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Lasers in Medical Science Aug 2023This study aimed to evaluate the efficacy of Shock Wave Enhanced Emission Photoacoustic Streaming (SWEEPS) in the removal of remaining pulp tissue from the root canal...
The efficacy of a novel SWEEPS laser-activated irrigation compared to ultrasonic activation in the removal of pulp tissue from an isthmus area in the apical third of the root canal.
This study aimed to evaluate the efficacy of Shock Wave Enhanced Emission Photoacoustic Streaming (SWEEPS) in the removal of remaining pulp tissue from the root canal isthmus area in lower molars and compare it with ultrasonically activated irrigation (UAI) and conventional needle irrigation (NI). Forty-one lower molars with isthmuses between mesial canals were included in the study. The teeth were randomly distributed into experimental groups (n = 12/each) based on the final irrigation protocol (SWEEPS, UAI, or NI) and a control group (C) (n = 5). The traditional access cavity of the mesial part of each tooth was made in all samples. The mesial root canals in the experimental groups were instrumented with a Wave One Gold Primary (25/.07) file using 3% sodium hypochlorite (NaOCl) while the distal canal served as a control for the presence of pulp tissue. No treatment was performed in the C group. Sections from the isthmus region were processed for histopathology to measure the remaining pulp tissue (RPT). The results were analyzed using analysis of variance and the Kruskal-Wallis test (α = 0.05). There were no significant differences in the relative surface area of root canals and isthmus among the groups (p > 0.05). Samples in the SWEEPS group had significantly less RPT than UAI, NI, and C (p = 0.003, 0.014, 0.003, respectively). There were no significant differences between the UAI and NI (p = 0.583). SWEEPS was the most efficient in debridement of the root canal isthmus area. UAI and NI showed similar but lower efficiency.
Topics: Dental Pulp Cavity; Gold; Lasers; Root Canal Therapy; Ultrasonic Waves; Molar; Humans
PubMed: 37599293
DOI: 10.1007/s10103-023-03857-4 -
European Endodontic Journal Aug 2023To compare rotations to failure and tip separation length of a nickel-titanium (Ni-Ti) rotary in- strument within a simulated mesio-buccal canal of a mandibular molar...
OBJECTIVE
To compare rotations to failure and tip separation length of a nickel-titanium (Ni-Ti) rotary in- strument within a simulated mesio-buccal canal of a mandibular molar with a conventional or contracted endodontic cavity.
METHODS
Two identical lithium disilicate #30 crowns were milled. A conventional or contracted endodontic cavity was prepared. A custom glass tube was fabricated with taper and length replicating a mesio-buccal canal, including buccal and lingual curvature, and placed at the mesio-buccal orifice of each crown, held in a silicone mold. Instrumentation was simulated using 30/.04 Ni-Ti rotary files following manufacturer recommended 1.8 Nm torque and 500 RPM (n=20 per access type). Instrumentation was video recorded to determine time (sec- onds) and rotations to failure. The length of broken tips was measured. The experimental data were compared using a t-test (significance level 0.05). Stresses in the instruments were examined using finite element analysis.
RESULTS
Number of rotations to failure (mean±standard deviation) was 599±126 for conventional and 465±65 and for contracted access; tip separation lengths (mean±standard deviation) were 3.99±0.29 for conventional and 4.90±1.02 mm for contracted access. Number of rotations to failure and tip separation lengths were signifi- cantly different between the two access openings (p<0.001). Finite element analysis confirmed higher file curva- ture and accompanying higher stress levels with contracted access and the maximum stress further from the tip.
CONCLUSION
Within the limitations of this study, the contracted access caused earlier failure of the Ni-Ti in- strument with longer tip separation lengths than the conventional access due to higher stresses towards the middle section of the instrument. (EEJ-2022-11-143).
Topics: Root Canal Preparation; Dental Pulp Cavity; Nickel; Titanium
PubMed: 38219039
DOI: 10.14744/eej.2023.41033 -
BMC Oral Health Sep 2023This study aimed to assess the root canal morphology of primary molars using cone-beam computed tomography (CBCT).
