Evaluation of Root Canal Preparation Using Rotary System and Hand Instruments Assessed by Micro-Computed Tomography.

BACKGROUND: Complete mechanical preparation of the root canal system is rarely achieved. Therefore, the purpose of this study was to evaluate and compare the root canal shaping efficacy of ProTaper rotary files and standard stainless steel K-files using micro-computed tomography. MATERIAL AND METHODS: Sixty extracted upper second premolars were selected and divided into 2 groups of 30 teeth each. Before preparation, all samples were scanned by micro-computed tomography. Thirty teeth were prepared with the ProTaper system and the other 30 with stainless steel files. After preparation, the untouched surface and root canal straightening were evaluated with micro-computed tomography. The percentage of untouched root canal surface was calculated in the coronal, middle, and apical parts of the canal. We also calculated straightening of the canal after root canal preparation. Results from the 2 groups were statistically compared using the Minitab statistical package. RESULTS: ProTaper rotary files left less untouched root canal surface compared with manual preparation in coronal, middle, and apical sector (p<0.001). Similarly, there was a statistically significant difference in root canal straightening after preparation between the techniques (p<0.001). CONCLUSIONS: Neither manual nor rotary techniques completely prepared the root canal, and both techniques caused slight straightening of the root canal.

Cytotoxic effect of endodontic irrigants in vitro.

BACKGROUND: Cytotoxicity of root canal irrigants is important due to their close contact with host tissues. The aim of this study was to assess the cytotoxic effect of NaOCl 3%, Chx 2%, and MTAD on rat periodontal ligament fibroblasts, at 0.1 and 100 µl/mL, using WST-1 colorimetric method. MATERIAL AND METHODS: Rat ligamental fibroblasts were exposed to the irrigants and their viability was assessed after 1, 24, 48, and 72 h. The measurements were determined using WST-1 assay, using a micro ELISA reader. RESULTS: At 100 ml/L all 3 irrigants were strongly cytotoxic, although CHX was less so than NaOCl and MTAD. At the 0.1 ml/L concentration, NaOCl and MTAD were only moderately cytotoxic, whereas Chx was highly deleterious to cell viability at all time points. There was a significant influence of the dilution rate of the substance, because the odds ratio for cell viability being over 50% was increased 51 times between the 100 ml/L and 0.1 ml/L dilutions. CONCLUSIONS: It seems that irrigating solutions should be used at lower concentrations to enhance cell viability.

Position of the mental foramen in Kosovarian population.

The aim of this study was to determine the position, shape, number and radiographic appearance of the mental foramen in a selected Kosovarian population. Five hundred panoramic radiographs of dental Kosovarian patients were selected and analyzed according to the mental foramen position, shape, radiographic appearance, number and symmetry. The mean distance in the horizontal plane of the mental foramen to the posterior border of the mandibular ramus was 67.5 mm and for distance from the mental foramen to symphysis menti 24.84 mm. In the vertical plane the mean distance of the mental foramen to alveolar crest was 20.38 mm and 14.68 mm for distance of the mental foramen to the lower border of mandible. The majority of mental foramen was oval in shape and the most frequent radiographic appearance was the separated type. Accessory mental foramina were detected in < 1% of the cases and the mental foramen was not bilaterally symmetrical but no statistical differences were found. This study showed that the most common position of the mental foramen investigated using panoramic radiographs from a selected group in Kosovarian population was between the first and second mandibular premolars with distinct tendency to be positioned near to the second mandibular premolar.

Effects of preparation techniques on root canal shaping assessed by micro-computed tomography.

BACKGROUND: Root canal shaping without any procedural error is of the utmost preference. Therefore, the purpose of this study was to use micro-computed tomography to evaluate and compare the root canal shaping efficacy of ProTaper rotary files and standard stainless steel K-files. MATERIAL AND METHODS: Sixty extracted upper second premolars were selected and were divided into 2 groups of 30. Before preparation, all samples were scanned by micro-CT. Then, 30 teeth were prepared with stainless steel files and the remaining 30 with ProTaper rotary files. Canal transportation and centering ability before and after root canal shaping were assessed using micro-CT. The amount and direction of canal transportation and the centering ratio of each instrument were determined in the coronal, middle, and apical parts of the canal. The 2 groups were statistically compared using one-way ANOVA. RESULTS: ProTaper rotary files gave less transportation (p<0.001) and better centering ability (p<0.00001) compared with stainless steel files. CONCLUSIONS: The manual technique for preparation of root canals with stainless steel files produces more canal transportation, whereas rotary files remain more centered in the canal.

Prevalence of apical periodontitis and endodontic treatment in a Kosovar adult population.

BACKGROUND: Despite numerous studies on the prevalence of apical periodontitis (AP) and endodontic treatment in diverse geographical populations, there are currently no data on the prevalence of these conditions in populations of adults native to Kosovo. Therefore, little is known about how widespread these conditions are, and whether there is any correlation between root canal treatment and AP. The purpose of our research was to address this anomaly by investigating AP and endodontic treatment in an adult Kosovar population based on radiographic examination. METHODS: The sample used for this study consisted of randomly selected individuals referred to the University Dentistry Clinical Center of Kosovo in the years 2006-2007. Orthopantomographs of 193 patients were evaluated. The periapical status of all teeth (with the exception of third molars) was examined according to Ørstavik's Periapical Index. The quality of the root canal filling was rated as 'adequate' or 'inadequate' based on whether all canals were filled, the depth of fill relative to the radiographic apex and the quality of compaction (absence/presence of voids). Data were analyzed statistically using the Chi-square test and calculation of odds ratios. RESULTS: Out of 4131 examined teeth, the prevalence of apical periodontitis (AP) and endodontic treatment was 12.3% and 2.3%, respectively. Of 95 endodontically-treated teeth, 46.3% were associated with AP. The prevalence of AP increased with age. The prevalence in subjects aged over 60 years old (20.2%) was higher than in other age groups. A statistically significant difference was found for the frequency of endodontically-treated teeth associated with AP in the 40-49 year age group (P < 0.001). Of some concern was the discovery that only 30.5% of the endodontically-treated teeth examined met the criteria of an acceptable root canal filling. Inadequately root-filled teeth were associated with an increased AP risk. CONCLUSIONS: The prevalence of AP and the frequency of endodontically-treated teeth with AP in this Kosovar population are higher than those found in other countries. Inadequate root canal fillings were associated with an increased prevalence of AP.

Lead concentrations in teeth from people living in Kosovo and Austria.

The objective of this study was to compare lead concentrations in 86 human permanent teeth extracted from residents of three different geographical regions. The study included 31 permanent teeth from residents of Mitrovica (Kosovo), 32 from Klina (Kosovo) and 23 from Graz (Austria). The concentrations of lead were measured using Agilent 7500c inductively coupled plasma mass spectrometer (ICP-MS) (Agilent, Waldbronn, Germany). The comparisons between groups were based on the geographic area, age and gender. The highest lead level was found in teeth extracted from Mitrovica residents (22.3 mg/kg), followed by Klina (3.2 mg/kg), and Graz (1.7 mg/kg). Lead levels in teeth from Mitrovica residents are significantly higher (p < 0.0001) than in other two groups, possibly due to environmental contamination with lead. Overall results in this study support the concept that tooth lead level may present an important indicator in evaluating environmental exposure of human population to heavy metals.