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Rathod P, Patel A, Ikhar A, Chandak M, Kurundkar S, Pawar L, Singh S, Pawar P, Manik K. Overview of Interim and Temporary Restorations of Teeth During Endodontic Treatment. Cureus 2024; 16:e60591. [PMID: 38894783 PMCID: PMC11185024 DOI: 10.7759/cureus.60591] [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: 05/08/2024] [Accepted: 05/19/2024] [Indexed: 06/21/2024] Open
Abstract
Root canal treatment of vital, non-infected teeth can often be completed in a single visit, negating the necessity for dressing and provisionalization. Conversely, cases involving infected canals typically demand multiple visits, during which antibacterial medicaments are applied, making effective provisionalization crucial for varying durations. The key components of a successful root canal treatment include adequate canal shape to promote efficient obturation, thorough chemical and mechanical debridement, and complete removal of pulp tissue remnants and bacteria. The primary cause of pain following the initiation of endodontic treatments is often attributed to inadequate debridement or incomplete removal of the pulp tissue, closely followed by insufficient temporary restorations. This review aims to comprehensively overview provisionalization materials used during and immediately after endodontic procedures.
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Affiliation(s)
- Pratik Rathod
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Aditya Patel
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Anuja Ikhar
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Manoj Chandak
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Shwetana Kurundkar
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Lalit Pawar
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Shefali Singh
- Department of Orthodontics, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Paresh Pawar
- Department of Pediatric and Preventive Dentistry, Pacific Dental College and Hospital, Pacific Academy of Higher Education & Research University, Udaipur, IND
| | - Khyati Manik
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Wuersching SN, Moser L, Obermeier KT, Kollmuss M. Microleakage of Restorative Materials Used for Temporization of Endodontic Access Cavities. J Clin Med 2023; 12:4762. [PMID: 37510877 PMCID: PMC10381707 DOI: 10.3390/jcm12144762] [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: 06/07/2023] [Revised: 07/06/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023] Open
Abstract
A tight temporary seal applied to an access cavity is thought to improve endodontic outcomes. This study aims to assess the bacterial and glucose microleakage of different types and combinations of temporary restorations. Human-extracted incisors were instrumented, dressed with a calcium hydroxide paste, and sealed with Cavit W (CW), CW/Ketac Molar (CW/KM), CW/Smart Dentin Replacement (CW/SDR), Intermediate restorative material/KM (IRM/KM), or Clip F (CF). Standardized 3D-printed hollow test specimens were manufactured and temporized in the same manner. The specimens were examined for bacterial and glucose leakage for 28 days. Data were analyzed using a Kaplan-Meier survival analysis. CW/SDR and CF showed the least bacterial and glucose leakage over time. CW, CW/KM, and IRM/KM had similarly high levels of glucose leakage, but CW/KM and IRM/KM provided a tighter seal against bacterial penetration than CW. CW/SDR and CF should be considered for the sealing of access cavities of teeth previously restored with methacrylate-based materials.
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Affiliation(s)
- Sabina Noreen Wuersching
- Department of Conservative Dentistry and Periodontology, LMU University Hospital, LMU Munich, 80336 Munich, Germany
| | - Luise Moser
- Department of Conservative Dentistry and Periodontology, LMU University Hospital, LMU Munich, 80336 Munich, Germany
| | - Katharina Theresa Obermeier
- Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, LMU University Hospital, LMU Munich, 80337 Munich, Germany
| | - Maximilian Kollmuss
- Department of Conservative Dentistry and Periodontology, LMU University Hospital, LMU Munich, 80336 Munich, Germany
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Alkadi M, Algahtani FN, Barakat R, Almohareb R, Alsaqat R. Assessment of the effect of spacer material on gap and void formation in an endodontic temporary restoration using micro-computed tomography. Sci Rep 2023; 13:4354. [PMID: 36927887 PMCID: PMC10020472 DOI: 10.1038/s41598-023-31290-8] [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: 12/18/2022] [Accepted: 03/09/2023] [Indexed: 03/18/2023] Open
Abstract
This study aimed to evaluate the effect of two spacer materials (cotton pellet and polytetrafluoroethylene [PTFE]) on gap and void formation in the Cavit restoration used for endodontic temporization. Thirty-four extracted human single-rooted premolars were matched and allocated into two groups (n = 17/group) according to the access cavity spacer (cotton pellet or PTFE). Standardized endodontic access cavities were prepared in all the teeth. Subsequently, the teeth were scanned by micro-computed tomography (micro-CT) to determine the volume of the access cavities. The teeth were then temporized by placing either cotton pellet or PTFE as spacer materials on the canal orifices, followed by the Cavit restoration. Following the temporization procedure, the teeth were subjected to a second micro-CT scan to determine the percentage volume of gaps and voids along the margins and within the Cavit restoration, respectively. Statistical analysis was performed using the Shapiro-Wilk and Wilcoxon signed-rank tests with a 5% significance level. The PTFE spacer was associated with significantly less gap formation between the Cavit restoration and the access cavity walls (P < 0.05) compared with the cotton pellet. No difference existed in void formation between the groups (P > 0.05). These findings indicate that the spacer material placed under the Cavit restoration can influence the quality of overlying restoration. PTFE was associated with less gap formation and, therefore, performed better than the cotton pellet as a spacer material beneath the Cavit restoration during endodontic treatment.
