Matür daimi dişlerde vital pulpa tedavilerine güncel bir bakış-derleme makalesi

Çürükle ekspoze matür daimi dişlerin tedavisinde geleneksel kök kanal tedavisine alternatif olarak vital pulpa tedavilerinin uygulanması tartışmalı bir konudur. Diş pulpasının bir kısmının veya tamamının sağlığını korumayı amaçlayan vital pulpa tedavileri minimal müdahale prensibine dayanmaktadır ve indirekt kuafaj, direkt kuafaj, parsiyel pulpotomi ve total pulpotomi prosedürlerini içermektedir. Vital pulpa tedavileri kök kanal tedavisi ile karşılaştırıldığında daha hızlı ve teknik olarak daha az karmaşık olmasıyla birlikte kanal tedavisi sonrası görülebilen renk değişikliği, kök kırığı veya rezidüel periapikal inflamasyon gibi istenmeyen etkiler açısından daha avantajlıdır. Vital pulpa tedavilerinin geleneksel endikasyonları, geri dönüşümlü pulpitis teşhisi konmuş, kök oluşumu tamamlanmış veya henüz tamamlanmamış dişlerin tedavisi ile sınırlı kalmıştır. Bununla birlikte, rejeneratif endodontinin ortaya çıkışı ve invaziv müdahaleyi azaltmayı amaçlayan biyolojik temelli tedavilerin teşviki, çürükle ekspoze pulpanın histopatolojisinin ve iltihaplı pulpanın iyileşme potansiyelinin daha iyi anlaşılması, hidrofilik kalsiyum silikat simanlar gibi yüksek sızdırmazlık yeteneği ve biyoaktif poyansiyeli olan yeni materyallerin geliştirilmesi, vital pulpa tedavilerinin geri dönüşümsüz pulpitise işaret eden belirti ve semptomları olan dişlerde de bir tedavi protokolü olarak benimsenmesini teşvik etmiştir. Bununla birlikte mevcut kanıtların büyük bir bölümü nispeten düşük hasta sayısı içeren çalışmalarla desteklenmektedir. Sonuç olarak daha temsili pulpa teşhis araçlarının geliştirilmesi ve kanıta dayalı yönetim stratejilerinin oluşturabilmesi için bu konuyla ilgili iyi tasarlanmış ileriye dönük araştırmalara olan ihtiyaç devam etmektedir

Intraoperative Pain During Glide Path Creation with the Use of a Rotary or Reciprocating System

Objectives: The objective of this study was to compare the intraoperative pain levels of patients caused from using different glide path systems in creating the glide path before the root canal shaping the teeth with asymptomatic irreversible pulpitis.Materials and Methods: The study included 88 patient with asymptomatic irreversible pulpitis in mandibular molar tooth. The teeth were randomly assigned to four groups according to use of glide path files: R-pilot (RP), WaveOne Gold Glider (WOG G), One G (OG), Proglider (PG). In all the groups, the patients were asked to specify the pain level by using Visual Analogue Scale (VAS). Kruskall-Wallis and Mann-Whitney U was used to determine significant differences at p< 0.05.Results: In the present study, it was determined that the lowest intraoperative pain level was observed in PG, followed by OG, RP, and WOG G. Statistically significant differences were observed between PG and RP and between PG and WOG G groups (p<.05).Conclusion: All of the file systems used in creating the glide path in root canal treatment caused intraoperative pain. The minimum intraoperative pain was found with PG glide path file, whereas RP and WOG G caused higher level of intraoperative pain

Cone beam computed tomography evaluation of maxillary molar root canal morphology in a Turkish Cypriot population

The aim of this retrospective study was to review, analyse and characterize the root canal morphology of maxillary molars, using cone beam computed tomography (CBCT), in a group of the Turkish Cypriot population. The sample for this cross-sectional study consisted of retrospective evaluation of CBCT scans of 290 adult patients (age range 16–80). The number of roots and their morphology, the number of canals per tooth and the root canal configurations were also classified according to the method of Vertucci. Pearson's chi-square test was performed for canal configurations, sides and gender (p < 0.05). Among the 373 first molars, there was no single-rooted specimen, 2 (0.53%) teeth had 2 roots, 365 (97.8%) teeth had 3 roots and 6 ones (1.6%) had 4 roots. Among the 438 second molars, 14 (3.1%) were single-rooted, 26 (5.9%) teeth had 2 roots, 392 (89.4%) teeth had 3 roots and 6 teeth (1.3%) had 4 roots. No sex difference was found in the frequency of additional canals both in the maxillary first and second molars. Occurrence of additional canals did not differ with age. These results provide detailed knowledge of the root canal anatomy of the maxillary molar teeth in this particular population, which is of clinical importance for dental professionals when performing endodontic treatment

Evaluation of the sealing ability of different root canal sealers: a combined SEM and micro-CT study

<div><p>Abstract Objective: The purpose of this study was to analyze the ability of multiple compounds to seal the dental tubules using scanning electron microscopy (SEM) and micro-computed tomogra-phy (micro-CT). Material and Methods: Twenty-four single-root human mandibular premolars were selected and instrumented with nickel-titanium rotary file and the final file size was #40/06. They were then randomly allocated into 2 groups, and all samples were filled with single cone gutta-percha (#40/06) and one of the tested sealers (AH Plus and EndoSequence BC sealers). All specimens were scanned using micro-CT and then three from each group were randomly selected for SEM analysis. Results: According to SEM, both root canal sealers showed sufficient adaptation to dentin along the whole length of the root canal, though the coronal sections presented superior sealing than the apical sections. Micro porosity analyses revealed that the volume of closed pores and the surface of closed pores had the largest values in the coronal sections, followed by the middle and the apical sections for both sealants (p<0.05). However, no significant difference was observed for those two parameters between AH Plus and EndoSequence BC sealers in any of the three sections (p>0.05), whereas they were larger in the apical section when the AH Plus sealer was used. Conclusions: By using the single cone technique, neither EndoSequence or AH Plus pro-vides a porosity-free root canal filling. The EndoSequence BC sealer may have similar sealing abilities regarding the whole root canal as the AH Plus sealer. A better sealing effect could be obtained in the coronal and middle sections of a root canal than the apical part by using the tested sealers.</p></div