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The pushout bond strength of root fillings at radicular dentin was investigated employing NaOCl, CHX, and homoeopathic mother tincture (Arnica montana) as an irrigant. Sixty human permanent single-rooted extracted teeth were decoronated. The root canals were instrumented using Pro taper universal rotary system (Dentsply Tulsa Dental; Tulsa, Oklahoma) and were prepared up to F3 apical size. The roots were then randomly divided into three groups according to irrigation solution (n = 20) according to the final irrigation regimen: Group I: 3 mL 5.25% NaOCl followed by 3 mL Saline (control); Group II: 3 mL Arnica montana (10%, w/v) followed by 3 mL Saline; Group III: 3 mL CHX followed by 3 mL Saline. The canals were dried using paper points. The canals were coated with AH Plus sealer (Dentsply DeTey, Konstaz, Germany) with the aid of a Lentulo spiral (Dentsply DeTey, Konstaz, Germany) and obturated with #F3 gutta-percha. Each root was then horizontally sliced into three slices, labelled coronal, middle, and apical, each measuring 2 mm thick. Furthermore, at a crosshead speed of 2 mm/min, the test was carried out using the universal testing apparatus. The 5.25% NaOCl significantly decreased the bond strength of AH Plus to dentin. Both CHX and Arnica montana were capable of reversing the compromised pushout of AH Plus to NaOCl-treated dentin. After using NaOCl as an irrigant, the danger of diminished binding capacity of AH Plus to root canal walls arises. Final irrigation with Arnica montana and CHX reduces this risk. [ABSTRACT FROM AUTHOR]

Introduction: GuttaFlow Bioseal (Roeko-Coltene/Whaledent, Langenau, Germany), TotalFill Bioceramic (FKG Dentaire SA, La Chaux-de-Fonds, Switzerland), and AH Plus root canal sealers (Dentsply, DeTrey, Germany) are used to prevent communication between periapical space and the root canal. This study aims to evaluate the apical microleakage of three endodontic sealers. Materials and Methods: Seventyfive freshly extracted mandibular premolars were prepared and obturated with single-cone gutta-percha, then grouped into three groups according to the sealers used. The data were analyzed using one-way analysis of variance (ANOVA) and Tukey honestly significant difference (HSD) test. Results: The least mean dye penetration was shown by GuttaFlow Bioseal sealer (1.31 mm), followed by TotalFill Bioceramic sealer (1.57 mm) and AH Plus sealer (2.63 mm); no dye penetration was found in the negative control group. One-way analysis of variance (ANOVA) showed statistically significant difference among all experimental groups (P < 0.001); Tukey test shows significant differences between all groups except for a nonsignificant difference between GuttaFlow Bioseal and TotalFill Bioceramic sealer (P= 0.6). Conclusion: All sealers showed varying levels of apical microleakage, with the least penetration in the GuttaFlow Bioseal group. [ABSTRACT FROM AUTHOR]

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Background: Inadequate obturation techniques of the root canal system have been found to be the most frequent reason of failure post root canal treatment. An ideal endodontic sealer should fulfill all ideal requisites. The present study aimed to compare apical sealing ability between bioceramic (BC) sealer, GuttaFlow, and AH Plus. Methodology: One hundred and twenty-five curved roots of maxillary and mandibular third molar teeth with fully formed apex were collected for this study. The root canals were cleaned and shaped using a standard single-cone preparation to file at the established working length and divided into five groups of 25 each. Dye leakage was carried out. Group A: with GP, using EndoSequence BC sealer with conventional with 4% gutta-percha (Brasseler USA, Savannah, Georgia, USA); Group B: with ceramic coated with 4% gutta-percha (Brasseler USA, Savannah, Georgia, USA); Group C: with GP, using AH Plus sealer (Dentsply, De-Trey Konstanz, Germany) with 4% gutta-percha; Group D: with GuttaFlow bioseal (Roeko-Coltène/Whaledent, Langenau, Germany) with 4% Gutta-percha; and Group E is a negative control group. Statistical analysis was done using the Statistical Package for the Social Sciences software and Student's unpaired t-test. Results: The group AH Plus showed more leakage values than the GuttaFlow group and of two groups of BC sealer and negative control. Student's unpaired t-test disclosed no significant difference (P < 0.05) between the groups. Conclusion: None of the sealers used in the study could completely seal the apical foramen to have a fluid-tight seal. [ABSTRACT FROM AUTHOR]

