Dissolving efficacy of some organic solvents on gutta-percha.

Braz Oral Res. 2007;21(4):303-307

Authors: Magalhães BS, Johann JE, Lund RG, Martos J, Del Pino FA

The aim of this study was to evaluate the solubility of gutta-percha in four organic solvents used in endodontics. The solubility of gutta-percha (Dentsply) was assessed in xylol, orange oil, eucalyptol, chloroform and distilled water. A hundred and fifty samples of gutta-percha were prepared using a standardized stainless steel mould and divided into five groups for immersion in the different solvents tested and in distilled water (control group) for 2, 5 and 10 minutes. The means of gutta-percha dissolution in the solvents were obtained by the difference between the pre-immersion original weight and the post-immersion weight in a digital analytical scale (Gehaka - AG2000). Data were statistically analyzed by Analysis of Variance (ANOVA) and multiple comparisons with Scheffes test (p < 0.05). The best solvency capacity was obtained with xylol. Chloroform, orange oil and eucalyptol presented similar results, and distilled water did not promote alterations in the gutta-percha.

PMID: 18060255 [PubMed - as supplied by publisher]

Clinical relevance of trans 1,4-polyisoprene aging degradation on the longevity of root canal treatment.

Braz Dent J. 2007;18(2):97-101

Authors: Maniglia-Ferreira C, Valverde GB, Silva JB, Paula RC, Feitosa JP, Souza-Filho FJ

This in vivo study investigated the time of degradation of root filling material (trans 1,4-polyisoprene) retrieved from endodontically treated teeth and correlated the occurrence of degradation with the longevity of endodontics. Thirty-six root-filled teeth with different filling times (2 to 30 years) and with and without periapical lesions were selected. All teeth presented clinical indication for root canal retreatment. The association among filling time, presence of periapical lesion and root filling material degradation was investigated. Root filling samples were retrieved from the root canals using a Hedstr&#xF6; m file without solvent. The trans 1,4-polyisoprene was isolated by root filling solubilization in chloroform followed by filtration and centrifugation. GPC and FT-IR were the analytical techniques utilized. Degradation of trans 1,4-polyisoprene occurred with time, as a slow process. It is an oxidative process, and production of carboxyl and hydroxyl groups in the residual polymer were observed. Statistically significant decrease of molar mass was observed after 5 (p=0.0001) and 15 (p=0.01) years in teeth with and without periapical lesion, respectively. Bacteria participated in polymer degradation. Gutta-percha aging was proven an important factor for the long-term success of endodontic treatment. The findings of the present study showed that, after 15 years, polymer weight loss may decrease the capacity of the filling mass to seal the root canal space and prevent re-infection, thus compromising significantly the longevity of root canal therapy.

PMID: 17982546 [PubMed - in process]

Effect of post space preparation on apical seal: influence of time interval and sealer.

Med Oral Patol Oral Cir Bucal. 2007 Oct;12(6):E464-8

Authors: Corrêa Pesce AL, González López S, González Rodríguez MP

OBJECTIVE: To assess the efficacy of two sealants to preserve the apical seal after root canal preparation and cementation of posts at 24 h or 72 h after endodontic treatment. STUDY DESIGN: Sixty human single-root teeth were instrumented and obturated using lateral compaction technique with EndoFill [30] or AH-Plus) [30] and were prepared in one of three ways, leaving a 3 mm gutta percha remnant in all cases: without cast post preparation, with preparation after 24 h or after 72 h. After cementing the posts, the specimens were thermal cycled at 5 and 55 degrees C in water baths, submerged in 2% methylene blue dye for 72 h, embedded in acrylic resin and cut transversally into three 1-mm apical sections. Dye leakage was quantitatively assessed as the percentage leaked area. RESULTS AND CONCLUSION: Comparison of the apical sections showed significant differences in leakage with both sealers among the three preparation groups (p<0.001). No significant differences between sealers were found in any preparation group or in the same sections.

PMID: 17909515 [PubMed - indexed for MEDLINE]

Dental trauma: restorative procedures using composite resin and mouthguards for prevention.

J Contemp Dent Pract. 2007;8(6):89-95

Authors: Santos Filho PC, Quagliatto PS, Simamoto PC, Soares CJ

AIM: The aim of this article is to describe a step-by-step protocol for emergency care of a patient with a dentoalveolar injury in the anterior region of the mouth as well as the fabrication of a mouthguard to prevent future trauma. BACKGROUND: Dental trauma is one of the most serious oral health problems in active children and adolescents. Care of traumatized patients requires immediate initial emergency treatment followed by integrated procedures to restore damaged oral structures along with a subsequent trauma prevention strategy. Dentoalveolar injuries in the anterior region of the mouth are often characterized by tooth avulsion and coronal fracture. They are managed using procedures such as dental splinting, endodontic therapy with its unique characteristics, and restorative techniques to re-establish function and esthetics as well as protective mouthguards. REPORT: A 16-year-old male presented with avulsion of his maxillary central incisors as a result of a direct, unintentional impact with an opponent during a basketball game. The teeth had been stored in physiological serum immediately following the injury and the patient received immediate care. On clinical examination, the right central incisor was fractured at the incisal third of the crown but no bone fractures were found. The teeth were reimplanted and splinted. The fractured right central incisor was restored following endodontic treatment and a mouthguard was fabricated for the patient. SUMMARY: The dentist must be knowledgeable about the most efficient and suitable treatment for each traumatic scenario in order to provide appropriate care for dental injuries. Coordinated multi-disciplinary action is fundamental in the successful treatment of these injuries. The dental mouthguard is an effective device for protecting the teeth and supportive structures during physical activities and must be part of the protective equipment used by athletes. It is the responsibility of the dental professional to make parents, trainers, and athletic associations aware of the risks associated with physical activities without orofacial protection; this should encourage the proper use of all protective devices to prevent dentoalveolar injuries that compromise oral functions, esthetics, and increase the cost of healthcare.

PMID: 17846676 [PubMed - indexed for MEDLINE]

Effectiveness of a silicon-based root canal sealer for filling of simulated lateral canals.

Braz Dent J. 2007;18(1):20-3

Authors: Barbizam JV, Souza M, Cecchin D, Dabbel J

The purpose of this in vitro study was to evaluate the ability of a silicon-based root canal sealer, compared to zinc oxide and eugenol and an epoxy resin-based sealers, for filling of simulated lateral canals. Thirty extracted single-rooted human teeth were selected, conventional access was made and the working length was established 1 mm from the apical foramen. Three simulated lateral canals, one in each root third (coronal, middle and apical) were prepared in both the mesial and distal surfaces of each tooth using a size 15 reamer adapted to a low-speed handpiece. Each root canal was instrumented using ProTaper rotary files up to file F3 at the working length, and then irrigated with 2.5% NaOCl followed by EDTA. The teeth were assigned to 3 groups (n=10), according to the root canal sealer: Roeko Seal (Group 1), Sealer 26 (group 2) and Grossman's sealer (Group 3). Gutta-percha cold lateral condensation technique was performed in all groups. Postoperative radiographs were taken and the images were projected for evaluation of the quality of lateral canal filling. Data were submitted to statistical analysis by Kruskal Wallis test at 5% significance level. The results showed that Grossman's sealer filled a larger number of lateral canals than Roeko Seal (p<0.05) and Sealer 26 (p<0.01). It may be concluded that Roeko Seal silicone-based root canal sealer was not as effective as the Grossman's sealer for filling of simulated lateral canals. The lateral canals localized in the apical third of the root were more difficult to be filled.

PMID: 17639195 [PubMed - indexed for MEDLINE]

Apical extrusion of debris by manual and mechanical instrumentation.

