Effects of combined and single use of EDTA, RC-Prep, and NaOCl on mineral content of root dentin were evaluated in vitro using energy dispersion spectrometric microanalysis. Thirty-six standardized midroot dentin specimens obtained from human anterior teeth were used. Specimens were polished and divided into six experimental groups. The first two groups were treated with EDTA or RC-Prep followed by NaOCl irrigation. Groups 3 to 5 were treated with EDTA, RC-Prep, and NaOCl, respectively. The last group was irrigated with saline solution as a control. Levels of calcium, phosphorus, and magnesium were measured in the root dentin after treatments. The results showed that (i) EDTA combined with NaOCl irrigation as final flush and NaOCl alone changed the calcium/phosphorus ratio of root dentin significantly (p < 0.05); and (ii) there was a significant increase in the magnesium level after the use of chelating agent combined with NaOCl (p < 0.05). It was concluded that using NaOCl irrigation as final flush altered the effectiveness of chelating agents on root dentin.
This report examines three clinical cases of root-filled teeth with primary endodontic lesions. During endodontic surgery, an area of incomplete root bifurcation beginning in the coronal or middle third of the root surface and terminating at or near the apical foramen were observed. The radicular grooves of two teeth were eliminated using a round bur ("saucerization"), and the resulting defect was filled with a bone substitute or calcium sulfate and covered by an absorbable collagen membrane. The other tooth was extracted, the groove was eliminated with a similar technique, and the tooth was replanted. Bacteria have been reported in chronic apical lesions. Our observations suggest that after conventional endodontic therapy, the etiology of a nonresolving primary endodontic lesion may be bacteria of endodontic origin sequestered within the protective confines of an apical-radicular groove.
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