Background and Aims:Extrusion of any debris during endodontic treatment may potentially cause post-operative complications such as flare-ups. The purpose of this in vitro study was to assess the amount of apically extruded debris during the root canal preparation using rotary and reciprocating nickel-titanium instrumentation systems.Materials and Methods:In this study, 60 human mandibular first premolars were randomly assigned to 3 groups (n = 20 teeth/group). The root canals were instrumented according to the manufacturers’ instructions using the Reciprocating single-file system WaveOne™ (Dentsply Maillefer, Ballaigues, Switzerland) and full-sequence rotary Hyflex CM™ (Coltene Whaledent, Allstetten, Switzerland) and ProTaper™ (Dentsply Maillefer, Ballaigues, Switzerland) instruments. The canals were then irrigated using bidistilled water. The debris that was extruded apically was collected in preweighed eppendorf tubes and assessed with an electronic balance and compared.Statistical Analysis Used:The debris extrusion was compared and statistically analyzed using analysis of variance and the post hoc Student-Newman-Keuls test.Results:The WaveOne™ and ProTaper™ rotary instruments produced significantly more debris compared with Hyflex CM™ rotary instruments (P < 0.05).Conclusions:Under the conditions of this study, all systems that were used resulted in extrusion of apical debris. Full-sequence rotary instrumentation was associated with less debris extrusion compared with the use of reciprocating single-file systems.
Context:
Pulpotomy is a procedure in which part of an exposed vital pulp is removed, usually as a means of preserving the vitality and function of the remaining part.
Aim:
The aim is to compare the effectiveness of Dycal (CH), EndoSequence, and Titanium-prepared platelet-rich fibrin with EndoSequence (T-PRF) as pulpotomy agents in mature permanent molars with irreversible pulpitis.
Settings and Design:
Sixty permanent mandibular molars with carious exposure and symptoms of irreversible pulpitis were randomly allocated to three groups.
Subjects and Methods:
Full pulpotomy was performed using Dycal, EndoSequence, and T-PRF with EndoSequence as pulpotomy agents. Pain intensity was analyzed using a Numeric Rating Scale score at baseline 24 h, 7 days, 6 months, and 1 year. The clinical and radiographic evaluations were done at 6 months and 1 year.
Statistical Analysis:
Nonparametric tests (Kruskal–Wallis, Chi-square) were applied to analyze the data as the normality test does not follow a normal distribution.
Results:
T-PRF and EndoSequence showed effective results when compared clinically, and there was no significant difference between radiographic success rates among the three groups at (
P
= 0.325 at 6 months, 0.466 at 12 months) follow-up.
Conclusion:
T-PRF and EndoSequence showed higher success rates among Dycal, EndoSequence as pulpotomy agents in teeth with irreversible pulpitis.
The main objective of this case study is to present an unusual maxillary first molar root canal configuration with seven root canals; three mesiobuccal, two distobuccal and two palatal canals diagnosed during treatment procedure confirmed by Cone Beam Computed Tomography. A 26-year-old man with the chief complaint of spontaneous pain in his left posterior maxilla was referred to by his general dentist. From the clinical and radiographic results, a diagnosis of apical periodontitis was made and the patient was recommended for endodontic care. The CBCT axial images of the patient showed that the palatal and distobuccal roots have a type IV and type II canal pattern of Vertucci, respectively, while the mesiobuccal root showed a type XV canal configuration of Sert and Bayirli. Canals have been successfully treated with rotary files and filled using a single-cone technique. In endodontically difficult situations, the use of CBCT imaging will promote a deeper understanding of the intricate root canal anatomy, which essentially helps the clinician to more effectively explore the root canal system and clean, shape, and obturate it.
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