An In Vitro Study of the Number of Distal Roots and Canals in mandibular First Molars in Iranian Population

INTRODUCTION: The purpose of this study was to evaluate the number of distal roots and canals in mandibular first molars and their internal anatomy radiographically within Iranian population. MATERIALS AND METHODS: A total of 310 distal roots of mandibular first molars were incorporated in this study and evaluated in terms of number of roots and number and types of canals. Root canal systems were studied in vitro by means of radiography and based on Vertucci’s classifications. RESULTS: It was shown that 4.5% of the teeth in this study had two distal roots, of which, 100% indicated type I for both distobuccal and distolingual roots. Among all the teeth, 43.2% had two canals, 24.2% two apical foramina, and 38.7% two orifices in their distal roots. According to Vertucci’s classification 54.9% of the teeth were type I, 19% type II, 1.9% type III, 14.2% type IV, 4.2% type V, 1% type VI, 0.3% type VII and 0% type VIII. CONCLUSION: In as many as 43.2% of all teeth assessed in this study, bicanaled distal roots were observed, dentists are always recommended to search for the second canal in distal roots of mandibular first molars. In case the second canal in the distal root is missed, failure of endodontic treatment will be anticipated. A rectangular type access cavity design allows better visualization and negotiation of the probable second canals within the distal roots of mandibular first molars

Endodontic Treatment of Two-Canalled Maxillary Central and Lateral Incisors: A Case Report

Familiarity with the intricacies and variations of root canal morphology is essential for successful endodontic treatment. Maxillary central and lateral incisors are known to be single-rooted with one canal, however, this case report describes endodontic treatment of maxillary central and lateral incisors with two buccopalatal root canals

Retreatment of a 6-Canalled Mandibular First Molar with Four Mesial Canals: A Case Report

Successful root canal treatment requires adequate knowledge regarding morphologic variations in root canal system of teeth. This report describes a six-canalled mandibular first molar with four mesial root canals requiring endodontic retreatment. The two additional canals in the mesial root were found during retreatment with the aid of illumination and magnification. In conclusion, the possibility of atypical morphology and additional canals should never be over looked

Evaluation of the doxycycline release from AH26 sealer-doxycycline combination: An ex vivo study

INTRODUCTION: The purpose of this ex vivo study was to determine the releasing characteristics and doxycycline dentinal diffusion of AH26 sealer-doxycycline combination from apical 3mm of tooth root and apical foramen.MATERIALS & METHODS: One-hundred and two recently extracted single-rooted human teeth were decoronated and prepared with #3 and #4 Gates-Glidden drills and rotary Mtwo files. Smear layer was removed; all surfaces except for apical 3mm of each root were sealed with two coats of nail polish. To quantify the release and diffusion of the doxycycline at different time intervals (30 min, 48 and 72 h) after root canal obturation, the samples were randomly divided into three groups (n=30; 0.5 h, 48 h, 72 h). To evaluate the release of doxycycline from AH26 sealer-doxycycline combination at six concentrations of antibiotic including 0.5%, 1%, 2%, 5%, 10% and 20%; each experimental group was divided into six equal subgroups (n=5). Root canals were filled with gutta-percha and AH26-doxycycline combinations and then were placed in vials containing 1.25mL of phosphate buffer saline solution (PBS). After 30 min, 48 and 72 h, the amount of doxycycline released from specimens into PBS were determined by measuring the absorbance values using UV spectrophotometry at λmax=350 nm. Data were analyzed using two-way ANOVA. RESULTS: The findings of this study revealed that AH26 sealer-doxycycline combination released variable measures of antibiotic at each time interval and in the various concentrations. At 30 min, no statistically significant differences were obtained between the results of subgroups, but at 48 and 72 h these differences were significant (P < 0.001). The results also showed that differences between 0.5 h, 48 h and 72 h were significant within subgroups (P < 0.01). CONCLUSION: Under the conditions of this ex vivo study, doxycycline can be released from AH26 sealer-antibiotic combination through 3mm of apical root and apical foramen at 30 min, 48 and 72 h after mixing the sealer with doxycycline at concentrations of 0.5% up to 20%.

Marginal Adaptation of New Bioceramic Materials and Mineral Trioxide Aggregate: A Scanning Electron Microscopy Study

Introduction: This study aimed to compare the marginal adaptation of new bioceramic materials, EndoSequence Root Repair Material (ERRM putty and ERRM paste), to that of mineral trioxide aggregate (MTA) as root-end filling materials. Materials and Methods: Thirty-six extracted human single-rooted teeth were prepared and obturated with gutta-percha and AH-26 sealer. The roots were resected 3 mm from the apex. Root-end cavities were then prepared with an ultrasonic retrotip. The specimens were divided into three groups (n=12) and filled with MTA, ERRM putty or ERRM paste. Epoxy resin replicas from the resected root-end surfaces and longitudinally sectioned roots were fabricated. The gaps at the material/dentin interface were measured using scanning electron microscope (SEM). Transversal, longitudinal, and overall gap sizes were measured for each specimen. The data were analyzed using the Kruskal-Wallis test. Results: In transversal sections, no significant difference was found between MTA, ERRM putty and ERRM paste (P=0.31). However, in longitudinal sections, larger gaps were evident between ERRM paste and dentinal walls compared to MTA and ERRM putty (P=0.002 and P=0.033, respectively). Considering the overall gap size values, the difference between three tested materials was not statistically significant (P=0.17). Conclusion: Within the limits of this study, the marginal adaptation of ERRM paste and putty was comparable to that of MTA. However, ERRM putty might be more suitable for filling the root-end cavities because of its superior adaptation compared to ERRM paste in longitudinal sections

