Sealing ability of a mineral trioxide aggregate for repair of lateral root perforations.

A scoring system for registration of apical periodontitis in radiographs is presented. The system is termed the periapical index (PAI) and provides an ordinal scale of 5 scores ranging from 1 (healthy) to 5 (severe periodontitis with exacerbating features). Its validity is based on the use of reference radiographs of teeth with verified histological diagnoses. Results from studies involving 11 observers and 47 selected radiographs document that the PAI system is reasonably accurate, reproducible and able to discriminate between sub-populations. It may also allow for results from different researchers to be compared. The system may be suitable for the analysis of periapical radiographs in epidemiological studies, in clinical trials and in retrospective analyses of treatment results in endodontics.

The periapical index: A scoring system for radiographic assessment of apical periodontitis

In vitro bacterial penetration of coronally unsealed endodontically treated teeth

Calcium hydroxide has been included within several materials and antimicrobial formulations that are used in a number of treatment modalities in endodontics. These include, inter-appointment intracanal medicaments, pulp-capping agents and root canal sealers. Calcium hydroxide formulations are also used during treatment of root perforations, root fractures and root resorption and have a role in dental traumatology, for example, following tooth avulsion and luxation injuries. The purpose of this paper is to review the properties and clinical applications of calcium hydroxide in endodontics and dental traumatology including its antibacterial activity, antifungal activity, effect on bacterial biofilms, the synergism between calcium hydroxide and other agents, its effects on the properties of dentine, the diffusion of hydroxyl ions through dentine and its toxicity. Pure calcium hydroxide paste has a high pH (approximately 12.5-12.8) and is classified chemically as a strong base. Its main actions are achieved through the ionic dissociation of Ca2+ and OH- ions and their effect on vital tissues, the induction of hard-tissue deposition and the antibacterial properties. The lethal effects of calcium hydroxide on bacterial cells are probably due to protein denaturation and damage to DNA and cytoplasmic membranes. It has a wide range of antimicrobial activity against common endodontic pathogens but is less effective against Enterococcus faecalis and Candida albicans. Calcium hydroxide is also an effective anti-endotoxin agent. However, its effect on microbial biofilms is controversial.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1365-2591.2011.01886.x

Properties and applications of calcium hydroxide in endodontics and dental traumatology.

It has been recognized for many years that root canal instrumentation produces a smear layer that covers the surfaces of prepared canal walls. This layer contains inorganic and organic substances such as fragments of odontoblastic processes and necrotic debris. There is a lack of agreement regarding the effect of the smear layer on the quality of instrumentation and obturation, but the smear layer itself may be infected and may protect the bacteria within the dentinal tubules. Various methods have been used to remove the smear layer. Conflicting results have been obtained from numerous in vitro studies regarding the significance of the presence or the removal of the smear layer.

Clinical implications of the smear layer in endodontics: a review.

A comparison of methods used in root canal sealability studies

https://suffolkrootcanal.co.uk/wp-content/uploads/2015/04/An-evaluation-of-the-use-of-amalgam-cavit-and-calcium-hydroxide-in-the-repair-of-furcation-perforations-ElDeeb-1982.pdf

An evaluation of the use of amalgam, Cavit, and calcium hydroxide in the repair of furcation perforations

Endodontic recall radiographs: How reliable is our interpretation of endodontic success or failure and what factors affect our reliability?

The purposes of this 2-year longitudinal study were to: compare the clinical effectiveness of patient applied sodium bicarbonate, hydrogen peroxide, and sodium chloride (S/P) to the use of conventional oral hygiene methods and to investigate the motivational effect of using phase-contrast microscopy in teaching effective oral hygiene. Initially, 972 subjects were screened for signs of periodontitis. From these, 347 with early to moderate periodontitis were selected and each was randomly assigned to one of four home treatment regimens after scaling and root planing. The four treatment regimens included: conventional oral hygiene procedures, conventional oral hygiene procedures plus phase-contrast demonstration of subgingival microbial forms for oral hygiene motivation, S/P oral hygiene, and S/P oral hygiene plus phase-contrast demonstration of subgingival microbial forms for oral hygiene motivation. Plaque, bleeding, gingival inflammation, probing depth, and clinical attachment level were recorded at baseline, 8, 16, and 24 months. Subjects were recalled for reinforcement of oral hygiene and periodontal prophylaxis at various intervals. Data were analyzed based on disease severity, location of index sites and compliance. The results indicated that both conventional oral hygiene procedures and the S/P regimen were effective in reducing clinical signs of disease when combined with professional care. There were no differences between the two regimens in clinical effectiveness and trends favoring microscopic viewing of subgingival plaque for motivational purposes were not statistically significant.

Salt and peroxide compared with conventional oral hygiene. I. Clinical results.

Ninety extracted human teeth were used to compare the microleakage of composite resin over, amalgam core, and regular crown preparations under a complete cast gold crown cemented with zinc phosphate cement as determined by 2% fluorescein dye solution Specimens were compared with and without aging after cementation in a thermal bath by cycling some of them between 4 degrees C and 60 degrees C in a 2% fluorescein dye bath and others in a similar bath held at 37 degrees C Fluorescein dye (under ultraviolet light) demonstrated microleakage of the specimens between the crown-tooth interface and the core-tooth interface There were no significant differences in the microleakage due to aging The specimens held at 37 degrees C in the fluorescein dye bath showed no significant differences between the core preparations and the regular crown preparations However, when specimens were thermally cycled between 4 degrees C and 60 degrees C, there were significant differences With thermal cycling, the regular crown preparations were better able to resist microleakage at the crown-tooth interface than either the composite resin core or the amalgam core preparations The results of this investigation seem to indicate a need for further evaluation of core build-ups under cemented complete gold crowns

James R. Jensen

Papers

A comparison of methods used in root canal sealability studies

An evaluation of the use of amalgam, Cavit, and calcium hydroxide in the repair of furcation perforations

Endodontic recall radiographs: How reliable is our interpretation of endodontic success or failure and what factors affect our reliability?

Salt and peroxide compared with conventional oral hygiene. I. Clinical results.

Microleakage of composite resin and amalgam core material under complete cast crowns.