Like most dentists, I first heard the name Jens Andreasen when I was a dental student in the 1970s, but little did I realize, or even imagine, back then the influence that Jens had already had on our profession and especially on the subject of dental traumatology, as well as how that influence would grow on me over the ensuing years. In the 1980s, I had the great fortune to study endodontics under the mentorship of Geoffrey Heithersay in Adelaide, Australia. Geoff and Jens were great friends. Geoff often talked about Jens with insights into his work and papers before they had been published because of their personal friendship. As I became more and more interested in dental traumatology, my admiration for Jens increased exponentially. Then, in 2007, when I was dean of the dental school in Perth, Western Australia, I invited Jens to be a visiting professor. He spent 2 wonderful weeks with our staff and graduate and undergraduate students—what an opportunity that was for everyone here! Jens was incredibly generous with his time, not just during that visit but for his entire career. He lectured all over the world and with multiple visits to many places.

Avulsion of permanent teeth is one of the most serious dental injuries, and a prompt and correct emergency management is very important for the prognosis. The International Association of Dental Traumatology (IADT) has developed a consensus statement after a review of the dental literature and group discussions. Experienced researchers and clinicians from various specialties were included in the task group. The guidelines represent the current best evidence and practice based on literature research and professionals' opinion. In cases where the data did not appear conclusive, recommendations were based on the consensus opinion or majority decision of the task group. Finally, the IADT board members were giving their opinion and approval. The primary goal of these guidelines is to delineate an approach for the immediate or urgent care of avulsed permanent teeth.

Instrumentation creates space for canal irrigation, disinfection and root filling. All of these have an impact on the method and size of instrumentation, depending on the philosophy of the dentist and the limitations and requirements set by the equipment used in each phase, especially in root filling. Optimal root filling has many requirements which have been difficult if not impossible to fulfill. Gutta-percha has been and still is the core material of choice in root fillings, but it requires the use of a sealer in order to obtain better short term and long term seal. However, numerous studies on leakage after root filling have suggested that complete, permanent sealing of the canal against leakage from the oral cavity is usually not obtained. This review takes a critical look at presently available methods for canal instrumentation and filling, and challenges these as far less than optimal with regard to ease of operation, time and technical skills required, weakening of the root/tooth structure and quality of the seal. The authors discuss the above factors from the point of view of bioceramic materials in root filling. Is there a hope of a better future in root filling?

Introduction: Patient preferences should be taken into account by clinicians when treatment planning. The purposes of this study were to describe the number of visits patients preferred when undergoing root canal therapy (RCT) and to assess whether their preferences were related to hypothetical treatment success rates. Methods: Self-administered questionnaires were mailed to 351 consecutive patients scheduled for initial RCT appointments in the University of Iowa College of Dentistry's graduate or faculty endodontic clinic. The questionnaires ascertained demographic information; preferences for 1-visit versus 2-visit RCT given different hypothetical success rate scenarios for the 2 approaches, as well as patient dental history. Univariate frequency distributions were generated, and relationships between hypothetical success rates and patient preferences were evaluated. Results: Questionnaires were returned by 124 patients (35% response). Given equal success rates, 78% of respondents preferred 1-visit RCT, compared with 7% who preferred 2-visit RCT and 16% who would follow their dentist's recommendation. As success rates for 2-visit RCT went from equal to 5% better to 10% better to 20% better compared with 1-visit RCT, the proportion of respondents who preferred 2-visit RCT increased from 7% to 34% to 46% to 65%, respectively. Regardless of success rates, approximately 5% of respondents said they would prefer 2-visit RCT, and 20% would do whatever their dentist recommended. Conclusions: Although most respondents preferred 1-visit RCT regardless of success rates, many would prefer 2-visit RCT if its success rate were greater than that of 1-visit RCT. This finding confirms the importance of discussing success rates and considering patients' wishes when treatment planning. (J Endod 2012;38:1322-1325)

OBJECTIVE: The aim of this in vitro study was to evaluate the bond strength of different root canal sealers to dentin. MATERIAL AND METHODS: Forty extracted single-rooted human teeth were examined and the coronal and middle thirds of the canals were prepared with a 1.50 mm post drill (FibreKor Post System, Pentron). The teeth were allocated in two experimental groups, irrigated with 2.5% NaOCl+17% EDTA or saline solution (control group) and instrumented using Race rotary files (FKG) to a size #40 at the working length. Then, the groups were divided into four subgroups and filled with Epiphany sealer (Group 1), EndoREZ (Group 2), AH26 (Group 3) and Grossman's Sealer (Group 4). After 2 weeks of storage in 100% humidity at 37ºC, all teeth were sectioned transversally into 2-mm-thick discs. Push-out tests were performed at a cross-head speed of 1 mm/min using a universal testing machine. The maximum load at failure was recorded and expressed in MPa. RESULTS: Means (±SD) in root canals irrigated with 2.5% NaOCl and 17% EDTA were: G1 (21.6±6.0), G2 (15.2±3.7), G3 (14.6±4.5) and G4 (11.7±4.1).Two-way ANOVA and Tukey's test showed the highest bond strength for the Epiphany's group (p< 0.01) when compared to the other tested sealers. Saline solution decreased the values of bond-strength (p<0.05) for all sealers. CONCLUSION: Epiphany sealer presented higher bond strength values to dentin in both irrigating protocols, and the use of 2.5% NaOCl and 17% EDTA increased the bond strength values for all sealers.

