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[Evaluation of the height of the apical delta of maxillary anterior teeth. Surgical significance].

It's a study dealing with the apical delta position in the management of peri-apical lesions. The study was carried out from the observation of root canal systems of 150 teeth mainly central, lateral incisors and canines. The study has been bounded by the conservative dentistry and oral surgery departments of the UCAD Dental Institute. It lasted from February to November 2001. We noted that the maximal height of the apical deltas comparison to the apices is 1.6 mm. So, the height of 3 mm section proposed by MEYER during the apicectomies is enough to eliminate the major part of the accessory canals.

Apicoectomy↗

The use of mineral trioxide aggregate to create an apical stop in previously traumatized adult tooth with blunderbuss canal. Case report.

The case presented here demonstrates an alternative to conventional treatments in managing a non-vital blunderbuss canal. The use of MTA (mineral trioxide aggregate) to establish an apical stop allows for expedient completion of root canal therapy with predictable results. Following root canal therapy, non-vital bleaching techniques may be employed, offering a means of restoring the tooth to its natural shade without the need for additional tooth preparation. Surgery is avoided, and the technique can easily be followed by the general practitioner.

Adult↗

[Pitfalls to avoid in the cleaning and shaping of the pulp canal].

Chemomechanical instrumentation of the root canal system is without doubt the most important but most challenging part of endodontic treatment. The first essential in cleaning and shaping is gaining direct access to the root canals. A properly prepared endodontic access opening can eliminate many of the technical problems encountered in root canal treatment. Excessive calcification in the root canal system and performing root canal treatment through existing artificial crowns however can be a challenge for the clinician. Secondly, enlargement of a curved root canal often results in loss of working length, incomplete removal or extrusion of the root canal content and unwanted alterations in the canal shape, such as transportation (stripping, zipping, elbow formation), ledge formation and perforation. This article focuses on the causes and effects of procedural errors during root canal cleaning and shaping. Each of these complications is addressed in a manner designed to prevent problems rather than to manage them once they are recognized. Throughout the immense amount of literature published the last 30 years on this topic, concensus is obtained concerning the preferential procedure of cleaning and shaping the root canal.

Crowns↗

[110th year Nederlands Tijdschrift voor Tandheelkunde. 2. Root canal treatment, intra-canal disinfectants and bacterial culture: past and present].

Fifty years ago the Dutch Journal of Dentistry published methods and opinions concerning root canal treatment. Qualitative bacterial culture, inclusion of aggressive disinfectants, as well as antibiotics and widening of the apical constriction were carried out. Nowadays, because of several reasons, these are not clinical practice anymore. Controversy over the clinical consequences of bacterial presence in tubules and in the peri-apical area prevailed in the past and seem to be prevalent once again.

Dental Disinfectants↗

Facio-lingual width of the alveolar base.

Importance is attached to assessment of anterior facio-lingual maxillary and mandibular apical base widths in determining limits to incisor root movements. There is absence of similar assessment of facio-lingual base widths for premolars and molars. The aims of this paper are two-fold: to determine the strength of associations between the facio-lingual widths of the anterior and buccal alveolar apical bases, and to determine if an association might exist between the posterior alveolar base width and specific lateral cephalometric measurements. Comparative measurements were made on 40 adult Thai skulls and their companion mandibles using lateral cephalometric radiographs, linear tomography, and direct measurements of the dento-alveolar and basal structures. Wide variation was found in facio-lingual widths of the alveolar bases. No significant correlations were found between the facio-lingual widths of the anterior and posterior alveolar bases in the maxillae and mandible. Significant inverse correlations were found between the alveolar base widths at the mandibular incisors and the FP-MP and PP-MP angles, and between maxillary incisor base widths and the gonial angle. Importantly, no cephalometric indicators were found to predict posterior alveolar base widths. There is a need to continue to search for assessment indicators.

Adolescent↗

The effects of water and acetone-based dentin adhesives on apical microleakage.

In this study, the aim was to assess the in vitro apical microleakage of a resin-based sealer used with two different adhesives. Thirty nine freshly extracted maxillary incisors were used. The teeth were decoronated at the cemento-enamel junction with a water-cooled fissure bur. Chemo-mechanical debridement of the root canals was accomplished with the step-back technique. The smear layer was removed by 19% ethylenediamine tetra acetic acid (EDTA). The roots were then divided into three experimental groups of thirteen teeth in each. Specimens in group 1 were filled with gutta-percha, AH Plus sealer, and water-based adhesive system (Syntac Single Component). Group 2 specimens were filled with gutta-percha, AH Plus sealer, and acetone-based dentin adhesive (Prime & Bond NT ). Specimens of group 3 were filled with only gutta-percha and AH Plus sealer (no adhesive was applied). The teeth were immersed into 2% methylene blue solution. Apical sealing qualities were assessed by measuring the linear dye penetration with a stereomicroscope. Dentin tubule penetration was observed under scanning electron microscopy (SEM). Results showed no statistically significant difference between the materials used, however, the leakage in group 2 was less than group 1 and 3.

Acetone↗

[Initial clinic research on curved canal preparation by reverse flaring technique].

OBJECTIVE: Curved canal preparation is much difficult in root canal therapy(RCT). Step back technique and routine technique are still regular methods in curved canal preparation. The purpose of this study was to introduce a new method reverse flaring technique, and to investigate its preparation efficiency in intermediate-curvature canals. METHODS: 48 cases of lower first molars RCT were collected, which were first treated because of pulpitis or apical periodontitis in West China College of Stomatology, Sichuan University from Nov. 2001 to Aug. 2003, mesial canal curvature was intermediate (30 degrees-60 degrees), determined by Schineider method. Cases were divided into two groups, in reverse flaring technique group, canal preparation in 27 cases were finished by reverse flaring technique, 21 cases by step back technique as control. In working length determination and fitting master cone stages, cases in two groups which fit full working length were recorded, determined by radiograph, and analyzed by chi 2 test. RESULTS: In working length determination stage, cases which fit full working length in reverse flaring technique group were significantly more than that of step back technique group (P < 0.05), in fitting master cone stage, cases which fit full working length in reverse flaring technique group were also significantly more than that of step back technique group(P < 0.05). CONCLUSION: In working length determination stage, cases which fit full working length in reverse flaring technique group were significantly more than that of step back technique group (P < 0.05), in fitting master cone stage, cases which fit full working length in reverse flaring technique group were also significantly more than that of step back technique group(P < 0.05).

Adult↗

Current concepts in gutta-percha removal in endodontic retreatment.

Effective removal of gutta-percha (GP) in endodontic retreatment is a significant factor in creating successful outcomes from failed procedures. Ideally, gutta-percha removal must be efficient, not predispose the tooth to subsequent failure through iatrogenic events, and clean the existing canals so that subsequent irrigants can effectively and biomechanically cleanse the root canal system. All things being equal, it is recommended that GP be removed without solvents in the coronal two-thirds of canals as much as possible and with solvents in the apical third. Rotary nickel titanium files and the SystemB heat source (SybronEndo, Orange, CA) are significant adjuncts in effective GP removal.

Chloroform↗