scholarly journals Outcome of Root Canal Treatment of Necrotic Teeth with Apical Periodontitis Filled with a Bioceramic-Based Sealer

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Kawther Bel Haj Salah ◽  
Sabra Jaâfoura ◽  
Mahdi tlili ◽  
Marwa Ben Ameur ◽  
Saida Sahtout
Keyword(s):  
Treatment Group ◽  
Root Canal ◽  
Apical Periodontitis ◽  
Root Canal Treatment ◽  
Inclusion Criteria ◽  
Root Canal Filling ◽  
Radiographic Findings ◽  
Periapical Lesions ◽  
Single Cone

Introduction. Apical periodontitis is among the most common pathologies in endodontics. The treatment of apical periodontitis has always been an important occupation in the modern practice of endodontics, and the failure has been associated with nonhermetic root canal filling. With that in mind, bioceramic-based sealers have been incorporated into endodontic practice. The purpose of this study was to evaluate the outcome of nonsurgical root canal treatment (RCT), using a single-cone and Bioroot RCS filling of necrotic teeth with apical periodontitis. Materials and Methods. This follow-up study included patients treated in the department of Restorative Dentistry and Endodontics in the Dental Clinic of Monastir, from January 2018 to December 2019. The study intended to include all adult patients presenting a symptomatic or asymptomatic apical periodontitis. Once the diagnosis was performed, the patients were divided into two groups: a one-session treatment group and a two-session treatment group. All cases were obtured with BioRoot using a single-cone technique with a minimum of a 6-month recall. At 6-month follow-ups, teeth were classified as healed, healing (success), or not healed (failure), based on clinical and radiographic findings. Results. Twelve patients met the inclusion criteria, six patients per group. Seven patients returned for follow-ups. At 6-month follow-ups, the overall success rate was 100%, with 57.1% determined to be “healed” and 42.8% determined to be “healing.” All the PAI scores decreased compared to the baseline situation. Conclusion. The results obtained showed the contribution of BioRoot RCS in the healing of periapical lesions. Accordingly, bioceramic-based sealers seem to optimize the prognosis of root canal treatments.

scholarly journals Healing of a tooth with an overinstrumented apex, extensive transportation and periapical lesion using a 5 mm calcium hydroxide apical plug: an 8-year follow-up report

2012 ◽  
Vol 23 (5) ◽  
pp. 608-611
Author(s):  
Ronaldo Araújo Souza ◽  
Yara T. Corrêa Silva-Sousa ◽  
Suely Colombo ◽  
Maurício Lago ◽  
Marco Antonio Hungaro Duarte ◽  
...  
Keyword(s):  
Calcium Hydroxide ◽  
Root Canal ◽  
Apical Periodontitis ◽  
Filling Material ◽  
Root Canal Filling ◽  
Apical Constriction ◽  
Gutta Percha ◽  
Open Apices ◽  
Canal Transportation

Besides the risk of filling material extrusion throughout the apex, a satisfactory apical seal can be difficult to achieve in canals with open apices or iatrogenic enlargements of the apical constriction. These situations pose a challenge to root canal filling. This paper describes the root canal filling of a maxillary right canine with an overinstrumented apex, complete loss of the apical stop, extensive canal transportation and apical periodontitis. A 5 mm calcium hydroxide apical plug was placed before root canal filling. The plug was made by soaking paper points with saline, dipping the points in calcium hydroxide powder and then applying it to the apex several times, until a consistent apical plug was obtained. The canal was then irrigated with saline in order to remove any residual calcium hydroxide from the root canal walls, dried with paper points and obturated with an inverted #80 gutta-percha cone and zinc oxide-eugenol based sealer by the lateral condensation technique. An 8-year radiographic follow-up showed formation of mineralized tissue sealing the apical foramen, apical remodeling and no signs of apical periodontitis.

