Endodontic Treatment of Periapical Lesions Using Bioceramic Sealers

This article presents clinical cases of successful endodontic treatment of the main types of combined apical and marginal pathology. Based on the results obtained, the optimal method that ensures a successful treatment result for this pathology in one visit, often without subsequent surgical manipulations, is an adequate endodontic mechanical intervention with subsequent obturation of the root canals with a bioceramic sealer, which is confirmed by the literature data.

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Endodontic treatment of perioapical lesions using bioceramic sealers

Эндодонтия Today ◽

10.36377/1683-2981-2021-19-1-61-70 ◽

2021 ◽

Vol 19 (1) ◽

pp. 61-70

Author(s):

B. R. Shumilovich ◽

V. V. Rostovtsev ◽

I. S. Bishtova ◽

D. E. Khrenov ◽

R. V. Selin

Keyword(s):

Zirconium Dioxide ◽

Calcium Phosphates ◽

Glass Ceramics ◽

Endodontic Treatment ◽

Optimal Method ◽

Root Canals ◽

Treat Ment ◽

Comprehensive Examination ◽

Surgical Manipulations ◽

Mechanical Intervention

A number of researchers note the fact that today, in more than 5.7% of the teeth in patients over 40-45 years old with apical periodontal lesions, during a comprehensive examination, lesions of the marginal periodontium are also diagnosed.Materials and methods. The success of endodontic treatment of such teeth with the use of traditionally used polymer sealers is extremely low. Pathology develops due to a mixed apical-periodontal microflora. The use of bioceramic sealers has been reported to significantly improve the prognosis for endodontic intervention. Bioceramics inherently is the most biocompatible material and consists of aluminum oxide, zirconium dioxide, bioactive glass, glass ceramics, composite components and coatings, hydroxyapatite and resorbable calcium phosphates.Results. This article presents clinical cases of successful endodontic treatment of the main types of combined apical and marginal pathology. 9-11 months after treatment, the diagnosed signs of perio-dontal and periapical pathology are not determined.Conclusions. Based on the results obtained, the optimal method that ensures a successful treat-ment result for this pathology in one visit, often without subsequent surgical manipulations, is an ade-quate endodontic mechanical intervention with subsequent obturation of the root canals with a bioc-eramic sealer, which is confirmed by the literature data.

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Continued Root-End Growth and Apexification Using a Calcium Hydroxide and Iodoform Paste (Metapex®): Three Case Reports

The Journal of Contemporary Dental Practice ◽

10.5005/jcdp-11-5-63 ◽

2010 ◽

Vol 11 (5) ◽

pp. 63-70 ◽

Cited By ~ 4

Author(s):

Shobha Tandon ◽

N. Sridhar

Keyword(s):

South Korea ◽

Root Growth ◽

Calcium Hydroxide ◽

Clinical Significance ◽

Case Reports ◽

Endodontic Treatment ◽

Permanent Teeth ◽

Root Canals ◽

Disposable Plastic ◽

Clinical Cases

Abstract Aim The aim of these case reports is to present a treatment to promote root-end growth and apexification in nonvital immature permanent teeth in children. Methods and Materials Three cases were presented where the calcium hydroxide and iodoform paste Metapex® was placed in the root canals of immature permanent teeth using disposable plastic tips. The teeth involved were evaluated radiographically at regular intervals for the first 12 months after placement of the paste. At the end of 12 months all the cases showed continued root growth and apical closure (apexification) with no evidence of periapical pathology. Conventional endodontic treatment was then performed. Results In all three of the clinical cases presented, a combination of calcium hydroxide and iodoform paste (Metapex®) was used and showed promising results in inducing root-end growth and closure after 12 months. Conclusion In these three clinical cases, the calcium hydroxide and iodoform paste Metapex® (Meta Biomed Co. Ltd., South Korea) was found to induce apical closure when assessed radiographically. Over a period of 12 months all the cases showed continued root growth. Clinical Significance The calcium hydroxide and iodoform paste Metapex® promoted continued root-end growth with apexification in the nonvital immature permanent teeth treated. Citation Sridhar N, Tandon S. Continued Root-Growth and Apexification Using a Calcium Hydroxide and Iodoform Paste (Metapex®): Three Case Reports. J Contemp Dent Pract [Internet]. 2010 October; 11(5):063-070. Available from: http://www.thejcdp.com/journal/view/volume11- issue5-sridhar

