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International Journal of Environmental... Apr 2020Most simulation models used at university dental clinics are typodonts. Usually, models show idealized eugnathic situations, which are rarely encountered in everyday...
Most simulation models used at university dental clinics are typodonts. Usually, models show idealized eugnathic situations, which are rarely encountered in everyday practice. The aim of this study was to use 3D printing technology to manufacture individualized surgical training models for root tip resection (apicoectomy) on the basis of real patient data and to compare their suitability for dental education against a commercial typodont model. The training model was designed using CAD/CAM (computer-aided design/computer-aided manufacturing) technology. The printer used to manufacture the models employed the PolyJet technique. Dental students, about one year before their final examinations, acted as test persons and evaluated the simulation models on a visual analogue scale (VAS) with four questions (Q1-Q4). A training model for root tip resection was constructed and printed employing two different materials (hard and soft) to differentiate anatomical structures within the model. The exercise was rated by 35 participants for the typodont model and 33 students for the 3D-printed model. Wilcoxon rank sum tests were carried out to identify differences in the assessments of the two model types. The alternative hypothesis for each test was: "The rating for the typodont model is higher than that for the 3D-printed model". As the p-values reveal, the alternative hypothesis has to be rejected in all cases. For both models, the gingiva mask was criticized. Individual 3D-printed surgical training models based on real patient data offer a realistic alternative to industrially manufactured typodont models. However, there is still room for improvement with respect to the gingiva mask for learning surgical incision and flap formation.
Topics: Computer-Aided Design; Education, Dental; Humans; Models, Anatomic; Printing, Three-Dimensional
PubMed: 32331445
DOI: 10.3390/ijerph17082901 -
Indian Journal of Dental Research :... 2019Cemental tear represents a rare form of root surface fracture which makes teeth prone to periodontal breakdown. The diagnosis of cemental tear becomes a challenge as it...
Cemental tear represents a rare form of root surface fracture which makes teeth prone to periodontal breakdown. The diagnosis of cemental tear becomes a challenge as it is usually neglected or misdiagnosed and is also underreported in the literature. Correct diagnosis and early treatment of cemental tear can prevent further periodontal breakdown and may preserve the affected tooth for a longer duration. This case presents the diagnosis, treatment, and an analysis of a right maxillary lateral incisor with an improper endodontic treatment coupled with a cemental tear. Despite surgical removal, the cemental tear led to the development of an endodontic periodontal lesion. This article intends to help recognize early signs and symptoms of cemental tear and establish timely diagnosis. It determines that if the periodontal destruction caused by cemental tears is diagnosed and treated early, it may be possible to prevent further periodontal breakdown and preserve the tooth for a longer period.
Topics: Adult; Apicoectomy; Dental Cementum; Endodontics; Follow-Up Studies; Humans; Incisor; Male; Maxilla; Periodontal Diseases; Radiography, Dental; Regenerative Endodontics; Tooth Fractures; Treatment Outcome
PubMed: 30900675
DOI: 10.4103/ijdr.IJDR_746_17 -
Journal of Clinical and Experimental... Oct 2019The knowledge of root canal anatomy and of the anatomical relationship should be considered mandatory when planning surgical endodontics. The aim of the study was to...
BACKGROUND
The knowledge of root canal anatomy and of the anatomical relationship should be considered mandatory when planning surgical endodontics. The aim of the study was to investigate the anatomical features of mandibular premolars, evaluating their relationship with mental nerve.
MATERIAL AND METHODS
CBCT scans were evaluated recording the number of roots, root canal configuration and the relationship with mental nerve of 100 mandibular premolars. After simulating a resection of 3 mm of the root, the shape and the number of canals, and the distance to the buccal and lingual bone plate and to the mental foramen was evaluated.
RESULTS
The one root - one canal configuration was the most common configuration. The mental foramen was located at the level of MSPs in 40% cases, and it was between MSP and MFP in 46% of cases. The distance between the apex and the vestibular plate was lower than the distance to the lingual one.
CONCLUSIONS
We found a significant heterogeneity in the anatomy of mandibular premolars. CBCT could be considered important when planning surgical endodontics in this region. Cone-Beam Computed Tomography, bicuspid, root canal, root canal therapy, apicoectomy, mandibular nerve.
PubMed: 31636856
DOI: 10.4317/jced.55848 -
Clinical Case Reports Jan 2021The complexity of the nonsurgical endodontic retreatment should be weighed against the benefit of surgical approach. This case report describes uncommon diagnosis and...
The complexity of the nonsurgical endodontic retreatment should be weighed against the benefit of surgical approach. This case report describes uncommon diagnosis and successful nonsurgical endodontic management of mandibular first premolar with a previous history of failed apicoectomy and incomplete root-end resection using mineral trioxide aggregate and cone-beam computed tomography.
