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Free Full Text ArticleIn vitro evaluation of the effectiveness of the chemomechanical preparation a...
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In vitro evaluation of the effectiveness of the chemomechanical preparation against Enterococcus faecalis after single- or multiple-visit root canal treatment.

Braz Oral Res. 2007;21(4):308-313

Authors: Gurgel-Filho ED, Vivacqua-Gomes N, Gomes BP, Ferraz CC, Zaia AA, Souza-Filho FJ

The purpose was to assess the elimination of Enterococcus faecalis in vitro in human mandibular premolars after chemomechanical preparation with or without the use of a calcium hydroxide dressing. After 60 days of contamination with E. faecalis, the root canals were prepared using the Crown-Down technique combined with 2% chlorhexidine gel irrigation. Then, the specimens were divided into two experimental groups, treated in a single visit or in multiple visits, and two control groups. The multiple-visit group received a dressing with calcium hydroxide for 14 days (CalenTM) and the single-visit group did not receive any medication. In the two control groups, the canals were filled with BHI after chemomechanical preparation with 2% chlorhexidine gel or distilled water. Microbial samples were taken from the root canals for colony forming unit count for each phase of the treatment using sterile paper points inside the root canal lumen. Data were ranked and analyzed by the Kruskal-Wallis statistical test. The residual microbial colonies were then assessed. The results showed that chemomechanical preparation using 2% chlorhexidine gel with no intra-canal dressing reduced by 100% the E. faecalis contamination of the root canal lumen. The calcium-hydroxide group that received the 14-day intra-canal dressing allowed a small number of bacteria to grow between visits, but without statistical differences between groups.

PMID: 18060256 [PubMed - as supplied by publisher]


Free Full Text ArticleEffect of intracanal medication with calcium hydroxide and 1% chlorhexidine i...
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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, Duülgergil 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]


Free Full Text ArticleInfluence of sodium hypochlorite-based irrigants on the susceptibility of int...
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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]


Free Full Text ArticleA scanning electron microscopic evaluation of root canal wall cleanliness aft...
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A scanning electron microscopic evaluation of root canal wall cleanliness after calcium hydroxide removal using three irrigation regimens.

J Contemp Dent Pract. 2007 Jan 1;8(1):11-8

Authors: Naaman A, Kaloustian H, Ounsi HF, Naaman-Bou Abboud N, Ricci C, Medioni E

AIMS: The aims of this in vitro study were to evaluate debris and smear layer elimination capability effectiveness of 5.25% sodium hypochlorite (NaOCl) after calcium hydroxide removal from the root canal and to determine if ethylenediaminetetraacetic acid (EDTA) and citric acid have any additional effects on debris and smear layer removal. METHODS AND MATERIALS: All irrigation regimens are associated with ultrasonics. Thirty-six pulpless single-rooted teeth were divided into three groups on the basis of the irrigation regimen, namely 5.25% NaOCl alone, 5.25% NaOCl with 17% EDTA pH 7 (NaOCl-EDTA), and 5.25% NaOCl with 50% citric acid (NaOCl-CA). All root canals were instrumented with the Protaper rotary system (Dentsply-Maillefer, Ballaigues, Switzerland) using a crown-down approach. The apical foramen of each tooth was enlarged to a size 30 with a 0.09 taper. After longitudinal sectioning, the dentin walls were microphotographed using scanning electron microscopy (SEM) at a 1500x magnification. Using a grid and a 5-step scale these microphotographs were scored by three investigators in order to evaluate debris and smear layer residuals. Data were statistically evaluated using Kruskal-Wallis and Mann-Whitney tests. RESULTS: In the coronal third the lowest score obtained with NaOCl-CA was similar to NaOCl-EDTA. When using NaOCl-EDTA, mean debris scores were similar to the control group (NaOCl) and lower than NaOCl-CA in the middle and apical thirds. Regarding the mean smear layer score, NaOCl-CA was the lowest in the coronal, middle, and apical thirds with a statistically significant difference (p < 0.001). CONCLUSION: When the total surface of the root was evaluated, NaOCl-EDTA was superior in removing debris, but the association of NaOCl-CA enabled the most effective removal of the smear layer.

