sodium-hypochlorite and Foreign-Bodies

The case of a lower molar with apical periodontitis, which had previous root canal treatment and a fractured instrument in the distal root beyond the foramen, is presented.. The simultaneous presence of a foreign body (endodontic instrument or material) in periapical tissues and microorganisms in the root canal, are etiological factors in the formation or maintenance of a periapical lesion, and can lead to failure in endodontic treatment.. This instrument was removed through the staging platform technique, by using ultrasound and an Instrument removal system (IRS) microtube under microscope visual amplification. All the canals were re-instrumented, irrigated with sodium hypochlorite and passive ultrasonic irrigation, removal of smear layer and intracanal medication with calcium hydroxide for 8 days, after which they were filled. The symptoms disappeared and clinical and radiograph 2-year follow-up shows healing of periapical tissues.. The combined use of visual magnification microscope, ultrasound and the IRS system by staging platform technique, allowed the removal of an endodontic instrument beyond the foramen, which made it possible to apply a conventional disinfection protocol.. Endodontic re-treatment by conservative approach of complicated cases it is an option with good clinical prognosis, before apical surgery or extraction.

Topics: Adult; Calcium Hydroxide; Equipment Failure; Female; Follow-Up Studies; Foreign Bodies; Gutta-Percha; Humans; Microsurgery; Periapical Abscess; Periapical Periodontitis; Periapical Tissue; Retreatment; Root Canal Filling Materials; Root Canal Irrigants; Root Canal Preparation; Sodium Hypochlorite; Tooth, Nonvital; Ultrasonic Therapy

The aim of this in vitro study was to assess the amount of apically extruded debris and irrigant using Reciproc vs self-adjusting fle (SAF) and to investigate the effect, if any, of gravitational force via mandibular and maxillary positioning of the teeth.. Forty human mandibular premolars were randomly assigned to four groups of 10 teeth each. The root canals were instrumented according to the manufacturers' instructions using the Reciproc and SAF. Sodium hypochlorite was used as the irrigant. The apically extruded debris was collected in pre-weighted glass vials using the Myers and Montgomery method, and teeth were placed in vials both in downward and upward positions. After drying, the mean weight of debris was assessed with a microbalance and statistically analyzed using two-way ANOVA with Bonferroni correction.. All instrumentation techniques and positions caused measurable apical extrusion of debris. A significant difference was observed according to position and instrument used (p < 0.05). The Reciproc extruded significantly more debris than SAF and vial downward position extruded significantly more debris than upward position (p < 0.05).. Under the conditions of this study, all systems caused apical debris extrusion, especially in the downward position.. According to results of this study, the SAF was associated with less debris extrusion compared to the Reciproc in both mandibular and maxillary positions.

Topics: Equipment Design; Foreign Bodies; Humans; Materials Testing; Periapical Tissue; Random Allocation; Root Canal Irrigants; Root Canal Preparation; Sodium Hypochlorite; Tooth Apex; Vibration

The aim of this study was to compare two different thermoplastic techniques--a core-carrier technique (Thermafil) and warm vertical compaction--in terms of overextension of root canal filling in vivo.. Flaring of 88 teeth was conducted using Pro Files .04 as finishing files, and the teeth were obturated using Thermafil. Flaring of 74 teeth was performed using Pro Files .06 as finishing files, and the teeth were obturated using warm vertical compaction.. Seventy (80 %) of the teeth obturated using Thermafil and 31 (42 %) teeth obturated using warm vertical compaction show extruded root canal filling. In contrast to Thermafil, there is a higher rate of extruded root canal filling of teeth with more than one root canal using warm vertical compaction.. Thermafil demonstrated a higher rate of extruded root canal filling compared to warm vertical compaction. Warm vertical compaction is a more predictable method of filling compared to Thermafil.. Root canal filling extrusion will cause irritation of the surrounding tissue and impair repair processes. In the present in vivo study, there was a higher rate of root canal filling extrusion using Thermafil compared to warm vertical compaction.

