OBJECTIVE: To investigate the clinical and radiographic outcomes of 3 years after partial pulpotomy with iRoot BP Plus in immature permanent teeth with complex crown fracture and to provide refe-rence for the clinical application. METHODS: The study was prospectively designed and 104 immature permanent teeth with complex crown fracture were randomly allocated into two groups (n=52). The experiment group received iRoot BP Plus as the pulp capping agent while the control group received calcium hydroxide as the pulp capping agent. After partial pulpotomy, all teeth were clinically and radiographically assessed at the end of 1, 3, 6, 12, 18, 24, 30, and 36 months. The success rate in the two groups was evaluated to see if there was significant difference. The root canal wall thickness in the treated teeth was compared both between the groups and within the groups with those of the corresponding healthy teeth on the opposite side, in the same patient. RESULTS: Excluding those lost to follow-up, there were 44 teeth in calcium hydroxide group (8 teeth accounting for 15.4% were lost to follow up) and 45 teeth in iRoot BP Plus group (7 teeth accounting for 13.5% were lost to follow up) in the end. There was no intergroup difference in the success rate between calcium hydroxide group and iRoot BP Plus group (per-protocol analysis: 80% vs. 87%; intent-to-treat analysis: 67% vs. 75%). The non-inferiority margin was -10%. The 95% confidence interval of the difference in success rate was -8% to 22%. There was no significant difference in root development between the experimental teeth and contralateral control teeth. The thickness of upper 1/3 root canal in the iRoot BP Plus group was thinner than that in the CH group [(1.82±0.21) mm vs. (1.91±0.20) mm, P=0.047]. CONCLUSION iRoot BP Plus used in pulpotomy can effectively preserve the living pulp and promote the development of root in the young permanent teeth with complex crown fracture.
Humans ; Tooth Fractures ; Calcium Hydroxide/therapeutic use* ; Female ; Male ; Child ; Pulp Capping and Pulpectomy Agents ; Pulpotomy/methods* ; Prospective Studies ; Dental Pulp Capping/methods* ; Adolescent ; Dentition, Permanent ; Drug Combinations ; Tooth Crown/injuries* ; Root Canal Filling Materials ; Silicones

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

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

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

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

One-step apexification using mineral trioxide aggregate (MTA) has been reported as an alternative treatment modality with more benefits than the use of long-term calcium hydroxide for teeth with open apex. However, orthograde placement of MTA is a challenging procedure in terms of length control. This case series describes the sequence of events following apical extrusion of MTA into the periapical area during a one-step apexification procedure for maxillary central incisor with an infected immature apex. Detailed long-term observation revealed complete resolution of the periapical radiolucent lesion around the extruded MTA. These cases revealed that direct contact with MTA had no negative effects on healing of the periapical tissues. However, intentional MTA overfilling into the periapical lesion is not to be recommended.
Adolescent ; Adult ; Aluminum Compounds ; adverse effects ; Apexification ; methods ; Calcium Compounds ; adverse effects ; Dental Fistula ; therapy ; Dental Pulp Necrosis ; therapy ; Drug Combinations ; Female ; Follow-Up Studies ; Foreign Bodies ; etiology ; Gutta-Percha ; therapeutic use ; Humans ; Incisor ; pathology ; Longitudinal Studies ; Male ; Oxides ; adverse effects ; Periapical Abscess ; therapy ; Root Canal Filling Materials ; adverse effects ; Root Canal Obturation ; adverse effects ; Root Canal Preparation ; methods ; Silicates ; adverse effects ; Tooth Apex ; pathology ; Treatment Outcome ; Wound Healing ; physiology

Actinomyces ; isolation & purification ; Actinomycosis ; microbiology ; Apicoectomy ; methods ; Candida albicans ; isolation & purification ; Candidiasis ; microbiology ; Enterococcus faecalis ; isolation & purification ; Foreign Bodies ; complications ; Gram-Positive Bacterial Infections ; microbiology ; Humans ; Microsurgery ; methods ; Periapical Periodontitis ; etiology ; microbiology ; surgery ; therapy ; Radicular Cyst ; complications ; Root Canal Filling Materials ; therapeutic use ; Root Canal Therapy ; methods

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

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