PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Tooth Apex”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 613 records · Page 34Linked to original sources
PubMed2003

Smear layer production by 3 rotary reamers with different cutting blade designs in straight root canals: a scanning electron microscopic study.

OBJECTIVES: The design of the cutting blade of rotary instruments may affect the outcome of root canal instrumentation in terms of cleanliness. The aim of this scanning electron microscopic study was to compare the quality and amount of smear layer generated in the apical third of straight root canals by 2 rotary nickel-titanium reamers and 1 rotary steel reamer with different cutting blade designs. STUDY DESIGN: Seventy intact, single-rooted human mandibular premolars with straight, fully developed roots were selected for this study. Before instrumentation, the cervical portion of all teeth was removed by using a microtome (Isomet), leaving 13-mm-long roots. Automated preparation was performed with ProFile (n = 20) and Hero 642 (n = 20) reamers by using the crown-down technique and with a stainless steel engine reamer (Mani; n = 20) by using a reaming motion. All root canals were instrumented to No. 40. A control group (pulp extirpation with barbed broaches; n = 10) was also included. Irrigation with 3 mL of a 1% sodium hypochlorite (NaOCl) solution was performed after each instrumentation. After the instrumentation, each root was split longitudinally, and a scanning electron microscope was used to examine the selected areas of the canal walls at the apical third from 2 different perspectives. A 4-category scoring system for smear layer was used, and the resulting scores were statistically analyzed. RESULTS: The least smear layer remained in the Hero 642 group at the selected apical third of straight root canals (P < .05). However, all instruments left a smear layer. The surface texture of the smear layer, in addition to the depth and the frequency of packed materials into the dentinal tubules, varied with instrument type. CONCLUSION: These data revealed that the design of the cutting blade of rotary instruments can affect root canal cleanliness in straight root canals. This information may be useful in the selection of nickel-titanium rotary reamers.

Dental Alloys↗
PubMed1997

Demineralization of resected root-ends with methylene blue dye.

OBJECTIVES: This study evaluated the ability of methylene blue solutions of different concentration, pH, and time exposure to remove the smear layer from resected root-ends. STUDY DESIGN: Resected root-ends were treated with either 2% methylene blue dye for intervals of 5 to 11 minutes or 1% methylene blue for 7 to 9 minutes and examined with a scanning electron microscope for smear layer removal. Two minute applications of saline solution and 50% citric acid served as controls. RESULTS: All methylene blue solutions were found to be ineffective in removing the smear layer at all time intervals tested. An experimental solution of 1% methylene blue in 50% citric acid was found to predictably remove the smear layer during a 2 minute application and retained all the favorable staining characteristics of the dye. Fifty percent citric acid solutions applied for 3 minutes appeared to overdemineralize the root-end and gave poorer results than 2 minute applications. CONCLUSIONS: Smear layer removal was pH dependent. Methylene blue solutions are clinically unsuitable for smear layer removal.

Adult↗
PubMed1998

Position of the mental foramen in a North American, white population.

UNLABELLED: Knowledge of the position of the mental foramen is important both when administering regional anesthesia and performing periapical surgery in the mandible. Although it is often possible to identify the mental foramen by palpation and radiographically, knowing the normal range of possible locations is essential. Standard anatomic texts have data collected from dried skulls, but often of unknown origin or from an ethnic group that does not represent the North American population. OBJECTIVES: This study identified the position of the mental foramen in a more representative sample of the North American population. Ethnic and gender differences were also investigated and the symmetry of location within individuals analyzed. STUDY DESIGN: Regional dissections of 105 human cadavers were carried out to identify the normal range of position of the mental foramen. The vertical and horizontal position was recorded with the two adjacent teeth used as references. If the two adjacent teeth were not present the foramen was not included in the study. RESULTS: The results indicated that the mental foramen was, on average, between the premolars, therefore not statistically different from previous studies. However, there appears to be a greater range than generally reported, which is of considerable clinical significance. Examples of dissections of unusually positioned mental foramina are given.

Anesthesia, Dental↗
PubMed1998

The topography of root ends resected with fissure burs and refined with two types of finishing burs.