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Affiliation(s)
- Manal Alkadi
- Dental Clinics Department, King Abdullah bin Abdulaziz University Hospital, Princess Nourah Bint Abdulrahman University, Box 84428, Riyadh, 11671, Saudi Arabia
| | - Fahda N Algahtani
- Division of Endodontics, Department of Clinical Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, Box 84428, Riyadh, 11671, Saudi Arabia.
| | - Reem Barakat
- Dental Clinics Department, King Abdullah bin Abdulaziz University Hospital, Princess Nourah Bint Abdulrahman University, Box 84428, Riyadh, 11671, Saudi Arabia
| | - Rahaf Almohareb
- Division of Endodontics, Department of Clinical Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, Box 84428, Riyadh, 11671, Saudi Arabia
| | - Reem Alsaqat
- Dental Clinics Department, King Abdullah bin Abdulaziz University Hospital, Princess Nourah Bint Abdulrahman University, Box 84428, Riyadh, 11671, Saudi Arabia
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Abbott PV. Present status and future directions - managing endodontic emergencies. Int Endod J 2021; 55 Suppl 3:778-803. [PMID: 34958512 DOI: 10.1111/iej.13678] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 12/20/2021] [Accepted: 12/26/2021] [Indexed: 11/28/2022]
Abstract
Endodontic emergencies are common in both general dental practices and specialist Endodontic practices. The aim of this review is to provide an overview of endodontic emergencies. Endodontic emergencies can be a result of many different conditions of the pulp, root canal and periradicular tissues. They may occur before endodontic treatment has been started, between appointments when treatment is being performed over multiple visits, or after endodontic treatment has been completed. In the latter situation, the emergency may be very soon after the treatment or it may occur many years later, in which case it is usually a new disease process as a result of the root canal system becoming infected. An emergency can be a stressful situation for both the patient and the dentist (or endodontist) as it is usually an unexpected event. It is incumbent on dental professionals to provide timely assistance to patients who have an emergency, and it is also important to allow sufficient time to manage the situation comprehensively. Management of endodontic emergencies should follow the principles of the 3D's - Diagnosis, Definitive dental treatment and Drugs - and in that sequence. An accurate diagnosis, the first "D", is essential so the appropriate treatment can be provided. Diagnosis requires a thorough understanding of the various conditions that can cause the emergency and this can be helped by having a comprehensive classification of the various conditions. The diagnosis should also direct the clinician to the appropriate definitive dental treatment, the second "D". Root canal treatment will not always be required as some cases can be managed conservatively. Other cases may require root canal re-treatment. The specific details of how the treatment is done can also vary, according to the diagnosis. The final "D" is Drugs - the use of drugs should also be dependent on the diagnosis and the dental treatment. Drugs should only be an adjunct following the treatment. The clinician must also differentiate between inflammation and infection in order to provide the appropriate treatment and to prescribe the appropriate medication for effective pain relief and resolution of other symptoms or signs such as swelling.
