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]

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, Negrão 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]

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]

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]

Treatment of pulp floor and stripping perforation by mineral trioxide aggregate.

J Formos Med Assoc. 2006 Jun;105(6):522-6

Authors: Tsai YL, Lan WH, Jeng JH

Mineral trioxide aggregate (MTA) has been widely used to repair various kinds of tooth perforations, but its use for obturation of the entire root canal has not been reported. We report two cases of tooth perforation successfully repaired with MTA. The first patient was a 78-year-old male with calcified canal and pulp floor perforation in the left maxillary first premolar. After bypass of the calcified palatal canal, both buccal and palatal canals were filled with gutta percha, and the pulp floor perforation was repaired with MTA. Clinical success with no evident radicular lesion was found at the 18-month follow-up. The second patient was a 51-year-old female with a stripping perforation in a C-shaped root canal of the right mandibular second molar detected after removal of a post. Following root canal debridement and calcium hydroxide therapy to control inflammation at the stripping perforation site, apical and furcation bone healing were observed by radiographic examination. The stripping perforation was repaired by obturation of the entire C-shaped root canal with MTA. Observation at the 9-month follow-up revealed bone healing without any clinical symptoms and signs. These cases suggest that MTA is an alternative root canal obturation material for treatment of stripping perforation in a C-shaped root canal and for repair of pulp floor perforation.

PMID: 16801043 [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]

Anatomical redesign for the treatment of dens invaginatus type III with open apexes: a literature review and case presentation.

J Am Dent Assoc. 2006 Feb;137(2):180-5

Authors: Silberman A, Cohenca N, Simon JH

BACKGROUND: Dens invaginatus is a rare dental anomaly that may give rise to many complex anatomical forms. The complexity of the internal anatomy may create challenges for the complete removal of the diseased pulpal tissue and the subsequent sealing of the canal system. CASE DESCRIPTION: The authors discuss the modification of the internal anatomy under the operating microscope, allowing the clinician better access to treat predictably the canal system with conventional or alternative techniques. CONCLUSION AND CLINICAL IMPLICATIONS: Considering the anatomical variations and the challenges that a dens invaginatus may present, a practitioner may consider a modification of the internal anatomy of the canal system to gain better access for proper instrumentation, disinfection and sealing of the root canal system using conventional or contemporary techniques.

PMID: 16521383 [PubMed - indexed for MEDLINE]

Outcome of endodontic treatment of teeth filled using lateral condensation versus vertical compaction (Schilder's technique).

J Contemp Dent Pract. 2006 Feb 15;7(1):17-24

Authors: Aqrabawi JA

The purpose of this prospective clinical and radiographic investigation was to assess the treatment results following endodontic therapy of teeth filled with lateral condensation versus teeth filled with vertical compaction of warm gutta-percha. A total of 290 patients were treated using the standardized step-back technique for canal preparation, which were filled with either lateral condensation or vertical compaction in one single session. Five years later, the treatment results were assessed clinically and radiographically and related to the type of the obturation technique using Chi-square analysis. Of the 340 teeth that were reexamined, 160 teeth were filled with lateral condensation, and 180 teeth were filled with vertical condensation. The results showed a significantly higher success rate for the vertical compaction versus the lateral condensation technique of teeth presented with preoperative periapical lesions P<0.04. Regardless of the preoperative periapical status of the teeth, no statistically significant difference was found between the two techniques. The overall success rate of both filling techniques was 80.3%.

PMID: 16491144 [PubMed - indexed for MEDLINE]

[The influence of smear layer and different sealers on apical microleakage of root canals obturated with Ultrafil-3D system]

Shanghai Kou Qiang Yi Xue. 2005 Dec;14(6):648-51

Authors: Du R, Zhu YQ

PURPOSE: To evaluate the sealing properties of Ultrafil-3D system with three different root canal sealers in absence or presence of smear layer. METHODS: 64 straight single-root anterior teeth were selected and root canals were instrumented. 60 teeth were divided into two groups with or without smear layer. Each group was then divided into three subgroups, three different sealers (AH-plus, Roekoseal, CRCS) were applied in each subgroup when the root canals were obturated with Ultrafil-3D system (using Firm set gutta-percha). Other 4 teeth were used as control. After dyed in 2% methyl blue for 5 days, all teeth were longitudinally split from mesiodistal surface into two parts. The linear length of dye was measured for apical microleakage. SAS6.04 software was used for statistical analysis. RESULTS: (1) The linear dye penetration was significantly higher in group A (CRCS) compared with that in group B (AH-plus) and in group C (Roekoseal) (P<0.05). (2) Whether the smear layer was absent or present, the apical microleakage had no significant difference when using gutta-percha of Ultrafil-3D system with the same sealer (P>0.05). CONCLUSION: Root-canal obturation with Ultrafil-3D gutta-percha can obtain better sealing ability when AH-plus or Roekoseal is applied as sealer. Removing the smear layer can not significantly reduce the apical microleakage.