PMID: 17211500 [PubMed - indexed for MEDLINE]


Free Full Text ArticleA scanning electron microscopic evaluation of different root canal irrigation...
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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]


Free Full Text ArticleThe role of Carisolv and different auxiliary chemical substances in the remov...
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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]


Free Full Text ArticleAntimicrobial efficiency of some antiseptic products on endodontic microflora...
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Antimicrobial efficiency of some antiseptic products on endodontic microflora isolated from gangrenous pulp tissue.

J Contemp Dent Pract. 2006 Sep 1;7(4):53-62

Authors: Shurrab MY

AIM: The aims of the study are to investigate the bactericidal effect of three antiseptics (chlorhexidine solution, povidone-iodine solution, and Walkhoff solution) and to determine the minimum inhibitory concentration and their effect on different microbial species. METHODS AND MATERIALS: The study was performed on microflora derived from root canals with simple and complicated pulp gangrene and on pure strains of Enterococcus and Candida albicans. RESULTS: Chlorhexidine and povidone-iodine proved to have antibacterial and antifungal effects if used in the treatment of pulp gangrene and in cases not responding to conventional therapy. CONCLUSION: According to the obtained results, the spectrum of antibacterial agents used in infected canal irrigation can be enlarged to include the agents tested.

PMID: 16957791 [PubMed - indexed for MEDLINE]


Free Full Text ArticleA comparison of the efficacy of Er,Cr:YSGG laser and rotary instrumention in ...
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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 d&#xE9;bridement 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]


Free Full Text ArticleEffect of rotary instrumentation and of the association of calcium hydroxide ...
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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]


Free Full Text ArticleEndodontic treatment of a supernumerary tooth fused to a mandibular second mo...
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Endodontic treatment of a supernumerary tooth fused to a mandibular second molar: a case report.

J Oral Sci. 2006 Mar;48(1):39-41

Authors: Ghoddusi J, Zarei M, Jafarzadeh H

Since abnormal tooth morphology can predispose to caries and periodontal disease, careful management of fused teeth is essential. In this paper we report a rare case of a fused molar and supernumerary tooth and describe its management. Caries was removed from the tooth complex under local anesthesia. The pulp chamber of the supernumerary tooth was exposed without involvement of second molar pulp chamber. The root canal of the supernumerary tooth was prepared using the step back technique and copious irrigation with 2.6% sodium hypochlorite. Obturation using the lateral condensation technique with gutta-percha and AH26 sealer was subsequently performed and final restoration was accomplished with composite resin. Nine months after the treatment, no clinical or radiographic concern is apparent, and the second molar tooth has remained vital.

PMID: 16617200 [PubMed - indexed for MEDLINE]


Free Full Text Article[Scanning electron microscopic study on the use of traditional Chinese medica...
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[Scanning electron microscopic study on the use of traditional Chinese medical irrigant in ultrasonic root canal instrumentation]

