e-ISSN 2459-1726
Turkish Endodontic Journal (TEJ) - Turk Endod J: 7 (1)
Volume: 7  Issue: 1 - 2022
1.Micro-computed tomography analysis of root canal orifices in maxillary fused molars
Defne Toplu, Cangül Keskin, Ali Keleş
doi: 10.14744/TEJ.2022.43531  Pages 1 - 6
Purpose: This study outlines a two-dimensional analysis of root canal orifices in maxillary second molars showing different types of root fusion.
Methods: A total of 150 extracted fused maxillary second molar teeth with mature roots free of fractures, or deep caries extending to root dentine, were scanned on a micro-computed tomography (micro-CT) device (SkyScan 1172, Bruker-micro-CT, Kontich, Belgium) at 9 µm (pixel size), 100 kV, 100 µA. Specimens were classified according to the fusion type. In each specimen’s axial slices of the pulp chamber floor, the area, perimeter, roundness, major diameter, and minor diameter values were measured. One-way analysis of variance test followed by post hoc Tukey test was performed to evaluate the area, perimeter, roundness, major diameter, minor diameter, and interorifice distances between different fusion types.
Results: The perimeter and area of the mesiobuccal 2 (MB2) canal orifice were statistically smaller than other orifices in all fusion types (p< 0.05). Major and minor diameter values of MB2 were also significantly smaller than that of mesiobuccal (MB) in fusion types 1 to 4 (p< 0.05), apart from type 6, in which major and minor diameters of MB, MB2, and distobuccal orifices were similar (p> 0.05). The largest area and perimeter values were measured in the palatal (P) canal orifice irrespective of the fusion type (p< 0.05).
Conclusion: The fusion type does not affect the area and minor diameter of the canal orifices. All morphological parameters examined were similar for MB and MB2 canal orifices regardless of the fusion type.

2.Comparison of different irrigation activation techniques on postoperative pain after endodontic treatment: A randomized clinical trial
Uygar Hızarcı, Sibel Koçak, Baran Can Saglam, Mustafa Murat Koçak
doi: 10.14744/TEJ.2021.62634  Pages 7 - 12
Purpose: To evaluate the effects of different irrigation activation methods on postoperative pain using a visual analog scale (VAS), using XP-endo Finisher (XPF), EndoActivator (EA), and passive ultrasonic irrigation (PUI) activation techniques compared with the conventional irrigation (CI) method.
Methods: Twenty-five maxillary or mandibular nonvital teeth having a single root canal were allocated to each group. The root canals were prepared with the TF-Adaptive system. Three different activation techniques, XPF, PUI, and EA techniques, were applied during the final irrigation. The canal treatments were completed in a single appointment and postoperative pain analysis was evaluated using VAS after 12, 24, and 48 h.
Results: No difference was found in the 12- and 24-h time intervals between the groups (p>.05). A statistically significant difference was found between CI and XPF groups at 48 h (p<.05).
Conclusion: All activation techniques resulted in postoperative pain. Irrigant activation with XPF caused less postoperative pain than the conventional needle irrigation at 48 h while XPF demonstrated similar and tolerable results with PUI and EA after root canal treatment.

3.The effect of different endodontic access cavity designs on the amount of apically extruded debris
Meltem Memiş, Ertuğrul Karataş
doi: 10.14744/TEJ.2021.74046  Pages 13 - 20
Purpose: The present study aimed to examine the effect of different endodontic access cavity designs on the amount of apically extruded debris.
Methods: Sixty caries-free mandibular first molars were used. Before starting the access cavity preparations, all teeth were scanned on a cone beam computed tomography to outline the pulp chamber of the teeth. Four groups were planned according to the prepared cavity design as follows (n = 15 each): the traditional endodontic cavity (TEC), the conservative endodontic cavity (CEC), the truss endodontic cavity (TREC), and the ninja endodontic cavity (NEC) groups. The weight of extruded debris was determined by subtracting the initial weights of the tubes from the final weights of the tubes containing the debris.
Results: Significantly less apical debris extrusion was observed in the NEC group compared with the CEC and TEC groups. There was no significant difference in the amount of apically extruded debris between the TREC group and the CEC and TEC groups.
Conclusion: NEC and TREC design was associated with less debris extrusion than the TEC and CEC designs.

