The influence of endodontic access cavity design on the efficacy of canal instrumentation, microbial reduction, root canal filling and fracture resistance in mandibular molars

Abstract Background: This study aims to compare the percentage of dentin removed, instrumentation efficacy, root canal filling and load at fracture between contracted endodontic cavities, and traditional endodontic cavities on root canal therapy in premolars. Methods: Forty extracted intact human first premolars were imaged with micro-CT and randomly assigned to the contracted endodontic cavity (CEC) or traditional endodontic cavity (TEC) groups. CEC was prepared with the aid of a 3D-printed template, canals were prepared with a 0.04 taper M-Two rotary instrument, and cavities were restored with resin. Specimens were loaded to fracture in an Instron Universal Testing Machine after a fatigue phase. The data were analyzed by the independent samples T test and Mann-Whitney U test, appropriate post hoc tests. Results: In the premolars tested in vitro, the percentage of dentin removed in the premolars with two dental roots in the CEC group (3.85% ± 0.42%) was significantly smaller (P < 0.05) than in the TEC group (4.94% ± 0.5%). The untouched canal wall (UCW) after instrumentation for TECs (16.43% ± 6.56%) was significantly lower (P< .05) than the UCW (24.42% ± 9.19%) for CECs in single-rooted premolars. No significant differences were observed in the increased canal volume and surface areas in premolars between the TEC and CEC groups (P > 0.05). CECs conserved coronal dentin in premolars with two dental roots but no impact on the instrument efficacy. There were no differences between the CEC groups and the TEC groups in the percentage of filling material and voids (P > 0.05). In addition, the mean load at failure of premolars did not significantly differ between the CEC and TEC groups and there was no significant difference in the type of fracture (P > 0.05). Conclusion: The results of this study suggest that CEC could not improve the fracture resistance of the endodontically treated premolars. The instrumentation efficacy and the percentage of filling material did not significantly differ between CECs and TECs in premolars. Keywords: 3D-printed template, contracted endodontic cavities, instrumentation efficacy, root canal filling, fracture resistance

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Root canal filling quality of mandibular molars with EndoSequence BC and AH Plus sealers: A micro‐ CT study

Australian Endodontic Journal ◽

10.1111/aej.12373 ◽

2019 ◽

Vol 46 (1) ◽

pp. 82-87 ◽

Cited By ~ 1

Author(s):

Rafael Nigri Roizenblit ◽

Fabiola Ormiga Soares ◽

Ricardo Tadeu Lopes ◽

Bernardo Camargo Santos ◽

Heloisa Gusman

Keyword(s):

Root Canal ◽

Micro Ct ◽

Root Canal Filling ◽

Mandibular Molars ◽

Ah Plus

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The concept of monobloc in Endodontic - A review

CODS Journal of Dentistry ◽

10.5005/cods-6-2-83 ◽

2014 ◽

Vol 6 (2) ◽

pp. 83-89

Author(s):

BS Deepak ◽

T Sophia ◽

J Deepa ◽

GK Mallikarjun

Keyword(s):

Root Canal ◽

Fracture Resistance ◽

Canal Wall ◽

Recent Past ◽

User Friendliness ◽

Root Canal Filling ◽

Filling Materials ◽

Root Canal Filling Materials ◽

New Generation ◽

Root Canal Sealers

Abstract The creation of a homogenous filling within the root canal has always been one of the most sought after objectives in the field of Endodontics. While conventional root canal filling materials have given predictable results, the pursuit of developing alternative sealers or techniques that bond simultaneously to canal wall dentin as well as filling materials has continued. Breakthroughs in dentin adhesive technology in the recent past have built a new generation of bondable root canal sealers and post systems. Thus arose the concept of monoblocs, with its purported advantages of simultaneously improving the seal and fracture resistance of the filled canals. The added advantages of reduced application steps and overall improvements in their user friendliness led to the aggressive marketing of materials claiming to achieve the ‘monobloc effect’. On the other hand the credibility of this concept in practice has launched controversial discussions. This review attempts to throw light on the various dimensions of the concept of monoblocs as well as to scrutinize the potential of various root canal filling materials to create monoblocs. How to cite this article Sophia T, Deepak BS, Deepa J, Mallikarjun GK. The concept of monobloc in Endodontics - A review. CODS J Dent 2014;6;83-89

