European Endodontic Journal最新文献

This is a series of 7 cases in which the operator penetrated lateral canals with instruments. Two teeth presented with irreversible pulpitis, 4 with necrotic pulps, and 1 with previous treatment. Except for the teeth with pulpitis, all the others were associated with apical periodontitis. The main root canal was always relatively straight, with the lateral canals at the middle third of the root. Suggestive images of lateral canal presence were seen on periapical radiographs in five cases. The clinician introduced intentionally small hand instruments in the lateral canal in 5 cases, while the penetration was fortuitous in the others. The lateral canals were obturated in all cases. Follow-up examination was possible in five cases, all of them showed evidence of successful clinical and radiographic outcomes. Introducing files into lateral canals may permit some preparation and penetration of irrigant solution, favoring disinfection and, consequently, enhancing the treatment outcome. (EEJ-2023-05-063).

criteria were randomized to each irrigant, 65 in the NaOCl and 60 in the NSS groups. ProRoot® MTA was used as a pulp dressing material in both groups and teeth were followed for 12 months. The primary outcome was the success of VPT; requiring both clinical and radiographic success to be considered as success. The hypothesis was that the absolute difference of VPT success in the NSS group was not worse than that in the NaOCl group, by a margin of 5%. The secondary outcome was discoloration; percentages of discolorations between both groups were compared. Results: Using a per protocol analysis, the absolute difference of VPT success between the NSS and NaOCl groups was 2.08% (95% CI: -1.95, 6.1). Perceptible gray discolorations were 80% and 63% in NaOCl and NSS groups (difference -17%; 95% CI: -40.0, 6.2; p=0.15). Conclusions: For MTA-VPT procedure, irrigation with NSS was not worse than that with NaOCl. However, both irrigants caused discoloration. (EEJ-2023-05-065).

Objective: Syringe irrigation, commonly used for delivering sodium hypochlorite (NaOCl) during root canal treatment, requires careful handling to prevent NaOCl extrusion into periapical tissues. This randomized controlled in vitro study aimed to quantify syringe plunger forces exerted by dental undergraduates and to assess the impact of an educational intervention on adherence to safe irrigant delivery parameters.

Methods: Fifty-two undergraduates performed syringe irrigation at three intervals: baseline (T1), after two weeks (T2), and after 12 weeks (T3). At T1, irrigation was conducted without prior educational intervention, while at T2, it was preceded by an intervention. The educational intervention involved a short video highlighting safe irrigation practices, including plunger force and time recommendations for syringe irrigation. At T3, the undergraduates were randomly allocated to two groups: One received a repeated intervention, while the other did not. Syringe irrigation was performed on a 3D-printed tooth using two side-vented cannulas: one of 25 Gauge (G) and another of 30 G. A syringe equipped with a force sensor recorded the plunger forces. Based on earlier research, plunger forces exceeding 10 Newtons (N) for the 25 G cannula and 40 N for the 30 G cannula were deemed critical. The data were subjected to descriptive statistical analyses.

Results: Overall, the mean of maximum values of plunger forces remained under 10 N for the 25 G and below 20 N for the 30 G cannulas, with only few measurements exceeding 40 N. Instances of surpassing the critical plunger force threshold were more common with the 25 G side-vented cannula than with the 30 G variant. At T3, the group that received the repeated educational intervention exhibited lower average maximum plunger forces for both types of cannulas compared with the group that did not receive the intervention.

Conclusion: Integrating plunger force measurements with targeted educational interventions presents an effective approach for instructing undergraduates in the proper techniques of syringe irrigation. The findings suggest that, generally, undergraduates do not apply excessive plunger forces that could risk apical irrigant extrusion. The implementation of repeated educational interventions has been shown to decrease the plunger forces exerted by undergraduates, underscoring its effectiveness in fostering safe endodontic irrigation.

Introduction: Childhood experiences of pain associated with dental treatment can induce dental anxiety. Inferior alveolar nerve blocks are eight times more likely to fail in patients with irreversible pulpitis.

Purpose: The objective was to compare the effectiveness of lignocaine and lignocaine with pre-operative oral ibuprofen for pulpectomy in 5 to 9-year-old children.

Methods: One hundred and twenty-two children requiring pulpectomy in mandibular posterior teeth were included. The children were assigned to one of the two groups, Treatment group A: Pre-operative with oral ibuprofen and local anaesthesia with 2% lignocaine (with adrenaline 1: 80000); Treatment group B: Pre-operative with oral placebo and local anaesthesia with 2% lignocaine (with 1: 80000 adrenaline). Pain and pulse rate were recorded at baseline, one hour after administration of oral medication, fifteen minutes following administration of Inferior Alveolar Nerve Block (IANB), and also during the course pulpectomy. The results were statistically analysed using chi square test and repeated measures analysis of variance (ANOVA) Results: In treatment group A, 90.16% children had IANB success. In treatment group B, 9.83% had IANB success. The difference in the success rate between two groups was statistically significant (p<0.001) with an odds ratio of 84.

