No abstract

All root canals had residual filling material after retreatment even when additional instruments were used.

Effective irrigant delivery and agitation are prerequisites to promote root canal disinfection and debris removal and improve successful endodontic treatment. This paper presents an overview of the currently available technologies to improve the cleaning of the endodontic space and their debridement efficacy. A PubMed electronic search was conducted with appropriate key words to identify the relevant literature on this topic. After retrieving the full-text articles, all the articles were reviewed and the most appropriate were included in this review. Several different systems of mechanical activation of irrigants to improve endodontic disinfection were analysed: manual agitation with gutta-percha cones, endodontic instruments or special brushes, vibrating systems activated by low-speed hand-pieces or by sonic or subsonic energy, use of ultrasonic or laser energy to mechanically activate the irrigants and apical negative pressure irrigation systems. Furthermore, this review aims to describe systems designed to improve the intracanal bacterial decontamination by a specific chemical action, such as ozone, direct laser action or light-activated disinfection. The ultrasonic activation of root canal irrigants and of sodium hypochlorite in particular still remains the gold standard to which all other systems of mechanical agitation analyzed in this article were compared. From this overview, it is evident that the use of different irrigation systems can provide several advantages in the clinical endodontic outcome and that integration of new technologies, coupled with enhanced techniques and materials, may help everyday clinical practice.

The purpose of this study was to investigate the influence of chlorhexidine (CHX) concentration on the microtensile bond strength (muTBS) of contemporary adhesive systems. Eighty bovine central incisors were used in this study. The facial enamel surface of the crowns was abraded with 600-grit silicon carbide paper to expose flat, mid-coronal dentin surfaces. The tested materials were Scotchbond Multipurpose (SMP), Single-Bond (SB), Clearfil SE Bond (CSEB) and Clearfil Tri S Bond (CTSB). All the materials were applied according to manufacturer's instructions and followed by composite application (Z250). The teeth were randomly divided into 16 groups: for the etch-and-rinse adhesives (SMP and SB), 0.12% or 2% CHX was applied prior to or after the acid etching procedure. For the self-etch adhesives (CSEB and CTSB) 0.12% or 2% CHX was applied prior to the primer. Control groups for each one of the adhesive systems were also set up. The specimens were immediately submitted to muTBS testing and the data were analyzed using Analysis of Variance and the Tukey post hoc test (alpha = .01). The failure patterns of the specimens were observed using scanning electron microscopy. The effects of 2% CHX were statistically significant (p < 0.01) for the self-etch adhesives but were not significant for the etch-and-rinse adhesive systems. Analysis of the data demonstrated no statistical difference between the etch-and-rinse adhesive systems. CHX-based cavity disinfectants in concentrations higher than 0.12% should be avoided prior to the self-etch adhesive systems evaluated in this study to diminish the possibilities of reduction in bond strength.

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.

Objective:This study investigated the influence of the last apical instrument of the ProTaper system with and without 2.5% sodium hypochlorite for cleaning mandibular central incisors.Material and Methods:Thirty two mandibular central incisors were divided into six study groups: Group I – F1 instrument with 2.5% sodium hypochlorite; Group II – F1 and F2 with 2.5% sodium hypochlorite; Group III – F1, F2 and F3 with 2.5% sodium hypochlorite; Group IV – F1 with distilled water; Group V – F1 and F2 with distilled water; Group VI – F1, F2 and F3 with distilled water. The two remaining teeth comprised the negative control group. The specimens were prepared following the principles of the technique suggested by the manufacturer and then submitted to histological preparation and morphometric analysis. Data were analyzed statistically by the Kruskal Wallis test at 1% significance level.Results:There was statistically significant difference (p<0.01) between all study groups, except between Groups I and VI.Conclusions:It was concluded that no technique allowed complete cleaning of the root canals. However, the technique of finishing preparation of the apical third with the F3 instrument with 2.5% sodium hypochlorite irrigation was the most effective.

Combined use of different methods increased the detection ofthe second canal in MB roots, but without statistical difference among CBCT, operating microscope, Start X and clinical analysis.

The objective of this study was to classify the morphology of bifid mandibular canals and to evaluate their relationship with the roots of third molars, using cone beam computed tomography (CBCT) scans. The CBCT scans of 75 patients were analyzed and the bifurcations were classified according to Langlais et al. (1985). The relationship of bifurcation and third molars was established according to the following classification: class A -uninvolved, class B -close relationship, class C -intimate relationship and class D -absence of third molars. Data were submitted to descriptive statistics, and the results indicated that the patients' mean age was 48.2 (± 13.2) years. Unilateral bifurcation (Type 1) was the most frequent type (72.6%), followed by unilateral Type 2 (19.3%). Class D was the most frequent (57.33%), followed by class C (21.33%), class B (13.33%) and class A (8%). It could be concluded that most cases presented unilateral bifid mandibular canals extending to the third molar or adjacent regions, and when present, the roots seemed to be a continuation of the bifid mandibular canal.