Compared with cold lateral condensation and continuous wave of condensation which are classically used in clinical, newly emerging single-cone obturation technique is easy-to-operate as well as time-saving. Especially when combined with bioceramic root canal sealers of improved physicochemical and biological properties, single-cone obturation technique showed satisfactory short-term outcomes in clinical observations. However, difficulties still exist in avoiding the root canal overfilling and in operating the retreatment. Besides, the long-term effects of single-cone obturation with bioceramic sealers still remain unclear. This article makes an overview on the history and development of single-cone obturation ,and provides analysis of its pros and corns. Furthermore, we would also like to summarize its clinical application and look into its future improvements.
Epoxy Resins/chemistry* ; Gutta-Percha/chemistry* ; Retreatment ; Root Canal Filling Materials/therapeutic use* ; Root Canal Obturation/methods* ; Root Canal Therapy

OBJECTIVETo evaluate the clinical effect of pulp revascularization procedure for immature teeth with apical periodontitis.

METHODSNine immature permanent teeth diagnosed with chronic or acute apical periodontitis were recruited. According to a standard pulp revascularization procedure, the canal was disinfected with copious irrigation and a combination of three antibiotics, followed by a blood clot created in the canal. Patients were recalled periodically after the treatment. Clinical and radiographic evidence of healing was evaluated.

RESULTSEighteen to 24 months after treatment, 6 teeth showed complete resolution of the radiolucency and closure of the apex and thickening of the dentinal walls. One tooth showed healing of periodontal lesion, but the root mature was not observed. Two teeth had recurrent apical periodontitis and no evidence of healing. Apexification was performed later.

CONCLUSIONSPulp revascularization could be an effective treatment for immature permanent teeth with apical periodontitis, and root elongation and narrowing canal space were observed in appropriate cases. If the treatment failed, traditional apexification could be started instead.

Child ; Female ; Humans ; Male ; Neovascularization, Physiologic ; Periapical Periodontitis ; therapy ; Root Canal Filling Materials ; therapeutic use ; Root Canal Therapy ; methods ; Treatment Outcome

OBJECTIVETo study the clinical effects of demineralized dentin matrix (DDM) as a apexificating agent.

METHODSHuman teeth were crushed into fragments and were deflated, demineralized, lyophilized to produce DDM. The DDM was used as an apexificating agent to treat 57 teeth compared with calcium hydroxide. X-ray film and clinical observation were undertaken after half a year, one year and two years.

RESULTSOne year later, a barrier in the tooth apex was found in the X-rays film. Then permanent filling material was used. After two years, DDM group had a healing rate of 92.86%, was higher than that of 91.30% in calcium hydroxide group, but there were no statistical significance.

CONCLUSIONThe findings suggest that DDM can be used as a new apexificating agent. One year after the apexification is the best opportunity to change the apexificating agent to a permanent root canal filling material.

Adolescent ; Adult ; Child ; Dental Materials ; therapeutic use ; Dental Pulp Necrosis ; therapy ; Dentin ; Humans ; Root Canal Filling Materials ; therapeutic use ; Root Canal Therapy ; methods ; Tooth Apex ; drug effects ; Tooth Root ; growth & development

This study aimed to present a new method based on numeric calculus to provide data on the theoretical volume ratio of voids when using the cold lateral compaction technique in canals with various diameters and tapers. Twenty-one simulated mathematical root canal models were created with different tapers and sizes of apical diameter, and were filled with defined sizes of standardized accessory gutta-percha cones. The areas of each master and accessory gutta-percha cone as well as the depth of their insertion into the canals were determined mathematically in Microsoft Excel. When the first accessory gutta-percha cone had been positioned, the residual area of void was measured. The areas of the residual voids were then measured repeatedly upon insertion of additional accessary cones until no more could be inserted in the canal. The volume ratio of voids was calculated through measurement of the volume of the root canal and mass of gutta-percha cones. The theoretical volume ratio of voids was influenced by the taper of canal, the size of apical preparation and the size of accessory gutta-percha cones. Greater apical preparation size and larger taper together with the use of smaller accessory cones reduced the volume ratio of voids in the apical third. The mathematical model provided a precise method to determine the theoretical volume ratio of voids in root-filled canals when using cold lateral compaction.
Dental Pulp Cavity ; drug effects ; Epoxy Resins ; therapeutic use ; Gutta-Percha ; therapeutic use ; Humans ; Models, Theoretical ; Root Canal Filling Materials ; therapeutic use ; Root Canal Preparation ; methods ; Surface Properties ; Titanium ; therapeutic use

OBJECTIVETo evaluate the results of calcium hydroxide-based sealer Sealapex in the treatment of chronic apical periodontitis.