PubMed: 33489194
DOI: 10.1002/ccr3.3551 -
Journal of Conservative Dentistry and... Apr 2024Dentinal microcracks formed during apical resection may lead to increased susceptibility to root fracture and improper sealing of apical preparation that may negatively...
BACKGROUND
Dentinal microcracks formed during apical resection may lead to increased susceptibility to root fracture and improper sealing of apical preparation that may negatively influence the outcome of endodontic microsurgery.
AIMS
This study was performed to analyze the root-end surface for dentinal microcracks using a scanning electron microscope (SEM) after resection with high-speed bur and trephine drill.
MATERIALS AND METHODS
Thirty extracted single-rooted maxillary premolar teeth were selected and randomly distributed into two groups ( = 15). Working length was established using a #15 K-type file. Canals were prepared with a rotary Ni-Ti system to size 30/0.06 using endomotor, irrigated with 3% sodium hypochlorite, dried with paper points, and obturated with gutta-percha cones using a single-cone technique. All samples were mounted on preformed molds and poured using a mixture of sawdust and gypsum. In Group A; tungsten carbide bur was used to perform a freehand apicoectomy. In Group B; a trephine drill was used with a three-dimensional guide to perform 3 mm of root resection. Apicoectomy was performed in both groups under a dental operating microscope. Resected root ends were inspected for microcracks using SEM. The Shapiro-Wilk and Mann-Whitney U-test were used for statistical analysis.
RESULTS
Microcracks were observed in all samples in both study groups. Trephine drill produced more microcracks on the resected root surface compared to the use of high-speed tungsten carbide bur with a statistically significant difference ( < 0.05).
CONCLUSIONS
The trephine drill used during targeted endodontic microsurgery produced more microcracks on the resected root dentine surface compared to the high-speed tungsten carbide bur used during freehand apicoectomy.
PubMed: 38779202
DOI: 10.4103/JCDE.JCDE_77_24 -
Clujul Medical (1957) 2018Therapeutic decision in dentistry is a complex cognitive process for the practitioners because it involves taking into consideration several factors, including patients'...
BACKGROUND AND AIM
Therapeutic decision in dentistry is a complex cognitive process for the practitioners because it involves taking into consideration several factors, including patients' preferences. The hypothesis of this study was that apicoectomy might be indicated more often than necessary and in order to confirm or invalidate it a survey was designed. We also aimed to explore whether the preferences were associated or not with dentist-related or practice-related characteristics.
METHODS
The survey included questions about treatment options in case of four scenarios, each one concerning an anterior and a posterior tooth with apical periodontitis, with or without previous endodontic treatment and also general questions, such as medical specialties, age and years of experience. The distribution of the questionnaires was done by email and direct distribution in the dental offices, in Cluj County, Romania.
RESULTS
After descriptive statistical analysis was performed, preferences rates were subjected to Chi-square test (including McNemar test for significance). Statistically significant differences were considered when p≤0.05.
CONCLUSIONS
The results indicate that dentists prefer nonsurgical endodontic treatment in case of a tooth with apical periodontitis. Apicoectomy was the second option treatment preferred by general dentists, oral and maxillo-facial surgeons, prosthodontists and endodontists.
PubMed: 29440958
DOI: 10.15386/cjmed-789 -
National Journal of Maxillofacial... 2020In most of the cystic lesions appearing in the oral cavity, proper diagnosis and treatment remains a challenge. As glandular odontogenic cyst (GOC) is a rare type of...
In most of the cystic lesions appearing in the oral cavity, proper diagnosis and treatment remains a challenge. As glandular odontogenic cyst (GOC) is a rare type of developmental odontogenic cyst, it was not included in our differential diagnosis. The report of GOC was quite surprising as it was rare and never came in this discussion. A 25-year-old male patient was reported to our center with a chief complaint of painless swelling in the right anterior region of the maxilla. The swelling was oval shaped and diffuse extending from the distal aspect of 11 to the mesial aspect of 14 and superiorly extending into the sulcus. Working diagnosis was a periapical cyst, so conventional treatment of root canal treatment, cyst enucleation, and apicoectomy was done. This article presents a rare case which was primarily misdiagnosed and treated and has been subsequently revealed histopathologically as a rare clinicopathological entity.
PubMed: 33897198
DOI: 10.4103/njms.NJMS_84_18 -
Restorative Dentistry & Endodontics Aug 2018The aim of this study was to evaluate the biocompatibility of newly proposed root-end filling materials, Biodentine, Micro-Mega mineral trioxide aggregate (MM-MTA),...
