Bacterial leakage of mineral trioxide aggregate as compared with zinc-free amalgam, intermediate restorative material, and Super-EBA as a root-end filling material.

Several dye leakage studies have demonstrated the fact that mineral trioxide aggregate (MTA) leaks significantly less than other root-end filling materials. The purpose of this study was to determine the time needed for Serratia marcescens to penetrate a 3 mm thickness of zinc-free amalgam, Intermediate Restorative Material (IRM), Super-EBA, and MTA when these materials were used as root-end filling materials. Fifty-six, single-rooted extracted human teeth were cleaned and shaped with a series of .04 Taper rotary instruments (Pro-series 29 files). Once the canals were prepared in a crown down approach, the ends were resected and 48 root-end cavities were ultrasonically prepared to a 3 mm depth. The teeth were then steam sterilized. Using an aseptic technique, under a laminar air flow hood, the root-end cavities were filled with amalgam, IRM, Super-EBA, and MTA. Four root-end cavities were filled with thermoplasticized gutta-percha without a root canal sealer and served as positive controls. Another four root-end cavities were filled with sticky wax covered with two layers of nail polish and served as negative controls. The teeth were attached to presterilized (ethylene oxide gas) plastic caps, and the root ends were placed into 12-ml vials of phenol red broth. Using a micropipette, a tenth of a milliliter of S. marcescens was placed into the root canal of each tooth. To test the sterility of the apparatus set-up, the root canals of two teeth with test root-end filling materials and one tooth from the positive and negative control groups were filled with sterile saline. The number of days required for S. marcescens to penetrate the four root-end filling materials and grow in the phenol red broth was recorded and analyzed. Most of the samples filled with zinc-free amalgam leaked bacteria in 10 to 63 days. IRM began leaking 28 to 91 days. Super-EBA began leaking 42 to 101 days. MTA did not begin leaking until day 49. At the end of the study, four of the MTA samples had not exhibited any leakage. Statistical analysis of the data indicated Mineral Trioxide Aggregate to be a most effective root-end filling material against penetration of S. marcescens.

Repair of furcal perforations with mineral trioxide aggregate: two case reports.

Furcal perforation is an unfortunate incident that can occur during root canal therapy or post preparation of multirooted teeth. Studies have shown that the materials currently used to repair these iatrogenic accidents are inadequate. The poor prognosis of furcation perforations is probably due to bacterial leakage or lack of biocompatibility of repair materials. On the basis of the recent physical and biologic property studies of the newly introduced mineral trioxide aggregate, this material may be suitable for closing the communication between the pulp chamber and the underlying periodontal tissues. These case reports support this hypothesis.

An alternative treatment for the severely resorped maxillary lateral incisor: a sequela of ectopic eruption.

At times dental crowding, maxillary arch inadequacy, or an abnormal lingual or horizontal position restricts the eruption of the maxillary cuspid. This ectopic eruption can cause the canine to compress the blood supply to the periodontal tissues of the adjacent lateral incisor. If undiagnosed and untreated, physiological and chemical changes are induced, and the lateral root undergoes resorption. When the resorption is severe enough to endanger the retention of the lateral, an endeosseous stabilizer can be placed through the root and extended into the bone to stabilize the tooth artificially. Two cases demonstrate the technique and success of such treatment.

Intentional replantation. A viable alternative for selected cases.

When conventional endodontic treatment or retreatment is not possible, the operator may choose to intentionally extract and replant the involved tooth. Intentional replantation consists of extracting the tooth, finding and correcting the defect, and replanting the tooth in its socket. This article discusses the indications, contraindications, and recommended techniques for intentional replantation. Several successful case reports are described in which intentional replantation was used as a last resort.