Topics: Composite Resins; Dental Materials; Dental Pulp Cavity; Dental Restoration, Permanent; Edetic Acid; Epoxy Resins; Foreign Bodies; Gutta-Percha; Hot Temperature; Humans; Periapical Tissue; Radiography; Resin Cements; Retrospective Studies; Root Canal Filling Materials; Root Canal Irrigants; Root Canal Obturation; Root Canal Preparation; Sodium Hypochlorite; Tooth Apex

The objective of this study was to evaluate the success rates of standardized techniques for removing or bypassing fractured instruments from root canals and determine whether visualization of the fractured instrument with the aid of an operating microscope has any impact on the success rates.. In this prospective study, attempts were made to visualize 112 fractured instruments under a dental operating microscope after creating a straight-line access to the fragment. By using ultrasonic tips alone or associated with bypassing, the Ruddle technique was attempted to remove the 68 visible instruments. Bypassing was performed for the 44 nonvisible fragments. The χ(2) test was performed to assess whether any significant difference occurred between the success rates observed for the visible and nonvisible fractured instrument groups.. The overall success rate (removal and bypassing) was 70.5% (n = 79). In the visible fragment group, the success rate was 85.3% (n = 58), and in the nonvisible fragment group it was 47.7% (n = 21). Success rates were significantly higher when the fragment was visible (P = .0009).. The standardized techniques used in this study for removing or bypassing fractured instruments were effective, and approximately 2 times greater success rate was obtained when the fragment was visible inside the root canal compared with when it was nonvisible.

Topics: Bicuspid; Cuspid; Dental Materials; Dental Pulp Cavity; Equipment Design; Equipment Failure; Foreign Bodies; Humans; Incisor; Microsurgery; Molar; Piezosurgery; Prospective Studies; Root Canal Irrigants; Root Canal Preparation; Sodium Hypochlorite; Titanium; Treatment Outcome; Zirconium

The purpose of this study was to identify the influential factors responsible for clinical instrument separation of reused ProTaper Universal rotary instruments (Dentsply Maillefer, Ballaigues, Switzerland).. Six thousand one hundred fifty-four root canals in 2,654 teeth were prepared using ProTaper Universal files in endodontic clinics. Separation incidence was determined based on the number of treated teeth or canals. Data were collected including the size of fractured instrument, the length and location of a broken segment within the root canal, and the curvature of canal. The chi-square test and independent samples t test were used to determine the statistical significance.. The overall instrument separation incidences were 2.6% according to the number of teeth and 1.1% according to the canal number, respectively. Separation incidences according to the number of teeth or canals were significantly higher (P < .05) in molars than those in premolars or anterior teeth. Because of its largest diameter, F3 file presented the highest separation incidence according to the number of teeth (1.0%) or canals (0.4%); 47.5% instrument separation of mandibular molars and 61.5% instrument separation of maxillary molars happened in the mesiobuccal canals. Moreover, 91.4% fragments were located in the apical third of root canals, and 54.2% instrument separation occurred in severely curved canals. There was a significant difference (P < .05) in the mean fracture length between shaping (2.42 ± 0.73 mm) and finishing files (3.32 ± 0.73 mm).. Separation incidence according to the canal number is more reliable than that according to the number of teeth because of the variable canal number in different teeth. The tooth type, rotary file size, canal location, and anatomy were correlated with the instrument separation of reused ProTaper Universal files.

Topics: Bicuspid; Dental Alloys; Dental Pulp Cavity; Edetic Acid; Equipment Design; Equipment Failure Analysis; Equipment Reuse; Foreign Bodies; Humans; Microscopy, Electron, Scanning; Molar; Nickel; Radiography, Bitewing; Root Canal Irrigants; Root Canal Preparation; Root Canal Therapy; Rotation; Sodium Hypochlorite; Stress, Mechanical; Surface Properties; Titanium; Tooth Apex; Torque

Topics: Dental Pulp Cavity; Foreign Bodies; Humans; Root Canal Irrigants; Root Canal Therapy; Rubber Dams; Sodium Hypochlorite

Thirty-three human maxillary incisors were secured in the openings of a glass vial. Root canals were instrumented to the apical constriction with a step-back technique and a patency file was not used throughout the root canal preparation. The irrigant, 1% NaOCl, was delivered by means of a plastic syringe with a 23-gauge needle and the overflow was suctioned with an aspirator. The total volume of irrigant used was 10 ml. Apically extruded debris and NaOCl were measured. The apical constriction was then deliberately enlarged. With a step-back technique a new 'apical constriction' was created, coronally to the original one. A patency file was again not used, and irrigation was identical to the that used during the initial root canal preparation. Extruded debris and NaOCl in each bottle were again measured. Results indicated that there was significant difference in the amounts of extruded material before and after the enlargement of the apical constriction with greater extrusion when the constriction remained intact.

Topics: Anti-Infective Agents, Local; Dental Pulp Cavity; Foreign Bodies; Humans; Incisor; Maxilla; Needles; Periapical Tissue; Root Canal Irrigants; Root Canal Preparation; Sodium Hypochlorite; Statistics as Topic; Syringes; Tooth Apex