Quality of Root Canal Obturation Performed by Senior Undergraduate Dental Students

The aim of the present study was to assess the quality of canal obturation performed by undergraduate denal students at Saveetha Dental College and Hospitals, Chennai. Records of 200 endodontically treated teeth from patients who were visited by undergraduate students between month of November 2014 to May 2015. Periapical radiographs of all treated teeth were assessed in terms of canal obturation quality (adequate density and length). Forty-five percent of teeth fulfilled the criteria of an acceptable root canal obturation. Adequate length and density of root filling was found in 89% and 34% of teeth, respectively. There was a significant difference between maxillary and mandibular teeth regarding the length of root canal obturation. A significant difference was observed between molars and other tooth types. The frequency of root canals with an acceptable filling was significantly greater in the anterior teeth compared to premolars or molars. The technical quality of root canal treatment performed by undergraduate dental students was found to be less than ideal

An Accuracy of an Improved Electronic Measuring Device for Root Canal Length

Root ZX (ZX), a newly manufactured electric root canal length measuring device, has been recently introduced to the market. The manufacturer claims that it can accurately measure the root canal length in existence of electrolytes such as pulp tissue, blood or necrotic tissue in the root canal. This study was done in the clinic of Matsumoto Dental College to determine whether or not ZX had the properties claimed by the manufacturer, using Root Canal Meter (RCM) as control. The results obtained were as follows: 1. When the root canal length measured by a small size reamer (#25 or 30) was compared with that measured by a finally used reamer, in 12 of 20 pulpectomy cases (60.0%) the latter was 0.26±0.18mm longer than the former. On the other hand, in 9 of 13 infected root canal treatment cases (69.2%) at the root canal enlargement, the root canal length measured by a finally used reamer was 0.41±0.29mm longer than that measured by a small size reamer. 2. The differences between the root canal length remeasured at the time of root canal filling and that at the first appointment were examined. In 15 of 20 pulpectomy cases (75.0%), the root canal length of root canal filling was 0.67±0.78mm shorter than that measured at the first appointment. On the other hand, in 9 of 13 infected root canal treatment cases (69.2%), the root canal length at root canal filling was 0.52±0.37mm shorter than that measured at the first appointment. In either case, the root canal length of the first appointment tended to be shorter than that at root canal filling. 3. When a reamer tip was inserted into the root canal until the ZX meter pointed to 0.5 manufacture\u27s the apical constriction reading according to the manual, the RCM reading was also examined. In the case of root canal enlargement, 10 pulpectomy cases (50.0%) and 5 infected root canal treatment cases (38.5%) indicated 40μA or greater of RCM. At the time of root canal filling, 8 pulpectomy cases (40.0%) and 7 infected root canal treatment cases (53.8%) were 40μA or greater. In approximately half of the cases, it was recognized that the reamer tips overextended beyond the apical foramen. 4. The location of the tip of gutta-percha point was examined using a dental X-ray taken immediately after root canal filling was performed. In 11 pulpectomy cases (61.1%) and 5 infected root canal treatment cases (41.7%), the master corn tips extruded from the radiographic root apex. 5. It may be concluded that ZX can measure the root canal length in existence of electrolytes but is somewhat affected by electrolytes

In vitro evaluation of efficacy of different rotary instrument systems for gutta percha removal during root canal retreatment

Background: Complete removal of old filling material during root canal retreatment is fundamental for predictable cleaning and shaping of canal anatomy. Most of the retreatment methods tested in earlier studies have shown inability to achieve complete removal of root canal filling. Therefore the aim of this investigation was to assess the efficacy of three different rotary nickel titanium retreatment systems and Hedstrom files in removing filling material from root canals. Material and Methods: Sixty extracted mandibular premolars were decoronated to leave 15 mm root. Specimen were hand instrumented and obturated using gutta percha and AH plus root canal sealer. After storage period of two weeks, roots were retreated with three (Protaper retreatment files, Mtwo retreatment files, NRT GPR) rotary retreatment instrument systems and Hedstroem files. Subsequently, samples were sectioned longitudinally and examined under stereomicroscope. Digital images were recorded and evaluated using Digital Image Analysing Software. The retreatment time was recorded for each tooth using a stopwatch. The area of canal and the residual filling material was recorded in mm 2 and the percentage of remaining filling material on canal walls was calculated. Data was analysed using ANOVA test. Results: Significantly less amount of residual filling material was present in protaper and Mtwo instrumented teeth ( p < 0.05) compared to NRT GPR and Hedstrom files group. Protaper instruments also required lesser time during removal of filling material followed by Mtwo instruments, NRT GPR files and Hedstrom files. Conclusions: None of the instruments were able to remove the filling material completely from root canal. Protaper universal retreatment system and Mtwo retreatment files were more efficient and faster compared to NRT GPR fles and Hedstrom files

