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At least 325 records · Page 18Linked to original sources

PubMed2004

Success rate of endodontic treatment of teeth with vital and nonvital pulps. A meta-analysis.

OBJECTIVE: The purpose of this study was to use meta-analysis statistics to determine the influence of factors such as apical limit (short vs. overextension), status of the pulp (vital vs. nonvital), and periapical status (presence or absence of radiolucency) on endodontic prognosis. Study design The study-list was obtained by using a MEDLINE search and Japana Centra Revuo Medicina search. Only those papers in which the criteria for success or failure was exactly described were accepted. RESULTS: The cumulative success rate of 82.8 +/- 1.19% (average +/-95% confidence interval) was obtained for vital pulp; and 78.9 +/- 1.05%, for nonvital ones. There was a significant difference between the 2 groups.The cumulative success rates with overextension, flush, and underextension in vital teeth were 70.8 +/- 1.44, 86.5 +/- 0.88, and 85.5 +/- 0.98% respectively. There was a significant difference between flush and overextension and between flush and underextension. The rates for nonvital pulp were similar to those for vital ones. CONCLUSION: The root canal should be filled to within 2 mm of the radiographic apex.

Adult↗

PubMed2005

An in vitro comparison of root canal measurement in primary teeth.

To compare the accuracy of root canal lengths in primary teeth determined by tactile sense, electronic apex locator, conventional radiography, and digital radiography in primary teeth. The study sample consisted of twenty 20 extracted, single-rooted primary teeth. A comparison was made between the working length measurements obtained by tactile sensation, electronic apex locator, conventional film, and digital radiography, using stereomicroscopic measurements to obtain real canal length. The mean readings obtained were 15.91+/-2.06 by tactile measurement, 15.94 94+/-1.42 by apex locator, 16.06+/-1.73 by conventional radiography, and 15.91+/-1.60 by digital radiography. No statistically significant differences were seen between the techniques.

Dental Pulp Cavity↗

PubMed1998

An in vivo evaluation of an electronic apex locator that uses the ratio method in vital and necrotic canals.

The purpose of this study was to compare the canal length determined by an apex locator to the apical constriction in both vital and necrotic canals. Informed consent was obtained from patients waiting to have teeth extracted. The teeth were anesthetized, isolated, and accessed. The pulp was considered vital if bleeding was present in the pulp chamber. The Root ZX was used to measure the root canal length. The file was cemented into place, and the tooth was extracted. Twenty-nine teeth containing 34 cemented files were studied, and the distance from the apical constriction was measured. The Root ZX was 82.3% accurate to within 0.5 mm of the apical constriction. The mean distance from the apical constriction was 0.21 mm in vital cases versus 0.49 mm for necrotic cases. There was no statistical difference between the ability of the Root ZX to determine the apical constriction in vital canals versus necrotic canals.

Adult↗

PubMed2004

Relationship of radiologic and histologic signs of inflammation in human root-filled teeth.

The aim of this study was to determine the relationship between histologic and radiologic signs of inflammation in human root-filled teeth. In addition, other factors with possible importance for apical inflammation were assessed. Fifty-three block sections of root-filled teeth were gathered from human cadavers. The blocks were radiographically exposed, sectioned, and stained with hematoxylin and eosin. Histologic sections were categorized as inflamed or uninflamed. Radiographically, the roots were assigned as apical lucency, widened periodontal ligament (PDL), or no lucency. Presence and contents of accessory canals were recorded (empty, tissue, or filling material). Statistical analysis was performed with the Chi-square test. All roots had accessory canals; 12 showed tissue remnants, and the others were empty. Of the cases, 49% were histologically uninflamed at the apex, and 52% appeared radiographically intact. The odds ratio of finding a histologically inflamed apex with radiologic lucency versus a radiographically intact apex was 9.2 (p = 0.002). The odds ratio of finding a histologically uninflamed apex with a radiologically tight coronal seal versus an unacceptable seal was 3.7 (p = 0.053). It may be concluded that there are relationships between radiologic and histologic signs of inflammation in human root canal-treated teeth. There appears to be a tendency that the radiologically determined quality of the coronal seal has an impact on the histologic state of the root-filled tooth. No relationship was detected between unfilled lateral or accessory canals and the status of inflammation at the periapex (51% inflamed, 49% uninflamed).

