Endodontics

Root canal samples, taken from periapical tissue exudates during routine root canal treatment procedures, were processed for identification of tumor necrosis factor using a mouse anti-human monoclonal antibody and enzyme-linked immunosorbent assay. Detectable levels of tumor necrosis factor were identified in periapical tissue exudates in chronic apical periodontitis.

A mandibular first molar with more than four canals is an interesting example of anatomic variations, especially when four of these canals are located in distal roots. This report describes a case of a mandibular first molar with six canals (two mesial and four distal canals in two distal roots). The canals were equipped with a K-file and irrigated with NaOCl (5.25%) and normal saline as the final irrigant. The canals were filled laterally with gutta percha and AH26 sealer (De Trey, Dentsply, Switzerland). This case shows a rare anatomic configuration and points out the importance of looking for additional canals.

This study was conducted to observe the rat subcutaneous connective tissue reaction to implanted dentin tubes that were filled with mineral trioxide aggregate, Sealapex, Calciobiotic Root Canal Sealer (CRCS), Sealer 26, and the experimental material, Sealer Plus. The animals were sacrificed after 7 and 30 days, and the specimens were prepared for histological analysis after serial sections with a hard-tissue microtome. The undecalcified sections were examined with polarized light after staining according to the Von Kossa technique for calcium. At the tube openings, there were Von Kossa-positive granules that were birefringent to polarized light. Next to these granulations, there was irregular tissue, like a bridge, that was Von Kossa-positive. The dentin walls of the tubes exhibited a structure highly birefringent to polarized light, usually like a layer, in the tubules. These results were observed with all the studied materials, except the CRCS, which didn't exhibit any kind of...

IntroductionObtaining hemostasis in the surgical crypt during periradicular surgery is essential. It allows for improved visibility and contributes to a dry environment suitable for the placement of moisture-sensitive root-end filling material. Although current materials may not be moisture sensitive during setting, hemostasis is important for proper placement of root-end filling materials during apical surgery. A new hemostatic agent, HemCon dental

The demand for aesthetic restoration is a key factor in the placement and popularity of direct composites. New technologies have been implemented over a period of time in the shade matching of composites, which is more reliable than the conventional approach to date. Difficulty with rapidly evolving technologies and inflationary pressure due to increased costs can be the reason why most practitioners use the Vita classic shade guide as traditional method. These traditional shade guides are often manufactured according to the properties of porcelain materials rather than composite resin options.
Aim: This article compares the color difference (ΔE) between Vita classic shade tab and customized composite shade tab using spectophotometric analysis for predictable shade matching in direct composite restorations.
Materials and Methods: In order to compare the customized composite shade tab (A1 and A2) with the regular Vita classic shade tab (A1 and A2), five A1 and A2 shade tabs were fabricated from two separate composite brands (AmelogenTM Plus-ULTRADENT, Coltene Brilliant) in order to obtain a total of twenty samples (n=5 each). The fabrication of the customized shade tabs was done using Smile line Style Italiano mini guide kit. All the twenty samples, (customized composite A1, A2 shade tabs) and the Vita classic A1 and A2 shade tab were subjected to spectrophotometric analysis using Data color 650 sphectrophotometer to measure the CIE-Lab values. Based on CIE-Lab parameters obtained from computerized spectrophotometry digital reading of A1, A2 customized composite shade tab and A1, A2 Vita classic shade tabs, the Euclidean distance (ΔE) between two color points (composite-Vita classic) was calculated for the determination of color differences.
Conclusion: There was a perceptible color difference between the most commonly used Vita classic shade tab and the customized shade tab. Therefore, shade matching in direct composite restoration requires customized composite shade tabs to achieve predictable results.
Keywords: Shade guide, Spectrophotomter, Shade matching, Customized composite shade tab.

A new circuit was designed to automatically compensate for measurement errors of an electronic apex locator in various electrolytes. Thirty-one root canals were clinically tested for accuracy. A file was inserted into the canal until the apex signal was obtained, at which point the file was immobilized with glass-ionomer cement. After extraction, the apical area was exposed and the position of the file tip was examined under an operating microscope. Distances from the major foramen and cemento dentinal junction (CDJ) were recorded. The average distance from the major foramen was -0.13 mm with a range of -1.28 mm and +0.46 mm. The average distance in 26 detectable CDJ samples was +0.18 mm with a range of -0.98 mm and +0.65 mm. The measurements, which were within +/- 0.5 mm, were 94% (29/31) from the major foramen and 92% (24/26) from the CDJ. Measurement consistencies within one SD were 81% for the major foramen and 65% for the CDJ, respectively. Measurements within two SD were 97% f...

Dental trauma can lead to injuries in teeth and their supporting structures, which occurs most commonly in young patients and varies in severity from enamel fractures to avulsions. Root fractures are relatively uncommon among dental traumas, mostly affecting the permanent dentition. It has been reported that root fractures can undergo healing, whereas pulp necrosis can also occur.In this report, we present a case of the utilization of cone-beam computed tomography (CBCT) in the detection of possible cervical or internal resorption secondary to a mid-horizontal fracture in a 36-year-old male patient. The fractured teeth spontaneously healed and were diagnosed radiographically after 28 years. Initially, conventional radiographs showed fractured fragments with radiolucent lines. Because of possible invasive cervical resorption and doubt over internal resorption in the conventional images, it was decided to examine the teeth with cone-beam computed tomography with three-dimensional reconstructions.The images clearly showed the displaced fragments of the root fracture. Despite the appearance in the conventional radiograph, no evidence of cervical or internal resorption was detected in the teeth other than the healed root fracture.It was concluded that CBCT images should be obtained for root fractures, especially those in which cervical or internal resorption is suspected from routine conventional radiographs.

