Root canal treatment of a dilacerated mandibular premolar using a novel instrumentation approach. A case report

Endodontic Treatment of a Dilacerated Maxillary Second Premolar With a Severely Curved Root Canal: A Case Report and Literature Review

Dilaceration is a developmental anomaly characterized by a sharp change in the axial inclination between the crown and the root of a tooth. Severe root curvature in a dilacerated tooth can greatly complicate root canal treatment. This case report details the successful endodontic treatment of a dilacerated maxillary second premolar with significant root curvature. It highlights the importance of a thorough understanding of root canal anatomy and demonstrates the effectiveness of using pre-curved hand files along with heat-treated nickel-titanium rotary instruments in navigating complex root structures to achieve successful treatment outcomes.

Endodontic Treatment of a Mandibular Second Molar Featuring Vertucci Type V Configuration in the Distal Root: A Case Report

Successful root canal treatment relies primarily on thorough shaping, cleaning, and filling of the entire root canal system. Neglecting even a single canal can significantly raise the risk of post-treatment apical periodontitis. While the distal root of mandibular second molars typically has one canal, they can also present with anatomical variations, including the presence of a Vertucci Type V configuration. This article discusses a case in which a Vertucci Type V configuration in a mandibular second molar was effectively identified and treated.

Present status and future directions -Management of curved and calcified root canals

Root canal curvature and calcification introduce factors that increase the risk of procedural accidents during root canal treatment. The inability to achieve patency to the apical third, asymmetrical dentine removal leading to transportation, perforation and instrument fracture inside the curved trajectories are some of the procedural problems that might jeopardize the management of intraradicular infection and result in poor treatment outcomes. In fact, curved and constricted canals introduce such complexity that total instrumentation concepts and specially designed instruments have been developed to deal with the challenge. This narrative review seeks to provide and consolidate the principles necessary for understanding the dynamics of curved and constricted canal management and to improve the understanding for future developments in this field.

An Arithmetic Crown-down Dynamic Tactile Instrumentation Technique: A Case Report of an S-shaped Root Canal

The preparation of severely curved S-shaped double-curved root canals can be technically challenging. A novel root canal instrumentation technique is proposed, which modifies 2 techniques: the McSpadden crown-down technique and the tactile controlled activation technique. In the McSpadden crown-down technique, the root canal is divided into 2 portions: the coronal zone and the apical zone. However, rather than focusing on the length of file engagement, a formula is proposed to calculate the maximum insertion depths of higher tapered instruments to prevent overflaring of the canal and preserve pericervical dentin. Tactile-controlled activation involves activating martensitic nickel-titanium rotary files upon engagement and then immediately withdrawing the files. The proposed technique recommends 3 apical strokes after the initial engagement before withdrawal to minimize instrumentation time. This novel technique is described in a case report involving the management of an S-shaped double-curved maxillary lateral incisor. The technique presents a new method of crown-down instrumentation that prevents overflaring and avoids instrument separation.

Retrospective evaluation of endodontic case reports published in the International Endodontic Journal and the Journal of Endodontics for their compliance with the PRICE 2020 guidelines

AIM

To evaluate, retrospectively, the quality of previously published case reports in Endodontics according to the PRICE 2020 guidelines.

METHODOLOGY

An electronic literature search was conducted in PubMed database on 12 March 2020, to identify case reports published during the last five years in the International Endodontic Journal and the Journal of Endodontics. For each of the included case reports, information regarding fulfilment of each of the items of the PRICE 2020 guidelines was extracted as '0' (not present in the manuscript), '1' (present in the manuscript) and 'NA' (not applicable) and translated into a score (percentage of items fulfilled). Additionally, the percentage of papers fulfilling each item was calculated.

RESULTS

Overall, 70 endodontic case reports were identified. The scores of the papers ranged between 56.41% and 79.55%, with a mean score of 70.26 ± 4.36% (SD). The percentage of papers fulfilling each item of the applicable PRICE 2020 items ranged widely, between 0% and 100%. The median of the percentage of all the items (n = 47) was 97.01% and mean 73.33 ± 36.28% (SD). The lowest scores were recorded for specific items in the following domains: 'Case Report Information'-Items 6c, 6g-i, 'Patient Perspective'-Item 8a and 'Quality of Images'-Items 12c-d.

CONCLUSIONS

Several areas with low reporting rates were identified in case reports published over the last 5 years in Endodontics. Authors should be encouraged to follow the PRICE 2020 guidelines in order to increase the quality and improve reproducibility of their case reports.

Buckling Resistance of Various Nickel-Titanium Glide Path Preparation Instruments in Dynamic or Static Mode

INTRODUCTION

The aim of this study was to compare the buckling resistance of nickel-titanium (NiTi) instruments for glide path preparation depending on the test mode (static vs dynamic).

METHODS

The conventional PathFile (PF; Dentsply Sirona, Ballaigues, Switzerland) and heat-treated ProGlider (PG, Dentsply Sirona) and WaveOne Gold Glider (WG, Dentsply Sirona) were evaluated. The instrument tips were placed in a small dimple prepared in an aluminum cube in a customized device. The file was then pushed in the axial direction at a 1.0-mm/s crosshead speed with rotation (dynamic mode) or without rotation (static mode). The dynamic mode of WG used its dedicated reciprocating rotation, whereas the others were rotated continuously at 300 rpm. The axial load and lateral buckling displacement were simultaneously measured. Data were analyzed statistically using 2-way analysis of variance (P = .05).

RESULTS

The buckling resistance in the dynamic mode was higher than in the static mode for PG and WG (P < .05), whereas PF was not influenced by test modes (P > .05). In the dynamic mode, the PG required the highest buckling load followed by PF and WG (P < .05). In the static mode, the WG showed the lowest load (P < .05). The dynamic mode showed significantly more upper level lateral buckling displacement than in the static mode (P < .05).

CONCLUSIONS

When the glide path preparation instruments moved in the dynamic mode as in clinical situations, the buckling resistance of the heat-treated NiTi glide path instruments was higher than in the static condition. The heat-treated instruments may have better buckling resistance than the conventional NiTi instrument in clinical situations.

PRICE 2020 guidelines for reporting case reports in Endodontics: explanation and elaboration

Case reports play a key role in showcasing new, unusual or rare disease(s), and the impact of newer therapeutic approaches or interventions. The Preferred Reporting Items for Case reports in Endodontics (PRICE) 2020 guidelines are being introduced exclusively for Endodontics by adapting and integrating the CAse REport (CARE) guidelines and Clinical and Laboratory Images in Publications principles. The PRICE 2020 guidelines have been developed to help authors improve the completeness, accuracy and transparency of case reports in Endodontics and thus enhance the standard of manuscripts submitted for publication. The aim of this document is to provide a comprehensive explanation for each item in the PRICE 2020 checklist along with examples from the literature that demonstrate compliance with these guidelines. This information will highlight the importance of each item and provide practical examples to help authors understand the necessity of providing comprehensive information when preparing case reports. A link to this PRICE 2020 explanation and elaboration document is available on the Preferred Reporting Items for study Designs in Endodontology website at http://www.pride-endodonticguidelines.org.