Shanghai Kou Qiang Yi Xue. 2006 Feb;15(1):77-80

Authors: Wang Q, Xiong SJ, Lin XJ, Liu GX

PURPOSE: To evaluate the cleaning ability of traditional Chinese medicine Jieeryin used as ultrasonic root canal irrigant. METHODS: A total of 20 extracted human single-rooted teeth were divided into 4 groups: normal saline, 3.33% Jieeryin, 30% Jieeryin and 2.5% sodium hypochlorite. After ultrasonic root canal preparation a 15#-K type ultrasonic file was inserted into the root canal without contacting the root canal wall and the ultrasonic irrigation was kept for 10 seconds. The cleaning of the cervical, middle and apical thirds of the root canal walls was evaluated by scanning electron microscope. The data were analyzed statistically by ANOVA and Bonferroni test. RESULTS: The cleaning ability of 30% Jieeryin was similar to that of 2.5% NaClO (P>0.05) in the cervical third, and it was significantly better than 3.33% Jieeryin (P<0.01) and normal saline (P<0.05). There was significant difference between the cervical third and the middle or apical thirds (P<0.01) of 30% Jieeryin. There was no significant difference between the four groups in the middle third (P>0.05). In the apical third, 2.5% NaClO was significantly better than normal saline (P>0.05). No significant difference was found between 3.33% Jieeryin and saline in all thirds. CONCLUSION: Cleaning by 30% Jieeryin or 2.5% NaClO with ultrasonic technique was superior compared to the cleaning by 3.33% Jieeryin or normal saline in the cervical third.

PMID: 16525616 [PubMed - in process]


Free Full Text ArticleEffect of the sodium hypochlorite and citric acid association on smear layer ...
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Effect of the sodium hypochlorite and citric acid association on smear layer removal of primary molars.

Braz Oral Res. 2005 Oct-Dec;19(4):261-6

Authors: G&#xF6;tze Gda R, Cunha CB, Primo LS, Maia LC

This study aimed to assess the capacity of a sodium hypochlorite and citric acid (CA) association (the latter at different concentrations) in removing coronal smear layer (SL) of primary teeth. For this purpose, the pulp chamber roof and floor of 28 primary molars were removed to obtain enamel and dentine disks. SL was produced on the internal walls of the disks using high-speed drills. The disks were irrigated with 1% sodium hypochlorite and citric acid at different concentrations (CA-4%, CA-6%, CA-8% and CA-10%), and with 0.9% sodium chloride. The samples were split and observed under SEM. Scores were attributed to the obtained photomicrographs, according to the amount of SL present. It was noted that all the tested concentrations of citric acid used after the sodium hypochlorite were capable of removing SL. The results were analyzed by the Kruskal-Wallis test, and there was no significant statistical difference among the scores of the groups tested. However, it was observed that CA-8% and CA-10% caused peritubular dentine destruction, and that CA-4% presented a larger number of samples with dense SL. Based on these results, 6.0% citric acid in association with 1% sodium hypochlorite is suggested as auxiliary chemical substances for primary teeth irrigation.

PMID: 16491253 [PubMed - indexed for MEDLINE]


Free Full Text Article[Comparison of the effects of 5 irragant combinations on cleaning of anterior...
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[Comparison of the effects of 5 irragant combinations on cleaning of anterior straight root canal walls]

Shanghai Kou Qiang Yi Xue. 2005 Jun;14(3):293-7

Authors: Li C, DU R, Zhu YQ

PURPOSE: To evaluate the effect of 5 kinds of irrigant combinations on cleaning of anterior straight root canal walls. METHODS: 25 extracted human maxillary anterior teeth, with a single straight root were randomly divided into 5 groups. They were instrumented with K-files and conventional preparation technique. The irrigations were as follow: in group 1,the canals were irrigated with 1% NaOCl and 3% H2O2 in sequence during and after instrumentation.In group 2,the canals were irrigated with 1% NaOCl during instrumentation and after instrumentation being irrigated with 17% EDTA. In group 3,irrigation during and after instrumentation was accomplished using 17% EDTA and 1% NaOCl in sequence. In group 4,irrigation during instrumentation was accomplished using 17% EDTA and 1% NaOCl in sequence, and after instrumentation being irrigated with 17% EDTA.In group 5,the canals were irrigated with 17% EDTA, 1% Triton X-100 and 1% NaOCl in sequence during instrumentation and irrigated with 17% EDTA after instrumentation. The total amount of irrigant was 22ml and the irrigation time was 7 minutes in each root canal. The root was split longitudinally and 3 specimens in each group were evaluated regarding to the smear layer, debris and erosion of dentinal tubules with SEM at the coronal, middle and apical thirds. RESULTS: In group 1, typical amorphous smear layer and abundance of debris were seen on the wall of canals. In group 2, the smear layer was removed partly in coronal and middle thirds, but the apical surface of the canal walls were covered with a typical amorphous smear layer. Although irrigants of group 3 could remove smear layer effectively, it resulted in moderate erosion of dentinal tubules. In group 5, part of the smear layer was removed on the surface of coronal and middle thirds but abundance of debris were present on the surface at the apical levels. Severe erosion was noted on the root canal surfaces in this group. Irrigation of group 4 had the best result: it not only removed smear layer effectively ,but also had no erosion on dentinal tubules. CONCLUSION: Using the combination of 17% EDTA and 1% NaOCl can remove smear layer effectively and has no erosion on the dentinal tubules under the condition of strict time control and irrigation sequence. Supported by Phosphor Plan (No.01QB14025) of Science and Technology of Shanghai Municipality.

