Evolution of Protein Molecules

Root canal irrigants.

Prevention of infective endocarditis

https://www.endoexperience.com/documents/PetersetalRotaryArticle.pdf

Current Challenges and Concepts in the Preparation of Root Canal Systems: A Review

https://www.rpcendo.com/vItPfwcx/PDF3.pdf

Enterococcus faecalis: Its Role in Root Canal Treatment Failure and Current Concepts in Retreatment

Dens invaginatus is a dental anomaly that can predispose the tooth to pulp and periapical pathology.Different endodontists treated 6 maxillary incisors with dens invaginatus associated with apical periodontitis. Cone-beam computed tomography was used to help with diagnosis and treatment planning in most patients. Four patients received diagnoses of Oehlers type II dens invaginatus and the other 2 as type III. In some patients with type II, the invagination had to be perforated to permit access to the apical part of the true root canal. Both the true canal and the invagination (pseudocanal) were treated in all cases using an antimicrobial regimen based on chemomechanical preparation with sodium hypochlorite irrigation and supplementary disinfection approaches. Calcium hydroxide medication was used in all but 1 case. The root canal and invagination were often filled using thermoplasticized gutta-percha techniques, sometimes using an apical plug with a bioceramic material in teeth with large apical openings. All treated patients had favorable clinical and radiographic outcomes.Regardless of the complex anatomic variations, common strategic therapeutic approaches were identified that might serve as recommendations for proper management of teeth with dens invaginatus and apical periodontitis. These approaches include cone-beam computed tomographic planning, aggressive disinfection using sodium hypochlorite ultrasonic or sonic activation and calcium hydroxide intracanal medication, and thermoplasticized gutta-percha obturation of both the root canal and invagination. 

Management of teeth with dens invaginatus and apical periodontitis: A case series.

Preparation of the root canal system is recognized as being one of the most important steps in achieving successful endodontic treatment outcomes. However, thorough root canal preparation is quite demanding for the clinician because of the highly variable root canal anatomy and the inability to visualize this anatomy from routine periapical radiographs. In addition to mechanical shaping, it is well accepted that the use of antimicrobial irrigating agents is beneficial in dissolving inflamed as well as necrotic infected pulp tissue and disrupting the intracanal biofilm. Additionally, the use of interappointment antimicrobial dressings has also been recommended for teeth with periapical disease as a result of root canal infection.

Instrumentation and Disinfection of Root Canals

This retrospective study evaluated the outcome of the endodontic treatment/retreatment of teeth with intraoral sinus tracts. Seventy-two teeth from 70 individuals were included. One operator treated all teeth over about 20 years. Time for the sinus tract to heal was recorded. Treatment outcome was evaluated after at least 1 year and classified as healed, healing or diseased. The overall healed rate of periradicular lesions was 73.6% (74.1% for treatment and 72.2% for retreatment). In 6 (8.3%) teeth, lesions were healing. Thirteen teeth (18.1%) exhibited persistent disease. In 68/72 (94.4%) cases, the sinus tract healed in less than 1 month. No preoperative/intraoperative variable affected the outcome (P > 0.05). Missing restorations had a negative impact (P < 0.05). Healing of both the sinus tract quickly after treatment and the periradicular lesion later were usually achieved. Closure of the sinus tract in the first month was a good predictor of lesion healing.

Clinical and radiographic outcome of the root canal treatment of infected teeth with associated sinus tract: A retrospective study

In daily endodontic practice, the clinician basically faces 3 conditions that require treatment: vital pulps, necrotic pulps and retreatment cases. Root canals of vital teeth are free of infection, which if present is restricted to the exposed portion of the coronal pulp. The success of the endodontic treatment will depend on the maintenance of the aseptic chain during intracanal procedures. This paper reviews the biologic principles of the endodontic treatment of vital teeth, with the purpose to provide the clinician with better conditions to improve the treatment outcome.

/pdf/principios-biologicos-do-tratamento-endodontico-de-dentes-e7c2jrnu0y.pdf

Princípios biológicos do tratamento endodôntico de dentes com polpa viva

Adequate removal of the previous filling material may be pivotal to a favorable outcome of root canal retreatment of teeth with post-treatment periodontitis in order to permit the access of irrigants and medicaments to persistent bacteria. However, even with recent technological advances, including the introduction of specially designed instruments, no technique has been shown to predictably promote complete filling removal. Supplementary approaches used after chemomechanical preparation, including the use of finishing instruments, ultrasonics and laser, have shown promising results in enhancing root canal cleaning and disinfection. This narrative review addresses the importance and implications of maximal filling removal during retreatment and discusses the effectiveness of different techniques and supplementary approaches used for this purpose.

/pdf/removal-of-the-previous-root-canal-filling-material-for-143ak97c.pdf

José F. Siqueira

Papers

Management of teeth with dens invaginatus and apical periodontitis: A case series.

Instrumentation and Disinfection of Root Canals

Clinical and radiographic outcome of the root canal treatment of infected teeth with associated sinus tract: A retrospective study

Princípios biológicos do tratamento endodôntico de dentes com polpa viva

Removal of the Previous Root Canal Filling Material for Retreatment: Implications and Techniques