OBJECTIVES: This study compared the surface topography of roots resected with #57, Lindeman, and Multi-purpose burs. Further comparisons were made after refinements with either a multifluted carbide or an ultrafine diamond finishing bur. STUDY DESIGN: Three groups of single-rooted human teeth were resected with each resection bur, and resin replicas of the root ends were made. Root ends from each resection bur group were finished with either a multifluted carbide or an ultrafine diamond finishing bur, and the root ends were replicated. All replicas were evaluated at a magnification of x20 for smoothness and surface irregularities. Data analysis was done with the Wilcoxon signed rank test and the chi-square test at a significance level of p < 0.05. RESULTS: The Multi-purpose bur produced a smoother and more uniplanar surface than the #57 bur and caused less damage to the root than either the #57 or the Lindeman bur. The multifluted carbide finishing bur tended to improve the smoothness of the root end, while the ultrafine diamond tended to roughen the surface. CONCLUSIONS: The Multi-purpose bur produced the smoothest and most uniplanar resected root-end surface with the least root shattering. The multifluted carbide finishing bur produced a smoother surface than the ultrafine diamond bur.

Apicoectomy↗
PubMed1998

Histopathologic and radiographic findings of the simple bone cyst.

OBJECTIVE: The purpose of this study is to examine the correlation between histopathologic and radiographic findings and to discuss the cause of the simple bone cyst. STUDY DESIGN: Histopathologically, we classified 53 simple bone cysts into two types. Type A has a connective tissue membrane and type B has a partially thickened wall with dysplastic bone formation. Radiographically, we evaluated the following: margin, radiolucency, or radiopacity, relationship with tooth apices, bucco-lingual bone expansion, and displacement of the mandibular canal. RESULTS: Bone expansion and radiopacity were closely related to histopathologic findings although there was no correlation between the histopathologic findings and radiographic margin, relationship with tooth apices, and displacement of mandibular canal. Local recurrence was more likely to be observed in patients diagnosed as having type B than type A lesions. CONCLUSIONS: Type A and type B bone cysts may have different causes. Cysts determined radiographically to be radiopaque, those diagnosed as type B histopathologically, and cysts that have been treated surgically should all be followed by radiographic examinations.

Adolescent↗
PubMed2001

Calcium hydroxide retention in wide root canals with flaring apices.

Calcium hydroxide (CH) is used to induce apexification in immature, pulpless teeth with wide root canals and flaring apices. Three placement methods of CH were compared in vitro, for their ability to enhance CH retention in the canal. Barium sulfate (BS), added as radiopacifier, was studied for its effects on the radiographic follow up of CH retention, as well as on the ability to detect voids in the CH. Calcium hydroxide filled teeth were kept in phosphate buffered saline-containing tubes in a shaker water bath. Radiographs were taken weekly to follow the retention or loss of the material; they were scanned and stored as digitized images. Quantitative evaluations were done on these images, using a computerized gray scale. Condensed CH was better retained in root canals than either lentulo-placed paste or commercial injected paste. Barium sulfate in the CH paste enabled better detection of voids in the paste filling the canal, however, it obscured the disappearance of CH from the canal, due to a residual radiopacity effect. The results supported (a) condensation of calcium hydroxide as a preferred method that improves its retention in wide root canals, and (b) discontinuing the use of barium sulfate as a radiopacifier in apexification procedures.

Analysis of Variance↗
PubMed2002

The use of MTA in teeth with necrotic pulps and open apices.

Three clinical cases have been treated with the use of an apical plug of MTA for apexification. All three cases were central incisors that had suffered premature interruption of root development as a consequence of trauma. According to the treatment protocol, the root canals were rinsed with 5% NaOCl; then, calcium hydroxide paste was placed in the canals for 1 week. Consequently, the apical portion of the canal (4 mm) was filled with MTA. The remaining portion of the root canals was then closed with thermoplastic gutta-percha. At 6-month and 1-year follow-up period the clinical and radiographic appearance of the teeth showed resolution of the periapical lesions. MTA appears to be a valid option for apexification with its main advantage being the speed at which the treatment can be completed.

Adolescent↗
PubMed2004

Endodontics: Part 7. Preparing the root canal.

