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Aim: The purpose of this study was to compare the diagnostic and treatment-planning decision making of cohorts of dental surgeons with different experiences and specialty backgrounds., Methodology: Periapical radiographs of 20 teeth in patients referred for an opinion regarding the provision of endodontic surgical retreatment were taken using a paralleling technique and a film holder. The radiographs were photographed and black and white photographic prints produced to provide an image 10.5 times larger than the original radiograph. Each image was related to a clinical scenario. Each participant was asked to assess whether a periradicular lesion, as manifested by a radiolucency, was present and what clinical management would be prescribed. Ten participants in each of seven groups took part in the study. These groups were chosen to represent those dentists who were most likely to be involved in decision making in similar cases., Results: In 12 out of 20 cases interobserver agreement for radiographic analysis was 'excellent' (above 90%) or 'good' (between 70 and 90%). There was less agreement for treatment decisions than for radiographic analysis and the order of agreement for cases for diagnosis was not the same as for treatment. No case achieved 'excellent' percentage interobserver agreement. The average percentage interobserver agreement of the endodontists was significantly greater than the average percentage interobserver agreement for the other groups for both radiographic assessment and treatment decisions., Conclusions: Differences in specialty backgrounds amongst the participants in this study affected both endodontic diagnostic and treatment decisions. Endodontists showed the most consistent agreement amongst the specialty groups.

Objective: To identify techniques commonly used in the management of periradicular disease by general dental practitioners and to ascertain views on continuing professional education in endodontics.Design: Data was collected via a postal questionnaire distributed to 617 general dental practitioners in Scotland (33% of practitioners registered with the Dental Practice Board).Results: 417 (69%) questionnaires were completed and returned. Only 24.9% of respondents used rubber dam routinely. The majority of respondents used hand instruments for preparation with either sodium hypochlorite or local anaesthetic being used most frequently for irrigation. The mean time for treatment of a single rooted tooth was 71 minutes. The demand for continuing education courses was high with 340 and 197 respondents requesting endodontic and rubber dam courses, respectively.Conclusions: Traditional methods for preparing the root canal using hand instruments were favoured by most dentists. The major disincentive to the use of rotary instruments and new techniques for obturating with thermally softened gutta-percha was expense. The importance of rubber dam isolation requires reiteration and more continuing education courses are required to update clinical skills. [ABSTRACT FROM AUTHOR]

The purpose of this review is to evaluate the evidence implicating nonsurgical endodontic procedures in inducing infective endocarditis (IE). The literature is reviewed and findings about dental procedures that elicit bacteraemia [in particular root canal treatment (RCT)], sequelae of bacteraemia, relationship between IE and RCT and variation between antibiotic prophylaxis (AP) guidelines are highlighted. At present, there is still significant debate as to which dental procedures require chemoprophylaxis and what antibiotic regimen should be prescribed. Currently, there are insufficient primary data to know whether AP is effective or ineffective against IE. Practitioners are bound by current guidelines and medico-legal considerations. Thus, the profession requires clear, uniform guidelines that are evidence-based. [ABSTRACT FROM AUTHOR]

Evaluates published literature examining fiber-based endodontic post systems. Form of endodontic publications; Evidence for carbon-fiber posts and quartz-fiber posts.

Review article Calcium hydroxide has been used in endodontology for many years. The aim of this paper is to review the various formulations of calcium hydroxide that have been described, with specific reference to the vehicle used to carry the compound. The requirements for a vehicle are described, and ex vivo and in vivo studiesreviewed. Vehicles can be classified into aqueous, viscous and oily, the clinical properties of calcium hydroxide changing depending on the vehicle. The review also describes the use of various active components that have been added to calcium hydroxide, including antimicrobial and anti-inflammatory agents. This review will help clinicians to make informed judgements about which formulations of calcium hydroxide should be used for specific endodontic procedures. [ABSTRACT FROM AUTHOR]

A Neodymium-yttrium aluminium garnet (Nd-YAG) pulsed laser was used in vitro to determine whether various laser energy levels from 0.75 W to 1.7 W at 15 pulses s1 (pps) were able to (i) remove debris from the walls of prepared root canals (ii) remove pulpal tissue from unprepared canals and (iii) create a fused apical plug from dentine chips, hydroxyapatite (HAP) or low-fusing dental porcelain. Single-rooted teeth were sectioned at the amelocemental junction and the crowns discarded. The root canals of 50 teeth were prepared chemomechanically and allocated to four groups of 10 teeth for laser treatment. One group was left unlased as a control. After lasing, the teeth were spilt longitudinally, stained and examined for residual debris. Results showed that there was no statistically significant difference between the groups (P<0.05). A further 20 teeth were not prepared and lased in the coronal one-third of the root canal at different energy levels; five teeth were not lased. The teeth were split and examined as previously. The results showed that lasing cleaned the coronal part of the root canal almost completely of pulpal tissue. In the final part of the study laser energy was applied to dentine chips, HAP and low-fusing procelain in an attempt to produce a fused apical plug. The laser was unable to melt the dentine chips but some hardening of HAP occurred when combined with blue food-colouring, with or without glycerine, at energy levels of 1.0 W, at 15 pps for 30 s. Superficial hardening of low-fusing porcelain occurred at 1.0 W, 15 pps for 30 s which increased when 1.5 W was applied at 15 pps for 30s. [ABSTRACT FROM AUTHOR]

