scholarly journals Nonsurgical Root Canal Treatment of a Mandibular First Premolar with Taurodontism Managed with Minimally Invasive Endodontics: A Case Report

2020 ◽  
pp. 1-6
Author(s):  
Ling-Chang Shen ◽  
Ling-Chang Shen ◽  
Wan-Chuen Liao ◽  
O. A. Peters

A 67-year-old male patient was referred for further treatment of a mandibular left first premolar. The tooth presented with slight percussion tenderness and the periodontal probing depth was normal. There was no soft tissue swelling. The radiographic image exhibited a temporary restoration in the previously initiated access cavity of the mandibular left first premolar. The diagnosis of the mandibular left first premolar was previously initiated therapy associated with symptomatic apical periodontitis. The tooth presented four root canals and the characteristics of taurodontism. Two buccal root canals bifurcated at the apical third. The pulpal floor was examined under a dental operating microscope and four canal orifices were identified. TruNatomy Glider was used for glide path preparation. TruNatomy Prime file was selected for final root canal preparation in order to maximally preserve the radicular dentin. Root canal irrigation was achieved by using RC-Prep and 2.5% NaOCl between each file application. Canal blockage was avoided by multiple recapitulations with K-files (#10) between changing each rotary file. Obturation of the canals were performed by using TruNatomy Conform Fit® Gutta-Percha cones and AH Plus® root canal sealer via the warm lateral condensation technique. CBCT was arranged for confirmation after root canal treatment of the mandibular left first premolar and showed a good outcome. The clinical procedures and instruments could provide the practitioners for reference while managing such a difficult case.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Cheng Wen ◽  
Yuanyuan Kong ◽  
Jian Zhao ◽  
Yang Li ◽  
Ya Shen ◽  
...  

Abstract Background This study aimed to compare the use of photon-initiated photoacoustic streaming (PIPS) and conventional needle irrigation (CNI) in conjunction with different concentrations of sodium hypochlorite (NaOCl) to remove Enterococcus faecalis (E. faecalis) suspended bacteria and biofilms from root canal systems with different diameters or tapers. Methods Artificial root canal samples (n = 480) were randomly divided into three groups (n = 160/group). The canals were prepared to fit file sizes #10/.02, #25/.02, or #25/.06. The size #10/.02 group was incubated for seven days. The size #25/.02 or #25/.06 group was incubated for 2 days. A stable biological model of E. faecalis infection was established. The root canals were washed with distilled water or with 1%, 2%, or 5.25% NaOCl combined with CNI or PIPS. Bacterial suspensions and biofilms were assessed using an ATP assay kit and fluorescence microscopy. Image-Pro Plus was used to analyse the average fluorescence intensity to determine the most suitable root canal irrigation solution. Results In the CNI and PIPS groups, the ATP value of the 5.25% NaOCl subgroup was the lowest, followed by that of the 2% and 1% NaOCl subgroups. The ATP value of the distilled water subgroup was the highest (P < 0.05). When the root canal taper was 0.02, the ATP value of the #10/.02 + PIPS group was significantly lower than that of the #25/.02 + CNI group (P < 0.05). The average fluorescence intensity of the #10/.02 + PIPS group was lower than that of the #25/.02 + CNI group (P < 0.05). When the apical diameter was #25, the ATP value of the 0.02 taper in the PIPS group was lower than that of the 0.06 taper in the CNI group (P < 0.05), and the average fluorescence intensity of the 0.02 taper + PIPS group was lower than that of the 0.06 taper + CNI group (P < 0.05). PIPS combined with 2% and 5.25% NaOCl effectively improved the long-term antibacterial effect after irrigation and re-culture for 6 h. Conclusions Compared with CNI, PIPS has greater ability to remove bacteria in root canals with a small preparation diameter and a small taper. PIPS with 2% and 5.25% NaOCl exhibited superior antibacterial and bacteriostatic effects.


2006 ◽  
Vol 20 (3) ◽  
pp. 235-240 ◽  
Author(s):  
Chaves Medici Mônika ◽  
Izabel Cristina Fröner

The purpose of this study was to assess the effectiveness of endodontic irrigants in removing the smear layer from instrumented root canal walls using Scanning Electron Microscopy (SEM). The endodontic irrigants used were: 1% sodium hypochlorite (NaOCl); 1% NaOCl mixed to 17% EDTAC; 2% chlorhexidine gel; and Ricinus communis gel. Photomicrographs of the middle and apical thirds were evaluated with the aid of the Fotoscore - v. 2.0 software. The results indicated that the mixture of sodium hypochlorite and EDTAC completely removed the smear layer from dentinal walls. The other endodontic irrigants were not as efficient in cleansing the root canals.


