Virtual dental expo

Check Page Ranking

Home
Dental tourism
Conferences
Dental books
Bad breath
Kids caries
Smoking effects
Patient info
Dental Videos
Wisdom tooth
Diabetes
Drugs of choice
Endo tips    Better Endo    Endo abstracts    Endo discussions

The opinions within this web page are not ours. Authors have been given due credit

Roots Digest 2

From: kendo To: ROOTS Sent: Monday, July 06, 2009 3:32 AM Subject: [roots] Uh oh.........the smell of napalm Part 2 Continued from Page 1
Fig 4a Panel of anatomic preparations from the classic work by Professor Walter Hess of Zurich The Anatomy of the root canals of teeth of the permanent dentition, London, 1925, John Bale, Sons & Danielsson.
Fig 4b - Vertucci FJ 1984.Two thousand four hundred human permanent teeth were decalcified, injected with dye, and cleared in order to determine the number of root canals and their different morphology, the ramifications of the main root canals, the location of apical foramena and transverse anastomoses, and the frequency of apical deltas
Table I and II derived from Antibiotics and the Treatment of Endodontic Infections Summer 2006 American Association of Endodontics Colleagues for Excellence

Figs 5a, 5b Flat field sensors provide a sense of the extent of osseous pathology; however, the periapical radiographic image corresponds to a two-dimensional aspect of a three dimensional structure. Periapical lesions confined within the cancellous bone are usually not detected. Thus a lesion of a certain size can be detected in a region covered by a thin cortex, whereas the same size lesion cannot be detected in a region covered by thicker cortex
Fig 6 All cone beam tomography units provide correlated axial, coronal and sagittal multiplanar volume reformations. Basic enhancements include zoom or magnification and visual adjustments to narrow the range of grey-scale, in addition to the capability to add annotation and cursor-driven measurement.
Fig 7 Strategic extension of the access perimeter is too often undervalued in terms of successful endodontic treatment outcomes. The shape of the chamber must be regressed to its native state to ensure that axial interference is negated as an instrument traverses the length of the root canal space.
Fig 8a Dystrophic calcification confounds even the most experienced clinician. The key to identification of the orifices is to regress the inner space using the continuum, cusp tip, pulp horn, canal orifice. In lieu of an ultrasonic tip which tends to chop the stone and scatter debris, gross removal is best done with a diamond bur in a high speed handpiece. The fine removal of residue can be done with a multi-fluted carbide bur to trace the fusion lines
Fig 8b Keeping the chamber wet with alcohol improves optics and highlights colour differential. The most important tool for orifice identification in addition to dyes is a micro-etcher. The satin finish produced highlights the disparity between the natural tooth structure of the floor and the secondary and tertiary dentin of the calcified orifice.
Fig 9 Micro-etching ensures the removal of oils and debris as well as eliminating the residue in fusion lines and fissures. Routine dentin bonding is then performed. The composite chosen in this instance is Permaflo® Purple (UPI, South Jordan, UT) which enables differentiation of restoration and tooth structure should re-entry be necessary.
Fig 10 A vast array of equipment exists in the marketplace to optimize irrigation protocols. Radical change may well be in the offing, however, R&D on bio-active obturating materials may prove to be the defining variable in total asepsis.
Fig 11 Numerous investigators have shown that the concept of keeping the apical foramen foramen as small as practical does not mean a size 20 or 25 file. This Schilderian concept should read as small as the apical morphology permits in order to ensure that the free flow of irrigant to the apical terminus enables more definitive cleaning of the apical segment of the root canal space.
Fig 12 The artist/clinician recognizes that negative space surrounding an object is equally important as the object itself. In the case of root canal therapy, the positive space is alterable, but must be created in balance with the encompassing negative space to ensure morphologic integrity.
Contd....Page 3


