Endodontic Treatment of 46 with Four Root Canals: Case Presentation

Pacijentica u dobi od 30 godina javila se zbog povremenih smetnji u području 46. Nakon kliničkog pregleda kojim je utvrđena rubna pukotina na ispunu, bolnost na okomitu perkusiju i avitalnost zuba, učinjene su osnovne rtg snimke na kojima je vidljiva periapeksna promjena u području distalnoga korijena. Provedena je instrumentacija četiriju korijenskih kanala modificiranom “Balancedforce” tehnikom. Kanali su ispunjeni Diaket punilom i standardiziranim gutaperka štapićima tehnikom hladne lateralne kondenzacije. U svim fazama provedene su radiološke kontrole.A female patient, aged 30 years, was admitted because of temporary pain in area 46. A clinical examination established a lateral fissure in the filling, sensitivity to vertical percussion and avitality of the tooth. Preoperative radiograph showed periapical change of the distal root. Instrumentation of the four root canals was performed by “Balanced Force Technique”. The canals were filled with Diaket sealer and standardized gutta-percha points by “cold lateral condensation technique ”. Radiographs were taken at all stages

Leakage of Different Canal Obturation Techniques

Svrha rada bila je ispitati propusnost ispuna korijenskih kanala izrađenih tehnikom hladne lateralne kondenzacije, tehnikom tople lateralne kondenzacije (Touch’n Heat) i tehnikom Thermafil. Za pokus je rabljen uzorak od 70 jednokorijenskih trajnih zuba. Korijenski kanali svih zuba obrađeni su tehnikom “step-back”. Slučajnim odabirom zubi su podijeljeni u tri skupine po 20 uzoraka i ispunjeni su gore navedenim tehnikama. Deset uzoraka bilo je u kontrolnoj skupini. Nakon petnaestodnevnog stvrdnjavanja u sterilnoj fiziološkoj otopini uzorci su izvađeni, osušeni, premazani izolacijskim lakom te stavljeni u kušalicu uz dodatak boje. Nakon sedam dana podvrgnuti su procesu bistrenja. Prozirnost zuba postignuta je demineralizacijom u dušičnoj kiselini, dehidracijom u etilnom alkoholu i uranjanjem zuba u metil-silicilat. Prodor boje očitan je stereomikroskopom. Rezultati su statistički obrađeni dvosmjernom analizom varijance s “post hoc” LSD testovima. Temeljem dobivenih rezultata statistički znatno manji prodor boje izmjeren je kod uzoraka punjenih tehnikom Touch’n Heat (0,63 mm ±0,35) i Thermafilom (0,71 mm ±0,57) u usporedbi s tehnikom hladne lateralne kondenzacije (1,31 mm ±0,75).The aim of this study was to assess leakage of root canals obturated using different techniques: cold lateral condensation, warm lateral condensation (Touch’n Heat) and Thermafil. The experimental sample had 70 single rooted permanent teeth. Root canals were instrumented using step-back technique. The teeth were randomly assigned to three groups of 20 samples and obturated using experimental techniques. Ten samples were used as control samples. After a fifteen-day setting period in sterile saline, the samples were taken out, dried, covered by insulating varnish and placed in test-tube with dye. After seven days, the samples were subjected to demineralisation in nitrogen acid, dehidration in ethanol and submerged in methyl-silicilate, thus rendering them transparent. Dye penetration was then read using stereomicroscope. The results were processed by two-way analysis of variance with LSD post hoc test. The results indicate significantly lower dye-penetration in samples obturated using Touch’n Heat technique (0.63±0.35mm) and Thermafil (0.71±0.57mm), when compared to the sample obturated using cold lateral condensation (1.31 ±0.75mm)

