Giornale Italiano di Endodonzia

Endodontics: the central core within a multidisciplinary approach

Sandro Rengo — 2024-11-07

Successful treatment of a damaged upper molar using 3D Technology: a case report with 4 years follow-up

Bodgan Oprea — 2024-10-17

Aim: The aim of this case report is to describe, in a stepwise manner, the diagnosis, treatment planning, execution, and rehabilitation of a damaged upper molar using Sicat Endo software and a computer-aided design/computer-aided manufacturing (CAD/CAM) system.

Summary: A patient with no painful symptoms presented to our clinic to complete a treatment that had been initiated a year ago (left unfinished for personal reasons) to save the tooth. Clinical tests indicated a previously initiated therapy and normal apical tissues. Cone beam computed tomography (CBCT) was used for the diagnosis and treatment planning of the root canal procedure. The planning of the previously designed access cavity and identification of all the root canals was performed with Sicat Endo software (Sicat, Bonn, Germany). Additionally, the quality of the final root canal obturation was evaluated using Sicat Endo software. The final crown restoration was fabricated using a CAD/CAM system and pressed lithium disilicate material. Our case report revealed a successful four-year follow-up of a one-session endodontic treatment of a maxillary molar and CAD/CAM final restoration using digital technologies and 3D software.

Key learning points

• In the present case report, Sicat Endo Software was used for root canal treatment planning and for assessing the quality of final obturation.

• The present case report utilized CAD/CAM technology for one-session treatment.

• This case report presents a middle-term follow-up of four years on the use of digital technologies for one-session endodontic therapy and prosthetic rehabilitation.

A comparison in the efficacy of 3D-printed guides versus traditional endodontic access: an ex-vivo study

Alvaro Garcia-Sanchez — 2024-10-28

Aim: This ex-vivo study aimed to evaluate the accuracy and efficacy of digitally designed 3D-printed endodontic guides (3DGs) to achieving a conservative endodontic access preparation on maxillary molars in comparison to a traditional endodontic access (TRAD).

Methodology: Eighty extracted maxillary molars were divided into two groups: (1) TRAD access and (2) 3DG access. Two operators with varying levels of experience performed both approaches. Time allocated to perform each procedure was recorded. Volumetric analysis was done by comparing data from the pre- and the post-operative CBCTs.

Results: Both operators with the 3DG cavity access located 100% of the canals present, while the TRAD groups missed 30.76–81.81% of second mesiobuccal canals. Time required and substance loss were significantly lower in the 3DG group vs. the TRAD group.

Conclusions: Within the limitation of this study, the use of an endodontic 3DGs helped in preserving a significantly more dental structure in a significantly less time.

The treatment options for the management of internal root resorption

Rūta Prialgauskė — 2024-11-07

Aim: This systematic review aimed to analyze and compare the outcomes of reported treatment options for managing IRR in mature teeth.

Methodology: Literature search was conducted using the PubMed, Wiley Online Library and EBSCOhost databases. Clinical trials, case reports/series, which were conducted over a nine-year period describing methodology of IRR treatment were included.

Results: From 38 cases of twenty included manuscripts, 19 – described REP, 19 – entire root canal treatment for the management of IRR. The eligible studies showed low risk of bias. The clinical symptoms of causative tooth such as pain or sinus tract, if was related, disappeared during follow up period. Bone destruction healing process was assessed during radiological evaluation despite the applied IRR management method. The resorption area reduced in size or was repaired by mineralized tissue formation in all cases treated by REP.

Conclusion: Despite the differences in treatment protocols analyzed for managing of IRR, the outcomes of root canal treatment and REP were comparable and favorable. Based on the limitations of this review, both methods are applicable for treating IRR after evaluating the specific clinical situation in practice.

Comparative analysis of debris extrusion and instrumentation time among various endodontic file systems: an in vitro study

Carlos Eduardo Fontana — 2024-11-07

Aim: Debris extrusion during endodontic procedures, characterized by the unintended displacement of root canal debris, poses significant clinical challenges, potentially leading to postoperative pain and infection. In this study, we aimed to evaluate the differences in debris extrusion and instrumentation time among various endodontic file systems.

Methodology: 120 mandibular first molars were included in the study, with 15 specimens in each group: Protaper Next, HyFlex CM, HyFlex EDM, WaveOne Gold, Reciproc Blue, Trunatomy, PTUltimate, and Rmotion. Both debris extrusion and instrumentation time for these systems were assessed. Descriptive analyses were performed, and statistical comparisons were made using the Kruskal-Wallis test (p<0.05).

Results: Protaper Next and HyFlex CM exhibited significantly higher mean debris extrusion compared to other systems. On the other hand, the remaining systems, showed lower mean debris extrusion. HyFlex CM was the most time-consuming, while WaveOne Gold, R-Motion, and Reciproc Blue were among the quickest. HyFlex EDM demonstrated a balanced performance, being efficient in both debris extrusion and time.

Conclusions: The findings suggest that while some systems significantly minimize debris extrusion and reduce instrumentation time, the choice of an endodontic file system should be guided by specific clinical conditions and operator preference based on our comparative analysis.