Prevalence of missed canals in endodontically treated teeth: A cone-beam computed tomography study.

Background: This study aimed to measure the prevalence of untreated root canals and periapical lesions in endodontically treated teeth using cone-beam computed tomography (CBCT) and their association with the coronal seal. Material and Methods: This cross-sectional study assessed CBCT images of studied patients alongside documented information from their dental examinations. The assessment method for analyzing CBCT images after including endodontically treated teeth was the presence of missed canals, and periapical lesions were analyzed in three dimensions. Results: The evaluations from 772 teeth demonstrated that 89.4% of teeth had the proper coronal seal, 13.3% owned missed root canals, and 29.4% had periapical lesions. Most untreated canals belonged to maxillary first molars (71.8%) and mandibular lateral incisors (33.3%). The prevalence of periapical lesions was highest in mandibular lateral incisors (58.3%) and maxillary second molars (55.8%). In teeth with missed canals, the most periapical lesions were observed in the first premolars of both jaws. In teeth with the lack of proper coronal seal, the periapical lesions were observed in 55.6% of teeth with untreated root canals. Conclusions: The results revealed a high prevalence of missed canals and periapical lesions in endodontically treated teeth in our study population. Key words:Untreated Root Canals, Periapical Lesions, 3-D Dental Imaging, Dental Treatment Failure.

A Comparison of Antibacterial Properties of Tachyplesin, Thanatin, and Enterocin P on Enterococcus faecalis.

OBJECTIVE: Enterococcus faecalis (E. faecalis) is one of the persistent microorganisms responsible for the failure of root canal treatments. This study investigated the antibacterial property, the time-killing of 3 peptides, namely Tachyplesin, Thanatin, and Enterocin P, on E. faecalis. METHODS: In this study, recombinant peptides were synthesized via secretory synthesis. The peptides were then purified and isolated using affinity chromatography after which their purification was evaluated through SDS-PAGE. The antimicrobial activity of peptides against E. faecalis was tested using the minimum inhibitory concentration test (MIC), the minimum bactericidal concentration test (MBC), and the time-killing assay. RESULTS: Based on antimicrobial tests, a similar value was observed for the MIC and MBC in the recombinant peptide of Enterocin P. The concentration of MBC was twice as much as that of MIC for Tanatin and Tachyplesin. The time-killing-assay antimicrobial test showed that Enterocin P has a better pattern and antimicrobial activity than the other two peptides; all three peptides have weaker antimicrobial activities than sodium hypochlorite. CONCLUSION: Considering the equivalence of MIC and MBC in the recombinant peptide of Enterocin P, it can be a viable replacement for traditional disinfectants and medicaments used in root canal treatment procedures.

Endodontic Management of a Maxillary Premolar with a Rare Configuration (Three Buccolingually Positioned Canals in a Single Root) as Confirmed by Cone Beam Computed Tomography: a Case Report.

Missed canals pose a potential risk in the treatment of teeth with anatomical variations, even when multi-angled radiographs have been used. Incomplete mechanical and chemical debridement of the root canal system can lead to treatment failure. Therefore, clinicians must have adequate knowledge of normal root canal systems as well as any possible variations in order to prevent any failure during or after the treatment of teeth with anatomical variations. Any case report of such rare variations would add to this critically required body of knowledge. The current case report presents the diagnosis and endodontic treatment of a maxillary first premolar with one root and three canals (one palatal and two buccal canals, all buccolingually positioned, bifurcating in the apical region), which was different from premolars with 3 canals reported up to now. This configuration describes an unusual root canal system for the maxillary first premolar and does not fit into any of the well-known root canal classification systems.

Treatment of a Hopeless Tooth with Combined Endodontic-periodontal Lesion Using Guided Tissue Regeneration: A Case Report with One Year Follow-up.

Endodontic-periodontal lesions have always been a challenge for treatment due to the reduced success rate in comparison to endodontic or periodontal lesions alone. This case report describes surgical/endodontic management of supra-erupted non-vital maxillary incisor with primary periodontal and secondary endodontic lesions with mobility grade III and severe horizontal and vertical loss of attachment apparatus in a 55 years old woman with aggressive periodontitis. The successful results at one-year follow-up revealed that with an appropriate case selection strategy, proper regeneration method and soft tissue enhancement, severe combined endo-perio lesions may treat.

Management of Pulp Canal Obliteration in Mandibular Incisors with Guided Endodontic Treatment: A Case Report.

Successful management of mandibular incisors with pulp canal obliteration using guided endodontics is described, for the first time in Iran. A 58-year-old man was referred for root canal treatment of teeth #24, #25 and #26. Upon radiographic examination, partial obliteration of the root canal system was detected. Cone-beam computed tomography (CBCT) was requested to enhance the diagnosis and detection of root canals. Next, a 3-dimensional (3D) guide was designed and printed to aid in localization and access to the root canal system with minimal destruction of the tooth structure. With the use of a targeted 3D guide, a conservative access cavity was prepared to avoid unnecessary removal of tooth structure. The teeth were successfully treated endodontically. Obtained results revealed that the technique can be effective and predictable for the management of calcified canals.