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    ABSTRACT: This study investigates the effects of Nd:YAG laser irradiation combined with different irrigation protocols on the marginal seal of root fillings. Limited information exists regarding the effects of morphologic changes to root canal (RC) walls after Nd:YAG laser irradiation after smear-layer removal with EDTA on the sealing ability of root fillings. The 75 root-filled teeth (5 × 15 teeth) were analyzed for through-and-through leakage by using capillary flow porometry (CFP). The RC cleaning procedure determined the assignment to a group: (1) irrigation with NaOCl 2.5% and EDTA 17% or standard protocol (SP), (2) SP + Nd:YAG lasing (dried RC), (3) NaOCl 2.5% + Nd:YAG lasing (dried RC), (4) SP + Nd:YAG lasing (wet RC), or (5) NaOCl 2.5% + Nd:YAG lasing (wet RC). Groups 1r to 5r consisted of the same filled teeth with resected apices up to the most apical point of the preparation length. Resection was performed after the first CFP measurement. Roots were filled with cold lateral condensation. CFP was used to assess minimum, mean flow and maximum pore diameters after 48 h, and immediately after these measurements, including root resection. Statistics were performed by using nonparametric tests (p > 0.05). An additional three roots per group were submitted to SEM of the RC wall. Through-and-through leakage was observed in all groups. Statistically significant differences were observed in maximum pore diameter: 1r > 3r, and 1r > 5r; in mean flow pore diameter: 1r > 2r, 2r < 4r (p < 0.05). Typical Nd:YAG glazing effects were observed when the smear layer was present and exposed to the laser fiber (i.e., in the groups without use of EDTA) or when the fiber tip made direct contact with a smear-layer free RC wall. The reduction in through-and-through leakage is significantly higher with the Nd:YAG laser as smear-layer modifier than when smear layer is removed with an EDTA rinsing solution.
    Photomedicine and laser surgery 10/2010; 28 Suppl 2:S43-50. · 1.76 Impact Factor
  • M A A De Bruyne, R J G De Moor
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    ABSTRACT: To evaluate ex vivo the long-term sealing ability of the SE Resilon Epiphany system as an apical root-end filling material. A total of 60 standardized horizontal bovine root sections were divided into three groups filled with either gutta-percha with AH 26, tooth-coloured mineral trioxide aggregate (MTA) or Resilon pellets with Epiphany SE, and submitted to capillary flow porometry at 48 h, 1 and 6 months to assess the minimum, mean flow and maximum pore diameters. Results of the different materials and results by material and time were analysed statistically using nonparametric tests; the level of significance was set at 0.05. Resilon had smaller pore diameters than gutta-percha and MTA at 48 h and smaller mean flow and maximum pore diameters than gutta-percha and MTA at 1 month. At 6 months Resilon had larger minimum pore diameters than gutta-percha. Although not always statistically significant, the minimum, mean flow and maximum pore diameters of gutta-percha and MTA diminished with time. This was not the case for Resilon, where the same parameters increased. All materials leaked at all times. Resilon performed better than gutta-percha and MTA in the short-term, but the seal of MTA and gutta-percha improved over time whereas the seal of Resilon deteriorated. It is critical to evaluate the performance of materials in the long-term contrary to most studies which are short-term.
    International Endodontic Journal 10/2009; 42(10):884-92. · 2.05 Impact Factor
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    ABSTRACT: Many lasers (i.e., different wavelengths) are available today for clinical applications. Not all lasers are to be used for cavity preparation and removal of carious tissues. Erbiumlasers (Er:YAG and Er,Cr:YSGG) are suitable for these purposes (the wavelengths coincide with the highest absorption peaks of water and hydroxyapatite). The advantages during cavity preparation and caries removal are smear layer free cavity walls, selective and localised removal of tooth substance, a restricted need or the absence of anaesthesia, and cavity walls with a higher acid resistance resulting in a better protection against secondary decay. Possible side effects of erbium lasers with water cooling and used with respect for correct power setting are minimal and can be compared with those of rotary instruments. Erbium laser tooth preparation is now one of the options in the minimal invasive approach. The needs for acid etching has been debated for long. At present it has become clear that acid etching is mandatory to obtain a good adhesion and retention with resin composites.
