A comparison of mesial molar root canal preparations using two engine-driven instruments and the balanced-force technique.

The purpose of this study was to compare the effects of two engine-driven, nickel-titanium instrument systems with hand files in the final shape of slight and moderately curved canals. A total of 72 mesial roots of extracted human mandibular molars were divided into three groups: ProFile .04 taper, Pow-R rotary systems, and Flex-R hand-filing technique. The roots were mounted and cross-sectioned at two different horizontal levels using a modified Bramante technique. Pre- and postinstrumented cross-sectional roots were imaged, recorded, and computer analyzed. Results showed that, at the middle third, in almost all groups, there was a tendency of cutting more toward the mesial side with only one exception: Pow-R cut more to the distal side (danger zone) (p < 0.02). At the apical third, Flex-R (p < 0.03) and ProFile (0.001) transported to the mesial side (danger zone) when the curvature increased. When the three techniques were compared analyzing each side and considering the two groups of curvature, at the middle third in the moderately curved-canal group, Flex-R cut statistically more than Pow-R toward the lingual side. The other comparisons showed no statistically significant difference. When the techniques were compared in relation with the degree of curvature, in the apical third, ProFile .04 cut statistically more toward the mesial side in the moderately curved canal group than in the slightly curved canal group. The other comparisons showed no statistically significant difference. Canal preparation time was shorter with hand instrumentation (p < .05) in a few instances.

Effectiveness of oxidative potential water as a root canal irrigant.

AIM: The aim of this study was to evaluate the effectiveness of oxidative potential water (OPW) as an irrigant, based on its ability to remove the smear layer and/or debris from instrumented root canals. METHODOLOGY: One hundred and twenty root canals from extracted human maxillary incisors were instrumented using a conventional step-back technique with irrigation from sodium hypochlorite (NaOCl) or oxidative potential water (OPW). After instrumentation, the canals were irrigated by syringe or ultrasound using 15% EDTA or OPW as an irrigant. The volume of each irrigant used for syringe irrigation was 10, 20, and 30 mL, respectively, whilst the duration for ultrasonic irrigation was 1, 3, and 5 min, respectively. After irrigation, each root was split longitudinally in two with cutting pliers, and the specimens were prepared for SEM observation. The presence of debris and smear layer on each canal wall was assessed using a three-point scale for each parameter. RESULTS: Smear layer was effectively removed with EDTA both introduced via syringe and via ultrasonic irrigation. A similar effect was observed with OPW via syringe irrigation following instrumentation with 5% NaOCl. The canal walls in any of these cases showed open and patent dentinal tubules following smear layer removal. Some specimens irrigated with EDTA exhibited the effect of demineralization on the dentine resulting in funnelling of tubule orifices. Syringe irrigation was more effective in smear layer removal, except for ultrasonic irrigation with 15% EDTA, whilst ultrasonic irrigation was more effective in debris removal including the use of OPW as irrigant following instrumentation with 5% NaOCl. Neither syringe nor ultrasonic irrigation with OPW following instrumentation with OPW removed smear layer or debris effectively. CONCLUSIONS: The most effective irrigation technique for smear removal was 15% EDTA irrigation by means of syringe following instrumentation with 5% NaOCl solution. However, the most effective irrigation technique for debris removal was ultrasonic irrigation regardless of irrigant used. OPW irrigation by means of syringe following instrumentation with 5% NaOCl showed a similar effect to that of 15% EDTA irrigation for removal of smear layer and debris.

A comparison of the relative efficacies of four hand and rotary instrumentation techniques during endodontic retreatment.

AIM: The purpose of this study was to quantify the amount of remaining gutta-percha/scaler on the walls of root canals when two engine-driven instruments (Quantec and ProFile) and two hand instruments (K-file and Hedström file) were used to remove these materials. The amount of apically extruded debris and the time required for treatment were also recorded. METHODOLOGY: One hundred extracted mandibular premolars were prepared using a modified step-back, flare technique and obturated with the lateral condensation technique. After repreparation with the test instruments, the specimens were cut transversally at the cervical, middle and apical thirds with steel discs and the three sections were split longitudinally. The amount of residual debris on the canal walls in each section was examined using a stereomicroscope. RESULTS: In all groups the cervical and middle thirds showed no debris. In the apical third, obturating material was observed in some specimens. No statistically significant difference was found between the two groups for incidence of debris, although the Hedström group showed a greater number of samples with remaining gutta-percha/sealer. When analysing dirty specimens only, there was a statistically significant difference between the four groups (P < 0.01) with the Hedström group having significantly less length of canal wall with remaining obturation material than the Quantec group. There was no significant difference amongst the groups for weight of extruded debris. However, there was a significant difference amongst the groups for mean treatment time with the Hedström file group requiring significantly less time than the Quantec group (P < 0.001); no significant differences were found between the other groups. Six instruments fractured in the Quantec group, four in the ProFile group, two in the Hedström group and two in the K-type group. CONCLUSIONS: The results showed that overall, all instruments may leave filling material inside the root canal. During retreatment there is a risk of instrument breakage, especially rotary instruments.