PMID: 16400499 [PubMed - in process]

In vitro biocompatibility tests of two commercial types of mineral trioxide aggregate.

Braz Oral Res. 2005 Jul-Sep;19(3):183-7

Authors: Ribeiro DA, Matsumoto MA, Duarte MA, Marques ME, Salvadori DM

Recently, regular and white mineral trioxide aggregate (MTA) are being used in Dentistry as retrofilling materials. Genotoxicity and cytotoxicity tests form an important part of cancer research and risk assessment of potential carcinogens. Thus, the goal of this study was to examine the genotoxicity and cytotoxicity of regular and white MTA in vitro by the single cell gel (comet) assay and trypan blue exclusion test, respectively. Mouse lymphoma cells were exposed to two presentation forms of MTA at final concentrations ranging from 1 to 1,000 microg/mL for 3 h at 37 degrees C. The results showed that both compounds tested did not produce genotoxic effects at all concentrations evaluated. Likewise, no statistically significant differences (p > 0.05) were observed in cytotoxicity. Taken together, our results suggest that regular and white MTA are not genotoxins and are not able to interfere in cellular viability as assessed by single cell gel (comet) assay and trypan blue assay, respectively.

PMID: 16308605 [PubMed - indexed for MEDLINE]

Effect of different dye solutions on the evaluation of the sealing ability of Mineral Trioxide Aggregate.

Braz Oral Res. 2005 Apr-Jun;19(2):119-22

Authors: Tanomaru Filho M, Figueiredo FA, Tanomaru JM

Alkaline materials have shown incompatibility with methylene blue dye in leakage experiments. The goal of the present study was to analyze the effect of different dyes on the evaluation of the apical sealing ability of Mineral Trioxide Aggregate root-end fillings. Fifty-six extracted human canines were submitted to root canal instrumentation and obturation. After apical resection, retrograde cavities were prepared and teeth were randomly divided into four experimental (n = 13) and two control groups (n = 2). The following root-end filling materials were used: groups 1 and 2--Pro Root MTA (Dentsply), groups 3 and 4--zinc oxide-eugenol cement (ZOE). Teeth in groups 1 and 3 were immersed in 2% methylene blue solution, while teeth in groups 2 and 4 were immersed in 0.2% rhodamine B in a reduced pressure environment for 48 hours. Teeth were then longitudinally sectioned and leakage was evaluated. Results were submitted to statistical analysis (ANOVA and Tukey's test). Group 1 presented the least leakage (p < 0.05). It was concluded that the evaluation of the sealing ability of MTA is influenced by the dye used, since this material presented better sealing ability when evaluated with Methylene Blue, but was similar to ZOE when evaluated with rhodamine B.

PMID: 16292444 [PubMed - indexed for MEDLINE]

Influence of apical patency and filling material on healing process of dogs' teeth with vital pulp after root canal therapy.

Braz Dent J. 2005;16(1):9-16

Authors: Holland R, Sant'Anna J&#xFA;nior A, Souza V, Dezan Junior E, Otoboni Filho JA, Bernabé PF, Nery MJ, Murata SS

The purpose of this study was to investigate the periapical healing process of dogs' teeth with or without apical patency and after root canal filling with two types of sealers. Forty roots of premolars and incisors were utilized. The root canals were over-instrumented and dressed with a corticosteroid-antibiotic solution for 7 days to obtain ingrowth of periapical connective tissue into the canals. After this period, the tissue was removed in half of the specimens (groups with patency) and preserved in the other half (groups without patency). Canals were filled by lateral condensation technique with gutta-percha points and either a calcium hydroxide-based sealer (Sealer Plus) or a Grossman's cement (Fill Canal). The animals were killed by anesthetic overdose 60 days after the endodontic treatment and anatomic pieces were obtained and prepared for histologic examination. Data were evaluated in a blind analysis on the basis of several histomorphologic parameters. The groups without patency had better results (p=0.01) than those in which the ingrown connective tissue was removed. Comparing the sealers, Sealer Plus had significantly better results (p=0.01) than Fill Canal. In conclusion, both the apical patency (presence or absence) and the type of root canal filling material influenced the periapical healing process in dogs' teeth with vital pulp after root canal treatment. The use of a calcium hydroxide-based sealer in teeth without apical patency yielded the best results among the experimental conditions proposed.

PMID: 16113927 [PubMed - indexed for MEDLINE]

Periapical surgery using the ultrasound technique and silver amalgam retrograde filling. A study of 71 teeth with 100 canals.

