Quantitative evaluation of debris extruded apically using reciprocating versus continuous rotation single file with rotary and hand glide path file

Chemomechanical root canal preparation (CMRCP) is an important step in root canal treatment. However, one of its negative consequences is apical extrusion of debris of the root canal system contributing to treatment failure and flare-ups. Glide path preparation (GPP) is the initial phase of CMRCP and is crucial for assessing root canal anatomy and establishing unobstructed access to the apical part of the canal. Materials and methods: Forty human mandibular permanent central and lateral incisors were selected; the debris collection apparatus was prepared and the teeth were then divided into four groups: Group 1: Rotary glide path preparation with ProGlider followed by instrumentation with Wave One files. Group 2: Rotary glide path preparation with ProGlider followed by instrumentation with One Shape files. Group 3: Hand glide path preparation with K-file followed by instrumentation with Wave One files. Group 4: Hand glide path preparation with K-file followed by instrumentation with One Shape files. The collected debris was weighed in an analytical digital balance and the collected data were statistically analyzed. Results: No significant difference was present between groups with the same method of glide path preparation or between Wave One and One Shape files. Rotary glide path preparation produced less debris than hand preparation (p≤0.05). Conclusions: Extrusion of debris was observed in all test groups. Rotary glide path preparation could be preferred in clinical practice as it is associated with less debris extrusion than the manual method.

Root perforations: a review of diagnosis, prognosis and materials

Abstract: Root perforation results in the communication between root canal walls and periodontal space (external tooth surface). It is commonly caused by an operative procedural accident or pathological alteration (such as extensive dental caries, and external or internal inflammatory root resorption). Different factors may predispose to this communication, such as the presence of pulp stones, calcification, resorptions, tooth malposition (unusual inclination in the arch, tipping or rotation), an extra-coronal restoration or intracanal posts. The diagnosis of dental pulp and/or periapical tissue previous to root perforation is an important predictor of prognosis (including such issues as clinically healthy pulp, inflamed or infected pulp, primary or secondary infection, and presence or absence of intracanal post). Clinical and imaging exams are necessary to identify root perforation. Cone-beam computed tomography constitutes an important resource for the diagnosis and prognosis of this clinical condition. Clinical factors influencing the prognosis and healing of root perforations include its treatment timeline, extent and location. A small root perforation, sealed immediately and apical to the crest bone and epithelial attachment, presents with a better prognosis. The three most widely recommended materials to seal root perforations have been calcium hydroxide, mineral trioxide aggregate and calcium silicate cements. This review aimed to discuss contemporary therapeutic alternatives to treat root canal perforations. Accordingly, the essential aspects for repairing this deleterious tissue injury will be addressed, including its diagnosis, prognosis, and a discussion about the materials actually suggested to seal root canal perforation.

Debris extrusion and foraminal deformation produced by reciprocating instruments made of thermally treated NiTi wires

Abstract Objective To evaluate the amount of apically extruded debris, percentage of foraminal enlargement and apical foramen (AF) deformation that occurred during root canal preparation with different reciprocation systems: Reciproc, WaveOne (M-Wire), and ProDesign R (Shape Memory Technology Wire) at two different working lengths (WLs): 0.0 and 1.0 mm beyond the AF. Material and methods The AF of 120 root canals in 60 mesial roots of mandibular molars were photographed with stereomicroscope and randomly assigned into four groups: manual, Reciproc (REC), WaveOne (WO), and ProDesign R (PDR); subsequently, they were further subdivided according to the WL (n=15). Teeth were instrumented, coupled to a dual collecting chamber, and then another photograph of each AF was captured. Extrusion was analysed by determining the weight of extruded debris. Each AF diameter was measured in pre- and post-instrumentation images to determine deformation, which was analysed, and afterwards the final format of AFs was classified (circular/oval/deformed). Results We found no significant differences when analysing each system at different WLs. When considering each WL, REC and WO showed highest extrusion values (P<.05); for AF enlargement, differences were observed only for WO, when it was used beyond the AF; differences were observed among M-Wire groups beyond the AF (P<.05). AF deformation was observed in all groups; PDR showed the lowest AF deformation values at both WLs; M-Wire groups showed 50% strain beyond the AF. Conclusion Authors concluded that beyond the apical limit, the alloy and taper are important aspects when considering extrusion and deformation.

