INTRAOSSEOUS DELIVERY SYSTEM (stabident and X- tip)

The X-tip system consists of two parts: a drill and a guide sleeve component . The drill has a special hollow needle which leads the guide sleeve through the cortical plate, where it is separated and withdrawn. The remaining guide sleeve is designed to accept a 27-gauge needle to inject the anesthetic solution. The guide sleeve is removed after the IO injection is complete.                                                                                               

Stabident system is composed of a perforator driven by a slow-speed handpiece and a solid 27-gauge wire with a beveled end that, when activated, drills a small hole through the cortical plate . The anesthetic solution is delivered to cancellous bone through the 27-gauge ultra-short injector needle placed in the hole made by the perforator.

                                                                    REF:JADA,2003,134,11

MTA as root canal sealer

Mineral trioxide aggregate (MTA) is used primarily to seal lateral root perforations, as a root-end filling material .MTA can also be used for a variety of other applications  including pulp capping and pulpotomy procedures

Newer developments of MTA include its use as a root canal sealer. Currently, three MTA sealer formulations are available; Endo-CPM-Sealer ,MTA Obtura and ProRoot Endo Sealer.

The composition of CPM sealer after mixing is reported to be 50% MTA (Si02, K20, A1203, SO3, CaO and Bi203), 7% Si02, 10% CaCO3, 10% Bi203, 10% BaSO4, 1% propylene glycol alginate, 1% propylene glycol, 1% sodium citrate and 10% calcium chloride .

MTA-Obtura is a mixture of white MTA with a proprietary viscous liquid.

ProRoot Endo Sealer is calcium silicate based endodontic sealer. The major components of the powder of ProRoot Endo Sealer are tricalcium silicate and dicalcium silicate, with inclusion of calcium sulphate as setting retardant, bismuth oxide as radiopacifier and a small amount of tricalcium aluminate.

Sealers based on MTA have been reported to be biocompatible, stimulate mineralization and encourage apatite-like crystalline deposits along the apical and middle thirds of canal walls .

                                                                                REF;IEJ,2011,44(9)

Endovac

The EndoVac is a new irrigation system. A delivery/evacuation tip is attached to a syringe of irrigant and the high speed suction of the dental chair . A small tube attaches either a macro- or microcannula to the suction. The delivery/evacuation tip places irrigant in the chamber and siphons off the excess to prevent overflow. The macrocannula is plastic with an open end that measures International Standards Organization (ISO) size 55 with a .02 taper. The microcannula is stainless steel and has 12 small, laterally positioned, offset holes in 4 rows of 3, with a closed end measuring ISO size 32 . As these cannulas are placed in the canal, negative pressure pulls irrigant from a fresh supply in the chamber, down the canal to the tip of the cannula, into the cannula, and out through the suction hose.

                                                                                          REF: JOE ,2007,33.

APEXUM procedure

This procedure is based on a device that removes the chronically inflamed periapical tissues through a root canal access by a procedure that is minimally invasive compared with open-flap apical surgery

 Apexum  instrument kit consists of

The Apexum kit consists of two devices, the Apexum NiTi Ablator and Apexum PGA Ablator.

The Apexum NiTi Ablator consists of a specially preshaped Nitinol wire. One end is bent and is designed to enter the periapical tissues through the root canal and apical foramen, whereas the other end has a latch-type connector to allow its attachment to a low-speed contra-angle handpiece. The bent part is initially concealed in a straight super elastic Nitinol tube that serves as a sheath allowing its introduction up to the apical foramen. When pushed, the wire emerges from its sheath and through the apical foramen and resumes its preshaped form. The special retrograde design of the bent part allows it to rotate in the periapical soft tissues at 200 to 250 rpm and coarsely grind them while being deflected from the surrounding bone.

The second device is the Apexum PGA Ablator, built from a Nitinol shaft. It has a bioabsorbable  filament is attached, which is designed to enter the periapical bony crypt and rotate at 5,000 to 7,000 rpm, turning the tissue that was initially minced with the NiTi Ablator into a thin suspension that may be flushed through the root canal.

                                                                                    REF: JOE, 2009,35(2).

CALCIUM HYDROXIDE ( antibacterial activity and mineralisation mechanism )

1. Calcium hydroxide is antibacterial depending on the availability of free hydroxyl ions .
2. Denaturation of proteins ,DNA break down and lipidic peroxidation are main actions responsible for antimicrobial activity of calcium hydroxide
3. It has a very high p11 (hydroxyl group) that encourages repair and active calcification. There is an initial degenerative response in the immediate vicinity followed rapidly by a mineralization and ossification response .
4. The alkaline pH of calcium hydroxide neutralizes lactic acid from osteoclasts and prevents dissolution of mineralized components of teeth. This pH also activates alkaline phosphatase that plays an important role in hard tissue formation .
5. Calcium hydroxide activates the calcium-dependent adenosine triphosphatase reaction associated with hard tissue formation .

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                                                                                    REF: JOE, 2009, 35 (4)

BUC ultrasonic tips

BUC-1

The BUC-1 can be used for gross dentin removal, moving access line angles, cutting a groove in the mesial access wall to drop into MB2 canals, and for quickly and carefully unroofing pulp chambers. Its radiused tip geometry also allows effortless entry into each canal orifice and facilitates the creation of a smoothly troughed surface, which is helpful in finding reclusive MB2 canal

BUC-2 and BUC-2A

The BUC-2, with its disk-like radiused tip, can be used to smoothly and safely plane attached pulp stones from the pulp chamber floor without scoring it. In molars, it can be used to horizontally smooth the pulp chamber floor without cutting past it to get to the darker colored dentin. The smaller version BUC-2A has a 1.0mm diameter and can be used for corners of molar access prep and bicuspid access prep.

BUC-3

The BUC-3 is an extremely active instrument with a sharp tip. It is used for chasing canals halfway up a root or for digging around a post or carrier-based obturator to remove it. It has a water port placed near the cutting surface of the tip for increased washing and cooling of the operative site.

RESILON-EPIPHANY SYSTEM

Resilon

organic part: thermoplastic synthetic polymer – polycaprolactone,

inorganic part: bioactive glass, bismuth oxychloride, barium sulphate

Epiphany (sealer)

organic part: BisGMA, ethoxylated BisGMA, UDMA, hydrophilic

difunctional methacrylates

inorganic part: calcium hydroxide, barium sulphate, barium glass,

bismuth oxychloride, silica

Resilon Primer

sulfonic acid terminated functional monomer, HEMA, water.

                                                                            Ref-Adv in med science-2006