Application of High-Frequency Conduction for Persistent Apical Periodontitis: A Case Report

2021 ◽  
Vol 7 (4) ◽  
Author(s):  
Toshihiko Tominaga ◽  
◽  
Eiichiro Tada ◽  
Kazuki Takahira ◽  
Tsutomu Sugaya ◽  
...  
Keyword(s):  
Root Canal ◽  
High Frequency ◽  
Root Resorption ◽  
Root Surface ◽  
Apical Periodontitis ◽  
Root Canal Filling ◽  
Tissue Inflammation ◽  
External Root Resorption ◽  
Ultrasonic Irrigation

We report the case of a 39-year-old male with Persistent Apical Periodontitis (PAP) caused by infection in an uninstrumented area, wherein conventional chemical root canal treatment is not possible, which was sterilized via highfrequency conduction. He underwent root canal filling after multiple endodontic treatments for tooth #4. As symptoms recurred, he was referred to our department with the chief complaint of dull pain during mastication. Present symptoms were percussion pain of the tooth, buccal mucosa swelling at the apical portion, and grade 1 mobility. Radiography revealed inadequate root canal filling. A radiolucent image 5×6 mm in diameter and with an unclear boundary was observed around the apex. External root resorption was mainly observed in the apical foramen, with a crown root ratio of approximately 1:1. Using 6% sodium hypochlorite under dental microscopy, chemomechanical root canal preparation was performed. Passive ultrasonic irrigation and calcium hydroxide application were conducted three times; however, periapical tissue inflammation did not subside. Therefore, the patient was diagnosed with PAP, and the uninstrumented area was sterilized via high-frequency conduction. High-frequency currents were applied to the apex, root surface, and periapical lesion at 500 kHz and 90 V; periapical tissue inflammation resolved after 2 weeks. Subsequently, the root canal was filled. Follow-up radiography revealed a bone regeneration-like image at 2 months. Bone defects healed at 11 months. Although surgical endodontic therapy is conventionally performed in PAP patients, high-frequency conduction could be a minimally invasive nonsurgical endodontic treatment option for uninstrumented areas in PAP patients.

scholarly journals Common Operative Procedural Errors and Clinical Factors Associated with Root Canal Treatment

2017 ◽  
Vol 28 (2) ◽  
pp. 179-190 ◽  
Author(s):  
Carlos Estrela ◽  
Jesus Djalma Pécora ◽  
Cyntia R.A. Estrela ◽  
Orlando A. Guedes ◽  
Brunno S.F. Silva ◽  
...  
Keyword(s):  
Root Canal ◽  
Tooth Loss ◽  
Operative Procedure ◽  
Disease Diagnosis ◽  
Root Canal Treatment ◽  
Clinical Factors ◽  
Endodontically Treated Teeth ◽  
Root Canal Filling ◽  
Factors Associated

Abstract Operative procedural errors must be well analyzed in order to avoid influence negatively the root canal treatment (RCT) prognosis. The successful RCT prevents tooth loss and avoids pain and apical periodontitis. This review aimed to categorize common operative procedure errors and clinical factors associated with RCT. Based on this, will be approached common errors of procedures within the clinical operative sequence: endodontic treatment planning, pulp and periapical disease diagnosis, anaesthesia, access cavity preparation, isolation with rubber dam, root canal preparation, root canal filling and retreatment, restoration of endodontically treated teeth, postoperative pain, follow up of endodontically treated teeth. The professional must remind that in each phase of RCT an operative error may have adverse implication on prognosis, and these errors characterize risk factors to failure. The knowledge of probable operative procedural errors and its consequences are essentials to avoid future problems to the tooth health.

scholarly journals Perawatan saluran akar pada gigi molar pertama kanan mandibula dengan pulpitis ireversibel simtomatikRoot canal treatment of mandibular right first molar with symptomatic irreversible pulpitis

2021 ◽  
Vol 32 (3) ◽  
pp. 127
Author(s):  
Lydiawati Wibisono ◽  
Hendra Dian Adhita Dharsono
Keyword(s):  
Case Report ◽  
Root Canal ◽  
Root Canal Treatment ◽  
Spontaneous Pain ◽  
Root Canal Filling ◽  
Root Canals ◽  
Pulp Inflammation ◽  
Indirect Composite ◽  
Irreversible Pulpitis