Estudio clínico prospectivo del dolor posoperatorio en pacientes, asociado al uso de la lima de pasaje / A prospective clinical study of postoperative pain in patients, associated with the use of an apical patency file

Objetivo: evaluar, en pacientes, el dolor posoperatorio asociado al uso de la lima de pasaje, en dientes con y sin vitalidad pulpar. Materiales y métodos: se analizaron 400 dientes (n=400) con indicación de tratamiento endodóntico, según el criterio de inclusión diseñado para este estudio. Fueron distribuidos en dos grupos de 200 cada uno. Sólo en uno de los grupos, se utilizó una lima de pasaje. Todos los tratamientos fueron realizados en una sesión operatoria. Previamente al tratamiento endodóntico, se evaluó la vitalidad pulpar. Posteriormente, se agregó a los 400 pacientes un cuestionario para evaluar la presencia o la ausencia de dolor posoperatorio, 326 de los cuales lo devolvieron correctamente respondido. Resultados: no hubo diferencias estadísticamente significativas entre los dos grupos en cuanto a la presencia de dolor posoperatorio y la vitalidad pulpar (p>0,05). Conclusión: el empleo de la lima de pasaje no incidiría en la presencia de dolor posoperatorio.

Intracanal medications versus placebo in reducing postoperative endodontic pain – a double – blind randomized clinical trial

This prospective randomized, double-blind factorial study aimed to compare the efficacy of three different intracanal medicaments with the placebo in controlling the postoperative pain after complete root canal preparation. The study was performed on 64 mandibular molars of 64 patients with diagnosis of pulp necrosis and acute apical periodontitis. After chemomechanical procedures using the stepback technique and 1% sodium hypochlorite, the teeth were randomized into four treatment groups (n=16). In group I, canals were filled with calcium hydroxide paste mixed with 2% chlorhexidine gel, group II received 2% chlorhexidine gel, group III was treated with calcium hydroxide paste, and group IV received no dressing (control). Before dismissal, preoperative pain experience was recorded using a visual analog pain scale. Patients were then instructed to quantify the degree of pain experienced 4 h after treatment and daily for a further 24, 48, 72 and 96 h. Two-way repeated measures ANOVA test and post hoc Tukey's HSD test revealed that at each time interval groups I and II were significantly more effective in reducing the postoperative pain values than groups III and IV (p<0.05). Dunnett's test showed that groups I and II differed significantly from control whereas difference between group III and control was not significant (p>0.05). Patients with pulp necrosis and acute apical periodontitis that had been dressed with chlorhexidine alone and calcium hydroxide plus chlorhexidine gave rise to less pain than that experienced by patients who had a calcium hydroxide dressing alone or no dressing at all.

