scholarly journals Inadvertent Apical Extrusion of Sodium Hypochlorite with Evaluation by Dental Volumetric Tomography

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Elif Delve Başer Can ◽  
Meriç Karapınar Kazandağ ◽  
Rabia Figen Kaptan
Keyword(s):  
Tissue Injury ◽  
3D Visualization ◽  
Root Apex ◽  
Apical Constriction ◽  
Maxillary Bone ◽  
Affected Area ◽  
Apical Extrusion ◽  
Working Length ◽  
Soft Tissue Complication ◽  
Routine Procedures

This case report describes the tissue injury caused by inadvertently extruded NaOCl through the apical constriction. A 56-year-old female patient with complaints of pain, swelling, and ecchymosis on the left side of her face was referred to our clinic. The symptoms had emerged following root canal treatment of the maxillary left first premolar, and a soft tissue complication due to apical extrusion of NaOCl was diagnosed. Antibiotics and analgesics were prescribed. DVT images revealed that the buccal root apex had perforated the maxillary bone. The patient was followed up every other day and became asymptomatic on the 10th day. Endodontic therapy was completed with routine procedures. Determining working length precisely and following irrigation protocols meticulously are indispensable to prevent this type of complication. 3D visualization of the affected area may reveal the cause of the incident.

scholarly journals An in vivo Evaluation of Different Methods of Working Length Determination

2013 ◽  
Vol 14 (4) ◽  
pp. 644-648 ◽  
Author(s):  
Nitin Shah ◽  
Sarita Singh ◽  
Jyoti Mandlik ◽  
Kalpana Pawar ◽  
Paras Gupta ◽  
...  
Keyword(s):  
Tactile Sensation ◽  
Pulp Chamber ◽  
In Vivo Evaluation ◽  
Extraction Working ◽  
Apical Constriction ◽  
Working Length ◽  
Length Measurements ◽  
Length Determination ◽  
Electronic Apex Locator

ABSTRACT Objective The purpose of this in vivo study was to compare the ability of digital tactile, digital radiographic and electronic methods to determine reliability in locating the apical constriction. Materials and methods Informed consent was obtained from patients scheduled for orthodontic extraction. The teeth were anesthetized, isolated and accessed. The canals were negotiated, pulp chamber and canals were irrigated and pulp was extirpated. The working length was then evaluated for each canal by digital tactile sensation, an electronic apex locator (The Root ZX) and digital radiography. The readings were then compared with post-extraction working length measurements. Results The percentage accuracy indicated that EAL method (Root ZX) shows maximum accuracy, i.e. 99.85% and digital tactile and digital radiographic method (DDR) showed 98.20 and 97.90% accuracy respectively. Clinical significance Hence, it can be concluded that the EAL method (Root ZX) produced most reliable results for determining the accurate working length. How to cite this article Mandlik J, Shah N, Pawar K, Gupta P, Singh S, Shaik SA. An in vivo Evaluation of Different Methods of Working Length Determination. J Contemp Dent Pract 2013;14(4):644-648.

scholarly journals Gradual correction of proximal tibia deformity for Blount disease in adolescent and young adults

2019 ◽  
Vol 27 (3) ◽  
pp. 230949901987398 ◽  
Author(s):  
Aik Saw ◽  
Zi Hao Phang ◽  
Mohammed Khalid Alrasheed ◽  
Roshan Gunalan ◽  
Mohammed Ziyad Albaker ◽  
...  
Keyword(s):  
Young Adults ◽  
Soft Tissue ◽  
External Fixator ◽  
Surgical Outcome ◽  
Tissue Injury ◽  
Femoral Condyle ◽  
Soft Tissue Injury ◽  
Gradual Correction ◽  
Soft Tissue Complication ◽  
Blount Disease

