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Mente J, Leo M, Michel A, Gehrig H, Saure D, Pfefferle T. Outcome of Orthograde Retreatment after Failed Apicoectomy: Use of a Mineral Trioxide Aggregate Apical Plug. J Endod 2015; 41:613-20. [DOI: 10.1016/j.joen.2015.01.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Revised: 01/02/2015] [Accepted: 01/04/2015] [Indexed: 11/28/2022]
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Jain M, Singhal A, Gurtu A, Vinayak V. Influence of Ultrasonic Irrigation and Chloroform on Cleanliness of Dentinal Tubules During Endodontic Retreatment-An Invitro SEM Study. J Clin Diagn Res 2015; 9:ZC11-5. [PMID: 26155554 PMCID: PMC4484146 DOI: 10.7860/jcdr/2015/12127.5864] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2014] [Accepted: 03/09/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND Ultrasonic irrigation has been proved for its remarkable cleaning efficiency in the field of endodontics. But its role in endodontic re-treatment has been understated. There is not much data available to understand the effect of ultrasonic irrigation for the evaluation of cleanliness of dentinal tubules when it is used with or without chloroform, a gutta percha solvent during endodontic retreatment. AIM To compare the influence of ultrasonic irrigation with syringe irrigation on cleanliness of dentinal tubules after gutta perch removal for endodontic retreatment with or without the use of chloroform a gutta percha solvent using scanning electron microscope (SEM). MATERIALS AND METHODS Freshly extracted 45 human mandibular premolar teeth for periodontal and orthodontic reasons were taken and were occlusally adjusted to a working length of 19 mm. The root canals of all teeth were prepared chemo mechanically to a master apical file size 40 and were divided in various groups. In Group 1 (n = 5; control group), the canals remained unfilled. In Groups 2 and 3 (n = 20 each), the canals were filled using lateral compaction with gutta-percha and AH plus sealer, removal of root fillings was undertaken after 2 weeks using Gates Glidden drills and H files without chloroform in Group 2 and with chloroform in group 3. The specimen of Group 2 and 3 were further divided into two subgroups I and II (n=10). In subgroup I, irrigation was done using side vented needles and sodium hypochlorite. In subgroup II irrigation was done using passive ultrasonic irrigation with sodium hypochlorite. Thereafter, the roots were split and the sections were observed under SEM. The number of occluded dentinal tubules /total number of dentinal tubules were calculated for the coronal, middle and apical third of each root half. Statistical analysis was performed using one-way ANOVA followed by Tukey's test using standardized technique. RESULT Results indicated that the cleanest dentinal tubules were found in the control group (Group 1 where the canals were unfilled) followed by the non chloroform group with ultrasonic irrigation (Group 3 subdivision II) followed by chloroform group with ultrasonic irrigation (Group 2 subdivision II), the non chloroform group with syringe irrigation (Group 3 subdivision I) and least cleanliness was found in the chloroform group with syringe irrigation (Group 2 subdivision I). CONCLUSION Under the limitations of this study it could be concluded that both ultrasonic and syringe irrigation showed cleaner canals when chloroform was not used. Irrigation when done with ultrasonics leads to cleaner tubules than syringe irrigation. Hence, mechanical methods of retrieval in conjunction with use of passive ultrasonic irrigation should be a part of retreatment protocol.
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Affiliation(s)
- Mahak Jain
- Consultant Endodontist, Ramlal Memorial Charitable Hospital, Sahanpur, Uttar Pradesh, India
| | - Anurag Singhal
- Head of Department, Department of Conservative Dentistry & Endodontics, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
| | - Anuraag Gurtu
- Professor, Department of Conservative Dentistry & Endodontics, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
| | - Vineet Vinayak
- Professor, Department of Conservative Dentistry & Endodontics, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
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153
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Selective Root Retreatment: A Novel Approach. J Endod 2015; 41:1382-8. [PMID: 25906919 DOI: 10.1016/j.joen.2015.02.035] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Revised: 02/18/2015] [Accepted: 02/22/2015] [Indexed: 11/23/2022]
Abstract
Root canal retreatment is traditionally considered an "all or none" treatment approach. It is typically recommended that all restorative and obturation materials be removed from all roots regardless of the presence or absence of periapical pathosis. In contrast, surgical endodontics is not viewed as an "all or none" treatment approach. Traditionally, only the diseased root(s) is addressed via root-end resection and root-end filling. The use of cone-beam computed tomographic imaging allows for a more accurate evaluation of the periapical status of individual roots associated with multirooted teeth. This information has introduced a novel and conservative treatment alternative for previously endodontically treated teeth with multiple roots presenting with post-treatment disease. This new approach is termed selective root retreatment. Advanced imaging allows the clinician to make predictable treatment decisions with respect to the presence or absence of periapical pathosis of individual roots as opposed to making assumptions about the tooth as a whole. Selective root retreatment combines the approach of nonsurgical retreatment with the selectivity of surgical root resection. In this manner, retreatment could be limited to a single root or roots clearly showing periapical pathosis while leaving the root(s) with no visible or perceived pathosis untouched.
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154
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Chalakkal P, Akkara F, Ataide IDND, Pavaskar R. Apicoectomy versus apexification. J Clin Diagn Res 2015; 9:ZD01-3. [PMID: 25859529 DOI: 10.7860/jcdr/2015/10078.5516] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Accepted: 09/09/2014] [Indexed: 11/24/2022]
Abstract
The aim was to evaluate treatment outcomes after apicoectomy and apexification in adjacent non-vital maxillary central incisors with large periapical radiolucencies, in a 10-year-old boy. The patient had complained of tenderness in the upper central incisors on mastication and gave a history of trauma to those teeth three years ago. On examination, there were found to be non-vital. Apexification (using Metapex) and apicoectomy (obturation with gutta percha) were performed on 11 and 21, respectively. Radiographical observations were made six months, one year and two years, post-operatively. Apical repair was found to be more favorable after apicoectomy than apexification, for a non-vital maxillary central incisor with an open apex and large periapical radiolucency.
