When the use of root canal retreatment and apical surgery experiences difficulty in treating endodontic diseases, intentional replantation is an optional clinical technique used to retain the tooth. A 28-year-old female complained of chewing discomfort at the mandibular second molar after undergoing root canal treatment 3 month ago. History record and radiographic examination revealed that a C-shaped root canal system was filled with gutta-percha in the mandibular second molar. A radiolucency area existed at the root furcal area with a thin canal wall in the distal and mesial roots. Intentional replantation was used to treat this tooth. The clinical and radiographic results showed that intentional replantation and nano-biomaterial application facilitated infection control, tooth retention, and periodontal tissue regeneration.
Female ; Humans ; Adult ; Tooth Replantation ; Root Canal Therapy ; Dental Pulp Cavity ; Gutta-Percha/therapeutic use* ; Tooth Root ; Molar/surgery* ; Retreatment

OBJECTIVE: To study the effect of various intracanal materials on the accuracy of oral maxillofacial cone-beam computed tomography (CBCT) for the diagnosis of vertical root fracture (VRF). METHODS: A total of twenty-four structurally intact single root canal dried and isolated teeth extracted for orthodontic treatment or periodontal disease were collected. The teeth were decrowned along the cemento-enamel junction (CEJ) and then used as samples for the study after conventional root canal preparation and post preparation. The 24 samples were divided into two groups with 12 samples in each group. Group A was the control group (no VRF group). According to intracanal materials, they were divided into five subgroups: blank group, fiber post group, gutta-percha point group, titanium post group and gold-palladium post group. Group B was the experimental group (VRF group), and subgroups were grouped as above. The VRF model was prepared by a unified method in the VRF group: the root was completely fractured in the buccolingual direction with a custom root canal nail and then cemented and reset. The control group was not subjected to the simulation of VRF. Titanium post and gold-palladium post were made according to the individuality of the root canal preparation, and the tightness of the post to the root canal wall was confirmed by X-ray radiograph. Then all the samples were scanned by CBCT in the isolate swine mandibular alveolar sockets. The diagnostic accuracy was statistically analyzed via blind interpretation by experienced endodontic specialists and oral and maxillofacial medical imaging specialists. RESULTS: The accuracy of the diagnosis of VRF in the blank group, fiber post group, gutta-percha point group, titanium post group, and gold-palladium post group in CBCT was 95.83%, 91.67%, 87.50%, 79.17%, and 45.83%, respectively. Compared with the blank group, the differences were not statistically significant in the fiber post group (P>0.999), the gutta-percha point group (P=0.500) and the titanium post group (P=0.125). The lowest diagnostic accuracy of VRF was found in the gold-palladium post group, and the difference was statistically significant compared with all other groups (P < 0.001). CONCLUSION Various intracanal materials have different degrees of influence on the diagnostic accuracy of VRF diagnosis in CBCT. The influence of fiber post, gutta-percha point and titanium post was small, while the influence of gold-palladium post was significant.
Animals ; Cone-Beam Computed Tomography/methods* ; Gold ; Gutta-Percha ; Palladium ; Swine ; Titanium ; Tooth Fractures/diagnostic imaging* ; Tooth Root/injuries* ; Reproducibility of Results

OBJECTIVE: To evaluate the clinical effect of root canal obturation therapy using cold flowable gutta-percha on young permanent teeth after apexification. METHODS: Ninety cases of young permanent teeth with pulp necrosis or periapical periodontitis treated by apexification were randomly divided into two groups. The cases in each group were divided into single root canal and multiple root canal according to the number of the root canal, and divided into classifications Ⅰ, and Ⅱ/Ⅲ/Ⅳ according to Frank's classification of root development after apexification. Cold flowable gutta-percha and warm gutta-percha obturation techniques were used for root canal obturation of the two groups. The operation time was recorded, and the patients' therapy pain degree was evaluated by visual analog scale (VAS) immediately after operation. Periapical X-ray was performed after operation to evaluate the effect of the root canal filling. The total length of the root was divided into equal three parts on the X-ray film, and three-dimensional tightness of the apical, middle, and coronal region of the root canals were statistically analyzed respectively. Clinical examinations and X-ray examination were performed 6 and 12 months after the operation to evaluate the treatment success rate. RESULTS: The operation time of cold flowable gutta-percha group was significantly lower than that of the control group, which were 51 s and 74 s (P < 0.05); The percentages of pain and discomfort in the two groups were 26.67% and 40.00%, respectively. There were two cases of underfilling and no overfilling in both groups. The percentages of proper filling and tight three-dimensional obturation in the experimental and control groups were 71.11% and 60.00% respectively; and the percentages of tight three-dimensional obturation in the apical third areas were 86.67% and 66.67%, the difference was significant (P < 0.05). There was no significant difference in the three-dimensional tightness between the two groups in the middle and coronal third areas. The percentages of tight three-dimensional obturation in classification Ⅰ groups were 86.67%, 83.33%, 93.33% and 76.67%, 90.00%, 96.67% in experimental and control group, respectively; The percentages of classification Ⅱ/Ⅲ/Ⅳ groups were 86.67%, 86.67%, 100.00% and 46.67%, 86.67%, 100.00%, respectively, and the difference was significant (P < 0.05). There were no apical lesions that occurred in either group during the one-year review period. CONCLUSION The application of cold flowable gutta-percha on young permanent teeth root canal obturation after apexification can achieve good obturation effect. The root obturation effect in the apical third area is significantly better than that of warm gutta-percha obturation techniques. Cold flowable gutta-percha can shorten the clinical treatment time and ameliorate the patients' therapy comfort.
Apexification ; Dental Pulp Cavity ; Gutta-Percha ; Humans ; Radiography ; Root Canal Filling Materials ; Root Canal Obturation ; Root Canal Preparation