PMID: 15995780 [PubMed - in process]


Free Full Text ArticleInfluence of Er: YAG laser irradiation on apical sealing of four different se...
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Influence of Er: YAG laser irradiation on apical sealing of four different sealers.

Braz Dent J. 2004;15(3):190-3

Authors: Mello I, Robazza CR, Antoniazzi JH

The sealing of the root canal system is of fundamental importance for successful endodontic treatment. To obtain an adequate apical seal, many factors must be considered such as the presence of smear layer and the sealer applied. After canal preparation, this layer must be removed because it prevents close contact between the dentinal walls and the sealing material. The goal of this study was to evaluate the sealing ability of four different sealers after smear layer removal with either 17% EDTA-T irrigation or Er:YAG laser irradiation of 46 teeth. The canals were sealed with four different sealers: Sealapex, Ketac Endo, AH Plus and N-Rickert. The method for smear layer removal did not influence apical sealing. AH Plus and N-Rickert allowed less dye leakage when compared to Sealapex and Ketac Endo.

PMID: 15798821 [PubMed - in process]


Free Full Text ArticleHistological study of the effect of some irrigating solutions on bacterial en...
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Histological study of the effect of some irrigating solutions on bacterial endotoxin in dogs.

Braz Dent J. 2004;15(2):109-14

Authors: Silva LA, Leonardo MR, Assed S, Tanomaru Filho M

The aim of this study was to evaluate, histopathologically, the effectiveness of mechanical preparation of root canals using different irrigating solutions in dog teeth filled with LPS after pulpectomy. A total of 120 root canals of 6 mongrel dogs were filled with a solution of LPS after pulpectomy. The irrigating solutions used were saline, 1, 2.5, and 5% sodium hypochlorite, and 2% chlorhexidine. No irrigation was used in the control group. The animals were sacrificed after 60 days and the teeth were fixed and demineralized. Subsequently, serial 6-microm sections were stained with hematoxylin and eosin and Mallory's trichrome for histopathological analysis and Brown-Brenn for verification of bacterial contamination. Analysis showed that the inflammatory infiltrate was statistically less intense in the groups in which the root canals were irrigated with 5% sodium hypochlorite and 2% chlorhexidine. However, none of the irrigating solutions completely inactivated the harmful effects of LPS. Mechanical preparation associated with different irrigating solutions did not completely inactivate LPS.

PMID: 15776192 [PubMed - indexed for MEDLINE]


Free Full Text ArticleThe effectiveness of three instrumentation techniques on the elimination of E...
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The effectiveness of three instrumentation techniques on the elimination of Enterococcus faecalis from a root canal: an in vitro study.

J Contemp Dent Pract. 2005 Feb 15;6(1):94-106

Authors: Colak M, Evcil S, Bayindir YZ, Yigit N

The in vitro reduction of a bacterial population in a root canal by mechanical instrumentation using three techniques was evaluated. Root canals inoculated with a Enterococcus faecalis (E. faecalis) suspension were instrumented using hand Hedstroem files, Giromatic files, and Hero 642 rotary instruments. Irrigation was performed using sterile saline solution. Root canals were sampled before and after instrumentation. After serial dilutions, samples were plated onto Mitis-Salivarius agar and the colony forming units grown were counted. All instruments tested were able to significantly reduce the number of bacterial cells in the root canal, however, the results of this study indicated that Hedstroem files, Giromatic, and Hero 642 techniques were not significantly different in their ability to reduce intracanal bacteria.

