Influence of Access Cavity Design on Root Canal Detection, Instrumentation Efficacy, and Fracture Resistance Assessed in Maxillary Molars

A Patient came with the complaint of pain in the lower right back region of the jaw. Root canal treatment was planned. While preparing for the bio-mechanical procedure, the Hand pro taper fractured in the apical third. Iatrogenic occurred as a result of the fracture of the endodontic instrument. Retrieval of the fractured instrument was planned to complete the cleaning and shaping of the canal. The removal of the fractured instrument was planned to be done under the Dental Operating Microscope. The use of an operating microscope enhanced the illumination and the magnification of the instrument. This illumination and magnification helped in the precision of removal. The ultrasonic tip enabled to reach of the fractured instrument in the canal and loosen the dentin around the fractured instrument. It allowed easy retrieval of the fractured instrument. During the retrieval procedure, the fractured instrument was bypassed before the use of the ultrasonic tip. After the removal of the fractured instrument, cleaning and shaping were completed, followed by obturation, definitive restoration, and prosthesis. As the removal of the fractured instrument enabled complete cleaning and shaping, it improved the prognosis of the case. When the endodontic instrument gets fractured, it should be analyzed over the radiograph to assess the fracture level, the anatomy of the root canal, size of the fractured instrument, check accessibility, stage of fracture, etc. If all the above criteria are met with the removal of the instrument only then, replacement should be tried. Otherwise, it may lead to a severe loss of root dentin, decreasing fracture resistance of the root.

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The effect of root canal preparation size and taper of middle mesial canals on fracture resistance of the mandibular molar teeth: An in vitro study

Journal of Endodontics ◽

10.1016/j.joen.2021.06.002 ◽

2021 ◽

Author(s):

Yağmur Kılıç ◽

Emrah Karataşlıoğlu ◽

Mehmet Emin Kaval

Keyword(s):

Root Canal ◽

Fracture Resistance ◽

In Vitro Study ◽

Vitro Study ◽

Root Canal Preparation ◽

Mandibular Molar ◽

Molar Teeth

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The ability of Reciproc instruments to reach full working length without glide path preparation: a clinical retrospective study

PeerJ ◽

10.7717/peerj.3583 ◽

2017 ◽

Vol 5 ◽

pp. e3583 ◽

Cited By ~ 9

Author(s):

Andreas Bartols ◽

Bernt-Peter Robra ◽

Winfried Walther

Keyword(s):

Retrospective Study ◽

Root Canal ◽

Primary Root ◽

Primary Treatment ◽

Endodontic Treatment ◽

Binary Logistic Regression Model ◽

Root Canals ◽

Maxillary Molars ◽

Glide Path ◽

Working Length

Background Reciproc instruments are the only contemporary root canal instruments where glide path preparation is no longer strictly demanded by the manufacturer. As the complete preparation of root canals is associated with success in endodontic treatment we wanted to assess the ability and find predictors for Reciproc instruments to reach full working length (RFWL) in root canals of maxillary molars in primary root canal treatment (1°RCTx) and retreatment (2°RCTx) cases. Methods This retrospective study evaluated 255 endodontic treatment cases of maxillary molars. 180 were 1°RCTx and 75 2°RCTx. All root canals were prepared with Reciproc instruments. The groups were compared and in a binary logistic regression model predictors for RFWL were evaluated. Results A total of 926 root canals were treated with Reciproc without glide path preparation. This was possible in 885 canals (95.6%). In 1°RCTx cases 625 of 649 (96.3%) canals were RFWL and in 2°RCTx cases 260 of 277 (93.9%). In second and third mesiobuccal canals (MB2/3) 90 out of 101 (89.1%) were RFWL with Reciproc in 1°RCTx and in the 2°RCTx treatment group 49 out of 51 cases (96.1%). In mesio-buccal (MB1) canals “2°RCTx” was identified as negative predictor for RFWL (OR 0.24 (CI [0.08–0.77])). In MB2/3 canals full working length was reached less often (OR 0.04 (CI [0.01–0.31])) if the tooth was constricted and more often if MB2/3 and MB1 canals were convergent (OR 4.60 (CI [1.07–19.61])). Discussion Using Reciproc instruments, the vast majority of root canals in primary treatment and retreatment cases can be prepared without glide path preparation.