OBJECTIVES: This study aimed to evaluate the efficacy of three methods in root canal retreatment to remove the filling material in the root canals. METHODS: Ninety tooth roots filled by gutta percha or plasticized material (n=45, each) were randomly divided into three groups (n=15). WaveOne (WaveOne group), 1^#P drill+WaveOne (1^#P+WaveOne group), and ultrasound P5 working end ET25+ProTaper Universal (P5+ProTaper Universal group) were used to remove the root canal filling material and prepare for root canal. The operating time of each canal was recorded and the percentage of residual filling material area was measured on the root canal wall of the mesial and distal dissected root section. The degree of deviation of the root canal after operation was measured for the root samples filled by gutta percha. RESULTS: The type of root filling material and the method of root canal retreatment had no significant effect on the percentage of residual area of the filling material (P>0.05). However, the remaining filling material area of apical 1/3 of the root canal was significantly higher than that of cervical 1/3 of the root canal (P<0.05). The average operating times for removing gutta-percha or plasticized material in the W and 1^#P+WaveOne groups were significantly less than that in the P5+ProTaper Universal group (P=0.000). The root canal retreatment methods had no significant effect on the curvature of the root canal (P=0.650). CONCLUSIONS WaveOne single file's cleaning ability and center positioning ability were similar to those of ProTaper Universal. Moreover, WaveOne can be independently used for most root canals without a pathway when removing the root canal fillings, thereby simplifying the process of root canal retreatment.
Equipment Design ; Gutta-Percha ; Nickel ; Root Canal Filling Materials ; Root Canal Preparation/methods* ; Titanium

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

OBJECTIVES: The safety of root canal filling with 200 °C hot gutta-percha was investigated to study the effect of continuous wave technique combined with high-temperature injectable gutta-percha condensation technique on the surface temperature of periodontal tissue. METHODS: CT technique and Mimics, Geomagic, and Solidworks software were utilized to build the entity models of alveolar bone, dentin and root canal, periodontal ligament, and blood flow, respectively, which were then assembled in Solidworks into a finite element model of tooth with blood flow. By utilizing ABAQUS collaborative simulation platform, fluid-structure coupling was analyzed on the whole process of root canal filling. Consequently, the surface temperature of the periodontal tissue was obtained. RESULTS: In the absence of blood flow, the temperature of the periodontal ligament surface reached 50.048 ℃ during root canal filling with 200 ℃ gutta-percha. Considering blood flow, the temperature of periodontal ligament surface was 39.570 ℃. CONCLUSIONS The temperature of the periodontal ligament surface increased when the continuous wave root canal was filled with 200 ℃ gutta-percha, and the periodontal tissue was not damaged.
Dental Pulp Cavity ; Finite Element Analysis ; Gutta-Percha ; Hot Temperature ; Humans ; Periodontium ; Root Canal Filling Materials ; Root Canal Obturation ; Temperature

