (14%) doing so. A significantly higher proportion of endodontists (98.5%) used ultrasonics for removal of fractured instruments compared with GDPs (75.8%). The most common complication of fractured instrument retrieval was thought to be excessive removal of dentine (67%). The majority of respondents (88.5%) reported that they would leave the unsuccessfully removed file in situ and obturate the root canal.Conclusion Both endodontists and GDPs were aware of the limitations of root canal anatomy when removal of fractured instruments was considered. Excessive removal of dentine, the most common complication associated with the removal process, suggests the need for more conservative techniques. Both endodontists and GDPs demonstrated a conservative approach when management of fractured instruments failed. Further studies regarding attitudes of GDPs and endodontists towards some specific aspects of fractured instruments management are required.

PURPOSE This study evaluated in vivo 2 different obturation techniques (lentulo spiral mounted in a slow-speed handpiece and hand-held) in primary teeth. METHODS The study was carried out on 24 children (mean age = 6.71 years) who had received 50 single-visit zinc oxide and eugenol (ZOE) pulpectomies in primary molars. The root canal filling materials were deposited into the canals either by a lentulo spiral mounted in a slow-speed handpiece or by a hand-held lentulo spiral. Evaluation of pulpectomized molars was performed by both authors immediately and 6 months following treatment using specific clinical and radiographic criteria. In cases of disagreement, the lower rank was selected. RESULTS The study found 64% (16/25) optimal filling (if 1 or more of the canals having ZOE ended at the radiographic apex or up to 2 mm short of the apex) when the lentulo spiral mounted in the slow-speed handpiece was used. It also found a 96% (21/22) clinical success rate in the group obturated by ...

Apical periodontitis is a sequel to endodontic infection and manifests itself as the host defense response to microbial challenge emanating from the root canal system. It is viewed as a dynamic encounter between microbial factors and host defenses at the ...

The search for new devices and technologies for endodontic procedures always has been challenging. Since the development of the ruby laser by Maiman in 1960 and the application of the laser for endodontics by Weichman in 1971, a variety of potential applications for lasers in endodontics have been proposed. With the development of thinner, more flexible and durable laser fibres, laser applications in endodontics have increased. Since laser devices are still relatively costly, access to them is limited. The purpose of this paper is to summarise laser applications in endodontics, including their use in pulp diagnosis, dentinal hypersensitivity, pulp capping and pulpotomy, sterilisation of root canals, root canal shaping and obturation and apicectomy. The effects of lasers on root canal walls and periodontal tissues are also reviewed.

The objective of this study was to compare the quality of Guttaflow (Coltene/Whaledent, Langenau, Germany), Resilon/Epiphany (Jeneric/Pentron, Kusterdingen, Germany), and EndoREZ (Ultradent Products, Inc, South Jordan, UT) root canal fillings. Thirty single-rooted teeth were randomly assigned to three groups: Resilon/Epiphany, EndoREZ, and Guttaflow. After radiography of the root canal fillings, the roots were sectioned horizontally at the level of 2 mm and 4 mm from the apex. The area of voids and adaptation to canal walls and points were evaluated using light microscopy and calculated through a computer program. The radiographs showed no significant differences between the materials (p > 0.05, Mann-Whitney U test). Evaluation of cross-sections revealed sealer adaptation >99% to the root canals and >98% to the points. Resilon/Epiphany had significantly higher values at 98.8% (standard deviation [SD] = 3.9%) than EndoREZ at 98.7% (SD = 1.1%), and Guttaflow at 98.5 (SD = 2.1...

In cases of disrupted apical constriction effort is made to create an apical stop and subsequently instrument and obturate the canal up to this point. The aim of this study was to in vitro evaluate the sealing ability of three root canal sealers used with the lateral compaction technique ...