Cadaver↗

PubMed1999

Accuracy of four electronic apex locators: an in vitro evaluation.

In the present study, the accuracy and operator dependency of four electronic canal length measuring devices (Apex Finder AFA Model 7005, Apex-Finder, Neosono Ultima EZ and Apit 2) were compared under a set of specified conditions. The electronic apex locators were tested in unflared dry, flared wet and flared dry canals, and in a gelatin as well as in a sodium hypochlorite sponge model. Fifteen extracted single-canaled teeth were selected. The differences between canal lengths obtained by the electronic apex locators and actual canal lengths were scored. Only the Apex-Finder was found to be unreliable (measurements higher than +/- 0.5 mm from the apical foramen). This device was also found to be particularly dependent on operator. A ranking based on a precision of +/- 0.1 mm from the apical foramen showed the Apex Finder AFA Model 7005 to be the most accurate. Early coronal flaring did not ensure better or more precise readings. The gelatin model was evaluated to be more suitable for testing electronic apex locators in vitro than the sodium hypochlorite model.

Analysis of Variance↗

PubMed1997

Electrical impedance measurements of root canal length.

Electronic methods are now widely used during endodontic treatment for the assessment of root canal length. These commonly measure the electrical resistance or impedance between the root canal and the buccal mucosa. A number of studies have been undertaken to determine the accuracy of commercially available instruments. The aims of this investigation were to determine the electrical impedance characteristics of the root canal and periapical tissues in vivo, measure the changes relative to the distance of an endodontic instrument from the apical constriction and propose an equivalent circuit modelling the periapical tissues. The length of the root canals of 20 previously untreated teeth were determined using radiographic and electronic methods. Minimal canal preparation was carried out and measurements were made with a size 10 K-Flex file. A microprocessor-controlled LCR analyser was used to measure the electrical impedance characteristics of each root canal. The instrument measured the series and parallel resistive (RS, RP) and capacitance (CS, CP) component of the tissues at two test frequencies, 100 Hz and 1 kHz. Measurements were made for each root canal when the diagnostic file was placed at the apical constriction and repeated when the file was withdrawn to -0.5, -1.0, -1.5, -2.0 and -5.0 mm from the foramen. Readings were taken for each canal after the canal had been dried with paper points, and flooded first with deionised water and then with sodium hypochlorite. The root canals were then prepared, cleaned and obturated using standard endodontic procedures. The LCR analyser selected the series resistance component as the major measurement parameter. There was a clear increase in series resistance (RS) with increasing distance from the radiographic apex for dry canals and those containing deionised water and sodium hypochlorite. The mean resistance for dry canals was markedly higher than for those containing fluid, ranging from 22.19 k omega to 92.07 k omega in comparison with 9.32 k omega to 12.10 k omega for deionised water and from 7.46 k omega to 8.92 k omega for canals containing sodium hypochlorite. There was a marked change in the series and parallel resistive component with distance from the apex, suggesting a complex relationship between the impedance of the smear layer and bulk dentine. The impedance characteristics of a root canal were a complex electrical network comprising resistive and capacitive series and parallel elements.

Dental Pulp Cavity↗

PubMed2006

Accuracy of the Raypex-4 and Propex apex locators in detecting horizontal and vertical root fractures: an in vitro study.

Unforeseen root fractures during endodontic therapy are often difficult to diagnose and treat. Apex locators have been shown to be accurate in measuring the working lengths of root canals, and it was postulated whether they could also be used to determine the position of root fractures. This study was undertaken to assess the accuracy of two different apex locators in determining the position of fractures. One hundred single rooted teeth were randomly divided into two groups. One group had simulated horizontal fractures cut into them and the other group had vertical fractures. All fractures were detected in both groups using both a Propex (third generation) and a Raypex-4 (fourth generation) apex locator. The actual lengths of the fractures were then measured under 2.5 times magnification, and the results subjected to statistical analysis. Both locators produced similar results and were found to be very accurate, with measurements that correlated closely to the actual lengths. Clinically, treatment options for root fractures vary depending on their location. Thus apex locators may be a valuable aid in not only determining the presence of a root fracture, but also its exact location, which will help the clinician decide on the most appropriate management.