Pendahuluan: Pulpitis ireversibel simtomatik ditandai dengan hipersensitivitas terhadap stimulus termal, yang menyebabkan nyeri spontan atau rasa sakit yang bertahan 30 detik atau lebih setelah stimulus dihilangkan, nyeri yang parah, persisten, dan sulit dilokalisir, dapat menjalar ke telinga, pelipis, mata atau leher. Kondisi pulpa yang terinflamasi tidak dapat kembali pulih dan perawatan saluran akar merupakan pilihan perawatan. Tujuan laporan kasus ini membahas mengenai perawatan saluran akar dengan pulpitis ireversibel simtomatik untuk menghentikan inflamasi pulpa dan mempertahan gigi. Laporan kasus: Pasien laki-laki berusia 35 tahun datang ke klinik dengan keluhan gigi belakang kanan bawah terasa sakit berdenyut sejak 1 minggu yang lalu. Gigi tersebut pernah dilakukan penambalan sementara 4 bulan sebelumnya dan tambalan tersebut patah serta nyeri spontan. Pemeriksaan radiologis gigi 46 menunjukkan gambaran radiolusen pada bagian mahkota hingga mencapai tanduk pulpa, terdapat 2 akar, dengan akar mesial dilaserasi ke arah distal dan akar distal lurus, serta saluran akar yang menghilang pada 2/3 dan 1/3 saluran akar distal dan mesial, tidak terdapat pelebaran membran periodontal, lamina dura normal dan tidak terdapat kelainan periapikal. Gigi 46 dilakukan anestesi lokal, dilanjutkan pembukaan akses dan ekstirpasi pulpa, kemudian preparasi saluran akar menggunakan nikel titanium rotary ProTaper Next® (Maillefer, Switzerland) dengan teknik crown down dan pengisian saluran akar. Restorasi follow up overlay komposit indirek pada gigi 46. Simpulan: Pulpitis ireversibel simtomatik pada gigi molar dengan akar dilaserasi terbukti dapat ditangani dengan perawatan saluran akar yang adekuat, ditandai dengan hilangnya keluhan pada pasien dalam kasus ini.Kata kunci: Pulpitis ireversibel simtomatik, perawatan saluran akar, teknik crown down. ABSTRACTIntroduction: Symptomatic irreversible pulpitis is characterised by hypersensitivity to the thermal stimuli, which causes spontaneous pain that lasts 30 seconds or more after the stimulus removed, severe, persistent and difficult to localise, can radiate to the ears, temples, eyes, or neck. The inflamed pulp does not recover; thus, root canal treatment is the treatment option. This case report was aimed to discuss the root canal treatment for symptomatic irreversible pulpitis to stop the pulp inflammation and preserve the teeth. Case report: A 35-year-old male patient came to the clinic with complaints of pulsating pain in the mandibular right molar since one week prior. The tooth had a temporary filling four months earlier, and the filling was fractured, and the pain was spontaneous. Radiological examination of tooth 46 showed radiolucent images on the crown until the pulp horn, there were found two roots, with mesial roots dilated distally and straight distal roots, and root canals that disappeared in the two-third and one-third of the distal and mesial root canals, no dilation of the periodontal membrane, normal lamina dura and no periapical abnormalities. Tooth 46 was subjected to local anaesthesia, followed by access opening and pulp extirpation, then the root canal preparation was performed using the ProTaper Next® rotary nickel-titanium (Maillefer, Switzerland) with the crown-down technique and root canal filling. Indirect composite overlay follow-up restoration was conducted of tooth 46. Conclusion: Symptomatic irreversible pulpitis in molars with dilacerated roots proved to be manageable with adequate root canal treatment, marked by the loss of the patients’ complaints.Keywords: Symptomatic irreversible pulpitis, root canal treatment, crown-down technique.

scholarly journals Influence of Two Root Canal Obturation Techniques with Resin Based Sealer to Enterococcus faecalis Penetration

2019 ◽  
Vol 1 (2) ◽  
pp. 55
Author(s):  
Aryadi Subrata ◽  
Anastasia Elsa Prahasti ◽  
Bernard Ongki Iskandar
Keyword(s):  
Enterococcus Faecalis ◽  
Root Canal ◽  
Root Canal Treatment ◽  
Root Canal Filling ◽  
Gutta Percha ◽  
Single Cone ◽  
Ah Plus ◽  
Bacterial Leakage ◽  
Warm Vertical Compaction

