Giornale Italiano di Endodonzia

The modern management of endodontic complications

Sandro Rengo — 2024-03-21

not available

Assessing dentinal tubule penetration of an innovative bioactive glass-based root canal sealer through confocal laser scanning microscopy: an in vitro analysis

Sourabh Barbhai — 2024-03-26

Aim: To assess and compare the dentinal tubule penetration of zinc oxide eugenol (ZOE)-based, resin-based, bioceramic, and novel bioactive glass-based root canal sealers using a confocal laser scanning microscope (CLSM).

Methods: A total of 48 single-rooted permanent teeth were categorized into four groups (n=12) and treated with gutta-percha along with ZOE sealer (Tubli-Seal EWT), resin-based sealer (AH Plus), bioceramic sealer (BioRoot RCS), and bioactive glass (Nishika Canal Sealer-BG). Cross-sections of the roots at 3 mm and 6 mm from the apex were examined under a CLSM to evaluate dentinal tubule penetration.

Results: Results indicated that bioceramic sealers exhibited the highest depth of dentinal tubule penetration at both levels, followed by bioactive glass and resin-based sealers. ZOE-based sealer demonstrated the least tubule penetration. Bioactive glass displayed the highest percentage of sealer penetration at 3 mm and 6 mm, with no statistically significant difference observed between bioceramic and bioactive glass groups regarding depth and percentage of dentinal tubule penetration at both levels.

Conclusions: Of particular significance is the bioactive glass group, demonstrating the most substantial sealer penetration percentage compared to the other groups at both examined depths.

Applicability of photobiomodulation and antimicrobial photodynamic therapy for pain management after endodontic treatment: a randomized clinical trial

Monique de Carvalho Souza — 2024-04-09

Aim: To evaluate the use of photobiomodulation (PBM), alone or combined with antimicrobial photodynamic therapy (aPDT), for pain management after endodontic treatment.

Methodology: Randomized parallel-group superiority trial. The allocation sequence was generated using an online true random number generator. To ensure blinding, participants were informed about the study and the devices that would be used, but not about group allocation. Ninety mandibular molars diagnosed with symptomatic irreversible pulpitis were selected and randomly divided into three groups (n=30): Group 1, control (CT); Group 2, photobiomodulation (PBM); and Group 3, PBM + aPDT. All canals were instrumented by the Reciproc system in a single visit. The incidence and intensity of pain were evaluated before and 6, 12, 24, and 48 hours after endodontic treatment, using a visual analogue scale (VAS). The results were analysed using the Kruskal–Wallis test followed by Dunn’s test.

Results: The combination of PBM and aPDT after conventional endodontic treatment resulted in a significant reduction in pain compared to conventional endodontic treatment alone or followed by PBM alone (p<0.05). Preoperative pain was significantly greater than pain at 6, 12, 24, and 48 hours after endodontic treatment (p<0.05) in all groups. There were no adverse effects attributable to low-level light therapy in any participants.

Conclusion: Our findings suggest that the combination of photobiomodulation and photodynamic therapy is a promising alternative for this purpose.

Treatment planning and therapy of a severely compromised two-rooted maxillary central incisor

Andreas Krokidis — 2024-02-06

Aim: This case report presents the diagnosis and therapy of a severally compromised two-canal maxillary central incisor.

Summary: Tooth #21 was refereed for treatment. 2D and 3D Radiographic evaluation revealed the presence of a severely compromised two-canal central incisor. Root canal therapy was performed. In the two-year follow-up the tooth was fully functional.

Key learning points:

• Meticulous treatment planning and treatment is a valid option even in complicated and compromised cases.

• Root canal treatment can provide concrete therapeutical choices even in heavily compromised cases.

Root canal treatment of a maxillary first molar with unusual anatomy: a case report

Archika Singh — 2024-03-14

Aim: To describe the management of a maxillary first molar with six root canals, two in each root.

Summary: A 36-year-old male patient presented with a complaint of discoloration and decay on an upper left back tooth. Clinical examination revealed the presence of deep occlusal caries on the maxillary left first molar. A detailed clinical and radiographical examination led to a diagnosis of pulp necrosis with asymptomatic apical periodontitis. Non-surgical root canal treatment was performed. Due to the suspected anatomical variation, Cone beam computed tomography (CBCT) imaging was obtained. CBCT imaging and clinical identification using the DOM revealed the presence of six root canals, two in each root, with the code (³26 MB²DB²P^2-1) using Ahmed et al. system. Root canal treatment was successfully performed and confirmed radiographically. The tooth was restored with a resin composite restoration. The patient was referred for prosthodontic evaluation for extracoronal restoration.

Key learning points:

This case highlights how clinicians must approach root canal treatment with a comprehensive mindset that considers the potential for extraordinary anatomical complexities.
Preoperative knowledge of root canal anatomy and proper armamentarium are mandatory for successful root canal treatment procedures.