Med Oral Patol Oral Cir Bucal. 2005;10 Suppl 1:E67-73

Authors: Martí-Bowen E, Peñarrocha-Diago M, García-Mira B

INTRODUCTION: Periapical surgery using ultrasound allows the treatment of root canals of difficult access, with the sacrifice of little root tissue. As a result, periapical disorders which were condemned to treatment failure in the past can now be dealt with successfully. MATERIAL AND METHODS: In 71 teeth presenting 100 root canals treated with ultrasound and subjected to retrograde filling with silver amalgam, the course and short-term success of management was evaluated in relation to lesion size, the magnitude of apical resection, and the size of the retrograde filling cavity. The duration of follow-up was one year, with post-treatment controls after 6 and 12 months. RESULTS: After 6 months, the percentage clinical and radiological success was 92% and 58%, respectively. One year after periapical surgery the corresponding percentages were 95% and 80%. Global success after 6 months was 63%, versus 84.2% after 12 months. No statistically significant relation was observed between treatment success and the size of the periapical lesion, the amount of apex resected, or the size of retrograde filling. CONCLUSION: Periapical surgery using ultrasound and retrograde filling with silver amalgam affords a high success rate after 12 months.

PMID: 15800469 [PubMed - indexed for MEDLINE]

Do procedural errors cause endodontic treatment failure?

J Am Dent Assoc. 2005 Feb;136(2):187-93; quiz 231

Authors: Lin LM, Rosenberg PA, Lin J

BACKGROUND: This article reviews the effect of endodontic procedural errors, such as underfilling, overfilling, root perforations and separated instruments, on the outcome of endodontic therapy. TYPES OF STUDIES REVIEWED: Filling the root canal more than 2 millimeters from the radiographic apex (underfilling) or beyond the radiographic apex (overfilling), perforations of the root canal system and instrument separation are possible complications of endodontic therapy. Although these procedural errors may have different causes, they all may affect the outcome of treatment. RESULTS: Endodontic procedural errors are not the direct cause of treatment failure; rather, the presence of pathogens in the incompletely treated or untreated root canal system is the primary cause of periradicular pathosis. Procedural errors typically are due to several factors. Among them is a lack of understanding of the root canal anatomy, the principles of mechanical instrumentation and tissue wound healing. CLINICAL IMPLICATIONS: Procedural errors impede endodontic therapy, thus increasing the risk of treatment failure, especially in teeth with necrotic pulps and periradicular lesions. However, procedural errors often are preventable.

PMID: 15782522 [PubMed - indexed for MEDLINE]

A modified hemostat for endodontic instruments.

J Am Dent Assoc. 2005 Jan;136(1):80

Authors: Zuckerman GR

PMID: 15693501 [PubMed - indexed for MEDLINE]

Pathogenesis of apical periodontitis and the causes of endodontic failures.

Crit Rev Oral Biol Med. 2004;15(6):348-81

Authors: Nair PN

Apical periodontitis is a sequel to endodontic infection and manifests itself as the host defense response to microbial challenge emanating from the root canal system. It is viewed as a dynamic encounter between microbial factors and host defenses at the interface between infected radicular pulp and periodontal ligament that results in local inflammation, resorption of hard tissues, destruction of other periapical tissues, and eventual formation of various histopathological categories of apical periodontitis, commonly referred to as periapical lesions. The treatment of apical periodontitis, as a disease of root canal infection, consists of eradicating microbes or substantially reducing the microbial load from the root canal and preventing re-infection by orthograde root filling. The treatment has a remarkably high degree of success. Nevertheless, endodontic treatment can fail. Most failures occur when treatment procedures, mostly of a technical nature, have not reached a satisfactory standard for the control and elimination of infection. Even when the highest standards and the most careful procedures are followed, failures still occur. This is because there are root canal regions that cannot be cleaned and obturated with existing equipments, materials, and techniques, and thus, infection can persist. In very rare cases, there are also factors located within the inflamed periapical tissue that can interfere with post-treatment healing of the lesion. The data on the biological causes of endodontic failures are recent and scattered in various journals. This communication is meant to provide a comprehensive overview of the etio-pathogenesis of apical periodontitis and the causes of failed endodontic treatments that can be visualized in radiographs as asymptomatic post-treatment periapical radiolucencies.

PMID: 15574679 [PubMed - indexed for MEDLINE]

Fracture resistance of roots endodontically treated with a new resin filling material.