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Prevalence and risk factors of Apical periodontitis in endodontically treated teeth: cross-sectional study in an Adult Moroccan subpopulation

BMC Oral Health ◽

10.1186/s12903-021-01491-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Imane El Ouarti ◽

Sanaa Chala ◽

Majid Sakout ◽

Faiza Abdallaoui

Keyword(s):

Risk Factors ◽

Root Canal ◽

Cross Sectional Study ◽

Apical Periodontitis ◽

Treatment Quality ◽

Gingival Inflammation ◽

Endodontically Treated Teeth ◽

Root Canal Filling ◽

Cross Sectional ◽

Cavity Design

Abstract Background The present study aimed at investigating the prevalence of Apical periodontitis in a Moroccan Adult subpopulation with a non-surgical root canal treatment and to assess associated risk factors including endodontic treatment quality, periodontal health status, coronal restoration cavity design and quality. Methods A total of 358 endodontically treated teeth were evaluated after more than 1-year period in a Moroccan subpopulation according to predetermined criteria. Studied parameters were assessed clinically and radiographically. The association between coronal restoration quality, cavity design, periodontal status, root canal filling quality, coronal restoration related features, presence or absence of the opposing dentition and the periapical status was determined. Data were analyzed using chi-square test, odds ratio and logistic regression. Results The present study revealed that gingival health, coronal restoration with CL II cavity design, and root canal filling quality influenced periapical status of endodontically treated teeth. Multivariate analysis showed that this association was statistically significant for gingival inflammation (95% CI 1.08–3.91, OR 2.05, p = 0.02), inadequate coronal restoration (95% CI 1.16–4.04, OR 2.16, p = 0.01), inadequate root canal filling length and homogeneity (95% CI 1.24–3.01, OR 1.93, P = 0.004), (95% CI 1.41–4.44, OR 2.50, p = 0.002) respectively. Conclusions The present study revealed that inadequate coronal restorations especially with large proximal margins (CL II cavity design) and gingival inflammation increased the risk of apical periodontitis in endodontically treated teeth. Prevalence of Apical periodontitis in the present study was 72.1%.

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Radiographic prevalence of root canal ramifications in a sample of root canal treatments in a Brazilian Dental School

Brazilian Oral Research ◽

10.1590/s1806-83242007000200004 ◽

2007 ◽

Vol 21 (2) ◽

pp. 112-117

Author(s):

Iadasa de Quadros ◽

Alexandre Augusto Zaia ◽

Caio Cezar Randi Ferraz ◽

Francisco José de Souza Filho ◽

Brenda Paula Figueiredo de Almeida Gomes

Keyword(s):

Undergraduate Students ◽

Root Canal ◽

Chemical Substance ◽

Dental School ◽

X Rays ◽

State University ◽

Root Canal Filling ◽

Mandibular Molars ◽

Maxillary Premolars ◽

Maxillary Incisors

The aim of this study was to radiographically investigate the presence of root canal ramifications found after endodontic treatment, and to determine any relationship between their presence and the type of the auxiliary chemical substance used. The study evaluated 1,470 endodontic treatments performed by final year undergraduate students at the Dental School of Piracicaba, State University of Campinas (UNICAMP), SP, Brazil, during the period from 1998 to 2000. The X-rays taken during treatment were evaluated in order to establish the presence of ramifications of the root canal system. The initial X-ray did not show the presence of any canal ramifications. After filling, X-rays showed only 3 ramification types: 3.06% of lateral canals, 2.99% of apical deltas, and 0.1% of interradicular canals. The maxillary premolars showed the highest number of lateral canals (n = 13), followed by mandibular premolars (n = 10) and maxillary incisors (n = 10). Apical deltas were mostly found in mandibular molars (n = 14), followed by maxillary incisors (n = 9). Only mandibular molars had interradicular canals. The detection of ramifications increased with the use of EDTA. However, no statistically significant relationship was found between the type of auxiliary chemical substance used and the number of root canal ramifications detected after root canal filling. It was concluded that the frequency of root canal ramifications found radiographically was low in treatments performed by undergraduate students.

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

Journal of Endodontics ◽

10.1016/j.joen.2017.05.006 ◽

2017 ◽

Vol 43 (10) ◽

pp. 1657-1662 ◽

Cited By ~ 40

Author(s):

Gabriela Rover ◽

Felipe Gonçalves Belladonna ◽

Eduardo Antunes Bortoluzzi ◽

Gustavo De-Deus ◽

Emmanuel João Nogueira Leal Silva ◽

...

