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Juha W, Sarkis E, Alsayed Tolibah Y. Three-dimensional assessment of obturation volume in lateral canals after three obturation techniques with bioceramic sealer: an in vitro comparative study. BDJ Open 2024; 10:50. [PMID: 38886384 PMCID: PMC11183128 DOI: 10.1038/s41405-024-00240-5] [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: 04/05/2024] [Revised: 05/21/2024] [Accepted: 05/31/2024] [Indexed: 06/20/2024] Open
Abstract
OBJECTIVE This study aimed to evaluate the obturation ability of simulated lateral canal in mandibular premolars at three levels (3, 5, and 7 mm) from the apex using gutta-percha and BC Sealer HiFlow (BCHiF) with different obturation techniques, including continuous wave compaction (CWC), cold lateral condensation (CLC), and single cone (SC) techniques, by a 3D assessment method of the obturation volume with cone beam computed tomography (CBCT) and MIMICS software analysis. METHODS Thirty intact human mandibular premolars were decoronated, instrumented up to #30 taper 4%, and uniformly irrigated with 5.25% NaOCl and 17% EDTA. Six simulated lateral canals (3 pairs) were prepared at 3, 5, and 7 mm from the apex in each root, using #10 modified C-file. CBCT images were obtained, and lateral canal volumes were calculated using MIMICS software. The samples were divided into three groups: CWC (n = 10), CLC (n = 10), and SC (n = 10). All groups were obturated with BCHiF and gutta-percha. Another CBCT image was taken post-obturation, and 3D lateral canal obturation volume percentages were calculated using MIMICS software. Data were analyzed using SPSS software with One-way ANOVA and Sidak tests (α = 0.05). RESULTS Significant differences were observed in the 3D lateral canal obturation volume percentage at all three levels (P < 0.05). Both CWC and CLC techniques demonstrated higher 3D lateral canal obturation volume percentages (x ¯ = 89.64% andx ¯ = 73.28%; respectively) compared to the SC group)x ¯ = 43.10%). CONCLUSION BCHiF combined with the CWC technique has a higher ability to achieve preferable 3D obturation volume in the simulated lateral canal at 3, 5, and 7 mm. CLINICAL RELEVANCE In cases requiring endodontic treatment with lateral canals, the CWC obturation technique using BCHiF with gutta-percha may offer better outcomes compared to other obturation techniques.
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Affiliation(s)
- Wahid Juha
- Department of Endodontics, Aleppo University, Aleppo, Syria
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Song Y, Rong M, Ye Y, Zhang H, Chu H, Yang Y, Wang Y, Gan Z. Pathogenic factors of maxillary sinus mucosal thickening observed by cone-beam computed tomography (CBCT). Appl Radiat Isot 2024; 208:111241. [PMID: 38503200 DOI: 10.1016/j.apradiso.2024.111241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 12/19/2023] [Accepted: 02/15/2024] [Indexed: 03/21/2024]
Abstract
OBJECTIVE To explore the pathogenic factors associated with maxillary sinus mucosal thickening with Cone-beam computed Tomography (CBCT). METHODS From 2016 through 2020, 93 patients with periapical periodontitis or periodontitis in the maxillary posterior dental region were selected. RESULTS The preoperative thickness of the periodontitis group was significantly higher than that of the periapical periodontitis group (P < 0.05). The difference achieves statistical significance for the comparison of the thickness change with various severity of inflammation (F = 54.824, P = 0.000), the change with time (F = 312.741, P = 0.000). and the change with the interaction severity of inflammation and time(F = 86.132, P = 0.000). CONCLUSIONS Patients with maxillary sinus mucosa thickening caused by periodontitis and periapical periodontitis should be extracted their infectious teeth and get thoroughly debridement. Maxillary sinus augmentation can perform favorable efforts 3-6 months after extracting teeth.
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Affiliation(s)
- Yingying Song
- Department of Pediatric Stomatology, Stomatological Hospital, Southern Medical University, Guangzhou, 510280, Guangdong, People's Republic of China
| | - Mingdeng Rong
- Department of Periodontics and Implantology, Stomatological Hospital, Southern Medical University, Guangzhou, 510280, Guangdong, People's Republic of China
| | - Yingxin Ye
- Department of Stomatology, Binhaiwan Central Hospital of Dongguan, Dongguan, 523000, Guangdong, People's Republic of China
| | - Hanfei Zhang
- Department of Stomatology, Binhaiwan Central Hospital of Dongguan, Dongguan, 523000, Guangdong, People's Republic of China
| | - Hongxing Chu
- Department of Periodontics and Implantology, Stomatological Hospital, Southern Medical University, Guangzhou, 510280, Guangdong, People's Republic of China
| | - Yong Yang
- Department of Periodontics and Implantology, Stomatological Hospital, Southern Medical University, Guangzhou, 510280, Guangdong, People's Republic of China
| | - Yarong Wang
- Department of Periodontics and Implantology, Stomatological Hospital, Southern Medical University, Guangzhou, 510280, Guangdong, People's Republic of China
| | - Zekun Gan
- Department of Periodontics and Implantology, Stomatological Hospital, Southern Medical University, Guangzhou, 510280, Guangdong, People's Republic of China.
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Sedani S, Kriplani S, Thakare A, Patel A. The Hidden World Within: Microbial Dynamics in Root Canal Systems. Cureus 2024; 16:e60577. [PMID: 38894761 PMCID: PMC11184535 DOI: 10.7759/cureus.60577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 05/18/2024] [Indexed: 06/21/2024] Open
Abstract
Several hundred different microbial taxa have made the oral cavity their home because of their evolution in multiple species communities within the special ecosystem. On the other hand, the dental pulp or internal tissue of the tooth is a connective tissue that is physiologically sterile and where any microbial infiltration is a harmful indication. It causes the pulp tissue to become inflamed, which leads to the death of the pulp and diffuses infection with inflammation to the peri-radicular tissues. Comprehending the biology of biofilms, the microbial makeup, and the host's reaction to infections in the pathobiology of root canal infections has received a lot of attention throughout the last few decades. Such comprehensive knowledge is required to design preventive medicines as well as clinically effective treatment regimens. Surprisingly, clinical approaches have concentrated more on radiographically perfecting channel preparation than on debridement of these intricate root canal systems, despite the clear realization that root canal infections are biofilm mediated. Since the present comprehension of the microbial etiopathogenesis of apical periodontitis highlights the significance of focusing on procedures such as "canal cleaning" and chemo-mechanical disinfection, the exclusive purpose of endodontic therapy is mainly missed while discussing "canal shaping." We thoroughly examine the state of our knowledge of the composition and functional traits of the root canal microbiome in this review. We also go into the difficulties with root canal disinfection and the cutting-edge approaches that try to solve these difficulties. In conclusion, we present essential guidance for prospective research areas, underscoring their significance as crucial considerations in the field of frontiers in oral health.
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Affiliation(s)
- Shweta Sedani
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Simran Kriplani
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Akash Thakare
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Aditya Patel
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Korsós SA, Staszyk C, Boone M, Josipovic I, Vogelsberg J, Vlaminck L. Micro-CT and histological examination of accessory canals in 34 equine cheek teeth. Front Vet Sci 2024; 11:1396871. [PMID: 38659446 PMCID: PMC11039908 DOI: 10.3389/fvets.2024.1396871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 03/27/2024] [Indexed: 04/26/2024] Open
Abstract
Accessory canals and apical deltas have been extensively studied in human dentistry. Their clinical role as a difficult to clean reservoir for bacteria during endodontic treatments has been well described. Many papers describe in detail the pulp anatomy of equine dentition but little attention has been given to their apical ramifications. The goal of this paper is to describe the presence and anatomy of these accessory canals and apical deltas in healthy equine cheek teeth and discuss their possible relevance in the light of equine endodontics. To accomplish this, 15 maxillary and 19 mandibular healthy cheek teeth were collected ranging from Triadan 06 s to 11 s with eruption ages from 4 to 9 years. Their root anatomy was documented in detail based on micro computed tomography images. A subset of 3 teeth also underwent histological examination. Accessory canals were found in all but two teeth examined. Up to 44 accessory canals per tooth have been found with locations ranging from the root furcation down to the apex of the root and with highly variable diameters. Apical deltas in different stages of development were found in 84% of the roots. The presence of accessory canals identified on microCT images could be confirmed using histological examination although some of them were obliterated by reparative dentin. Accessory canals can be found in most equine cheek teeth and add complexity to their endodontic anatomy. This could have important implications for their treatment in case of pulp pathology. In humans, failure to remove bacterial biofilm from such canals has been associated with failure of endodontic treatment. Research on diseased equine teeth is required to gain a better understanding of their clinical relevance in horses.
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Affiliation(s)
- Szabolcs A. Korsós
- Department of Large Animal Surgery, Anaesthesia and Orthopaedics, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
| | - Carsten Staszyk
- Institute of Veterinary-Anatomy,-Histology and -Embryology, Faculty of Veterinary Medicine, Justus-Liebig-University Giessen, Giessen, Germany
| | - Matthieu Boone
- Department of Physics and Astronomy – Radiation Physics, Faculty of Science, Radiation Physics Research Group – Centre for X-ray Tomography of the UGent, Ghent University, Ghent, Belgium
| | - Iván Josipovic
- Department of Physics and Astronomy – Radiation Physics, Faculty of Science, Radiation Physics Research Group – Centre for X-ray Tomography of the UGent, Ghent University, Ghent, Belgium
| | - Jörg Vogelsberg
- Institute of Veterinary-Anatomy,-Histology and -Embryology, Faculty of Veterinary Medicine, Justus-Liebig-University Giessen, Giessen, Germany
| | - Lieven Vlaminck
- Department of Large Animal Surgery, Anaesthesia and Orthopaedics, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
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Monteiro TM, Cortes-Cid VO, Marceliano-Alves MFV, Campello AF, Bastos LF, Lopes RT, Siqueira JF, Alves FRF. Intracanal removal and apical extrusion of filling material after retreatment using rotary or reciprocating instruments: A new approach using human cadavers. Int Endod J 2024; 57:100-107. [PMID: 37886883 DOI: 10.1111/iej.13990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 10/10/2023] [Accepted: 10/12/2023] [Indexed: 10/28/2023]
Abstract
AIM This study compared intracanal removal of filling as well as the frequency and volume of extruded material after retreatment with either HyFlex or Reciproc instruments in mandibular teeth from cadavers. METHODOLOGY The root canals of 14 pairs of contralateral single-rooted teeth in mandibles of cadavers were instrumented with Reciproc R40 and filled using lateral compaction. The mandibles were scanned in a micro-computed tomographic (micro-CT) device before and after retreatment procedures. The contralateral teeth were assigned to two groups (n = 14) according to the retreatment protocol using either HyFlex or Reciproc instrument systems. In the HyFlex group, the HyFlex Remover instrument was worked 3 mm short of the working length (WL), followed by HyFlex CM 40.04 and 50.04 at the WL. In the Reciproc group, the R50 instrument was worked up at the coronal two thirds, followed by two more cycles until the WL was reached. Pre- and post-operative micro-CT images were analysed for extrusion and intracanal removal of filling material. RESULTS After retreatment, extrusion of filling material occurred in 11 (78%) and 14 (100%) teeth from HyFlex and Reciproc groups respectively (p > .05). A similar volume of extruded material was observed after retreatment with both systems (p > .05). A significant decrease in the intracanal filling volume was verified after retreatment with both tested systems (p < .05). However, residual filling material was found in all root canals, regardless of the system. The amount of filling material removed (HyFlex = 80.8%; Reciproc = 65.9%) and the operation time was similar between systems (p > .05). CONCLUSIONS A high frequency of filling material extrusion was observed after retreatment with the two systems in a cadaver model, with no significant difference between them. Both protocols obtained similar efficacy in filling material removal procedures, although none completely cleaned the canals.
