Objective. Outcome of pulpectomy in 2 treatment sessions with calcium hydroxide as an intracanal dressing was compared to a procedure comprising instrumentation and root-filling in 1 session.Study design. Subjects with a vital pulp condition (N = 256) were recruited to a randomized clinical trial. Outcome parameters included radiographic signs of apical periodontitis and painful symptoms at clinical follow-ups 1 week and 1-3 years after treatment.Results. Of 244 subjects available for final recall, 17 presented with periapical radiolucency. Lesions were evenly distributed among the 2 treatment groups. Postoperative pain recorded I week after permanent filling was significantly associated with overfilling (P = .001), with no difference between treatment groups. There was no association with presence of overfilling and radiographic lesion at end point of recall.Conclusions. Study confirms that pulpectomy may be carried out at a high rate of success if due attention is given to aseptic operating procedures, proper instrumentation and filling. Under these conditions an interappointment dressing with calcium hydroxide does not seem to influence outcome.
Strengthening of Resilon-filled roots via an adhesive interface should be reflected by improvement in the interfacial strength and dislocation resistance between the root fillings and intraradicular dentin. This study compared the interfacial strengths of Resilon/Epiphany and gutta-percha/AH Plus using a thin-slice push-out test design. Failure modes of root slices after push-out testing were examined with environmental scanning electron microscopy. The gutta-percha group exhibited significantly higher interfacial strength than the Resilon group, when premature failures that occurred in Resilon root slices were included in the statistical analysis. The gutta-percha root slices failed exclusively along the gutta-percha/sealer interface. The Resilon root slices failed predominantly along the sealer/dentin interface with recognizable, fractured resin tags. Detachment of the Resilon from the Epiphany sealer was also surprisingly observed in some specimens. The similarly low interfacial strengths achieved with both types of root filling challenges the concept of strengthening root-filled teeth with the new endodontic material.
The purpose of this study was to evaluate the time needed to remove several types of fiber posts using two different bur kits. Estimates refer to the time needed to pass the fiber post until arriving at the gutta-percha. Sixty extracted anterior teeth were treated endodontically. A post space with a standard depth of 10 mm was prepared in each root canal. The sample was randomly divided into 3 groups of 20 specimens each. Three different types of posts were cemented: group 1, Conic 6% tapered fiber posts (Ghimas); group 2, FRC Poster fiber posts (Ivoclar-Vivadent); and group 3, Composipost carbon fiber posts (RTD). To remove the post, for half of each group's specimens the burs from the RTD fiber posts removal kit were used (subgroup A). From the other half of the teeth in each group (subgroup B), posts were removed by using a diamond bur and a Largo bur. Composipost carbon fiber posts (group 3) took significantly less time to remove than the other two types of posts (p < 0.05). For the bur kits, the procedure involving the use of a diamond and a Largo bur (subgroup B) was significantly faster (p < 0.05). The interaction between the type of post and the type of bur kit used was not significant (p > 0.05).
Because of inconsistency often found between in vitro testing and in vivo performance, a new restorative bonding system was evaluated by the placement of restorations in vivo in teeth to be extracted. The microleakage was determined following extraction after 3 months of clinical service. In each of the sample teeth, two restorations were placed on the labial surface, one in the middle of the enamel portion and the other extending over the cementoenamel portion. The results of this pilot study indicated that bonding to conditioned enamel with the new adhesive material is effective, and bonding to conditioned dentin appears to be clinically adequate.
The efficacy of newly developed adhesive restorative materials is commonly described by in vitro test results such as bond strength and microleakage data. Due to the inconsistency often found between in vitro testing and in vivo performance, the purpose of the present investigation was to restore teeth scheduled for extraction in vivo with an experimental restorative bonding system and to evaluate the microleakage of the restorations by common laboratory techniques following extraction after 3 months of clinical service. Two restorations were placed in each of seven anterior teeth, one in the middle of the labial enamel portion and the other labially extending over the cementoenamel junction (CEJ). Six of the seven fillings completely surrounded by enamel showed no microleakage. However, two of the restorations crossing the CEJ revealed microleakage originating from the cervical margins. In spite of the small number of fillings assessed, the experimental enamel-dentin adhesive compound tested is preliminarily considered a promising new system.