The ethical debate between what patients want, need and can afford, and what treatment clinicians think they should receive

Endodontic emergencies are common procedures in dental practice, and need to be addressed as soon as possible. The initial treatment is usually extirpation of the pulp –also known as emergency root canal treatment (ERCT), –followed by complete cleaning, shaping and obturation ofthe root canal system. Root canal therapy (RCT) needs to be completed with a definitive restoration to increase long term prognosis of the tooth. Both of these carry additional costs. Patients treated in government facilities often have limited access to follow-up care due to long waiting lists, financial constraints or logistical challenges

Knowledge and attitude of adolescents regarding e-cigarettes: A scoping review

The World Health Organization Framework Convention on Tobacco Control has informed countries to ban or regulate electronic cigarettes (e-cigarettes) because of their health adverse effects. Although e-cigarettes are regulated, their popularity has increased among teens

Evaluation of Root Canal Transportation Centering Ratio and Remaining Dentine Thickness in Curved Root Canals Prepared with WaveOne Gold in Combination with Different Glide Path Techniques

The aim of this in vitro study was to investigate various glide path preparation instruments followed by root canal preparation with the reciprocating Primary WaveOne Gold instrument in curved mesial root canals of extracted human mandibular molars. Micro Computed Tomography (micro-CT) was used. Canal transportation, centering ability and effect on remaining dentine thickness were evaluated over the apical, midroot and coronal levels (3 mm, 5 mm and 7 mm from the root apex). In addition, preparation times for glide path preparation and final canal preparation with the Primary WaveOne Gold instrument were also recorded and compared. Sixty curved mesio-buccal root canals were randomly divided into four groups. These groups were Group 1: no further glide path preparation (n=15); Group 2: glide path enlarged with the use of pre-curved size 10,15 and 20 stainless steel K-files (n=15); Group 3: manual glide path enlargement with a size 10 K-file and further preparation with rotary PathFiles no.1-3 (n=15); and Group 4: manual glide path enlargement with a size 10 K-file and further preparation with the reciprocating WaveOne Gold Glider (n=15). Micro-CT was used to scan teeth before and after glide path preparation. The final canal preparation was done with the Primary WaveOne Gold instrument after which all 60 specimens were scanned again by means of micro-CT. The three-dimensional images obtained before instrumentation, after glide path preparation and again after final canal preparation with the Primary WaveOne Gold instrument were reconstructed and interpreted. Centering ratio values, canal transportation, remaining dentine thickness as well as glide path and final canal preparation times were recorded and compared between the four glide path groups with the use of a one-way analysis of variance (ANOVA) for parametric and Kruskal-Wallis H test for non-parametric comparisons. Statistical significance was set at p< 0.05. PathFiles performed most favourably when mean centering ratios were compared over all three levels from the root apex. However, no statistically significant difference in the mean centering ratios was found after glide path preparation when K-files, PathFiles and the WaveOne Gold Glider were compared. Mean combined transportation over the apical, midroot and coronal levels after glide path preparation was statistically significantly higher in the K-file preparation groups compared to the PathFile and WaveOne Gold Glider groups. There was no statistically significant difference in the mean combined centering ratios or transportation values of the various glide path groups in combination with the Primary WaveOne Gold instrument over the apical, midroot and coronal levels. Although not statistically significant, the highest mean transportation values were seen in the group where no glide path was prepared prior to final canal preparation with the Primary WaveOne Gold Instrument. All glide path groups performed similarly in evaluation of preservation of dentine when they were used in combination with the Primary WaveOne Gold instrument. Not having a prior glide path resulted in the most dentine thickness reduction after final canal instrumentation with the Primary WaveOne Gold instrument. Glide path preparation was statistically significantly fastest with the use of the WaveOne Gold Glider (p<0.0001). Having no prior glide path preparation resulted in statistically slower final canal preparation in combination with the Primary WaveOne Gold instrument compared to the other three glide path preparation groups (K-files, PathFiles and WaveOne Gold Glider) (p<0.0001).Dissertation (MSc Dentistry)--University of Pretoria, 2017.OdontologyMSc DentistryUnrestricte

A comparison of failure rates and canal preparation times between WaveOne Gold and One Curve file systems with and without glide path preparation in simulated canals

The aim of this study was to compare the failure rate and canal preparation times of the Primary WaveOne Gold file (Dentsply Sirona, Ballaigues, Switzerland) with the One Curve file (Micro Méga, Besançon, France). The influence of glide path preparation on failure rate and final preparation times were also evaluated. Endo training blocks (Dentsply Sirona) with simulated canals were separated into four groups: Group 1: Primary WaveOne Gold with WaveOne Gold Glider; Group 2: Primary WaveOne Gold without glide path; Group 3: One Curve with One G; Group 4: One Curve without glide path. The number of training blocks that were shaped before instrument fracture occurred was recorded. Glide path and final preparation times were also recorded. Where no glide path was prepared, One Curve file prepared a significantly higher number of canals (14.33± 0.58) than the Primary WaveOne Gold (4.6 ± 1.34) before instrument fracture occurred (p&lt;0.001). The One Curve with One G Glide Path file prepared significantly higher number of simulated canals (28±1.41) than the Primary WaveOne Gold with WaveOne Gold Glider (15 ± 1.41) before instrument fracture (p&lt;0.001). Glide path preparation times with WaveOne Gold Glider (4.8s) were significantly faster compared to the One G Glide Path file (7.29s)(p&lt;0 .001). Significantly faster final canal preparation times were achieved in groups where glide path were prepared (p&lt;0.001). One Curve files exhibits a greater fracture resistance than Primary WaveOne Gold files. Glide path preparation increases the longevity of preparation files and results in faster final canal preparation