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

South African Dental Journal ◽

10.17159/2519-0105/2020/v75no10a4 ◽

2020 ◽

Vol 75 (10) ◽

pp. 553-563

Author(s):

Maheshan Pillay ◽

Martin Vorster ◽

Peet J Van der Vyver

Keyword(s):

Adverse Effect ◽

Literature Review ◽

Root Canal ◽

Nickel Titanium ◽

Endodontic Treatment ◽

Risk Of Fracture ◽

Periapical Lesions ◽

Root Canals ◽

Infected Root ◽

Infected Root Canal

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.

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Incidence and quality of root canal fillings in undergraduate dental students

RGO - Revista Gaúcha de Odontologia ◽

10.1590/1981-863720190005720180088 ◽

2019 ◽

Vol 67 ◽

Author(s):

Beethoven Estevão COSTA ◽

Giovanna Morais de LIMA ◽

Stéphanie Quadros TONELLI ◽

Eduardo NUNES ◽

Frank Ferreira SILVEIRA

Keyword(s):

Root Canal ◽

Dental Students ◽

Endodontic Treatment ◽

High Quality ◽

Root Canal Filling ◽

Periapical Lesions ◽

Root Canals ◽

Low Prevalence

ABSTRACT Objective: The purpose of this study was to evaluate the incidence of endodontic treatment and the quality of root canal fillings in Brazilian undergraduate dental students. The study was similar those conducted 10, 20, 30, and 40 years earlier. Methods: A total of 407 undergraduate dental students were evaluated by using questionnaires to identify endodontic treatments, with each treatment being radiographed for the analysis of the presence of a periapical radiolucency and the quality of the root canal filling. Results: Forty root canal fillings were found: 32 (80%) completely filled, seven (17.5%) incompletely filled, and one (2.5%) overfilled. Conclusion: This study showed a low prevalence of endodontic treatment in dentistry students, and the evaluated root canals that were filled were high quality, with few cases suggesting periapical lesions.

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Penatalaksanaan non-bedah kasus previously initiated therapy gigi molar pertama maksila dengan lesi periapikal dan konfigurasi dua saluran akar mesiobukal Non-surgical management of previously initiated therapy of the maxillary first molar with periapical lesions and two mesiobuccal canals configuration

Jurnal Kedokteran Gigi Universitas Padjadjaran ◽

10.24198/jkg.v33i3.29525 ◽

2021 ◽

Vol 33 (3) ◽

pp. 262

Author(s):

Diatri Nariratih ◽

Hendra Dian Adhita Dharsono

Keyword(s):