Purpose: Management of Blount disease in adolescents and young adults is complex and associated with high risk of morbidities. Gradual correction with external fixator can minimize soft tissue injury and allow subsequent adjustment in degree of correction. This study investigates the surgical outcome and complication rate of gradual correction of neglected Blount disease through single-level extra-articular corticotomy. Methods: Patients treated for Blount disease using external fixator from 2002 to 2016 were recruited for the study. We used Ilizarov and Taylor Spatial Frame (TSF) external fixator to perform simultaneous correction of all the metaphyseal deformities without elevating the tibia plateau. Surgical outcome was evaluated using mechanical axis deviation (MAD), tibial femoral angle (TFA), and femoral condyle tibial shaft angle (FCTSA). Results: A total of 22 patients with 32 tibias have been recruited for the study. The mean MAD improved from 95 ± 51.4 mm to 9.0 ± 37.7 mm (medial to midpoint of the knee), mean TFA improved from 31 ± 15° varus to 2 ± 14° valgus, and mean FCTSA improved from 53 ± 14° to 86 ± 14°. Mean duration of frame application is 9.4 months. Two patients developed pathological fractures over the distracted bones, one developed delayed consolidation and other developed overcorrection. Conclusions: Correction of Blount disease can be achieved by gradual correction using Ilizarov or TSF external fixator with low risk of soft tissue complication. Longer duration of frame application should be considered to reduce the risk of pathological fracture or subsequent deformation of the corrected bone.

An In Vivo Evaluation of Two Types of Files used to Accurately Determine the Diameter of the Apical Constriction of a Root Canal: An In Vivo Study

2009 ◽  
Vol 10 (4) ◽  
pp. 43-50 ◽  
Author(s):  
Narendra Manwar ◽  
Sumeet Darda ◽  
D.D. Shori
Keyword(s):  
Root Canal ◽  
Univariate Analysis ◽  
File Size ◽  
In Vivo Evaluation ◽  
Apical Constriction ◽  
Iso Standard ◽  
Mean Values ◽  
Canal Diameter ◽  
Working Length

Abstract Aim The aim of this study was to compare sizes of the first instrument with or without a taper that binds at the apical constriction of a root canal after coronal flaring. Methods and Materials A total of 310 canals were evaluated in patients presenting for root canal therapy. Canals with intact apices were selected. After gaining straight line endodontic access, the coronal third was flared using Gates-Glidden drills. Working length was determined using an apex locator. ISO Standard K-files (tapered) were passively introduced into the canals starting with a No. 15 file. The first K-file size to bind against the canal walls without pushing and to reach the working length was recorded as the FKFB (First K File to Bind). Next, ISO Standard Lightspeed files (non-tapered instruments) starting with No. 20 were then gently introduced by hand to each canal in ascending order to the working length. The first size of a Lightspeed instrument to bind against the canal walls and reach the working length was recorded as FLSB (First Light Speed to Bind). In all instances a larger file was introduced to ensure it could not reach the same depth (i.e., working length). Statistical analysis was carried out using a univariate analysis of variance (ANOVA). Results The average size of the FLSB to bind against the canal walls first at the working length was approximately two ISO sizes larger than the FKFB (P<0.001). Conclusion The clinician should consider introducing a non-tapered instrument to working length after coronal flaring because determination of the initial narrow apical canal diameter plays a major factor in identifying the extent of final apical shaping. Because the first non-tapered instrument that binds the apical constriction is larger than the corresponding tapered instrument, it better reflects the actual narrow apical diameter of the canal. Clinical Significance The initiation of canal instrumentation with a K-file size three sizes beyond the mean values of the FLSB will result in greater final enlargement of the canal compared to starting with the FKFB. This increased canal enlargement facilitates improved mechanical and chemical cleansing of the root canal ensuring removal of more microorganisms and their substrates, thus, improving the outcome of the treatment. Citation Darda S, Manwar N, Chandak M, Shori DD. An In Vivo Evaluation of Two Types of Files used to Accurately Determine the Diameter of the Apical Constriction of a Root Canal: An In Vivo Study. J Contemp Dent Pract 2009 July; (10)4:043-050.

scholarly journals Influence of cervical preflaring on determination of apical file size in maxillary molars: SEM analysis

