ENDO, 03/2016

Due to the biologic nature of endodontic diseases; the complex anatomy of the root canal; and the shortcomings and limitations of currently available instruments and materials for root canal treatment; the occurrence of problems is an immanent part of root canal treatment and consequently anticipation, prevention and management of such problems should be part of any treatment concept. The following paper tries to identify several major problems during root canal treatment and suggests a problem-based treatment approach, in order to prevent the occurrence of such issues. Beginning with diagnosis, differential therapy, estimation of degree of case difficulty, preparation of the access cavity, management of intracanal problems, a number of clinically relevant topics will be addressed. The aim of the following review is to convince the reader to accept problems as a part of daily endodontic treatment; to anticipate possible problems as a part of treatment planning; and to include prevention and management of problems into the routine concept for each root canal treatment. Keywords: management, prevention, problems, root canal treatment

Due to the biologic nature of endodontic diseases, the complex anatomy of the root canal, and the shortcomings and limitations of currently available instruments and materials for root canal treatment, the occurrence of problems is an immanent part of root canal treatment and consequently anticipation, prevention and management of such problems should be part of any treatment concept. The following paper tries to identify several major problems during root canal treatment and suggests a problembased treatment approach in order to prevent the occurrence of such problems. Beginning with diagnosis, differential therapy, estimation of degree of case difficulty, preparation of the access cavity and management of intracanal problems, a number of clinically relevant topics will be addressed. The aim of the following review is to convince the reader to accept such problems as a part of daily endodontic treatment; to anticipate possible problems as a part of the treatment planning; and to include prevention and management of problems in the routine concept for each root canal treatment. Keywords: management, prevention, problems, root canal treatment

Objective: To evaluate the incidence and severity of postoperative pain and analgesics intake after root canal treatment of molars using single file systems: WaveOne (WO; Dentsply Maillefer, Ballaigues, Switzerland) and One Shape (OS; Micro Méga, Besançon, France) versus the Self Adjusting File (SAF; ReDentNova, Ra'anana, Israel). Methods: One hundred and forty-one patients with vital molars indicating for conventional singlevisit root canal treatment were randomly assigned to one of three groups (n = 47) according to the instrumentation system used: WaveOne, One Shape and SAF. Participants were asked to rate the intensity of postoperative pain on a Functional Pain Scale and to record the quantity of prescribed analgesic medication taken after 24 h, 48 h, 72 h and 7 days. Data were statistically analysed using SPSS software (version 20; Chicago, Illinois, USA). Intergroup analysis was performed using the Kruskal-Wallis, followed by Mann-Whitney U tests for intragroup comparison. The Friedman test was applied for comparison between different time intervals. The level of significance was set at P 0.05. Results: Patients treated with the SAF system were associated with significantly less postoperative pain and lower analgesic intake compared to the other two groups at the four timepoints assessed. Conclusion: The SAF system caused less postoperative pain and lower intake of analgesic medication at the timepoints assessed. Keywords: Nickel-Titanium instruments, One Shape, Self Adjusting File, WaveOne

Aim: Electromagnetic interference (EMI) emitted by smartphones can disrupt the functioning of some medical devices. The aim of the present in vivo study was to determine the effect of two smartphones (IPhone 5S and Samsung Galaxy S5) on the reliability of two electronic apex locators (EALs) (Novapex and Root ZX II). Materials and methods: Twelve patients were enrolled in the present study. Thirty-one root canals from sixteen teeth in need of root canal treatment were selected, after clinical and radiographic examination. The effect of smartphones (IPhone 5S and Samsung Galaxy S5) on both tested EALs (Novapex and Root ZX II) was determined under two different conditions: no smartphone in the operatory room (control group); and smartphones with Wi-Fi and Bluetooth setting activated and placed in physical contact with the EAL to maximise the chance of detecting EMI. The EWL was measured three times per tooth under each condition. To evaluate the reliability of EALs when used near smartphones, all measurements were submitted to ANOVA and Tukey's test with a significance level of 5%. Results: It was possible to determine EWL under all the experimental conditions. No significant differences (P > 0.05) were found for EWL measurements in the presence or absence of smartphones for the two tested EALs. A linear correlation between the two different tested EALs in the presence or absence of smartphones was also observed. Conclusion: It can be concluded that mobile phones used in the present study did not affect accuracy of EWL measurements in vivo. Keywords: cell phones, electronic apex locator, endodontics, Odontometry

Aim: The aim was to evaluate the bacterial reduction achieved by ProTaper Next (PTN) system in root canals contaminated with Enterococcus faecalis. ProTaper Universal (PTU) and WaveOne (WO) systems were used as references for comparison. Materials and methods: A hundred human mandibular premolars were selected and ninety-five were contaminated with E. faecalis for 4 weeks. Then the teeth were randomly divided into six groups (n = 15): PTN + 2.5% NaOCl; PTU + 2.5% NaOCl; WO + 2.5% NaOCl; PTN + saline solution; PTU + saline solution; and WO + saline solution. Positive and negative control groups were created with five specimens each. The irrigation volume was standardised for all experimental groups. Samples taken before (S1) and after (S2) chemomechanical procedures were cultured and the colony-forming units (CFUs) were counted. The paired t-test was used for intragroup analysis, and one-way ANOVA for intergroup analysis. When significant differences were found amongst the groups, the Tukey test was used. The significance levels were set at 5% (P 0.05). Results: After root canal instrumentation (S2), there was a significant reduction in bacterial load in all groups (P 0.01). The WO/saline solution group showed a lower level of bacterial reduction when compared with the other tested groups (P 0.01). Groups irrigated with NaOCl showed a higher level of bacterial reduction when compared with saline solution irrigation (P 0.01), with no statistical differences amongst the systems used (P > 0.05). Conclusion: The PTN system was as effective as PTU and WO in the removal of bacteria during root canal treatment. Keywords: Enterococcus faecalis, ProTaper Next, Root canal instrumentation, sodium hypochlorite

Aim: This study presents the results of a retrospective evaluation of treatment of immature non-vital teeth using mineral trioxide aggregate (MTA) for root-end closure. Methods: Forty-six teeth with incomplete root development presenting with apical periodontitis were treated at a dental office limited to endodontics using MTA for apical closure. Success of treatment was defined as absence of clinical symptoms or radiographical signs of pathology and was assessed at least 1 year after treatment. The radiographs were evaluated by two calibrated endodontists. Results: Follow-up examination was performed on 95.6% (n = 44) of the teeth included in the study. The mean recall interval was 2.6 years. Success rate for the evaluated cases was 72.7%. Conclusion: This study showed a significant correlation between the success rate and the length of the recall interval (t-test, P = 0.046). The success rate significantly increased with increasing recall intervals. Keywords: apical barrier, apical closure, clinical outcome, immature apices, MTA, open apex, recall interval