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Background The objective of this report was to highlight the importance of using a dental operating microscope (DOM) to locate supernumerary canals and diagnose variations in root canals using cone-beam computed tomographic (CBCT) images. Case presentation A 35-year-old Chinese female had repeated swelling in the upper right posterior maxilla for 3 months and was referred to evaluate symptomatic apical periodontitis and mesotaurodonts for upper right first permanent molar and upper right second permanent molar. Root canal therapy was proposed and conducted with the use of DOM and CBCT. Conclusions Proper diagnosis and careful clinicoradiological examination are necessary, and it is essential to reinforce the knowledge of the rare morphology of root canals for clinicians.

Aim. To determine possible alternative algorithms for root canal disinfection through the combined use of chemical and physiotherapeutic irrigation techniques under in vitro conditions.Materials and methods. Single-root teeth removed according to orthodontic indications were used as a substrate for the formation of a biofilm. The formation of a mixed biofilm is carried out in several stages, successively introducing the following strains: Streptococcus sanguinis; Fusobacterium nucleatum; Porphyromonas gingivalis. Cultivation was carried out under fluid conditions under anaerobic conditions, for 168 hours. After the cultivation, the teeth were treated using: a solution of chlorhexidine bigluconate 2%; a solution of sodium hypochlorite 3%; photodynamic exposure with Fotoditazin photosensitizer; 1.0% sodium hypochlorite solution in combination with photodynamic exposure. The results were evaluated using scanning electron microscopy.Results. The results of scanning electron microscopy revealed differences between the samples of the control group and the comparison group. The number of bacterial cells was significantly lower in the comparison group than in the control group, however, in all samples, the presence of microbial biofilm sites was noted with varying degrees of severity. In the samples where standard concentrations were used, there was a change in the ultrastructure of the walls of the dentine tubules with its partial destruction and obturation by its own fragments of the walls with the presence of microbial cells. When using the photodynamic effect of destruction was not observed. The microbial landscape had a similar species composition, and more fragments of biofilm and individual cells were observed only in the case of PDT without a combination with an antiseptic.Conclusions. A comprehensive approach to endodontic treatment using photodynamic therapy together with antiseptic solutions in low concentrations allows us to achieve the best effect of pathogen eradication in comparison with the standard chemomechanical method.

BACKGROUND & OBJECTIVE: Missed root/canal is one of the main causes of endodontic failure. Permanent mandibular canine is considered to be a single rooted tooth. The complex pattern of root canal system poses difficulty in the root canal treatment and the prognosis becomes uncertain if the debridement and obturation of the root canals is not satisfactory therefore our objective of the study is to assess frequency of two roots in permanent mandibular canine of Pakistani population using CBCT scan. METHODOLOGY: A descriptive; retrospective study was planned by using Cone Beam Computerized Tomography (CBCT) images of the past 02 year, i.e. December 2017 till November 2018. Images were assessed for the number of roots in permanent mandibular canines using software NNTVIEWER NewTOM. Data was entered and analyzed using SPSS 21. RESULTS: 134 permanent mandibular canines of 67 patients were studied. 64.2% of the images were of male patients while 35.8% were of females. Mean age of the patients was 48.12 ± 15.92 years. 7 (5.22%) out of 134 canines had two roots. 4 patients (5.97%) had canines with 2 roots of which 3 patients (4.48%) had bilateral two-rooted canines and 1 patient (1.49%) had unilateral two-rooted canines. Frequency of two roots in mandibular canines had no association with gender (p= 0.127). CONCLUSION: All mandibular permanent canines were single rooted but 5.2% of the permanent mandibular canines had two roots.

Background and objectives Laser-activated irrigation of dental root canals is being increasingly used as its efficacy has been shown to be superior compared with conventional techniques. The method is based on laser-initiated localized fluid evaporation and subsequent rapid bubble expansions and collapses, inducing microfluid flow throughout the entire volume of the cavity. The irrigation efficacy can be further improved if optimally delayed "SWEEPS" double laser pulses are delivered into the canal. This study aims to show that the irrigation efficacy, as measured by the induced pressure within the canal, is related to the double pulse delay, with the maximal pressure generated at an optimal delay. The second aim is to find a method of determining the optimal delay for different cavity dimensions and/or laser parameters. Study design/materials and methods Experiments were made in transparent models of root canals where Er:YAG laser (λ = 2.94 μm, pulse duration tp = 25 or 50 microseconds, and pulse energies up to EL = 40 mJ) was used with a combination of cylindrical and conical fiber-tip geometries (diameters 400 and 600 µm). High-speed photography (60,000 fps) and average pressure measurements inside the canal were used for process characterization. Results The results show that a pressure amplification of more than 1.5 times occurs if the laser pulse delay approximately coincides with the bubble oscillation time. Correlations between normalized oscillation time and canal diameter for a wide range of laser pulse energies (R2 = 0.96) and between the average pressure within the canal and the bubble oscillation periods (R2 = 0.90) were found. A relationship between the bubble oscillation time and the diameter of the treated cavity was found depending on the bubble oscillation time in an infinite fluid reservoir. Conclusions The bubble oscillation time within a constrained volume can be determined based on the known oscillation time in infinite space, which offers a fast and simple solution for optimization of the laser parameters. These findings enable determination of optimal conditions for shock wave generation, and improvement of root canal irrigation at the same dose of laser energy input, leading to improved treatment efficacy and safety. Lasers Surg. Med. © 2020 The Authors. Lasers in Surgery and Medicine published by Wiley Periodicals, Inc.

Introduction: In recent years, endodontic dental treatment associated with periodontal inflammation in the provision of emergency and planned dental care is not provided with the appropriate standard and quality. Clinical case: Clinical observation is done to a patient suffering from exacerbation of chronic periodontitis, who underwent restoration of 2.6 teeth with light-cured filling material 15 years ago, and intraroot pins of which are made of materials that are not approved for medical practice use. Conclusion: The use of inappropriate material in medical practice for tooth restoration gives the patient the right to seek for material and moral compensation for bodily harm.

Introduction: The aim of this systematic review was to systematically evaluate and summarize the outcomes of in vitro studies comparing Endoactivator irrigation and Endovac irrigation techniques for removing calcium hydroxide (Ca[OH]2) medicament from the root canals. Materials and Methods: The research question was developed according to the population, intervention, comparison, and outcome strategy. A computerized literature search was conducted in Medline, PubMed, Google Scholar, and Embase. A hand search of the reference lists of identified articles was performed to separate relevant articles. Two reviewers critically assessed the studies that fulfilled the inclusion criteria and processed. Evaluation of the risk of bias of the studies was performed independently by the two reviewers. Results: After study selection, 61 were assessed for eligibility. Of these, 13 met the inclusion criteria and were included in the systematic review. Since significant heterogeneity was found in the methodologies, it was not possible to conduct a meta-analysis. Conclusions: On the basis of available evidence, we determined that Endoactivator irrigation technique showed better performance in removing Ca(OH)2 intracanal medicaments from middle third and coronal third area of the root canals and Endovac irrigation technique showed better performance from the apical third area of the root canals. Due to the limitations, small sample sizes, and low number of included studies, further research is needed to confirm our results.

