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Brazilian Oral Research Oct 2018Evidence shows the polymicrobial etiology of endodontic infections, in which bacteria and their products are the main agents for the development, progression, and... (Review)
Review
Evidence shows the polymicrobial etiology of endodontic infections, in which bacteria and their products are the main agents for the development, progression, and dissemination of apical periodontitis. Microbial factors in necrotic root canals (e.g., endotoxin) may spread into apical tissue, evoking and supporting a chronic inflammatory load. Thus, apical periodontitis is the result of the complex interplay between microbial factors and host defense against invasion of periradicular tissues. This review of the literature aims to discuss the complex network between endodontic infectious content and host immune response in apical periodontitis. A better understanding of the relationship of microbial factors with clinical symptomatology is important to establish appropriate therapeutic procedures for a more predictable outcome of endodontic treatment.
Topics: Bacterial Infections; Cytokines; Dental Pulp Cavity; Dental Pulp Diseases; Endotoxins; Humans; Lipopolysaccharides; Matrix Metalloproteinases; Periapical Periodontitis
PubMed: 30365610
DOI: 10.1590/1807-3107bor-2018.vol32.0069 -
Journal of Applied Oral Science :... 2009The purpose of this paper is to discuss critically the antibacterial efficacy of intracanal medicaments on bacterial biofilm. Longitudinal studies were evaluated by a... (Review)
Review
The purpose of this paper is to discuss critically the antibacterial efficacy of intracanal medicaments on bacterial biofilm. Longitudinal studies were evaluated by a systematic review of English-language articles retrieved from electronic biomedical journal databases (MEDLINE, EMBASE, CENTRAL) and handsearching records, using different matches of keywords for root canal biofilm, between 1966 and August 1st, 2007. The selected articles were identified from titles, abstracts and full-text articles by two independent reviewers, considering the tabulated inclusion and exclusion criteria. Disagreements were resolved by consensus. The search retrieved 91 related articles, of which 8.8% referred to in vivo studies demonstrating the lack of efficacy of endodontic therapy on bacterial biofilm. Intracanal medicaments were found to have a limited action against bacterial biofilm.
Topics: Biofilms; Dental Pulp Cavity; Humans; Root Canal Irrigants
PubMed: 19148398
DOI: 10.1590/s1678-77572009000100002 -
Brazilian Dental Journal 2022A contemporary technological revolution has started a new era in the metaverse of Endodontics, a world of virtual operational possibilities that use an exact replica of...
A contemporary technological revolution has started a new era in the metaverse of Endodontics, a world of virtual operational possibilities that use an exact replica of the natural structures of the maxillofacial complex. This study describes a modeling method for root canal endoscopy using modern cone-beam CT (CBCT) software in a series of clinical cases. The method consists in acquiring thin CBCT slices (0.10mm) in the coronal, sagittal, and axial planes. A specific 3D volume filter, the pulp cavity filter of the e-Vol DX CBCT software, was used to navigate anatomical root canal microstructures, and to scan them using root canal endoscopy. The pulp cavity filter should be set to synchronize CBCT scans from 2D mode - multiplanar reformations (MPR) - to 3D mode - volumetric reconstruction. This filter, when adopting the option of volumetric reconstruction, the developed algorithm leaves the dentin density in transparent mode so that the pulp cavity may be visualized. The algorithm applied performs the suppression (visual) of areas with dentin density. This ensures 3D visualization of the slices and the microanatomy of the root canal, as well as a dynamic navigation throughout the pulp cavity. This computational modeling method adds new resources to Endodontics, which may impact the predictability of root canal treatments positively. The virtual visualization of the internal anatomy of an exact replica of the canal ensures better communications, reliability, and clinical operationalization. Root canal endoscopy using this novel CBCT filter may be used for clinical applications together with innovative digital and virtual-reality resources that will be naturally incorporated into the principles of Endodontics.
Topics: Computer Simulation; Cone-Beam Computed Tomography; Dental Pulp Cavity; Endodontics; Endoscopy; Reproducibility of Results; Root Canal Therapy; Spiral Cone-Beam Computed Tomography
PubMed: 36043565
DOI: 10.1590/0103-6440202205078 -
International Journal of Oral Science Aug 2019Bone remodelling keeps going through the lifespan of human by bone formation and bone resorption. In the craniofacial region, mandibles act as the main force for biting...
