A matched irrigation and obturation strategy for root canal therapy

AbstractIn root canal therapy, irrigating solutions are employed to eliminate the bacterial load and also prepare dentin for sealer interaction. The aim of this research was to assess how irrigating solutions employed on their own or in sequence affected the tooth structure. The best way to prepare the tooth for obturation using hydraulic calcium silicate cement (HCSC) sealers and gutta-percha, thus guiding clinicians on a matched irrigation-obturation strategy for optimized root canal treatment was investigated. The effect of irrigating solutions on dentine was investigated by assessing changes in dentin microhardness, ultrastructure and mineral content, organic/inorganic matter, surface roughness and Young’s modulus. The interaction of four root canal sealers with the dentin was analysed by assessing the changes in microhardness of the dentin after sealer placement and also the sealer to dentin interface by scanning electron and confocal laser microscopy. The irrigating solutions damaged the dentin irreversibly both when used on their own and in combination. The best sequence involved sodium hypochlorite followed by chelator and a final rinse with sodium hypochlorite and obturation using HCSC sealers that enabled the restoration of dentin properties. The HCSC sealers did not rely on chelator irrigating solutions for a good material adaptation to dentin.

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Apical and periapical repair of dogs' teeth with periapical lesions after endodontic treatment with different root canal sealers

Pesquisa Odontológica Brasileira ◽

10.1590/s1517-74912003000100013 ◽

2003 ◽

Vol 17 (1) ◽

pp. 69-74 ◽

Cited By ~ 17

Author(s):

Mário Roberto Leonardo ◽

Antônio Alberto Medeiros Salgado ◽

Léa Assed Bezerra da Silva ◽

Mário Tanomaru Filho

Keyword(s):

Sodium Hypochlorite ◽

Root Canal ◽

Microscopic Analysis ◽

Periapical Lesion ◽

Periapical Lesions ◽

Root Canals ◽

Gutta Percha ◽

Ah Plus ◽

Root Canal Sealers ◽

Hematoxylin Eosin

The aim of this study was to evaluate the apical and periapical repair after root canal treatment of dogs' teeth with pulp necrosis and chronic periapical lesion using different root canal sealers. After periapical lesion induction, forty-four root canals of 3 dogs were submitted to biomechanical preparation using 5.25% sodium hypochlorite as an irrigating solution. A calcium hydroxide dressing (Calen PMCC) was applied for 15 days and the root canals were filled using the lateral condensation technique with gutta-percha points and Sealapex, AH Plus or Sealer Plus for sealing. After 180 days, the animals were sacrificed by anesthetic overdose and the obtained histological sections were stained with hematoxylin-eosin for optical microscopic analysis of the apical and periapical repair. The groups filled with Sealapex and AH Plus had better histological repair (p < 0.05) than the group filled with Sealer Plus, that had unsatisfactory results.

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Nanodiamond–Gutta Percha Composite Biomaterials for Root Canal Therapy

ACS Nano ◽

10.1021/acsnano.5b05718 ◽

2015 ◽

Vol 9 (11) ◽

pp. 11490-11501 ◽

Cited By ~ 66

Author(s):

Dong-Keun Lee ◽

Sue Vin Kim ◽

Adelheid Nerisa Limansubroto ◽

Albert Yen ◽

Akrivoula Soundia ◽

...

Keyword(s):

Root Canal ◽

Root Canal Therapy ◽

Gutta Percha ◽

Composite Biomaterials

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Συμβολή εις την μελέτην της αξίας ενιών εμφρακτικών υλικών των ριζικών σωληνών δια ραδιενεργών ισοτόπων (S35)

10.12681/eadd/5528 ◽

1967 ◽

Author(s):

Ζαχαρίας Μαντζαβίνος

Keyword(s):

Root Canal ◽

Multiple Point ◽

Multiple Points ◽

Single Root ◽

Gutta Percha ◽

Silver Point ◽

Autoradiographic Technique ◽

Root Canal Sealers

The present study was performed in order to evaluate, by the autoradiographic technique the sealing properties of three root canal sealers, combined with gutta - percha and silver points, in vitro. A total of one hundred and five extracted human, single root teeth were used and divided into five groups according to the filling combinations tested. The teeth were filled, using two techniques, of the single and multiple points. Autoradiographies, using S35, in all instances, were performed and the results obtained were compared with the respective dental radiograms The obtained results lead to the following conclusions: 1. Silver and gutta - percha points may be always combined with sealers. Otherwise the root canal is not adequately sealed. 2. A gutta - percha point, without sealer, produced a superior filling to silver point. 3. It seems possible to obtain a complete obturation of the rootcanal with the combination of gutta - percha and Grosman’s Sealer using the multiple - point technique. 4. It follows in effectivness, the combination of silver point and Grossman’s sealer.5. The combination of gutta - percha point with Zinc - oxide eugenol sealer and chloropercha are the least efficient. 6. Finally it must be stressed that since the conditions of the present study do not correspond exactly to those encountered in vivo, extrapolation of the results obtained, to man has to be performed with caution.

