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Kim KH, Lévesque C, Malkhassian G, Basrani B. Efficacy of the GentleWave System in the removal of biofilm from the mesial roots of mandibular molars before and after minimal instrumentation: An ex vivo study. Int Endod J 2024; 57:922-932. [PMID: 38374488 DOI: 10.1111/iej.14044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 01/29/2024] [Indexed: 02/21/2024]
Abstract
AIM To compare the efficacy of Enterococcus faecalis biofilm removal using the GentleWave System (GWS) (Sonendo Inc, CA) on non-instrumented versus minimally instrumented root canal systems. METHODOLOGY Thirty-four mandibular molars were autoclaved and allocated to four groups: Negative control (n = 5); positive control (n = 5); Group 1: non-instrumentation + GWS (NI + GWS) (n = 12); and Group 2: minimal instrumentation + GWS (MI + GWS) (n = 12). Of 34 samples, 24 samples with Vertucci type 2 configuration within the mesial root of each sample were allocated to Groups 1 and 2 and then matched based on the working length and root canal configuration. After inoculation of samples with E. faecalis for 3 weeks, the GWS was used on Group 1 without any instrumentation and Group 2 after instrumentation of mesial canals until size 20/06v. CFU and SEM analysis were used. RESULTS Log10 (CFU/mL) from the positive control, and Group 1 and 2 were 7.41 ± 0.53, 3.41 ± 1.54, and 3.21 ± 1.54, respectively. Both groups showed a statistically significant difference in the reduction of viable E. faecalis cells compared to the positive control (Group 1 [p = .0001] and Group 2 [p < .0001]), whilst showing no significant difference between the two tested groups (p < .05). CONCLUSION The use of GWS on the non-instrumented root canal system could be an effective disinfection protocol in removing the biofilm without dentin debris formation.
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Affiliation(s)
- Kwang Ho Kim
- Endodontics, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Céline Lévesque
- Microbiology, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Gevik Malkhassian
- Endodontics, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Bettina Basrani
- Endodontics, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
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Liu SM, Peng L, Zhao YJ, Han B, Wang XY, Wang ZH. Accuracy and efficiency of dynamic navigated root-end resection in endodontic surgery: a pilot in vitro study. BMC Oral Health 2024; 24:582. [PMID: 38764019 PMCID: PMC11103819 DOI: 10.1186/s12903-024-04306-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Accepted: 04/29/2024] [Indexed: 05/21/2024] Open
Abstract
BACKGROUND The operation accuracy and efficiency of dynamic navigated endodontic surgery were evaluated through in vitro experiments. This study provides a reference for future clinical application of dynamic navigation systems in endodontic surgery. MATERIALS AND METHODS 3D-printed maxillary anterior teeth were used in the preparation of models for endodontic surgery. Endodontic surgery was performed with and without dynamic navigation by an operator who was proficient in dynamic navigation technology but had no experience in endodontic surgery. Optical scanning data were applied to evaluate the length and angle deviations of root-end resection. And the operation time was recorded. T tests were used to analyze the effect of dynamic navigation technology on the accuracy and duration of endodontic surgery. RESULTS With dynamic navigation, the root-end resection length deviation was 0.46 ± 0.06 mm, the angle deviation was 2.45 ± 0.96°, and the operation time was 187 ± 22.97 s. Without dynamic navigation, the root-end resection length deviation was 1.20 ± 0.92 mm, the angle deviation was 16.20 ± 9.59°, and the operation time was 247 ± 61.47 s. Less deviation was achieved and less operation time was spent with than without dynamic navigation (P < 0.01). CONCLUSION The application of a dynamic navigation system in endodontic surgery can improve the accuracy and efficiency significantly for operators without surgical experience and reduce the operation time.
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Affiliation(s)
- Si-Min Liu
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, PR China
- Fourth Clinical Division, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, PR China
| | - Li Peng
- Department of General Dentistry II, National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Yi-Jiao Zhao
- Center for Digital Dentistry, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, PR China
| | - Bing Han
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, PR China
| | - Xiao-Yan Wang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, PR China
| | - Zu-Hua Wang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, PR China.
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Isufi A, Hsu TY, Chogle S. Robot-Assisted and Haptic-Guided Endodontic Surgery: A Case Report. J Endod 2024; 50:533-539.e1. [PMID: 38280513 DOI: 10.1016/j.joen.2024.01.012] [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: 09/03/2023] [Revised: 12/10/2023] [Accepted: 01/15/2024] [Indexed: 01/29/2024]
Abstract
There has been a significant increase in robot-assisted dental procedures in the past decade, particularly in the area of robot-assisted implant placement. The objective of this case report was to assess the initial use of the Yomi Robot's assistance and haptic guidance during endodontic microsurgery. The robot was used during the osteotomy and root-end resection of the first and second upper left premolars. The report aims to inform clinicians of the initial implementation of this cutting-edge technology in endodontics and its potential to enhance endodontic microsurgery. The Yomi Robot was used in performing osteotomy and root-end resection during apical surgery in a patient presenting with symptomatic upper left first and second premolars. The treatment procedure was decided after clinical examination, chart data, and radiographic examinations, which showed periapical lesions on both premolars, taking into consideration the failed endodontic retreatment on the first premolar, the post and ceramic coronal restorations on both teeth, and the desire of the patient to save them. The Yomi Robot system provides auditory, visual, and physical guidance to clinicians during surgery while using a cone-beam computed tomography scan for precision planning with greater accuracy and minimized potential for human error. Further studies are needed to prepare a protocol for robotic-guided procedures in endodontics.
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Affiliation(s)
- Almira Isufi
- Department of Endodontics, Boston University Henry M. Goldman School of Dental Medicine, Boston, Massachusetts.
| | - Tun-Yi Hsu
- Department of Endodontics, Boston University Henry M. Goldman School of Dental Medicine, Boston, Massachusetts
| | - Sami Chogle
- Department of Endodontics, Boston University Henry M. Goldman School of Dental Medicine, Boston, Massachusetts
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4
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Mon A, Kim ME, Kum KY, Kwon HB. 3D finite element analysis of stress distribution on the shape of resected root-end or with/without bone graft of a maxillary premolar during endodontic microsurgery. J Dent Sci 2024; 19:837-845. [PMID: 38618133 PMCID: PMC11010716 DOI: 10.1016/j.jds.2023.08.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/29/2023] [Indexed: 04/16/2024] Open
Abstract
Background/purpose Apical root resection pattern affects the stress distribution behavior in the apical region of the resected tooth. The purpose of the study was to compare the biomechanical responses of resected teeth between endodontic microsurgery (horizontal resection) and targeted endodontic microsurgery (round resection). Materials and methods Five different models were developed. The basic model without resection (NR) was regarded as the control model, and the others involved: horizontal resection without bone grafting (HN), horizontal resection with bone grafting (HG), round resection without bone grafting (RN), and round resection with bone grafting (RG) models. A static load of 100 N was applied to the buccal and palatal cusps of all the teeth in a 30° oblique direction. The maximum von-Mises stress and tooth displacement values were analyzed and compared. Results Both the HN and RN models exhibited lower stress distribution values on bone compared with the NR (control) model. Regarding maximum stress distribution at the root apex, the stress value of the RN model was slightly higher compared to the HN model, whereas the RG model displayed a slightly lower stress value in comparison with the HG model. For maximum tooth displacement value, there were no significant differences between the HN and RN models, as well as the HG and RG models. Conclusion The round resection pattern had comparable stress distribution behaviors at the root apex and tooth displacement values with the horizontal resection pattern. Targeted endodontic microsurgery might provide better biomechanical response of the resected tooth after root-end resection.
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Affiliation(s)
- Aein Mon
- Dental Research Institute and Department of Prosthodontics, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Mi-El Kim
- Dental Research Institute and Department of Oral Anatomy, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Kee-Yeon Kum
- Dental Research Institute and Department of Conservative Dentistry, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Ho-Beom Kwon
- Dental Research Institute and Department of Prosthodontics, School of Dentistry, Seoul National University, Seoul, Republic of Korea
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Harinkhere C, Patni PM, Jain P, Raghuwanshi S, Pandey SH, Bilaiya S. Comparison of the sealing ability amongst orthograde apical plugs of mineral trioxide aggregate plus, mineral trioxide aggregate repair HP, and Biodentine after root resection: a bacterial leakage study. Odontology 2024; 112:364-371. [PMID: 37632561 DOI: 10.1007/s10266-023-00847-4] [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: 01/30/2022] [Accepted: 08/15/2023] [Indexed: 08/28/2023]
Abstract
This study aimed to analyse the effect of root-end resection on the sealing ability of orthograde apical plugs of three root-end filling materials (MTA Repair HP, Biodentine, MTA Plus) using the bacterial leakage method and compare it with the retrograde root-end filling technique. Eighty-four extracted mandibular premolar teeth with single root and single straight canals were selected and randomly divided into two main experimental groups (n = 36) depending on the apical plug placement technique and a control: Group I: orthograde technique, followed by root-end resection; Group II: retrograde root-end filling technique; one control Group III (n = 12): obturation with gutta-percha, followed by root-end resection. Experimental groups were further subdivided into three subgroups A, B, and C (n = 12) depending on the three different root-end filling materials used. An apical plug of 3 mm thickness was obtained in both the experimental groups. The apical sealing ability was evaluated with the dual-chamber bacterial leakage method. Statistical analysis was performed using the Kaplan-Meier survival analysis test. By the end of 30 days, the occurrence of turbidity indicating bacterial leakage was 75% in MTA Repair HP, 83.3% in Biodentine, and 91.7% in MTA Plus samples. This trend of turbidity was similar in both orthograde and retrograde technique. The control group showed turbidity in all the samples (100%). More MTA Repair HP samples (25%) survived the 30 days observation period with no bacterial leakage compared to Biodentine (16.7%) and MTA Plus (8.3%). The sealing ability of already set root-end filling materials placed through the orthograde technique did not deteriorate after root-end resection. Also among three root-end filling materials, MTA Repair HP presented the lowest bacterial microleakage followed by Biodentine and MTA Plus, respectively.
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Affiliation(s)
- Chhaya Harinkhere
- Department of Conservative Dentistry and Endodontics, Sri Aurobindo College of Dentistry, Indore, Madhya Pradesh, India.
| | - Pallav Mahesh Patni
- Department of Conservative Dentistry and Endodontics, Sri Aurobindo College of Dentistry, Indore, Madhya Pradesh, India
| | - Pradeep Jain
- Department of Conservative Dentistry and Endodontics, Sri Aurobindo College of Dentistry, Indore, Madhya Pradesh, India
| | - Swadhin Raghuwanshi
- Department of Conservative Dentistry and Endodontics, Sri Aurobindo College of Dentistry, Indore, Madhya Pradesh, India
| | - Sanket Hans Pandey
- Department of Conservative Dentistry and Endodontics, Sri Aurobindo College of Dentistry, Indore, Madhya Pradesh, India
| | - Sakshi Bilaiya
- Department of Conservative Dentistry and Endodontics, Sri Aurobindo College of Dentistry, Indore, Madhya Pradesh, India
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Nabeel M, Abu-Seida AM, Elgendy AA, Tawfik HM. Biocompatibility of mineral trioxide aggregate and biodentine as root-end filling materials: an in vivo study. Sci Rep 2024; 14:3568. [PMID: 38347030 PMCID: PMC10861467 DOI: 10.1038/s41598-024-53872-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 02/06/2024] [Indexed: 02/15/2024] Open
Abstract
This study evaluated the biocompatibility of mineral trioxide aggregate (MTA) and Biodentine (BD) as root-end filling materials. Six mongrel dogs were divided into two equal groups according to the evaluation period; group A: one month and group B: three months. Three premolars of the same quadrant in each arch were used, summing up 36 teeth (6 teeth/dog). These teeth were randomly subdivided into three subgroups according to the root-end filling material used: MTA, BD and no root-end filling material (control). Endodontic access cavities were performed for induction of periapical pathosis. After the infection period, root canal instrumentation and obturation were accomplished. One day after root canal procedures, root-end surgery was performed. Surgical access was achieved and the root-end was resected approximately 3 mm above the apex. Root-end cavity was prepared ultrasonically and filled with the tested materials. All samples were evaluated by radiography and histopathology (Inflammation and new hard tissue formation). Data were collected and subjected to statistical analysis. In group A, MTA subgroup exhibited significant higher mean inflammatory score than BD subgroup (P < 0.05) while no significant difference was recorded between MTA and BD subgroups in group B (P > 0.05). Regarding mean mineralization score, there was no significant difference between all subgroups in both groups A and B (P > 0.05). Biodentine exhibited favorable biocompatibility in the initial stage of healing than MTA and comparable biomineralization. Clinical relevance: Biodentine could be considered as an acceptable alternative to MTA in peri-radicular surgeries.
