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Hydraulic calcium silicate-based (HCSB) or “bioceramic” sealers are widely used for root canal obturation and rapidly gaining popularity among general practitioners and endodontists. The premixed or fifth-type HCSB materials can be used with all root canal obturation techniques, such as cold lateral and warm vertical compaction or a single-cone technique. Meanwhile, the fourth-type HCSB sealers are sensitive to heat and desiccation, therefore suitable for cold root canal obturation techniques. Although all obturation techniques are equally effective and not superior to each other, the single-cone obturation technique is easier to apply, and is more time-consuming and clinically appealing in modern endodontics. This article will introduce and discuss the most popular HCSB sealers and root canal obturation techniques used in conjunction with these materials.

The better understanding of the clinically important behavioral features of new instrument systems has an important significance for the clinical endodontics. This study aimed to investigate the shaping and centering ability as well as cyclic fatigue resistance of HyFlex CM (CM), HyFlex EDM (EDM) and EdgeFile (EF) thermally treated nickel&ndash, titanium (NiTi) endodontic instrument systems. Sixty curved root canals of the mesial roots of mandibular molars were randomly assigned into three groups (n = 20) and shaped using CM, EDM and EF files up to the size 40 and taper 04 of the instruments. &micro, CT scanning of the specimens before and after preparation was performed and the morphometric 2D and 3D parameters were evaluated in the apical, middle and coronal thirds of root canals. In each group, 40.04 instruments (n = 20) were subjected to the cyclic fatigue resistance test in artificial root canals at 37 &deg, C temperature until fractures occurred, and the number of cycles to failure (NCF) was calculated. The fractographic analysis was performed using a scanning electron microscope, evaluating topographic features and surface profiles of the separated instruments. The one-way analysis of variance with post hoc Tuckey&rsquo, s test was used for statistical analysis of the data, the significance level was set at 5%. All systems prepared the comparable percentage of root canal surface with the similar magnitude of canal transportation in all root thirds (p &gt, 0.05), but demonstrated significantly different resistance to cyclic fatigue (p &lt, 0.05). The most resistant to fracture was EF, followed by EDM and CM. The length of the fractured fragments was not significantly different between the groups, and fractographic analysis by SEM detected the typical topographic features of separated thermally treated NiTi instrument surfaces.

The fourth and fifth types of hydraulic calcium silicate-based sealers are rapidly gaining popularity among clinicians due to their exceptional biological, physicochemical properties, and simplified clinical application. These materials can be used with all root canal obturation techniques, such as cold lateral or warm vertical compaction techniques, and especially a single-cone technique. Although all obturation techniques are equally effective and not superior to each other, the single-cone obturation technique is easier to apply, is more time-consuming, and clinically appealing in modern endodontics. This chapter will introduce and discuss the most popular hydraulic calcium silicate–based sealers and root canal obturation techniques used in conjunction with these materials.

To analyze the need for referral to a specialist and to identify the reasons of referrals among Lithuanian general dental practitioners.Questionnaires were sent to all 2879 Lithuanian dental practitioners registered on the Lithuanian Dental Chamber license registry. The questionnaire was made with multiple-choice answers. Respondents were asked to choose only one category of answer that best fitted their clinical attitude. Questions included in the questionnaire concerned general and specific information regarding the need and main reasons for endodontic referral.Of the 2879 questionnaires mailed, 1532 questionnaires containing useful information were returned. The response rate was 53.2%. Of the 1532 respondents, 1431 were general dental practitioners. Majority (72.1%) of the respondents performed complicated root canal treatment by themselves. Almost half (49.6%) of them would like to refer patients to an endodontist. Two of the reasons, which restricted their decision, were the shortage of endodontists and high cost of the procedures in the specialized clinics. Approximately 19% of the respondents referred patients to an endodontist. The main reasons for referral were fractured instruments (86.6%), dental trauma (83.6%), difficulties in diagnostics (79%) followed by persistent symptoms (78.1%).The findings of the present study suggest that the need for referral of patients to an endodontist among Lithuanian dental practitioners exists. The main reasons for referrals were complications of endodontic treatment, traumatic injuries, difficulties in diagnostic procedures, and persistent symptoms.

The purpose of this study was to gather information about the various aspects, technical and biological, of endodontic treatment as performed by Lithuanian general dental practitioners and to compare their choices with established endodontic treatment standards of undergraduate education.Questionnaires were sent to all 2,850 Lithuanian dental practitioners. The structured questionnaire included inquiries about gender, duration of professional activity, working environment, details about instruments and materials.From total 1532 (53.8%) questionnaires were returned. Only responses from general dental practitioners (1431) were included. Of the respondents 66% never used a rubber dam. Most practitioners relied on conventional stainless steel instruments. The NiTi hand files were often and routinely used by 32.2% of the respondents. Sodium hypochlorite was the most popular choice as a root canal irrigant. Calcium hydroxide paste was used as an inter-appointment medicament. Cold-lateral condensation root filling method was used by 72.8% of the respondents while 15.6% used a paste for the root filling.The results of this study indicate that the recently graduated dental practitioners were following the recommended standard of endodontic treatment better than those with a longer time from the graduation. It is important to improve the quality of existing courses of continuous education in endodontology in order to ensure the necessary competency in clinical practice. The low use of a rubber dam and low adoption of new technologies in Lithuania is not acceptable and needs to be changed.

Research data regarding attitudes of general dental practitioners towards endodontic therapy is rare. The present review summarizes existing literature and analyzes human factors that could potentially influence the outcome of endodontic treatment in general dental practice. Root canal treatment usually fails when treatment falls short of acceptable standards. The results of questionnaire surveys from several countries indicate that differences between daily general practice and academic teaching exist. The results of studies indicated that majority of general practitioners disregard the most basic principles of endodontic treatment. The most striking finding is the generally negative attitude amongst general dental practitioners towards performing endodontic treatment and adoption of new technologies in a daily endodontic practice. The results confirm that root canal treatment is technically demanding and in general practice is carried out under less than optimal conditions. This review shows the importance of continuous dental education for practitioners in order to update their knowledge.