Este estudo prospectivo randomizado, duplo-cego, fatorial teve como objetivo comparar a eficácia de três diferentes medicamentos intracanal com o placebo no controle da dor pós-operatória após a preparação completa do canal radicular. O estudo foi realizado em 64 molares inferiores de 64 pacientes com diagnóstico de necrose pulpar e periodontite apical aguda. Após os procedimentos químico-mecânicos com a técnica escalonada (stepback) e hipoclorito de sódio a 1%, os dentes foram divididos aleatoriamente em quatro grupos de tratamento (n=16 por grupo). No grupo I, os canais foram preenchidos com pasta de hidróxido de cálcio misturado com 2% de clorexidina gel, grupo II receberam 2% de clorexidina gel, grupo III foi tratado com uma pasta de hidróxido de cálcio e do grupo IV não receberam curativo (controle). Antes de liberar o paciente, a sensação de dor pré-operatória foi registrada com uma escala visual analógica. Os pacientes foram instruídos para quantificar o grau de dor experimentada após 4 h de tratamento e diariamente após 24, 48, 72 e 96 h. Os testes ANOVA a dois critérios para medidas repetidas e teste de Tukey post hoc HSD revelaram que, a cada intervalo de tempo, o grupo I e grupo II foram significativamente mais (p<0,05) eficazes na redução da dor pós-operatória que os grupos III e IV. Além disso, o teste de Dunnett mostrou que o grupo I e grupo II diferiram significativamente com o controle enquanto que a diferença entre o grupo III e controle foi não significativo. Pacientes com necrose pulpar e periodontite apical aguda que receberam curativos de demora de clorexidina e hidróxido de cálcio mais clorexidina apresentaram menos dor do que aqueles que receberam curativo de hidróxido de cálcio ou não receberam qualquer curativo.

Acidentes e complicações em Endodontia causados por hipoclorito de sódio: revisão de literatura / Accidents and complications in Endodontics caused by sodium hypochlorite: Literature review

Essa revisão de literatura aborda os acidentes e complicações que podem ser causados pelo manuseio inadequado do hipoclorito de sódio (NaOCl) durante o tratamento endodôntico. Essa solução tem sido utilizada desde 1920, em concentrações de 0,5% a 5,25%, como irrigante antimicrobiano para apoiar o preparo biomecânico dos canais radiculares. É clinicamente comprovado que é um agente lubrificante, antisséptico e com propriedade solvente de tecido orgânico. Porém, acidentes potencialmente graves, ais como queimaduras de pele e mucosa intrabucal, edema de glote, obstrução de vias aéreas superiores, parestesia, hemorragia, etc, podem ocorrer quando utilizado inadvertidamente. Dessa maneira, cuidados de técnica, armazenamento e manuseio devem ser tomados, com a finalidade de se evitar essas complicações indesejáveis. O profissional, ainda, deve estar capacitado para identificar e solucionar os problemas quando surgirem

Accidental ingestion of a barbed wire broach and its endoscopic retrieval: Prevention better than cure.

Ingestion of instruments is a potential complication that can occur during dental procedures. We report a case of accidental ingestion of an endodontic barbed wire broach during root canal treatment and its subsequent retrieval by endoscopic methods. Although prevention is the best approach, proper management of such an event is also crucial. The objective of this report is to draw attention to the potentially serious complications that can occur if preventive techniques are not practised, and to discuss the accepted guidelines for management of such an event.

Displacement of endodontic instruments in inferior alveolar canal.

Endodontic instrument breakage is a common occurrence during root canal treatment but the displacement of the separated instrument into the inferior alveolar canal is rare and has never been reported. We hereby present an unusual case of displacement of a separated instrument in the inferior alveolar canal and its retrieval by a simple technique.

Effects of Gates-Glidden, LA Axxess and orifice shaper burs on the cervical dentin thickness and root canal area of mandibular molars

This study evaluated the increase of the instrumented area and dentin thickness in the mesial and distal aspects of mesial canals of mandibular molars after the use of Gates Glidden (GG), LA Axxess (LA) and Orifice Shaper (OS) instruments. A total of 53 canals from 27 mandibular molars were embedded in resin and divided into 3 groups. The roots were sectioned 3 mm below the cementoenamel junction and the images were captured before and after instrumentation. The increase of the instrumented area in terms of percentages and the remaining dentin thickness, in mm, at the mesial and furcal aspects were calculated using the Image tools software. Data were analyzed using the Kruskal-Wallis and Dunn's test. The significance level was set at 5 percent. All instruments promoted cervical flaring with different amounts of dentin removal at the mesial and distal aspects of the root canals. Statistically significant difference (p<0.05) was found between LA and all other instruments after using the first instrument. Regarding dentin thickness, no significant difference (p>0.05) was found between the mesial and distal walls in all groups. It may be concluded that LA 35.06 and GG 3 burs produced the thinnest dentin walls, and thus their use in mesial canals of mandibular molars should be done with caution.