A radiographic recall evaluation of 894 endodontic cases treated by dental students at the University of Oklahoma College of Dentistry was conducted by faculty. The purpose of this study was to determine the success of standardized nonsurgical endodontic treatments by using radiographic techniques of determination and to compare the results to similar studies at other dental schools. Cases were labeled as successful, acceptable, questionable, and failing. Observations included time since treatment, age, gender, and tooth type. The combined percentage of successful and acceptable cases was 91.05%. Differences in percentage of success among recall time intervals were statistically significant (p < 0.01), as were the percentages of success between tooth types treated (p < 0.05). Success rate was not affected by age or gender (p > 0.05). The overall rate of successful and acceptable cases in this study was found to compare favorably with those from recall studies conducted at o...

ABSTRACT : The root canal system is an arborizational, anastomotic, byzanthine, labyrinthine complexity, morphologically comparable to a mosaic. While primary canals exist, the tributaries, accessory branches and lumina of dentinal tubules harbour extensive tissue and microflora which if left untreated remains vector for persistent and refractory pathology. Therefore root canal  shaping and cleaning is of utmost importance in the success of root canal treatment. Number of systems are available for effective shaping accounting from hand files to nickel titanium rotary files to the new single file concept “WAVE ONE” KEYWORDS : Wave One, Reciprocating Motion, Nickel Titanium, Reverse  Balanced Force Technique, vCJD
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Eighty freshly extracted teeth were endodontically prepared and filled with gutta-percha and either a zinc oxide-eugenol-based sealer or AH26 to determine what effect these sealers, with widely differing properties, would have on apical microleakage after either immediate or delayed dowel space preparation. The teeth were randomly assigned to 1 of 4 groups, and the post space was made either immediately after filling or after being stored in 100% humidity for 1 wk. They were then immersed in a 2% methylene blue solution under vacuum, washed, and split longitudinally. The extent of dye penetration was read by five independent observers and the results analyzed. The only significant difference was in the delayed preparation group with zinc oxide-eugenol sealer, which showed greater leakage than the other groups.

Closed root canals likely have an oxygen-free environment; most bacteria in canals are anaerobic. These bacteria and other debris are difficult to remove. Unknown is tissue dissolution with chemicals under these anaerobic conditions. This study evaluated and compared dissolving properties of calcium hydroxide (Ca(OH)2) and sodium hypochlorite (NaOCI) on bovine pulp tissue in aerobic and anaerobic environments. Sixty bovine pulp specimens were dried, then randomly divided into six groups. Groups A and B were immersed in Ca(OH)2 + water solution, whereas group C and D were in 2.5% NaOCI. Groups E and F (controls) specimens were placed in distilled water. Groups A, C, and E were incubated anaerobically, and groups B, D, and F were incubated under regular atmospheric conditions, all for 7 days. Percentages of weight loss were compared between groups. Results showed the following: (a) both chemicals partially dissolved pulp tissue, (b) anaerobic environment did not alter tissue-dissolving properties of Ca(OH)2 or NaOCI, and (c) Ca(OH)2 and NaOCI were equal and more effective than water.

The purpose of the present study was to assess the effect of the presence of surfactants over time on free available chlorine (FAC), pH, viscosity, and surface tension of sodium hypochlorite (NaOCl) preparations. Three preparations containing surfactant (Chlor-XTRA 6% [Vista Dental Products, Racine, WI], Hypocelle 4% Forte [Dentalife, Ringwood, Australia], and White King Lemon [Pental, Shepparton, Australia]) and 2 without, Vista 6% (Vista Dental Products) and Hypocelle 4% Forte plain (Dentalife), were tested. The solutions were stored in closed plastic bottles and protected from light at a constant 20°C for 213 days. FAC was measured using iodometric titration, whereas pH, surface tension, and viscosity were measured using a pH meter, pendant drop method, and rheometer, respectively. The influence of the type of solution and the presence of surfactant over time on FAC was compared with the aid of linear regression models. Two-way analysis of variance was used to evaluate the effect...

Severe pain and/or swelling following a root canal treatment appointment are serious sequelae. Information varies or is incomplete as to the incidence of these conditions and related factors. In this study, data were collected at root canal treatment appointments on demographics, pulp/periapical diagnoses, presenting symptoms, treatment procedures, and number of appointments. Patients that then experienced a flare-up (a severe problem requiring an unscheduled visit and treatment) had the correlating factors examined. Statistical determinations were by chi-square analysis with significance at 0.05 or less. Nine hundred forty-six visits resulted in an incidence of 3.17% flare-ups. Flare-ups were positively correlated with more severe presenting symptoms, pulp necrosis with painful apical pathosis, and patients on analgesics. Fewer flare-ups occurred in undergraduate patients and following obturation procedures. There was no correlation between patient demographics or systemic conditio...