Traditional and Conservative Molar Endodontic Access Cavity Designs: A Classification and Overview

Minimally invasive endodontics' specific focus on dentine preservation is gaining popularity. Before deciding on the appropriate endodontic access cavity design, clinicians should investigate the advantages and disadvantages associated with different treatment modalities. The purpose of this article is to provide a summary of possible advantages and disadvantages of different endodontic access cavity designs with the focus on traditional, conservative and ultra-conservative endodontic access cavities, specifically in molar teeth. No conclusive evidence is found in the literature favouring one access cavity design above another and clinicians are advised to evaluate each case individually when deciding on the appropriate access cavity design for that specific case. Fracture resistance, proper shaping in order to facilitate irrigation and disinfection, as well as canal location and orifice detection are some of the contributing factors in selecting an appropriate access cavity design that will be highlighted in this article

Fracture of endodontic instruments - Part 1: Literature review on factors that influence instrument breakage

Instrument fracture is a serious complication during endodontic treatment of teeth, having an adverse effect on the outcome of the nickel titanium (NiTi) treatment, especially if the fracture prevents apical access to the infected root canal. Despite the advent of NiTi files, the risk of fracture during the endodontic preparation of root canals, especially in severely curved canals, remains a serious concern. The fracture of NiTi files during preparation may result in a compromised prognosis for the tooth. In the presence of periapical lesions, instrument fracture may reduce the chances of successful healing

Pulpotomy: An alternative treatment modality to conventional root canal treatment

Vital pulp therapy is considered a successful treatment modality in primary and immature permanent teeth. The development of bioactive material has led to vital pulp therapy and pulpotomy treatment becoming a popular treatment modality in permanent teeth. This literature review investigates pulpotomy procedures on permanent teeth as a viable option, as opposed to conventional root canal treatment, as presented in the case report included.Aim The aim of this study is to evaluate literature on the reported success of pulpotomy treatment in mature permanent teeth. For this reason, the study specifically reviewed literature detailing the use of pulpotomies including the materials required for the procedure.MethodThe literature review is focused on studies using MTA and bioactive alternatives as pulpotomy material. An electronic search was done on EBSCOhost to source 58 articles published from 1979 to 2022. Results Literature investigated reports that pulpotomy treatment with bioactive materials shows promising results and therefore the possibility exists of it being a suitable treatment option or alternative to conventional root canal treatment

Modern considerations when approaching fractured endodontic instruments - Part 2: A review of the literature and clinical techniques

Once root canal treatment is considered, the treating clinicians must be aware of the real possibility that complications and unforeseen accidents can occur during any stage of the treatment. Complications and accidents may include instrument separation, root perforation on different levels and ledge formation

Comparison of forward and reverse single-file reciprocation for root canal instrumentation in curved mandibular molar canals - a Micro-CT analysis

To compare (i) canal centering ability and transportation of Primary WaveOne Gold in combination with WaveOne Gold Glider with ProTaper Next X2 in combination with ProGlider using Micro-CT, and (ii) difference in final preparation times between these two preparation groups. Mesiobuccal canals of 50 mandibular first molars were used. Teeth were randomly divided into two preparation groups. Results were analysed using a one-way analysis of variance (ANOVA). Apically, ProGlider/ProTaper Next X2 demonstrated better centering ratio values and lower transportation values compared to WaveOne Gold Glider/Primary WaveOne Gold (p&lt;.05). No differences were found in the mean combined centering ratios and transportation values between groups (p&gt;.05). No statistically significant differences between the canal preparation times were found (p&lt;.06). The combination of ProGlider /ProTaper Next X2 yields better results for transportation and centering ability apically compared to WaveOne Gold Glider in combination with Primary Wave-One Gold

Factors influencing apical debris extrusion during endodontic treatment - A review of the literature

The primary cause of a periapical inflammatory lesion is intra-radicular microbial infection. Prevention and elimination of apical periodontitis is achieved through successful endodontic treatment. Endodontic treatment is designed to maintain and restore the health of the periapical tissues and prevent periapical disease. It may be defined as the combination of mechanical instrumentation of the root canal system with bactericidal irrigation and obturation with an inert material. Technically, the goal of instrumentation and irrigation is to debride and entirely remove infected tissue debris from the root canal system and create a uniform conical shape that allows medicament delivery and adequate obturation. Microbiologically, the goal of instrumentation and irrigation is to eliminate micro-organisms, reduce their survival in the root canal system and neutralise any antigenic potential of the microbial components remaining in the canal