Este estudo avaliou o aumento da área do canal e a espessura de dentina na parede mesial e distal dos canais mesiais de molares inferiores após o uso de Gates Glidden (GG), La Axxess (LA), Orifice Shaper (OS). Um total de 53 canais mesiais de 27 molares inferiores foram incluídos em resina e divididos em 3 grupos. As raízes foram seccionados 3 mm abaixo da junção cemento-esmalte e as imagens foram capturadas antes e depois da instrumentação. O aumento da área do canal em percentagem e a espessura da dentina remanescente nas paredes mesial e furca foram calculados utilizando o software Image Tools. Os dados foram analisados utilizando o Kruskal-Wallis e teste de Dunn. O Nível de significância foi de 5 por cento. Todos os instrumentos promoveram o aumento da área cervical, com diferentes quantidades de remoção da dentina nas paredes mesial e distal do canal radicular. Diferença estatística (p<0,05) foi encontrada entre LA e todos os outros instrumentos após o uso do primeiro instrumento. Quanto à espessura da dentina, não houve diferença significativa (p>0,05) entre as paredes mesial e distal de todos os instrumentos analisados. O LA 35.06 e GG 3 mostraram a menor espessura da parede e sua utilização em canais mesiais de molares inferiores deve ser feito com cuidado.

Procedural errors during root canal preparation using rotary NiTi instruments detected by periapical radiography and cone beam computed tomography

This study detected procedural errors created by rotary nickel-titanium (NiTi) instruments during root canal preparation by two imaging methods. Forty extracted human maxillary and mandibular molars were divided randomly into two groups and treated by two endodontists (n=10) and two undergraduate dental students (n=10). The ProTaper UniversalTM Rotary System was used to shape the canals and then they were filled using AH PlusTM sealer and gutta-percha. Periapical radiographs (PR) and cone beam computed tomography (CBCT) images were obtained and two examiners, who evaluated them to verify the occurrence of procedural errors (fractured instruments, perforations, and canal transportation). The Chi-square test at 0.05 level of significance was used for statistical analyses. There were no significant differences (p>0.05) between the imaging methods. In the analysis of procedural errors, there was no significant difference (p>0.05) between the groups of operators (endodontists vs. students) nor between tooth groups (maxillary molars vs. mandibular molars). In view of the low incidence of procedural errors during root canal preparation performed by students the introduction of rotary NiTi instruments has potential in undergraduate teaching. PR and CBCT permitted the detection of procedural errors, but the CBCT images offer more recourse for diagnosis.

O objetivo deste estudo foi determinar erros de procedimentos ocorridos durante o preparo de canais radiculares após o uso de instrumentos de níquel-titânio (NiTi) acionados a motor, avaliados por dois métodos de exame por imagens. Quarenta molares humanos extraídos, superiores e inferiores, foram aleatoriamente divididos em dois grupos e tratados por dois especialistas em Endodontia (n=10) e dois estudantes de Odontologia (n=10). O sistema rotatório ProTaper UniversalTM foi usado para preparar os canais radiculares e, a seguir estes foram obturados com cimento AH PlusTM e guta percha. Radiografias periapicais (RP) e tomografia computadorizada de feixe cônico (TCFC) foram obtidas e avaliadas por dois examinadores para verificar a ocorrência de erros de procedimentos (instrumentos fraturados, perfurações e transporte apical). O teste do qui-quadrado com nível de significância de 0,05 foi usado para análise estatística. Frente a comparação dos métodos de exames por imagens não houve diferenças significantes (p>0,05). Na análise de erros de procedimentos (fraturas de instrumentos, perfurações e transportes apicais) não houve diferenças estatisticamente significantes nos níveis de operadores e nem entre grupos de dentes. Em vista da baixa incidência de erros de procedimentos durante o preparo de canais radiculares realizados por estudantes, a introdução de instrumentos de NiTi apresenta potencial no ensino da graduação. RP e TCFC permitiram detectar erros de procedimentos durante o preparo de canais radiculares, porém, a TCFC oferece maiores recursos para o diagnóstico.