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Affiliation(s)
- Mohamed Nabeel
- Department of Endodontics, Faculty of Oral & Dental Medicine, Misr International University, Cairo, Egypt
| | - Ashraf M Abu-Seida
- Department of Surgery, Anesthesiology and Radiology, Faculty of Veterinary Medicine, Cairo University, Giza Squa, PO Box 12211, Giza, Egypt.
| | - Abeer A Elgendy
- Department of Endodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Hossam M Tawfik
- Department of Endodontics, Faculty of Oral & Dental Medicine, Misr International University, Cairo, Egypt
- Department of Endodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
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Bieszczad D, Wichlinski J, Kaczmarzyk T. Treatment-Related Factors Affecting the Success of Endodontic Microsurgery and the Influence of GTR on Radiographic Healing-A Cone-Beam Computed Tomography Study. J Clin Med 2023; 12:6382. [PMID: 37835026 PMCID: PMC10573613 DOI: 10.3390/jcm12196382] [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: 08/01/2023] [Revised: 09/20/2023] [Accepted: 09/27/2023] [Indexed: 10/15/2023] Open
Abstract
The primary objective of this retrospective study was to assess the correlation between treatment-related factors (resection angle, depth of retrograde filling, length of resected root and use of guided tissue regeneration-GTR) evaluated using cone-beam computed tomography (CBCT) scans and the treatment outcomes of endodontic microsurgery (EMS). The secondary purpose of this research was to evaluate the influence of the GTR technique on the radiographic healing state, taking into account the initial parameters of periapical lesions. In 161 cases, the local factors (volume of a lesion, bone destruction pattern, presence/absence of cortical bone destruction) were measured using preoperative CBCT images before undergoing EMS. At least one year after surgery, the outcome of EMS was classified as a success or a failure (based on radiographic and clinical criteria). Using postoperative CBCT, treatment-related factors (resection angle, depth of retrograde filling, and length of resected root) were measured. Additionally, the status of radiographic healing was evaluated (in accordance with modified PENN 3D criteria). Eighteen cases (11.18%) were classified as failures, and 143 were classified as successes (88.82%). Univariate analysis showed that there was no statistically significant influence of treatment-related factors on the healing outcome of EMS. An exact Fischer's test showed the significant impact of GTR on radiographic healing (P < 0.001) in apical lesions (P < 0.001), lesions with a volume between 100 mm3 and 450 mm3 (P < 0.009) and over 450 mm3 (P < 0.001), lesions with the destruction of one plate (P < 0.001), and lesions with the destruction of two plates (through and through) (P = 0.022). The use of GTR in apical lesions, lesions with volumes over 100 mm3, and lesions with the destruction of at least one plate is significantly associated with better radiographic healing.
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Affiliation(s)
- Daniel Bieszczad
- NZOZ Centrum Stomatologii s.c. Justyna Wichlinska, Jaroslaw Wichlinski, ul. 3-go Maja 16, 38-300 Gorlice, Poland; (D.B.); (J.W.)
| | - Jarosław Wichlinski
- NZOZ Centrum Stomatologii s.c. Justyna Wichlinska, Jaroslaw Wichlinski, ul. 3-go Maja 16, 38-300 Gorlice, Poland; (D.B.); (J.W.)
| | - Tomasz Kaczmarzyk
- Chair of Oral Surgery, Institute of Dentistry, Medical College, Jagiellonian University, ul. Montelupich 4, 31-155 Krakow, Poland
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Zhao D, Xie W, Li T, Wang A, Wu L, Kang W, Wang L, Guo S, Tang X, Xie S. New-designed 3D printed surgical guide promotes the accuracy of endodontic microsurgery: a study of 14 upper anterior teeth. Sci Rep 2023; 13:15512. [PMID: 37726360 PMCID: PMC10509208 DOI: 10.1038/s41598-023-42767-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 09/14/2023] [Indexed: 09/21/2023] Open
Abstract
We aimed to design a novel three-dimensional (3D) printed surgical guide and evaluate its accuracy in assisting endodontic microsurgeries. A new 3D printed surgical guide was designed by computer-aided design and computer-aided manufacturing (CAD/CAM) technology and applied to 7 patients who underwent endodontic microsurgeries of upper anterior teeth from 2020.01 to 2020.12 as the experimental group. 7 patients who suffered from endodontic microsurgeries operated by the same surgeon without using the surgical guide from 2019.01 to 2019.12 were selected as the control group. Cone beam computed tomography (CBCT) was performed more than 12 months after operation, and the accuracy of apical resection was compared between the two groups. The accuracy of the microsurgery focused on the length and angle of the root apical resection. In the study, CBCT data and oral digital scanning data were used to reconstruct 3D models of periapical lesions with soft and hard tissue information, based on which we designed the new 3D printed surgical guides. The guides were successfully applied to the apectomy in endodontic microsurgeries. The deviation of the apical resection length of the experimental group (0.467 ± 0.146 mm) was better than that of the control group (1.743 ± 0.122 mm) (P < 0.0001), and the deviation of the apical resection angle of the experimental group (9.711 ± 3.593°) was significantly less than that of the control group (22.400 ± 3.362°) (P < 0.0001). The 3D-printed surgical guide could effectively guide endodontic microsurgery and improve its accuracy by fixing both the position and the angle of apectomy. The new type of surgical guide could accurately localize the root apex and guide the apical resection.
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Affiliation(s)
- Dan Zhao
- Department of Endodontics, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210008, Jiangsu, People's Republic of China
| | - Weige Xie
- Department of Endodontics, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210008, Jiangsu, People's Republic of China
| | - Tianguo Li
- Department of Endodontics, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210008, Jiangsu, People's Republic of China
| | - Anqi Wang
- Nanjing Tongren Hospital, Nanjing, 210008, Jiangsu, People's Republic of China
| | - Li Wu
- Department of Endodontics, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210008, Jiangsu, People's Republic of China
| | - Wen Kang
- Department of Endodontics, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210008, Jiangsu, People's Republic of China
| | - Lu Wang
- Nantong Stomatological Hospital, The Affiliated Nantong Stomatological Hospital of Nantong University, Nantong, 226000, Jiangsu, People's Republic of China
| | - Shiliang Guo
- Department of Endodontics, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210008, Jiangsu, People's Republic of China
| | - Xuna Tang
- Department of Endodontics, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210008, Jiangsu, People's Republic of China
| | - Sijing Xie
- Department of Endodontics, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210008, Jiangsu, People's Republic of China.
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Javed F, Zafar K, Khan FR. Outcome of intentional replantation of endodontically treated teeth with periapical pathosis: A systematic review and meta-analysis. AUST ENDOD J 2023; 49 Suppl 1:494-507. [PMID: 36354086 DOI: 10.1111/aej.12707] [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: 12/09/2021] [Revised: 08/02/2022] [Accepted: 10/23/2022] [Indexed: 11/11/2022]
Abstract
The purpose of the present review was to examine success, survival and failure following intentional replantation of endodontically treated teeth with existing periapical pathosis and to determine the factors that might affect the outcome of replantation. Clinical trials, longitudinal studies, case series with >10 cases and at least 1-year follow-up were included. The average rate of success following intentional replantation was 77.23%. Meta-analysis revealed the mean weighted survival to be 85.9% (95% CI: 79.6-91.2) Common complications include inflammatory root resorption (0%-27%) and ankylosis (0%-25%). Variables influencing successful outcome include extra alveolar dry time <15 min; root-end resection (2-3 mm) and cavity preparation (3 mm); manipulation of the tooth using the crown only; and use of an appropriate storage media. The review concludes that intentional replantation is a viable treatment option with acceptable survival rates for endodontically treated teeth with periapical pathosis.
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Affiliation(s)
- Faizan Javed
- Operative Dentistry & Endodontics, The Aga Khan University, Karachi, Pakistan
| | - Kamil Zafar
- Endodontics, Baqai Dental College, Karachi, Pakistan
| | - Farhan R Khan
- Operative Dentistry & Endodontics, The Aga Khan University, Karachi, Pakistan
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10
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Chen C, Zhang R, Zhang W, Wang F, Wang Z, Qin L, Bian Z, Meng L. Analysis of the Accuracy of a Dynamic Navigation System in Endodontic Microsurgery: A Prospective Case Series Study: Accuracy of DNS in EMS. J Dent 2023; 134:104534. [PMID: 37149255 DOI: 10.1016/j.jdent.2023.104534] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 04/27/2023] [Accepted: 05/03/2023] [Indexed: 05/08/2023] Open
Abstract
OBJECTIVES To evaluate the accuracy of a dynamic navigation system (DNS) for guided osteotomy and root-end resection during endodontic microsurgery (EMS) and assess its prognosis. METHODS Nine patients who met inclusion criteria underwent DNS-guided EMS. Osteotomy and root-end resection were performed with assistance of DNS (DHC-ENDO1, DCARER Medical Technology, Suzhou, China). The preoperative virtually planned path and postoperative cone-beam computed tomography images were superimposed using DNS software. Accuracy was assessed based on deviations in the platform, apex, and angle of the osteotomy, as well as in the length and angle of the root-end resection. Follow-up evaluations were performed after at least a year postoperatively. RESULTS Among the nine patients (11 teeth with 12 roots), the mean platform, apex, and angular deviation of the osteotomy were 1.05 mm, 1.2 mm, and 6.24°, respectively. The mean length and angle deviation of the root-end resection were 0.46 mm and 4.9°, respectively. Significant differences were observed according to tooth position. The platform and apex deviated significantly less in the posterior than in the anterior teeth (p < .05). No significant differences were observed according to arch type, side, and depth of the surgical path (p > .05). Eight patients were evaluated after at least a year postoperatively; clinical and radiographic evaluation revealed a 90% success rate (9/10 teeth). CONCLUSIONS This study demonstrated high accuracy of DNS in EMS. Furthermore, DNS-guided EMS had a success rate similar to that of freehand EMS over a short-term follow-up. Further study with a larger sample size is necessary. CLINICAL SIGNIFICANCE The present novel DNS technology is a viable method for guided osteotomy and root-end resection in EMS. CLINICAL TRIAL REGISTRATION NUMBER ChiCTR2100042312.