Endodontic treatment of maxillary incisors may be considered straight forward. However, in some instances, they may exhibit aberrant morphology. One of these rare variations in tooth morphology is dens invaginatus. To improve the endodontic prognosis of such teeth, a detailed evaluation of the tooth under treatment is important, which requires comprehensive clinical and radiographic examinations, including periapical radiography and cone-beam computed tomography (CBCT), which is highly recommended whenever atypical root canal morphology is suspected on a periapical radiograph. The current case report discusses the diagnosis of type IV dens invaginatus in a maxillary lateral incisor using CBCT.

The high morphological complexity of premolars, has led to propose different techniques for successful endodontic therapy. The purpose of this report is to describe the ProTaper manual technique in a second mandibular premolar showing a high anatomical complexity. A patient of 19 years old co- mes to the clinic of endodontic in the Regional Hospi- tal (Temuco), diagnosed with irreversible pulpitis on tooth 35. Radiographic examination found that the tooth has two roots. For clinical suspicion of the presence of a third canal a Cone Beam computed tomography was requested, which confirmed the existence of a distolingual canal. Because it is a complex case, the increased taper endodontic technique was performed, allowing us to complete the endodontic therapy in less time and with less difficulty.

Background/Aim: To analyze the internal morphology of mandibular incisors with two root canals using cone-beam computed tomography (CBCT). Material and Methods: 289 (143 central and 146 lateral) extracted intact mandibular incisors were radiographed for detection of a second root canal. The teeth presenting a second root canal were imaged with CBCT and evaluated regarding: root canal type, the distance of the cementoenamel junction (CEJ) to the bifurcation of the canals and the distance of the canal fusion to the apical foramen (in teeth in which canals rejoined). Results: Out of 143 central and 146 lateral mandibular incisors, 41 (28.7%) and 44 (30.1%) teeth respectively showed a second root canal. Types II, III, V and an additional type to Vertucci's classification were identified. Type III was the most prevalent and presented in 30 (73.2%) central and 34 (77.3%) lateral mandibular incisors with two root canals. The mean values of the distance of the CEJ to the canal bifurcation were 4.2 mm and 4.0 mm for central and lateral mandibular incisors respectively. The mean values of the distance of the canal fusion to the apical foramen 5.5 mm and 5.1 mm for central and lateral mandibular incisors respectively. Conclusions: Mandibular incisors with two root canals mainly present with Vertucci's Type 3 canal configuration. The canal bifurcation was identified mostly at the coronal and middle thirds of the root, while the canal fusion occurred in the middle third of the root.

Background: We aimed to evaluate the efficacy of mineral trioxide aggregate (MTA) in the treatment of endodontic disease. Methods: Oversell, 384 patients with endodontic disease treated in Xuzhou Stomatological Hospital, Xuzhou, China, from June 2015 to June 2017 were selected, and randomly divided into four groups with 96 cases per group. The repair effects of MTA, zinc phosphate cement (ZPC), silver amalgam and light-curing calcium hydroxide (LCH) on the teeth and dental pulp of patients in the four groups were compared. Meanwhile, the ill symptoms of the patients were observed to confirm whether they could be alleviated. Besides, whether the repair effects were related to ages of patients, perforation diameters of diseased teeth and repair materials was discussed. Results: The success rates of MTA group, ZPC group, LCH group and silver amalgam group were 90.6%, 68.7%, 70.8% and 52.1%, respectively. The success rate of MTA group was significantly higher than that of ZPC group, silver amalgam group and LCH group. When the success rates of four groups were compared, the differences were statistically significant (P=0.0072). The patient's age, repair material and perforation diameter were positively correlated with MTA repair effect (P=0.003, P=0.002, P=0.01). The patients' teeth in each group were repaired with different materials, and the reexamination was conducted 4 weeks later. Three patients in the silver amalgam group were found to have gingival swelling. Conclusion: The therapeutic effect of MTA was significant in the treatment of endodontic disease, and it is worthy of clinical application.

Karatekin, Anil Ozgun/0000-0001-7383-7037 WOS: 000533886900019 PubMed: 31751375 Aim To compare the efficiency of continuous wave obturation and cold lateral condensation techniques and filling time in C-shape canals of 3-dimensional (3D)-printed resin teeth shaped with Reciproc Blue (VDW) or Hyflex EDM (Coltene/Whaledent). Methodology One tooth with C1-type orifice and root canal morphology and one with C2-type orifice and C2-C3 root canal morphology were selected based on CBCT. Two replicas of selected teeth were manufactured with a 3D-printer and their canals were instrumented with Reciproc Blue or Hyflex EDM. These 4 instrumented replicas were scanned with CBCT. Identical 10 replicas of each group (total of 40) were produced using a 3D-printer and randomly divided into 2 groups (n = 5), root filled with either continuous wave obturation (CW) or cold lateral condensation (LC). Horizontal cross-sections of C1-type were made at 2, 4, 6, 8 mm and C2-type at 2, 4, 6 mm from the apical foramen. Gutta-percha, sealer and void areas were evaluated with image analysis sofware. Data were analysed using nonparametric Kruskal-Wallis and Mann Whitney-U tests and the Factorial ANOVA was used for interaction effects. Time required to fill canals was evaluated using the Mann-Whitney U test. Results For C1-type, LC had more gutta-percha and less sealer compared to CW in 2-mm sections (p0.05). In both C-types, there was no significant difference in the percentages of gutta-percha, sealer and voids between Reciproc Blue and Hyflex EDM-shaped groups at any level (p>0.05). Time spent for the LC technique and filling C1-type was significantly longer than when using the CW technique and filling C2-type (p

Nonsurgical endodontic therapy of a right maxillary first molar with three roots and seven root canals. This unusual morphology was diagnosed using a dental operating microscope (DOM) and confirmed with the help of cone-beam computed tomography (CBCT) images. CBCT axial images showed that both the palatal and distobuccal root have a Vertucci type II canal pattern, whereas the mesiobuccal root showed a Sert and Bayirli type XVIII canal configuration. The use of a DOM and CBCT imaging in endodontically challenging cases can facilitate a better understanding of the complex root canal anatomy, which ultimately enables the clinician to explore the root canal system and clean, shape, and obturate it more efficiently.

