Iranian Endodontic Journal
Volume:4 Issue: 2, Spring 2009

Various methods commonly used for cleaning and shaping root canals have not been successful in completely eradicating bacteria due to anatomic complexity and root canals irregularities. Disinfecting the canals with intracanal irrigants in addition to proper cleaning and shaping can produce a successful outcome. Antimicrobials with sustained antibacterial activity would be desirable for irrigation. The purpose of this study was to compare the antimicrobial substantivity of Carvacrol and 5.25% NaOCl in infected bovine root dentin. One hundred and twenty dentin tubes prepared from bovine incisors were infected in vitro for 14 days with Enterococcus (E) faecalis. The specimens were divided into four groups including 1) Carvacrol, 2) NaOCl, 3) infected dentin tubes (positive control); and 4) sterile dentin tubes (negative control). Dentin chips were collected at five intervals (days 0, 1, 3, 7 and 28) using round burs with sequentially increasing diameters (which includes five layers of dentin) into Brain Heart Infusion (BHI) broth. In order to compare the pre- and post-irrigation antimicrobial activity of the irrigants the colony-forming units (CFU) were counted and classified as ‘CFU-before’ and ‘CFU-after’. After culturing, the number of CFU with the various experimental time and dentinal layers was recounted. Two-way ANOVA test was used to analyze the effects of time and materials. One-way ANOVA and supplemental Tukey HSD test were used for pair comparison. CFU was significantly reduced in NaOCl group when compared to all other experimental groups (P<0.05). The substantivity of NaOCl was significantly greater than Carvacrol. Further studies are required to investigate and approve Carvacrol as a final irrigant.

Open-apex teeth with irreversible pulpitis require complex and difficult treatment. Providing the right environment for apexogenesis and pulp protection is vital for their long term prognosis. The young pulp of open apex tooth, however, is better equipped against irritation and assault. The aim of this study was to evaluate pulp inflammation in open apex canine teeth of cats. In this in vivo study, twelve cats with open apex canines were used. Pulps were iatrogenically exposed and the animals were sacrificed at one, seven, thirty and ninety days after pulp exposure. Samples were prepared for histological evaluations. During the first and seventh day, changes were limited to acute inflammation in the coronal pulp. During the first month pulp changes in 45.5% of samples were similar to the seventh day. In the other samples necrosis and abscess spread to the end of the root, and internal resorption and periapical abscess were observed. In 45.5% of samples in the apical region vital tissue was barely observed (during 90 days); in 54.5% of samples however, complete pulp necrosis, internal resorption and a large periapical lesion was observed. In one and seven-day periods pulp tissue was vital; however, in the thirty and ninety-day periods, minority of the pulp samples were vital.

Pulpectomy of primary teeth is commonly carried out with hand files and broaches; a tricky and time consuming procedure. The purpose of this in vitro study was to compare the cleaning efficacy and time taken for instrumentation of deciduous molars using hand K-files and Flex Master rotary system. In this study, 68 canals of 23 extracted primary molars with at least two third intact roots and 7-12 mm length were selected. After preparing an access cavity, K-file size #15 was introduced into the root canal and India ink was injected with an insulin syringe. Sixty samples were randomly divided in to experimental groups in group I (n=30), root canals were prepared with hand K-files; in group II (n=30), rotary Flex Master files were used for instrumentation, and in group III 8 remained samples were considered as negative controls. After clearing and root sectioning, the removal of India ink from cervical, middle, and apical thirds was scored. Data was analyzed using student''s T-test and Mann-Whitney U test. There was no significant difference between experimental groups cleaning efficacy at the cervical, middle and apical root canal thirds. Only the coronal third scored higher in the hand instrumented group (P<0.001). Instrumentation with Flex Master rotary files was significantly less time consuming (P<0.001). Although there was no difference in cleanliness efficacy at the apical and middle thirds, the coronal third was more effectively cleaned with hand files. Predictably, time efficiency was a significant advantage with rotary technique.