This paper presents clinical protocols for the emergency, early and post treatment complications of the avulsed tooth. The biological basis for these protocols is presented so that the reader understands the clinical decisions that have been made. Most of the protocols described in this article, but not all, have been adopted in the official guidelines of the International Association of Dental Traumatology. Some experimental results are promising and they have therefore been included in the review to stimulate colleagues to further research.

INTRODUCTION:The effect of endodontic involvement on tooth loss has not been quantified, so the present study aimed to assess this relationship after controlling for other relevant risk factors for tooth loss. METHODS:We analyzed data from 791 participants (18,798 teeth) in the Veterans Affairs Dental Longitudinal Study. Potential tooth-level and person-level covariates were fitted into marginal proportional hazards models, including both apical radiolucencies (AR) and root canal therapy (RCT) status as time-dependent variables. Survival curves were plotted for teeth according to their AR and RCT status. RESULTS:Both current AR and RCT status were associated with increased risk of tooth loss (P < .01), after controlling for baseline levels of periodontal disease, caries, tooth type, number of proximal contacts, number of teeth, age, education, and smoking history. Root canal filled (RCF) teeth seemed to have better survival than non-RCF teeth among teeth with AR but worse survival than non-RCF teeth among teeth without AR. CONCLUSIONS:Endodontic involvement was associated with tooth loss, controlling for other potential risk factors. Additional prospective studies are needed to provide better evidence as to the impact of endodontic involvement on tooth loss.

Journal of Esthetic and Restorative DentistryVolume 22, Issue 3 p. 178-178 COMMENTARY. “biological restoration”: root canal and coronal reconstruction Martin Trope DMD, Martin Trope DMD Adjunct Professor UNC, Clinical Professor, University of Pennsylvania, 1601 Walnut Street, Suite 40, Medical Arts Building, Philadelphia, PA 19102, USASearch for more papers by this author Martin Trope DMD, Martin Trope DMD Adjunct Professor UNC, Clinical Professor, University of Pennsylvania, 1601 Walnut Street, Suite 40, Medical Arts Building, Philadelphia, PA 19102, USASearch for more papers by this author First published: 02 June 2010 https://doi.org/10.1111/j.1708-8240.2010.00332.xCitations: 3 This commentary is accompanied by article, “‘Biological Restoration’: Root Canal and Coronal Reconstruction,” Patrícia Corrêa-Faria, DDS, Carlos Eduardo Pinto de Alcântara, DDS, Marcus Vinícius Caldas-Diniz, DDS, Adriana Maria Botelho, MS, PhD, Karine Taís Aguiar Tavano, DOI 10.1111/j.1708-8240.2010.00331.x Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume22, Issue3June 2010Pages 178-178 RelatedInformation

The purpose of this study was to assess the healing of periapical tissues using three different materials (IRM [L.D. Caulk Inc, Dentsply International Inc, Milford, DE], Geristore [Den-Mat, Santa Maria, CA], and MTA [ProRoot MTA; Dentsply Tulsa Dental Specialties, Tulsa, OK]) after endodontic microsurgery in an animal model. Using beagle dogs as a study model, 48 bicuspids were accessed, instrumented, and intentionally infected. The surgical procedures were performed after 30 days following the radiographic confirmation of periapical radiolucencies. The root canals were still infected and had no disinfection procedure carried out. The root ends were resected, retrograde preparations were completed, and the experimental materials were placed under surgical operating microscopy. After a period of 6 months, digital radiographic images of the periradicular areas were taken. The samples were prepared for histologic evaluation. Although Geristore showed no radiographic difference when compared with the other groups, it showed the least favorable healing in the histologic evaluation. Our histologic and radiographic results showed no statistical difference between MTA and IRM.

Objective. Despite not having been formally evaluated in the endodontic literature, claims have been made regarding the acceptability of the paper point technique (PPT) in estimating the location of the apical foramen (AF). Our aim was to investigate the repeatability and accuracy of PPT in estimating AF location in a cohort of dental patients.Study design. Root canals with <= 10 degrees of curvature (n = 71) in unsalvageable anterior and premolar teeth were measured using PPT as described in the literature. An endodontic file was cemented in each canal to the position indicated by PPT. Teeth were extracted and microscopic computerized tomography scanned.Results. The PPT was 0.5 mm short to 0.5 mm long of AF in 87% of the canals. Repeated measurements in a given canal were within 0.19 mm of each other 95% of the time.Conclusion. For relatively straight root canals, PPT appears to be similar to current clinically acceptable techniques in estimating AF location. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;108:e101-e105)

This study investigated the effect of potent intracanal corticosteroids on periodontal healing of replanted avulsed teeth and evaluated the systemic absorption of these corticosteroids. Sixty-seven extracted dog premolar roots were randomly assigned to one of the following groups: groups 1-3 filled with gutta-percha and replanted immediately and after 40 and 60 minutes, respectively; groups 4 and 5 filled with 0.05% clobetasol; and groups 6 and 7 filled with 0.05 % fluocinonide. Groups 4 and 6 were replanted after 40 minutes and groups 5 and 7 after 60 minutes. After 4 months, roots were evaluated histologically for signs of periodontal healing. Roots treated with clobetasol and fluocinonide healed more favorably than roots filled with gutta-percha and were different from each other at 60 minutes. No change in the systemic corticosteroid blood concentration was observed in any group. Corticosteroids were efficacious in the beagle model as intracanal medicaments for promoting favorable postavulsion periodontal healing.

