Micro-computed tomography (micro-CT) evaluation of root canal morphology in immature maxillary third molars.

The endodontic treatment of immature permanent teeth with necrotic pulp is a significant clinical challenge. The success of regenerative endodontic procedure is highly dependent on disinfection of the root canal and an accurate anatomical knowledge of the root canal. The aim of this study was to use micro-computed tomography (micro-CT) analysis to investigate the configuration of root canals in the upper permanent third maxillary molars with incomplete root development in their coronal, apical and middle third portions. Thirty immature third permanent maxillary molars were scanned using a micro-CT system. Then, we measured the diameters and areas of the root canal in the coronal, middle and apical third of the roots. The ratio between the long and short diameter of each root canal was then calculated and the canals were divided into several groups: round, oval, long oval, flat and irregular. The round configuration was not observed in the distobuccal and mesiobuccal roots in any of their anatomical regions. Oval and long oval canals predominated in the distobuccal root. The greatest variations were observed in the mesiobuccal root, with the ribbon-shaped canal predominating in the middle region and an irregular shape in the apical region. In the coronal region of the palatal canal, the round configuration predominated; in the middle third, we observed an almost equivalent distribution between round and oval configurations; apically, the oval shape predominated. In conclusion, we observed significant complexity and variation in the morphology and configuration of root canals in immature permanent molars, thus generating additional obstacles for the success of regenerative endodontics.

Regenerative endodontic treatment of immature permanent teeth after mechanical instrumentation with XP-Endo Finisher.

INTRODUCTION: The traditional treatment of immature permanent teeth with necrotic pulp involves creating an apical barrier by using calcium hydroxide or an MTA plug for an extended period of time. A novel therapeutic approach called regenerative endodontic procedures (REP) is used to allow root development to continue.

Application of Contemporary Magnifying Methods in the Diagnostics of Occlusal Carious Lesions on First Permanent Molars in Children.

INTRODUCTION: Dental operating microscopes (DOM) enable dentists to examine, with the aid of magnification and photodocumentation in clinical conditions, the occlusal anatomy of newly erupted permanent molars and to detect any early carious lesions more precisely. AIM: To determine the advantages of magnifying technology in detecting early occlusal carious lesions in newly erupted permanent first molars. MATERIALS AND METHODS: We examined 176 first molars of 44 children divided into two age groups: 7-8 and 9-10 years. The surfaces of each of the teeth were examined after they were cleaned with a brush without paste. The diagnoses were first made using only illumination and a clinical examination. These were followed by a visual examination of the occlusal surface using a DOM at ×8 magnification. A photo of the occlusal surface was then taken with a camera at the respective magnification for the purposes of photodocumentation. RESULTS: This study demonstrated that dental operating microscopes increased by 7% the rate of successful detection of early caries lesions on the occlusal surfaces. There was also a significant increase of the number of diagnosed cavitated caries in the dentine in comparison with those detected with naked eye. Using DOMs in pediatric dentistry facilitates the more detailed and precise diagnosing of early stage carious lesions and/or cavitations in the fissures. CONCLUSION: The use of a DOM facilitates differential diagnosing between deep fissures and early carious lesions, which is a key point in the assessment of occlusal surfaces of newly erupted permanent molars, necessary for their preventative sealing and micro-invasive treatment.

Comparative Analysis of Root Dentin Loss when Using Modern Mechanical Cleaning Instruments in Immature Permanent Teeth.

INTRODUCTION: The full decontamination and disinfection of the root canal system is essential for the success of regenerative endodontic procedures. The current literature does not have information regarding mechanical cleaning of immature teeth with contemporary endodontic instuments. AIM: To compare the thickness and volume of the dentin removed from the roots of immature teeth after endodontic preparation using XP-endo Finisher, GentleFile Brush and a standard H-file scraping technique through micro-computed tomography. METHODS: The study included 51 immature permanent molars. Endodontic access was prepared and without performing preliminary extirpation of the pulp, the teeth were divided into three groups. The first group of teeth were instrumented for two minutes with XP-endo Finisher, the second - two minutes with Gentlefile Brush, in the third group the root canals walls were scraped with a No. 40 H-file. The thickness and the volume of the removed dentin was assessed using micro-CT imaging before and after the use of the instruments. RESULTS: There is no statistically significant difference in the mean values of thickness of dentin removed between the teeth, prepared with XP-endo finisher and Gentlefile Brush. When comparing the mean values of volume of dentin removed between the separate groups, a statistically significant difference was discovered for every compared pair with the highest volume of removed dentin in the group prepared with a hand instrument. CONCLUSION: The endodontic systems tested when used in immature permanent teeth remove significantly less quantity of hard dental structures compared to a hand file for scraping the root canal.