• Title/Summary/Keyword: Endodontic Treatment

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A CAD/CAM-based strategy for concurrent endodontic and restorative treatment

  • Escobar, Patricia Maria;Kishen, Anil;Lopes, Fabiane Carneiro;Borges, Caroline Cristina;Kegler, Eugenio Gabriel;Sousa-Neto, Manoel Damiao
    • Restorative Dentistry and Endodontics
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    • v.44 no.3
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    • pp.27.1-27.12
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    • 2019
  • This case report describes a technique in which endodontic treatment and permanent indirect restoration were completed in the same clinical appointment with the aid of a computer-aided design/computer-aided manufacturing (CAD/CAM) system. Two patients were diagnosed with irreversible pulpitis of the mandibular first molar. After access preparation, root canals were located, irrigation was performed until bleeding ceased, and the coronal tooth structure was prepared for indirect restoration. Then, utilizing an interim 3-mm build-up of the endodontic access cavity, a hemi-arch digital scan was performed with an intraoral scanner. Subsequent to digital scanning, restoration design was performed simultaneously with the endodontic procedure. The root canals were shaped using the Race system under irrigation with 2.5% sodium hypochlorite followed by root canal filling. The pulp chamber was subsequently filled with a 3-mm-thick composite resin restoration mimicking the interim build-up previously utilized to facilitate block milling in the CAD/CAM system. Clinical try-in of the permanent onlay restoration was followed by acid etching, application of a 5th generation adhesive, and cementation of the indirect restoration. Once the restoration was cemented, rubber dam isolation was removed, followed by occlusal adjustment and polishing. After 2 years of follow-up, the restorations were esthetically and functionally satisfactory, without complications.

Characteristics of teeth referred to a dental university hospital for endodontic reason (근관치료적 이유로 치과대학병원으로 의뢰된 치아들의 특성)

  • Jeon, Su-Jin;Hwang, Soo-Jeong;Seo, Min-Seock
    • Journal of Dental Rehabilitation and Applied Science
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    • v.35 no.3
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    • pp.143-152
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    • 2019
  • Purpose: The aim of this study is to investigate the characteristics of patients and teeth referred to a university dental hospital for endodontic problem. Materials and Methods: From January, 2017 to December, 2018, patients who were referred to a university dental hospital for endodontic problem were collected from clinical records. A total of 1171 patient records were analyzed. The status of the referred teeth was divided into three groups according to whether they were treated endodontically based on radiographs and clinical records at the time of referred visit. Results: 69.9% of the referred teeth were maxillary and mandibular first and second molars. The average time from referral to actual visit is 9.03 days and 65.6% of the case referred with referring letter. The most primary reasons of referral were persistent clinical symptom (pain, swelling, and sinus tract) (37.9%), diagnosis difficulty (16.7%), blockage of canal space (13.8%) and difficult tooth anatomy (11.4%). In the case of referral before endodontic treatment, the most primary reason of referral was failure to make a proper diagnosis. If the teeth were referred in the middle of endodontic treatment, the most primary reason of referral was persistent clinical symptom and blockage of canal space. In the case of referral after root canal filling, the most primary reason of referral was persistent clinical symptom. Conclusion: In the case of molars, the rate of persistent clinical symptom and blockage of canal space were the most primary reason of referral, and the rate of apical surgery and management of trauma was high in the case of anterior teeth.

YouTube as an information source for instrument separation in root canal treatment

  • Yagiz Ozbay;Neslihan Yilmaz Cirakoglu
    • Restorative Dentistry and Endodontics
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    • v.46 no.1
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    • pp.8.1-8.7
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    • 2021
  • Objectives: The reliability and educational quality of videos on YouTube for patients seeking information regarding instrument separation in root canal treatment were evaluated. Materials and Methods: YouTube was searched for videos on instrument separation in root canal treatment. Video content was scored based on reliability in terms of 3 categories (etiology, procedure, and prognosis) and based on video flow, quality, and educational usefulness using the Global Quality Score (GQS). Descriptive statistics were obtained and the data were analyzed using analysis of variance and the Kruskal-Wallis test. Results: The highest mean completeness scores were obtained for videos published by dentists or specialists (1.48 ± 1.06). There was no statistically significant difference among sources of upload in terms of content completeness. The highest mean GQS was found for videos published by dentists or specialists (1.82 ± 0.96), although there was no statistically significant correlation between GQS and the source of upload. Conclusions: Videos on YouTube have incomplete and low-quality content for patients who are concerned about instrument separation during endodontic treatment, or who experience this complication during endodontic treatment.

Prevention and Solution of the Fracture of Nickel-Titanium Endodontic Instruments (니켈티타늄 전동파일 파절의 예방 및 처치)

  • Kim, Hyeon-Cheol
    • The Journal of the Korean dental association
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    • v.54 no.8
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    • pp.640-650
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    • 2016
  • Nickel-Titanium (NiTi) rotary instruments have brought a big step toward "efficient" practice of endodontic procedure. The rotary files help clinicians to reduce their working time and also increase the clinical success rate with minimal procedural errors. However, NiTi instruments still have a few drawbacks including unpredictable fatigue fracture. Clinicians may reduce the potential risk of instruments fracture by following some clinical guidelines for rotary instruments. In some clinical cases of instruments fracture, we may try to remove the instruments' fragments or bypass the fragment to reach the apical canal. In some limited cases, the fractured instruments' fragments would not jeopardize the clinical prognosis of root canal treatment. Nevertheless, it is impossible to be overemphasized that the prevention of file fracture is much easier than the removal of fracture fragment. Clinicians need to understand the fracture mechanisms and, in clinic, need to discard the used instruments timely.

