Objective: To identify whether root canal irrigants with calcium chelation ability play a role in the removal of calcium hydroxide (CH) from the root canals when compared to non-chelators.
Methods: The protocol is registered in the Open Science Framework registry (doi 10.17605/OSF.IO/CHG2Q). PubMed, Scopus, Embase, Cochrane Library, ProQuest, Google Scholar, Science direct and open grey databases were searched until March 2021. Laboratory studies comparing the effectiveness of calcium chelators in the removal of CH with non-chelators delivered using needle irrigation, irrigation agitation or instrumentation techniques were included. The quality of included studies was appraised using a modified Joanna Briggs Institute critical appraisal checklist for a randomised clinical trial. Two independent reviewers were involved in study selection, data extraction, appraising the quality of studies. Any disagreements were resolved by a third reviewer.
Results: The current review included 17 studies, with 16 being of "moderate" quality and one of "low" quality. Due to methodological differences within the included studies, quantitative analysis was not performed. Laboratory studies were only included in the current review because no clinical study exists on this topic. Evidence from the review indicates that calcium chelators are superior to non-chelators in the removal of CH when used with needle irrigation, passive ultrasonic irrigation and instrumentation techniques.
Conclusion: Calcium chelators are superior in the removal of CH from the root canal system over non-chelators.
Objective: The aim of this study was to compare the pull-out bond strength of prefabricated titanium posts cemented with novel fast-setting calcium silicate, zinc phosphate, or glass ionomer cements.
Methods: Sixty extracted human maxillary incisors were selected and received root canal treatment. Post space was prepared for titanium ParaPost XP size 5 (diameter=1.25 mm). The posts were cemented using novel calcium silicate cement, zinc phosphate cement, or glass ionomer cement (n=20). Specimens were stored in phosphate-buffered saline for 4 weeks. Subsequently, the posts were subjected to axial tensile force until bond failure. Data were analyzed by one-way ANOVA followed by multiple comparisons.
Results: The posts cemented with novel calcium silicate cement (10.5±3.8 MPa) demonstrated significantly higher bond strength than zinc phosphate (8.0±2.6 MPa) and glass ionomer cements (8.0±2.7 MPa) (P<0.05).
Conclusion: Within the limitation of the study, the pull-out bond strength of titanium post cemented with novel calcium silicate cement in endodontically treated teeth was superior to zinc phosphate and glass ionomer cements.
Objective: Apical surgery is an intervention to treat teeth with persistent or recurrent endodontic infection. The proximity of the mental foramen and mandibular canal may pose a risk of altered sensation when performing surgical interventions in the posterior mandible. The objective of this study was to determine the rate of neurosensory disturbances after apical surgery of mandibular premolars and molars. The secondary objective was to evaluate whether the occurrence of altered sensation correlated with the distances from the apex or the periapical lesion to the relevant anatomical structures.
Methods: The charts of patients treated from September 1999 to December 2015 were retrospectively evaluated if an apical surgery had been performed in mandibular premolars or molars, and a minimum period of 1-year follow-up was documented. Patients with trauma or other surgical interventions in the same hemimandible were excluded. Cases with postsurgical altered sensation were defined as the test group. From the pool of unaffected cases, patients were selected to serve as controls. Two- or three-dimensional radiographs of test and control cases were assessed with regard to the shortest distances from the root apices/lesions to the mental foramen or mandibular canal.
Results: The study population included 243 patients with 249 apical surgeries, of which 12.9% led to postoperative neurosensory disturbances. Sensation returned to normal within 22 days on average. The most frequent findings were hyperesthesia or paresthesia. With regard to the treated type of tooth, second premolars resulted more frequently (22.6%) in altered sensation than the other teeth (11.2 to 13.0%; p=0.310). There were no significant differences when comparing test and control cases regarding the measured distances in radiographs from the apex/lesion to the relevant anatomical structures.
Conclusion: Altered sensation may typically occur following apical surgery in posterior mandibular teeth. However, in all cases of the present study, skin sensitivity in the lip/chin region returned to normal. The clinician must be particularly careful when performing apical surgery of second premolars due to the proximity of the mental foramen.
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