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Biomedical subjects

C E del Rio

Publications and source records attributed to C E del Rio.

At least 19 recordsLinked to original sources

A comparison of root canal preparations using Ni-Ti hand, Ni-Ti engine-driven, and K-Flex endodontic instruments.

This study used a modified Bramante technique and new digital subtraction software to compare root canals prepared by nickel-titanium (Ni-Ti) hand, Ni-Ti engine-driven, and stainless steel hand endodontic instruments. Sixty mesial canals of extracted human mandibular molars were randomly divided into five groups. The roots were embedded in clear resin and cross-sectioned in the apical and mid-root areas. In group A, canals were instrumented using a quarter turn/pull technique with K-Flex files. In group B, canals were prepared with Ni-Ti hand files (Mity files) using the same technique as in group A. Group C was prepared with NT Sensor engine-driven files. Group D canals were prepared with Ni-Ti Canal Master "U" hand instruments. Group E was prepared with engine-driven Ni-Ti Lightspeed instruments. Digitized images of the uninstrumented canals were compared with images of the instrumented canals. Engine-driven Ni-Ti instruments (Lightspeed and NT Sensor file) and hand instrumentation with the Canal Master "U" caused significantly less canal transportation (p < 0.05), remained more centered in the canal (p < 0.05), removed less dentin (p < 0.05), and produced rounder canal preparations than K-Flex and Mity files. Engine instrumentation with Lightspeed and NT Sensor file was significantly faster than hand instrumentation (p < 0.05).

Analysis of Variance

Effect of nickel-titanium engine-driven instrument rotational speed on root canal morphology.

Thirty-six mesial canals in 18 extracted human mandibular molars were randomly allocated to three experimental groups. Specimens were prepared and evaluated using a modified Bramante technique. Teeth were sectioned at the midroot and apical regions. Canals were prepared with the Lightspeed instruments rotating at 750, 1300, or 2000 rpm. Digitized uninstrumented and instrumented canal images were compared via subtraction software. There was no significant difference (p <0.05) among the three experimental groups in the amount of dentin removed, canal transportation, or the ability of the instrument to remain centered in the canal.

Alloys

Incidence of periradicular pathoses in endodontic treatment failures.

Biopsy reports from 150 periradicular tissue specimens obtained from teeth refractory to nonsurgical endodontic therapy were reviewed. The specimens were submitted by postdoctoral dental students in the Department of Endodontics, and the biopsy reports were prepared by oral pathologists at the University of Texas Health Science Center at San Antonio. The study found that 59.3% of the periradicular lesions were granulomas, 22% cysts, 12% scars, and 6.7% other pathoses. The majority (56%) of endodontically treated cases which failed to heal were recognized within 2 yr after the completion of therapy. The most common location for surgical retreatment was the anterior maxilla, followed by the posterior maxilla, the posterior mandible, and the anterior mandible. The periapical granuloma was the predominant pathosis at each location.

Adolescent

Histological evaluation of ultrasonic debridement comparing sodium hypochlorite and water.

Twenty extracted human mandibular first and second molars with mesial canal curvatures of 18 to 35 degrees were randomly divided into two groups. Following routine endodontic access and canal length determination one of the mesial root canals was ultrasonically instrumented, using tap water in the first group or 2.6% sodium hypochlorite irrigation in the other. In both groups the other mesial canal was used as a control. The mesial roots were decalcified, serially sectioned, and stained with hematoxylin and eosin. Wall planing and soft tissue debridement were blindly evaluated using the light microscope. Mean canal wall planing and soft tissue debridement scores were compared by multiple t tests. Sodium hypochlorite, in conjunction with ultrasonic instrumentation, was more effective than tap water in wall planing when the entire root length was considered. Sodium hypochlorite, in conjunction with ultrasonic instrumentation, was more effective than tap water in soft tissue debridement in the middle third of the canal. Both irrigants were ineffective in conjunction with ultrasonic instrumentation in removing soft tissue from the main canal, the isthmus between canals, the canal fins, and the multiple branches or deltas often encountered in the apical one-third of the canal.

Humans

Cavitational bone defect: a diagnostic challenge.

A patient with a history of trauma to the maxillary left anterior region presented with chronic pain of unknown etiology. Root canal therapy and periradicular surgery failed to resolve the persistent pain. A second surgical procedure revealed a bone cavity superior and distopalatally to the apex of the maxillary left lateral incisor. The suspected etiology was necrotic bone removed from the bone cavity.

Adult

Reactions of rat odontogenic tissues to heat.