Braz Dent J. 2007;18(1):16-9

Authors: Leonardi LE, Atlas DM, Raiden G

The aim of the present study was to assess the presence of apically extruded debris and evaluate the influence of canal curvature on the amount of debris produced by manual and mechanical techniques. Forty single-rooted mature teeth with 15 to 30 degree of root canal curvature were selected. The presence of only one foramen was confirmed using a magnifying lens. A size 15 K-file was placed up to the apical foramen to determine the patency. Working length was determined with the same instrument, 1 mm short of the foramen. According to the employed technique, the groups were labeled as follows: Group 1 - Manual instrumentation with Mor-flex files; Group 2 - Mechanical instrumentation with Cursor and Mor-flex files; Group 3 - Manual instrumentation with Flexi-cut files; Group 4 - Mechanical instrumentation with Cursor and Flexi-cut files. During instrumentation, the root canals were irrigated with 20 mL. Debris extruded through the apical foramen was collected using the Myers and Montgomery technique. The values (in mg) were: Group 1: 0.422 +/- 0.683; Group 2: 0.688 +/- 0.795; Group 3: 0.409 +/- 0.323; Group 4: 0.810 +/- 0.708. Data were analyzed statistically by ANOVA at 5% significance level. There was no statistically significant difference among the groups (p<0.05). No statistically significant differences were found between slight and moderate curvatures in terms of the amount of extruded debris (p>0.05).

PMID: 17639194 [PubMed - indexed for MEDLINE]

Residual antibacterial activity of chlorhexidine digluconate and camphorated p-monochlorophenol in calcium hydroxide-based root canal dressings.

Braz Dent J. 2007;18(1):8-15

Authors: Soares JA, Leonardo MR, Tanomaru Filho M, Silva LA, Ito IY

The purpose of this study was to evaluate the residual antibacterial activity of several calcium hydroxide [Ca(OH)2]-based pastes, placed in root canals of dogs' teeth with induced chronic periapical lesions. Root canals were instrumented with the ProFile rotary system and filled with 4 pastes: G1 (n=16): Ca(OH)2 paste + anesthetic solution; G2 (n=20): Calen paste + camphorated p-monochlorophenol (CMCP); G3 (n=18): Calen; and G4 (n=18): Ca(OH)2 paste + 2% chlorhexidine digluconate. After 21 days, the pastes were removed with size 60 K-files and placed on Petri plates with agar inoculated with Micrococcus luteus ATCC 9341. Pastes that were not placed into root canals served as control. After pre-diffusion, incubation and optimization, the inhibition zones of bacterial growth were measured and analyzed by Mann-Whitney U test at 5% significance level. All pastes showed residual antibacterial activity. The control samples had larger halos (p<0.05). The mean residual antibacterial activity halos in G1, G2, G3 and G4 were 7.6; 10.4; 17.7 and 21.4 mm, respectively. The zones of bacterial growth of G4 were significantly larger than those of G1 and G2 (p<0.05). In conclusion, regardless of the vehicle and antiseptic, all Ca(OH)2-based pastes showed different degrees of measurable residual antibacterial activity. Furthermore, unlike CMCP, chlorhexidine increased significantly the antibacterial activity of Ca(OH)2.

PMID: 17639193 [PubMed - indexed for MEDLINE]

Restoration of a vertical tooth fracture and a badly mutilated tooth using canal projection.

Indian J Dent Res. 2007 Apr-Jun;18(2):87-9

Authors: Velmurugan N, Bhargavi N, Lakshmi N, Kandaswamy D

Management of vertically fractured tooth or a perforation frequently poses problem during endodontic management. Such teeth often need a pre-endodontic restoration prior to initiation of root canal therapy to aid in the placement of rubber dam clamp. This paper describes a simple method of placement of a pre-endodontic restoration using the canal projection technique using hollow metallic needles as sleeves.

PMID: 17502715 [PubMed - indexed for MEDLINE]

Evaluation of working length determination methods: an in vivo / ex vivo study.

Indian J Dent Res. 2007 Apr-Jun;18(2):60-2

Authors: Shanmugaraj M, Nivedha R, Mathan R, Balagopal S

This comparative study was done to determine the accuracy in measuring the working length of root canal using tactile method, electronic apex locator and radiographic method, in vivo and comparing the lengths so measured to the actual working length, ex vivo, after extraction. Thirty single-rooted teeth scheduled for extraction were selected for the study. After obtaining the consent from patients, a preoperative radiograph was taken and access opening was done. Working length was determined by tactile method, by using Ingle's radiographic method and by using a Foramatron-IV digital apex locator. The teeth were then extracted and the actual working length was determined by placing an endodontic file in the root canal 0.5 mm short of the apex. The results indicated that among the three methods, the electronic apex locator showed the highest accuracy and the highest reliability for working length determination.

PMID: 17502709 [PubMed - indexed for MEDLINE]

Specialty dentistry for the hemophiliac: is there a protocol in place?

Indian J Dent Res. 2007 Apr-Jun;18(2):48-54

Authors: Kumar JN, Kumar RA, Varadarajan R, Sharma N

Restorative dental care for the hemophiliac patient is of paramount importance for the fact that advanced dental conditions and subsequent treatments prove to be more complicated and risky. Quite often, dental health is neglected by hemophiliacs for fear of bleeding during procedures. Surprisingly, even dental specialists avoid these candidates and contribute to the conversion ofa simple dental patient to an oral surgical patient. The complexities involved in diagnosing a bleeding disorder and the rarity of a standardized protocol to handle such patients contribute to this problem. This article prescribes a simple protocol to diagnose bleeding disorders and a modified scheme for endodontic and periodontal therapy in a hemophiliac patient.

PMID: 17502707 [PubMed - indexed for MEDLINE]

Cutaneous sinus tracts of dental origin.

Med J Aust. 2007 Mar 5;186(5):264-5

Authors: Barrowman RA, Rahimi M, Evans MD, Chandu A, Parashos P

PMID: 17391091 [PubMed - indexed for MEDLINE]

Effect of intracanal medication with calcium hydroxide and 1% chlorhexidine in endodontic retreatment cases with periapical lesions: an in vivo study.

J Formos Med Assoc. 2007 Mar;106(3):217-24

Authors: Ercan E, Dalli M, Du&#xFC;lgergil CT, Yaman F

BACKGROUND/PURPOSE: Calcium hydroxide (Ca(OH)(2)) has been widely used as an intracanal medicament for endodontic retreatment, but very few studies used both Ca(OH)(2) and 1% chlorhexidine (CHX) as intracanal medicaments. The purpose of this study was to assess the in vivo effectiveness of a combination of Ca(OH)(2) and 1% CHX as intracanal medicaments in endodontic retreatment cases with periapical lesions. METHODS: Previous cases of endodontically treated teeth with periapical pathosis in 70 patients (36 men and 34 women, age range 18-60 years) were included. Of these teeth, 59 had received root canal treatment and 11 had been subjected to previous apical surgery, indicating endodontic failure. Following the routine procedures, including canal reshaping and irrigation with 2% CHX, a canal medication material containing Ca(OH)(2) powder and a 1% CHX solution was placed into the root canals. Over a 6-week period, the intracanal medication was periodically changed until the teeth became asymptomatic. Patients were recalled at 3-month intervals for radiographic and clinical examination. RESULTS: Our clinical and radiographic assessment of retreatment cases showed complete healing in 41 (64%) teeth, incomplete healing in 9 (14%) teeth, and failure in 14 (22%) teeth. For complete healing teeth, the healing time varied from 6 to 36 months. The size of the periapical lesions and previous surgical treatment had no influence on the prognosis. CONCLUSION: Our results suggest that a combination of Ca(OH)(2) and 1% CHX can be successfully used as intracanal medicament for disinfection in endodontic retreatment cases with periapical lesions.

PMID: 17389166 [PubMed - indexed for MEDLINE]

MB2 in maxillary second molar.

Indian J Dent Res. 2007 Jan-Mar;18(1):38-40

Authors: Prakash R, Bhargavi N, Rajan J, Joseph R, Velmurugan N, Kandaswamy D

Occurrence of the second mesiobuccal canal (MB2) is a frequent finding. Literary reports have shown it to be found more in the cases of the maxillary first molar. However the maxillary second molars have also been found with this variation in a number of canals. This paper presents a case report on the occurrence of a second mesiobuccal canal or the MB2 in the maxillary second molar.

