Reaction of periradicular tissues to root canal treatment: benefits and drawbacks

Siqueira, José F.

doi:10.1111/j.1601-1546.2005.00134.x

Cited by 101 publications

(97 citation statements)

References 192 publications

(281 reference statements)

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“…To obtain circumferential cleaning and shaping of these recesses, specific instrumentation motions such as brushing have been recommended for use. 15,16 However, as reported by Plotino et al 13 , little information on the preparation of ovoid root canals using NiTi rotary instruments with this specific motion is available in the literature.…”

Section: A B Discussionmentioning

confidence: 90%

“…[8][9] Siqueira 15 emphasized the need for instrumentation to touch all root canal walls and remove substantial amounts of pulp tissue and bacteria, and suggests that the size of the preparation ideally should incorporate anatomic irregularities which can be difficult, and sometimes impossible, to carry out in canals that are not round in their cross-sections. To obtain circumferential cleaning and shaping of these recesses, specific instrumentation motions such as brushing have been recommended for use.…”

Section: A B Discussionmentioning

confidence: 99%

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Influence of Hero Apical instruments on cleaning ovoid-shaped root canals

et al. 2011

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The cleaning capacity of Hero 642 nickel-titanium files, complemented by the Hero Apical instruments in flattened roots, was determined by histological analysis, considering the area of action of the instruments on the coronal walls and the presence of remaining debris. Twenty-four single-canal, human mandibular incisors were divided into three groups and prepared as follows: GI, instrumented with Hero 642 NiTi files 30/.06, 25/.06, 20/.06, 25/.06, and 30/.06; GII, instrumented as GI followed by Hero Apical size 30/.06; GIII, instrumented as GI followed by Hero Apical sizes 30/.06 and 30/.08, then returning to 30/.06 with pendulum movements. The apical thirds were prepared for histological processing, analyzed at 40× magnification and the images were examined morphometrically. Statistical analysis showed that GIII presented the best results for removing debris (5.22% ± 4.13), with more contact between the instruments and the root canal walls (19.31% ± 0.15). This differed statistically from GI (14.04% ± 4.96 debris removal, with 42.96% ± 7.11 instrument contact) and GII (12.62% ± 5.76 debris removal, with 35.01% ± 0.15 instrument contact). Root canal preparation with Hero 642, complemented by Hero Apical instruments (30/.06 and 30/.08, then re-instrumented with Hero Apical 30/.06 using pendulum movements), was more efficient for debris removal and allowed more contact of the instruments with the root canal walls. GII presented the worst results.

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Section: A B Discussionmentioning

confidence: 90%

Section: A B Discussionmentioning

confidence: 99%

Influence of Hero Apical instruments on cleaning ovoid-shaped root canals

et al. 2011

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“…Patency file does not clean the apical foramen. 9 However, in necrotic pulp with aperiapical lesion, bacteria may be present beyond the apical constriction. In such cases, instrumentation beyond the apical constriction is desirable from the biological point of view.…”

Section: Extrusion Of Root Canal Contentsmentioning

confidence: 99%

Establishing Apical Patency: To be or not to be?

Mohammadi¹,

Jafarzadeh

Shalavi

et al. 2017

The Journal of Contemporary Dental Practice

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Introduction:The apical portion of the root canal is very complex and challenging during endodontic treatment. Root canal preparation and obturation to the apical constriction may provide the best prognosis. Incomplete debridement, foramen transportation, and inadequate seal in the apical portion are considered to be responsible for treatment failure. The technique "apical patency" is considered as a way for maintaining the apical part the free of the debris by recapitulation, using a small K-file through the area of the apical foramen. This term was firstly proposed by Buchanan. In this technique, the smallest diameter file is set 1 mm longer than working length and recapitulated after each instrument to prevent packing of debris in the apical part. Apical patency has been found to be effective in achieving an apical seal with gutta-percha. Teeth prepared with a step back method and with maintained apical patency may show less leakage when obturated with cold lateral condensation technique. Data regarding the effect of apical patency on the healing of periapical tissue are very scarce, and it has been shown that the patency file has detrimental effect on the healing of periapical tissues in animal studies. However, using patency file in endodontic treatment is controversial and further studies are needed. The purpose of this article is to review the effect of using a patency file on the extrusion of root canal contents, the apical seal, postoperative pain, and healing of periapical tissues. Furthermore, the effect of establishing patency on reaching irrigation solutions to the apical portion of the canal and prognosis of root canal treatment are discussed.

