• Restorative Dentistry and Endodontics
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• v.46 no.4
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• pp.50.1-50.8
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• 2021

Although several techniques have been proposed to remove fiber-reinforced composite (FRC) post, no safe and efficient technique has been established. Recently, a guided endodontics technique has been introduced in cases of pulp canal obliteration. This study describes 2 cases of FRC post removal from maxillary anterior teeth using this guided endodontics technique with a dental operating microscope. Optically scanned data set from plaster cast model was superimposed with the data set of cone-beam computed tomography. By implant planning software, the path of a guide drill was selected. Based on them, a customized stent was fabricated and utilized to remove the FRC post. Employing guided endodontics, the FRC post was removed quickly and safely with minimizing the loss of the remaining tooth structure. The guided endodontics was a useful option for FRC post removal.

• Restorative Dentistry and Endodontics
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• v.44 no.4
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• pp.38.1-38.8
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• 2019

Navigation of the main root canal and dealing with a dens invaginatus (DI) is a challenging task in clinical practice. Recently, the guided endodontics technique has become an alternative method for accessing root canals, surgical cavities, and calcified root canals without causing iatrogenic damage to tissue. In this case report, the use of the guided endodontics technique for two maxillary lateral incisors with multiple DIs is described. A 16-year-old female patient was referred with the chief complaint of pain and discoloured upper front teeth. Based on clinical and radiographic findings, a diagnosis of pulp necrosis and chronic periapical abscess associated with double DI (Oehler's type II) was established for the upper left lateral maxillary incisor (tooth #22). Root canal treatment and the sealing of double DI with mineral trioxide aggregate was planned for tooth #22. For tooth #12 (Oehler's type II), preventive sealing of the DI was planned. Minimally invasive access to the double DI and the main root canal of tooth #22, and to the DI of tooth #12, was achieved using the guided endodontics technique. This technique can be a valuable tool because it reduces chair-time and, more importantly, the risk of iatrogenic damage to the tooth structure.

• Restorative Dentistry and Endodontics
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• v.47 no.2
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• pp.17.1-17.8
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• 2022

Endodontic microsurgery is a predictable treatment option when orthograde treatment or retreatment is unsuccessful or unfeasible. However, when there is a gross compromise of periapical bone, achievement of bone regeneration after the surgical procedure may be hampered. In such cases, the application of guided tissue regeneration principles, with adjunctive use of leukocyte platelet-rich fibrin to fill the bone defect as a bone substitute and as a membrane to cover the site, provides a cost-effective solution with the benefits of accelerated physiological healing and reduced post-surgical pain and discomfort. This case report presents 2 cases of endodontic microsurgery of the upper lateral incisors with loss of buccal cortical plate, where platelet-rich fibrin was successfully applied.

• Restorative Dentistry and Endodontics
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• v.46 no.3
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• pp.46.1-46.9
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• 2021

The aim of this review was to evaluate the effects of different access cavity designs on endodontic treatment and tooth prognosis. Two independent reviewers conducted an unrestricted search of the relevant literature contained in the following electronic databases: PubMed, Science Direct, Scopus, Web of Science, and OpenGrey. The electronic search was supplemented by a manual search during the same time period. The reference lists of the articles that advanced to second-round screening were hand-searched to identify additional potential articles. Experts were also contacted in an effort to learn about possible unpublished or ongoing studies. The benefits of minimally invasive access (MIA) cavities are not yet fully supported by research data. There is no evidence that this approach can replace the traditional approach of straight-line access cavities. Guided endodontics is a new method for teeth with pulp canal calcification and apical infection, but there have been no cost-benefit investigations or time studies to verify these personal opinions. Although the purpose of MIA cavities is to reflect clinicians' interest in retaining a greater amount of the dental substance, traditional cavities are the safer method for effective instrument operation and the prevention of iatrogenic complications.

• Restorative Dentistry and Endodontics
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• v.47 no.4
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• pp.35.1-35.9
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• 2022

Although the success rates of microsurgery and micro-resurgery are very high, the influence of a recurrent perforation combined with radicular cyst remains unclear. A 21-year-old white female patient had a history of root perforation in a previously treated right maxillary lateral incisor. Analysis using cone-beam computed tomography (CBCT) revealed an extensive and well-defined periapical radiolucency, involving the buccal and palatal bone plate. The perforation was sealed with bioceramic material (Biodentine) in the pre-surgical phase. In the surgical phase, guided tissue regeneration (GTR) was performed by combining xenograft (lyophilized bovine bone) and autologous platelet-rich fibrin applied to the bone defect. The root-end preparation was done using an ultrasonic tip. The retrograde filling was performed using a bioceramic material (Biodentine). Histopathological analysis confirmed a radicular cyst. The patient returned to her referring practitioner to continue the restorative procedures. CBCT analysis after 1-year recall revealed another perforation in the same place as the first intervention, ultimately treated by micro-resurgery using the same protocol with GTR, and a bioceramic material (MTA Angelus). The 2-year recall showed healing and bone neoformation. In conclusion, endodontic micro-resurgery with GTR showed long-term favorable results when a radicular cyst and a recurrent perforation compromised the success.