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Affiliation(s)
- Paul V Abbott
- UWA Dental School, The University of Western Australia, Western Australia, Australia
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Common Temporization Techniques Practiced in Saudi Arabia and Stability of Temporary Restoration. Int J Dent 2021; 2021:4965500. [PMID: 34777500 PMCID: PMC8580691 DOI: 10.1155/2021/4965500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 10/21/2021] [Indexed: 12/02/2022] Open
Abstract
Introduction Coronal leakage is detrimental to the long-term success of root canal treatment (RCT). While much emphasis is being placed on the quality of the final restoration, little attention is given to the temporary restoration placed in between root canal treatment appointments. The aim of this study was to survey temporization techniques practiced in Saudi Arabia and the frequency of observing temporary material breakdown or complete loss. Materials and Methods An online questionnaire was distributed among general dentists, dental specialists, and clinical trainees in undergraduate and postgraduate dental programs. The sample size was estimated at 370 participants. Data were analyzed using descriptive statistics and chi-square tests. Results The total number of participants who met the inclusion criteria was 525. The majority of them (94.6%) were practicing two-visit RCT. The most common temporization materials were Cavit (50.3%) followed by glass ionomer cement (32%). The majority (72.6%) of participants claimed they allow a thickness of 2-3 mm for temporary restorations. Many participants (60.4%) used a spacer material during temporization, and the cotton pellet was the most common spacer material. Temporary restoration breakdown or complete loss was a common observation. Although the duration between the two RCT visits was 2 weeks or less for 83.6% of participants, only 19.6% of participants claimed that they rarely observed temporization breakdown. Conclusion Two-visit RCT is commonly practiced in Saudi Arabia, and endodontists performed significantly more single-visit procedures. Temporization practices may lack uniformity; however, clinicians were more likely to use calcium sulfate-derived material for two weeks or less. They allow for 2-3 mm thickness restoration and use a cotton pellet as a spacer. According to their clinical observation, temporary material breakdown or complete loss was frequent. This mandates further attention in research and education.
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Djouiai B, Wolf TG. Tooth and temporary filling material fractures caused by Cavit, Cavit W and Coltosol F: an in vitro study. BMC Oral Health 2021; 21:74. [PMID: 33593339 PMCID: PMC7885448 DOI: 10.1186/s12903-021-01431-4] [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: 08/20/2020] [Revised: 01/12/2021] [Accepted: 02/07/2021] [Indexed: 11/30/2022] Open
Abstract
Background Tooth fractures can occur after temporary inter-appointment endodontic filling, resulting in not preserving and thus extraction of the affected tooth. The purpose of this investigation was therefore to evaluate the tooth substance fracture potential given by the expansion of endodontic temporary filling materials. Methods
Tooth and access cavities were prepared in 80 mandibular molars. Four groups of 20 teeth each (Cavit, Cavit W and Coltosol F and control) were included. To simulate a clinical situation, the teeth were endodontically pre-treated and a calcium hydroxide dressing was placed. The cavities were filled with the corresponding temporary filling material, with exception of the control group, and kept submerged in distilled water for 15 days. The teeth were examined every 24 h by two calibrated observers under a stereomicroscope (7.5×), fractures of the temporary filling material and tooth structure were photo-documented, and the results statistically analyzed. Kaplan–Meier survival analysis were calculated to illustrate (survival = no fracture) probabilities to evaluate the time when the temporary filling material, tooth structure or both together occurred. Log-rank test was performed in order to assess significant differences between the materials and the subgroups used. Results Fractures were observed only in the Coltosol F group (p < 0.01), at the end of the observation period, a total of 13 teeth (65%) showed temporary filling material and eight teeth (40%) showed tooth structure fractures. No fractures in the pulp chamber area were observed at the end of the observation period in any group. Conclusions Within the limitations of the current in vitro study, the results obtained suggest that tooth structure fractures caused by a temporary filling material can occur during endodontic treatment, thus compromising the success of the treatment.
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Affiliation(s)
- Bedram Djouiai
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
| | - Thomas Gerhard Wolf
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland. .,Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.