Introduction: Root canal treatment is done to maintain the teeth to last as long as possible in the oral cavity. This can be done with three main stages, such as biomechanical preparation, sterilization and root canal filling. The hermetic seal of root canal filling has an important role in the success of root canal treatment. Objective: The aim of this in-vitro study is to compare the microbial leakage of root canals filled with RealSeal sealer/Resilon Points and AH Plus sealer/conventional gutta-percha points using single cone obturation technique and warm vertical compaction technique. Methods: Thirty-two extracted human mandibular premolars with single canals were decoronated to a standardized root length of 15 mm and prepared using crown-down technique to a master apical file size 30/.09. Teeth were divided into four experimental groups (n = 7 each group) and controls (n = 1 each group). Teeth in the first group were obturated using single master gutta percha cone and AH Plus sealer and second group were obturated with single Resilon gutta percha cone using RealSeal sealer. Third experimental group was filled with warm vertical condensed gutta-percha using AH Plus sealer and fourth group was filled with warm vertical condensed Resilon gutta-percha using RealSeal sealer. The coronal chamber of each sample were inoculated with Enterococcus faecalis. Results: There were no significant differences between the four experimental groups (P = 0.182). The differences occurred only in the survival time from each group. Group 4 (Warm Vertical Condensation - RealSeal) has the lowest leakage rate among other groups and the fastest leakage occurred in group 1 (Single Cone - AH Plus). Conclusion: The single-cone techniques does not insure durable apical seal against bacterial leakage. Warm vertical compaction technique using Resilon gutta-percha and RealSeal sealer appears to be more effective in minimizing bacterial leakage than gutta-percha and AH Plus sealer.

scholarly journals Influence of Two Root Canal Obturation Techniques with Resin Based Sealer to Enterococcus faecalis Penetration

2019 ◽  
Vol 2 (1) ◽  
pp. 21
Author(s):  
Aryadi Subrata ◽  
Anastasia Elsa Prahasti ◽  
Bernard Ongki Iskandar
Keyword(s):  
Enterococcus Faecalis ◽  
Root Canal ◽  
Root Canal Treatment ◽  
Root Canal Filling ◽  
Gutta Percha ◽  
Single Cone ◽  
Ah Plus ◽  
Bacterial Leakage ◽  
Warm Vertical Compaction

  Introduction: Root canal treatment is done to maintain the teeth to last as long as possible in the oral cavity. This can be done with three main stages, such as biomechanical preparation, sterilization and root canal filling. The hermetic seal of root canal filling has an important role in the success of root canal treatment.   Objective: The aim of this in-vitro study is to compare the microbial leakage of root canals filled with RealSeal sealer/Resilon Points and AH Plus sealer/conventional gutta-percha points using single cone obturation technique and warm vertical compaction technique.   Methods: Thirty-two extracted human mandibular premolars with single canals were decoronated to a standardized root length of 15 mm and prepared using crown-down technique to a master apical file size 30/.09. Teeth were divided into four experimental groups (n = 7 each group) and controls (n = 1 each group). Teeth in the first group were obturated using single master gutta percha cone and AH Plus sealer and second group were obturated with single Resilon gutta percha cone using RealSeal sealer. Third experimental group was filled with warm vertical condensed gutta-percha using AH Plus sealer and fourth group was filled with warm vertical condensed Resilon gutta-percha using RealSeal sealer. The coronal chamber of each sample were inoculated with Enterococcus faecalis.   Results: There were no significant differences between the four experimental groups (P = 0.182). The differences occurred only in the survival time from each group. Group 4 (Warm Vertical Condensation - RealSeal) has the lowest leakage rate among other groups and the fastest leakage occurred in group 1 (Single Cone - AH Plus).   Conclusion: The single-cone techniques does not insure durable apical seal against bacterial leakage. Warm vertical compaction technique using Resilon gutta-percha and RealSeal sealer appears to be more effective in minimizing bacterial leakage than gutta-percha and AH Plus sealer.

scholarly journals Root Canal Treatment of Mandibular Second Premolars with Three Root Canals-Report of Four Rare Cases

2020 ◽  
Vol 24 (1) ◽  
pp. 49-52
Author(s):  
Ioannis Molyvdas ◽  
Anna Digka ◽  
Georgios Mikrogeorgis
Keyword(s):  
Root Canal ◽  
Root Canal Treatment ◽  
Periapical Lesions ◽  
Root Canals ◽  
Gutta Percha ◽  
Complex Anatomy ◽  
Present Complex ◽  
Working Length ◽  
Periapical Healing