    Revue belge de médecine dentaire. 02/2009; 64(2):71-80.
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    ABSTRACT: To investigate microleakage in class V cavities following restoration with conventional glass-ionomer cements (CGICs) or resin-modified glass-ionomer cements (RMGICs), following Er:YAG laser or conventional preparation. The sealing ability of GICs in Er:YAG-lased cavities has not been studied extensively. Three hundred and twenty class V cavities were assigned to four groups: those in groups A and B were prepared using an Er:YAG laser, and those in groups C and D were conventionally prepared. In groups B and D the surface was additionally conditioned with cavity conditioner. Each group was subdivided according to the GIC used: groups 1 (Fuji II), 2 (Fuji IX), 3 (Fuji II LC) and 4 (Fuji VIII). After thermocycling, the specimens were immersed in a 2% methylene blue solution, sectioned oro-facially, and analyzed for leakage. The effect of the conditioner was analyzed using a scanning electron microscope (SEM). Significant differences between occlusal and gingival margins were found in all groups (p < 0.05) except B4, D3, and D4. Comparison of preparation methods (groups A-D) revealed significant differences at the occlusal margin in groups 1 and 3, but in all groups at the gingival margin (p < 0.05). Laser preparation without conditioning allowed more leakage (p < 0.05). Comparison of filling materials (groups 1-4) revealed significant differences in groups B and C at the occlusal margin, and in all groups at the gingival margin (p < 0.05). In these groups, laser-prepared cavities (with or without conditioning) restored with Fuji II LC and Fuji VIII showed the least leakage at both margins. RMGICs allowed less microleakage than CGICs. Complete marginal sealing was not achieved and conditioning is recommended.
    Photomedicine and laser surgery 12/2008; 26(6):541-9. · 1.76 Impact Factor
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    ABSTRACT: The aim of this study was to investigate the microleakage in class V cavities restored with four conventionally setting glass ionomers (CGIs) and one resin-modified glass ionomer (RMGI) following erbium:yttrium-aluminium-garnet (Er:YAG) laser or conventional preparation. Four hundred class V cavities were assigned to four groups: A and B were prepared by an Er:YAG laser; C and D were conventionally prepared. In groups B and D, the surface was additionally conditioned with Ketac conditioner. Each group was divided into five subgroups according to the glass ionomer cement (GIC) used: groups 1 (Ketac Fil), 2 (Ketac Molar), 3 (Ionofil Molar), 4 (Ionofil Molar Quick) and 5 (Photac Fil Quick). After thermocycling, a 2% methylene blue solution was used as dye. Scanning electron microscope (SEM) photographs were taken to show the conditioner's effect. Complete marginal sealing could not be reached. PhotacFil showed less microleakage than the conventionally setting glass ionomer cements (CGICs) investigated. Conditioning laser-prepared cavities did not negatively influence microleakage results except for Ionofil Molar Quick.
    Lasers in Medical Science 09/2008; 25(2):171-80. · 2.40 Impact Factor
  • Mieke A A De Bruyne, Roeland J G De Moor
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    ABSTRACT: To evaluate (1) the apical seal of root-end cavities using mineral trioxide aggregate (MTA) and glass-ionomer cement in teeth with and without cracks after ultrasonic root-end preparation and (2) the obturation efficiency of the materials in the root-end cavities. Sixty teeth with root-end cavities were divided into 3 groups: teeth without cracks (-) (group A) and teeth with cracks (+) (group B). The third group (4 teeth) served as a control. Groups A and B were each divided into 2 subgroups: Groups 1A and 1B were filled with Fuji IX capsules (GC) after treatment with cavity conditioner; groups 2A and 2B were filled with white MTA (Dentsply). The teeth were immersed in india ink and cleared. Apical leakage was measured from the resection surface to the maximal point of ink infiltration. Obturation efficiency was scored as good (acceptable), irregular (acceptable), or poor (unacceptable). Statistical analysis was performed using nonparametric and Fisher exact tests. Apical leakage could be arranged in the following order: Fuji IX+ > MTA+ > Fuji IX- > MTA-. Significant differences between Fuji IX- and Fuji IX+ (P < .001) and between MTA- and MTA+ (P < .001) were demonstrated. Fuji IX showed significantly more unacceptable fillings than did MTA (P < .005). No correlation between obturation efficiency and apical leakage was demonstrated (P > .05). The presence of cracks originating from the root canal negatively influences the seal of root-end filling materials and is probably of major clinical importance. MTA and Fuji IX showed equal sealing capacity, but MTA showed better obturation efficiency in the root-end cavity than Fuji IX.