Research into root canal preparation has led to significant changes in instrumentation techniques. Hand files should be manipulated by the balanced-force technique. Recent designs of endodontic instruments have variable tapers giving improved shaping ability. Nickel-titanium rotary instruments will rapidly and safely open the main root canals creating deep space to permit full permeation of irrigant solutions. Practitioners considering changing their endodontic technique are advised to attend hands-on practical courses to gain competence before using these in clinical practice.

Anti-Infective Agents, Local↗
PubMed2004

Endodontics: Part 8. Filling the root canal system.

The purpose of the obturation phase of a root filling is two-fold; to prevent microorganisms from re-entering the root canal system, and to isolate any microorganisms that may remain within the tooth from nutrients in tissue fluids. The seal at the apical end of the root canal is achieved by a well-fitting gutta-percha master point, and accessory points, although heated techniques may result in a better seal. The seal at the coronal end is achieved by the application of a layer of resin-modified glass ionomer cement as accessory canals may lead from the floor of the pulp chamber to the furcation area. It must always be remembered that success will only be achieved if the root canal system has been as thoroughly debrided as possible of infected material.

Dental Leakage↗
PubMed1998

Assessment of apical root resorption using digital reconstruction.

OBJECTIVES: To assess the in vitro and in vivo accuracy of a mathematical computer-based reconstruction of two images that are not taken with the same recording geometry for the measurement of apical root resorption following orthodontic treatment. METHODS: A gold standard for root resorption in vitro was developed from 10 extracted upper central incisors using calipers. Radiographs made with five different projection angles were reconstructed mathematically by two observers. The calculated loss of length was compared with the gold standard. Eighty-two upper central incisors from 61 patients were radiographically evaluated for the prevalence and degree of apical root resorption after orthodontic fixed appliance therapy. The relative amount of reduction was calculated after mathematical reconstruction. RESULTS: The inter-observer error in vitro was 1.8%. The 95% confidence intervals for the difference with the gold standard are small. The duplicate measurement in vivo error was 2.2% and the correlation between duplicate measurements was 0.94. The mean loss of tooth length was 7.8% (s.d. 6.9). CONCLUSIONS: The prevalence of root resorption corresponds well with that in the literature. Digital reconstruction is a reliable method to correct for different projection angles and to monitor the effects of orthodontic movement in serial dental radiographs.

Confidence Intervals↗
PubMed2000

Comparison of observer performance in determining the position of endodontic files with physical measures in the evaluation of dental X-ray imaging systems.

OBJECTIVE: To examine the feasibility of substituting observers determining the accuracy of endodontic measurements for measurements of physical qualities in comparison of digital imaging systems. METHODS: Sensors from six digital imaging systems were compared for signal-to-noise ratio (SNR), modulation transfer function (MTF) and detective quantum efficiency (DQE). A total of 45 canals in teeth from human cadavers were instrumented to their apical foramina. Endodontic files, ranging in size from size 8 to size 20, were glued in place at random distances from the apical foramina spanning a range of +/- 3 mm. The teeth were imaged with the six digital systems and dental X-ray film. Fifteen dentists independently measured the distance from the end of the file to the apical foramen. Results were expressed as the measurement error. Measurement error was compared to SNR, MTF and DQE for each digital system. RESULTS: CDR (Schick, New York, NY, USA), Digora (Sordex, Helsinki, Finland) and Dexis (Provision Dental Systems, Palo Alto, CA, USA) produced the highest SNR values followed closely by RVG-4 (Trophy, Croissy-Beavborg, France). Sens-A-Ray (Dent-X/Regam Medical Systems, Sundsvall, Sweden), Dexis and the RVG-4 produced the best MTF results. Dexis had the greatest DQE. The mean measurement errors (in mm) were: Film 0.65, Dexis 0.69, CDR 0.71, RVG-4 0.74, Digora 0.89, Sens-A-Ray 0.97, and Visualix-2 (Gendex, Monza, Italy) 0.98. CONCLUSIONS: Digital systems closely approximate film in their accuracy when used for endodontic measurement providing that the assessment instruments have similar resolving power. DQE was the best physical predictor of system accuracy when compared with endodontic length measurements. MTF and SNR alone did not accurately predict observer precision.

Cadaver↗
PubMed2005

Apical root resorption six and 12 months after initiation of fixed orthodontic appliance therapy.

