Bacterial microleakage and post space timing for two endodontic sealers: an in vitro study.

AIM: The effects of immediate versus delayed post space preparation on the apical seal using resin and zinc oxide eugenol (ZOE) sealers were compared by a bacterial leakage model. METHODOLOGY: Eighty-six premolars were randomly assigned to four experimental groups of 20 teeth. Three teeth were assigned to each control group, either positive (filled only with guttapercha) or negative (not obturated but root surfaces completely covered). Obturation was achieved by gutta-percha with resin or gutta-percha with a ZOE sealer and lateral condensation technique. Post space was prepared either immediately or a week later, while the obturated teeth had been stored in 100 percent relative humidity at 37 degrees C. The teeth were inserted into plastic vials and suspended in glass bottles. All teeth were covered with cyanoacrylate and layers of nail varnish but the apical 3 mm and were sterilized using gamma rays. Phenol red lactose broth was inoculated into the vials. Staphylococcus epidermidis was introduced into the root canal access of the teeth. Turbidity of the broth in the vials (discoloration) was evaluated daily for a period of 70 days. The data was analyzed statistically with Pearson Chi Square and two ways with ANOVA at 45 days and 70 days. RESULTS: When the depth of time was considered, the mean time of leakage showed no differences between immediate and delayed preparation for resin AH26 versus ZOE Dorifil at 45 and 70 days (p = 0.37 and p = 0.217, respectively). In 45 days, considering the number of teeth with leakage, there was a significant difference between immediate preparation and delayed preparation in AH26 sealer groups (p = 0.028). No difference was present between immediate and delayed preparation groups for the ZOE sealer groups (p = 0.14). CONCLUSION: According to the results of this study and despite type of sealer, immediate post space preparation did not achieve better sealing than delayed post space preparation. Resin AH26 showed the least leaking teeth in 45 days, but it made no difference in 70 days.

Autogenous attachment technique with esthetics in mind: trauma management case report.

The majority of dental trauma involves anterior teeth, especially the maxillary central incisors. A crown fracture with pulp tissue involvement, severe sensitivity, and pain is certainly unpleasant for the patient. This case report will discuss the endodontic therapy and restoration with an autogenous tooth fragment attachment technique. When treating an emergency situation that involves trauma, it is challenging to provide the patient with both pain relief and esthetic restoration.

Interleukin-8 is increased in gingival crevicular fluid from patients with acute pulpitis.

Irreversibly inflamed pulp (IIP) constitutes both a pathophysiologic and a diagnostic challenge. Gingival crevicular fluid (GCF) samples were obtained with Periopaper strips from IIP and adjacent and contralateral teeth for interleukin-8 (CXCL8) and tumor necrosis factor-alpha (TNF-alpha) measurements. Pain intensity was reported by using a verbal numeric scale (1-10). TNF-alpha (n = 25) was not detectable in GCF, whereas CXCL8 (n = 17) was significantly greater in IIP (302.1 +/- 164.9 pg/mL) compared with adjacent (139 +/- 138.58 pg/mL; P = .0072) or contralateral (173.8 +/- 166.4 pg/mL; P = .0231) teeth. A subgroup of high pain (>5) patients (n = 7) had CXCL8 IIP levels (323.6 +/- 148.4 pg/mL) that were significantly different from the contralateral teeth (P = .0262); however, they did not differ from the adjacent teeth (P = .1649), suggesting that neighboring teeth might also have inflammation. Another group of patients (n = 7) who had received local anesthesia before sampling had very low IIP CXCL8 levels. GCF CXCL8 levels might be a useful measurement for staging patients with acute pulpitis.

Endodontic management of an impacted premolar.

This report demonstrates a simple endodontic solution to an interdisciplinary case of a patient with multiple gene deficiencies. An adolescent patient presented with an impacted premolar that could not be extracted due to high-risk conditions. A suspicious degree of radiolucency around the crown was clinically diagnosed as dentigerous cyst. The treatment dilemma and implementation are discussed. This case report offers a different treatment option for impacted teeth when significant differential diagnosis of a pericoronal lesion dictates treatment.