OBJECTIVES
The aim of this study was to evaluate the biocompatibility of newly proposed root-end filling materials, Biodentine, Micro-Mega mineral trioxide aggregate (MM-MTA), polymethylmethacrylate (PMMA) bone cement, and Smart Dentin Replacement (SDR), in comparison with contemporary root-end filling materials, intermediate restorative material (IRM), Dyract compomer, ProRoot MTA (PMTA), and Vitrebond, using human periodontal ligament (hPDL) fibroblasts.
MATERIALS AND METHODS
Ten discs from each material were fabricated in sterile Teflon molds and 24-hour eluates were obtained from each root-end filling material in cell culture media after 1- or 3-day setting. hPDL fibroblasts were plated at a density of 5 × 10/well, and were incubated for 24 hours with 1:1, 1:2, 1:4, and 1:8 dilutions of eluates. Cell viability was evaluated by XTT assay. Data was statistically analysed. Apoptotic/necrotic activity of PDL cells exposed to material eluates was established by flow cytometry.
RESULTS
The Vitrebond and IRM were significantly more cytotoxic than the other root-end filling materials ( < 0.05). Those cells exposed to the Biodentine and Dyract compomer eluates showed the highest survival rates ( < 0.05), while the PMTA, MM-MTA, SDR, and PMMA groups exhibited similar cell viabilities. Three-day samples were more cytotoxic than 1-day samples ( < 0.05). Eluates from the cements at 1:1 dilution were significantly more cytotoxic ( < 0.05). Vitrebond induced cell necrosis as indicated by flow cytometry.
CONCLUSIONS
This study demonstrated that Biodentine and Compomer were more biocompatible than the other root-end filling materials. Vitrebond eluate caused necrotic cell death.
PubMed: 30135845
DOI: 10.5395/rde.2018.43.e24 -
Evaluation of Apically Extruded Debris Using Continuous Rotation, Reciprocation, or Adaptive Motion.Brazilian Dental Journal 2018The aim of this study was to compare the amount of apically extruded debris during root canal instrumentation using ProTaper Next (PTN), Twisted File (TF) Adaptive, and... (Comparative Study)
Comparative Study
The aim of this study was to compare the amount of apically extruded debris during root canal instrumentation using ProTaper Next (PTN), Twisted File (TF) Adaptive, and Reciproc instruments. Forty-five extracted human maxillary canines were selected and randomly assigned into 3 groups. The root canals were prepared using PTN instruments with continuous rotation (n=15), TF Adaptive instruments with adaptive motion (n=15), Reciproc instruments with reciprocating motion (n=15). During the preparations, canals were irrigated using distilled water and material extruded apically was collected in pre-weighed Eppendorf tubes. After a 5-day drying period in an incubator, the tubes were weighed and the dry weight of the extruded debris was calculated. Data distributions were assessed via the Shapiro-Wilk test, and groups were compared via the Kruskal-Wallis test. The greatest amount of debris extruded by TF Adaptive and the least by PTN, but the difference was insignificant between groups (p=0.259). All instrumentation systems were associated with debris extrusion.
Topics: Apicoectomy; Cuspid; Dental Pulp Cavity; Equipment Design; Humans; In Vitro Techniques; Maxilla; Motion; Root Canal Preparation; Rotation; Therapeutic Irrigation; Tooth Apex
PubMed: 29972449
DOI: 10.1590/0103-6440201801967 -
Australian Endodontic Journal : the... Dec 2022To evaluate the filling ability of two orthograde obturation techniques followed by the apical resection with or without retrograde obturation through micro-computed...
To evaluate the filling ability of two orthograde obturation techniques followed by the apical resection with or without retrograde obturation through micro-computed tomography (CT). Thirty-two single-rooted permanent teeth were prepared and randomised into four groups (n = 8) according to the orthograde obturation technique (single cone technique [SCT] and mineral trioxide aggregate placement) combined or not with retrograde obturation. The volume of voids (VoV) within the entire endodontic space, the apical 3 mm, and 1 mm after root resection was calculated by micro-CT. Statistical analysis showed no significant difference among the groups regarding the total VoV in all root canals, as well as within the apical 1 mm after root resection. The SCT and apical resection without retrograde filling showed significantly better results in terms of VoV at the apical 3 mm after root resection. Within the study limitations, SCT associated with apical resection without retrograde preparation exhibited a similar or less amount of voids than the other groups.
Topics: X-Ray Microtomography; Root Canal Filling Materials; Retrograde Obturation; Apicoectomy; Tooth Root; Root Canal Obturation; Dental Pulp Cavity; Root Canal Preparation
PubMed: 35665570
DOI: 10.1111/aej.12634