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Azerbaycan Saytlari

 »  Home  »  Endodontic Articles 12  »  Temporization for endodontics
Temporization for endodontics
Introduction.



H. J. Naoum & N. P. Chandler
Brindabella Specialist Centre, Dann Close, GARRAN, ACT 2605, Australia.
Department ofO ral Rehabilitation, School of Dentistry, University of Otago, Dunedin, New Zealand.  


Introduction.
Bacterial infection is the most common cause of pulpal and periradicular disease (Kakehashi et al.1965, Moller et al. 1981). Successful root-canal treatment requires effective mechanical and chemical debridement, elimination of bacteria and pulp tissue remnants and proper canal shaping to facilitate effective obturation. Rootcanal treatment can be carried out in a single visit in vital, non-infected teeth, eliminating the need for dressing and temporization (Orstavik 1997). Many clinical cases with infected canals require dressing with antibacterial medicaments in a multivisit treatment in which effective temporization for different periods of time becomes mandatory (Sjogren et al. 1997). Lack of satisfactory temporary restorations during endodontic therapy ranked second amongst the contributing factors in continuing pain after commencement of treatment (Abbott 1994). Accordingly, temporary filling materials must provide an adequate seal against ingress of bacteria, fluids and organic materials from the oral cavity to the root-canal system, and at the same time prevent seepage of intracanal medicaments. Furthermore, these materials are required to allow ease of placement and removal, provide acceptable aesthetics, and protect tooth structure during treatment. Many materials can be used to achieve some of these goals. For effective interappointment temporization, it is essential to have adequate knowledge of temporization techniques and material properties in order to satisfy a wide variety of clinical requirements such as time, occlusal load and wear, complexity of access and absence of tooth structure.
In the past, the sealing ability of temporary filling materials was tested commercially either to improve products or for marketing purposes. One of the earliest studies was conducted by Fraser (1929) to test the sealing ability and antibacterial effect of nine materials. Fraser used small glass ampoules, 5 cm long and 6 mm in diameter with a 5-mm constriction from the open end. The lower compartments of the ampoules were filled with sterile broth, whilst the test materials were mixed and used to fill the open end to the level of constriction. The ampoules were then immersed in a £ask filled with sufficient broth seeded with bacteria to cover them completely. The lower compartments of the ampoules were regularly checked to confirm bacterial penetration. To determine the antibacterial effect of the test materials, agar plates cultured with bacteria were used. Fraser concluded that all freshly mixed cements and copper amalgam had an antibacterial effect, and both were more efficient than gutta-percha stopping in preventing bacterial penetration (Fraser 1929). Grossman (1939) emphasized the importance of achieving a bacteria-tight seal between visits. He tested many materials (or combinations) for leakage using 3-mm-diameter glass tubes. Methylene blue dye alone, methylene blue dye mixed with saliva or bacteriological tests using Bacillus prodigious were used to test 2-3 mm thickness of the materials. Grossman concluded that zinc oxide and eugenol (ZOE) cements provided the best seal when compared to gutta-percha and oxyphosphate cements (Grossman 1939).Despite the relative simplicity of these studies, they represent the earliest attempts to investigate the seal of temporary restorative materials.
The aim oft his review is to examine the variety of materials and techniques used for short- and long-term restorations for endodontics. Contemporary endodontic, operative dentistry and fixed prosthodontic texts were consulted, and a database search performed using Medline. Because of the extensive lineage of some of the materials and techniques, a range of older texts were also examined, and data provided by manufacturers studied.

Temporization of access cavity in tooth structure.
A state of sterility must be maintained until a definitive coronal restoration is placed following root-canal obturation. The following studies have assessed the sealing ability of temporary restorative materials in intact teeth where the interim restorations were entirely in direct contact with the tooth structure. A variety of materials and methods were used to evaluate microleakage, which makes data from studies difficult to compare (Tables 1and 2).

Table 1. Summary of in vitro studies on leakage of temporary endodontic materials in access cavities in tooth structure.

Summary of in vitro studies on leakage of temporary endodontic materials in access cavities in tooth structure

Table 2. Summary of in vivo studies on leakage of temporary endodontic restorative materials.

Summary of in vivo studies on leakage of temporary endodontic restorative materials