Due to the complex micro-anatomy of the root canal system, mechanical instrumentation leaves significant portions of the root canal walls untouched; therefore, complete elimination of bacteria from the root canal by cleaning with instrumentation alone is unlikely. It has long been postulated but not demonstrated, that any pulp tissue left in the root canals can serve as bacterial/fungal/viral (microorganism nutrients) nutrients. Furthermore, tissue remnants also impede the antimicrobial effects of root canal irrigants and medicaments and prevent intimate adaptation of the root canal filling to the dentin.
View Article and Find Full Text PDFAim: The purpose of this review is to address the smear layer removing the ability of root different canal irrigants including ethylenediaminetetraacetic acid (EDTA), a mixture of tetracycline, acid and detergent (MTAD), tetraclean, citric acid, Q-Mix, maleic acid, and smear clear.
Background: Smear layer is a layer which is produced during instrumentation. It contains both organic and inorganic materials.
As the root canal system shows different and complicated anatomies, mechanical instrumentation alone has not the ability to provide a bacteria-free environment in root canals. On the other aspect, necrotic tissue remaining can decrease the effects of root canal irrigants and medicaments and also interfere with the adaptation of root canal fillings to dentin. As a result, certain disinfection and irrigation procedures are required to remove the remaining tissues from the root canal area thoroughly and also be able to eliminate the microorganisms.
View Article and Find Full Text PDFIntroduction: As the root canal system considered to be complex and unpredictable, using root canal irrigants and medicaments are essential in order to enhance the disinfection of the canal. Sodium hypochlorite is the most common irrigant in endodontics. Despite its excellent antimicrobial activity and tissue solubility, sodium hypochlorite lacks some important properties such as substantivity and smear layer removing ability.
View Article and Find Full Text PDFThe microbial biofilm is an important factor for human infection. Finding effective antimicrobial strategies should be considered for decreasing antimicrobial resistance and controlling the infectious diseases. Treatment of infected canal systems may not be able to remove all bacteria and so bacterial persistence after treatment may occur.
View Article and Find Full Text PDFUnlabelled: Commonly used irrigants do not always eradicate the entire microbial flora in infected root canals. Therefore, several other strategies, such as photodynamic therapy (PDT) have been developed. Photoactivated disinfection is based on the interaction of a photosensitive antibacterial agent and a light source.
View Article and Find Full Text PDFMicroorganisms and their by-products play a critical role in pulp and periradicular pathosis. Therefore, one of the main purposes of root canal treatment is disinfection of the entire system of the canal. This aim may be obtained using mechanical preparation, chemical irrigation, and temporary medication of the canal.
View Article and Find Full Text PDFThe purpose of the review was to assess the effect of root canal irrigants on dentin bonding. A PubMed-based search was conducted on the articles published from 1980 to 2016. A brief overview and reviewing the effect on dentin bonding of common root canal irrigation solutions such as sodium hypochlorite (NaOCl), chlorhexidine (CHX), ethylenediaminetetraacetic acid (EDTA), mixture of a tetracycline, acid and a detergent (MTAD) and ozone was conducted.
View Article and Find Full Text PDFThe mechanical debridement of the root canal system fails to completely remove debris from the root canal walls. So, one or more irrigants must be used for complete disinfection of the root canal system (RCS). One possible way to improve the bactericidal efficacy of the disinfecting solutions is to incorporate different detergents as surface active agents to help reduce the surface tension and increase the wettability of the solutions.
View Article and Find Full Text PDFIntroduction: The apical portion of the root canal is very complex and challenging during endodontic treatment. Root canal preparation and obturation to the apical constriction may provide the best prognosis. Incomplete debridement, foramen transportation, and inadequate seal in the apical portion are considered to be responsible for treatment failure.
View Article and Find Full Text PDFMicroorganisms should be considered to have the major role in starting and perpetuation of pulpo-periapical diseases. Using intracanal medicaments is necessary to gain a bacteria-free environment in the canal system. Calcium hydroxide (abbreviated as Ca(OH)), which is the most commonly used medicament in endodontic therapy, has been shown to be effective against primary sources of infection; however, its effectiveness against some microorganisms, such as Candida albicans and Enterococcus faecalis has not been proved.
View Article and Find Full Text PDFSince the invention of laser, various applications for lasers in endodontics have been proposed, such as disinfection of the root canal system, canal shaping, pulp diagnosis, and apico-ectomy. One of the major applications of laser in endodontics is apicoectomy. The aim of this article is to review the benefits and drawbacks of laser applications in apicoectomy, including effect on apical seal, effect on dentin permeability, effect on postsurgery pain, effect on crack formation, effect on root-end morphology, effect on treatment outcome, and connective tissue response to laser-treated dentin.