PMID: 17347545 [PubMed - indexed for MEDLINE]

Apical seal comparison of low-temperature thermoplasticized gutta-percha technique and lateral condensation with two different master cones.

Med Oral Patol Oral Cir Bucal. 2007 Mar;12(2):E175-9

Authors: Pérez Heredia M, Clavero González J, Ferrer Luque CM, González Rodríguez MP

AIM: To compare the apical sealing in mesio-buccal canals of extracted molars obturated with low-temperature thermoplasticized gutta-percha or cold lateral condensation techniques using a .06 or a .02 mm/mm tapered gutta-percha master cone. The secondary aim was to evaluate the depth of spreader penetration in root canals using a .06 or a .02 mm/mm tapered gutta-percha master cone. METHODOLOGY: Forty-four mesio-buccal curved canals (25-40 degree) were instrumented with .06 nickel-titanium rotary instruments and randomly distributed into two control groups (n=4) and three experimental groups (n=12) for obturation by the Ultrafil 3D system or by cold lateral condensation with .06 or .02 tapered master cone. Canal sealer AH-Plus was used. The depth of spreader penetration was recorded in millimetres. Roots were covered with two layers of nail polish, immersed in India ink for 7 days, transversally sectioned and examined with a stereomicroscope. Student s t test was used to determine whether there was a difference in spreader penetration between groups. Kruskal-Wallis test was used to determine whether there was a difference in leakage. RESULTS: There were no differences among the three groups (p=0.396), which showed a very similar mean microleakage (0.42, 0.75 and 0.42). The difference in spreader penetration between the groups filled by cold lateral condensation was significant (p=0.001) CONCLUSION: The Ultrafil 3D system and cold lateral condensation techniques with .06 or .02 tapered master cones were equally effective in the apical sealing of curved canals. The spreader penetrated deeper using a .02 mm/mm tapered gutta-percha master cone.

PMID: 17322810 [PubMed - indexed for MEDLINE]

Root resorption and orthodontic treatment. Review of the literature.

Minerva Stomatol. 2007 Jan-Feb;56(1-2):31-44

Authors: Pizzo G, Licata ME, Guiglia R, Giuliana G

The aim of this paper was to provide a systematic review of the literature on the root resorption caused by orthodontic treatment. Original papers on this subject, published in English from January 2000 until December 2005, were located in the MEDLINE/PubMed database. Other sources were taken from the references of the selected papers. Root resorption is the most common sequela of the orthodontic treatment. It is an inflammatory process that leads to an ischemic necrosis localized in the periodontal ligament when the orthodontic force is applied. The onset and progression of root resorption are associated with risk factors related to the orthodontic treatment such as the duration of treatment, the magnitude of the force applied, the direction of the tooth movement, the method of force application (continuous versus intermittent), the orthodontic movement. Patient-related risk factors are the individual susceptibility on a genetic basis, some systemic diseases, anomalies in root morphology, dental trauma, and previous endodontic treatment. The prevention of root resorption during the orthodontic treatment may be performed controlling the risk factors. The periodic radiographic control during the treatment is necessary in order to detect the occurrence of root damages and quickly reassess the treatment goals.

PMID: 17287705 [PubMed - indexed for MEDLINE]

Sealer penetration and marginal permeability after apicoectomy varying retrocavity preparation and retrofilling material.

Braz Dent J. 2006;17(4):323-7

Authors: Winik R, Araki AT, Negr&#xE3;o JA, Bello-Silva MS, Lage-Marques JL

Apicoectomy failure is generally related to inappropriate marginal sealing of the retrocavity, which allows percolation of microorganisms and their products from root canal system to periapex. This study evaluated tubular penetration of canal sealers and marginal permeability after retrocavity irradiation with Er;Cr:YSGG laser and retrofilling with MTA or cyanoacrylate. Twenty-two single-rooted teeth were decoronated and endodontically treated, their apical 3 mm were resected and the root ends were retroprepared with a low-speed bur. Twenty roots were randomly assigned to 4 groups (n=5): GI and GII--retrofilling with MTA and cyanoacrylate, respectively; GIII and GIV--retrocavity irradiation with Er;Cr:YSGG laser (2.78 microm, 4 W, 20 Hz, 70.8 J/cm(2)) and retrofilling with MTA and cyanoacrylate, respectively. The remaining 2 roots served as positive and negative controls. The analysis of rhodamine B dye infiltration (p=0.05) demonstrated that laser irradiation and MTA retrofilling presented significantly higher permeability rates (p<0.05). Retrofilling with cyanoacrylate showed significantly lower permeability, either when laser was used or not on retrocavity. SEM analysis depicted more cyanoacrylate penetration through dentinal tubules when compared to MTA, suggesting a more efficient marginal sealing. Based on these results, it may be concluded that cyanoacrylate provided a less permeable retrofilling regardless of the retropreparation method, suggesting a more favorable condition to the establishment of the periapical healing.

PMID: 17262147 [PubMed - indexed for MEDLINE]

Influence of sodium hypochlorite-based irrigants on the susceptibility of intracanal microbiota to biomechanical preparation.

Braz Dent J. 2006;17(4):310-6

Authors: Soares JA, Pires Júnior DR

This study evaluated the microbiological conditions of root canals, using smears and culture from anterior teeth and premolars with necrotic pulps associated with chronic periapical pathologies, before and after biomechanical preparation (BMP). During double-flared instrumentation, 1, 2.5 and 5% sodium hypochlorite (NaOCl)-based irrigants were used in 3 groups: GI (n=39), GII (n=36) and GIII (n=36), respectively. Before BMP, all cultures were positive and the smears showed microbiologically diverse morphotypes, including fusiforms, pleomorphic, rods, cocci and filaments. Quantitatively, 20, 20 and 23 morphotypes were identified in GI, GII and GIII, respectively). After BMP, the percentages of negative cultures in GI, GII and GIII were 74.2%, 86.3% and 93.4% (p>0.05) and the number of morphotypes decreased to 14, 15 and 5, respectively. All teeth with 2 root canals and/or associated fistulas were microbiologically negative after BMP, regardless of irrigant concentration. Gram-negative morphotypes were more susceptible to the action of irrigants. After irrigation with 5% NaOCl, only structural arrangements consisting of Gram-positive cocci and bacilli persisted. Thus, BMP plus 5% NaOCl offered the best antiseptic potential because in the few positive cultures a significant reduction in the number of microbiological morphotypes was also shown (p<0.05).

PMID: 17262145 [PubMed - indexed for MEDLINE]

Smear layer removal and chelated calcium ion quantification of three irrigating solutions.

Braz Dent J. 2006;17(4):306-9

Authors: Marques AA, Marchesan MA, Sousa-Filho CB, Silva-Sousa YT, Sousa-Neto MD, Cruz-Filho AM

The purpose of this study was to evaluate, by scanning electron microscopy (SEM), smear layer removal and quantify, by atomic absorption spectrophotometry, the amount of calcium ion present in the chelating solutions after their use. Sixteen extracted canines were instrumented using the step-back technique and were assigned to 3 groups according to the irrigating solution used: G1: 1 mL 17% EDTAC between each file; G2: 1 mL 17% CDTA; G3: 1 mL 17% EGTA. The solutions were collected after use. The teeth were cleaved longitudinally, evaluated under SEM and assessed for smear layer by blinded examiners and scored from 1 to 4. In order to quantify calcium ion release, the collected solutions were examined by atomic absorption spectrophotometry. Freidman's test was used for statistical analysis of SEM values and showed that canals irrigated with 17% EDTAC and 17% CDTA had significantly less smear layer throughout the canals than 17% EGTA (p<0.01). For analysis of the collected solutions, Tukey's test was used and showed that EDTAC and CDTA had a greater amount of calcium ions (22.8+/-7.54 and 60.6+/-20.67 microg/mL, respectively) compared to EGTA (70.5+/-14.2 microg/mL) (p<0.01). The association both methodologies may contribute to the understanding of how these solutions act in the root canal.