Bone remodelling keeps going through the lifespan of human by bone formation and bone resorption. In the craniofacial region, mandibles act as the main force for biting and chewing, and also become susceptible to a common bone-loss disease, namely, apical periodontitis, once infected dental pulp is not treated timely, during which bone resorption occurs from the apical foramen to the apical bone area. Although conventional root canal treatment (RCT) can remove the most of the infection, chronical apical periodontitis due to incomplete removal of dental pulp and subsequent microleakage will become refractory and more challenging, and this process has scarcely been specifically studied as a bone remodelling issue in rat models. Therefore, to study chronical and refractory apical periodontitis owing to incomplete cleaning of infected dental pulp and microleackage in vivo, we establish a modified rat model of gradually progressive apical periodontitis by sealing residual necrotic dental pulp and introducing limited saliva, which simulates gradually progressive apical periodontitis, as observed in the clinical treatment of chronical and refractory apical periodontitis. We show that bone-loss is inevitable and progressive in this case of apical periodontitis, which confirms again that complete and sound root canal treatment is crucial to halt the progression of chronical and refractory apical periodontitis and promote bone formation. Interestingly, bone remodelling was enhanced at the initial stage of apical periodontitis in this model while reduced with a high osteoblast number afterwards, as shown by the time course study of the modified model. Suggesting that the pathological apical microenvironment reserve its hard tissue formation ability to some degree but in a disturbed manner. Hopefully, our findings can provide insights for future bone regenerative treatment for apical periodontitis-associated bone loss.
Topics: Animals; Bone Remodeling; Dental Pulp Cavity; Dental Pulp Necrosis; Female; Humans; Male; Periapical Periodontitis; Rats; Regeneration; Root Canal Therapy
PubMed: 31451690
DOI: 10.1038/s41368-019-0058-x -
Medical Science Monitor Basic Research Jun 2013Root canal shaping without any procedural error is of the utmost preference. Therefore, the purpose of this study was to use micro-computed tomography to evaluate and...
BACKGROUND
Root canal shaping without any procedural error is of the utmost preference. Therefore, the purpose of this study was to use micro-computed tomography to evaluate and compare the root canal shaping efficacy of ProTaper rotary files and standard stainless steel K-files.
MATERIAL AND METHODS
Sixty extracted upper second premolars were selected and were divided into 2 groups of 30. Before preparation, all samples were scanned by micro-CT. Then, 30 teeth were prepared with stainless steel files and the remaining 30 with ProTaper rotary files. Canal transportation and centering ability before and after root canal shaping were assessed using micro-CT. The amount and direction of canal transportation and the centering ratio of each instrument were determined in the coronal, middle, and apical parts of the canal. The 2 groups were statistically compared using one-way ANOVA.
RESULTS
ProTaper rotary files gave less transportation (p<0.001) and better centering ability (p<0.00001) compared with stainless steel files.
CONCLUSIONS
The manual technique for preparation of root canals with stainless steel files produces more canal transportation, whereas rotary files remain more centered in the canal.
Topics: Analysis of Variance; Dental Instruments; Dental Pulp Cavity; Humans; Root Canal Preparation; Stainless Steel; X-Ray Microtomography
PubMed: 23760162
DOI: 10.12659/MSMBR.889350 -
Journal of Ayub Medical College,... 2017With root canal treatment, the organic debris and micro-organisms from pulp space is removed and an ideal canal preparation is achieved that is conducive of hermetic...
BACKGROUND
With root canal treatment, the organic debris and micro-organisms from pulp space is removed and an ideal canal preparation is achieved that is conducive of hermetic obturation. The purpose of this study was to correlate the pre-operative canal curvature with the postoperative curvature in human extracted teeth prepared with K-3 rotary systems.
METHODS
The root canal preparation was carried out on extracted human molars and premolars using K-3 endodontic rotary files. A pre and post-operative image of the teeth using digital radiograph were taken in order to compare pre and post-operative canal curvature. The images were saved in an images retrieval system (Gendex software, USA). Change in the canal curvature was measured using the software measuring tool (Vixwin software, USA). Student paired t-test and Pearson correlation test was applied at 0.05 level of significance.
RESULTS
There is a statistically significant difference between pre-operative and post-operative canal curvature (p-value <0.001) and a strong positive correlation (91% correlation) between pre-operative and post-operative canal curvature in teeth prepared with the K-3 rotary files.
CONCLUSIONS
A significant difference between pre and post instrumentation curvature was found. Degree of canal curvature was not correlated with time taken for canal preparation.
Topics: Dental Alloys; Dental Pulp Cavity; Humans; Molar; Nickel; Root Canal Preparation; Stainless Steel; Tissue Culture Techniques; Titanium
PubMed: 28718229
DOI: No ID Found -
Journal of Endodontics Apr 2007The term monoblock has become familiar in the endodontic literature with recent interest in the application of dentin adhesive technology to endodontics. Endodontic... (Review)
Review
The term monoblock has become familiar in the endodontic literature with recent interest in the application of dentin adhesive technology to endodontics. Endodontic monoblocks have generated controversial discussions among academicians and clinicians as to whether they are able to improve the quality of seal in root fillings and to strengthen roots. This review attempts to provide a broader meaning to the term monoblock and to see how this definition may be applied to the materials that have been used in the past and present for rehabilitation of the root canal space. The potential of currently available bondable materials to achieve mechanically homogeneous units with root dentin is then discussed in relation to the classical concept in which the term monoblock was first employed in restorative dentistry and subsequently in endodontics.