Morphology of Root Canal Cross-sections of Resected Roots of First and Second Lower Molars

Precise preparation of the root canal ostium with a view to hermetical closing with retrograde root filling is an important prognostic factor determining the success of the procedure of tooth resection. Root canals interconnected with a narrow isthmus may cause problems both in endodontic treatment and in retrograde filling. The aim of this work is the research of the transverse cross-section of root canals of first and second lower molars on the resection model. The research encompasses 100 randomly selected molar teeth: 50 first and 50 second lower molars. The tooth root apexes were cut 3 mm below the apex and examined under an electron microscope, special attention being paid to the shape of root canal cross-sections. In the group of first molar teeth, in 20% the presence of an isthmus between canals in the proximal roots was observed; in the group of second molar teeth an isthmus between the canals of proximal roots occurred in 18% of the cases. It seems that the relatively high percentage (20%-18%) of the occurrence of an isthmus, 3 mm below the root apex, between two elongated transverse cross-section proximal root canals of first and second molars should encourage particular caution in the retrograde filling of the above-mentioned canals during the procedure of resection

Thermoplastic endodontic obturation – TC system: case report

The TC system, developed in 2002, allows the endodontic filling by means of a non-conventional technique that uses gutta-percha at alpha phase,thermoplasticized in its own oven, placed into canal through a McSpadden compactor, without using a main cone. Objective: The aim of this case report was to show the TC system used for root canal filling. Case report: Three teeth of a patient was indicated for endodontic treatment, so TC system was used for the root filling. Conclusion: This technique showed to be effective for the root canal filling

Nanodiamond-Gutta Percha Composite Biomaterials for Root Canal Therapy.

Root canal therapy (RCT) represents a standard of treatment that addresses infected pulp tissue in teeth and protects against future infection. RCT involves removing dental pulp comprising blood vessels and nerve tissue, decontaminating residually infected tissue through biomechanical instrumentation, and root canal obturation using a filler material to replace the space that was previously composed of dental pulp. Gutta percha (GP) is typically used as the filler material, as it is malleable, inert, and biocompatible. While filling the root canal space with GP is the standard of care for endodontic therapies, it has exhibited limitations including leakage, root canal reinfection, and poor mechanical properties. To address these challenges, clinicians have explored the use of alternative root filling materials other than GP. Among the classes of materials that are being explored as novel endodontic therapy platforms, nanodiamonds (NDs) may offer unique advantages due to their favorable properties, particularly for dental applications. These include versatile faceted surface chemistry, biocompatibility, and their role in improving mechanical properties, among others. This study developed a ND-embedded GP (NDGP) that was functionalized with amoxicillin, a broad-spectrum antibiotic commonly used for endodontic infection. Comprehensive materials characterization confirmed improved mechanical properties of NDGP over unmodified GP. In addition, digital radiography and microcomputed tomography imaging demonstrated that obturation of root canals with NDGP could be achieved using clinically relevant techniques. Furthermore, bacterial growth inhibition assays confirmed drug functionality of NDGP functionalized with amoxicillin. This study demonstrates a promising path toward NDGP implementation in future endodontic therapy for improved treatment outcomes

Overview of Root End Filling Materials

Root end filling is one of the most important aspects of the periradicular surgery. The purpose of root end filling material is to establish a impermeable seal of all the apical avenues of the root canal system and prevent the percolation of bacteria or their products between the root canal systems and periradicular tissues. The purpose of this article is to provide with a comprehensive review of studies on sealing ability, biocompatibility and clinical outcomes of Amalgam, Zinc Oxide Eugenol cements, Intermediate Restorative Material, Glass Ionomer Cement, Retroplast. Mineral Trioxide Aggregate and Biodentine when used as root end filling material