References

1.  Farzaneh M, Abitbol S, Lawrence H, Friedman S. Treatment Outcome in Endodontics
    The Toronto Study. Phase II: Initial Treatment. J Endod 2004 May;30(5):302-309
2.  Bero L, Rennie D. The Cochrane Collaboration. Preparing, maintaining, and disseminating systematic reviews of
    the effects of health care. JAMA 1995 Dec;274(24): 1935-1938
3.  Salehrabi R, Rotstein I. Endodontic treatment outcomes in a large patient population in the USA: an epidemiological
    study. J Endod 2004 Dec;30(12):846-50
4.  Cagidiaco MC, García-Godoy F, et al. Placement of fiber prefabricated or custom made posts affects the 3-year survival
    of endodontically treated premolars. Am J Dent 2008 Jun;21(3):179-84
5.  Dietschi D, Duc O, Krejci I, Sadan A. Biomechanical considerations for the restoration of endodontically treated teeth:
    a systematic review of the literature, Part II (Evaluation of fatigue behavior, interfaces, and in vivo studies).
    Quintessence Int 2008 Feb;39(2):117-29
6.  Aquilino SA, Caplan DJ. Relationship between crown placement and the survival of endodontically treated teeth.
    J Prosthet Dent  2002 Mar;87(3):256-63
7.  Dorn SO, Moodnik RM, Feldman MJ, Borden BG. Treatment of the endodontic emergencies: A report on a questionnaire.
    Part I. J Endod 1977;3:94 100
8.  Gatewood RS, Himel VT, Dorn SO. Treatment of the endodontic emergency: A decade later. J Endod 1990;16:284 91
9.  Siqueira, J F. Endodontic infections: Concepts, paradigms, and perspectives.
    OS, OM, OP, OR & Endo Sept 2002;94(3):281-293
10.Siqueira JF Jr, Guimarães-Pinto T, Rôças IN. Effects of chemomechanical preparation with 2.5% sodium hypochlorite and
    intracanal medication with calcium hydroxide on cultivable bacteria in infected root canals.
    J Endod. 2007 Jul;33(7):800-5
11.Baumgartner JC, Hutter JW, Siqueira JF. Endodontic Microbiology and Treatment of Infections.
    In: Cohen S, Hargreaves KM, editors. Pathways of the Pulp. Ninth ed. St. Louis: Mosby; 2006
12.Baumgartner JC, Xia T. Antibiotic susceptibility of bacteria associated with endodontic abscesses.
    J Endod 2003;29(1):44-47
13.Khemaleelakul S, Baumgartner JC, Pruksakorn S. Identification of bacteria in acute endodontic infections and their
    antimicrobial susceptibility. Oral Surg Oral Med Oral Pathol 2002;94(6):746-55
14.Grondahl H-G, Huumonen S.  Radiographic manifestation of periapical inflammatory lesions.
    Endodontic Topics 2004;8:55-67
15.Scarfe WC, Farman AG, Sukovic P.  Clinical applications of cone-beam computed tomography in dental practice.
    JCDA 2006;72:75-80
16.Pinksy HM et al.  Accuracy of three-dimensional measurements using cone-beam CT.
    Dentomaxillofacial Radiology 2006;35:410-6
17.Iwai et al. Estimation of effective dose from limited cone beam x-ray CT examination.
    Dental Radiology (Japanese) 2001;50:251-9
18.Patel S, Dawood A, Whaites E, Pitt Ford T. The potential applications of cone beam computed tomography in the
    management of endodontic problems. Int EndoJournal 2007;40:818-30
19.Estrela C. Accuracy of Cone Beam Computed Tomography and Panoramic and Periapical Radiography for Detection of
    Apical Periodontitis. J Endo 2008;34(3):273-279
20.Simon JHS, Enciso R, Malfaz JM, Rogers R, Bailey-Perry M, Patel A. Differential diagnosis of large periapical
    lesions using cone-beam computed tomography measurements and biopsy. J Endod 2006;32:833 7
21.Iqbal MK, Johansson AA, Akeel RF, Bergenholtz A, Omar R. A retrospective analysis
    of factors associated with the periapical status of restored, endodontically treated