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Affiliation(s)
- Paul Chalakkal
- Lecturer, Department of Pedodontics & Preventive Dentistry, Goa Dental College & Hospital , Bambolim, Goa, India
| | - Francis Akkara
- Professor, Department of Oral and Maxillofacial Surgery, Goa Dental College and Hospital , Bambolim, Goa, India
| | - Ida De Noronha De Ataide
- Professor and Head, Department of Conservative Dentistry and Endodontics, Goa Dental College and Hospital , Bambolim, Goa, India
| | - Rajdeep Pavaskar
- Lecturer, Department of Conservative Dentistry and Endodontics, Goa Dental College and Hospital , Bambolim, Goa, India
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155
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Secondary Treatment for Asymptomatic Root Canal Treated Teeth: A Cost-effectiveness Analysis. J Endod 2015; 41:812-6. [PMID: 25747377 DOI: 10.1016/j.joen.2015.01.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 01/11/2015] [Accepted: 01/18/2015] [Indexed: 11/21/2022]
Abstract
INTRODUCTION When faced with a clinically asymptomatic root canal treated tooth with certain radiographic findings (e.g., underextended or overextended root fillings or persistent periapical lesions), clinicians need to decide between endodontically retreating the tooth before restoration or not retreating it now but possibly later on. The present study compared the cost-effectiveness of both strategies. METHODS A Markov model was constructed following a root canal treated, clinically asymptomatic molar with one of the described radiographic findings in a 50-year-old patient during his lifetime. Hazard functions were derived from systematically and non-systematically assessed literature, and costs were estimated for German health care. Monte Carlo microsimulations were performed for teeth with composite restorations, crowns, or post-core crowns, and costs per year of tooth retention were calculated. RESULTS Regardless of the radiographic findings, not performing immediate retreatment was found to be significantly less costly (589-954 Euro) and more effective (retention time, 25-29 years) than immediately performing secondary root canal treatment (1163-1359 Euro, 25-27 years). Both strategies had similar effectiveness only for teeth that received post-core crowns, whereas immediate retreatment remained more expensive. The uncertainty around the obtained strategy ranking was low. CONCLUSIONS The high costs for secondary root canal treatment do not seem to be outweighed by the increased risks associated with certain radiographic findings in asymptomatic teeth. Our results should be interpreted with caution because the quality of the underlying data is limited.
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156
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Outcome of nonsurgical retreatment and endodontic microsurgery: a meta-analysis. Clin Oral Investig 2015; 19:569-82. [DOI: 10.1007/s00784-015-1398-3] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Accepted: 01/02/2015] [Indexed: 01/23/2023]
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157
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Tooth Retention through Endodontic Microsurgery or Tooth Replacement Using Single Implants: A Systematic Review of Treatment Outcomes. J Endod 2015; 41:1-10. [DOI: 10.1016/j.joen.2014.09.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Accepted: 09/01/2014] [Indexed: 12/20/2022]
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Sharma R, Hegde V, Siddharth M, Hegde R, Manchanda G, Agarwal P. Endodontic-periodontal microsurgery for combined endodontic-periodontal lesions: An overview. J Conserv Dent 2014; 17:510-6. [PMID: 25506135 PMCID: PMC4252921 DOI: 10.4103/0972-0707.144571] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2014] [Revised: 08/24/2014] [Accepted: 09/19/2014] [Indexed: 12/28/2022] Open
Abstract
Endodontic and periodontal microsurgery has surpassed the success rates for traditional endodontic and periodontal surgical procedures. Excellent healing results are being attributed to both the techniques, when employed, for isolated endodontic or periodontal defects. Combined endodontic-periodontal lesions have been referred to as a true challenge, requiring not only endodontic microsurgical management but also concurrent bone grafting and membrane barriers techniques. The prevention of epithelial downgrowth and regeneration of periodontal cementum, fiber, and bone seals the fate of these cases. Achieving primary closure with submergence of grafts has a positive effect on GTR outcome. New techniques of periodontal microsurgery, such as minimally invasive papilla preserving flaps with passive internal mattress suturing, have managed to obtain 90% primary flap closure over grafted sites. Root surface treatment and conditioning has also shown to be beneficial for GTR. Endodontic microsurgery for the combined lesion has not integrated these advances yet. These advances, along with a recently suggested treatment strategy, are ushering in the level next in management of the combined lesions. This article offers an overview of the combined lesion, the disease, its classification, treatment strategy, regenerative tools, microsurgical recommendations, and outcome studies.
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Affiliation(s)
- Ritu Sharma
- Department of Conservative Dentistry and Endodontics, Sharda University, Greater Noida, Uttar Pradesh, India
| | - Vivek Hegde
- Department of Conservative Dentistry and Endodontics, MA Rangoonwala College of Dental Sciences and Research Centre, Pune, Maharashtra, India
| | - M Siddharth
- Department of Periodontics, School of Dental Sciences, Sharda University, Greater Noida, Uttar Pradesh, India
| | - Rashmi Hegde
- Department of Periodontics, MA Rangoonwala College of Dental Sciences and Research Centre, Pune, Maharashtra, India
| | - Gunsha Manchanda
- Department of Conservative Dentistry and Endodontics, Sharda University, Greater Noida, Uttar Pradesh, India
| | - Pratul Agarwal
- Department of Conservative Dentistry and Endodontics, Sharda University, Greater Noida, Uttar Pradesh, India
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159
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Silva EJNL, Orlowsky NB, Herrera DR, Machado R, Krebs RL, Coutinho-Filho TDS. Effectiveness of rotatory and reciprocating movements in root canal filling material removal. Braz Oral Res 2014; 29:1-6. [PMID: 25466331 DOI: 10.1590/1807-3107bor-2015.vol29.0008] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2013] [Accepted: 08/27/2014] [Indexed: 11/22/2022] Open
Abstract
The purpose of this study was to compare the efficacy of reciprocating and rotary techniques for removing gutta-percha and sealer from root canals. Forty straight and oval single-rooted premolars were prepared up to size 30, filled with gutta-percha and sealer, and then randomly allocated to two experimental retreatment groups: ProTaper Retreatment System (PTRS) and WaveOne System (WS). Procedural errors, time of retreatment and apically extruded material were recorded for all the roots. The roots were radiographed after retreatment. The percentage of residual material was calculated using image analysis software. The data were analyzed by Kolmogorov-Smirnov and t tests, with a significance level set at 5%. No system completely removed the root filling material from the root canal. No significant differences were observed between the systems, in terms of residual filling material in any tested third (p > 0.05). WS was faster in removing filling material than PTRS (p < 0.05). Extrusion was observed in 4 cases in PTRS and in 5 cases in WS. No procedural errors were observed in either group. It can be concluded that although no differences were observed in the efficacy of PTRS and WS for removing root filling material, WS was faster than PTRS.