SummaryBackground/Aim: The aim of root canal treatment is the thorough cleaning, shaping and obturation of the root canals. Variations in root canal anatomy increase the difficulty of the root canal treatment and therefore the possibility of failure. The mandibular premolars often present complex anatomy and the existence of mandibular second premolars with three root canals is very scarce. This report presents the successful endodontic management of four mandibular second premolars with three root canals.Cases Report: In all cases working length was estimated using the working length radiograph and an apex locator. Canal orifices were enlarged with Gates-Glidden drills and manual instrumentation performed with Stainless Steel reamers and Hedstroem files, using either step-back or crown-down technique. Sodium hypochlorite (NaOCl) 2.5% was used as an irrigant. Root canal obturation were then performed using the cold lateral condensation technique with gutta-percha points and Roth’s 801 canal sealer. The cases were scheduled for clinical and radiographic follow-up examination. Clinically in all follow-up examinations the teeth were asymptomatic. For the three cases with periapical lesions, post treatment radiographs, demonstrated periapical healing. Additionally, in the case without periapical lesion, the 9 months recall radiograph revealed healthy periapical conditions.Conclusions: Mandibular premolars should never be underestimated and the clinician should always be alerted for anatomic variations.

scholarly journals NON-SURGICAL MANAGEMENT OF A LARGE CYSTIC LESION WITH SURGICAL DECOMPRESSION: A CASE REPORT WITH 14 MONTHS FOLLOW UP

2021 ◽  
Vol 9 (02) ◽  
pp. 265-272
Author(s):  
Shwetank Shrivastava ◽  
◽  
Ashish K. Jain ◽  
Rahul D. Rao ◽  
Meenakshi Verma ◽  
...  
Keyword(s):  
Case Report ◽  
Root Canal ◽  
Cystic Lesion ◽  
Case Reports ◽  
Root Canal Treatment ◽  
Cystic Lesions ◽  
Saline Irrigation ◽  
Periapical Lesions ◽  
Apical Surgery

The main aim of this case report was to report the clinical efficacy of decompression for treating large periapical lesions. Tooth with large periapical cystic lesions were treated with decompression after root canal treatment. A conventional decompression technique such as aspiration/irrigation technique was used in this case. An 18-G needle with a syringe was used to aspirate the cystic lesion. Two needles were then inserted into the lesion copious saline irrigation was delivered from 1 needle and until clear saline was expressed from the other. Complete enucleation and root-end surgery was not done in the case. Healed lesions or lesions in healing were observed after 14 months. On the basis of the presented case and published case reports regarding large periapical cystic lesions, conservative decompression may be used for certain cases before or in lieu of apical surgery. Decompression enables healing of large, persistent periapical lesions after root canal treatment.

Analysis of Root Canal Treated Primary Incisor After Trauma

2012 ◽  
Vol 36 (3) ◽  
pp. 257-262 ◽  
Author(s):  
PN Tannure ◽  
TKS Fidalgo ◽  
R Barcelos ◽  
LG Primo ◽  
LC Maia
Keyword(s):  
Root Canal ◽  
Root Resorption ◽  
Dental Trauma ◽  
Positive Association ◽  
Early Years ◽  
Root Canal Treatment ◽  
Traumatic Injuries ◽  
Periapical Lesions ◽  
Therapy Success

Background: The low number of clinical studies of traumatized teeth submitted to root canal treatment is completely out of proportion to the seriousness that dental trauma imposes on children in early years. Aim. This study evaluates the outcomes of root canal treatment (RCT) in traumatized primary incisors and identifies the predisposing factors associated with therapy success. Methods: This is a retrospective study conducted with all dental records of 704 patients who had one or more teeth with traumatic injuries. Patients with irreversible pulp changes in primary teeth leading to RCT with a 24 month follow-up met the inclusion criteria. Results: Twenty-five maxillary incisors of 17 children were evaluated. The children’s age at the time of therapy ranged from 24 to 72 months (mean 47.3). Pulp necrosis was the most common disorder (84.0%) and pre-operative periapical lesions were observed in 52.0%. Coronal discoloration was found in 48.0%. The roots were filled with ZOE paste (68.0%) or Guedes-Pinto paste (32.0%). Overall RCT success rate was 68.0%. The absence of pre-operative periapical lesions (p = 0.02) and pathological root resorption (p = 0.02) presented positive association with therapy success. Success was not associated to filling paste (p = 0.49), filling extent (p = 0.44), of discoloration (p = 0.39) nor the patients’ age (p = 0.59). Conclusions: RCT was considered successful in 68.0% of the cases at the 24 month follow-up. Failure of RCT in traumatized primary incisors was associated with pre-operatory periapical lesions and pathological root resorption. The filling paste, the filling extent and the patient’s age were unrelated with therapy success.

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