METHODSA total of 100 cases with chronic apical periodontitis were included and divided into two groups, calcium hydroxide sealer (Sealapex) group and ZOE sealer group, and Sealapex and ZOE sealer were respectively used. All cases were followed up for two years after treatment and the clinical results compared between the two groups. The evaluation was based on clinical examination and radiographic assessment using periapical index (PAI) and digital subtraction radiography (DSR) technique.

RESULTSThere was no significant difference between the ZOE group and Sealapex group in overall healing rates and mean quantitative analysis at 3 months and 2 years after treatment (P = 0.206, 0.776). A correlation was found between PAI and DSR (P < 0.01, gamma = 0.58).

CONCLUSIONSSealapex sealer could obtain satisfactory effects for the treatment of chronic apical periodontitis. The combination of DSR and PAI methods was able to monitor the radiographic bone changes of periapical disease.

Calcium Hydroxide ; therapeutic use ; Chronic Disease ; Female ; Follow-Up Studies ; Humans ; Male ; Periapical Periodontitis ; therapy ; Periodontal Index ; Radiography, Dental, Digital ; Root Canal Filling Materials ; therapeutic use ; Treatment Outcome

The time domain entombment of bacteria by intratubular mineralization following orthograde canal obturation with mineral trioxide aggregate (MTA) was studied by scanning electron microscopy (SEM). Single-rooted human premolars (n=60) were instrumented to an apical size #50/0.06 using ProFile and treated as follows: Group 1 (n=10) was filled with phosphate buffered saline (PBS); Group 2 (n=10) was incubated with Enterococcus faecalis for 3 weeks, and then filled with PBS; Group 3 (n=20) was obturated orthograde with a paste of OrthoMTA (BioMTA, Seoul, Korea) and PBS; and Group 4 (n=20) was incubated with E. faecalis for 3 weeks and then obturated with OrthoMTA-PBS paste. Following their treatments, the coronal openings were sealed with PBS-soaked cotton and intermediate restorative material (IRM), and the roots were then stored in PBS for 1, 2, 4, 8 or 16 weeks. After each incubation period, the roots were split and their dentin/MTA interfaces examined in both longitudinal and horizontal directions by SEM. There appeared to be an increase in intratubular mineralization over time in the OrthoMTA-filled roots (Groups 3 and 4). Furthermore, there was a gradual entombment of bacteria within the dentinal tubules in the E. faecalis inoculated MTA-filled roots (Group 4). Therefore, the orthograde obturation of root canals with OrthoMTA mixed with PBS may create a favorable environment for bacterial entombment by intratubular mineralization.
Aluminum Compounds ; therapeutic use ; Calcification, Physiologic ; physiology ; Calcium Compounds ; therapeutic use ; Crystallization ; Dental Pulp Cavity ; microbiology ; Dentin ; microbiology ; Drug Combinations ; Enterococcus faecalis ; ultrastructure ; Humans ; Methylmethacrylates ; therapeutic use ; Microscopy, Electron, Scanning ; Oxides ; therapeutic use ; Root Canal Filling Materials ; therapeutic use ; Root Canal Obturation ; methods ; Root Canal Preparation ; instrumentation ; Silicates ; therapeutic use ; Time Factors ; Zinc Oxide-Eugenol Cement ; therapeutic use

OBJECTIVETo evaluate the clinical effect of sequential therapy for traumatized maxillary central incisor with horizontal mid-root fracture.

METHODSTwenty maxillary central incisors with horizontal mid-root fracture following dental trauma were included in our study. The distance between root fracture plane and root apical segment was more than 5 mm. The sequential therapy included stabilizing the traumatized incisor with a flexible splint after repositioning the coronal segment of the tooth, temporarily filling with calcium hydroxide after root preparation, sealing the root apex with warm gutta-percha obturation technique and internal fixation with fiber post combined with composite resin adhesion. The patients were followed for 6 to 24 months.