Adaptation and placement of alpha-phase gutta-percha delivered with a plastic core-carrier, Thermafil, was compared to the lateral condensation of gutta-percha in a specific tooth model. Fifty-one mandibular molar roots with separate canals, patent canal orifices and curvatures greater than 15 degrees were cleaned and shaped with K-files and 2.5% sodium hypochlorite to a size 30 at the apex, and flared with Hedstrom files to create a continuously tapering funnel preparation. Canals were randomly obturated with Sealapex root canal sealer and either alpha-phase gutta-percha on a plastic Thermafil carrier, or standard beta-phase gutta-percha with lateral condensation. Roots were radiographed from the proximal and evaluated by three examiners, based on established criteria for overall material adaptation, apical adaptation, and filling material extrusion. Thermafil provided a statistically significant better overall canal obturation (P<0.001), while, in the apical third, both techniques were not significantly different (P>0.05). When the apical orifice was patent there was a significant propensity for the extrusion of filling materials beyond the apex (P<0.001) with the Thermafil technique. [ABSTRACT FROM AUTHOR]

It is essential that a competent bond should exist between the gutta-percha point used to obturate a prepared root canal and. the sealer cement, in order to avoid the risks of both periapical leakage and possible disruption of the point during preparation of the tooth for a post crown. An experimental method was established whereby disruption between the two media could be examined. Shear tests were carried out using both smooth surfaced and sandblasted gutta-percha points, and comparisons in their bond strengths were made. Statistical analysis showed that roughening the gutta-percha points significantly improved the bond strength between point and sealer. [ABSTRACT FROM AUTHOR]

This study investigated the movement of root canal sealer during the placing of a gutta-percha root filling. Using transparent simulated tooth models, three techniques of introducing sealer were examined; these were with the gutta-percha point, with a reamer, or with a Lentulo spiral filler. The use of a Lentulo spiral filler showed consistently more apical extrusion of sealer than with the other techniques. The results demonstrated that the overall coating of sealer was not affected by whatever technique was employed. [ABSTRACT FROM AUTHOR]

The purpose of this study was to assess long-term coronal leakage in root fillings achieved by 2 gutta-percha techniques using 2 calcium hydroxide-containing sealers. The root canals of 90 single-rooted teeth with mature apices were prepared chemomechanically. The teeth were placed randomly into four experimental groups (n = 20) and obturated with either lateral condensation of cold gutta-percha or a thermo-plasticized gutta-percha delivery, system, JS Quickfill, using Sealapex or Apexit as the sealer. A further five teeth were placed in each of negative or positive control groups. After root filling the teeth were sectioned at the cernentoenamel junction and stored in saline solution at 37° for 1 yr. Coronal leakage was then determined with an India ink tracer (using a reduced pressure model) and a clearing technique. The extent of coronal leakage was measured at ×6 magnification. Non-parametric analysis showed that there was significantly more leakage with the thermally softened gutta-percha technique than with lateral condensation (p<0.05). There was no significant difference in leakage between the groups obturated with lateral condensation (p>0.005) but, with the thermoplasticized technique, there was more leakage ,with the sealer Sealapex (p<0.05). [ABSTRACT FROM AUTHOR]

This paper reviews the evidence that coronal leakage of root canals may lead to failure of root-canal therapy. The causes of coronal leakage and methods by which this leakage may be prevented are described. [ABSTRACT FROM AUTHOR]

This paper describes an experimental methodology for assessing the combined effect of differing endodontic posts and cements, which are important structural elements of restorations for the root filled tooth. The focus is upon the strength of the restoration when subjected to cyclic combined direct and torsional shear forces at magnitudes and frequencies representative of those present during normal mastication. The paper describes the experimental facilities and procedures with respect to the modelling of the restoration and application of the loads. After a predetermined number of load cycles the modelled restoration is removed and examined in detail using microleakage techniques. [ABSTRACT FROM AUTHOR]

There are various factors that influence the outcome of root canal treatment and the quality of the coronal restoration may be one of these. This literature review aims to evaluate the evidence of the link between the restoration of the root filled tooth and post-root canal treatment failure. Methods: The search of the literature included interrogation of Pubmed, Medline, Cross Search and Scopus databases, together with hand searches. Conclusion: The evidence from clinical and laboratory studies shows that the quality of the coronal restoration has an influence on the prognosis of root canal treatment. A high quality coronal restoration should be placed as soon as possible after root canal treatment in order to prevent coronal leakage and thereby provide protection for the root canal system. [ABSTRACT FROM AUTHOR]

This paper highlights one aspect of a presentation to be given at the BDA Conference and is written in the context of dentistry in primary care. Careful oral health assessment as a foundation to good treatment planning and quality dentistry is not new, but there are a number of important new perspectives emerging across countries and healthcare systems in terms of the content and role of such an assessment in modern dental practice. [ABSTRACT FROM AUTHOR]