PMID: 15719081 [PubMed - indexed for MEDLINE]


Free Full Text ArticleSmear layer removal capacity of disinfectant solutions used with and without ...
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Smear layer removal capacity of disinfectant solutions used with and without EDTA for the irrigation of canals: a SEM study.

Pesqui Odontol Bras. 2003 Oct-Dec;17(4):349-55

Authors: Menezes AC, Zanet CG, Valera MC

The purpose of this study was to carry out a scanning electron microscopic (SEM) analysis of the cleaning qualities and smear layer removal from root canal walls, instrumented and irrigated with 2.5% NaOCl, 2.0% chlorhexidine and saline solutions. Fifty extracted teeth were used in this study. All teeth were radiographed to determine the existence of a single canal. The crowns were cut at the cervical limit and the root canals were instrumented with K-type files up to size 45. During root canal preparation, irrigations were made with the different solutions being evaluated: Group 1: 2.5% NaOCl (10 roots); Group 2: 2.5% NaOCl and 17% EDTA for 2 minute (10 roots); Group 3: 2.0% chlorhexidine (10 roots); Group 4: 2.0% chlorhexidine and 17% EDTA for 2 minutes (10 roots); Group 5: saline solution (5 roots); Group 6: saline solution and 17% EDTA for 2 minutes (5 roots). After instrumentation, the canals were irrigated with each one of the solutions and the roots were cut in the buccolingual direction for SEM analysis, at the cervical, middle and apical thirds, to ascertain the presence or absence of smear layer and debris. SEM analysis was performed by three calibrated examiners and scores were submitted to Kruskal-Wallis test at the significance level of p = 5%. Results showed that the use of 17% EDTA decreased the smear layer significantly (p < 0.05) for all evaluated solutions in all thirds. When EDTA was not used, a significantly higher quantity of smear layer on the apical third was observed only in the NaOCl groups. The use of 17% EDTA was significant for debris removal except for the chlorhexidine groups. The following conclusion could be drawn: the use of 17% EDTA was necessary to enhance cleanness of the root canals.

PMID: 15107918 [PubMed - indexed for MEDLINE]


Free Full Text ArticleInferior alveolar nerve paresthesia relieved by microscopic endodontic treatm...
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Inferior alveolar nerve paresthesia relieved by microscopic endodontic treatment.

Bull Tokyo Dent Coll. 2003 Nov;44(4):209-12

Authors: Yatsuhashi T, Nakagawa K, Matsumoto M, Kasahara M, Igarashi T, Ichinohe T, Kaneko Y

We experienced two cases of inferior alveolar nerve paresthesia caused by root canal medicaments, which were successfully relieved by microscopic endodontic treatment. In the first case, the paresthesia might have been attributable to infiltration of calcium hydroxide into the mandibular canal through the root canals of the mandibular left second molar tooth. In the second case, the paresthesia might have been attributable to infiltration of paraformaldehyde through the root canals of the mandibular right second molar tooth. The paresthesia was relieved in both cases by repetitive microscopic endodontic irrigation using physiological saline solution in combination with oral vitamin B12 and adenosine triphosphate.

PMID: 15103918 [PubMed - indexed for MEDLINE]


Free Full Text ArticleInfluence of passive ultrasonic activation on the penetration depth of differ...
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Influence of passive ultrasonic activation on the penetration depth of different sealers.

