Outcome of Endodontic Treatment through Existing Full Coverage Restorations: An Endodontic Practice Case Series.

INTRODUCTION: This case series assessed the outcome of nonsurgical endodontic treatment completed through retained full coverage restorations (FCRs) in a board-certified endodontist private practice. The number of cases completed by the first author was 153. METHODS: All cases were performed following a standardized protocol for treatment and restoration depending on the type of FCR. Number of cases that showed up for 2- to 4-year follow-up was 127, with 83% recall rate. The age range of patients was 33-95 years, with mean age of 54.734 years. The mean recall time was 2.448 years. FCRs and their distribution were as follows: 4 anterior teeth, 14 premolars, and 109 molars. There were 103 nonsurgical root canal treatments and 24 retreatments. Patients who presented for recall had 74 porcelain fused to metal crowns, 17 zirconia crowns, 15 abutments of porcelain fused to metal bridges, 14 lithium disilicate crowns, 5 gold crowns, 1 full metal crown, and 1 gold onlay. RESULTS: There were no endodontically related failures. Six cases failed; 3 were due to vertical root fractures, 1 was due to horizontal root fracture, and 2 were due to extensive recurrent caries causing restorative failure. The percentage of healed cases following the American Association of Endodontists outcome criteria adopted in 2004 with intact retained FCR was 95.3%. CONCLUSIONS: The results suggest predictable favorable outcomes for nonsurgical endodontic treatment through FCR following the proposed protocol for diagnosis, treatment, and restoration.

Evaluation of resin sealer penetration of dentin following different final rinses for endodontic irrigation using confocal laser scanning microscopy.

The aim of the study was to assess the depth of sealer penetration into dentinal tubules following different final rinses and indirectly evaluate precipitation of irrigating solutions. Methods: 52 extracted maxillary incisors were prepared to size 40/04 with 6% sodium hypochlorite irrigating solution. Following power analysis, teeth were randomly divided into 4 groups (n = 13) according to final rinse. Group 1 - 17% EDTA, Saline and 2% Chlorhexidine solution; Group 2 - SmearOFF™; Group 3 - Qmix® ; and Group 4 - saline control. Obturation was performed with gutta percha and resin sealer mixed with rhodamine-B-isothiocyanate dye using warm vertical compaction. Teeth were sectioned into apical, middle, and coronal thirds using Buehler diamond saw at 3, 6 and 9 mm from the apex. Sections were examined under confocal laser scanning microscopy, and images were exported to Image J software to measure the maximum depth of sealer penetration circumferentially. Data were analysed using a generalised linear model and post hoc multiple comparisons with significance set at P < 0.05. Group 3 had the highest depth of penetration. There were statistically significant differences between Groups 2 and 3 and control for all sections, Group 1 and control in apical section only. Conclusion: Recently developed final rinses produced higher sealer penetration and more patent dentinal tubules than using EDTA and chlorhexidine sequentially.