Background/Purpose: The objectives of this study were to identify the bilateral distolingual (DL) canals / roots of the mandibular first molars and second mesiobuccal (MB2) canals of the maxillary first molars in the same Turkish individuals using cone-beam computed tomography (CBCT). Materials and Methods: A total of 150 CBCT images including all mandibular and maxillary first molars were retrospectively investigated in a Turkish subpopulation. The patient age, sex and presence of roots and root canals were assessed. The frequency, of bilateral DL canals, DL roots, and MB2 canals were reviewed. Data were analyzed using Fisher’sexact test and Chi-square test. Results: The prevalences of right DL canals, DL roots and MB2 canals were 31.3, 14.0 and 34.7%, respectively. The prevalences of left DL canals, DL roots and MB2 canals were 31.3, 4 and 27.3%, respectively. There was no statistically difference in the frequency of right and left DL canals, DL roots of mandibular first molars and MB2 canals of maxillary first molars according to gender. Conclusion: CBCT is a competent tool for the detection of additional distolingual canals/roots and second mesio buccal canals, and it is a valuable aid for dentists providing root canal treatment.

WOS: 000419184800008, PubMed ID: 29114431, It is very important that the dentists have sufficient information about possible variations in the expected root canal configurations in order to achieve success in endodontic treatment. In addition to having adequate knowledge on the variations of the root canal anatomy, periapical radiographs from different angles, careful examination of the pulp chamber floor, and use of dental operation microscope during the procedure are also important factors that contribute to the diagnosis of the additional roots and canals. The aims of this article are to present the diagnostic approach and root canal treatments of two maxillary first premolar teeth with three canals in two patients.

Twinning is referred to the development of two separate teeth that arose from the complete separation of one tooth bud. To the best of our knowledge very few cases of twinning in primary or permanent dentition have been previously reported. Here, we report an additional case of twinning involving primary maxillary left lateral incisor and a literature review of clinical and radiographic findings of previous reported cases of gemination and twinning is also discussed. A six-year-old male patient reported to the dental clinic with the complaint of decay in the left front teeth region of the upper jaw. On clinical examination, dentinal caries was observed on the labial surface of primary maxillary left lateral incisor. The tooth showed a deep groove present in relation to the labial surface and incisal edge and continued cervically as a shallow groove. The patient had normal compliment of teeth for his age. The intra-oral periapical radiograph of the maxillary anterior region revealed large crown and a radiolucent notch was observed in relation to the incisal edge of the maxillary left primary lateral incisor. Relatively one pulp chamber and two root canals were observed in relation to the primary maxillary left lateral incisor, which was suggestive of a case of twinning involving primary maxillary left lateral incisor. This present case is the first case report of twining seen in primary dentition.

Background. The success of endodontic treatment is provided by a thorough instrumental and antiseptic treatment of infected root canals, and it depends on the composition of filling material, the degree of adhesion to dentin, hermetic obturation of apical foramen, solubility of sealer.Objective. The study was aimed to evaluate the effectiveness of root canal obturation with BioRootTM RCS sealer in the treatment of patients with chronic apical periodontitis.Materials and methods. Endodontic treatment of 23 teeth in 20 patients with chronic apical periodontitis by method of lateral compaction of gutta-percha was carried out. In the main group root canals were obturated with BioRootTM RCS, in the control group the canals were filled with Apexit Plus. The percentage of efficient or non-efficient cases was evaluated on the basis of radiographic comparison of treated chronic apical periodontitis immediately after obturation, in three, six months and one year. Radiographic conditions were defined as existing state, improvement and worsening.Results. In a year of dynamic evaluation the final results were: in the main group – 54.55% of the patients had complete bone healing, in 27.27% of cases the focus of bone destruction was decreased by ½ or more of the initial sizes, 18.18% – resorption lesion was decreased by less than ½; in the control group – 33.33% of improvement, 25.0% of existing state and 41.66% of worsening.Conclusions. BioRootTM RCS using for root canals obturation in the treatment of chronic apical periodontitis we proved the high effectiveness of the treatment undertaken: complete healing or improvement of radiographic conditions of periapical bone destruction with X-ray signs of bone regeneration.

Made available in DSpace on 2019-09-11T20:51:34Z (GMT). No. of bitstreams: 0 Previous issue date: 2016 Resumo Este estudo clínico investigou e quantificou bactérias cultiváveis e seus níveis de endotoxinas na infecção endodôntica persistente, determinando a sua antigenicidade contra macrófagos e células de fibroblastos através de IL-1?#61666; e TNF-?#61665;; e avaliando sua relação com características clínicas e radiográficas. As amostras dos canais radiculares foram obtidas após a desobturação. Técnicas de cultura foram utilizadas para determinar a contagem de bactérias e a quantificação de endotoxinas foram determinadas por ensaio de LAL. Análise por PCR (16S rDNA) foi utilizada para a detecção bacteriana. Células 264,5 macrófagos e fibroblastos V79 foram estimuladas com conteúdo endodôntico. IL-1?#61666; e TNF-?#61665; produzidas pelas células avaliadas foram medidas por ensaio de ELISA. As medianas de bactérias e endotoxinas foram 1,24x105 UFC/mL e 9,62 EU/mL, respectivamente. Porphyromonas endodontalis foi a espécie mais frequentemente detectada. Níveis mais elevados de endotoxinas foram encontrados em dentes com dor à palpação (23,56 EU/mL) quando comparado a sua ausência (8,21 EU/mL). Maiores áreas de destruição óssea foram relacionados com níveis mais elevados de endotoxinas e IL-1?#61666; e TNF-?#61665;. O estudo revelou presença de espécies de bactérias Gram-negativas em infecção endodôntica persistente, com níveis elevados de endotoxinas relacionados a maior destruição óssea periapical e presença de sintomatologia. Além disso, grandes áreas de destruição óssea foram relacionados com níveis mais elevados de IL-1?#61666; e TNF-?#61665; secretadas por macrófagos e fibroblastos. Abstract This clinical study investigated and quantified cultivable bacteria and their levels of endotoxins in persistent endodontic infection, determining their antigenicity against macrophages and fibroblast cells by IL-1β and TNF-α secretion and evaluating their relationship with clinical and radiographic features. Samples from the root canals were obtained after root filling removal. Culture techniques were used to determine the bacterial count and the endotoxins were determined by LAL-assay. PCR analysis (16S rDNA) was used for bacterial detection. Raw 264.5 macrophages and V79 fibroblast were stimulated with endodontic contents. ELISA assay measured the amounts of IL-1ß/TNF-?#61537; secretion. Bacteria and endotoxin medians were 1.24x105 CFU/mL and 9.62 EU/mL, respectively. Porphyromonas endodontalis was the most frequently detected species. Higher levels of endotoxins were found in teeth with pain on palpation (23.56 EU/mL) rather than in its absence (8.21 EU/mL). Larger areas of bone destruction were related to higher levels of endotoxins and IL-1β and TNF-α secretion. The study findings revealed the presence of Gram-negative bacteria species in persistent endodontic infection, with their endotoxins related to both severity of bone destruction and development of symptomatology. Moreover, larger areas of bone destruction were related to higher levels of IL-1β and TNF-α secreted by macrophages and fibroblast cells. [Gomes, Brenda Paula Figueiredo de Almeida] Universidade Estadual de Campinas, Brazil Cardoso, Flávia Goulart da Rosa] Universidade de Taubaté, Brazil Cardoso, Flávia Goulart da Rosa; Chung, Adriana; Martinho, Frederico Canato; Camargo, Carlos Henrique Ribeiro; Carvalho, Claudio Antônio Talge; Valera, Marcia Carneiro] Universidade Estadual Paulista, Brazil