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Affiliation(s)
- Chen Chen
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China;; Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Rui Zhang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China;; Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Wei Zhang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China;; Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Fushi Wang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China;; Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Zan Wang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China;; Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Li Qin
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China;; Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Zhuan Bian
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China;; Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Liuyan Meng
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China;; Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China;.
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11
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Iandolo A, Amato A, Pisano M, Sangiovanni G, Abdellatif D, Fornara R, Simeone M. Histological Evaluation of Root Canals by Performing a New Cleaning Protocol “RUA” in Endodontic Surgery. Dent J (Basel) 2023; 11:dj11030078. [PMID: 36975575 PMCID: PMC10047649 DOI: 10.3390/dj11030078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 02/11/2023] [Accepted: 03/08/2023] [Indexed: 03/12/2023] Open
Abstract
Aim: To enhance cleaning during retro-preparation in endodontic microsurgery. Materials and Methods: Forty mandibular premolars were instrumented, filled with a single cone technique, and then retro-preparation was performed and assigned to experiment A. In group A1, the cavity created by the retro preparation was cleansed with 2 mL of normal sterile saline. In group A2, the retro cavity was cleaned with 2 mL of sterile saline after the retro preparation. All the irrigation solutions mentioned above were delivered using an endodontic needle with a lateral vent and a gauge of 30. Subsequently, in group A2, 17% EDTA gel and 5.25% gel were inserted into the cavity and activated using ultrasonic tips. After the irrigation protocols, the specimens were decalcified for histological evaluation. Results: In the experiment, the amount of hard tissue debris was significantly greater in group A1 compared to group A2 (p < 0.05). Conclusions: The samples in group A2, where the new protocol was performed, showed statistically significant results.
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Affiliation(s)
- Alfredo Iandolo
- Department of Medicine and Surgery, University of Salerno, 84084 Salerno, Italy
- Correspondence: or ; Tel.: +39-3287028233
| | - Alessandra Amato
- Department of Medicine and Surgery, University of Salerno, 84084 Salerno, Italy
| | - Massimo Pisano
- Department of Medicine and Surgery, University of Salerno, 84084 Salerno, Italy
| | | | - Dina Abdellatif
- Department of Endodontics, Faculty of Dentistry, University of Alexandria, Alexandria 21526, Egypt
| | | | - Michele Simeone
- Department of Endodontics, Faculty of Dentistry, University of Naples, Federico II, 80126 Naples, Italy
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12
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Setzer FC, Kratchman SI. Present Status and Future Directions - Surgical Endodontics. Int Endod J 2022; 55 Suppl 4:1020-1058. [PMID: 35670053 DOI: 10.1111/iej.13783] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/30/2022] [Accepted: 05/31/2022] [Indexed: 11/29/2022]
Abstract
Endodontic surgery encompasses several procedures for the treatment of teeth with a history of failed root canal treatment, such as root-end surgery, crown- and root resections, surgical perforation repair, and intentional replantation. Endodontic microsurgery is the evolution of the traditional apicoectomy techniques and incorporates high magnification, ultrasonic root-end preparation and root-end filling with biocompatible filling materials. Modern endodontic surgery uses the dental operating microscope, incorporates cone-beam computed tomography (CBCT) for preoperative diagnosis and treatment planning, and has adopted piezoelectric approaches to osteotomy and root manipulation. Crown- and root resection techniques have benefitted from the same technological advances. This review focuses on the current state of root-end surgery by comparing the techniques and materials applied during endodontic microsurgery to the most widely used earlier methods and materials. The most recent additions to the clinical protocol and technical improvements are discussed, and an outlook on future directions is given. While non-surgical retreatment remains the first choice to address most cases with a history of endodontic failure, modern endodontic microsurgery has become a predictable and minimally invasive alternative for the retention of natural teeth.
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Affiliation(s)
- F C Setzer
- Department of Endodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - S I Kratchman
- Department of Endodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
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Sa A, Jb P, M B, I G, O D, Tordik PA, Fc M. REAL-TIME 3D IMAGE-GUIDED NAVIGATION SYSTEM IN ENDODONTIC MICROSURGERY - A CADAVER STUDY. J Endod 2022; 48:922-929. [PMID: 35489425 DOI: 10.1016/j.joen.2022.04.012] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 04/17/2022] [Accepted: 04/19/2022] [Indexed: 12/17/2022]
Abstract
INTRODUCTION This study evaluated the accuracy and efficiency of 3D Dynamic Navigation System (3D-DNS) to perform minimally invasive osteotomy (MIO) and root-end resection (RER) in endodontic microsurgery (EMS) and investigated the viability of root-end cavity preparation (RECP) and fill (REF) in MIO. METHODS We divided 48 tooth roots in cadaver heads into two groups: 3D-DNS (n = 24) and freehand (n = 24). Cone beam computed tomography (CBCT) scans were taken before and after surgery. First, we verified virtual 3D-DNS accuracy using three outcome measures: 2D and 3D virtual deviations and angular deflection (AD). Second, we investigated 3D-DNS's accuracy for performing MIO in two outcome measures: Osteotomy size and volume. Third, we determined the 3D-DNS accuracy for RER in three outcomes: Resected root length, root length after resection, and resection angle. We investigated the viability of RECP and REF and measured REF depth and volume, as well, recording procedural times and number of mishaps. RESULTS 2D and 3D virtual deviations and AD were lower in the 3D-DNS than FH (p<.05). Osteotomy height, length, and volume were all reduced when using 3D-DNS (p < .05). The resection angle was lower for the 3D-DNS (p<.05). RECP and REF were completed in 100% of the roots. The REF depth achieved was ∼ 3mm. Osteotomy time, RER time, and total procedure time were all significantly shortened using 3D-DNS (p < .05). CONCLUSIONS 3D-DNS enabled our surgeon to perform accurate and efficient EMS with minimally invasive osteotomy and RER. The surgeon was also able to conduct RECP with adequate REF in minimally invasive osteotomy performed using 3D-DNS guidance.
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Affiliation(s)
- Aldahmash Sa
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry Baltimore Maryland; College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Price Jb
- Clinical Professor & Director of Oral Radiology - Department of Oncology and Diagnostic Sciences, School of Dentistry, University of Maryland, Baltimore, Maryland
| | - Behzad M
- Clinical instructor - Department of Oral and Maxillofacial Surgery, University of Maryland, Baltimore, Maryland
| | - Griffin I
- Clinical Assistant Professor - Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry Baltimore Maryland
| | - Dianat O
- Clinical Instructor - Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry Baltimore Maryland
| | - P A Tordik
- Clinical Associate Professor - Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry Baltimore Maryland
| | - Martinho Fc
- Clinical Associate Professor - Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry Baltimore Maryland.
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Corsentino G, Mazzitelli C, Mazzoni A, Ambu E, Perotto C, Franciosi G, Grandini S. Sealing ability of two root-end filling materials at different retro-preparation lengths. J Oral Sci 2022; 64:80-84. [PMID: 34980823 DOI: 10.2334/josnusd.21-0309] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
PURPOSE The aim of the present study was to evaluate the sealing performance, expressed as microleakage (ML), of two root-end filling materials when used at different retro-preparation lengths. METHODS Fifty single-rooted human teeth were collected for the study. The teeth were cut at the cement-enamel junction and endodontic treatment was performed. Each root was cut at 3 mm from the apex and then stored in wet condition. The teeth were divided into three groups according to the retro-preparation length: control group (no retro-preparation); group 1 (retro-preparation of 3 mm); group 2 (retro-preparation of 9 mm). The teeth were equally allocated to either Biodentine or Super EBA treatment group. The teeth were immersed in 3% methylene blue dye solution for 24 h. The samples were split longitudinally and the depth of dye penetration was examined through light microscopy. RESULTS No significant statistical differences were found at different retro-preparation lengths (P > 0.05). Differences were found between materials (P > 0.05). CONCLUSION Biodentine showed significantly lower ML when compared to Super-EBA and no statistical significative differences were observed when samples were retro-prepared at 3 mm or 9 mm.
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Affiliation(s)
- Giacomo Corsentino
- Department of Endodontics and Restorative Dentistry, University of Siena
| | - Claudia Mazzitelli
- Department of Biomedical and Neuromotor Sciences, University of Bologna-Alma Mater Studiorum
| | - Annalisa Mazzoni
- Department of Biomedical and Neuromotor Sciences, University of Bologna-Alma Mater Studiorum
| | - Emanuele Ambu
- Department of Endodontics and Restorative Dentistry, University of Siena
| | - Cristina Perotto
- Department of Endodontics and Restorative Dentistry, University of Siena
| | - Giovanni Franciosi
- Department of Endodontics and Restorative Dentistry, University of Siena
| | - Simone Grandini
- Department of Endodontics and Restorative Dentistry, University of Siena
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Kumar P, Gowri S, Jayasheelan N, Kutty S, Shetty D, Banu K. An in vitro investigation of the sealing ability of biodentine and mineral trioxide aggregate as retrofilling materials after the use of various irrigating solutions. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2022; 14:S563-S567. [PMID: 36110671 PMCID: PMC9469458 DOI: 10.4103/jpbs.jpbs_687_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/17/2021] [Accepted: 12/21/2021] [Indexed: 11/04/2022] Open
Abstract
Aim: Materials and Methods: Statistical Analysis: Results: Conclusion:
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16
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Mody A, Arora R, Chauhan P, Gautam K, Taneja P, Marya CM. A Scanning Electron Microscopic Study on Effect of Blood and Artificial Salivary Contamination on Marginal Adaptation of Mineral Trioxide Aggregate, When Used as a Retrograde Filling Material: An In Vitro Study. Int J Clin Pediatr Dent 2021; 14:674-680. [PMID: 34934282 PMCID: PMC8645609 DOI: 10.5005/jp-journals-10005-2012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aim and objective The present study was conducted to evaluate the marginal adaptability of mineral trioxide aggregate (MTA) as a root-end filling material when manipulated using two different IV fluids intended for pediatric usage; in the presence of blood and salivary contamination. Materials and methods Sixty single-rooted teeth were selected. Conventional endodontic root canal preparation was performed on all specimens followed by root-end resection and retrograde cavity preparation. The roots were randomly divided into two groups (n = 30). In the specimens of group I, fresh blood was used as a contaminant and in group II artificial saliva was used as a contaminant. In both groups, MTA (e-MTA, Kids-e-Dental®) manipulated using either Ringer's lactate IV fluid (n = 15) or Tetraspan IV fluid (n = 15) was used for root-end filling in blood or artificial saliva-coated retrocavities. Furthermore, these roots were placed in beakers pooled with fresh phlebotomized blood or artificial saliva. After incubating for 48 hours, the roots were divided longitudinally to expose the retrofilled cavities and were then sputter-coated with gold-platinum dust. To assess the marginal adaptation of MTA to radicular dentin "maximum gap width" and "gap perimeter" were measured in images obtained from scanning electron microscopy of root specimens. SPSS 21 was employed for statistical analysis at (p < 0.05). Mann-Whitney U test and ANOVA were used for analyzing the data obtained. Results The gap width was more among samples exposed to blood (p < 0.05) than artificial saliva. No significant difference was reported in the gap perimeter when cavities were filled with MTA mixed with either IV fluids (p > 0.05). Conclusion Exposure to blood during setting had a negative effect on gap width when retrocavities were filled with MTA using Tetraspan. No effect was seen on the arch perimeter in retrocavities filled with MTA mixed with Ringer's lactate or Tetraspan. Clinical significance For avoiding failure, it is critical to select a biocompatible root-end filling material with high sealing ability. Hence, by doing the same, the clinical situation can be simulated. How to cite this article Mody A, Arora R, Chauhan P, et al. A Scanning Electron Microscopic Study on Effect of Blood and Artificial Salivary Contamination on Marginal Adaptation of Mineral Trioxide Aggregate, When Used as a Retrograde Filling Material: An In Vitro Study. Int J Clin Pediatr Dent 2021;14(5):674-680.