2008 ◽  
Vol 9 (5) ◽  
pp. 68-75 ◽  
Author(s):  
Rafael Brandao Ferreira ◽  
Melissa Andreia Marchesan ◽  
Yara Teresinha Silva-Sousa ◽  
Manoel Sousa-Neto

Abstract Aim The aim of this in vitro study was to evaluate the cleaning capacity of different auxiliary chemical substances energized with ultrasound in radicular dentin using morphologic analysis. Methods and Materials Twenty-eight single-canal, mandibular incisors were prepared with the Hero 642 canal preparation system following the sequence: 25/12, 30/06, 35/02, and 40/02, 1 mm from the apex. The specimens were then divided into four groups of seven teeth. During biomechanical preparation the teeth were irrigated with 2 ml of distilled water between files. Each group of specimens (n=7) received a final irrigation with 100 ml of the following irrigants that were activated with ultrasound for 3 minutes: Group 1- distilled water; Group 2- 0.2% chlorhexidine digluconate (CHX); Group 3- 2.5% sodium hypochlorite (NaOCl); and Group 4-the filtrate obtained after combining 0.2% CHX and 2.5% NaOCl. The apical portions of the root canals from each group were then submitted to histological processing and analyzed using optical microscopy. Results Results showed statistical differences between the groups (p<0.01). Groups 1 and 2 (distilled water and 0.2% CHX respectively) were statistically similar in terms of a greater amount of debris, whereas 2.5% NaOCl and the filtrate were more efficient in removal of debris. Conclusion There is no additional benefit in terms of debris removal from root canal walls by irrigating with the filtrate obtained from the combination of NaOCl and CHX when compared to using NaOCl alone. Clinical Significance The findings of this study suggest the time and expense of preparing and using a combination of NaOCl and CHX is not warranted compared to using NaOCl alone for root canal irrigation. Citation Ferreira RB, Marchesan MA, Silva-Sousa YT, Sousa-Neto M. Effectiveness of Root Canal Debris Removal Using Passive Ultrasound Irrigation with Chlorhexidine Digluconate or Sodium Hypochlorite Individually or in Combination as Irrigants. J Contemp Dent Pract 2008 July; (9)5:068-075.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Ming Zhang ◽  
Jian Xie ◽  
Yan-huang Wang ◽  
Yan Feng

Abstract Background Understanding the anatomical morphology of the root canal is key for successful root canal treatment. The aims of this case presentation are to report a unique case of root canal treatment involving five root canals in the mandibular first premolar and to highlight the importance of variation in root canals of mandibular first premolars in clinical practice. Case presentation A 25-year-old male with intermittent pain in relation to the lower right posterior teeth over 3 weeks was diagnosed with symptomatic pulpitis in tooth #44. Four root canals were found, including mesiobuccal, distobuccal-1, distobuccal-2, and distolingual roots, and the Mtwo rotary system was used for root canal preparation. The four root canals were filled after 2 weeks, when a fifth canal was found, located in the buccal cavity. The fifth canal was confirmed to be the mesiolingual root canal by cone beam computed tomography (CBCT) and was found to be curved. After completion of the root canal filling, CBCT was performed, and a three-dimensional root canal image was reconstructed. After 1 week of observation, the tooth was repaired using composite resin filling. Conclusions This is the first case presentation of a fifth canal of the mandibular first premolar and advances our understanding of variations in the anatomy of the mandibular first premolar. This case report provides a reference for the treatment of mandibular first premolars.


2007 ◽  
Vol 54 (3) ◽  
pp. 160-169
Author(s):  
Goran Stojilkovic ◽  
Jovanka Gasic ◽  
Jelena Dakovic

Introduction: Root canal irrigation plays an important part in the endodontic therapy. Inadequate irrigation or instrumentation without irrigation increase the accumulation of debris on the cutting surfaces of instruments as well as debris and smear layer on root canal walls. Aim: The aim of this study was to evaluate smear layer removal after irrigation with saline, 5% NaOCl, 15% EDTA and the combination of 15% EDTA and 5% NaOCl. Materials and Methods: The study was conducted at the Clinic for Dentistry and Institute for biomedical research of the School of Medicine in Nis. Twenty five premolars, extracted from orthodontic reasons, were allocated to 5 groups (A-E) of 5 teeth. Root canals of all teeth were instrumented using hand K files. Samples from Group A were instrumented without irrigation (control group). In Group B, the irrigation was done using saline, in Group C 5% NaOCl, in Group D 15% EDTA and in Group E the combination of 15% EDTA and 5% NaOCl. After the treatment, all samples were prepared for scanning electron microscopy (SEM). Central parts of root canals were examined and photomicrographs were taken at different magnification. The amount of debris and smear layer was quantified and the data were statistically analyzed. Results: All four treatment modalities (B, C, D, E) induced changes in the appearance of dentinal walls and the amount of debris and the smear layer compared to the control group (A). The difference between the control group and Group B was statistically significant (p<0.01) and highly significant between the control group and Groups C, D and E (p<0.0001). The combined use of 15% EDTA and 5% NaOCl for irrigation and 1 min final rinse resulted in a complete elimination of the smear layer; the use of saline, 5% NaOCl or 15% EDTA alone failed to remove the debris and smear layer completely. Conclusion: The use of singular solutions for root canal irrigation significantly reduces the amount of debris and the smear layer whereas the combined use of NaOCl and EDTA results in the complete elimination of the smear layer from root canal walls.