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Affiliation(s)
| | - Nayra Bittencourt Orlowsky
- Department of Endodontics, Faculdade de Odontologia, Universidade Estadual do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Daniel Rodrigo Herrera
- Department of Restorative Dentistry, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | | | - Renato Liess Krebs
- Department of Endodontics, Faculdade de Odontologia, Universidade Estadual do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Tauby de Souza Coutinho-Filho
- Department of Endodontics, Faculdade de Odontologia, Universidade Estadual do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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160
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Estrela C, Silva JA, Decurcio DA, Alencar AHG, Estrela CRA, Faitaroni LA, Batista AC. Monitoring Nonsurgical and Surgical Root Canal Treatment of Teeth with Primary and Secondary Infections. Braz Dent J 2014; 25:494-501. [DOI: 10.1590/0103-6440201302437] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Accepted: 09/30/2014] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to monitor nonsurgical and surgical root canal treatment (RCT) of teeth with primary and secondary infections and apical periodontitis (AP). This prospective clinical study comprised the treatment of 80 patients with primary and persistent secondary infections and AP. Of this initial sample, forty patients did not return. Periapical index using cone beam computed tomography scans (CBCTPAI) was used to aid diagnosis, planning and to determine the better therapeutic strategy. Twenty patients (26 teeth) diagnosed with primary infection and AP received conventional RCT and were followed up for 10 to 36 months. Twenty patients (31 teeth) diagnosed with persistent secondary infection were submitted to periapical surgical and followed up for 6 to 30 months. The results showed RCT successful in 19/26 cases with complete AP healing (5/26 with partial repair) in 10-36 months of follow up. For the surgically managed cases, effectiveness of surgical therapy was detected in 10/31 cases with complete healing (10/31 cases with partial repair) within 6-30 months follow up. The return of patients for clinical and radiographic follow-up, and obedience to the proposed time period was very short from ideal. The levels of success in both therapeutic protocols were high. RCT failures were detected even with rigorous standard clinical protocols.
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161
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162
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Removal of filling materials from oval-shaped canals using laser irradiation: a micro-computed tomographic study. J Endod 2014; 41:219-24. [PMID: 25447502 DOI: 10.1016/j.joen.2014.09.026] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Revised: 09/20/2014] [Accepted: 09/27/2014] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The aim of this study was to assess the efficacy of lasers in removing filling remnants from oval-shaped canals after retreatment procedures with rotary instruments using micro-computed tomographic imaging. METHODS The root canals of 42 mandibular canines were prepared and obturated using the warm vertical compaction technique. Retreatment was performed with rotary instruments, and the specimens were distributed in 3 groups (n = 14) according to the laser device used in a later stage of retreatment procedure: Er:YAG, Er:YAG laser-based photon-induced photoacoustic streaming, and Nd:YAG. The specimens were scanned in a micro-computed tomographic device after root canal filling and each stage of retreatment at a resolution of 13.68 μm. The percentage differences of the remaining filling material before and after laser application within and between groups were statistically compared using the paired sample t test and 1-way analysis of variance test, respectively. Significance level was set at 5%. RESULTS Overall, filling residues were located mainly in the apical third and into canal irregularities after the retreatment procedures. After using rotary instruments, the mean percentage volume of the filling remnants ranged from 13%-16%, with no statistical significant difference between groups (P > .05). Within groups, additional laser application had a significant reduction in the amount of the remaining filling materials (P < .05). A comparison between groups showed that Er:YAG laser application after the use of rotary instruments had a significantly higher removal of filling remnants (~13%) than Er:YAG laser-based photon-induced photoacoustic streaming (~4%) and Nd:YAG (~3%) (P < .05). CONCLUSIONS None of the retreatment procedures completely removed the filling materials. The additional use of lasers improved the removal of filling material after the retreatment procedure with rotary instruments.
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163
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Schwendicke F, Stolpe M. Direct Pulp Capping after a Carious Exposure Versus Root Canal Treatment: A Cost-effectiveness Analysis. J Endod 2014; 40:1764-70. [DOI: 10.1016/j.joen.2014.07.028] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Revised: 07/16/2014] [Accepted: 07/20/2014] [Indexed: 11/25/2022]
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164
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Jang JH, Lee JM, Yi JK, Choi SB, Park SH. Surgical endodontic management of infected lateral canals of maxillary incisors. Restor Dent Endod 2014; 40:79-84. [PMID: 25671217 PMCID: PMC4320281 DOI: 10.5395/rde.2015.40.1.79] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Accepted: 08/21/2014] [Indexed: 11/29/2022] Open
Abstract
This case report presents surgical endodontic management outcomes of maxillary incisors that were infected via the lateral canals. Two cases are presented in which endodontically-treated maxillary central incisors had sustained lateral canal infections. A surgical endodontic treatment was performed on both teeth. Flap elevation revealed vertical bone destruction along the root surface and infected lateral canals, and microscopy revealed that the lateral canals were the origin of the lesions. After the infected lateral canals were surgically managed, both teeth were asymptomatic and labial fistulas were resolved. There were no clinical or radiographic signs of surgical endodontic management failure at follow-up visits. This case report highlights the clinical significance and surgical endodontic management of infected lateral canal of maxillary incisor. It is important to be aware of root canal anatomy variability in maxillary incisors. Maxillary central incisors infected via the lateral canal can be successfully managed by surgical endodontic treatment.
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Affiliation(s)
- Ji-Hyun Jang
- Department of Conservative Dentistry, Kyung Hee University Dental Hospital at Gangdong, Seoul, Korea
| | - Jung-Min Lee
- Department of Conservative Dentistry, Graduate School, Kyung Hee University, Seoul, Korea
| | - Jin-Kyu Yi
- Department of Conservative Dentistry, Kyung Hee University Dental Hospital, Seoul, Korea
| | | | - Sang-Hyuk Park
- Department of Conservative Dentistry, Kyung Hee University Dental Hospital at Gangdong, Seoul, Korea. ; Oral Biology Research Institute, School of Dentistry, Kyung Hee University, Seoul, Korea
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165
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Affiliation(s)
- Jamie Dickie
- Lecturer and Honorary Registrar in Restorative Dentistry, Glasgow Dental Hospital and School, 378 Sauchiehall Street, Glasgow, G2 3JZ
| | - John McCrosson
- Former Lecturer and Honorary Consultant in Restorative Dentistry, Glasgow Dental Hospital and School, 378 Sauchiehall Street, Glasgow, G2 3JZ
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166
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Keçeci AD, Ureyen Kaya B, Sener E. Determination of canal orifice co-ordinates and MB2 incidence of maxillary first molars in a Turkish sub-population. Acta Odontol Scand 2014; 72:354-61. [PMID: 24495011 DOI: 10.3109/00016357.2013.837959] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To measure the co-ordinates of the root canal orifices and to determine the incidence of mesiobuccal-2 (MB2) in maxillary first molars in a Turkish sub-population. MATERIALS AND METHODS Standard digital photographs were taken under a stereomicroscope from the occlusal aspect of each tooth (n = 176) before and after crown removal. Canal orifices were negotiated under moderate magnification using dental loupes. The coordinates of the orifices and the distances of each from the central fossa were measured by using geographic software. Intensity maps of the orifice locations were created by using the co-ordinates of all canal orifices. A representative map was drawn using the mean values of orifice locations and access projection area. RESULTS In the right maxillary first molars, the mean values for the (X, Y) co-ordinates were (0.67, 2.68) for mesiobuccal-1 (MB1), (0.81, 0.84) for MB2, (-1.12, 1.26) for distobuccal-1 (D1), (-0.89, 0.23) for distobuccal-2 (D2) and (0, -2.50) for palatinal (P); the corresponding mean values in the left maxillary first molars were (-0.78, 2.56), (-0.98, 0.90), (0.99, 1.18), (0.69, 0.78) and (0.00, -2.53), respectively. The average MB1-MB2 distance was 1.97 mm. Distobuccalcanal orifices were localized at the distal side of the center in 98.3% of teeth. The incidence of MB2 was 46.02%. CONCLUSIONS The distobuccal canal orifice is mostly located on the distal side of the central fossa. Thus, it should be considered that the access cavity of the maxillary molars may not be always limited mesially. The incidence of MB2 in this sub-population was 46.02%, which is of great importance clinically.
