CLINICAL TECHNIQUE: It is generally accepted that the success of root-canal treatment is mainly dependent on the proper cleaning, shaping and hermetic obturation of root canals. Obturation of the root canal is of importance as 60% of endodontic failures are attributable to incomplete obliteration of the root-canal system. The clinical application of many obturation techniques used today demands the preservation of the natural apical construction or the preparation of an artificial equivalent during chemo-mechanical preparation. However, in clinical practice there are cases where the apical foramen is wide because of over-instrumentation, root-end resection during periradicular surgery, root resorption or because the apex of the root is incompletely formed. Thus the preparation of an artificial apical stop is very difficult to achieve. It is a common experience that performing usual gutta-percha condensation techniques in such canals often results in overfilling and therefore special obturation techniques are needed. Some clinical cases of teeth with wide apical foramen treated by a special obturation method are presented in this paper. In this method the end point of the primary gutta-percha cone is elasticized with a heated instrument and inserted into the root canal to record the internal morphology of the apical portion.

Background. Esophagogastroduodenoscopy (EGD) and colonoscopy (CS) can evoke anxiety, embarrassment, and discomfort. These concerns can culminate in panic attacks, which may traumatize patients and significantly decrease their compliance to the procedure. The objective of this study was to evaluate the relationship between preendoscopic anxiety and the possibility of a panic attack during an elective gastrointestinal endoscopy (EGE). Methods. The study population comprised of 79 Greek outpatients. The examination was carried out without the use of conscious sedation. Patients' anxiety levels were assessed before the procedure using the Greek version of the Spielberger State-Trait Anxiety Inventory (STAI-Y). Results. Seventy-nine patients were enrolled: 45 EGD and 34 CS. Females had higher state and trait anxiety levels than males (48.14 ± 7.94 versus 44.17 ± 7.43, P < 0.05; and 43.68 ± 6.95 versus 39.86 ± 7.46, P < 0.05). Patients who experienced panic attack had significantly higher levels of both trait and state anxiety, compared to those who were panic-free. There was no significant relationship between panic attacks and sex or type of procedure. Conclusions. Patients who experience panic attacks during endoscopic procedures appear to have significantly higher anxiety levels before the procedure. Administering the STAI questionnaire prior to the endoscopy seems to be a useful screening method for vulnerable patients.