Introduction: The cleaning mechanisms and characteristics of passive ultrasonic irrigation (PUI) are not yet completely understood. The aim of this study was to investigate whether the oscillatory direction of the ultrasonically driven file had an influence on dentin debris removal from artificially made grooves in standardized root canals. Methods: Each of 20 ex vivo root canal models with a standard groove in the apical portion of one canal wall filled with dentin debris received PUI repeatedly, either with file oscillation toward the groove or with file oscillation perpendicular to the groove. After each irrigation procedure, the amount of dentin debris in the groove was evaluated by photographs of the groove and by scoring. The oscillations of the ultrasonic file were also visualized in vitro by using high-speed imaging at a time scale relevant to the cleaning process, order 10 microseconds. Results: A nonparametric analysis showed significantly more dentin debris reduction when the file oscillated toward the groove (P = .002). High-speed imaging showed that the oscillation of the file is in a single plane, resulting in high-velocity jets emanating from the file tip in the direction of the oscillations. Conclusions: Oscillation of the ultrasonically driven file toward the groove is more effective in removing dentin debris from the groove than oscillation perpendicular to the groove, which can be related to the fact that there is a high-velocity jet from the file tip in a single direction following the file oscillation and a relatively slow inflow in the perpendicular direction. (I Endod 2010;36:1372-1376)

The aim of this study was to evaluate the cleaning capacity of Profile .04 files combined with different irrigating solutions in flattened root canals using histological, morphometrical and SEM analyses. Eighty human mandibular incisors were prepared with Profile .04 instruments and randomly divided into 4 groups according to the irrigating solutions used (n=20): G1: distilled water (control); G2: 1% sodium hypochlorite (NaOCl); G3: 1% NaOCl alternated with 17% EDTA, and G4: 1% NaOCl with RCPrep cream. Ten teeth of each group were evaluated with an optical microscope to determine the percentage of root canal debris. The remaining teeth were evaluated under scanning electron microscopy (SEM). Data were analyzed statistically by ANOVA and Tukey's test (α=0.01).There was a significant difference (p

This study evaluated the efficiency of different techniques for removal of filling material from root canals, using computed tomography (CT). Sixty mesial roots from extracted human mandibular molars were used. Root canals were filled and, after 6 months, the teeth were randomly assigned to 3 groups, according to the root-filling removal technique: Group A - hand instrumentation with K-type files; Group B - reciprocating instrumentation with engine-driven K-type files; and Group C rotary instrumentation with engine-driven ProTaper system. CT scans were used to assess the volume of filling material inside the root canals before and after the removal procedure. In both moments, the area of filling material was outlined by an experienced radiologist and the volume of filling material was automatically calculated by the CT software program. Based on the volume of initial and residual filling material of each specimen, the percentage of filling material removed from the root canals by the different techniques was calculated. Data were analyzed statistically by ANOVA and chi-square test for linear trend (?=0.05). No statistically significant difference (p=0.36) was found among the groups regarding the percent means of removed filling material. The analysis of the association between the percentage of filling material removal (high or low) and the proposed techniques by chi-square test showed statistically significant difference (p=0.015), as most cases in group B (reciprocating technique) presented less than 50% of filling material removed (low percent removal). In conclusion, none of the techniques evaluated in this study was effective in providing complete removal of filling material from the root canals. O objetivo do presente estudo foi avaliar a eficácia de diferentes técnicas na remoção de material obturador dos canais radiculares, através da tomografia computadorizada (TC). Sessenta raízes mesiais de molares inferiores humanos extraídos foram utilizadas. Os canais radiculares foram obturados e, após 6 meses, os dentes foram divididos aleatoriamente em 3 grupos, de acordo com a técnica de desobturação: Grupo A - instrumentação manual com limas tipo K; Grupo B - instrumentação oscilatória com limas tipo K acopladas a contra-ângulo NSK acionado por motor elétrico; e Grupo C - instrumentação rotatória com limas ProTaper associadas a contra-ângulo NSK acionado por motor elétrico. As imagens de TC foram feitas para avaliar o volume de material obturador encontrado no interior dos canais radiculares antes e após a desobturação. A região do material obturador foi demarcada nos dois momentos por um radiologista experiente e o volume foi calculado automaticamente pelo programa do TC. A partir do volume de material obturador inicial e remanescente de cada espécime o cálculo da porcentagem de material obturador removido. Os dados foram analisados pela análise de variância (ANOVA) e pelo teste qui-quadrado (?=0,05). A comparação das médias das porcentagens de material obturador removido não demonstrou diferença estatisticamente significante (p=0,36) entre os grupos. Analisando a associação do percentual de material obturador removido (baixo ou alto) com as diferentes técnicas de desobturação, através do teste Qui-quadrado, encontrou-se diferença estatisticamente significante (p=0,015), com maior número de casos com menos de 50% de seu material obturador removido (baixa remoção) no Grupo B. Em conclusão, nenhuma das técnicas estudadas foi capaz de remover completamente o material obturador do interior dos canais radiculares.

In the present study, periapical radiographs were analyzed to investigate the number of canals of the buccal root of maxillary 1st premolars with longitudinal sulcus, and compare the number of apical foramina observed on the radiographs to that revealed by scanning electron microscopy (SEM). Thirty-nine human maxillary 1st premolars had their crowns and palatal roots removed and the root canals (C) were explored with endodontic files until the tip of the instrument was visualized exiting the apical foramen/foramina (AF). Radiographs were taken with files inside the root canals and the specimens were classified as follows: 1C/1AF; 2C/2AF; 1C/2AF; 2C/1AF. Apices were examined under SEM and the number of apical foramina (considering those measuring >80 µm in diameter) was recorded. Only 17.1% (n=6) of the specimens had 1C/1AF; 77.2% (n=27) had 2AF in which 42.9% (n=15) had 2C and 34.3% (n=12) had 1C; 5.7% (n=2) had 2C/1AF. SEM examinations showed that 46.1% (n=18) of the specimens had 2AF; 23.1% (n=9) had 1AF; 23.1% (n=9) had 3AF; 7.7% (n=3) had 4AF. Radiographic and SEM findings for the number of AF coincided in 62.8% of the cases. A buccal longitudinal sulcus in the maxillary 1st premolar is usually accompanied by total bifurcation (42.9%) or apical bifurcation (34.3%) of the root canal. SEM identified a statistically higher number of apical foramina than radiographs (p80 µm) foram obtidos. A avaliação radiográfica demonstrou que 17,1% (n=6) das raízes apresentaram 1C/1FA 77,2% (n=27) tinham 2FA, sendo 42,9% (n=15) oriundos de 2C, e 34,3% (n=12) de 1C; 5,7% (n=2) apresentaram 2C terminando no mesmo FA. Em MEV, 46,1% (n=18) dos ápices apresentaram 2FA; 23,1% (n=9), apenas 1FA; 23,1% (n=9), 3 FA; e 7,7% (n=3), 4 FA. Houve correlação entre o diagnóstico radiográfico e MEV quanto ao número de FA em 62,8% dos casos. O sulco longitudinal vestibular no primeiro pré-molar superior predispõe à bifurcação total (42,9%) ou apical (34,3%) do canal radicular; sendo o método radiográfico estatisticamente inferior (p

