The aim of this study was to compare conventional needle irrigation (CNI), passive ultrasonic irrigation (PUI), and XP-endo Finisher (XPF) techniques in terms of modified triple antibiotic paste (mTAP) removal. Materials and Methods: A total of 30 mandibular premolars were instrumented to a size F3 file. A mixture of mTAP was prepared by mixing 3 antibiotics, including 250 mg ciprofloxacin, 250 mg metronidazole, and 150 mg clindamycin, with 1 ml distilled water and applied into the root canals. The teeth were allocated into 3 equal groups, irrigation/agitation was performed and teeth were divided into two halves. The removal of mTAP was evaluated with a scanning electron microscope by using the 4 grade scoring system. Results: In the apical thirds, significant difference was found between PUI and CNI groups (p<0.05), whilst no significant difference was found among the other irrigation activation regimens (p> 0.05). No statistically significant difference was found between all groups in the middle third. In the coronal thirds, XPF removed significantly more mTAP than the CNI group (p<0.05). However, no difference was recorded among other groups (p>0.05). Conclusions: Passive ultrasonic irrigation and XPF file agitation demonstrated superior efficacy in removing mTAP from root canals compared to CNI.
Background To determine the frequency of sodium hypochlorite (NaOCl) extrusion and evaluate the outcome of the injury. Methods A total of 1123 teeth indicated root canal treatment were included. An open‐ended needle was used during/after the instrumentation. Acute burning pain during irrigation was considered as NaOCl extrusion. Negative aspiration was applied for patients with extrusion, and appropriate treatment was planned due to the symptoms. The number of patients who experienced extrusion and symptoms were recorded. Analysis of variance (ANOVA), at P < 0.05, was used to compare the data groups. Results NaOCl extrusion rate was found at 0.89%, and the injury with swelling that differential diagnosis of NaOCl accident caused by extrusion rate was 0.18%. The most common findings besides acute pain, as a sign of extrusion (n = 10), were accompanying apical bleeding (n = 6) and swelling (n = 2). According to the number of visits, a significant correlation was found between the symptoms (P = 0.010). No serious injury such as a neurological sign, tissue necrosis or trismus occurred in any patient. Conclusions Demographic characteristics of the patients and preoperative condition of teeth were not related to NaOCl extrusion. The increasing number of visits may affect the probability of an accident. Negative aspiration immediately may be crucial in preventing severe injuries.
This study aimed to evaluate dentinal tubule penetration of the root canal filling material using various techniques such as cold lateral compaction, new generation thermoplastic core carrier and continuous-wave obturation. The root canals of premolar teeth were instrumented, and the teeth were allocated randomly to three groups (n = 15/group). After the obturation with three different techniques, three sections of 2-mm thickness at 2, 5 and 8-mm from the apex were examined under a confocal laser scanning microscope. The data were analysed of variance with a significance level of P < 0.05. There was no significant difference between techniques when parameters were evaluated in total (penetration depth P = 0.418, penetration area P = 0.701). The mean value of the cold lateral compaction group for maximum penetration depth was obtained higher than continuous wave (P = 0.004), whilst there was no significant difference between the thermoplastic core carrier and the other groups.
Presence of missed canals results in unsuccess root canal treatment because of insufficient cleaning and obturation. The incidence of a maxillary second molar with two palatal roots and a mandibular second premolar with three roots has been rarely reported in literature. This case report describes the endodontic management of a maxillary second molar with two buccal and two palatal roots and mandibular second premolar with three separate roots. Successful endodontic treatment requires a detailed knowledge of root canal anatomy to overcome the anatomic variations of the root canal system. This would help in reducing endodontic failure due to incomplete cleaning and obturation.
Objectives: This study evaluated the effect of instrumentation techniques on the postoperative pain after single-visit root canal treatment. Materials and Methods:Sixty patients having an indication of endodontic treatment were included. Only single rooted teeth were selected The patients were randomly divided into 2 groups. In group 1; the root canals were instrumented using ProTaper Next instruments with rotational motion, in group 2 TF Adaptive instruments with adaptive motion were used during instrumentation. Treatments were completed in a single appointment. Postoperative pain questionnaires were scored by patients using a four-point pain intensity scale for 12, 24, and 48 hours. Mann Whitney-U, Friedman and Wilcoxon tests were used for analyzing the final data. Results:The comparison of time intervals between groups demonstrated no difference between both groups (p>0.05). In both groups, the postoperative pain values of 12h time period were significantly higher than both other periods, and significant difference was found between 24h and 48h time periods (p<0.05). The postoperative pain values of 48h time period were significantly lower than the other two time periods (p<0.05). Conclusions:Both instrumentation techniques caused postoperative pain. The pain scores indicated that both techniques caused limited discomfort associated with slight pain which did not require any additional treatment and medication.
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