Cristina Coralia Nistor

The aim of this article was to establish the prevalence of root resorption in endodontically treated teeth, by means of cone-beam computed tomography (CBCT). Material and method. We analysed 609 endodontically treated teeth from patients who visited two private dental offices over a period of 3 years (2020-2023). We searched for any sign of root resorption, internal, external and apical. Results. The overall prevalence of root resorption in root canal treated teeth was 6.57%. Of these, 82.5% had apical periodontitis (AP). 67.57% were external apical inflammatory resorption, 21.62% were external cervical resorption and 18.92% were internal resorption. Conclusions. Root resorption of permanent teeth is an unfavourable condition, which can involve endodontically treated teeth. The most frequent form of resorption was external apical. Posterior teeth presented the highest percentage of resorptions. From the prognosis point of view, it is crucial that they are diagnosed in the early stages. CBCT has an invaluable role in accurately diagnosing this condition.

This "in vitro" study is intended to demonstrate the possible negative effects on dentin structure during decontamination of the endodontic system, assisted by the dental laser. An upper central incisor (21), that was extracted due to severe endo-periodontal pathology, was treated endodontically, using rotary files, Hyflex EDM, Coltene, up to 25 ISO with taper 04, and then was sectioned longitudinally with the help of a fine diamond disc. On each half of the tooth, three burn lesions were artificially created, by activating the laser tip from 3 W to 6.5 W, for 10 seconds. The dental laser used was Epic X, Biolase, and the two pieces of tooth were investigated by stereomicroscopy and optical microscopy in reflected light. For the extension of the burn lesion, we have studied the depth of the dental structures damaged and the width compared to the surface of the root canal. The outcomes confirms the safe use of the EpicX diode laser, Biolase, in endodontic treatments, as long as the manufacturer's instructions are followed ( 1.5 W). Thus, the thermal risk of damaging the radicular dentin is avoided.

Aim. The aim of this study was to assess the endodontic morphology of mandibular bicuspids in a Romanian population, by means of cone-beam computed tomography (CBCT). Material and method. 507 mandibular premolars were analysed on CBCT scans. We observed: number of roots and prevalence of C-shaped configurations, number and configuration of root canals, position of the bifurcation. Results. For first premolars, Vertucci I (1-1) was the most frequent configuration 66%; 32.8% had 2 canals and 1.2% presented 3 canals; C-shaped first premolars was found in 12.8% of the cases. For second premolars, Vertucci I was prevalent, in 94.55%, two canals were in 5.06% and 3 canals in 0.39% of the cases; C-shaped in 3.11%. The average bifurcation depth was 12.88 mm. Conclusions. Our study found that mandibular premolars are mainly single-rooted and most of the cases present Vertucci type I canal morphology. The finding of variations in this study was not low, compared with other studies. Knowledge and understanding of root canal morphology is paramount for a successful endodontic treatment.

Aim: Our study aimed to identify the procedural errors of endodontic treatment and to establish the prevalence of apical periodontitis (AP) in root canal treated teeth by means of cone-beam computed tomography (CBCT). Material and method: There were a total of 604 treated permanent teeth. We looked for apical radiolucency and errors, such as: incomplete filling, missed canals, instrument fracture, perforation, overfilling, non-homogeneous fillings. Results. The overall prevalence of AP was 58.6%. The most frequent error was incomplete filling (42.88%), followed by low-density fillings (34.1%), missed canals (26.32%), overfilling (15.72), perforations (3.8%), fractured instruments (2.64%). Risk factors identified that were significantly associated with AP were: incomplete filling more than 2 mm, missed canals, perforations, non-homogeneous fillings, fractured instruments, tooth type (posterior) and cast posts. Conclusions. Prevalence of AP in endodontically treated teeth in this study was high. Poor quality root canal obturations were associated with post-treatment apical disease. CBCT is a precise imaging diagnostic tool and accurately highlights the technical parameters of the canal obturation, but also the presence of AP even in the early stages.

The aim of this study was to identify the prevalence of missed second mesio-buccal (MB2) root canal in root canal treated (RCT) maxillary first (MFM) and second molars (MSM) by means of cone-beam computed tomography (CBCT) and the association between missed MB2 and apical periodontitis (AP). Material and method. We analyzed 539 CBCT scanned maxillary molars (MM), from patients who visited two private offices over a period of five years. Results. The prevalence of RCT was 40.25%. The prevalence of AP among MM with RCT was 44.23%. The overall prevalence of missed MB2 canals was 52.53%. The overall prevalence of AP among MM with missed MB2 canals was 53.5%. 63.54% for MM with RCT and AP had missed MB2. Conclusions. There was a high prevalence of AP among endodontically treated maxillary molars. Also, there was a high prevalence of missed MB2 canal for these group of teeth and, consequently for the AP associated with a missed root canal.

The aim of this study was to evaluate the root and root canal morphology of maxillary second premolars and their relation to the maxillary sinus in a Romanian population using cone-beam computed tomographic (CBCT) imaging. A total of 280 cone-beam computed tomographic images of maxillary second premolars were obtained from 263 patients who required a preoperative assessment for treatment plan. The number of roots and root canals and root canal configuration were investigated and categorized using Vertucci's criteria and the relationship between the root apices of maxillary second premolars and the floor of the maxillary sinus was studied. The majority of maxillary second premolars were single rooted. The most common configuration was type I, followed by type II Vertucci, for the premolars with 2 canals. The roots of the maxillary second premolars were predominantly outside the maxillary sinus. Maxillary second premolars in this study had a wide range of root and root canal internal anatomy variations.

Root perforations represent artificial communication between the endodontic system and the periodontal space or the oral cavity. While it is true that they can reduce the success rates of endodontic treatment in the long term, nevertheless, with the new bioceramic materials, the evolution is promising. The aim of this retrospective study was to assess the prevalence of perforations in root canal-treated maxillary and mandibular posterior teeth based on findings from images taken using cone-beam computed tomography (CBCT) and to review the most predictable, appropriate non-surgical treatment procedures for the clinical management of these conditions, highlighting some relevant clinical cases of complex oral rehabilitation.

The root canal irrigation going along with instrumentation is a mandatory attitude in current endodontic practice. To increase the evacuation efficacy of dental pulp remnants, dentin debris and bacterial biofilms from root canals and lateral irregularities including canal isthmuses, various procedures of irrigants activation were conceived. If not yet quite satisfactory, among various techniques of irrigant activation currently used the passive ultrasonic activation proved to be more efficient to achieving cleaning and disinfection of root canal isthmuses.

Separated instruments represent one of the procedural mishaps during endodontic treatment. Left unadressed, this complex situation may jeopardize the long term prognosis of root canal treatment. Clinical management depends on multiple factors. The options for approaching these situations are: removal of the fractured segment, bypassing and sealing the fragment within the root canal space. The aim of our study is to demonstrates the value of endodontic treatment in the successful management of these conditions and its contribution to complex oral rehabilitation.