2005 ◽  
Vol 16 (3) ◽  
pp. 181-186 ◽  
Author(s):  
José Roberto Vanni ◽  
Roberto Santos ◽  
Orlando Limongi ◽  
Danilo M. Zanello Guerisoli ◽  
Alexandre Capelli ◽  
...  
Keyword(s):  
Cross Sections ◽  
Root Apex ◽  
Sem Analysis ◽  
Pulp Tissue ◽  
Maxillary Molars ◽  
Canal Diameter ◽  
Working Length ◽  
Major Discrepancy ◽  
Post Hoc

The purpose of this study was to investigate the influence of cervical preflaring on determination of the initial apical file in mesiobuccal roots of maxillary molars. Fifty first molars with degree of curvature of the mesiobuccal root between 10° and 15° were utilized. After standard access opening and removal of pulp tissue, the working length (WL) was determined at 1 mm from the root apex. Five groups (n=10) were formed at random, according to the type of cervical preflaring performed. In group 1, the size of the initial apical file was determined without cervical preflaring. In groups 2 to 5, the cervical and middle thirds of the canals were preflared with Gates-Glidden drills, K3 Orifice Opener instruments, ProTaper instruments and LA Axxess burs, respectively. Canals were sized manually with K-files, starting with size 08 K-files, inserted passively up to the WL. File sizes were increased until a binding sensation was felt at the WL and the size of the file was recorded. The binding instruments were fixed into the canals at the WL with methylcyanacrylate. Cross-sections of the WL region were examined under scanning electron microscopy and the discrepancies between the canal diameter and the diameter of first file to bind at the WL were calculated using UTHSCSA ImageTool software. Data were analyzed statistically by ANOVA and multiple comparisons were done by Tukey's HSD post-hoc test. Significant differences (p<0.001) were found among the groups. The major discrepancy was observed for the group without preflaring (mean 0.1543 mm ± 0.0216). Cervical preflaring with LA Axxess burs produced the least discrepancies between the canal size and the diameter of the initial apical instrument (mean 0.026 mm ± 0.0037), followed by ProTaper files (mean 0.0567 mm ± 0.0354). Canals preflared with Gates-Glidden drills and K3 Orifice Opener instruments showed statistically similar discrepancy results to each other (p>0.05) (means 0.1167 mm ± 0.0231 and 0.1313 mm ± 0.0344, respectively). In conclusion, preflaring of the cervical and middle thirds improved the determination of the initial apical instrument. Canals preflared with LA Axxess burs showed a more accurate binding of the files to the anatomical diameter at the WL in the mesiobuccal roots of maxillary first molars.

scholarly journals Apex Locator - Booster to Dentist : Literature Review

2020 ◽  
Vol 3 (07) ◽  
Author(s):  
Swati Manhas ◽  
Sonia Lakra ◽  
Mehak ◽  
Abhishek Sharma ◽  
Kriti Garg ◽  
...  
Keyword(s):  
Literature Review ◽  
Root Canal ◽  
Root Canal Treatment ◽  
Apical Constriction ◽  
Precise Control ◽  
3 Dimensional ◽  
Working Length ◽  
Electronic Method ◽  
Length Determination

Successful root canal treatment depends on thorough cleaning & shaping and 3- dimensional fluid impervious obturation of tooth within the confines of canals. To achieve this objective  the apical constriction must be detected accurately during canal preparation and precise  control over  working length  during the  procedure must  be maintained.  There are  many methods  of working length determination including  radigraphs  and electronic method(apex locator). Introduction of apex locators  have definitely served  as an effective adjuvant  to radiographs. 

scholarly journals Accuracy of Working Length Measured by Apex Locator and Digital Radiography

2021 ◽  
Vol 30 (1) ◽  
pp. 24-28
Author(s):  
Ghulam Ishaq Khan ◽  
◽  
Muhammad Talha Khan ◽  
Saroosh Ehsan ◽  
Anam Fayyaz ◽  
...  
Keyword(s):  
Digital Radiography ◽  
Root Canal ◽  
Reference Points ◽  
Radiographic Measurement ◽  
Apical Constriction ◽  
Actual Length ◽  
Actual Working ◽  
Working Length ◽  
Length Determination ◽  
Electronic Apex Locator

