The effect of different final irrigation solutions on apical impermeability

Aim: This study aimed to compare ethylenediaminetetraacetic acid (EDTA), phytic acid, and citric acid as chelation agents in final irrigation procedures on teeth with apical impermeability. Methodology: We used 66 mandibular premolar teeth with a single root and single canal extracted for periodontal or orthodontic reasons. All teeth crowns were removed to achieve a 14-mm root length. Mechanical preparation of the root canal was completed with a Reciproc R25 (VDW, Munich, Germany) file system. Teeth were randomly separated into three groups: Group 1: 5 ml 17% EDTA, Group 2: 5 ml 1% phytic acid, and Group 3: 5 ml 20% citric acid. We used 6 ml 5.25% sodium hypochlorite (NaOCl) in the mechanical preparation of all groups. Three teeth were selected for both the positive and negative control groups. All teeth in the experimental groups were filled by the lateral condensation method using AH Plus canal sealer and gutta-percha. For hardening of the canal sealer, samples were kept at 37 oC and at 100% humidity in a drying oven for 7 days. Later, following removal from the drying oven, two layers of nail polish were used to cover all but the apical 2 mm of each tooth. The teeth were then kept in 2% methylene blue solution at 37 oC for 7 days. The root was divided by cutting in the buccolingual direction and gutta-percha was removed. The dye leakage was measured linearly in millimeters (mm) under a stereomicroscope. Results: As a result of the apical leakage assessment, the lowest apical leakage is observed in the phytic acid group. There was a statistically significant difference between the phytic acid group and citric acid group. There was no statistically significant difference between other groups. Conclusion: While phytic acid showed similar results with EDTA on apical impermeability, it was more effective than citric acid. How to cite this article: Akın Tartuk G, Kaya S, Adıgüzel Ö. The effect of different final irrigation solutions on apical impermeability. Int Dent Res 2021;11(Suppl.1):201-5. https://doi.org/10.5577/intdentres.2021.vol11.suppl1.28 Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

Single visit endodontics

A successful endodontic treatment depends upon localization, proper chemo mechanical preparation of the root canal system, debridement, shaping, disinfection, and three-dimensional obturation of canal system. To achieve this, endodontic therapy used to be performed in multiple visits for complete disinfection of the canals in other words for the better success of endodontic therapy.1

Aesthetic Rehabilitation of Anterior Incisor: Post and core treatment –A Case Report

This case report describes the post and core treatment of a maxillary central incisor. An 18-year-old female patient reported to the Department of Conservative Dentistry and Endodontics with the chief complaint of pain in upper front tooth region. On clinical examination, there was Ellis class III fracture resulting in loss of significant tooth structure necessitating post and core treatment. Treatment was initiated with removal of carious region, canal was located, working length was established followed by chemo mechanical preparation and obturation. Post space preparation was done in the canal followed by post cementation and core build up. Keywords: Post, core, ceramic, crown lengthening.

The effect of triple antibiotic paste as an intracanal medication with an anti-inflammatory drug on post-operative pain of asymptomatic uniradicular necrotic teeth: a double blind randomized clinical trial

Background: Flare-ups may occur after root canal treatment which consist of acute exacerbation of asymptomatic pulpal and/or periradicular pathologic condition. The causative factors of interappointment pain include mechanical, chemical or microbial irritation to the pulp or periradicular tissues. The potential role of microorganisms in interappointment pain is why the success of endodontic treatment depends on complete eradication of microorganisms capable of causing an intraradicular or extraradicular infection. This can be achieved by mechanical cleaning and shaping, in conjunction with irrigation and antibacterial agents. The aim of this study was to assess the ability of triple antibiotic paste with the anti-inflammatory drug diclofenac potassium versus calcium hydroxide used as an intra-canal medication in reducing post-operative pain. Methods: 84 patients with asymptomatic uniradicular necrotic teeth were randomly assigned into two groups according to the intra-canal medication used: calcium hydroxide group (CH) and triple antibiotic paste with diclofenac potassium group (TAPC). In the first treatment session, intracoronal cavity preparation was performed after rubber dam isolation followed by chemo-mechanical preparation using rotary Protaper Universal files with saline irrigation followed by intra-canal medication placement then postoperative pain was assessed at 24, 48 and 72 hours postoperatively using Visual Analogue Scale (VAS). In the second treatment session, intracanal medications were removed by irrigation using saline followed by obturation. Results: Both intracanal medicaments resulted in a statistically significant decrease in mean pain value from 24 to 48 and 72 hours postoperatively. While when comparing both groups, TAPC intracanal medication showed less post-operative pain compared to that of the CH group at 24, 48 and 72 hours with a statistically significant difference at 48 hours only. Conclusion: Both intracanal medicaments were efficient in reducing post-operative pain in asymptomatic uniradicular necrotic teeth. Trial registration: Clinicaltrial.gov NCT02907489, 20/09/2016.