PMID: 17262144 [PubMed - indexed for MEDLINE]

Ex vivo analysis of the debris remaining in flattened root canals of vital and nonvital teeth after biomechanical preparation with Ni-Ti rotary instruments.

Braz Dent J. 2006;17(3):233-6

Authors: Sasaki EW, Versiani MA, Perez DE, Sousa-Neto MD, Silva-Sousa YT, Silva RG

The purpose of this study was to assess the presence of apical debris remaining in the apical third of flattened root canals of vital and nonvital teeth after biomechanical preparation with Ni-Ti rotary instruments. Fresh-extracted human mandibular incisors were used in this study. The teeth had clinical indication for extraction and were submitted to cold pulp vitality testing and radiographic examination. Eighteen teeth were selected and randomly assigned to two groups (n=9), according to the clinical diagnosis, i.e., pulp vitality or pulp necrosis. The canals were instrumented with the ProTaper NiTi rotary system in the following sequence: S1--up to the middle third; SX--at the cervical third; S2--up to the apical third; and S1, F1, F2, F3--at the working length. The canals were irrigated with 1% sodium hypochlorite, dried and were submitted to the histological processing. Sections from the apical third were analyzed by an optical microscope (X40) that was coupled to a computer where the images were captured and analyzed using specific softwares. A grid was placed over these images to assess the total canal area and the areas with debris. Mann-Whitney U-test showed no statistically significant difference (p>0.05) between the teeth with pulp vitality (6.49 +/- 3.39) and those with pulp necrosis (5.95 +/- 2.22). It may be concluded that the clinical condition of pulp tissue did not interfere with the amount of debris remaining in the apical third of flattened root canals prepared with Ni-Ti rotary instruments.

PMID: 17262131 [PubMed - indexed for MEDLINE]

Retention of radicular posts varying the application technique of the adhesive system and luting agent.

Braz Oral Res. 2006 Oct-Dec;20(4):347-52

Authors: Fonseca TS, Alfredo E, Vansan LP, Silva RG, Sousa YT, Saquy PC, Sousa-Neto MD

This study evaluated in vitro the retention of intracanal cast posts cemented with dual-cure resin varying the application method of the primer/adhesive solution and luting agent in the prosthetic space prepared to receive the posts. Sixty endodontically treated maxillary canines had their crowns discarded, and their roots were embedded in acrylic resin. The prosthetic spaces were prepared with Largo burs mounted on a low-speed handpiece coupled to a parallelometer in order to maintain length and diameter of intraradicular posts constant and to guarantee that the preparations were parallel after casting. Two groups (n = 30) were randomly formed according to the device used to apply the adhesive system: microbrush or standard bristle brush (control). Each group was divided into 3 subgroups (n = 10) according to the technique used to place the luting agent into the root canal: using only a lentulo spiral before setting the post, applying it onto the post surface, or combining both methods. After 72 hours, the tensile force required to dislodge each post was determined by a universal testing machine (Instron 4444) set at a speed of 1 mm/min. The results indicated that the use of the microbrush yielded higher bond strength values (0.1740 +/- 0.04 kN) than those recorded for the bristle brush tip (0.1369 +/- 0.04 kN, p < 0.001). Bonferroni's test demonstrated a higher retention (p < 0.001) in radicular post cemented with the technique that combined both methods (lentulo + post: 0.1787 +/- 0.03 kN) than that obtained with lentulo (0.1461 +/- 0.065 kN) or post (0.1416 +/- 0.03 kN) alone. The interactions between the adhesive system and luting agent application techniques presented statistical difference (p < 0.001). It was concluded that the best performance in terms of tensile strength among the tested conditions was obtained when the adhesive system was applied with a microbrush and the luting agent was taken into the root canal with lentulo spirals alone (0.1961 +/- 0.04 kN) and combining both methods (lentulo + post: 0.1911 +/- 0.02 kN).

PMID: 17242797 [PubMed - indexed for MEDLINE]

A multi-disciplinary approach in the management of a traumatized tooth with complicated crown-root fracture: A case report.

J Indian Soc Pedod Prev Dent. 2006 Dec;24(4):197-200

Authors: Heda CB, Heda AA, Kulkarni SS

A 13-year-old boy had fractured his maxillary right central incisor. The fracture line involved 2/3rd of the crown, compromising the pulp and extended subgingivally on the palatal aspect invading the biologic width. The procedure used to manage this case included endodontic treatment of residual tooth orthodontic extrusion to move the fracture line above the alveolar bone. Finally the tooth was restored prosthodontically.

PMID: 17183184 [PubMed - indexed for MEDLINE]

In vitro comparison of NiTi rotary instruments and stainless steel hand instruments in root canal preparations of primary and permanent molar.

J Indian Soc Pedod Prev Dent. 2006 Dec;24(4):186-91

Authors: Nagaratna PJ, Shashikiran ND, Subbareddy VV

This study is an attempt to compare the NiTi rotary and K-files hand instrumentation on root canal preparation of primary and permanent molars for their efficiency in preparation time, instrument failure and shaping the canals. About 20 primary mandibular second molar (I) and 20 permanent mandibular first molar (II) were selected. Each was further divided into 10 for K-files (a) and 10 for NiTi (b) groups, respectively. Results showed that preparation time Ib Ia and IIab<IIa, which was highly significant. In instrument failure, Ia (40%), IIa (30%) showed more deformation but not fracture and Ib (10%), IIb (20%) showed fracture, but not deformation. Profiles showed good canal taper and smoothness compared to the K-files. To conclude profile 0.04 taper 29 series, prepared canal rapidly than conventional K-file with good taper, smoothness though the flow was not satisfactory. Instrument failure with K-files was less. In primary teeth preparation time, instrument failure with profile was less compared to the permanent. To conclude it's encouraging to use the profiles in primary teeth.

PMID: 17183182 [PubMed - indexed for MEDLINE]

Accuracy of electronic apex locator in length determination in the presence of different irrigants: An in vitro study.

J Indian Soc Pedod Prev Dent. 2006 Dec;24(4):182-5

Authors: , Muthu MS, Sivakumar N

Determining the root canal length accurately had been a challenge in endodontics. Introduction of apex locators have definitely served as an effective adjuvant to radiographs. This in vitro study had attempted to compare the effectiveness of electronic apex locator in the presence of various canal contents. Comparison of the length determined by apex locators with the radiographic length was also made. The results of the study had shown that the length of root canals can be accurately made irrespective of the canal contents.

PMID: 17183181 [PubMed - indexed for MEDLINE]

Interdisciplinary approach to endodontic therapy for uncooperative children in a dental school environment.

J Dent Educ. 2006 Dec;70(12):1362-5

Authors: Soares F, Britto LR, Vertucci FJ, Guelmann M

The aim of this study was to describe an interdisciplinary approach for endodontic therapy of behavior-challenging children and to report the efficacy of sedation techniques for these procedures. Sedation records of thirty-two patients who received root canal treatment were reviewed. Age at treatment in months, gender, year of treatment, tooth type, status of root maturation (open or closed apex), etiological factor(s), sedation protocol, and outcome were the variables analyzed. The collected information was entered into a computerized flowchart and the data analyzed using descriptive statistics. Midazolam in combination with meperidine or hydroxyzine were the most common protocols used (46 percent and 40 percent of the cases, respectively). Only two (6 percent) treatments were aborted due to uncontrolled behavior during sedation. We conclude that cooperation between pediatric dentists and endodontists is fundamental to achieving success when providing root canal treatment for uncooperative child patients.

PMID: 17170328 [PubMed - indexed for MEDLINE]

The radiographic outcomes of direct pulp-capping procedures performed by dental students: a retrospective study.

