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Al-Qudah A, Afaneh A, Hassouneh L. A Case Report of a Maxillary Second Molar with Two Distinct Palatal Canals, Confirmed by CBCT. Clin Cosmet Investig Dent 2023; 15:199-203. [PMID: 37790248 PMCID: PMC10542588 DOI: 10.2147/ccide.s431563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 09/21/2023] [Indexed: 10/05/2023] Open
Abstract
Cases of unusual and complex root canal morphology could be difficult to diagnose and treat. This report describes the diagnosis and management of a rare maxillary right second molar (tooth #17) with two distinct palatal canals. The tooth was diagnosed with irreversible pulpitis and symptomatic apical periodontitis. Non-surgical root canal treatment was performed. Accurate diagnosis and comprehensive treatment of cases with unusual root canal morphology can be achieved by evaluation of periapical radiographs at different angulations, advanced magnification techniques, and the Cone Beam Computed Tomography (CBCT) scanning. Clinicians should be aware that two separate palatal canals could exist in maxillary second molar teeth.
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Affiliation(s)
- Aladdin Al-Qudah
- Department of Conservative Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Asem Afaneh
- Department of Conservative Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Layla Hassouneh
- Department of Conservative Dentistry, Jordan University of Science and Technology, Irbid, Jordan
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da Silva TA, de Araújo LP, Gobbo LB, Soares ADJ, Gomes BPFDA, de Almeida JFA, Ferraz CCR. Outcome of root canal treatment of teeth with chronic apical periodontitis treated with foraminal enlargement and 2% chlorhexidine gel: a retrospective cohort study. J Endod 2023:S0099-2399(23)00320-5. [PMID: 37307870 DOI: 10.1016/j.joen.2023.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 05/30/2023] [Accepted: 06/05/2023] [Indexed: 06/14/2023]
Abstract
INTRODUCTION This retrospective cohort study aimed to estimate the success rate (SR) of primary root canal treatment on teeth with a diagnosis of pulp necrosis (PN) and asymptomatic apical periodontitis (AAP) when using 2% chlorhexidine gel as an auxiliary chemical substance (ACS) and foraminal enlargement instrumentation technique. METHODS This study evaluated 178 patients with 206 teeth submitted to primary root canal treatment performed by graduate residents in endodontics. The inclusion criteria were patients who underwent treatment over a period of 1 to 7 years on teeth with a diagnosis of PN and AAP. The SR was evaluated clinically and radiographically and categorized considering strict' (complete resolution of periradicular lesion) or 'loose' (reduction in the size of existing periradicular lesion) criteria. Cases of clinical and/or radiographical absence of repair were classified as a failure. Two calibrated examiners independently assessed treatment outcomes using the ImageJ software. RESULTS The SR were 81.1% (95% CI: 75.7% - 86.4%) and 87.4% (95% CI: 82.8% - 91.9%) when considering the 'strict' or 'loose' criteria, respectively. Females had a higher SR when strict criteria were applied. Also, the SR was significantly reduced when there was an increase in the patient's age. CONCLUSION Within the limitations of this study, it was found that teeth with a diagnosis of PN and AAP and treated associating the use of 2% chlorhexidine gel and foraminal enlargement achieved substantial SR. Gender and age were prognostic factors that played a significant role in the SR. Future randomized controlled trials should further investigate the effects of foraminal enlargement and 2% chlorhexidine gel as an ACS.
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Affiliation(s)
- Tamares Andrade da Silva
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, SP, Brazil
| | - Lucas Peixoto de Araújo
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, SP, Brazil. Professor at the School of Dentistry, Catholic University of Pelotas (UCPEL), Pelotas, RS, Brazil
| | - Leandro Bueno Gobbo
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, SP, Brazil
| | - Adriana de Jesus Soares
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, SP, Brazil
| | | | - José Flávio Affonso de Almeida
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, SP, Brazil
| | - Caio Cezar Randi Ferraz
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, SP, Brazil.