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Affiliation(s)
- Thamyres M Monteiro
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Duque de Caxias, Brazil
| | - Victor O Cortes-Cid
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Duque de Caxias, Brazil
| | | | - Andrea F Campello
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Duque de Caxias, Brazil
- Department of Endodontics, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, Brazil
| | - Luan F Bastos
- Department of Nuclear Energy, Rio de Janeiro Federal University, Rio de Janeiro, Brazil
| | - Ricardo T Lopes
- Department of Nuclear Energy, Rio de Janeiro Federal University, Rio de Janeiro, Brazil
| | - José F Siqueira
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Duque de Caxias, Brazil
- Department of Endodontics, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, Brazil
| | - Flávio R F Alves
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Duque de Caxias, Brazil
- Department of Endodontics, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, Brazil
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Comparative effects of SWEEPS technique and antimicrobial photodynamic therapy by using curcumin and nano-curcumin on Enterococcus faecalis biofilm in root canal treatment. Photodiagnosis Photodyn Ther 2022; 40:103130. [PMID: 36162755 DOI: 10.1016/j.pdpdt.2022.103130] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 09/13/2022] [Accepted: 09/19/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVES This study aimed to compare the antimicrobial effects of the shock wave enhanced emission photoacoustic streaming (SWEEPS) technique and Antimicrobial photodynamic therapy (aPDT) with curcumin and nano-curcumin photosensitizers on Enterococcus faecalis (E. faecalis) biofilm in root canals of extracted teeth. MATERIALS AND METHODS This experimental study was conducted on extracted single-rooted human teeth. The teeth were decoronated at the cementoenamel junction, the root canals were instrumented with BioRace system, and their apices were sealed. Smear layer was removed, and the teeth were autoclave-sterilized. E. faecalis strains were cultured in sterile brain heart infusion (BHI) and a bacterial suspension with 0.5 McFarland standard concentration was prepared. The root canals were inoculated with the bacterial suspension and incubated at 37 °C for 4 weeks. The teeth were then divided into 12 groups (curcumin, nano-curcumin, curcumin + LED, nano-curcumin + LED, curcumin + SWEEPS, nano-curcumin + SWEEPS, curcumin + LED + SWEEPS, nano-curcumin + LED + SWEEPS, SWEEPS, positive control and negative control). The number of colony forming units (CFUs) was counted and analyzed by one-way ANOVA and Tukey's test. RESULTS A significant difference was noted in colony count among the groups (P<0.001). LED alone had the lowest and nano-curcumin + LED + SWEEPS had the highest root canal cleaning efficacy. SWEEPS along with curcumin, nano-curcumin, and LED significantly decreased the bacterial count compared with other groups (P<0.05). CONCLUSION Application of the SWEEPS technique with curcumin and nano-curcumin as photosensitizer activated by LED in aPDT improved the reduction of E. faecalis in root canals.
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Siqueira JF, Rôças IN. Present status and future directions - microbiology of endodontic infections. Int Endod J 2021; 55 Suppl 3:512-530. [PMID: 34958494 DOI: 10.1111/iej.13677] [Citation(s) in RCA: 85] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 12/22/2021] [Accepted: 12/26/2021] [Indexed: 11/29/2022]
Abstract
Apical periodontitis has a microbial aetiology and is one of the most common inflammatory diseases that affect humans. Fungi, archaea and viruses have been found in association with apical periodontitis, but bacteria are by far the most prevalent and dominant microorganisms in endodontic infections. Bacterial infection of the root canal system only occurs when the pulp is necrotic or was removed for previous treatment. In some specific cases, including acute and chronic abscesses, the bacterial infection may reach the periradicular tissues. Intracanal bacteria are usually observed as sessile multispecies communities (biofilms) attached to the dentinal root canal walls. Infection in the main root canal lumen can spread to other areas of the root canal system. Although more than 500 bacterial species have been detected in endodontic infections, a selected group of 20 to 30 species are most frequently detected and may be considered as the core microbiome. There is a high interindividual variability in the endodontic microbiome in terms of species composition and relative abundance. Obligate anaerobic species are more abundant in the intraradicular bacterial communities of teeth with primary apical periodontitis, while both anaerobes and facultatives dominate the communities in post-treatment apical periodontitis. Bacterial interactions play an essential role in determining the overall virulence of the community, which has been regarded as the unit of pathogenicity of apical periodontitis. This article reviews the microbiologic aspects of endodontic infections and provides perspectives for future research and directions in the field.
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Affiliation(s)
- José F Siqueira
- Department of Dental Research, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, RJ, and Department of Endodontics and Molecular Microbiology Laboratory, Faculty of Dentistry, Grande Rio University, Rio de Janeiro, RJ, Brazil
| | - Isabela N Rôças
- Department of Dental Research, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, RJ, and Department of Endodontics and Molecular Microbiology Laboratory, Faculty of Dentistry, Grande Rio University, Rio de Janeiro, RJ, Brazil
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Martins JNR, Silva EJNL, Marques D, Belladonna FG, Simões-Carvalho M, da Costa RP, Ginjeira A, Braz Fernandes FM, Versiani MA. Comparison of five rotary systems regarding design, metallurgy, mechanical performance, and canal preparation-a multimethod research. Clin Oral Investig 2021; 26:3299-3310. [PMID: 34860307 DOI: 10.1007/s00784-021-04311-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 11/20/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVES To compare the design, metallurgy, mechanical performance, and canal preparation of 5 rotary systems. MATERIAL AND METHODS A total of 735 25-mm NiTi instruments (sizes 0.17[0.18]/.02v, 0.20/.04v, 0.20/.07v, 0.25/.08v, 0.30/.09v) from ProTaper Gold, ProTaper Universal, Premium Taper Gold, Go-Taper Flex, and U-File systems were compared regarding overall geometry and surface finishing (stereomicroscopy and scanning electron microscopy), nickel and titanium ratio (energy-dispersive spectroscopy), phase transformation temperatures (differential scanning calorimetry), mechanical performance (torsional and bending tests), and unprepared canal surface (micro-CT). One-way ANOVA and Mood's median tests were used for statistical comparisons with a significance level set at 5%. RESULTS Stereomicroscopic analysis showed more spirals and high helical angles in the Premium Taper Gold system. All sets of instruments had symmetrical spirals, no radial lands, no major defects, and an almost equiatomic ratio between nickel and titanium elements, while differences were observed in their tips' geometry and surface finishing. At room temperature (20 °C), DSC test revealed martensitic characteristics for ProTaper Gold and Go-Taper Flex, and mixed austenite plus R-phase for the Premium Taper Gold, while ProTaper Universal and U-Files had full austenitic characteristics. Overall, larger instruments had higher torque resistance and bending load values than smaller ones, while a lack of consistency and mixed values were observed in the angle of rotation. The 0.25/.08v and 0.30/.09v instruments of ProTaper Universal and U-File had the highest maximum torques, the lowest angles of rotation, and the highest bending loads than other tested systems (P < .05). No significant difference was noted regarding the untouched root canal walls after preparation with the tested systems (P > .05). CONCLUSIONS Although differences observed in the overall geometry and phase transformation temperatures have influenced the results of mechanical tests, unprepared canal surface areas were equivalent among systems. CLINICAL RELEVANCE Root canal preparation systems with similar geometries might present different mechanical behaviors but equivalent shaping ability.
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Affiliation(s)
- Jorge N R Martins
- Faculdade de Medicina Dentária, Universidade de Lisboa, Cidade Universitária, 1649-003, Lisbon, Portugal.
- Grupo de Investigação Em Bioquimica E Biologia Oral, Faculdade de Medicina Dentária, Unidade de Investigação Em Ciências Orais E Biomédicas (UICOB), Universidade de Lisboa, Lisbon, Portugal.