J Am Dent Assoc. 2004 May;135(5):646-52

Authors: Teixeira FB, Teixeira EC, Thompson JY, Trope M

BACKGROUND: The authors evaluated the fracture resistance of endodontically treated teeth filled with either gutta-percha or a new resin-based obturation material. METHODS: The authors prepared and randomly divided 80 single-canal extracted teeth into five groups: lateral and vertical condensation with gutta-percha, lateral and vertical condensation with the new resin-based obturation material, and a control group with no filling material. The specimens were stored in 100 percent humidity for two weeks, mounted in polyester resin and loaded to failure. RESULTS: The authors found statistically significant differences among the experimental groups (P < .05). The groups with the new material displayed higher mean fracture loads and the gutta-percha groups lower mean fracture load values than the control unfilled group. However, the differences were not significant. The groups with the new material displayed significantly higher mean fracture loads than gutta-percha groups independent of the filling technique used. CONCLUSIONS: Filling the canals with the new resin-based obturation material increased the in vitro resistance to fracture of endodontically treated single-canal extracted teeth when compared with standard gutta-percha techniques. CLINICAL IMPLICATIONS; If other properties of the new resin-based obturation material compare favorably with those of gutta-percha for filling the root canal, it should be considered as a replacement for gutta-percha, as the results of this study indicate that it could provide enhanced resistance to tooth fracture.

PMID: 15202759 [PubMed - indexed for MEDLINE]

Assessment of morphological changes and permeability of apical dentin surfaces induced by Nd:Yag laser irradiation through retrograde cavity surfaces.

J Contemp Dent Pract. 2004 May 15;5(2):102-13

Authors: Arisu HD, Bala O, Alimzhanova G, T&#xFC;rköz E

The purpose of this in vitro study was to observe the morphological changes and apical dye penetration at apical dentin surfaces induced by Nd:YAG laser irradiation at different power settings with and without a laser initiator. Seventy five single rooted human maxillary anterior teeth were used. Following the establishment of the working lengths, the root canals were enlarged with step-back technique. The apex of each root was resected 3 mm perpendicular to its long axis. Standard Class I cavities of 2 mm depth and 2 mm width were prepared. The teeth were randomly divided into five groups with fifteen teeth in each. In Group 1, the retrograde cavity preparations were lased with Nd:YAG laser at 2 W and those in Group 2 preparations were lased with Nd:YAG laser at 3.2 W. In Group 3, the retrograde cavity surfaces were lased with Nd:YAG laser at 2 W following the application of India ink. Group 4 was lased with the same settings of Group 2 after an absorbent cotton point soaked with India ink was inserted into the cut dentinal surfaces and the inner walls of the apical preparations. Group 5 served as control. Five teeth from each group were examined using scanning electron microscopy (SEM). The amounts of smear layer, debris, and recrystalized dentin present were assessed and scored. Retrograde cavities of ten teeth from each group were filled with amalgam to examine apical dye penetration. The teeth were immersed in 2% basic fuscin and kept for 48 hours. Dye penetration was evaluated by stereomicroscope at a magnification of X10. The results showed the usage of India ink with Nd:YAG laser enhanced the amount of melting and recrystalization of dentin and the radiation and initiator increased the leakage.

PMID: 15150638 [PubMed - indexed for MEDLINE]

The effects of water and acetone-based dentin adhesives on apical microleakage.

J Contemp Dent Pract. 2004 May 15;5(2):93-101

Authors: Karadag LS, Bala O, T&#xFC;rköz E, Mihçioğlu T

In this study, the aim was to assess the in vitro apical microleakage of a resin-based sealer used with two different adhesives. Thirty nine freshly extracted maxillary incisors were used. The teeth were decoronated at the cemento-enamel junction with a water-cooled fissure bur. Chemo-mechanical debridement of the root canals was accomplished with the step-back technique. The smear layer was removed by 19% ethylenediamine tetra acetic acid (EDTA). The roots were then divided into three experimental groups of thirteen teeth in each. Specimens in group 1 were filled with gutta-percha, AH Plus sealer, and water-based adhesive system (Syntac Single Component). Group 2 specimens were filled with gutta-percha, AH Plus sealer, and acetone-based dentin adhesive (Prime & Bond NT ). Specimens of group 3 were filled with only gutta-percha and AH Plus sealer (no adhesive was applied). The teeth were immersed into 2% methylene blue solution. Apical sealing qualities were assessed by measuring the linear dye penetration with a stereomicroscope. Dentin tubule penetration was observed under scanning electron microscopy (SEM). Results showed no statistically significant difference between the materials used, however, the leakage in group 2 was less than group 1 and 3.

PMID: 15150637 [PubMed - indexed for MEDLINE]

Root-end filling materials alter fibroblast differentiation.

J Dent Res. 2004 May;83(5):408-13

Authors: Bonson S, Jeansonne BG, Lallier TE

Root-end filling materials are commonly used following endodontic surgical procedures; however, their effect on adjacent soft tissues is poorly understood. We predict that, due to the differences in their chemical composition, these materials will have profoundly different effects on the survival and differentiation of fibroblasts. Many of the root-end filling materials examined were initially cytotoxic to both PDL and gingival fibroblasts in co-culture experiments; however, this was reduced after the materials were washed in either mineral trioxide aggregate (MTA) or hybrid ionomere composite resin (HICR) for 2 wks. Additionally, PDL fibroblasts displayed enhanced proliferation on MTA and survival on amalgam when compared with gingival fibroblasts. MTA preferentially induced alkaline phosphatase expression and activity in both PDL and gingival fibroblasts. In contrast, HICR inhibited alkaline phosphatase expression and activity. In addition, MTA and HICR repressed pleiotrophin in PDL fibroblasts, while HICR repressed periostin in both fibroblasts. Thus, root-end filling materials differentially affect periodontal fibroblast differentiation. Abbreviations: mineral trioxide aggregate (MTA), zinc-oxide eugenol cement (ZOEC), hybrid ionomer composite resin (HICR), reverse-transcriptase polymerase chain-reaction (RT-PCR).