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Affiliation(s)
- Anuja Mody
- Department of Pediatric and Preventive Dentistry, Private Practice, Prabhadevi, Worli, Mumbai, Maharashtra, India
| | - Ruchi Arora
- Department of Pediatric and Preventive Dentistry, Darshan Dayal Dental College and Hospital, Loyara, Udaipur, Rajasthan, India
| | - Prabhav Chauhan
- Department of Pediatric and Preventive Dentistry, Private Practice, Greater Noida, Uttar Pradesh, India
| | - Kompal Gautam
- Department of Periodontology and Implantology, Siyaram Hospital, Jaipur, Rajasthan, India
| | - Pratibha Taneja
- Department of Public Health Dentistry, Private Practice, Gurugram, Haryana, India
| | - C M Marya
- Department of Public Health Dentistry, Sudha Rustagi College of Dental Science and Research, Faridabad, Haryana, India
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Possible Causes for Failure of Endodontic Surgery - A Retrospective Series of 20 Resurgery Cases. Eur Endod J 2021; 6:235-241. [PMID: 34650019 PMCID: PMC8461483 DOI: 10.14744/eej.2021.14238] [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] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE This study aimed to evaluate unsuccessful endodontic surgery cases for possible causes for treatment failure and evaluate if a nonsurgical retreatment (NSRTX) approach could have been a better alternative to resurgery. METHODS Analyses of clinical and cone-beam computed tomography (CBCT) images, periapical radiographs, and chart documentation determined study parameters. Preoperative factors were age, sex, tooth type, signs and/or symptoms, presence of periapical radiolucency, previous root canal treatment, timeline since previous endodontic surgery, presence of posts, cores, and restorations. The intra-operative factors were microsurgical classification, previous techniques, and current techniques utilized. Postoperative factors were signs and/or symptoms, time to follow-up, and healing status. The accessibility of the root canal system and the quality of the existing root filling were used to evaluate NSRTX as an alternative to resurgery. RESULTS A total of 1073 surgical cases from 2011-2019 were reviewed. In 14 patients, 20 cases matched the inclusion criteria and allowed for data extraction. The mean time since the previous surgery was 2.9+-2.1 years, with a mean follow-up of 9.1+-5.8 months after the resurgery. Possible reasons for failure identified were: insufficient root-end filling (leaking, off-axis preparation, lack of depth, overfill) n=12/20, 60.0%; missed anatomy (main and lateral canals, isthmus) n=9/20, 45.0%; incomplete resection n=6/20, 30.0%. In 18/20 cases (90.0%), resurgery appeared to be indicated for 2/20 cases (10.0%). Therefore, NSRTX may have been a potential alternative. CONCLUSION Further evidence for possible causes of failure of endodontic surgery was provided, which were primarily iatrogenic. The evaluation of CBCT and high magnification intra-operative images proved beneficial for identifying critical issues for all investigated cases.
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Li H, Guo Z, Li C, Ma X, Wang Y, Zhou X, Johnson TM, Huang D. Materials for retrograde filling in root canal therapy. Cochrane Database Syst Rev 2021; 10:CD005517. [PMID: 34647617 PMCID: PMC8515509 DOI: 10.1002/14651858.cd005517.pub3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Root canal therapy is a sequence of treatments involving root canal cleaning, shaping, decontamination, and obturation. It is conventionally performed through a hole drilled into the crown of the affected tooth, namely orthograde root canal therapy. When it fails, retrograde filling, which seals the root canal from the root apex, is a good alternative. Many materials are used for retrograde filling. Since none meets all the criteria an ideal material should possess, selecting the most efficacious material is of utmost importance. This is an update of a Cochrane Review first published in 2016. OBJECTIVES To determine the effects of different materials used for retrograde filling in children and adults for whom retrograde filling is necessary in order to save the tooth. SEARCH METHODS An Information Specialist searched five bibliographic databases up to 21 April 2021 and used additional search methods to identify published, unpublished, and ongoing studies. We also searched four databases in the Chinese language. SELECTION CRITERIA We selected randomised controlled trials (RCTs) that compared different retrograde filling materials, with the reported success rate that was assessed by clinical or radiological methods for which the follow-up period was at least 12 months. DATA COLLECTION AND ANALYSIS Records were screened in duplicate by independent screeners. Two review authors extracted data independently and in duplicate. Original trial authors were contacted for any missing information. Two review authors independently assessed the risk of bias of the included studies. We followed Cochrane's statistical guidelines and assessed the certainty of the evidence using GRADE. MAIN RESULTS We included eight studies, all at high risk of bias, involving 1399 participants with 1471 teeth, published between 1995 and 2019, and six comparisons of retrograde filling materials. - Mineral trioxide aggregate (MTA) versus intermediate restorative material (IRM): there may be little to no effect of MTA compared to IRM on success rate at one year, but the evidence is very uncertain (risk ratio (RR) 1.09, 95% confidence interval (CI) 0.97 to 1.22; I2 = 0%; 2 studies; 222 teeth; very low-certainty evidence). - MTA versus super ethoxybenzoic acid (Super-EBA): there may be little to no effect of MTA compared to Super-EBA on success rate at one year, but the evidence is very uncertain (RR 1.03, 95% CI 0.96 to 1.10; 1 study; 192 teeth; very low-certainty evidence). - Super-EBA versus IRM: the evidence is very uncertain about the effect of Super-EBA compared with IRM on success rate at 1 year, with results indicating Super-EBA may reduce or have no effect on success rate (RR 0.90, 95% CI 0.80 to 1.01; 1 study; 194 teeth; very low-certainty evidence). - Dentine-bonded resin composite versus glass ionomer cement: compared to glass ionomer cement, dentine-bonded resin composite may increase the success rate of the treatment at 1 year, but the evidence is very uncertain (RR 2.39, 95% CI 1.60 to 3.59; 1 study; 122 teeth; very low-certainty evidence). Same result was obtained when considering the root as unit of analysis at one year (RR 1.59, 95% CI 1.20 to 2.09; 1 study; 127 roots; very low-certainty evidence). - Glass ionomer cement versus amalgam: the evidence is very uncertain about the effect of glass ionomer cement compared with amalgam on success rate at one year, with results indicating glass ionomer cement may reduce or have no effect on success rate (RR 0.98, 95% CI 0.86 to 1.12; 1 study; 105 teeth; very low-certainty evidence). - MTA versus root repair material (RRM): there may be little to no effect of MTA compared to RRM on success rate at one year, but the evidence is very uncertain (RR 1.00, 95% CI 0.94 to 1.07; I2 = 0%; 2 studies; 278 teeth; very low-certainty evidence). Adverse events were not assessed by any of the included studies. AUTHORS' CONCLUSIONS Based on the present limited evidence, there is insufficient evidence to draw any conclusion as to the benefits of any one material over another for retrograde filling in root canal therapy. We conclude that more high-quality RCTs are required.
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Affiliation(s)
- Honglin Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Zhiyong Guo
- Department of Oral Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Chunjie Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xiangyu Ma
- Department of Endodontics, State Key Laboratory of Oral Diseases, West China College of Stomatology, Sichuan University, Chengdu, China
- Department of Endodontics, Mianyang Hospital of TCM, Mianyang, China
| | - Yan Wang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xuedong Zhou
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Trevor M Johnson
- Faculty of General Dental Practice (UK), RCS England, London, UK
| | - Dingming Huang
- Department of Endodontics, State Key Laboratory of Oral Diseases, West China College of Stomatology, Sichuan University, Chengdu, China
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Nagy E, Braunitzer G, Gryschka DG, Barrak I, Antal MA. Accuracy of digitally planned, guided apicoectomy with a conventional trephine and a custom-made endodontic trephine: An in vitro comparative study. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2021; 123:388-394. [PMID: 34601166 DOI: 10.1016/j.jormas.2021.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 09/27/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE Static guided trephine apicoectomy has been developed as a less invasive and more accurate alternative to conventional freehand apicoectomy with drills. Overpenetration is a frequent issue with this procedure, which deteriorates accuracy and raises safety concerns. A safety improvement to address this problem is presented. MATERIALS AND METHODS Guided apicoectomies were performed in porcine mandibles with either a conventional bone trephine or a custom-made endo-trephine with built-in depth control. The deviation of the apical endpoint of the trephine from the digital surgical plan was analyzed. Overpenetration frequency was recorded. RESULTS Procedures performed with the custom trephine were significantly more accurate both along the x-axis and globally, but no significant difference was found for the y and z axes. Overpenetration frequency was 70% in the conventional trephine group versus 38% in the stop trephine group. CONCLUSION The results indicate that the lack of physical depth control can interfere with the accuracy (and safety) of these procedures to a significant extent, as visual cues (such as the depth markings on a conventional trephine) are insufficient to prevent overpenetration. Our results show that custom-made trephines with a built-in stop offer an optimal solution for this problem.
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Affiliation(s)
- Eszter Nagy
- Department of Operative and Esthetic Dentistry, Faculty of Dentistry, University of Szeged, Szeged, Hungary
| | | | - Dániel Gerhard Gryschka
- Department of Operative and Esthetic Dentistry, Faculty of Dentistry, University of Szeged, Szeged, Hungary
| | - Ibrahim Barrak
- Faculty of Medicine, Department of Oral and Maxillofacial Surgery, University of Szeged, Szeged, Hungary
| | - Mark Adam Antal
- Department of Operative and Esthetic Dentistry, Faculty of Dentistry, University of Szeged, Szeged, Hungary; Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, UAE.
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20
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Rencher B, Chang AM, Fong H, Johnson JD, Paranjpe A. Comparison of the sealing ability of various bioceramic materials for endodontic surgery. Restor Dent Endod 2021; 46:e35. [PMID: 34513641 PMCID: PMC8410994 DOI: 10.5395/rde.2021.46.e35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 03/03/2021] [Accepted: 03/10/2021] [Indexed: 11/23/2022] Open
Abstract
Objectives Endosequence Bioceramic Root Repair Material (BC-RRM) is used in endodontic microsurgery. It is available as a paste and a putty. However, no studies to date have examined the sealing ability of these forms alone or in combination as root-end filling materials. Hence, this study aimed to compare the sealing properties of these 2 forms of BC-RRM. Materials and Methods Forty-two extracted upper anterior teeth were divided into 3 experimental groups, a positive and negative control. After the root canal treatment, the root ends were resected, retroprepared and retrofilled with either putty, paste + putty or mineral trioxide aggregate (MTA). The teeth were mounted in tubes so the apical 3 mm was submerged in Brain Heart Infusion (BHI) broth. The coronal portions of the canals were inoculated with Enterococcus faecalis and BHI broth and incubated for 30 days. The broth in the tubes was analyzed for colony forming units to check for leakage of bacteria from the canal. The teeth from the groups were sectioned and analyzed using scanning electron microscopy (SEM). The Kruskal-Wallis test and analysis of variance were used to analyze the data with a significance level p < 0.05. Results The BC-RRM and MTA groups showed similar sealing ability. The positive control showed leakage in all samples. The SEM imaging showed the presence of bacteria in all experimental groups at the material-tooth interface. Conclusions No significant differences were noted in the experimental groups, providing sufficient evidence that any combination could be effectively used during endodontic microsurgery.