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Alves Dos Santos GN, Faria-E-Silva AL, Ribeiro VL, Pelozo LL, Candemil AP, Oliveira ML, Lopes-Olhê FC, Mazzi-Chaves JF, Sousa-Neto MD. Is the quality of root canal filling obtained by cone-beam computed tomography associated with periapical lesions? A systematic review and meta-analysis. Clin Oral Investig 2022; 26:5105-5116. [PMID: 35618962 DOI: 10.1007/s00784-022-04558-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 05/17/2022] [Indexed: 11/03/2022]
Abstract
AIM To evaluate the influence of root canal filling quality on periapical lesion status using cone-beam computed tomography (CBCT). MATERIALS AND METHODS The bibliographic search was conducted in electronic databases of PubMed, Embase, Scopus, and Web of Science without restrictions related to the year of publication and language. Inclusion criteria were prospective or retrospective cohort studies that followed periapical pathosis for, at least, 1 year. Three reviewers independently evaluated the eligibility for inclusion, extracted data, and assessed the risk of bias. The quality of the studies was based on the Newcastle-Ottawa Scale. This meta-analysis was performed to evaluate the quality of treatment by the homogeneity and apical extension of the filling. RESULTS Of the 1179 studies initially recovered, six cohort studies were included, out of which four were considered with a low risk of bias. The results showed that the absence of gaps in the filling reduced the chance of unhealed periapical lesions by 2.39 times (RR = 2.39; 95% CI: 1.62-3.53; p < 0.00001; I2 = 55%). An apical filling extension of 0-2 mm below the apex also contributed significantly to the absence of unhealed periapical lesions (RR = 1.49; 95% CI: 1.15-1.94; p = 0.003; I2 = 2%). CONCLUSION The homogeneity and apical extension of the filling influenced the presence of unhealed periapical lesions in endodontically treated teeth evaluated using CBCT. CLINICAL RELEVANCE Apical extension of the filling ranging between 0 and 2 mm short of the apical foramen and the homogeneity of the filling without gaps are directly related to the success rate of root canal treatment.
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Affiliation(s)
- Guilherme Nilson Alves Dos Santos
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Av. do Café, s/n, Ribeirão Preto, São Paulo, 14020-904, Brazil
| | | | - Vitor Luís Ribeiro
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Av. do Café, s/n, Ribeirão Preto, São Paulo, 14020-904, Brazil
| | - Laís Lima Pelozo
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Av. do Café, s/n, Ribeirão Preto, São Paulo, 14020-904, Brazil
| | - Amanda Pelegrin Candemil
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Av. do Café, s/n, Ribeirão Preto, São Paulo, 14020-904, Brazil
| | - Matheus L Oliveira
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Fabiane Carneiro Lopes-Olhê
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Av. do Café, s/n, Ribeirão Preto, São Paulo, 14020-904, Brazil
| | - Jardel Francisco Mazzi-Chaves
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Av. do Café, s/n, Ribeirão Preto, São Paulo, 14020-904, Brazil
| | - Manoel Damião Sousa-Neto
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Av. do Café, s/n, Ribeirão Preto, São Paulo, 14020-904, Brazil.
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Oncu A, Huang Y, Amasya G, Sevimay FS, Orhan K, Celikten B. Silver nanoparticles in endodontics: recent developments and applications. Restor Dent Endod 2021; 46:e38. [PMID: 34513644 PMCID: PMC8411004 DOI: 10.5395/rde.2021.46.e38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 12/05/2020] [Accepted: 01/04/2021] [Indexed: 12/02/2022] Open
Abstract
The elimination of endodontic biofilms and the maintenance of a leak-proof canal filling are key aspects of successful root canal treatment. Several materials have been introduced to treat endodontic disease, although treatment success is limited by the features of the biomaterials used. Silver nanoparticles (AgNPs) have been increasingly considered in dental applications, especially endodontics, due to their high antimicrobial activity. For the present study, an electronic search was conducted using MEDLINE (PubMed), the Cochrane Central Register of Controlled Trials (CENTRAL), Google Scholar, and EMBASE. This review provides insights into the unique characteristics of AgNPs, including their chemical, physical, and antimicrobial properties; limitations; and potential uses. Various studies involving different application methods of AgNPs were carefully examined. Based on previous clinical studies, the synthesis, means of obtaining, usage conditions, and potential cytotoxicity of AgNPs were evaluated. The findings indicate that AgNPs are effective antimicrobial agents for the elimination of endodontic biofilms.
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Affiliation(s)
- Aysenur Oncu
- Department of Endodontics, Ankara University Faculty of Dentistry, Ankara, Turkey
| | - Yan Huang
- Department of Dental Hygiene Research & Development in Health & Care, Artevelde University of Applied Sciences, Ghent, Belgium
| | - Gulin Amasya
- Department of Pharmaceutical Technology, Ankara University Faculty of Pharmacy, Ankara, Turkey
| | - Fatma Semra Sevimay
- Department of Endodontics, Ankara University Faculty of Dentistry, Ankara, Turkey
| | - Kaan Orhan
- Department of Dentomaxillofacial Radiology, Ankara University Faculty of Dentistry, Ankara, Turkey
| | - Berkan Celikten
- Department of Endodontics, Ankara University Faculty of Dentistry, Ankara, Turkey
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Santos-Junior AO, Tanomaru-Filho M, Pinto JC, Tavares KIMC, Torres FFE, Guerreiro-Tanomaru JM. Effect of obturation technique using a new bioceramic sealer on the presence of voids in flattened root canals. Braz Oral Res 2021; 35:e028. [PMID: 33605358 DOI: 10.1590/1807-3107bor-2021.vol35.0028] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 11/19/2020] [Indexed: 12/24/2022] Open
Abstract
The aim of this study was to evaluate the filling ability of a new ready-to-use calcium silicate-based sealer using thermoplastic or single-cone technique in flattened root canals. Twenty-four flattened distal canals of mandibular molars with a buccolingual diameter 4 or more times larger than the mesiodistal diameter were selected. The root canals were prepared and filled (n = 12), according to the following techniques: thermoplastic or single-cone technique using Bio-C Sealer. The teeth were scanned using Skycan 1176 micro-computed tomography (micro-CT) - voxel size 8.74 µm, before and after filling the root canal. The percentage of voids in the filled root canals was evaluated, and the data were statistically analyzed using the unpaired t-test (α = 0.05). The root canals filled using the thermoplastic technique created a smaller percentage of voids in the cervical/middle thirds than those filled using the single-cone technique (p < 0.05). There was no difference in the percentage of voids using either technique in the apical third (p > 0.05). The flattened root canals in the cervical/middle thirds were better filled using the ready-to-use calcium silicate-based sealer associated to the thermoplastic technique, compared with the single-cone technique. In the apical third, the techniques showed similar filling ability.
