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Root canal debridement, which includes the removal of infected tissues and microbial biofilms, is considered the corner stone of root canal treatment. Chemical adjuncts play a multitude of functions in this regard, as tissue solvents, antimicrobial agents and for removing the smear layer. These adjuncts (irrigants) are usually delivered using a syringe and needle. With increasing knowledge of the complexity of root canal anatomy and tenacity of microbial biofilms, the need for strategies that potentiate the action of these irrigants within the root canal system cannot be overemphasized. Several such activated irrigation strategies exist. The aim of this review is to comprehensively discuss the different irrigant activation methods from the context of clinical studies.

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• REVOLUCIONANDO LA ENDODONCIA: LA IMPORTANCIA DE IRRIGANTES MÚLTIPLES PARA UNA DESINFECCIÓN EFECTIVA DEL SISTEMA DE CONDUCTOS RADICULARES UNA REVISIÓN NARRATIVA
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The present report presents a case of dens invaginatus (DI) in a patient with 4 maxillary incisors. A 24-year-old female complained of swelling of the maxillary left anterior region and discoloration of the maxillary left anterior tooth. The maxillary left lateral incisor (tooth #22) showed pulp necrosis and a chronic apical abscess, and a periapical X-ray demonstrated DI on bilateral maxillary central and lateral incisors. All teeth responded to a vitality test, except tooth #22. The anatomic form of tooth #22 was similar to that of tooth #12, and both teeth had lingual pits. In addition, panoramic and periapical X-rays demonstrated root canal calcification, such as pulp stones, in the maxillary canines, first and second premolars, and the mandibular incisors, canines, and first premolars bilaterally. The patient underwent root canal treatment of tooth #22 and non-vital tooth bleaching. After a temporary filling material was removed, the invaginated mass was removed using ultrasonic tips under an operating microscope. The working length was established, and the root canal was enlarged up to #50 apical size and obturated with gutta-percha and AH 26 sealer using the continuous wave of condensation technique. Finally, non-vital bleaching was performed, and the access cavity was filled with composite resin.

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While it is reasonably well known that certain dental procedures increase the temperature of the tooth's surface, of greater interest is their potential damaging effect on the pulp and tooth-supporting tissues. Previous studies have investigated the responses of the pulp, periodontal ligament, and alveolar bone to thermal irritation and the temperature at which thermal damage is initiated. There are also many in vitro studies that have measured the temperature increase of the pulp and tooth-supporting tissues during restorative and endodontic procedures. This review article provides an overview of studies measuring temperature increases in tooth structures during several restorative and endodontic procedures, and proposes clinical guidelines for reducing potential thermal hazards to the pulp and supporting tissues.

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Citations

Citations to this article as recorded by  

• Development and performance test of a micro bubble irrigation system for root canal cleaning of tooth
  Gilhwan Sung, Jaeyong Sung, Myeong Ho Lee
  Journal of the Korean Society of Visualization.2016; 14(1): 40.     CrossRef

The purpose of this study was to compare the dye leakage of MTA (mineral trioxide aggregate) apical plug produced by two orthograde placement techniques (hand condensation technique and ultrasonically assisted hand condensation technique).

To simulate straight canal, 60 transparent acrylic blocks with straight canal were fabricated. These transparent acrylic blocks were divided into 2 groups (Group C; hand condensation technique (HC) and Group U; ultrasonically assisted hand condensation technique (UAHC)) of 30 blocks with each MTA application method. Each group was divided into 2 subgroups (n = 15) with different canal size of #70 (subgroup C70 and subgroup U70) and #120 (subgroup C120 and subgroup U120). After apical plug was created, a wet paper point was placed over the MTA plug and specimen was kept in a humid condition at room temperature to allow MTA to set. After 24 hours, remaining canal space was backfilled using Obtura II. All specimens were transferred to floral form socked by 0.2% rhodamine B solution and stored in 100% humidity at room temperature. After 48 hours, resin block specimens were washed and scanned using a scanner. The maximum length of microleakage was measured from the scanned images of four surfaces of each resin block using Photoshop 6.0.

Statistical analysis was performed with Mann-Whitney U test. Group U of UAHC had significantly lower leakage than Group C of HC in #70-size canal (subgroup U70) (p < 0.05).

During root canal preparation procedures, the potential for instrument separation is always present. Files, a lentulo, a Gates-Glidden (GG) bur or any manufactured obstruction can be left behind in the canal. Nickel-titanium (NiTi) rotary files are in common usage in these days. Despite their undeniable advantages, there is a potential risk of separation within the canals. It is very rapid, unpredictable, and creates a great deal of stress for the practitioner.

When an endodontic instrument separates, the best option is to remove it. Ultrasonic instruments and microscopes have improved the success rate for removing separated instruments. But it is difficult and not always possible. Therefore prevention is the key.

In this case report, several management methods of separated file in the canal are presented.

The aim of this study was to evaluate the effectiveness of sealer placement in simulated root canal extensions. Forty resin blocks were attained from the Endo-training Bloc. In each block, the simulated root canal was made with #20, 08taper GT file. After each block was longitudinally split into two halves, a standardized groove was prepared on one canal wall of two halves to simulate the canal extensions with various irregularities. The two halves of each block were assembled and all simulated root canals were obturated by single cone method with AH26 sealer. Four different methods of sealer placement were used: group A, #20 K-file; group B, ultrasonic file; group C, lentulo spiral; group D, EZ-Fill bi-directional spiral. All obturated blocks were stored in 100% humidity at 37℃ for 1 week. Using a low speed saw, each block was sectioned horizontally. Images of the sections were taken using a stereomicroscope at × 30 magnification and a digital camera. The amount of the sealer in the groove was evaluated using a scoring system, a higher score indicated better sealing effectiveness. The data was statistically analysed by Fisher's Exact Test.

The sealing score was the lowest, specially at the middle area of canal extensions in group A, and that was statistically significant difference from other groups. In conclusion, the ultrasonic file, lentulo spiral and EZ-Fill bi-directional spiral were effective methods of sealer placement in simulated canal extensions. The K file was the least effective method, specially at the middle area of canal extensions.

Citations

Citations to this article as recorded by  

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