J Am Dent Assoc. 2006 Dec;137(12):1699-705

Authors: Al-Hiyasat AS, Barrieshi-Nusair KM, Al-Omari MA

BACKGROUND: The decision between pulp capping and root canal therapy after pulp exposure is a clinical issue. The aim of the authors' study was to evaluate the outcome of direct pulp-capping procedures performed by dental students. METHODS: The authors followed the treatment outcomes of 193 patients with 204 pulp exposures with direct pulp capping. They determined the outcome of pulp capping radiographically using periapical radiographs taken at least three years after pulp exposure. The outcome was considered as successful if the tooth was present and not associated with periapical radiolucency or root canal treatment; otherwise, the outcome was considered as being a failure. RESULTS: Overall, the success rate of pulp capping was 59.3 percent. The success was associated more with mechanical exposure than with carious exposure (92.2 versus 33.3 percent) (P < .001), more with permanent restoration than with temporary restoration (80.8 versus 47.3 percent) (P < .001) and more with class I occlusal restoration (83.8 percent) than with proximal multiple surface restorations (Class II, 56.1 percent; Class III, 58.8 percent; mesial-occlusal-distal, 28.6 percent) (P = .009). Patients' age, sex, and tooth location and position had no significant effect on the outcome (P > .05). CONCLUSION: The success rate of direct pulp capping was 92.2 percent with mechanical exposure and 33.3 percent with carious exposure. CLINICAL IMPLICATIONS: Direct pulp capping is recommended after mechanical exposure with immediate placement of permanent restoration, while root canal therapy would be the choice of treatment if the exposure was due to caries.

PMID: 17138715 [PubMed - indexed for MEDLINE]

A scanning electron microscopic evaluation of different root canal irrigation regimens.

Braz Oral Res. 2006 Jul-Sep;20(3):235-40

Authors: M&#xF4;nika CM, Fröner IC

The purpose of this study was to assess the effectiveness of endodontic irrigants in removing the smear layer from instrumented root canal walls using Scanning Electron Microscopy (SEM). The endodontic irrigants used were: 1% sodium hypochlorite (NaOCl); 1% NaOCl mixed to 17% EDTAC; 2% chlorhexidine gel; and Ricinus communis gel. Photomicrographs of the middle and apical thirds were evaluated with the aid of the Fotoscore - v. 2.0 software. The results indicated that the mixture of sodium hypochlorite and EDTAC completely removed the smear layer from dentinal walls. The other endodontic irrigants were not as efficient in cleansing the root canals.

PMID: 17119706 [PubMed - indexed for MEDLINE]

Histologic evaluation of pulpotomy performed with ethyl-cyanoacrylate and calcium hydroxide.

Braz Oral Res. 2006 Jul-Sep;20(3):226-30

Authors: de Albuquerque DS, Gominho LF, Dos Santos RA

The aim of this study was to evaluate histological aspects of the pulp-dentin complex of dogs submitted to pulpotomy and capped with ethyl-cyanoacrylate and calcium hydroxide. Thirty dog teeth were divided into 2 groups of 15 as follows: Group 1 - ethyl-cyanoacrylate; Group 2 - calcium hydroxide. The pulpotomies were carried out following all of the treatment precautions recommended for dogs. After 30 days the specimens were submitted to histological preparation and were then blindly evaluated by a histologist. Data were analyzed statistically by the Fisher exact test, comparing the two groups. After 30 days, the presence of a hard tissue barrier was observed in 83.3% of Group 1, and in 100% of Group 2 (p = 0.478). A continuous hard tissue barrier was observed in 50% of the ethyl-cyanoacrylate group and 75% of the calcium hydroxide group (p = 0.652). It can be concluded that both materials induced hard tissue barrier formation, but Group 2 had a higher percentage than Group 1, with no significant statistical differences; the differences observed between the different barriers (continuous/non-continuous) were not significant between groups and there was no pulpal necrosis in either group.

PMID: 17119705 [PubMed - indexed for MEDLINE]

Biological response of pulps submitted to different capping materials.

Braz Oral Res. 2006 Jul-Sep;20(3):219-25

Authors: Briso AL, Rahal V, Mestrener SR, Dezan Junior E

Pulp capping is a procedure that comprises adequate protection of the pulp tissue exposed to the oral environment, aiming at the preservation of its vitality and functions. This study evaluated the response of the dental pulps of dog teeth to capping with mineral trioxide aggregate (MTA) or calcium hydroxide P.A. For that purpose, 37 teeth were divided into two groups, according to the capping material employed. Two dogs were anesthetized and, after placement of a rubber dam, their pulps were exposed in a standardized manner and protected with the experimental capping materials. The cavities were then sealed with resin-modified glass ionomer cement and restored with composite resin. After sixty days, the animals were killed and the specimens were processed in order to be analyzed with optic microscopy. It was observed that MTA presented a higher success rate compared to calcium hydroxide, presenting a lower occurrence of infection and pulp necrosis.

PMID: 17119704 [PubMed - indexed for MEDLINE]

Knowledge and attitude of 2,000 parents (urban and rural - 1,000 each) with regard to avulsed permanent incisors and their emergency management, in and around Davangere.

J Indian Soc Pedod Prev Dent. 2006 Sep;24(3):116-21

Authors: Shashikiran ND, Reddy VV, Nagaveni NB

It is well recognized today that for long-term success, the management of traumatized teeth optimally should be carried out as soon as possible. Since, majority of traumatic injuries occur at home, the ultimate prognosis of an avulsed tooth may depend on knowledge of the treatment procedure, possessed by his or her parents. The purpose of this study was therefore to evaluate the parental knowledge and attitude regarding the emergency management of avulsed teeth in children (in Davangere--both urban and rural, 1,000 each).

PMID: 17065777 [PubMed - indexed for MEDLINE]

The role of Carisolv and different auxiliary chemical substances in the removal of bovine root canal smear layer.

J Oral Sci. 2006 Sep;48(3):99-103

Authors: Antonio AG, Maia LC, Primo LG, Moraes RS, Cunha CB

To evaluate the effectiveness of Carisolv and different auxiliary chemical substances in root canal smear layer (SL) removal. SL was produced in the centre of 40 hemi-disks of bovine root dentine. The samples were divided into four irrigation groups (G): GI (control) - 0.9% NaCl; GII - 1% NaOCl + 0.9% NaCl; GIII - Carisolv + 0.9% NaCl; GIV - 1% NaOCl + 10% citric acid solution + 0.9% NaCl. The photomicrographs (SEM analysis) were coded (0 - absence of SL; 1 - moderate SL; 2 - dense SL with visible tubules; 3 - dense SL with no visible tubules). GIV was more effective in SL removal (P < 0.01). It should be noted that GI and GIII obtained score 3 in 100% of the samples (P > 0.01). Conclusion: NaOHCl, citric acid and NaCl solutions, when used together, presented a better performance in the removal of SL when compared to the other solutions.

PMID: 17023740 [PubMed - indexed for MEDLINE]

Methodologies for assessment of apical and coronal leakage of endodontic filling materials: a critical review.

J Oral Sci. 2006 Sep;48(3):93-8

Authors: Ver&#xED;ssimo DM, do Vale MS

Apical leakage continues to be a topic of great interest, because in spite of the advances in Endodontics, clinical failures still occur. Most failures are probably attributed to the proliferation of bacteria that remain viable after chemical-mechanical preparation and cause periapical tissue irritation. Coronal leakage has aroused researchers' interest over the last few years, since canals may be re-contaminated after loss of coronal sealing or fracture of the remaining tooth. In this review, the various methodologies used for assessing root canal sealing capacity are critically analyzed, as they are not standardized, which makes it difficult to compare the results obtained when different methodologies are used, even though the same substrate is being assessed.

PMID: 17023739 [PubMed - indexed for MEDLINE]

Implant therapy versus endodontic therapy.