Dental Pulp Cavity↗

PubMed2002

Measurement of the distance between the minor foramen and the anatomic apex by digital and conventional radiography.

The purpose of this study was to determine the distance between the minor foramen and the anatomic apex from digital and conventional radiographs. Thirty permanent single-canal teeth with mature root apex were used. After access preparation, a K-file was inserted into the canal until the tip of the file was just seen at the minor foramen under a x40 stereomicroscope. The file was fixed in the canal by filling the access with composite resin. The teeth with files in the canals were radiographed using a Schick CDR digital system and conventional radiography with E-speed film. For digital radiographs, the distance between the file tip and the center of radiographic apex was directly measured from the computer screen by using Schick CDR measurement software. For conventional radiographs, the distance was measured under a stereomicroscope at a magnification of x10 with a calibrated millimeter ruler. The mean distance was 0.494 mm measured from conventional radiographs and 0.594 mm from digital radiographs. These results agree with the current conception that endodontic working length should terminate 1 mm from the radiographic apex. There was a significant difference between the measurements on digital radiographs and those on conventional radiographs (p < 0.05, paired t test). However, the 0.1-mm difference has no clinical significance, because clinically, the working length is generally measured to the nearest 0.5 mm.

Dental Pulp Cavity↗

PubMed2006

[A study on the accuracy of electronic root canal length measurement and its influential factors].

PURPOSE: To study the accuracy of JUSTY-II electronic apex locator and the influential factors on the accuracy of root canal working length measurement. METHODS: 148 teeth, including 71 teeth with pulpitis, 46 with necrotic pulp and 31 with apical periodontitis, were divided into two groups in random. The accuracy of electronic root canal working length measurement group was compared with that of the manual measurement group by Chi(2) test. The influence of clinical types, root canal in dry or moisture conditions and root canal preparation on the accuracy of root canal working length measurement was analyzed. RESULTS: The accuracy of electronic apex locator was 87.84%, while it was 43.24% in manual measurement, the difference was significant (P<0.01). The accuracy in the group of apical periodontitis was significantly lower than that of the other groups (P<0.05). Root canal in dry or moisture conditions had no effect on the accuracy of root canal length measurement, but root canal preparation could decrease the accuracy of measurement (P<0.05). CONCLUSION: Electronic apex locator is an accurate and convenient device in measurement of root canal working length. Apical periodontitis and root canal preparation can decrease the accuracy of measurement.

Bicuspid↗

PubMed2005

The isthmuses of the mesial root of mandibular molars: a micro-computed tomographic study.

AIM: To investigate the prevalence of root canal isthmuses in the apical 5 mm of the mesial root of mandibular molars by means of micro-computed tomography (MCT) and to describe the morphology of the isthmuses. METHODOLOGY: Twenty extracted mandibular first molars that had fully formed roots were selected. The mesial roots were sectioned from the distal roots and subjected to MCT. The number of sections showing isthmuses in each of the apical 5 mm of the root canals was recorded. In each one of the apical 5 mm of the 20 roots examined, 40 sections were observed, giving a total of 800 sections observed in each group. Data were analysed as a contingency table using the chi-square statistic to test the null hypothesis that location of the sections in each of the apical 5 mm and presence of the isthmus were independent. RESULTS: Isthmuses were found to be present at all levels with prevalence figures between 17.25 and 50.25%. The chi-square test indicated a significant difference in the distribution of isthmuses with section (P = 0.001). It was found that sections in the first millimetre from the apex had fewer isthmuses than expected and that sections in the third millimetre from the apex had more isthmuses than expected under the null hypothesis. Calcifications were found to be present in most isthmuses, occasionally lateral canals originated from the central part of the isthmuses. CONCLUSIONS: Isthmuses were present in the vast majority of roots observed. The third millimetre from the apex showed more isthmuses than expected. The results of clinical and surgical endodontic procedures performed in the mesial root of mandibular molars may be affected by this aspect of the root canal anatomy.