OBJECTIVE: The objective of this study was to compare the measurements of electronic and radiographic method of working lengths calculation with actual working length of root canals. Precise working length determination is the most important part for successful root canal procedure. The most commonly used methods to determine the working length in root canal treatment are radiography and electronic apex locator. METHODOLOGY: A cross sectional study was done over a period of 06 months in the Department of Operative Dentistry, Fatima Memorial Hospital, Lahore. Sixty patients who were recommended extraction of their premolar teeth with sixty canals were selected by convenience sampling. The Root ZX* apex locator was used to determine electronic working length exactly identifying the apical constriction. Reference points were identified and radiographic working length were determined 1mm short of radiographic apex. The teeth were extracted along with file cemented before extraction inside root canal. The actual length of the root canal was then calculated using the same files and reference point with 3.5X magnification. Pearson chi square test was applied to compare the apex locator and digital radiographic measurement with actual working length. RESULTS: The Root ZX® apex locator was 95% accurate to identify the apical constriction as compared 70% accuracy given by radiographs within 0.5 mm of the apex. CONCLUSION: Electronic apex locator was more accurate as compared to digital radiography in working length determination. KEYWORDS: Working length (WL), Electronic apex locators (EAL), Radiographic working length(RWL), Apical constriction (AC) HOW TO CITE: Khan GI, Khan MT, Ehsan S, Fayyaz A, Malik HA, Hussain S. Accuracy of working length measured by apex locator and digital radiography. J Pak Dent Assoc 2021;30(1):24-28.

scholarly journals Apical Extrusion of Intracanal Debris Using Two Engine Driven and Step-Back Instrumentation Techniques: An In-Vitro Study

2008 ◽  
Vol 02 (04) ◽  
pp. 233-239 ◽  
Author(s):  
Alper Kustarci ◽  
Neslihan Akdemir ◽  
Seyda Herguner Siso ◽  
Demet Altunbas
Keyword(s):  
Stainless Steel ◽  
Analysis Of Variance ◽  
Statistical Significance ◽  
In Vitro Study ◽  
Type Stainless Steel ◽  
Rotary Instruments ◽  
Apical Extrusion ◽  
Working Length ◽  
Significant Difference

ABSTRACTObjectives: The purpose of this study was to compare in-vitro the amount of debris extruded apically from extracted teeth, using K3, Protaper rotary instruments and manual step-back technique.Methods: Forty five human single-rooted mandibular premolar teeth were randomly divided into 3 groups. The teeth in 3 groups were instrumented until reaching the working length with K3, Protaper rotary instruments and K-type stainless steel instruments with manual step-back technique, respectively. Debris extruded from the apical foramen was collected into centrifuge tubes and the amount was determined. The data obtained were analyzed using Kruskal-Wallis one-way analysis of variance and Mann-Whitney U tests, with P=.05 as the level for statistical significance.Results: Statistically significant difference was observed between K3, Protaper and step-back groups in terms of debris extrusion (P<.05). Step-back group had the highest mean debris weight, which was significantly different from the K3 and Protaper groups (P<.05). The lowest mean debris weight was related to K3 group, which was significantly different from the Protaper group (P<.05).Conclusions: Based on the results, all instrumentation techniques produced debris extrusion. The engine-driven Ni-Ti systems extruded significantly less apical debris than step-back technique. However, Protaper rotary instruments extruded significantly more debris than K3 rotary instruments. (Eur J Dent 2008;2:233-239)

Morphological Changes of The Root Apex In Anterior Teeth With Periapical Periodontitis: An In-Vivo Study