J Am Dent Assoc. 2006 Oct;137(10):1440-3

Authors: Christensen GJ

PMID: 17012725 [PubMed - indexed for MEDLINE]

Apical leakage of Resilon obturation material.

J Contemp Dent Pract. 2006 Sep 1;7(4):45-52

Authors: Bodrumlu E, Tunga U

AIM: The aim of this study was to assess the apical sealing ability of Resilon obturation material. METHODS AND MATERIALS: Forty-two single rooted extracted human teeth were selected and randomly divided into three groups. They were obturated using lateral condensation with gutta-percha and AH 26/AH plus and Resilon; also, 12 root canals were used as control groups. The apical leakage was measured using the dye penetration methodology. RESULTS: The teeth filled with gutta-percha and AH 26 displayed the most apical leakage. The least apical leakage was shown with Resilon. DISCUSSION: The differences in leakage among the groups, gutta-percha with AH 26 (2.4 mm, SD:1.87), gutta-percha with AH plus (2.1 mm, SD: 1.69), and Resilon (1.7 mm, SD:1.32), were statistically significant (p< 0.001). CONCLUSION: Based on the data of this study, all groups produced a satisfactory seal. However, Resilon and Epiphany sealer showed the least apical leakage.

PMID: 16957790 [PubMed - indexed for MEDLINE]

Reasons for permanent tooth extractions in Japan.

J Epidemiol. 2006 Sep;16(5):214-9

Authors: Aida J, Ando Y, Akhter R, Aoyama H, Masui M, Morita M

BACKGROUND: There has been no nationwide study in Japan on reasons for extraction of permanent teeth. This survey was aimed to determine the reasons for extraction of permanent teeth in Japan. METHODS: Five thousand, one hudred and thirty-one dentists were selected by systematic selection from the 2004 membership directory of the Japan Dental Association. The dentists selected were asked to record the reason for each extraction of permanent teeth during a period of one week from February 1 through 7, 2005. Reasons for tooth extraction were assigned to five groups: caries, fracture of teeth weakened by caries or endodontics, periodontal diseases, orthodontics, and other reasons. RESULTS: A total of 2,001 dentists (response rate of 39.1%) returned the questionnaires, and information on 9,115 extracted teeth from 7,499 patients was obtained. The results showed that caries and its sequela (totally 43.3%, 32.7% and 10.6%, respectively) and periodontal disease (41.8%) were the main reasons for teeth extraction. Extraction due to caries or fracture was commonly observed in all age groups over 15 years of age, whereas periodontal disease was predominant in the groups over 45 years of age. CONCLUSIONS: Most of the permanent teeth were extracted due to caries and its sequela and periodontal disease. Prevention and care for dental caries for all age groups and periodontal disease for over middle age groups are required.

PMID: 16951541 [PubMed - indexed for MEDLINE]

A comparison of the efficacy of Er,Cr:YSGG laser and rotary instrumention in root canal debridement.

J Am Dent Assoc. 2006 Sep;137(9):1261-6

Authors: Radatti DA, Baumgartner JC, Marshall JG

BACKGROUND: The authors evaluated the efficacy of an erbium,chromium: yttrium,scandium,gallium,garnet (Er,Cr:YSGG) laser-powered hydrokinetic system (HKS) versus that of rotary instrumentation for root canal d&#xE9;bridement. METHODS: The authors studied four uninstrumented controls and two test groups of 18 matched pairs of teeth. Teeth from each pair underwent different instrumentation but received identical irrigation solutions. The instrumentation protocol involved either rotary instrumentation or the Er,Cr:YSGG laser. The irrigation groups received 0.5 milliliter of distilled water or 5.25 percent sodium hypochlorite (NaOCl) between instruments. The authors measured the amount of debris remaining at 2 and 4 mm from the apex as a percentage of total lumen area. RESULTS: Lased canals had significantly more debris than did canals that received rotary instrumentation (Wilcoxon signed rank test, P < .001). With distilled water irrigation, the debris remaining in lased canals at both the 2-and 4-mm levels was not statistically different from that remaining in uninstrumented controls. Rotary instrumentation yielded significantly less remaining debris than did laser instrumentation (Wilcoxon signed rank test, P < .001). With 5.25 percent NaOCl irrigation, there was no difference in remaining debris between the two groups (Wilcoxon signed rank test , P < .001). The lased group received significantly more irrigant than did the rotary group (Wilcoxon rank sum test, P < .001). CONCLUSIONS: This study indicates that the débridement efficacy of the HKS with distilled water irrigation is unacceptable; with 5.25 percent NaOCl irrigation, it is similar to that of rotary instrumentation. CLINICAL IMPLICATIONS: If the HKS is to be used for débridement, then NaOCl irrigation must be used for predictable tissue removal.

PMID: 16946431 [PubMed - indexed for MEDLINE]

Mineral trioxide aggregate.

J Am Dent Assoc. 2006 Sep;137(9):1214, 1216; author reply 1216

Authors: Needleman HL

PMID: 16946419 [PubMed - indexed for MEDLINE]

Effectiveness of rotary and hand files in gutta-percha and sealer removal using chloroform or chlorhexidine gel.

Braz Dent J. 2006;17(2):139-43

Authors: Bueno CE, Delboni MG, de Ara&#xFA;jo RA, Carrara HJ, Cunha RS

The purpose of this study was to assess in vitro the efficacy of nickel-titanium K3 rotary files and hand files for removal of gutta-percha and sealer from obturated root canals using either chloroform or chlorhexidine as solvents. Sixty extracted single-rooted bovine teeth with straight, large canals were prepared, obtured and randomly assigned to 3 groups (n=20). The teeth were stored at 37 degrees C for 1 month and then the gutta-percha and sealer were removed using different techniques, as follows. Group I: size 3 Gates-Glidden drills plus size 30 hand K-files and Hedström files and chloroform; Group II: K3 NiTi rotary files and chloroform; and Group III: K3 NiTi rotary files and 2% chlorhexidine gel. Radiographs were taken and scanned and the images were digitized. The total area of the canal and the area with remaining obturation material were measured in millimeters using a computed image analysis system (ImageLab). Data were analyzed statistically by one-way ANOVA and Tukey test at 5% significance level. The groups differed statistically (p<0.05) with respect to the average percentage of remaining gutta-percha and sealer, presenting the following sequence of effectiveness (from most to least effective): Group I (15.48%), Group II (28.42%) and Group III (35.96%). The findings of this study showed that, despite the technique used for removal of filling material, none of the retreated canals were completely free of gutta-percha and sealer remnants. The use of stainless steel hand files resulted in a lesser amount of filling debris than the use of nickel-titanium rotary instruments.

PMID: 16924342 [PubMed - indexed for MEDLINE]

Anatomical variations of mandibular premolars in Chennai population.

Indian J Dent Res. 2006 Jan-Mar;17(1):7-10

Authors: Iyer VH, Indira R, Ramachandran S, Srinivasan MR

AIM: To analyse the prevalence of anatomical variations of mandibular premolars in Chennai population. METHODOLOGY: It was observed, during the routine treatment of mandibular premolars that aberrations were becoming common. This necessitated an encompassing study on 500 patients, evaluating the occurrence of these aberrations. The parameters of this study included sex predilection, unilateral/ bilateral occurrences, and comparison of the incidence of anatomical variations in mandibular first and second premolar canal configuration. The study pattern was designed to observe these premolars using Radiovisiography (RVG) in different angulations to highlight the anatomical aberrations. The results were subjected to statistical analysis, which were performed using SPSS (Statistical Package for Social Science) statistical program version 10.0.5. Descriptive statistics were computed for all the variables. RESULT: The present study revealed high incidence of anatomical aberrations in mandibular premolars among Chennai population. Out of the 500 patients studied, 123 patients [24.6%] showed anatomical variance in the canal configuration. There was high incidence of Vertucci's Type IV canal configuration as compared to Type V, Type II and Type VIII in the descending order of occurrence. CONCLUSION: Within the limitations of this in-vivo study, it was inferred that the incidence of aberrations in the canal configuration of mandibular premolars is common and due considerations are to be given during endodontic intervention.

