Pete Mines

Irrigation trends among American Association of Endodontists members: a web-based survey.

INTRODUCTION The purpose of this study was to determine current trends in irrigation selection among endodontists. METHODS An invitation to participate in a web-based survey (QuestionPro) was e-mailed to 3844 members of the American Association of Endodontists. Survey participants were asked between 10 and 14 questions based on their individual responses. Among other questions, participants were asked about their irrigant selection, irrigant concentration, smear layer removal, and use of adjuncts to irrigation. RESULTS A total of 3707 survey invitations were successfully delivered by e-mail after accounting for several undeliverable e-mail invitations. There were 1102 participants, with an overall completion rate of 28.5% (n = 1054). Our data indicate that >90% of respondents primarily use sodium hypochlorite, with 57% of them using it at a concentration >5.0%. Seventy-seven percent of respondents aim to remove the smear layer during endodontic treatment. At least 45% of respondents reported using an adjunct to irrigation. CONCLUSIONS Most of the respondents are using full-strength sodium hypochlorite and are routinely removing the smear layer during endodontic treatment. In addition, almost half of the respondents are using an adjunct, such as ultrasonic activation, to aid in their irrigation technique.

Comparison of the Obturation Density of Cold Lateral Compaction Versus Warm Vertical Compaction Using the Continuous Wave of Condensation Technique

The purpose of this in vitro study was to compare quantitatively the density of standard cold lateral gutta-percha compaction and warm vertical compaction by using the continuous wave of condensation technique. Forty transparent acrylic blocks with 30-degree, curved root canals were instrumented using Gates Glidden burs and Profile 0.06 taper rotary nickel-titanium files in a crown-down manner. The blocks were weighed and randomly assigned to two evenly distributed groups. Group A was obturated with the cold lateral-compaction technique using medium-fine, gutta-percha accessory points until the canal was completely filled. Group B was obturated with the continuous wave of condensation technique until the canal was completely filled. The blocks were weighed again after obturation. Data were analyzed using a two-sample t test at the 5% significance level. Results demonstrated that the continuous wave of condensation technique resulted in a significantly greater density compared with cold lateral compaction. Warm vertical compaction using the continuous wave of condensation technique in acrylic blocks resulted in a greater gutta-percha fill by weight compared with standard cold lateral compaction.

Use of the microscope in endodontics: A report based on a questionnaire

A survey regarding operating microscope (OM) usage and training was mailed to 3356 active members of the American Association of Endodontists (AAE) in the United States. Data from 2061 questionnaires indicate that 52% of the endodontists surveyed have access to and use the OM in their practice. The frequency of use as a function of years since completing endodontic training was as follows: < 5 yr, 71%; 6 to 10 yr, 51%; and > 10 yr, 44%. The OM was used most often for retrieval of separated instruments, root-end preparations, and root-end fillings. Of the respondents who use the OM, 36% report they do not use it as often as anticipated. The most common reasons reported were positional difficulties, inconvenience, and increased treatment time. The information collected from the survey reveals that the more training the operator has on the microscope, the more likely he or she is to use it for all procedures.

Use of the Microscope in Endodontics: Results of a Questionnaire

The purpose of this study was to investigate the frequency and characteristics of operating microscope (OM) utilization among endodontists in the United States. The study also investigated how OM use has changed since a similar study was published nearly a decade ago. A web-based survey regarding OM usage was e-mailed to 2340 active members of the American Association of Endodontists (AAE) in the United States. Data from 1091 questionnaires indicated that 90% of the endodontists surveyed have access to and use the OM in their practice. The frequency of use as a function of years since completing endodontic training was as follows: <10 years, 95%; 10-15 years, 90%; 16-20 years, 82%; >21 years, 78%. Previous studies found that shorter operators needed to adopt a strained position to view mandibular molars. Our results indicated with strong correlation (r = 0.90) that shorter endodontists used the microscope more often than taller endodontists. The OM was used most frequently for root-end inspection, locating canal orifices, and root-end filling, respectively. Of the practitioners who used the OM, 59% used it without limitation, 86% used it equally between the maxillary and mandibular arch, and 84% used it as often as anticipated. The most common limitations to OM use were positional difficulty, limited field of view, and inconvenience, respectfully. The use of the OM by endodontists increased from 52% in 1999 to 90% in 2007.

Surgical Trends among Endodontists: The Results of a Web-based Survey

The purpose of this survey was to investigate the frequency and characteristics of surgery among active endodontists in the United States. The survey also inquired about residency and postresidency training in endodontic surgery. A Web-based questionnaire regarding endodontic surgery was distributed via e-mail to 2,532 active members of the American Association of Endodontists in the United States. Data from 1,045 surveys, a 41% response rate, indicate that 91.2% of respondents are performing some form of root-end surgery with 89.6% using the operating microscope and ultrasonic instrumentation. Of those surveyed, 33.3% felt as though their endodontic residency training in surgery was inadequate, and 47.9% went on to acquire additional training in surgery postresidency. The anterior maxilla is the most common site of endodontic surgery as indicated by the respondents. Our results show that the most difficult process for surgery is access and visualization followed by root-end filling. Additionally, 53.9% of respondents answered that they are not referring any of their surgical cases, whereas 34.3% of responding endodontists are referring at least some endodontic surgery to oral surgeons; 6.6% of respondents also indicated that they are placing implants.