2021 ◽  
Author(s):  
Chen-chen Zhang ◽  
Ya-jing Liu ◽  
Wei-dong Yang ◽  
Qian-nan Zhang ◽  
Ming-zhu Zha ◽  
...  
Keyword(s):  
Morphological Changes ◽  
Root Apex ◽  
Cone Beam ◽  
Reconstruction Technique ◽  
Apical Constriction ◽  
Anterior Teeth ◽  
The Mean ◽  
The Difference ◽  
Periapical Periodontitis

Abstract Introduction: The aim was to analyze the morphological changes of root apex in anterior teeth with periapical periodontitis. Methods: 32 untreated anterior teeth with periapical periodontitis were enrolled, compared with the healthy contralateral teeth. Cone-beam computed tomography was used to measure diameter of the apical constriction. 3D reconstruction technique was used to reconstruct the teeth, analysis the constriction forms, and measure the distances of constriction to apical foramen and anatomical apex respectively. Results: The difference value between buccolingual and mesiodistal diameter was (0.06±0.09) mm in periapical periodontitis and (0.04±0.04) mm in healthy teeth (p<0.05). The mean distances between apical constriction and anatomical apex were (0.97±0.25) mm and (1.59±0.48) mm in periapical periodontitis and healthy teeth. The mean distances of apical constriction to apical foramen were (0.39±0.12) mm and (0.70±0.18) mm in periapical periodontitis and healthy teeth. The most common form of apical construction was flaring (65.6%) in periapical periodontitis. Conclusions: The anterior teeth with periapical periodontitis had shorter distances of apical constriction to anatomical apex and apical foramen, bigger disparities between the diameters of buccolingual and mesiodistal, and higher proportion of flaring apical construction.

scholarly journals An in vivo Study to determine the Effects of Early Preflaring on the Working Length in Curved Mesial Canals of Mandibular Molars

2013 ◽  
Vol 14 (2) ◽  
pp. 163-167 ◽  
Author(s):  
Mahmoud K AL-Omiri ◽  
Azhar Iqbal ◽  
Iftikhar Akbar
Keyword(s):  
In Vivo Study ◽  
Tactile Sensation ◽  
Apical Constriction ◽  
Mandibular Molars ◽  
Working Length ◽  
Group A ◽  
Length Determination

ABSTRACT Aim To evaluate the effects of a preflaring method on the determination of working length in the curved mesial canals of mandibular molars. Materials and methods Ninety mandibular molars with apical curvature of 30 to 40° were selected and randomly divided into two groups; each containing 45 teeth. In the first group, the initial instrumentation was performed with preflaring on the mesiobuccal canal (preflared group), and in the second group; the instrumentation was performed without preflaring on the mesiobuccal canal (nonpreflared group). A size 15 K-file was inserted in the mesiobuccal canals until the apical constriction could be felt by tactile sensation and a radiograph was taken to identify the distance between the file tip and radiographic apex. The location of the tip was classified as (a) within 1 mm of the radiographic apex, (b) more than 1 mm of the radiographic apex, or (c) overextended beyond the radiographic apex. The collected data was statistically analyzed and probability value was set to be ≤ 0.05. Results The file tip was significantly closer to the true working length in the canals with early preflaring compared to the canals without early preflaring (p < 0.005). In the preflared group; 75.5% of the cases had the file tip in location ‘a’, 13.3% in location ‘b’, and 11.1% in location ‘c’. In the nonpreflared group; 33.3% of the cases had the file tip in location ‘a’, 53.3% in location ‘b’ and 13.3% in location ‘c’. Conclusion Preflaring the coronal portion of curved canals greatly improved the access to the apical constriction, and thus enhanced correct working length determination. If the coronal portion of the curved canals is not preflared, the clinician cannot discern the accuracy of what they feel apically. Thus, preflaring is a highly recommended procedure especially in curved canals for better determination of correct working length. How to cite this article Iqbal A, Akbar I, AL-Omiri MK. An in vivo Study to determine the Effects of Early Preflaring on the Working Length in Curved Mesial Canals of Mandibular Molars. J Contemp Dent Pract 2013;14(2):163-167.

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