    Quintessence international (Berlin, Germany: 1985) 08/2008; 39(8):685-92. · 0.64 Impact Factor
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    ABSTRACT: Oral and facial piercing with different kinds of body art are being observed more frequently in medical and dental practices. Principally, piercing is not a new form of body art and is traditional in different geographical areas. In this review, the possible risks and complications are described. Postprocedural complications are oedema, haemorrhage and infection. Other adverse outcomes include mucosal or gingival trauma, chipped or fractured teeth, increased salivary flow, calculus build-up, and interference with speech, mastication and swallowing. Dentists, and oral- and maxillofacial surgeons should be in the position to advise patients with orofocial piercings or those who plan to have this type of body art performed.
    Revue belge de médecine dentaire. 02/2007; 62(2):104-12.
  • M A A De Bruyne, R J E De Bruyne, R J G De Moor
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    ABSTRACT: To evaluate the long-term sealing ability of a variety of materials when used as root-end fillings. A total of 140 standardized horizontal bovine root sections (external diameter: 7 mm, height: 3 mm; internal diameter: 2.5 mm) were divided into seven groups, filled with either gutta-percha with AH26, Ketac Fil, Fuji IX, Tooth-Colored MTA, IRM, Ketac Fil with conditioner or Fuji IX with conditioner and submitted to capillary flow porometry at 1 and 6 months to assess minimum, mean flow and maximum pore diameters. Results of the different materials and results by material were analysed statistically using non-parametric tests; the level of significance was set at 0.05. There were no significant differences between the minimum pore diameters associated with the materials at each time. At 1 month the mean flow pore diameters of Ketac Fil were significantly larger than those of gutta-percha, Ketac Fil with conditioner, Fuji IX with conditioner and IRM. There were significant differences between the maximum pore diameters at 1 month (all>IRM; Fuji IX>gutta-percha, Ketac Fil with conditioner, Fuji IX with conditioner) and 6 months (Fuji IX>gutta-percha, IRM; Ketac Fil>gutta-percha, IRM). There were significant differences in the minimum pore diameters between the different points in time for each material except IRM, in the mean flow pore diameters for each material and in the maximum pore diameters for each material except MTA. All materials were associated with capillary flow. IRM root-end fillings had through pores that were smaller than those associated with other materials. Conventionally setting glass-ionomer cements had the largest pores, although dentine conditioning improved their performance. The seal of all materials improved after 6 months.
    International Endodontic Journal 06/2006; 39(6):493-501. · 2.05 Impact Factor
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    ABSTRACT: This in vitro study evaluated the root-end sealing ability of gutta-percha + AH26 (GP), Ketac-Fil, Fuji IX (FIX), tooth-colored MTA (MTA), IRM, Ketac-Fil + conditioner (Ketac-FilC), and Fuji IX + conditioner (FIXC). A total of 140 standardized bovine root sections were divided into seven groups, filled with the mentioned root-end filling materials, and, at 48 h, submitted to capillary flow porometry to assess minimum, mean flow and maximum pore diameters. Results were statistically analyzed using nonparametric Kruskal-Wallis and Dunn tests. Level of significance was set at 0.05. Using the Kruskal-Wallis tests we found that there was no significant difference between the minimum pore diameters of the different materials, but significant differences between the mean flow (p < 0.001) and maximum (p < 0.001) pore diameters could be demonstrated. For the mean flow pore diameters, there was a significant difference between FIX and all other materials, between Ketac-Fil and IRM and between Ketac-FilC and IRM. Concerning maximum pore diameters, there was a significant difference between FIX and all other materials, between Ketac-Fil and MTA, GP and IRM, FIXC and IRM, and Ketac-FilC and IRM. The data showed that each sample had leaked. Glass ionomer cements leaked more than other materials, although dentin conditioning diminished the maximum through pore diameters. This maximum pore diameter, which corresponds to the largest leak in the sample, together with the size of bacteria and their metabolites, will be indicative of the eventual leakage along the root-end filling materials.
