Ten-year in vitro assessment of the surface status of three retrofilling materials.

Sixty-one maxillary central incisors were collected, cleaned, and divided into six groups of 10 teeth, with one tooth as a control. Half of the teeth were resected with a high-speed bur and half with a slow-speed bur, and prepared for retrofillings. Retrofillings of EBA cement and Ketac cement were placed in 10 teeth, each of the high-speed and slow-speed groups. Similarly++, zinc containing amalgam was placed in 10 teeth of the high-speed group, and zinc-free amalgam was placed in 10 teeth in the slow-speed group. A single operator completed all retrofills. They were stored in physiological saline for 10 yr. After that period, the apical portions were photographed at X 30 magnification and evaluated by the authors for marginal discrepancies, root crazing, staining, voids, and roughness. Overall, EBA cement++ and amalgam rated better than Ketac cement in every category except root crazing. Perhaps, as some studies have suggested, EBA cement may replace amalgam as the retrofill material of choice.

Surgically treating a benign cementoblastoma while retaining the involved tooth.

The authors describe the case of a patient who had tenderness when biting and mild sensitivity to palpation as well as a radiopaque lesion attached to the mesial root of a mandibular first molar. Evidence pointed to a benign cementoblastoma. The dentist redid the original endodontic treatment and surgically removed the lesion, leaving the involved tooth intact. The authors suggest that in certain cases, it may be possible to remove benign cementoblastomas affecting molars without extracting the involved teeth.

Endodontic implications of the variability of the root canal systems of posterior teeth.

Variations in the morphology of roots and root canal systems create challenges which the dental practitioner must be able to recognize. Endodontic therapy is predictable and successful only to the extent that the root canal system can be debrided, disinfected and sealed against future contamination. In order to accomplish these goals it is necessary to become familiar with the variability of the system we seek to treat.

Endodontic implications of anatomical variations and developmental anomalies in maxillary and mandibular anterior teeth.

Endodontic treatment of maxillary and mandibular anteriors does not generally offer strenuous challenges to the skilled practitioner. Most cases are relatively straightforward and can be treated without complication. Anatomical and developmental variations do exist in these teeth, however, which can add an enormous degree of technical complexity, and even doom endodontic treatment to failure. The prudent clinician must be aware of these variations, modify treatment procedures accordingly, and inform the patient of these possible causes of treatment failure.

Management of traumatized permanent incisor teeth with horizontal root fractures.

Proper management of permanent incisors with horizontal root fractures includes careful diagnosis, continued re-evaluation and a conservative treatment approach. The location of the root fracture and pulpal vitality status both play important roles in proper treatment decisions. A thorough examination, judicious treatment and follow-up on the part of both dentist and patient can result in long term retention of many of these traumatized teeth.

A standard predetermined endodontic preparation concept.

Cleaning and shaping the root canal system is the most tedious and demanding phase of endodontic therapy. Using a predetermined endodontic preparation allows for a routine approach to instrumentation and produces high-quality results with better efficiency. Schilder states, "Inherent in the concept of cleaning and shaping is the fact that each root canal system, like each carious lesion, is different from another and that, within certain prescribed guidelines no two root canal preparations should be exactly alike, anymore than any two intracoronal preparations are exactly alike." The concept of predetermined preparation does not conflict with Schilder's statement, it merely refines prescribed instrumentation guidelines and establishes instrumenting parameters. The goals of endodontic instrumentation are to: (1) instrument with control so that there is enlargement without deviation from the original canal; (2) instrument to a size that is consistent with total mechanical and chemical debridement; (3) debride the root canal system from its coronal orifice to the periodontal ligament, regardless of canal curvature; and (4) create a canal shape that tapers from the coronal orifice to the apical opening. The authors will discuss each endodontic goal as it is accomplished in the predetermined preparation. Techniques for instrumenting to the predetermined sizes are also described.

Endodontic management of trauma to permanent teeth.

Oral trauma is a common event. It has been estimated that up to 20% of the United States population has sustained injuries to the teeth. In a perspective study, Andreasen reported that one of every two Danish children had sustained an oral injury by age 14. This article will discuss the different types of injuries that can happen to permanent teeth, endodontic management of these injuries, and possible complications. Exarticulations (totally avulsed teeth) will not be thoroughly discussed.

Endodontics: errors in instrumentation.

The authors provide a pictorial review of technical errors in endodontic instrumentation. Examples of separated instruments, abrupt constriction, laceration, canal transportation, and control zone errors are provided. The potential problems and effect on prognosis associated with these errors are explained.

Spontaneous apical closure of an avulsed immature incisor.

Apical closure of nonvital teeth can be achieved by appropriate endodontic intervention. A case is reported in which apical maturation appears to have occurred without treatment and in the presence of sporadic drainage from a sinus tract stoma.