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Contribution of Root Canal Treatment to the Fracture Resistance of Dentin

Journal of Endodontics ◽

10.1016/j.joen.2018.10.004 ◽

2019 ◽

Vol 45 (2) ◽

pp. 189-193 ◽

Cited By ~ 5

Author(s):

Weishi Yan ◽

Carolina Montoya ◽

Marit Øilo ◽

Alex Ossa ◽

Avina Paranjpe ◽

...

Keyword(s):

Root Canal ◽

Fracture Resistance ◽

Root Canal Treatment

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Fracture Resistance of Endodontically Treated Teeth Obturated with Different Root Canal Sealers (In vitro study)

Egyptian Dental Journal ◽

10.21608/edj.2019.72581 ◽

2019 ◽

Vol 65 (2) ◽

pp. 1567-1575

Author(s):

Abeer Saba ◽

Heba ElAsfouri

Keyword(s):

Root Canal ◽

Fracture Resistance ◽

In Vitro Study ◽

Vitro Study ◽

Endodontically Treated Teeth ◽

Root Canal Sealers

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A short review on the root canal configuration of primary maxillary molars

Bioinformation ◽

10.6026/973206300161033 ◽

2020 ◽

Vol 16 (12) ◽

pp. 1033-1036

Author(s):

Deepa Gurunathan ◽

Keyword(s):

Root Canal ◽

Short Review ◽

Type I ◽

Cochrane Central Register ◽

Population Number ◽

Second Molar ◽

Root Canals ◽

Maxillary Molars ◽

Root Canal Morphology ◽

Canal Morphology

It is of interest to compile available information on the root canal morphology of primary maxillary molars from known literature. The literature resources used to collect data include Medline/PubMed, The Cochrane Central Register of Clinical Trials, SIGLE and Science Direct. Data consists of type of population, number of teeth per study, number of root canals, canal length and type of root canal configuration. We used data from a total of 13 studies (951 primary maxillary molars). Maxillary molars (1st and 2nd) are dominant for two roots variant. The first molar the mean root length ranges from 7.9mm – 8.1mm. The second molar ranges from 7.2mm-8.5mm. Type I (explain in a phrase) canal morphology is the common variant in both the molars. Data shows that Root Canal morphology shows variations with the diagnostic aid (example micro CT) used and in different ethnic populations.

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Fracture Resistance of Immature Incisors Following Root Filling with Various Bioactive Endodontic Cements Using an Experimental Bovine Tooth Model

European Journal of Dentistry ◽

10.1055/s-0039-1695654 ◽

2019 ◽

Vol 13 (02) ◽

pp. 156-160 ◽

Cited By ~ 1

Author(s):

Pegah Sarraf ◽

Mohammad Hossein Nekoofar ◽

Mohammad Saeed Sheykhrezae ◽

Paul M. H. Dummer

Keyword(s):

Root Canal ◽

Fracture Resistance ◽

Acrylic Resin ◽

Control Group ◽

Control Groups ◽

Cem Cement ◽

Filling Materials ◽

Gutta Percha ◽

Significant Difference ◽

And Control

Abstract Objective The aim of this study was to compare the fracture resistance of immature bovine roots when using ProRoot MTA, CEM Cement, and Biodentine as root filling materials. Materials and Methods An immature bovine tooth model was developed by removing the coronal and apical portions of 70 bovine incisors 8 mm above and 12 mm below the cementoenamel junction (CEJ). The specimens were then divided into five groups: ProRoot MTA, CEM Cement, Biodentine, gutta-percha/AH26 sealer, and control. All groups received a 5-mm apical plug with a temporary restorative material. Then, the remaining root canal space was filled with one of the afore-mentioned materials. After setting, the specimens were mounted in acrylic resin. Then, 3 mm coronal to the CEJ from the buccal side of the teeth and at a 135°angle to the long axis, the specimens were loaded until fracture. Results The specimens in the Biodentine (2196 N) and ProRoot MTA (2103 N) groups had significantly greater fracture resistance in comparison to the control group (p = 0.01). No significant difference was found between CEM Cement, gutta-percha and sealer AH26, and control groups. No significant differences occurred between the four experimental groups (p = 0.45). Conclusion Filling the root canal space with ProRoot MTA and Biodentine contributed to higher fracture resistance values.

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