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

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

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

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)

Micro CT Pilot Evaluation Of Removability Of Two Endodontic Sealers

Purpose: This study compared the removability of AH Plus and EndoSequence BC sealers using in vitro micro-computed tomography. Methods: Ten single-canal, extracted human teeth were cleaned and shaped with ProTaper NEXT rotary files to size X5 (50/0.06) (DentsplySirona). Canals were obturated with a single cone gutta-percha and either AH Plus (Dentsply-Sirona) (Group A) or EndoSequence BC (Brasseler) (Group B). ProTaper Universal Retreatment files (Dentsply-Sirona) were used to remove obturation materials after 90 days at 37o C/100% humidity. Each tooth was scanned using micro-computed tomography (SkyScan 1272; Bruker) at an isotropic resolution of 6 μm from which the percent of material removed was calculated. Two-sample t-tests and one-way ANOVA were used for analysis. Results: The percent removal of materials in the coronal third was 92.9% ± 7.3% (Group A) and 93.2% ± 6.1% (Group B). Removal in the middle third was 94.9% ± 8.5% (Group A) and 96.5% ± 6.1% (Group B). Apical third removal was 76.2% ± 27.9% (Group A) and 70.1% ± 30.8% (Group B). No statistically significant differences were determined between the two sealers or among the sectional thirds within each group (P \u3e 0.05). Conclusion: AH Plus and EndoSequence BC sealers exhibit the same removability at all canal levels of 70% to 96%, with better removal coronally

Natural Products For Infectious Diseases

Editorial introduction to Natural Products For Infectious Diseases, the 2016 special issue of Evidence-Based Complementary and Alternative Medicine, including 7 research articles and 1 review article addressing the efficacies of natural products for treating infectious diseases, such as infection by multidrug-resistant bacteria, viral influenza, coccidiosis, leishmaniasis, infectious septic shock, and biofilm formation. These articles represent pharmacological activity tests, investigation of action mechanisms of natural products, clinical trials with scientific statistical analyses, and phytochemical analyses of bioactive components in medicinal plants, which are important for scientific validation of the use of natural products in alternative and complimentary medicine

Comprehensive Review Of Current Endodontic Sealers

Endodontic sealers for non-surgical root canal treatment (NSRCT) span many compositions and attributes. This comprehensive review discusses current types of endodontic sealers by their setting reaction type, composition, and properties: zinc oxide-eugenol, salicylate, fatty acid, glass ionomer, silicone, epoxy resin, tricalcium silicate, and methacrylate resin sealers. Setting time, solubility, sealing ability, antimicrobial, biocompatibility, and cytotoxicity are all aspects key to the performance of endodontic sealers. Because sealing ability is so important to successful outcomes, the relative degree of microleakage among all the relevant sealers was calculated by way of a meta-analysis of relevant literature. Compared to AH Plus, tricalcium silicate sealers show the lowest relative microleakage among the sealers assessed, followed by silicone sealers and other non-AH Plus epoxy resin sealers. Tricalcium silicate sealers also exhibit the most favorable antimicrobial effect and excellent biocompatibility. Future sealers developed should ideally combine a hermetic seal with therapeutic effects

Micro-Computed Tomographic Evaluation Of Single-Cone Obturation With Three Sealers

ObjectivesThis study used micro-computed tomography (µCT) to compare voids and interfaces in single-cone obturation among AH Plus, EndoSequence BC, and prototype surface pre-reacted glass ionomer (S-PRG) sealers and to determine the percentage of sealer contact at the dentin and gutta-percha (GP) interfaces. Materials and MethodsFifteen single-rooted human teeth were shaped using ProTaper NEXT size X5 rotary files using 2.5% NaOCl irrigation. Roots were obturated with a single-cone ProTaper NEXT GP point X5 with AH Plus, EndoSequence BC, or prototype S-PRG sealer (n = 5/group). ResultsThe volumes of GP, sealer, and voids were measured in the region of 0–2, 2–4, 4–6, and 6–8 mm from the apex, using image analysis of sagittal µCT scans. GP volume percentages were: AH Plus (75.5%), EndoSequence BC (87.3%), and prototype S-PRG (94.4%). Sealer volume percentages were less: AH Plus (14.3%), EndoSequence BC (6.8%), and prototype S-PRG (4.6%). Void percentages were AH Plus (10.1%), EndoSequence BC (5.9%), and prototype S-PRG (1.0%). Dentin-sealer contact ratios of AH Plus, EndoSequence BC, and prototype S-PRG groups were 82.4% ± 6.8%, 71.6% ± 25.3%, and 70.2% ± 9.4%, respectively. GP-sealer contact ratios of AH Plus, EndoSequence BC, and prototype S-PRG groups were 65.6% ± 29.1%, 80.7% ± 25.8%, and 87.0% ± 8.6%, respectively. Conclusions Prototype S-PRG sealer created a low-void obturation, similar to EndoSequence BC sealer with similar dentin-sealer contact (\u3e 70%) and GP-sealer contact (\u3e 80%). Prototype S-PRG sealer presented comparable filling quality to EndoSequence BC sealer