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Affiliation(s)
- Benjamin Rencher
- Department of Endodontics, School of Dentistry, University of Washington, Seattle, WA, USA
| | - Ana M Chang
- Department of Periodontics, University of Washington, Seattle, WA, USA
| | - Hanson Fong
- Department of Material Science and Engineering, University of Washington, Seattle, WA, USA
| | - James D Johnson
- Department of Endodontics, School of Dentistry, University of Washington, Seattle, WA, USA
| | - Avina Paranjpe
- Department of Endodontics, School of Dentistry, University of Washington, Seattle, WA, USA
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Kanagasingam S. The 2020 Guidelines for Periradicular Surgery: What You Need to Know. Prim Dent J 2020; 9:20-23. [PMID: 33225846 DOI: 10.1177/2050168420963350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Shalini Kanagasingam
- Senior Clinical Lecturer, Course Lead MSc & MClinDent Endodontology, School of Dentistry, Faculty of Clinical and Biomedical Sciences, University of Central Lancashire, Preston, UK
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Premjith, Shetty D, Kailar A, Pare S, Kumar P, Ragher M. The Effect of Root End Cavity Preparation Using Er,Cr:YSGG Laser, Ultrasonic Retrotip, and Bur on the Apical Microleakage of Retrograde Cavity Filled with MTA Plus. J Pharm Bioallied Sci 2020; 12:S299-S303. [PMID: 33149475 PMCID: PMC7595512 DOI: 10.4103/jpbs.jpbs_90_20] [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: 01/31/2020] [Revised: 03/02/2020] [Accepted: 03/09/2020] [Indexed: 11/17/2022] Open
Abstract
Aim: The sealing ability of the retrograde material is greatly affected by the technique used for root end preparation. Advances in retrograde preparation techniques such as lasers has shown to provide an efficient outcome. The study was to evaluate and compare the effect of various techniques of retrograde cavity preparation on apical microleakage. Materials and Methods: Forty-five single rooted teeth were decoronated. Biomechanical preparation was carried out up to size F2 ProTaper system and obturated. Glass–ionomer cement was used as an access restorative material. The apical root resection was done at 3 mm from the apex at angulation of 90° to the long axis of the root. The allocation of the samples was done into three groups of 15 each. Group A: Retrograde cavities prepared using conventional round bur; Group B: Retrograde cavities prepared using ultrasonic retro preparation diamond tip; and Group C: Retrograde cavities prepared using “Erbium, chromium: yttrium, scandium, gallium, garnet” (Er,Cr:YSGG). The retrograde cavities hence prepared were filled with MTA Plus. Nail varnish was used to coat the samples except at the apical end. Samples were immersed in methylene blue for 24h. Stereomicroscope was used for examination of the sectioned teeth. The data were analyzed using one-way analysis of variance (ANOVA) and post hoc Tukey test. Results: Results showed very highly significant difference between laser and bur (P value = 0.001). Conclusion: Retrograde preparation with Er,Cr:YSGG showed significantly less microleakage when compared to the use of ultrasonic retrotip and burs.
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Affiliation(s)
- Premjith
- Private practitioner, Conservative Dentistry & Endododontics, Trivandrum, Kerala, India
| | - Divya Shetty
- Department of Conservative Dentistry and Endodontics, AJ Institute of Dental Sciences, Mangaluru, Karnataka, India
| | - Ashika Kailar
- Private practitioner, Conservative Dentistry & Endododontics, Mangaluru, Karnataka, India
| | - Sharath Pare
- Department of Conservative Dentistry and Endodontics, AJ Institute of Dental Sciences, Mangaluru, Karnataka, India
| | - Pradeep Kumar
- Department of Conservative Dentistry and Endodontics, Yenepoya Dental College, Yenepoya (Deemed to be University), Mangaluru, Karnataka, India
| | - Mallikarjuna Ragher
- Department of Prosthodontics, Yenepoya Dental College, Mangaluru, Karnataka, India
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Palma PJ, Marques JA, Casau M, Santos A, Caramelo F, Falacho RI, Santos JM. Evaluation of Root-End Preparation with Two Different Endodontic Microsurgery Ultrasonic Tips. Biomedicines 2020; 8:biomedicines8100383. [PMID: 32998221 PMCID: PMC7601836 DOI: 10.3390/biomedicines8100383] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 09/19/2020] [Accepted: 09/25/2020] [Indexed: 02/06/2023] Open
Abstract
The aim of this study is to compare root-end preparation performed with two different ultrasonic tips-CVDentus and NSK-and respective time requirements. After root-end resection, 32 teeth were randomly divided in two groups, according to the ultrasonic tip used for root-end preparation. Preparation time was recorded. Photomicrographs were taken to assess the following parameters: root surface microcracking, marginal integrity and presence of debris. One ultrasonic tip from each group was analyzed through scanning electron microscopy before and after root-end preparation. The significance level was set at α = 0.05. Incidence of microcracks in both groups was 12.5%. Solely intracanal microcracking was found, consistently positioned within the widest side of the remaining dentine. No statistically significant differences were verified between both experimental groups regarding marginal integrity (p = 0.102) and preparation time (p = 0.780), whereas statistical differences (p = 0.003) were found concerning the presence of debris (the minimum registered score was mostly verified in CVDentus group). NSK tips showed major morphological changes, with extensive surface wear and noticeable loss of particles, which was not verified on CVDentus tips. Our findings suggest significant differences regarding root-end preparation walls quality, with CVDentus tips showing better results. Concerning microcracking, as well as preparation time and marginal integrity, both ultrasonic tips showed similar results. Qualitative analysis exposed NSK tips major morphological changes and wear after use, which was not verified on CVDentus tips.
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Affiliation(s)
- Paulo J. Palma
- Institute of Endodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal; (J.A.M.); (J.M.S.)
- Center for Innovation and Research in Oral Sciences (CIROS), Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal
- Correspondence: ; Tel.: +351-239-249-151
| | - Joana A. Marques
- Institute of Endodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal; (J.A.M.); (J.M.S.)
| | - Margarida Casau
- Dentistry Department, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal; (M.C.); (A.S.)
| | - André Santos
- Dentistry Department, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal; (M.C.); (A.S.)
| | - Francisco Caramelo
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Laboratory of Biostatistics and Medical Informatics (LBIM), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal;
| | - Rui I. Falacho
- Institute of Oral Implantology and Prosthodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal;
| | - João Miguel Santos
- Institute of Endodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal; (J.A.M.); (J.M.S.)
- Center for Innovation and Research in Oral Sciences (CIROS), Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal
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Peng L, Zhao J, Wang ZH, Sun YC, Liang YH. Accuracy of root-end resection using a digital guide in endodontic surgery: An in vitro study. J Dent Sci 2020; 16:45-50. [PMID: 33384777 PMCID: PMC7770308 DOI: 10.1016/j.jds.2020.06.024] [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: 03/06/2020] [Revised: 06/27/2020] [Indexed: 12/04/2022] Open
Abstract
Background/Purpose It is difficult to achieve accurate root-end resection clinically. This in vitro study was conducted to evaluate the operation accuracy of a digital endodontic surgical guide. Materials and methods 56 extracted maxillary anterior teeth were prepared for endodontic surgical models. The models were randomly divided into 4 groups equally according to the guide (with guide/no guide) and the operator (experienced/inexperienced). Endodontic microsurgeries were performed on models in each group. The deviations in length and angle of the root-end resection were measured based on the optical scanning data of the pre- and postoperative teeth. The general linear model was performed to analyze the effect of a guide on root-end resection deviation. Results Using a guide, the mean length deviation for experienced/inexperienced operators reduced from 0.99 mm (95% CI [confidence interval, CI], 0.66–1.33 mm)/1.18 mm (95% CI, 0.50–1.86 mm) to 0.31 mm (95% CI, 0.20–0.42 mm)/0.31 mm (95% CI, 0.24–0.37 mm). The mean angle deviation for experienced/inexperienced operators reduced from 16.74° (95% CI, 10.61–22.86°)/15.06° (95% CI, 9.19–20.94°) to 5.04° (95% CI, 3.31–6.77°)/6.79° (95% CI, 4.91–8.67°). The difference was significant between procedures performed with and without a guide (P < 0.01). Conclusion Application of the digital guide in vitro endodontic surgery could improve the accuracy of root-end resection.
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Affiliation(s)
- Li Peng
- Department of General Dentistry Ⅱ, Peking University School and Hospital of Stomatology, Beijing, China
| | - Jing Zhao
- Dental Clinic, Peking University International Hospital, Beijing, China
| | - Zu-Hua Wang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Yu-Chun Sun
- Center of Digital Dentistry, Department of Prosthodontics, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Research Center of Engineering and Technology for Digital Dentistry of Ministry of Health, Beijing Key Laboratory of Digital Stomatology, National Clinical Research Center for Oral Diseases, Beijing, China
| | - Yu-Hong Liang
- Dental Clinic, Peking University International Hospital, Beijing, China.,Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology, Beijing, China
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Ray JJ, Giacomino CM, Wealleans JA, Sheridan RR. Targeted Endodontic Microsurgery: Digital Workflow Options. J Endod 2020; 46:863-871. [DOI: 10.1016/j.joen.2020.02.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 02/12/2020] [Accepted: 02/17/2020] [Indexed: 10/24/2022]
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26
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Hawkins TK, Wealleans JA, Pratt AM, Ray JJ. Targeted endodontic microsurgery and endodontic microsurgery: a surgical simulation comparison. Int Endod J 2020; 53:715-722. [DOI: 10.1111/iej.13243] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 10/30/2019] [Indexed: 12/12/2022]
Affiliation(s)
- T. K. Hawkins
- Department of Endodontics US Air Force Postgraduate Dental School Uniformed Services University JBSA‐Lackland TX USA
| | - J. A. Wealleans
- Department of Endodontics US Air Force Postgraduate Dental School Uniformed Services University JBSA‐Lackland TX USA
| | - A. M. Pratt
- Department of Endodontics US Air Force Postgraduate Dental School Uniformed Services University JBSA‐Lackland TX USA
| | - J. J. Ray
- Department of Endodontics US Air Force Postgraduate Dental School Uniformed Services University JBSA‐Lackland TX USA
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Antal M, Nagy E, Sanyó L, Braunitzer G. Digitally planned root end surgery with static guide and custom trephine burs: A case report. Int J Med Robot 2020; 16:e2115. [PMID: 32304137 DOI: 10.1002/rcs.2115] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Revised: 04/13/2020] [Accepted: 04/14/2020] [Indexed: 02/01/2023]
Abstract
INTRODUCTION Apicoectomy is an endodontic surgical intervention that requires high precision. The computer-assisted static guided approach has proven to increase the precision of dental implantation in a significant manner. The authors sought to transfer this precision to root-end resection with the use of custom designed trephine burs manufactured specifically for use in targeted endodontic microsurgery. METHODS A set of custom bone trephines were designed and manufactured, then their digital models were integrated into an already existing implant surgical planning software, in cooperation with the software developer. Apicoectomy was performed in an actual case with the help of the new system. RESULTS It has become possible to plan root end removal in the virtual space and to manufacture 3D printed static surgical guides to help the execution of the surgery. A patient with persistent periapical lesion was successfully treated without complication. The 6-month follow-up found uneventful healing. CONCLUSION The presented system is a step toward a standardized digital system and workflow dedicated to guided endodontic surgery.
