Apical Dimension of Root Canal Clinically Assessed with and without Periapical Lesions.

To clinically evaluate the dimension of the more apical extent of the root canal after appropriate preflaring in the case of primary treatment and retreatment with and without the presence of periapical radiolucency, 392 single-rooted teeth with only one canal were evaluated during endodontic therapy. The canals were divided in two groups depending on the presence or absence of periapical radiolucency. After preflaring of the root canal the size of the root canal terminus (apical canal dimension) was gauged with hand-held Light Speed LS1 files inserted at the estimated working length and established with the use of an electronic apex locator. The dimension recorded in the computer database was represented by the largest instrument able to reach the electronically established working length. The differences between the treatment groups were assessed using the Mann-Whitney U test and the significance level was set at P < 0.05. Teeth with lesions had a significantly greater diameter in the apical region than teeth without lesions (P < 0.001). The dimension of the apical portion of the root canal is larger in the case of periapical radiolucency. This involves verifying this parameter in order to use the correct sized instruments and to obtain an efficient cutting action at the apical level.

Incidence of periapical lesions and clinical symptoms after pulpectomy--a clinical and radiographic evaluation of 1- versus 2-session treatment.

OBJECTIVE: Outcome of pulpectomy in 2 treatment sessions with calcium hydroxide as an intracanal dressing was compared to a procedure comprising instrumentation and root-filling in 1 session. STUDY DESIGN: Subjects with a vital pulp condition (N = 256) were recruited to a randomized clinical trial. Outcome parameters included radiographic signs of apical periodontitis and painful symptoms at clinical follow-ups 1 week and 1-3 years after treatment. RESULTS: Of 244 subjects available for final recall, 17 presented with periapical radiolucency. Lesions were evenly distributed among the 2 treatment groups. Postoperative pain recorded 1 week after permanent filling was significantly associated with overfilling (P = .001), with no difference between treatment groups. There was no association with presence of overfilling and radiographic lesion at end point of recall. CONCLUSIONS: Study confirms that pulpectomy may be carried out at a high rate of success if due attention is given to aseptic operating procedures, proper instrumentation and filling. Under these conditions an interappointment dressing with calcium hydroxide does not seem to influence outcome.

Interfacial strength of Resilon and gutta-percha to intraradicular dentin.

Strengthening of Resilon-filled roots via an adhesive interface should be reflected by improvement in the interfacial strength and dislocation resistance between the root fillings and intraradicular dentin. This study compared the interfacial strengths of Resilon/Epiphany and gutta-percha/AH Plus using a thin-slice push-out test design. Failure modes of root slices after push-out testing were examined with environmental scanning electron microscopy. The gutta-percha group exhibited significantly higher interfacial strength than the Resilon group, when premature failures that occurred in Resilon root slices were included in the statistical analysis. The gutta-percha root slices failed exclusively along the gutta-percha/sealer interface. The Resilon root slices failed predominantly along the sealer/dentin interface with recognizable, fractured resin tags. Detachment of the Resilon from the Epiphany sealer was also surprisingly observed in some specimens. The similarly low interfacial strengths achieved with both types of root filling challenges the concept of strengthening root-filled teeth with the new endodontic material.