BACKGROUND
This study aimed to assess the root canal morphology of primary molars using cone-beam computed tomography (CBCT).
METHODS
This cross-sectional study evaluated 60 maxillary and mandibular primary first and second molars on CBCT scans of patients retrieved from the archives of Hamadan School of Dentistry between 2018-2020. The teeth were evaluated regarding the number of roots and canals, canal type according to the Vertucci's classification, and root surface concavities. Data were analyzed descriptively and by independent t-test.
RESULTS
The most frequent number of canals and roots in the maxillary right and left first molars was 3 canals (60%) and 3 roots (80%). These values were 4 canals (80%) and 5 canals (50%) with 3 roots in the maxillary right and left second molars, respectively, 4 canals (100%) and 2 roots (50%), and 3 canals (60%) and 2 roots (50%) in mandibular right and left first molars, respectively, and 4 canals (92.3%) and 3 roots (61.5%) in mandibular right and left second molars. Vertucci's type IV was the most common canal type in mesial and distal canals, type I was the most common in mesiobuccal, mesiolingual, distobuccal, and distolingual, and types I and II were the most common in the palatal canal. The maximum and minimum concavities were noted in the buccal (26.7%) and mesial (8.3%) surfaces, respectively.
CONCLUSIONS
A wide variation exists in the number of roots and canals of maxillary and mandibular primary molars, which calls for further attention in treatment of such teeth.
Topics: Humans; Dental Pulp Cavity; Cross-Sectional Studies; Root Canal Therapy; Molar; Cone-Beam Computed Tomography
PubMed: 37749546
DOI: 10.1186/s12903-023-03414-z -
Journal of Endodontics Jan 2024This worldwide study examined the root and root canal characteristics of maxillary premolars and explored how demographic factors impact the outcomes. (Meta-Analysis)
Meta-Analysis
Worldwide Assessment of the Root and Root Canal Characteristics of Maxillary Premolars - A Multi-center Cone-beam Computed Tomography Cross-sectional Study With Meta-analysis.
INTRODUCTION
This worldwide study examined the root and root canal characteristics of maxillary premolars and explored how demographic factors impact the outcomes.
METHODS
Observers from 44 countries assessed 26,400 maxillary premolars using cone-beam computed tomography and employed a standardized screening method to gather data on multiple canal morphology and 3-rooted configuration (primary outcomes), as well as secondary outcomes related to root and root canal anatomies. Demographic factors such as ethnicity, sex, and age were collected for each participant. The intra- and inter-observer tests ensured observer reliability. Primary outcomes were represented as odds ratios and untransformed proportions accompanied by 95% confidence interval (CI) forest plots. Meta-analysis compared sub-groups and identified sources of heterogeneity (α = 5%).
RESULTS
The overall prevalence of multiple canal morphology in the first premolar was 93.5% (95% CI, 93.3%-94.7%), while in the second premolar, it was 49.7% (95% CI, 44.9%-54.6%). The proportion of 3-rooted configuration was 1.8% (95% CI, 1.4%-2.1%) in the first premolar and 0.4% (95% CI, 0.3%-0.5%) in the second. Asian countries generally displayed fewer roots and root canals, while European nations showed higher counts (P < .05). Males exhibited higher percentages and odds ratios for both outcomes in both premolars. Younger patients demonstrated lower percentages of multiple root canal morphologies (P < .05). Factors such as tooth side, voxel size and field-of-view did not influence the outcomes (P > .05).
CONCLUSIONS
The worldwide assessment of root and root canal characteristics of maxillary premolars has revealed a discernible influence of various factors such as tooth type, geographical region, ethnicity, sex, and age.
Topics: Male; Humans; Dental Pulp Cavity; Bicuspid; Cross-Sectional Studies; Reproducibility of Results; Tooth Root; Maxilla; Cone-Beam Computed Tomography; Multicenter Studies as Topic
PubMed: 37898333
DOI: 10.1016/j.joen.2023.10.009 -
Journal of Endodontics Nov 2023The controversial issue of whether the Archaea domain plays a role in endodontic infections is the focus of this systematic review with meta-analysis. The aim is to... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
The controversial issue of whether the Archaea domain plays a role in endodontic infections is the focus of this systematic review with meta-analysis. The aim is to emphasize the significance of minority microbial domains in oral dysbiosis by evaluating the prevalence of archaea in root canals and its association with clinical parameters such as symptomatology and type of endodontic infection.