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“…Hence, the man etiologic role in these diseases is played by bacterial flora inhabiting the apical root portion. 2 Literature has a paucity of studies that stress on the division and analysis of the pulp canal segments. The reason for this disparity might be the technique used for collecting the samples from the pulp canals.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Bacteriological Profile in the Apical Root Segment of the Patients with Primary Apical Periodontitis

Tatikonda

Sudheep

Biswas

et al. 2017

The Journal of Contemporary Dental Practice

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Introduction: Apical periodontitis usually results from bacterial accumulation and contamination occurring in the root-canal system, and extending beyond the apical foramen to involve the periapical tissues. Literature has a paucity of the studies that stress on the division and analysis of the pulp canal segments. The reason for this disparity might be the technique used for collecting the samples from the pulp canals. Hence, we carried out the present study to evaluate the microbial flora in the apical part of the roots with necrotic pulp canals. Materials and methods:The present study included the assessment of 40 freshly extracted teeth that had necrotized pulpal tissue along with the presence of periapical periodontal lesions. Removal of the soft tissue lesions attached to the root portion of the teeth along with apical periodontal lesions was done with the help of scalpel blade, after rinsing them with a sterile solution of saline. Thorough cleaning of the root surfaces was done with hydrogen peroxide followed by rapid disinfection with the help of sodium hypochlorite at varying concentrations. Sectioning of the root portion of all the specimens with the help of a disk was done perpendicular to the long axis of the teeth at a distance of roughly 5 to 6 mm from the teeth's apicalmost point. Cryotubes were used for transferring the specimens of apical portions containing 1 mL of buffer and were subjected to immediate frozen processing at a temperature of -20°C. A 10 K-type file was used for the initial collection of the samples followed by subsequent incubation of the files and paper pints in the incubation cabinet. Subsequent deoxyribonucleic acid (DNA) extraction from the samples was done following the procedure described by Siqueira et al. Paster et al's modification of the reverse-capture checkerboard assay was used in the present study. Semiquantitative data were used for overcoming the difficulties arising due to obtaining the counts of the polymerase chain reaction (PCR)-based analysis of specimens.Results: A positive result for the 16S ribosomal ribonucleic acid (rRNA) gene primer was observed only in two examined specimens of all the samples of the apical portion of the root canals in the present study. Negative result was shown by all the control group specimens, which were sterile samples. Presence of bacteria was confirmed by PCR in 38 out of 40 examined specimens. Amount of bacterial taxa, out of these 24 samples, ranged up to 6. Pseudoramibacter alactolyticus, Porphyromonas endodontalis, Dialister oral species, Bacteroidetes species, Streptococcus species, Olsenella uli, Synergistes species, Fusobacterium nucleatum, Parvimonas micra, Treponema denticola, and Filifactor alocis were the specific species detected. Bacteroidetes species was the only species that were detected at levels at or above 10 5 . Heavy bacterial infections were noticed in more than 45% of the cases at the periradicular part of the root canals. Conclusion:Microbial flora of the apical segment of the root with necroti...

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Reaction of periradicular tissues to root canal treatment: benefits and drawbacks

Cited by 101 publications

References 192 publications

Influence of Hero Apical instruments on cleaning ovoid-shaped root canals

Influence of Hero Apical instruments on cleaning ovoid-shaped root canals

Establishing Apical Patency: To be or not to be?

Evaluation of Bacteriological Profile in the Apical Root Segment of the Patients with Primary Apical Periodontitis

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