Topics: Dental Bonding; Dental Pulp Cavity; Dentin; Elasticity; Humans; Post and Core Technique; Root Canal Filling Materials; Stress, Mechanical; Surface Properties; Tooth, Nonvital
PubMed: 17368325
DOI: 10.1016/j.joen.2006.10.009 -
Journal of Radiology Case Reports Nov 2023The mandibular second molar exhibits a wide range of intricate root canal variations, which can present challenges and difficulties in achieving successful root canal... (Review)
Review
The mandibular second molar exhibits a wide range of intricate root canal variations, which can present challenges and difficulties in achieving successful root canal treatment. This report focuses on two specific cases involving a root canal variation in a typical taurodontism of the mandibular second molar. To provide a comprehensive analysis and illustration of the anatomical structure of intraoral taurodontism and the important considerations for root canal treatment, we utilized advanced imaging techniques such as cone beam computed tomography (CBCT) and a dental microscope. By combining these tools, we were able to gain a deeper understanding of the complex root canal system and make informed decisions during the treatment process.
Topics: Humans; Dental Pulp Cavity; Spiral Cone-Beam Computed Tomography; Tooth Root; Mandible; Tooth Abnormalities
PubMed: 38638554
DOI: 10.3941/jrcr.v17i11.5212 -
Scientific Reports Sep 2018To develop a novel strategy for sealing and obturating dental root canals by tooth-like tissue regeneration, premolars with mature root apices were freshly collected,...
To develop a novel strategy for sealing and obturating dental root canals by tooth-like tissue regeneration, premolars with mature root apices were freshly collected, and root canals were prepared by following the clinical protocols in vitro. The teeth were immersed in supersaturated calcium and phosphate solution containing gallic acid and fluoride. At certain intervals, the dental roots were taken out, and their mineral precipitates were characterised by scanning electron microscopy, energy-dispersive spectroscopy mapping, X-ray diffraction and transmission electron microscopy. The cytocompatibility of the mineralizing products were evaluated with rabbit bone-marrow-derived mesenchymal stem cells in vitro. Results showed that the precipitates were mainly composed of fluoridated hydroxyapatite with ahexagonal prism morphology. Fluoridated hydroxyapatite initially nucleated and grew from the root canal dentine surface to the root canal centre. The fluoridated hydroxyapatite precipitate and root canal dentine intergraded together such that the interface became hardly distinguishable. The fluoridated hydroxyapatite precipitate grew into and obturated the dentinal tubules. In the root canal, the regenerated fluoridated hydroxyapatite densely packed and bundled together with a c-axis extension. After 7 days of mineralisation, the root canal was completely obturated, and the apical foramen was sealed. The mineralizing products had good biocompatibility with the cells, and the cells grew well on the mineralized surface. Biomimetic mineralisation strategy provides a novel means to regenerate tooth-like tissue to seal the root canal system permanently other than by passive synthetic material filling.
Topics: Animals; Biomimetic Materials; Dental Pulp Cavity; Dental Restoration, Permanent; Durapatite; Female; Humans; Male; Materials Testing; Mesenchymal Stem Cells; Microscopy, Electron, Transmission; Rabbits; Root Canal Obturation; Tooth Calcification; Tooth Root; X-Ray Diffraction
PubMed: 30190589
DOI: 10.1038/s41598-018-31643-8 -
BMC Oral Health Sep 2023The purpose of this study was to survey the prevalence of C-shaped root canal system in mandibular first premolar in Chinese population by reading Cone-beam computed...
OBJECTIVES
The purpose of this study was to survey the prevalence of C-shaped root canal system in mandibular first premolar in Chinese population by reading Cone-beam computed tomography (CBCT) images and to analyze its anatomical characteristics by CBCT and Micro-computed tomography (Micro-CT).
METHODS AND MATERIALS
The prevalence and the morphologic features of C-shaped root canal system were evaluated by observing CBCT images of 760 patients (1520 mandibular first premolars). 66 mandibular first premolars with C-shaped root canal system were scanned by Micro-CT. The morphologic features including radicular groove, C-shaped root canal categories in the cross-sections and in the 3D models, accessory and connecting canals, apical foramina and accessory foramina, were analyzed using image software.
RESULTS
C-shaped root canal system was identified in 16.9% of mandibular first premolars. The minimum mesial wall thickness most commonly occurred at the lingual site (69.7%). Regarding to the cross-sectional classification, the maximum was C2 (41.5%). In the 3D classification, the most common was S (34.8%). Accessory canals were observed in 36.4% of the samples and occurred mostly in the middle and apical regions. 42.4% samples had 1-3 variable connecting canals, and 40.9% samples had only one apical foramen.
CONCLUSIONS
The incidence of C-shaped root canal system in mandibular first premolars was 16.9% in the Chinese population. The anatomy was very complex and variable, mostly distributed in the middle and apical regions of the root canal. The mesial wall of C-shaped canal was extremely thin on the lingual side.
Topics: Humans; X-Ray Microtomography; Bicuspid; Cross-Sectional Studies; East Asian People; Spiral Cone-Beam Computed Tomography; Mandible; Dental Pulp Cavity; Cone-Beam Computed Tomography; Tooth Root
PubMed: 37777733
DOI: 10.1186/s12903-023-03271-w