2018 ◽  
Vol 91 (3) ◽  
pp. 322-327
Author(s):  
Kavita Dube ◽  
Pradeep Jain

Objectives. The aim of this study is to evaluate electrolyzed saline, produced from a custom-made chair side apparatus for its cleaning effect on root canal walls.Methods. A chair side apparatus has been designed to produce and dispense electrolytically activated solutions (Electrolyzed saline) for the purpose of root canal irrigation. Two different solutions, one, which is oxidizing in nature, consisting primarily of Chlorine derivatives and another, reducing in nature, consisting primarily of sodium hydroxide, are obtained. A combination of these two solutions was used for root canal irrigation in extracted teeth. Root canals were split and the samples were subjected to Scanning electron microscopic evaluation.Results. Under the conditions of this study, electrolyzed saline significantly cleaned the root canal surfaces well, opening the dentinal tubules and removing the smear layer.Significance. There has been a constant search for the ideal root canal irrigant. Sodium hypochlorite has been vastly used but its toxicity and storage risks are of concern. Electrolyzed saline has been produced from saline and the apparatus prepares and dispenses the solution chair side, obviating storage needs.


2012 ◽  
Vol 2 (8) ◽  
pp. 406-407
Author(s):  
Dr. Ramta Bansal ◽  
◽  
Dr. Aditya Jain ◽  
Dr. Ramta Bansal

Materials ◽  
2021 ◽  
Vol 14 (10) ◽  
pp. 2661
Author(s):  
Kiche Shim ◽  
Young-Eun Jang ◽  
Yemi Kim

Background: This clinical trial aimed to compare the effects of bioceramic sealer and resin-based sealer on the incidence and intensity of postoperative pain. Methods: Patients with anterior teeth or premolars requiring root canal treatment were assigned to group 1 (n = 51). Those with molars requiring treatment were assigned to group 2 (n = 57). In groups 1En and 2En, root canals were obturated with Endoseal MTA using the single-cone technique. In groups 1AH and 2AH, the sealer used was AH Plus with the continuous wave technique. On the day of canal filling, each patient was instructed to indicate their pain intensity over the 7 day postoperative period, at rest and, while biting, using a visual analog scale. Results: There was no significant difference in the incidence or intensity of postoperative pain between the Endoseal MTA and AH Plus groups during the 7 day postoperative period (p > 0.05). Less time was needed to seal the root canals with Endoseal MTA, especially in group 2 (p < 0.05). Conclusions: Endoseal MTA and AH Plus had similar effects on the incidence and intensity of postoperative pain. The obturation time was shorter when using Endoseal MTA compared to AH Plus.


Author(s):  
Tae Yeon Lee ◽  
Sung Eun Yang ◽  
Hye Min Kim ◽  
Min Joo Kye

Abstract Objectives The purpose of this study was to analyze and to compare retrospectively the characteristics, the treatment process, and the prognosis of cracked teeth by comparing recent data with data from 10 years ago. Materials and Methods Sixty-eight cracked teeth from March 2009 to June 2010 (2009 data) and 185 cracked teeth from March 2019 to June 2020 (2019 data) were analyzed. The characteristics of cracked teeth and the treatment method depending on probing depth, caries, and symptoms, and prognosis depending on pocket depth and apical lesions were analyzed using R version 3.3.3 (R Foundation for Statistical Computing, Vienna, Austria) and T&F version 3.0 (YooJin BioSoft, Korea). To compare proportions, the two-sample proportion test was performed. The distribution of proportions within the samples from 2009 and 2019 data was analyzed using the Chi-square test or binomial test. A p-value <0.05 was considered to indicate statistical significance. Results Significantly fewer cracked teeth received root canal treatment before crown in 2019 than in 2009 (p = 0.032). In both 2009 and 2019, symptomatic cracked teeth and those with deep periodontal pockets (>6 mm) were significantly more likely to receive root canal treatment. In both years, cracked teeth with a probing depth less than 6 mm or without an apical lesion were significantly more likely to be asymptomatic at 3-month and 6-month follow-ups (p < 0.001). Conclusion Cracked teeth with a deep periodontal pocket or symptoms had a higher likelihood of endodontic treatment, and the presence of a deep periodontal pocket or apical lesion was associated with a higher risk of persistent symptoms. Therefore, clinicians should consider these factors when planning treatment and predicting patients’ prognosis.


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