Objective: The aim of this ex vivo study was to evaluate the accuracy of endodontic file length measurement on digital periapical radiographs after application of contrast inversion digital enhancement. Materials and Methods: Forty single-rooted single-canal mature permanent human teeth with canals measuring 20-24 mm in length were used in this study. ISO #08 K-files were placed in the root canals of the teeth. The file lengths were measured with a digital caliper as the gold standard. Standard periapical digital images were obtained with the Digora storage phosphor plates and Digora Optime scanner as the original images. The contrast inversion option of Scanora software program version 5.1 was used to produce enhanced images. Three radiologists and three endodontists measured file lengths on the original and enhanced images. The measurements were compared using repeated measures ANOVA and Bonferroni tests (α=0.05). Results: There were significant differences between the measurement accuracy of the original and enhanced images (p

Aim : To evaluate the potential antibacterial effect of recurrent doses of topical gaseous ozone on the Enterococcus faecalis biofilms growth in human root canals in vitro. Materials and Method s: One hundred and thirty four human single.rooted mandibular premolars were enlarged to a size 35 K.File. Each root canal were inoculated with an overnight culture of Enterococcus faecalis ATCC 29212 in tryptic soy broth for 24 hours and incubated for 7 days at 37‹C. At 7.day interval, 4 specimens were prepared for Scanning Electron Microscope (SEM) analysis to confirm the presence and purity of biofilms whilst the other contaminated root canals were irrigated and disinfected. One hundred root canals of total 134 specimens were selected to create the experimental groups and divided into 5 subgroups. In each experimental group (n = 20) root canals), recurrent ozone doses were applied with different irrigation and disinfection protocols in 5 different time intervals. Bacterial growth was analyzed by counting viable E. faecalis on tryptic soy agar plates. Results : According to intergroup comparison results observed in the final sample collection analysis, the amount of remaining bacteria in the positive control group were found to be significantly higher compared to Groups 1, 2, 3, 4, 5 and the material control group (P < 0.01). The remaining amount of bacteria in the last count of Group 1 were found to be significantly higher compared to Group 2 (P < 0.05), Group 4 (P < 0.01), Group 5 (P < 0.05) and the material control group (P < 0.01). Conclusion : The application of topical gaseous ozone in recurrent doses provides a positive effect in the removal of E. faecalis biofilm from root canals. However, during disinfection procedure, the combined use of recurrent doses of topical gaseous ozone with 2% NaOCl enhanced its antibacterial effect against E. faecalis biofilm. Key words : Antibacterial effect, disinfection, Enterococcus faecalis biofilm, irrigation, recurrent doses, root canals, topical gaseous ozone

Made available in DSpace on 2019-09-12T16:53:48Z (GMT). No. of bitstreams: 0 Previous issue date: 2014 Objective: This study sought to assess if discoloration of tooth structures occurs after photodynamic therapy (PDT) and to determine the efficacy of a protocol to remove the photosensitizers. Background data: PDT has been used in root canal treatment to enhance cleaning and disinfection of the root canal system. PDT uses a low power laser in association with a dye as a photosensitizer. Photosensitizers can induce staining of the dental structures, resulting in an unaesthetic appearance. Methods: Forty teeth were randomly divided into four groups according to the photosensitizer used and pre-irradiation time: 0.01% methylene blue for 5 min (MB5); 0.01% methylene blue for 10 min (MB 10); 0.01% toluidine blue for 5 min (TB5); and 0.01% toluidine blue for 10 min (TB 10). Specimens were irradiated with a 660 nm diode laser with a 300 mu m diameter optical fiber, at 40 mW power setting for 3 min. Immediately after, the photosensitizers were removed with Endo-PTC cream +2.5% sodium hypochlorite (NaOCl). The shade was measured by a Vita Easyshade spectrophotometer based on the CIELAB color system (L*a*b* values) at three different experimental times: before PDT (T0), immediately after PDT (T1), and after removal of the photosensitizer (T2). Results: The results showed a decrease in the averages of the L*a*b* coordinate values after PDT (T1) in all the groups, when compared with the number at T0, with a significant statistical difference in group MB10. After photosensitizer removal (T2), all the values of the coordinates increased with significant statistical differences (p < 0.05) between T1 and T2 in L* and a*. Conclusions: It can be concluded that both methylene blue and toluidine blue dyes cause tooth discoloration, and that Endo-PTC cream associated with 2.5% NaOCl effectively remove these dyes, regardless of the pre-irradiation time used for PDT. [Figueiredo, Romulo Aguiar; Carvalho, Erica dos Santos; Habitante, Sandra Marcia; Raldi, Denise Pontes] Universidade de Taubaté (Unitau), Dept Dent, Sao Paulo, Brazil [Anami, Lilian Costa] UNESP Sao Paulo State Univ, Inst Sci & Technol, Dept Dent Mat & Prosthodont, Sao Paulo, Brazil [Mello, Isabel] Univ Manitoba, Div Endodontol, Dept Restorat Dent, Winnipeg, MB, Canada

Aim(i) To evaluate the effect of needle type and insertion depth, root canal size and irrigant flow rate on the entrapment of air bubbles in the apical part of a root canal (apical vapor lock) during syringe irrigation using experiments and a Computational Fluid Dynamics (CFD) model, (ii) to investigate whether the irrigant contact angle affects bubble entrapment, (iii) to examine if an established vapor lock can be removed by syringe irrigation.MethodologyBubble entrapment during irrigation of straight artificial root canals of size 35 or 50 was evaluated by real-time visualizations. The irrigant was delivered by a closed-ended or an open-ended needle positioned at 1 or 3mm short of working length (WL) and at a flow rate of 0.033-0.260mLs(-1). Results were analysed by nonparametric tests at 0.05 significance. Selected cases were also simulated by a two-phase CFD model.ResultsA vapor lock was observed in 48% of the cases investigated experimentally. Increasing the apical size, using an open-ended needle, positioning the needle closer to WL and delivering the irrigant at higher flow rate resulted in significantly smaller vapor lock. An increased contact angle resulted in the entrapment of a larger bubble when a low flow rate was used. Both brief insertion of the needle to WL whilst irrigating at a flow rate of 0.083mLs(-1) and delivering the irrigant at 0.260mLs(-1) without changing the needle position were capable of removing an established vapor lock.ConclusionsApical vapor lock may occur under certain conditions, but appears to be easily prevented or removed by syringe irrigation.

