(searched for: Bioceramic Endodontic Sealers in the Clinical Practice)
International Journal of Dentistry, Volume 2021, pp 1-8; https://doi.org/10.1155/2021/8816628
Introduction. Apical periodontitis is among the most common pathologies in endodontics. The treatment of apical periodontitis has always been an important occupation in the modern practice of endodontics, and the failure has been associated with nonhermetic root canal filling. With that in mind, bioceramic-based sealers have been incorporated into endodontic practice. The purpose of this study was to evaluate the outcome of nonsurgical root canal treatment (RCT), using a single-cone and Bioroot RCS filling of necrotic teeth with apical periodontitis. Materials and Methods. This follow-up study included patients treated in the department of Restorative Dentistry and Endodontics in the Dental Clinic of Monastir, from January 2018 to December 2019. The study intended to include all adult patients presenting a symptomatic or asymptomatic apical periodontitis. Once the diagnosis was performed, the patients were divided into two groups: a one-session treatment group and a two-session treatment group. All cases were obtured with BioRoot using a single-cone technique with a minimum of a 6-month recall. At 6-month follow-ups, teeth were classified as healed, healing (success), or not healed (failure), based on clinical and radiographic findings. Results. Twelve patients met the inclusion criteria, six patients per group. Seven patients returned for follow-ups. At 6-month follow-ups, the overall success rate was 100%, with 57.1% determined to be “healed” and 42.8% determined to be “healing.” All the PAI scores decreased compared to the baseline situation. Conclusion. The results obtained showed the contribution of BioRoot RCS in the healing of periapical lesions. Accordingly, bioceramic-based sealers seem to optimize the prognosis of root canal treatments.
IIUM Journal of Orofacial and Health Sciences, Volume 2, pp 14-25; https://doi.org/10.31436/ijohs.v2i1.55
The use of bioceramic root canal sealers in endodontics is a promising approach because of the advantages such as improved flow properties, biocompatible and could promote the formation of hard tissue. Due to the recent technology and limited scientific evidence, the effectiveness of bioceramic root canal sealers remains unclear. This article focuses on the physicochemical properties, biocompatibility, biomineralisation, retreatability, 3D obturation and current practice of using bioceramic root canal sealers. The relevant articles for this review were searched manually from Google Scholar and PubMed using keywords ‘bioceramic root filling material AND endodontics’, ‘bioceramic root canal sealers AND endodontics’, ‘cytotoxicity AND bioceramic root canal sealers’, ‘bioceramic root canal sealers AND physicochemical properties’, ‘biomineralisation AND bioceramic root canal sealers’ and ‘retreatment efficacy AND bioceramic root filling materials’. Since the clinical data concerning the obturation with bioceramic root canal sealers is lacking, the selection of materials should be made based on the available scientific evidence, individual cases, material availability and operator’s preference.
Modern Research in Dentistry, Volume 5, pp 536-540; https://doi.org/10.31031/mrd.2020.05.000620
Viresh Chopra* Senior Lecturer in Oman Dental College, Muscat, Oman Course leader, Endodontology, Oman dental College, Muscat Private practice limited to microscopic Endodontics *Corresponding author: Viresh Chopra, Senior Lecturer in Oman Dental College, Muscat, Oman Submission: June 10, 2020;Published: November 13, 2020 DOI: 10.31031/MRD.2020.05.000620 ISSN:2637-7764Volume5 Issue4 Case of failed root canal treatment associated with a previous inadequate root canal treatment and faulty post placement. The patient reported with symptomatic apical periodontitis. Patient information Tooth Figure 1:Periapical radiograph inadequate root canal treatment in 46. Periapical radiolucency associated with the mesial roots can be seen. Metallic threaded post can be seen in the distal canal. The patient was informed about the problem and advised retreatment in 46. Patient advised about post removal to be done, presence of cracks to be explored and retreatment to be done along with location of missed canals will be attempted. Treatment plan Procedures in the first visit: Buccal infiltration anesthesia was administered, and the tooth was isolated with rubber dam isolation. The retreatment was initiated under microscope. Occlusal surface showed resin composite restoration along with metallic post head (Figure 2). Figure 2: Rubber dam isolation of tooth 46. Occlusal surface with resin composite and head of the metallic threaded post. The first step was to remove resin composite restoration and expose the occlusal part of the metallic post. (Figure 3a&3b) Once the occlusal part of the post is exposed, Endodontic ultrasonic tips were used to unscrew/loosen the post and facilitate its removal from the canal (Figure 4). The post was loosened with the help of ultrasonic tips and removed from the canal (Figure 5a&5b). Figure 3: Removal of resin composite restoration to expose the head and further the occlusal part of the metallic post. Figure 4: Post removal with the help of Endodontic ultrasonic tips. Figure 5: a. The distal canal after removal of the metallic post. b. Metallic post after removal. Treatment procedure for the second appointment: Removal of gutta percha from the pulp chamber and the canals was planned in the second appointment. Also, exploration of the access cavity was done for presence of any cracks or extra canals present. Removal of previous gutta percha from the canals was done by using Endoshaper file from FKG. The gutta percha was first softened with the use of gutta percha solvent and then endo shaper file was introduced at 2500rpm to facilitate the removal of gutta percha from the canal (Figure 6a&6b). Figure 6: a. Gutta percha removed from the pulp chamber. b. Gutta percha removed from the canals. In addition to the removal of gutta perchas, final cleaning and shaping of the canal was planned in this visit. If the patient remained comfortable throughout