Efficiency of a digital electrofulguration system in contaminated root canals in vitro

Decontamination of the root canal (RC) system is essential for successful endodontic therapy. In this in vitro study, it was evaluated the disinfection potential of an electrofulguration device, the Endox® Endodontic System (EES), in RC infected with Enterococcus faecalis. Sixty-five human lower premolars were instrumented with MTwo® system. The specimens were distributed into six experimental groups (n = 10), according to the irrigation protocol: 2% chlorhexidine gel (CHX); CHX + EES; 5.25% sodium hypochlorite (NaOCl); NaOCl + EES; saline solution (SS); and SS + EES. Five specimens were untreated (control). RC samples were collected before (C1) and after EES treatment (C2), after chemo-mechanical preparation (CMP) (C3), and after final EES treatment (C4). All samples were plated for colony forming units (CFU/mL) onto solid media. The data were analyzed by Wilcoxon and Friedman tests for intragroup comparisons and by Kruskal Wallis test followed by Dunn’s test for intergroup comparisons (α = 0.05). Treatment with the EES did not significantly reduce the number of CFU/mL as compared to baseline levels (C1 vs. C2, p> 0.05). After CMP (C3), all groups showed a significantly reduced amount of CFU/mL (p <0.05), with no difference between CHX- and NaOCl-treated samples (p >0.05). Lastly, treatment with the EES following CMP (C4) did not significantly reduce the amount of CFU/mL (C3 vs. C4, p> 0.05). To conclude, the use of the Endox® Endodontic System did not result in considerable bacterial reduction at all operative times, while treatment with NaOCl and CHX was equally efficient for this purpose.

Dentinal Microcracks after Root Canal Instrumentation Using Instruments Manufactured with Different NiTi Alloys and the SAF System: A Systematic Review

Aim: The aim of this systematic analysis was to assess the prevalence of dentinal microcracks at various levels (3, 6, and 9mm from the apex) after using instruments made with conventional, R-Phase, and M-Wire NiTi alloys and the SAF system. Materials and Methods: Electronic searches were conducted in the databases Embase, Cochrane Library, Scopus, PubMed, and Web of Science. To arrange search methods, “MeSH” terms and/or keywords typically associated with the subject were paired with the Boolean operators “AND” and “OR.” Additional searches were conducted on the websites of four separate endodontic journals. After reading the titles and excluding duplicates, 1000 of the 1343 documents originally found were eliminated. Upon reviewing the abstracts, 310 of the remaining 343 experiments were also eliminated. Based on qualifying requirements, only 13 of the remaining 33 articles were included in the qualitative review. Results: All systems triggered dentinal microcracks; however, when chemo-mechanical preparation was performed using Self-Adjusting File (SAF) and systems manufactured with R-phase technology—K3XF and Twisted File Adaptive (TFA)—less of these defects were found when compared to those manufactured with traditional NiTi—ProTaper Universal and Mtwo—and with M-Wire—ProTaper Next, Reciproc, and WaveOne. Conclusions: A lower prevalence of dentinal microcracks was observed after using SAF and endodontic systems manufactured with R-phase.

Evaluation of coronary microleakage in temporary restorative materials used in endodontics

In various situations in the day-to-day of the endodontic clinic, the professional is faced with the need to carry out the work in more than one session. Therefore, it is imperative to select the appropriate temporary restorative material, which does not allow marginal percolation and prevents contamination of the root canal system. Microleakage consists of the passage of fluids from one place to another, and in the oral cavity, it can occur towards the inside of the tooth via the material-tooth interface, taking microorganisms, toxins and chemical substances into the root canal, which would promote the treatment failure. For this, it is necessary to maintain the aseptic chain, through chemical-mechanical preparation and, if there is a need to use a temporary restorative material to seal the endodontic access cavity, it should act as a real barrier to marginal infiltrations. Temporary restorative materials are used in Endodontics to ensure efficient sealing between treatment sessions, as well as after the end of treatment, until the tooth is definitively restored. Several researches are carried out in search of an ideal restorative material. Various materials have been the subject of research and investigation. However, it is essential to perform a temporary restoration in endodontic procedures of multiple consultations, preventing contamination of the root canal system. This article consists of a literature review that addresses the relationship between coronary microleakage and the performance of temporary restorative materials, widely used between endodontic treatment sessions.