[A root canal treatment that has proved to be ineffective: considerations, possibilities and choices]. / Een niet effectief gebleken wortel­kanaalbehandeling: overwegingen, kansen en keuzes.

If a root canal treatment has proved to be ineffective, different treatment options are possible. It starts, however, with the discussion whether the tooth can or should be saved. Many considerations play a role in this choice: the clinical and radiographic findings, the professional's ideas, the patient, the scientific insights that alter the value of various factors during evaluation and the availability of a good alternative treatment. All these factors must be carefully weighed in order to reach a well-balanced decision with the patient. Simple extraction and replacement is not supported by the literature.

[A non-healing dark area: surgical treatment or non-surgical retreatment?]. / Een niet-genezen zwarting: herbehandeling of chirurgie?

There are a lot of studies discussing success rates of root canal treatment. They show a big variety in their outcomes. Success rates are reported between 54 and 96 percent with a majority reporting a figure towards the higher end of the range. Despite high success rates reported, there are still cases showing no healing after an evaluation period. At that point the dentist has to make a decision: retreatment or surgical endodontics. To make this decision various factors influencing the outcome should be considered carefully. The overall conclusion is that when failure occurs, endodontic retreatment is the first treatment of choice. Periapical surgery is a treatment option which should carefully be considered in specific circumstances.

[Research methods in dentistry 4. Methods for evaluating the sealing ability of filling materials in the root canal]. / Onderzoeksmethoden in de tandheelkunde. 4. Methoden om de afsluiting van vulmaterialen in het wortelkanaal te evalueren.

In the past many in vitro studies were presented on the efficiency of the apical closure of the root canal. Such studies are relatively easy to perform in contrast to clinical studies. In order to determine which type of apical seal will give the best result, many techniques are evaluated. These results from in vitro studies are difficult to apply to the clinical situation. The results of clinical studies on root canal treatments are not always in accordance with the findings of in vitro studies. It remains a challenge to design a research protocol with an improved predictive value for the clinical situation.

Monitoring pulp vitality after transplantation of teeth with mature roots: a case report.

AIM: To initiate discussion on the value of routine root canal treatment for transplanted teeth. SUMMARY: Autotransplantation is an accepted treatment option to replace missing teeth. It is generally considered that revascularization of the pulp following such a procedure is more favourable in teeth with immature roots. In teeth with closed apices root canal treatment is considered necessary. This paper presents a case of pulp revascularization in a transplanted tooth with mature roots and casts doubt on whether root canal treatment is essential in such situations. An alternative treatment protocol is proposed. KEY LEARNING POINTS: * Following transplantation original pulp tissue may survive the operation. * Teeth with obliterated pulp space do not become necrotic more often than those without obliteration. * Monitoring the tooth is an acceptable alternative to automatic root canal treatment for transplanted teeth. * Root canal treatment should be undertaken only upon occurrence of pathological signs.

[Intracanal medication used in general dentistry]. / Middelen voor toepassing in het wortelkanaal gebruikt door algemeen practici.

In order to investigate the use of intracanal substances during root canal treatment 400 dentists were asked to take part in a questionnaire survey. Questions related to the substances used, the reason for use and the way they were used. Studied were the possible influences by the variables 'year of graduation', 'number of patients in practice', 'dental school'. The results show a general use of sodiumhypochlorite and calciumhydroxide. Also a frequent use of substances with possible systemic side effects was reported. A positive trend is the fewer use of these medicaments by dentists who qualified more recently.

[Formaldehyde in dental materials]. / Formaldehyde in tandheelkundige materialen.

The use of formaldehyde in dentistry has been discussed for years. This because of the possible systemic effects of its use. This paper addresses the possible systemic effects of the use of formaldehyde and the question in which dental products formaldehyde is a component. The indications for the use of formaldehyde as its alternatives are listed. The conclusion is that for nearly all dental indications for the use of formaldehyde good alternatives are available.