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Gemmell A, Stone S, Edwards D. Investigating acute management of irreversible pulpitis: a survey of general dental practitioners in North East England. Br Dent J 2020; 228:521-526. [DOI: 10.1038/s41415-020-1419-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Erdem Hepsenoglu Y, Eyuboglu TF, Özcan M. Postoperative Pain Intensity after Single- versus Two-visit Nonsurgical Endodontic Retreatment: A Randomized Clinical Trial. J Endod 2018; 44:1339-1346. [DOI: 10.1016/j.joen.2018.05.017] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 05/24/2018] [Accepted: 05/27/2018] [Indexed: 11/15/2022]
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Sasaki K, Yamamoto T, Ikawa T, Shigeta Y, Shigemoto S, Ando E, Ogawa T, Ihara K. Pre-endodontic Post and Core Technique for Endodontic and Prosthodontic Treatment. J Contemp Dent Pract 2018; 19:117-122. [PMID: 29358547 DOI: 10.5005/jp-journals-10024-2223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Displacement of provisional fixed prostheses may result in undesirable and embarrassing outcomes in dental treatments, especially in endodontic treatment. Development of certain counter measures has been necessary to avoid such discomforts. AIM The aim of this report was to propose a pre-endodontic post and core technique to achieve smooth progress of the treatment. MATERIALS AND METHODS The patient was a 59-year-old male diagnosed with an infraocclusion caused by wear of his teeth. He received full mouth provisional fixed restorations for a complete oral rehabilitation. Displacement and fracture of the restorations frequently occurred during the observation period for the function of the restorations. Therefore, the pre-endodontic post and core technique was applied to the abutment teeth before their endodontic treatments were started. The technique consisted of three steps as follows: Step 1: Caries removal and dowel preparation were performed for the abutment teeth having apical periodontitis. Composite cores were indirectly fabricated, which had access holes for endodontic treatment. Step 2: The cores were bonded to the teeth. In endodontic treatment, rubber dam appliances were easily placed owing to the core, and proper tooth isolation was accomplished. Step 3: Fiberposts were bonded to the dowel holes through the access holes after the root canal filling. During endodontic treatment, displacement and/or fracture of the provisional restorations did not occur. CONCLUSION The pre-endodontic post and core technique was effective in obtaining improved retention of provisional restoration, appropriate isolation for endodontic treatment, and sufficient retention of the post and core. CLINICAL SIGNIFICANCE The pre-endodontic post and core technique is useful for avoiding the discomforts in dental treatments, namely, a smooth transition from endodontic to prosthodontic treatment can be achieved.
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Affiliation(s)
- Keita Sasaki
- Department of Fixed Prosthodontics, School of Dental Medicine, Tsurumi University, Yokohama, Japan
| | - Takatsugu Yamamoto
- Department of Operative Dentistry, School of Dental Medicine Tsurumi University, Yokohama, Japan, Phone: +81455808550, e-mail:
| | - Tomoko Ikawa
- Department of Fixed Prosthodontics, School of Dental Medicine, Tsurumi University, Yokohama, Japan
| | - Yuko Shigeta
- Department of Fixed Prosthodontics, School of Dental Medicine, Tsurumi University, Yokohama, Japan
| | - Shuji Shigemoto
- Department of Fixed Prosthodontics, School of Dental Medicine, Tsurumi University, Yokohama, Japan
| | - Eriko Ando
- Department of Fixed Prosthodontics, School of Dental Medicine, Tsurumi University, Yokohama, Japan
| | - Takumi Ogawa
- Department of Fixed Prosthodontics, School of Dental Medicine, Tsurumi University, Yokohama, Japan
| | - Keisuke Ihara
- Dental Technician Training Institute, School of Dental Medicine Tsurumi University, Yokohama, Japan
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Malmberg L, Björkner AE, Bergenholtz G. Establishment and maintenance of asepsis in endodontics - a review of the literature. Acta Odontol Scand 2016; 74:431-5. [PMID: 27310020 DOI: 10.1080/00016357.2016.1195508] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Successful endodontic treatment depends on effective measures to eliminate and prevent infection of root canals. Initially treatment should start with isolation and disinfection of the operating field. This review makes an inventory of the available knowledge regarding its establishment and maintenance. MATERIALS AND METHODS A literature search was conducted in the PubMed database in order to identify clinical trials examining disinfection or unintentional contamination of the endodontic operative field. A list of 115 articles was obtained and screened. Five relevant articles were identified. These articles were read in full text. The reference lists from these articles were checked manually for additional studies and three studies were obtained. A total of eight articles met the inclusion criteria. RESULTS There was a great variety in terms of aim, method, and material of the included studies. None could prove a totally reliable aseptic operative field and not one chemical, or combination of chemicals, were found in more than one study. CONCLUSIONS No study documented complete asepsis following initial disinfection, and no study could document predictable maintenance of an established bacteria-free surface. Critical appraisal and standardization of the disinfection and aseptic procedures in endodontics are needed.
