Clinical Cases in Endodontics; Chapter 1: Introduction

Chapter 1 of Clinical Cases in Endodontics, a problem-based text that presents a wide range of real cases in endodontics. Clinical Cases in Endodontics presents actual clinical cases, accompanied by academic commentary, that question and educate the reader about essential topics in endodontic therapy. It begins with sets of cases illustrating the most common diagnoses and the steps involved in preparing a treatment plan. Subsequent chapters continue in this style, presenting exemplary cases as the basis of discussing various treatment options, including nonsurgical root canal treatment, re-treatment, periapical surgery, internal and external resorption, emergencies and trauma, and treating incompletely developed apices. The progression from common to increasingly challenging clinical cases enables readers to build their skills, aiding the ability to think critically and independently. The Clinical Cases series is designed to recognize the centrality of clinical cases to the profession by providing actual cases with an academic backbone. Clinical Cases in Endodontics applies both theory and practice to real-life cases in a clinically relevant format. This unique approach supports the trend in case-based and problem-based learning, thoroughly covering the full range of endodontic treatment. Unique case-based format supports problem-based learning Promotes independent learning through self-assessment and critical thinking Covers all essential topics within endodontics Presents numerous illustrations and photographs throughout to depict the concepts described Clinical Cases in Endodontics is an ideal resource for students mastering endodontic treatment, residents preparing for board examinations, and clinicians wanting to learn the most recent evidence-based treatment protocols

High-pressure melting experiments of Fe3S and a thermodynamic model of the Fe-S liquids for the Earth’s core

Melting experiments on Fe3S were conducted to 75 GPa and 2800 K in laser-heated and internally resistive-heated diamond anvil cells with in-situ x-ray diffraction and/or post-mortem textural observation. From the constrained melting curve, we assessed the thermal equation of state for Fe3S liquid. Then we constructed a thermodynamic model of melting of the system Fe–Fe3S including the eutectic relation under high pressures based on our new experimental data. The mixing properties of Fe–S liquids under high pressures were evaluated in order to account for existing experimental data on eutectic temperature. The results demonstrate that the mixing of Fe and S liquids are nonideal at any core pressure. The calculated sulphur content in eutectic point decreases with increasing pressure to 120 GPa and is fairly constant of 8 wt% at greater pressures. From the Gibbs free energy, we derived the parameters to calculate the crystallising point of an Fe–S core and its isentrope, and then we calculated the density and the longitudinal seismic wave velocity (Vp) of these liquids along each isentrope. While Fe3S liquid can account for the seismologically constrained density and Vp profiles over the outer core, the density of the precipitating phase is too low for the inner core. On the other hand, a hypothetical Fe–S liquid core with a bulk composition on the Fe-rich side of the eutectic point cannot represent the density and Vp profiles of the Earth's outer core. Therefore, Earth's core cannot be approximated by the system Fe–S and it should include another light element

Pink Tooth of Mummery In The Maxillary Left Canine After Fixed Partial Denture (FPD) Preparation

Pink tooth of Mummery is typically found after trauma. However, this case report describes an unusual occurrence of pink tooth in a 67-year-old Caucasian male after fixed partial denture (FPD) tooth preparation. Pink tooth in this case may be due to one or more factors: tooth reduction and heat generation during tooth preparation; heat generation during polymerization of provisional material; and hyperocclusion of a provisional FPD. This case highlights the importance of choosing the appropriate materials and techniques to avoid pulpal complications after dental prosthesis work

The Use Of Lasers For Direct Pulp Capping

Direct pulp capping helps extend the life of a diseased tooth by maintaining tooth vitality. Nowadays, lasers are more frequently used during direct pulp capping in the clinic, but their use has not been previously reviewed. This review presents the basic properties of currently available lasers, scientific evidence on the effects of laser application on direct pulp capping, and future directions for this technology. An extensive literature search was conducted in various databases for articles published up to January 2015. Original in vitro, in vivo, and clinical studies, reviews, and book chapters published in English were included. Various laser systems have been increasingly and successfully applied in direct pulp capping. Lasers offer excellent characteristics in terms of hemostasis and decontamination for field preparation during direct pulp capping treatment; however, the sealing of exposed pulp with one of the dental materials, such as calcium hydroxide, mineral trioxide aggregates, and bonded composite resins, is still required after laser treatment. Clinicians should consider the characteristics of each wavelength, the emission mode, irradiation exposure time, power, type of laser tip, and the distance between the laser tip and the surface being irradiated

Current Status Of Direct Pulp-Capping Materials For Permanent Teeth

Direct pulp-capping is a method for treating exposed vital pulp with dental material to facilitate the formation of reparative dentin and to maintain vital pulp. Two types of pulp-capping materials, calcium hydroxide and mineral trioxide aggregate, have been most commonly used in clinics, and an adhesive resin has been considered a promising capping material. However, until now, there has been no comprehensive review of these materials. Therefore, in this paper, the composition, working mechanisms and clinical outcome of these types of pulp-capping materials are reviewed