PMID: 15111634 [PubMed - indexed for MEDLINE]

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]

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]

Cytotoxic effects of cyanoacrylates used as retrograde filling materials: an in vitro analysis.

Pesqui Odontol Bras. 2003 Apr-Jun;17(2):113-8

Authors: de Azevedo CL, Marques MM, Bombana AC

Cyanoacrylate has been used in medicine and dentistry for many years. It has been used as a postextraction dressing and retrograde filling material in endodontic surgery. The aim of this study was to evaluate the cytotoxic effects of Histoacryl and other two homologue ethyl cyanoacrylates, Super Bonder and Ultrabond, on cultured fibroblasts, using the Trypan blue dye exclusion assay. The cyanoacrylates were applied to round glass coverslips, which were placed in contact with NIH 3T3 cells. After 0, 6, 12 and 24 h (short-term assay; viability) and 1, 3, 5 and 7 days (long-term assay; survival), the cells were examined under phase light microscopy and counted. The data were compared by the Kruskal-Wallis test. In the short-term experiments, only the cultures of the Ultrabond group (GIV) presented significant smaller percentages of cell viability than the cultures of the other groups (GI: control; GII: Super Bonder; GIII: Histoacryl). Although the cultures of the Super Bonder group (GII) presented smaller percentages of cell viability than cultures of the other groups (GI, GIII, GIV) at the long-term assay, this group was the only experimental group presenting a continuous and progressive cell growth. Our results have shown an in vitro biocompatibility of Histoacryl and ethyl cyanoacrylate homologues. These cyanoacrylates could therefore be of importance for endodontic purposes.

PMID: 14569351 [PubMed - indexed for MEDLINE]

Coronal microleakage assessed by polymicrobial markers.

J Contemp Dent Pract. 2003 Aug 15;4(3):1-10

Authors: Britto LR, Grimaudo NJ, Vertucci FJ

Studies have shown significant bacterial leakage following exposure of sealed root canals to artificial and natural saliva. The objective of this study was to determine contamination via bacterial migration in artificial saliva in endodontically treated teeth using different obturation techniques and sealers. A total of 144 extracted, human mandibular anterior teeth were cleaned and shaped to a #40 master apical file using hand and rotary instrumentation. One hundred and twenty teeth were divided into two experimental groups. The teeth in Group 1 were obturated with gutta-percha using lateral compaction and five different sealers, and the teeth in Group 2 were obturated with gutta-percha using thermomechanical compaction and five different sealers. The remaining 24 teeth were prepared as positive and negative controls. All specimens, except the negative controls, were inoculated every five days with Anaerobic streptococci (NCTC 9891) related to Peptostreptococcus micros and Prevotella intermedia (ATCC 25611). The contamination onset time was continuously recorded and turbid broths cultured for bacteria identification. The controls behaved as expected. Regardless of the combination between obturation techniques and different sealers, all broths became turbid during this experiment. The correlation between the obturation techniques and the sealers revealed statistical significance using ANOVA (p<0.0001), followed by the Duncan Multiple Range Test, which determined the ranking between these interactions. The combination of MicroSeal obturation technique with Ketac-Endo sealer allowed a slower rate of coronal-apical bacterial migration.

PMID: 12937592 [PubMed - indexed for MEDLINE]

Ruptured duodenal varices successfully treated with balloon-occluded retrograde transvenous obliteration: usefulness of microcatheters.

AJR Am J Roentgenol. 2003 Sep;181(3):725-7

Authors: Sonomura T, Horihata K, Yamahara K, Dozaiku T, Toyonaga T, Hiroka T, Sato M

PMID: 12933468 [PubMed - indexed for MEDLINE]

Apical and periapical repair of dogs' teeth with periapical lesions after endodontic treatment with different root canal sealers.

