Aim To evaluate the effectiveness of five instruments used for irrigant agitation during the removal of calcium hydroxide [Ca(OH)2] paste in simulated internal root resorption (IRR) cavities created in extracted maxillary central incisors. Methodology Seventy maxillary central incisors with a single canal were selected. The canals were accessed and instrumented with Reciproc R50, then the roots were split in the bucco‐lingual direction and the halves separated. Simulated IRR cavities were created, in both halves of the roots, 5 mm from the apex with a spherical bur. The specimens were reconstructed with cyanoacrylate glue and allocated into seven groups: negative control – no treatment; positive control – filled with Ca(OH)2 without performing any irrigation protocol; the other groups were divided according to the instrument used for irrigant agitation, namely: Ultrasonic, EndoActivator®, EDDY®, XP‐endo® Finisher and XP‐endo® Shaper. The specimens were cleaved and analysed using optical microscopy and scanning electron microscopy, to compare the Ca(OH)2 remnants between them. Then, the IRR cavities created by the burs were cleaned and subjected to a protocol of demineralization with 20% nitric acid, the roots reconstructed, and the irrigant agitation methods, as well as the microscopic analysis was repeated. Analysis of the images of Ca(OH)2 remaining in the simulated IRR cavities after irrigation was performed by two calibrated examiners based on a previously established scoring system. The data were statistically compared by Kruskal–Wallis test, Mann–Whitney U‐test and Wilcoxon tests, with the significance level set at 5%. Results There was a significant difference in the effectiveness of the instruments in relation to the cavity creation method (bur vs. bur/acid) and evaluation method (optical microscopy and scanning electron microscopy) (P < 0.05). The XP‐endo® Finisher and EDDY® groups were associated with significantly more effective removal of Ca(OH)2 when the IRR cavities were created using the acid protocol and analysed by scanning electron microscopy. Conclusion None of the instruments tested were able to completely remove the Ca(OH)2 paste from the simulated IRR cavities; however, the EDDY® and XP‐endo® Finisher removed more Ca(OH)2 in the bur/acid cavity creation method analysed by scanning electron microscopy.
This study aimed to evaluate the performance of the Wave One, Easy ProDesign Logic and One Shape systems in the preparation of long oval root canals. Forty-two mandibular incisors were randomized into three groups: Group I, Wave One Primary (WO) (#25.08); Group II, Easy ProDesign Logic (EPL) (#25.06) and Group III, One Shape (OS) (#25.06). Micro-computed tomography scans were obtained pre- and post-preparation of the samples. Instrument fractures or loss of working length did not occur in any of the groups. There was a statistically significant difference in total root canal volume between the WO and EPL (p<0.05) and OS systems (p<0.05) The mean percentages of instrumented canal area in the middle thirds were 76.9% in the WO, 62.3% in the EPL and 71.8% in the OS (p>0.05). The OS system had the strongest correlation between volume increase and instrumented area (R=0.63). The WO, EPL and OS systems presented mean preparation times of 2.13 min, 0.54 min, and 2.21 min (p<0.05), respectively. All three systems enabled the safe preparation of long oval root canals. The WO system most effectively increased root canal volume, but it did not affect the instrumented areas. The OS system had the strongest correlation between volume increase and instrumented area, while the EPL system was the fastest.
This article describe a rare case of multiple taurodontism involving all molars in a 17-year-old male. Volumetric cone-beam computed tomography was used to investigate internal and external root morphology, including that of a maxillary first molar which required endodontic treatment and retreatment. Medical history was not contributory; however, Klinefelter syndrome was the diagnostic hypothesis in this case.
This ex vivo study assessed the effectiveness of two activation modes to increase the intracanal temperature of 5.25% NaOCl solution and the time for a preheated-irrigant to return to its initial temperature. Ten single-rooted extracted human teeth were used. Thermocouples were adapted to the root surface and the temperature was registered following two activation modes: ultrasound (US) and thermal. Furthermore, a preheated-solution (45°C/60°C) was flushed into root canal to test the time needed to return to its initial temperature. Data were analysed using two-way ANOVA and Tukey's post-hoc tests (P = 0.05). Statistical analysis showed differences between the activation modes. US and thermal activation increased from 37 to 40.4°C and to 62.8°C respectively in 60 s. Time for preheated-irrigant to return to its initial temperature was longer for 60°C. Preheating irrigant at 60°C and using thermal activation to keep it warm may represent a further step of the irrigation protocol.
Dens invaginatus, a developmental malformation resulting from the invagination of enamel, has been associated with increased prevalence of pulpal and periapical diseases. Case report: This anomaly is classified according to the severity (types I-III). Management of type III dens invaginatus is complex and an endodontic challenge. This case report describes the management of the endodontic retreatment type III dens invaginatus in a maxillary lateral incisor. Conclusion: Nonsurgical treatment can be effective to treat type III dens invaginatus. CBCT is an important diagnostic tool that allowed the management of such case.
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