This study aimed to compare the efficacy of MTAD, Glyde and EDTA in removing the post-preparation smear layer and debris produced in apical third of curved molar root canals. Forty extracted human maxillary first molars with curved mesiobuccal canals (30˚-35˚), similar root lengths and morphologies were divided into 3 experimental groups (n=12) and one control group (n=4). Canals were prepared by RaCe rotary files and were treated with the following materials between each two files: Group A (control group); 5 mL of distilled water, Group B; 1 mL of 17% ethylenediamine tetra-acetic acid (EDTA) for 1 min, Group C; BioPureä MTAD (according to the manufacturer’s instruction; 5mL for 5 min), and Group D; Glyde File Prep alternated with sodium hypochlorite (NaOCl) between each two files. Debridement of the apical third was evaluated using scanning electron microscope (SEM) (×5000). The data were statistically analyzed using the Kruskal-Wallis and Mann-Whitney U tests (P<0.05). Statistical analysis of the data showed that MTAD and 17% EDTA were effective in removing smear layer and debris from the apical thirds. MTAD was more effective than EDTA in smear layer removal. Glyde did not adequately debride curved root canals of molar teeth. MTAD and 17% EDTA were effective in debriding the apical third of curved molar root canals during endodontic treatment, whereas Glyde File Prep does not provide adequate debridement.

The aim of this study was to compare the antimicrobial effects of MTAD, sodium hypochlorite (NaOCl) and their combination on endodontic micro-organisms. Zone of Inhibition (ZI) and Minimum Inhibitory Concentration (MIC) were the techniques used. In ZI technique blood agar plates were inoculated with organisms, paper discs were soaked with irrigants and maximum zones of bacterial inhibition were recorded. In the MIC technique the irrigants were serially diluted in TSB tubes and 0.1 mL of the tested microbe solutions were added. Results were obtained on the basis of turbidity and growth on agar plates. Statistical analyses were carried out using ANOVA and Tukey tests. In ZI technique, we investigated 120 specimens including 5 microbial species, 3 irrigants and their control groups, each with 6 repetitions. The results demonstrated MTAD greater antimicrobial efficacy compared to NaOCl, and their mixture (M+N) against Staphylococcus (S) aureus, Enteric (E) bacteria and Enterococcus (E) faecalis (P)

The aim of this study was to evaluate the amount of dentine removed after canal preparation using stainless steel (SS) hand instruments or rotary ProFile instruments. Thirty-six extracted human teeth with root canal curvatures less than 30º were embedded in clear polyester resin. The roots were cut horizontally at apical 2, 4 and 7 mm. Dentin thickness was measured at each section and the sections were accurately reassembled using a muffle. Root canals were randomly prepared by SS hand instruments or rotary ProFile instruments. Root sections were again separated, and the remaining dentin thickness was measured. Mann-Whitney U and t tests were performed for analytic comparison of the results. The thickness of removed dentin was significantly different between the two used methods (P<0.05). Significantly greater amounts of dentin was removed mesially in all sections in hand instrumentation group (P<0.001). ProFile rotary instrumentation prepares root canals with a greater conservation of tooth structure.

This in vitro study measured and compared pH and phosphate and calcium ions release of a new endodontic material (CEM cement), mineral trioxide aggregate (MTA), and Portland cement (PC) using UV-visible technique, atomic absorption spectrophotometry methods, and pH meter, respectively. Each material was placed in a plastic tube (n=10) and immersed in a glass flask containing deionized water. Half of the samples were tested for determining pH and released ions after 1h, 3h, 24h, 48h, 7d and 28d. Remaining samples (n=5), were evaluated after 28d. Data was analyzed using one way ANOVA and Tukey tests. Results indicated that all materials were highly alkaline and released calcium and low concentration of phosphate ions in all the time intervals. CEM cement released considerably higher concentration of phosphate during the first hour (P<0.05). This novel endodontic cement promoted alkaline pH in a similar manner to MTA and released calcium and phosphate. These conditions can stimulate the calcification process and explain the basic physico-chemical mechanisms of hard tissue regeneration of CEM cement.

Familiarity with the intricacies and variations of root canal morphology is essential for successful endodontic treatment. Maxillary central and lateral incisors are known to be single-rooted with one canal, however, this case report describes endodontic treatment of maxillary central and lateral incisors with two buccopalatal root canals.