When Maxillofacial CBCT Permits Fortuitously to Diagnose Primary Non-Hodgkin's Lymphoma: A Case Report.

A 47-year-old male with an unremarkable medical history was referred for atypical endodontic pain and treatment of his left upper molars. Clinical and radiographic examinations revealed an extensive, undefined osteolytic area around these teeth. A subsequent bone biopsy diagnosed diffuse large B-cell lymphoma, a high-grade non-Hodgkin's lymphoma. The hematology team prescribed six cycles of chemotherapy, supplemented by two cycles of methotrexate. Practitioners should be alerted by atypical tooth pain to consider 3D imaging to exclude malignant pathology as early as possible. Teaching point: An atypical tooth pain should alert the practitioner and guide them towards 3D imaging to eliminate diagnostic of malignant pathology as early as possible.

Comparative analysis of canal transportation and centring ability of three Ni-Ti rotary endodontic systems: Protaper®, MTwo® and Revo-S™, assessed by micro-computed tomography.

The aim of this study was to use high-resolution micro-CT to evaluate the effects of three Ni-Ti rotary endodontic instruments, Mtwo® (VDW, München, Germany), ProTaper® (Dentsply-Maillefer, Ballaigues, Switzerland) and Revo-S™ (MicroMega, Besançon, France), on canal transportation and centring ratio. Fifty-four mesial roots of extracted mandibular molars with an angle of curvature of 25-35° were randomly divided into three groups of eighteen. Each group was instrumented with a previously unused Ni-Ti rotary system. The final instruments used were #30/0.05 taper (Mtwo®), F3 #30/0.09 apical taper (ProTaper®) and AS30 #30/0.06 taper (Revo-S™). Teeth were scanned before and after instrumentation using micro-computed tomography with a spatial resolution of 20 µm to measure volume and shaping changes. All images were filtered to improve signal-to-noise ratio. To determine the perimeter of roots and canals exactly, images were segmented in each slice with an edge detection process. Canal transportation and centring ratio were evaluated at 1, 3, 5 and 7 mm from the end of each root. The method developed by Gambill et al. was chosen. ANOVA was conducted with the significance threshold set at p < 0.05. No statistically significant differences were found among the three groups in terms of canal transportation or centring ratio at any level. These systems give similar results with regard to the tested shaping parameters. Under the tested conditions and within the limitations of this study, these systems were able to produce centred preparations of curved canals with minimal transportation.

Sealer penetration and adaptation in the dentinal tubules: a scanning electron microscopic study.

INTRODUCTION: Tubular penetration and adaptation of the sealer can determine the sealability of the root filling. The aim of this study was to assess, in vitro, the tubular adaptation and penetration depth and the adaptation to the root canal walls in the apical, middle, and coronal third of the root canal of 5 different sealers used in combination with softened gutta-percha cones. METHODS: Fifty-two single-rooted teeth were prepared and filled with 5 different sealers and softened gutta-percha cones. Thereafter, the roots were cross-sectioned and prepared for scanning electron microscopic evaluation. Adaptation of the sealer to the root canal and tubular walls and tubular penetration were assessed. RESULTS: AH Plus (Dentsply De Trey, Konstanz, Germany), an epoxy resin sealer, showed the best tubular adaptation and penetration. CONCLUSIONS: The tubular penetration and adaptation varies with the different physical and chemical properties of the sealers used. AH Plus showed the most optimal tubular penetration and adaptation to the root canal wall of the sealers tested.