In Vitro Study to Compare the Coronal Microleakage of Tempit UltraF, Tempit, IRM, and Cavit by Using the Fluid Transport Model

An adequate coronal seal is critical for the success of root canal therapy. The purpose of this study was to assess and compare the coronal microleakage of 4 temporary filling materials used to seal the access cavity in root canal treated teeth. Standardized access cavities were prepared in 55 extracted human, single canal teeth. They were instrumented by using a crown-down method to a size 45 file. The smear layer was removed with a 1-minute soak with 17% ethylenediaminetetraacetic acid followed by a 10-minute soak with 5.25% NaOCl and dried with paper points. All roots were obturated with gutta-percha and AH Plus sealer by using the continuous wave of condensation technique. The teeth were randomly divided into 4 groups of 10 teeth, with the remaining teeth serving as positive and negative controls. The access openings of the teeth in the experimental groups were filled with 4 mm of Cavit, IRM, Tempit, or Tempit-Ultra-F. All teeth were stored in 100% humidity at 37 degrees for 10 days, allowing sealer to set before testing. After thermocycling for 500 cycles (5 degrees C-55 degrees C), microleakage was measured by using the fluid transport model at 10 psi. All materials tested leaked. Kruskal-Wallis and Mann-Whitney U analysis indicated significantly less leakage (P < .05) with Tempit UltraF compared with Cavit and IRM. There were no statistically significant differences between Tempit Ultra-F and Tempit or between Cavit, IRM, and Tempit.

Effect of 2% Chlorhexidine Gel as an Intracanal Medication on the Apical Seal of the Root-Canal System

The purpose of this study was to determine what effect intracanal medications might have on the apical seal of the root-canal system. Forty-two teeth were cleaned and shaped in a crown-down manner to a size #50 K-file. The teeth were divided into three groups: (A) immediate obturation; (B) intracanal placement of calcium hydroxide placed for 14 days; and (C) 2% chlorhexidine gel placed for 14 days. After 14 days, these materials were removed using copious irrigation and obturation was completed on groups B and C. Obturation was performed using the continuous wave of condensation technique using AH Plus sealer in all groups. Leakage was evaluated 60 days after obturation by using a fluid-filtration device. Using the one-way ANOVA test, there was no statistically significant difference in leakage between the three groups. Under the conditions of this study, 2% chlorhexidine gel and calcium hydroxide paste did not adversely affect the apical seal of the root-canal system.

The Use of Intraosseous Anesthesia among Endodontists: Results of a Questionnaire

The purpose of this study was to investigate the use of supplemental intraosseous (IO) anesthesia among endodontists in the United States. The study also looked at the types of anesthetic solutions commonly used for IO anesthesia and in which diagnostic conditions IO anesthesia is used. A Web-based survey of 2,528 active members of the American Association of Endodontists was sent out by e-mail. Data from 833 respondents were collected with a response rate of 33%. It was discovered that 94.77% of the respondents used some form of IO anesthesia, with the periodontal ligament injection (PDL) being the most commonly administered (49.78%). Symptomatic irreversible pulpitis is the pulpal diagnosis for which respondents most often use some form of IO anesthesia (61.99%), and 2% lidocaine with epinephrine 1:100,000 is the most common anesthetic solution used in IO anesthesia (37.62%). Although more than half of the respondents use some form of IO anesthesia more than twice a week, newer IO anesthesia delivery systems such as Stabident (Fairfax Dental, San Francisco, CA) and X-Tip (Dentsply International, Johnson City, TN) are used less often than the PDL injection.

The Use of Guided Tissue Regeneration Techniques among Endodontists: A Web-based Survey

INTRODUCTION The purpose of this study was to determine factors and clinical situations that influence an endodontists decision to use guided tissue regeneration (GTR) techniques during endodontic root-end surgery. METHODS An invitation to participate in a web-based survey was e-mailed to 3,750 members of the American Association of Endodontists. Data were collected from 1,129 participants, representing a 30.1% completion rate. The number of questions varied from 3 to 11 depending on individual responses. RESULTS 40.7% of respondents who perform root-end surgeries also use GTR techniques. The clinical situation in which GTR techniques are used most often is for transosseous lesions. Barrier membranes and bone replacement grafts are each used by more than 85% of respondents using GTR techniques. Insufficient training and insufficient evidence in support of its use were selected as the predominant reasons for not using GTR techniques at 42.4% and 32%, respectively. CONCLUSIONS Although over 40% of respondents are currently using GTR techniques in conjunction with their root-end surgeries, a majority of those who do not use GTR indicated they would consider using these techniques with better evidence and available training.