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A literature review on complications and management of use sodium hypochlorite in endodontics

IP Indian Journal of Conservative and Endodontics ◽

10.18231/j.ijce.2021.042 ◽

2021 ◽

Vol 6 (4) ◽

pp. 191-193

Author(s):

Sunny Sharma ◽

Sonali ◽

Asusa ◽

Chander Udhey ◽

Puneet Kour ◽

...

Keyword(s):

Soft Tissue ◽

Literature Review ◽

Sodium Hypochlorite ◽

Root Canal ◽

Direct Contact ◽

Tissue Injury ◽

Soft Tissue Injury ◽

The Other ◽

Root Canal Therapy ◽

Other Hand

The most commonly used irrigant in the field of endodontics is sodium hypochlorite in the procedure of root canal therapy. Although the use of sodium hypochlorite is quite safe but on the other hand when it comes in to direct contact with the soft tissue, it can result in soft tissue injury.

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The Penetration Ability of Calcium Silicate Root Canal Sealers into Dentinal Tubules Compared to Conventional Resin-Based Sealer: A Confocal Laser Scanning Microscopy Study

Materials ◽

10.3390/ma12030531 ◽

2019 ◽

Vol 12 (3) ◽

pp. 531 ◽

Cited By ~ 4

Author(s):

Yemi Kim ◽

Ban-Suk Kim ◽

Yong-Min Kim ◽

Donghee Lee ◽

Sin-Young Kim

Keyword(s):

Root Canal ◽

Laser Scanning ◽

Laser Scanning Microscopy ◽

Confocal Laser ◽

Intensity Level ◽

Single Cone ◽

Penetration Ability ◽

Ah Plus ◽

Root Canal Sealers ◽

Apical Area

The purpose of this study was to compare the penetration ability of calcium silicate root canal sealers and conventional resin-based sealer using confocal laser scanning microscopy (CLSM). A total of 60 recently extracted single-rooted human premolars were used in this study. The root canals were prepared to a size 40/0.06 taper with ProFile rotary instruments and irrigated with NaOCl and EDTA. After drying all canals, the specimens were randomly divided into three experimental groups (n = 20): Group 1, gutta-percha (GP)/AH Plus with continuous wave compaction; group 2, GP/BioRoot RCS with a single-cone technique; and group 3, GP/Endoseal MTA with a single-cone technique. All experimental samples were sectioned perpendicular to their long axis using a low-speed diamond wheel at the apical, middle, and coronal third levels. The penetration abilities of all samples were evaluated using CLSM. A Kruskal–Wallis analysis and a series of Mann–Whitney U post hoc tests were performed. A higher intensity level was found in the coronal area and a lower intensity level in the apical area in all the experimental groups. The AH Plus group showed higher sum fluorescence intensity in the apical and coronal thirds compared with the BioRoot RCS and Endoseal MTA groups, whereas the BioRoot RCS group showed a higher intensity level in the middle third, similar to the AH Plus group. The maximum sealer penetration depth was low in the apical area and high in the coronal area in the AH Plus and Endoseal MTA groups. In the BioRoot RCS group, maximum sealer penetration was observed in the middle third. In conclusion, there were significant differences in sealer penetration pattern and distance according to the root level and sealer type.