- Centro de Estudo de Medicina Dentária Baseada Na Evidência (CEMDBE) - Cochrane Portugal, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal.
| | - Emmanuel João Nogueira Leal Silva
- Department of Endodontics, School of Dentistry, Grande Rio University (UNIGRANRIO), Rio de Janeiro, Rio de Janeiro, Brazil
- Department of Endodontics, Fluminense Federal University, Niteroi, Rio de Janeiro, Brazil
| | - Duarte Marques
- Faculdade de Medicina Dentária, Universidade de Lisboa, Cidade Universitária, 1649-003, Lisbon, Portugal
- Grupo de Investigação Em Bioquimica E Biologia Oral, Faculdade de Medicina Dentária, Unidade de Investigação Em Ciências Orais E Biomédicas (UICOB), Universidade de Lisboa, Lisbon, Portugal
- Centro de Estudo de Medicina Dentária Baseada Na Evidência (CEMDBE) - Cochrane Portugal, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal
- LIBPhys-FCT UID/FIS/04559/2013, Lisbon, Portugal
| | | | - Marco Simões-Carvalho
- Department of Endodontics, Fluminense Federal University, Niteroi, Rio de Janeiro, Brazil
| | - Rui Pereira da Costa
- Faculdade de Medicina Dentária, Universidade de Lisboa, Cidade Universitária, 1649-003, Lisbon, Portugal
| | - António Ginjeira
- Faculdade de Medicina Dentária, Universidade de Lisboa, Cidade Universitária, 1649-003, Lisbon, Portugal
- Grupo de Investigação Em Bioquimica E Biologia Oral, Faculdade de Medicina Dentária, Unidade de Investigação Em Ciências Orais E Biomédicas (UICOB), Universidade de Lisboa, Lisbon, Portugal
| | - Francisco Manuel Braz Fernandes
- CENIMAT/I3N, Department of Materials Science, NOVA School of Science and Technology, Universidade NOVA de Lisboa, Caparica, Portugal
| | - Marco Aurélio Versiani
- Dental Specialty Center, Brazilian Military Police, Belo Horizonte, Minas Gerais, Brazil
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Zeng C, Everett J, Sidow S, Bergeron BE, Tian F, Ma J, Tay FR. In vitro evaluation of efficacy of two endodontic sonic-powered irrigant agitation systems in killing single-species intracanal biofilms. J Dent 2021; 115:103859. [PMID: 34706267 DOI: 10.1016/j.jdent.2021.103859] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 10/15/2021] [Accepted: 10/18/2021] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE To evaluate the efficacy of two sonic-powered irrigation systems, EDDY and EndoActivator, in killing intracanal biofilms. METHODS Eighty-three instrumented, autoclaved single-rooted human premolars were inoculated with Enterococcus faecalis (ATCC-29212) for 21 days to generate mature, single-species biofilms. The teeth were devided into four groups: irrigation with saline (N = 11); irrigation with 2% NaOCl without agitation (N = 24); irrigation with 2% NaOCl with agitation by the EndoActivaor (N = 24); irrigation with 2% NaOCl with agitation by the EDDY (N = 24). Colony-forming unit (CFU) counts and XTT assay were used to evaluate bacterial load. Additional teeth were split into root-halves for fluorescence staining to examine the percentages of live/dead bacteria in the dentinal tubules present in different canal locations (coronal, mid-root and apical portions). RESULTS Agitation of 2% NaOCl by EDDY or EndoActivator reduced bacteria load more proficiently than the use of 2%NaOCl without agitation (p < 0.05). No significant difference was detected between the two sonic-powered irrigant agitation systems (p > 0.05). Confocal laser scanning microscopy indicated that both devices had better intratubular bacteria killing efficacy than the use of 2% NaOCl only in all parts of the canal space (p < 0.05), with no significant difference detected between EDDY and EndoActivator (p > 0.05). Elimination of intracanal and intratubular bacteria were less efficient in the apical portion of the canal space for all experimental groups. CONCLUSION The two sonic-powered irrigant activation systems demonstrated comparable intracanal bacteria reduction efficacy when 2% NaOCl was used for disinfecting E. faecalis biofilms in single-rooted teeth. CLINICAL SIGNIFICANCE With the use of 2% NaOCl as irrigant, the EDDY and EndoActivator sonic-powered irrigant agitation systems have improved and equivalent intracanal bacteria reduction efficacy but are incapable of completely killing all bacteria that resided within the dentinal tubules of root canals.
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Affiliation(s)
- Chang Zeng
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Joseph Everett
- The Dental College of Georgia, Augusta University, Augusta, GA, USA
| | - Stephanie Sidow
- The Dental College of Georgia, Augusta University, Augusta, GA, USA
| | - Brian E Bergeron
- The Dental College of Georgia, Augusta University, Augusta, GA, USA
| | - Fucong Tian
- The Dental College of Georgia, Augusta University, Augusta, GA, USA
| | - Jingzhi Ma
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Franklin R Tay
- The Dental College of Georgia, Augusta University, Augusta, GA, USA.
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Kalyoncuoğlu E, Keskin C, Keleş A, Aydemir H. Metallurgical characterisation and torsional resistance of blue thermomechanically treated nickel titanium instruments after simulated ex vivo retreatment procedure. AUST ENDOD J 2021; 48:121-130. [PMID: 34670014 DOI: 10.1111/aej.12584] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 09/06/2021] [Accepted: 10/06/2021] [Indexed: 12/29/2022]
Abstract
To compare used and unused Reciproc Blue and Reciproc after retreatment, the instruments were used in the mesiobuccal canals of maxillary molars with curvature. The torsional resistances were tested and then unused instruments were subjected to XRD, DSC and microhardness tests. Student's t, ANOVA and Tukey's tests were performed (α-level 0.05). The torsional strength of used Reciproc Blue was not significantly different than unused ones (P > .05), while torsional strength of Reciproc decreased significantly (P < .05). DSC and XRD indicated that Reciproc Blue exhibited prominent transformation peaks corresponding austenite to R-phase. Microhardness of Reciproc was significantly higher (P < .05). A second reuse of Reciproc Blue for retreatment could be considered safe in terms of torsional strength. Blue treatment also decreased surface microhardness of the instrument and changed phase composition by increasing the R-phase.
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Affiliation(s)
- Elif Kalyoncuoğlu
- Department of Endodontics, Faculty of Dentistry, Ondokuz Mayıs University, Samsun, Turkey
| | - Cangül Keskin
- Department of Endodontics, Faculty of Dentistry, Ondokuz Mayıs University, Samsun, Turkey
| | - Ali Keleş
- Department of Endodontics, Faculty of Dentistry, Ondokuz Mayıs University, Samsun, Turkey
| | - Hikmet Aydemir
- Department of Endodontics, Faculty of Dentistry, Ondokuz Mayıs University, Samsun, Turkey
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Valencia YM, Vertuan GC, Alcalde MP, Vivan RR, Reis Só MV, Duarte MAH. Effect of Irrigating Agitation after Root End Preparation on the Wall Cleaning and Bond Strength of Calcium Silicate Material in Retrograde Obturation. Eur J Dent 2021; 15:707-713. [PMID: 34303319 PMCID: PMC8630967 DOI: 10.1055/s-0041-1729454] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Objective
This study aimed to evaluate the cleaning efficacy of irrigant activation with a new ultrasonic tip in root-end preparations and to determine its influence on the bond strength of calcium silicate-based material.
Materials and Methods
Maxillary canines were prepared and filled, and their root ends resected. Root-end cavities were ultrasonically prepared and randomly distributed into four groups according to the final irrigation protocols: G1 (ultrasonic irrigation [UI] + saline solution [SS]), G2 (syringe irrigation [SI] + SS), G3 (UI + ethylenediaminetetraacetic acid [EDTA]), and G4 (SI + EDTA). Cleaning efficacy analysis employed 72 specimens (
n
= 18) split longitudinally for imaging of the same areas by scanning electron microscopy (SEM). The percentage of dentinal tubules opened before and after irrigation was used as evaluation parameter. Push-out testing employed 40 specimens (
n
= 10) sectioned apical region perpendicularly, which slice was placed on a testing machine for the bond strength measurement and failure mode was assessed by SEM. The data were statistically analyzed (α ≤ 0.05).
Results
G3 (UI + EDTA) removed the smear layer more effectively, showed the best tubule opening (
p
< 0.05), and presented the highest mean bond strength values (
p
< 0.05). Failure modes were predominantly adhesive, except for the G3 (UI + EDTA) group, in which they were mainly mixed (80%).
Conclusion
The results of this study suggest that EDTA 17% agitation promoted better cleaning and smear layer removal, improving the push-out bond strength of calcium silicate material in retrograde obturation.
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Affiliation(s)
- Yahir Muñoz Valencia
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Gislene Cristina Vertuan
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Murilo Priori Alcalde
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Rodrigo Ricci Vivan
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Marcus Vinícius Reis Só
- Department of Dentistry, University Federal of the Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Marco Antonio Hungaro Duarte
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
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12
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Cusicanqui Méndez DA, Cardenas Cuéllar MR, Feliz Pedrinha V, Velásquez Espedilla EG, Bombarda de Andrade F, Rodrigues PDA, Cruvinel T. Effects of curcumin-mediated antimicrobial photodynamic therapy associated to different chelators against Enterococcus faecalis biofilms. Photodiagnosis Photodyn Ther 2021; 35:102464. [PMID: 34320428 DOI: 10.1016/j.pdpdt.2021.102464] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 07/18/2021] [Accepted: 07/22/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND The aim of this study was to evaluate curcumin-mediated antimicrobial photodynamic therapy (aPDT) action combined or not with ethylenediaminetetraacetic acid (EDTA) and hydroxyethylidene bisphosphonate (HEBP) on Enterococcus faecalis biofilms. METHODS Enterococcus faecalis biofilms were grown on dentin bovine discs in brain heart infusion (BHI) medium with 1% glucose, in aerobic conditions at 37°C for 7 days. Then, they were randomly distributed to one of experimental conditions, as follows: control, 75 J.cm-2 LED, 600 μmol.L-1 curcumin, 17% EDTA, 18% HEBP, 600 μmol.L-1 curcumin plus 75 J.cm-2 LED, 600 μmol.L-1 curcumin plus 17% EDTA, 600 μmol.L-1 curcumin plus 18% HEBP, 600 μmol.L-1 curcumin plus 17% EDTA and 75 J.cm-2 LED or 600 μmol.L-1 curcumin plus 18% HEBP and 75 J.cm-2 LED. The viability of microorganisms and the vitality of biofilms were determined by colony forming unit counts and confocal scanning laser microscopy (CSLM), respectively. Statistical analysis was conducted by Kruskal Wallis and Dunn's post-hoc tests (α = 0.05). RESULTS The results showed that all combinations of aPDT with chelators significantly reduced the viability of microbial cells and the vitality of biofilms in comparison to control, even when considering deeper layers of biofilms. CONCLUSION The combination of curcumin with EDTA and HEBP similarly improved the effect of aPDT on E. faecalis biofilms.
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Affiliation(s)
| | - Maricel Rosario Cardenas Cuéllar
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, SP, Brazil
| | - Victor Feliz Pedrinha
- Laboratory of Dental Materials, Graduate Program in Dentistry, School of Dentistry, Federal University of Pará, Pará, Brazil
| | | | - Flaviana Bombarda de Andrade
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, SP, Brazil
| | - Patrícia de Almeida Rodrigues
- Laboratory of Dental Materials, Graduate Program in Dentistry, School of Dentistry, Federal University of Pará, Pará, Brazil
| | - Thiago Cruvinel
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, SP, Brazil.
