Treatment outcome of young molars obstructed by fractured endodontic instruments: two case reports

Ultrasonic tips and anatomic finishing files have been used as strategies to improve the cleaning and disinfection of root canals, especially in complex anatomies. These instruments are also subjected to fractures, which can hinder the endodontic treatment and negatively affect the outcome. This article presents two cases of successful management of intracanal-fractured instruments with unfavourable prognosis, emphasizing on treatment protocols and outcomes. Two 14-year-old female patients underwent root canal treatment of teeth 37 (case 1) and 47 (case 2). During the final irrigation protocols, case 1 presented a fractured XP-Clean file within the mesiobuccal canal and within the distal canal in case 2, which also showed fractured E1-Irrisonic tips within the mesiobuccal and distal canals. Non-surgical management and bypassing retained instrument fragments were successful in both cases and they may be considered adequate approaches.

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Clinical features and endodontic treatment of two-rooted mandibular canines: Report of four cases

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh1410592s ◽

2014 ◽

Vol 142 (9-10) ◽

pp. 592-596 ◽

Cited By ~ 2

Author(s):

Igor Stojanac ◽

Milica Premovic ◽

Milan Drobac ◽

Bojana Ramic ◽

Ljubomir Petrovic

Keyword(s):

Root Canal ◽

Case Reports ◽

Anatomical Variation ◽

Anatomical Variations ◽

Endodontic Treatment ◽

Careful Examination ◽

Root Canals ◽

Working Length ◽

Canal Systems ◽

Root Canal Morphology

Introduction. Predictable endodontic treatment depends on the dentist?s knowledge about root canal morphology and its possible anatomic variations. The majority of mandibular canines have one root and root canal, but 15% may have two canals and a smaller number may have two distinct roots. The following clinical reports describe endodontic treatment of mandibular canines with two roots and two root canals. Outline of Cases. Four clinical case reports are presented to exemplify anatomical variation in the human mandibular canine. Detailed analysis of the preoperative radiographs and careful examination of the pulp chamber floor detected the presence of two root canal orifices in all canines. Working length was determined with an electronic apex locator and biomechanical preparation was carried out by using engine driven BioRaCe Ni-Ti rotary instruments in a crown-down manner, followed by copious irrigation with 1% sodium hypochlorite. Definitive obturation was performed using cold lateral condensation with gutta-percha cones and Top Seal paste. The treatment outcome was evaluated using postoperative radiographs. Conclusion. Endodontists should be aware of anatomical variations of the treated teeth, and should never presume that canal systems are simple.

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Non-surgical management of periapical lesions with triple antibiotic paste: A case reports

10.25259/aujmsr_23_2020 ◽

2020 ◽

Vol 2 ◽

pp. 120-123

Author(s):

Munish Singla ◽

Iyana Garg ◽

Vandana Goyal ◽

Harleen Kaur ◽

Litik Mittal

Keyword(s):

Case Report ◽

Surgical Management ◽

Root Canal ◽

Case Reports ◽

Endodontic Treatment ◽

Root Canal Treatment ◽

Periapical Lesion ◽

Present Case Report ◽

Periapical Lesions ◽

Triple Antibiotic Paste

Sterilization of root canal space is foremost for the success of the endodontic treatment which is usually carried out with intracanal irrigants and medicaments. Triple antibiotic paste (metronidazole, ciprofloxacin, and minocycline) is used to achieve sterilization and healing of periradicular area. In the present case report, the triple antibiotic paste was used for non-surgical management of periapical lesion for 3 weeks. After 3 weeks, the tooth became asymptomatic that was then obturated. Hence, it is confirmed that conventional root canal treatment, along with intracanal medicaments (triple antibiotic paste), can non-surgically manage the periapical lesions and further promotes healing.

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ANALYSIS OF THE CAUSES OF FAILURE OF ENDODONTIC TREATMENT AND THE CAUSES OF TOOTH EXTRACTION WITH A DIAGNOSIS OF CHRONIC APICAL PERIODONTITIS

The actual problems in dentistry ◽

10.18481/2077-7566-2019-15-1-28-32 ◽

2019 ◽

Vol 15 (1) ◽

pp. 28-32 ◽

Cited By ~ 3

Author(s):

Илья Куратов ◽

Ilia Kuratov ◽

Марина Нагаева ◽

Marina Nagaeva ◽

Мария Корнеева ◽

...