Dental Pulp Cavity↗

PubMed1998

Endodontic working length assessment. Comparison of storage phosphor digital imaging and radiographic film.

OBJECTIVE: This study compared the difference in interpretation of the position of endodontic file tips between two imaging systems: photostimulable storage phosphor luminescence imaging versus radiographic film. STUDY DESIGN: Thirteen patients were selected at random. Preoperative and trial file length radiographs were made with a dual image receptor composed of a Digora Digital Imaging Plate and a piece of Ektaspeed Plus film. Exposure techniques for E-speed film were used. Root length and file length measurements were made from digital images with the Digora system's measuring tools. Measurements were also made on radiographic film with a 7 x measuring magnifier. Root length, file length, and their difference were compared for both film and digital images. RESULTS: Differences were found to be less in digital than in film images. Photostimulable storage phosphor luminescence imaging performed similarly to Ektaspeed Plus film for measuring root lengths, but file tip positions (especially of small file sizes) were difficult to visualize with E-speed film. CONCLUSIONS: The smaller difference between file tip and root apex found with digital imaging suggests that this technique is more accurate to assess trial file length. This imaging modality for assessing file positions during root canal treatment may be beneficial to the practitioner.

Bicuspid↗

PubMed2001

An audit of root canal treatment performed by undergraduate students.

AIM: The objective of this study was to audit the quality of root canal treatment performed by undergraduate students on adult patients. METHODOLOGY: All root canal treatment completed by first and second clinical year undergraduates over a 12-month period were included in the study. The availability and readability of pretreatment, diagnostic length, try-in point and postoperative radiographs were noted for each case. All readable postoperative radiographs of primary treatments were examined for quality of the root filling, categorized as complete, incomplete apical, incomplete apical and lateral or not assessable. The distance from the radiographic apex of the root to the apical extent of each root filling was measured to 0.1 mm precision. RESULTS: Undergraduates performed primary treatment on 157 teeth. A postoperative radiograph was available in 97% of cases. A try-in point radiograph was unavailable in one-fifth of cases. Twenty-seven teeth (13%) were categorized as satisfactory in terms of both radiographic quality and distance of the root filling from the radiographic apex. CONCLUSIONS: Overall, the technical quality of root canal treatment completed by undergraduate students was poor.

Adult↗

PubMed2001

Eruption process of upper permanent canine.

The purpose of this study was to investigate normal eruptive pattern of upper permanent canine. One hundred and fifty-one panoramic radiographs were used. Inclination of upper canine and lateral incisor, length and horizontal and vertical positions of cusp and root apex of the canine were evaluated. The canine erupted with increasing distal inclination and with no significant changes of the lateral incisor. Developmental changes of the canines relative to palatal plane and midline were shown by figures.

Analysis of Variance↗

PubMed1998

A SEM study of in vivo accuracy of the Root ZX electronic apex locator.

Twenty-nine unprepared, vital teeth were used to evaluate the accuracy of the Root ZX in locating the root canal foramen. After extraction of the teeth, a scanning electron microscope analyzed the relation of the file tip to the foramen. The sample was divided into two groups (Group A and Group B) according to the presence of a normal apical foramen (along the root main axis) or of a lateral foramen (deviating from the root main axis). With a tolerance level of +/- 0.5 mm, a clinical accuracy rate of 82.75% was recorded in the total sample. With a +/- 1.0-mm tolerance level, an accuracy of 100% was found. The error in locating the apex was significantly smaller in cases with a normal apical foramen (Group A) than in cases with a lateral foramen (Group B) (p < 0.001). An accuracy of 100% at the +/- 0.5-mm tolerance level was registered in Group A.

Dental Instruments↗

PubMed2001

A study in two centres of variations in the time of apical barrier detection and barrier position in nonvital immature permanent incisors.