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167
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Long-term outcome of non-surgical root canal treatment: a retrospective analysis. Odontology 2014; 103:185-93. [PMID: 24908421 DOI: 10.1007/s10266-014-0159-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Accepted: 03/25/2014] [Indexed: 10/25/2022]
Abstract
This study investigated the long-term clinical outcome of root canal treatment. 240 root-treated teeth (n = 61 patients) were initially classified on the basis of radiographic presence/absence of initial apical periodontitis (IAP) and clinical data. The final outcome measure was the periapical healing (healed/disease). The outcome at 6-9 months was correlated with the outcome at 10 years following treatment. Prognostic factors for the periapical healing were assessed. Extraction data were recorded. Univariate and multivariate logistic regression analysis was used to identify risk indicators for apical periodontitis (AP) development. Chi-square analysis was performed to evaluate a possible relationship between the 6-9 months outcome and the final outcome related to IAP. Mean observation time was 14 ± 3.7 years. Survival rate was 84.6% and healing rate was 79% (10-19 years). Predictors of outcome (p < .05) were considered statistically significant. Multivariate logistic regression analysis showed that initial pulpal and periapical status and the quality of root canal filling as assessed two-dimensionally were independent predictors of outcome. The 6-9 months evaluation appears to be an indicator for the final outcome of primary root canal treatment both in the presence and in the absence of IAP. An initial radiolucency associated with an unsatisfactory quality and extent of root canal filling significantly diminishes the possibility of achieving long-term radiographic success. For those with uncertain healing at 6-9 months (91%), clinicians should consider the high healing rate when estimating the prognosis and adjust the decision making accordingly.
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168
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Rios MDA, Villela AM, Cunha RS, Velasco RC, De Martin AS, Kato AS, Bueno CEDS. Efficacy of 2 Reciprocating Systems Compared with a Rotary Retreatment System for Gutta-percha Removal. J Endod 2014; 40:543-6. [DOI: 10.1016/j.joen.2013.11.013] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Revised: 10/21/2013] [Accepted: 11/12/2013] [Indexed: 11/26/2022]
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169
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170
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Treatment Decisions in 330 Cases Referred for Apical Surgery. J Endod 2014; 40:187-91. [DOI: 10.1016/j.joen.2013.10.024] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Revised: 10/15/2013] [Accepted: 10/19/2013] [Indexed: 11/18/2022]
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171
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Comparative assessment of the incidence of vertical root fractures between conventional versus surgical endodontic retreatment. Clin Oral Investig 2014; 18:2015-21. [DOI: 10.1007/s00784-013-1182-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Accepted: 12/26/2013] [Indexed: 10/25/2022]
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172
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KELEŞ A, ŞIMŞEK N, ALÇIN H, AHMETOGLU F, YOLOGLU S. Retreatment of flat-oval root canals with a self-adjusting file: An SEM study. Dent Mater J 2014; 33:786-91. [DOI: 10.4012/dmj.2014-054] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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173
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Song M, Kim SG, Lee SJ, Kim B, Kim E. Prognostic Factors of Clinical Outcomes in Endodontic Microsurgery: A Prospective Study. J Endod 2013; 39:1491-7. [DOI: 10.1016/j.joen.2013.08.026] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Accepted: 08/27/2013] [Indexed: 11/25/2022]
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174
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Corbella S, Taschieri S, Tsesis I, Del Fabbro M. Postextraction implant in sites with endodontic infection as an alternative to endodontic retreatment: a review of literature. J ORAL IMPLANTOL 2013; 39:399-405. [PMID: 23834016 DOI: 10.1563/aaid-joi-d-11-00229] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The aim of this literature review is to evaluate the outcomes of implants placed after extraction of teeth with infections of endodontic origin. An electronic search was performed through electronic databases (Medline and Embase) using the terms "immediate implant," "post-extractive implants," "endodontic infection," "infected site," and "extraction socket" combined with the use of Boolean operators ("AND" and "OR"). Only articles on human subjects were considered. At least 12 month of mean follow-up was required for inclusion. No restriction was placed regarding study design. Ten studies were included in this review. Survival rates ranged from 92% to 100%. A total of 497 implants were placed in sites with endodontic infection. In nine studies the use of bone substitutes was associated with immediate implant placement. Because of the low number of included studies and the heterogeneity of study design, more well-designed studies are required to assess the relevance of this treatment alternative.
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Affiliation(s)
- Stefano Corbella
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
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175
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Butt N, Talwar S. In-vitro evaluation of various solvents for retrieval of mineral trioxide aggregate and their effect on microhardness of dentin. J Conserv Dent 2013; 16:199-202. [PMID: 23833450 PMCID: PMC3698580 DOI: 10.4103/0972-0707.111313] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2013] [Revised: 01/31/2013] [Accepted: 03/08/2013] [Indexed: 11/04/2022] Open
Abstract
AIM Organic acids have the potential to decrease the strength of mineral trioxide aggregate (MTA) during retreatment. However, this might cause alterations in dentin composition and structure. The aim of this study was to assess the efficacy of chemicals on surface microhardness of white MTA (WMTA) and dentin. MATERIALS AND METHODS White MTA-Angelus(®) was mixed and packed into tooth molds. Six experimental groups (n = 15) were formed and exposed to 2% carbonic acid, 2% chlorhexidine gluconate, 5.25% sodium hypochlorite, 10% citric acid, 20% tartaric acid, and normal saline for 10 min and 20 min intervals on 1 and 21 days of setting, respectively. Vickers microhardness of WMTA and dentin for each specimen was measured before and after exposure. Data were subjected to repeated-analysis of variance (ANOVA) and post-hoc tests. RESULTS Carbonic acid was effective in significantly reducing the surface hardness of WMTA on both 1 and 21 days; followed by citric and tartaric acid (P < 0.05). Two percent chlorhexidine gluconate and NaOCl were effective on 1-day set WMTA. All chemicals, except 2% chlorhexidine, decreased microhardness of dentin significantly (P < 0.05) at 20 min interval. CONCLUSION Cautious use of these chemicals not exceeding 10 min is mandatory to prevent significant alterations in mechanical properties of tooth during MTA retrieval.