Keyword(s):

Conservative Treatment ◽

Retrospective Analysis ◽

Root Canal ◽

Tooth Extraction ◽

Apical Periodontitis ◽

Endodontic Treatment ◽

Treatment Protocols ◽

Root Canals ◽

Dental Patient ◽

Causes Of Failure

Object. Causes of failure of endodontic treatment and causes of tooth extraction with a diagnosis of chronic apical periodontitis. Purpose ― to analyze the causes of failure of endodontic treatment and the causes of tooth extraction with a diagnosis of chronic apical periodontitis to determine ways to improve the effectiveness of conservative treatment. Methodology. A retrospective analysis of 864 medical records of a dental patient and 532 results of x-ray examinations of patients who underwent tooth extraction was carried out. 198 dentists-therapists of the city of Tyumen and the South of the Tyumen region were interviewed to determine the shortcomings of endodontic treatment. During the survey, doctors expressed their subjective opinion about the main reasons for the failure of therapeutic treatment of teeth with apical periodontitis and the reasons for their subsequent tooth extraction. Results. According to the survey, the failure of conservative treatment is most often associated with non-compliance with treatment protocols and the complexity of the anatomical structure of the root canals, as well as the inability to adequately clean the root canal system. A retrospective analysis of the data related to tooth extraction revealed that the main cause of tooth extraction is chronic apical periodontitis, which accounts for 69 %. The main reason for the removal of teeth diagnosed with chronic apical periodontitis was a significant destruction of the crown. Summary. In the course of this work, we justified the need to improve existing methods of conservative treatment of apical periodontitis. Improvement of endodontic treatment should be aimed at the development and implementation of effective methods of root canal cleaning and irrigation solution activation. In order to improve the prognosis of endodontic treatment and reduce the proportion of tooth extractions for periodontitis, it is necessary to improve the quality of the final restoration and to monitor its tightness.

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Endodontic therapy of a mandibular premolar with three root canals: Two case reports

Stomatoloski glasnik Srbije ◽

10.2298/sgs1003163i ◽

2010 ◽

Vol 57 (3) ◽

pp. 163-169

Author(s):

Jugoslav Ilic ◽

Mirjana Vujaskovic ◽

Ruzica Nedeljkovic

Keyword(s):

Root Canal ◽

Case Reports ◽

Accurate Diagnosis ◽

Endodontic Treatment ◽

Canal System ◽

Therapeutic Challenge ◽

Root Canals ◽

Root Canal System ◽

Preoperative Radiograph ◽

Canal Morphology

The most important requirements for successful endodontic treatment are accurate diagnosis and good knowledge of canal morphology. A mandibular second premolars rarely have more than one root and one root canal. Data from the literature indicate low percentage of a mandibular premolars with three or more root canals. Unusual morphology of the root canal system is diagnostic and therapeutic challenge. It is very important to analyze preoperative radiograph and to explore thoroughly the entrance of the root canal. The aim of this study was to present two patients who had lower second premolars with three canals that required endodontic therapy.

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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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Endodontic instruments fracture in root canal: Integrative review

Journal of Clinical Images and Medical Case Reports ◽

10.52768/2766-7820/1374 ◽

2021 ◽

Vol 2 (5) ◽

Author(s):

Pâmela de Medeiros Dantas ◽

◽

Renata Correia Sotero Dália Torres ◽

Robeci Alves Macedo Filho ◽

Sandra Aparecida Marinho ◽

...

Keyword(s):

Literature Review ◽

Root Canal ◽

Case Reports ◽

Treatment Success ◽

Endodontic Treatment ◽

Root Canals ◽

Dental Instruments ◽

Specific Protocol ◽

Rotary Instruments ◽

Dental Anatomy

Introduction: Endodontic instruments fracture is related to several factors from internal dental anatomy and type, to operator inability and inexperience. Objective: To review case reports related to fracture of endodontic instruments inside the root canal. Methodology: A literature review was carried out using papers available in the PubMed and Lilacs databases. Only case reports were included, with no restriction on language and publication year Results: It was analyzed eight papers with 11 instrument fracture cases, with the highest prevalence (45.5%) of rotary instruments fracture, occurring mainly in middle-cervical and middle-apical root canals thirds. In 90.9% of cases, techniques used for removal showed successful results and in only one case (9.1%), the technique was unsuccessful and the instrument was kept inside the root canal. Final considerations: Endodontic instruments fracture is a complication can directly affect prognosis and endodontic treatment success. Several techniques and devices can be used to remove fractured fragments inside root canals, however, there is no specific protocol for their removal. Keywords: accidents; endodontics; fracture; dental instruments; prognosis.