    teeth.  Int J Prosthodont 2003;16:31 8
22.Siqueira JF Jr, Rocas IN, Favieri A, Abad EC, Castro AJ, Gahyva SM. Bacterial leakage
    in coronally unsealed root canals obturated with 3 different techniques. Oral Surg
    Oral Med Oral Pathol Oral Radiol Endod 2000;90:647 50
23.Schwartz RS, Fransman R. Adhesive Dentistry and Endodontics: Materials, Clinical Strategies and Procedures for
    Restoration of Access Cavities: A Review. J Endod March 2005;(31)3:151-165
24.Zehnder M, Kosicki D, et al. Tissue-dissolving capacity and antibacterial effect of buffered and unbuffered
    hypochlorite solutions. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology & Endodontics;(94):756-762
25.Sjogren U, Figdor D, Persson S, Sundqvist G. Influence of Infection at the time of root filling on the outcome of
    endodontic treatment of teeth with apical periodontitis. Int Endo Journal Sept 1997;(30)5:297-306
26.Siqueira JF, Rôças IN, et al. Chemomechanical Reduction of the Bacterial Population in the Root Canal after
    Instrumentation and Irrigation with 1%, 2.5%, and 5.25% Sodium Hypochlorite. J EndodonJune 2000;(26)6:331-334
27.Torabinejad M, Cho Y, Khademi AA, Bakland LK, Shabahang S. The effect of various concentrations of sodium
    hypochlorite on the ability of MTAD to remove the smear layer. J Endod 2003;(29):233 239
28.Siqueira JF Jr, Rocas IN, Santos SR, Lima KC, Magalhaes FA, de Uzeda M. Efficacy of instrumentation techniques and
    irrigation regimens in reducing the bacterial population within root canals. J Endod 2002;28:181 184
29.Niu W, Yoshioka T, Kobayashi C, Suda H. A scanning electron microscopic study of dentinal erosion by final irrigation
    with EDTA and NaOCl solutions. Int Endod J 2002;35:934–939
30.Lin LM, Rosenberg PA, Lin J. Do procedural errors cause endodontic treatment failure? JADA 2005;(136) 2:187-193
31.De-Deus G et al.  Dye extraction results on bacterial leakproof root fillings. J Endo Sept 2008;(34)9:1093-5
32.Barthel CR, Moshonov J, Shuping G, Orstavik D. Bacterial leakage versus dye leakage in obturated root canals.
    Int Endod J 1999;32:370 5
33.Kersten HW, Moorer WR. Particles and molecules in endodontic leakage. Int Endod J 1989;22:118-24
34.Oliver CM, Abbott PV. Correlation between clinical success and apical dye penetration.
    Int Endod J 2001;34:637-44
35.Paqué F, Sirtes G. Apical sealing ability of Resilon/Epiphany versus gutta-percha/AHPlus: immediate and 16-months
    leakage. Int Endod J. 2007 Sep;40(9):722-9
36.Cruse WP, Bellizzi R. A historic review of endodontics 1689-1963, Part I. J Endod,1980; 6:495-499
37.Blaney JR.  The biologic aspect of root canal therapy. Dental Items of Interest 1927;49:681-708
38.Schilder H. Filling root canals in three dimensions. Dental Clinics of North America 1967;723-44
39.Ingle H: Endodontics, ed 5, Hamilton, London, 2002 BC Decker
40.Wu MK, Fan B, Wesselink PF. Leakage along apical root fillings in curved root canals. I.
    Effects of apical transportation on seal of root fillings J Endodon 2000;(26):210
41.Siqueira JF Jr. Aetiology of the endodontic failure: why well-treated teeth can fail. Int Endod J 2001;34:110
42.Roggendorf et al. Bacterial leakage in filled root canals using four root canal sealers. IEJ Dec 2007;40(2):
    Abstract R3.86
43.Roedl et al. Bond strength to root canal dentine following different irrigation protocols using a new testing method.
    IEJ Dec 2007;(40)12:Abstract R3.66
44.Raina R et al. Evaluation of the Quality of the Apical Seal in Resilon/Epiphany and Gutta-Percha/AH Plus filled