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Successful Use of MTA Fillapex as a Sealant for Feline Root Canal Therapy of 50 Canines in 37 Cats

Journal of Veterinary Dentistry ◽

10.1177/0898756420948140 ◽

2020 ◽

Vol 37 (2) ◽

pp. 77-87

Author(s):

Susan Thorne ◽

Norman Johnston ◽

Vicki J. Adams

Keyword(s):

Root Canal ◽

Root Resorption ◽

Endodontic Treatment ◽

Inert Material ◽

Root Canal Therapy ◽

Gutta Percha ◽

Oral Pain ◽

Single Cone ◽

Pulp Exposure ◽

Periapical Disease

Intentional or unintentional pulp exposure of cat canines can lead to periapical disease, osteomyelitis, and oral pain. Root canal therapy (RCT) allows the retention of cat canines with pulp exposure by removing the infected pulp and replacing it with an inert material. This study used MTA Fillapex™ as a root canal sealant with gutta percha single cone obturation in 37 cats (50 canine teeth). Roots were classified as “successful,” “no evidence of failure (NEF),” or “failed” at 6-month radiographic reviews. Therapy was considered “successful” if a preoperative periapical lucency had healed or not formed after treatment and any preoperative external inflammatory root resorption (EIRR) had stabilized without progression. Therapy was categorized as “NEF” if a periapical lucency had remained the same or decreased in size but not completely resolved and any preoperative EIRR had stabilized without progression. “Failed” if a periapical lucency had occurred or increased in size posttreatment or if EIRR had developed or progressed posttreatment. Thirty-two canine teeth (64%) were classified as “successful,” 14 canine teeth (28%) were classified as “NEF,” and 4 canine teeth (8%) were classified as “failed”. The study concluded that RCT using MTA Fillapex as a root canal sealant is a suitable endodontic treatment for fractured cat canines, especially those that are periodontally or endodontically challenged.

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Radiographic analysis of root canal fillings: influence of two sealers on the perception of voids

Brazilian Dental Journal ◽

10.1590/s0103-64402010000200009 ◽

2010 ◽

Vol 21 (2) ◽

pp. 142-147 ◽

Cited By ~ 5

Author(s):

Augusto Bodanezi ◽

Etiene de Andrade Munhoz ◽

Norberti Bernardineli ◽

Ana Lúcia Álvares Capelozza ◽

Ivaldo Gomes de Moraes ◽

...

Keyword(s):

Sensitivity And Specificity ◽

Root Canal ◽

Ex Vivo ◽

Radiographic Analysis ◽

Radiographic Images ◽

Significance Level ◽

Root Canals ◽

Gutta Percha ◽

Root Canal Sealers

The aim of this ex vivo was to investigate if two radiopaque root canal sealers with different formulations would influence the radiographic perception of root canal fillings. The root canals of 48 extracted maxillary canines were prepared and randomly assigned to 3 groups of 16 specimens each. In each group, the root canals were filled by lateral condensation of gutta-percha and one of the tested sealers: Endométhasone, Sealer 26, or a non-radiopaque sealer. A through-and-through void was simulated in half of the specimens from each group (n=8). The buccolingual radiographic images obtained were randomly interpreted for voids existence by a radiologist and an endodontist. The differences in sensitivity and specificity between groups and examiners were compared using, respectively, Fisher's Exact and McNemar tests at 5% significance level. Both radiopaque sealers caused a significant decrease in sensitivity at the coronal part of fillings. The use of Endométhasone increased specificity values for both coronal and apical portions of the root canal fillings. In conclusion, the tested sealers influenced the radiographic perceptions of laterally condensed root canal fillings in a different way.

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Microbiology and management of endodontic infections in children

Journal of Clinical Pediatric Dentistry ◽

10.17796/jcpd.28.1.uwjxq61753506255 ◽

2004 ◽

Vol 28 (1) ◽

pp. 13-17 ◽

Cited By ~ 24

Author(s):

Itzhak Brook

Keyword(s):

Root Canal ◽

Anaerobic Bacteria ◽

Bacterial Invasion ◽

Restorative Material ◽

Root Canal Therapy ◽

Tooth Structure ◽

Systemic Spread ◽

Amoxicillin Clavulanate ◽

Endodontic Infections ◽

Aerobic And Anaerobic

The first step in the origination of caries is the formation of a dental plaque. Dental caries can lead to destruction of enamel and dentin resulting in bacterial invasion of the pulp. Invasion of the pulp and the periapical areas can promote the development of dento-alveolar abscess and spread of the infection to other anatomical areas. Several oral acid producing aerobic and anaerobic bacteria, including Streptococcus mutans, Lactobacillus acidophilus, and Actinomyces viscosus, are capable of initiating the carious lesion. The organisms that predominate in pulpitis and dento-alveolar abscess are Prevotella, Porphyromonas, Fusobacterium, and Peptostreptococcus spp. Treatment of caries involves removal of all affected tooth structure and proper replacement with a restorative material. Once pulpitis has developed the infected tissue should be removed and root canal therapy instituted, or the tooth should be extracted. Extraction, root canal therapy and/or drainage of pus usually are indicated for an abscess. Antimicrobial therapy supplementing the dental care should be considered, especially when local or systemic spread of the infection is suspected. Penicillin or amoxicillin are generally effective against most of the aerobic and anaerobic bacteria recovered. The patient whose oral cavity may harbor penicillin-resistant organisms should be considered for treatment with drugs effective against these organisms. These agents include amoxicillin-clavulanate, clindamycin or the combination of metronidazole plus amoxicillin or a macrolide.