4.Detection, characterization, and antimicrobial susceptibility of Globicatella sanguinis isolated from endodontic infections in Ouagadougou, Burkina Faso
Wendpoulomdé Aimé Désiré Kaboré, Simavé René Dembélé, Nicolas Barro
doi: 10.14744/TEJ.2021.91300  Pages 21 - 27
Purpose: Globicatella sanguinis is an emerging pathogen rarely recognized as a cause of infection. The objective of this study was to investigate the role of this bacterium in endodontic infections in Burkina Faso and to determine its susceptibility to antibiotics.
Methods: This cross-sectional descriptive study was conducted at the Municipal Center of Oral Health of Ouagadougou from June to October 2014. Clinical data were collected using a sheet. Bacteria were isolated by streaking method on selective medium, and identification was done by API 20 Strep gallery. Antibiotic susceptibility was determined by the diffusion method on solid medium.
Results: A total of 125 patients were within aged 19–40 years (55.2%). Apical periodontitis accounted for 50.4%, and endodontic cellulitis accounted for 49.6% of endodontic infections. Five isolates of G. sanguinis have been identified. They were resistant (100%) to cefotaxime, metronidazole, and penicillin G. Spiramycin showed an intermediate sensitivity of 60%. Isolates showed good sensitivity (100%) to trimethoprim–sulfamethoxazole, amoxicillin–clavulanic acid, and tazobactam–piperacillin. One of them produced extended spectrum β-lactamases.
Conclusion: The severity of infections caused by G. sanguinis reflects difficulties to eradicate these bacteria from the root canal system.

5.Antimicrobial efficacy of calcium hypochlorite in endodontics: A systematic review of in vitro studies
Reshma Rajasekhar, Sooraj Soman, Varsha Maria Sebastian
doi: 10.14744/TEJ.2021.41736  Pages 28 - 42
Purpose: This systematic review analyzes the antimicrobial effectiveness of calcium hypochlorite (Ca(OCl)2) compared to other disinfection strategies used in endodontics.
Methods: In vitro studies on human teeth were included, whereas in vivo studies on animals, bovine teeth, and artificial or immature teeth and review articles were excluded. A search on PubMed, Scopus, Trip, ScienceDirect, and Wiley Online Library until June 2021 for research published in English language was conducted, and additional manual searching using references from eligible studies was also performed. Articles were then transferred to a reference management software, from which titles and abstracts were screened. Selected articles were then retrieved in full text, and data extraction was done using Microsoft Excel. Risk of bias assessment was performed using the methods adapted from previous systematic reviews on in vitro studies.
Results: In total, 11 articles were included in this study, wherein a high to moderate overall quality was observed. Ten studies showed moderate risk of bias, whereas only one study exhibited a low risk of bias. Based on the available evidence, Ca(OCl)2 demonstrated good antimicrobial efficacy, which is comparable to that of sodium hypochlorite as an irrigant.
Conclusion: Ca(OCl)2 can be a potential irrigant in endodontics, and its potency depends on its concentration and duration of action, which needs further analysis.

6.CBCT evaluation and treatment of maxillary second molar with two palatal roots
Ayşe Nur Kuşuçar, Damla Kırıcı
doi: 10.14744/TEJ.2022.74936  Pages 43 - 46
Careful evaluation of the internal anatomy of a root canal is critical for successful endodontic treatment. An additional root or missing canal can lead to treatment failures and poor prognosis. The two palatal canals in the maxillary second molar tooth are rare, and its incidence reported in the literature is less than 2%. The unique anatomy of the maxillary second molar teeth is complex to treat due to its posterior location. Superimposition of the anatomical structures on the radiographs of this region may result in a second palatal root canal undiagnosed. The current case report presents non-surgical re-treatment of maxillary second molar with two palatal roots. CBCT image confirmed the presence of nontreated palatal root. The extra palatal root of the tooth had been treated, and the patient’s symptoms resolved.

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