Characteristics of Root Canal Filling Materials for Primary Teeth: A Review of Literature

Objectives Different root canal filling materials show different clinical and radiographic success rates. Since there is controversy on the best root canal filling material in primary dentition, the aim of this study was to summarize information about root canal filling materials for primary teeth in terms of biocompatibility, cytotoxicity, resorption rate, and survival rate. Methods By searching online databases, studies that addressed biocompatibility, cytotoxicity, resorption, and survival rates of different root filling materials in primary teeth from 1985 to 2020 were evaluated and the required data were extracted. The results were tabulated and compared. Results Due to methodological discrepancies, different studies show different and sometimes inconsistent results, which make it hard to reach a final conclusion; but it seems that Vitapex and Maisto's paste are more biocompatible and have a good survival rate. Zinc oxide eugenol (ZOE) and calcium hydroxide have lower cytotoxicity among different filling materials. However, due to low resorption rate, ZOE can affect permanent successors. Conclusion Based on the unique characteristics of each patient, different filling materials may be used for a clinically optimal dental treatment.&nbsp

The use of Bioceramics as root-end filling materials in periradicular surgery: a literature review

Introduction: Periradicular surgery involves the placement of a root-end filling following root-end resection, to provide an apical seal to the root canal system. Historically several materials have been used in order to achieve this seal. Recently a class of materials known as Bioceramics have been adopted. The aim of this article is to provide a review of the outcomes of periradicular surgery when Bioceramic root-end filling materials are used on human permanent teeth in comparison to “traditional” materials. Methods &amp; results: An electronic literature search was performed in the databases of Web of Science, PubMed and Google Scholar, between 2006 and 2017, to collect clinical studies where Bioceramic materials were utilised as retrograde filling materials, and to compare such materials with traditional materials. In this search, 1 systematic review and 14 clinical studies were identified. Of these, 8 reported the success rates of retrograde Bioceramics, and 6 compared treatment outcomes of mineral trioxide aggregate (MTA) and traditional cements when used as root-end filling materials. Conclusion: Bioceramic root-end filling materials are shown to have success rates of 86.4–95.6% (over 1–5 years). Bioceramics has significantly higher success rates than amalgam, but they were statistically similar to intermediate restorative material (IRM) and Super ethoxybenzoic acid (Super EBA) when used as retrograde filling materials in apical surgery. However, it seems that the high success rates were not solely attributable to the type of the root-end filling materials. The surgical/microsurgical techniques and tooth prognostic factors may significantly affect treatment outcome

Is there a "safety zone" in the mandibular premolar region where damage to the mental nerve can be avoided if periapical extrusion occurs?

The mandibular premolars are located close to the mental foramina (Fig. 1). As such, various events affecting these teeth, such as odontogenic infection1 and orthodontic, endodontic, periodontal or surgical misadventure, may result in neurosensory disturbance of the mental nerves.2-4 In one retrospective study, the incidence of mental paresthesia resulting from periapical infection or pathology was 0.96. In another 0.24 of cases in the same study, mental paresthesia was a complication of root canal treatment (caused by severe overfill in one case and iatrogenic perforation of mechanical instrumentation through the root and into the mental nerve in the second case).1 The incidence of mental paresthesia resulting from orthodontic, periodontal and surgical misadventure cannot be determined but is presumably low, as most such cases have been reported as individual case reports. In endodontology, elimination of infection from the pulp and dentin followed by adequate intracanal preparation and proper sealing constitute the basic principles of root canal treatment. Ideally, mechanical preparation and filling should be limited to the root canal, as overinstrumentation or extrusion of chemical fillings beyond the apical foramen to the adjacent nerve may give rise to neurosensory disturbances such as anesthesia, paresthesia or dysesthesia.5 Unfortunately, cases of endodontic extrusion of various filling or irrigation agents continue to be reported, despite recent advances in endodontology