Twenty-four Wistar rats were anesthetized and 200 degrees C heat was applied for 4 minutes to each mandibular left first molar. Eight of these rats were then killed at 2, 8, and 14 weeks. The subject and control teeth were radiographed and compared. They were then prepared for histologic evaluation and scored for levels of inflammation in both the pulpal and periradicular tissues. Furcal, interproximal, and apical radiographic changes were found at all three time intervals. These changes involved progressively larger percentages of teeth at 8 and 14 weeks. Histologically, complete necrosis and/or abscess formation were found in the coronal portions of all experimental pulps. With time, inflammatory changes increased in intensity and progressed through the radicular pulps, resulting in necrosis or calcific changes and, finally, inflammatory changes in the periradicular areas. The pathosis created by the application of heat was devoid of microorganisms as evaluated by the Brown and Brenn stain.

Animals

Comparison of the Canal Master endodontic instrument and K-type files for enlargement of curved root canals.

Twenty mandibular molars with 40 mesial curved root canals were instrumented with a circumferential technique using K files and the Canal Master instrumentation technique by junior dental students whose only endodontic experience had been completion of a preclinical endodontic course. Preoperative and postoperative radiographs were taken facially and mesially with instruments in place. The canals were evaluated radiographically for transportation 1 mm and 4 mm from the apex. The mesial roots were cross-sectioned at the same level. The sections were evaluated for roundness of the canal preparation. It was concluded that the Canal Master instrumentation technique transported the root canal less and produced rounder preparations than the K file circumferential technique. There appears to be a greater tendency for breakage with the Canal Master.

Dental Pulp Cavity

Temperature changes in thermoplasticized gutta-percha: a comparison of two ultrasonic units.

With the use of an extracted human tooth as in vitro model, this study measured temperature changes in the surface of gutta-percha while it was being ultrasonically thermoplasticized. Two sources of ultrasonic oscillation were used: a Cavitron 2001 ultrasonic unit with a file in a PR-30 insert and an ENAC ultrasonic unit with a plugger or file. Temperature elevation in the apical third of the tooth was minimal with either instrument (1.66 degrees C to 3.74 degrees C). The temperature rise in the middle third was higher with the ENAC unit, although probably still within clinically acceptable limits (range, 6.35 degrees C to 19.10 degrees C). The time taken for each unit to thermoplasticize the gutta-percha and reach a predetermined distance in the experimental model was recorded and defined as instrument efficiency. The Cavitron unit that had the PR-30 insert with a No. 25 file required 0.48 sec/mm, whereas the ENAC unit with a No. 25 file required 10.83 sec/mm and the ENAC unit with a plugger required 8.38 sec/mm. It appears that the Cavitron unit with a PR-30 insert was more than 22 times as efficient as the ENAC unit for thermoplasticizing gutta-percha under the experimental conditions used in this study.

Chemical Phenomena

Histological evaluation of ultrasonic and sonic instrumentation of curved root canals.

Fifty extracted human mandibular first and second molars with mesial canal curvatures of 18 to 35 degrees were randomly divided into five groups. After routine endodontic access and canal length determination, one of the mesial root canals was instrumented using tap water and one of the following instrumentation methods: (a) hand instrumentation; (b) ultrasonic instrumentation with the Cavi-Endo unit; (c) ultrasonic instrumentation with the Enac unit; (d) sonic instrumentation with the Medidenta unit; and (e) sonic instrumentation with the Endostar 5 unit. The other mesial canal was used as a control. The mesial roots were decalcified, serially sectioned, stained with hematoxylin and eosin, and blindly evaluated using the light microscope. The mean canal wall planing and soft tissue debridement scores were compared by analysis of variance. There was no statistically significant difference among the groups for wall planing or soft tissue debridement.

Humans

Cutaneous sinus tracts of dental etiology.

Intermittently draining cutaneous sinus tracts in the area of the face and neck may be caused by chronic dental infection. Diagnosis of the cause may be challenging but is the key to successful therapy. Two cases of these uncommon lesions are presented; one involved a mandibular molar and the other a mandibular incisor. Nonsurgical endodontic treatment was performed. Healing was rapid and uneventful.

Adolescent

The pulpal response to topically applied citric acid.

Citric acid is currently being used to aid in the reattachment of periodontal tissues to tooth roots which have become separated as a result of periodontitis. The present study examines the effect of topically applied citric acid on the dental pulp. Citric acid, pH 1, was applied for 3 minutes on instrumented premolar teeth in six dogs. As a control, saline solution was applied on similarly instrumented premolars. The teeth were removed 1, 6, 24, 48, 72, and 144 hours after citric acid application. After histologic preparation, the pulps were examined for inflammatory cell infiltrates, odontoblast displacement into the dentinal tubules, hyperemic capillaries in the odontoblast layer, hemorrhage, abscess formation, irregular dentin, and the thickness of the dentin remaining beneath the treated area. There was no statistically significant response to the citric acid over the saline controls. Nor was the pulpal response, as examined above, correlated to the thickness of the remaining dentin. The results suggest that citric acid, pH 1, when applied to tooth roots during surgical reattachment therapy, does not adversely affect the pulp.

Administration, Topical