Canal configuration of the mesiobuccal root of the maxillary first molar of a Japanese sub-population.

AIM: The aim of this study was to determine the percentage of anatomical canal configurations of the mesiobuccal root of the maxillary first molar in Japanese patients. METHODOLOGY: Three hundred teeth were obtained from general dentists who knew absolutely that they were extracted from Japanese patients. The distobuccal and palatal roots were amputated for radiographic convenience. Preoperative radiographs were taken of the remaining crown and mesiobuccal root (MBR) from mesiodistal and buccopalatal directions for each tooth. Routine endodontic access cavities were prepared and size 08 files were placed through the orifice into the MBR until they were seen at the apex. In some cases preparation of the canal orifice with a long shank round burr was necessary to gain access. In seven teeth, no access to the apex was possible and these teeth were eliminated. In the other 293 teeth, the MBR canal(s) was (were) enlarged up to size 15 file. If another canal opening was found at the apex a 08 file was inserted into the second opening and passed coronally. Postoperative radiographs with file(s) in place were taken from the two directions, as before. RESULTS: Of the 293 teeth, 123 (42.0%) were Type II, 89 (30.4%) showed Type III systems and 10 (3.4%) were Type IV. Suggestions for identification and treatment of the second canal in the MBR are presented. CONCLUSIONS: The proportion of cases with two canals in the mesiobuccal root of maxillary first molars from Japanese patients was high and similar to that described from studies of other ethnic populations.

Sealing ability of composite resin placed over calcium hydroxide and calcium sulphate plugs in the repair of furcation perforations in mandibular molars: a study in vitro.

The purpose of this study was to evaluate in vitro the sealing ability of various materials in the repair of furcation perforations in mandibular molars by measuring coronal microleakage with Indian ink. Ninety extracted mandibular molars were embedded individually into a plaster of Paris block, with the roots surrounded by a simulated periodontal ligament of silicone. Subsequently, a standard coronal access opening was prepared, the root canal orifices were located and a perforation was made with a size 012 round bur in a water-cooled high-speed handpiece directly into the centre of the floor of the pulp chamber. The perforations were repaired with amalgam, composite resin, calcium sulphate under composite resin and calcium hydroxide under composite resin. The teeth were coated with two layers of nail polish, leaving the access opening area uncovered, and immersed in Indian ink for 4 days at 37 degrees C. The teeth were sectioned longitudinally and dye penetration measured from the coronal level of the repair material to the apical end of the perforation. All experimental groups revealed dye penetration in varying degrees, but there was no significant difference amongst them (Kruskal-Wallis test P < 0.05). Calcium sulphate and calcium hydroxide prevented overextrusion of composite resin when used under this repair material.

Sealing ability of composite resin placed over calcium hydroxide and calcium sulphate plugs in the repair of furcation perforations in mandibular molars: a study in vitro / Capacidade de selamento da resina composta sobre um lado de hidroxido de calcio e sulfato de cálcio tampando o reparo da perfuração de furca no molar mandibular: um estudo in vitro

The purpose of this study was to evaluate in vitro the sealing ability of various materials in the repair of furcation perforations in mandibular molars by measuring coronal microleakage with Indian ink. Ninety extracted mandibular molars were embedded individually into a plaster of Paris block, with the roots surrounded by a simulated periodontal ligament of silicone. Subsequently, a standard coronal access opening was prepared, the root canal orifices were located and a perforation was made with a size 012 round bur in a water-cooled high-speed handpiece directly into the centre of the floor of the pulp chamber. The perforations were repaired with amalgam, composite resin, calcium sulphate under composite resin and calcium hydroxide under composite resin. The teeth were coated with two layers of nail polish, leaving the access opening area uncovered, and immersed in Indian ink for 4 days at 37ºC. The teeh were sectioned longitudinally and dye penetration measured from the coronal level of the repair material to the apical end of the perforation. All experimental groups revealed dye penetration in varying degrees, but there was no significant difference amongst them (Kruskal-Wallis test P<0.05). Calcium sulphate and calcium hydroxide prevented overextrusion of composite resin when used under this repair material

Two canals in mesiobuccal roots of maxillary molars.