Case Report ◽

Surgical Management ◽

Root Canal ◽

Anatomical Variations ◽

Nickel Titanium ◽

Endodontic Treatment ◽

Radiographic Examination ◽

Periapical Lesions ◽

Root Canals

ABSTRAKPendahuluan: Penatalaksanaan kasus penyakit pulpa yang disertai dengan lesi periapikal dapat dilakukan dengan perawatan saluran akar tanpa intervensi bedah. Preparasi biomekanis pada perawatan endodontik non-bedah dapat mengeliminasi bakteri dari saluran akar dan mencegah terjadinya infeksi berulang setelah dilakukannya obturasi. Kompleksitas anatomi menyebabkan keterbatasan preparasi biomekanis saluran akar, sehingga perawatan dapat mengalami kegagalan. Variasi anatomi saluran akar pada gigi molar pertama rahang atas umumnya terdapat pada bagian palatal akar mesiobukal yang disebut sebagai saluran akar mesiobukal kedua dengan insidensi 94%. Saluran akar mesiobukal kedua berukuran lebih sempit dan dangkal dibandingkan saluran akar mesiobukal pertama, sehingga dibutuhkan beberapa metode untuk menentukan lokasi orifis tersebut. Tujuan laporan kasus ini adalah membahas mengenai penatalaksanaan non-bedah gigi pasca perawatan endodontik parsial yang disertai dengan lesi periapikal. Laporan kasus: Pasien perempuan berusia 28 tahun datang dengan keluhan gigi belakang kiri atas sakit berdenyut sejak 1 bulan, gigi tersebut pernah dirawat saluran akarnya beberapa tahun sebelumnya. Pemeriksaan klinis menunjukkan terdapat tambalan permanen pada gigi 26. Pemeriksaan radiografis menunjukkan adanya gambaran radiopak pada email mesio-oklusal hingga mencapai dasar kamar pulpa, pelebaran ligamen periodontal, terputusnya lamina dura, serta lesi periapikal pada akar mesial dan palatal. Preparasi akses dilakukan pada gigi 26, dilanjutkan dengan penentuan lokasi orifis mesiobukal kedua. Empat saluran akar dipreparasi menggunakan instrumen rotary nickel titanium dengan teknik crown down dan dilakukan obturasi teknik kondensasi lateral. Restorasi definitif berupa mahkota penuh porselen. Simpulan: Lesi periapikal sembuh setelah dilakukan preparasi pada saluran akar mesiobukal kedua sehingga pengetahuan mengenai anatomi dan variasi internal saluran akar gigi sangat penting dalam keberhasilan perawatan endodontik non-bedah.Kata kunci: Perawatan endodontik non-bedah; previously initiated therapy; lesi periapical; mesiobukal kedua ABSTRACTIntroduction: The management of pulp disease cases accompanied by periapical lesions can be done by root canal treatment without surgical intervention. Biomechanical preparations for non-surgical endodontic treatment can eliminate bacteria from the root canal and prevent re-infection after obturation. However, the complexity of the anatomy limits the biomechanical preparation of the root canal so that treatment can fail. Anatomical variations of the root canal in the maxillary first molars are generally found in the palatal part of the mesiobuccal root, which is the second mesiobuccal root canal with an incidence of 94%. The second mesiobuccal root canal is narrower and shallower than the first mesiobuccal root canal, so several methods are needed to determine the location of the orifice. The purpose of this case report was to discuss the non-surgical management of teeth after partial endodontic treatment accompanied by periapical lesions. Case report: A 28-year-old female patient complained of throbbing pain in the left upper back tooth for one month. The tooth had had its root canal treated several years before. Clinical examination revealed permanent fillings on tooth 26. Radiographic examination showed the radiopaque appearance of mesio-occlusal enamel to the floor of the pulp chamber, widening of the periodontal ligament, rupture of the lamina dura, and periapical lesions of the mesial and palatal roots. Access preparation was performed on tooth 26, followed by the determination of the location of the second mesiobuccal orifice. Four root canals were prepared using a rotary nickel titanium instrument with a crown down technique and obturation with lateral condensation technique. The definitive restoration is a full porcelain crown. Conclusions: Periapical lesions healed after preparation of the second mesiobuccal root canal. This result proves that knowledge of the anatomy and internal variations of the root canal is fundamental in the success of non-surgical endodontic treatment.Keywords: Non-surgical endodontic treatment; previously initiated therapy; periapical lesions; second mesiobuccal canal

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Association of calcium hydroxide and metronidazole in the treatment of dog's teeth with chronic periapical lesion

Journal of Applied Oral Science ◽

10.1590/s1678-77572006000500007 ◽

2006 ◽

Vol 14 (5) ◽

pp. 334-340

Author(s):

Sônia Regina Panzarini ◽

Valdir Souza ◽

Roberto Holland ◽

Eloi Dezan Júnior

Keyword(s):