OBJECTIVES: To study barrier formation in nonvital, immature permanent incisors being treated using the apexification technique in two centres, and to establish the effect of the frequency of change of calcium hydroxide (CaOH) on barrier detection times. DESIGN: A retrospective study of the time of detection and the position of barriers. RESULTS: There were no significant differences between the two centres in terms of the average frequency of change of each CaOH dressing, the distribution of barrier detection times or the position of barriers (P > 0.05). There was a total of 107 teeth and the time of barrier detection was significantly earlier in more frequently dressed teeth (P = 0.013). Of the teeth with a barrier detection time of less than 9 months, 60.7% were dressed more frequently than every 3 months, as opposed to 39.1% of teeth with longer barrier times (P = 0.027). The mean time of barrier detection for all cases was 43.3 weeks. The majority of barriers were located at or near the apex. CONCLUSION: The frequency of change of CaOH can increase the speed of barrier detection but does not appear to affect the position.

Analysis of Variance↗

PubMed2005

Determining the apical terminus of root-end resected teeth using three modern apex locators: a comparative ex vivo study.

AIM: To assess ex vivo the accuracy of various electronic apex locators in locating the apical terminus of root-end resected teeth. METHODOLOGY: Ninety extracted human posterior teeth (182 root canals) were prepared to a minimum size of 40 and filled with gutta-percha and sealer. After resection of the apical 3 mm of the root, the root canal filling was removed using HERO rotary instruments. The size of the root canal at the apical terminus after removal of the filling ranged from size 50 to 90. The root canal length to the apical terminus was determined using 3 apex locators (Root ZX, Raypex4 and Apex Pointer). A new mounting model that utilized a micrometer was used to perform the measurements and to visually determine the actual position of the apical terminus. The frequency of locating the apical terminus and the corresponding 95% confidence interval (CI) were calculated. Additionally, the coefficient of repeatability of each apex locator and the limits of inter-operator agreement were determined. RESULTS: All apex locators showed an acceptable repeatability (0.02-0.03 mm coefficient of repeatability) and narrow limits of inter-operator agreement (+0.07 and -0.07 mm). The accuracy of determining the apical terminus within 1 mm in the root canal was as follows: Root ZX 90% (164/182 root-canals) [95%CI: 86-94%], Raypex4 74% (135/182 root-canals) [95%CI: 68-80%], and Apex Pointer 71% (129/182 root canals) [95%CI: 65-77%]. No over-instrumentation resulted when the Root ZX device was used. In contrast, using the Raypex4 or the Apex Pointer device resulted in over-instrumentation in 8 of 182 root canals (4%). CONCLUSIONS: Under the conditions of this study all three apex locators were able to detect the apical terminus of root-end resected teeth with an acceptable range. The Root ZX device was the most accurate without over-instrumentation of the root canals.

Dental Pulp Cavity↗

PubMed2000

Management of wide open apices in non-vital permanent teeth with Ca(OH)2 paste.

A retrospective study on 15 non-vital immature incisor teeth was done using Ca(OH)2 Pulpdent paste. A success rate of 100 percent was achieved within one year. The variables influencing the time taken for apexification were also evaluated. The teeth were followed up to a period of 24 months. It was found that older children having narrow open apex had a shorter treatment time than the younger children (NS); teeth without periapical infection showed some amount of root growth and closing of apex that was faster than those with periapical infection (p < 0.001). The calcified bridge formed following apexification is a porous structure. This investigation provides information about the time taken and procedure required to achieve apical barrier formation in non-vital immature incisors.

Adolescent↗

PubMed2000

Bone-like tissue growth in the root canal of immature permanent teeth after traumatic injuries.

Following a severe traumatic incident to permanent immature teeth, the growth of calcified tissue in the pulp space may occasionally occur. This calcified tissue may be diffuse or in intimate contact with the dentine. It has been suggested that a wide open apex, severe damage to the root sheath, and the absence of infection are only some of the predisposing factors leading to this metaplasia of pulp tissue into bone-like tissue. Five cases are described.

Adolescent↗