The purpose of this study was to examine extracted root canal treated maxillary molars cleared for: (i) the presence of a mesiopalatal (MP) canal in both first and second molars, (ii) the extension of MP canal from the pulp to the apical area, and (iii) the incidence of two foramina in the MB root. Seventy-two extracted maxillary molars (42 first and 30 second molars) were root canal treated by graduate students. The mesiobuccal (MB) roots of these samples were rendered transparent using a clearing technique. The results demonstrated that 52.3% of first and 40% of second molars had two canals obturated in the MB root. After clearing the same roots, the presence of MP canals rose to 80.9% and 66.6%, respectively. The MP canals were root canal treated as far as the foramen in 35.2% of first and 35% of second molars. However, after making them transparent, 91.1% and 90% showed the presence of this canal to the anatomical apex. The MB roots of the root canal treated first molars showed the presence of two foramina in 47% of cases but in 88.2% after clearing. The second molars showed 50% and 70%, respectively. The differences between root canal treated teeth before and after clearing were significantly different in almost all comparisons in both first and second molars. The only exception was when the presence of two foramina was compared before and after the clearing process in second molars (McNemar test P < 0.05).

Effectiveness of eucalyptol and d-limonene as gutta-percha solvents.

Eucalyptol and d-limonene were evaluated for their ability to serve as a substitute solvent for chloroform. The amount of time required to soften and remove the gutta-percha in 72 instrumented and filled simulated root canals in epoxy blocks was measured. After preparation to the apices of the block canals with a #60 file, four different filling techniques were used. These obturations were softened with each solvent and then removed, first using a #15 Hedstrom file inserted to full working length, and then removing the remaining filling mass with a #60 reamer. The two instrument placements were timed: one for the Hedstrom file insertion to the apex and the other for the reamer to remove the filling material. Neither the different solvents nor the filling techniques had a significant effect on the times required for the H-files to reach the apex. However, the times for the reamer to remove the filling materials were effected both by the filling techniques and the solvents used.

Removal of smear layer in the root canal using oxidative potential water.

We investigated oxidative potential water (OPW) for its ability to remove the smear layer using a scanning electron microscope. OPW has been studied mainly in Japan and is known to suppress bacteria and viruses without harming living systems. We found that OPW used as in irrigant during and after root canal instrumentation is as effective as 5% NaOCl or 17% EDTA for opening and keeping patent the dentinal tubules.

Sealing ability of thermoplasticized gutta-percha fill techniques as assessed by a new method of determining apical leakage.

One hundred fifty-nine extracted single-rooted maxillary human teeth were instrumented and randomly divided into nine groups of 17 teeth each and 6 control teeth. Experimental groups were obturated with Thermafil, Obtura II, Ultrafil Regular Set gutta-percha, and Ultrafil Firm Set gutta-percha, each with or without root canal sealer. A control group was obturated using the lateral condensation technique and sealer. Teeth were immersed in a resorcinol-formaldehyde resin for 5 days at 4 degrees C, and the resin was allowed to polymerize completely for 4 days at room temperature. Teeth were then sectioned horizontally at 1.5, 2.5, and 3.5 mm from the anatomical apex, and examined under a stereomicroscope at x25 magnification. The resin filled the spaces in the gap between the canal wall and the gutta-percha and this was measured at each of the three levels. The ratio of the area of the resin to the total area of the canal was obtained as the mean leakage area. The results showed no significant difference in the mean leakage area at the same level for the different obturation materials. However, the leakage was significantly less for all materials when root canal sealer was used.

Changes in cell proliferative activity in granulation tissue invading the root canal.

