Aim: To evaluate two- and three-dimensionally the effect of resorbable collagen-based bone-filling material on periapical healing of endodontic lesions with four-wall defects following endodontic microsurgery (EMS).
Methodology: This parallel, randomized controlled superiority clinical trial involved 86 lesions with the strictly endodontic origin and four-wall defect morphology. EMS procedures were performed by calibrated postgraduate residents.
Endodontic surgery encompasses several procedures for the treatment of teeth with a history of failed root canal treatment, such as root-end surgery, crown and root resections, surgical perforation repair and intentional replantation. Endodontic microsurgery is the evolution of the traditional apicoectomy techniques and incorporates high magnification, ultrasonic root-end preparation and root-end filling with biocompatible filling materials. Modern endodontic surgery uses the dental operating microscope, incorporates cone-beam computed tomography (CBCT) for preoperative diagnosis and treatment planning, and has adopted piezoelectric approaches to osteotomy and root manipulation.
View Article and Find Full Text PDFBackground: The authors' aim was to describe 2 endodontically treated mandibular first premolars with apical and mesiolingual radiolucencies on radiographs with different approaches that were resolved with intentional replantation.
Case Description: In case 1, a 58-year-old man reported biting sensitivity on endodontically treated mandibular first premolar with good quality restorations. A periapical radiograph (PAX) and cone-beam computed tomography (CBCT) image revealed 2 low-density areas located at the apical and mesiolingual aspects of the root.
Endodontic microsurgery is a predictable and successful procedure when using techniques that have been developed over the past several years. One of the steps during surgery involves curettage of the entire lesion. However, there are cases in which the lesion has advanced to invade anatomic structures like the nasal fossa, maxillary sinus, mandibular canal, neighboring vital teeth, or through and through to the palate.
View Article and Find Full Text PDFIntroduction: The purpose of this randomized clinical trial was to evaluate healing after endodontic microsurgery (EMS) using mineral trioxide aggregate (MTA) versus EndoSequence root repair material (RRM; Brasseler, Savannah, GA) as root-end filling materials.
Methods: Two hundred forty-three teeth with persistent or recurrent apical periodontitis were randomly assigned to either the MTA or RRM group. EMS was performed, and follow-up visits with clinical and radiographic investigation were scheduled at 6, 12, and 24 months with follow-up cone-beam computed tomographic (CBCT) imaging after 12 months.
Introduction: The objective of this article was to present a surgical treatment option for teeth with incomplete vertical root fracture in maxillary and mandibular posterior teeth.
Methods: Four cases are presented in which 1 endodontically treated maxillary or mandibular molar had an incomplete vertical root fracture involving 1 of the roots. The tooth underwent a flap elevation procedure to visualize the pattern of bone loss and assess the extent of root fracture.
Compend Contin Educ Dent
December 2009
From digital radiography units to office computer systems, there are several pieces of equipment that make up today's high-tech dental office. Recently, advances in dental imaging have allowed cone-beam computed tomography (CBCT), which is a form of 3-dimensional radiography, to gain increasing popularity as another major office component. In consideration of the current economic conditions, cost has become a definite obstacle for many practitioners.
View Article and Find Full Text PDFThe field of endodontics has seen vast improvements in technology and techniques over the past several years. Perhaps the one area of endodontics that has improved the most is the way in which surgery is performed. With the use of state-of-the-art instruments, new and improved materials, and a surgical operating microscope, the gap has narrowed between biological concepts and the ability to achieve consistently successful clinical results.
View Article and Find Full Text PDFThe field of endodontics has seen vast improvements in technology and techniques over the past several years. Perhaps the one area of endodontics that has improved the most is the way in which surgery is performed. With the use of state-of-the-art instruments, new and improved materials, and a surgical operating microscope, the gap has narrowed between biological concepts and the ability to achieve consistently successful clinical results.
View Article and Find Full Text PDFThe authors report on data from a self-assessment questionnaire filled out by 199 patients undergoing periradicular microscopic surgery at two private endodontic offices and at graduate endodontic clinics of the University of Pennsylvania. Regression analysis was performed using pain and swelling as dependent variables and age, sex, type of teeth, location, periapical lesion, and remedication as independent variables. Pain and swelling were significantly related to females and younger patients (p < 0.
View Article and Find Full Text PDFEndodontic surgery has now evolved into endodontic microsurgery. By using state-of-the-art equipment, instruments and materials that match biological concepts with clinical practice, we believe that microsurgical approaches produce predictable outcomes in the healing of lesions of endodontic origin. In this review we attempted to provide the most current concepts, techniques, instruments and materials with the aim of demonstrating how far we have come.
View Article and Find Full Text PDFThis study compared three methods for creating the most centered staging platform (SP) around separated instruments (SI) in curved canals. Green .04 ProFiles, notched at D(3), were separated in the apical third of 42 mesiobuccal canals of maxillary and mandibular molars.
View Article and Find Full Text PDFBackground: The maxillary central incisor is considered to be the least difficult subject for a clinical endodontic experience. However, the internal anatomy of maxillary central incisors can present a number of variations, including multiple accessory canals.
Case Description: This article highlights the clinical significance and management of accessory canals located in the apical one-third of maxillary central incisors.
As with any dental treatment, procedural mishaps can occur during root canal therapy. One such occurrence is the perforation of a root or pulpal floor. After a perforation occurs, the goals are to "sterilize" (decontaminate) the site and then seal the perforation.
View Article and Find Full Text PDFWith all the technology that has been introduced in endodontics, there are now several ways to instrument and obturate root canals. Practitioners often develop their own "hybrid" technique after sharing ideas with several colleagues. The purpose of this article is to describe a technique of obturation, hoping that others may incorporate some aspects into their own "hybrid" style.
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