Pesqui Odontol Bras. 2003 Jan-Mar;17(1):69-74

Authors: Leonardo MR, Salgado AA, da Silva LA, Tanomaru Filho M

The aim of this study was to evaluate the apical and periapical repair after root canal treatment of dogs' teeth with pulp necrosis and chronic periapical lesion using different root canal sealers. After periapical lesion induction, forty-four root canals of 3 dogs were submitted to biomechanical preparation using 5.25% sodium hypochlorite as an irrigating solution. A calcium hydroxide dressing (Calen PMCC) was applied for 15 days and the root canals were filled using the lateral condensation technique with gutta-percha points and Sealapex, AH Plus or Sealer Plus for sealing. After 180 days, the animals were sacrificed by anesthetic overdose and the obtained histological sections were stained with hematoxylin-eosin for optical microscopic analysis of the apical and periapical repair. The groups filled with Sealapex and AH Plus had better histological repair (p < 0.05) than the group filled with Sealer Plus, that had unsatisfactory results.

PMID: 12908063 [PubMed - indexed for MEDLINE]

Tissue reactions after intraosseous implantation of three retrofilling materials.

Bull Tokyo Dent Coll. 2003 Feb;44(1):1-7

Authors: Morinaga K, Nakagawa K, Carr GB

Bone tissue reactions to EBA, IRM, and cyanoacrylate cement (Base Liner) were studied in the rat mandible using an intraosseous implant method. Osseous cavities (1.4 mm in diameter) were surgically created in the mandibles, and materials were implanted in 60 male Wistar rats. Each specimen was evaluated histologically after 4 and 8 weeks. The development of fibrous connective tissue in direct apposition to the material was observed in the EBA and IRM groups at 4 weeks. A slight degree of macrophage infiltration was seen in the EBA group. After the 8-week observation period, IRM and EBA were frequently separated from the bone cavity by a fibrous connective tissue layer (p < 0.01). The Base Liner appeared to be in direct apposition to the osseous tissue in several areas (p < 0.01). These findings indicate that Base Liner reacts favorably with osseous tissue, compared with the EBA and IRM materials tested and seems to be a biocompatible material.

PMID: 12772580 [PubMed - indexed for MEDLINE]

[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]

Evaluation of apical leakage of root canals obturated with Nd: YAG laser-softened gutta-percha, System-B, and lateral condensation techniques.

J Contemp Dent Pract. 2002 Feb 15;3(1):16-26

Authors: Maden M, G&#xF6;rgül G, Tinaz AC

In endodontics, a laser can be used as a heat source and gutta-percha can be softened by a laser and used in the root canals. The System-B endodontic heat source unit was designed for the obturation of the root canal system with a single continuous wave of thermoplasticized gutta-percha. The aim of this study was to compare the apical leakage of lateral condensation; Nd: YAG laser-softened gutta-percha and System-B techniques. Fifty-five extracted, single root human maxillary anterior and premolar teeth were used in this study. After working length determination, the "step-back technique" was used to prepare the root canals. The teeth were randomly divided into three experimental groups of 15 each and two control groups of 5 specimens each. The first group was obturated by lateral condensation, the second group by gutta-percha softened with an Nd: YAG laser, and the third group was obturated using the System-B technique. Apical leakage of the roots was evaluated by dye penetration using a stereomicroscope after sectioning the roots. The results of the first and third groups were similar, and the results of the second group showed differences when compared with the other groups. However, variance analysis revealed there was no statistically significant difference among the results.

PMID: 12167910 [PubMed - indexed for MEDLINE]

Microleakage of packable composites used in post spaces condensed using different methods.

J Contemp Dent Pract. 2002 May 15;3(2):23-30

Authors: Görgül G, Alaçam T, Kivanç BH, Uzun O, Tinaz AC

The aim of this in vitro study was to evaluate the apical and coronal microleakage of a packable composite material compacted by either hand or ultrasonic condensers when placed in post spaces. Forty-two extracted anterior teeth were used. After conventional obturation of the root canals, parallel post spaces 5 mm in depth and 2 mm in diameter were prepared using Gates Glidden and diamond burs. A primer and a dentin bonding agent (Prime & Bond NT) was applied to the etched surface for 30 seconds and light polymerized for 40 seconds. Surefil packable composite resin was inserted in four equal increments and each polymerized for 40 seconds. Half of the specimens were compacted with an ultrasonic tip and the other half with a mechanical hand compactor. After immersion in the dye, the teeth were sectioned longitudinally and dye penetration was evaluated using a stereomicroscope and microleakage recorded in mm. A One-Way Analysis of Variance indicated the two condensing methods were not statistically different (p>0.05). When microleakage was compared within groups, there was also no statistical difference between coronal or apical microleakage (p>0.05). In an in vitro environment, ultrasonic condensers do not offer any advantage over hand condensers. Both the coronal and apical portions of the root had microleakage indicating that regardless of the condensation method and the use of a packable composite, there is still microleakage that could potentially create further clinical problems.

PMID: 12167905 [PubMed - indexed for MEDLINE]

Influence of the spatulation of two zinc oxide-eugenol-based sealers on the obturation of lateral canals.

