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Variation in root canal morphology, especially in maxillary first molar presents a constant challenge for a clinician in their detection and management. This case report describes the successful root canal treatment of a three rooted right maxillary first molar presenting with three canals each in the mesiobuccal and distobuccal roots and one canal in the palatal root. The clinical detection of this morphologic aberration was made using a dental operating microscope, and the canal configuration was established after correlating and computing the clinical, radiographic and cone-beam computed tomography (CBCT) scan findings. CBCT images confirmed the configuration of the canals in the mesiobuccal and distobuccal roots to be Al-Qudah and Awawdeh type (3-2) and type (3-2-1), respectively, whereas the palatal root had a Vertucci type I canal pattern. This report reaffirms the importance of careful examination of the floor of the pulp chamber with a dental operating microscope and the use of multiangled preoperative radiographs along with advanced diagnostic aids such as CBCT in identification and successful management of aberrant canal morphologies.
Cone-Beam Computed Tomography* ; Dental Pulp Cavity* ; Molar*

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Autotransplantation combined with orthodontic treatment: a case involving the maxillary central incisors with root resorption after traumatic injury.

Manuel Marques FERREIRA ; Hugo M FERREIRA ; Filomena BOTELHO ; Eunice CARRILHO

Restorative Dentistry & Endodontics.2015;40(3):236-240. doi:10.5395/rde.2015.40.3.236

Traumatic dental injury can result in avulsion of anterior teeth. In young patients, it is a challenge to the dental professional because after replantation, late complications such as ankylosis require tooth extraction. Although prosthetic and orthodontic treatment, and implant placement have been described as the options for intervention, autogenous tooth transplantation could be an effective procedure in growing patients if there is a suitable donor tooth available. This case presents the treatment of a patient who suffered a traumatic injury at 9 years old with avulsion of tooth 21, which had been replanted, and intrusion of tooth 11. Both teeth ankylosed; thus they were removed and autotransplantation of premolars was carried out. After transplantation, the tooth underwent root canal treatment because of pulpal necrosis. Orthodontic treatment began 3 months after transplantation and during 7 years' follow-up the aesthetics and function were maintained without signs of resorption.
Ankylosis ; Autografts* ; Bicuspid ; Dental Pulp Cavity ; Esthetics ; Follow-Up Studies ; Humans ; Incisor* ; Necrosis ; Replantation ; Root Resorption* ; Tissue Donors ; Tooth ; Tooth Extraction

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Fracture resistance of upper central incisors restored with different posts and cores.

Maryam REZAEI DASTJERDI ; Kamran AMIRIAN CHAIJAN ; Saeid TAVANAFAR

Restorative Dentistry & Endodontics.2015;40(3):229-235. doi:10.5395/rde.2015.40.3.229

OBJECTIVES: To determine and compare the fracture resistance of endodontically treated maxillary central incisors restored with different posts and cores. MATERIALS AND METHODS: Forty-eight upper central incisors were randomly divided into four groups: cast post and core (group 1), fiber-reinforced composite (FRC) post and composite core (group 2), composite post and core (group 3), and controls (group 4). Mesio-distal and bucco-lingual dimensions at 7 and 14 mm from the apex were compared to ensure standardization among the groups. Twelve teeth were prepared for crown restoration (group 4). Teeth in other groups were endodontically treated, decoronated at 14 mm from the apex, and prepared for posts and cores. Resin-based materials were used for cementation in groups 1 and 2. In group 3, composite was used directly to fill the post space and for core build-up. All samples were restored by standard metal crowns using glass ionomer cement, mounted at 135degrees vertical angle, subjected to thermomechanical aging, and then fractured using a universal testing machine. Kruskal-Wallis and Mann-Whitney U tests were used to analyze the data. RESULTS: Fracture resistance of the groups was as follows: Control (group 4) > cast post and core (group 1) > fiber post and composite core (group 2) > composite post and core (group 3). All samples in groups 2 and 3 fractured in restorable patterns, whereas most (58%) in group 1 were non-restorable. CONCLUSIONS: Within the limitations of this study, FRC posts showed acceptable fracture resistance with favorable fracture patterns for reconstruction of upper central incisors.
Aging ; Cementation ; Crowns ; Glass Ionomer Cements ; Incisor* ; Tooth

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Changes in SIRT gene expression during odontoblastic differentiation of human dental pulp cells.

Young Eun JANG ; Su Hee GO ; Bin Na LEE ; Hoon Sang CHANG ; In Nam HWANG ; Won Mann OH ; Yun Chan HWANG

Restorative Dentistry & Endodontics.2015;40(3):223-228. doi:10.5395/rde.2015.40.3.223