OBJECTIVES: The obturation quality of MTA, Biodentine, Total Fill BC root canal sealer (RCS), and warm gutta-percha (WGP) in teeth with simulated internal root resorption (IRR) was evaluated by using micro-computed tomography.MATERIALS AND METHODS: Standardized IRR cavities were created using 40 extracted maxillary central incisor teeth and randomly assigned into 4 groups (n = 10). IRR cavities were filled with MTA, Biodentine, Total Fill BC RCS (bulk-fill form) and WGP + Total Fill BC RCS. Percentage of voids between resorptive cavity walls and obturation material (external void), and inside the filling materials (internal voids) were measured.RESULTS: Total Fill BC sealer in the bulk-fill form presented significantly highest values of external and internal void percentages (p < 0.05). Biodentine showed a significantly lowest external void percentage (p < 0.05). WGP + Total Fill BC RCS presented significantly lower values of internal void percentages than all groups (p < 0.05), except Biodentine (p > 0.05).CONCLUSION: None of the filling materials were created void-free obturation in resorption cavities. Biodentine may favor its application in teeth with IRR over Angelus MTA and bulk-fill form of Total Fill BC.
Calcium ; Dental Pulp Cavity ; Gutta-Percha ; Incisor ; Pemetrexed ; Root Resorption ; Tooth

There are several causes of tooth discoloration following root canal treatment. In this study, we evaluated the effects of sealers on tooth discoloration and internal bleaching. Twenty-four teeth were divided into 4 groups: control group, AH plus, Endosequece BC, and MTA fillapex group. Root canal filling was performed using each sealer conventionally and non-vital bleaching was performed with sodium perborate. The L, a, and b values were measured using Vita easyshade. Tooth discoloration after root canal treatment occurs irrespective of the type of sealers and may cause discoloration with only gutta-percha cone. The effect of non-vital bleaching following the use of calcium silicate-based sealers such as Endosequece BC and MTA fillapex was higher than that of AH plus. Therefore, it needs careful use of sealers in endodontics and calcium silicate-based sealers have advantages of bleaching in case of discolored tooth.
Calcium ; Dental Pulp Cavity ; Endodontics ; Gutta-Percha ; Pemetrexed ; Sodium ; Tooth Discoloration ; Tooth

OBJECTIVE: This study evaluated the presence of residual root canal filling material after retreatment using micro-computed tomography (micro-CT). MATERIALS AND METHODS: Extracted human teeth (single- and double-rooted, n = 21/each; C-shaped, n = 15) were prepared with ProFile and randomly assigned to three subgroups for obturation with gutta-percha and three different sealers (EndoSeal MTA, EndoSequence BC sealer, and AH Plus). After 10 days, the filling material was removed and the root canals were instrumented one size up from the previous master apical file size. The teeth were scanned using micro-CT before and after retreatment. The percentage of remaining filling material after retreatment was calculated at the coronal, middle, and apical thirds. Data were analyzed using the Kruskal-Wallis test and Mann-Whitney U test with Bonferroni post hoc correction. RESULTS: The tested sealers showed no significant differences in the percentage of remaining filling material in single- and double-rooted teeth, although EndoSeal MTA showed the highest value in C-shaped roots (p < 0.05). The percentage of remaining filling material of AH Plus and EndoSeal MTA was significantly higher in C-shaped roots than in single- or double-roots (p < 0.05), while that of BC sealer was similar across all root types. EndoSeal MTA showed the highest values at the apical thirds of single- and double-roots (p < 0.05); otherwise, no significant differences were observed among the coronal, middle, and apical thirds. CONCLUSIONS: Within the limitations of this study, a large amount of EndoSeal MTA remained after retreatment, especially in C-shaped root canals.
Dental Pulp Cavity ; Gutta-Percha ; Humans ; Pemetrexed ; Retreatment ; Root Canal Obturation ; Tooth

The present report presents a case of dens invaginatus (DI) in a patient with 4 maxillary incisors. A 24-year-old female complained of swelling of the maxillary left anterior region and discoloration of the maxillary left anterior tooth. The maxillary left lateral incisor (tooth #22) showed pulp necrosis and a chronic apical abscess, and a periapical X-ray demonstrated DI on bilateral maxillary central and lateral incisors. All teeth responded to a vitality test, except tooth #22. The anatomic form of tooth #22 was similar to that of tooth #12, and both teeth had lingual pits. In addition, panoramic and periapical X-rays demonstrated root canal calcification, such as pulp stones, in the maxillary canines, first and second premolars, and the mandibular incisors, canines, and first premolars bilaterally. The patient underwent root canal treatment of tooth #22 and non-vital tooth bleaching. After a temporary filling material was removed, the invaginated mass was removed using ultrasonic tips under an operating microscope. The working length was established, and the root canal was enlarged up to #50 apical size and obturated with gutta-percha and AH 26 sealer using the continuous wave of condensation technique. Finally, non-vital bleaching was performed, and the access cavity was filled with composite resin.
Abscess ; Bicuspid ; Dental Pulp Calcification ; Dental Pulp Cavity ; Dental Pulp Necrosis ; Female ; Gutta-Percha ; Humans ; Incisor ; Tooth ; Tooth Bleaching ; Ultrasonics ; Young Adult