Survey of attitudes, materials and methods preferred in root canal therapy by general dental practice in Turkey: Part 1.

OBJECTIVE: To gather information on the materials and methods employed in root canal treatment by dentists in Turkey. METHODS: A questionnaire was distributed to 1,527 dentists who attended the Turkish Dental Association Congress. Respondents were asked to choose one or more suitable answers for the questions. Data was gathered for demographic and professional information regarding stages, materials, and methods commonly used in endodontic therapy. The collected data was analyzed using the statistical package SPSS. Descriptive statistics were given as frequencies (n) and percent (%). Chi-square (χ(2)) test was used to investigate the influence of gender and the years of professional activity for the materials and techniques employed. RESULTS: The response rate was 49%. A total of 97% of respondents were working in a general dental practice. Of respondents, 44% were using an agent containing arsenic or aldehyde. Only 5.1% of the respondents preferred the rubber dam isolation method. Sodium hypochlorite was the most popular choice (73%) as a root canal irrigation solution. Calcium hydroxide was the most commonly used medicament (53%). Most of the practitioners (77%) preferred radiographs for working-length determination. Root canal preparation done solely with K-Files or in combination with other instruments was preferred by 73.1% of the respondents. Ni-Ti hand or rotary files were used by 79.7% of the practitioners. Polymer based root canal sealers were the sealers most frequently chosen (48.4%). The majority of the respondents (66.2%) preferred cold lateral condensation as an obturation technique. Gender affected the preference of intracanal medicament, periapical radiographs for working-length determination, root canal instrument, root canal sealers, and root canal obturation technique (P<.05). Years of professional experience affected the preference of devitalizing agents, irrigation solutions, intracanal medicament, root canal instrument, root canal sealer, and root canal obturation technique (P<.05). CONCLUSIONS: It is clear that a number of dentists, irrespective of the time elapsed since their graduation, relied on techniques, and used products and materials that are currently favoured by expert opinion. Unfortunately, it was noted that some practitioners are still using arsenic- and aldehyde-containing devitalizing agents, and most did not use rubber dam as an isolation method.

Root canal shaping using rotary nickel-titanium files in preclinical dental education in Turkey.

The purposes of this study were to evaluate the ability of a group of third-year dental students without any endodontic clinical experience to use the ProTaper Instruments (Dentsply Maillefer) to decrease the amount of straightening of curved canals on human molar teeth and to determine the incidence of instrument fractures and instrumentation time. Thirty-one undergraduate dental students in Turkey received a training session. The students prepared a total of 144 root canals in human mandibular or maxillary molar teeth with ProTaper. Fifty-six teeth were excluded due to unreadable image, misinformation, or straight or severe curve. Using pre- and post-preparation digital radiographs, the straightening of curved root canals was investigated. Loss of working length and incidence of fracture were also noted. A total of eighty-eight curved root canals were selected. Mesiobuccal or mesiolingual roots with curvatures of between 20° and 43° as assessed by Schneider's method and working length of between 15 mm and 22.5 mm were included in the study. The means of the curved root canals before and after the instrumentation were 29.5° ± 6° and 27° ± 6.3°, respectively. The means of the working length before and after the instrumentation were 19 mm ± 2.1 mm and 18.3 mm ± 1.9 mm, respectively. A statistically significant difference between straightening of curved root canals and loss of working length was found between before and after instrumentation (p<0.000). The mean straightening of curved root canals and loss of working length after preparation with the size F1 ProTaper file were 2.5 mm ± 3.6 mm and 0.7 mm ± 0.6 mm, respectively. Only two F1 ProTaper instruments fractured at the apical level. The study concluded that rotary instruments performed adequately with inexperienced operators who received a brief structured training session.

Quality of root canal fillings performed by undergraduate dental students.