PMID: 16900889 [PubMed - indexed for MEDLINE]

Dentin penetrability evaluation of three different dyes in root-end cavities filled with mineral trioxide aggregate (MTA).

Braz Oral Res. 2006 Apr-Jun;20(2):132-6

Authors: Vogt BF, Xavier CB, Demarco FF, Padilha MS

The purpose of this study was to evaluate the penetration of three dyes in MTA root-end fillings. In 30 single-rooted teeth, cavities for retrofilling were prepared with an ultrasound appliance and filled with MTA. The specimens were randomly assigned to three groups (n = 10) and immersed in the following solutions: 2% methylene blue (MET), 50% silver nitrate (NIT) and 0.2% rhodamine B (ROD). Two transversal slices (1 mm) of the retrofilling region were obtained and evaluated using the Image Tool 3.0 software to obtain a quantitative evaluation (in mm2) of the dye penetration around the retrofillings. Data were submitted to statistical analysis using Students t-test. The lowest degree of dye penetration was observed for the NIT group, in both slices (p < 0.05). Dye penetration was significantly larger in the ROD group when compared to the NIT group, in both slices (p < 0.05), and to the MET group, only in slice 1 (p < 0.05). Within the limitations of this study, it was concluded that the choice of dye could influence the penetration evaluation in root-end filling studies, and that the NIT had the lowest penetration capacity in the apical dentine.

PMID: 16878206 [PubMed - indexed for MEDLINE]

Evaluation of the antimicrobial activity of each component in Grossman's sealer.

Braz Oral Res. 2006 Apr-Jun;20(2):127-31

Authors: Savioli RN, Pecora JD, Mian H, Ito IY

The antimicrobial activity of Grossman's sealer and its components was evaluated on 13 different strains using the double layer well-diffusion method. Results revealed that Grossman's sealer presented antimicrobial activity against all the tested strains. Among the components of the cement, sodium tetraborate presented the greatest antimicrobial activity, both in type and diameter of the halo and ring of inhibition. Sealer powder, rosin, and eugenol presented similar activity, with no effect on P. aeruginosa and C. albicans. Among these, only eugenol had an effect on E. coli. Zinc oxide was only active against S. sobrinus and E. coli. Barium sulfate and bismuth subcarbonate did not show any antimicrobial effect.

PMID: 16878205 [PubMed - indexed for MEDLINE]

Effect of rotary instrumentation and of the association of calcium hydroxide and chlorhexidine on the antisepsis of the root canal system in dogs.

Braz Oral Res. 2006 Apr-Jun;20(2):120-6

Authors: Soares JA, Leonardo MR, da Silva LA, Tanomaru Filho M, Ito IY

This study aimed at evaluating the antisepsis of the root canal system (RCS) and periapical region (PR) provided by rotary instrumentation associated with chlorhexidine + calcium hydroxide as intracanal medicament. Chronic periapical lesions were induced in 26 pre-molar roots in two dogs. After microbiological sampling, automatic instrumentation using the Profile system and irrigation with 5.25% sodium hypochlorite solution, with a final rinse of 14.3% EDTA followed by profuse irrigation with physiological saline were carried out in 18 root canals. After drying the canals, a paste based on calcium hydroxide associated with a 2% chlorhexidine digluconate solution was placed inside them. After 21 days, the medication was removed, leaving the root canals empty and coronally sealed. After 96 hours, a final microbiological sample was obtained, followed by histomicrobiological processing by the Brown & Brenn method. Eight untreated root canals represented the control group (C-G). Based on the Mann-Whitney test at a confidence level of 5% (p < 0.05), the procedures of antisepsis used offered significant efficacy (p < 0.05) resulting in 100.0% of the canals free of microorganisms. In the C-G, an elevated incidence of various microbial morphotypes was confirmed in all sites of the RCS, with the presence of microbial colonies in the periapical region. In contrast, the experimental group showed a similar pattern of infection in the RCS, although less intense and a reduced level of periapical infection (p < 0.05). It was concluded that adequate instrumentation followed by the application of calcium hydroxide + chlorhexidine offered significant elimination of microorganisms.

PMID: 16878204 [PubMed - indexed for MEDLINE]

An in vitro comparative study of apically extruded debris resulting from conventional and three rotary (Profile, Race, FlexMaster) instrumentation techniques.

J Oral Sci. 2006 Jun;48(2):85-8

Authors: Zarrabi MH, Bidar M, Jafarzadeh H

Canal preparation is one of the most important stages of endodontic therapy, and various techniques have been applied for it. The present study was conducted to compare the quantity of debris extruded from the apical foramen during canal preparation during the manual technique and with the use of three rotary systems (Profile, Race, FlexMaster). One hundred single-rooted premolars were divided into four groups of 25 teeth each. For collection of debris, vials containing distilled water and weighed before canal preparation were used. Groups H, P, R and F were prepared by the manual step-back technique, and with the use of the Profile system, Race system and FlexMaster system, respectively. After canal preparation, the vials were dried thoroughly and reweighed. The difference between the weights of the vials at the two stages was taken as the debris weight. The mean debris weights were compared by one-way ANOVA. Group H had the highest mean debris weight, which was significantly different from those of the rotary groups (P < 0.001). The lowest mean debris weight was related to group R, which was significantly different from that of group F but not significantly different from that of group P. It was concluded that the Race system induces less extruded debris than the manual technique and the FlexMaster system.

PMID: 16858137 [PubMed - indexed for MEDLINE]

Endodontic or dental implant therapy: the factors affecting treatment planning.

J Am Dent Assoc. 2006 Jul;137(7):973-7; quiz 1027-8

Authors: Torabinejad M, Goodacre CJ

BACKGROUND: Clinicians are confronted with difficult choices regarding whether a tooth with pulpal and/or periapical disease should be saved through endodontic treatment or be extracted and replaced with an implant. METHODS: The authors examined publications (research, literature reviews and systematic reviews) related to the factors affecting decision making for patients who have oral diseases or traumatic injuries. RESULTS: The factors to be considered included patient-related issues (systemic and oral health, as well as comfort and treatment perceptions), tooth- and periodontium-related factors (pulpal and periodontal conditions, color characteristics of the teeth, quantity and quality of bone, and soft-tissue anatomy) and treatment-related factors (the potential for procedural complications, required adjunctive procedures and treatment outcomes). CONCLUSIONS: On the basis of survival rates, it appears that more than 95 percent of dental implants and teeth that have undergone endodontic treatment remain functional over time. CLINICAL IMPLICATIONS: Clinicians need to consider carefully several factors before choosing whether to perform endodontic therapy or extract a tooth and place an implant. The result should be high levels of comfort, function, longevity and esthetics for patients.

PMID: 16803823 [PubMed - indexed for MEDLINE]

A retrospective clinical evaluation of two-unit cantilevered resin-bonded fixed partial dentures.

J Am Dent Assoc. 2006 Jun;137(6):783-8

Authors: Botelho MG, Leung KC, Ng H, Chan K

BACKGROUND: The authors conducted a study to examine the clinical performance of two-unit cantilevered resin-bonded fixed partial dentures (RBFPDs) that were inserted at The Prince Philip Dental Hospital, University of Hong Kong. METHODS: The authors recalled patients who had received two-unit cantilevered RBFPDs at least 24 months before the recall examination. The authors recorded the following data: patient's sex and age, operator's experience, prosthesis cementation date, endodontic treatment if performed, bone support, tooth mobility, the presence of shim-stock contacts on the abutment or pontic in intercuspal position, and the presence of aproximal axial contacts adjacent to the prosthesis. They also recorded the date of any debonding with subsequent treatment. They asked the patients qualitative questions about their prostheses. RESULTS: A total of 269 prostheses were placed in 214 patients and had a mean service life of 51.7 months +/- 19.5 months standard deviation, with a range of 13.2 to 141.6 months. Of 14 failed prostheses, 12 debonded, resulting in a success rate of 94.8 percent and clinical retention rate of 95.5 percent. No discernable rotation or drifting of the abutments was apparent in any of the prostheses. Overall patient satisfaction with RBFPDs was good, with an average assessment score of 8.5. CONCLUSIONS: The authors observed a 95.5 percent clinical retention rate of 269 two-unit RBFPDs, with no apparent drifting of the abutments. Longer-term follow-up studies are required. CLINICAL IMPLICATIONS: Two-unit RBFPDs are conservative and clinically retentive prostheses in the short to medium term.