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Affiliation(s)
- Naziya Butt
- Department of Conservative Dentistry and Endodontics, Maulana Azad Institute of Dental Sciences, Maulana Azad Medical College Complex, Bahadur Shah Zafar Marg, New Delhi, India
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176
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Er O, Uzun O, Ustun Y, Canakcı BC, Yalpı F. Effect of solvents on the accuracy of the Mini Root ZX apex locator. Int Endod J 2013; 46:1088-95. [PMID: 23611038 DOI: 10.1111/iej.12111] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2012] [Accepted: 03/06/2013] [Indexed: 11/28/2022]
Abstract
AIM To evaluate ex vivo, the effects of three solvents on the accuracy of a contemporary electronic root canal length measurement device (ERCLMD), the Mini Root ZX. METHODOLOGY The actual working length (AWL) of 56 extracted maxillary incisor teeth were measured with an ERCLMD. All root canals were prepared with the ProTaper system to AWL. Of them, 20 were filled with gutta-percha and a resin-based sealer (Group A), 20 with gutta-percha and a zinc oxide/eugenol-based sealer (Group B), and 16 roots were used as the control group (Group C). Removal of the root filling and repreparation processes were performed using the ProTaper system. Guttasolv and Resosolv were used as the solvents in Group A and Guttasolv and Endosolv E in Group B. After the removal of the root fillings had been achieved, the same ERCLMD was used to measure the working length (WL). Differences between AWL and WL measurements were analysed by paired t-test, and the accuracy of ERCLMD was assessed using chi-squared tests. RESULTS There were significant differences between AWL and WL measurements in subgroups A2 (Resosolv group) and B2 (Endosolv E group). In these subgroups, WL was shorter than AWL (P < 0.05). Also, the accuracy of the Resosolv group was significantly lower than the others (P < 0.05) at a ±0.5 mm margin of error. CONCLUSIONS Removing root fillings may require use of a solvent. In these cases, ERCLMDs may exhibit a lower accuracy, thus operators must exercise additional care when measuring the working length using ERCLMDs.
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Affiliation(s)
- O Er
- Department of Endodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
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177
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Tsesis I, Rosen E, Taschieri S, Telishevsky Strauss Y, Ceresoli V, Del Fabbro M. Outcomes of Surgical Endodontic Treatment Performed by a Modern Technique: An Updated Meta-analysis of the Literature. J Endod 2013; 39:332-9. [PMID: 23402503 DOI: 10.1016/j.joen.2012.11.044] [Citation(s) in RCA: 124] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2012] [Revised: 11/21/2012] [Accepted: 11/26/2012] [Indexed: 10/27/2022]
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178
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Hargreaves KM, Diogenes A, Teixeira FB. Treatment options: biological basis of regenerative endodontic procedures. J Endod 2013; 39:S30-43. [PMID: 23439043 PMCID: PMC3589799 DOI: 10.1016/j.joen.2012.11.025] [Citation(s) in RCA: 203] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2012] [Revised: 11/12/2012] [Accepted: 11/12/2012] [Indexed: 12/14/2022]
Abstract
Dental trauma occurs frequently in children and often can lead to pulpal necrosis. The occurrence of pulpal necrosis in the permanent but immature tooth represents a challenging clinical situation because the thin and often short roots increase the risk of subsequent fracture. Current approaches for treating the traumatized immature tooth with pulpal necrosis do not reliably achieve the desired clinical outcomes, consisting of healing of apical periodontitis, promotion of continued root development, and restoration of the functional competence of pulpal tissue. An optimal approach for treating the immature permanent tooth with a necrotic pulp would be to regenerate functional pulpal tissue. This review summarizes the current literature supporting a biological rationale for considering regenerative endodontic treatment procedures in treating the immature permanent tooth with pulp necrosis.
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Affiliation(s)
- Kenneth M Hargreaves
- Department of Endodontics, University of Texas Health Science Center at San Antonio, San Antonio, Texas 78229, USA.
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179
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Effects of Dissolving Solutions on the Accuracy of an Electronic Apex Locator-Integrated Endodontic Handpiece. ScientificWorldJournal 2013; 2013:475178. [PMID: 24379743 PMCID: PMC3860120 DOI: 10.1155/2013/475178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Accepted: 10/26/2013] [Indexed: 11/30/2022] Open
Abstract
The effects of three dissolving agents on the accuracy of an electronic apex locator- (EAL-) integrated endodontic handpiece during retreatment procedures were evaluated. The true lengths (TLs) of 56 extracted incisor teeth were determined visually. Twenty teeth were filled with gutta-percha and a resin-based sealer (group A), 20 with gutta-percha and a zinc oxide/eugenol-based sealer (group B), and 16 roots were used as the control group (group C). All roots were prepared to TL. Guttasolv, Resosolv, and Endosolv E were used as the dissolving solutions. Two evaluations of the handpiece were performed: the apical accuracy during the auto reverse function (ARL) and the apex locator function (EL) alone. The ARL function of the handpiece gave acceptable results. There were significant differences between the EL mode measurements and the TL (P < 0.05). In these comparisons, Tri Auto ZX EL mode measurements were significantly shorter than those of the TL.