The low explained variance of identified risk factors for apical root resorption in orthodontic patients suggests effects of parameters related to individual predisposition. Our purpose was to explore this hypothesis. We evaluated standardized periapical radiographs of the maxillary incisors made before treatment (T1) as well as at about six and 12 months after bracket placement (T2 and T3) of 247 patients aged 10.1 to 57.1 years at T1. The radiographs were converted to digital images, and commercially available software was used to correct for differences in projection. The results showed that 20.2%, 7.7%, and 5.3% of the patients had > or =1 tooth with >2.0, 3.0, and 4.0 mm resorption at T3, respectively. Pearson's correlation revealed an association between resorption from T1 to T2 and from T2 to T3 (P < .01). The risk of > or =1 tooth with >1.0 mm resorption from T2 to T3 was 3.8 times higher (95% CI 2.4-6.0) in patients with > or =1 tooth with >1.0 mm from T1 to T2 than in those without. Also, resorption was more pronounced (P < .001) from T2 to T3 in patients with > or =1 tooth with >1.0 mm and >2.0 resorption from T1 to T2 than in those without. The explained variance of identified risk factors was <10%. Orthodontic patients with detectable root resorption during the first six months of active treatment are more likely to experience resorption in the following six-month period than those without.

Adolescent↗
PubMed2002

Dynamic torque and apical forces of ProFile.04 rotary instruments during preparation of curved canals.

AIM: To analyse torque and force generated whilst shaping curved canals using rotary instruments. METHODOLOGY: A specially designed computer-controlled testing platform was used to record events during the shaping of straight and curved canals in plastic blocks and in extracted human teeth using ProFile.04 instruments. Size 40 apical stops were prepared using crown-down, apical preparation and step-back procedures. Maximum torque, apically directed force and the numbers of revolutions were recorded at a resolution of 100 samples s-1. Load causing separation as required by the ISO 3630-1 test and cyclic fatigue was also recorded. Mean maximum scores were calculated and statistically tested using one- and two-way analyses of variance. RESULTS: Highest and lowest torque scores were recorded, respectively, in straight canals in plastic blocks at 25 Nmm and in natural canals at 14 Nmm. Significant differences were recorded for canal type and preparation phase (P < 0.0001). Loads causing separation varied from 3.7 to 32.3 Nmm. Apically directed forces ranged from 1 to 7.5 N. Again, there were significant differences depending on canal type and preparation phase (P < 0.0001). The number of revolutions during preparation ranged from 18 to 41. Size 15, 30 and 45 ProFile.04 instruments separated after 581, 430 and 402 revolutions, respectively, in a standard cyclic fatigue test. CONCLUSIONS: The new torque-testing platform details physical parameters during preparation of curved canals. To improve predictability, instrumentation sequences must be tested for excessively high torsional moments or forces. This study indicated that up to 10 curved canals could be safely prepared with a sequence of ProFile. 04 rotary instruments without separation due to cyclic fatigue. Efforts should continue to correlate root canal anatomy with torque and force generated during rotary root canal preparation.

Analysis of Variance↗
PubMed1998

Preparation of the apical part of the root canal by the Lightspeed and step-back techniques.

This study measured in vitro the displacement of natural canal centres in 18 human teeth before and after shaping by the step-back or Lightspeed techniques. Experimental roots (n = 9 per group), embedded in clear plastic, were cross-sectioned using a 0.1-mm-thick band saw at distances 1.25 mm, 3.25 mm and 5.25 mm from the apices. A stereo microscope was used to take 35 mm slides of the cut surfaces of the sectioned roots and canals. The slides of the uninstrumented canals were scanned into a computer and saved. Each sectioned root was then reassembled and the canals shaped by the step-back or Lightspeed technique. File size 40 and instrument size 50 were selected as the master apical file and master apical rotary for the step-back and Lightspeed groups, respectively. The 18 prepared canals were photographed, and the 35 mm slides scanned and computer stored as previously. This allowed the positions of the pre- and postinstrumented roots to be electronically superimposed for subsequent analyses. Displacements of the root canal centres before and after preparation were assessed in relation to the cross-sectional diameter of the files or instruments used. In addition, increases in cross-sectional area of the root canals after preparation were evaluated in relation to the cross-sectional area of the files or instruments used. Engine-driven nickel-titanium Lightspeed instruments caused significantly less (P < 0.001) displacement of the canal centres, so roots in the Lightspeed group remained better centred than those in the step-back group. The mean cross-sectional area after preparation in the Lightspeed group was significantly less (P < 0.001) than that recorded in the step-back group. Clinically, this implies less apical transportation and less dentine destruction with the Lightspeed technique than with the step-back technique.