Seal Materials as a Retrograde-Fill in an Ultrasonically Prepared Cavity

Svrha ovoga rada bila je utvrditi kakvoću brtvljenja mineralnog trioksida (MTA), Super EBA i IRM cementa u ultrazvučno izrađenom kavitetu tehnikom prodora boje. Pokus je izveden na 35 jednokorijenskih trajnih zuba kojima su kanali obrađeni konvencionalnom “step-back” tehnikom i ispunjeni tehnikom hladne lateralne kondenzacije. Nakon što su se stvrdnuli u fiziološkoj otopini, vršci korijena su resecirani i izrađeni su retrogradni kaviteti ultrazvučnim nastavkom dubine 3 mm i promjera 1,5 mm te su ispunjeni po 10 uzoraka MTA, IRM, Super EBA cementom i 5 uzoraka kontrolne skupine amalgamom. Uzorci su stavljeni u kušalicu s dodatkom boje i kada je postignuta prozirnost zuba rezultati su očitani stereomikroskopom uz uporabu kalibrirane skale na okularu. Utvrđeno je statistički znatno manje propuštanje kod uzoraka ispunjenih mineralnim trioksidom u usporedbi s IRM i Super EBA cementom.The aim of the study was to evaluate the sealing quality of mineral threeoxide aggregate (MTA), Super EBA and IRM cement in an ultrasonically prepared cavity using a dye penetrating technique. The experiment was carried out on 35 single rooted permanent teeth. Their roots were treated by a conventional “step back” technique and filled by a cool lateral condensation technique. After hardening in a physiological solution, root-ends were resectioned and a retrograde cavity 1.5 mm in diameter, 3 mm deep was prepared by an ultrasonic tip. MTA, Super EBA, IRM, filled ten samples and a control group of 5 samples were filled by amalgam. A dye was added to the samples, which were left in a testing rood. After reaching tooth transparency, results were noted by a stereomicroscope with the use of a calibrated scale on the ocular. Statistical results indicated that samples filled with MTA had least leakage in comparison to those filled with IRM and Super EBA cement

Tumor Necrosis Factor-Alpha in Peripical Tissue Exudates of Teeth with Apical Periodontitis

Aim. The aim of this study was to determine tumor necrosis factor-alpha (TNF-α) levels in periapical exudates and to evaluate their relationship with radiological findings. Methodology. Periapical exudates were collected from root canals of 60 single-rooted teeth using absorbent paper points. TNF-α levels were determined by enzyme-linked immunosorbent assays. The samples were divided into three groups according to the periapical radiolucent area. Results. Nonparametric Kruskal-Wallis test revealed significant differences between TNF-α concentrations in control group (40, 57±28, 15 pg/mL) and group with larger radiolucent areas (2365, 79±582, 95 pg/mL), as well as between control and canals with small radiolucent areas (507, 66±278, 97) (P<.05). Conclusions. The levels of TNF-α increase significantly in teeth with periapical pathosis, from smaller to bigger lesions. This research and its results have shown that objective analysis of the TNF-α levels enables establishment of a relationship between different concentrations of TNF-α and different radiological changes

The Mutagenic Potential of Chloroform, Orange Oil, Eucalyptus Oil and Halothane by Salmonella/Microsome Assay

Svrha rada bila je ispitati mutagenu aktivnost četiriju komercijalno dostupnih otapala gutaperke Salmonella/mikrosomskim testom. Ispitana su bila otopala: kloroform, narančino ulje, eukaliptusovo ulje i halotan u količinama od 10 μl, 30 μl, 50 μl, 100 μl i 200 μl. Upotrijebljen je standardni Ames test inkorporacije na ploči pri čemu su rabljene bakterije Salmonella typhimurium soja TA 98 i TA 100 s metaboličkom aktivacijom enzimom S9. Rezultati istraživanja pokazuju citotoksičnu aktivnost eukaliptusova ulja u svim koncentracijama, narančina ulja u koncentracijama od 50 μl i većima. Kloroform je pokazao citotoksičnost u koncentracijama od 100 μl i 200 μl. Niti jedno otapalo gutaperke nije pokazala mutagenu aktivnost Ames testom u ispitivanim koncentracijama.The aim of this study was to examine mutagenic activity of four commercially available gutta-percha solvents by means of the Salmonella/ microsome assay. The examined solvents were: chloroform, orange oil, eucalyptus oil and halothane in amounts of 10 μl, 30 μl, 50 μl, 100 μl and 200 μl. Standard plate incorporation Ames test was preformed by using two tester strains of Salmonella typhimurium, TA 98 and TA 100, with metabolic activation of S9. The results showed toxicity of eucalyptus oil in all aliquots, orange oil in aliquots of 50 μl and above and chloroform in aliquots of 100 μl and 200 μl, but all four substances responded negative to the Ames test. These results indicate that the tested solvents do not possess mutagenic activity toward the Salmonella strains used

Remaining Filling on the Root Canal Walls after Retreatment with Three Gutta-percha Solvents