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Affiliation(s)
- Márk Antal
- Faculty of Dentistry, Department of Esthetic and Operative Dentistry, University of Szeged, Szeged, Hungary
| | - Eszter Nagy
- Faculty of Dentistry, Department of Esthetic and Operative Dentistry, University of Szeged, Szeged, Hungary
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Effects of Dimensions of Root-End Fillings and Peripheral Root Dentine on the Healing Outcome of Apical Surgery. Eur Endod J 2020; 4:49-56. [PMID: 32161887 PMCID: PMC7006549 DOI: 10.14744/eej.2019.76376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 05/07/2019] [Indexed: 11/20/2022] Open
Abstract
Objective: The objective of this study was to assess dimensions of root-end fillings (REFs), as well as peripheral root dentine (PRD) and their effects on the healing outcome of apical surgery. Methods: Cone beam computed tomography (CBCT) scans were utilized to measure the REF length and width and the PRD thickness in 61 roots of 53 teeth 1 year after apical surgery. Measurements were taken in the mesio-distal as well as bucco-lingual directions. The REF alignment with respect to the root axis was also evaluated. In addition, the dimensions of REF and PRD were assessed for possible correlations with the healing outcome. Criteria for determining the healing outcome included clinical and radiographic parameters. Results: The mean REF length was 2.02±0.52 mm. No significant differences were observed with regard to tooth groups, but one-canal roots had a significantly longer mean REF than two-canal roots (P=0.006). The mean REF widths were 1.14±0.24 mm mesio-distally and 2.61±1.24 mm bucco-lingually. Roots with two canals presented a significantly wider REF (P<0.001) in the bucco-lingual dimension but had a significantly narrower REF in the mesio-distal direction (P<0.001) compared to roots with single canals. PRD measured on average 1.19±0.23 mm at the resection level and 1.44±0.27 mm at the coronal end of the REF. Almost all REFs were perfectly aligned with the longitudinal axis of the roots. With regard to healing outcomes, no correlations were found with REF and PRD values, respectively. Conclusion: The mean REF length was 2.02 mm. On average, a thickness >1 mm of peripheral root dentine was maintained. The REF or PRD dimensions had no statistical effect on the healing outcome.
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Nepal M, Shubham S, Tripathi R, Khadka J, Kunwar D, Gautam V, Gautam N. Spectrophotometric analysis evaluating apical microleakage in retrograde filling using GIC, MTA and biodentine: an in-vitro study. BMC Oral Health 2020; 20:37. [PMID: 32013975 PMCID: PMC6998061 DOI: 10.1186/s12903-020-1025-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Accepted: 01/28/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The present study compares the apical microleakage of three different root-end filling materials in which the retrograde cavity is prepared by two different burs. METHODS Eighty extracted single rooted maxillary and mandibular premolars were taken. Root canal treatment was completed. Apical 3 mm of all the teeth were resected with diamond disk. The tooth were divided into four groups with two subgroups for each group containing 10 tooth (N = 10) as: Group IA (Negative Control and IB (Positive Control); Group IIA and IIB: Prepared with round carbide bur and round diamond bur respectively, filled with GIC; Group IIIA and IIIB: Prepared with round carbide bur and round diamond bur respectively, filled with MTA; Group IVA and IVB: Prepared with round carbide bur and round diamond bur, filled with Biodentine. After applying two coats of nail varnish leaving apical 3 mm (except for negative control group) all teeth were immersed in 2% methylene blue for 3 days and again in 65% nitric acid for next 3 days for extraction of dye. The obtained solution was then transferred to eppendorf tube and centrifuged in microcentrifuges at 14,000 revolution per minutes (RPM) for 5 min. Optical density or absorbance of the supernatant solution was measured with UV spectrophotometer at 550 nm. RESULTS The absorbance of the supernatant solution after dye extraction is decreasing in the order of positive control> GIC > MTA > Biodentine> negative control group. The significant difference was observed between GIC and MTA (p = 0.0001) and GIC and Biodentine (p = 0.0001) with two different burs but statistically non-significant difference was observed between MTA and Biodentine with Carbide bur (p = 0.127) and Diamond bur (p = 0.496) respectively. CONCLUSIONS Within the limitations of the present study, it can be concluded that Biodentine and MTA showed less microleakage as compared to GIC. There is no significant difference between mean microleakage of MTA and Biodentine. However, the mean OD of the Biodentine was least of all evaluated materials. Preparation of the root-end using round carbide bur as well as round diamond burs showed comparable microleakage for all three filling materials.
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Affiliation(s)
- Manisha Nepal
- Department of Conservative Dentistry and Endodontics, Universal College of Medical Sciences, Bhairahawa, Nepal.
| | - Snigdha Shubham
- Department of Conservative Dentistry and Endodontics, Universal College of Medical Sciences, Bhairahawa, Nepal
| | - Rupam Tripathi
- Department of Conservative Dentistry and Endodontics, Universal College of Medical Sciences, Bhairahawa, Nepal
| | - Jwolan Khadka
- Department of Conservative Dentistry and Endodontics, KIST Medical College, Lalitpur, Nepal
| | - Deepa Kunwar
- Department of Conservative Dentistry and Endodontics, Gandaki Medical College, Pokhara, Nepal
| | - Vanita Gautam
- Department of Conservative Dentistry and Endodontics, Universal College of Medical Sciences, Bhairahawa, Nepal
| | - Narayan Gautam
- Department of Biochemistry, Universal College of Medical Sciences, Bhairahawa, Nepal
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Jadun S, Monaghan L, Darcey J. Endodontic microsurgery. Part two: armamentarium and technique. Br Dent J 2019; 227:101-111. [PMID: 31350492 DOI: 10.1038/s41415-019-0516-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Modern endodontic microsurgery has a high reported success rate of up to 93.5%, making it a viable treatment option in the management of periapical disease when orthograde root treatment is not possible or inappropriate. This high success rate is intimately related to advanced techniques that have allowed practitioners to overcome historical barriers to the success seen in traditional surgical endodontics. When comparing traditional root-end surgery and endodontic microsurgery there are key differences when considering the flap design, access armamentarium, size of osteotomy, instruments used and root-end material. This paper highlights such key differences and advises practitioners on the techniques and instruments used to achieve high success rates, firmly establishing non-surgical endodontic treatment as an important treatment option in well-selected cases.
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Affiliation(s)
- Sarah Jadun
- University Dental Hospital of Manchester, Oral Surgery, Higher Cambridge Street, Manchester, UK
| | - Liam Monaghan
- University Dental Hospital of Manchester, Orthodontic Department, Higher Cambridge Street, Manchester, UK
| | - James Darcey
- University Dental Hospital of Manchester, Restorative Department, Higher Cambridge Street, Manchester, UK.
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31
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Weissman A, Goldberger T, Wigler R, Kfir A, Blau–Venezia N. Retrograde root canal retreatment with pre‐bent ultrasonic files. A retrospective outcome study. Int Endod J 2019; 52:1547-1555. [DOI: 10.1111/iej.13176] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 06/18/2019] [Indexed: 11/26/2022]
Affiliation(s)
- A. Weissman
- Department of Endodontology The Goldschleger School of Dental Medicine Tel Aviv University Tel Aviv Israel
| | - T. Goldberger
- Department of Endodontology The Goldschleger School of Dental Medicine Tel Aviv University Tel Aviv Israel
| | - R. Wigler
- Department of Endodontology The Goldschleger School of Dental Medicine Tel Aviv University Tel Aviv Israel
| | - A. Kfir
- Department of Endodontology The Goldschleger School of Dental Medicine Tel Aviv University Tel Aviv Israel
| | - N. Blau–Venezia
- Department of Endodontology The Goldschleger School of Dental Medicine Tel Aviv University Tel Aviv Israel
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32
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Restrepo‐Restrepo FA, Cañas‐Jiménez SJ, Romero‐Albarracín RD, Villa‐Machado PA, Pérez‐Cano MI, Tobón‐Arroyave SI. Prognosis of root canal treatment in teeth with preoperative apical periodontitis: a study with cone‐beam computed tomography and digital periapical radiography. Int Endod J 2019; 52:1533-1546. [DOI: 10.1111/iej.13168] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 06/13/2019] [Indexed: 01/15/2023]
Affiliation(s)
- F. A. Restrepo‐Restrepo
- POPCAD Research Group Laboratory of Immunodetection and Bioanalysis Faculty of Dentistry University of Antioquia Medellín Colombia
| | - S. J. Cañas‐Jiménez
- POPCAD Research Group Laboratory of Immunodetection and Bioanalysis Faculty of Dentistry University of Antioquia Medellín Colombia
| | - R. D. Romero‐Albarracín
- POPCAD Research Group Laboratory of Immunodetection and Bioanalysis Faculty of Dentistry University of Antioquia Medellín Colombia
| | - P. A. Villa‐Machado
- POPCAD Research Group Laboratory of Immunodetection and Bioanalysis Faculty of Dentistry University of Antioquia Medellín Colombia
| | - M. I. Pérez‐Cano
- POPCAD Research Group Laboratory of Immunodetection and Bioanalysis Faculty of Dentistry University of Antioquia Medellín Colombia
| | - S. I. Tobón‐Arroyave
- POPCAD Research Group Laboratory of Immunodetection and Bioanalysis Faculty of Dentistry University of Antioquia Medellín Colombia
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Abstract
Root end resections play an important role in the success of periapical surgery. Beveling of the root end resections can vary significantly depending on the surgical technique, the root and canal morphology. The intention of this article was to clinically assess the root resections bevels and to estimate their relation to applied periapical surgeries. A prospective clinical study consisted of sixty periapical surgeries performed on teeth with chronic periapical lesions. Thirty periapical surgeries were performed in a conventional manner, while thirty were contemporary ultrasonic surgeries. Following the completion of strictly planned and performed intraoperative procedures, the resection bevels were assessed. To obtain the real bevel angles a compass was used. Root resections were significantly less beveled in all teeth operated with contemporary ultrasonic surgery, with mean values between 2.1° to 7.8°. The number of roots and their dilacerations didn't influence the root resection bevel. For comparison, root resections were significantly beveled in all conventionally operated teeth, with mean values of 46°. Due to the technical limitations of the conventional periapical surgery, mandibular premolars were exclusively operated with ultrasonic periapical surgery, with mean values of resection bevel not exceeding 20.7°. Significantly lesser resection bevel associated with ultrasonic periapical surgery contributes to root preservation and favorable surgical outcome.