PMID: 16803807 [PubMed - indexed for MEDLINE]

Endodontic therapy.

J Am Dent Assoc. 2006 Jun;137(6):722, 724; author reply 724, 726

Authors: Kolzet DJ

PMID: 16803799 [PubMed - indexed for MEDLINE]

Endodontic management of taurodontic teeth.

Indian J Dent Res. 2005 Oct-Dec;16(4):177-81

Authors: Prakash R, Vishnu C, Suma B, Velmurugan N, Kandaswamy D

Taurodontism is a morpho-anatomical change in the shape of the tooth in which the body of the tooth is enlarged and the roots are reduced in size. Although taurodontism is a dental rarity, this unusual radicular form should merit circumspect considerations in planning and treatment. Endodontic management in taurodont teeth has been described as complex and difficult. The present paper describes the successful completion of endodontic treatment in three taurodontic teeth with appropriate use of instruments and techniques and also emphasizes the need for post endodontic rehabilitation.

PMID: 16761713 [PubMed - indexed for MEDLINE]

Mineral trioxide aggregate pulpotomies: a case series outcomes assessment.

J Am Dent Assoc. 2006 May;137(5):610-8

Authors: Witherspoon DE, Small JC, Harris GZ

BACKGROUND: The greatest threats to developing teeth are dental caries and traumatic injury. A primary goal of all restorative treatment is to maintain pulp vitality so that normal root development or apexogenesis can occur. If pulpal exposure occurs, then a pulpotomy procedure aims to preserve pulp vitality to allow for normal root development. Historically, calcium hydroxide has been the material of choice for pulpotomy procedures. Recently, an alternative material called mineral trioxide aggregate (MTA) has demonstrated the ability to induce hard-tissue formation in pulpal tissue. The authors describe the clinical and radiographic outcome of a series of cases involving the use of MTA in pulpotomy procedures. METHODS: Twenty-three cases in 18 patients were treated with MTA pulpotomy procedures in an endodontic private practice. All of the patients had been referred to the practice for diagnosis and treatment of a symptomatic tooth. All of the authors provided treatment. Pulpal exposures were either due to caries or complicated enamel dentin fractures. RESULTS: Nineteen teeth in 14 patients were available for recall. The mean time of recall was 19.7 months. Of the 19 cases, 15 involved healed teeth, and three involved teeth that were healing. One of 19 cases involved a tooth with persistent disease. CONCLUSIONS: MTA may be useful as a substitute for calcium hydroxide in pulpotomy procedures. Further research, however, is required to clarify this conclusion. CLINICAL IMPLICATIONS: MTA conceivably could replace calcium hydroxide as the material of choice for pulpotomy procedures, if future research continues to show promising results.

PMID: 16739540 [PubMed - indexed for MEDLINE]

The evaluation of the carbon fiber post system on restoration of teeth defect in children.

Chin Med J (Engl). 2006 May 20;119(10):809-13

Authors: Zhang XH, Wang XZ

BACKGROUND: Post and post-core systems are used to restore extensively damaged teeth. Among these systems, cast alloy post and core, prefabricated threaded alloy post and prefabricated simple alloy post are most frequently applied in China nowadays. In Europe and North America a combined application of the fiber post, resin-core and crown has been applied to restore seriously destructed teeth with satisfactory results in recent years. This study was intended to evaluate the clinical effect of carbon fiber post system on restoration of child anterior tooth defect after root canal therapy, based on 3 - 5 years' observation. METHODS: One hundred and six children with incompletely established occlusion were observed and followed for an average of 42 months (ranging from 36 to 60 months). Eighty-five upper teeth and forty-one lower teeth were restored with carbon fiber post system and composite jacket crown. Periodic check-up was conducted for periodontal condition and restoration effect. RESULTS: One hundred and twenty-one (96.2%) restorations were successful. Four jacket crowns (3.0%) were lost. One tooth (0.8%) had slight gingival inflammation. Tooth root or post fracture and gingival stain were not observed. X-ray showed there was no obvious change in aspects including the width of periodontal membrane, the density of alveolar bone and the height of alveolar ridge crest. CONCLUSIONS: Carbon-fiber post system can satisfy the clinical requirements of young patients who have residual anterior crown and root caused by trauma or caries, and have incomplete occlusion and have completed root canal therapy. This system helps realize good esthetic result for patients and easy practice for dentists. Carbon fiber post is safe and convenient, especially for sick children.

PMID: 16732982 [PubMed - indexed for MEDLINE]

Analysis of the sealing ability of different obturation techniques in oval-shaped canals: a study using a bacterial leakage model.

Braz Oral Res. 2006 Jan-Mar;20(1):64-9

Authors: De Deus G, Murad CF, Reis CM, Gurgel-Filho E, Coutinho Filho T

The aim of this study was to evaluate the sealing ability of 3 obturation techniques in oval canals using a bacterial leakage model. Seventy mandibular incisors with oval canals were selected after buccolingual and mesiodistal radiographs, and divided into three groups. After instrumentation, the canals were obturated respectively by lateral condensation (G1), warm vertical condensation (G2) and Thermafil (G3). Five root canals were not obturated and served as positive controls; five teeth with intact crowns served as negative controls. All teeth were mounted on a 2 chamber apparatus and then exposed to human saliva. The number of days required for the entire contamination of the root canals was recorded, observing the turbidity of the BHI broth, for a period of 100 days. 84.21% of the samples from the lateral condensation group (G1); 84.21% of the samples from the warm vertical condensation group (G2); and 89.47% of the samples from the Thermafil System group (G3) showed no contamination at the end of the study. No statistical significant difference was found among the three techniques. The quality of the apical seal in the three techniques tested was similar.

PMID: 16729177 [PubMed - indexed for MEDLINE]

The influence of the surgical operating microscope in locating the mesiolingual canal orifice: a laboratory analysis.

Braz Oral Res. 2006 Jan-Mar;20(1):59-63

Authors: Coutinho Filho T, La Cerda RS, Gurgel Filho ED, de Deus GA, Magalh&#xE3;es KM

The aim of this study was to evaluate the influence of using the surgical operating microscope (SOM) for detection of the mesiolingual (ML) canal orifice in extracted first maxillary permanent molars. One hundred and eight human first maxillary permanent molars were randomly selected and mounted onto a dental chair mannequin. Conventional access cavity was prepared and an attempt was made to locate the mesiolingual canal orifice using only a sharp explorer, a mirror and a #10 K-file. A mesiolingual canal orifice was either located or not located. If not located, the teeth were then evaluated by using a surgical operating microscope (SOM). The mesiobuccal roots of all teeth where the ML canal orifice had not been located were sectioned in an axial plane and the sections were explored with an adjunctive use of the SOM at a 25 X magnification. ML canal orifices were detected in 58 teeth using only a sharp explorer, a mirror and #10 K-file. In the remaining 50 teeth, 37 ML canal orifices were located by using the SOM and 3 ML canal orifices were located after root sectioning. In 10 teeth, the ML canal orifices were not found. The results of this study showed a high incidence of a ML canal in the mesiobuccal roots of the first maxillary molars (90.7%) and demonstrated that the adjunctive use of the SOM increased the ability of the dental clinician to locate the ML canal orifice.

PMID: 16729176 [PubMed - indexed for MEDLINE]