Solving endodontic isolation problems with interim buildups of reinforced glass ionomer cement

Fracture patterns of glass-ionomer cement overlays versus stainless steel bands during endodontic treatment: an ex-vivo study

AIM

To compare fracture patterns of posterior teeth temporized with: mesio-occlusal-distal (MOD) glass-ionomer cement (GIC) interim restorations, stainless steel (SS) bands, GIC dome overlays and GIC dome overlays with occlusal temporary restorations.

METHODOLOGY

The root canals of 92 extracted human premolars and molars were prepared with rotary NiTi instruments and dressed with calcium hydroxide paste prior to cavity preparation for standardized MOD restorations. Teeth were divided into four groups (n = 23) and temporarily restored with: GIC interim restorations (GIC group), stainless steel bands (SS group), GIC dome overlays (GIC-O group) or GIC dome overlays with intermediate restorative material (IRM) in the access cavities (GIC-IRM group). Teeth were subjected to compressive axial load until fracture; fracture forces and fracture modes were recorded. Statistical analysis included Kaplan-Meier plots, Cox proportional hazards model, one-way analysis of variance, chi-square and Fisher's exact tests.

RESULTS

There was a significantly higher risk of failure in the GIC group compared with the SS (P < 0.001), GIC-O (P < 0.001) and GIC-IRM (P = 0.001) groups. The mean fracture force for SS was significantly higher than GIC-O (P = 0.03) and GIC-IRM (P < 0.001). GIC fracture force was significantly lower than all other groups (P < 0.001). Significantly fewer unfavourable fractures were observed in SS compared with GIC (P = 0.001), GIC-O (P = 0.007) and GIC-IRM (P < 0.001).

CONCLUSIONS

Glass-ionomer cement dome overlays with reduced cuspal height and occlusal inclines may be recommended for broken-down posterior teeth, without any risk of poor aesthetics, gingival irritation or further proximal tooth structure loss. Stainless steel bands may only need to be used in extensively broken-down teeth or in the presence of parafunctional habits.

Use of a molar clamp to isolate two adjacent single-rooted teeth: a clinical aid

AIM

To emphasize the importance of rubber dam isolation in root canal treatment and to present a technique to simultaneously isolate two single-rooted teeth using a molar clamp.

SUMMARY

Isolation of two adjacent teeth with inadequate tooth structure is a challenge. The split-dam technique or using two clamps have drawbacks. This report presents a technique to simultaneously isolate two adjacent single-rooted teeth that are difficult to isolate by conventional methods. Its advantages are efficiency, reduction of radiation exposure, better access, good visibility and isolation.

KEY LEARNING POINTS

The basis of this technique is to isolate two teeth as two roots of a molar tooth. The indications for this technique are two adjacent prepared crowns and crownless roots. The appropriate molar clamp can be selected on the basis of the mesial-distal clamp jaw distance being equal to the mesial-distal spacing of the two roots. The buccal-lingual jaw distance of the clamp should be smaller than the dimension of the roots to provide adequate retention.

Temporization for endodontics

Teeth undergoing root-canal therapy are susceptible to microbial contamination from oral fluids both during and after treatment. With the exception of single-visit treatment, the use of a temporary restoration is mandatory. This review aims to provide an overview of the materials and techniques used for short- and long-term restorations during and immediately after endodontic treatment, and to make clinical recommendations. Further research is necessary to determine the effectiveness of temporary restorations in the conditions of the oral environment, especially with respect to leakage and functional demands.

Practical application of infection control in endodontics

The transmission of infections in an endodontic practice is a significant concern for both patients and dental health care providers. This article offers a review and practical application of infection control methods in the practice of endodontics.