Coronal And Apical Leakage Among Five Endodontic Sealers

Purpose: The aim of this study was to use dye penetration to measure apical and coronal leakage simultaneously in single-canal teeth that had been treated endodontically using a single-cone obturation technique. Methods: One hundred single-canal, extracted human teeth were cleaned and shaped with ProTaper NEXT rotary files to size-X5 (50/.06), then randomly assigned to five sealer groups for single-cone gutta-percha obturation. The teeth were soaked in 0.6% rhodamine B at 37°C for seven days, then the roots were ground mesiodistally and the maximum apical and coronal dye penetration was measured. Differences in leakage among the sealer groups were examined using the Kruskal-Wallis test. Pairwise comparisons were made using the Mann-Whitney test with Bonferroni correction. Results: The mean values (mm) of dye penetration for AH Plus, Pulp Canal Sealer, NeoSEALER Flo, EndoSequence BC, and Super-Bond RC Sealer were 0.200, 0.300, 0.675, 0.850, and 0.900 apically, whereas 1.675, 2.075, 4.800, 6.500, and 4.125 coronally. Pairwise comparisons showed significant apical differences between AH Plus/Super-Bond RC Sealer (P = 0.047) and significant coronal differences between AH Plus/NeoSEALER Flo (P = 0.001), AH Plus/EndoSequence BC (P \u3c 0.01), AH Plus/Super-Bond RC Sealer (P \u3c 0.01), Pulp Canal Sealer/NeoSEALER Flo (P = 0.010), Pulp Canal Sealer/EndoSequence BC (P \u3c 0.01), and Pulp Canal Sealer/Super-Bond RC Sealer (P \u3c 0.01). Conclusion: Coronal leakage was worse than apical leakage for all sealers. AH Plus exhibited the least leakage apically and coronally; Super-Bond RC Sealer showed the most leakage apically, and EndoSequence BC showed the most leakage coronally

Use Of Micro-CT To Examine Effects Of Heat On Coronal Obturation

Purpose: The aim of this study was to categorize the effects of heat on coronal obturation with gutta-percha and sealer using X-ray micro-computed tomography (micro-CT). Methods: Ten single-rooted, extracted human teeth were shaped using ProTaper NEXT files to size X5 (#50/Taper 6%) with 2.5% NaOCl irrigation. A single ProTaper NEXT X5 gutta-percha point was then inserted with epoxy resin (AH Plus) or tricalcium silicate (EndoSequence BC) sealer (n = 5/group), and cut at the cemento-enamel junction. The teeth were scanned using micro-CT (SkyScan1272) to obtain 11 sagittal 2-D images. Three calibrated raters categorized the coronal 0.5 mm of the images into four categories: “swirled sealer and/or gutta-percha without voids” (I), “uniform voids and sealer/gutta-percha” (II), “non-uniform voids and sealer/gutta-percha” (III), and “swirled sealer and/or guttapercha with voids” (IV). Intra-rater and inter-rater reliability were then calculated. Chi-square tests were conducted to determine the significance of differences in each category between sealers. Results: The intra-class correlation coefficient was 0.55 (same rater/two different times) and Fleiss’ kappa (different raters/same image) was 0.34. Categories I, II, III, and IV accounted for 16.4%, 4.2%, 30.3%, and 49.1% for AH Plus, and 6.7%, 4.2%, 27.3%, and 61.8% for EndoSequence BC, respectively. Conclusion: Category IV was most common and Category II the least common. Significant differences were evident between sealers for Category I (P \u3c 0.01)

Internal and external resorption in a lower molar with an associated endodontic-periodontic lesion: A case report

This article describes a unique case in which both internal and external inflammatory resorption and endodontic-periodontic lesions were present at the same time in the patient's left mandibular first molar. Based on clinical and radiographic findings, it was determined that the nature of this case was a pulpal infection-induced inflammatory resorption and furcation lesion. After root canal therapy, the furcation lesion and external inflammatory resorption were completely resolved. This case indicates that the correct diagnosis of the stimulating factor for tooth resorption and determination of the primary origin of endodontic-periodontic lesions are critical for clinical management and success

Impact Of Two Distinct Dental Anesthesia Simulation Models On The Perception Of Learning By Students

We evaluated an infiltration anesthesia simulation model (IAM) and a conduction anesthesia simulation model (CAM) on the perception of learning by Mexican dental students. Our aim was to compare the perception of learning by dental students trained with two distinct dental anesthesia simulation model (DASM) with dental students who were not trained with a DASM. 3 groups participated in the study: G1 (N=12 students) learned to block the mental nerve (BMN) by participating in a theoretical lecture (stage 1) and a clinical demonstration (stage 2); G2 (N=12 students) learned the BMN by participating in the stage 1, stage 2, and training with the CAM; G3 (N=12 students) learned the BMN by participating in the stage 1, stage 2, and training with the IAM. The groups performed the BMN in a clinical exercise. Working-time of all participants was timed. Perception of learning for all participants was evaluated with a 5-point Likert Scale. The results showed that statistically significant differences were found between score of G1 and score of G2 and score of G3 (P\u3c0.05). No statistically significant differences were found between scores of G2 and scores of G3. G1, G2 and G3 showed an average working-time of 12:42 minutes, 9.75 minutes and 8:03 minutes, respectively (P\u3c0.05). We concluded that the IAM and CAM showed a positive impact on the perception of learning, and the students trained with the IAM showed a shorter working time compared with the students trained with the CAM