Svrha istraživanja bila je utvrditi količinu zaostale gutaperke i cementa na stijenkama korijenskoga kanala nakon uporabe triju različitih otapala gutaperke: eukaliptusova ulja, halotana i narančina ulja. Sedamdeset jednokorijenskih zuba je instrumentirano «step back» tehnikom te ispunjeno gutaperkom i Diaket cementom tehnikom hladne lateralne kondenzacije. Nakon 180 dana pohrane u fiziološkoj otopini uzorci su podijeljeni u tri skupine. Revizija je napravljena ručnim instrumentima s dodatkom otapala. Postupak je završen kada nije bilo tragova gutaperke i cementa na instrumentu ili na papirnatome štapiću. Zubi su raskoljeni te snimljeni kamerom montiranom na steromikroskop. Površina zaostale gutaperke i cementa izračunane su računalnim programom «ISSA». Najviše je punila zaostalo na stijenkama korijenskoga kanala nakon revizije s narančinim uljem (3,85 ±3,15 mm2), zatim s halotanom (3,72 ±2,52 mm2), a najbolji su rezultati postignuti s eukaliptusovim uljem (2,82 ±1,31 mm2), ali bez statistički znatne razlike.The aim of the investigation was to evaluate the amount of remaining gutta-percha and cement on dentine walls of the root canal after retreatment with three different gutta-percha solvents: eucalyptus oil, halothane and orange oil. Seventy one-rooted teeth were instrumented by “step-back” technique and filled with gutta-percha and Diaket cement using a cold lateral condensation technique. After 180 days storing in saline solution the samples were divided into three groups. Retreatment was done by hand instruments with the addition of solvent. The procedure was considered finished when there were not obvious traces of guttapercha and cement on the instrument or paper point. The teeth were split and photographed by camera mounted on a stereomicroscope. The area of remaining gutta-percha and cement was calculated by computer program “ISSA”. The greatest amount of remaining root canal filling was found after retreatment with orange oil (3.85 ±3.15 mm2), followed by halothane (3.72 ±2.52 mm2), and the best result was achieved with eucalyptus oil (2.82 ±1.31 mm2), but without statistical significance

Endodontic Retreatment with Eucalyptol and Chloroform Solvent

Kloroform je bio najčešće rabljena otopina za otapanje gutaperke u korijenskom kanalu. Rasprave o sigurnosti njegove uporabe potakle su uporabu novih tekućina za otapanje gutaperke. Svrha rada bila je usporediti djelotvornost i vrijeme potrebno za otapanje gutaperke eukaliptolom i kloroformom. Trideset jednokorijenskih zuba sterilizirano je, obrađeno i ispunjeno gutaperkom, te pohranjeno u 0,9% otopini Na- Cl sedam dana. Uzorci su podijeljeni u dvije skupine. Jedna je tretirana eukaliptolom, a druga kloroformom. Revizija se smatrala završenom kad više nije bilo vidljivih tragova gutaperke na metalnim instrumentima i papirnim štapićima. Zubi su uzdužno rascijepljeni i fotografirani. Površine zaostatne gutaperke i punila izmjerene su računalnim programom. Rezultati su statistički obrađeni Student t-testom i pokazali su da nema značajne razlike u otapanju gutaperke između dviju skupina.Chloroform has been the most widely used solvent in endodontic retreatment, but due to concerns about its safety, alternatives have been sought. The purpose o f this study was to compare the effectiveness of gutta-percha removal and time of retreatment between eucalyptol and chloroform used as solvents. Thirty single root teeth were sterilized, prepared, obturated, and stored in 0.9 % physiological solution (Na- Cl) for seven days, after which they were randomly divided into two groups for retreatment. The teeth were retreated using either eucalyptol or chloroform as the solvent. Retreatment was deemed complete when there was no evidence o f gutta-percha on the files or paper points. Teeth were split longitudinally and photographed. The surfaces of remaining gutta-percha and sealer were measured using computer software. The results showed no significant difference in gutta-percha removal between the two groups

Fluid Movement Along the Root Fillings Placed by Three Different Gutta-Percha Techniques

Svrha rada bila je ispitati propusnost ispuna korijenskih kanala punjenih tehnikom hladne lateralne kondenzacije, “Touch’n Heatom” i “Thermafil” tehnikom te konstrukcijom za prijenos tekućine. Materijali i postupci: Za rad je rabljen uzorak od 70 jednokorijenskih trajnih zuba obrađenih tehnikom “step-back”. Slučajnim odabirom zubi su podijeljeni u tri skupine po 20 uzoraka i ispunjeni navedenim tehnikama, a koristilo se punilo Diaket. Propusnost ispuna mjereila se konstrukcijom za prijenos tekućine (pomakom mjehurića zraka u mikropipeti povezanoj s uzorkom). Rezultati: Statistički znatano manje propuštanje ustanovljeno je kod uzoraka ispunjenih Thermafilom (0,46 µL ±0,13) u odnosu prema uzorcima ispunjenima Touch’n Heatom (0,77 µL ±0,50) i tehnikom hladne lateralne kondenzacije (0,71 µL ±0,19). Zaključak: U ovom su radu uzorci punjeni tehnikom “Thermafil” pokazali najmanju propusnost.Objective of work: To asses the leakage of three different root canal filling techniques: cold lateral condensation, Touch’n Heat and Thermafil technique by fluid transport model. The root canals of 70 single rooted teeth were prepared using step-back technique and obturated with tested techniques and Diaket sealer. The leakage was measured by the movement of an air bubble in a capillary glass tube connected to the experimental root. Thermafil technique showed statistically significantly less leakage (0,46 µL ±0,13) than Touch’n Heat (0,77 µL ±0,50) and cold lateral condensation technique (0,71 µL ±0,19). Under the conditions of this study, specimens obturated with Thermafil techniques showed the least leakage