Ultrasonically activated irrigation is an advanced dental technique for irrigation of the root canal system during a root canal treatment. The basic cleaning mechanism is a result of acoustic streaming induced by an oscillating file, leading to mixing of the irrigant and pressure and shear stresses on the walls of the root canal. Here the induced acoustic streaming, pressure, and shear stress are investigated in a two-dimensional cross-section of the root canal, using a combination of theory, numerical predictions, and experimental validation through high-speed particle tracking velocimetry. Acoustic streaming theory describes very well the flow induced by an ultrasonically oscillating endodontic file. It consists of an oscillatory component, which is dominant near the file, and a steady component, or jet, along the axis of oscillation. The importance of the oscillatory component for both the pressure and the shear stress is apparent, as it is two to three orders of magnitude higher than the steady component. A confinement affects the formation of the steady jets; meanwhile the oscillatory velocities and associated pressure and shear stress are increased. Previous work considering only the steady component of the flow therefore, underestimated the hydrodynamic effects induced by ultrasonic files. (C) 2014 Acoustical Society of America.

Morphological variations like additional roots and root canals in human deciduous dentition are rare. Knowledge of the morphology, variation of root and root canals of deciduous teeth are useful for successful endodontic treatment and exodontia. Presented here is a case report of the supernumerary roots and additional root canals of deciduous mandibular second molar (85) with congenitally bilateral missing of mandibular permanent second premolar (35 and 45) tooth bud.

Aim (i) To quantify in a simulated root canal model the file-to-wall contact during ultrasonic activation of an irrigant and to evaluate the effect of root canal size, file insertion depth, ultrasonic power, root canal level and previous training, (ii) To investigate the effect of file-to-wall contact on file oscillation. Methodology File-to-wall contact was measured during ultrasonic activation of the irrigant performed by 15 trained and 15 untrained participants in two metal root canal models. Results were analyzed by two 5-way mixed-design anovas. The level of significance was set at P < 0.05. Additionally, high-speed visualizations, laser-vibrometer measurements and numerical simulations of the file oscillation were conducted. Results File-to-wall contact occurred in all cases during 20% of the activation time. Contact time was significantly shorter at high power (P < 0.001), when the file was positioned away from working length (P < 0.001), in the larger root canal (P < 0.001) and from coronal towards apical third of the root canal (P < 0.002), in most of the cases studied. Previous training did not show a consistent significant effect. File oscillation was affected by contact during 94% of the activation time. During wall contact, the file bounced back and forth against the wall at audible frequencies (ca. 5 kHz), but still performed the original 30 kHz oscillations. Travelling waves were identified on the file. The file oscillation was not dampened completely due to the contact and hydrodynamic cavitation was detected. Conclusion Considerable file-to-wall contact occur-red during irrigant activation. Therefore, the term ‘Passive Ultrasonic Irrigation’ should be amended to ‘Ultrasonically Activated Irrigation’

Some lasers have demonstrated to provide effective disinfection when used as adjunctive device to the conventional treatment. The aim of this in vitro study was to determine the effectiveness of the erbium, chromium:yttrium scandium gallium garnet (Er, Cr:YSGG) laser by measuring its bactericidal effect inside the root canal experimentally colonized with Enterococcus faecalis. The laser was tested at different irradiation times (30 and 60s) and energy of impulses (75 and 25mJ). A total of 52 single-rooted extracted human teeth were endodontically prepared with rotary instrumentation. All were sterilized and inoculated with a suspension of E. faecalis (105 bacteria/ml). The teeth were randomized into three treatment (group 1, group 2, and group 3) and one control groups. In all groups, teeth were chemically irrigated with 5.25% sodium hypochlorite and 17% ethylenediaminetetraacetic acid. Groups 1 and 2 were also irradiated at 30 and 60s, respectively, with an Er, Cr:YSGG laser at 75mJ. Teeth of group 3 were treated with laser for 60s at 25mJ. Samples were processed to detect the presence of E. faecalis. For all groups, a bactericidal effect was observed. The use of laser at 75mJ with an irradiation time of 30 and 60s eliminated a percentage of 92.3 and 100% of E. faecalis, respectively. In the control group, a reduction of 92.3% was observed. Lower percentage of reduction (46.1%) was obtained in teeth treated with laser at 25mJ for 60s. No statistical differences were observed between the groups (P = 0.543, Fisher's exact test). The results indicated a bactericidal effect of Er, Cr:YSGG laser irradiation at the settings used in this study. The highest bactericidal effect of this laser was observed at 60s of irradiation time, using an energy pulse of 75mJ. © 2013 Springer-Verlag London.

During a root canal treatment, an antimicrobial fluid is injected into the root canal to eradicate all bacteria from the root canal system. Agitation of the fluid using an ultrasonically vibrating miniature file results in a significant improvement in the cleaning efficacy over conventional syringe irrigation. Numerical analysis of the oscillation characteristics of the file, modeled as a tapered, driven rod, shows a sinusoidal wave pattern with an increase in amplitude and decrease in wavelength toward the free end of the file. Measurements of the file oscillation with a scanning laser vibrometer show good agreement with the numerical simulation. The numerical model of endodontic file oscillation has the potential for predicting the oscillation pattern and fracture likeliness of various file types and the acoustic streaming they induce during passive ultrasonic irrigation.

IntroductionThe aim of this study was to evaluate the removal of dentin debris from artificially made grooves in standardized root canals by 6 different final irrigation techniques.MethodsConventional syringe irrigation, manual dynamic activation (MDA) with tapered or nontapered gutta-percha (GP) cones, the Safety Irrigator system, continuous ultrasonic irrigation (CUI), and apical negative pressure (ANP) irrigation were tested ex vivo in 20 root canals with a standardized, debris-filled groove in the apical portion of one canal wall. After each irrigation procedure, the groove was photographed, and the residual amount of dentin debris was scored.ResultsThere was no significant difference between the MDA with a nontapered GP cone, the Safety Irrigator, and the ANP irrigation. These techniques produced better cleaning efficacy than syringe irrigation (P < .005) but significantly worse than the MDA with a tapered cone (P < .05). CUI was significantly better than all the other techniques tested in this study (P < .001).ConclusionsCUI was the most effective technique in dentin debris removal from the apical irregularities, and syringe irrigation alone was the least effective. MDA technique was more effective with a tapered GP cone than with a nontapered one.

Introduction: It is not clear whether increasing theultrasonic intensity would enhance the cleaning efficacyof passive ultrasonic irrigation (PUI) inside a root canal.The aim of this study was to evaluate the effect of theultrasonic intensity on PUI to remove dentin debrisand whether there is any lateral effect beyond the ultrasonictip. Methods: Each of 15 in vitro root canalmodels with four standard depressions in the apicalpart of one canal wall were filled with dentin debrisand received PUI repeatedly. The most apical depressionwas localized apically from the ultrasonic tip. The highestintensity was applied in group 1, the lowest intensitywas applied in group 3, and syringe irrigation wasperformed in group 4 as a control. Before and after irrigation,images of the canal wall with depressions weretaken and compared. The removal of dentin debris inthe depressions was categorized as clean or not clean.The data were analyzed by means of the chi-squaretest. The oscillation amplitude of the ultrasonic file ateach intensity was recorded in vitro using timeresolvedhigh-speed imaging. Results: Group 1 (highestintensity) exhibited significantly better cleaning than allthe other groups (P < .05); no significant difference wasfound between the four levels of the depressions withinany of the four groups. High-speed imaging showed thatthe amplitude of the oscillating file increased as theintensity went up, which leads to a higher velocity ofthe irrigant around the file. Conclusions: Higher ultrasonicintensity resulted in a higher amplitude of theoscillating file and, consequently, enhanced the cleaningefficacy of PUI.

