Effect of preflaring on Root ZX apex locators.

The Root ZX apex locator is an example of a generation of apex locators that identify the terminus of the canal by measuring a ratio between two electrical impedances. Studies have shown this device to have a high degree of accuracy. However, the manufacturer warns that the performance of these devices is limited by the presence of calcifications and dentinal shaving obstructions. An in vitro study was designed to determine if preflaring of canals would facilitate the passage of files to the apical foramen by eliminating cervical interferences and to see what effect this would have on the performance of the Root ZX apex locator. Thirty-two canals were divided into two groups. Group 1 was not manipulated before use of the Root ZX apex locator and served as control. In group 2, the canals were preflared before the use of the Root Zx apex locator. The working length files were secured in place and measured with the linear measurement tool used by the Visilog 5 imaging program. Results of this study suggest that preflaring of canals will allow working length files to more consistently reach the apical foramen (p = 0.015), which in turn increases the efficacy of the Root ZX apex locator.

Rubber latex allergy and the endodontic patient.

Increasingly, patients with rubber latex allergy are being seen in dental offices. Health care workers, persons allergic to certain foods and those with certain medical histories are potentially latex-sensitive. This article presents the case of a patient with a history of severe rubber latex allergy and the associated management of an endodontically involved tooth. The possibility of the latex allergic patient being sensitive to gutta-percha obturation material is also raised.

Factors affecting the negotiability of second mesiobuccal canals in maxillary molars.

Factors affecting the negotiability of MB2 canals were evaluated by studying 87 extracted maxillary molars that had undergone previous endodontic treatment in the endodontic technique laboratory. The mesiobuccal roots were resected and radiographed, after which a #08 file was used in an attempt to negotiate those roots with the potential for a second mesiobuccal canal. The file was then intentionally separated in the MB2 canals that could be negotiated. The roots were decalcified, cleared, and observed under a stereomicroscope. Several factors that could interfere with the total or partial negotiation of MB2 canals were identified and included accumulation of debris and sealer that blocked access to these canals, dentinal debris produced with the pathfinding instrument, the presence of anatomical variations, diffuse calcifications, and pulp stones.

Hazards of laser smoke during endodontic therapy.

The purpose of this study was to evaluate the potential for spreading bacterial contamination from the root canal to the patient and the dental team via the smoke produced by the laser. Five extracted teeth were deliberately inoculated with a specific strain of Escherichia coli. The canals were subjected to an agron laser. The smoke plume was captured and cultured. All of the cultures were positive for growth of the E. coli used. It was concluded that the laser smoke does present a hazard of bacterial dissemination and that precautions must be taken to protect against spreading infections when using lasers in the root canal.

Chronic pain associated with a foreign body left under the soft tissue flap during periapical surgery.

A case is reported of a patient who requested treatment for chronic pain of 7 yr duration. After several unsuccessful endodontic procedures, a cotton pellet was discovered under the soft tissue near the apex of the left maxillary cuspid. It was theorized that the cotton was left under the tissue flap during a previous apicoectomy procedure. After the cotton was removed the patient subsequentially reported that the pain was relieved.

Retrievability of Thermafil plastic cores using organic solvents.

Twenty distal roots of extracted mandibular first and second molars were instrumented, then obturated using Thermafil obturating material with solid plastic core carriers. To simulate a retreatment process, the gutta-percha was softened using one of four solvents, chloroform, xylene, eucalyptol, or halothane. A K file was used to advance the solvent into the gutta-percha and to engage the plastic carrier. In all but one case, the plastic carriers were easily removed from the root canal. It was concluded that the plastic carriers used with the Thermafil obturation media do not present a difficult obstacle for removal should the root require retreatment.

Long-term sealing ability of a calcium hydroxide sealer.

A calcium hydroxide sealer (Sealapex) was compared with a zinc oxide and eugenol sealer (Tubli-Seal) over a 32-wk interval to examine solubility in an in vitro simulation. After obturation with gutta-percha and the appropriate sealer, specimens were immediately immersed in a saline solution to challenge the sealers' solubility. The solutions were changed weekly to allow for a continued dissolution of the sealers and to prevent establishment of an equilibrium between the solution and the sealers. The 2- and 32-wk specimens were removed from the solutions, immersed in India ink for 3 days, and then made transparent by a clearing process. Microscopic examination was used to determine the linear penetration of the ink for each tooth. Results revealed that Sealapex statistically had no greater dissolution (based upon linear penetration) than Tubli-Seal at both 2 and 32 wk. It is suggested that Sealapex has a sealing ability comparable to Tubli-Seal and can withstand long-term exposure to tissue fluids without significant leakage. This may allow time for the biochemical action of the calcium hydroxide to stimulate physiological calcification of the apical foramen.