the appointment and if time permits obturation was also planned in the same appointment. Once the removal of gutta perchas were done. Access cavity was explored for presence of cracks and extra canals. No extra canals were found. Endodontic hand files were used to determine working length along with electronic apex locator. The working length was verified with periapical radiograph (Figure 7). The canals were finally cleaned and shaped with Hyflex CM files up to size 25/04. EDTA gel, saline, 2.5% sodium hypochlorite and EDTA liquid were used as irrigants alternatively (Figure 8). Ultrasonic agitation of the irrigates was done with Endoultra from Dentsply. Clinically the fit of the master cones was checked and the verified with a peri apical radiograph at the calculated working length (Figure 9). Total fill, a bioceramic sealer from FKG was used along with gutta-percha as the core obturating material. The premixed sealer was applied in the canals with the help of disposable dispending tips. The master cones were coated with the sealer and placed inside the canals. The gutta percha was cut at the orifice level with heated Plugger. All the canals were obturated and the pulp chamber cleaned of any gutta percha or sealer (Figure 10). Immediate postoperative radiograph was taken to verify the final obturation. Figure 7: Periapical radiograph showing working length determination after gutta percha removal. Figure 8: Clinical picture showing irrigant inside the canals and pulp chamber. Figure 9: Periapical radiograph to verify the fit of the master cones at the correct working length. Irrigation protocol Flushing with saline between irrigants is must, as it will stop the irrigants from reacting with each other. Materials used for obturation Figure 10: Immediate clinical picture showing obturation of all the canals up to the canal orifice. Total fill bioceramic sealer from FKG, Hyflex CM rotary endodontic files from Coltene. Figure 11: Immediate post-obturation periapical radiograph confirming the obturation of all the canals up to the calculated working length. Proper cleaning and shaping of the root canals along with adequate disinfection is one of the important requirements for the success of the endodontic treatment. Failure to achieve adequate disinfection through irrigation will lead to left over microorganisms or pulpal debris leading to post-treatment infections (Figure 11). Endodontic ultrasonic tips should be used to stay conservative while removing metallic posts or broken files from the root canals. Excessive removal of tooth structure might lead to fracture of the tooth due to low strength. If a post has to be placed inside the root canal, then it should be placed up to adequate length to be stable as the retention of the post inside the canal is directly proportional to the length of the post in the canal. In this case, Hyflex CM rotary files were used from Coltene. The files were used with TCA technique. According to this technique: Copious irrigation should be maintained throughout the procedure and Endodontic files should...
ARCHIVES OF HEALTH INVESTIGATION, Volume 9, pp 503-506; https://doi.org/10.21270/archi.v9i6.4959
Pulp diseases commonly happens because of the actions of bacteriological factors and show their characteristic signs and symptoms over the time. With pulp necrosis, a degenerative process starts and when there is no early treatment, it is possible to occur periapical lesions as a result of aggression to the pulp. In cases of periapical secondary lesions, clinical signs and symptoms persist and are related to secondary infection due to persistent bacterial contamination, also to operative factors, inadequate obturation or poor coronary restoration. This study aimed to report a case of endodontic retreatment and clinical and radiographic follow-up for 8 years, of chronic periapical abscess case, in which after retreatment, clinical signs and symptoms are no longer observed and bone neoformation is noticed. Descriptors: Periapical Diseases; Endodontics; Periapical Abscess. Referências Alani AH. 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PLoS ONE, Volume 14; https://doi.org/10.1371/journal.pone.0223575
Recently, a new generation of bioceramic root canal sealers has been introduced onto the market. Many in vitro studies have investigated the antimicrobial properties of these sealers, but their comparative efficacy in antimicrobial activity is still unknown. Three electronic databases were searched: MEDLINE and Embase via the OvidSP platform, and Web of Science, up to June 25, 2019. Studies were included irrespective of study design, type of publication and language. Reporting quality was assessed by two authors independently. Meta-analysis was not performed due to studies being highly heterogeneous. We included 37 studies that analysed the antimicrobial effects of bioceramic sealers. Most of them used a planktonic cell model, with the exception of nine studies which used biofilms. It was not possible to make direct comparison of results from studies and to give a clear conclusion about the comparative antimicrobial activity of these materials because the studies used heterogeneous sources and ages of microorganisms, setting and contact times of sealers, and antimicrobial tests. Furthermore, some materials showed completely different results when tested with different methods. In conclusion, multiple in vitro studies have shown that bioceramic sealers may have various degrees of antimicrobial activity. However, it is still impossible to make conclusions about their comparative efficacy and to recommend the use of one over another in clinical practice because the studies available were conducted in different ways, which makes meta-analysis futile. A uniform methodological approach, consistent definitions and studies on humans are urgently needed in this field of research so that recommendations for practice can be made.
Clinical Oral Investigations, Volume 24, pp 417-424; https://doi.org/10.1007/s00784-019-02920-1
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Archives of Oral Biology, Volume 58, pp 1232-1237; https://doi.org/10.1016/j.archoralbio.2013.04.002
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