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Paresthesia diagnosed using cone-beam computed tomography: a case report

  • Kumar, Umesh;Kaur, Charan Kamal;Vashisht, Ruchi;Rattan, Vidya
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.20 no.2
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    • pp.95-99
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    • 2020
  • Various dental procedures, such as injection administration, surgical treatment, and endodontic treatment, can cause injury to the nerves. The most commonly injured nerves are the inferior alveolar and lingual nerves. This can manifest as altered sensation to the area of innervation of the injured nerve, such as the lower lip, chin, teeth, tongue, and mucosa. Altered sensations or loss of sensation are relatively infrequent complications in daily dental practice. Here, we report an uncommon case of altered sensation in the midfacial region caused by an endodontic procedure and discuss the need to consider local dental causes in the differential diagnosis of numbness in the facial region.

Endodontic management of central incisor associated with large periapical lesion and fused supernumerary root: a conservative approach

  • Badole, Gautam P.;Shenoi, Pratima R.;Parlikar, Ameya
    • Restorative Dentistry and Endodontics
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    • v.43 no.4
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    • pp.44.1-44.9
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    • 2018
  • Fusion and gemination are developmental anomalies of teeth that may require endodontic treatment. Fusion may cause various clinical problems related to esthetics, tooth spacing, and other periodontal complications. Additional diagnostic tools are required for the diagnosis and the treatment planning of fused tooth. The present case report describes a case of unilateral fusion of a supernumerary root to an upper permanent central incisor with large periapical lesion in which a conservative approach was used without extraction of supernumerary tooth and obturated with mineral trioxide aggregate to reach a favorable outcome.

ENDODONTIC TREATMENT WITH CALCIUM HYDROXIDE OF REPLANTED TOOTH : A CASE REPORT (재식한 치아에서 수산화 칼슘을 사용한 근관치료)

  • Moon, Sang-Hee;Kim, Wang-Kwen;Lee, Chang-Seop;Lee, Sang-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.26 no.1
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    • pp.96-102
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    • 1999
  • Tooth avusion implies total displacement of teeth out of its socket. Its frequency range from 0.5 to 16% of traumatic injuries. Replantation procedure is used for the treatment of avulsed tooth. However, its major complications are pulp necrosis, inflammatory root resorption and replacement root resorption. This paper describes 10 years and 2 months old male patient whose both maxillary central incisors were avulsed due to fall-down with slightly underdeveloped root apices. Teeth were replanted 2 hours after accident. Right central incisor's pulp tissues were extirpated and filled with $Vitapex^{(R)}$(calcium hydroxide) at 3-4 weeks after replantation, but left central incisor was filled at 8-9 weeks. Right central incisor showed little inflammatory resorption in apical portion, whereas left central incisor showed severe root resorption. During 18 months' follow-up period, left central incisor showed slightly ankylosis while right central incisor did not. Based upon the above-mentioned results, the following conclusions can be drawn: 1. Inflammatory resorption could be suppressed by endodontic treatment with calcium hydroxide. 2. When apex formation is doubted in replanted tooth due to avulsion, early endodontic treatment with calcium hydroxide seems to act positively for better prognosis.

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Root canal treatment of dens invaginatus and fused tooth

  • Park, So-Young;Bae, Kwang-Shik;Lim, Sung-Sam;Baek, Seung-Ho
    • Proceedings of the KACD Conference
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    • 2001.05a
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    • pp.247-251
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    • 2001
  • ;A dental developmental anomaly is defined as an isolated aberration in tooth form, caused by a disturbance or abnormality which occurred during tooth development. There are numerous types of dental anomalies, and a considerable variation in the extent of the defects occurs with each type. Teeth with these anomalies pose unique challenges. Since the defects are not always apparent clinically, they can confuse diagnosticians investigating the etiology of pulpal pathosis. When endodontic treatment is required, the defects often hinder access cavity preparation and canal instrumentation. Treatment planning also becomes more challenging, since the defects can create complicated periodontal problems, and the malformed teeth can be difficult to restore, particularly those weakened by endodontic therapy. Fusion is defined as the joining of two developing tooth germs resulting in a single large tooth structure. The incidence of fusion is < 1% in the Caucasian population, and it is believed that physical force or pressure produces contact of the developing teeth. Clinically and radiographically, a fused tooth usually appears as one large crown with at least partially separated roots and root canals. There may be a vertical groove in the tooth crown delineating the originally separate crowns. Dens invaginatus is a deep surface invagination of the crown or root that is lined by enamel. Teeth in both maxillary and mandibular arches may be affected, but the permanent maxillary lateral incisor is the tooth most commonly involved. Studies have revealed an incidence ranging from 0.25% to as high as 10%. The invagination ranges from a slight pitting to an anomaly occupying most of the crown and root. The invagination frequently communicates with the oral cavity, allowing the entry of irritants and microorganism either directly into pulpal tissues or into an area that is deparated from pulpal tissues by only a thin layer of enamel and dentin. This continuous ingress of irritants and the subsequent inflammation usually lead to necrosis of the adjacent pulp tissue and then to periapical or periodontal abscesses. If the invagination extends from the crown to the periradicular tissue and has no communication with the root canal system, the pulp may remain vital. Recommended treatment of fused tooth and dens invaginatus has been reported in the endodontic literature. This case report describes the endodontic treatment of a maxillary laterl incisors having fused crown and dens invaginatus.natus.

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