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180
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Asgary S, Ehsani S. Periradicular surgery of human permanent teeth with calcium-enriched mixture cement. IRANIAN ENDODONTIC JOURNAL 2013; 8:140-4. [PMID: 23922577 PMCID: PMC3734518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2013] [Revised: 03/10/2013] [Accepted: 04/27/2013] [Indexed: 10/31/2022]
Abstract
INTRODUCTION Root-end preparation and restoration with an endodontic material are required when nonsurgical endodontic retreatment has failed or is impossible. The present clinical study reports the treatment outcomes of periradicular surgery using calcium-enriched mixture (CEM) cement. MATERIALS AND METHODS A prospective outcome study of periradicular surgery using CEM was conducted on 14 permanent teeth with persistent apical periodontitis. Using a standardized surgical protocol, 2-3 mm of the root apex was resected; approximately 3 mm deep root-end cavities were ultrasonically prepared and filled with CEM cement. All patients were available for recall. RESULTS Clinical and radiographic examination revealed complete healing of periradicular lesions, i.e. regeneration of periodontal ligament and lamina dura in 13 teeth (93% success) during a mean time of 18 months; moreover, the teeth were functional and asymptomatic. CONCLUSION Favorable treatment outcomes in this prospective clinical study suggested that CEM cement may be a suitable root-end filling biomaterial.
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Affiliation(s)
- Saeed Asgary
- Iranian Center for Endodontic Research, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sara Ehsani
- Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Evin, Tehran, Iran,Corresponding author: Sara Ehsani, Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Evin, Tehran, Iran. Tel: +98-21 22413897, Fax: +98-21 22427753,
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181
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Fulton AJ, Fiani N, Arzi B, Lommer MJ, Kuntsi-Vaattovaara H, Verstraete FJM. Outcome of surgical endodontic treatment in dogs: 15 cases (1995-2011). J Am Vet Med Assoc 2012; 241:1633-8. [PMID: 23216039 DOI: 10.2460/javma.241.12.1633] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To document the short- and long-term outcomes of surgical endodontic treatment in dogs in a clinical setting. DESIGN Retrospective case series. ANIMALS 15 dogs that underwent surgical endodontic treatment. PROCEDURES Medical records of dogs that underwent surgical endodontic treatment at 3 institutions from January 1995 to December 2011 were reviewed. Information extracted included signalment, history, initial clinical signs, physical and radiographic examination findings, treatment, and outcome. Outcome was determined through evaluation of the pre- and postoperative radiographs as well as clinical and radiographic findings at follow-up evaluations. On the basis of radiographic findings, treatment was considered successful if the periapical lesion and bone defect created by surgery had completely healed and no new root resorption was detected; a treatment was considered to have no evidence of failure if the periapical lesion remained the same or had not completely resolved and root resorption was static. RESULTS 15 dogs were treated by means of apicoectomy and retrograde filling following a failed or complicated orthograde root canal treatment. The mean long-term follow-up time was 15.2 months (range, 3 to 50 months). On radiographic evaluation, 10 of 15 dogs had successful resolution of the periapical disease; 5 dogs had no radiographic evidence of failure of endodontic treatment. All dogs were considered to have a successful clinical outcome. CONCLUSIONS AND CLINICAL RELEVANCE Surgical endodontic treatment was an effective option for salvaging endodontically diseased but periodontally healthy teeth of dogs in which orthograde treatment was unsuccessful and nonsurgical retreatment was unlikely to succeed.
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Affiliation(s)
- Amy J Fulton
- William R. Pritchard Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California-Davis, 95616, USA
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182
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Good ML, McCammon A. Removal of gutta-percha and root canal sealer: a literature review and an audit comparing current practice in dental schools. ACTA ACUST UNITED AC 2012; 39:703-8. [PMID: 23367635 DOI: 10.12968/denu.2012.39.10.703] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- M-L Good
- Consultant, Department of Restorative Dentistry, The Royal Hospitals, Belfast Health and Social Care Trust, Grosvenor Road, Belfast, BT12 6BP, Northern Ireland
| | - A McCammon
- Vocational Trainee, Whitehead, Carrickfergus, Northern Ireland
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183
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Fayazi S, Bayat-Movahed S, White SN. Rapid endodontic management of type II dens invaginatus using an MTA plug: a case report. SPECIAL CARE IN DENTISTRY 2012; 33:96-100. [DOI: 10.1111/j.1754-4505.2012.00300.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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184
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Corbella S, Taschieri S, Leone A, Rodolfi A, Francetti L. Il posizionamento di impianti in siti infetti come alternativa al trattamento endodontico secondario: revisione della letteratura. GIORNALE ITALIANO DI ENDODONZIA 2012. [DOI: 10.1016/j.gien.2012.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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185
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Kapoor V, Paul S. Non-surgical endodontics in retreatment of periapical lesions - two representative case reports. J Clin Exp Dent 2012; 4:e189-93. [PMID: 24558553 PMCID: PMC3917646 DOI: 10.4317/jced.50765] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2011] [Accepted: 01/05/2012] [Indexed: 11/05/2022] Open
Abstract
This article reports non-surgical endodontic retreatment of two patients with persistent or recurrent periapical lesions, who had previously undergone surgical and non-surgical endodontic therapy respectively. It further discusses and reviews the relevance of classification of periapical lesions, the explanation behind healing of periapical lesions by endodontic therapy alone, causes of persistence of periapical lesions, choice of treatment modalities (whether surgical or non - surgical) and materials such as intracanal medicaments and irrigants for optimal healing. Key words:Non-surgical, retreatment, periapical, calcium hydroxide, chlorhexidine irrigation.
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Affiliation(s)
- Varun Kapoor
- B.D.S., M.D.S. Conservative Dentistry and Endodontics. Senior Lecturer, Swami Devi Dyal Hospital and Dental College, Golpura, Panchkula
| | - Samrity Paul
- B.D.S., M.D.S. Oral and Maxillofacial Surgery, Senior Lecturer, Swami Devi Dyal Hospital and Dental College, Golpura, Panchkula
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186
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Lee W, Shon WJ, Baek SH, Kum KY, Kim HC. Outcomes of intentionally replanted molars according to preoperative locations of periapical lesions and the teeth. J Dent Sci 2012. [DOI: 10.1016/j.jds.2012.03.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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187
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Evans GE, Bishop K, Renton T. Update of guidelines for surgical endodontics – the position after ten years. Br Dent J 2012; 212:497-8. [DOI: 10.1038/sj.bdj.2012.418] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2012] [Indexed: 11/09/2022]
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188
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Marques da Silva B, Baratto-Filho F, Leonardi DP, Henrique Borges A, Volpato L, Branco Barletta F. Effectiveness of ProTaper, D-RaCe, and Mtwo retreatment files with and without supplementary instruments in the removal of root canal filling material. Int Endod J 2012; 45:927-32. [DOI: 10.1111/j.1365-2591.2012.02051.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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189
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Esposito S, Cardaropoli M, Cotti E. A suggested technique for the application of the cone beam computed tomography periapical index. Dentomaxillofac Radiol 2012; 40:506-12. [PMID: 22065800 DOI: 10.1259/dmfr/78881369] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES Cone beam CT (CBCT) produces undistorted three-dimensional (3D) images of the maxillofacial region with a radiation dosage lower than conventional CT. The periapical index score (PAI) is commonly used to follow up the lesions in the bone using periapical radiographs. Recently, a new PAI based on CBCT was introduced (CBCT-PAI). The aim of this technical report is to present a modified reproducible method to assess the CBCT-PAI. METHODS CBCT was used to evaluate a periapical bone lesion observed in the area of tooth number 13 before treatment and 2 years after treatment. The modified CBCT-PAI was applied to both the examinations to measure the lesion. The dimensional analysis of the lesion was performed in each plane, assessing three fixed and reproducible dimensions: mesiodistal (M-D), buccolingual (B-L) and coronoapical (C-A). The images were evaluated by three mutually independent examiners. Data were collected and reported in a chart. The results were compared with each other and with the PAI score from the periapical radiographs. RESULTS The three observers reported the same measurements of the lesion for each plane. The CBCT-PAI follow-up showed a reduction of the size of the lesion (5D vs 4D) but also an increase in the erosion of the buccal cortical plate. The comparison of CBCT-PAI with classic PAI showed the first method to be more precise. CONCLUSIONS This technical report shows how the CBCT-PAI can be applied to the CBCT exam of a periapical lesion in a reproducible way.