J Contemp Dent Pract. 2004 Feb 15;5(1):115-25

Authors: Karadag LS, Tinaz AC, Mih&#xE7;ioğlu T

Correct use of instruments and irrigating solutions are major factors during chemo-mechanical preparation of root canals. Ultrasonically activated files and solutions are used for debridement of canals. In this study 42 single rooted anterior human teeth were used. The roots were divided into two groups. One group received an application of 17% ethylenediamine tetra acetic acid (EDTA) of 1 ml for 1 min using an ultrasonically energized file. The other group received an application of 17% EDTA of 1 ml for 0.5 min using an ultrasonically energized file. The groups were divided again into two subgroups. The roots were filled with a resin based sealer, AH26 and a glass ionomer sealer--Endion with lateral condensation technique. The roots were separated into two halves. The specimens were viewed through a scanning electron microscope (SEM). Statistical differences between the groups and regions were analyzed with Variance and Duncan tests. Under the conditions of this study, it can be said that ultrasonically activated irrigation did not reduce the smear layer effectively at 1 min and 0.5 min time intervals. According to this result, no difference was observed between the penetration of sealers.

PMID: 14973565 [PubMed - indexed for MEDLINE]


Free Full Text ArticleIn vitro evaluation of the effects of the interaction between irrigating solu...
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In vitro evaluation of the effects of the interaction between irrigating solutions, intracanal medication and Er:YAG laser in dentin permeability of the endodontic system.

Pesqui Odontol Bras. 2003 Jul-Sep;17(3):278-85

Authors: Rald DP, Lage-Marques JL

The purpose of this study was to evaluate in vitro the effects of different associations between irrigating solutions (EDTA-T and citric acid), intracanal medicament (NDP), and Er:YAG laser irradiation on dentin permeability. Fifty-one extracted single-rooted teeth were instrumented and divided into seven groups. Groups GI and GII had final irrigation with a demineralizing solution only (EDTA-T and citric acid, respectively). Groups GIII and GIV had final irrigation with EDTA-T and citric acid, respectively, plus an association of irrigating solution and Er:YAG laser. Groups GV and GVI had final irrigation with EDTA-T and citric acid, respectively, plus an association of intracanal medication and Er:YAG laser. Group GVII (control group) had final irrigation with distilled water. All root canals were filled with NDP associated with rhodamine B dye. After the experimental period, the samples were transversely cut into six 2.0 mm thick slices for subsequent reading using the ImageLab software. Analysis of the results allowed us to conclude that there were statistically significant differences (p < 0.05) between the groups as to the penetration of the dye-intracanal medication solution. Groups III and IV presented smaller values of dentinal permeability when compared to the other groups. The best results were obtained with the interaction between a demineralizing irrigating solution and the association of intracanal medicament and laser Er:YAG (groups V and VI). In these groups the observed penetration of the intracanal medicament plus dye solution in the apical third was, on average, 29% greater than in the other groups.

PMID: 14762508 [PubMed - indexed for MEDLINE]


Free Full Text Article[A comparative study of root smear layer removal using different pH EDTA salts]
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[A comparative study of root smear layer removal using different pH EDTA salts]

Shanghai Kou Qiang Yi Xue. 2003 Jun;12(3):197-9

Authors: Ma R, Liu Z, Zhu CL

OBJECTIVE: To evaluate the effect of different pH EDTA salts on removing root canal smear layers. METHODS: Sixty human teeth with single root were instrumented using step-back technique, then were irrigated with several irrigating solutions including A: 0.9% saline; B: 5.25% NaOCl +3% H2O2; C: 15% EDTA (pH = 6.5); D: 15% EDTA (pH = 13); E: 15% EDTA (pH = 6.5) 25% NaOCl +3% H2O2; F: 15% EDTA (pH = 13) 25% NaOCl +3% H2O2. After the teeth were split, the root canal walls were examined with scanning electron microscopy at the coronal, middle and apical thirds for smear layer removal. RESULTS: Except A and B group, all the groups were effective on removing smear layer at the coronal, middle thirds of the root canal, group C had a stronger effect to remove smear layer than group D (P < 0.05), group E was the most effective among these groups. However, these groups were all ineffective on removing smear layer at the apical thirds of root canal. CONCLUSIONS: 15% EDTA (pH = 6.5) 25% NaOCl +3% H2O2 was the most effective irrigation on removing smear layer.