Antibacterial Substantivity of Carvacrol and sodium hypochlorite in infected bovine root dentin

INTRODUCTION: Various methods commonly used for cleaning and shaping root canals have not been successful in completely eradicating bacteria due to anatomic complexity and root canals irregularities. Disinfecting the canals with intracanal irrigants in addition to proper cleaning and shaping can produce a successful outcome. Antimicrobials with sustained antibacterial activity would be desirable for irrigation. The purpose of this study was to compare the antimicrobial substantivity of Carvacrol and 5.25% NaOCl in infected bovine root dentin. MATERIALS AND METHODS: One hundred and twenty dentin tubes prepared from bovine incisors were infected in vitro for 14 days with Enterococcus (E) faecalis. The specimens were divided into four groups including 1) Carvacrol, 2) NaOCl, 3) infected dentin tubes (positive control); and 4) sterile dentin tubes (negative control). Dentin chips were collected at five intervals (days 0, 1, 3, 7 and 28) using round burs with sequentially increasing diameters (which includes five layers of dentin) into Brain Heart Infusion (BHI) broth. In order to compare the pre- and post-irrigation antimicrobial activity of the irrigants the colony-forming units (CFU) were counted and classified as “CFU-before” and “CFU-after”. After culturing, the number of CFU with the various experimental time and dentinal layers was recounted. Two-way ANOVA test was used to analyze the effects of time and materials. One-way ANOVA and supplemental Tukey HSD test were used for pair comparison. RESULTS: CFU was significantly reduced in NaOCl group when compared to all other experimental groups (P<0.05). CONCLUSION: The substantivity of NaOCl was significantly greater than Carvacrol. Further studies are required to investigate and approve Carvacrol as a final irrigant

Subcutaneous Tissue Responses to Three Endodontic Irrigants: A Comparative Study

Introduction: This study aimed to compare the subcutaneous tissue responses to MTAD (mixture of a tetracycline isomer, an acid, and a detergent), 17% EDTA, and 2.6% NaOCl. Materials and Methods: Thirty-six Wistar albino rats were used for this study.  Test solutions were injected subcutaneously into predetermined areas on the animal dorsum. The rats were then randomly divided into three groups of twelve each and sacrificed at 2 hours, 2 days, and 2 weeks. The severity of inflammation induced by each irrigant at different time intervals was assessed histologically. The data were analyzed using Kruskal-Wallis and Friedman tests. Results: The difference in severity of inflammatory reactions induced by tested irrigants at the different time intervals was statically significant (P<0.05). There was no significant difference between the severity of inflammation induced by MTAD and 2.6% NaOCl at the various time intervals (P>0.05). Subcutaneous tissue responses to MTAD were not different from those observed in 17% EDTA specimens at 2-hour and 2-day intervals (P>0.05). Conclusion: Under the conditions of this study, MTAD has the same toxicity as 2.6% NaOCl

In Vitro Comparison of the Effectiveness of Chlorhexidine and Two Calcium Hydroxide Formulations on Enterococcus Faecalis

INTRODUCTION: The aim of this in vitro study was to compare the effectiveness of three intracanal medicaments in disinfecting the root canal and dentin of experimentally infected human teeth with Enterococcus faecalis (EF). MATERIALS AND METHODS: One hundred extracted human single-rooted teeth were used. After root canal preparation, teeth were mounted in epoxy resin. Following sterilization, the teeth were infected for 28 days with EF. Then root canals were filled with one of three different disinfectants: viscous 2% Chlorhexidine (CHX), calcium hydroxide paste (CH) or a mixture of CH and CHX (n=30 in each group). Antimicrobial assessments were performed at 1, 3 and 7 days (n=10 in each time period). Microbial samples were obtained from root canals before and after the experiment. Also dentin samples were examined. The data was analyzed using Two- Way ANOVA test. RESULTS: The findings showed that there was no difference between experimental groups at different time periods. The mixture of CH/CHX in 7 days was able to eliminate EF completely from root canal system. The most elimination of EF was from dentinal tubules. CONCLUSION: According to the results of this in vitro study, viscous 2% CHX, mixture of CH with distilled water and 2% CHX are all effective disinfectants

Regenerative Endodontic Treatment: Report of Two Cases with Different Clinical Management and Outcomes

Endodontic intervention in necrotic immature permanent teeth is usually a clinical challenge. With appropriate case selection, regenerative treatment can be effective, providing a desirable outcome. However, there is still no consensus on the optimal disinfection protocol or the method to achieve predictable clinical outcome. This article presents two cases of regenerative treatment in necrotic immature teeth, using mineral trioxide aggregate (MTA) and BiodentineTM as coronal barriers and different irrigants, which led to different clinical outcomes