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Darcey J, Taylor C, Roudsari RV, Jawad S, Hunter M. Modern Endodontic Planning Part 2: Access and Strategy. DENTAL UPDATE 2015; 42:709-10, 712-4, 717-8 passim. [PMID: 26685470 DOI: 10.12968/denu.2015.42.8.709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Poor access and iatrogenic damage can result in failed root canal treatment. Understanding tooth anatomy improves access and ensures that the clinician is cleaning and shaping the whole root canal system. If a canal is missed treatment usually fails. This paper revisits tooth anatomy and discusses how to ensure that access is optimized, but not at the expense of precious tooth structure. The concept of multi-visit root canal treatment is also addressed with emphasis on the, often overlooked, aspect of temporization. CPD/Clinical Relevance: Good anatomical knowledge of teeth is the cornerstone of endodontics. Once root treatment has begun the clinician must be logical about how many visits to take and how to temporize teeth between such visits.
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Sivakumar JS, Suresh Kumar BN, Shyamala PV. Role of provisional restorations in endodontic therapy. J Pharm Bioallied Sci 2013; 5:S120-4. [PMID: 23946564 PMCID: PMC3722693 DOI: 10.4103/0975-7406.113311] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Revised: 05/04/2013] [Accepted: 05/04/2013] [Indexed: 11/06/2022] Open
Abstract
Root-canal treatment can be carried out in single visit in vital, non-infected teeth, eliminating the need for dressing and provisionalization. Many clinical cases with infected canals require dressing with antibacterial medicaments in a multivisit treatment in which effective provisionalization for different periods of time becomes mandatory. Successful root-canal treatment requires effective mechanical and chemical debridement, elimination of bacteria and pulp tissue remnants and proper canal shaping to facilitate effective obturation. Lack of satisfactory temporary restorations during endodontic therapy ranked second amongst the contributing factors in continuing pain after the commencement of treatment. This review aims to provide an overview of the materials used for provisionalization during and immediately after endodontic treatment.
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14
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Abstract
This case report describes the diagnosis and endodontic therapy of maxillary fused second and third molars, using cone-beam computed tomography (CBCT). A 31-year-old Chinese male, with no contributory medical or family/social history, presented with throbbing pain in the maxillary right molar area following an unsuccessful attempted tooth extraction. Clinical examination revealed what appeared initially to be a damaged large extra cusp on the buccal aspect of the distobuccal cusp of the second molar. However, CBCT revealed that a third molar was fused to the second molar. Unexpectedly, the maxillary left third molar also was fused to the second molar, and the crown of an unerupted supernumerary fourth molar was possibly also fused to the apical root region of the second molar. Operative procedures should not be attempted without adequate radiographic investigation. CBCT allowed the precise location of the root canals of the right maxillary fused molar teeth to permit successful endodontic therapy, confirmed after 6 months.