ObjectiveThis study examined methods used for reprocessing endodontic instruments in general dental practice and determined the degree of residual visual contamination and blood contamination on 250 reprocessed files collected from 25 general dental practices.Materials and methodsA questionnaire was administered to 25 general dental practitioners to obtain information on the re-processing of used endodontic files. Ten files which had been used and reprocessed were also collected from each practice. These were examined visually under a dissecting light microscope for residual contamination and then tested for blood deposits using the Kastle-Meyer test.ResultsNineteen of the 25 practices used stainless steel hand files. No practitioners used endodontic files as single use devices. Ninety-two per cent of the practitioners discarded and replaced files when they were bent or damaged. Several decontamination methods were reported. The two combinations employed most frequently were manual cleaning and autoclaving or manual cleaning, followed by ultrasonic cleaning and autoclaving. Of the 250 files, 75% showed some degree of visual contamination and seven percent tested positive for residual blood. Blood contaminated files were significantly more heavily contaminated when examined visually. Large variations were found in residual contamination of files collected from practices using the same methods of decontamination.ConclusionsWhile all practitioners re-used endodontic files, the variations in decontamination methods reported indicate a lack of clarity on best practice. This study demonstrates that endodontic files are not reliably decontaminated by methods currently employed in dental practice. [ABSTRACT FROM AUTHOR]

To evaluate the impact of European Society of Endodontology curriculum guidelines on undergraduate teaching in the UK.A postal questionnaire was designed by two authors (WPS, GB) in 2003. This included open and closed questions relating to endodontic curricula and the impact of curriculum guidelines. This was sent with a cover letter to the thirteen UK undergraduate schools. Data harvest was completed a year after the initial questionnaires were sent. Responses were collated and analysed qualitatively and quantitatively.Eight (62%) questionnaires were returned. Analysis revealed divergence from aspects of curriculum guidelines. Guidelines were applied by seven schools. Four schools had not applied guidelines related to endodontic surgery as this was taught by Departments of Oral Surgery. One respondent stated that the established curriculum was too inflexible to allow application. There was wide variation in curriculum structure with combinations of outcome, competency and problem-based learning. No schools had a separate department of Endodontology. All schools felt graduates should be competent at de-novo treatment of single and multi-rooted teeth. In general, competence was expected in single canal re-treatment but not multi-rooted teeth. Patient recruitment proved a major barrier to meeting guidelines. Number of cases to be completed by graduation ranged from 6 to 14 in total. Three schools felt that guidelines were not achievable citing lack of time, funds and appropriate staff.All schools provided operative techniques classes prior to clinical treatment. These ranged from 20 to 120 hours (mean 43, S.D. 35.24.). Cases completed in these classes varied. For single rooted teeth this ranged from one to six (mean 2.57). For multi-rooted teeth this ranged from one to three (mean 2.14). Most schools had at least one faculty member with a special interest in Endodontology. In seven schools however, teaching was also carried out by staff with no special interest. Five schools did not have a separate endodontic clinic. Five respondents had undergraduate learning in outreach centres. Trauma teaching was mainly carried out by in Departments of Paediatric Dentistry.There is wide variation in the delivery of endodontic curricula in the U.K. Whilst curriculum guidelines are available, there are barriers to delivering these. Consideration should be given to revision of guidelines in light of their evident inapplicability in some areas. [ABSTRACT FROM AUTHOR]

Aim This study evaluated in vitro the effect of using the operating microscope on repairing furcation perforations using Vitrebond and MTA. Methodology Forty-six human molar teeth were mounted into a jig positioned in a simulated jaw. The teeth were allocated randomly to four groups (n = 10). Furcal perforations were made in the teeth using an ISO 012 round bur in a slow speed handpiece. Each material was used to repair a group of teeth with and without the use of the operating microscope. The remaining six teeth provided positive and negative controls. All groups were stored in 100% humidity and the repair materials allowed to set for 72 h at room temperature before being assessed for the quality of placement under ×26 magnification. The quality of the repair was assessed by an operator who was unaware of the distribution of teeth amongst the groups at ×26 magnification. The repair was assessed as being clinically acceptable where the perforation had been filled to within 0.5 mm of the furcal side or a slight overfill was present. Unacceptable repair was recorded if the repair did not extend to within 0.5 mm of the furcal side of the perforation or there was gross overfill. Leakage at the repair was then tested using India ink to fill the pulp chambers of the teeth. The teeth were then demineralized, dehydrated in alcohol and rendered transparent in methyl salicylate. Dye penetration into the furcation repair was evaluated at ×26 magnification. Results There was no difference in the acceptability of the repair with either material whether or not the operating microscope was used. However, recognition of the perforation site and placement of the filling material was facilitated by using the microscope. The perforations repaired with MTA leaked significantly less to the tracer dye than those with Vitrebond (P < 0.001). Conclusion MTA demonstrated significantly less signs of dye leakage compared with Vitrebond. Although the use of the OM facilitated... [ABSTRACT FROM AUTHOR]