Calcium Hydroxide ◽

Root Canal ◽

Study Groups ◽

Group Iv ◽

Endodontic Treatment ◽

Group Iii ◽

Periapical Lesions ◽

Root Canals ◽

Group I ◽

Periapical Healing

One of the primary objectives of endodontic treatment of teeth with pulp necrosis is the elimination of microorganisms from the root canal system, as effectively as possible, especially in cases with chronic periapical lesions. AIM: The purpose of this study was to analyze the response of the periapical tissue of dogs' teeth with chronic periapical lesions to endodontic treatment performed with utilization of metronidazole, calcium hydroxide, and an association of both as root canal dressings. METHODOLOGY: Forty root canals were submitted to pulpectomy and the root canals were kept exposed to the oral environment for 6 months. Then, they were submitted to biomechanical preparation and divided into 4 study groups with 10 specimens: group I - no root canal dressing; group II - calcium hydroxide; group III - metronidazole; group IV - calcium hydroxide associated to metronidazole. After 15 days, the root canals were filled with Fill Canal sealer. After 90 days, the animals were killed and the especimens processed for histological analysis. RESULTS: Calcium hydroxide dressing provided a significantly better outcome compared to other experimental groups (alpha = 0.01). Also, the results of the association of metronidazole and calcium hydroxide were similar to those observed for the metronidazole group. The worst results were obtained by the no root canal dressing group. CONCLUSION: The use of metronidazole alone or associated with Calcium hydroxide, did not improve periapical healing when compared to Calcium hydroxide dressing.

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Synergistic Antimicrobial Action of Chlorhexidine and Ozone in Endodontic Treatment

BioMed Research International ◽

10.1155/2014/592423 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 13

Author(s):

Rita Noites ◽

Cidália Pina-Vaz ◽

Rita Rocha ◽

Manuel Fontes Carvalho ◽

Acácio Gonçalves ◽

...

Keyword(s):

Flow Cytometry ◽

Candida Albicans ◽

Enterococcus Faecalis ◽

Sodium Hypochlorite ◽

Endodontic Treatment ◽

Periapical Lesions ◽

Root Canals ◽

Single Root ◽

Gaseous Ozone ◽

Infected Root

Objectives. The aim of this study was to determine whether irrigation with sodium hypochlorite, chlorhexidine, and ozone gas, alone or in combination, were effective againstEnterococcus faecalisandCandida albicans; these are microorganisms frequently isolated from teeth with periapical lesions resistant to endodontic treatment.Material and Methods. 220 single root teeth, recently extracted, were inoculated withCandida albicansandEnterococcus faecalis. The formulations tested were sodium hypochlorite at 1, 3, and 5% chlorhexidine at 0.2% and 2% and ozone gas applied for different periods of time. The combination of sodium hypochlorite at 5% and chlorhexidine at 2%, with gaseous ozone, were also assessed. For the most active treatments the mechanism of action was assessed through flow cytometry.Results. Sodium hypochlorite, chlorhexidine, and gaseous ozone alone were ineffective in completely eliminating the microorganisms. The association of chlorhexidine at 2% followed by ozone gas for 24 seconds promoted the complete elimination ofCandida albicansandEnterococcus faecalis. Flow cytometry shows that ozone and chlorhexidine act differently, which could explain its synergic activity.Conclusions. This new disinfection protocol, combining irrigation with chlorhexidine at 2% and ozone gas for 24 seconds, may be advantageous when treating infected root canals.

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Use of MTA in teeth with incomplete root formation or open foramina: introduction of a protocol and report of clinical cases

RGO - Revista Gaúcha de Odontologia ◽

10.1590/1981-86372014000300000151337 ◽

2014 ◽

Vol 62 (3) ◽

pp. 325-330

Author(s):

Antônio Edgar KRÖLING ◽

Carlos Roberto BERGER ◽

Carlos Antônio PELLISSARI ◽

Maicon Alves Junqueira GOMES

Keyword(s):

Physical Properties ◽

Calcium Hydroxide ◽

Root Formation ◽

Root Resorption ◽

Endodontic Treatment ◽

Physical Barrier ◽

Mineralized Tissue ◽

Root Canals ◽

Clinical Cases

Apexification is the endodontic procedure performed in order to induce the formation of a physical barrier of mineralized tissue in teeth with incomplete root formation. It is mainly performed when, for any reason, pulpal necrosis occurs in teeth with incomplete root formation and also in those cases where the foramen is open, due to root resorption. In these situations, conventional endodontic treatment becomes difficult or virtually impossible, because of the large foramen. The apexification procedure, in these cases, is generally performed by means of successive changes of calcium hydroxide dressings, aiming to induce the formation of a physical barrier of mineralized tissue, thus permitting the obturation of root canals. The protocol introduced in this article, as well as the clinical cases reported, illustrate an option for faster treatment, conducted within three sessions, by using a MTA cap or plug, material that offers good biological and physical properties.

