ENDO, 04/2015

Aim: To review the literature over the last 10 years on AH Plus, focusing on physicochemical properties, penetration of dentinal tubules, influence on the resistance to vertical root fracture, adhesion, antibacterial effect, biocompatibility, tooth discolouration, retreatability and the effect of increased temperature. Methodology: An electronic search in the database PubMed for 2005 to 2014 was performed using the search term 'AH Plus'. Only original research publications were selected; reviews, case reports, studies not focusing on sealers and studies dealing with sealing ability or where leakage of sealers was investigated were excluded. Results: 610 publications were found from which 180 were selected for this review. There was great variance in the results of these studies. Concerning penetration into dentinal tubules, adhesion to the root canal wall, antibacterial effects, biocompatibility, removal during retreatment, effect of increased temperature, AH Plus performed equal or even superior compared to other sealers. Setting time and dimensional change did not completely fulfill the requirements of the ISO 6876 and ANSI/ADA No. 57 specifications in all studies. Discolouration may appear after application of AH Plus into the pulp chamber. Conclusion: Most of the studies confirmed that AH Plus fulfills the requirements of a root canal filling material as defined by the specifications for root canal filling materials and the guidelines of the European Society of Endodontology (ESE). Keywords: adhesion, AH Plus, biocompatibility, physicochemical properties, root canal sealer

There is a narrow margin between success and failure of root canal treatment due to the complex anatomy of the root canal system. Visualisation of the complexity of the root canal system is offered by the impressive anatomical images taken by Walter Hess, an anatomist from Zurich, at the end of the last century. The endodontium includes, in total, the main communicating root canals, numberless small lateral canals and several ramifications. In the dental practice, the location, shaping and sealing of root canals which are closely related and have ramifications, represent a special challenge for the clincian and is very often an almost insolvable task. This highlights how the knowledge of anatomy decides the technical parameters of the root canal treatment and, at the same time, it decides upon the probability of success. Therefore, the following overview presents explanations concerning the incidence and classifications of ramifications and lateral canals in the literature and their clinical significance, as well as the resulting consequences and the treatment strategies illustrated by several clinical cases. Keywords: access cavity, branched root canal systems, dental operating microscope, intracanal endodontic diagnostics, tooth anatomy

Technological advances in optics, computer systems and materials have introduced new strategies in the application of minimal intervention within the scope of endodontics, without compromising treatment efficiency and effectiveness. Although the prevalence of dental diseases and the provision of dental services vary in different countries, the same general principles of prevention must apply throughout the world. This article aims to present different perspectives in the application of minimally invasive endodontics in the light of prevention strategies and dental education, centred on the patient's long-term care. Keywords: education, endodontics, minimal intervention, prevention

Fusion is an uncommon abnormality resulting from the joining of adjacent tooth germs in different stages of development. The prevalence of this anomaly in permanent teeth is approximately 0.1%. Fused teeth can lead to different complications and usually require a multidisciplinary approach. This case report presents the use of cone beam computed tomography evaluation and retreatment of a fused maxillary lateral incisor and canine. Keywords: anatomic variations, canine, CBCT, fusion, lateral incisor

The final success of root canal treatment depends on the correct diagnosis of the endodontic disease and the knowledge of pulp chamber and root canal anatomy. The anatomy of the roots is always complex because of its variability; there are secondary canals, apical deltas, anastomoses, isthmuses and apical curvatures. The root canal treatment becomes more and more difficult when clinicians have to treat teeth with anatomical anomalies. This article reports two infrequent cases of mandibular anterior teeth with root anomalies. The first one is a mandibular incisor with three root canals treated in one visit through an endodontic laserassisted treatment to enhance the decontamination of root canals. The second one is a clinical case of a mandibular canine with two roots and two canals treated with conventional root canal treatment and subsequently rehabilitated with a fibre post and complete metal-ceramic crown. The aim of this article is to point out the importance of the correct study of the root anatomy before root canal treatment, based on accurate radiographic evaluation. Keywords: anatomical anomalies, diagnosis in endodontics, mandibular canine, mandibular incisors, root canal treatment