    Journal of Endodontics 04/2006; 32(3):206-9. · 2.93 Impact Factor
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    ABSTRACT: Piercing of the tongue and perioral regions is an increasingly popular expression of body art, with more patients coming in for a routine check-up with tongue and/or lip piercings. Several complications of oral piercing have been reported, some of which are life-threatening. In the present clinical survey the prevalence of both tongue and lip piercing complications in oral health was assessed in a group of 50 patients. The most common dental problem registered was chipping of the teeth, especially in association with tongue piercing. Gingival recession was seen as a result of lip piercing with studs. Post-procedural complications included oedema, haemorrhage and infection. Therefore, dentists and oral and maxillofacial surgeons should be given more authority to advise patients with oral and facial piercings or those who plan to acquire this type of body art.
    British dental journal 11/2005; 199(8):506-9. · 0.81 Impact Factor
  • F J H W Depraet, M A A De Bruyne, R J G De Moor
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    ABSTRACT: To evaluate ex vivo the effect of Nd:YAG laser irradiation with and without black ink on instrumented root canal walls, and the degree of both coronal and apical microleakage of filled root canals. Seventy-two single-rooted teeth were instrumented up to a size 40 K-file, and then divided into six groups of 10 teeth: groups 1 and 4 remained unlased and acted as control groups, groups 2 and 5 were treated with a Nd:YAG laser (Fidelis Plus, Herzele, Belgium), groups 3 and 6 were treated with a laser and black ink; the remaining 12 teeth served as positive and negative controls. The laser was operated at 1.5 W, 15 Hz, four times for 5 s with a 20-s interval. Groups 4-6 were filled using cold lateral condensation of gutta-percha and AH26. After storage in water for 48 h at 37 degrees C, through-and-through leakage (L in microL day-1) was measured for 48 h under a pressure of 1.2 atm using a fluid transport model and recorded as L=0 (L1), 0<L<or=10 (L2), L>10 (L3). After the assessment of leakage with the fluid transport model, the teeth were immersed in rhodamine B solution for 48 h at 37 degrees C. Apical and coronal dye leakage was scored after longitudinal splitting of these teeth. All teeth of groups 1-3 were split longitudinally and observed under SEM for evaluation of remaining smear layer. Through-and-through leakage was only observed in the group lased with black ink (two samples-L2). Apical and coronal dye leakage was observed in all groups; there were no statistically significant differences amongst the three experimental groups. The through-and-through leakage, measured with the fluid transport model in two teeth of group 6, was confirmed in the dye leakage test (rhodamine B dye was observed along the total length of the root filling). There was evidence of melted and ablated root canal dentine in the laser-treated groups. These findings were more obvious in root canals lased in association with black ink. All apical foramina in the lased group remained patent. Nd:YAG laser irradiation with black ink increased the amount of melted and ablated dentine areas compared with that without black ink. Nd:YAG lasing in association with black ink did not result in a reduction of either coronal or apical microleakage in root filled teeth.
    International Endodontic Journal 06/2005; 38(5):302-9. · 2.05 Impact Factor
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    M A A De Bruyne, R J G De Moor
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    ABSTRACT: To compare the integrity of root apices of cadaver and extracted teeth after resection, ultrasonic root-end cavity preparation at medium and low ultrasonic power settings and retrieval. Root canal treatment, perpendicular root-end resection and root-end preparation were performed on single-rooted anterior and premolar teeth (49 teeth in situ in maxillary and mandibular jaws from cadavers and 45 extracted teeth). Apical root-end cavities were prepared with the S12/90 degrees D tip and the Suni-Max ultrasonic unit (Satelec, Merignac, France) at the intensity prescribed by the manufacturer (power 7 at power mode S) (34 cadaver teeth, 30 extracted teeth) and at a lower intensity (power 4 at power mode S) (15 cadaver teeth, 15 extracted teeth). After ultrasonic preparation the cadaver teeth were retrieved from the jaws. Exaflex impressions (GC Corporation, Tokyo, Japan) were made of the root apices after resection, root-end preparation and retrieval. These impressions were processed for SEM analysis, and the recordings evaluated for cracks and marginal chipping. In general, extracted teeth showed significantly more cracks and chipping than cadaver teeth. Lowering the ultrasonic power from medium to low intensity resulted in equal scores for cracks on extracted teeth and for chipping on cadaver teeth, in higher scores for cracks on cadavers and in lower scores for chipping on extracted teeth. Complete cracks and cracks originating from the root surface occurred only in extracted teeth. The number of cracks and degree of chipping caused by ultrasonic root-end preparation was higher on extracted teeth than on cadaver teeth. Lowering the ultrasonic power from medium to low intensity cannot be recommended as it resulted in more cracks and equal chipping on cadaver teeth. Investigation of techniques and materials should be conducted in situ and not on extracted teeth.
