Root Canal Stripping: Malpractice or Common Procedural Accident-An Ethical Dilemma in Endodontics.

Root canal stripping is defined as an oblong, vertical perforation that appears especially in the middle section of curved root canals during endodontic treatments with nickel-titanium (Ni-Ti) instruments. Its occurrence may drastically affect the outcome of the treatment, transforming a common otherwise efficient endodontic procedure into a complication such as tooth extraction. In order to discuss the ethical and legal consequences, two cases of dental strip perforations are herewith presented. Due to the existence of risk factors for dental strip perforation, experience of the clinician and the use of magnification and modern imagistic methods (CBCT) may avoid or reduce the frequency of this type of accidents. Under correct working circumstances, dental stripping should not be regarded as a malpractice but as a procedural accident. However, the patient must always be informed, before and during the endodontic procedure, about the event and the possible complications that may occur.

Cone beam computed tomography as a method of quantitative and qualitative analysis of alveolar crest in the frontal mandibular area.

UNLABELLED: New radiographic maxillofacial techniques, cone beam computerized tomography (CBCT) are a necessity in the assessment of jaw bone offer to effectively evaluate the treatment. AIM: To quantitatively and qualitatively evaluate anterior mandibular area on CBCT comparing to orthopantomography (OPG). MATERIAL AND METHODS: Fifty-one dental patients, aged between 20 and 77 years, were quantitatively analyzed and 81 dental patients, aged between 20 and 79 years, were qualitatively analyzed. ANOVA and Mann-Whitney tests were used for statistical analyses. RESULTS: Strong statistical significant differences were recorded between CBCT and OPG assessments for all groups of teeth (p<0.001), when evaluation was performed on distances to mandibular base. When assessing the distance to the incisive canal, the differences were recorded only for the left canine zone. Mean densities of central incisor, lateral incisor and canine regions, were 1,400-1,425 HU, 1,212-1,224 HU, and 1,150-1,175 HU, respectively. There was a marginal statistical evidence that bone density was lower in canine zone comparing to central incisor area (p=0.08). CONCLUSIONS: Measurements on CBCT are more accurate when compared with OPG. Bone density of central incisor region is higher. Therefore, CBCT permits the clinician to have all necessary information when planning dental implants.