Obtaining a correct working length is critical to the success of endodontic therapy. The aim of this clinical study was to compare the effect of working length determination using electronic apex locator or working length radiograph on the length adequacy of final working length as well as the final obturation.A total of 84 patients with 188 canals were randomized into two groups; in group 1, the working length was determined by working length radiograph, whereas in group 2, it was determined by the Raypex5 electronic apex locator (VDW, Munich, Germany). Length adequacy was assessed in each group for master cone and final obturation radiography and categorized into short, acceptable, and over cases.There was no statistically significant difference between the rates of acceptable (master cone radiography: group 1 = 82.1% and group 2 = 90.4%; final radiography: group 1 = 85.7% and group 2 = 90.4%) and short cases (master cone radiography: group 1 = 7.1% and group 2 = 8.7%; final radiography: group 1 = 1.2% and group 2 = 1%) between the two groups. Over cases in master cone radiography were significantly more in group 1 (10.7%) than group 2 (1%) (χ2, p = 0.00). However, this category did not show a significant difference for final obturation between group 1 (13.1%) and group 2 (8.7%).The results of endodontic treatment using the Raypex5 electronic apex locator are quite comparable, if not superior, to radiographic length measurement regarding the rates of acceptable and short cases. Furthermore, in addition to reducing the radiographic exposure, electronic apex locators are superior in reducing overestimation of the root canal length.

This study evaluated in vivo 2 different obturation techniques (lentulo spiral mounted in a slow-speed handpiece and hand-held) in primary teeth. The study was carried out on 24 children (mean age = 6.71 years) who had received 50 single-visit zinc oxide and eugenol (ZOE) pulpectomies in primary molars. The root canal filling materials were deposited into the canals either by a lentulo spiral mounted in a slow-speed handpiece or by a hand-held lentulo spiral. Evaluation of pulpectomized molars was performed by both authors immediately and 6 months following treatment using specific clinical and radiographic criteria. In cases of disagreement, the lower rank was selected. The study found 64% (16/25) optimal filling (if 1 or more of the canals having ZOE ended at the radiographic apex or up to 2 mm short of the apex) when the lentulo spiral mounted in the slow-speed handpiece was used. It also found a 96% (21/22) clinical success rate in the group obturated by the lentulo spiral mount...

Background Despite numerous studies on the prevalence of apical periodontitis (AP) and endodontic treatment in diverse geographical populations, there are currently no data on the prevalence of these conditions in populations of adults native to Kosovo. Therefore, little is known about how widespread these conditions are, and whether there is any correlation between root canal treatment and AP. The purpose of our research was to address this anomaly by investigating AP and endodontic treatment in an adult Kosovar population based on radiographic examination. Methods The sample used for this study consisted of randomly selected individuals referred to the University Dentistry Clinical Center of Kosovo in the years 2006-2007. Orthopantomographs of 193 patients were evaluated. The periapical status of all teeth (with the exception of third molars) was examined according to Ørstavik's Periapical Index. The quality of the root canal filling was rated as 'adequate' or 'ina...

Previous studies have indicated that vertical root fracture tends to occur in a buccolingual direction, where dentin thickness is greatest. Factors potentially influencing the location and direction of root fracture include root canal shape, external root morphology, and dentin thickness. In this finite-element study, simulated root sections were varied systematically with respect to canal size and shape, external root morphology, and dentin thickness to determine their relative contribution to vertical root fracture. Similar models were constructed based on cross-sections of human tooth roots that had been fractured clinically or experimentally. Finite-element models demonstrated that canal curvature seems more important than external root morphology, in terms of stress concentration, and that reduced dentin thickness increases the magnitude but not the direction of maximum tensile stress. Models based on actual root fractures showed a strong similarity between tensile-stress distr...

The aim of this study was to compare the in vitro sealing ability of ProRoot MTA, ProRoot MTA (Tooth-Coloured Formula), ordinary Portland cement and white Portland cement when used as root-end filling materials. Twenty-four single-rooted human premolars were prepared and obturated using standard techniques, then retrofilled with the test materials. The prepared teeth were immersed in 1% methylene blue dye for 72 hours and then assessed for dye leakage. The depth of dye penetration was measured and expressed as a percentage of the length of the retrofilling. Data was analysed using ANOVA and Fisher's Least Significant Test (LSD) (p < 0.05). None of the teeth in any of the test groups showed leakage beyond the retrofillings. Given the low cost and apparently similar sealing ability of the cements, it is reasonable to consider Portland cement as a possible substitute for MTA as a root-end filling material. However, further tests, especially in vivo biocompatibility tests, need to be conducted before Portland cement can be recommended for clinical use.