OBJECTIVES: The purpose of this study was to evaluate the radiographic quality of root canal fillings performed by first and second clinical year dental students at the Faculty of Dentistry in Süleyman Demirel University, Turkey. METHODS: The technical quality of 833 root canal fillings was evaluated by three examiners according to the density of the filling and the distance between the end of the filling and the radiographic apex. A root canal with acceptable filling length and homogeneous root filling was defined as being good quality endodontic work (GQEW). A treated tooth was defined as having good quality endodontic work tooth (GQEW-T) when all its canals had a GQEW rating. RESULTS: A Chi-square (χ(2)) test at the 0.05 significance level was used for the statistical analysis of the data. Of a total of 833 root canals, 662 (79.47%) root fillings were classed as GQEW. Two hundred fifty canals (73.4%) (135 teeth) treated by first clinical year dental students were defined as GQEW-T while 412 canals (204 teeth) (73.9%) treated by second clinical year dental students were defined as GQEW-T (P>.05). Most of the GQEW-T were defined in anterior teeth (90.1%), whereas the fewest were in molar teeth (46.6%) for both first and second clinical year dental students (P<.001). CONCLUSIONS: The quality of root canal fillings in anterior teeth performed by undergraduate dental students in Isparta, Turkey was satisfactory. However, to improve the success with molar teeth, education about newer techniques and instruments must be incorporated into the preclinical and clinical curriculum.

Repair of Furcal Iatrogenic Perforation with Mineral Trioxide Aggregate: Two Years Follow-up of Two Cases.

Furcal perforation is usually an undesired complication that can occur during preparation of endodontic access cavities or exploring canal orifice of multirooted teeth. Inadequacy of the repair materials has been a contributing factor to the poor outcome of repair procedures. On the basis of the recent physical and biologic property studies of the relatively new introduced mineral trioxide aggregate, this material may be suitable for closing the communication between the pulp chamber and the underlying periodontal tissues. There are few reports on repair of furcal perforation with MTA in molar teeth. The purpose of this case report was to describe the treatment of two furcal perforation using MTA in molar teeth. The perforations were cleaned with NaOCl and saline solution and sealed with MTA without internal matrix. Finally, the teeth were endodontically treated and coronally restored with composite resin and ceramic veneer crown and bridge. After 2 years, the absence of periradicular radiolucent lesions, pain, and swelling along with functional tooth stability indicated a successful outcome of sealing perforations in two cases.

Comparative investigation of 2 rotary nickel-titanium instruments: protaper universal versus protaper.

OBJECTIVE: The objective of this study was to evaluate whether the changes in the design of the ProTaper canal instruments contribute to the shaping ability of the instrument in terms of the morphology of curved canals measured by the cross-sectional area using the Bramante method. STUDY DESIGN: Ten extracted human mandibular molars with root canal curvatures between 25 degrees and 41 degrees were used. Ten mesiobuccal canals were instrumented with ProTaper and 10 mesiolingual canals were instrumented with ProTaper Universal rotary instruments. Pre- and postoperative sections were obtained from the coronal, middle, and apical portions and analyzed. Statistical analysis was performed using the Student t test (P < .05). RESULTS: No statistically significant difference was observed in terms of amount of dentin removed, transportation, variation of canal shape factor or change in working length, and working time (P > .05). Only one instrument fracture (F2 in the ProTaper group) and 2 instrument deformations (S1 and F3 in ProTaper and ProTaper Universal, respectively) were noted. CONCLUSION: Within the limitations of this study, the modifications on ProTaper instruments were found to not create any discrepancy on the shaping abilities of instruments and the evaluated other factors. In addition, both rotary nickel-titanium instruments prepared a well-shaped root canal with minimal canal transportation.

A successful treatment of vertical root fracture: a case report and 4-year follow-up.

This case report describes a successful treatment of vertically fractured tooth which was reconstructed with a self-etching dual-cured adhesive resin cement and intentionally replanted without using rotation in conjunction with a bio-absorbable barrier membrane. At a follow-up consultation 4 years later, the tooth was asymptomatic, and attachment gain and bone regeneration were observed. In addition, no ankylosis was detected clinically or radiographically.