METHODS
The search strategy involved researching 6 databases and the gray literature. Publications were accepted in any year or language that identified archaea in samples from endodontic canals. A 2-step selection process narrowed the final choice to 16 articles. The methodological quality of the studies was evaluated using tools from the Joanna Briggs Institute, and the certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach.
RESULTS
The results showed that archaea were present in 20% (95% [confidence interval] CI = 8%-32%) of individuals with endodontic samples analyzed. The samples were about twice as likely to be archaeal-positive if collected from individuals with primary vs. persistent/secondary infection (odds ratio = 2.33; 95% CI = 1.31-4.14; I = 0%), or individuals with self-reported vs. symptom-free infections (odds ratio = 2.67; 95% CI = 1.47-4.85; I = 0%). Methanogenic archaea were reported in 66% of the included studies. Representative members of phyla Thaumarchaeota and Crenarchaeota were also identified.
CONCLUSIONS
Archaea are present in about one-fifth of the infected root canals. Recognized biases in experimental approaches for researching archaea must be addressed to understand the prevalence and roles of archaea in endodontic infections, and to determine whether the decontamination process should include the elimination or neutralization of archaea from root canals (International Prospective Register of Systematic Reviews protocol = CRD42021264308).
Topics: Humans; Archaea; Dental Pulp Cavity; Dental Pulp Diseases; Dysbiosis
PubMed: 37544428
DOI: 10.1016/j.joen.2023.07.025 -
Journal of Clinical Medicine Dec 2023The distinction between where the pulp chamber ends and the root canal system begins is poorly defined within the existing literature.
BACKGROUND
The distinction between where the pulp chamber ends and the root canal system begins is poorly defined within the existing literature.
METHODS
This paper aimed to describe a range of accurate methods to define the transition from pulp chamber to root canal in different first molar root morphologies using micro-focus computed tomography (micro-CT).
METHODS
The sample consisted of 86 mandibular and 101 maxillary first molars from the skeletal collections housed in the Department of Anatomy and Histology of the Sefako Makgatho Health Sciences University and the Pretoria Bone Collection. A stepwise approach using the cemento-enamel junction (CEJ) and dedicated landmarks was followed to create an automated cross-sectional slice.
RESULTS
Transition from pulp chamber to root canal could be accurately determined on maxillary and mandibular teeth. The occurrence of two separate roots in mandibular molars was 97.7%, with the remaining 2.3% having an additional disto-lingual root, with no mandibular molars displaying fused roots. In the maxillary molars, 92.1% had three separate roots and 7.9% displayed root fusion. Within this group, one tooth displayed a C-shaped root canal configuration and one a mesotaurodont-type morphology.
CONCLUSION
The suggested methodology to determine orifice location was found to be appropriate in all morphological types.
PubMed: 38202078
DOI: 10.3390/jcm13010071 -
The Canadian Veterinary Journal = La... Feb 2024The study of the morphological parameters of teeth on dental radiographic images, especially evaluation of the pulp canal/root ratio (PCRR), has been presented as a...
BACKGROUND
The study of the morphological parameters of teeth on dental radiographic images, especially evaluation of the pulp canal/root ratio (PCRR), has been presented as a reliable method to estimate age both in humans and animals. Evaluating PCRR involves a simple, nondestructive procedure that can be used both in living individuals and in cadavers. There is a scarcity of studies assessing the relationship between PCRR and age in dogs .
OBJECTIVE
The aim of this study was to evaluate the relationship between PCRR and age in Yorkshire terrier dogs.