Conclusion: Oral medication with ibuprofen is effective in increasing the success rate of IANB with lignocaine for the treatment of irreversible pulpitis of 5 to 9-year-old children. (EEJ-2023-09-122).

Objective: Childhood experiences of pain associated with dental treatment can induce dental anxiety. Infe-rior alveolar nerve blocks are eight times more likely to fail in patients with irreversible pulpitis. The objective was to compare the effectiveness of lignocaine with and without pre-operative oral ibuprofen for controlling pain in primary mandibular molars scheduled for pulpectomy procedures in 5 to 9-year-old children.

Methods: One hundred and twenty-two children diagnosed with irreversible pulpitis in mandibular posterior teeth and scheduled for pulpectomy procedures were included. The children were assigned to one of the two groups, Treatment group A: Pre-operative with oral ibuprofen and local anaesthesia with 2% lignocaine (with adrenaline 1: 80000); Treatment group B: Pre-operative with oral placebo and local anaesthesia with 2% ligno-caine (with 1: 80000 adrenaline). Pain and pulse rate were recorded at baseline, one hour after administration of oral medication, fifteen minutes following administration of Inferior Alveolar Nerve Block (IANB), and also during the course pulpectomy. The results were statistically analysed using chi square test and repeated mea-sures analysis of variance (ANOVA).

Results: In treatment group A, 90.16% children had IANB success compared to 9.83% in group B.. The differ-ence in the success rate between two groups was statistically significant (p<0.001) with an odds ratio of 84.

Conclusion: Oral medication with ibuprofen is effective in increasing the success rate of IANB with lignocaine for the treatment of irreversible pulpitis of 5 to 9-year-old children.

Objective: This study investigated the effect of static and dynamic conditions on the solubility of three en-dodontic sealers: AH Plus (an epoxy-resin-based sealer), Bio-C Sealer (a bioceramic sealer), and EndoSequence BC (a bioceramic sealer).

Methods: Plastic moulds were used to create 150 specimens, which were divided into three groups, with each group being filled with one of the three sealers. After the setting time, the specimens were removed from the moulds, dried, and weighed. Thirty specimens from each group were subdivided into three subgroups and stored in distilled water for 30, 60, or 90 days, while the remaining 20 specimens in each group were subdivid-ed into four subgroups and subjected to 0, 20, 50, or 100 thermocycling cycles. After storage time and thermo-cycling, the specimens were reweighed, and the weight loss and solubility percentage were calculated. The data were analysed using one-way ANOVA, Post Hoc Tukey, and Pearson correlation tests (p<0.05).

Results: The results showed that AH Plus had the lowest solubility, followed by EndoSequence BC and then Bio-C Sealer (p<0.0001). Both static and dynamic conditions had a negative effect on the solubility of all tested sealers, with the effect being more pronounced in bioceramic sealers. The increase in storage days and the number of thermocycling cycles were significantly correlated with the increasing solubility levels of all tested sealers (p<0.0001).

Conclusion: The increased solubility of endodontic sealers may have a negative impact on long-term treat-ment outcomes. Both static and dynamic conditions can affect the solubility of endodontic sealers.

Objective: This study aimed to compare the effectiveness of lidocaine with magnesium sulphate in patients undergoing root canal treatment following irreversible pulpitis.

Methods: A total of 86 patients were randomised to receive 1.8 ml of 2% lidocaine replaced with 0.2 ml of 10% magnesium sulphate with 1: 80,000 epinephrine (n=43) as MGS group and 1.8 ml of 2% lidocaine with 1: 80,000 epinephrine (n=43) as LDC group. Preoperative visual analogue scale (VAS) pain scores were record-ed. Patients were instructed to report any perioperative pain felt during the access cavity preparation and when introducing the first patency file (#10 k) in the root canal and perioperative VAS recorded.

Results: The success rate of the inferior alveolar nerve block (IANB) was higher in the MSG group. The mean+-SD of perioperative pain was 0.16+-0.37 in the MSG group and 3.13+-0.77 in the LDC group. The MGS group produced better anaesthetic efficacy with a p-value of 0.01.

Conclusion: Based on the results, adding 10% magnesium sulphate to 2% lidocaine increased the effective-ness of IANB in patients with symptomatic irreversible pulpitis of mandibular molar teeth.