Dental Instruments↗
PubMed1998

A teaching model for endodontic surgery.

It is often difficult to achieve realistic simulation in teaching endodontic surgery. There is relatively little material available to students other than animal tissue or human cadavers. We propose a working model for the teaching of this discipline, constructed from casts of a natural skull which reproduce anatomical features such as gingiva, maxillary sinus, or mandibular canal, for example. This model, made of polyurethane resin containing mineral particles, which closely simulates the radiological and tactile differences of the relative densities of spongy bone, cortical bone and teeth, permits close simulation of the conditions under which endodontic surgery may be performed.

Education, Dental↗
PubMed1998

Effect of calcium hydroxide as an intracanal dressing on apical leakage.

In this in vitro study, we investigated the effects of the use of two different calcium hydroxide (Ca(OH)2) preparations as an intracanal dressing on the sealing ability of two different sealers were investigated. Eighty-eight freshly extracted, single-rooted maxillary anterior teeth were used. After the root canals were hand-instrumented, they were divided into six groups of 10 each. The root canals were dressed with Ca(OH)2 paste, either mixed with sterile water (in groups 1 and 2) or with glycerine (in groups 3 and 4). The dressed root canals were incubated in 100% humidity at 37 degrees C for 7 days. In groups 5 and 6, the root canals were not dressed. After the root canal dressings were removed by irrigation with 5.25% NaOCl and reaming with a K-type file, all canals of the experimental groups were obturated with sealer and gutta-percha using a cold lateral condensation technique. Calciobiotric Root Canal Sealer, (CRCS), (in groups 1, 3 and 5) and Diaket (in groups 2, 4 and 6) were used as sealers. All specimens were placed in India ink for 7 days, and the amount of apical leakage was scored. Eight further prepared specimens were dressed with Ca(OH)2 plus water or Ca(OH)2 plus glycerine and examined with scanning electron microscopy (SEM) following the removal of dressings. There was a statistical difference in the leakage patterns amongst the 6 experimental groups (P < 0.05). Specimens in group 2 exhibited less leakage than the other experimental groups, except group 4 (P < 0.05). There were no other significant interactions. SEM examination revealed that Ca(OH)2 crystals were present on the surface of smear layer in both groups where Ca(OH)2 paste had been placed, but they did not penetrate into the dentinal tubules.

Analysis of Variance↗
PubMed1998

Shaping ability of Quantec Series 2000 rotary nickel-titanium instruments in simulated root canals: Part 1.

The aim of this study was to determine the shaping ability of Quantec Series 2000 nickel-titanium instruments in simulated canals. A total of 40 simulated root canals made up of four different shapes in terms of angle and position of curvature were prepared by Quantec instruments using the technique recommended by the manufacturer. Part 1 of this two-part report describes the efficacy of the instruments in terms of preparation time, instrument failure, canal blockages, change in canal length and three-dimensional canal form. The time necessary for canal preparation was on average 5.7 min and was significantly influenced (P < 0.01) by canal shape. One instrument fractured and three size nine instruments deformed; however, canal shape did not influence significantly instrument failure. All of the canals remained patent, none became blocked with debris. The majority of the canals maintained working distance (26 out of 40), however the mean change in length differed significantly (P < 0.05) between canal types. Overall, canals with 40 degrees curves lost length whilst those with 20 degrees curves gained in length. Examination of intracanal impressions revealed that preparation with Quantec Series 2000 instruments produced canals with definite apical stops, smooth canal walls and good flow and taper. However, the quality of apical smoothness and flow was influenced significantly (P < 0.0001) by canal shape with specimens having 40 degrees canals displaying less desirable qualities. Under the conditions of this study, Quantec Series 2000 rotary nickel-titanium instruments prepared simulated canals rapidly, safely and with good three-dimensional form.

Dental Instruments↗