ANIMALS AND PROCEDURES
Dental radiographs of 53 Yorkshire terrier dogs from the database of the Odontovet Veterinary Dentistry Center (Brazil) were analyzed. Using ImageJ software, 3 consecutive measurements of the widths of 2 roots (mesial and distal) and their respective pulp canals were taken at both mandibular molar teeth (left, 309 and right, 409). The PCRR was then calculated using width means.
RESULTS
The PCRR decreased with increasing age in both mesial (0.21 ± 0.09 in animals aged < 24 mo, 0.12 ± 0.04 in animals aged between 25 and 96 mo, and 0.09 ± 0.03 in dogs aged > 96 mo) and distal (0.24 ± 0.11, 1.01 ± 0.03, and 0.09 ± 0.03, by the same order) roots. A statistically significant, moderate negative correlation was demonstrated between age and PCRR of the mesial [ (97) = -0.545; < 0.001] and distal [ (98) = -0.578; < 0.001] roots.
CONCLUSION AND CLINICAL RELEVANCE
This work contributes to the knowledge of PCRR in dogs and its relationship with age, paving the way for further studies using larger samples in different canine breeds.
Topics: Humans; Dogs; Animals; Dental Pulp Cavity; Tooth Root; Mandible; Molar
PubMed: 38304483
DOI: No ID Found -
BMC Oral Health Oct 2023This study was assessed the biocompatibility of three different root canal sealers (Well-Root St, GuttaFlow Bioseal, and AH-Plus) following implantation in rat...
OBJECTIVES
This study was assessed the biocompatibility of three different root canal sealers (Well-Root St, GuttaFlow Bioseal, and AH-Plus) following implantation in rat subcutaneous tissues, using histopathological immunohistochemical analysis.
METHODS
Four groups of eighty-four male rats each underwent subcutaneous dorsal implantation of a polyethylene tube, either empty or filled. Tissues were collected, fixed, and processed for histological analysis after 7, 15, and 30 d. Slides were photographed and digitally processed to identify lymphocytes and macrophages using Cluster of differentiation 3 (CD3) and cluster of differentiation 68 (CD68) markers, respectively. P was set at 0.05, when lymphocyte and macrophage infiltration was compared between groups and observation times using one-way analysis of variance (ANOVA).
RESULTS
Histopathological analysis of all groups revealed an inflammatory reaction followed by the emergence of a fibrous capsule after 7 days. After 30 days, the thickness of the fibrous capsule and the inflammatory response subsided. CD3 staining for immunohistochemical analysis revealed that the AH-Plus group had the highest mean percentage of lymphocyte infiltration at 7 and 15 days, followed by the Well-Root St, GuttaFlow Bioseal, and Control groups. After 30 days, no discernible difference was observed between the groups in terms of the mean percentage of lymphocyte infiltration. After 7, 15, and 30 days, there was a significant difference in the mean percentage of macrophage infiltration across the groups, as demonstrated by CD68 staining. After 7, 15, and 30 days, the AH-Plus group had the highest mean percentage of macrophage infiltration, followed by the Well-Root St. and GuttaFlow Bioseal groups, while the control group had the lowest mean percentage.
CONCLUSION
All observational periods showed minimal inflammatory reactions to GuttaFlow Bioseal. After subcutaneous tissue implantation in a rat model, the initial inflammatory reactions to Well-Root St and AH-Plus had abated by day 30, and all tested sealers had outstanding biocompatibility.
Topics: Animals; Male; Rats; Analysis of Variance; Dental Pulp Cavity; Drug Combinations; Gutta-Percha; Root Canal Filling Materials
PubMed: 37794396
DOI: 10.1186/s12903-023-03473-2 -
Journal of Endodontics Dec 2023This study aimed to assess the fracture resistance of mandibular first molars after preparation with 3 different access cavity designs and 2 rotary systems using finite...
INTRODUCTION
This study aimed to assess the fracture resistance of mandibular first molars after preparation with 3 different access cavity designs and 2 rotary systems using finite element analysis.