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13
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Korona-Glowniak I, Piatek D, Fornal E, Lukowiak A, Gerasymchuk Y, Kedziora A, Bugla-Płoskonska G, Grywalska E, Bachanek T, Malm A. Patterns of Oral Microbiota in Patients with Apical Periodontitis. J Clin Med 2021; 10:jcm10122707. [PMID: 34205290 PMCID: PMC8234888 DOI: 10.3390/jcm10122707] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 06/15/2021] [Accepted: 06/17/2021] [Indexed: 11/23/2022] Open
Abstract
In this study, microbial diversity of the root canal microbiota related to different endodontic infections was investigated. In total, 45 patients with endo–perio lesions (8 patients), chronic periapical periodontitis (29 patients) and pulp necrosis (8 patients) were recruited. In 19 (42.2%) patients there was secondary infection of root canals. Microbial specimens were collected from root canals of non-vital teeth with or without changes in periapical area visible in X-ray. Then, oral microbiota were detected and identified using the culture method and real-time PCR amplification primers and hydrolysis-probe detection with the 16S rRNA gene as the target. Overall, 1434 species/genes from 41 different genera of 90 various microbial species were retrieved. Of the major reported phyla, Firmicutes (62.9%), Actinobacteria (14.0%), Bacteroidetes (12.1%), Proteobacteria (9.1%) and Fusobacteria (4.2%) were detected. Of the bacterial species, 54.6% were strict anaerobes. Corynebacterium matruchotii (p = 0.039) was present significantly more frequently in chronic periapical periodontitis. Moreover, the higher values of Decayed, Missing and Filled Permanent Teeth index were positively correlated with relative abundance of Actinomyces spp. (p = 0.042), Lactobacillus spp. (p = 0.006), Propionibacterium spp. (p = 0.024) and Rothia spp. (p = 0.002). The multivariate analyses revealed differences in total root canal samples, where components that affected grouping of root samples into four main categories were identified. Anaerobic Gram-negative bacteria predominated in root canals of teeth with pulp necrosis and periapical lesions. Facultative anaerobic Gram-positive bacteria predominated in canals with secondary infections. All detected members of mixed population groups that might serve as keystone species contributed to the entire community in its clinical relevance.
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Affiliation(s)
- Izabela Korona-Glowniak
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, Medical University of Lublin, 20-093 Lublin, Poland;
- Correspondence: ; Tel.: +48-814487105
| | - Dominika Piatek
- Department of Conservative Dentistry with Endodontics, Faculty of Medical Dentistry, Medical University of Lublin, 20-093 Lublin, Poland; (D.P.); (T.B.)
| | - Emilia Fornal
- Department of Pathophysiology, Faculty of Medicine, Medical University of Lublin, 20-090 Lublin, Poland;
| | - Anna Lukowiak
- Institute of Low Temperature and Structure Research, Polish Academy of Science, 50-422 Wroclaw, Poland; (A.L.); (Y.G.)
| | - Yuriy Gerasymchuk
- Institute of Low Temperature and Structure Research, Polish Academy of Science, 50-422 Wroclaw, Poland; (A.L.); (Y.G.)
| | - Anna Kedziora
- Department of Microbiology, Faculty of Biological Sciences, University of Wroclaw, 51-148 Wroclaw, Poland; (A.K.); (G.B.-P.)
| | - Gabriela Bugla-Płoskonska
- Department of Microbiology, Faculty of Biological Sciences, University of Wroclaw, 51-148 Wroclaw, Poland; (A.K.); (G.B.-P.)
| | - Ewelina Grywalska
- Department of Clinical Immunology, Faculty of Medicine, Medical University of Lublin, 20-093 Lublin, Poland;
| | - Teresa Bachanek
- Department of Conservative Dentistry with Endodontics, Faculty of Medical Dentistry, Medical University of Lublin, 20-093 Lublin, Poland; (D.P.); (T.B.)
| | - Anna Malm
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, Medical University of Lublin, 20-093 Lublin, Poland;
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14
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Ekici Ö, Aslantaş K, Kanık Ö, Keles A. Temperature and time variations during apical resection. Acta Odontol Scand 2021; 79:156-160. [PMID: 33245674 DOI: 10.1080/00016357.2020.1850855] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The aim of this study was to investigate temperature and time variations during root-end resection. MATERIAL AND METHODS Sixty human premolars were selected. The root canals were enlarged up to ProTaper X3 rotary instrument. A thermocouple was placed into the root canal 1 mm behind the resection line. The teeth were randomly divided into six groups according to the apical resection method: steel bur, tungsten carbide bur, Lindeman bur, diamond bur, laser and ultrasonic surgical piezo with a diamond tip. The root ends were resected 3 mm away from the root apex. The temperature of the root dentine during resection was recorded as maximum temperature, mean temperature and temperature change. The time required for apicectomy was recorded for each group. The Kruskal-Wallis method was used to analyse the differences between temperature changes during apical resections. The significance level was set at 5%. RESULTS There was no significant difference between bur groups in terms of temperature increase. The maximum temperature in piezo surgery was significantly higher than the Lindeman, tungsten and steel burs (p < .001). In addition, the maximum temperature in laser surgery was higher than the Lindeman bur (p < .05). An increase in the temperature was mostly seen in piezo surgery and the least temperature change occurred in the Lindeman bur. Mean time stayed under 1 min in each group. CONCLUSIONS Although piezo caused the highest temperature increase, the measured temperature increase was within physiological limits in all tested techniques.
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Affiliation(s)
- Ömer Ekici
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Kubilay Aslantaş
- Department of Mechanical Engineering, Faculty of Technology, Afyon Kocatepe University, Afyonkarahisar, Turkey
| | - Özgür Kanık
- Department of Restorative Dentistry, Faculty of Dentistry, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Ali Keles
- Department of Endodontics, Faculty of Dentistry, Ondokuz Mayıs University, Samsun, Turkey
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15
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Paula-Silva FWG, Arnez MFM, de Campos Chaves Lamarque G, Petille R, Ribeiro-Santos FR, de Sena MF, Nelson-Filho P, da Silva LAB. Osteoclast formation, inflammation, and matrix metalloproteinase-9 are downregulated in bone repair following root canal treatment in dogs teeth. Clin Oral Investig 2021; 25:4699-4707. [PMID: 33449195 DOI: 10.1007/s00784-021-03784-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 01/06/2021] [Indexed: 01/26/2023]
Abstract
OBJECTIVES The aim of this study was to investigate the inflammatory infiltrate, osteoclast formation, and expression of MMP-9 during the healing phase following root canal treatment in teeth with apical periodontitis. MATERIALS AND METHODS Apical periodontitis was induced in dogs teeth, and root canal treatment was performed in a single visit or using calcium hydroxide as intracanal medication. One hundred and eighty days following treatment the presence of inflammation was examined, and the tissues were stained to detect osteoclasts by means of a tartrate resistant alkaline phosphatase (TRAP) assay. Synthesis of MMP-9 was detected using Western blotting and immunohistochemistry. RESULTS Teeth with apical periodontitis that had root canal therapy performed in a single visit presented a higher synthesis of MMP-9 compared with root canal treatment using calcium hydroxide. Treatment with calcium hydroxide resulted in a reduced amount of inflammatory cells and MMP-9 positive cells. Osteoclast formation, the number of MMP-9 positive osteoclasts and cementocytes, was reduced following root canal treatment, regardless of the root canal treatment protocol used. CONCLUSION Root canal treatment reduced the amount of inflammatory cells and osteoclasts in periapical area. The use of calcium hydroxide as intracanal medication resulted in a lower synthesis of MMP-9, though the number of osteoclasts and MMP-9 positive osteoclasts were similar between the groups. CLINICAL RELEVANCE Periapical bone repair following root canal treatment is impacted by therapy performed either in single visit or using calcium hydroxide dressing measured by inflammatory cell recruitment, osteoclast formation, and MMP-9 synthesis.
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Affiliation(s)
| | - Maya Fernanda Manfrin Arnez
- Department of Pediatric Clinics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | | | - Renato Petille
- Department of Pediatric Clinics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Fernanda Regina Ribeiro-Santos
- Department of Pediatric Clinics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
- Universidade de Pernambuco, Arco Verde, PE, Brazil
| | - Marina Fernandes de Sena
- Department of Pediatric Clinics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Paulo Nelson-Filho
- Department of Pediatric Clinics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Léa Assed Bezerra da Silva
- Department of Pediatric Clinics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
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16
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Smoking and Radiolucent Periapical Lesions in Root Filled Teeth: Systematic Review and Meta-Analysis. J Clin Med 2020; 9:jcm9113506. [PMID: 33138302 PMCID: PMC7692336 DOI: 10.3390/jcm9113506] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/22/2020] [Accepted: 10/27/2020] [Indexed: 12/23/2022] Open
Abstract
Aim: This systematic review and meta-analysis aimed to investigate the association between smoking habits and the prevalence of radiolucent periapical lesions (RPLs) in root-filled teeth (RFT). Methods: The Population, Intervention, Comparison, and Outcome (PICO) question was: in adult patients who have RFT, does the absence or presence of a smoking habit affect the prevalence of RPLs associated with RFT? Systematic MEDLINE/PubMed, Wiley Online Database, Web of Science, Scopus, and PRISMA protocol were used to evaluate and present the results. Studies comparing smokers with control non-smoker subjects, including RFT, and providing data on the prevalence of RFT with RPLs, were included. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system was used for certainty in the evidence. The risk of bias was assessed according to Cochrane Collaboration common scheme for bias and ROBINS-I tool. Cumulative meta-analysis was performed with a random effects model. PROSPERO registration code: CRD42020165279. Results: Four studies reported data on inclusion criteria, representing data from 9257 root-filled teeth—4465 from non-smokers and 4792 from smoker patients. The meta-analysis provided an odds ratio indicating a significant association between smoking and higher prevalence of root filled teeth with radiolucent periapical lesions (OR = 1.16; 95% CI = 1.07–1.26; p = 0.0004). The certainty of the literature assessment was moderate per GRADE. The ROBINS-I tool classified three studies as low risk of bias, and the fourth as moderate risk of bias. Conclusions: Moderate, quality scientific evidence indicates a weak but significant relationship between smoking and the prevalence of RPLs in RFT. Smoking can be considered a negative prognostic factor for the outcome of root canal treatment. Endodontic providers should be aware of the relationship between smoking and persistent apical periodontitis, assessed as RPLs, in RFT.
