Lack of Correlation Between the Penetration of Two Types of Sealers and Interfacial Adaptation to Root Dentine.

OBJECTIVE: This study aimed to determine the correlation between sealer penetration into dentinal tubules and interfacial adaptation to root canal walls using a hydraulic calcium silicate-based sealer, Endosequence Bioceramic Sealer (Brasseler USA, Savannah, GA, USA), and an epoxy resin-based sealer, AH Plus (Dentsply DeTrey, Konstanz, Germany). METHODS: Sixty-four maxillary central incisors were endodontically prepared with nickel-titanium rotary instruments and randomly assigned into two groups (n=32). Roots were filled with gutta-percha using a single-cone technique in conjunction with one of the two sealers, AHP or BCS. Sealers were mixed with Rhodamine B and analysed under a confocal laser scanning microscope. Transverse sections at 5 mm from root apex were obtained. The circumference of the root canal wall was first outlined and measured to determine the circumferential percentage of sealer penetration. The regions along the canal walls where the sealer had penetrated the dentinal tubules were delineated and measured. Then, the outlined distances were divided by the canal circumference. The width of each gap was measured and pooled for each specimen for comparison to determine the interfacial adaptation. The measurements were repeated twice to ensure reproducibility. Mann-Whitney tests were performed to compare continuous variables between AHP and BCS groups. The correlation between gap width and percentage of sealer penetration was investigated using the Spearman correlation coefficient. RESULTS: No significant difference was observed between groups regarding the percentage of sealer penetration (P>0.05) and the gap width (P>0.05). Also, there was no significant correlation between the two variables analysed for AHP (r=0.165; P>0.05) and BCS (r=-0.147; P>0.05) and in the overall sample (r=0.061; P>0.05). CONCLUSION: The present results show no correlation between interfacial adaptation and sealer penetration in dentinal tubules in the total sample and among sealer subgroups. The ability of root canal sealers to penetrate dentinal tubules cannot be considered a sign of better interfacial adaptation.

Influence of the Maxillary Sinus on the Accuracy of the Root ZX Apex Locator: An Ex Vivo Study.

This study evaluated the accuracy of the Root ZX (J. Morita, Tokyo, Japan) electronic apex locator in determining the working length when palatal maxillary molar roots are in a relationship with the sinus. Seventeen human maxillary molars with vital pulp were scheduled for an extraction and implant placement as part of a periodontal treatment plan. The access cavity was prepared, and a #10 K file (Dentsply Maillefer, Ballaigues, Switzerland) was inserted into the palatal root using the Root ZX apex locator in order to determine the electronic working length (EWL); then, the teeth were extracted. To determine the real working length (RWL), a #10 K file was introduced into the root canal until its tip touched a glass plate. EWL and RWL were compared. Images reconstructed with CBCT (cone beam computerized tomography) revealed that eight palatal roots were related to the maxillary sinus, whereas nine were not. The results showed a significant difference between the EWL and the RWL of the palatal roots related to the sinus (p < 0.001). No significant difference was observed in measurements of roots not in contact with the sinus (p > 0.05). Within the study limitations, the reliability of Root ZX was influenced by the relationship of the roots with the maxillary sinus.

Bone Lid Technique Using a Piezoelectric Device for the Treatment of a Mandibular Bony Lesion.

Different techniques for the enucleation of jaw cyst lesion in the oral and maxillofacial regions have been proposed, including the bone lid technique. The purpose of this case report is to describe the case of a cystic lesion, approached with the bone lid technique performed using a piezoelectric device, with an 8-month clinical and radiographic follow-up. A 14-year-old male patient was treated for a suspicious lesion detected on a panoramic radiograph. The concerned area was surgically accessed, and a radiographically predetermined bony window was drawn, and the beveled bony lid was removed. The underlying lesion was enucleated and sent for pathology as a routine procedure, and the removed bony lid was repositioned in situ and secured with a collagen tape. Healing was uneventful with limited swelling and reduced pain. A complete radiographic bone healing at the previously diseased site was confirmed with an 8-month cone beam computed tomography (CBCT) scan with no buccal bone resorption nor ridge collapse. The bone lid technique with a piezoelectric device was noninvasive and atraumatic in this case. Further studies are needed and could lead to the adaptation of this approach as a possible standard of care.