Root canal models were implanted in rats in order to investigate histologically the movement of granulation tissue invading apical canals and dead spaces and changes in cell proliferative activity as indicated by 3H-thymidine. The models were prepared to have 1, 2, and 3 mm apical canals, with and without dead spaces, to simulate preparations short of the apex and obturation to several levels. After 12 wks implantation of the models without dead spaces, granulation tissue invading 1 mm apical canals did not degenerate and cell proliferative activity remained high. However, tissue invading the 2 and 3 mm apical canals tended to be necrotic and cell proliferative activity was decreased. In the models with dead spaces, the tissue in the 1 and 2 mm apical canals developed and invaded the dead spaces, and still possessed proliferative activity 12 wks after implantation. In contrast, the tissue in the 3 mm apical canals did not invade the dead spaces, even after 12 wks, and no proliferative activity was observed.

Synthesis, structure and antitumor activity of a new water-soluble platinum complex, (1R,2R-cyclohexanediamine-N,N')[2-hydroxy-4-oxo-2-pentenoato(2-)-O2] platinum(II).

The reaction of dihydroxo(1R,2R-cyclohexanediamine)platinum(II) with 2,4-dioxopentanoic acid gave a water-soluble complex, (1R,2R-cyclohexanediamine-N,N')[2-hydroxy-4-oxo-2-pentenoato (2-)-O2] platinum(II). The structure of the complex was determined by X-ray crystal analysis. The data indicated a chelation of the acetylacetonato part of 2,4-dioxo-pentanoic acid to platinum(II). The complex showed moderate antitumor activity against murine leukemia L1210 in mice (T/C = 195% at a dose of 200 mg/kg) and high activity against cisplatin-resistant L1210 leukemia (T/C = 275% at a dose of 25 mg/kg).

Sealing ability of Thermafil with and without sealer.

The purpose of this study was to evaluate the apical sealing ability of root canals filled using three obturating techniques. Sixteen maxillary first molars were obturated with Thermafil, 16 with Thermafil and a ZOE sealer, and 16 with laterally condensed gutta-percha. Two canal instrumentation methods were used, conventional step-back preparation with K-Flex files and traditional instrumentation combining reaming with reamers and filing with K-Flex files. Following obturation, the teeth were prepared for evaluation of the seal using India ink and a Profile Projector. The depth of penetration of the dye was statistically evaluated for each of the three roots with an analysis of variance. For sealing ability, there was no significant difference at the p < 0.05 level between the conventional step-back preparation and the traditional instrumentation technique. However, a significant difference was present at the p < 0.05 level for the obturation techniques. The mean linear dye penetration for the Thermafil technique was greater than that for lateral condensation.

Synthesis, structure and antitumor activity of a water-soluble platinum complex, (1R,3R,4R,5R)-(-)-quinato(1R,2R-cyclohexanediamine)platinum (II).

The reaction of dihydroxo(1R,2R-cyclohexanediamine)platinum(II) with (-)-quinic acid gave a water soluble complex, (-)-quinato(1R,2R-cyclohexanediamine)platinum(II). The crystal structure of the complex was determined by X-ray analysis. The data indicate a chelation of the alpha-hydroxycarboxylic acid part of quinic acid to platinum(II). The complex shows moderate antitumor activity against murine leukemia L1210 at high doses (T/C x 100 = 179% at a dose of 200 mg/kg).

Autotransplantation using endosseous implants as stabilizers.

The surgical transfer of a tooth from one site to another in the same individual is known as autotransplantation. Usually the tooth transferred is an unerupted or partially erupted third molar which is placed into a first molar position with some external fixation. In this case report, the first molar was already missing and the second molar was hopeless. An erupted third molar was autotransplanted into the second molar site and endosseous implants were used to stabilize the tooth. A fixed bridge was placed 6 months later and the progress followed for 4 yr.

Systemic distribution of 14C-labeled formaldehyde applied in the root canal following pulpectomy.

The systemic distribution of 14C-labeled formaldehyde which had been placed in the root canals of the canines of cats following pulpectomies was studied using liquid scintillation counting and wholebody autoradiographic technique. Radioactive 14C which had been placed in the canals was found in the plasma 30 min after the root canal procedure. The recovery of systemic 14C radioactivity increased with time. In addition, it seemed that approximately 3% of the dose placed in the teeth was excreted in the urine within 36 h. Whole-body autoradiograms indicated extensive concentration of 14C radioactivity in tissues other than those analyzed with the liquid scintillation technique.