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Affiliation(s)
- Marina Kacarska
- Faculty of Dentistry, Department of Oral Surgery, University Ss. Cyril and Methodius, Skopje
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Matsunaga S, Yamada M, Kasahara N, Kasahara M, Odaka K, Fujii R, Miyayoshi N, Sekiya S, Sako R, Sugiuchi A, Abe S, Furusawa M. Tooth Root Cross-section Variations of Significance for Endodontic Microsurgery and Predicted Risk of Concealed Canal Isthmus Based on Cross-sectional Morphology: Three-dimensional Morphological Analysis of Japanese Maxillary First Molars Using Micro-CT. J HARD TISSUE BIOL 2019. [DOI: 10.2485/jhtb.28.153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
| | | | - Norio Kasahara
- Department of Forensic Odontology and Anthropology, Tokyo Dental College
| | | | - Kento Odaka
- Department of Oral and Maxillofacial Radiology, Tokyo Dental College
| | - Rie Fujii
- Department of Endodontics, Tokyo Dental College
| | | | - Sayo Sekiya
- Department of Endodontics, Tokyo Dental College
| | - Ryo Sako
- Department of Endodontics, Tokyo Dental College
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Periapical Microsurgery: Do Root Canal–retreated Teeth Have More Dentinal Defects? J Endod 2018; 44:1487-1491. [DOI: 10.1016/j.joen.2018.06.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 06/23/2018] [Accepted: 06/29/2018] [Indexed: 12/15/2022]
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36
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Ma X, Li C, Jia L, Wang Y, Liu W, Zhou X, Johnson TM, Huang D. Materials for retrograde filling in root canal therapy. Cochrane Database Syst Rev 2016; 12:CD005517. [PMID: 27991646 PMCID: PMC6463971 DOI: 10.1002/14651858.cd005517.pub2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Root canal therapy is a sequence of treatments involving root canal cleaning, shaping, decontamination and obturation. It is conventionally performed through a hole drilled into the crown of the affected tooth, namely orthograde root canal therapy. For teeth that cannot be treated with orthograde root canal therapy, or for which it has failed, retrograde root filling, which seals the root canal from the root apex, is a good alternative. Many materials, such as amalgam, zinc oxide eugenol and mineral trioxide aggregate (MTA), are generally used. Since none meets all the criteria an ideal material should possess, selecting the most efficacious material is of utmost importance. OBJECTIVES To determine the effects of different materials used for retrograde filling in children and adults for whom retrograde filling is necessary in order to save the tooth. SEARCH METHODS Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 13 September 2016); the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 8) in the Cochrane Library (searched 13 September 2016); MEDLINE Ovid (1946 to 13 September 2016); Embase Ovid (1980 to 13 September 2016); LILACS BIREME Virtual Health Library (1982 to 13 September 2016); and OpenSIGLE (1980 to 2005). ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. We also searched Chinese BioMedical Literature Database (in Chinese, 1978 to 20 September 2016); VIP (in Chinese, 1989 to 20 September 2016); China National Knowledge Infrastructure (in Chinese, 1994 to 20 September 2016); and Sciencepaper Online (in Chinese, to 20 September 2016). No restrictions were placed on the language or date of publication when searching the electronic databases. SELECTION CRITERIA We selected randomised controlled trials (RCTs) only that compared different retrograde filling materials, with reported success rate that was assessed by clinical or radiological methods for which the follow-up period was at least 12 months. DATA COLLECTION AND ANALYSIS Two review authors extracted data independently and in duplicate. Original trial authors were contacted for any missing information. Two review authors independently carried out risk of bias assessments for each eligible study following Cochrane methodological guidelines. MAIN RESULTS We included six studies (916 participants with 988 teeth) reported in English. All the studies had high risk of bias. The six studies examined five different comparisons, including MTA versus intermediate restorative material (IRM), MTA versus super ethoxybenzoic acid cement (Super-EBA), Super-EBA versus IRM, dentine-bonded resin composite versus glass ionomer cement and glass ionomer cement versus amalgam. There was therefore little pooling of data and very little evidence for each comparison.There is weak evidence of little or no difference between MTA and IRM at the first year of follow-up (risk ratio (RR) 1.09; 95% confidence interval (CI): 0.97 to 1.22; 222 teeth; quality of evidence: low). Insufficient evidence of a difference between MTA and IRM on success rate at the second year of follow-up (RR 1.06; 95% CI: 0.89 to 1.25; 86 teeth, 86 participants; quality of evidence: very low). All the other outcomes were based on a single study. There is insufficient evidence of any difference between MTA and Super-EBA at the one-year follow-up (RR 1.03; 95% CI: 0.96 to 1.10; 192 teeth, 192 participants; quality of evidence: very low), and only weak evidence indicating there might be a small increase in success rate at the one-year follow-up in favour of IRM compared to Super-EBA (RR 0.90; 95% CI: 0.80 to 1.01; 194 teeth; quality of evidence: very low). There was also insufficient and weak evidence to show that dentine-bonded resin composite might be a better choice for increasing retrograde filling success rate compared to glass ionomer cement at the one-year follow-up (RR 2.39; 95% CI: 1.60 to 3.59; 122 teeth, 122 participants; quality of evidence: very low). And there was insufficient evidence of a difference between glass ionomer cement and amalgam at both the one-year (RR 0.98; 95% CI: 0.86 to 1.12; 105 teeth; quality of evidence: very low) and five-year follow-ups (RR 1.00; 95% CI: 0.84 to 1.20; 82 teeth; quality of evidence: very low).None of these studies reported an adverse event. AUTHORS' CONCLUSIONS Based on the present limited evidence, there is insufficient evidence to draw any conclusion as to the benefits of any one material over another. We conclude that more high-quality RCTs are required.
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Affiliation(s)
- Xiangyu Ma
- Mianyang Hospital of TCMDepartment of EndodonticsFucheng RoadMianyangSichuanChina621000
- West China College of Stomatology, Sichuan UniversityDepartment of Endodontics, State Key Laboratory of Oral DiseasesNo. 14, Section 3, Ren Min Nan RoadChengduSichuanChina610041
| | - Chunjie Li
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan UniversityDepartment of Head and Neck OncologyNo. 14, Section Three, Ren Min Nan RoadChengduSichuanChina610041
| | - Liuhe Jia
- West China College of Stomatology, Sichuan UniversityDepartment of Endodontics, State Key Laboratory of Oral DiseasesNo. 14, Section 3, Ren Min Nan RoadChengduSichuanChina610041
- Beijing Jishuitan HospitalDepartment of DentistryNo 31, Xinjiekou East Street, Xicheng DistrictBeijingChina100035
| | - Yan Wang
- West China Hospital of Stomatology, Sichuan UniversityDepartment of Pediatric Dentistry, State Key Laboratory of Oral DiseasesNo. 14, Section 3, Renmin South RoadChengduSichuanChina610041
| | - Wenwen Liu
- School and Hospital of Stomatology, Peking UniversityDepartment of VIP Dental Service & Geriatric DentistryBeijingChina
- West China College of Stomatology, Sichuan UniversityDepartment of Oral Implantology, State Key Laboratory of Oral DiseasesNo. 14, Section Three, Ren Min Nan RoadChengduSichuanChina610041
| | - Xuedong Zhou
- West China College of Stomatology, Sichuan UniversityDepartment of Endodontics, State Key Laboratory of Oral DiseasesNo. 14, Section 3, Ren Min Nan RoadChengduSichuanChina610041
| | - Trevor M Johnson
- RCS EnglandFaculty of General Dental Practice (UK)35‐43 Lincoln's Inn FieldsLondonUKWC2A 3PE
| | - Dingming Huang
- West China College of Stomatology, Sichuan UniversityDepartment of Endodontics, State Key Laboratory of Oral DiseasesNo. 14, Section 3, Ren Min Nan RoadChengduSichuanChina610041
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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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von Arx T, Janner SFM, Jensen SS, Bornstein MM. The resection angle in apical surgery: a CBCT assessment. Clin Oral Investig 2016; 20:2075-2082. [PMID: 26696114 DOI: 10.1007/s00784-015-1695-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 12/14/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The primary objective of the present radiographic study was to analyse the resection angle in apical surgery and its correlation with treatment outcome, type of treated tooth, surgical depth and level of root-end filling. MATERIALS AND METHODS In the context of a prospective clinical study, cone beam computed tomography (CBCT) scans were taken before and 1 year after apical surgery to measure the angle of the resection plane relative to the longitudinal axis of the root. Further, the surgical depth (distance from the buccal cortex to the most lingual/palatal point of the resection plane) as well as the level of the root-end filling relative to the most coronal point of the cut root face was determined. Treated teeth were categorized into four groups (maxillary and mandibular anterior and posterior teeth). The final material comprised 62 treated roots in 55 teeth. RESULTS The mean calculated resection angle of all roots was 17.7° ± 11.4° (range -9.6° to 43.4°). Anterior maxillary roots presented the highest mean angle (25.8° ± 10.3°) that was significantly different from the mean angle in posterior maxillary roots (10.7° ± 9.4°; p < 0.001) and from the mean angle in posterior mandibular roots (15.1 ± 9.8°; p < 0.05). In roots with a shallow resection angle (≤20°), the rate of healed cases was higher than in roots with an acute resection angle (>20°), however without reaching statistical significance (p = 0.0905). Angles did not correlate either with the surgical depth or with the retrofilling length. CONCLUSIONS Statistically significant differences were observed comparing resection angles of different tooth groups. However, the angle had no significant effect on treatment outcome. CLINICAL RELEVANCE Contrary to common belief, the resection angle in maxillary anterior teeth was greater than in the other teeth. The surgeon is advised to pay attention to the resection angle when bevelling maxillary anterior teeth in apical surgery.
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Affiliation(s)
- Thomas von Arx
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland.
| | - Simone F M Janner
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland
| | - Simon S Jensen
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland.,Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital, Copenhagen, Denmark
| | - Michael M Bornstein
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland
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Tawil PZ. Periapical Microsurgery: Can Ultrasonic Root-end Preparations Clinically Create or Propagate Dentinal Defects? J Endod 2016; 42:1472-5. [DOI: 10.1016/j.joen.2016.07.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 06/15/2016] [Accepted: 07/19/2016] [Indexed: 11/26/2022]
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Abstract
A better understanding of endodontic disease and the causes of treatment failure has refined the role of surgery in endodontics. The advent of newer materials, advances in surgical armamentarium and techniques have also led to an improved endodontic surgical outcome. The aim of this article is to provide a contemporary and up-to-date overview of endodontic surgery. It will focus primarily on the procedures most commonly performed in endodontic surgery.
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Affiliation(s)
- B S Chong
- Professor/Honorary Consultant in Restorative Dentistry, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London
| | - J S Rhodes
- Specialist in Endodontics, Poole, Dorset
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Jain A, Ponnappa KC, Yadav P, Rao Y, Relhan N, Gupta P, Choubey A, Bhardwaj S. Comparison of the Root End Sealing Ability of Four Different Retrograde Filling Materials in Teeth with Root Apices Resected at Different Angles - An Invitro Study. J Clin Diagn Res 2016; 10:ZC14-7. [PMID: 26894168 DOI: 10.7860/jcdr/2016/15437.7042] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 11/24/2015] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Insufficient apical seal is the significant reason for surgical endodontic disappointment. The root-end filling material utilized should avoid egress of potential contaminants into periapical tissue. AIM The aim of this study was to compare the sealing ability of four root-end filling materials MTA, Portland cement, IRM, RMGIC in teeth with root apices resected at 0 and 45 angle using dye penetration method under fluorescent microscope. MATERIALS AND METHODS Hundred extracted human maxillary anterior teeth were sectioned horizontally at the cement-enamel junction. After cleaning, shaping and obturation with gutta-percha and AH Plus sealer, the tooth samples were randomly divided in two groups (the root apices resected at 0° and 45° to the long axis of the root). The root resections were carried out by removing 2 mm and 1 mm in both the groups. Following which 3 mm deep root-end cavities were prepared at the apices and the root were coated with nail varnish except the tip. The teeth in both the group were randomly divided into four subgroups each (Pro root MTA, Portland cement, IRM and Light cure nano GIC Ketac N-100). All the retrofilled samples were stored in acrydine orange for 24 hours after which they were cleaned and vertically sectioned buccolingually. The sectioned root samples were observed under fluorescent microscope. RESULTS The root apex sealing ability of Mineral Trioxide Aggregate (MTA) was superior to Portland cement, Intermediate Restorative Material (IRM) and LC GIC. IRM demonstrated the maximum apical leakage value among all the materials. Portland cement and LC GIC showed comparable sealing ability. CONCLUSION The angulation whether 0° or 45° angle did not affect the sealing ability of all the four materials used, MTA proved to be one of the superior materials for root-end filling.