Keyword(s):

Root Canal ◽

Fracture Resistance ◽

Maxillary Molars ◽

Cavity Design

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The effect of timing temporary cements to treat induced pulp necrosis in the teeth of dogs

Pesquisa Veterinária Brasileira ◽

10.1590/s0100-736x2007000200006 ◽

2007 ◽

Vol 27 (2) ◽

pp. 85-88

Author(s):

Léslie M. Domingues-Falqueiro ◽

Jonathan Ferreira ◽

Fernanda M. Lopes ◽

Agnes Tymoszczenko ◽

Marco A. Gioso

Keyword(s):

Root Canal ◽

Microbial Reduction ◽

Endodontic Treatment ◽

Microbiological Analysis ◽

Single Session ◽

Root Canal Filling ◽

Root Canals ◽

Gutta Percha ◽

Dressing Materials ◽

Block Section

During endodontic therapy (pulpectomy, root canal debridement and root canal filling) microbiological management is a major concern. Bacteria present in dentine tubules, apical foramina and apical delta are causally related to failure of the procedure. Studies have shown that during single session endodontic treatment bacteria remain within dental structures. The aim of the present study was to evaluate endodontic treatment performed as two sessions, using temporary endodontic dressing materials for different periods in four groups of experimental dogs. A total of 80 roots of second and third upper premolar teeth and second, third and fourth lower premolar teeth were divided into four groups. The pulp chamber was opened with burrs and the pulp exposed for 60 days to induce pulpal inflammation and necrosis. Groups II, III and IV were treated with calcium hydroxide plus camphorated paramono-chlorophenol (PMCC) for 7, 15 and 30 days, respectively. In all groups, the root canals were filled with zinc oxide-eugenol and gutta-percha cones. Clinical and radiographical measurements were performed every 2 weeks. After 60 days a small block section containing the teeth, surrounding periapical tissues and the periodontium was removed for histological and microbiological study. Histological analysis revealed intense inflammatory response in all groups. Microbiological analysis showed microbial reduction inversely proportional to the period of time that the intracanal temporary medicament was left in place.

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Technical Quality of Root Canal Filling in Preclinical Training at Strasbourg University Using Two Teaching Protocols

European Journal of Dentistry ◽

10.1055/s-0039-1698848 ◽

2019 ◽

Vol 13 (04) ◽

pp. 521-526 ◽

Cited By ~ 2

Author(s):

Naji Kharouf ◽

Joseph Hemmerlé ◽

Youssef Haikel ◽

Davide Mancino

Keyword(s):

Root Canal ◽

Technical Quality ◽

Root Canal Filling ◽

Root Canals ◽

Mandibular Molars ◽

Maxillary Molars ◽

Chi Squared ◽

Canal Systems ◽

Preclinical Training

Abstract Objectives The aim of this study was to compare two teaching protocols according to the technical quality of root canal therapy (RCT) and the procedural errors occurred in preclinical training. Materials and Methods Two different groups of students were concerned. The first one (G1) performed a crown-down technique to shape the root canal systems and cold lateral condensation technique to fill them. The second one (G2) performed a step-down technique without initial manual scouting to shape the root canal systems, and cold hydraulic condensation technique, to fill them. G2 used clinical operative microscope to check the access cavity preparation. Statistical Analysis The quality of RCTs and procedural errors were recorded and analyzed using chi-squared test and t-test. Results Four hundred sixty-eight root canals from 152 maxillary molars were treated by the G1 students: 46.6% canals were judged as acceptable. Four hundred sixty-nine root canals from 152 mandibular molars were treated by G1: 58.8% canals were judged as acceptable. Five hundred fifteen root canals from 156 maxillary molars were treated by G2 students: 84.1% canals were judged as acceptable. Four hundred ninety-three root canals from 156 mandibular molars were treated by G2: 90.9% canals were judged as acceptable. Among the errors, the incidence of “ledges” and “fractured instruments” was statistically significant in G1 compared with G2, both on maxillary and on mandibular molars. Conclusions The molar RCTs performed by G2, who got benefit from the new teaching protocol, resulted in a better quality of root filling and in fewer procedural errors compared with the molar RCTs performed by G1.

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