• Restorative Dentistry and Endodontics
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• v.48 no.3
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• pp.31.1-31.11
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• 2023

Objectives: This retrospective cohort study examined the incidence of interappointment emergencies during multiple-visit molar root canal treatments conducted by undergraduate students. Treatments performed without the use of intracanal medicament were compared to treatments that incorporated calcium hydroxide as an intracanal medicament. Materials and Methods: Interappointment emergencies, defined as instances of pain or swelling that required the patient to make an unscheduled follow-up visit, were recorded for up to 2 months after the intervention. To avoid the influence of obturation on the observed incidence of emergency visits, only unscheduled visits occurring between the start and end of the root canal treatment were included. Results: Of the 719 patients included in this study, 77 (10.7%) were recorded as experiencing interappointment emergencies. Of these emergencies, 62% occurred within 2 weeks following the most recent intervention. In the group of patients who did not receive intracanal medicament, the incidence of interappointment emergencies was 11.9% (46 of 385 patients). In comparison, this rate was 9.3% (31 of 334 patients) among those who received calcium hydroxide as an intracanal medicament (odds ratio, 1.33; 95% confidence interval, 0.82-2.15; p = 0.249). Conclusions: Interappointment emergencies may arise at any point during root canal treatment, but they most commonly occur within the first 2 weeks following intervention. The omission of intracanal medicament in multiple-visit molar root canal treatments, performed by undergraduate students, did not significantly increase the incidence of these emergencies.

• Restorative Dentistry and Endodontics
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• v.25 no.3
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• pp.435-445
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• 2000

The purpose of this study was to compare the leakage of four different obturation techniques in conjunction with immediate apical barrier of ${\beta}$-tricalcium phosphate(TCP) in teeth with open apex. Eighty single-rooted human premolar teeth were prepared and sectioned horizontally, so maximum diameter in apex was 4mm. Apical defects that were similar to open apex, were created with #1/2 round bur and SF104R bur. The apical foramen were opened to a size 80 file extended 3mm beyond the apex. The teeth were placed into the oasis block soaked saline to simulate periapical tissue often associated with pulpless teeth and received apical barriers consisting of TCP followed by obturation using lateral condensation technique, vertical condensation technique, continuous wave technique and thermoplasticized gutta-percha injection technique. Two unobturated teeth served as positive and negative controls. Teeth were immersed in resorcinol-formaldehyde resin for S days at $4^{\circ}C$, and the resin was allowed to polymerize completely for 4 days at room temperature. Teeth were then sectioned horizontally at 1.5mm(level 1), 2.5mm(level 2) and 3.5mm(level 3) from the apex, and examined under a stereomicroscope at ${\times}40$ magnification. The photographs were taken at ${\times}40$ magnification of the filling in each level and scanned. The leakage length in tooth/resin interface was measured at each of the three levels. Each ratio of leakage was obtained by calculating the ratio of the leakage length of canal wall infiltrated with resin to the total length of the canal and was analyzed statistically(One-way ANOVA and Scheffe test). The result were as follows : 1. At the level 1, there was the least leakage in the thermoplasticized gutta-percha injection technique group(group 4), but there was statistically significant(p<0.05). 2. At the level 2, there was the least leakage in the thermoplasticized gutta-percha injection technique group(group 4), and the most leakage in the continuous wave technique group(group 3). There was statistically significant difference between the thermoplasticized gutta-percha injection technique group and the continuous wave technique group(p<0.05). 3. At the level 3, there was the least leakage in the thermoplasticized gutta-percha injection technique group(group 4), but there were no statistically significant differences between other groups(p>0.05). These results suggest that thermoplasticized gutta-percha injection technique which had 1mm apical gutta-percha matrix after the formation of TCP apical barrier, can demonstrate favorable apical sealing.

• Restorative Dentistry and Endodontics
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• v.20 no.1
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• pp.142-151
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• 1995

The purpose of this study was to compare and estimate the physical properties of five root canal sealers classified Calciobiotic root canals sealer as calcium hydroxide based sealer, Apatite root sealer type II as calcium phosphate based sealer, AH-26 as resin based sealer, Canals and Pulpdent root canals sealer as zinc oxide eugenol based sealer. The author investigated dimensional change and flow rate of canal sealers, diametral tensile strength and shear bond strength of sealers to dentin to evaluate the physical properties on affect of complete obturation of root canal and performed the total 100 specimens of each 25 sealers under the condition of root temperature according to manufacturer's instructions. All specimens were stored at $37{\pm}1^{\circ}C$ in 100 % relative humidity. A microscope for measurement of micro distance is used for the dimensional change test and evacuation methods using vaccum were used for the flow rate test. The result differed by the storage time measured on the tests of diametral tensile strength and shear bond strength to dentin. The following results were obtained ; 1 On the test of dimensional change, Canals and Pulpdent expanded slightly, AH-26 and Apatite showed the severe shrinkage after 48 hours. 2. AH-26 and Apatite were the excellent with each 24.59mm, 31.19mm after 3 minutes in the aspect of flow property. 3. On the diametral tensile strength, Calciobiotic root canals sealer showed the highest strength with 27.13kg/$cm^2$ after 48 hours, Apatite root sealer type II showed highest strength with 84.57kg/$cm^2$ after 120 hours. 4. On the shear bond strength to dentin, AH-26 was most excellent with 55.73kgf/$cm^2$ after 24 hours and with 134.71kgf/$cm^2$ after 120 hours.