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17
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Al-Sakati H, Kowollik S, Gabris S, Balasiu A, Ommerborn M, Pfeffer K, Henrich B, Raab WHM. The benefit of culture-independent methods to detect bacteria and fungi in re-infected root filled teeth: a pilot study. Int Endod J 2020; 54:74-84. [PMID: 32894604 DOI: 10.1111/iej.13404] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Accepted: 09/01/2020] [Indexed: 10/23/2022]
Abstract
AIM To identify dominant microorganisms in root filled teeth with apical periodontitis by Pan-PCRs in comparison with a culture-dependent approach, focusing on fungal species profiling. METHODOLOGY The root filling material (gutta-percha) removed from 42 teeth with periapical radiolucencies undergoing root canal retreatments was analysed by molecular genetics techniques. Real-Time Pan-PCRs were conducted for the diagnosis of predominant bacteria (targeting 16S rDNA) and fungi (targeting ITS1-2 region). Identification of microorganisms was performed by Sanger sequencing of the PCR products and BLAST analysis. Additionally, subgingival plaque samples were collected and cultured to review the composition of the microbial flora. The McNemar test and the repeated measures anova were used for statistical analyses (significance level was set at P < 0.05). RESULTS Overall, 42/42 plaque samples had bacterial growth, whereas 32/42 gutta-percha samples had bacterial growth with a dominance of Streptococcus spp. (12/42) and Enterococcus faecalis (9/42). The mean number of bacterial taxa per gutta-percha sample was 1.6 cultivatable taxa, significantly lower than in the plaque sample that had six taxa/sample (P < 0.001). Fungus-specific cultures were negative for gutta-percha samples, and only one plaque sample had growth of a fungus. In total, 36/42 plaque samples were positive in bacterial Pan-PCRs. In bacterial Pan-PCRs of 31/42 gutta-percha samples, dominant microorganisms were identified including Streptococcus spp. (5/42) and E. faecalis (4/42). Moreover, in 7/42 gutta-percha samples, DNA of bacteria which are difficult-to-cultivate in microbiology routine culture (Acinetobacter,Pyramidobacter,Bacteroidetes,Synergistes,Atopobium and Pseudoramibacter) was found. DNA of Candida spp. was detected in 5/42 root canals by fungal Pan-PCR (1/5) and genus-specific Candida-PCR (5/5). CONCLUSIONS Pan-PCR assays remain appropriate as a broad-range approach for the detection of a dominant pathogen in gutta-percha samples which have less diverse microbial composition. The molecular genetic Pan-PCR approach has the advantage of detecting microorganisms that are as-yet-uncultivable or difficult-to-cultivate and should be therefore complement conventional microbiological diagnostics.
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Affiliation(s)
- H Al-Sakati
- Department of Conservative and Preventive Dentistry, Periodontology and Endodontology, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany.,Institute of Medical Microbiology and Hospital Hygiene, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany
| | - S Kowollik
- Department of Conservative and Preventive Dentistry, Periodontology and Endodontology, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany
| | - S Gabris
- Department of Conservative and Preventive Dentistry, Periodontology and Endodontology, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany
| | - A Balasiu
- Institute of Medical Microbiology and Hospital Hygiene, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany
| | - M Ommerborn
- Department of Conservative and Preventive Dentistry, Periodontology and Endodontology, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany
| | - K Pfeffer
- Institute of Medical Microbiology and Hospital Hygiene, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany
| | - B Henrich
- Institute of Medical Microbiology and Hospital Hygiene, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany
| | - W H-M Raab
- Department of Conservative and Preventive Dentistry, Periodontology and Endodontology, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany
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18
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Cigarette Smoking and Root Filled Teeth Extraction: Systematic Review and Meta-Analysis. J Clin Med 2020; 9:jcm9103179. [PMID: 33008023 PMCID: PMC7601225 DOI: 10.3390/jcm9103179] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 09/28/2020] [Accepted: 09/29/2020] [Indexed: 12/22/2022] Open
Abstract
Aim: The aim of this systematic review and meta-analysis was to investigate the possible association between smoking habits and the occurrence of root-filled teeth (RFT) extraction. Material and Methods: The Population, Intervention, Comparison, and Outcome (PICO) question was in adult patients who had RFT, does the absence or presence of smoking habits affect the prevalence of extracted RFT? Systematic MEDLINE/PubMed, Wiley Online Database, Web of Science, and PRISMA protocol was used to evaluate and present the results. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system was used for certainty in the evidence. The risk of bias was assessed according to Cochrane Collaboration common scheme for bias and ROBINS-I tool. Cumulative meta-analysis was performed with a random effects model. PROSPERO registration code: CRD42020165279. Results: After search strategy, 571 articles were recovered, seven were selected for full-text analysis, and two reported data on inclusion criteria, including 516 RFT, 351 in non-smokers, and 165 in smoker subjects. The meta-analysis provided an odds ratio indicating significant association between smoking and the prevalence of extracted RFT (OR = 3.43, 95% CI = 1.17–10.05, p = 0.02, I² = 64%). The certainty of the literature assessment was low per GRADE. Both studies were considered as moderate risk of bias. Conclusions: Tobacco smoking should be considered a negative prognostic factor for the outcome of root canal treatment, although the quality of the evidence is low. RFT of smoking patients are three times more likely to be extracted. Continuing to smoke after endodontic treatment may increase the risk of treatment failure. However, the overall strength of evidence is low. This must be considered a limitation of the present study and the conclusion should be valued with caution.
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19
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The Apical Root Canal System of Teeth with Posttreatment Apical Periodontitis: Correlating Microbiologic, Tomographic, and Histopathologic Findings. J Endod 2020; 46:1195-1203. [DOI: 10.1016/j.joen.2020.05.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 05/28/2020] [Accepted: 05/28/2020] [Indexed: 01/20/2023]
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20
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Karamifar K, Tondari A, Saghiri MA. Endodontic Periapical Lesion: An Overview on the Etiology, Diagnosis and Current Treatment Modalities. Eur Endod J 2020; 5:54-67. [PMID: 32766513 PMCID: PMC7398993 DOI: 10.14744/eej.2020.42714] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 07/09/2020] [Indexed: 12/16/2022] Open
Abstract
Nonsurgical and surgical endodontic treatments have a high success rate in the treatment and prevention of apical periodontitis when carried out according to standard and accepted clinical principles. Nevertheless, endodontic periapical lesions remain in some cases, and further treatment should be considered when apical periodontitis persists. Although several treatment modalities have been proposed for endodontically treated teeth with persistent apical periodontitis, there is a need for less invasive methods with more predictable outcomes. The advantages and shortcomings of existing approaches for the diagnosis and treatment of endodontic periradicular lesions are discussed in this review.
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Affiliation(s)
- Kasra Karamifar
- From the Department of Restorative Dentistry, Rutgers School of Dental Medicine, New Jersey, USA
| | - Afsoon Tondari
- Department of Restorative Dentistry, Dental Branch, Shiraz Azad University, Shiraz, Iran
| | - Mohammad Ali Saghiri
- From the Department of Restorative Dentistry, Rutgers School of Dental Medicine, New Jersey, USA
- Department of Endodontics, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, USA
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21
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Ionescu A, Harris D, Selvaganapathy PR, Kishen A. Electrokinetic transport and distribution of antibacterial nanoparticles for endodontic disinfection. Int Endod J 2020; 53:1120-1130. [PMID: 32383495 DOI: 10.1111/iej.13321] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 04/30/2020] [Accepted: 05/01/2020] [Indexed: 12/14/2022]
Abstract
AIM To assess a novel, noninvasive intervention capable of mobilizing charged antibacterial nanoparticles to the apical portions of the root canal system, utilizing the principles of electrokinetics. METHODS Experiments were conducted in three stages. Stage-1: A computer model was generated to predict and visualize the electric field and current density distribution generated by the proposed intervention. Stage-2: Transport of chitosan nanoparticles (CSnp) was evaluated qualitatively using a transparent microfluidic model with fluorescent-labelled CSnp. Stage-3: An ex vivo model was utilized to study the antimicrobial efficacy of the proposed treatment against 3-week-old monospecies E. faecalis biofilms. Scanning electron microscopy (SEM) was also utilized in this stage to confirm the deposition of CSnp. RESULTS The results of the computer simulations predicted an electric field and current density that reach their maxima at the apical constriction of the root canal. Correspondingly, the microfluidic experiments demonstrated rapid, controlled CSnp transport throughout the simulated root canal anatomy with subsequent distribution and deposition in the apical constriction as well as periapical regions. Infected root canals when subjected to the novel treatment method resulted in a mean bacterial reduction of 2.1 log CFU. SEM analysis revealed electrophoretic deposition of chitosan nanoparticles onto the root canal dentine walls in the apical region. CONCLUSION The findings from this study demonstrate that the combination of cationic antibacterial nanoparticles with a low-intensity electric field results in particle transportation (electrophoresis) and deposition within the root canal. This results in a synergistic antibiofilm efficacy and has the potential to enhance root canal disinfection.