View Article and Find Full Text PDFMicroorganisms have been considered to have played a critical role in the initiation and development of pulpo-periapical diseases. Some evidences have shown that mechanical instrumentation may leave considerable portions of canal surfaces undebrided. Therefore, some supplemental methods, such as the use of chemical solutions and/or lasers, have been introduced to further disinfect the complicated canal anatomy and destroy as many microorganisms as possible.
View Article and Find Full Text PDFPatients typically associate dental care with pain. Pain has both physiological and psychological components. Endodontic post-treatment pain continues to be a significant problem facing the dental profession.
View Article and Find Full Text PDFAccurate knowledge of canal anatomy is a key factor in the success of root canal treatment. Confluent canals are defined as two canals with a common apical foramen in a root. The purpose of this paper is to review prevalence, instrumentation and obturation of confluent root canals.
View Article and Find Full Text PDFOne of the main causes of endodontic treatment failure is the clinician's inability to localize all the root canals. Due to the complex anatomy of the root canal system, missed canals are not uncommon. There are several strategies to decrease the possibility of missed root canals starting with good pre-operative radiographies.
View Article and Find Full Text PDFThe most difficult clinical considertions in orthograde root canal treatment are generally related to the anatomy of the teeth. Three-canalled maxillary and mandibular premolars (mini-molars) have been reported in several studies. The purpose of this paper was to review various aspects of three-canalled premolars including incidence, clinical and radiographic diagnosis, racial predisposition, access cavity preparation, instrumentation and obturation.
View Article and Find Full Text PDFRoot resorption (RR) is defined as the loss of dental hard tissues because of clastic activity inside or outside of tooth the root. In the permanent dentition, RR is a pathologic event; if untreated, it might result in the premature loss of the affected tooth. Several hypotheses have been suggested as the mechanisms of root resorption such as absence of the remnants of Hertwig's epithelial root sheath (HERS) and the absence of some intrinsic factors in cementum and predentin such as amelogenin or osteoprotegerin (OPG).
View Article and Find Full Text PDFUsing ultrasonic devices in endodontics can enhance the antibacterial and tissue dissolving ability of different root canal irrigants such as sodium hypochlorite (NaOCl) which is the most common irrigant with excellent antibacterial and tissue dissolving abilities. However, due to its high surface tension, its penetration into the irregularities of the root canal system is a challenge. The purpose of this paper was to review the different ultrasonic devices, different types of ultrasonic irrigation, the effect(s) of ultrasonic activation on the antibacterial and biofilm-removal abilities of NaOCl as well as the effect of ultrasonic activation on the smear layer removal ability of NaOCl.
View Article and Find Full Text PDFGenotoxicity is an action on cell's genetic material which may affect its integrity. This includes certain types of radiations and also certain chemical compounds. Genotoxic materials are those with affinity to interact with DNA but render them potentially carcinogenic or mutagenic.
View Article and Find Full Text PDFResilon is a thermoplastic synthetic polymer-based endodontic material alternative to gutta-percha. It contains bioactive glass and also radiopaque fillers. It has the same handling properties as gutta-percha.
View Article and Find Full Text PDFSuccessful root canal treatment depends on having comprehensive information regarding the root(s)/canal(s) anatomy. Dentists may have some complication in treatment of third molars because the difficulty in their access, their aberrant occlusal anatomy and different patterns of eruption. The aim of this review was to review and address the number of roots and root canals in third molars, prevalence of confluent canals in third molars, C-shaped canals, dilaceration and fusion in third molars, autotransplantation of third molars and endodontic treatment strategies for third molars.
View Article and Find Full Text PDFThe purpose of this study was to determine the effect of a separated rotary instrument on the time required for bacterial penetration of obturated root canals using Resilon. Eighty-four extracted human maxillary premolars with single canals were used in this study. Group 1 consisted of teeth obturated with gutta-percha and AH-26 sealer (n=15); Group 2 consisted of teeth obturated similarly to Group 1 but without a separated file; Group 3 consisted of teeth obturated with Resilon and Epiphany sealer (n=15); and Group 4 consisted of teeth obturated similarly to Group 3 but without a separated file.
View Article and Find Full Text PDFN Y State Dent J
March 2015
Fungi, especially Candida albicans, play an important role in persistent/secondary endodontic infections. There are several irrigants and medicaments in the field of endodontics. The purpose of this paper is to review the antifungal activity of sodium hypochlorite, chlorhexidine, MTAD, Tetraclean, EDTA, calcium hydroxide and MTA.
View Article and Find Full Text PDFSince the introduction of engine-driven nickel-titanium (NiTi) instruments, attempts have been made to minimize or eliminate their inherent defects, increase their surface hardness/flexibility and also improve their resistance to cyclic fatigue and cutting efficiency. The various strategies of enhancing instrument surface include ion implantation, thermal nitridation, cryogenic treatment and electropolishing. The purpose of this paper was to review the metallurgy and crystal characteristics of NiTi alloy and to present a general over review of the published articles on surface treatment of NiTi endodontic instruments.
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