Pesqui Odontol Bras. 2002 Apr-Jun;16(2):127-30

Authors: Pecora JD, Ribeiro RG, Guerisoli DM, Barbizam JV, Marchesan MA

The objective of this research was to evaluate, in vitro, the importance of the correct manipulation of endodontic sealers, correlating it with flow rate and with the consequent obturation of root canals. Twenty-four human canines were prepared, 1 mm from the apex, with K-files up to size 50, by means of the step-back technique. Six lateral canals were then drilled in each tooth, with size 10 file fixed to a low-speed handpiece. The teeth were randomly divided into 4 groups, and root canals were obturated either with the Endométhasoneregister mark or target sealer or Grossman sealer, prepared at ideal or incorrect clinical consistency. After obturation by means of the lateral condensation technique, the teeth were radiographed and evaluated as to the number of sealed lateral canals. Statistical analysis revealed significant differences (p < 0.001) between the tested sealers, and indicated the higher capacity of the well-manipulated Grossman sealer to fill lateral canals. It can be concluded that the flow rate of a sealer and its correct manipulation are very important for the satisfactory obturation of lateral canals.

PMID: 12131985 [PubMed - indexed for MEDLINE]

The outcome of root canal treatment. A retrospective study within the armed forces (Royal Air Force).

Br Dent J. 2001 Feb 10;190(3):140-4

Authors: Peak JD, Hayes SJ, Bryant ST, Dummer PM

OBJECTIVE: The objective of this study was to investigate the outcome of conventional root canal treatment in a general practice setting within the Royal Air Force dental service. Design Retrospective review. METHODS: Teeth that had been root-filled for 12 months or more by Royal Air Force dental practitioners in patients attending a large Royal Air Force dental centre were included in the study. Following clinical and radiographic review the root fillings were classified as 'definitely successful', 'probably successful' or 'failed' The effect on success of several variables on the outcome was investigated. RESULTS: Out of a total of 406 teeth, 59% were maxillary teeth and 41% were mandibular teeth. Sixty-nine per cent of the total sample had pre-existing periapical radiolucencies. Cold lateral condensation of gutta-percha was the most widely used filling technique (64% of all cases). Fifty per cent of the teeth had root fillings within 2 mm of the radiographic apex, 32% were greater than 2 mm from the radiographic apex and 18% were overfilled. Cold lateral condensation was the most successful (92% overall) filling technique. Maxillary anterior teeth had a better success rate (96%) than other tooth types. Teeth with pre-existing periapical radiolucencies had a higher success rate (87%) than those cases where there was no pre-existing periapical radiolucency (80%). Root fillings that were less than 2 mm from the radiographic apex of the tooth had a higher success rate (88% overall) than those that were greater than 2 mm from the radiographic apex (77% overall). Of the 406 cases, 57% (n=231) were classified as definitely successful, 28% (n=114) were classified as probably successful and 15% (n=62) were classified as failures. Thus, the overall success rate combining definitely successful and probably successful root fillings was 85% (n=344). CONCLUSIONS: Root fillings placed using cold lateral condensation of gutta-percha to within 2 mm of the radiographic apex of the tooth were associated with the best outcome.

PMID: 11236917 [PubMed - indexed for MEDLINE]

21st-century endodontics.

J Am Dent Assoc. 2000 Jun;131 Suppl:39S-46S

Authors: Glickman GN, Koch KA

BACKGROUND: Endodontics as a discipline has offered patients the opportunity to maintain their natural teeth. As the population expands and ages, the demand for endodontic therapy can be expected to increase as patients seek dental options to keep their teeth for a lifetime. CLINICAL IMPLICATIONS: New materials, techniques and instruments are entering the market-place to assist dentists in providing patients with more predictable and reliable endodontic treatment. In addition, these new systems make the delivery of endodontic services more efficient. This article describes these advances in endodontic treatment for dentists interested in incorporating these advances into their clinical practice.

PMID: 10860344 [PubMed - indexed for MEDLINE]

The reinforced composite post and core.

J Am Dent Assoc. 2000 May;131(5):667

Authors: Kroll RG

PMID: 10832260 [PubMed - indexed for MEDLINE]

Repairing iatrogenic root perforations.

J Am Dent Assoc. 2000 Feb;131(2):196-201

Authors: Behnia A, Strassler HE, Campbell R

BACKGROUND: Post preparation is an integral part of restoring endodontically treated teeth in indicated cases. Iatrogenic perforation of the root can result from preparing post space and can severely compromise the prognosis of the tooth. CASE DESCRIPTION: Two years after a patient's maxillary lateral incisor was restored with a post-retained composite resin, he went to a dental school emergency clinic with a chief complaint of soft-tissue swelling adjacent to the tooth. The authors took a periapical radiograph that revealed evidence of a circumscribed radiolucent lesion associated with the distal midroot area and a periapical radiolucency. Based on the radiograph, the authors suspected that the canal preparation for the post and the post placement had perforated the root at the base of the post. CLINICAL IMPLICATIONS: The authors used a combined surgical and orthograde approach with a biocompatible restorative material and a clear, plastic light-transmitting post to repair the iatrogenic perforation.