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Affiliation(s)
- S Esposito
- Department of Conservative Dentistry and Endodontics, University of Cagliari, Italy
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190
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Washington JT, Schneiderman E, Spears R, Fernandez CR, He J, Opperman LA. Biocompatibility and osteogenic potential of new generation endodontic materials established by using primary osteoblasts. J Endod 2011; 37:1166-70. [PMID: 21763915 DOI: 10.1016/j.joen.2011.05.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2011] [Revised: 04/19/2011] [Accepted: 05/03/2011] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Generex A and Generex B (calcium silicate based), Capasio (calcium-phospho-alumino silicate based) along with Ceramicrete-D (magnesium phosphate based) are being introduced as a new generation of endodontic materials with the potential to facilitate bone healing. The aim of this study was to evaluate the biocompatibility and osteogenic potential of these new materials by using primary osteoblasts. METHODS Primary osteoblasts were prepared from rat calvaria and exposed to mineral trioxide aggregate (MTA), Generex A, Generex B, Capasio, and Ceramicrete-D prepared to standardized size and shape (n = 5). Trypan blue staining was used to evaluate cell viability from 1-6 days. Mineralization potential was evaluated by scanning electron microscopy for the presence of mineralized nodules. Data were analyzed by Kruskal-Wallis and Mann-Whitney U tests. RESULTS Only Generex A and MTA allowed cell growth and proliferation throughout the experiment. There were statistically significant differences between groups throughout the experiment beginning on day 1. The greatest amount of cell growth was consistently observed with Generex A and MTA. There was no difference in mineralized nodule formation between any test materials. CONCLUSIONS Generex A was the only new generation endodontic material that supported primary osteoblast growth; no material besides MTA facilitated nodule formation.
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Affiliation(s)
- Jelani T Washington
- Department of Endodontics, Texas A&M Health Science Center, Baylor College of Dentistry, Dallas, Texas, USA
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191
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Setzer FC, Kohli MR, Shah SB, Karabucak B, Kim S. Outcome of endodontic surgery: a meta-analysis of the literature--Part 2: Comparison of endodontic microsurgical techniques with and without the use of higher magnification. J Endod 2011; 38:1-10. [PMID: 22152611 DOI: 10.1016/j.joen.2011.09.021] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2011] [Revised: 09/26/2011] [Accepted: 09/30/2011] [Indexed: 02/02/2023]
Abstract
INTRODUCTION The aim of this study was to investigate the outcome of root-end surgery. It identifies the effect of the surgical operating microscope or the endoscope on the prognosis of endodontic surgery. The specific outcomes of contemporary root-end surgery techniques with microinstruments but only loupes or no visualization aids (contemporary root-end surgery [CRS]) were compared with endodontic microsurgery using the same instruments and materials but with high-power magnification as provided by the surgical operating microscope or the endoscope (endodontic microsurgery [EMS]). The probabilities of success for a comparison of the 2 techniques were determined by means of a meta-analysis and systematic review of the literature. The influence of the tooth type on the outcome was investigated. METHODS A comprehensive literature search for longitudinal studies on the outcome of root-end surgery was conducted. Three electronic databases (ie, Medline, Embase, and PubMed) were searched to identify human studies from 1966 up to October 2009 in 5 different languages (ie, English, French, German, Italian, and Spanish). Review articles and relevant articles were searched for cross-references. In addition, 5 dental and medical journals (ie, Journal of Endodontics, International Endodontic Journal, Oral Surgery Oral Medicine Oral Pathology Oral Radiology and Endodontics, Journal of Oral and Maxillofacial Surgery, and International Journal of Oral and Maxillofacial Surgery) dating back to 1975 were hand searched. Following predefined inclusion and exclusion criteria, all articles were screened by 3 independent reviewers (S.B.S., M.R.K., and F.C.S.). Relevant articles were obtained in full-text form, and raw data were extracted independently by each reviewer. After agreement among the reviewers, articles that qualified were assigned to group CRS. Articles belonging to group EMS had already been obtained for part 1 of this meta-analysis. Weighted pooled success rates and a relative risk assessment between CRS and EMS overall as well as for molars, premolars, and anteriors were calculated. A random-effects model was used for a comparison between the groups. RESULTS One hundred one articles were identified and obtained for final analysis. In total, 14 studies qualified according to the inclusion and exclusion criteria, 2 being represented in both groups (7 for CRS [n = 610] and 9 for EMS [n = 699]). Weighted pooled success rates calculated from extracted raw data showed an 88% positive outcome for CRS (95% confidence interval, 0.8455-0.9164) and 94% for EMS (95% confidence interval, 0.8889-0.9816). This difference was statistically significant (P < .0005). Relative risk ratio analysis showed that the probability of success for EMS was 1.07 times the probability of success for CRS. Seven studies provided information on the individual tooth type (4 for CRS [n = 457] and 3 for EMS [n = 222]). The difference in probability of success between the groups was statistically significant for molars (n = 193, P = .011). No significant difference was found for the premolar or anterior group (premolar [n = 169], P = .404; anterior [n = 277], P = .715). CONCLUSIONS The probability for success for EMS proved to be significantly greater than the probability for success for CRS, providing best available evidence on the influence of high-power magnification rendered by the dental operating microscope or the endoscope. Large-scale randomized clinical trials for statistically valid conclusions for current endodontic questions are needed to make informed decisions for clinical practice.