• Restorative Dentistry and Endodontics
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• v.24 no.3
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• pp.482-489
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• 1999

The purpose of this study was to compare sealing ability between lateral condensation and continuous wave of condensation in depend of root canal curvature. In this study, we divided fifty-six human molar teeth into two group in depend of Schneider method, and then subdivided them into four experimental group (each group is composed of twelve teeth) by canal curvature and obturation method, and eight teeth were served as positive and negative controls. Specimens were prepared by Quantac 2000 series file and obturated by lateral condensation or System B. Specimens were immersed in india ink for 7 days, decalcified by 10% nitric acid, dehydrated by 75, 95 and 100% alcohol in order, cleared by methyl salicylate and then measured of dye penetration with stereomicroscope(${\times}6.5$ magnification) and Image Pro plus. The data were analyzed stastically by one-way ANOVA and Scheffe test. The data were as follows: 1. The mean leakage was $0.725{\pm}1.167$ for group A, $0.813{\pm}0.921$ for group B, $0.809{\pm}0.997$ for group C, $1.111{\pm}1.147$ for group D, but no significant difference among them(p>0.05). 2. Lateral condensation had better sealing ability than continuous wave of condensation, but no significant difference among them(p>0.05). 3. There was no significant difference between root canal curvature degree and microleakage(p>0.05).

• Restorative Dentistry and Endodontics
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• v.45 no.2
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• pp.24.1-24.9
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• 2020

Objectives: It is known that bioactive materials interact with the dentin to undergo biomineralization. The exact role of moisture in this interaction is unknown. Here, we investigate the effects of dentin moisture conditions on the dislocation resistance of two bioactive root canal sealers (MTA Fillapex [Angelus Solucoes Odontologicas] and GuttaFlow BioSeal [Colténe/Whaledent AG]) at 3 weeks and 3 months after obturation. Materials and Methods: Mandibular premolars (n = 120) were prepared and randomly divided into 3 groups based on the dentin condition: group 1, dry dentin; group 2, moist dentin; group 3, wet dentin. Each group was divided into 2 subgroups for root canal filling: MTA Fillapex and GuttaFlow BioSeal. Dislocation resistance was evaluated by measuring the push-out bond strength at 3 weeks and 3 months. Failure modes were examined under a stereomicroscope. Data were statistically analyzed by Kruskal-Wallis test with a significance level of 5%. Results: Moist dentin resulted in higher bond strength values for both materials at both time points. This was significantly higher than wet and dry dentin for both the sealers at the 3 months (p < 0.05), while at 3 weeks it was significant only for GuttaFlow Bioseal. The different moisture conditions demonstrated similar trends in their effects on the dislocation resistance of the 2 root canal sealers. Conclusions: The dentin moisture conditions had a significant impact on its interaction with the bioactive materials tested. Maintaining moist dentin, but not dry or wet dentin, may be advantageous before the filling root canals with bioactive sealers.

• Restorative Dentistry and Endodontics
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• v.15 no.2
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• pp.46-57
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• 1990

The purpose of this study was to spectrophotometrically investigate the sealing effect of the ultrasonic canal obturation with softened gutta-percha utilizing an endosonic plugger by means of ultrasonic vibrations and heat. The 120 extracted human central and lateral incisors with single root were randomly selected, and the root canals were instrumented up to size #60 file by conventional method. The prepared canals were obtruated with gutta-percha by lateral condensation method, McSpadden technique and ultrasonic condensation method, with or without sealer. All specimens were immersed in 2% methylene blue in an incubator at $37^{\circ}C$ for 10 days. The teeth were then dissolved in 5ml of 60% nitric acid solution and the dye present within the root canal system was returned to solution. The leakage of dye was quantitatively measured via spectrophotometric method. The obtained data statistically evaluated usint two-way ANOVA and Student's t-test. The results were as follows : No statistically significant difference in leakage was observed between the lateral condensation method and ultrasonic condensation method, with and without sealer. When sealer was used or not, McSpadden technique showed significantly greater leakage than lateral or ultrasonic condensation method. Statistical analysis of the data indicated that the canals obturated in conjunction with sealer demonstrated less dye leakage than the canals obturated without sealer(p<0.01), except McSpadden technique. The ultrasonic condensation method appeared comparable sealing ability to the lateral condensation method.