L929 cell response to root perforation repair cements: an in vitro cytotoxicity assay

This study compared the cytotoxicity of an experimental epoxy-resin and calcium hydroxide-based cement (MBPc), gray mineral trioxide aggregate (MTA) and white mineral trioxide aggregate (WMTA) using the agar overlay method with neutral red dye. L929 cells were seeded into 6-well culture plates where 48-h set test materials were placed on the agar overlay, in triplicate. Teflon and natural rubber served as negative and positive controls. After an incubation period of 24 h at 37ºC in a humidified atmosphere of 5 percent CO2 in air, a discolored area around the samples and the positive controls could be observed and measured per quadrant. The mean values were compared and converted into grades to classify the results according to the table of cytotoxicity grades according to the Standard Operating Procedures (SOP) of the Oswaldo Cruz Foundation, Brazil. The nonviable cell areas and the morphological changes in the cells were observed with an inverted microscope. The results showed grade 1 (slight) for the two types of MTA (p>0.05) and grade 2 (mild) for the MBPc (p<0.001). All samples met the requirements of the test as none of the cultures showed reactivity higher than grade 2.

O objetivo deste estudo foi comparar a citotoxicidade de um cimento experimental à base de resina epóxica e hidróxido de cálcio (MBPc), do agregado trióxido mineral (MTA) cinza e do MTA branco, utilizando o ensaio de difusão em agar com o corante vermelho neutro. Células L929 foram semeadas em placas de 6 poços e sobre elas a camada de agar, onde foram colocados os materiais endurecidos por 48 h, em triplicata, além de teflon como controle negativo e látex como controle positivo. Após 24 h em estufa umidificada a 37ºC com 5 por cento CO2, um halo claro se formou ao redor das amostras e dos controles positivos. As medidas foram tomadas, por quadrante, e as médias foram comparadas e convertidas em graus para qualificar os resultados, de acordo com a tabela de grau de citotoxicidade do POP/FIOCRUZ. As zonas de inibição e as alterações da morfologia celular foram avaliadas sob microscópio invertido. Os resultados revelaram grau 1 (leve) para os dois tipos de MTA (p>0,05) e grau 2 (branda) para o MBPc (p<0,001). Todas as amostras foram consideradas satisfatórias, pois nenhuma cultura exposta aos cimentos revelou toxicidade superior ao grau 2.

Evaluation of the apical infiltration after root canal disruption and obturation

The aim of this study was to evaluate two root canal filling techniques used in teeth that had their apical foramen disrupted and compare the apical infiltration with an ideal clinical situation. Twenty-seven freshly extracted single-rooted teeth were selected and radiographed to confirm the existence of a single and straight root canal. The crowns were removed at a mean distance of 11 mm from the apex. The teeth had the root canals instrumented and were randomly assigned to 3 groups (n=9): ND group - root canals were filled using the lateral compaction technique and no disruption was performed; DRF group - the apical constriction was disrupted by advancing a #40 K-file 1 mm beyond the original working length, the canals were reinstrumented to create an apical ledge at 1 mm from the apical foramen and were obturated with a master gutta-percha cone with same size as the last file used for reinstrumentation; DF group - the teeth had the apical constriction disrupted and the canals were obturated with a master gutta-percha cone that fit at 1 mm from the apex. The teeth were submitted to dye leakage test with Rhodamine B for 7 days, using vaccum on the initial 5 min. The teeth were sectioned longitudinally and the leakage was measured in a linear fashion from apex to crown. There was no statistically significant difference (p>0.05) between the groups that had the apical foramen disrupted (DF, DRF), but significant difference was found between the disrupted groups and the non-disrupted one (p<0.01). In conclusion, none of the evaluated techniques was able to prevent apical infiltration, so working length so the working length determination has to be established and maintained carefully.