Made available in DSpace on 2013-08-12T18:59:07Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-01-01 Made available in DSpace on 2013-09-30T18:33:41Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-01-01 Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-20T13:47:08Z No. of bitstreams: 0 Made available in DSpace on 2014-05-20T13:47:08Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-01-01 Item merged in doublecheck by Felipe Arakaki (fe.arakaki@gmail.com) on 2015-11-17T17:56:39Z Item was identical to item(s): 16374, 71010 at handle(s): http://hdl.handle.net/11449/16738, http://hdl.handle.net/11449/71528 Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) The resin cements are responsible to retention of the indirect materials decreasing marginal leakage, increasing failure resistance compared with conventional cementation. The cementation within root canal is very hard due unfavorable conditions regarding the application of adhesive techniques caused by inadequate access. Therefore, considering the possibility to decrease steps of cementation, this study was performed to evaluate the bond strength of self-adhesive resin cement (RelyX (TM) U100, 3M ESPE) and resin cement combined with self-ecthing adhesive system (Panavia (R) F 2.0, Kuraray) light-cured with Quartz Tungsten Halogen (QTH) following storage at 37 degrees C immediately after light-curing, 24 and 48 hours and 7 days. The root canals were prepared to receive the glass fiber post in the depth of 10 mm, irrigated with 17% EDTA and NaOCl, rinsed with distilled water and dried using paper points. The roots were perpendicularly sectioned into approximately 1 mm thick sections, obtaining ninety-six slices (n = 12). The slices were trimmed using a cylindrical diamond bur in the proximal surfaces until it touched the post and attached into a device, which were mounted on a strength tester (Bisco) and loaded in tension at a speed of 0.5 mm/min until failure occurred at specimens. The analysis of variance (ANOVA) and Tukey's post-hoc tests showed significant statistical differences (P < .05) to all resin cements immediately after light-curing and 24 hours, 48 hours and 7 days. The Panavia (R) F 2.0 showed higher mean values than RelyX (TM) U100 for all storage times, however no different statistically significant was reported (P > .05). The resin cements 24 and 48 hours after light-curing were statistically similar among themselves (P > .05). The both resin cement showed similar bond strength into root canal on different storage times. The highest bond strength values of the resin cements were showed 7 days after curing. Department of Restorative Dentistry Araraquara School of Dentistry University of São Paulo State - UNESP, 1680 Humaitá St., 14801-903 Araraquara - SP Department of Restorative Dentistry Faculty of Dentistry University of Toronto, Toronto, ON M5G 1G6 Crown and Bridge Department Faculty of Dentistry Suez Canal University, Ismailia University of Ribeirão Preto, 2.201 Costábile Romano Ave, Ribeirão Preto - SP Department of Restorative Dentistry Araraquara School of Dentistry University of São Paulo State - UNESP, 1680 Humaitá St., 14801-903 Araraquara - SP

Introduction: Multiple activations of the irrigant by using pulsed ultrasound may enhance the removal of dentin debris because of repeated acceleration of the irrigant. The aim of this study was to evaluate the effect of pulsed ultrasound on passive ultrasonic irrigation (PUI) in its ability to remove artificially placed dentin debris from a simulated apical oval extension within standardized root canals. Methods: Each of 20 in vitro root canal models with a standard groove in the apical portion of one canal wall filled with dentin debris received Phi repeatedly, either without pulsation (group1) or with pulsation (730 milliseconds on/100 milliseconds off in group 2, 400 milliseconds on/400 milliseconds off in group 3, and 100 milliseconds on/670 milliseconds off in group 4), corresponding to duty cycles of 100%, 88%, 50%, and 13%, respectively. After each irrigation procedure, the amount of dentin debris in the groove was evaluated by taking photographs of the groove and scoring. The irrigation procedures were also visualized in vitro using high-speed imaging performed in glass root canal models. Results: The debris score was significantly lower only in group 3 (p = 0.023). The in vitro visualization showed increased streaming and cavitation during the start-up phase of each pulse. Conclusions: PUI with a pulsation pattern of 400 milliseconds on/400 milliseconds off and a duty cycle of 50% is more effective in removing dentin debris from a simulated apical oval extension in standardized root canals than continuous ultrasonic activation. Duty cycles of 13% and 88% showed no difference compared with continuous oscillation. (J Endod 2010;36:1887-1891)

Introduction: An important virulence factor of Enterococcus faecalis is its ability to form biofilms. Most studies on biofilm formation have been carried out by using E. faecalis monocultures. Given the polymicrobial nature of root canal infections, it is important to understand biofilm formation of E. faecalis in the presence of other microorganisms. Methods: Eight clinical strains of E. faecalis were tested for biofilm formation on hydroxyapatite disks in the presence and absence of a Streptococcus mutans biofilm. Results: Significantly more E. faecalis viable cells were found in biofilms in the presence of S. mutans. This phenomenon was, however, strain-dependent. Of the 8 strains tested, biofilm formation of strains AA-OR34, ER5/1, and V583 was not influenced by S. mutans biofilms. Conclusions: The results from this study, especially the strain difference, underline the importance of studying biofilm formation in a more realistic multispecies setting. (J Endod 2009;35:1249-1252)