(1) Background: Which are the adhesion characteristics of four root canal sealers: two experimental (dual cure resin based endodontic sealer (E1-DCR) and bioceramic based sealer (E2-BC)), and two commercial (RealSeal and TotallFill BC (FKG Germany)). (2) Methods. One-hundred-twenty extracted monoradicular teeth received mechanic-antiseptic preparation and then endodontic filling using gutta-percha in combination with one of the four sealers. Samples from the apical third were selected from each tooth and were randomly distributed for Scanning Electron Microscopy (SEM), Atomic Force Microscopy (AFM) and push-out bond strength. Fourier Transform Infrared (FTIR) Spectroscopy was made exclusively for experimental sealers. (3) Results. The two experimental materials did not present a significant difference in apical sealing ability based on SEM evaluation. Gaps were identified in case of RealSeal samples and also lower penetration into the dentinal tubules compared to TotalFill BC. On AFM analysis a more pronounced penetration into the tubules was observed in case of E2-BC sealer was observed. E1-DCR registered a lower bond strength (0.7177 ± 0.55) in the apical third compared to Total Fill BC (p = 0.01). (4) Conclusions. Within the limitations of the current study, it can be stated that the two experimental sealers' characteristics are comparable to that of the two consecrated materials. [ABSTRACT FROM AUTHOR]

In vitro studies have shown that rapid penetration of bacteria in the entire root canal system may occur after endodontic treatment without a coronal seal. A proper restorative technique is necessary to ensure a coronal seal and protection of the residual dental structure. The aim of this in vitro study was to evaluate the coronal sealing ability of the most relevant clinical materials by means of dye penetration (neutral red dye, Sigma-Aldrich, Germany), through a light spectrometric device, and to establish which one of the tested dental materials possesses the best sealing ability. Forty-two extracted teeth were prepared and used for this experiment; they were sealed with 5 different cements. The flow composite had the best absorbance value with 0.00675 ± 0.00096 (mean ± standard deviation) for monoradicular samples and 0.025 ± 0.00129 for pluriradicular samples. Under the constraints of the present study, both flowable and packable composite materials can be recommended as orifice sealing materials to prevent microleakage in an endodontically treated tooth. To assess the clinical superiority of any material, further in vivo studies are required. [ABSTRACT FROM AUTHOR]

Aim: To compare the effectiveness of two preparation systems and two irrigation techniques in calcium hydroxide removal from straight root canals. Methodology: Forty-four mandibular premolar teeth were included in this study. The teeth were filled with a calcium hydroxide-based paste and randomly divided into two different preparation groups (Reciproc 50 (R50; VDW, Munich, Germany) and ProTaper Universal F5 (PTU; Dentsply Maillefer, Ballaigues, Switzerland). Subsequently, the groups were divided into two subgroups and irrigated using EDDY (VDW, Munich, Germany) and CanalBrush (CB; Roeko, Langenau, Germany) irrigation activation systems. The percentage of calcium hydroxide removed from the canal walls was analyzed using a dental operating microscope (DOM) at 25× magnification. An independent samples t-test, a Mann-Whitney U, Wilcoxon's tests were used for statistical analysis. Results: There was no significant difference in calcium hydroxide removal throughout the root canal using the R50 and PTU F5 preparation systems (P = 0.847). Both activation systems significantly increased the amount of calcium hydroxide removed from the root canal. Conclusion: EDDY and CB significantly improved calcium hydroxide removal. There was no significant difference between the R50 and PTU F5 systems in calcium hydroxide removal. [ABSTRACT FROM AUTHOR]

Aim: To investigate and compare the prevalence of root canal fillings, apical periodontitis and endodontic treatment needs in a German subpopulation in 1944 and 2004, respectively. Methodology: Two hundred panoramic radiographs taken from 1994 and 2004, respectively, were evaluated using the Periapical Probability Index (PRI). The technical quality of the root canal fillings in terms of length and homogeneity was estimated. Minimum and maximum endodontic treatment needs were calculated. Statistical analysis was performed using the chi-square and Fisher exact test at P < 0.05. Results: There was a total of 4660 teeth without root canal fillings for radiographs taken in 1994 and 4244 teeth for those in 2004. In teeth without root canal fillings in 1994, the frequency of PRI 4 was 1.0% and PRI 5 was 1.2%. In 2004, PRI 4 was 1.1% and PRI 5 was 2.4%. The difference was not significant (P > 0.05). A total of 168 teeth (3.4%) in 1994 and 217 (4.8%) in 2004 were root canal filled and the difference was significant (P < 0.05). The frequency of PRI score 4 and 5 for the root canal-filled teeth was 8.5% and 26.1% for 1994, and 6.9% and 31.8% in 2004, respectively, The difference was not significant (P> 0.05). The percentage of short root canal fillings was 52.7% in 1994, and 50.8% in 2004. In 1994, 48.6% of the root canal fillings were scored as inhomogenous, and in 2004 the percentage was 40.6%. There were no significant differences concerning the radiographic quality of root canal fillings (P > 0.05). Endodontic treatment need was calculated as 3.7% of all teeth in 1994, and 4.6% in 2004. Retreatment need was calculated as 49.7% of canal-filled teeth for 1994 and 54.5% of root canal-filled teeth for 2004. Conclusion: The prevalence of apical periodontitis in root canal-filled teeth and the need for retreatment increased over the observation period. There were no significant improvements in the technical quality of endodontic treatment from 1994 and 2004. [ABSTRACT FROM AUTHOR]

