Objectives: This study aimed to assess root canal transportation of curved canals following glide path preparation by PathFile and Scout RaCe rotary systems compared with manual instrumentation with stainless steel (SS) hand files using cone-beam computed tomography (CBCT). Materials and Methods: This in-vitro experimental study was conducted on extracted human mandibular first and second molars (n=51) with 25-45° canal curvature in their mesiobuccal root. All teeth underwent CBCT and were randomly divided into three groups (n=17). In group 1, a glide path in the mesiobuccal canal was created using SS hand files to the working length. In groups 2 and 3, after canal negotiation with a #8 SS hand file, a glide path was created with PathFile and Scout RaCe systems, respectively. The teeth underwent CBCT. Pre- and postoperative CBCT scans were compared to calculate the magnitude of canal transportation at 3, 6, and 9 mm from the apex. The results were analyzed using the Kruskal-Wallis and Freedman tests (P<0.05). Results: Manual instrumentation caused significantly higher canal transportation at 3 and 9 mm from the apex compared with rotary systems (P<0.05). PathFile and Scout RaCe were not significantly different at 3 (P=0.39) or 9 mm (P=0.99). No significant difference was noted in canal transportation among the three groups at 6 mm (P=0.15). Conclusion: Scout RaCe and PathFile cause less canal transportation than manual instrumentation with SS files when used for glide path preparation in curved canals, especially in the apical third.
Introduction. If the teeth are impacted by a chronic irritant, the pulp space possibly will undergo calcific changes that may impede access opening during root canal treatment. In such cases that conventional endodontic treatment is impossible or impractical, intentional replantation may be considered as a last solution to preserve the tooth. Methods. After failing to perform conventional root canal therapy for a necrotic calcified right mandibular second premolar, the tooth was gently extracted. The root apex was resected and the root end cavity was prepared and filled with calcium enriched mixture (CEM) cement. Then, the extracted tooth was replanted in its original position. Results. After a year the tooth was asymptomatic, and the size of periapical radiolucency was remarkably reduced and no clinical sign of ankylosis was observed. Conclusion. Intentional replantation of the necrotic calcified teeth could be considered as an alternative to teeth extraction, especially for the single-rooted teeth and when nonsurgical and surgical endodontic procedures seem impossible.
Coronal discoloration of endodontically treated teeth is a challenge in clinical dentistry. This study aimed to compare coronal discoloration induced by White Mineral Trioxide Aggregate and Calcium-enriched mixture cement. Fifty single-rooted, unrestored premolar teeth extracted for orthodontic reasons were selected. After access cavity preparation, all the root canals were instrumented with MTWO rotary files up to #40.6%. The specimens were randomly assigned to two experimental groups, White Mineral Trioxide Aggregate and Calcium-enriched mixture cement groups (n = 20), and two control groups (n = 5). In the White Mineral Trioxide Aggregate and Calcium-enriched mixture cement groups, the material was condensed via the access cavity 3 mm below the cementoenamel junction to a thickness of 3 mm. Tooth color was assessed using computer analysis of digital images. Tooth color measurements were recorded at eight time intervals: before material placement (but after tooth preparation), at 24 h, 48 h, one week, two weeks, four weeks, eight weeks, and sixteen weeks after material placement. Data were analyzed using t-test, ANOVA, repeated measure ANOVA, and Tukey HSD tests. The significance level was set at 5% for all the tests. Cervical discoloration of teeth in both experimental groups significantly increased over time (p < 0.05). However, samples in the White Mineral Trioxide Aggregate group showed more discoloration in cervical regions than Calcium-enriched mixture cement specimens after two, four, eight, and sixteen weeks (p < 0.05). Applying both White Mineral Trioxide Aggregate and Calcium-enriched mixture cement induced coronal discoloration; however, White Mineral Trioxide Aggregate samples exhibited greater cervical discoloration than Calcium-enriched mixture cement specimens after two, four, eight, and sixteen weeks.
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