    International Endodontic Journal 06/2005; 38(5):310-9. · 2.05 Impact Factor
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    ABSTRACT: (i) To compare the root-end sealing ability of IRM Caps (IRM), Fuji IX Capsules (Fuji IX) and Pro Root MTA Tooth-Coloured Formula (MTA) in teeth obtained from cadavers. (ii) Further research on leakage study methodology by means of comparison of the fluid transport method (FTM) and capillary flow porometry (CFP). Root canal treatment was performed on 33 cadaver teeth in situ 2 weeks prior to root resection and ultrasonic retropreparation (S12/90 degrees D-tip on Suni-Max), after which the teeth were retrieved from the cadavers. Two teeth were kept as positive and negative controls. The other teeth were divided in three different groups at random, with each group receiving one of the retrofill materials. Retrofills were exposed to water 5 min after placement. The teeth were stored at 37 degrees C for 12 h after which the root filling was removed. Microleakage (L in microL day(-1)) was measured for 24 h under a pressure of 1.2 atm using FTM and recorded as L = 0, 0 < L < or = 10, L > 10. The measurements were repeated after 1 and 6 months. After 6 months, leakage was also assessed by CFP in order to measure through pores and their diameters. Results were analysed statistically using nonparametric Kruskal-Wallis and Mann-Whitney U-tests, and Spearman correlation coefficients between the results of both methods were calculated. The level of significance was set at 0.05. (i) A statistically significant difference could be demonstrated between Fuji IX and IRM at 1 month with FTM. FTM revealed a significant difference between Fuji IX and the other materials at 6 months, whereas CFP did not. However, using both methods, Fuji IX showed the best result. (ii) When comparing both techniques, CFP demonstrated through pores in all teeth, whereas with FTM in only 14 of the 31 teeth could through pores be demonstrated. A positive correlation between both methods was demonstrated. Under the conditions of this study (i) the conventionally setting glass-ionomer cement Fuji IX showed the best results when used as a root-end material and (ii) CFP appeared to be a useful method for leakage evaluation of through pores in endodontics.
    International Endodontic Journal 03/2005; 38(2):129-36. · 2.05 Impact Factor
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    ABSTRACT: Incomplete filling of the root canal is one of the major causes of endodontic failure. Endodontic filling techniques and materials which perfectly seal the canal are essential for the success of endodontic treatment. Different in vitro tests are being used to test the sealing efficiency of endodontic filling techniques and materials. A large amount of these tests are leakage tests which measure the penetration of a tracer along the root canal filling. Tracers mainly are dyes, radio-isotopes, bacteria, bacterial metabolites, fungi and others. Apart from the tracer penetration techniques there are also other techniques. The electrochemical technique measures electrical current passing through the void along the root canal filling. The fluid transport method evaluates through-and-through voids along the canal filling. With this technique pressure on the water at the coronal side of the root canal filling is increased. In case of leakage, this will be registered based on the movement of an air bubble in a capillary attached to the end of the root. All of the described methods have their limitations. The largest limitations are the low reproducibility of some of the methods and the absence of standardization. Capillary flow porometry, a method well-known from the industry, has recently been applied in dentistry. With this method through pores can be evaluated in a standardised and reproducible way. Voids which do not extend along the entire root canal filling still have to be evaluated with other methods. Despite of the shortcomings of the in vitro leakage tests, they remain useful as an initial screening of new materials and techniques for canal obturation.