The aim of this study was to compare the transportation and centering abilities of the ProGlider (PG; Dentsply-Sirona, Ballaigues, Switzerland), WaveOne Gold Glider (WOGG; Dentsply-Sirona), and R-Pilot (RP; VDW, Munich, Germany) file systems and the changes in the structure model index (SMI), surface area, and root canal volume (after creating the glide path in the mandibular first molar teeth's mesial canals with moderate curvature) using the micro–computed tomographic (micro-CT) method. In the present study, 24 mandibular first molar teeth with 2 separate mesial canals and moderate (10°–20°) curvature were used. After scanning with micro-CT imaging before the procedure, the teeth were divided into 3 groups, PG, WOGG, and RP (n = 10/each group), followed by the glide path procedure. After the root canal preparation, changes in the root canals regarding the volume, surface area, SMI, transportation made by the files, and the change of their centering ability in the apical, middle, and coronal third were analyzed by micro-CT imaging. The data were statistically evaluated using 1-way analysis of variance and the Kruskal-Wallis test with a significance level set at 5% (P <.05). The WOGG and RP file systems showed better centering abilities at all thirds compared with the PG file system (P <.05). No significant difference was found in the apical third between the groups in terms of canal transportation degree (P >.05). However, in the WOGG and RP groups, less transportation was observed in the middle and coronal thirds compared with the PG group (P <.05). When the SMI changed, after the root canal preparation was compared, no significant differences were found between the groups (P >.05). Nevertheless, the changes in volume and surface area of the root canal in the WOGG and RP groups were significantly lower than in the PG group (P <.05). The WOGG and RP file systems caused similar levels of change in the root canal systems based on all parameters. Moreover, it was determined that the PG file system caused a significantly higher volume and surface area increase than the WOGG and RP file systems. • We compared the shaping abilities of the ProGlider (PG), WaveOne Gold Glider (WOGG), and R-Pilot (RP) single-file glide path nickel-titanium file systems using micro–computed tomographic imaging. • The changes in the volume and surface area in the PG group were found to be significantly higher than in the WOGG and RP groups. • From the perspective of transportation, there was no significant difference at the apical third between all groups, but less transportation was observed in the WOGG and RP groups compared with the PG group at the middle and coronal thirds. [ABSTRACT FROM AUTHOR]

Aim: This study investigated the sealing ability produced by AH Plus (Dentsply DeTrey, Konstaz, Germany), EndoSequence BC sealer (Brasseler USA, Savannah, GA, USA), GuttaFlow (Coltène/ Whaledent, Altstätten, France) and MTA Fillapex (Angelus, Londrina, Brazil). Methdos: A total of forty-six single-root human canines were prepared and randomly divided into four experimental groups (n=10): MTA Fillapex, EndoSequence BC Sealer, AH Plus or GuttaFlow. Teeth with intact crowns served as negative controls (n=3) and teeth filled with only gutta-percha served as positive controls (n=3). Teeth were mounted in a two-chamber apparatus and exposed to Enterococcus faecalis. The number of days over a 60-days period was recorded for the appearance of turbidity in the lower chamber. Kaplan- Meier method was used to estimate the survival curves. The nonparametric log-rank test was used to compare the survival curves using a significance level of 0.05. Results: The results at the end of the observation time were further analyzed by chi-square testing. All positive controls leaked within 24 h, whereas none of the negative controls leaked after 60 days. EndoSequence BC Sealer and MTA Fillapex had significant less bacterial leakage (P<0.05) than the other tested sealers. No significant difference between AH Plus and GuttaFlow was observed (P>0.05). Conclusion: In conclusion, calcium-silicate based root canal sealers promoted improved sealing ability when compared to other endodontic sealers. [ABSTRACT FROM AUTHOR]