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Affiliation(s)
- A Ionescu
- Faculty of Dentistry, Dental Research Institute, University of Toronto, Toronto, ON, Canada
| | - D Harris
- Faculty of Dentistry, Dental Research Institute, University of Toronto, Toronto, ON, Canada
| | - P R Selvaganapathy
- Department of Mechanical Engineering, McMaster University, Hamilton, ON, Canada
| | - A Kishen
- Faculty of Dentistry, Dental Research Institute, University of Toronto, Toronto, ON, Canada
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22
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Mazzi-Chaves JF, Silva-Sousa YTC, Leoni GB, Silva-Sousa AC, Estrela L, Estrela C, Jacobs R, Sousa-Neto MDD. Micro-computed tomographic assessment of the variability and morphological features of root canal system and their ramifications. J Appl Oral Sci 2020; 28:e20190393. [PMID: 32049137 PMCID: PMC6999120 DOI: 10.1590/1678-7757-2019-0393] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 10/23/2019] [Indexed: 11/22/2022] Open
Abstract
Objectives This study assessed the incidence and variability features of root canals system (RCS) and their ramifications according to Pucci & Reig (PR) (1944) and the American Association of Endodontists (AAE) (2017) by micro-computed tomography (μCT). Methodology 500 representative extracted human teeth of each tooth group (n=50) (maxillary/mandibular central and lateral incisors, canines, first and second premolars and molars) were scanned by μCT with a resolution of 26.70 μm. The reconstructed cross-sections images and the visualization of the continuous slices in the transversal axis were performed using DataViewer software. RCS were classified according to Pucci & Reig (main canal, collateral canal, lateral canal, secondary canal, accessory canal, intercanal, recurrent canal) and AAE (main canal, accessory canal, lateral canal). The apical deltas were assessed for both classifications. The prevalence of apical deltas was evaluated using the Chi-squared test (p<0.05). Results According to PR, a higher incidence of lateral canals was observed in maxillary canines (10%), central incisors (8%) and first premolars (6%). Using AAE, the highest incidence of lateral canals was observed in the mandibular first premolars (85%), first and second molars (84%), lateral incisors (67%), canines (59%), and in maxillary first premolars (52%). Regarding accessory canals, the PR showed a frequency in 2% of the maxillary lateral incisors and maxillary and mandibular first premolars and 3% of mandibular first and second molars. On the other hand, the AAE showed the highest incidence of accessory canals in 86% of the maxillary first premolars, 71% in mandibular lateral incisors, 69% in mandibular first premolars, 65% in mandibular canines, and 56% in maxillary canines. The PR showed the lowest incidence of apical deltas for all dental groups when compared with AAE (p=0.004). Interestingly, distal canals in maxillary molars showed a significant discrepancy between classifications (p=0.027). Conclusions μCT enabled accurately describing the RC system and related ramifications, adding to the PR and AAE classifications, with some discrepancies reported for maxillary molars. Clinical Relevance This μCT study enabled a thorough description of the variability among root canals and their ramifications, including clinically relevant details on the presence and location of lateral canals and accessories in all human tooth groups, beyond the currently existing classification systems.
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Affiliation(s)
- Jardel Francisco Mazzi-Chaves
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Odontologia Restauradora, Ribeirão Preto, São Paulo, Brasil.,University of Leuven, Faculty of Medicine, Departament of Imaging and Pathology, OMFS IMPATH Research Group, Leuven, Belgium
| | | | - Graziela Bianchi Leoni
- Universidade de Ribeirão Preto, Faculdade de Odontologia, Ribeirão Preto, São Paulo, Brasil
| | | | - Lucas Estrela
- Universidade Federal de Goiás, Faculdade de Odontologia, Goiânia, Goiás, Brasil
| | - Carlos Estrela
- Universidade Federal de Goiás, Faculdade de Odontologia, Goiânia, Goiás, Brasil
| | - Reinhilde Jacobs
- University of Leuven, Faculty of Medicine, Departament of Imaging and Pathology, OMFS IMPATH Research Group, Leuven, Belgium
| | - Manoel Damião de Sousa-Neto
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Odontologia Restauradora, Ribeirão Preto, São Paulo, Brasil
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Manoil D, Al‐Manei K, Belibasakis GN. A Systematic Review of the Root Canal Microbiota Associated with Apical Periodontitis: Lessons from Next‐Generation Sequencing. Proteomics Clin Appl 2020; 14:e1900060. [DOI: 10.1002/prca.201900060] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 11/14/2019] [Indexed: 12/13/2022]
Affiliation(s)
- Daniel Manoil
- Division of Oral DiseasesDepartment of Dental MedicineKarolinska Institute Huddinge 14152 Sweden
| | - Khaled Al‐Manei
- Division of Oral DiseasesDepartment of Dental MedicineKarolinska Institute Huddinge 14152 Sweden
- Division of EndodonticsDepartment of Restorative Dental ScienceCollege of DentistryKing Saud University Riyadh 11545 Saudi Arabia
| | - Georgios N. Belibasakis
- Division of Oral DiseasesDepartment of Dental MedicineKarolinska Institute Huddinge 14152 Sweden
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A novel antibacterial resin-based root canal sealer modified by Dimethylaminododecyl Methacrylate. Sci Rep 2019; 9:10632. [PMID: 31337813 PMCID: PMC6650501 DOI: 10.1038/s41598-019-47032-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 07/09/2019] [Indexed: 02/05/2023] Open
Abstract
Persistent apical periodontitis, mainly caused by microorganisms infections, represents a critical challenge for endodontists. Dimethylaminododecyl methacrylate (DMADDM) is a well-studied and potent antibacterial agent used in various studies described in the literature. The aim of this study is to develop a novel antibacterial root canal sealer by incorporating DMADDM into EndoREZ and investigate the properties of the resulting material. Different mass fractions (0, 1.25%, 2.5%, and 5%) of DMADDM were incorporated into EndoREZ and the cytotoxicity, apical sealing ability and solubility of the resulting material were evaluated. Furthermore, a direct contact test, determination of colony-forming units, a crystal violet assay, scanning electronic microscopy and live/dead bacteria staining were performed to evaluate the antibacterial effect of the sealer to multispecies bacteria (Enterococcus faecalis, Streptococcus gordonii, Actinomyces naeslundii, and Lactobacillus acidophilus), in planktonic cells or biofilms. Fluorescence in situ hybridization and quantitative real-time polymerase chain reaction were carried out to assess the composition of the multispecies biofilms. No difference on the cytotoxicity, apical sealing ability and solubility between sealers containing DMADDM (1.25%, 2.5%) and EndoREZ (0%) could be determined. However, when the mass fraction of DMADDM increased to 5%, significantly different properties were found compared to the 0% (p < 0.05) group. Moreover, incorporating DMADDM into the sealer could greatly improve the antibacterial properties of EndoREZ. In addition, the composition ratio of E. faecalis could be decreased in multispecies microecology in sealers containing DMADDM. Therefore, a EndoREZ sealer material containing DMADDM could be considered useful in clinical applications for preventing and treating persistent apical periodontitis.
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Meto A, Colombari B, Sala A, Pericolini E, Meto A, Peppoloni S, Blasi E. Antimicrobial and antibiofilm efficacy of a copper/calcium hydroxide-based endodontic paste against Staphylococcus aureus, Pseudomonas aeruginosa and Candida albicans. Dent Mater J 2019; 38:591-603. [PMID: 31257304 DOI: 10.4012/dmj.2018-252] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Endodontic biofilm is a microbial community, enclosed in a polymeric matrix of polysaccharide origin where are found pathogens, like bacteria and opportunistic fungi responsible for various endodontic pathologies. As clinical importance is the fact, that biofilm is extremely resistant to common intracanal irrigants, antimicrobial drugs and host immune responses. The aim of this study was to evaluate the in vitro efficacy of a Cu/CaOH2-based endodontic paste, against bacteria and fungi, such as Staphylococcus aureus, Pseudomonas aeruginosa and Candida albicans. We found that such compound significantly reduced microbial replication time and cell growth. Moreover, biofilm formation and persistence were also affected; treated biofilms showed both a reduced number of cells and levels of released pyoverdine. This study provides the first evidence on effectiveness of this endodontic compound against microbial biofilms. Given its wide range of action, its use in prevention and treatment of the main oral biofilm-associated infections will be discussed.
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Affiliation(s)
- Aida Meto
- School of Doctorate in Clinical and Experimental Medicine, University of Modena and Reggio Emilia
| | - Bruna Colombari
- Department of Surgical, Medical, Dental and Morphological Sciences with interest in Transplant, Oncological and Regenerative Medicine; University of Modena and Reggio Emilia
| | - Arianna Sala
- Department of Surgical, Medical, Dental and Morphological Sciences with interest in Transplant, Oncological and Regenerative Medicine; University of Modena and Reggio Emilia
| | - Eva Pericolini
- Department of Surgical, Medical, Dental and Morphological Sciences with interest in Transplant, Oncological and Regenerative Medicine; University of Modena and Reggio Emilia
| | - Agron Meto
- Department of Therapy, Faculty of Dental Medicine, Aldent University
| | - Samuele Peppoloni
- Department of Surgical, Medical, Dental and Morphological Sciences with interest in Transplant, Oncological and Regenerative Medicine; University of Modena and Reggio Emilia
| | - Elisabetta Blasi
- Department of Surgical, Medical, Dental and Morphological Sciences with interest in Transplant, Oncological and Regenerative Medicine; University of Modena and Reggio Emilia.,School of Specialization in Microbiology and Virology, University of Modena and Reggio Emilia
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Reciproc and Reciproc Blue in the removal of bioceramic and resin-based sealers in retreatment procedures. Clin Oral Investig 2019; 24:405-416. [DOI: 10.1007/s00784-019-02956-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 05/07/2019] [Indexed: 12/12/2022]
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Toubes KM, Tonelli SQ, Oliveira BJD, Duarte G, Nunes E, Silveira FF. Apical periodontitis associated with a calculus-like deposit: A case report of a rare fan-shaped manifestation. Ann Med Surg (Lond) 2019; 41:1-5. [PMID: 30962929 PMCID: PMC6434093 DOI: 10.1016/j.amsu.2019.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 03/04/2019] [Accepted: 03/05/2019] [Indexed: 11/05/2022] Open
Abstract
Introduction Bacterial biofilms can be calcified. Granulomas or cystic lesions are the most commonly found entities in endodontics. Surprisingly, this case report presents a rare radiopaque image, in a fan shape, of a calculus-like deposit in the periapical region of the maxillary left central incisor. Case presentation A 34-year-old male, with a history of trauma, presented with apical periodontitis associated with an uncommon image, similar to a calculus-like deposit adhered to the apical region of the maxillary left central incisor. Nonsurgical endodontic intervention was performed, followed by apicoectomy and histopathological analysis of the collected material. The results of the biopsy were not compatible with a cyst or granuloma but showed fibrous connective tissue with calcified areas. Discussion Correct diagnosis in endodontics is possible with a well-conducted anamnesis, complementary imaging exams and, in some cases, histopathological analysis. The periapical calculus-like deposit, associated with a periapical radiolucent lesion, was a result of the body's fight for healing, producing unusual radiopacity. Conclusion The presence of the calculus-like deposit in a fan shape at the root surface represented dystrophic calcification as a manifestation of the attempt to heal. In the present case, apicoectomy and tissue biopsy for histological evaluation were fundamental for the correct diagnosis. Root canal is critical area for biofilm development. Extraradicular biofilm on the surface of the root may cause persistent periapical lesions. Uncommon radiopaque image association with endodontic periapical lesions was related. Persistent periapical lesions associate with extraradicular biofilm represents a challenge for Endodontic treatment. Only surgical resection was capable to repair the injury.