RESULTSTwo cases healed without sign of fracture line and eighteen cases healed with sign of fracture line. No case failed. Abnormal mobility and translocation, percussion pain, gingival swelling, sinus tract and periodontal pocket were not observed in all the traumatized teeth.Radiology showed normal root apex and periodontium.

CONCLUSIONSSequential therapy for maxillary central incisor with horizontal mid-root fracture could acquire a satisfactory therapeutic effect.

Adult ; Bone Cements ; therapeutic use ; Calcium Hydroxide ; therapeutic use ; Composite Resins ; Female ; Follow-Up Studies ; Humans ; Incisor ; injuries ; Male ; Maxilla ; Middle Aged ; Periodontal Splints ; Root Canal Filling Materials ; therapeutic use ; Root Canal Preparation ; Root Canal Therapy ; methods ; Tooth Fractures ; therapy ; Tooth Root ; injuries ; Young Adult

OBJECTIVEThe purpose of this article was to observe the effect of Vitapex Paste in apexilication.

METHODS64 younger permanent teeth with underdeveloped apex and necrotic pulp were randomly selected. After root canals were prepared and sterilized, Vitapex paste was used in the apexification. All the teeth were observed for three years.

RESULTS24 teeth (37.5%) were successful, 37 teeth (57.81%) were progressive, 3 teeth (4.69%) were failed. Altogether 61 teeth were effective, the effective rate was 95.31%.

CONCLUSIONVitapex paste was effective for the younger permanent teeth in the apexification.

Adolescent ; Calcium Hydroxide ; therapeutic use ; Child ; Drug Combinations ; Female ; Follow-Up Studies ; Humans ; Male ; Root Canal Filling Materials ; therapeutic use ; Silicones ; therapeutic use ; Tooth Apex ; drug effects ; growth & development

Mineral trioxide aggregate (MTA) is considered at the present time as the gold standard for root-end filling in endodontic surgery. However, this biocompatible material presents several drawbacks such as a long setting time and handling difficulties. The aim of this article is to present a new commercialized calcium silicate-based material named Biodentine with physical improved properties compared to MTA in a clinical application. Two endodontic microsurgeries were performed by using specific armamentarium (microsurgical instrumentation, ultrasonic tips) under high-power magnification with an operatory microscope. Biodentine was used as a root-end filling in order to seal the root canal system. The two cases were considered completely healed at 1 year and were followed for one more year. The 2-year follow-up consolidated the previous observation with absence of clinical symptoms and radiographic evidence of regeneration of the periapical tissues.
Calcium Compounds ; therapeutic use ; Female ; Follow-Up Studies ; Humans ; Microsurgery ; instrumentation ; Middle Aged ; Periapical Diseases ; therapy ; Periapical Tissue ; diagnostic imaging ; physiology ; Radiography, Bitewing ; Regeneration ; physiology ; Retrograde Obturation ; methods ; Root Canal Filling Materials ; therapeutic use ; Root Canal Preparation ; instrumentation ; Silicates ; therapeutic use ; Ultrasonic Surgical Procedures ; instrumentation ; Wound Healing ; physiology

This case report is to present a maxillary first molar with one O-shaped root, which is an extended C-shaped canal system. Patient with chronic apical periodontitis in maxillary left first molar underwent replantation because of difficulty in negotiating all canals. Periapical radiographs and cone-beam computed tomography (CBCT) were taken. All roots were connected and fused to one root, and all canals seemed to be connected to form an O-shape. The apical 3 mm of the root were resected and retrograde filled with resin-modified glass ionomer. Intentional replantation as an alternative treatment could be considered in a maxillary first molar having an unusual O-shaped root.
Adult ; Anatomic Variation ; Apicoectomy ; methods ; Cone-Beam Computed Tomography ; methods ; Dental Pulp Cavity ; diagnostic imaging ; pathology ; Glass Ionomer Cements ; therapeutic use ; Humans ; Male ; Maxilla ; Molar ; diagnostic imaging ; pathology ; Periapical Periodontitis ; therapy ; Retrograde Obturation ; methods ; Root Canal Filling Materials ; therapeutic use ; Root Canal Preparation ; methods ; Tooth Replantation ; methods