PMID: 10680387 [PubMed - indexed for MEDLINE]

Formation of a facial hematoma during endodontic therapy.

J Am Dent Assoc. 2000 Jan;131(1):67-71

Authors: Mehra P, Clancy C, Wu J

BACKGROUND: Sodium hypochlorite, or NaOCl, is one of the most commonly used irrigating solutions in endodontic practice. Its clinically proven antibacterial, solvent and lubricating properties make it a very appealing choice as an intracanal medicament. CASE DESCRIPTION: The authors present a case of facial hematoma formation after an inadvertent injection of NaOCl into the periapical tissues. The NaOCl solution caused extensive tissue destruction. Management of the condition required the hospitalization, intravenous antibiotic therapy and multiple intraoral surgical incisions to facilitate drainage. CLINICAL IMPLICATIONS: Use of NaOCl must be confined to the root canal system. This report reviews this intracanal medicament's potential toxicity and emphasizes the need for clinicians to remain cognizant of possible problems while using the solution.

PMID: 10649874 [PubMed - indexed for MEDLINE]

A technique for stabilizing gutta-percha carriers.

J Am Dent Assoc. 1998 Jun;129(6):775-6

Authors: Kaplowitz GJ

PMID: 9631619 [PubMed - indexed for MEDLINE]

Canal adaptation and coronal leakage: lateral condensation compared to Thermafil.

J Am Dent Assoc. 1995 Mar;126(3):351-6

Authors: Baumgardner KR, Taylor J, Walton R

In a comparison of different obturating techniques and materials, lateral plus vertical compaction of gutta-percha had the least coronal leakage. Using increments of gutta-percha is indicated for tapered canals and those with irregular anatomy.

PMID: 7897104 [PubMed - indexed for MEDLINE]

Evaluation of intracytoplasmic particles in histiocytes after endodontic therapy with a hydrophilic plastic.

J Dent Res. 1977 Jul;56(7):795-801

Authors: Kronman JH, Goldman M, Lin PS, Goldman LB, Kliment C

The presence of granules within the cytoplasm of periapical tissue histiocytes had been observed in teeth which had a root canal overfilled with a hydrophilic plastic polymer. SEM examinations revealed these granules to be barium sulfate, which was added to the polymer for radiopacity. X-ray spectra revealed strong calcium peaks in bone adjacent to the histiocytes, which showed strong barium peaks. In addition, between the histiocytes and the bone a greater concentration of calcium was seen. Because the histiocytes and not the plastic polymer contained barium sulfate, the evidence for this material's biocompatibility is greatly enhanced.

PMID: 409743 [PubMed - indexed for MEDLINE]

Cementum regeneration in replanted teeth with differing pulp treatment.

J Dent Res. 1976 Mar-Apr;55(2):235-8

Authors: Woehrle RR

Cementum regeneration on exposed dentinal root surfaces of replanted teeth not subjected to replantation. The implication was that secondary reattachment of replanted teeth was largely dependent on the status of supporting alveolar tissues. The role of the replant appeared essentially passive, reacting as a substrate for cementum deposition that may be more or less acceptable to the regenerating periodontal tissues as dictated by the extraoral history. Although the pattern of cementum deposition was unaltered by replantation, the quantity of new cementum deposited on exposed dentin did appear to be affected by pulpal treatment; thus, an indication was given that survival of replanted teeth may be influenced by pulpal procedures.

PMID: 1062422 [PubMed - indexed for MEDLINE]

Measurement of the tensile strength of dental restorative materials by use of a diametral compression test.

J Dent Res. 1971 Mar-Apr;50(2):436-42

Authors: Williams PD, Smith DC

PMID: 5290881 [PubMed - indexed for MEDLINE]

Implanting teeth with methyl-2-cyanoacrylate adhesive.

J Dent Res. 1967 Mar-Apr;46(2):337-9

Authors: Huebsch RF

PMID: 5228066 [PubMed - indexed for MEDLINE]

Osteosclerotic changes in the periapical region of filled root canals in the rat molar.

J Dent Res. 1966 Nov-Dec;45(6):1747-51

Authors: Bordoni N, Egozcue MI, Erausquin J

PMID: 5226540 [PubMed - indexed for MEDLINE]

The root treatment of teeth with open apices.

Proc R Soc Med. 1966 Oct;59(10):1035-6

Authors: Friend LA

PMID: 5955761 [PubMed - indexed for MEDLINE]

Necrosis of the periodontal ligament in root canal overfillings.

J Dent Res. 1966 Jul-Aug;45(4):1084-92

Authors: Erausquin J, Muruz&#xE1;bal M, Devoto FC, Rikles A

PMID: 5224077 [PubMed - indexed for MEDLINE]