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Affiliation(s)
- Airton Oliveira Santos-Junior
- Universidade Estadual Paulista - Unesp, School of Dentistry , Department of Restorative Dentistry , Araraquara , SP , Brazil
| | - Mário Tanomaru-Filho
- Universidade Estadual Paulista - Unesp, School of Dentistry , Department of Restorative Dentistry , Araraquara , SP , Brazil
| | - Jáder Camilo Pinto
- Universidade Estadual Paulista - Unesp, School of Dentistry , Department of Restorative Dentistry , Araraquara , SP , Brazil
| | | | - Fernanda Ferrari Esteves Torres
- Universidade Estadual Paulista - Unesp, School of Dentistry , Department of Restorative Dentistry , Araraquara , SP , Brazil
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Türker SA, Uzunoğlu-Özyürek E, Kaşikçi S, Öndeş M, Geneci F, Çelik HH. Filling quality of several obturation techniques in the presence of apically separated instruments: A Micro-CT study. Microsc Res Tech 2020; 84:1265-1271. [PMID: 33378798 DOI: 10.1002/jemt.23685] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 11/09/2020] [Accepted: 12/15/2020] [Indexed: 11/05/2022]
Abstract
Separated root canal instruments may affect the quality of root canal obturation and hence the survival of endodontically treated teeth. Obturation techniques may influence filling-quality. The aim was to evaluate the obturation quality of teeth filled with different obturation techniques in the presence of apically separated instruments using micro-computed tomography (μ-CT). Notched ProTaper F2 rotary-files were separated in the apical third of 36-human mandibular incisors with single root/canal and mature apex. Samples were filled by an endodontist according to one of the following obturation techniques (n = 12): cold lateral-compaction (CLC), single-cone (SC) and thermoplastic injection (TI). Samples were scanned by the Skyscan 1,274® μ-CT device after 1-week at 37°C in 100% humidity. Images of the sections were evaluated with CTan software in terms of total-volume and volume percentage of the filling materials and voids between coronal end of the separated instrument and gutta-percha/sealer filled void-free sections. Data was analyzed using Kruskal-Wallis and Mann Whitney-U tests with a significance level of 5%. Kruskal-Wallis revealed differences among groups (p < 0.05).Pairwise comparisons revealed that less volume of voids were measured in SC (0.02 ± 0.03 mm3 ) compared to CLC (0.15 ± 0.16 mm3 ) and TI (0.18 ± 0.24 mm3 ) (p < 0.05); while TI was statistically similar with CLC (p > 0.05). Percentages of volumes of voids and filling materials were as follows for SC, CLC and TI, respectively: 8.88 ± 18.52% and 24.45 ± 38.40%, 46.92 ± 33.53% and 53.07 ± 33.53%, 40.54 ± 33.85% and 42.79 ± 34.45%. The obturation technique may have a significant impact on the volume of voids in the presence of a separated file. No obturation technique produced a void-free root canal filling.
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Affiliation(s)
- Sevinç Aktemur Türker
- Faculty of Dentistry, Department of Endodontics, Zonguldak Bülent Ecevit University, Zonguldak, Turkey
| | - Emel Uzunoğlu-Özyürek
- Faculty of Dentistry, Department of Endodontics, Hacettepe University, Ankara, Turkey
| | - Sena Kaşikçi
- Faculty of Dentistry, Department of Endodontics, Zonguldak Bülent Ecevit University, Zonguldak, Turkey
| | - Melike Öndeş
- Faculty of Dentistry, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Ferhat Geneci
- Faculty of Medicine,Department of Anatomy, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Hakan Hamdi Çelik
- Faculty of Medicine, Department of Anatomy, Hacettepe University, Ankara, Turkey
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