The purpose of this study was to assess the knowledge of elementary school staff members regarding the management of traumatic dental injuries (TDI) before and after an educational intervention aimed to increase TDI knowledge. Using a newly developed reliable survey instrument, we tested our elementary school staff participants about TDI before (time(0)), immediately after (time(1)), and three months after (time(2)) the intervention. Schools were randomized into three groups: no intervention/control (C), pamphlets (P), and pamphlets + lecture (P + L). Outcomes of interest were TDI knowledge over time relative to the interventions vs controls. Statistical analysis involved a repeated measures linear model. At time(0), TDI knowledge was low among all three groups. At time(1), knowledge increased among all groups and is given by P > P+L > C. For time(2) vs time(1), the P + L group retained the knowledge while in both the C and P groups the knowledge level decreased. Between time(1) and time(2), significant differences were found between both intervention groups when compared with the control (P vs C and P + L vs C: both P < 0.05). In summary, both P and P + L groups significantly improved TDI knowledge among elementary school staff, and this difference held up over time. These interventions have the potential to improve TDI management by elementary school staff when faced with such injuries.

We evaluated the association between radiographically assessed extension and density of root canal fillings and postoperative apical radiolucencies (ARs) by using data from 288 participants in the Veterans Affairs Dental Longitudinal Study. Study subjects were not Veterans Affairs patients; all received their medical and dental care in the private sector. Generalized estimating equations were used to account for multiple teeth within subjects and to control for covariates of interest. Defective root filling density was associated with increased odds of postoperative AR among teeth with no preoperative AR (odds ratio, 3.0; 95% confidence interval [CI], 1.3-7.1), although preoperative AR was the strongest risk factor for postoperative AR (odds ratio, 29.2; 95% CI, 13.6-63.0 among teeth with ideal density). Compared with well-extended root fillings, neither overextended nor underextended root fillings separately were related to postoperative AR, but when those 2 categories were collapsed into one poorly extended category, poor extension was related to postoperative AR (odds ratio, 1.8; 95% CI, 1.1-3.2).

The purpose of this study was to assess the knowledge of elementary school staff members regarding the management of traumatic dental injuries (TDI) before and after an educational intervention aimed to increase TDI knowledge. Using a newly developed reliable survey instrument, we tested our elementary school staff participants about TDI before (time(0)), immediately after (time(1)), and three months after (time(2)) the intervention. Schools were randomized into three groups: no intervention/control (C), pamphlets (P), and pamphlets + lecture (P + L). Outcomes of interest were TDI knowledge over time relative to the interventions vs controls. Statistical analysis involved a repeated measures linear model. At time(0), TDI knowledge was low among all three groups. At time(1), knowledge increased among all groups and is given by P > P+L > C. For time(2) vs time(1), the P + L group retained the knowledge while in both the C and P groups the knowledge level decreased. Between time(1) and time(2), significant differences were found between both intervention groups when compared with the control (P vs C and P + L vs C: both P < 0.05). In summary, both P and P + L groups significantly improved TDI knowledge among elementary school staff, and this difference held up over time. These interventions have the potential to improve TDI management by elementary school staff when faced with such injuries.

The aim of this in vitro study was to evaluate the bond strength of Epiphany resin-based sealer to dentin walls after placement of calcium hydroxide [Ca(OH)2] dressings. Fifteen extracted single-rooted human teeth were instrumented using 2.5% NaOCl + EDTA as irrigants. The teeth were randomly assigned to 3 groups (n=5), according to the intracanal dressing: G1= Ca(OH)2 + saline; G2= Ca(OH)2 + 2% chlorhexidine gluconate (CHX) gel; and G3= saline (control). After 10 days of storage in 100% humidity at 37 degrees C, the dressings were removed and the root canals were filled with Epiphany sealer. After additional 48 h of storage, the specimens were sectioned transversally into 2-mm-thick discs. Push-out tests were performed (1 mm/min, Instron 4411) and the maximum loads at failure were recorded in MPa. One-way ANOVA and Newman-Keuls tests showed a statistically significant decrease in bond strength when a Ca(OH)2 dressing was used before root canal filling with Epiphany (G1= 10.18 +/- 1.99 and G2= 9.98 +/- 2.97) compared to the control group (13.82 +/- 3.9) (p< 0.05). It may be concluded that the use of Ca(OH)2 as an intracanal dressing material affected the adhesion of Epiphany to the root canal walls, but even though the values were within the acceptable range found in the literature.