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Lin HC, Pai SF, Hsu YY, Chen CS, Kuo ML, Yang SF. Use of Rubber Dams During Root Canal Treatment in Taiwan. J Formos Med Assoc 2011; 110:397-400. [DOI: 10.1016/s0929-6646(11)60058-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2010] [Revised: 04/28/2010] [Accepted: 04/29/2010] [Indexed: 10/18/2022] Open
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Nixdorf DR, Moana-Filho EJ, Law AS, McGuire LA, Hodges JS, John MT. Frequency of nonodontogenic pain after endodontic therapy: a systematic review and meta-analysis. J Endod 2010; 36:1494-8. [PMID: 20728716 PMCID: PMC2941431 DOI: 10.1016/j.joen.2010.06.020] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2010] [Revised: 06/20/2010] [Accepted: 06/22/2010] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Little is known about ill-defined pain that persists after endodontic procedures, including an estimate of the problem's magnitude. We conducted a systematic review of prospective studies that reported the frequency of nonodontogenic pain in patients who had undergone endodontic procedures. METHODS Nonodontogenic pain was defined as dentoalveolar pain present for 6 months or more after endodontic treatment without evidence of dental pathology. Endodontic procedures reviewed were nonsurgical root canal treatment, retreatment, and surgical root canal treatment. Studies were searched in four databases electronically, complemented by hand searching. A summary estimate of nonodontogenic tooth pain frequency was derived using random-effects meta-analysis. RESULTS Of 770 articles retrieved and reviewed, 10 met inclusion criteria, and nine had data on both odontogenic and nonodontogenic causes of pain. A total of 3,343 teeth were enrolled within the included studies and 1,125 had follow-up information regarding pain status. We identified 48 teeth with nonodontogenic pain and estimated a 3.4% (95% confidence interval, 1.4%-5.5%) frequency of occurrence. In nine articles containing data regarding both odontogenic and nonodontogenic causes of tooth pain, 56% (44/78) of all cases were thought to have a nonodontogenic cause. CONCLUSIONS Nonodontogenic pain is not an uncommon outcome after root canal therapy and may represent half of all cases of persistent tooth pain. These findings have implications for the diagnosis and treatment of painful teeth that were previously root canal treated because therapy directed at the tooth in question would not be expected to resolve nonodontogenic pain.
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Affiliation(s)
- Donald R Nixdorf
- Division of TMD & Orofacial Pain, School of Dentistry, University of Minnesota, Minneapolis, MN 55455, USA.
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Abstract
Rubber dam has been available to the dental profession for over 140 years. During this time, the use of rubber dam has been perfected, universally taught and recommended by professional organizations. Unfortunately, its consistent use has been rejected by many in the profession. The literature suggests that rubber dam is not used routinely by dental practitioners for root canal treatment. Many unfounded reasons have been cited for its lack of use, including concerns over patient acceptance, time required for application, cost of equipment and materials, insufficient training, difficulty in use and low treatment fees. Failure to use rubber dam has been shown to influence the choice of root canal irrigant, has a negative impact on treatment outcome and places the patient at risk of swallowing or aspirating materials and instruments. Methods to popularize rubber dam amongst general practitioners are discussed.
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Affiliation(s)
- I A Ahmad
- Private Dental Practice, Amman, Jordan.
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18
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Cooper JR, Blalock JS. A suggested solution for endodontic provisional challenges. Oper Dent 2009; 34:356-8. [PMID: 19544827 DOI: 10.2341/08-62] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Jeril R Cooper
- School of Dentistry, Department of General Dentistry, Medical College of Georgia, Augusta, GA, USA.
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Abstract
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.
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Affiliation(s)
- H J Naoum
- Brindabella Specialist Centre, 5 Dann Close, GARRAN, ACT 2605, Australia
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20
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Saunders WP, Chestnutt IG, Saunders EM. Factors influencing the diagnosis and management of teeth with pulpal and periradicular disease by general dental practitioners. Part 2. Br Dent J 1999; 187:548-54. [PMID: 10630043 DOI: 10.1038/sj.bdj.4800328] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To identify techniques commonly used in the management of periradicular disease by general dental practitioners and to ascertain views on continuing professional education in endodontics. DESIGN Data was collected via a postal questionnaire distributed to 617 general dental practitioners in Scotland (33% of practitioners registered with the Dental Practice Board). RESULTS 417 (69%) questionnaires were completed and returned. Only 24.9% of respondents used rubber dam routinely. The majority of respondents used hand instruments for preparation with either sodium hypochlorite or local anaesthetic being used most frequently for irrigation. The mean time for treatment of a single rooted tooth was 71 minutes. The demand for continuing education courses was high with 340 and 197 respondents requesting endodontic and rubber dam courses, respectively. CONCLUSIONS Traditional methods for preparing the root canal using hand instruments were favoured by most dentists. The major disincentive to the use of rotary instruments and new techniques for obturating with thermally softened gutta-percha was expense. The importance of rubber dam isolation requires reiteration and more continuing education courses are required to update clinical skills.
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