• Restorative Dentistry and Endodontics
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• v.14 no.2
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• pp.38-48
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• 1989

The purpose of this study was to investigate the proper consistency of root canal sealer needed in obtaining an efficient canal obturation in injection-thermoplasticized low-temperature ($70^{\circ}C$) gutta-percha method. The sealer was made by incorporating zinc oxide powder into $0.5m{\ell}$ of eugenol and then the $0.5m{\ell}$ of mixture slurry was placed between two flat glass plates. The consistency was determined by measuring the degree of spread of the slurry at loading the 120gm of weight from the top plate. The sealer was prepared according to P/L ratio corresponding to the acquired consistency of 65.45mm, 46.80mm, 28.95mm and 22.60mm. The distal roots were obtained by cutting off from 125 extracted human lower molars and the root canals were prepared by using step-back method. The prepared canals were coated with the sealers on their walls and obturated by using the injection-thermoplasticized low-temperature ($70^{\circ}C$) gutta-percha method. All specimens were immersed in 2% methylene blue dye solution for 48 hours at $37^{\circ}C$. Calipers was used to measured the dye penetration into the root canals from apical constrictions. The results were as follows : The canals obturated without sealer showed significantly more leakage than the canals obturated with sealer. Within the consistency from 65.45mm to 22.60mm, the sealer of 65.45mm appeared significantly better than that of 28.95mm and 22.60mm in the canals obturated by injection-thermoplasticized gutta-percha method, and better than that of 46.80mm without statistical significance.

• Restorative Dentistry and Endodontics
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• v.39 no.2
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• pp.132-136
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• 2014

The presence of radix entomolaris (RE) in a mandibular first molar is a common occurrence in certain ethnic groups, but the presence of RE in a mandibular second molar is a rare occurrence. In the present case, RE was identified from preoperative radiographs and confirmed using cone-beam computed tomography (CBCT). The access cavity was modified to locate the RE. Cleaning and shaping were performed with nickel-titanium rotary instruments. Obturation was completed with gutta-percha cones using AH Plus (Dentsply Detrey GmbH) as sealer. From the CBCT axial images, the RE was determined to have a Type III curvature by the De Moor classification, Type B separate RE by the Carlsen and Alexandersen classification, and radiographically, a Type i image by the Wang classification. The presence of RE in the mandibular second molar makes it essential to anticipate and treat the distolingual root canal. This case report highlights the usefulness of CBCT for assessing RE in the mandibular second molar, which can help the clinician in making a confirmatory diagnosis and assessing the morphology of the root canal.

• Restorative Dentistry and Endodontics
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• v.41 no.2
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• pp.148-153
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• 2016

Tooth transposition is a disorder in which a permanent tooth develops and erupts in the normal position of another permanent tooth. Fusion and gemination are developmental disturbances presenting as the union of teeth. This article reports the nonsurgical retreatment of a very rare case of fused teeth with transposition. A patient was referred for endodontic treatment of her maxillary left first molar in the position of the first premolar, which was adjacent to it on the distobuccal side. Orthopantomography and periapical radiography showed two crowns sharing the same root, with a root canal treatment and an associated periapical lesion. Tooth fusion with transposition of a maxillary molar and a premolar was diagnosed. Nonsurgical endodontic retreatment was performed. At four yr follow-up, the tooth was asymptomatic and the radiolucency around the apical region had decreased, showing the success of our intervention. The diagnosis and treatment of fused teeth require special attention. The canal system should be carefully explored to obtain a full understanding of the anatomy, allowing it to be fully cleaned and obturated. Thermoplastic techniques were useful in obtaining hermetic obturation. A correct anatomical evaluation improves the set of treatment options under consideration, leading to a higher likelihood of esthetically and functionally successful treatment.

• Restorative Dentistry and Endodontics
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• v.48 no.1
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• pp.5.1-5.22
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• 2023

This systematic review and network meta-analysis aimed to answer the following focused research question: "Does the type of endodontic sealer affect the postoperative pain in patients who received endodontic treatment?" Different databases and grey literature were surveyed. Only one randomized controlled trial were included. The risk of bias in the studies was evaluated by using the Cochrane Collaboration's tool. A random-effects meta-analysis was conducted to compare the risk and intensity of postoperative pain. The quality of the body of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation approach. Out of 11,601 studies, 15 remained for qualitative analyses and 12 for meta-analysis. Seven studies were classified at high risk of bias, and 8 studies raised some concerns. No significant differences between the endodontic materials were observed in the direct comparisons, both in risk and in intensity of postoperative pain (pairwise comparisons with 2 studies: I² = 0%; p > 0.05 and 8 studies: I² = 23%; p > 0.05, respectively). The certainty of the evidence was graded as low or moderate. There was no difference in the risk and intensity of postoperative pain after filling with different endodontic sealers. Further systematic reviews should be conducted.