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Application of a Chairside Anaerobic Culture Test for Endodontic Treatment

International Journal of Dentistry ◽

10.1155/2010/942130 ◽

2010 ◽

Vol 2010 ◽

pp. 1-8 ◽

Cited By ~ 1

Author(s):

Masahiro Yoneda ◽

Seidai Kita ◽

Nao Suzuki ◽

Sonia M. Macedo ◽

Kosaku Iha ◽

...

Keyword(s):

Bacterial Infections ◽

Endodontic Treatment ◽

Anaerobic Culture ◽

Periapical Lesions ◽

Culture Test ◽

Root Canals ◽

Gutta Percha ◽

Root Canal System ◽

Treatment Procedures ◽

Lesion Treatment

Periapical lesions are caused by bacterial infections. The fundamental objective of endodontic treatment is to eliminate bacteria present in the root canal system because they play an important role in the development and maintenance of periapical lesions. Therefore, confirming the absence of bacteria before filling root canals is important. Anaerobic culture tests have been used in many endodontic cases, and they have brought about good treatment outcomes. These tests, however, require specific apparatuses and bacteriological techniques. Here, we report a chairside anaerobic culture test that does not require any specialized apparatuses or techniques. We also report two endodontic cases in which this simple test was used. Both patients were diagnosed with chronic purulent periapical lesions. After confirming the absence of bacteria in the root canals, they were filled with gutta-percha points. At followup, the radiolucencies showed recovery, although longterm observation is under way. From these results, the authors conclude that this simple chairside anaerobic culture test is effective for evaluating periapical lesion treatment procedures.

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Microbiological status of root canal after unsuccessful endodontic treatment

Stomatoloski glasnik Srbije ◽

10.2478/sdj-2018-0019 ◽

2018 ◽

Vol 65 (4) ◽

pp. 195-204

Author(s):

Jelena Nešković ◽

Milica Jovanović-Medojević ◽

Đurica Grga ◽

Branka Popovic ◽

Slavoljub Živković

Keyword(s):

Root Canal ◽

Three Dimensional ◽

Endodontic Treatment ◽

Filling Material ◽

Endodontically Treated Teeth ◽

Root Canal Filling ◽

Complete Control ◽

Periapical Lesions ◽

Root Canals ◽

Microbiological Status

Summary Introduction The main objective of endodontic treatment is to eliminate infection from root canal and prevent reinfection by three-dimensional hermetic obturation of the canal system. Endodontic failure can occur due to inability of complete control and elimination of infection from the root canal. The aim of this study is to investigate, by PCR technique, microbiological status of previously endodontically unsuccessfully treated teeth immediately after the removal of obturation material. Material and Methods The analysis included 30 teeth indicated for endodontic retreatment. After removing previous root canal filling material, the bacteriological sample was taken by sterile instrument (# 15) and paper points. Standard PCR technique was used to analyze the incidence of E.faecalis, P.micros, P.intermedia, P. endodontalis and A.actinomycetemcomitans. Results Positive bacteriological findings were registered in 80% of cases, while bacteria were not identified in 20% of all samples (all taken from the root canals without significant changes in periapical tissue). From 24 canals with identified bacteria, 17 had affected apical periodontium. The most dominant microbe in root canals with positive bacteriological finding was E.faecalis (83.3% of the canals) and P.intermedia (75%). In case of teeth with chronic periapical changes, the most common was E. faecalis (94%) and P.intermedia (82.3%). Conclusion The presence of periapical lesions significantly affects microbiological status of endodontically treated teeth. The presence of bacteria was confirmed in most teeth with periapical lesions, while the most frequently identified bacteria were E. faecalis, P.intermedia and P.micros.

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