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Affiliation(s)
- Anurag Jain
- Senior Lecturer, Department of Conservative Dentistry and Endodontics, Maharana Pratap College of Dentistry and Research Centre , Gwalior, India
| | - K C Ponnappa
- Professor and Head, Department of Conservative Dentistry and Endodontics, Coorg Institute of Dental Sciences . Virajpet, Coorg, Karnataka, India
| | - Pankaj Yadav
- Resident, Department of Conservative Dentistry and Endodontics, Maulana Azad Institute of Dental Sciences , New Delhi, India
| | - Yogesh Rao
- Senior Lecturer, Department of Prosthodontics, Maharana Pratap College of Dentistry and Research Centre , Gwalior, India
| | - Nikhil Relhan
- Senior Lecturer, Department of Dentistry, U.P. RIMS and R, Saifai, Etawah, Uttar Pradesh; Department of Conservative Dentistry and Endodontics. Pacific Dental College and Hospital , Udaipur, Rajasthan, India
| | - Priyanka Gupta
- Senior Lecturer, Department of Conservative Dentistry and Endodontics, Maharana Pratap College of Dentistry and Research Centre , Gwalior, India
| | - Ashish Choubey
- Post Graduate Student, Department of Conservative Dentistry and Endodontics, Maharana Pratap College of Dentistry and Research Centre , Gwalior, India
| | - Shivanshu Bhardwaj
- Post Graduate Student, Department of Conservative Dentistry and Endodontics, Maharana Pratap College of Dentistry and Research Centre , Gwalior, India
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Abstract
In the past, the interaction between dentoalveolar surgery and restorative dentistry has been limited to the removal of teeth with pulp and/or periradicular disease or those that were unrestorable. However, with the increasing dental awareness of the population and the retention of teeth into later life, the interaction between dentoalveolar surgery and restorative dentistry is becoming a fundamental aspect of clinical practice. Indeed, endodontic and implant surgery are core activities that facilitate the retention of a functional dentition.
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Bernardes RA, Húngaro Duarte MA, Vivan RR, Baldi JV, Vasconcelos BC, Bramante CM. Scanning electronic microscopy analysis of the apical surface after of root-end resection with different methods. SCANNING 2015; 37:126-130. [PMID: 25652816 DOI: 10.1002/sca.21188] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Revised: 12/22/2014] [Accepted: 12/29/2014] [Indexed: 06/04/2023]
Abstract
To compare the time dispensed and the surface characteristics when a root-end resection was performed with a surgical ultrasonic device (VarioSurg, NSK, Japan) or with a Zekrya bur. Forty distal roots of freshly extracted mandibular molars were selected and divided into four different groups: (G1) stainless steel insert with ultrasound; (G2) diamond insert with ultrasound; (G3) stainless steel and diamond inserts with ultrasound, and (G4) Zekrya burs. The time required for the root-end resection was timed and the surface characteristics were evaluated via scanning electronic microscopy. The median times for the root-end resections were: 115.9 s for G1, 249.8 s for G2, 112.7 s for G3, and 7.44 s for G4, the latter presented a smoother root-end surface. There was no statistically significant difference in the comparisons between G3 group and G4 group (Zekrya burs). The other groups where the root-end resections were with ultrasonic devices proportioned a prolonged time to resection with irregular surfaces.
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Affiliation(s)
- Ricardo Affonso Bernardes
- Department of Dentistry, Endodontics and Dentistry Material, Bauru Dental School, University of São Paulo, Bauru, São Paulo, Brazil; Brazilian Dental Association, Taguatinga, Federal District, Brazil
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Mandava P, Bolla N, Thumu J, Vemuri S, Chukka S. Microleakage evaluation around retrograde filling materials prepared using conventional and ultrasonic techniques. J Clin Diagn Res 2015; 9:ZC43-6. [PMID: 25859524 DOI: 10.7860/jcdr/2015/11071.5595] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Accepted: 01/01/2015] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The importance of the retrograde cavity preparation and the material used to restore is of utmost importance to achieve successful surgical endodontics. AIM The aim of the present study is to evaluate the apical micro-leakage of root end cavities filled with Mineral trioxide aggregate, Biodentine and light cure GIC using two different cavity preparation techniques that is conventional bur preparation and ultrasonic tip preparation. MATERIALS AND METHODS Eighty extracted single rooted human teeth (except mandibular incisors) with one canal, fully developed apices and without any major carious lesion are collected for the study. The teeth were sectioned at CEJ to standardize the length. Roots are instrumented upto master apical file 40 K size and obturated with gutta percha and AH plus sealer in lateral condensation technique. The teeth were then resected apically at 90° angle axis to the long axis of the root removing 3 mm of the apex. The teeth were divided in to four groups of 20 each- • Group I- samples restored with MTA. • Group II- samples restored with Biodentine. • Group III- (Positive control group)- samples restored with Light activated GIC. • Group IV - (negative control group)- no filling material. Each group is divided into two subgroups (a, b) of ten teeth each 1. Retropreparation done with ultrasonic retrotip. 2. Retropreparation done with conventional bur. The teeth were then immersed in 0.5% Rhodamine B dye for 48 h. The teeth were split longitudinally and the interface between the restored material and the canal wall is observed under Confocal laser scanning microscope. Depth of dye penetration was examined under stereomicroscope. RESULTS The statistical analysis was performed by One way ANOVA, t test. Pair wise comparision was done by Newman - Keuls multiple post hoc test. The mean values of Dye penetration for Group Ia (321.23), Group Ib (490.11), Group IIa (1065.14), Group IIb (1170.96), Group IIIa (1888.90), Group IIIb (2025.35). The samples prepared with ultrasonic retrotip showed less microleakage but it is statistically not significant. CONCLUSION MTA showed significantly less microleakage when compared to Biodentine and light cure GIC and there is no statistical difference between the ultrasonic retrotip preparation and conventional bur preparation.
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Affiliation(s)
- Pragna Mandava
- Senior Lecturer, Department of Conservative Dentistry and Endodontics, SIBAR Institute of Dental Sciences , Guntur, Andhra Pradesh, India
| | - Nagesh Bolla
- Professor and HOD, Department of Conservative Dentistry and Endodontics, SIBAR Institute of Dental Sciences , Guntur, Andhra Pradesh, India
| | - Jayaprakash Thumu
- Professor and HOD, Department of Conservative Dentistry and Endodontics, St. Joseph Dental College , Eluru, Andhra Pradesh, India
| | - Sayesh Vemuri
- Professor, Department of Conservative Dentistry and Endodontics, SIBAR Institute of Dental Sciences , Guntur, Andhra Pradesh, India
| | - Sunil Chukka
- Professor, Department of Conservative Dentistry and Endodontics, SIBAR Institute of Dental Sciences , Guntur, Andhra Pradesh, India
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Tawil PZ, Saraiya VM, Galicia JC, Duggan DJ. Periapical microsurgery: the effect of root dentinal defects on short- and long-term outcome. J Endod 2015; 41:22-7. [PMID: 25282374 PMCID: PMC4306457 DOI: 10.1016/j.joen.2014.08.007] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Revised: 08/09/2014] [Accepted: 08/18/2014] [Indexed: 11/25/2022]
Abstract
INTRODUCTION The purpose of this prospective clinical study was to evaluate the clinical outcome of endodontic microsurgery on roots exhibiting the presence or absence of dentinal defects at 1-year and 3-year follow-up period. METHODS One hundred fifty-five teeth were treated with periapical microsurgery using a modern microsurgical protocol in a private practice setting. The root apices were resected and inspected for dentinal defects with a surgical operating microscope and a 0.8-mm head diameter light-emitting diode microscope diagnostic probe light. After inspection, root-end preparations were performed using ultrasonic tips, and root-end fillings were placed. Follow-up visits occurred at 1 year and 3 years postoperatively. The primary outcome measure used was the change in the radiographic apical bone density, and the secondary outcome measure used was the absence of clinical symptoms. RESULTS Of the 155 treated teeth, a total of 134 teeth were assessed at the 1-year follow-up and 127 teeth at the 3-year evaluation. In the "intact" group, 94.8% healed at 1 year, and 97.3% healed at 3 years. In the "dentinal defect" group, 29.8% healed at 1 year, and 31.5% healed at 3 years. The baseline root condition of either "dentinal defect" or "intact" showed a statistical difference in the healing outcome at both 1 and 3 years. CONCLUSIONS This prospective periapical microsurgery study showed a significant superior clinical outcome for intact roots when compared with roots with dentinal defects at both 1 year and at 3 years postoperatively.
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Affiliation(s)
- Peter Z Tawil
- Department of Endodontics, UNC School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
| | - Veeral M Saraiya
- Department of Endodontics, UNC School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Johnah C Galicia
- Department of Endodontics, University of the Pacific, Stockton, California
| | - Derek J Duggan
- Department of Endodontics, UNC School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Jang Y, Hong HT, Roh BD, Chun HJ. Influence of Apical Root Resection on the Biomechanical Response of a Single-rooted Tooth: A 3-dimensional Finite Element Analysis. J Endod 2014; 40:1489-93. [DOI: 10.1016/j.joen.2014.03.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Revised: 02/25/2014] [Accepted: 03/07/2014] [Indexed: 11/26/2022]
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Abella F, de Ribot J, Doria G, Duran-Sindreu F, Roig M. Applications of Piezoelectric Surgery in Endodontic Surgery: A Literature Review. J Endod 2014; 40:325-32. [DOI: 10.1016/j.joen.2013.11.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Revised: 11/14/2013] [Accepted: 11/20/2013] [Indexed: 01/11/2023]
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49
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Liu Z, Zhang D, Li Q, Xu Q. Evaluation of Root-end Preparation with a New Ultrasonic Tip. J Endod 2013; 39:820-3. [DOI: 10.1016/j.joen.2013.03.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Revised: 02/23/2013] [Accepted: 03/03/2013] [Indexed: 11/28/2022]
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50
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Torres-Lagares D, Rodríguez-Martos R, Castellanos-Cosano L, Yáñez-Vico R, Segura-Egea JJ, Gutiérrez-Pérez JL. Confocal microscopy: a valid approach to evaluate the three-dimensional characteristics of root-end cavities. Med Oral Patol Oral Cir Bucal 2013; 18:e542-6. [PMID: 23524419 PMCID: PMC3668887 DOI: 10.4317/medoral.18440] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2012] [Accepted: 11/24/2012] [Indexed: 11/05/2022] Open
Abstract
Objective: To analyze, using confocal microscope, the three-dimensional characteristics of the root-end cavity preparations completed in root apices of extracted teeth determining their area, perimeter, circularity and cavo-surface angle.
Study design: Thirty-two single-rooted extracted teeth underwent endodontic treatment and apical resection. Root-end cavities were prepared according to 4 protocols, as follows: Group1, stainless steel ultrasonic tips (SST) at 33 KHz power; Group 2, SST at 30 KHz power; Group 3, diamond-coated ultrasonic tips (DCT) at 30 KHz power; and Group 4, DCT at 33 KHz power. Finally, root-end cavity was evaluated using a confocal microscope, recording its area, perimeter, circularity and cavo-surface angle.
Results: The largest cavity perimeter was found in the Group 2 (4.8 ± 1.6 mm) (p & 0.05). Root-end cavities performed using SST showed larger areas than those performed with DCT (p = 0.03). The power of vibration or the tip type did not show correlation with the perimeter, circularity and cavo-surface angle of the root-end cavity (p & 0.05).
Conclusions: Confocal microscopy is a useful approach to study the three-dimensional characteristics of the root-end cavity.
Key words:Confocal microscopy, root-end cavity, surgical root canal treatment, ultrasonic tips.
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