PMID: 14661329 [PubMed - indexed for MEDLINE]


Free Full Text ArticleAnalysis of the film thickness of a root canal sealer following three obturat...
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Analysis of the film thickness of a root canal sealer following three obturation techniques.

Pesqui Odontol Bras. 2003 Apr-Jun;17(2):119-25

Authors: de Deus GA, Martins F, Lima AC, Gurgel-Filho ED, Maniglia CF, Coutinho-Filho T

The aim of this study was to obtain a quantitative analysis of the film thickness of a root canal sealer formed after filling by three different techniques. Thirty human maxillary incisors were selected and access cavities were prepared using high-speed diamond stones and water spray. A size #15 K-Flexofile was introduced in the canal of each specimen until it was seen just at the apical foramen. The working length was determined to be 1 mm short of that position and the canals were prepared to an apical size of #45 K-Flexofile. Copious irrigation with 5.25% NaOCl (sodium hypochlorite) was used during and after instrumentation. The samples were divided into three groups and obturated as follows: G1 - lateral condensation, G2 - lateral condensation with an accessory cone, and G3 - continuous wave of condensation. The samples were evaluated in the cervical, middle and apical thirds. The film thickness of the root canal sealer was measured through a microscopic evaluation. Statistical analysis was obtained using the Wilcox test. Statistical analysis showed significant differences between G3 and G1, G3 and G2 (p < 0.05). In general, the lowest film thickness was observed in the continuous wave of condensation (G3). Lateral condensation with an accessory cone (G2) and lateral condensation (G1) demonstrated poorer results in this study, showing a higher film thickness. The small film thickness of the sealer obtained by the continuous wave of condensation technique may increase the clinical performance of this technique.

PMID: 14569352 [PubMed - indexed for MEDLINE]


Free Full Text Article[Intratubular penetration of root canal sealers]
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[Intratubular penetration of root canal sealers]

Pesqui Odontol Bras. 2002 Oct-Dec;16(4):332-6

Authors: de Deus G, Gurgel Filho ED, Ferreira CM, Coutinho Filho T

The purpose of this study was to evaluate the capacity of penetration of four endodontic sealers (Endo Fill, Sealapex, AH Plus and Pulp Canal Sealer) into dentinal tubules. Seventy-two extracted human maxillary anterior teeth were utilized in this study. The teeth were cleaned and shaped by means of the balanced-forces technique. The work length was established at 1 mm beyond the apex. Copious irrigation with 10 ml of 5.25% sodium hypochlorite was carried out. The teeth were divided in 8 groups - 4 had the smear layer maintained, and 4 had it removed. The smear layer was removed with a commercial solution of 17% EDTA, and the root canal system was flushed for 3 min. Finally, the roots were irrigated with 3 ml of 5.25% sodium hypochlorite. All teeth were sealed by means of the technique of the condensation wave with a medium nonstandardized cone. After filling, the roots were grooved, longitudinally split and examined under a scanning electron microscope (SEM). The focus of observation was the interface between the dentin and the sealing material. The Rickert sealer (Pulp Canal) presented the maximum penetration depths into the dentinal tubules, and Sealapex, the minimum. The Spearman test was used to determine whether there were significant differences between the groups. The removal of smear layer allowed significant penetration of the sealers (p <= 0.01).

PMID: 12612772 [PubMed - indexed for MEDLINE]


Free Full Text ArticleCommon dental emergencies.
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Common dental emergencies.