OBJECTIVES: The aim of this study was to investigate the expression of 7 different sirtuin genes (SIRT1-SIRT7) in human dental pulp cells (HDPCs), and to determine the role of SIRTs in the odontoblastic differentiation potential of HDPCs. MATERIALS AND METHODS: HDPCs were isolated from freshly extracted third molar teeth of healthy patients and cultulred in odontoblastic differentiation inducing media. Osteocalcin (OCN) and dentin sialophosphoprotein (DSPP) expression was analyzed to evaluate the odontoblastic differentiation of HDPCs by reverse transcription-polymerase chain reaction (RT-PCR), while alizarin red staining was used for the mineralization assay. To investigate the expression of SIRTs during odontoblastic differentiation of HDPCs, real time PCR was also performed with RT-PCR. RESULTS: During the culture of HDPCs in the differentiation inducing media, OCN, and DSPP mRNA expressions were increased. Mineralized nodule formation was also increased in the 14 days culture. All seven SIRT genes were expressed during the odontogenic induction period. SIRT4 expression was increased in a time-dependent manner. CONCLUSIONS: Our study identified the expression of seven different SIRT genes in HDPCs, and revealed that SIRT4 could exert an influence on the odontoblast differentiation process. Further studies are needed to determine the effects of other SIRTs on the odontogenic potential of HDPCs.
Dental Pulp* ; Dentin ; Gene Expression* ; Humans* ; Molar, Third ; Odontoblasts* ; Osteocalcin ; Real-Time Polymerase Chain Reaction ; RNA, Messenger ; Tooth

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Evaluation of the effects of two novel irrigants on intraradicular dentine erosion, debris and smear layer removal.

Melahat GORDUYSUS ; Selen KUCUKKAYA ; Nursel Pekel BAYRAMGIL ; Mehmet Omer GORDUYSUS

Restorative Dentistry & Endodontics.2015;40(3):216-222. doi:10.5395/rde.2015.40.3.216

OBJECTIVES: To evaluate the effects of copolymer of acrylic acid and maleic acid (Poly[AA-co-MA]) and calcium hypochlorite (Ca(OCl)2) on root canal dentin using scanning electron microscope (SEM). MATERIALS AND METHODS: Twenty-four single-rooted teeth were instrumented and the apical and coronal thirds of each root were removed, leaving the 5 mm middle thirds, which were then separated into two pieces longitudinally. The specimens were randomly divided into six groups and subjected to each irrigant for 5 min as follows: G1, Ca(OCl)2; G2, Poly(AA-co-MA); G3, Ca(OCl)2 + Poly(AA-co-MA); G4, sodium hypochlorite (NaOCl); G5, ethylenediaminetetraacetic acid (EDTA); G6, NaOCl+EDTA. The specimens were prepared for SEM evaluation. Smear layer, debris and erosion scores were recorded by two blinded examiners. One image from G3 was analyzed with energy dispersive spectroscopy (EDS) on suspicion of precipitate formation. Data were analyzed using the Kruskal-Wallis and Dunn tests. RESULTS: G1 and G4 showed the presence of debris and smear layer and they were statistically different from G2, G3, G5 and G6 where debris and smear layer were totally removed (p < 0.05). In G1 and G4, erosion evaluation could not be done because of debris and smear layer. G2, G3 and G5 showed no erosion, and there was no significant difference between them. G6 showed severe erosion and was statistically different from G2, G3 and G5 (p < 0.05). EDS microanalysis showed the presence of Na, P, and Ca elements on the surface. CONCLUSIONS: Poly(AA-co-MA) is effective in removing the smear layer and debris without causing erosion either alone or with Ca(OCl)2.
Calcium ; Dental Pulp Cavity ; Dentin* ; Edetic Acid ; Hypochlorous Acid ; Smear Layer* ; Sodium Hypochlorite ; Spectrum Analysis ; Tooth

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Do conventional glass ionomer cements release more fluoride than resin-modified glass ionomer cements?.

Maria Fernanda Costa CABRAL ; Roberto Luiz de Menezes MARTINHO ; Manoel Valcacio GUEDES-NETO ; Maria Augusta Bessa REBELO ; Danielson Guedes PONTES ; Flavia COHEN-CARNEIRO

Restorative Dentistry & Endodontics.2015;40(3):209-215. doi:10.5395/rde.2015.40.3.209

OBJECTIVES: The aim of this study was to evaluate the fluoride release of conventional glass ionomer cements (GICs) and resin-modified GICs. MATERIALS AND METHODS: The cements were grouped as follows: G1 (Vidrion R, SS White), G2 (Vitro Fil, DFL), G3 (Vitro Molar, DFL), G4 (Bioglass R, Biodinamica), and G5 (Ketac Fil, 3M ESPE), as conventional GICs, and G6 (Vitremer, 3M ESPE), G7 (Vitro Fil LC, DFL), and G8 (Resiglass, Biodinamica) as resin-modified GICs. Six specimens (8.60 mm in diameter; 1.65 mm in thickness) of each material were prepared using a stainless steel mold. The specimens were immersed in a demineralizing solution (pH 4.3) for 6 hr and a remineralizing solution (pH 7.0) for 18 hr a day. The fluoride ions were measured for 15 days. Analysis of variance (ANOVA) and Tukey's test with 5% significance were applied. RESULTS: The highest amounts of fluoride release were found during the first 24 hr for all cements, decreasing abruptly on day 2, and reaching gradually decreasing levels on day 7. Based on these results, the decreasing scale of fluoride release was as follows: G2 > G3 > G8 = G4 = G7 > G6 = G1 > G5 (p < 0.05). CONCLUSIONS: There were wide variations among the materials in terms of the cumulative amount of fluoride ion released, and the amount of fluoride release could not be attributed to the category of cement, that is, conventional GICs or resin-modified GICs.
Dental Materials ; Fluorides* ; Fungi ; Glass Ionomer Cements* ; Glass* ; Ions ; Molar ; Stainless Steel

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