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Staining Potential of Calcium Hydroxide and Monochlorophenol Following Removal of AH26 Root Canal Sealer

The Journal of Contemporary Dental Practice ◽

10.5005/jcdp-9-3-56 ◽

2008 ◽

Vol 9 (3) ◽

pp. 56-63 ◽

Cited By ~ 3

Author(s):

Ali Cemal Tinaz ◽

Baǧdagül Helvaciölu Kivanç ◽

Güliz Gürgül

Keyword(s):

Calcium Hydroxide ◽

Root Canal ◽

Filling Material ◽

Root Canal Sealer ◽

Tooth Structure ◽

Root Canals ◽

Gutta Percha ◽

Anterior Teeth ◽

Tooth Surfaces ◽

Tooth Preparation

Abstract Aim The focus of this study was to examine the staining potential of calcium hydroxide (Ca(OH)2) on tooth structure following the removal of AH26 root canal sealer. Methods and Materials Fifty maxillary anterior teeth were prepared and obturated with AH26 and gutta percha. The sealers were then removed 24 hours later and the teeth were randomly divided into two groups. Ca(OH)2 was then placed in the root canals of the first group of teeth as a medicament and camphorated monochlorophenol (CMCP) was placed in the second group of teeth after the filling material was removed. The color of the external tooth surfaces was determined before tooth preparation and two weeks after the placement of the medicaments. The Z test was used for statistical analysis. Results All experimental teeth showed varying degrees of coronal discoloration with the Ca(OH)2 group showing more discoloration than the CMCP group (p<0.05). Conclusion Using Ca(OH)2 as a medicament after removing AH26 caused progressive discoloration of the teeth, whereas using CMCP caused only slight discoloration. Clinical Significance To avoid staining of the treated tooth, AH26 root canal sealer must be completely removed from the dentin walls before using a medicament. Citation Tinaz AC, Kivanç BH, Görgül G. Staining Potential of Calcium Hydroxide and Monochlorophenol Following Removal of AH26 Root Canal Sealer. J Contemp Dent Pract 2008 March; (9)3:056-063.

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EDS analysis of gutta-percha cones disinfected by 1% and 2.5% sodium hypochlorite solutions

Brazilian Dental Science ◽

10.14295/bds.2015.v18i4.1140 ◽

2015 ◽

Vol 18 (4) ◽

pp. 84

Author(s):

Alessandra Sverberi Carvalho ◽

Flávia Martins Leal ◽

Rafaela Andrade Vasconcelos ◽

Rafael Binato Junqueira ◽

Simone Helena Ferreira Gonçalves

Keyword(s):

Statistical Analysis ◽

Sodium Hypochlorite ◽

Energy Dispersive Spectroscopy ◽

Root Canal ◽

Time Dependent ◽

Energy Dispersive ◽

Root Canal Treatment ◽

Control Groups ◽

Gutta Percha ◽

Eds Analysis

Objective: To evaluate the effects of 1% and 2.5% sodium hypochlorite (NaOCl) solutions at different periods of time on the composition of gutta-percha cones using Energy Dispersive Spectroscopy (EDS).Material and Methods: 110 master gutta-percha points were divided into 3 control groups and 8 experimental groups. Cones were immersed in 1% and 2.5% NaOCl for 30 minutes, 6, 12, 24 hours. Then, composition of the samples was analyzed by EDS. Statistical analysis was performed using the ANOVA and Tukey tests (p<0.05).Results: There was an increase of oxygen in experimental groups, and decrease of zinc when NaOCl was used, concentration and time-dependent.Conclusions: The disinfection with NaOCl solution causes alterations in the composition of gutta-percha cones. These modifications in gutta-percha structure might change important characteristics, increasing the risk of leakage and consequently failure of root canal treatment.

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