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Affiliation(s)
- Frank C Setzer
- Department of Endodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.
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192
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Vaishnavi C, Mohan B, Narayanan LL. Treatment of endodontically induced periapical lesions using hydroxyapatite, platelet-rich plasma, and a combination of both: An in vivo study. J Conserv Dent 2011; 14:140-6. [PMID: 21814354 PMCID: PMC3146105 DOI: 10.4103/0972-0707.82614] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2010] [Revised: 10/13/2010] [Accepted: 11/05/2010] [Indexed: 11/16/2022] Open
Abstract
Aim and Objectives: To evaluate bone regeneration in endodontically induced periapical lesions using Hydroxyapatite, Platelet-Rich Plasma (PRP), and a combination of Hydroxyapatite and Platelet-Rich Plasma for a period of one year. Materials and Methods: Twenty systemically healthy patients of both genders between the ages 20 and 40 years were included. To qualify, the patient had to have a tooth where non-surgical root canal therapy had failed, periapical radiolucency was present, and periapical root end surgery was required. The bony defect had to be confined to the apical area, with the bone covering the entire root surface coronally, with an intact lingual cortical plate. Patients were randomly divided into four groups, with five patients each, as follows: Group I — Replacement with Hydroxyapatite, Group II — Replacement with PRP, Group III — Replacement with PRP and Hydroxyapatite, and Group IV — Control group with no substitutes. The patients were evaluated both clinically and radiographically. Results: The radiographic evaluation revealed that Group I patients showed complete bone regeneration with evidence of a trabecular pattern, at the end of one year, Group II patients showed complete bone regeneration at the end of nine months, Group III patients showed complete bone regeneration at the end of six months, and Group IV patients showed bone regeneration, which was not satisfactory even after one year. Conclusions: The PRP and Hydroxyapatite combination facilitated better and faster bone regeneration when compared to PRP alone.
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Affiliation(s)
- C Vaishnavi
- Department of Conservative Dentistry and Endodontics, SRM Kattankulathur Dental College, Tamil Nadu, India
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193
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Inan U, Aydin C. Comparison of cyclic fatigue resistance of three different rotary nickel-titanium instruments designed for retreatment. J Endod 2011; 38:108-11. [PMID: 22152632 DOI: 10.1016/j.joen.2011.09.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2011] [Revised: 09/07/2011] [Accepted: 09/19/2011] [Indexed: 02/07/2023]
Abstract
INTRODUCTION A number of rotary nickel-titanium (NiTi) systems have been developed to provide better, faster, and easier cleaning and shaping of the root canal system, and recently, rotary NiTi systems designed for root canal retreatment have been introduced. Because the main problem with the rotary NiTi files is fracture, the aim of this study was to compare the cyclic fatigue resistance of 3 different rotary NiTi systems designed for root canal retreatment. METHODS Total of 60 instruments of 3 different rotary NiTi systems designed for root canal retreatment were used in this study. Twenty R-Endo R3, 20 ProTaper D3, and 20 Mtwo R (Retreatment) 25.05 instruments were tested. Cyclic fatigue testing of instruments was performed by using a device that allowed the instruments to rotate freely inside an artificial canal. Each instrument was rotated until fracture occurred, and the number of cycles to fracture for each instrument was calculated. Representative samples were also evaluated under a scanning electron microscope to confirm the fracture was flexural. Data were analyzed by using 1-way analysis of variance test. RESULTS R-Endo R3 instruments showed better cyclic fatigue resistance than ProTaper D3 and Mtwo R 25.05 instruments, and the difference was statistically significant (P < .05). There was no significant difference between ProTaper D3 and Mtwo R 25.05 groups. CONCLUSIONS The R-Endo R3 instruments were more resistant to fatigue failure than ProTaper D3 and Mtwo R 25.05.
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Affiliation(s)
- Ugur Inan
- Department of Endodontics, Faculty of Dentistry, 19 Mayis University, Samsun, Turkey.
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Ali Z, Keshani D. Indications for surgical endodontics and findings of an audit into referrals. DENTAL UPDATE 2011; 38:610-614. [PMID: 22238993 DOI: 10.12968/denu.2011.38.9.610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
UNLABELLED Peri-radicular surgery is a valuable treatment modality allowing thorough treatment of chronic infection of the peri-radicular tissues. It is important that this treatment option is prescribed appropriately and steps are taken to help improve outcomes of surgery. We discuss the indications for peri-radicular surgery, considerations when planning treatment for teeth where orthograde endodontics has failed and present the findings of an audit into the appropriateness of referrals for peri-radicular surgery to the Department of Oral and Maxillofacial Surgery at a District General Hospital. CLINICAL RELEVANCE This article highlights the indications and contra-indications for peri-radicular surgery to general dental practitioners.
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Naylor J, Mines P, Anderson A, Kwon D. The Use of Guided Tissue Regeneration Techniques among Endodontists: A Web-based Survey. J Endod 2011; 37:1495-8. [DOI: 10.1016/j.joen.2011.08.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2011] [Revised: 08/04/2011] [Accepted: 08/09/2011] [Indexed: 12/30/2022]
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Influenza del microscopio operatorio nella diagnosi intraoperatoria e nel ritrattamento chirurgico endodontico: studio clinico e radiografico con follow-up a un anno. DENTAL CADMOS 2011. [DOI: 10.1016/j.cadmos.2011.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Fahey T, O'Connor N, Walker T, Chin-Shong D. Surgical endodontics: a review of current best practice. ACTA ACUST UNITED AC 2011. [DOI: 10.1111/j.1752-248x.2011.01127.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Aguilar P, Linsuwanont P. Vital Pulp Therapy in Vital Permanent Teeth with Cariously Exposed Pulp: A Systematic Review. J Endod 2011; 37:581-7. [DOI: 10.1016/j.joen.2010.12.004] [Citation(s) in RCA: 170] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2010] [Revised: 12/08/2010] [Accepted: 12/20/2010] [Indexed: 10/18/2022]
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Il ruolo della strumentazione meccanica nei ritrattamenti endodontici. DENTAL CADMOS 2011. [DOI: 10.1016/j.cadmos.2010.11.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Kim SG, Solomon C. Cost-effectiveness of Endodontic Molar Retreatment Compared with Fixed Partial Dentures and Single-tooth Implant Alternatives. J Endod 2011; 37:321-5. [PMID: 21329815 DOI: 10.1016/j.joen.2010.11.035] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2010] [Revised: 11/24/2010] [Accepted: 11/30/2010] [Indexed: 10/18/2022]
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