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Nascimento EHL, Abrahão Elias MR, Vasconcelos VHF, Haiter-Neto F, Mendonça EF, Sousa TO. Ex Vivo Detection of Apical Delta in Premolars: A Comparative Study Using Periapical Radiography, Cone-beam Computed Tomography, and Micro-computed Tomography. J Endod 2019; 45:549-553. [PMID: 30954279 DOI: 10.1016/j.joen.2019.02.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Revised: 02/13/2019] [Accepted: 02/18/2019] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Imaging methods are essential for the correct identification of root canal anatomy, which is a key factor for successful endodontic therapy. This study aimed to evaluate the performance of periapical radiography (PR) and cone-beam computed tomographic (CBCT) imaging in identifying the apical delta (AD) using micro-computed tomographic imaging as the gold standard. METHODS PR and CBCT images of 110 human premolars (120 root canals) were obtained using the VistaScan digital intraoral system (Durr Dental, Beitigheim-Bissinger, Germany) and the 3D Accuitomo CBCT unit (J Morita, Kyoto, Japan), respectively. Two oral radiologists assessed the PR and CBCT images for the presence of ADs using a 5-point scale. Additionally, in the CBCT images, the number of apical foramina was also evaluated. The gold standard was established by means of micro-computed tomographic imaging. The diagnostic values related to PR and CBCT imaging were compared using the McNemar test. The detection of the number of foramina was compared using the paired t test (α ≤ 0.05). RESULTS ADs were present in 40 root canals (33.3%). Both PR and CBCT images differed significantly from the gold standard (P < .05) in the detection of ADs. CBCT imaging showed higher values than PR for all diagnostic tests (P < .05). Despite the moderate accuracy of PR (0.62) and CBCT imaging (0.73), these methods presented very low sensitivity values (0.07 and 0.35 for PR and CBCT, respectively). CBCT imaging had a tendency of underestimating the number of foramina (P < .05). CONCLUSIONS CBCT imaging showed better performance than PR in the detection of ADs; both imaging modalities underestimate its presence when compared with the gold standard. In general, the number of apical foramina cannot be reliably assessed using CBCT imaging.
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Affiliation(s)
| | - Marcela Ramos Abrahão Elias
- Department of Stomatology (Oral Diagnosis), Faculty of Dentistry, Federal University of Goias, Goiânia, Goiás, Brazil
| | | | - Francisco Haiter-Neto
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Sáo Paulo, Brazil
| | - Elismauro Francisco Mendonça
- Department of Stomatology (Oral Diagnosis), Faculty of Dentistry, Federal University of Goias, Goiânia, Goiás, Brazil
| | - Thiago Oliveira Sousa
- Department of Stomatology (Oral Diagnosis), Faculty of Dentistry, Federal University of Goias, Goiânia, Goiás, Brazil.
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Cho YS, Jung IY. Complete Healing of a Large Cystic Lesion Following Root Canal Treatment with Concurrent Surgical Drainage: A Case Report with 14-Year Follow-Up. J Endod 2019; 45:343-348. [DOI: 10.1016/j.joen.2018.12.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 12/04/2018] [Accepted: 12/06/2018] [Indexed: 12/20/2022]
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30
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Alfouzan K, Alfadley A, Alkadi L, Alhezam A, Jamleh A. Detecting the Second Mesiobuccal Canal in Maxillary Molars in a Saudi Arabian Population: A Micro-CT Study. SCANNING 2019; 2019:9568307. [PMID: 31001371 PMCID: PMC6436332 DOI: 10.1155/2019/9568307] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 02/20/2019] [Indexed: 05/09/2023]
Abstract
The aim of this study was to determine MB2 canal detectability in maxillary first and second molars obtained from a Saudi population using micro-CT. Maxillary first (n = 35) and second (n = 30) molars were scanned with micro-CT technology. The number of canals was recorded, and in case of having more than one canal, the level of extracanal detection was analyzed. The presence of extracanal was categorized based on the level they were first detected. Among the maxillary first molars, 28 (80%) and six (17%) teeth had two and three MB canals, respectively. Among the maxillary second molars, 24 (80%) and four (13%) teeth had two and three MB canals, respectively. The MB2 canal was detected at the chamber floor in 70% and 61% of the maxillary first and second molars, respectively. At 1 mm depth, the MB2 canal was found in 15% and 18% of the maxillary first and second molars, respectively. At 2 mm depth, the MB2 canal was found in 3% and 18% of the maxillary first and second molars, respectively. The remaining teeth had the MB2 canal at levels deeper than 2 mm. The MB2 canal was detected in 97% and 93%% of maxillary first and second molars, respectively. Among them, the MB2 canal could be immediately detected in 70% and 61% of the maxillary first and second molars, respectively, once the pulp chamber is exposed. However, the rest of the MB2 were observed at deeper levels in the root and this requires troughing preparation in the chamber floor.
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Affiliation(s)
- Khalid Alfouzan
- Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, National Guard Health Affairs, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Centre, National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Abdulmohsen Alfadley
- Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, National Guard Health Affairs, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Centre, National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Lubna Alkadi
- Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, National Guard Health Affairs, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Centre, National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Abdullah Alhezam
- Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, National Guard Health Affairs, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Centre, National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Ahmed Jamleh
- Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, National Guard Health Affairs, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Centre, National Guard Health Affairs, Riyadh, Saudi Arabia
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31
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Costa FFNP, Pacheco-Yanes J, Siqueira JF, Oliveira ACS, Gazzaneo I, Amorim CA, Santos PHB, Alves FRF. Association between missed canals and apical periodontitis. Int Endod J 2018; 52:400-406. [DOI: 10.1111/iej.13022] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 09/30/2018] [Indexed: 12/28/2022]
Affiliation(s)
- F. F. N. P. Costa
- Faculty of Dentistry; Department of Endodontics; Estácio de Sá University; Rio de Janeiro Brazil
| | - J. Pacheco-Yanes
- Faculty of Dentistry; Department of Endodontics; Estácio de Sá University; Rio de Janeiro Brazil
| | - J. F. Siqueira
- Faculty of Dentistry; Department of Endodontics; Estácio de Sá University; Rio de Janeiro Brazil
| | - A. C. S. Oliveira
- Faculty of Dentistry; Department of Endodontics; Estácio de Sá University; Rio de Janeiro Brazil
| | - I. Gazzaneo
- Faculty of Dentistry; Department of Endodontics; Estácio de Sá University; Rio de Janeiro Brazil
| | - C. A. Amorim
- Faculty of Dentistry; Department of Endodontics; Estácio de Sá University; Rio de Janeiro Brazil
| | | | - F. R. F. Alves
- Faculty of Dentistry; Department of Endodontics; Estácio de Sá University; Rio de Janeiro Brazil
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32
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Siqueira Junior JF, Rôças IDN, Marceliano-Alves MF, Pérez AR, Ricucci D. Unprepared root canal surface areas: causes, clinical implications, and therapeutic strategies. Braz Oral Res 2018; 32:e65. [PMID: 30365606 DOI: 10.1590/1807-3107bor-2018.vol32.0065] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 06/06/2018] [Indexed: 11/21/2022] Open
Abstract
Chemomechanical preparation is intended to clean, disinfect, and shape the root canal. This step is of utmost importance during treatment of infected teeth with apical periodontitis, because treatment outcome depends on how effectively the clinician eliminates bacteria, their products, and necrotic tissue that would serve as substrate for bacterial regrowth. Nonetheless, curvatures and complex internal anatomical variations of the root canal system can pose a high degree of difficulty in reaching these goals. In infected teeth, bacteria may persist not only in difficult-to-reach areas such as isthmuses, ramifications, dentinal tubules, and recesses from C-shaped or oval/flattened canals, but also in areas of the main canal wall that remain untouched by instruments. If bacteria withstand chemomechanical procedures, there is an augmented risk for post-treatment apical periodontitis. This article discloses the reasons why some areas remain unprepared by instruments and discusses strategies to circumvent this issue and enhance infection control during endodontic treatment/retreatment of teeth with apical periodontitis.
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Affiliation(s)
| | - Isabela das Neves Rôças
- Universidade Estácio de Sá, Faculty of Dentistry, Department of Endodontics, Rio de Janeiro, RJ, Brazil
| | | | - Alejandro Ron Pérez
- Universidade Estácio de Sá, Faculty of Dentistry, Department of Endodontics, Rio de Janeiro, RJ, Brazil
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Zhang N, Huang H, Su B, Ma X, Li Y. A human behavior integrated hierarchical model of airborne disease transmission in a large city. BUILDING AND ENVIRONMENT 2018; 127:211-220. [PMID: 32287976 PMCID: PMC7115769 DOI: 10.1016/j.buildenv.2017.11.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 10/06/2017] [Accepted: 11/06/2017] [Indexed: 05/19/2023]
Abstract
Epidemics of infectious diseases such as SARS, H1N1, and MERS threaten public health, particularly in large cities such as Hong Kong. We constructed a human behavior integrated hierarchical (HiHi) model based on the SIR (Susceptible, Infectious, and Recovered) model, the Wells-Riley equation, and population movement considering both spatial and temporal dimensions. The model considers more than 7 million people, 3 million indoor environments, and 2566 public transport routes in Hong Kong. Smallpox, which could be spread through airborne routes, is studied as an example. The simulation is based on people's daily commutes and indoor human behaviors, which were summarized by mathematical patterns. We found that 59.6%, 18.1%, and 13.4% of patients become infected in their homes, offices, and schools, respectively. If both work stoppage and school closure measures are taken when the number of infected people is greater than 1000, an infectious disease will be effectively controlled after 2 months. The peak number of infected people will be reduced by 25% compared to taking no action, and the time of peak infections will be delayed by about 40 days if 90% of the infected people go to hospital during the infectious period. When ventilation rates in indoor environments increase to five times their default settings, smallpox will be naturally controlled. Residents of Kowloon and the north part of Hong Kong Island have a high risk of infection from airborne infectious diseases. Our HiHi model reduces the calculation time for infection rates to an acceptable level while preserving accuracy.