    Revue belge de médecine dentaire. 02/2005; 60(2):92-106.
  • Roeland J G De Moor, Mieke A A De Bruyne
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    ABSTRACT: To evaluate and compare the sealability of root fillings in extracted teeth by using AH 26 and AH Plus in conjunction with three different obturation techniques. Root canals of 940 single-rooted teeth were prepared according to the crown-down/stepback technique (using both 2.5% NaOCl and File-Eze) before lateral condensation and hybrid condensation of gutta percha or obturation with Thermafil. Teeth were immersed in India ink for 90 hours after storage for 1 day, 1 week, 2 weeks, 1 month, and 6 months. The roots were split longitudinally, and the extent of dye penetration was measured using a stereomicroscope. Statistical analysis was performed using Kruskal-Wallis test and Mann-Whitney U test. There were no statistically significant differences in apical leakage within the AH 26 and the AH Plus groups, nor between the two sealer groups, at any observation period. Coronal leakage was significantly higher for Thermafil compared to hybrid condensation at 1 day, 1 week, and 2 weeks both for AH 26 and AH Plus. Coronal leakage was higher only for Thermafil compared to lateral condensation at 1 week for AH 26 and for lateral condensation compared to hybrid condensation at 1 week for AH Plus. Both AH 26 and AH Plus, when used with an identical gutta-percha obturation technique, resulted in comparable sealability at all evaluation times and in comparable coronal sealability at 1 and 6 months.
    Quintessence international 05/2004; 35(4):326-31. · 0.71 Impact Factor
  • M A A De Bruyne, R J G De Moor
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    ABSTRACT: The capacity to bond to dental tissues, especially to dentine, their long-term fluoride release and their biocompatibility make glass ionomer cements (GICs) advantageous for use in endodontics, as well as in restorative dentistry. This review provides information on the basic properties of GICs, such as adhesion, antimicrobial effects and biocompatibility, particularly as they relate to use in endodontics. Indications for the use of GICs in endodontics are orthograde root canal sealing, root-end filling, repair of perforations and root resorption defects, treatment of vertical fractures and maintenance of the coronal seal. The paper includes a review on each of these indications. It is concluded that in spite of the critical handling characteristics and the inconclusive findings regarding sealing ability and antimicrobial activity, there is substantial evidence to confirm their satisfactory clinical performance. Both soft tissue and bone compatibility make them suitable for use during endodontic surgery.
    International Endodontic Journal 03/2004; 37(2):91-104. · 2.05 Impact Factor
  • An De Witte, Mieke De Bruyne, Roeland De Moor
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    ABSTRACT: Calcium hydroxide is a widely used material in endodontic treatment due to its high alkalinity and antimicrobial properties. It is thought to create a favourable environment for periradicular repair and healing, and to stimulate hard tissue formation. The aim of the present retrospective study was to evaluate the effect of accidental and voluminous overextensions of calcium hydroxide pastes into periapical lesions and tissues on the prognosis of periapical healing. It was seen that calcium hydroxide overextensions did not disfavour healing, none of the endodontic treatments failed but healing was delayed in the majority of cases and in a number of cases extrusion induced immediate flare-ups. Therefore the deliberate extrusion of calcium hydroxide into periapical tissues is not advocated.
    Revue belge de médecine dentaire. 02/2003; 58(1):49-63.
  • R De Moor, M De Bruyne
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    ABSTRACT: Glass ionomer cements are currently used in endodontic therapy for sealing root canals (orthogradely and retrogradely), for sealing and restoring the pulp chamber, for repairing perforations and root resorption defects, and, rarely, for treating vertically fractured teeth. The successful use of these cements is the result of their particular characteristics: a chemical bond to dentin, which enhances the seal of the root canal and the reinforcement of the tooth; a good biocompatibility in the periradicular area and a fluoride release without loss of strength of the material. The fluoride release imparts an antimicrobial effect to combat root canal infection and attributes to bone mineralization after surgery. The present paper reviews the literature regarding the various applications of glass ionomer cements in present-day endodontics.
    Revue belge de médecine dentaire. 02/2000; 55(4):345-51.

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