    Root Canals by Using a Fluid Filtration Approach J Endod;(33)8:944-47
45.Teixeira FB, et al.  Fracture resistance of roots endodontically treated with a new resin filling material.
    JADA 2004;(135)5:646-652
46.Sly MM, Moore BK, Platt JA, Brown CE.  Push-out bond strength of a new endodontic obturation system
    (Resilon/Epiphany). J Endod. 2007 Feb;33(2):160-2
47.Williams C, Loushine R et al. A Comparison of Cohesive Strength and Stiffness of Resilon and Gutta-Percha.
    J Endod 2006;(32)6:553-5
48.Tay F, Loushine R et al. Ultrastructural Evaluation of the Apical Seal in Roots Filled with a Polycaprolactone-Based
    Root Canal Filling Material. J Endod 2005;(31)7:514-19
49.Kapalas A, Lambrianidis T. Factors associated with root canal ledging during instrumentation.
    Endod Dent Traumatol 2000;16:220–231
50.Souza, RA. Clinical and radiographic evaluation of the relation between the apical limit of root canal filling and
    success in Endodontics. Part 1 Braz Endod J 1998;3:43-48
51.AL-Omari MAO, Dummer PM. Canal blockage and debris extrusion with eight preparation techniques.
    J Endod 1995;21:154-158
52.McKendry DJ. Comparison of balanced forces, endosonic, and step-back filing instrumentation techniques:
    quantification of extruded apical debris. J Endod Jan 1990;16(1):24-7
53.Mullaney TP. Instrumentation of finely curved canals. Dent Clin North Am 1979;23:575 92
54.Morgan LF, Montgomery S. An evaluation of the crown-down pressureless technique. J Endod 1984;10:491 8
55.M. Al-Omari, P. Dummer. Canal blockage and debris extrusion with eight preparation techniques.
    J Endod 2006;21(3):154-158
56.P. Hankins, M. ElDeeb/ An evaluation of the canal master, balanced-force, and step-back techniques.
    J Endod 1996;22(3):123-130
57.Siqueira J, Araújo M, Garcia P, Fraga R, Dantas C. Histological evaluation of the effectiveness of five
    instrumentation techniques for cleaning the apical third of root canals. J Endod 1997;23(8): 499-502
58.Serota KS et al. Predictable endodontic success:  The apical control zone. Dentistry Today May 2003;(22)5:90-7
59.Peters OA, Peters C, et al. ProTaper rotary root canal preparation: effects of canal anatomy on final shape
    analysed by micro CT. Int Endo J February 2003;(36)2:86-92
60.Becker W. Immediate implant placement: Diagnosis, treatment planning and treatment steps for successful outcomes.
    J Calif Dent Assoc 2002;33:303-310
Toughest root canal

Retricted mouth opening

Deep decay

Upper second molar

Open sinus lift

Implant after extraction

Implant # 20

Implant # 30

Irreversible pulpitis

2 step necrotic case

Fracture

Lesion on MB

Endo perio case

Surgery or implant

Silver point removal

Series of cases

SS reamers and files

Single visit RCT

Ortho resorption

Apico retreatment

Apical perforation

Funky canine

Crown preparation

Two tough molars

Epiphany recall

To squirt or not

Core distal end

MTA miracles

Pain with LR

Instrument removal

3 canals upper Bi

Acute pain

Dental decay

Calcified chamber

Mandibular first molar

Ultrasonic activation

Fluorosis

TF and patency

Interim dressing

Huge lesion

Tough distal canal

Debris in pulp chamber

Access and success

Restricted mouth opening

Broken drill fragment

MB2 or lateral

Gutta percha cases

Another calcified

Big Perf

Canals and exit

Dam abuse

Amalgam replacement

Simple MTA case

MTA barrier

Restoration with simile

Immediate implant

Traumatic accident

Lesion on D root

Extract / Implant

Carious exposure