Am Fam Physician. 2003 Feb 1;67(3):511-6

Authors: Douglass AB, Douglass JM

Dental caries, a bacterial disease of teeth characterized by destruction of enamel and dentine, is often the underlying cause of dental pain. When a carious lesion impinges on the dental pulp, pulpitis follows and, ultimately, necrosis of the pulp occurs. Untreated necrosis may lead to a localized abscess or a spreading infection into the surrounding soft tissue that results in cellulitis. Immediate treatment involves antibiotic therapy for cellulitis, perhaps with drainage of abscesses, while definitive treatment requires root canal therapy or extraction of the involved tooth. Pericoronitis is an inflammation of the soft tissue overlying a partially erupted tooth. Localized cases respond to irrigation. Secondary cellulitis can develop. Definitive treatment may require surgical extraction of the underlying tooth or excision of the gum flap. Avulsion of a permanent tooth secondary to trauma is a true dental emergency. The tooth should be reimplanted on the spot, and the patient should be seen immediately by a dentist for splinting and antibiotic prophylaxis. Most dental problems can be prevented with regular dental care and steps to minimize risks of oral trauma.

PMID: 12588073 [PubMed - indexed for MEDLINE]


Free Full Text ArticleNonsurgical treatment for odontogenic maxillary sinusitis using irrigation th...
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Nonsurgical treatment for odontogenic maxillary sinusitis using irrigation through the root canal: preliminary case report.

Tohoku J Exp Med. 2002 May;197(1):47-53

Authors: Iikubo M, Sasano T, Shoji N, Sakamoto M

As a new nonsurgical treatment for odontogenic maxillary sinusitis (OMS), irrigation of the maxillary sinus through the root canal of the causal tooth was carried out to the patient with OMS that had proved refractory to conservative treatments (i.e., root-canal treatment of the causal tooth and antibiotic therapy). Clinical signs, symptoms, and radiographs before and after the new treatment revealed evidence of good healing. The clinical signs and symptoms, such as oppressive pain in the cheek and retrorhinorrhoea, entirely disappeared immediately after the irrigation (which was done only once) without pain, and the obstructed ostiomeatal unit was aerated on the follow-up CT images. There was no side effect associated with saline irrigation, nor any recurrence of symptoms since the irrigation. We therefore propose the irrigation through the root canal of the causal tooth as a new treatment for periapical disease-induced maxillary sinusitis, a technique that should ensure proper ventilation and drainage by relieving obstruction of the ostiomeatal unit.

PMID: 12180793 [PubMed - indexed for MEDLINE]


Free Full Text ArticleIn vitro effect of intracanal medicaments on strict anaerobes by means of the...
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In vitro effect of intracanal medicaments on strict anaerobes by means of the broth dilution method.

Pesqui Odontol Bras. 2002 Jan-Mar;16(1):31-6

Authors: Rosa OP, Torres SA, Ferreira CM, Ferreira FB

The determination of bacterial susceptibility to intracanal medicaments is a necessity. Nevertheless, few studies utilize the proper methodology to carry out that evaluation with anaerobes. In this study, the steps of a broth dilution method, carried out in microplates (microdilution) and tubes (macrodilution), to test the effect of traditional intracanal medicaments on anaerobic bacteria are described. The results are presented as values of minimal inhibitory and bactericidal concentrations (MIC and MBC). Standardized inocula of the anaerobic bacteria Prevotella nigrescens (ATCC 33563), Fusobacterium nucleatum (ATCC 25586) and Clostridium perfringens (ATCC 13124), in reinforced Clostridium medium (RCM) and supplemented Brucella broth, were submitted to different concentrations of calcium hydroxide, chlorhexidine digluconate, camphorated paramonochlorophenol and formocresol solutions. The drugs were diluted in the same culture broths, in microplates and tubes, and were then incubated in anaerobiosis jars at 37 degrees C for 48 or 96 hours. The determination of MICs was carried out through visual and spectrophotometric readings, and the determination of MBCs, through the plating of aliquots on RCM-blood agar. For that kind of study, the macromethod with spectrophotometric reading should be the natural choice. MICs and MBCs obtained with the macromethod were compatible with the known clinical performance of the studied medications, and the values varied according to the bacteria and culture media employed. RCM was the most effective medium and C. perfringens, the most resistant microorganism.

PMID: 11938715 [PubMed - indexed for MEDLINE]



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