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Affiliation(s)
- Nan Zhang
- Department of Mechanical Engineering, The University of Hong Kong, Hong Kong SAR, China
- Institute of Public Safety Research, Department of Engineering Physics, Tsinghua University, Beijing, China
| | - Hong Huang
- Institute of Public Safety Research, Department of Engineering Physics, Tsinghua University, Beijing, China
| | - Boni Su
- Electric Power Planning & Engineering Institute, Beijing, China
| | - Xun Ma
- Institute of Public Safety Research, Department of Engineering Physics, Tsinghua University, Beijing, China
| | - Yuguo Li
- Department of Mechanical Engineering, The University of Hong Kong, Hong Kong SAR, China
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Treatment Options for Failing Regenerative Endodontic Procedures: Report of 3 Cases. J Endod 2017; 43:1472-1478. [DOI: 10.1016/j.joen.2017.04.015] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2017] [Revised: 01/29/2017] [Accepted: 04/17/2017] [Indexed: 12/18/2022]
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Abstract
Thorough knowledge of anatomical complexities of the root canal system has a direct impact on the effectiveness of canal preparation and filling, and is an essential prerequisite for successful root canal treatment. A wide range of complex variations in root canal anatomy exists, including root canal configuration type, developmental anomalies and minor canal morphology such as accessory canals and apical deltas. Accessory canals and apical deltas have been associated with pulp disease, primary canal infection, canal reinfection and post-treatment disease. The current definitions of accessory canal anatomy are not standardized and potentially confusing. Given their role in endodontic disease and their impact on treatment outcomes, there is a need to have a simple classification of their anatomy to provide an accurate description of their position and path from the canal to the external surface of the root. The purpose of this article is to introduce a new system for classifying accessory canal morphology for use in research, clinical practice and training.
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Affiliation(s)
- H M A Ahmed
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - P Neelakantan
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR
| | - P M H Dummer
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
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36
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The Use of a Novel Approach for the Instrumentation of a Cone-beam Computed Tomography–discernible Lateral Canal in an Unusual Maxillary Incisor: Case Report. J Endod 2017; 43:1023-1027. [DOI: 10.1016/j.joen.2017.01.032] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Revised: 01/25/2017] [Accepted: 01/29/2017] [Indexed: 10/19/2022]
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37
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Micro-CT evaluation of apical delta morphologies in human teeth. Sci Rep 2016; 6:36501. [PMID: 27819309 PMCID: PMC5098143 DOI: 10.1038/srep36501] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 10/17/2016] [Indexed: 11/28/2022] Open
Abstract
The apical delta is an intricate system within the root canal and incompletely debridement may affect the long-term prognosis of root canal therapy. The aim of the present study is to investigate the morphologic features of apical deltas in human teeth with micro-computed tomography (micro-CT) using a centreline-fitting algorithm. One hundred and thirty-six apical deltas were detected in 1400 teeth. Molars had more apical deltas (15.8%) than anterior teeth (6.3%). In maxillary molars, the mesiobuccal root had a significantly higher prevalence of apical delta than the palatal root or the distobuccal root. The median vertical distance of the apical delta was 1.87 mm with 13% more than 3 mm. The median diameter and length of the apical delta branches were 132.3 and 934.5 μm. Apical delta branches were not straight with cross-sectional shapes being non-circular. These morphological features of apical delta may complicate debridement of the infected root canal system.
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Siqueira JF, Antunes HS, Rôças IN, Rachid CTCC, Alves FRF. Microbiome in the Apical Root Canal System of Teeth with Post-Treatment Apical Periodontitis. PLoS One 2016; 11:e0162887. [PMID: 27689802 PMCID: PMC5045198 DOI: 10.1371/journal.pone.0162887] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Accepted: 08/30/2016] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Bacteria present in the apical root canal system are directly involved with the pathogenesis of post-treatment apical periodontitis. This study used a next-generation sequencing approach to identify the bacterial taxa occurring in cryopulverized apical root samples from root canal-treated teeth with post-treatment disease. METHODS Apical root specimens obtained during periradicular surgery of ten adequately treated teeth with persistent apical periodontitis were cryogenically ground. DNA was extracted from the powder and the microbiome was characterized on the basis of the V4 hypervariable region of the 16S rRNA gene by using paired-end sequencing on Illumina MiSeq device. RESULTS All samples were positive for the presence of bacterial DNA. Bacterial taxa were mapped to 11 phyla and 103 genera composed by 538 distinct operational taxonomic units (OTUs) at 3% of dissimilarity. Over 85% of the sequences belonged to 4 phyla: Proteobacteria, Firmicutes, Fusobacteria and Actinobacteria. In general, these 4 phyla accounted for approximately 80% of the distinct OTUs found in the apical root samples. Proteobacteria was the most abundant phylum in 6/10 samples. Fourteen genera had representatives identified in all cases. Overall, the genera Fusobacterium and Pseudomonas were the most dominant. Enterococcus was found in 4 cases, always in relatively low abundance. CONCLUSIONS This study showed a highly complex bacterial community in the apical root canal system of adequately treated teeth with persistent apical periodontitis. This suggests that this disease is characterized by multispecies bacterial communities and has a heterogeneous etiology, because the community composition largely varied from case to case.
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Affiliation(s)
- José F. Siqueira
- Molecular Microbiology Laboratory, Department of Endodontics, Faculty of Dentistry, Estácio de Sá University, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Henrique S. Antunes
- Molecular Microbiology Laboratory, Department of Endodontics, Faculty of Dentistry, Estácio de Sá University, Rio de Janeiro, Rio de Janeiro, Brazil
- Department of Endodontics, Faculty of Dentistry, Grande Rio University, Duque de Caxias, Rio de Janeiro, Brazil
| | - Isabela N. Rôças
- Molecular Microbiology Laboratory, Department of Endodontics, Faculty of Dentistry, Estácio de Sá University, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Caio T. C. C. Rachid
- Institute of Microbiology Prof. Paulo de Góes, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Flávio R. F. Alves
- Molecular Microbiology Laboratory, Department of Endodontics, Faculty of Dentistry, Estácio de Sá University, Rio de Janeiro, Rio de Janeiro, Brazil
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Kang S, Kim HC, Lee CY, Jung IY, Kim E. Scanning electron microscopic examination of resected root apices obtained from endodontic microsurgery. SCANNING 2016; 38:455-461. [PMID: 26751015 DOI: 10.1002/sca.21296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Accepted: 12/17/2015] [Indexed: 06/05/2023]
Abstract
This study was designed to examine the morphological features of the resected root apices obtained from endodontic microsurgery using a scanning electron microscope (SEM) as well as their anatomical effect on the clinical outcome of the surgical treatment. One-hundred-six resected root apices from 91 patients/surgeries were obtained by endodontic microsurgery, and fixed immediately for storage. The resected apices were prepared for SEM to examine their morphological features, such as the number and size of the apical foramina. The patients were periodically checked up at least 1 year and the clinical outcome of the microsurgery was judged as a success or failure according to the Molven's criteria. The SEM findings and the clinical outcome of apical surgery were evaluated to see any potential correlation between them. The SEM examination revealed that 60.4% of specimens had more than two portals of exit on the resected root apices and the size of the major foramen was at least 386 micrometer and 334 micrometer from maxillary and mandibular molar, respectively. With a recall rate of 72.9%, 91.9% of the surgical cases were decided to have successful outcomes. Based on this SEM study, a relatively high frequency of multiple portals of exit was existed and the sizes of major foramina were bigger than that were reported in previous reports. The clinical outcomes of endodontic microsurgery were not correlated with the anatomical features of resected apical root apices. SCANNING 38:455-461, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Sumi Kang
- Department of Conservative Dentistry, Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, Korea
| | - Hyeon-Cheol Kim
- Department of Conservative Dentistry, School of Dentistry, Dental Research Institute, Pusan National University, Yangsan, Korea
| | - Chan-Young Lee
- Department of Conservative Dentistry, Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, Korea
| | - Il-Young Jung
- Department of Conservative Dentistry, Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, Korea
| | - Euiseong Kim
- Department of Conservative Dentistry, Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, Korea.
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Machado R, Ferrari CH, Back E, Comparin D, Tomazinho LF, Vansan LP. The Impact of Apical Patency in the Success of Endodontic Treatment of Necrotic Teeth with Apical Periodontitis: A Brief Review. IRANIAN ENDODONTIC JOURNAL 2016; 11:63-6. [PMID: 26843880 PMCID: PMC4731536 DOI: 10.7508/iej.2016.01.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Revised: 08/16/2015] [Accepted: 09/01/2015] [Indexed: 11/30/2022]
Abstract
Accumulation of soft tissue or dentinal remnants in the apical region is a common event that can cause blockage of root canals. This event can be avoided if apical patency is performed during the root canal shaping procedures. However, there is no consensus on the role of apical patency in relation to the success of endodontic treatment of necrotic teeth with apical periodontitis. Therefore, the purpose of this paper was to conduct a brief review on the role of apical patency in guaranteeing the success of endodontic treatments of necrotic teeth with apical periodontitis considering two other key points; the root canal anatomy and microbiology.
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Affiliation(s)
- Ricardo Machado
- Department of Multidisciplinary Clinic I and II and Supervised Stage in Multidisciplinary Clinic I (Endodontics), Paranaense University-UNIPAR, Francisco Beltrão, Paraná, Brazil
| | - Carlos Henrique Ferrari
- São Jose dos Campos Dental School, State University of São Paulo-UNESP, São Jose dos Campos, São Paulo, Brazil
| | - Eduardo Back
- Clinical Practice, Joinvile, Santa Catarina, Brazil
| | | | - Luiz Fernando Tomazinho
- Department of Multidisciplinary Clinic I and II and Supervised Stage in Multidisciplinary Clinic II (Endodontics), Paranaense University-UNIPAR, Francisco Beltrão, Paraná, Brazil
| | - Luiz Pascoal Vansan
- Department of Endodontics, Ribeirão Preto Dental School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
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Antunes HS, Rôças IN, Alves FR, Siqueira JF. Total and Specific Bacterial Levels in the Apical Root Canal System of Teeth with Post-treatment Apical Periodontitis. J Endod 2015; 41:1037-42. [DOI: 10.1016/j.joen.2015.03.008] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Revised: 02/09/2015] [Accepted: 03/08/2015] [Indexed: 11/26/2022]
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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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Fumei G, Ferretti G, Augusti D, Augusti G, Re D. Endodontic retreatment of a lower canine associated with a periapical lesion: case report of an unusual anatomy. GIORNALE ITALIANO DI ENDODONZIA 2014. [DOI: 10.1016/j.gien.2014.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Siqueira JF, Rôças IN. Present status and future directions in endodontic microbiology. ACTA ACUST UNITED AC 2014. [DOI: 10.1111/etp.12060] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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