Microbial infection plays an important role in the development of pulp necrosis and formation of periapical lesions. In vitro and in vivo research in this field, traditionally microbiological culture methods using paper point sampling and quantitative culture, faces difficulties in completely removing bacteria from the root canal system and analyzing sequential procedures. This study employed genetically engineered bioluminescent bacteria and a light-sensitive imaging system to allow real-time visualization of the infection. Ten extracted teeth incubated with P. aeruginosa were treated by mechanical instrumentation with K-files (#30 K-file, #35 K-file and #40 K-file) and chemical irrigation with sodium hypochlorite and hydrogen peroxide. Irrigation alone reduced the contamination in 18%; the first chemomechanical sequence (instrumentation with a #30 K-file + irrigation) provided 41% of reduction; the second sequence (#35 K-file + irrigation) achieved 62%; and the complete therapy (#30 K-file + #35 K-file + #40 K-file + irrigation) achieved 93% of bacterial reduction. These results suggest that the endodontic treatment is dependent on the association of a chemical and mechanical approaches and that root canal enlargement improves bacterial reduction probably because the irrigation has more access to the apical third. Infecções microbianas são um dos fatores principais no desenvolvimento de necrose pulpar e lesões periapicais. Tradicionalmente, estudos in vivo e in vitro utilizam cultura microbiológica com coletas com cones de papel e quantificação de unidades formadoras de colônia. A maior desvantagem deste método é a dificuldade de se remover as bactérias dos canais radiculares e a impossibilidade de promover a análise seqüencial deste procedimento. Este estudo empregou bactérias geneticamente modificadas para apresentarem bioluminescência e um sistema sensível a baixa luminosidade, permitindo a visualização em tempo-real da área infectada. Dez dentes extraídos foram incubados com P. aeruginosa e tratados endodonticamente com instrumentação mecânica com limas K (#30, #35 e #40) e irrigação com hipoclorito de sódio e peróxido de hidrogênio. A irrigação sozinha reduziu a contaminação inicial em 18%; a primeira seqüência de lima e irrigação (lima #30) obteve 41% de redução; a segunda seqüência (lima #35 e irrigação) obteve 62%; e o tratamento completo (lima #30, lima #35, lima #40 e irrigação) reduziu a contaminação bacteriana inicial em 93%. Os resultados sugerem que o tratamento endodôntico é dependente da associação dos procedimentos químico-mecânicos que promovem o alargamento do canal radicular, otimizando a redução microbiana, possivelmente devido ao maior acesso das substâncias químicas à porção apical do canal radicular.

A wide array of habits is found in children; of these inserting foreign objects in the oral cavity is a common practice among children. Children often tend to insert sharp objects mainly in the open carious lesions to relieve pain caused due to food lodgment. The objects sometimes break and get embedded in the root canals. Sometimes, the patients do not reveal this to parent out of fear and ultimately are diagnosed accidently by the dentists when the symptoms appear or while diagnosing some other lesion. These foreign objects may act as a possible cause of infection. Early diagnosis and treatment are mandatory in such cases to avoid further complications. Thorough case history, clinical, and radiographic examinations are essential to determine the nature, size, location of the foreign body, and the difficulty involved in its retrieval. This paper discusses series of three such case reports where the foreign objects were diagnosed, retrieved, and treatment was followed.

Children often tend to have the habit of inserting foreign objects in the oral cavity unknowingly for relief of dental pain. Sometimes, children do not reveal to their parents due to fear. These foreign objects may act as a potent source of infection and painful condition. The discovery of foreign bodies in the teeth is a special situation, which is often diagnosed accidentally. Detailed case history, clinical and radiographic examinations are necessary to come to a conclusion about the nature, size, location of the foreign body and the difficulty involved in its retrieval. Here is a case report, where foreign object was accidentally lodged in the carious deciduous molars by a child. How to cite this article: Dhull KS, Acharya S, Ray P, Dhull RS. Foreign Body in Root Canals of Two Adjacent Deciduous Molars: A Case Report. Int J Clin Pediatr Dent 2013;6(1):38-39.

Purpose To evaluate surface cleanliness of root canal walls along post space after endodontic treatment using 2 different irrigant regimens, obturation techniques, and post space preparation for adhesive bonding. Study design Forty teeth, divided into 4 groups, were instrumented, using Ni-Ti rotary files, irrigated with NaOCl or NaOCl + EDTA and obturated with cold lateral condensation (CLC) or warm vertical condensation (WVC) of gutta-percha. After post space preparation, etching, and washing procedure, canal walls were observed using a scanning electron microscope (SEM). Amount of debris, smear layer, sealer/gutta-percha remnants, and visibility of open tubules were rated. Results Higher amounts of rough debris, large sealer/gutta-percha remnants, thick smear layer, and no visibility of tubule orifices were recorded in all the groups at apical level of post space. At middle and coronal levels areas of clean dentin, alternating with areas covered by thin smear layer, smaller debris, gutta-percha remnants, and orifices of tubules partially or totally occluded by plugs were frequently observed. Conclusions After endodontic treatment, obturation, and post space preparation SEM analysis of canal walls along post space shows large areas (covered by smear layer, debris, and sealer/gutta-percha remnants) not available for adhesive bonding and resin cementation of fiber posts.

Introduction : The role of bacteria in pulpal and periradicular lesions is well established. However, the association of bacterial species with signs and symptoms of endodontic infection is not well elucidated. The purpose of this study was to investigate the types of bacterial species in infected root canals (using MicroSeq 500 16S ribosomal ribonucleic acid, rRNA) and the association of bacterial species with clinical signs and symptoms of different pulpal and periapical infections. Materials and Methods: Microbial samples were obtained from 92 adult patients (one tooth with single root canal for each patient). Clinical data including signs and symptoms were collected. Polymerase chain reaction (PCR) (MicroSeq 500 16S rRNA) was used to detect bacteria in the infected root canals. Results: A total of 179 bacterial species were identified. Actinomyces viscosus and Streptococcus sanguis were associated with the presence of pain. While Staphylococcus haemolyticus and Veillonella spp. were associated with pain of palpation, the pain to percussion was associated with Actinomyces spp., Actinomyces naeslundii, and Actinomyces viscosus. Also, Streptococcus mitis, Bacteroides spp., and Veillonella spp. were associated with periapical swelling. The presence of sinus tract was found to be significantly associated with Neisseria spp. and Staphylococcus haemolyticus. The wet canal was significantly associated with the presence of Propionibacterium acnes and Bacteroides spp. Conclusions: There are significant associations between the presence of some bacterial species with clinical signs and symptoms of infected root canals.

Background : Enterococcus faecalis has been widely used as a valuable microbiological pathogen for in vitro studies due to its ability to successfully colonize the root canal in a biofi lm-like style, invade dentinal tubules, and resist endodontic treatment procedures.The aim of this study was to compare the bactericidal effi cacy of photodynamic therapy (PDT), 2% chlorhexidine, 2.5% NaOCl, and combination of PDT and 2.5% NaOCl against E. faecalis . Materials and Methods: Sixty single-rooted teeth had their canals contaminated with E. faecalis in brain heart infusion broth and were incubated for 48 hours.The canals were then subjected to 2% chlorhexidine, 2.5% NaOCl, PDT (red light emitting diode 625 nm+ Toludine Blue) and PDT + 2.5% NaOCl. Controls consisted of no treatment (positive control) and without inoculation of bacterium (negative control). Following treatment, the canal contents were sampled with sterile paper points. The samples were dispersed in transport medium, serially diluted, and cultured on blood agar to determine the number of colony forming units (CFU). Data were analyzed by Mann-Whitney U test at 5% signifi cance level. The signifi cance level for all analyses was set at P

With the increasing number of reports of aberrant root canal morphology, the clinician needs to be aware of the variable anatomy. Various case reports have been published with the finding of middle mesial canal in mandibular first molar, however finding of middle distal canal in distal root of mandibular first molar is rare. This case report describes root canal treatment of two rooted mandibular first molar with five root canals (three in distal and two in mesial root), and Sert and Bayirli Type XVIII canal configuration in distal root.