Thai Endodontic Journal

Electronic apex locator: Principles, Evolution, Comparative analysis, and clinical applications in Endodontics

2025-03-26T08:36:32+07:00

Electronic apex locators are devices designed to determine root canal working length by measuring changes in electrical impedance within the canal. Since the initial concept based on electrical circuit principles introduced in 1918, electronic apex locators technology has advanced significantly. Contemporary devices employ multi-frequency alternating current and algorithm-based signal processing to improve accuracy. This review article aims to provide a comprehensive overview of electronic apex locators, including their working principles, generational development, factors affecting measurement accuracy, and recent technological innovations that enhance the efficacy of working length determination in endodontic procedures.

Extrusion of calcium silicate-based root canal sealers into the inferior alveolar canal: A review of literature

2025-04-21T17:05:57+07:00

Calcium silicate-based root canal sealers (CSS) have transformed root canal treatment with their excellent properties. However, the risk of extrusion into the inferior alveolar canal (IAC) may lead to nerve injuries and significant morbidity. Multiple factors contribute to extrusion, including anatomical variability, over-aggressive canal preparation, and the high flowability of CSS. Both non-surgical and surgical management strategies are discussed. Non-surgical interventions, including those that employ corticosteroids, B vitamins, and analgesics, show promise in reducing inflammation and supporting nerve recovery. In contrast, surgical techniques, including material removal and nerve decompression, are reserved for severe cases. Early diagnosis through advanced imaging, such as cone-beam computed tomography (CBCT), is crucial for effective intervention. Clinicians should conduct thorough preoperative assessments and refine obturation methods to minimize extrusion risks. Further research and the development of standardized guidelines are necessary to manage sealer extrusion into the IAC, which will enhance endodontic practice and minimize the risk of permanent nerve damage.

Regenerative endodontic procedures for avulsed immature permanent tooth with severe external root resorption

2025-05-07T10:19:41+07:00

Infection-related root resorption following the reimplantation of an avulsed tooth is a common and severe adverse outcome. This condition is particularly aggressive in teeth with immature root development. Additionally, treatment procedures are highly challenging due to difficulties in root canal disinfection, halting root resorption, and managing the immature root structure. The objective of this case study is to demonstrate the application of regenerative endodontic procedures in the treatment of an avulsed immature permanent tooth with severe infection-related root resorption. The treatment protocol included thorough root canal irrigation and the use of intracanal medication with triple antibiotic paste to eliminate infection and prevent further root resorption. After a 5-month disinfection period, during which the periapical lesion decreased in size, a blood clot was induced in the root canal, followed by coronal sealing. At the 1-year follow-up, the patient remained asymptomatic. Radiographic evaluation revealed cessation of root resorption, complete resolution of the periapical lesion, and restoration of continuous alveolar bone around the root surface. These case reports suggest that regenerative endodontic procedures can offer a promising treatment outcome for avulsed immature permanent teeth affected by infection-related root resorption.

Root Canal Treatment of Internal Replacement Root Resorption

2025-04-23T12:47:57+07:00

Internal replacement root resorption is a resorptive process originated within intra-radicular dentin followed by deposition
of hard tissue. The etiology is still unclear. Clinical managements are complicated in many aspects of treatment, including
differential diagnosis, access opening, root canal cleaning and the three-dimensional root canal obturation in the area of resorptive
defect. This case report aimed to present the root canal treatment procedures of maxillary central incisor with internal
replacement root resorption.