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Endodontic treatment of the teeth with different root canal curvatures: Two case reports

Stomatoloski glasnik Srbije ◽

10.2298/sgs0902091b ◽

2009 ◽

Vol 56 (2) ◽

pp. 91-96

Author(s):

Katarina Beljic-Ivanovic ◽

Nevenka Teodorovic ◽

Dejan Ostojic

Keyword(s):

Clinical Practice ◽

Root Canal ◽

Case Reports ◽

Endodontic Treatment ◽

X Rays ◽

Root Canals ◽

Root Canal Morphology ◽

Instruments And Techniques ◽

School Of Dentistry ◽

The Right

Endodontic treatment of the teeth with severe root canal curvatures has become one of the greatest problems in clinical practice. Recently, new instruments and techniques have been introduced in the endodontic procedure. The aim of this study was, on the basis of clinical practice, to show the possibilities of the endodontic treatment in the teeth with severely curved root canals, after dependable decision about endodontic instruments and techniques. This article presents a complete endodontic procedure in two teeth with different curvature shape of the root canal in patients that were treated at the Department of Restorative Dentistry and Endodontics, School of Dentistry, Belgrade. Coronal to apical 'crown down' technique was used for the root canal preparation with hand NiTi ProTaper instruments with progressive multicone design. The main reasons for choosing manual technique were complexity, shape of presented curvatures and better tactile sensation control of canal instruments in order to avoid possible mistakes and complications. Clinical X-rays of the teeth with permanent obturation clearly showed that extremes of the root canal morphology could be successfully solved by the right choice of all factors during endodontic procedure.

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Аpplying of high-frequency monopolar diathermocoagulation in the treatment of chronic pulpitis

Medical alphabet ◽

10.33667/2078-5631-2020-12-40-42 ◽

2020 ◽

Vol 1 (12) ◽

pp. 40-42

Author(s):

F. Yu. Daurova ◽

D. I. Tomaeva ◽

S. V. Podkopaeva ◽

Yu. A. Taptun

Keyword(s):

Root Canal ◽

High Frequency ◽

Antibacterial Effect ◽

Comparison Group ◽

Poor Quality ◽

Endodontic Treatment ◽

Root Canals ◽

The Third ◽

Before And After

Relevance: the reason for the development of complications in endodontic treatment is poor-quality instrumental treatment root canals.Aims: a study of the animicrobial action and clinical efficacy of high-frequency monopolar diathermocoagulation in the treatment of chronic forms of pulpitis.Materials and methods: 102 patients with various chronic forms of pulpitis were divided into three groups of 34 patients each. In the first two groups, high-frequency monopolar diathermocoagulation was used in endodontic treatment in different modes. In the third group, endodontic treatment was carried out without the use of diathermocoagulation (comparison group). The root canal microflora in chronic pulpitis in vivo was studied twice-before and after diathermocoagulation.Results: it was established that high-frequency monopolar diathermocoagulation in the effect mode is 3, power is 4 (4.1 W) and effect is 4, power is 4 (5.4 W) with an exposure time of 3 seconds, it has a pronounced antibacterial effect on all presented pathogenic microflora obtained from the root canals of the 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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Treatment of anatomic canal variations in premolar teeth: Five case reports

International Dental Research ◽

10.5577/intdentres.2021.vol11.suppl1.41 ◽

2021 ◽

Vol 11 (Suppl. 1) ◽

pp. 279-284

Author(s):

Emre Bodrumlu ◽

Esma Dinger

Keyword(s):

Root Canal ◽

Native Speakers ◽

Case Reports ◽

Anatomical Variations ◽

Root Canal Treatment ◽

Root Canals ◽

Treatment Indications ◽

Native Speakers Of English ◽

Root Canal Morphology ◽

Root Canal Instrumentation

Aim: The aim of this case report is to present a series of anatomical variations and endodontic treatments in four two-canal mandibular premolar teeth and three rooted three-canal maxillary second premolar teeth with root canal treatment indications identified via clinical and radiographic examinations. The success of root canal treatment is achieved with a thoroughly examined root canal morphology that has been accurately determined radiographically and clinically before adequate shaping, irrigation, and hermetic filling procedures. Root canals that are not found or not adequately disinfected can cause root canal treatment failure and complications, such as pain, swelling, or persistent fistula, also known as flare-up, after treatment. Canal variations in the teeth were detected via periapical radiographs during the root canal instrumentation stage. Methodology: The endodontic treatments of four two-canal mandibular premolar teeth and one triple-rooted three-canal maxillary second premolar with root canal treatment indications were described. Conclusion: To achieve full success in root canal treatment, anatomical variations should be examined in detail before and during treatment, and treatment should be completed with appropriate techniques. How to cite this article: Dinger E, Bodrumlu E. Treatment of anatomic canal variations in premolar teeth: Five case reports. Int Dent Res 2021;11(Suppl.1):279-84. https://doi.org/10.5577/intdentres.2021.vol11.suppl1.41 Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

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