Contaminación de las puntas de papel usando cuatro protocolos diferentes de manejo / Paper point contamination using four different management protocols

El tratamiento endodóntico debe garantizar la reducción o eliminación de los microorganismos que ocasionan patología pulpar. Las puntas de papel son útiles para secar el conducto antes de la obturación. Objetivo: identificar microorganismos presentes en las puntas de papel y determinar si se contaminan durante su manipulación con bacterias del ambiente o por contaminación cruzada, según cuatro protocolos diferentes de manejo. Materiales y métodos: se entregaron 6 cajas nuevas y selladas de puntas de papel Hygenic(R) a cuatro IPS para realiar el protocolo de manejo habitual. Se analizaron 26 puntas incubadas en caldo tripticasa soya, y siembra en agar tripticasa soya en presencia de turbidez, a 37º C de 24-28 horas. Las puntas se distribuyeron de la siguiente manera: control positivo: una punta de papel introducida en conducto con diagnóstico de necrosis pulpar. Control negativo: una punta de papel de caja sin destapar, manipulada en el laboratorio bajo condiciones estériles. Protocolos 1, 2, 3 y 4: seis para cada protocolo (24) se analizaron en el laboratorio. Resultados: según los diferentes protocolos propuestos para este trabajo, se encontró que en el protocolo 1 hubo contaminación en 2 cajas de puntas, se detectó presencia de S. aureus y Epidermidis. En protocolos 2, 3 y 4 no hubo presencia de microorganismos. Conclusiones: la contaminación que sufren las puntas de papel es mínima; no hubo diferencia significativa según los 4 protocolos de manejo usados en este trabajo.

Evaluation of the risk of a stripping perforation with gates-glidden drills: serial versus crown-down sequences

The aim of this study was to evaluate the remaining dentine/cementum thickness using Gates-Glidden burs in serial and crown-down sequences and to observe which of the two sequences is the safest for preparing mesial roots of molars. Thirty-six left and right human mandibular first molars were selected. Standard access cavities were made and initially explored with Flexofiles sizes 10 and 15 until the tip was visible at the apex. The teeth were embedded in a muffle specially developed for this study using a PVC tube with two parallel metal rods in its lid. Each tooth-block was sectioned 3 mm apically to the furcation using a low-speed saw with a diamond disc. The tooth-block was examined under a microscope and an initial image was captured by a digital video system with 8 X and 12 X magnifications. Finally, the tooth-blocks were reassembled in the muffle so that the canals could be instrumented. After instrumentation the area of each mesial canal as well as the smallest distance to the root furcation were measured again. The mesio-buccal canals (crown-down order) and the mesio-lingual canals (serial sequence) presented an average area of 0.46 ± 0.16 mm² and 0.88 ± 0.27 mm² (P < 0.01), respectively. The mean values of the smallest distance to the furcation for the mesio-buccal and mesio-lingual canals were 0.66 ± 0.19 mm and 0.39 ± 0.13 mm (P < 0.01), respectively. The remaining dentine/cementum thickness using Gates-Glidden burs was greater in the crown-down sequence than in the serial sequence.

A comparative evaluation of medicated calcium sulphate, hydroxylapatite, mineral trioxide aggregate (MTA) as barrier and their effect on the sealing ability of furcation perforation repair material--an in vitro study.