Leakage of Root-End Filling Materials

U radu je in vitro ispitano brtvljenje materijala za retrogradno punjenje korijenskih kanala: amalgama, Super EBA-cementa i IRM-a. Korijenski kanali trideset i četiriju jednokorijenskih zuba obrađeni su “step-back” tehnikom i punjeni tehnikom hladne lateralne kondenzacije. Vršci su korijena resecirani i izrađeni su retrogradni kaviteti I razreda dubine 2 mm. Skupine po 10 zuba punjene su jednim od navedenih materijala. Nakon sedam dana u boji uzorci su podvrgnuti procesu bistrenja. Prozirnost zuba postignuta je demineralizacijom u dušičnoj kiselini, dehidracijom u etilnom aloholu i uranjanjem zuba u metilsalicilat. Prodor boje očitan je stereomikroskopom. Temeljem dobivenih rezultata najbolje retrogradno brtvljenje postignuto je EBA-cementom, a amalgam i IRM pokazali su slabiju sposobnost brtvljenja.The in vitro quality o f the sealing ability of materials for retrograde root fillings: amalgam, Super EBA-seal and IRM has been examined. The root canals of thirty four single rooted teeth were treated by conventional “step-back” technique and obturated by gutta-percha and Diaket sealer using cold lateral condensation technique. The apex of the roots were resected and retrograde cavities o f Class I, 2 mm deep, were made. Three groups of 10 samples each were obturated by one o f the mentioned materials. After seven days in ink the samples underwent the “clearing ” process. The transparency of teeth was achieved by demineralization in nitric acid, dehidration in ethyl alcohol and by submerging the teeth in methyl-salicilat. The linear day penetration was measured by means o f a stereomicroscope. On the basis of the obtained results, in this study, the best retrograde sealing was achieved by using EBA-cement while amalgam and IRM showed poorer sealing ability

Antibacterial Activity of Calcium Hydroxide Root Canal Sealer (Apexit) - in vitro Study

Svrha ovog rada bila je odrediti in vitro antimikrobni učinak Apexita temeljenog na kalcijevu hidroksidu u neposrednom dodiru s bakterijama: Pseudomonas aeruginosa, Escherichia coli, Serratia marcescens i Staphylococcus aureus. Rabljen je Direct contact test (DCT) pri čemu je 10 μl bakterijske suspenzije (106 bakterija) ostavljeno u neposrednom dodiru s punilom 1 sat na 37°C. Pošto je dodan BHI medij (250 μl), mjeren je rast pojedine bakterije nakon 1 sat, 6 sati, 20 sati i 24 sata. Rezultati nakon jednog sata pokazali su da se broj E. coli i P. aeruginosa smanjio na 7-9 x 10 3, S. marcescens na 7 x 10 2 bakterija, a broj S. aureus bio je 1,4 x 10 5. cestosatni uzorci pokazali su da se broj P. aeruginosa smanjio na 10 1, a gram-pozitivne S. aureus na 7,5 x 10 4. Nakon 20 sati preživjela je jedino S. aureus (10 1). Dvadesetčetirisatni uzorci pokazali su potpunu inhibiciju rasta svih ispitivanih vrsta.The aim of this study was to determine the in vitro antimicrobial activity of calcium hydroxide root canal sealer (Apexit) in direct contact with Pseudomonas aeruginosa, Escherichia coli, Serratia marcescens and Staphylococcus aureus. The direct contact test (DCT) was performed. The sealer was mixed and placed on the side wall of microtiter plate wells and 10 μl of bacterial suspension (106 bacteria) was placed onto its surface. Bacteria were in direct contact with the sealer for 1 hour at 37°C. BHI broth (250 μl) was then added and the growth of each strain was measured after 1 hour, 6 hours, 20 hours and 24 hours. After 1 hour the number of E. coli and P. aeruginosa decreased to 7-9 x 10 3 and S. marcescens to 7 x 10 2 bacteria. The number of S. aureus was 1.4 x 10 5 bacteria. Six hour samples showed that the number of P. aeruginosa decreased to 10 1 and gram-positive S. aureus to 7.5 x 10 4. After 20 hours only S. aureus (10 1 bacteria) survived after prior contact with Apexit. The 24-hour samples showed complete bacterial growth inhibition of all the bacterial strains tested in DCT with Apexit