Objective: Extended reality (XR) technology using head-mounted devices enables the operator to visu-alise anatomical structures. We aimed to investigate student perceptions regarding applying XR simu-lation for transferring endodontic educational information between a lecturer in Japan and students in Saudi Arabia.

Methods: In this study, the students engaged with an XR simulation system and viewed teeth in virtual reality (VR). Pictures of dental anatomy were shown in the VR space, allowing participants to manipulate them. Then, the participants viewed a patient-specific three-dimensional printed model and three-dimensional root canal access guide in a second VR area. Before the sessions, the students completed a questionnaire on demograph-ic data and information concerning their VR experience. After the sessions, they completed a questionnaire evaluating the XR simulation system. The questionnaire included questions on dental anatomy, root canal access, usability, emotional impression, and data transfer.

Results: Eleven 5th-year dental students, comprising six male and five female students, were enrolled; three of them had previous VR experience, whereas eight did not. The highest levels of satisfaction were noted in the tooth anatomy (4.6+-0.4) and emotional impression (4.5+-0.5) domains, whereas the lowest level was noted in the data transmission domain (3.5+-0.9). Female participants and those without previous VR experience reported higher satisfaction levels across questionnaire domains compared to male participants and those with previous VR experience.

Conclusion: XR can be successfully used in dental education and integrated into online lectures. Restrictions on education caused by health crises can be averted by using XR. Further, fifth-generation networks can offer better data transmission than wireless fidelity.

Objective: This study aimed to address the lack of comparative analyses of newly developed bioceramic materials by examining the chemical composition, thermodynamic profile, and microscopic surface features of three bioceramic putties: EndoSequence BC Root Repair Material Fast Set Putty (ESRRM-FS), BIO-C Repair (BCR), and Cera Putty (CP).

Methods: Samples of each of the three bioceramic putty obtained directly from manufacturers were prepared for analysis of physicochemical composition and microscopic features by differential scanning calorimetry (DSC), thermogravimetric analysis (TGA), scanning electron microscopy (SEM) imagery, and energy-disper-sive X-ray spectroscopy (EDS). The data obtained was qualitatively and statistically analysed. Statistical signif-icance was determined at p≤0.05.

Results: DSC analysis indicated a standard polymeric vehicle for BCR and CP, coinciding with the polyethene glycol (PEG) thermal profile; the polymeric vehicle in ESRRM-FS remains to be identified. The material with the highest heat capacity was CP (p<0.05), followed by ESRRM-FS and BCR. TGA revealed an inflexion point at 394.12 ºC for ESRRM-FS, which may correspond to the mass loss of dihydroxylation of calcium hydroxide. A more homogenous structure was observed in scanning electron microscopy (SEM) images for ESRRM-FS. EDS analysis indicated BCR had minimal amounts of aluminium (2.06+-0.44%) and a lower percentage of cal-cium than ESRRM-FS (9.11+-1.38% vs. 11.3+-0.87%). CP was composed of aluminium (49.35+-7.01%), carbon (30.65+-5.62%), and oxygen (16.75+-2.44%); no silicon was identified. ESRRM-FS had no aluminium present and the highest calcium percentage (11.3+-0.87%) (p<0.05).

Conclusion: BCR is a Portland cement-derived material with a lower percentage of calcium than ESRRM-FS and minimal amounts of aluminium. CP is a monocalcium aluminate cement, mainly composed of aluminium, carbon, and oxygen. ESRRM-FS is a biphasic material with the highest calcium percentage among all materials studied and no aluminium.

Objective: This in vitro study aimed to compare and evaluate the effectiveness of different irrigation solutions, including Triton, 0.5% Chitosan nanoparticles (CNP), and 17% ethylenediaminetetraacetic acid (EDTA), on the smear layer removal of the root canal walls.

Methods: Forty extracted sound mandibular premolars were examined; the samples were decoronated to obtain a root length of 14 mm. Each sample was instrumented using ProTaper Next rotary file X4 (40/0.06). The samples were longitudinally sectioned and examined under a scanning electron microscope at 3000x magnification in the coronal, middle, and apical thirds using a four-level scoring system.

Results: Triton demonstrated the lowest mean smear layer removal (p>0.05) compared to the other irrigation solutions at all the levels of the root canal. No significant differences were observed (p>0.05) at the coronal and middle levels of the root canal between the CNP and EDTA groups. CNP demonstrated significantly more smear layer removal at the apical level compared to EDTA.

Conclusion: Smear layer removal was least effective with Triton at all the levels of the root canal compared to the other irrigation solutions tested in this study. CNP demonstrated superior smear layer removal at the apical level compared to the other irrigation solutions.