Artificial communication between the root canal system and supporting tissues of the tooth lowers the prognosis of the endodontic treatment. Studies have found that the second most common reason for failure association with endodontic treatment is root perforation. Hence a study was undertaken to evaluate the effect of calcium sulphate, hydroxylapatite and MTA as internal matrix and their ability on the sealing ability of the perforation repair material (GIC) on 70 recently extracted molar with non fused roots. MTA showed the least microleakage and best sealing ability and resin modified GIC when used alone without any internal matrix showed maximum microleakage and least sealing ability.

Instrumentación mecanizada: conformación de conductos curvos simulados con los sistemas Quantec, ProFile y la pieza de mano endodóntica M4 / Mechanical instrumentation: conformation of simulated curved root canals with the Quantec system, ProFile and the M4 endodontic handpiece

El objetivo de este estudio fue evaluar la conformación de conductos radiculares curvos simulados en bloques de resina acrílica, con la utilización de los sistemas Quantec, ProFile y la pieza de mano endodóntica M4. Se dividieron 45 conductos simulados al azar en tres grupos, que se instrumentaron con cada una de las técnicas. Los accidentes estudiados fueron: pérdida de longitud de trabajo, bloqueo del conducto, escalones, transportaciones, codos, perforaciones y fractura de instrumentos. Los resultados obtenidos se analizaron con la prueba de Chi cuadrado y se hallaron diferencias significativas para la presencia de escalón (p=0,024) entre ProFile y Quantec con la M4. También hubo diferencias significativas en cuanto a fractura de instrumentos (p=0.047) entre ProFile y la M4. No se observaron diferencias significativas para los otros accidentes analizados. De acuerdo con los resultados obtenidos podemos considerar las ventajas y desventajas de las variables analizadas. Una desventaja es la pérdida de longitud de trabajo con las tres técnicas. Otra es la formación de escalones y la fractura de instrumentos con los sistemas Quantec y ProFile. La aparición de bloqueo con la pieza de mano endodóntica Safety M4 fue importante, aunque no generó diferencias significativas

Alteraçäo da temperatura radicular externa durante o preparo para contençäo intra-radicular / Temperature changes on the external root during post space preparation

O objetivo deste trabalho foi comparar in vitro a alteraçäo de temperatura na superfície radicular externa durante o preparo para contençäo intra-radicular utilizando 4 técnicas de remoçäo da guta-percha: condensadores aquecidos, brocas de Peeso, Gates-Glidden e Largo, em 40 dentes pré-molares inferiores (unirradiculares) tratados endodonticamente. Experimento foi realizado em uma câmara com temperatura controlada em torno de 26ºC. Para a remoçäo da guta-percha do interior dos canais, foram calculados dois terços do comprimento da raiz, deixando em torno de 4 mm de obturaçäo apical. As mediçöes da temperatura radicular externa foram realizadas com um termopar acoplado a um multímetro e efetuadas em 3 regiöes: cervical (em torno de 3 mm abaixo da junçäo cemento-esmalte), média e apical...

Comparison of sealing efficacy of materials placed in lateral root perforations--an in vitro study.

An endodontic perforation interferes with the principal goal of sealing the root canal system. An in vitro study was conducted on comparative efficacy of three materials-Dispersalloy, Cavit and Prisma VLC Dycal when placed in lateral root perforations in cervical third areas. Root canals were prepared and irrigated thoroughly. Perforations were made with No. 2 round bur and sealed with Dispersalloy, Cavit and Prisma VLC Dycal. Dispersalloy Group I showed best sealing ability. Prisma VLC Dycal Group I too was comparable to Dispersalloy Group I in its sealing ability, followed by Cavit Group II, Prisma VLC Dycal Group II, Dispersalloy Group II in that order. Cavit Group I was least effective in sealing perforations.

Iatrogenia en endodoncia / Iatrogenia in endodontics

Ya sea por descuido, falta de atención o prisa, el profesional puede ocasionar alguna iatrogenia que irá a dificultar la limpieza de los conductos así como la correcta obturación