Root Surface Changes in Endodontically Treated Teeth following Orthodontic Movement.

INTRODUCTION: Orthodontically induced external root resorption has been labeled an unavoidable consequence of orthodontic tooth movement (OTM). The objective of this study was to investigate the change in surface area (mm2) and volume (mm3) of endodontically treated teeth (ETT) compared with contralateral teeth with a vital pulp (VPT) after OTM. METHODS: Seventy-six teeth were included in this retrospective analysis: ETT (n = 38) and VPT (n = 38). All teeth were evaluated using cone-beam computed tomographic imaging at 2 time periods: before OTM (T1) and after OTM (T2). Study teeth were segmented to include all areas contained within the lamina dura and then were converted into a mesh model for data calculation. The surface area (mm2) and volume (mm3) of each tooth were calculated at T1 and T2 based on the number of cubic voxels present within the mesh model. Statistical analysis was performed using a linear mixed-effects model. RESULTS: The average change in surface area after OTM in ETT was 13.01 mm2 and 19.95 mm2 in VPT (P < .05). The average percent change in surface area after OTM in ETT was 2.09% and 3.38% in VPT (P < .05). The average change in volume after OTM in ETT was 22.48 mm3 and 32.44 mm3 in VPT (P < .05). The average percent change in volume after OTM in ETT was 2.62% and 4.10% in VPT (P < .05). CONCLUSIONS: The results from this study suggest that ETT are less susceptible to root resorption after OTM than their vital counterparts.

A long-term retrospective analysis of single tooth implants and endodontic therapies in a university setting.

BACKGROUND: This study aimed to compare survival of single tooth implants (SI) to teeth receiving initial endodontic treatment (IET), non-surgical (NET), and surgical endodontic retreatments (SET). The secondary aim was to determine success rate and identify factors associated with the survival and success of implant and endodontic treatments. METHODS: A retrospective cohort study using electronic health records (January 1st, 1995 to April 30th, 2017) was conducted. Every case that qualified for the study in SI (n = 321), NET (n = 211), and SET (n = 79) was included and cases in IET (n = 642) were selected at random and with a 2 to 1 case ratio to SI for data extraction efficiency. Statistical analyses were conducted to compare survival rates and estimate success rates between the four groups adjusting for confounders. RESULTS: The 3 year survival rates for SI, IET, NET, and SET were 99.0%, 92.1%, 90.5%, and 89.5% while the 5 year survival rates for SI, IET, NET, and SET were 99.0%, 87.6%, 84.4%, and 81.1%, respectively. Generally, the SI group had the highest survival rate and the SET group had the lowest survival rate. Short implants (≤8 mm) were significantly associated with implant failure (P < 0.01). Teeth with composite restoration had lower survival rates in IET and NET than other restorations (P < 0.01 and < 0.01). CONCLUSION: Within the limitations of this study, single tooth implants and the endodontic treatments yielded predictable survival and success in the short term but the survival and success rates in endodontic treatments dropped more rapidly than single tooth implants during the longer follow-up period.

Retrievability of Calcium Silicate-based Root Canal Sealers During Retreatment: An Ex Vivo Study.

INTRODUCTION: The retrievability of calcium silicate-based sealers (CSSs) during nonsurgical retreatment has been equivocal. This study compared the retrievability of 3 different CSSs using 1 of 3 different solutions or no solution. METHODS: A total of 130 extracted teeth with a straight canal were decoronated to a standardized root length. The canals were instrumented to 35/.04 and divided into 3 groups (BC: EndoSequence BC sealer; EBC: EdgeBioceramic; NEO: NeoSEALERFlo), and each group was further divided into 4 subgroups (6% sodium hypochlorite; 5% acetic acid; carbonated water; no solution). After sealer placement, each master gutta-percha cone was placed intentionally 2 mm short of the working length (WL) to ensure the apical 2 mm was filled only with sealer. After storage for 21 days at 37°C and 100% humidity, retreatment was performed until apical patency was obtained. The operator was blinded to the CSS and solution used. Data were analyzed using analysis of variance to compare apical patency rates and the mock chair-times. RESULTS: Overall success rates for apical patency in BC, EBC, and NEO were 63.64%, 69.77%, and 100%, respectively. There was significantly higher apical patency rate in NEO than BC and EBC. The chair-time for NEO was significantly shorter than BC (P < .05) and EBC sealer (P < .001). There was no significant difference in the chair-time between BC and EBC sealer groups. CONCLUSION: BC, EBC, and NEO sealers in a straight canal were consistently retrievable when no solution was used. Compared with no solution, the retrievability of BC, EBC, and NEO decreased when solutions were used.

Radiographic Indications of Vertucci Type V Configuration in the Distal Root of Mandibular Molars: A Case Series.

Knowledge of the prevalent root canal anatomy and potential variations is necessary before the initiation of endodontic treatment. The purpose of this study was to aid in the detection and treatment of the Vertucci type V canal configuration when present in the distal root of the mandibular molars. This case series presents 3 radiographic indications of a type V configuration in the distal roots of the mandibular molars as revealed on conventional periapical radiographs: a "ghost" apex, a fast break canal, and eccentric canal tracing. Nonsurgical endodontic treatment was performed for 5 mandibular molars with the type V distal root canal. Four cases showed posttreatment resolution of symptoms and return of normal function. One case was classified as "failed" because of persistent symptoms and clinical signs. The tooth was surgically treated and subsequently healed. These case reports show the importance of visualizing and managing the anatomic variations of the canal system in distal roots of mandibular molars and incorporating these capabilities into clinical practice to enhance the occurrence of a successful outcome. Additionally, clinical guidelines are provided that can help clinicians overcome the challenges in diagnosing and treating such complex cases.

Artifacts interfering with interpretation of cone beam computed tomography images.

Artifacts in radiographic imaging are discrepancies between the reconstructed visual image and the content of the subject. In radiographic imaging, this means the grayscale values in the image do not accurately reflect the attenuation values of the subject. Structures may also appear that do not exist in the subject. Whatever the source or appearance of image artifacts, their presence degrades the accuracy of the image in relation to the true characteristics of the subject. One should therefore be aware of the presence of artifacts and be familiar with their characteristic appearances in order to enhance the extraction of diagnostic information.