Introduction The purpose of this study was to assess the mean distance between the mandibular canal and the apices of the adjacent teeth. Methods Six hundred twenty-seven full-size cone-beam computed tomographic radiographs (Planmeca Promax3D; Planmeca, Helsinki, Finland; volume 8 × 8cm, voxel size ≤0.2 mm) of a German population (female = 58.2%, male = 41.8%, mean age = 51 years) were analyzed to establish the shortest distance between the mandibular canal and the root apices of the second premolar and all molars using the multiplanar reconstruction of the manufacturer's software in 3 mutually orthogonal planes. The obtained metric data were statistically analyzed using Student-Neumann-Keuls and Scheffé tests. Concerning the position of the tooth, the left or right side, and the sex of the patients, the chi-square test was used. Results A total of 821 second mandibular premolars and 597 first, 508 second, and 48 third mandibular molars were included, and the mean distances were 4.2, 4.9, 3.1, and 2.6 mm, respectively. The occurrence of a direct relationship between the root tips and the mandibular canal was found in 3.2%, 2.9%, 15.2%, and 31.3% of the teeth. Women were almost twice as often affected as men. No significant differences were found concerning the location (right/left) of the teeth ( P > .05). Significantly shorter distances from the mandibular canal to the root apices were found in patients younger than 35 years compared with older patients ( P < .0012). Conclusions Direct communication between the root apices and the mandibular canal is not rare and has to be taken into consideration when performing surgical or endodontic procedures to avoid iatrogenic nerve damages. Distances depend on sex and age. [ABSTRACT FROM AUTHOR]

In vitro studies have shown that rapid penetration of bacteria in the entire root canal system may occur after endodontic treatment without an efficient coronal seal. A proper restorative technique is necessary to ensure this, but there are a lot of materials out there. The aim of this study is to determine which type of restorative materials offer the best possible outcome. The evaluation of the coronal sealing ability of the most relevant clinical materials was done by means of dye penetration (neutral red dye, Sigma-Aldrich, Germany), through the restorative material-tooth interface. Tests were done on all sampled using a light spectrometric device, to establish which one of the tested dental materials possesses the best sealing ability, as in the least microleakage. Forty-two extracted teeth were prepared and used for this experiment; they were sealed with 5 different restorative materials. The flow composite had the best absorbance value with 0.00675 ± 0.00096 (mean ± standard deviation) for monoradicular samples and 0.025 ± 0.00129 for pluriradicular samples. The best material for coronal reconstruction post-endodontic treatment is the flow composite, which had the best sealing ability, followed by the packable composite. [ABSTRACT FROM AUTHOR]

Artificial teeth are a useful teaching aid during endodontic education. This article describes the development of a simple and inexpensive model that can be equipped with artificial teeth. It shows that working length determination in artificial root canals using electronic apex locators is possible and that the embedding media has no influence on measurements. The model supports the application of current endodontic techniques and facilitates a validated evaluation of the treatments between students. Artificial teeth can be removed for visualization and replaced for further endodontic exercises. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate whether retreatment of root fillings was judged necessary or not and. which kind of retreatment was preferred among a group of general dental practitioners in Germany. A questionnaire comprising 19 cases of endodontically treated teeth with different case histories and several treatment options was sent to all general practitioners in Göttingen (Germany). The cases included teeth with periapical radiolucencies, pain, apical resorption, under- and overfilling, and unfilled root canals. Results obtained from 43 questionnaires returned indicate that non-intervention or further radiographic monitoring were preferred by the majority of general practitioners in 110 of 19 cases, even in the presence of periapical pathosis. Only five cases; were judged to require conservative endodontic retreatment and, in four cases, root resection. The results revealed large inter- and intra- individual discrepancies in the estimation of endodontic retreatment need. [ABSTRACT FROM AUTHOR]

The author focuses on the study on the errors associated on the prevalence of root canal fillings, apical periodontitis and endodontic treatment needs in Germany. The author regards the study of root canal treatment to be commonly associated with errors and defects. The author finds the remarkable and frightening data to be in conformity with other published results, suggesting that a discrepancy is present between the potential of root canal treatment based on clinical studies and realities.

Introduction: Alopecia areata is an autoimmune disease characterized by a small area of hair loss due to inflammatory reaction directed against hair follicles. The aim of this case report is to present the role of successful endodontic treatment in the therapy of alopecia areata. Case report: The patient is a 27-year-old male referred from the dermatologist for diagnostic procedures of possible dental infection associated with localized hair loss. According to the patient, the root canal treatment of tooth 24 was performed six months ago by a general dentist. The extra-oral examination revealed an alopecic area of an irregular shape, about 3 cm in diameter, located on the left occipital area. The suspected tooth 24 was slightly sensitive on palpation and percussion. The radiography confirmed the presence of inadequate root canal filling with apical periodontitis. The previous roots filling was removed and intra-canal medication over two weeks period was made. The obturation was performed by the lateral condensation technique, using AH Plus sealer (Dentsply DeTrey, Germany) and gutta-percha points. Results and conclusions: Six weeks after endodontic retreatment, first signs of clinical improvement have been observed. Close inspection revealed the appearance of new hair follicles at the site of alopecia areata. Bacterial infection related to poorly cleaned and obturated root canals may cause an inflammatory reaction of the host defense cells and consequently induce disease in distanced tissues. In this case, the endodontic retreatment and elimination of root canal infection gave positive results in the therapy of alopecia areata. [ABSTRACT FROM AUTHOR]