METHODS
Six 3-dimensionally printed mandibular first molars simulating natural teeth received traditional, conservative, and ultraconservative (truss) access cavity preparations. The root canals in each group were instrumented with either XP-Endo Shaper (FKG Dentaire, La Chaux-de-Fonds, Switzerland) or TruNatomy (Dentsply Sirona, Ballaigues, Switzerland) rotary files. The models were individually digitized, and micro-computed tomographic scans were transferred to Mimics software (Materialise NV, Leuven, Belgium) to create a geometric model of the tooth. The designed model was exported to 3-matic software (Materialise NV), and STL files were transferred to Geomagic Design X (3D Systems, Rock Hill, SC). Point cloud data were used for surfacing and transferred to ANSYS software (Ansys, Canonsburg, PA). A 200-N superficial force was applied vertically to the buccal cusps and central fossa, and the maximum and minimum equivalent von Mises stress values were calculated and reported.
RESULTS
The traditional and ultraconservative access cavity designs yielded the highest and the lowest von Mises stress values, respectively. In the ultraconservative cavity design, the stress values in pericervical dentin were lower in canal preparation with TruNatomy compared with XP-Endo Shaper. In the traditional and conservative cavity designs, stress was lower in the first 2 mm from the cementoenamel junction in the XP-Endo Shaper group and in the next 3 mm in the TruNatomy group.
CONCLUSIONS
Stress was lower in the ultraconservative and conservative cavity designs compared with the traditional design. Also, root canal preparation with TruNatomy yielded lower stress values in general compared with XP-Endo Shaper.
Topics: Dental Pulp Cavity; Finite Element Analysis; X-Ray Microtomography; Molar; Root Canal Preparation
PubMed: 37804945
DOI: 10.1016/j.joen.2023.09.014 -
BMC Oral Health Nov 2023It is currently unknown whether rotary file motion affects the best outcome of root canal retreatment. This experimental study compared the efficacy, efficiency, and...
Efficiency and complications in root canal retreatment using nickel titanium rotary file with continuous rotation, reciprocating, or adaptive motion in curved root canals: a laboratory investigation.
BACKGROUND
It is currently unknown whether rotary file motion affects the best outcome of root canal retreatment. This experimental study compared the efficacy, efficiency, and complications of single-use NiTi rotary files using continuous rotation, reciprocating, and adaptive motions in root canal filling removal in curved root canals. Reciproc blue R25 was used with reciprocating motion (RB), VDW.ROTATE retreatment files with continuous rotation (VR), and ProTaper NEXT X2 with continuous rotation (PTNc) or adaptive motion (PTNa).
METHODS
Forty mesial root canals of extracted mandibular first and second molars with an angle of curvature between 20°-40° and a radius of curvature between 5 and 10 mm were collected. The specimens were instrumented and obturated with gutta-percha and AH Plus sealer using the continuous wave of condensation technique. The specimens were randomly divided into 4 retreatment groups (n = 10), RB, VR, PTNc, and PTNa. The percentage of root canal filling removal in each group was analyzed using Micro-Computed Tomography (µCT). The motor running time, total time, root canal complication, and instrument complication were recorded and statistically analyzed (p-value < 0.05).
RESULTS
The pre-operative root canal curvature and root canal filling volume were comparable among groups. The percentage of root canal filling removal from the whole canal in the PTNc, RB, PTNa, and VR group was 98%, 96%, 95%, and 93%, respectively. A significant difference was observed between the PTNc and VR groups for the whole canal and the apical-third part. The motor running time and total time were significantly different between the groups. Instrument fracture was observed at 40% in the VR and 20% in the PTNa group, but none in the RB and PTNc groups.
CONCLUSIONS
The ProTaper NEXT X2 with continuous rotation and RB files can be used with high efficacy and efficiency in curved root canal retreatment. Continuous rotation is more efficacious and efficient than adaptive motion when using the NiTi rotary file. Single file retreatment can be used in small canals with high efficacy, cost-effectiveness, and less time consumption.
Topics: Humans; Root Canal Filling Materials; Dental Pulp Cavity; X-Ray Microtomography; Root Canal Preparation; Equipment Design; Gutta-Percha; Root Canal Obturation; Retreatment; Titanium
PubMed: 37974131
DOI: 10.1186/s12903-023-03610-x