• Restorative Dentistry and Endodontics
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• v.45 no.3
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• pp.27.1-27.9
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• 2020

Apical surgery for a mandibular molar is still challenging for many reasons. This report describes the applications of computer-guided cortical 'bone-window technique' using piezoelectric saws that prevented any nerve damage in performing endodontic microsurgery of a mandibular molar. A 49-year-old woman presented with gumboil on tooth #36 (previously endodontically treated tooth) and was diagnosed with chronic apical abscess. Periapical lesions were confirmed using cone-beam computed tomography (CBCT). Endodontic microsurgery for the mesial and distal roots of tooth #36 was planned. Following the transfer of data of the CBCT images and the scanned cast to an implant surgical planning program, data from both devices were merged. A surgical stent was designed, on the superimposed three-dimensional model, to guide the preparation of a cortical window on the buccal side of tooth #36. Endodontic microsurgery was performed with a printed surgical template. Minimal osteotomy was required and preservation of the buccal cortical plate rendered this endodontic surgery less traumatic. No postoperative complications such as mental nerve damage were reported. Window technique guided by a computer-aided design/computer-aided manufacture based surgical template can be considerably useful in endodontic microsurgery in complicated cases.

• Restorative Dentistry and Endodontics
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• v.37 no.3
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• pp.180-184
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• 2012

Traumatic injuries of the face often involve root fractures especially in anterior teeth. The prognosis and the treatment of the root fracture depend on the extent of the fracture line, general health and patient compliance. This case report outlines a new conservative trial treatment modality to stabilize the maxillary central incisors with horizontal root fracture on the cervical to middle third by fabricating canine guidance to remove loading on the traumatized maxillary central incisors during eccentric movements and thus inducing spontaneous healing of the fractured line between the fragments. Radiographs after thirty months showed adequate healing with no signs of pathological changes including root resorption, ankylosis or displacement. Long term follow-up revealed that vitality, stability and aesthetics were maintained and the patient was satisfied with the outcome.

• Restorative Dentistry and Endodontics
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• v.35 no.1
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• pp.1-4
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• 2010

The final preparation (MAF) size in infected root canals is still controversial. Nonetheless, recent studies demonstrated that larger apical preparation sizes produces a greater reduction in remaining bacteria and dentinal debris as compared to smaller apical preparation sizes. Therefore, clinicians should be practiced with treatment strategies guided by evidence-based information, especially in infected/failed root canals.

• Restorative Dentistry and Endodontics
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• v.40 no.4
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• pp.314-321
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• 2015

Tooth related factors such as palatoradicular groove can be one of the causes for localized periodontal destruction. Such pathological process may result in apicomarginal defect along with inflammation of pulp. This creates challenging situation which clinician must be capable of performing advanced periodontal regenerative procedures for the successful management. This case report discusses clinical management of apicomarginal defect associated with extensive periradicular destruction in a maxillary lateral incisor, along with histopathologic aspect of the lesion.

• Restorative Dentistry and Endodontics
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• v.48 no.4
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• pp.41.1-41.17
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• 2023

Objectives: This scientometric and bibliometric analysis explored scientific publications related to hydraulic calcium silicate-based (HCSB) sealers used in endodontology, aiming to describe basic bibliometric indicators and analyze current research trends. Materials and Methods: A comprehensive search was conducted in Web of Science and Scopus using specific HCSB sealer and general endodontic-related terms. Basic research parameters were collected, including publication year, authorship, countries, institutions, journals, level of evidence, study design and topic of interest, title terms, author keywords, citation counts, and density. Results: In total, 498 articles published in 136 journals were retrieved for the period 2008-2023. Brazil was the leading country, and the universities of Bologna in Italy and Sao Paolo in Brazil were represented equally as leading institutions. The most frequently occurring keywords were "calcium silicate," "root canal sealer MTA-Fillapex," and "biocompatibility," while title terms such as "calcium," "sealers," "root," "canal," "silicate based," and "endodontic" occurred most often. According to the thematic map analysis, "solubility" appeared as a basic theme of concentrated research interest, and "single-cone technique" was identified as an emerging, inadequately developed theme. The co-occurrence analysis revealed 4 major clusters centered on sealers' biological and physicochemical properties, obturation techniques, retreatability, and adhesion. Conclusions: This analysis presents bibliographic features and outlines changing trends in HCSB sealer research. The research output is dominated by basic science articles scrutinizing the biological and specific physicochemical properties of commonly used HCSB sealers. Future research needs to be guided by studies with a high level of evidence that utilize innovative, sophisticated technologies.